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Biological marker for
Alzheimer’s holds promise for earlier
diagnosis and treatment
Researchers at Robarts Research Institute at The University of Western
Ontario have found clear evidence that
increases in the size of the brain
ventricles are directly associated with
cognitive impairment and Alzheimer’s
disease.
Ventricles are fluid-filled cavities in the brain. The research, led
by Robarts scientist Robert Bartha, shows
the volume of the brain ventricles expands
as surrounding tissue dies. The research
was published online today in the neurology
journal Brain.
Currently, diagnosis for Alzheimer’s relies
on neuro-cognitive assessments, such as
testing of memory, ability to problem solve,
count, etc. Definitive diagnosis is not
possible until after death when an autopsy
can reveal the presence of amyloid plaques
and ‘tangles’ in brain tissue.
Previous research has shown the link between ventricle size and
Alzheimer’s over longer time intervals.
The research conducted at Robarts Research Institute shows that
ventricle size increases with mild cognitive
impairment before a diagnosis of Alzheimer’s
disease, and continues to increase with the
onset and progression of Alzheimer’s disease
after only six months.
“These findings mean that, in the future, by using magnetic resonance
imaging (MRI) to measure changes in brain
ventricle size, we may be able to provide
earlier and more definitive diagnosis,” said
Bartha, who is also an Associate Professor
in the Schulich School of Medicine &
Dentistry in Medical Biophysics.
“In addition, as new treatments for Alzheimer’s are developed, the
measurement of brain ventricle changes can
also be used to quickly determine the
effectiveness of the treatment.”
The research also showed that Alzheimer’s patients with a genetic
marker for Alzheimer’s disease exhibited
faster expansion in ventricle volume.
The research was performed by utilizing MRI scans from individuals from
across North America.
Graduate student Sean Nestor, a coauthor, examined 500 data sets of
individuals at baseline and six months
later.
The images were obtained from the Alzheimer's Disease Neuroimaging
Initiative (ADNI), a large multi-site trial
sponsored by the National Institutes of
Health in the United States and the
pharmaceutical industry.
The project includes an online database of imaging information gathered
from 800 people at more than 50 sites across
the U.S. and Canada.
The images are MRIs of individuals with no cognitive impairment, those
with mild cognitive impairment and people
with Alzheimer’s disease.
The database can be used by any primary researcher.
One of the ADNI sites is at London’s Lawson Health Research Institute,
and is led by Dr. Michael Borrie, a
co-investigator on the research.
Dr. Borrie is Medical Director of the Aging Brain and Memory Clinic and
Geriatric Clinical Trials Group at Parkwood
Hospital, St. Joseph’s Health Care, London,
a Lawson researcher and Chair of the
Division of Geriatric Medicine at Western’s
Schulich School of Medicine & Dentistry.
Examination of the MRIs was made possible by using software developed
by Cedara Software, the OEM division of
Merge Healthcare.
In the past, researchers would have to manually or semi-automatically
trace the ventricles in many brain images,
each showing a “slice” of the brain.
The Merge OEM software team, led by Vittorio Accomazzi, a coauthor in
the research, worked closely with the
researchers to refine the software to allow
the processing of large volumes of data very
quickly.
"This is one of the first major research studies published using data
from ADNI", said Borrie, "but there will be
many more neuroimaging and biomarker
discoveries to arise from the ADNI project.
"It is a tremendous opportunity for researchers anywhere in the world to
use the ADNI databases, to collaborate and
share their findings in a new way that will
move Alzheimer's disease research forward
more quickly, objectively and effectively.
"Already we are building new international collaborations, arising from
ADNI, that we could not have even imagined."
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