Periodic Reporting for period 1 - MES-CoBraD (Multidisciplinary Expert System for the Assessment & Management of Complex Brain Disorders)
Periodo di rendicontazione: 2021-04-01 al 2022-09-30
The Multidisciplinary Expert System for the Assessment & Management of Complex Brain Disorders (MES-CoBraD) is an interdisciplinary project combining Real-World Data (RWD) from multiple clinical and consumer sources through comprehensive, cost-efficient, and fast protocols towards improving diagnostic accuracy and therapeutic outcomes in people with Complex Brain Disorders (CoBraD), as reflected in Neurocognitive (Dementia), Sleep, and Seizure (Epilepsy) disorders and their interdependence. It brings together internationally recognized experts in medicine, engineering, computer science, social health science, law, and marketing and communication from across Europe, and combines clinical information and scientific research in CoBraD with technical innovation in secure data-sharing platforms, artificial intelligence algorithms, expert systems of precision and personalized care, and advanced data analytics, with a primary focus on improving the quality of life of patients, their caregivers, and the society at large. It leverages RWD from diverse CoBraD populations across cultural, socioeconomic, educational, and health system backgrounds, with special attention on including vulnerable populations and minorities in an equitable manner and engaging key stakeholders to maximize project impact.
With regards to prognostic objectives, (a) members of the MES-CoBraD Consortium have identified that pGFAP and pNfL levels differ in Frontotemporal Dementia and Alzheimer’s Disease, and their combination is useful for distinguishing between the two. Importantly, also, pGFAP is helpful to track disease severity and predict greater cognitive decline during follow-up in patients with FTD, a marker we have been lacking until now. Additionally, (b) our members identified that MRI-based cortical microstructure is a noninvasive biomarker that independently predicts subsequent cognitive decline, neurodegeneration, and clinical progression, a feature that can be useful in real world trials. Finally, (c) analyzing cognitive data from people with Down syndrome, scientific analyses support the need for population health plans to screen for AD-related cognitive decline from the fourth decade of life and provide longitudinal data to inform clinical trials in adults with DS to prevent AD.
With regards to protocols that assess therapeutic intervention efficacy and safety in CoBraD, we have identified that (a) Cognitive Behavioral Therapy for Insomnia is helpful in improving insomnia in people with Mild Cognitive Impairment, while at the same time allowing for tapering of central nervous system sedatives. We are actively pursuing in follow up assessments whether it also helps in delaying cognitive decline over time.
Scientific Objective 4: Implement an effective clinical management Expert System algorithm for CoBraD that is well-tolerated and accepted by patients and their caregivers
During the first 18 months of the project, we have provided technical partners with the scientific operations that an Expert System is required to perform for guiding the Assessment and Management of CoBraD. This is a representation of methodological operations identified in our hypothesis testing protocols (D4.2 D4.3) and whose high-level outputs are assessed through a defined validation framework and end-user feedback, including test-case executions, to examine if Platform modules are assessed as-intended. We anticipate, as planned from the start of the project, to start assessing this key objective from M24 onwards.