Approved research

Detecting early imaging phenotypes of tau associated dementia in the general population

Lay summary

Progressive Supranuclear Palsy (PSP) and Frontotemporal Dementia (FTD) are diseases that cause a devastating impact on their sufferers, resulting in progressive cognitive decline, problems with walking and other movements, and significantly reduced life expectancy. Currently no intervention exists that can stop or slow down the advance of disease in these conditions. The multiple failures in trials of treatment of various forms of dementia have in part been due to difficulties in recognising and targeting treatment at individuals with early or presymptomatic disease. Modern imaging techniques have demonstrated that brain network connections and brain structure are altered in patients with PSP and FTD. However, the order in which these changes appear over time is unclear, as is the extent to which they precede the onset of symptoms. We have characterised the structural imaging, functional imaging and cognitive changes seen in these conditions from a large cohort of patients with PSP and FTD seen in Cambridge. Our aim is to apply these imaging and cognitive testing derived "fingerprints" to identify a section of the general healthy population who most closely resemble those with the disease using a machine learning approach. We will then use outcome data from UK biobank to further characterise this group and their comparative health outcomes. This will give us an insight into how these markers change early in disease and in the general population, and the order in which any such change occurs. The potential to identify an at-risk population can inform novel trials of therapeutic intervention together with facilitating diagnosis, prognosis and monitoring of treatment.