Creating Novel, Low-Burden Cognitive and Imaging Biomarkers for Alzheimer’s Disease

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We’ve entered an era in which Alzheimer’s Disease (AD) is diagnosed by the detection of amyloid and tau (or even amyloid alone) via PET scans. While a tremendous asset, these scans face several clear challenges that limit their impact: their cost is significant, the required tracers must be synthesized and delivered quickly, and the level of radiation constrains longitudinal testing. Here, Stark will present work by our lab to develop low-burden, widely accessible tools to circumvent these challenges. We have shown how specific, targeted memory tests, that were designed to assess hippocampal function can play a vital role. These tasks can be self-administered remotely on a cellphone, making them highly scalable. In cognitively unimpaired older adults, performance on these tasks predicts AD biomarker status, and when combined with blood-based biomarkers, improves risk stratification and strengthens prognosis for future cognitive decline. This has important implications not only for screening, but also for identifying individuals most likely to decline, enriching clinical trials, and monitoring treatment response over time. Stark will also present recent work in the lab that develops techniques for using relatively brief diffusion MRI scans to non-invasively assess tau burden in the brain. Together, these approaches point toward a future in which low-burden assessments can be combined to improve AD screening, prognosis, and longitudinal monitoring of disease progression and therapeutic effects.

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