Measuring brain tissue damage accurately identifies cognitive decline, researchers say

Oct. 27 (UPI) — By analyzing brain tissue damage using a new MRI evaluation tool, researchers accurately identified people with early signs of cognitive decline up to 70% of the time, a study published Tuesday by the journal Academic Radiology found.

The approach uses magnetic resonance imaging to identify — and measure the number and size — of bright spots on the mostly gray images of the brain called white matter hyperintensities, or lesions, the researchers said.

These spots have long been linked to memory loss and emotional problems, especially as people age. Now, newly available MRI technologies could make it possible for them to be used for diagnosis of dementia, the researchers said.

“White matter lesion captured by MRI scans may reveal cognitive decline much earlier than behavioral symptoms,” study co-author Jingyun “Josh” Chen told UPI.

“Amounts of white matter lesions above the normal range should serve as an early warning sign for patients and physicians,” said Chen, a research assistant professor of neurology at New York University Langone Health.

Roughly 6 million adults in the United States have dementia, according to the Alzheimer’s Association.

Although the condition is common, it remains challenging to accurately diagnose, and no effective treatments exist, according to Chen and his colleagues.

The bright spots seen on MRI scans represent fluid-filled holes in the brain — lesions that are believed to develop from the breakdown of blood vessels that nourish nerve cells.

Earlier research has shown that increased numbers of spots and their presence in the center of the brain is linked with worsening dementia and other brain-damaging conditions, such as stroke and depression.

Current methods for grading white matter lesions, however, rely on little more than the “trained eye” using an imprecise three-point scale, according to the researchers.

The new tool, called the white matter hyperintensities toolbox and developed by Chen and his colleagues at NYU Grossman School of Medicine, is intended to provide neurologists with a uniform, objective method for calculating the spots’ volume and location in the brain.

For this study, Chen and his colleagues randomly selected 72 MRI scans from a national database of adults age 70 and older who participated in the Alzheimer’s Disease Neuroimaging Initiative, a research project seeking to identify clinical, imaging, genetic and biochemical biomarkers for the early detection and tracking of Alzheimer’s disease.

Using MRI techniques to map the brain’s surface, the researchers then used the new tool to calculate the precise position and volume measurements for all observed white matter spots or lesions.

When researchers cross-checked their measurements, they found that seven out of 10 calculations correctly matched the patient’s actual diagnosis.

With the standardized tracking and measuring tool, physicians could monitor the growth of white matter lesions in patients with suspected dementia, the researchers said.

White matter brain measures alone are not sufficient to diagnose early dementia, Chen said, but should be considered along with other factors. This includes a history of brain injury, memory loss and hypertension, as well as clear symptoms

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Eisai and Cogstate Expand Agreement for Global Development and Commercialization of Digital Cognitive Assessment Technologies

MELBOURNE, Australia, Oct. 25, 2020 /PRNewswire/ — Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, “Eisai”) and Cogstate, Ltd. (Headquarters: Melbourne, Australia and New Haven, USA, CEO: Brad O’Connor, “Cogstate”) announced today that the companies have entered into a collaboration whereby Eisai has secured the global development rights and exclusive commercialization rights of all cognitive function tests developed by Cogstate, including the “Cogstate Brief BatteryTM” (CBB) for use in healthcare and other markets. This global licensing deal is an expansion of an existing partnership executed in August 2019 whereby Eisai secured exclusive development and commercialization rights in Japan for all cognitive function tests developed by Cogstate, including the CBB. Both companies plan to proceed with development globally of CBB as a tool for individuals to self-assess brain performance to support healthy lifestyle choices and preventative measures in daily life, as well as a medical device to aid healthcare professionals in clinical diagnosis decisions.    

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Developed by Cogstate, the CBB is a scientifically validated digital tool that enables cognitive function self-checks and consists of four tests evaluating psychomotor function, attention, learning and memory, and working memory. In the United States, Europe, Australia, New Zealand and Canada, the CBB has been adapted as a medical device named “CognigramTM” that has achieved marketing authorization by regulators in these jurisdictions and provides informative results for healthcare professionals to support clinical examination to aid in the diagnosis of MCI and dementia.

In its medium-term business plan, EWAY2025, Eisai is aiming to become a “Medico Societal Innovator” (a company that changes society through creating medicines and providing solutions). Eisai is creating next-generation medical remedies focused on the neurology and oncology areas as well as building disease ecosystem platforms, in order to provide environments and solutions including digital solutions for early diagnosis and early treatment.

Cogstate aims to make assessment of brain health as simple, common and informative as assessment of blood pressure. Cogstate’s technology, which is easy to use and available in over 70 languages, is supported by extensive scientific validation, including more than 600 peer reviewed publications. Cogstate technology has been used extensively in clinical trials, including trials conducted by Eisai.

The global agreement between Eisai and Cogstate will allow the two companies to replicate many of the advancements that have already been launched in Japan, where Eisai has developed and launched a new digital tool using the CBB, named “NouKNOWTM” (pronounced “NOH-NOH”), a non-medical device for self-assessment of brain performance (brain health). Eisai is currently investigating the possibility of developing a medical device using the CBB in Japan.

In recent years, various research has demonstrated the possibility that decline in brain performance may be mitigated through major readjustments to lifestyle, such as regular exercise and sleep, a well-balanced diet, and social interaction. However, according to a survey by Eisai, the number of people taking correct preventive actions or habitually performing self-checks of cognitive function

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Insomnia With Short Sleep Linked to Cognitive Impairment



Dr Julio Fernandez-Mendoza

Insomnia with objective short sleep duration is associated with a significantly increased risk of cognitive impairment (CI), particularly as it relates to cardiometabolic health, new research suggests.

