Hyperspectral Retinal Observations for the Cross-sectional Detection of Alzheimer's Disease

NCT ID: NCT05604183

Last Updated: 2022-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-30

Study Completion Date

2023-12-29

Brief Summary

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Two devices will be tested in this research:

1. Mantis Photonics' hyperspectral camera for non-invasive retinal examination (i.e., a hardware medical device under investigation).
2. Blekinge CoGNIT cognitive ability test (i.e., an assessment).

Detailed Description

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Worldwide, millions of people are affected by neurodegenerative diseases (e.g., Alzheimer's disease, dementia). Those diseases are having a tremendous socio-economic impact on our society. The cost associated with treating and caring for those diseases is enormous. Overwhelming evidence indicates how selective lifestyle changes (e.g., reducing exposure to known risk factors) can sometimes significantly decrease the probability of developing the disease or delay its onset. However, the diseases must be diagnosed early for them to be effective. There is a lack of accessible, inexpensive, and non-invasive practices that would allow for an early diagnosis of different diseases, even at the primary physician's office. Mantis Photonics and Blekinge Tekniska Högskola (Institustionen för Hälsa) aim to fill this urgent unmet medical need.

Strong indications of the possibility of classifying Alzheimer's status based on hyperspectral scans of the retina have been published by different researchers. These results were obtained based on images taken with hyperspectral cameras with a different working principle than the Mantis Photonics camera. The working principle of the Mantis Photonics camera allows making a hyperspectral retinoscopy with the same spectral range and comparable or better spectral resolution with a machine that is more modular and lower in cost. There is thus reason to hypothesize retinal scans taken with the Mantis Photonics camera can be used for the same classification task.

Previous studies on the automated tablet computer cognitive test CoGNIT have established validity, reliability and sensitivity for testing patients with Normal Pressure Hydrocephalus (NPH) . Recently feasibility of testing in Mild Cognitive Impairment (MCI) was affirmed (Behrens, Berglund, \& Anderberg, CoGNIT Automated Tablet Computer Cognitive Testing in Patients With Mild Cognitive Impairment: Feasibility Study, 2022). In NPH patients, CoGNIT was more sensitive to cognitive impairment at baseline and cognitive improvement after shunt surgery than the Mini-Mental State Examination (MMSE).

Blood tests for amyloid-β and other biomarkers related to Alzheimer's disease are being investigated for clinical practice, but the technique is not accepted as a standard test. Research has shown that renal function influences amyloid-β clearance from the body. Also, analytical errors influence test results. Therefore, one can question the influence of normal repeatability of the blood test result.

The aim of this investigation is the evaluation, (further) development and comparison of non-invasive techniques for the evaluation of patients suffering mild cognitive impairment, in particular, the Mantis Photonics hyperspectral camera with classification machine learning model in combination with the CoGNIT test of Dr Behrens (Blekinge Tekniska Högskola). These techniques will be compared to the result of cerebrospinal fluid analysis (CSF), the reference biological diagnostic technique for Alzheimer's disease.

Conditions

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Alzheimer Disease, Early Onset Cognitive Impairment Cognitive Decline

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

The diagnosis of Amyloidosis (biomarker of Alzheimer's disease) is made based on the normal patient care consisting of the neurologist assessment and the Cerebro-Spinal Fluid analysis.

This diagnosis is used as golden standard for the model based on retinal images and cognitive test results.

Study Groups

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Subjects

On all subjects included in the study (see inclusion / exclusion criteria and informed consent) both procedures will be performed.

The result of these procedures (retinal scan, result from cognitive test and blood sample) will be used to build diagnostic classification models.

Group Type EXPERIMENTAL

non-invasive hyperspectral retinoscopy

Intervention Type PROCEDURE

The Principal Investigator or a trained medical nurse (under the supervision of the principal investigator) will take an image of the retina of the patient with the Mantis Photonics hyperspectral retinoscopy camera.

blood sample

Intervention Type PROCEDURE

The Principle Investigator or a trained medical nurse (under the supervision of the Principal Investigator) will draw a small blood sample according to the standard medical procedures for drawing blood samples.

Test of cognitive ability on tablet computer with CoGNIT software

Intervention Type DIAGNOSTIC_TEST

The Principle Investigator or a trained medical nurse (under the supervision of the Principal Investigator) will give the patient to perform the digital cognitive test on a commercial tablet computer. The Principal Investigator or the medical nurse will be available for the patient to ask questions while the test is ongoing.

Interventions

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non-invasive hyperspectral retinoscopy

The Principal Investigator or a trained medical nurse (under the supervision of the principal investigator) will take an image of the retina of the patient with the Mantis Photonics hyperspectral retinoscopy camera.

Intervention Type PROCEDURE

blood sample

The Principle Investigator or a trained medical nurse (under the supervision of the Principal Investigator) will draw a small blood sample according to the standard medical procedures for drawing blood samples.

Intervention Type PROCEDURE

Test of cognitive ability on tablet computer with CoGNIT software

The Principle Investigator or a trained medical nurse (under the supervision of the Principal Investigator) will give the patient to perform the digital cognitive test on a commercial tablet computer. The Principal Investigator or the medical nurse will be available for the patient to ask questions while the test is ongoing.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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eye-scan fundus image (of the eye) draw blood CoGNIT test Cognitive test Mental ability test

Eligibility Criteria

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Inclusion Criteria

* subject age over 18 years old
* The subject has undergone a lumbar puncture an cerebrospinal fluid analysis as part of the standard care.
* The subject has at least one healthy eye.
* The subject is applicable for taking a blood sample for the blood analysis test.
* The informed consent is provided, explained and understood by the person. The person has consented to the informed consent.

