Professor Dennis Chan, Consultant Neurologist at University Hospitals Sussex NHS Foundation Trust and Professor at UCL Institute of Cognitive Neuroscience, has led a study that shows people at risk of Alzheimer’s disease have impaired spatial navigation before problems with other mental functions, including memory.
It is hoped the findings might lead to developing a diagnostic support tool for the NHS in the coming years.
The research used virtual reality (VR) to test the spatial navigation of 100 asymptomatic midlife adults, aged 43-66 – around 25 years younger than their estimated age of dementia onset.
Participants had a hereditary or physiological risk of Alzheimer’s disease that put them at risk of the condition, a family history of Alzheimer’s disease, or lifestyle risk factors such as low levels of physical activity.
The study used a test designed by UCL Institute of Cognitive Neuroscience researchers Dr Andrea Castegnaro and Professor Neil Burgess, and participants were asked to navigate within a virtual environment while wearing VR headsets.
The researchers found that people at greater risk of developing Alzheimer’s disease, regardless of risk factor, were selectively impaired on the VR navigation task, without a corresponding impairment on other cognitive tests.
First author, Dr Coco Newton, UCL Institute of Cognitive Neuroscience, who carried out the work while at University of Cambridge, said: “Our results indicated that this type of navigation behaviour change might represent the very earliest diagnostic signal in the Alzheimer’s disease continuum – when people move from being unimpaired to showing manifestation of the disease.”
The researchers also found that there was a strong gender difference in how participants performed – with the impairment being observed in men and not women.
Dr Newton added: “We are now taking these findings forward to develop a diagnostic clinical decision support tool for the NHS in the coming years, which is a completely new way of approaching diagnostics and will hopefully help people to get a more timely and accurate diagnosis.
“This is particularly important with the emergence of anti-amyloid treatments for Alzheimer’s, which are considered to be most effective in the earliest stages of the disease.
“It also highlights the need for further study of the differing vulnerability of men and women to Alzheimer’s disease and the importance of taking gender into account for both diagnosis and future treatment.”
Professor Chan said: “We are excited by these findings for two main reasons. First, they improve detection of the clinical onset of Alzheimer’s disease, critical for prompt application of treatments.
“Second, the VR navigation test is based on our knowledge of the spatial properties of cells in the brain’s temporal lobe, and the application of cellular neuroscience to clinical populations helps bridge the gap in understanding how disease at the neuronal level can result in the clinical manifestation of disease. This knowledge gap currently represents one of the biggest barriers to progress in Alzheimer’s research.”
The study is published in Alzheimer’s & Dementia.
Last year, University Hospitals Sussex set out their five-year ambitions for healthcare research and innovation within the Trust and for the people of Sussex. The strategy empowers colleagues to build research and innovation into their careers and get them more active in research.