2023-10-03 20:15:40
Many people in the world are affected by Alzheimer’s disease. In Spain alone, the figure rises to more than 800,000 people, which exceeds the entire population of a city, for example, like Valencia, and this number continues to increase. Along with Alzheimer’s, there are other lesser-known types of dementia, but with similar symptoms such as memory, orientation or behavior problems. Doctors often have difficulty diagnosing these other types of dementia, as there is less information available about them.
Recently, a research group from the Polytechnic University of Madrid (UPM) in Spain, together with researchers from the CIEN Foundation and with support from the Reina Sofía Foundation, have studied the progression of one of these types of dementia, called hippocampal sclerosis. and they have discovered that it could be detected early using magnetic resonance imaging.
Each type of dementia is differentiated by the lesions it causes in the brain. These lesions are called pathologies and their presence can only be confirmed by analyzing the brain under a microscope, after the death of the patients. Furthermore, most patients with dementia present several of these pathologies at the same time, which further complicates the diagnosis. Despite these obstacles, an accurate diagnosis is vital to understand the clinical differences between patients and improve the treatment of each type of dementia.
Thanks to the study led by researchers Bryan Strange from the Polytechnic University of Madrid and Alberto Rábano from the CIEN Foundation, as well as researchers Diana Ortega-Cruz and Alicia Uceda-Heras, the progression of one of the pathologies can now be better understood. associated with dementia. Specifically, it is hippocampal sclerosis, a pathology that currently cannot be detected during the life of patients.
To better understand this pathology, the research team evaluated brain samples from patients with dementia belonging to the Vallecas Alzheimer Cohort – Reina Sofía Foundation Alzheimer Center (CAV-CAFRS). This is a unique project, developed by the CIEN Foundation with the support and equipment of the Reina Sofía Foundation, which allows studying the clinical trajectory of patients with dementia who generously donate their brain to the Tissue Bank of the CIEN Foundation. Under the microscope, researchers have observed changes associated with early phases of hippocampal sclerosis and have managed to establish a system to evaluate their severity. This system revealed important clinical differences, since patients in more advanced stages of the disease had a worse cognitive status. Furthermore, by analyzing magnetic resonance images of the brain of these patients, it was found that this classification also reflected changes in the brain structure associated with this pathology.
These results gave rise to subsequent work in which neuroimaging follow-up data from these patients were used. The researchers analyzed MRIs obtained over more than a decade, and detected that the structural changes associated with hippocampal sclerosis were present more than 11 years before their observation under the microscope. Until now, this pathology was understood as a late injury, present in very old people, since it could only be evaluated after death. The results of this research allow us to understand the duration of this disease during the patients’ lives, which could serve for its early detection.
Hippocampal sclerosis (HD) seen under the microscope. On the left, a hippocampus without HD (stage 0) and on the right, one affected by advanced HD (stage IV). Looking at the circle, you can see the massive loss of neurons (marked in blue) with HD. (Images: UPM)
In short, comparing patient follow-up data with their definitive diagnosis under the microscope allows us to obtain early diagnostic markers. “Our work reveals that MRI could anticipate the presence of hippocampal sclerosis in a non-invasive way, thus contributing to a more precise diagnosis of dementia,” declares researcher Diana Ortega-Cruz.
The first study is titled “Hippocampal sclerosis of aging at post-mortem is evident on MRI more than a decade prior.” The second, “A novel histological staging of hippocampal sclerosis that is evident in gray matter loss in vivo.” Both have been published in the academic journal Alzheimer’s and Dementia. (Source: UPM)
#Progress #early #diagnosis #dementias