New test could improve early detection of dementia

A research project at the University of Bath and the University of Bristol is to investigate the potential of a new test, Fastball, to detect dementia and Alzheimer’s disease at an early stage.

Researchers at the two universities have been awarded £1.5m in funding from the National Institute for Health and Care Research to scale up, test and develop the Fastball EEG dementia assessment at Southmead Hospital in Bristol.

Fastball, which has been developed by Dr George Stothart and Dr Liz Coulthard, is a non-invasive test which measures patients’ brainwaves while they watch a series of flashing images displayed on a screen. Users wear an electroencephalogram (EEG) headset, which is linked to a computer for analysis.

Stothart, Coulthard and colleagues have already demonstrated that Fastball is highly effective at picking up small, subtle changes in brainwaves that occur when a person remembers an image. Their research shows that this response changes as a person develops dementia, suggesting that this could be used to aid early diagnosis of the disease.

In the new five-year project, the team will test Fastball on more than 1,000 patients in a working dementia clinic at Southmead Hospital in Bristol.

Current diagnostic methods are imperfect

Dementia is typically diagnosed too late – sometimes up to 20 years after the disease has started to develop. By this stage, the disease has damaged the brain beyond repair. Current methods of diagnosis are imperfect, relying on a series of subjective questions to test a person’s memory. Reliability can be affected by the individual’s education, language skills or nervousness.

Fastball, however, is completely passive. The person doing the test does not need to understand the task or be aware of their memory response. It is also portable, meaning it can be carried out anywhere, including in a patient’s home.

By testing more people earlier and more regularly, the researchers believe that Fastball could help lower the age of diagnosis by up to five years in the short-term and by more in the future.

The research team will also work with a company called Cumulus Neuroscience  to develop the technology into a product that can be rolled out more widely in the NHS.

Stothart, the project co-lead and a cognitive neuroscientist at the University of Bath, said: “Nearly all of us will know someone, or be caring for someone, with dementia. The costs to families, and to the NHS is enormous and is set to rise as our population ages. Yet, dementia is currently diagnosed too late – typically up to 20 years after the disease has first begun.

“Quicker, more accurate ways to diagnose dementia are greatly needed so that patients can get treatments earlier and families can plan better for the future, which is why we are so excited for the potential of Fastball EEG and the development of our work through this significant new funding and the collaborations it will enable.”

Democratising the diagnosis of Alzheimer’s

Coulthard, an associate professor in dementia neurology at the University of Bristol and a neurologist at North Bristol NHS Trust, added: “Patients can wait a long time for diagnosis and some of our current tests can be inaccurate and sometimes stressful for them. A quick, easy-to-administer memory test, like Fastball, could transform a patient’s journey to diagnosis.

“As we adopt new treatments into clinical practice, we will need to scale-up our ability to diagnose people at an early stage of Alzheimer’s and avoid language barriers. Fastball offers the opportunity to improve Alzheimer’s diagnosis equitably.”

Brian Murphy, founder and chief scientific officer of Cumulus Neuroscience, which is supplying the EEG headset used in the project, described Alzheimer’s as a “devastating disease that affects brain function, memory, and other cognitive abilities.” He added: “As a passive test, Fastball EEG has the potential to democratise how Alzheimer’s is diagnosed, ensuring all patients have an opportunity for earlier intervention and treatment.”