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Artificial intelligence (AI) can be useful in healthcare.

AI can help with interpreting images and free up time forthe radiologists.

A new study from Sweden showed, for example, thatAI-supported mammography led to 20 per cent more cancer cases being detected, accordingto NRK (link in Norwegian).

The EU research project AI-Mind focuses on artificial intelligence and health.

The goal is to be able to identify who in the group with mildcognitive impairment is at high risk of developing dementia. They could be identifiedseveral years before a diagnosis is made today.

The research is led by Ira Haraldsen at Oslo UniversityHospital.

People with mild cognitive impairment have begun to experience that their memory is failing and have some problems with reasoning and attention. But that does not necessarily mean they have, or will develop,dementia.

The background for our project is a worldwide clinicalneed. Currently, we are not able to predict your risk of developing dementia ifyou are affected by mild cognitive impairment, Ira Haraldsen said during a recent event at Arendalsuka, an annual political festival in Norway.

She believes that the dementia diagnosis comes too late. Itcomes after clear symptoms have appeared.

By then, you can alleviate symptoms but you cant affect thecourse of the disease. What we want is to shift the diagnosisinto another time window, she said.

The research group plans to create a tool based onartificial intelligence for screening, or mass examination, of the population,Haraldsen explains in an interview with sciencenorway.no. Screening involvesexamining healthy people to detect disease or precursors to disease before symptomsappear.

The dream is population-based screening of, for example,all 55-year-olds, she said.

If it turns out that you are at high risk, you will befollowed up, and all risk factors contributing to dementia should be corrected,according to Haraldsen.

Ira Haraldsen is a psychiatrist and researcher at Oslo University Hospital. (Photo: Tone Herregrden)

The study will include 1,000 participants from Norway,Finland, Italy, and Spain.

Participants from Norway and Italy have already beenrecruited. There are still some missing from Spain and Finland.

The participants are between 60 and 80 years old and havemild cognitive impairment.

What is interesting is that among people with mildcognitive impairment, 50 per cent develop dementia and 50 per cent do not. Doctorstoday dont know which group you belong to, Haraldsen said.

Researchers in AI-Mind aim to separate these two groups. Whois on the way to developing dementia, and who can be reassured?

Karin Persson is a postdoctoral fellow at the Norwegian NationalCentre for Ageing and Health and is researching dementia.

She is not part of the project and writes in an email to sciencenorway.nothat AI-Mind is one of several large projects now trying to find effective waysto diagnose cognitive impairment and dementia early on.

Common to these new projects is the use of artificialintelligence and focus on developing methods that can predict which people withearly symptoms will develop dementia, she said.

The difference between various projects is the variables theyinput into the models: whether its cognitive tests, EEG, MRI images, geneticdata, biomarkers from spinal fluid, blood, and other imaging diagnostics, Perssonexplained.

I think artificial intelligence is here to stay, I believethat this is the way forward for effective diagnostics in this field, shewrites.

Participants in AI-Mind will take part in four studies overtwo years.

An electroencephalography (EEG) examination will then beconducted. This is an examination where a cap with electrodes measureselectrical activity in the brain.

Blood samples are taken, and participants take a testregarding their ability to think and remember.

Over the two years, researchers will see who gets worse andwho stays the same or improves.

Two algorithms will be trained to predict this. One istrained on EEG examinations. It analyses how different areas of the brain communicatewith each other.

It has been known for a long time that this changes when dementiadevelops, Haraldsen explains.

An example of EEG. (Photo: Svitlana Hulko / Shutterstock / NTB)

Haraldsen compares what happens in the brain to a footballteam.

When youre very good at football, the ball is constantlypassed from one player to another, back and forth. Then suddenly, Haaland stormstowards the goal, and then manages to score, she said at the event. That's how the brain is also constructed. It works all the time, whether we are asleep orawake. All areas are chaotically in contact all the time. Then a task comes along,and we do it.

You can see the difference between a football team that collaborateswell and one that doesn't. In the latter, maybe only two players pass to eachother and exclude the others.