Exclusion Criteria

* There are contra-indications for lumbar puncture (eg: brain tumor with suspicion of raised intracranial pressure, coagulopathies or ongoing anticoagulant medications) will be excluded from the study.
* When the subject suffers from excessive visual or auditive impairment, the he/she will be excluded from the CoGNIT track.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Blekinge Institute of Technology

OTHER

Sponsor Role collaborator

Blekinge County Council Hospital

OTHER

Sponsor Role collaborator

Mantis Photonics AB

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anders Behrens, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Blekinge Tekniska Högskola

Locations

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Blekinge Tekniska Högskola

Karlskrona, Blekine Län, Sweden

Site Status

Blekinge Hospital

Karlskrona, Blekinge County, Sweden

Site Status

Countries

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Sweden

Central Contacts

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Anders Behrens, MD, PhD

Role: CONTACT

+460702034496

Jan Alexander, Master

Role: CONTACT

0478779156

Facility Contacts

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Anders Behrens, MD, Phd

Role: primary

+460702034496

Anders Behrens, MD, PhD

Role: primary

+460702034496

References

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Behrens A, Berglund JS, Anderberg P. CoGNIT Automated Tablet Computer Cognitive Testing in Patients With Mild Cognitive Impairment: Feasibility Study. JMIR Form Res. 2022 Mar 11;6(3):e23589. doi: 10.2196/23589.

Reference Type BACKGROUND
PMID: 35275064 (View on PubMed)

Behrens A, Eklund A, Elgh E, Smith C, Williams MA, Malm J. A computerized neuropsychological test battery designed for idiopathic normal pressure hydrocephalus. Fluids Barriers CNS. 2014 Sep 25;11:22. doi: 10.1186/2045-8118-11-22. eCollection 2014.

Reference Type BACKGROUND
PMID: 25279138 (View on PubMed)

Behrens A, Elgh E, Leijon G, Kristensen B, Eklund A, Malm J. The Computerized General Neuropsychological INPH Test revealed improvement in idiopathic normal pressure hydrocephalus after shunt surgery. J Neurosurg. 2019 Feb 8;132(3):733-740. doi: 10.3171/2018.10.JNS18701. Print 2020 Mar 1.

Reference Type BACKGROUND
PMID: 30738407 (View on PubMed)

Budelier MM, Bateman RJ. Biomarkers of Alzheimer Disease. J Appl Lab Med. 2020 Jan 1;5(1):194-208. doi: 10.1373/jalm.2019.030080.

Reference Type BACKGROUND
PMID: 31843944 (View on PubMed)

Hadoux X, Hui F, Lim JKH, Masters CL, Pebay A, Chevalier S, Ha J, Loi S, Fowler CJ, Rowe C, Villemagne VL, Taylor EN, Fluke C, Soucy JP, Lesage F, Sylvestre JP, Rosa-Neto P, Mathotaarachchi S, Gauthier S, Nasreddine ZS, Arbour JD, Rheaume MA, Beaulieu S, Dirani M, Nguyen CTO, Bui BV, Williamson R, Crowston JG, van Wijngaarden P. Non-invasive in vivo hyperspectral imaging of the retina for potential biomarker use in Alzheimer's disease. Nat Commun. 2019 Sep 17;10(1):4227. doi: 10.1038/s41467-019-12242-1.

Reference Type BACKGROUND
PMID: 31530809 (View on PubMed)

Rasmussen J, Langerman H. Alzheimer's Disease - Why We Need Early Diagnosis. Degener Neurol Neuromuscul Dis. 2019 Dec 24;9:123-130. doi: 10.2147/DNND.S228939. eCollection 2019.

Reference Type BACKGROUND
PMID: 31920420 (View on PubMed)

Teunissen CE, Verberk IMW, Thijssen EH, Vermunt L, Hansson O, Zetterberg H, van der Flier WM, Mielke MM, Del Campo M. Blood-based biomarkers for Alzheimer's disease: towards clinical implementation. Lancet Neurol. 2022 Jan;21(1):66-77. doi: 10.1016/S1474-4422(21)00361-6. Epub 2021 Nov 24.

Reference Type BACKGROUND
PMID: 34838239 (View on PubMed)

Dallora AL, Alexander J, Palesetti PP, Guenot D, Selvander M, Berglund JS, Behrens A. Hyperspectral retinal imaging to detect Alzheimer's disease in a memory clinic setting. Alzheimers Res Ther. 2025 Oct 28;17(1):232. doi: 10.1186/s13195-025-01887-4.

Reference Type DERIVED
PMID: 41153055 (View on PubMed)

Related Links

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https://www.alzint.org/resource/world-alzheimer-report-2022/

World Alzheimer Report 2022 - Alzheimer's disease international

Other Identifiers

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CIV-22-06-039726

Identifier Type: OTHER

Identifier Source: secondary_id

MANTIS_2022_08_CrossSect_B

Identifier Type: -

Identifier Source: org_study_id

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