Ground-breaking EEG Test Could Diagnose Alzheimer’s Disease 5 Years Earlier

Dawn O'Shea

September 27, 2021

Researchers at the University of Bath have developed a ground-breaking simple two-minute test which could allow Alzheimer’s disease to be diagnosed five years earlier than with current methods.

The ground-breaking Fastball EEG test could pave the way for improved outcomes for patients with Alzheimer’s disease by diagnosing the condition earlier, allowing treatments to be initiated before significant clinical signs emerge.

Fastball EEG objectively measures recognition memory. Individuals passively view rapidly presented images, and EEG is used to assess their automatic ability to differentiate between images based on previous exposure, i.e., old/new. Crucially, the test requires no behavioural memory response or comprehension of the task.

A new article published in the journal  Brain  reports on the findings of a study in which younger adults, older adults and patients with Alzheimer’s disease (n=20 per group) completed the Fastball task. Following the test, participants completed a two-alternative forced choice (2AFC) task to measure their explicit behavioural recognition of previously seen stimuli.

The results show that significantly impaired recognition memory was detected in participants with Alzheimer’s disease compared with healthy older adults (P<.001), whereas behavioural recognition was not significantly different between patients with Alzheimer’s disease and healthy older adults.

Alzheimer’s disease patients could be discriminated with high accuracy from healthy older adult control participants using the Fastball measure of recognition memory (area under the curve [AUC], 0.86; P<.001), whereas discrimination performance was poor using behavioural 2AFC accuracy (AUC, 0.63; P=.148).

There were no significant effects of healthy ageing, with older and younger adult control participants performing equivalently in both the Fastball task and behavioural 2AFC task.

The team behind the Fastball EEG technology says the approach is cheap, portable and only requires technology already available in hospitals, making it easily scalable. They predict that Fastball EEG could help lower the age of diagnosis by up to five years. In longer term, they say it may offer opportunities to improve this further.

Lead researcher and cognitive neuroscientist Dr George Stothart of the Department of Psychology at the University of Bath explains: "Fastball offers a genuinely novel way of measuring how our brain is functioning. The person being assessed doesn’t need to understand the test, or even respond, they simply watch a screen of flashing images and by the way we manipulate the images that appear we can learn an enormous amount about what their brain is, or is not, able to do."

"The tests we currently use to diagnose Alzheimer’s miss the first 20 years of the disease, which means we are missing huge opportunities to help people. For decades now we have had tools in scientific research that have been able to probe how the brain is working, but we have never made the leap to a viable clinical tool for the objective assessment of cognition. We hope that Fastball may be that leap."

Dr Stothart said the ultimate use of Fastball would be as a dementia screening tool used in middle age for everyone, regardless of symptoms, similar to hypertension screening. We are a long way from that, he said, but this is a step towards that goal.

Stothart G, Smith LJ, Milton A, Coulthard E. A passive and objective measure of recognition memory in Alzheimer's disease using Fastball memory assessment. Brain. 2021 Sep 20 [Epub ahead of print]. doi: 10.1093/brain/awab154. PMID: 34544117

This article originally appeared on Univadis, part of the Medscape Professional Network.

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