Can an MRI detect any disease

Neurodegenerative Disease Early Warning System - Can Small Memory Problems Predict Dementia?

Early diagnosis, before the disease has fully developed, is not only important for timely therapy. Scientists are therefore looking for methods to detect dementia at an early stage.

In Germany there are currently more than one million people living with dementia. So far, the first signs of dementia have only been recognizable to a very limited extent. Only when objectifiable memory disorders occur, tests and imaging procedures can provide indications of a possible disease. The aim of current research is to be able to make a reliable diagnosis long before the first memory disorders occur. Scientists have taken an important step forward in this area in recent years. They pursue different approaches, all of which should ultimately enable an earlier diagnosis of neurodegenerative diseases. The new German Center for Neurodegenerative Diseases (DZNE) works together with universities and university clinics at various locations. One of them is the University of Bonn. Here, the group around private lecturer Dr. Frank Jessen and Prof. Dr. Wolfgang Maier new diagnostic methods that should be used before the first memory problems occur.

In a large-scale study with 2,415 patients aged 75 years and older, they investigated whether the risk of developing dementia could be determined by means of a purely subjectively perceived memory disorder. The study is carried out as part of the Degenerative Dementia Competence Network and with the support of the Federal Ministry of Education and Research (BMBF). The researchers were able to show that patients who report purely subjective memory disorders during a visit to the doctor - without measurable memory problems - are more likely to develop dementia at a later point in time than others. Professor Maier and Dr. Jessen see this as an opportunity to get an initial indication of whether a patient is prone to dementia at a very early stage and without complex methods. “This is a very promising approach that could gain in importance in the next few years,” says Professor Maier.

Changes in the brain indicate dementia

Today psychometric tests are the first to be used for the first memory disorders. These are scientifically proven and standardized function tests that are used to assess brain performance. If these tests reveal the first impairments, so-called imaging methods are used. The most important method for diagnosing dementia in the early stages is now magnetic resonance imaging, or MRI for short. With this procedure, structural changes in the brain can be detected. Such changes in certain brain regions indicate an early stage of dementia and enable an early diagnosis to be made today. However, the reverse is not possible: an inconspicuous finding with the help of the MRI procedure does not necessarily rule out an early stage of dementia. Because not every change in the brain can be detected with an MRI. Further research projects and an overview of the centers for imaging in the neurosciences in Germany can be found in Newsletter 43.

Questions about dementia - info hotline for doctors

Since October 2009 the German Center for Neurodegenerative Diseases (DZNE) and the Competence Network Degenerative Dementia (KNDD) have been offering a joint telephone hotline on dementia for general practitioners, neurologists and psychiatrists. You can find out about topics such as diagnostics, guideline-based treatment, medical care, nursing, clinical studies and the neurobiological basis of dementia. The hotline can be reached every Wednesday on 01803 779900 from 12.30 p.m. to 3.30 p.m. The call from the German landline network costs nine cents per minute.

An early and unequivocal diagnosis of dementia is very important because known therapy methods are only effective in certain phases of the disease. This is especially true for the very early stages of dementia, in which MRI technology does not provide a reliable answer. In addition, the various subtypes of dementia, which all have to be treated differently, can only be differentiated to a limited extent with the previous MRT technology.

Molecular changes usually reveal more than structural ones

That is why researchers at the German Center for Neurodegenerative Diseases now want to develop a diagnostic method that allows for better differentiation as early as possible. The scientists concentrate particularly on the molecular and neurochemical changes that occur in the brain in the case of dementia - long before structural changes can be detected. The substances involved, so-called biomarkers, serve as specific indicators. Among other things, the latest imaging methods are to be used to measure the biomarkers, which provide a higher resolution of the brain structure than previous methods and provide additional information about the metabolism in the brain. These are high-field 7 Tesla magnetic resonance tomography and positron emission tomography (PET). Some biomarkers are already being used today, such as the dew proteins and the Abeta peptides, which can be detected using biochemical tests in the patient's nerve water, the liquor. Six years in advance, a mild cognitive disorder can indicate the onset of Alzheimer's disease.

Postpone or even prevent dementia

But this is only the beginning of an early warning system against dementia, because the liquor-based method is associated with a clinical intervention for the patient. The DZNE researchers are therefore looking for biomarkers that can be detected in the blood. At the same time, they want to use state-of-the-art imaging processes to be able to diagnose structural changes in the brain more reliably in the future. “This research area is particularly important for the DZNE, which is why we are researching such biomarkers at several locations. To do this, we need high-resolution, non-invasive MRT technology, because only it provides reliable information about changes in the brain of dementia patients ”, says Prof. Pierluigi Nicotera, scientific director and chairman of the board of the German Center for Neurodegenerative Diseases. With the new methods, patients in the preliminary stages of dementia are to be observed over a longer period of time. The DZNE researchers will use the results to develop new preventive therapeutic approaches. The aim is to test the effect of possible drugs, but also of alternative methods such as the influence of physical and mental fitness on the development of dementia. Ultimately, the researchers want to postpone neurodegenerative diseases for several years and completely prevent dementia in the long term.

The DZNE - on the trail of neurodegeneration

The German Center for Neurodegenerative Diseases (DZNE) wants to understand the causes and risk factors that predetermine neurodegeneration and develop new diagnostic methods as well as therapy and care strategies. It is the first non-university center that was founded with the mandate to work closely with universities and university hospitals. In the DZNE, experts do research at the locations in Bonn, Tübingen, Munich, Rostock / Greifswald, Göttingen, Magdeburg and Witten as well as at the cooperation partner in Dresden. The DZNE is funded 90 percent by the Federal Ministry of Education and Research (BMBF) and ten percent by the respective federal states with a DZNE location.

Contact Person:
Prof. Dr. Pierluigi Nicotera
German Center for Neurodegeneratives
Diseases e. V. (DZNE)
Ludwig-Erhard-Allee 2
53175 Bonn
Tel .: 0228 43302-260
Fax: 0228 43302-279
Email: [email protected]

Prof. Dr. Wolfgang Maier
Clinic and Polyclinic for Psychiatry and Psychotherapy
University Hospital Bonn
Sigmund-Freud-Strasse 25
53105 Bonn
Tel .: 0228 287-15723
Fax: 0228 287-16097
Email: [email protected]