Dementia detection may be possible years before symptoms

A new study from UT Health San Antonio has made a significant discovery in the early detection of dementia. The research suggests that thinning of the cortical gray matter in the brain could be a key biomarker for dementia risk that is detectable 5 to 10 years before symptoms manifest.

The experts used magnetic resonance imaging (MRI) to analyze brain changes among participants from the Framingham Heart Study in Massachusetts and a diverse cohort from California.

Cortical gray matter 

The researchers meticulously examined data from 1,500 individuals, all around the ages of 70 to 74, tracking changes in their brain structure over a decade. 

The focus was on the cortical gray matter, a critical area of the brain that’s known to be affected in various forms of dementia, including Alzheimer’s disease.

“The big interest in this paper is that, if we can replicate it in additional samples, cortical gray matter thickness will be a marker we can use to identify people at high risk of dementia,” explained study lead author Dr. Claudia Satizabal.

“By detecting the disease early, we are in a better time window for therapeutic interventions and lifestyle modifications, and to do better tracking of brain health to decrease individuals’ progression to dementia.”

Focus of the study

The researchers noted that while dementias can affect different brain regions, Alzheimer’s disease and frontotemporal dementia impact the cortex. The experts compared participants with and without dementia at the time of MRI.

Study co-author Dr. Sudha Seshadri is the director of the Glenn Biggs Institute at UT Health San Antonio and senior investigator with the Framingham Heart Study.

“We went back and examined the brain MRIs done 10 years earlier, and then we mixed them up to see if we could discern a pattern that reliably distinguished those who later developed dementia from those who did not,” said Dr. Seshadri.

“This kind of study is only possible when you have longitudinal follow-up over many years as we did at Framingham and as we are building in San Antonio.”

“The people who had the research MRI scans while they were well and kept coming back to be studied are the selfless heroes who make such valuable discoveries, such prediction tools possible.”

Consistent findings

A remarkable aspect of this study is its consistency across different racial and ethnic groups. Dr. Satizabal pointed out that early dementia detection could revolutionize patient care and clinical trials. 

The results consistently showed that thicker ribbons correlated with better outcomes and thinner ribbons with worse outcomes.

“Although more studies are needed to validate this biomarker, we’re off to a good start,” said Dr. Satizabal. “The relationship between thinning and dementia risk behaved the same way in different races and ethnic groups.”

According to Dr. Seshadri, clinical trial researchers could use the thinning biomarker to minimize cost by selecting participants who haven’t yet developed any disease but are on track for it. 

Future directions

Dr. Satizabal said the team plans to explore risk factors that may be related to the thinning, including cardiovascular risk factors, diet, genetics and exposure to environmental pollutants.

“We looked at APOE4, which is a main genetic factor related to dementia, and it was not related to gray matter thickness at all,” said Dr. Satizabal.

“We think this is good, because if thickness is not genetically determined, then there are modifiable factors such as diet and exercise that can influence it.”

The study is published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

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