James Mastrianni, MD, PhD, hopes to predict Alzheimer's disease years before its onset.
Predicting Alzheimer's Disease
Years before it Starts
Could a new procedure predict whether you will develop Alzheimer’s disease? University of Chicago experts think so. With the help of diffusion tensor imaging, a special MRI that shows brain pathways, researchers here are the first to study a specific and highly dense region within the temporal lobe that could allow earlier detection of Alzheimer’s.
“With this new, non-invasive technique, we are able to see the connections between different areas of the brain, specifically those first affected with Alzheimer’s disease,” says James Mastrianni, MD, PhD, Associate Professor of Neurology and Director of the Center for Comprehensive Care and Research on Memory Disorders. “We are focusing on the very earliest changes in those pathways in people with mild memory problems to try to predict which ones are at greatest risk for developing the disease.”
Once it’s determined who’s at risk, they will then be able to offer selected therapies that are currently under development to modify the disease in the future. Through this pilot study, Mastrianni and his team hope to get a jump on what is expected to become the biggest epidemic in this country by 2040, falling behind only cancer as the second leading cause of death, according to the World Health Organization.
“At some point, we’re going to be able to predict Alzheimer’s disease several years before it starts,” says Mastrianni. “Once we can do that accurately, we will be able to start therapies to modify the biology of the disease and slow down the progression at a faster rate.”
In collaboration with Ana Solodkin, PhD, Research Associate and Assistant Professor of Neurology, who is now at the University of California, Irvine campus, the team has formed a partnership with NorthShore University HealthSystem to broaden the study, which will allow them to increase the numbers of participants to ensure the predictability of the tests.
Also instrumental in predicting Alzheimer’s disease is a spinal fluid test, in which Alzheimer’s disease-related proteins can be measured. “There’s good evidence that this test demonstrates alterations in the level of these proteins prior to the onset of Alzheimer’s disease symptoms,” Mastrianni says.
More recently, the Food and Drug Administration approved a PET scan that can detect a dye injected into the blood stream; the dye travels to the brain and binds to deposits that are associated with the disease. “This is something that we’ve been waiting on for a while,” he says. “There’s been a lot of research in this area for several years, and now there’s finally a compound that will be readily accessible to different centers.” In the past, researchers could make the compound themselves, but now they’ll be able to order it from a central location because the compound has a longer shelf-life.”
“We’re excited because there’s a new PET scanner coming to the University and that’s going to be one of our priorities as we develop another clinical trial for the scanner.”
In another effort to delay the onset of Alzheimer’s disease, the Center for Comprehensive Care and Research on Memory Disorders, which is a partnership between the departments of neurology, geriatric medicine, and psychiatry, will again partner with NorthShore to focus on early diagnosis and detection of mild memory problems in African Americans who often don’t get diagnosed as early as they should, says Mastrianni.
"We plan to apply the MRI scanning and spinal fluid testing to African Americans to see if there is any difference in this population,” he says. “All these early detection tests have the potential to predict who is likely to develop the disease.”
In addition to its own research studies, the University is part of a comprehensive international study that is testing a new drug that may serve as the first Alzheimer’s disease modifying agent. The drug acts to reduce the brain levels of one of the abnormal proteins that accumulate in the brain of Alzheimer’s patients. Right now, drugs used to treat the disease only mask the symptoms and don’t modify the biology of the disease, adds Mastrianni.
“This can be a real turning point,” he says. “In the meantime, we are continuing to look at ways to diagnose the disease much earlier, to predict who’s going to get the disease before they even have symptoms.