The best podcasts to Learn about Blood Tests for Alzheimer's Disease & Diagnosing Dementias

Whilst everyone may experience dementia and its symptoms differently, the pathway to diagnosis is very similar for most people, but could all that be about to change? Adam Smith, speaks to a Psychiatrist, a Neurologist and a Scientist. They discuss the current diagnosis pathway, the tests involved, and how that could change as with the development of blood based biomarkers. Exploring the science behind the new tests, their development, and how these new tests could be used in frontline services to improve accuracy, support clinical trials and to improve care – and is the NHS ready? Guests are: Dr Elizabeth Coulthard, Consultant Neurologist and Associate Professor at University of Bristol and North Bristol NHS Trust. Dr Josie Jenkinson, Consultant Psychiatrist for Older People and Clinical Academic at Surrey and Borders Partnership NHS Trust. Dr Amanda Heslegrave, Senior Research Fellow focussed on Biomarkers in Neurodegeneration at the UK Dementia Research Institute at University College London. Emerging blood-based biomarkers for Alzheimer disease are an exciting new development. They could provide an accessible, easy to delivery and inexpensive screening tool. Looking to the future, when disease-modifying or prevention treatments will be available, investigators are focused on how to detect the earliest biological signals of Alzheimer disease, perhaps even years or decades before clinical symptoms appear – and that’s when these tests could really become essential. However, how could they be used now? Could they improve accuracy of diagnosis? Replace the need for other more expensive tests? Ensure we no longer have to send people home, telling them they have Mild Cognitive Impairment? Reduce misdiagnosis? Patients and their families want to know, Is this Alzheimer disease, or something that can be reversed? Can we answer that question now? And Could this new biomarker help? All will be discussed in this weeks show.

Over the past decade, blood-based biomarkers for dementia have been increasingly studied as way to diagnose and track the progress of Alzheimer’s and other neurodegenerative diseases. In this podcast three leading blood-based biomarker pioneers come together to discuss the field, their research and motivations, current challenges and future directions of this field of research (they also reveal a little about themselves as people away from the lab too – find out which if them wants to drive refuse trucks…). In the host chair is Dr Nicholas Ashton, Associate Professor of Neurochemistry from University of Gothenburg and King’s College London. Nicks has more than a decade of experience in biofluid analysis and assay development for Alzheimer’s disease, which ranges from discovery mass spectrometry methods to ultra-sensitive immunoassays. Recently this has produced ultra-sensitive single molecular array (Simoa) assays for phosphorylated tau in blood, which are now widely used in research settings, therapeutics trials and being validated for clinical use. -- Nick’s guests are: Oskar Hansson, Professor of Neurology & Senior Consultant in Neurology at Lund University in Sweden. Oskar explores fluid and imaging biomarkers for neurodegenerative disorders. His inspiration came at medical school when diagnosing dementias. It became clear to him that we needed to be able to identify these diseases before widespread neurodegeneration and disabling symptoms have already developed. At these early disease stages, we are more likely to substantially slow down or even stop the disease progression by different types of interventions. Henrik Zetterberg, Professor of Neurochemistry, Senior Consultant in Clinical Chemistry, Head of Department at UK Dementia Research Institute at University College London and University of Gothenburg. With a background in molecular biology and medicine, Henrik has have spent the last 15 years developing biomarkers for Alzheimer's disease and other brain disorders - becoming a world expert in the process. He has published more than 1100 scientific articles and has received numerous awards.

Professor David Scott interviews Professor Henrik Zetterberg With a background in molecular biology and medicine, Prof Henrik Zetterberg has spent the past 15 years focusing on the development of biomarkers for Alzheimer’s disease and other brain disorders - becoming a world expert in the process. He has published more than 1100 scientific articles and has received numerous awards. Developing early tests for dementia One of the hallmarks of Alzheimer’s disease is the build-up of abnormal proteins in the brain. While usually broken down and eliminated under healthy conditions, in patients with the disease, fragments of the protein amyloid beta (Aβ) clump together to form plaques. Scientists believe this is a central event leading to the death of neurons, but there have been disappointing results from clinical trials that have attempted to target the disease mechanism. This has cast doubt on whether the event is a cause or a consequence of Alzheimer's disease. Whether or not Aβ plaque build-up is important in disease progression, problems in the trials may arise for other reasons, including; Treatment may have been given too late to stop the disease progression Evaluation of the biological changes following treatment may have been inadequate Prof Henrik Zetterberg’s team is working to address these issues by developing ultrasensitive new tests to help measure molecular changes in body fluids of people with Alzheimer's disease and other neurodegenerative conditions. If successful, these tests could be easily utilised to identify patients which are susceptible to these diseases much earlier, not only for recruitment into clinical trials but eventually for treatments developed against the disease. The team also hope to uncover previously unknown biological changes in body fluids, which may give an indication of harmful processes taking place in the brain much earlier in the disease timecourse.

Erica Dove interviews Professor Charlotte Teunissen, representing the Biofluid Based Biomarkers PIA. Charlotte Teunissen (full professor in Neurochemistry) aims to improve care of patients with neurological diseases by developing body fluid biomarkers for diagnosis, stratification, prognosis and monitoring treatment responses. Studies of her research group span the entire spectrum of biomarker development, starting with biomarker identification, followed by assay development and validation, and extensive clinical validation to ultimately implement novel biomarkers in clinical practice. She is responsible for the Alzheimer Center Amsterdam body fluid and leads several international biomarker networks, such as the CSF Society and the Alzheimer Association-Global Biomarker Standardization consortium, and the recently founded Coral proteomics consortium. She is the coordinator of the Marie Curie MIRIADE project, aiming to train 15 novel researchers into accelerate dementia biomarker development.

Great progress has been made over the past decade in the development of blood based bio-markers to diagnose Alzheimer’s disease and other forms of dementia. However, other areas have been quietly working away, and have also made significant progress. In this podcast we explore two of the newest and most innovative technologies being applied to detect biomarkers for dementia – looking at the retina and brainwaves. Dr Amanda Heslegrave, Senior Research Fellow at the UK Dementia Research Institute, University College London and one of the people behind the progress being made in blood-based biomarker field is out guest host. This weeks guests are: Dr Catherine Bornbaum, Head of Clinical Operations and Partnerships at Retispec. Catherine, uses innovative imaging technology combined with robust machine learning and artificial intelligence (AI) to detect biomarkers of neurodegenerative disease throughout the eye. The eye provides a simple and non-invasive way to measure the central nervous system; it is also the only organ where both neurons and blood vessels can be directly visualized at micron-level resolution. Dr George Stothart, Senior Lecturer at University of Bath. George is a cognitive neuroscientist who translates the findings of cognitive neuroscience into useful tools for clinicians and the wider world. His primary research focus is the development of a new EEG technique, known as Fastball, for the assessment of cognitive deficits in dementia. Fastball EEG is a completely passive test which measures brain waves the patient looks at a series of images on a computer screen over two minutes – a completely new assessment technique.