A brain scan technique called Cortical Disarray Measurement (CDM) is being tested in NHS clinics to see if it can predict which patients with mild memory problems will go on to develop Alzheimer’s disease. Currently, doctors diagnose Mild Cognitive Impairment (MCI) based on cognitive tests, but cannot reliably tell which patients will progress to dementia within a few years. This uncertainty leaves patients and families in limbo, and makes it difficult to plan care or target treatments. CDM analyses standard MRI scans to detect subtle changes in the brain’s cortical structure that are invisible to the naked eye. If CDM proves effective, it could give clinicians a concrete, early indicator of disease progression. This would allow patients to receive a more certain diagnosis sooner, enabling earlier access to support services and potential treatments. The project also includes a health economics analysis to determine whether adopting CDM across the NHS would save money by reducing unnecessary follow-ups and improving care pathways. The research is not fundamental science—it is a direct test of a diagnostic tool in a real-world clinical setting, with results expected within three years.
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This project tests whether Cortical Disarray Measurement (CDM) technology can demonstrate clinical effectiveness as a tool to support a more certain diagnosis for patients suspected of Mild Cognitive Impairment (MCI) due to Alzheimer s Disease (AD), and deliver a positive health economics outcome. CDM was developed by Dr Steven Chance and Prof Mark Jenkinson using extensive research datasets, results published in peer review journals. The next step is to demonstrate effectiveness in a real-world clinical setting. Objective one is to demonstrate clinical effectiveness. WP1 generates CDM results from MRI scans for 100 participants in the existing (BRAIID) study and compares to clinical assessments. This provides a checkpoint that CDM can distinguish groups as expected and an early opportunity to publish results WP2 generates CDM values from MRI scans (timepoint 1) for a cohort of 200 patients recruited in Southampton and Cardiff, suspected to have MCI due to AD. CDM results and predictions for speed of disease progression will be compared to patient performance in cognitive testing over 2 years and analysis of MRI scans taken 24 months later (timepoint 2). Objective two is to optimise the presentation of CDM results and other MRI scan data to support clinical decision making, and to communication with patients and their family. Objective three is to define current patient pathways and the impact of improved diagnosis on patient outcomes, and to deliver a national health economics analysis across primary, secondary and social care. The project lasts 36 months, with patient recruitment starting early for WP2 with follow-up scans taken after 24 months. This project will provide vital real-world clinical evidence to support regulatory submissions and clinical acceptance. A positive health economics case will support NHS adoption. Patient and public involvement is centre to the project so that benefits are maximised for patients and their families.
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