Wenna Duan, a doctoral student in computer science, uses magnetization transfer rate (MTR) as a visual biomarker for brain tissue health.

MTR is a measurement most commonly used in magnetic resonance imaging (MRI) when looking at the brain. An MRI shoots energy into tissue cells, disorienting them, and then is turned off. MTR measures the amount of time the tissue cells take to dissipate the energy and reorient themselves.

Duan determined that brain tissue, specifically white matter, dissipates the energy more slowly in a brain that is more likely to suffer from Alzheimer’s. By comparing the MTR of brains suffering from different stages of Alzheimer’s with undiagnosed scans, doctors would be able to diagnose before the patient suffers from symptoms such as memory loss.

It’s a potentially vital development in the fight against Alzheimer’s disease, which the Centers for Disease Control and Prevention reported led to the deaths of more than 120,000 Americans in 2017.

The International Society for Magnetic Resonance in Medicine (ISMRM) accepted Duan’s research for its 2019 annual conference, where it received a magna cum laude award, which is given to the top 15% of thousands of projects.

The process of comparing scans was not a quick one. Duan had to create a template made up from the average of thousands of scans from a specific stage of Alzheimer’s. Then, because brain shape and size varies, she had to manipulate the undiagnosed scans, one by one, to fit the size of the template.

“The most challenging part of it all was in the preprocessing, especially because I had to teach myself the science behind the data to use it,” Duan says. “It took around two months to process all of the brain scans, and there were some very late nights.”

The brain data was collected as both longitudinal, where one subject was observed over several years, and cross-sectional, where one time-point was observed in different stages of Alzheimer’s, by the Cardiovascular Health Study at the University of Pittsburgh.

Weiying Dai, an assistant professor of computer science who previously taught at the University of Pittsburgh, supervised Duan’s research at Binghamton and provided the database. Dai says Duan’s research has the potential to make big changes in the clinical field.

“Her research can also help to identify potential treatment groups when a new drug comes to play as we do not currently have a cure for Alzeihmer’s,” Dai says. “Her work is clearly application oriented. If successful, she will make a huge contribution to both method development and clinical application.”

Duan is continuing her research with hopes of reconfirming her findings until this process is used regularly to help patients.

Her collaboration with Dai began when she took a machine learning course Dai taught.

“I did research with her and didn’t know it was all MR related, but when I turned in the MR project, she introduced how significant those findings are in the clinical area,” Duan says. “I thought, ‘You are really impacting somebody,’ so I got very excited and I decided to continue with that.”

Olympia Berger is a family nurse practitioner at the Greater Binghamton Health Center, where she cares for patients with severe mental illness.

“Some of my geriatric patients wander,”  Berger says.  “I noticed that as their blood pressure dropped, I saw some cognitive changes.”

That led her to studying the effects of hypotension (for these purposes, a systolic reading of 140 or lower) on cognitive function, and to a theory that low blood pressure may trigger wandering. Decrease in regional cerebral blood flow is common in individuals with Alzheimer’s. In fact, patients who wander may have more advanced pathology and a more pronounced decrease in cerebral blood flow.  “No one has looked at changes in blood pressure before, during and after an episode of wandering,”  Berger says.  “Is that the body’s mechanism to increase cerebral blood flow?”

Berger notes that not all Alzheimer’s patients wander. Those who do — more often men than women — aren’t looking to go anywhere; they just seem to need to move. She has seen patients get up and walk when they’re in pain, even soon after having surgery.

Working with her advisor, Carolyn Pierce, an assistant professor of nursing and of bioengineering, Berger is following a small group of patients using an ambulatory blood pressure monitoring device. They hope to identify peak times for wandering to see if there are connections to mealtimes or blood pressure.

One idea they’re exploring is that senior citizens may need a higher blood pressure than younger people. If that’s true, it may suggest changes in blood-pressure medication and diet for this population.

For Berger, there’s no question that psychiatric and medical issues are related.  “You need,”  she says,  “to look at the whole person.”