Jorge Leite, who is passionate about brain research, neuromodulation and cognitive rehabilitation, is one of the most recent members of CINTESIS@RISE. The neuroscientist, who is also vice-rector for Research at Portucalense University and a university professor, explains that the main motivation for joining this Research Unit and Associate Laboratory was to be part of a network “capable of creating scale and dimension” and that allows “synergies and partnerships” to be established between groups from different areas.

“My contribution to science is to intervene in mental health and cognitive rehabilitation. As well as being underfunded, this area is undersized to meet the country’s needs. If we want to solve a public health problem, it’s essential to collaborate as a network. It’s a matter of scale. If we want to produce quality science with international impact, we need to have a comprehensive ecosystem with critical mass and share resources. We are in a position to produce results with a real impact on society,” he argues.

He was born on June 30, 1982, in Guimarães, and graduated in Psychology from the University of Minho (2001-2005). Although it wasn’t “passion at first sight”, it ended up becoming a lasting love, thanks to Neuropsychology and Psychopharmacology. At the end of the first year of his Master’s degree in Psychology, he was challenged to go on to do a PhD. It was 2007 and the University of Minho was setting up the first Neuropsychology laboratory in the country, equipped with innovative equipment for transcranial magnetic stimulation.

He specialized in non-invasive neuromodulation, a process that aims to alter the functioning of the brain without surgery. In Portugal, this was still an emerging field. That’s why he trained and worked in other countries, namely Germany (2008) and the Neuromodulation Center at Spaulding Rehabilitation Hospital/Harvard Medical School, collaborating with world-renowned specialists.

His path wasn’t planned from the start. Nor did it have to be. “If there’s one thing I’ve learned in my career, it’s that the path isn’t linear. There are a series of situations and opportunities that arise and condition our path,” he says.

In his doctorate, completed in 2011, Jorge Leite focused on studying the modulation of behaviors through the stimulation of brain regions, namely the modulation of cognitive flexibility, which is central to executive functioning and a predictor of adaptation and success in the school context, but which is affected by aging and certain pathologies. One of the objectives was to be able to alter the ability to plan when the rules change “in the middle of the game”, such as when we have to adapt to contingencies on a daily basis. An example? When you’re driving a car and have to suddenly swerve around an obstacle to avoid an accident.

“There are some neurological deficits and syndromes in which the brain perseveres in error. I wanted to know which regions of the brain we could use to alter cognitive flexibility. We discovered that we could modulate skills by interfering in different brain regions,” he explains.

After generating knowledge about the mechanisms and processes of brain functioning, especially cognition, it was time to translate this into clinical practice, optimizing the brain stimulation technique to enhance its beneficial effects. This is what he did when he developed a personalized intervention, using Neuroimaging techniques, for a teenager who suffered from severe Tourette’s syndrome and who, in two weeks, showed marked improvements. “We realized that this was an interesting way forward because the future is to individualize all interventions,” he says.

In 2017, he was the first author of a study that showed, for the first time, that it was possible to use electroencephalography to guide non-invasive neuromodulation, recording and stimulating at the same time, as was already the case with deep brain stimulation. This was his first project funded by the Portuguese Foundation for Science and Technology (FCT) as principal investigator.

In the second FCT-funded project that he led, the aim was to test the clinical applicability of neuromodulation in people with mild cognitive impairment, who are at increased risk of dementia, especially of the Alzheimer’s type. The idea is to delay the progression of age-related dementia. The study shows that cognitive stimulation plus cognitive training in older people boosts some results, but not very significantly. Not yet.

“It was surprising, but not totally unexpected. We have to start looking at the brain as something moldable and plastic. Although we have more knowledge about the link between brain mechanisms and different pathologies, modulating the brain is a whole other level,” he points out.

At the moment, he says, “the challenge is to guide this type of therapeutic intervention effectively. We are trying to understand how we can improve communication between different regions of the brain, using neurostimulation, to have an impact on cognitive functioning, particularly during the ageing process. If we promote this connectivity, we promote cognitive improvement. We also want to develop interventions with non-invasive brain stimulation to promote symptom improvement in psychiatric illnesses, such as depression and obsessive-compulsive disorder (OCD).”

The next step is to evolve from studies focused on small, homogeneous populations to large patient trials aimed at demonstrating the clinical applicability of neuromodulation-based interventions to increase or decrease the functioning of brain regions, more safely, more effectively and less expensively. In addition to its potential in preventing dementia and mental illness, neuromodulation can also play a role in situations such as traumatic brain injury and chronic pain.

Jorge Leite has published around 70 scientific papers, including articles in scientific journals and book chapters, and has participated in or supervised projects involving funding of around six million euros. His CV also includes several awards and distinctions.

What is your 1-Year Ambition?

I hope to have three preliminary studies getting into “cruising speed” on the use of brain neuromodulation. One is in aging, another is in obsessive-compulsive disorder and a third will probably be in pain. The aim is to start initial recruitment, prove that the interventions work and justify funding in larger trials.

What is your 10-Year Ambition?

My ambition is to move on from preliminary studies to large clinical trials that will generate a higher level of evidence on the effectiveness of non-pharmacological brain neuromodulation interventions, so that they can eventually be considered as a therapeutic option in cognitive rehabilitation and in altering dysfunctional brain functioning.

The focus is always on using knowledge of brain mechanisms to direct intervention. There is already sufficient evidence of its usefulness in diseases such as depression and some evidence of its usefulness in ageing.

If we can develop a safe, effective, well-tolerated and low-cost intervention, we will be contributing to quality of life and healthy ageing. Some of these methodologies have a residual cost, which could facilitate their application in the National Health Service.

At the moment, we are not yet ready to extend these interventions massively to the entire population. We are still in the research phase of defining criteria and parameters. But it is undeniable that they could even reduce drug dependence in certain conditions.

How is Life Beyond Research?

My free time is dedicated to my family. My wife also works in academia, in the field of Neurosciences, and we have two daughters, one aged seven and the other five. Regardless of our academic responsibilities, I’m never not there when they get home from school. My working hours are segmented because I can’t give up seeing them grow up. For me, it’s a pleasure, not an obligation. It’s also a question of mental health. With them, I’m not the scientist, nor the vice-rector, nor the university professor; I’m simply their dad, and all I care about is that they’re happy. I hope to give them support and resources so that they can face the challenges they will face in life.

 

Photo: Portucalense University