Researchers from Singapore discover new early warning marker for Alzheimer’s disease – visible on standard MRI images. The method could make expensive special diagnostics unnecessary.
A study from Nanyang Technological University shows: Enlarged perivascular spaces in the brain indicate an increased risk of Alzheimer’s disease. What’s special about it? Doctors can detect these abnormalities on traditional MRI scans – without additional tests or new technology.
Perivascular spaces surround the blood vessels in the brain like tiny channels. They transport toxic metabolic products away – a kind of body’s own wastewater system. If these rooms expand, the removal will stop. The “drains get clogged”.
The team led by Associate Professor Nagaendran Kandiah examined almost 1,000 subjects of Asian descent. The participants were divided into three groups: without cognitive problems, with subjective decline and with mild cognitive impairment.
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The result: Patients with cognitive impairment showed significantly more frequent enlarged perivascular spaces. These correlated strongly with tau proteins and beta-amyloid plaques – the key biochemical hallmarks of Alzheimer’s.
Standard MRI instead of expensive special tests
Until now, early diagnoses have often relied on invasive methods. Lumbar punctures provide nerve fluid for analysis, PET scans show protein deposits – both procedures are complex and expensive.
The new method integrates seamlessly into existing processes. MRIs are already part of the standard investigation for suspected dementia. Radiologists simply need to specifically look for the enlarged spaces.
“These findings could help identify people at higher risk of Alzheimer’s disease even before symptoms appear,” explains Dr. Rachel Cheong Chin Yee from Khoo Teck Puat Hospital. Clinics don’t need new hardware – just a sharper view of existing data.
Timing is crucial
The discovery comes at the right time. New antibody therapies such as lecanemab and donanemab specifically combat amyloid deposits. They work best in the early phases of the disease – exactly when the MRI method can begin.
Lead author Justin Ong emphasizes: Early intervention significantly slows the progression of memory loss. Every month you win counts.
At the same time, blood-based biomarkers are continuing to develop. The combination could revolutionize diagnostics: Blood test as an initial screeningMRI to confirm and localize the damage.
From research to practice
The NTU team is planning long-term studies. They are intended to show how many patients with enlarged spaces actually develop Alzheimer’s dementia. These data will refine the predictive power of the marker.
For the healthcare system this means: The tool is ready. Radiological guidelines are likely to be adjusted worldwide in the coming months. Evaluation of perivascular spaces could become a standard component in MRI reports.
The study deliberately focuses on Asian subjects – an often overlooked group in Alzheimer’s research. In doing so, it closes an important gap and makes the results more relevant for millions of people worldwide.
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