1 June 2021

Dementia, especially Alzheimer’s disease (AD), is prevailing as remarkable improvements in life expectancy over the past century. The number of people aged 65 or above is projected to grow to nearly 1.5 billion in 2050 according to WHO. This has a paradigm shift in the leading causes of disease and death. Moreover, AD is not only affecting the elderly, the youngest AD patient is only 23 year-old. We need to work together proactively to fight dementia early such that we avoid risking to loss our valuable function of the brain. Our goal is to detect AD before symptoms appear. Moreover, this approach can be applied to other neurodegenerative diseases (Fig. 1A).

Fig. 1. A. The idea of Smart Imaging Centre for Neurohealth Management is to use frontier technologies to predict the risk of diseases in the brain to advice the public the best time to seek medical consultation to preserve brain function. B. Our MRI imaging approach for identification of early AD. AD disease progression, at early stages (cognitively normal), there are many abnormal changes (i.e. 10–20 years before symptoms). Current diagnosis (blue arrow) focuses on MCI, which is the mid-stage of the disease. Our approach has indicated that we can detect AD much earlier (green arrow). C. Coronal and axial CEST images of mouse brain with hyperintensity of the lymphatic system. Human lymphatic system and abnormalities of human brain lymphatic system has been showed to associated with Alzheimer’s disease and other neurological disorders. Sagittal and coronal CEST images of human brain with hyperintensity of the lymphatic system (from our pilot human study). [J Huang and KWY Chan et al., Sci Advances 2020]

How can we fight AD proactively? The current hurdle is that we only seek medical consultation when there is a symptom. This indicates the middle or late stage of the disease where the treatment efficacy is greatly compromised. If we have the technology to detect AD before symptoms appear, we can apply treatment early and halt or slow down disease progression. In fact, we have a wide window for detecting early stages of AD (10–20 years before symptom onset, Fig. 1B, before MCI), when there is already observable changes in the brain.

Our imaging technology provides a robust mean to detect these early stages. After the media reported our findings in May last year (News reports), I received many enquiries and volunteers for the clinical trial. They are the family members of AD patients. All of them try their best to take care of their loved ones, and hope that the symptoms will not get worse; and hope that they will not forget them. I shared the same feeling as one of my loved one was taken away by AD. We had been pushing very hard to wider clinical trial (Fig. 1C).

In 2020, many clinical trial of AD drugs that focused on the late stage of the diseases have failed. In a long term, we anticipate that our technology could provide means to assess early stages of AD and related neuropathological changes. This could shed light to develop AD drugs that tackle these early pathology. Indeed, our team members (Prof. Kannie Chan, Prof. Youngjin Lee and Prof. Jin Young Kim) have already made achievements in this direction.

We hope our technology can fight AD proactively and contribute to the society towards ageing gracefully.