Results of a population-based analysis show that participants who reported poor sleep or chronic insomnia and who objectively slept less than 6 hours per night had a twofold increased risk for CI.

The findings suggest that insomnia with objective short sleep duration is a more severe phenotype that is associated with cardiovascular, cerebrovascular, and neurocognitive disease, according to the researchers. The findings also indicate that objective sleep measures may reflect a patient’s insomnia severity and phenotype.

“This is the first study to show that adults who complain of insomnia and sleep objectively fewer than 6 hours in the lab have a twofold increased prevalence of mild cognitive impairment, particularly cognitive impairment associated with vascular contributors such as stage 2 hypertension, type 2 diabetes, heart disease, or stroke,” Julio Fernandez-Mendoza, PhD, associate professor of psychiatry at Penn State University College of Medicine in Hershey, Pennsylvania, told Medscape Medical News.

The research was published online September 24 in Sleep.

Highly Prevalent

The prevalence of insomnia symptoms in the general population may be as high as 30%, and approximately 15% of the general population has chronic insomnia.

Previous research has established an association between insomnia and psychiatric disorders, but fewer studies have examined the association between insomnia and cognitive impairment.

Furthermore, many studies that have analyzed the relationship between sleep and cognitive impairment have relied on self-reported measures of sleep, rather than objective measures.

For the study, researchers examined data from the Penn State Adult Cohort, which was a random, population-based sample of 1741 adults. Each participant spent one night in the sleep laboratory, during which he or she underwent 8 hours of polysomnography.

Participants also completed a questionnaire about sleep disorders, physical and mental health status, and substance use. They reported having normal sleep, poor sleep, or chronic insomnia.

The investigators obtained each participant’s clinical history, including mental and physical health conditions. Participants also underwent a battery of neuropsychological tests, including the Mini-Mental State Examination, the Symbol Digit Modalities Test, and the Trail Making Test.  

The analysis included 1524 participants. The study population had a mean age of 48.9 years. Approximately 47% of participants were men, and about 92% were non-Hispanic Whites.

A total of 155 participants (10.2%) had CI. Overall, 899 participants (59%) reported normal sleep, 453 (30%) reported poor sleep, and 172 (11%) reported chronic insomnia.

Need for Objective Assessment

Poor sleep and chronic insomnia were not significantly associated with CI or possible vascular cognitive impairment (pVCI). However, objective short sleep duration was significantly linked to CI (odds ratio [OR], 1.90) and marginally associated with pVCI (OR, 1.53).

Participants with self-reported poor sleep or chronic insomnia who slept less than 6 hours had a significantly increased risk of CI (OR, 2.06 and 2.18, respectively), as well as increased risk of pVCI (OR, 1.94 and 2.33, respectively), compared with participants with

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Digital Medicine Platform for Treatment of Cognitive Disorder

Akili, a pioneer in therapeutic prescription digital medicine has closed successfully it’s $55 million financing Series C trial of medicine. This funding follows a successful trial, including study, developing and testing a novel digital medicine named AKL- T01. This flagship product of Akili aimed to treat a type of cognitive disorder- attention deficit/hyperactivity disorder (ADHD). Once approved and launched commercially, it would be the first digital and standalone therapeutic medicine for ADHD. Company’s other product in the pipeline and research, AKL-T02 will treat autism spectral disorder (ASD) or what simply known as autism.

Autism refers to another type of cognitive disorder, particularly in children, making them difficult to interact socially. The repetitive behavior and underdeveloped speech and verbal communication render them vulnerable in society. The reason behind autism could be genetic as well as environmental influence.

The above news has brought in a new ray of hope for an autism patient where there is no specific traditional medicine is available for its cure. This new development has the potential for treating this disorder, probably with more efficiency.

This funding will also help to advance products in the pipeline for treating multi sclerosis (MS) and depression. After approval by the U.S. Food and Drug Administration (FDA), it will be launched commercially for the patients. According to Akili AKL-T01 would be a standalone treatment for ADHD.

The company’s founder and CEO Eddie Martucci is quite happy with the response of investors and welcomed the financing. He said this financing indicates faith of people in his company’s potential in digital medicines and growth. According to him, the company will continue to grow and supply novel solutions in the redefined healthcare sector.

Akini Interactive is a company who believes in transforming healthcare through its digital therapeutics medicine solving Neuro-cognitive disorders. It believes in targeting specific cognitive area or nerve which has been suppressed by the dysfunction. The treatment includes, interestingly, not any pill, but customized action video games for patients to play.

Video games are designed by neuroscientists and entertainer engineered with algorithms to treat a cognitive disorder like depression. According to the company, highly-interactive and highly engaging games provide a therapeutic experience to patients which actually benefit them. Through high-end therapeutics interactive video games, the specific regions of the brain could become functional which has been suppressed by the disorder, improving the condition of the patient. There would second by second tracking of patient’s cognitive response and data available for any improvement in the patient’s condition.

AKL- T01 if approved by the FDA and then it would certainly indicate towards the acceptance of new healthcare solutions for patients. It has the capability to transform the whole healthcare process and system in coming years. This funding will boost the confidence of other investors, which are planning to invest or come together for such digital medicine research and development in the future and those patients who are searching for new areas to treat disorders like autism could be more than happy to read such positive …

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