The University of Wisconsin was awarded a $150 million grant by the National Institutes of Health, marking a pivotal moment in the pursuit of understanding Alzheimer’s disease and related dementias on a national scale, UW professor, director for the Wisconsin Alzheimer Insititute’s Biomarker Core and principal investigator Sterling Johnson said. 

The study, Clarity in Alzheimer’s disease and related dementias research through imaging, or “CLARiTI,” is a five-year initiative powered by a collaborative effort to engage a network of nine principal investigators at UW, alongside a multitude of field experts and approximately 35 NIH-funded Alzheimer’s centers scattered across the nation, Johnson said. 

“Achieving our goals will demand extensive collaboration and coordination,” Johnson said. 

While Alzheimer’s disease is often associated with the debilitating symptoms of dementia, the reality of diagnosing related dementias was uncovered through postmortem examinations of the pathology of individual brains afflicted by the condition, Johnson said. 

Contrary to popular perception, when examining the pathology of the brain, a significant proportion of cases reveal a complex interplay of pathologies, encompassing not only Alzheimer’s but also vascular dementia, Lewy body dementia and various other underlying factors, Johnson said. 

By delving into the intricacies of brain pathology, researchers aim to unravel and pinpoint the specific causes of dementia onset, recognizing the multifaceted nature of the disease process, Johnson said. 

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This groundbreaking research endeavor aims to revolutionize researchers’ understanding of dementia etiology — the study of causes for the disease. Johnson said the grant funding will facilitate an in-depth exploration of the diverse causal mechanisms underlying dementia manifestations, transcending the conventional view of dementia as a singular behavioral outcome, Johnson said. 

“This grant will help us assess the etiology of a person’s dementia, which is usually viewed as a behavior but can have many causes and those causes can overlap in the same person,” Johnson said. 

Johnson said a pivotal aspect of the study is leveraging cutting-edge biomarkers and imaging techniques to delineate the temporal trajectory of cognitive decline within individual patients. This approach offers insights into the inception of cognitive impairment and lays the groundwork for tailored interventions and prognostic assessments. 

Alzheimer’s typically starts about 20 years before symptoms appear, meaning by the time someone notices symptoms of Alzheimer’s, it’s often too late for optimal treatment, Johnson said.

“In this study, we use biomarkers and imaging to better understand each individual’s cognitive profile” Johnson said. “When did cognitive disease begin? When did amyloids [associated with Alzhiemers] start to cluster? When did vascular changes occur in the brain? In this study the aim is to better time stamp these events and create a more accurate cognitive profile of each individual person.”

Beyond Alzheimer’s disease, Johnson said he envisions the broader applicability of the study’s methodology to encompass a spectrum of cognitive disorders, including Parkinson’s disease and beyond. By refining diagnostic accuracy and distinguishing disease trajectories, the study aims to catalyze a paradigm shift toward personalized medicine in cognitive health.

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Amidst the burgeoning landscape of innovative pharmaceutical interventions, there is a pressing need for precise diagnostic tools to discern the diverse pathologies underpinning cognitive dysfunction, said Johnson. 

By furnishing clinicians with the means to delineate individualized disease profiles, the study harbors the potential to optimize treatment strategies, enhance prognostic accuracy and ultimately extend longevity and quality of life for affected individuals, Johnson said. 

In order to access novel and effective treatments, researchers must determine with accuracy which diseases are affecting each person, Johnson said. 

Currently, there are numerous promising and efficient medications available. One example is a recent breakthrough in Alzheimer’s treatment, where a new medication demonstrates remarkable efficacy in removing amyloid plaques from the brain. These plaques are believed to be a key factor in the development of Alzheimer’s disease, Johnson said. 

“In essence, the objective of this study is to establish a more exploratory approach to understanding cognitive diseases by gathering data on biomarkers and imaging,” Johnson said. “Our ultimate aim is to equip clinicians with the necessary tools to accurately diagnose an individual’s cognitive disease profile and determine its duration.”