Brain imaging in dementia (BRAIID): an observational longitudinal study to optimise image reporting in dementia clinical practice
Diagnosis of dementia and prediction of decline in individuals with cognitive complaints is often difficult, as symptoms, cognitive deficits and imaging pathology commonly vary between patients. Early diagnosis and identification of individuals at highest risk of decline is essential for signposting patients to appropriate care resources. Diagnosis is currently aided by cognitive screening assessments, brain imaging (functional and structural) and various biomarkers of neurodegenerative pathology. In the UK (99m)Tc-HMPAO single-photon emission computed tomography (SPECT) imaging is commonly used in preference to other diagnostic brain imaging modalities for diagnosis, however reporting standards vary widely between sites with infrequent use of sensitive objective measures. Furthermore, there is little data available on the prognostic utility of commonly indentified patterns seen on SPECT image analysis. The Brain Imaging in Dementia (BRAIID) study aims to maximise the use of imaging data acquired in the course of providing routine clinical care, and combine this with long-term follow up information on individuals with cognitive complaints in order to improve diagnostic and prognostic accuracy for the individual. The study and outcome measures are pragmatic and reflect the nature of clinical practice in dementia. Individuals scheduled to have an HMPAO-SPECT scan as part of their clinical diagnostic workup will be recruited, together with their carers, and followed to determine their clinical outcome. Outcomes from the BRAIID study of optimised screening measures, improved image reporting and identification of individuals at highest risk of decline are aimed at improving early diagnosis and prognosis accuracy for the individual.