Vascular damage to the white matter in the brain can cause all kinds of problems, for example in people’s language or memory. Researchers at UMC Utrecht have developed smart software that can predict which problems patients will face based on brain scans of such damage. Initially, the model is particularly useful for patients who come to the memory clinic, and who therefore often already have symptoms. Later, the researchers hope to be able to apply the software to people who do not yet suffer from anything.
The white matter is the “fiber optic network of the brain” through which information flows. It consists of the spurs (axons) of nerve cells, surrounded by an oily white substance called myelin. Myelin is a kind of insulating material that protects the axons. It is similar to the plastic sheath of fiber optic cables.
The older people get, the more the white matter in their brains gets damaged. But one damage is not the other. “Sometimes people have a lot of white matter damage, and they don’t suffer from it,” explains neurologist and researcher Matthijs Biesbroek. “Other times people function less well than before, even though they have relatively little white matter damage.” What matters most is where the damage is, not so much how much damage there is.
Until now, it was not possible to determine what consequences damage to the white matter has for individual patients, because it was not clear what the most important nodes are. Researchers at UMC Utrecht mapped these critical points. Based on that information, they developed smart software that can analyze brain scans. The software can predict what symptoms individual patients will face, and whether they are at risk of developing dementia, for example.
Mirthe Coenen and Matthijs Biesbroek
In the brain, the white matter is organized into different pathways. “To determine which of these white matter pathways are important, and which are less important, we needed a large group of patients,” Matthijs explains. The patients not only had to have brain images taken, they also had to have taken cognitive tests. In total, the Utrecht researchers used data from 3,525 patients from Europe, Asia and the United States.
The researchers looked at what damage to 20 different white matter pathways did to patients. “From our analysis, four pathways emerged that are clearly the most important for our functioning,” says neurologist in training and PhD candidate Mirthe Coenen. “By that I mean our memory, our language, the speed at which we process information, and what we call our ‘executive functions.’ Those are the higher cognitive processes needed to plan and direct activities.”
“By just looking at these four important white matter pathways, we seem to be very good at predicting what problems someone will have,” Mirthe continued. “The total amount of damage matters much less.” And the new Utrecht model has another advantage: it can be applied to brain scans that are standard at every memory clinic. Mirthe: “So we can quickly use this new technology to treat our patients.”
So to make the predictions, smart software is needed. The software analyzes how much white matter damage patients have, and where exactly that damage is located. With the naked eye, you can’t see that very well. Right now, the researchers are developing new software that can go through all the steps in the process fully automatically. They even have plans to use artificial intelligence to give the program the ability to learn. The software is expected to be ready in early 2023.
The results of this research were recently published in the scientific journal Alzheimer’s & Dementia.
