Developing brain scans to improve dementia drug trials
Researchers at the University of Cambridge are working to improve trials of new vascular dementia drugs, and help get effective treatments into the hands of patients sooner.
Small vessel disease (SVD) is the most common cause of vascular dementia. Unfortunately, there are few treatments to delay the progression of SVD and trials of new drugs are time consuming, expensive and it can often be difficult to monitor the effect of a treatment in these trials. While the final outcome of a drug trial needs to be a benefit in a person’s symptoms, there are multiple phases in clinical trials and – In the earlier stages – biological indications of a benefit can be a valuable alternative.
Prof Markus and his team want to identify features on MRI scans of people with SVD that reliably predict changes in memory and thinking ability or dementia progression. This would be a cost effective and time efficient way to measure the effect a new treatment is having on a person and identifying which treatments should go on to be tested in large, expensive, later-stage trials.
Finding new treatments for the diseases that cause dementia is the ultimate goal of dementia researchers the world over. Before any new drug can be offered to patients in a clinic, researchers must first show that it is effective and safe in clinical trials. This involves- testing the drug in people. Clinical trials cost hundreds of millions of pounds, require thousands of volunteers and can take many years to complete. Anything that helps to make this process faster, cheaper and more accurate will be enormously valuable and help to bring about new treatments sooner.
By reducing the number of participants required and the time it takes to test the drug, techniques pioneered in this project could allow researchers to take more potential treatments into clinical testing and boost the chances of finding an effective treatment sooner. Improving our understanding of the brain changes that are associated with any form of dementia is a crucial foundation for improving the use of brain scans in diagnosing the condition. This project could also result in new insights for researchers looking to improve the accuracy of a diagnosis of vascular dementia.
The researchers will analyse detailed MRI scans from people living with small vessel disease. They have access to scans from three different groups of people with SVD from the Netherlands and the UK – brain scan data from over 700 people. The volunteers in all three groups had multiple scans over several years at different stages in their disease. During this time they also undertook rigorous memory and thinking tests.
By carefully examining scans of different areas and structures in the brain, the team will identify even very small changes and relate these to changes in a person’s performance in tests of memory and thinking. They will then identify the brain changes that can be used to most accurately predict how memory and thinking problems progress.
Prof Hugh Markus
University of Cambridge
1 March 2016 - 1 March 2018
Full project name
Optimising multimodal MRI markers for use as surrogate markers in trials of vascular cognitive impairment due to cerebral small vessel disease