European scientists have taken several significant steps to enable earlier
diagnosis of Alzheimer’s disease in PredictAD, an EU-funded project. The
scientists have developed new approaches for measuring biomarkers for
diagnostics and a novel system for integrating the information systematically.
The system provides an objective method for measuring the state of the patient.
PredictAD is an EU-funded research project that develops objective and
efficient methods for enabling earlier diagnosis of Alzheimer's disease.
Diagnosis requires a holistic view of the patient combining information from
several sources, such as, clinical tests, imaging and blood samples.
aim of the PredictAD project is to develop an objective indicator to diagnose
Alzheimer’s disease at the earliest stage possible. Current diagnostic
guidelines emphasise the importance of various biomarkers in diagnostics. We
have developed novel approaches to extract biomarkers from imaging data,
electrophysiological data and blood samples, and a unique and clinically
useful software tool for integrating all these heterogeneous measurements.”
says the Scientific Coordinator of the project, Dr Jyrki Lötjönen from VTT
Technical Research Centre of Finland.
imaging for identifying atrophy
Atrophy in the
mediotemporal lobe is a well-known hallmark of Alzheimer's disease. Magnetic
resonance imaging is an excellent tool for measuring this tissue loss. In
current clinical practice, images are interpreted mostly only by visual
inspection but there is a great need for objective measurements.
has developed several methods to meet this need. “We have managed to develop
efficient tools for measuring the size of the hippocampus, the atrophy rate of
the hippocampus, and two modern approaches based on comparing patient data
with previously diagnosed cases available in large databases.” says the leader
of the imaging biomarkers work-package, professor Daniel Rueckert from
Imperial College London. Positron emission tomography (PET) imaging is another
imaging technology studied in the project. A novel tracer developed recently
especially for diagnostics of Alzheimer's disease provides promises for very
early diagnosis of the disease.
Detecting changes in the
electrophysiology of the brain
Alzheimer's disease is
known to affect the electromagnetic activity of the brain. In PredictAD, we
have studied the performance of a novel technology, transcranial magnetic
stimulation (TMS) combined with electroencephalographic (EEG) measures in
detecting the disease. The strength of TMS/EEG is that it allows direct and
non-invasive perturbation of the human cerebral cortex without requiring the
subject's collaboration. Our study has shown significant changes in
Alzheimer's patients compared with healthy aging people.
techniques to find biomarkers of the disease
level biomarkers are currently under extensive studies in Alzheimer's
research. Many biomarkers, such as tau proteins and -amyloid 42, measured
from the cerebrospinal fluid (CSF), the liquid surrounding the cerebral
cortex, have been found to be strongly related with the disease. One major
challenge of these biomarkers is that taking samples from CSF is an invasive
measurement limiting their usability in early diagnostics. Blood samples would
be an excellent source for detecting Alzheimer's disease as blood sampling is
not considered an invasive technique. PredictAD has studied the role of
metabolomic and protein compounds in Alzheimer's disease from blood samples.
The preliminary results reveal several promising compounds.
for measuring the state of the patient
clinicians make the final diagnosis by combining heterogeneous measurements
with information from interviews of the patient and relatives. This process
involves subjective reasoning and requires strong expertise from the
clinicians. Modern hospitals have huge data reserves containing hidden
information that could be utilised in diagnostics by systematic mathematical
PredictAD has designed a totally novel approach
for measuring objectively the state of the patient. This decision support
system, developed in close collaboration with clinicians, compares patient
measurements with measurements of other patients in large databases and
provides at the end an index and graphical representation reflecting the state
of the patient. “The PredictAD tool provides a new option to support decision
making”, says Prof. Hilkka Soininen from the University of Eastern Finland,
leading the clinical validation of the project.
for significant savings in health costs
Waldemar from Copenhagen University Hospital, Rigshospitalet emphasises the
importance of the Alzheimer's disease research: "Successful, early diagnostics
combined with the novel drugs under development and early psychosocial care
may delay the institutionalisation of patients, reducing suffering and the
costs to the society. It has been calculated that delaying the onset of the
disease by five years would halve all costs of Alzheimer's disease and
delaying onset and progression by only one year would reduce the number of
Alzheimer's cases by about 10%."
like GE Healthcare and pharmaceutical companies are investing heavily in this
area. Commercialisation of the results is already ongoing in PredictAD”, says
Dr Lennart Thurfjell from GE Healthcare Ltd leading the activities of
dissemination and exploitation.
Dementia has been recently
identified as a health priority both in Europe and in the USA. Alzheimer's
disease, the most common cause of dementia, alone accounts for costs
equivalent to about 1% of the gross domestic product (GDP) of the whole world
and the number of persons affected will double in the next 20 years. Early
diagnostics plays a key role in solving the problem because treatments of this
irreversible disease should be started in an early phase to be efficient.
Various treatments are currently under extensive development. So far, the lack
of systematic and objective ways to identify persons for treatments has been
With a consortium of top-level European research
and industry partners, the PredictAD project takes an important step towards
an early approach to Alzheimer’s disease prediction and management. Public and
private partners from eight research, academic, industrial and medical
organisations from five different European countries form the consortium: VTT
(Finland), GE Healthcare (UK), Nextim Ltd. (Finland), University of Eastern
Finland (Finland), Imperial College London (UK), Karolinska Institutet
(Sweden), University of Milan (Italy) and Copenhagen University Hospital,
PredictAD is organising a workshop
in Kuopio, Finland, on June 15, 2011. The purpose of the workshop is to
present and discuss results of the PredictAD project and recent innovations
for the early diagnosis of Alzheimer’s disease.
Photo 1: An
MRI scan reveals details of brain structure and function. Photo source:
the University of Eastern Finland.
Photo 2: Psychologist
Teemu Paajanen is assessing memory performance. Photo source: the
University of Eastern Finland. Photographer: Raija Törrönen
Photo 3: Dr
Pekka Miettinen is analysing MRI scans. Photo source: the University of
Eastern Finland. Photographer: Raija Törrönen