Understanding how to use information from brain scans to improve trials into dementia prevention

Lead researcher: Professor Nick Fox

Institution: University College London

Grant type: Project

Amount: £249,965

Duration: 2 years

Scientific title: Improving prevention trials in Alzheimer's disease through imaging

Why did we fund this project?

Comments from our Research Network:

'This research application is well presented and brings hope to the prospect of AD prevention, by building on data from worldwide studies.'

'This application encourages research into early diagnosis, and even prevention, probably the most important areas of biomedical research.'

'This study would seem to be a crucial follow on to so much work already done, in case drugs to date have not proven to be beneficial solely because they were given too late.'

What do we already know?

Currently, the drugs that are available to treat Alzheimer's disease only help with some of the symptoms for a short period of time. There are no drugs that slow or stop the underlying causes of the condition. 

It is known that the Alzheimer's hallmark amyloid protein begins to appear as clumps in brain cells years or even decades before symptoms start to show. Most clinical trials into dementia treatments have so far targeted these amyloid clumps after the people affected have begun to show symptoms. Sadly, most of these drugs have failed to show any benefit for people affected by the condition. 

One of the most promising avenues for developing a treatment for Alzheimer's is targeting the amyloid clumps before symptoms of dementia start to show. One way this is being investigated is through 'prevention' trials, which test potential drugs in people who are not showing outward signs of the condition but who have evidence of amyloid clumps in their brain. 

One of the main challenges in designing prevention trials is working out what can be measured in order to see whether the drug has worked. Usually trials into treatments for dementia will use tests of memory and thinking to see if there have been any improvements or slowing down of cognitive decline. However, these improvements may only be temporary and more measures are needed to give a more definite idea of whether the potential treatment is working. 

What will the researchers do?

This project is aiming to help with improving the design of prevention trials by investigating the role of brain scans during the process. Brain scans such as positron emission tomography (PET) can show if someone has amyloid in their brain.  

The researchers will make use of a large study called the Dominantly Inherited Alzheimer's Network (DIAN), which follows people who have a genetic link to Alzheimer's disease and are at higher risk of developing the condition. These people are therefore more likely to be showing early signs of dementia in their brains. The researchers will collect brain images from people taking part in this study and use these to find out which are the best signs to look out for when assessing how well the drug being used in a prevention trial is working.  They will also work out aspects such as how many scans need to be collected and at what times throughout these trials to get the most accurate picture of whether the drug is working or not. 

How will this benefit people with dementia?

Finding a way to prevent dementia or to stop the condition in its tracks is one of the top priorities for dementia researchers. As our understanding of the underlying causes of the condition grows, we also need to adapt the way that clinical trials are conducted in order to make sure that the results achieved are as accurate as possible. 

This project will inform the design of future trials and ensure that the results gained are a genuine representation of how the drug works. This will help us to understand whether any drugs being used in future clinical trials are effective at preventing dementia.