Improving diagnosis of Alzheimer’s disease by understanding changes seen in brain scans

Research project: The diagnostic importance of white matter changes in Alzheimer's disease

Lead Investigator: Dr Kirsty Elizabeth McAleese
Institution: Newcastle University 
Grant type: Junior Fellowship
Duration: 36 months
Amount: £224,936

Why did we fund this project?

Comments from members of our Research Network

'There are clear benefits to people with dementia and their carers because of the ability to provide an accurate diagnosis, one that distinguishes between Alzheimer's Disease and vascular dementia, and which leads to appropriate treatment.'

'The researcher's passion for subject shows through.'

'Clearly an important area of research, especially as it relates to the possibility of misdiagnosis.'

What do we already know?

The symptoms of Alzheimer's disease and vascular dementia can be very similar. Both conditions tend to first appear with memory lapses and difficulty thinking clearly. This means that an accurate diagnosis can sometimes be difficult, particularly in the early stages of the condition. 

The brain is divided into 'grey matter' and 'white matter'. The grey matter includes the surface of the brain which is responsible for thought and controlling senses and movement. The 'white matter' is the bundles of insulated cables and blood vessels which stretch up to the surface of the brain and travel through the spinal cord. It was originally thought that doctors could use brain scans to see the damage to small blood vessels in the white matter, which is characteristic of vascular dementia. 

However, recent research by Dr McAleese and colleagues has shown that white matter damage in the area of the brain that sits above the ear also occurs in Alzheimer's disease.  This white matter damage looks very similar to that found in vascular dementia meaning that brain scans to show white matter damage may not be a reliable way to diagnose either condition.

What does this project involve?

Dr McAleese will use brain tissue donated from 200 people, both those who lived with dementia and those who did not. Each person had an annual test of their memory and thinking abilities during their lifetime, which included brain scans. Brain tissue will be examined under the microscope to look for changes in blood vessels and structures. The tissue will also be used to assess chemicals and molecules that will indicate how well the cells of the brain are working. 

This study aims to identify white matter damage in the brains of people who had Alzheimer's disease and to see how it compares to the damage caused by small vessel disease. Dr McAleese and colleagues will test whether the early signs of damage to the white matter can predict the development of Alzheimer's disease. In addition they will determine whether the white matter damage has a direct connection with the person's ability to complete cognitive tests.

How will this benefit people with dementia?

Improving the diagnosis of Alzheimer's disease and vascular dementia would be of enormous benefit to those living with these conditions. This research is particularly innovative as it will investigate white matter damage in Alzheimer's disease which has not yet been closely investigated. 

An accurate diagnosis is vital for several reasons; firstly because the wrong diagnosis can lead to the person getting the wrong treatment as the drugs that are used to treat Alzheimer's disease are not suitable for vascular dementia. Also, the right diagnosis means those living with the condition can plan for the future and to receive the correct support.

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