Early Warning System for Neurodegenerative Diseases
When they have trouble remembering something, many older people ask themselves whether it is just old age making them a little forgetful, or whether it is a sign of the onset of dementia. Medical imaging technology such as magnetic resonance imaging (MRI), which visualises structural or molecular changes in the brain, can diagnose the causes behind such memory blips – but a negative result can give patients a false sense of security, as not all changes can be detected.
The technology is also not yet able to distinguish between various subtypes. “At the moment, it is becoming increasingly clear that there is only a very small time frame in which preventive therapy can be effective and that, where possible, patients should begin treatment before symptoms appear,” says Prof. Pierluigi Nicotera, Scientific Director of the German Center for Neurodegenerative Diseases. “What we need is a predictive diagnosis of potential dementia, and other processes to help predict the further course the disease will take.” The DZNE is thus working on a method of diagnosis that can detect different types of dementia at an early stage and predict how the disease will develop. The researchers are concentrating particularly on neurochemical and molecular changes that take place in the brain long before structural damage becomes apparent. Substances known as biomarkers indicate these changes. The scientists are currently measuring the levels of two biomarkers – tau proteins and amyloid-beta peptides – in patients’ cerebrospinal fluid.
This means that patients with a mild cognitive disorder can be diagnosed with Alzheimer’s at least six years before the disease manifests itself – even if the findings of the MRI were negative. But this just represents the very beginning of an early-warning system for dementia. “The cerebrospinal fluid method is still an invasive process,” explains Prof. Nicotera. “We have to find an inexpensive, automated way of detecting the presence of biomarkers in the blood. To do this, we need to identify new biomarkers.” He says that this could happen in as little as five years.
Researchers are to observe patients with mild brain disorders over a longer period of time, conducting tests to identify neurochemical markers of dementia in the blood and cerebrospinal fluid, and running high-resolution 7 Tesla MRT (including functional MRI) and positron emission technology (PET) scans. The short-term goal is to slow the onset of neurodegenerative diseases, preventing them from becoming actual dementia until years later. The long-term goal is to stop dementia – which has such a devastating impact on the lives of sufferers and their families – from taking hold at all.
