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The current techniques for detecting Alzheimer's disease only work when the typical plaques are formed in the brain, a point where therapy is no longer an option. However, studies show that the first changes caused by the disease occur at the level of proteins up to 20 years earlier.
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Detection at a much earlier stage
Researchers at the Ruhr-Universität Bochum (RUB) have developed a two-level method that can help detect the disease at a much earlier stage and improve the chances of treatment.
"This has paved the way for early-stage therapeutic approaches, where the still ineffective drugs on which we had built our hopes could prove effective," says Professor Klaus Gerwert of the RUB Biophysics Department.
The technique focuses on the diagnosis of amyloid beta protein folds about eight years before the appearance of the first clinical symptoms. The technique consists of a simple blood test.
However, in the first trial, the test detected 71% of Alzheimer's cases at an asymptomatic stage, but also resulted in 9% false positives. As such, researchers have further optimized their test.
To do this, they introduced a second biomarker. The researcher now uses the first blood test to identify high-risk individuals and additionally adds a specific dementia biomarker to perform a second set of tests.
"Thanks to the combination of the two analyzes, 87 out of 100 patients were correctly identified in our study", summarizes Klaus Gerwert. "And we reduced the number of diagnoses of false positives in healthy subjects to 3 out of 100. The second analysis is performed in cerebrospinal fluid extracted from the spinal cord.
"New clinical studies of early participants in the disease can be started," says Gerwert. He hopes that existing therapeutic antibodies will always have an effect. "Recently, two large promising studies have failed, including Crenezumab and Aducanumab – not least because it was probably already too late at the time of taking the treatment.The new test opens a new therapeutic window."
Before the formation of amyloid plaques
"Once the amyloid plaques are formed, it seems that the disease can no longer be treated," says Dr. Andreas Nabers, head of the research group and co-developer of the Alzheimer's sensor. "If our attempts to stem the progression of Alzheimer's disease fail, it will put a lot of pressure on our society."
The blood test was upgraded to a fully automated process at the RUB biophysics department. "The sensor is easy to use, robust in the fluctuation of biomarker concentration and standardized," says Andreas Nabers. "We are currently conducting extensive research to detect the second biomarker, tau, in the blood to provide a blood-only test in the future," concludes Klaus Gerwert.
The study was published in the March 2019 issue of the journal Alzheimer's and dementia: diagnosis, evaluation and surveillance of the disease.
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