James R Bateman, MD, MPH

A passion for how the brain works turned into dedication to neurological patient care

The way Alzheimer’s disease is diagnosed and treated is changing fast — and Trey Bateman, M.D., MPH, is at the forefront of the promising research and care pushing it forward.

Bateman is a behavioral neurologist specializing in diagnosing and treating people living with dementia, including Alzheimer’s disease, frontotemporal dementia, Lewy body dementia and rapidly progressive dementias such as Creutzfeldt-Jakob disease. His focus is on helping patients and families understand the complex cognitive and behavioral changes that these diseases bring while providing the most advanced diagnostic and treatment options available.

At VCU Health, he is using advanced imaging and blood-based biomarkers to diagnose dementia earlier and more precisely than ever before. This approach opens new doors for patients to access the next generation of disease-modifying therapies.

“The needs in the area of movement disorders and dementias are immense, and at VCU Health we are growing a program that excels at clinical care, research and education,” he said. “Our leaders have put the resources in place to make dementia and movement disorders care a priority.”

Bateman earned his medical degree and a master’s degree in public health from the University of North Carolina at Chapel Hill, then completed an internal medicine internship and neurology residency, both at UNC. He later attended the University of Colorado for a fellowship in behavioral neurology and completed a research fellowship at the W.G. Hefner VA Medical Center in Salisbury, N.C. Prior to joining VCU Health and the VCU School of Medicine Department of Neurology, Bateman was an assistant professor of neurology at the Wake Forest University School of Medicine and treated patients at the affiliated Wake Forest Baptist Health.

Bateman was drawn to the neurology field through a fascination with how the brain shapes behavior. While at UNC, he met the late Dr. Dan Kaufer, a pioneering behavioral neurologist who further solidified Bateman’s career path. “Today, I use my knowledge of how changes or injury to certain parts, pathways or networks in the brain lead to a number of symptoms, which then helps me diagnose complex cognitive and behavioral changes,” Bateman said. “I get to use my skills and education every day to help people understand what’s happening to themselves or someone they care about.”

But he doesn’t work alone, collaborating daily with neuropsychologists, nurses, social workers, speech and occupational therapists, mental health professionals and geriatricians to provide the best care possible for patients.

“I’m an excellent neurologist, but a poor substitute for a social worker or psychologist,” he said. “I play a role, but could not do my job without an extensive team of people. For conditions as complex as dementia, treatment takes a community of people who each have a unique skillset. And just because patients are not seeing me doesn’t mean I’m not actively engaged in their care, as our team communicates frequently about ongoing management decisions and issues.”

While there is no cure for Alzheimer’s, new disease-modifying treatments may slow the progression of the disease. Other conditions that have distressing symptoms can be managed with medications and therapies, and VCU Health providers can guide patients with community resources and provide ongoing, supportive and palliative care.

Still, new treatment tools provide new hope. Novel blood biomarkers can identify the biology of Alzheimer’s disease, “and with those new techniques comes easier access to testing and treatment,” Bateman said. “While the benefits of this first generation of disease-modifying therapies are modest, we’re already seeing encouraging progress in trials that offer the hope of safer and more effective therapies in years to come.”

Outside of patient care, he is an active researcher focused on improving early detection of specific causes of cognitive decline, understanding the behavioral and neuropsychiatric symptoms that emerge in the earliest stages of neurodegenerative disease, and exploring how brain injuries, traumatic stress, and environmental exposures influence the risk for Alzheimer’s and related disorders.

Advice to patients: “If you have been diagnosed with Alzheimer’s, give yourself time to grieve and process what a diagnosis means for you, your loved ones and your family. There is no right or wrong way to experience this illness. Take time to understand what medicine can and cannot do given your particular diagnosis. These diseases can also change depending on the stage of the illness. At the earliest stages, there may be fairly minimal impact, but as they progress, it’s important to understand what that means and taking action now to ensure that your preferences can be followed as time goes on. Finally, studies show that even low-intensity lifestyle interventions — sleep, diet, exercise — can lead to benefits in brain health. It’s likely that these interventions are going to have effects over a person’s life, so early engagement in brain health-promoting activities is important. Ideally, we can engage people in their midlife to reduce the risk later in life of Alzheimer’s and dementias.”