Combining two techniques could spot Alzheimer’s disease sooner
Southampton researchers have shown using both a brain scan and fluid test can help show if someone has Alzheimer’s disease.
Combining the techniques could enable diagnosis at an earlier stage, when treatment is more effective.
Alzheimer’s disease is the most common cause of dementia, which causes memory loss, confusion and communication difficulties. The number of people living with dementia was estimated to be 944,000 in 2021, and by 2050 this figure is expected to rise to 1.6 million.
The study was based at University Hospital Southampton (UHS). It was led by Prof Chris Kipps, Prof Jessica Teeling and Dr Sofia Michopoulou, funded by an NIHR Clinical Lectureship.
Dr Angus Prosser a Senior Research Fellow and Innovation Project Manager and Dr Matthew Guy the Head of Imaging Physics and awardee of Cohort 1 of the Research Leaders Program at UHS were also involved.
The results have been published in the Journal of Alzheimer’s disease.
Combining two techniques
The team analysed data from 91 patients referred to the Wessex Cognitive Disorders Clinic at UHS. All participants had a perfusion SPECT brain scan and a lumbar puncture.
The perfusion SPECT scan allowed the researchers to look for abnormalities with blood flow in the brain. This can be an early sign of Alzheimer’s disease. The scan is a type of nuclear imaging, which uses a radioactive substance and a special camera to create 3D images of the brain.
They used the lumbar puncture to take a sample of the participants’ cerebrospinal fluid. This is a clear liquid that surrounds the brain and spinal cord. They then analysed this to look for signs of brain inflammation, which can indicate that Alzheimer’s disease is progressing.
Complementary results
In the brains of people with Alzheimer’s disease, there can be a build-up of amyloid beta protein, which forms clumps or ‘plaques’. There are also tangles of tau protein. Both are hallmarks of the disease.
The researchers found the inflammation markers they studied in participants’ cerebrospinal fluid were good for measuring tau. Perfusion SPECT imaging, however, was better for indirectly evaluating amyloid.
Combining both techniques therefore allowed them to assess to two different aspects of the condition. This could give a more complete picture of the person’s brain health, and so may allow the disease to be diagnosed at an earlier stage.
Dr Michopoulou, Head of Nuclear Medicine Physics at UHS, said:
“These findings, from combining fluid tests and scans, have inspired us to explore alternative fluid tests. Currently, we are assessing blood biomarkers of inflammation to eliminate the requirement for a lumbar puncture, aiming to enhance accessibility.
“This research will expand to incorporate longitudinal cohorts in the PhD project Immune Markers of Progression of Alzheimer’s for Clinical Translation (IMPACT), jointly funded by UHS and the University of Southampton.”