This is something that happens in the early stages ofdementia and mild cognitive impairment. Some areas communicate too frequentlywith each other, and others are given lower priority, Haraldsen said.

Researchers are testing two types of artificialintelligence, which Haraldsen describes as classical machine learning and deeplearning.

They are asked to divide the participants into two groupsbased on EEG examinations: Those who will deteriorate and those who will not.

The classical machine learning algorithm is asked to lookfor characteristics that researchers know are indications of early-onsetdementia.

The deep learning model has more freedom and finds its ownpatterns. Many experts believe that this is the future of artificialintelligence in healthcare, Haraldsen explained. But it is more challenging tounderstand what the machine is doing and how it arrives at the answer.

Researchers are comparing whether humans and machines cometo the same result.

Eventually, a new artificial intelligence will use the EEGanalysis, along with the results from blood tests and the mental test, to saywho is at high risk of developing dementia.

It is known that changes in blood tests can be measuredseveral years before a patient receives a dementia diagnosis. Blood tests thatcan reveal the beginning of the disease have already been successfully tested.

The researchers believe that the AI they are developing can uncoverearly-stage dementia two to three years before a diagnosis is usually made.Later, it may be possible to push the time window even a couple of yearsearlier, Haraldsen believes.

The artificial intelligence is planned to be ready for usein 2026. But Haraldsen points out that part two of the study will be necessaryfor the algorithm to be approved for the market.

The results from the artificial intelligence must becompared to the most reliable way to diagnose dementia, which is to take aspinal fluid sample and imaging diagnostics with MRI or PET, Haraldsen explains.

Today there is no treatment that can cure dementia andAlzheimer's disease. Is there then any advantage to being diagnosed earlierthan today?

Karin Persson at the National Centre for Ageing and Healthanswers:

There is much ongoing research on the development ofdisease-modifying drugs, that is, medicines that do not only affect thesymptoms of dementia but can actually stop the disease development.

This especially applies to Alzheimer's disease, the mostcommon cause of dementia worldwide.

If these types of medications are to be effective, it willbe crucial to get to it early in the disease process before the brain is too attackedand damaged, she says.

There is a reason why there is a focus on early diagnosticsnow.

At the same time, there may be ethical challenges withgiving an early diagnosis, especially in cases where the disease cannot betreated. People who are working with this are concerned about these ethical challenges, Perssonsays.

The diagnosis must come at the right time. However, there are more treatments that are relevant to dementia other than medication, even if wecurrently have no cure to stop it, she says.

Patients who notice changes in their memory and thinking,i.e., their cognitive function, often want information about the cause, Perssoncontinues.

But it is essential that we balance correctly and that ethicalconsiderations are included in guidelines for diagnosis, she says.

There is a lot happening in the field when it comes to earlydiagnosis and medication.

Three new drugs have been approved in the USA(link in Norwegian). They arebased on removing amyloid plaques, a protein that accumulates in the brain withAlzheimer's disease, Persson explains.

They are being assessed by the European Medicines Agency.However, the effects of the medications are relatively small, and the sideeffects are potentially serious, the researcher explains.

So far, the follow-up time in the studies has beenrelatively short, and it will be interesting to see how the patients fare overa longer period, she says.

Overall, these are not medications that will be given to allpeople with Alzheimer's disease. Disease stage in the patient, risk of sideeffects, expected effect, and price will be important factors, Persson explains.

Regarding early diagnosis, an essential development is methodsfor looking at markers in blood. There have been good results here, which canmake early diagnosis easier.

Again, you have to have a clear thought about who will betested when these methods become clinically available. Currently, they are usedin research in Norway, with ethical principles in mind, Persson says.

Conflict of interest: Ira Haraldsen is chairman andco-founder of the company BrainSymph, as a spin-off of the AI-Mind project.

Translated by Alette Bjordal Gjellesvik.

Readthe Norwegian version of this article on forskning.no

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Researchers are developing artificial intelligence that will detect ... - Sciencenorway