For many years, research into dementia has thrown up as many questions as it has answers. Now, a new project is seeking to change that and at its heart lies the rapidly-advancing science of imaging technology.
Medical imaging technology has revolutionised health care over the past 30 years, developing at a staggering rate and allowing medical practitioners to see detail inside the body that was never available to them before. Imaging technologies that are routinely used include conventional X-Ray, molecular imaging, which is used in nuclear medicine, magnetic resonance imaging (MRI), ultrasound imaging, which uses high-frequency sound waves to produce images of soft tissue and internal body organs, and Positron Emission Tomography (PET), which is used to produce detailed three-dimensional images of the inside of the body.
The result has been that doctors have been able to detect disease much earlier and researchers can build up a better picture of the workings of the body. It is that potential that is driving the new research into dementias. So far, much of the work involving imaging has tended to focus on cancers but now the same technologies are being used on other conditions and among projects making use of the advances is the recently-launched Dementias Platform UK (DPUK), led by the Medical Research Council in the UK.
The MRC is providing £12m for an initial period of five years, supplemented by £4m from six partner companies and £37m from clinical research funding announced by Chancellor George Osborne in October 2014. Among those taking part are the universities of Cambridge, Edinburgh, Imperial College London, Oxford, Newcastle, University College London and Swansea, plus contributions from Cardiff, Manchester and Bristol. DPUK’s aims are early detection, improved treatment and ultimately, prevention, of dementias, which affect more than 600,000 people in the UK alone.
According to Dr Ross Maxwell, one of the medical experts involved, the project will use imaging technology to look deep into the brain to better understand changes that may be associated with the early stages of dementia. To do that, PET/MRI scanners will be installed at Cambridge, Edinburgh, ICL, Manchester and Newcastle universities. Dr Maxwell, Director of the PET Facility at Newcastle, said: “So far, imaging technologies have mainly been used in the field of cancer research, helping to develop new drugs by better understanding the effect that they are having on patients.
“However, the technology can also be used to research other conditions, including dementias, which is the focus of this project. “Just as researchers are increasingly focusing on sub-categories of cancer – we have learned that there is not just one type of any cancer – so there are different types of dementia. “This project will allow us to use imaging technologies to see changes in the brain which may lead to the development of markers which allow earlier detection of dementia and which will also allow for the development of drugs to treat the condition. “We will be able to assess what stage a patient’s Alzheimer’s has reached, for example. It has become clear that there is not just one treatment for a condition and by telling us what stage a patient’s condition has reached, the imaging technology will allow us to better target treatments.”
To carry out the work, the DPUK, which is in its very early stages, is creating the world’s largest study in dementias research, bringing together two million participants aged 50 and over, from 22 existing study groups within the UK. Included are people from the general population, people known to be at-risk of developing dementia, and people diagnosed with early-stage dementia. Researchers will use the information gleaned from imaging technology to look not just at the brain but also at the wider body because emerging evidence has linked the development of dementia with inflammatory, cardiovascular and metabolic disorders.
Dr Maxwell, who is based at the Newcastle Magnetic Resonance Centre, part of Newcastle University’s Campus for Ageing Vitality, said: “The technologies that we will use, including Positron Emission Tomography and MRI, have been around for some time but the way we are putting them together to investigate dementia makes the work cutting edge.
“This is a long-term project but it shows that something is being done to tackle dementias. It is a start and work already carried out at Newcastle is improving our understanding of dementias so can feed into the project. “What we are seeing is researchers bringing together skills from different fields. Research using imaging technology to look at the role of glucose in cancers, for example, already informs our knowledge of dementia because we are looking at changes in the brain in both cases. “This work is important because with an ageing population, we need to better understand how dementias work. Imaging can help us do this.”