Pioneering EEG test could dramatically increase early diagnosis of Alzheimer’s disease

A simple but revolutionary approach to the early diagnosis of Alzheimer’s disease is being developed by researchers as part of an initiative that could pave the way for better outcomes for people who develop the disease in the future.

The innovative research, led by psychologists at the University of Bath and funded by the dementia charity BRACE, uses a new method to passively measure brain activity. It involves participants watching a series of flashing images on a computer for two minutes, while their brain waves are measured using an EEG cap.

New research on this, published today in the journal Brain, shows that the technique is very effective at detecting small, subtle changes in brain waves that occur when a person remembers a picture. Importantly, the technique is completely passive, which means that the person doing the test does not need to understand the task or respond, and may not even be aware of their memory response.

The team behind “Fastball EEG” technology says the approach is cheap, portable, and builds on pre-existing technology already available in hospitals, making it easily scalable. They are now starting to use Fastball EEG in a study of the early stages of Alzheimer’s disease in collaboration with the Research Institute for the Care of Older People (RICE) and the Bristol Brain Center at Southmead Hospital.

Alzheimer’s disease is the underlying cause of about 60% of dementias, with an estimated prevalence rate in Europe and North America of 5-7% of the population. Estimates suggest the disease costs the UK economy around £ 26bn per year, with costs set to rise as the aging population increases in numbers.

Alzheimer’s disease is currently diagnosed using a combination of subjective and objective reports of cognitive decline, often involving memory tests administered in a clinic. These tests are subject to various biases, including assessment anxiety, but also require verbal and written communication skills which make them ineffective for some people.

To learn more about people’s disease at an earlier stage, drugs can be prescribed earlier when they can be more effective, like the recently approved aducanumab, the first modifying treatment for Alzheimer’s disease. Lifestyle interventions may also be implemented to help slow the progression of the disease. The current diagnosis of Alzheimer’s disease usually comes late in the progression of the disease.

In the near future, researchers hope that Fastball EEG could help lower the age of diagnosis by up to five years. In the longer term, they say this could offer opportunities to expand this further. They compare their future aspirations for its application to current screening tools used to test for high blood pressure in middle age.

Principal investigator and cognitive neuroscientist Dr George Stothart of the Department of Psychology at the University of Bath explains: “The Fastball offers a truly new way of measuring how our brains work. The person being assessed does not need to understand the test, or even answer, they are just looking at a screen of flashing images and by the way we manipulate the images that appear we can learn a lot about what their brain is or is not able to do.

“The tests we are currently using to diagnose Alzheimer’s disease miss the first 20 years of the disease, which means we’re missing out on huge opportunities to help people. For decades, we have had research tools available. scientist capable of probing brain function, but we have never made the leap to a viable clinical tool for the objective assessment of cognition. We hope that Fastball can be that leap.

“We are at a really exciting stage in its development. We are testing the tool at increasingly early stages of Alzheimer’s disease and expanding the type of brain function it can measure, to include language and visual processing. This will not only help us understand Alzheimer’s but also the many other less common forms of dementia.

“Ultimately, the holy grail of a tool like this would be a middle-aged dementia screening tool for everyone, regardless of symptoms, in the same way we test for it. high blood pressure. We’re a long way from it, but it’s a step towards that goal. “

Mark Poarch, Managing Director of BRACE, added: “We are delighted to be able to fund Dr. Stothart’s research, which clearly has exciting potential. This could lead to an early diagnostic tool that benefits countless people and help turn the tide against dementia. More generally, we have seen over the past year what happens when the world devotes resources to medical research to find a vaccine against a dangerous virus, and now we need to give dementia researchers the resources they have. need to achieve comparable breakthroughs. “

Dr Stothart and his colleagues will soon start work on a major £ 100,000 longitudinal study in dementia praecox funded by the Academy of Medical Sciences. The study will consist of testing patients with mild cognitive impairment using the new Fastball tool. Mild cognitive impairment is the first sign of Alzheimer’s disease for some patients, but many are not, and determining who will progress to Alzheimer’s disease may advance the diagnosis to the next level. ‘five years earlier.

The latest work is based on a proof of principle article published in May 2020 in the journal NeuroImage.