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Early stage screening of Alzheimer's disease by detecting subtypes of MCI...with a normal webcam POC.

A reliable and inexpensive diagnostic test that can be used in any doctor's office all over the world....

53% of patients with MCI are misdiagnosed

 

Nature.com

Identification of clusters of rapid and slow decliners among subjects at risk for Alzheimer’s disease.

Dragan Gamberger, Nada Lavrač, Shantanu Srivatsa, Rudolph E. Tanzi, P. Murali Doraiswamy Scientific Reports, 2017; 7

 

Why we use different digital biomarkers ?

Alzheimer's disease is a heterogenous condition with high individual variability in age of onset, rate of clinical decline as well as degree of underlying pathology...

There are 3 big subtypes of MCI:

1. Amnestic MCI (aMCI) single memory domain...AD

2. Multiple domains MCI...AD , Vascular Dementia

3. Non-amnestic MCI...Fronto temporal dementia, Lewy Body D

Vascular Dementia, Primary Progressive Aphasia, PD, AD

 

Our online neurocognitive touch screen test shall give us subjective data about working memory, executive function, processing speed, attention, episodic memory

With a normal webcam we can track and measure:

- working memory ( fixation, saccadic, scan path)

- executive function ( saccadic, scan path)

- processing speed: ( fixation, saccadic, scan path)

- attention: (fixation)

- episodic memory: ( fixation, saccadic)

 

 

 

Havard aging brain...our findings, convergent with reports from autopsy cohorts, CSF and other PET amyloid imaging studies, indicate that a similar proportion of 1/3 of clinically normal (CN) older individuals harbor evidence of amyloid-β (Aβ) accumulation, one of the hallmark pathologies of AD.

 

It remains unknown whether the majority of these Aβ+ CN will progress to the symptomatic stages of AD and over what time frame; however, the accumulated longitudinal data suggests that many of these individuals are indeed in the “preclinical stages of AD” and are at increased risk for cognitive decline. The challenge is that Aβ is only one piece of the puzzle, and our findings thus far support the hypothesis that evidence of Aβ is necessary, but not sufficient in isolation, to predict imminent decline along the AD trajectory.

. A combination of different digital biomarkers can make a diagnosis POC ( point-of-care)

5-15 years before first neurological sysmptoms appears...

  • eye-tracking
  • voice (verbal) tracking
  • EEG POC headset
  • TCD transcranial ultrasound doppler POC headset

For the first time we can monitoring an Alzheimer's patient at home

Diagnose Alzheimer's hospital New POC out the hospital

MRI scan = only in hospital

Too late

Atrophy may not be strongly evident in asymptomatic AD.

NOT specific for AD pathology.

Full alignment of standardized mapping

 

Mild Cognitive Impairment or MCI

MCI causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. Long-term studies suggest that 15-20 percent of the aged 65 and older may have MCI. There is a difference between normal aging cognitive decline and MCI. With all kind of rating scales it is not possible to see any difference.

Biomarkers for Alzheimer's disease can be really measured to indicate the presence or absense of the disease. For AD there is only one biomarker accepted amyloid beta. Preclinical b. amyloid as biomarker is difficult and very expensive to detect and it is only possible in hospitals. Digital biomarkers can be used outside the hospital POC ( in the waiting room or at home).

Blood glucose levels are a biomarker for diabetes and blood cholesterol for heart disease.

 

 

 

 

 

 

 

 

 

 

Guy Bisschops

guy@neuroteg.com

T: +32 11 397523

M: 0497 21 93 40

 

PET amyloid = hospital

Too late

Not available in all places

High cost

Expert reader training

RADIATION EXPOSURE

Monitoring not possible

Lumbar punction

spinal fluid

Collection invasive

Lab to lab variability

Full alignment of standarization of technique for CFS collection not obtained

NO standardization of assay

EEG sensor chip

TCD transcranial ultrasound doppler sensor chip

Not invasive = NO PAIN

NO radiation exposure

EYE TRACKING

Not invasive = NO PAIN

No radiation exposure

 

 

EEG abnormalities in Dementia Lewy Body (DLB) are more extensive than in Alzheimer's disease.

