What do we do:
Clinical research

Dra. Mercè Boada, Medical director

"There are many factors involved in making the diagnosis a diagnosis of excellence. At Fundació ACE we aim to generate synergies among all research programs to guarantee the maximum possible scope of our research."

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Biomarkers

Biomarkers are biological indicators that are used to find out if a person has the disease or in what phase it is. An example of biomarkers known is glucose, having a high level is an indicator of diabetes.

The information that is extracted from biomarkers is essential to fine-tune the diagnosis in cases where neuropsychological tests and the usual neuroimaging tests (eg scanner or resonance) can not be clarified with sufficient degree of certainty.

In Alzheimer's disease, the most studied biomarkers are those that are determined by the cerebrospinal fluid (LCR), a liquid that breaks the brain. The biomarkers in this liquid are the β-amyloid peptide42, the tau-total protein (t-tau) and the tau-phosphorylated (p-tau) protein.

These biomarkers measure both cerebral amyloidosis (β-amyloid42) and neurodegeneration (t-tau and p-tau). Both biomarkers help to increase diagnostic certainty in patients with mild cognitive impairment (DCL) and Alzheimer's disease according to the new diagnostic criteria (Alberts et al., 2011; McKhann et al., 2011).

In the Foundation, the biomarkers are determined in our laboratory by the technique of ELISA that is the most used. Our laboratory participates in the external quality control program of the Alzheimer's Association LCR (AA) (Mattsson N et al., 2013) biomarkers.

For the interpretation of the results of the analysis of biomarkers, the cutting points of each biomarker that is established in the laboratory are used and its value is the one used to indicate whether the biomarker is altered or not. If the three biomarkers are altered, it is considered that biomarkers are compatible with Alzheimer's disease and, if the three biomarkers are normal, it means that there is no Alzheimer's disease.

Neuroimaging

Neuroimaging is an essential tool for the study and prevention of Alzheimer's. It allows us to visualize the first signs and study the evolution of the disease.

In fact, together with biomarkers are the two ways we have to detect the changes that occur in early stages, ie before the first symptoms appear.

Thanks to this tool it is possible to identify in which phase of the disease a person is, and the characteristics of their state. This allows us to reach an accurate diagnosis and adapt the treatment, and with follow-up, quantify its effectiveness.

The main objectives of the Fundació ACE neuroimaging program are

  • detect when and how the disease begins to act,
  • and study the course that follows depending on different aspects.

That is why, with neuroimaging, we approach research from a holistic point of view, taking into account a multitude of factors that surround the human being, and considering all the biomarkers to which we have access.

Neuroimaging is in continuous technological development, and has now reached a high level of complexity and technological sophistication, which has placed it next to other biological measures in many areas of research.

Prevention

Before Alzheimer's disease manifests, there is a silent process that begins 15 to 20 years earlier. We are interested in detecting just this silent beginning, because when Alzheimer's manifests it is already too late to reverse the damage caused in the brain.

In Fundació ACE we are investigating the detection of the disease from that first moment, known as the preclinical phase of Alzheimer's. The objective is to understand the beginning of the disease in order to predict and prevent it.

In this line, we have two projects of our own and lead a European one to turn citizens into active agents of early detection.

Genetic meta-analysis of diagnosed

Genome-wide association analysis of dementia and its clinical endophenotypes reveal novel loci associated with Alzheimer disease and three causality networks of AD: the GR@ACE project.

 

bioRvix. doi:10.1101/528901

 

Sonia Moreno-Grau, Itziar de Rojas, Isabel Hernandez, Ines Quintela, Laura Montrreal, Montserrat Alegret, Begona Olasagarre, Laura Madrid, Antonio Gonzalez, Olalla Marona, Matiee Rosende-Roca, Ana Mauleon, Liliana Vargas, Asuncion Lafuente, Carla Abdelnour, Octavio Rodriguez-Gonzalez, Silvia Gil, Miguel Angel Santos-Santos, Ana Espinosa, Gemma Ortega, Angela Sanabria, Alba Perez-Cordon, Susana Ruiz, Nuria Aguilera, Juan Antonio Pineda, Juan Macias, Emilio Alarcon-Martin, Oscar Sotolongo-Grau, GR@ACE consortium, DEGESCO consortium, Alzheimer Disease Neuroimaging Initiative, Marta Marquie, Gemma Monte-Rubio, Sergi Valero, Jordi Clarimon, Maria Jesus Bullido, Guillermo Garcia-Ribas, Pau Pastor, Pascual Sanchez-Juan, Victoria Alvarez, Gerard Pinol-Ripoll, Jose Maria Garcia-Alberca, Jose Luis Royo, Emilio Franco, Pablo Mir, Miguel Calero, Miguel Medina, Alberto Rabano, Jesus Avila, Carmen Antunez, Luis Miguel Real, Adelina Orellana, Angel Carracedo, Maria Eugenia Saez, LLuis Tarraga, Merce Boada, Agustin Ruiz.