果冻影院

A new algorithm that can automatically disentangle different patterns of progression in patients with a range of different dementias, including Alzheimer鈥檚 disease, will enable individuals to be identified that may respond best to different treatments.

For the paper, , researchers devised and applied a new algorithm called SuStaIn (Subtype and Stage Inference) to routinely acquired MRI scans from patients with dementia.

The algorithm was able to identify three separate subtypes of Alzheimer鈥檚 disease, which broadly match those observed in post-mortems of brain tissue, and several different subtypes of frontotemporal dementia. Critically, however, this subtyping听could be done in life, using brain scanning,听and very early in the听disease process.

Being able to identify the subtypes early on in the disease process and using non-invasive MRI scanning means there is a better chance of identifying the best treatment for individuals.

Image source: Nature Communications

Professor Daniel Alexander (果冻影院 Centre for Medical Image Computing) said: 鈥淭his new algorithm has the unique ability to reveal groups of patients with different variants of disease. One key reason for the failure of drug trials in Alzheimer鈥檚 disease is the broad mixture of very different patients they test; a treatment with a strong effect on a particular subgroup of patients may show no overall effect on the full population so fail the drug trial.

鈥淪uStaIn provides a way to show treatment effects on distinct subgroups, potentially expediting treatments to market.鈥�

Classic studies of dementia in individuals take a single measurement based on their symptoms, and aren鈥檛 clear on what stage the disease is in.

SuStaIn uses medical imaging, which allows doctors to see how the disease is progressing, look at the specific locations of protein build up within the brain, and deduce which parts are degenerating.

Dr Alexandra Young (果冻影院 Centre for Medical Image Computing) said: 鈥淚ndividuals might present with similar symptoms to each other, but using SuStaIn we can find that they belong to different subgroups. This allows us to predict more accurately how their disease will progress and diagnose it earlier.鈥�

Professor Jonathan Schott (果冻影院 Institute of Neurology) said: 鈥淯nderstanding how different diseases evolve over time is critical if we are to design rational treatment trials and inform patients about prognosis.

鈥淭his is a major challenge for diseases that evolve over years, if not decades, and where there may be substantial differences in the underlying pathology, and pattern and rates of progression between patients."

This work shows that it is possible to tease out different disease patterns 鈥� some hitherto unknown 鈥� from single MRI scans taken from patients with a range of different dementias. As well as providing new insights into dementia, this work demonstrates the huge potential of SuStaIn to delineate disease subtypes in a range of other medical contexts.鈥�鈥�

The team are now looking for ways to apply the algorithm to other diseases, having recently presented it at the European Respiratory Society Conference on chronic obstructive pulmonary disease (COPD).

The report was produced with funding from the EPSRC, the Horizon 2020 EuroPOND project (), the MRC, the NIHR, ARUK, the Alzheimer鈥檚 Society, the Alzheimer鈥檚 Association, the Wolfson Foundation, the Weston Brain Institute, the Brain Research Trust, The Michael J. Fox Foundation for Parkinson鈥檚 Research, the ESRC, the Wellcome Trust, and the Associazione Italiana Ricerca Alzheimer ONLUS (AIRAlzh Onlus)-COOP Italia.听

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