brain imaging and early detection of · dr. andreana benitez, musc diagnosing alzheimer’s disease...

11/18/2019

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Brain Imaging and Early Detection of Alzheimer’s Disease

Jane Joseph, PhD Professor of Neuroscience

Medical University of South Carolina

SC Alzheimer’s Association Conference November 15, 2019

Facts about Alzheimer’s Disease https://alz.org/alzheimers-dementia/facts-figures

BETWEEN 2000 AND

2017 DEATHS FROM

HEART DISEASE HAVE

DECREASED 9% WHILE

ALZHIEMER’S RELATED

DEATHS

HAVE INCREASED

145%.

1 IN 3 SENIORS DIES WITH

ALZHEIMER'S OR ANOTHER

DEMENTIA. IT KILLS MORE THAN

BREAST CANCER AND

PROSTATE CANCER COMBINED.

ALZHEIMER'S DISEASE IS

THE 6TH LEADING CAUSE

OF DEATH IN THE UNITED

STATES.

SC HAS 8TH

HIGHEST

ALZHEIMER’S

DEATH RATE IN

THE US

https://alz.org/alzheimers-dementia/facts-figures





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Increased risk of AD in SC (data from SC Alzheimer’s Registry and Dr. Andrew Lawson at MUSC)

Risk is greater than the standard population

What are the risk factors for Alzheimer’s Disease?

• Age • Genetics

• Cardiovascular disease (stroke, diabetes, hypertension)

• Head injury • Excessive substance use • Unhealthy lifestyle

Not modifiable

Modifiable!

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Recent headlines

Cognitive

engagement:

Social activities

Mental “exercise”

Book clubs

Tai Chi

Don’t smoke

Exercise at least 150

minutes / week

Low-fat Diet Drink in moderation

It May Be Possible to Counter Some of the

Genetic Risk of Alzheimer’s With

These Lifestyle Changes

Cognitive

engagement:

Social activities

Mental “exercise”

Book clubs

Tai Chi

Recent headlines Even if you do just 2 or 3 of these, you reduce your risk for Alzheimer’s by 40%

Don’t smoke

Exercise at least 150

minutes / week

Low-fat Diet Drink in moderation

If you are at high genetic risk for Alzheimer’s you can reduce your risk by 50% if you adopt these lifestyle behaviors !!!

If you do 4 or 5, you reduce your risk by 60%

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Hippocampus

MRI

This type of MRI imaging does not show the changes in Alzheimer’s Disease until much later in the disease

Clinical trials for medications have repeatedly failed Clinical trials for medications have repeatedly failed Focus on early detection

Clinical trials for medications have repeatedly failed

Plaques A positive PET amyloid scan occurs in about 30% of healthy adults this scan is not very diagnostic

Clinical trials for medications have repeatedly failed Focus on early detection

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We need to develop brain

imaging markers that are

specific to AD and can be

used to detect AD earlier

Brain Imaging for Early Detection of Alzheimer’s


The brain is a network with many connections

Are brain “hubs” affected in Alzheimer’s Disease?

Can we detect these network changes much earlier in the disease process?

Hubs

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Research strategy to assess risk for AD using brain networks

A

B

F

G

D

C

E

If we know what the brain networks look

like in AD ….

MCI

… We can look for similarities in the

brains of people at risk

A

B

F

G

D

C

E

TBI


Healthy adults hub

Mild cognitive impairment

Hub is smaller and less connected in mild cognitive impairment

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How can you help?

Brain Imaging Research Opportunities at MUSC

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ADConnect: If you have a diagnosis of Alzheimer’s or Mild Cognitive Impairment

IAM: If you DO NOT have a diagnosis of Alzheimer’s

or Mild Cognitive Impairment and are

healthy

Brain Imaging Studies at MUSC

MRI imaging Cognitive Testing

Blood draw PET imaging

Follow-up visit at 1 or 2 yrs 45-85 years of age

Compensation Sponsored by the National Institute

on Aging

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Is the ADConnect Study for you?

Do you have a diagnosis of Alzheimer’s or Mild Cognitive Impairment?

Are you able to have MRI scanning?

Can you bring a study partner with you?

Can you come to MUSC for multiple visits?

Are you between 45-85 years of age?

What if you are not sure if you have Alzheimer’s Disease or Mild Cognitive Impairment?

