Pieter Droppert in a previous position worked as a Global Project Director for a phase II Alzheimer’s clinical trial program in emerging markets.  He maintains an interest in this area and the new products in drug development.

In a new post on Biotech Strategy Blog, Pieter writes about research published in the journal Neurology that showed magnetic resonance imaging (MRI) could detect pre-symptomatic Alzheimer’s disease (AD).

Brad Dickerson and colleagues from Mass General and Rush University in Chicago looked at two groups of subjects who were cognitively normal, and then over time investigated the brain differences seen in those patients who developed AD.

Their conclusion is that changes in cortical thickness are a biomarker for AD, in other words structural brain changes can be seen before they develop clinical symptoms.

This research is still very early and has a number of limitations, including the low sample size and the need for computer power to do the analysis.

That said, the promise of all the biomarkers under development to diagnose early stage AD, whether they be amyloid imaging of plaque through PET scans or via MRI, is they offer the hope of being able to detect those patients at risk before the brain becomes irreparable.

By the time clinical symptoms of dementia or mild cognitive impairment manifests itself, then it’s likely the damage has already been done, and the brain has been snagged or disrupted by the disease in a way that is hard to reverse.

Early detection of those individuals at risk allows the prospect of using neuroprotective drugs to delay the onset of clinical symptoms.

Recognition of the importance of preclinical diagnosis i.e. before symptoms develop was also shown by the announcement yesterday by the National Institute on Aging, a branch of the NIH – National Institutes on Health of new diagnostic guidelines for Alzheimer’s patients.

These guidelines divide patients into three diagnostic groups: preclinical, mild cognitive impairment (MCI) and dementia.  The preclinical group is completely new and a recognition that structural and molecular changes occur in the brain before clinical symptoms manifest themselves.

There is considerable research into AD biomarkers to suggest that in the next 5 years we will be able to detect those people at risk, but the challenge remains in developing new drugs that slow down or reverse the onset of the neuronal tangling that occurs.

AD is a disease that will touch many families as the population in many countries becomes older.  If you are interested in this area, you can read more on Biotech Strategy Blog.