Pelizaeus-Merzbacher disease (PMD), is a rare neurological disorder that disrupts myelin in the brain. A mutation in the PLP1 gene affects oligodendrocytes which are the cells that produce myelin. When PLP becomes mutated, it results in a build up inside the cell and stress becomes a factor in the endoplasmic reticulum. To counteract the stress, the body has an integrated stress response (ISR) to protect itself from any harm. In PMD, the ISR is activated for longer than it needs to be and ends up doing more harm than good which ends up killing the cells its supposed to protect. As oligodendrocytes die, myelin production stops and the brain enters a state of hypomyelination. In a study by Yanan Chan et al., researchers used a mouse model to discover, that deleting a protein named PERK reduced ISR activity. This resulted in the mice living two weeks longer with improved myelination. Over working the ISR can do the opposite of what its supposed to and actually drive the progression of disease.
On the contrary, Alzheimer's diseases isn't caused by myelin loss, instead its caused by damage to the hippocampus resulting in memory loss. During a study by Sabitha, K.R. et al., researchers used advanced single-cell techniques to show that the human brain can still generate immature neurons even in a disease state. One specific neuron, CA1, shows early changes in gene activity before any significant damage is visible. Disease isn't something that happens spontaneously, it is a slow build up of molecular changes that weaken memory circuits over time.
What connects the two studies is chronic cellular stress. In PMD, the ISR is supposed to playing a supportive role but instead does the oppoistire once its played its part for too long resulting in making the progression of disease quicker. In Alzheimer's disease, stress that accumulates over time slowly destroys the hippocampus and can't be seen until enough is lost. In both diseases, the damage starts at the molecular level. In PMD's case its myelin loss and in Alzheimer's it is the buildup of plaque. Understanding the shift of when molecular process are disrupting instead of helping would be key in slowing the development of neurodegeneration.
Chen, Y., Kunjamma, R.B., Lin, K. et al. Integrated stress response inhibition prolongs the lifespan of a Pelizaeus-Merzbacher disease mouse model by increasing oligodendrocyte survival. Nat Commun 17, 1285 (2026). https://doi.org/10.1038/s41467-025-68045-0
Disouky, A., Sanborn, M.A., Sabitha, K.R. et al. Human hippocampal neurogenesis in adulthood, ageing and Alzheimer’s disease. Nature (2026). https://doi.org/10.1038/s41586-026-10169-4