Alzheimer's Disease

Capturing Real-Time Changes in the Brain

Not too long ago, researchers could only study the biology of Alzheimer’s disease in patients after they died through an autopsy. But a new class of researchers at IU School of Medicine, led by Andrew J. Saykin, PSYD, are improving imaging technology and changing that.

Now, researchers can examine real-time changes in the brain in Alzheimer’s patients. Advanced MRI scanners, PET imaging and other technology, provide a non-invasive window to visualize the brains of patients with Alzheimer’s disease as well as those who may be at risk. The pictures look nothing like standard X-rays; they measure brain activity, blood flow, abnormal proteins, and even how fast the brain burns glucose to power itself.

Advancing Patient Care

The scans are crucial for several reasons. They can identify patients with evidence of Alzheimer’s, but who haven’t yet started showing symptoms. This is referred to as the pre-clinical stage. Studies are underway that test the effect of beginning treatment during this phase. Imaging also helps assess whether potential drugs work by measuring if they clear plaques and tangles, abnormal proteins in the brain that are hallmarks of the disease and if they slow atrophy or loss of brain volume.

Finally, marrying imaging with genetic analysis provides a powerful one-two punch. Pairing images with patients’ genetic profiles sheds light on how specific genetic variants affect the brain. For example, a multi-institutional team led by Saykin and other IU School of Medicine scientists discovered that a specific variant in an immune system gene is associated with higher rates of amyloid plaque buildup – and a higher risk for Alzheimer’s disease. Drugs that target the downstream effects of this gene are already used to treat rheumatologic and inflammatory conditions, and an antibody is being tested for some types of leukemia. Those therapies can now be evaluated as possible therapies for Alzheimer’s disease.

Taken together, advanced imaging, biomarkers from blood or cerebrospinal fluid, genomics and cognitive testing provide the foundation for an emerging precision medicine of Alzheimer’s disease and related dementias.

Advanced Imaging Technology

Advanced imaging technology is now available to detect changes in the brain in older adults who perform normally on memory tests but have “cognitive complaints” such as a self-perception of increasing forgetfulness. IU School of Medicine researchers are looking to understand which individuals are at risk even before they exhibit task performance problems.

While imaging technology and research evolves to allow earlier detection of Alzheimer’s disease, it also means analysis of Alzheimer’s disease patients on an individual level. The IU School of Medicine’s Center for Neuroimaging supports this work with valuable data and discoveries.

Faculty Expert

Andrew J. Saykin, PSYD

Andrew J. Saykin, PSYD

Director, Center for Neuroimaging