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Mem

ory

/ T

hin

kin

g

Time (in years)

Normal Aging

Preclinical

MCI (Mild Cognitive Impairment)

Dementia Mild

Moderate

Severe

+

-

0% ↥ Independence

↧ Dependence

1 in 3

develop

dementia

Alzheimer’s

disease

70%

2 in 3

stay

normal

Vascular

Disease

Other

Causes

Dr. Andreana Benitez, MUSC

Diagnosing Alzheimer’s Disease or Mild Cognitive Impairment

Important to track memory and cognition over time

Important to have insights from a loved one who knows you well

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MUSC Neurology, Neuropsychology Division Rapid Access Memory Program (RAMP)

Anticipated Launch ~ January 2020

Diagnosing Alzheimer’s Disease or Mild Cognitive Impairment

The RAMP program at MUSC

A focused evaluation of adults 65 years or older

followed in MUSC Primary Care who have subjective

concerns of decline in memory or cognition

Evaluations performed by MUSC Neuropsychology

faculty include diagnostic interview, cognitive testing,

and feedback

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The RAMP program at MUSC

Common diagnoses: normal age-related cognitive change mild cognitive impairment dementia mood disorder

Reports with

recommendations are returned to referring MUSC

Primary Care provider

Patients informed of opportunities to

participate in research and clinical trials

What will happen when you contact us?

Brief telephone screen

If eligible we will schedule you for an initial visit

We may ask you to release medical records so that we can determine your eligibility for the study

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What will happen at study visits?

Informed consent

Study partner will fill out questionnaires

Blood draw VISIT 1

(1.5 hours)

VISIT 3 (2 hours)

PET scanning

VISIT 2 (3.5 hours)

Cognitive testing

MRI scanning

What will happen at the follow-up visit? Follow-up visit is only for volunteers with Mild Cognitive Impairment

and their study partners

1-Year Follow-up (3.5 hours)

Cognitive testing

MRI scanning


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ADConnect Study Recruitment Status

Target enrollment is 120 participants plus study partners We are 10% toward our goal We are actively enrolling over the next 2-3 years!! Please call Laura Lohnes at 843-792-7709

Is the IAM Study for you?

Are you generally healthy with no major health issues?


Can you bring a study partner with you?

Can you come to MUSC for multiple visits?


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What will happen at study visits?

1 to 3 Visits (7-8 hours

total)

Informed consent


Cognitive testing

Blood draw

MRI scanning

PET scanning

What will happen at the follow-up visit?

2-Year Follow-up (2.5 hours)

Cognitive testing

MRI scanning

Informed Consent

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IAM Study Recruitment Status Target enrollment is 300 participants plus study partners We are 40% toward our goal We are actively enrolling over the next 1-2 years (all ages) But we need more participants between 75 and 85 years of age!! Please call Katrina Madden at 843-792-9186 or go to bitly link: //bit.ly/IAMstudy


Traumatic Brain

Injury may be a

risk factor for

Alzheimer’s

Disease In Alzheimer’s

Disease neurons

degenerate and

disrupt brain

communication

Brain imaging

may reveal early

signs of dementia

in TBI

? ?

?

Traumatic Brain Injury and Alzheimer’s Disease

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Is the TBI study for you?

We are recruiting people with or without Traumatic Brain Injury


Can you come to MUSC or the Ralph H. Johnson VAMC for multiple visits?


Sponsored by the Department of Defense


2 to 3 visits

Cognitive testing

MRI scanning

Informed Consent

PET scanning (only subjects with TBI)

6 month follow-up

Cognitive testing

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TBI Study Recruitment Status

Target enrollment is 30 participants with TBI and 30 participants without TBI We are 10% toward our goal We are actively enrolling over the next 2 years Please call Laura Lohnes at 843-792-7709

Dr. Jane Joseph’s Lab

Dr. Andreana Benitez’ Lab

Dr. Joseph Helpern’s Lab and

the Center for Biomedical

Imaging

Laura Lohnes

Shaquanda Ross-Simmons

Katrina Madden

Jacobo Mintzer

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Thank you!

Questions?

NIH/National Institute on Aging: R01 AG55132, R01AG054159

Department of Defense:

W81XWH-18-1-0816


Laura Lohnes: 843-792-7709

[email protected]

Katrina Madden: 843-792-9186

//bit.ly/IAMstudy [email protected]

Laura Lohnes: 843-792-7709

[email protected]

brain imaging and early detection of · dr. andreana benitez, musc diagnosing alzheimer’s disease...

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