RecruitingNCT05614310

Detecting Early Alzheimer's Using MR

Early Detection Of Alzheimer's Disease With GlucoCEST MRI: A Feasibility Study.

Sponsor

University of Aberdeen

Enrollment

60 participants

Start Date

Nov 15, 2022

Study Type

OBSERVATIONAL

Conditions

Alzheimer Disease

Summary

Alzheimer's disease (AD) is the most common cause of dementia, affecting approximately 10% of individuals aged ≥ 65. Most available treatments aim at controlling symptoms at an early stage rather than providing a cure. Therefore, an accurate and early diagnosis of AD with appropriate management will slow the progression of the condition. Reduced cerebral glucose levels have been observed in patients with early AD. Glucose hypometabolism can be assessed by administering a radioactive glucose analogue, 2-deoxy-2-(18F) fluoro-D-glucose (18FDG), and imaging with PET (positron emission tomography). The high cost and limited availability of PET-CT (PET - computed tomography) still hamper its general clinical application. Moreover, the use of radioactive tracers in combination with the additional ionizing radiation of CT is not suitable for repeated measurements. Therefore, currently, the provisional diagnosis of AD is still based on the combination of clinical history, neurological examination, cognitive testing over a period of time, and structural neuroimaging. This has major time and resource implications. A radically different and highly innovative means for imaging glucose with magnetic resonance imaging (MRI) has now been established, exploiting the interaction between hydroxyl protons in glucose and the protons in water; the method is termed glucose Chemical Exchange Saturation Transfer (glucoCEST). GlucoCEST MRI is a method that has no reliance on radiolabelled glucose analogues and could become widely implemented in clinic practice. We therefore aim to investigate the potential of glucoCEST MRI in Alzheimer's disease.

Eligibility

Min Age: 18 Years

Inclusion Criteria15

Development phase:
Controls (development group) must:
be \> 18 years
consent to the study
not report problems with memory.
Clinical phase
Patients must:
be ≥ 65 years,
able to provide informed consent to the study
have been clinically diagnosed with AD by the mental health team.
Controls must:
be ≥ 65 years
able to provide consent to the study
have a normal score in the ADAS-cog test and the Mini Mental State Examination test (MMSE)
not report problems with memory.

Exclusion Criteria8

Subjects will not be considered if they:
have a history of diabetes,
have history of a major stroke (mini-stroke/Transient Ischaemic Attacks or lacunar stroke are acceptable),
have contra-indications to MRI scanning such as implantable cardiac devices
have family history in AD, to exclude possible gene mutations associated with AD
have advanced AD who lack the capacity to consent.
Are pregnant (for developmental phase)
are unable to read or speak English

Interventions

OTHERMagnetic Resonance Imaging (MRI)

Participants will be asked to lie in the MRI scanner while we collect 3D T1- and T2-weighted images and a 3D FLAIR image to exclude pathology (e.g. stroke). Participants will ingest a glucose solution (75 g Dextrose) so dynamic glucoCEST images can be acquired to measure glucose uptake and clearance.

OTHERBlood Glucose Assessment

A blood testing meter will be used to measure the blood sugar levels before and after the scans. Normal reading for a nondiabetic person after fasting is 70-99 mg/dl (3.9-6 mmol/L). If abnormal blood sugar levels are detected (sugar levels outside the above normal range), the participant will no longer be eligible for the study and they will be withdrawn.

OTHERPositron Emission Tomography (PET)

Participants will be administered a radioactive glucose analogue, 2-deoxy-2-(18F) fluoro-D-glucose (18FDG) through a canula inserted into a vein in the arm or hand and asked to sit quietly for 1 h. After 1 h they will be asked to lie quietly and without talking in the PET scanner and a PET brain scan will be performed.

OTHERCognitive Assessment

Participants will be asked to undertake two cognitive tests (the Alzheimer's Disease Assessment Scale ADAS-cog test and the Mini Mental State Examination test - MMSE). These are standard clinical tests used to determine cognitive dysfunction in Alzheimer's disease.