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Scientists have developed a blood test to diagnose Alzheimer’s disease without the need for expensive or painful brain imaging lumbar puncture, where a sample of cerebrospinal fluid (CSF) is taken from the lower back. If validated, the test could enable faster diagnosis of the disease, meaning therapies could be started sooner.
Alzheimer’s is the most common form of dementia, but diagnosis remains a challenge – especially during the earlier stages of the disease.
Current guidelines recommend detecting three different markers: abnormal accumulations of amyloid and tau proteins, and neurodegeneration, the slow and progressive loss of nerve cells in certain areas of the brain. This can be done through a combination of brain imaging and CSF analysis. However, a lumbar puncture can be painful and people may experience headaches or back pain after the procedure, while a brain scan is expensive and time-consuming to plan.
Prof. Thomas Caricari of the University of Pittsburgh, Pennsylvania, USA, who participated in the study, said: “Many patients, even in the US, do not have access to MRI and PET scanners. Accessibility is a major issue.”
Developing a reliable blood test would be an important step forward. “The blood test is cheaper, safer and easier to administer, and may improve clinical confidence in diagnosing Alzheimer’s and selecting participants for clinical trials and monitoring the disease,” Karikari said.
Although current blood tests can accurately detect abnormalities in amyloid and tau proteins, detecting markers of nerve cell damage that are specific to the brain is more difficult. Karikari and his colleagues around the world focused on developing an antibody-based blood test that would detect a particular form of tau protein called brain-derived tau that is specific to Alzheimer’s disease.
They tested it in 600 patients at various stages of Alzheimer’s disease and found that levels of the protein correlated well with tau levels in CSF and could reliably distinguish Alzheimer’s disease from other neurodegenerative diseases. Levels of the protein also corresponded closely to the severity of amyloid plaques and tau tangles in the brain tissue of people who had died of Alzheimer’s. The study was published in the journal brain.
The next step will be to validate the test in a wider range of patients, including those of different racial and ethnic backgrounds and those suffering from different stages of memory loss or other potential symptoms of dementia.
Karikari also hopes that tracking blood levels of brain-derived tau can improve the design of clinical trials for Alzheimer’s treatments.
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