Canadian Study Aims to Improve Early Diagnosis and Treatment

The Ontario Neurodegenerative Disease Research Initiative (ONDRI) was designed by Ontario neuroscientists to improve early diagnosis and treatment of neurodegenerative diseases that are inflicted with dementia, such as Alzheimer’s disease.

The specifics of this initiative are detailed in an article titled “The Ontario Neurodegenerative Disease Research Initiative (ONDRI),” published in the Canadian Journal of Neurosciences.

Dementia is the leading cause of neurological disability in the aging population, and the cost of caring for patients with dementia is expected to increase significantly in the next 20 years. In order to effectively curb the rates of dementia, it is important to be able to identify — early and accurately — patients who are at a risk of developing dementia so they can be treated in a timely manner.

So, scientists in Ontario, Canada, are conducting a prospective group study that will use multiple approaches to predict the development and progression of cognitive or neuropsychological impairment. The study will include 600 patients from across Ontario for a period of three years.

The group will include patients afflicted with one of five diseases: Alzheimer’s disease or mild cognitive impairment (150 patients), Parkinson’s disease (150 patients), amyotrophic lateral sclerosis (90 patients), frontotemporal lobar degeneration (60 patients), and vascular cognitive impairment as a result of stroke (150 patients), at multiple centers in Ontario.

Researchers are hypothesizing that this multi-modal approach will be able to quickly detect a significant neuropsychological change over a short period of time, which then can allow physicians to predict the development and progression of dementia earlier. Additionally, researchers believe they will be able to identify different forms of dementia that can be associated with specific neural circuits that may be similar to, or differ, from the other dementia-causing disorders. The study also will evaluate the contribution of small-vessel pathology, which refers to a disorder that affects the small blood vessels of the brain, to the development of dementia, because studies have increasingly associated the two disorders.

Patients will be rigorously examined by multiple methods, including neuroimaging, detailed neuropsychological evaluations (including comprehensive speech and language assessments), genomics, evaluations of cognitive control of eye movements and retinal layer thickness and morphology, gait performance, and neurological disease.

Prior to the start of the study, ONDRI has already facilitated the development of standardized assessment protocols in order for direct comparison between the different disorders. This type of standardized tool will allow scientists to identify both unique and overlapping biomarkers of each disease.

The article’s authors added that “although the numbers of patients being studied is small (600) relative to larger prospective studies, patients enrolled in ODNRI will be a unique resource because they will be deeply endophenotyped and their de-identified data publicly available by request through the ONDRI publications and data analysis committee.”

The authors hope that through this approach they will be able to: (1) identify biomarkers for the identification of pre-symptomatic individuals; (2) obtain a better understanding of the overlap between the dementia-inducing neurodegenerative diseases, and; (3) administer personalized treatments, which are more likely to be effective at stopping disease progression than current treatments.

Upon the completion of this study, ONDRI data will be made available to the broader scientific community and eventually will be combined with data from other studies, such as the Brain Eye Amyloid Memory study and the Canadian Consortium on Neurodegeneration in Aging.

First results from the study are being presented at the American Academy of Optometry’s annual conference Oct. 11-14 in Chicago, Illinois. The presentation will cover the research regarding the ophthalmologic changes in this group.