A Structural Brain MRI Dementia Forecast Tool

DESCRIPTION provided by applicant Alzheimerandapos s disease AD the most common type of dementia is a devastating disease with no available treatment or prevention The current lifetime risk for a year old individual is estimated to be around Given current projections over million individuals will be diagnosed with Alzheimerandapos s disease by As the development of therapeutic strategies progresses through drug trials the current view is that the optimal window of opportunity to benefit an individual is years before symptoms appear in what is called the preclinical phase Preclinical AD is thought to begin with the abnormal accumulation of amyloid plaques in the brain In research and clinical trials identifying individuals with these plaques is possible with PET scans and cerebrospinal fluid CSF measures Yet with a cost of more than $ per scan PiB PET is an expensive means of screening and involves exposure to ionizing radiation a considerable health risk A CSF test necessitates an invasive lumbar puncture with the accompanying risks of headaches back pain bleeding infection and even potential brainstem herniation We propose to develop software tools that make use of structural MRI scan data to predict the amyloid status of cognitively normal individuals undergoing a screening process and for a set of individuals identify those most at risk of progressing to AD We believe a two step MRI PiB PET screening procedure will yield significant cost savings by reducing the number of expensive PET scans and might further help limit redundant radiation exposure due to unnecessary PET imaging in low risk individuals Lastly the identification of individuals with amyloid accumulation who are at risk of
imminent clinical decline will be invaluable for drug trial recruitment and future clinical management

PUBLIC HEALTH RELEVANCE The proposal is to build software tools that will predict amyloid status and forecast future clinical progression toward AD dementia The tools which examine measures derived from an MRI scan will be invaluable for pre screening stratifying and tracking individuals recruited for preclinical AD trials and will offer substantial cost savings b reducing the number of PET scans necessary to identify amyloid positive cognitively normal individuals