Monday , June 27 2022

Too premature to support the MRI screening for dementia is beneficial


Our Review Summary

This press release announced the results of a study that looked at the differences in brain MRI scans between older people who continued to develop symptoms of Alzheimer's disease and those who did not receive the disease.

The release said the findings, presented at the North American Radiological Society meeting in Chicago, suggest MRI scans may one day help to predict whether people will develop dementia.

The press release mentioned alternative ways to predict Alzheimer's, but said nothing about the possible damage or cost of using MRI, and did not explain that the method was not tested in a clinical trial.

Why does this matter?

A test to predict Alzheimer's disease may be helpful, but whenever such a test is being discussed, they should be reminded of limited treatment options for anyone who feels they are at greater risk. Potential costs and losses must be weighed against potential benefits.

One of the potential benefits outlined by authors is that people who are told to be at risk would have time to make financial and life arrangements before health problems. It's something each elderly person would ideally have on their list of tasks, not just those at risk.


Does the newsletter adequately quantify the benefits of the treatment / test / product / procedure?


The press release said that MRIs "predicted with 89% accuracy that would continue to develop dementia over three years" when looking at the entire brain, and accuracy increased to 95% have focused on certain parts of the brain. "

These percentages might seem impressive. However, the press release did not say how many people could benefit from a scan to detect early Alzheimer's, and how many could be subjected to testing that did not help but could cause harm (see "Explain Harms," ​​below).

For example, the lifetime risk of developing Alzheimer's disease was estimated at about 10-20%. According to our back calculations, if 100 elderly people were scanned regularly using MRI, up to 19 could benefit from an early warning. The other 81 or would not benefit or could be affected.

Does the press release seem to understand the quality of the evidence?


In his name, the press release rightly explained that this is a "small study".

He also provided details of how the study was conducted – primarily by identifying disproportionate white matter damage that occurred in 10 people in the '70s with significant cognitive decline compared to those who did not decrease and measuring the "white matter integrity" sample of 61 people.

Finally, he quoted a researcher who explains that what is needed is to get more control subjects and develop computerized tools that can more reliably compare patients individually scans to a standard base standard.

However, the press release did not explain that it was so not a randomized trial that could measure how well the MRI brain is actually functioning to predict Alzheimer's disease.

Does this release identify sources of funding and disclose conflicts of interest?


The defender – the Boerger research fund for Alzheimer's disease and neurocognitive disorders at the American Neuroradiology Society Foundation – is noted on the sidebar of the launch site, EurekAlert! We encourage media writers to include financiers in the text of the press release.

We have not noticed conflicts of interest among scholars.

Does the news statement set the true novelty of the approach?


The release showed that the study showed that by using MRI doctors could soon be able to tell people whether they are likely to develop Alzheimer's in the next few years.

The novelty suggested here is that the detected changes were in the white matter, rather than the gray cerebral cortex, where we traditionally believe plaques, tangles and loss of Alzheimer's nerve cells.

However, the concept of using MRI and tensor diffusion imaging to predict Alzheimer's is not new, and the press release did not explain how these findings add to the body of evidence on Alzheimer's detection.

Total score: 5 out of 10 Satisfactory

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