Brain scans are being used to spot the early stages of Alzheimer’s disease in a UK-based pilot that could revolutionise its diagnosis.
Doctors are using magnetic resonance imaging (MRI) scans to look at whether particular parts of the brain have started to shrink, which is a key physiological sign of Alzheimer’s.
By comparing the scans of 600 people with the condition and 600 without, they have developed a computer programme that can differentiate between the two with 85 per cent accuracy. Patients can be told within 24 hours.
A pilot clinical project at Maudsley Hospital in south London has just started. It will be evaluated for a year and, if successful, could be rolled out across the NHS.
Dr Andrew Simmons, a neuroimaging expert at the Institute of Psychiatry, which is attached to the hospital, explained that brain shrinkage started in the temporal lobe at the base of the brain.
He explained: “Broadly, we know from post-mortems that the first early signs of Alzheimer’s involve changes to the base of the brain, an area called the temporal lobe.
“We know that people with early Alzhemier’s have a relatively small amount of atrophy [brain wasting] of this area.”
As time progressed, the affected area “begins to spread out to the frontal lobe and the rest of the brain”, he said.
He said the advantage of the MRI method was that it could help doctors make a positive diagnosis of Alzheimer’s sooner. Without a diagnosis, patients cannot be prescribed three drugs – Aricept, Exelon and Reminyl – that help slow the onset of the disease.
Rob Howard, professor of geriatric psychiatry at the Maudsley, added that early diagnosis enabled people to “make appropriate plans to put their lives in order and seek the help that may be available”.
He went on: “The important thing about the development we’ve reported is that it’s available as a clinical service. We’re talking about something that is done in the clinic routinely and the results are made available to clinicians within a few hours of the patient having had a scan.”
Prof Simon Lovestone, director of research at the Institute of Psychiatry, said the brain scan method could potentially stop patients having to return to be retested for dementia using mental impairment score-cards.
Psychiatrists often told patients with small signs of dementia to return months later to see if they had deteriorated to the point of clinical dementia.
“Can you imagine what that feels like, to be told to go away and come back in six months time?” he said.
However, at the moment Alzheimer’s can only be formally diagnosed by observing symptoms.
Alzheimer’s accounts for roughly two-thirds of dementia cases in Britain. Less than half of dementia patients have been diagnosed.
The MRI project is an example of “translational research” – that which will have a direct benefit for NHS patients.
The Government has just announced that such research will receive £775 million worth of funding over the next five years.
Dr Anne Corbett of the Alzheimer’s Society welcomed the MRI scan project.
She said: “Doctors rely heavily on memory tests for diagnosing people with Alzheimer’s, which aren’t especially reliable. It’s therefore a positive step to see a new technology being tested that could diagnose Alzheimer’s earlier and more accurately.
“This is also a great example of how scientific advancements can be translated into real benefits for people with dementia. We need more investment in research to bring better diagnosis and treatments to people with dementia as quickly as possible.”
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