GRAND TOTAL EEG Score can help to differentiate DLB from AD with good sensivity and specificity..

Accurate diagnosis is needed for Dementia Lewy Body

Dementia with Lewy Bodies (DLB) may account for up to 30% of all dementia cases. The symptoms of DBL can be difficult to disentangle from other dementia subtypes. DLB is characterized by a build-up of abnormal proteins (Lewy bodies) in areas that control cognition, movement, allertness and behavior.

Eye tracking ( saccadic eye movement tracking) and EEG are very sensitive digital biomarkers to make an accurate diagnosis.

AD and DLB pathologies often overlap within individuals. An individual is diagnosed with Parkinson disease dementia ( PDD) or DLB depends on the timing of symptoms onset. In dementia with Lewy Bodies, cognitive decline occurs within one year of the onset of movement disorder symptoms.

DLB is sensivity to antipsychotic drugs. We see also REM behavior disorder. Visual hallucinations and fluctuations in cognition, attention and allertness.

Neuroteg AI

Centrum Zuid 1111

3530 Houthalen-Helchteren

Belgium

Tel: +32 11 397523

Mob: 0497 219340

 

info@neuroteg.com

 

These are the most commonly misdiagnosed conditions.

 

Parkinson’s disease

 

It is a degenerative disorder of the central nervous system with symptoms including tremors in hands, arms or legs, stiff muscles, and problems with balance or walking.

 

However, it is commonly mistaken for Alzheimer’s disease, stroke, stress, a traumatic head injury and essential tremor.

 

Grave’s disease

 

The condition causes an overactive thyroid gland, and is the most common cause of hyperthyroidism.

 

Symptoms include eyes bulging, anxiety, sweating, rapid pulse, unplanned weight loss or gain, and extreme tiredness.

 

Without treatment, it can prove life-threatening, however it is often mistaken for depression, ageing and under-exercising.

Fibromyalgia

 

It is a chronic arthritis-like disorder characterised by widespread pain.

 

However, symptoms - anxiety, sensitivity to pain and incapacitating fatigue - can be confused with rheumatoid arthritis and chronic fatigue syndrome.

 

Normal pressure hydrocephalus

 

It is a build-up of cerebrospinal fluid in the brain that most commonly occurs after a stroke or ahead injury from a fall.

 

Symptoms of unsteady gait, progressive dementia and urinary problems, can be interpreted as Alzheimer’s disease or Parkinson’s disease.

 

Multiple Sclerosis

 

The progressive autoimmune disease that attacks the central nervous system has symptoms including muscle spasms, lack of coordination, balance problems, blurred vision and cognitive impairment.

 

However, it is commonly mistaken for a viral infection, lupus, Alzheimer’s disease and bipolar disorder.

 

Coeliac disease

 

It is an autoimmune disorder marked by an inability to digest gluten, a protein in wheat, rye and barley.

 

Symptoms can include vomiting, abdominal pain and bloating, diarrhoea, weight loss, anaemia and leg cramps.

 

However it can be mistaken for irritable bowel syndrome, Crohn’s disease and cystic fibrosis

Chronic fatigue syndrome

 

The complex disorder has no known cause but symptoms include loss of memory or concentration, a sore throat, painful lymph nodes in neck or armpits, unexplained muscle or joint pain and extreme exhaustion.

 

It is often confused with sinus problems, hepatitis, fibromyalgia, lupus and rheumatoid arthritis.

 

Lupus

 

It is a chronic inflammatory disease, with symptoms including fatigue, kidney, heart and lung damage, rash and joint pain.

 

However, it can be mistaken for chronic fatigue syndrome, fibromyalgia and rheumatoid arthritis.

 

Aortic dissection

 

This is where a tear develops in the aorta, the largest blood vessel branching from the heart, which causes the inner and middle layers to separate.

 

Symptoms can include sudden chest or upper back pain, loss of consciousness, shortness of breath, sweating and weak pulse in one arm.

 

However it can be misdiagnosed as heartburn, heart attack and stroke.