A new study from Queen Mary University in London, England revealed that observing brain activity through a simple fMRI scan could predict dementia up to 9 years prior to diagnosis with about 80% accuracy. At the Centre for Preventive Neurology at Queen Mary’s Wolfson Institute of Population Health, professor Charles Marshall, Professor and Honorary Consultant Neurologist, guided a team of researchers in the pursuit of detecting changes within a neural pathway called the “default mode network,” which could indicate individuals who are at high risk of developing dementia. This testing goes beyond the traditional screening for dementia, which typically consists of memory tests and brain measurements that while insightful, are not very accurate in predicting diagnosis early (Ereira, et al., 2024).
Interconnected Brain Regions: The Default Mode Network
Professor Marshall and his team focused on a specific component of the brain called the “default mode network” or DMN, and its effect on the risk of developing dementia or Alzheimer’s disease. The DMN is a large-scale brain network connected between multiple different regions of the brain that control cognitive function. This is the first pathway to be affected by Alzheimer’s disease. This neural network is a constellation of connectivity that is responsible for intrinsic thinking, memory, cognitive functioning, future-planning, and more. Getting a closer look at the default mode network allows researchers to detect changes that could predict the likelihood of developing a detrimental disease (What Is The Default Mode Network, 2023).
What is an fMRI and Why is it Helpful?
An fMRI stands for “functional magnetic resonance imaging” and it is widely used for its ability to visualize activity in the brain. Compared to a regular MRI, an fMRI can more specifically indicate what areas of the brain have more blood flow, pinpointing areas that are most active. This type of scan has helped further understanding of the brain because it can detail which parts are in control of actions and cognitive function. Unlike an x-ray, there is no radiation from an fMRI scan and is overall safe (Functional MRI – Seeing Brain Activity as it Happens, 2023).
The Study: Brain Scans Show Probability of Disease
Professor Marshall and his research team used data from the UK Biobank- a biomedical database consisting of medical and genetic information for about a half a million people in the country- to gather fMRI studies from about 1,100 volunteers. Gathering information from fMRI scans allowed researchers to assign each participant a value defining their predictability in developing dementia. This value was determined based on a subjects’ connectivity pattern between 10 main regions in the brain; the value range depended on the subject’s connectivity pattern and if it resembled the connectivity of someone with dementia, or if their value belonged in the control group.
After creating the predictability model, the team compared the volunteers’ data within the UK Biobank. The researchers looked at specific risk factors that increased changes in the DMN, therefore increasing the likelihood of developing dementia. They found that two main factors affected the DMN and increased risk for dementia and Alzheimer’s disease- genetics and isolation. Marshall and his team discovered that this model accurately predicted the onset of disease up to 9 years prior to official diagnosis with over 80% accuracy (Ereira, et al., 2024).
Samuel Ereira, Academic Foundation Programme Doctor at the Centre for Preventive Neurology, and lead author noted: "Using these analysis techniques with large datasets we can identify those at high dementia risk, and also learn which environmental risk factors pushed these people into a high-risk zone. Enormous potential exists to apply these methods to different brain networks and populations, to help us better understand the interplays between environment, neurobiology and illness, both in dementia and possibly other neurodegenerative diseases. fMRI is a non-invasive medical imaging tool and it takes about 6 minutes to collect the necessary data on an MRI scanner, so it could be integrated into existing diagnostic pathways, particularly where MRI is already used" (Ereira, et al., 2024).
With this kind of accuracy, screening for dementia and Alzheimer’s could identify high risk individuals and give them the opportunity to take preventative measures years before diagnosis.
Hope for the Future
Professor Charles Marshall states, "Predicting who is going to get dementia in the future will be vital for developing treatments that can prevent the irreversible loss of brain cells that causes the symptoms of dementia. Although we are getting better at detecting the proteins in the brain that can cause Alzheimer's disease, many people live for decades with these proteins without developing symptoms of dementia. We hope that the measure of brain function that we have developed will allow us to be much more precise about whether someone is actually going to develop dementia, and how soon, so that we can identify whether they might benefit from future treatments" (Ereira, et al., 2024).
Most people either know first-hand or have heard from others the toll that dementia and Alzheimer’s takes, not only on the person with the disease itself but their friends and family as well. Dementia is a slow burning condition and it is difficult to watch someone start to lose their cognitive function and memory without any cure. Current screening and prevention is present yet vague, and without high accuracy testing - does it really give comfort?
In discovering a revolutionary ability to use a simple brain scan to more accurately predict the onset of dementia, this team of researchers could have created a new mainstream way of preventing and detecting the condition, which could transform the diagnosis rates of dementia across the world.
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Article produced by CTF volunteer writer, Samantha Marlin. References:
1. Sam Ereira, Sheena Waters, Adeel Razi, Charles R. Marshall. Early detection of dementia with default-mode network effective connectivity. Nature Mental Health, 2024; DOI: 10.1038/s44220-024-00259-5
2. Cleveland Clinic. (2023, May 27). Functional MRI – Seeing Brain Activity as it Happens. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/25034-functional-mri-fmri
3. What Is The Default Mode Network? (2023, March 3). https://www.simplypsychology.org/what-is-the-default-mode-network.html
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