Detecting Early Alzheimer's Using MR

Alzheimer's disease (AD) is the most common cause of dementia, affecting approximately 10% of individuals aged ≥ 65. Most available treatments aim at controlling symptoms at an early stage rather than providing a cure. Therefore, an accurate and early diagnosis of AD with appropriate management will slow the progression of the condition. Reduced cerebral glucose levels have been observed in patients with early AD. Glucose hypometabolism can be assessed by administering a radioactive glucose analogue, 2-deoxy-2-(18F) fluoro-D-glucose (18FDG), and imaging with PET (positron emission tomography). The high cost and limited availability of PET-CT (PET - computed tomography) still hamper its general clinical application. Moreover, the use of radioactive tracers in combination with the additional ionizing radiation of CT is not suitable for repeated measurements. Therefore, currently, the provisional diagnosis of AD is still based on the combination of clinical history, neurological examination, cognitive testing over a period of time, and structural neuroimaging. This has major time and resource implications.A radically different and highly innovative means for imaging glucose with magnetic resonance imaging (MRI) has now been established, exploiting the interaction between hydroxyl protons in glucose and the protons in water; the method is termed glucose Chemical Exchange Saturation Transfer (glucoCEST). GlucoCEST MRI is a method that has no reliance on radiolabelled glucose analogues and could become widely implemented in clinic practice. We therefore aim to investigate the potential of glucoCEST MRI in Alzheimer's disease.

Inclusion Criteria:Development phase:Controls (development group) must:be > 18 yearsconsent to the studynot report problems with memory.Clinical phasePatients must:be ≥ 65 years,able to provide informed consent to the studyhave been clinically diagnosed with AD by the mental health team.Controls must:be ≥ 65 yearsable to provide consent to the studyhave a normal score in the ADAS-cog test and the Mini Mental State Examination test (MMSE)not report problems with memory.Exclusion Criteria:Subjects will not be considered if they:have a history of diabetes,have history of a major stroke (mini-stroke/Transient Ischaemic Attacks or lacunar stroke are acceptable),have contra-indications to MRI scanning such as implantable cardiac deviceshave family history in AD, to exclude possible gene mutations associated with ADhave advanced AD who lack the capacity to consent.Are pregnant (for developmental phase)are unable to read or speak English