‘Fastball’ test to detect Alzheimer’s earlier gets major £1.5 million funding boost

A simple but revolutionary test to improve early detection for dementia and Alzheimer’s disease could soon be helping patients and their families, thanks to a significant £1.5 million funding boost awarded to the universities of Bath and Bristol.

Supported by the National Institute for Health and Care Research (NIHR)’s Invention for Innovation (i4i) funding, the project will see researchers Drs George Stothart and Liz Coulthard scale-up testing and development for their innovative ‘Fastball EEG’ dementia assessment at Southmead Hospital, Bristol.

‘Fastball’ is a passive, completely non-invasive test which measures patients’ brain waves whilst they watch a series of flashing images displayed on a screen. Developed in-house by the researchers, the technology requires users to wear an electroencephalogram (EEG) headset, which is linked to a computer for analysis.

Previous research from Dr Stothart, Dr Coulthard and colleagues has shown Fastball to be highly effective at picking up small, subtle changes in brain waves which occur when a person remembers an image. They have demonstrated that this response changes as a person develops dementia, offering hope as a breakthrough for early diagnosis.

Dementia is typically diagnosed too late, at a point at which the disease has damaged the brain beyond repair. This can be up to 20 years after dementia first started to develop. Current diagnosis often relies on a series of subjective questions to test a person’s memory, which is limited and can be impacted by a person’s education, language skills or nervousness.

Fastball, by contrast, is completely passive. This means the person doing the test does not need to understand the task or be aware of their memory response. Crucially, it is also portable, meaning that diagnoses in the future could be carried out anywhere, including in a patient’s home.

By testing more people earlier and more regularly, the team believes it could help lower the age of diagnosis by up to five years in the short-term and by more in the future. Recent findings from Alzheimer’s Research UK suggested that many people would want to know if they will develop Alzheimer’s in the future, even if they don’t yet have symptoms.

Through the new five-year NIHR project, the team will test Fastball on more than 1000 patients in a working dementia clinic at Southmead Hospital in Bristol. This represents the biggest study of any kind to use EEG to screen for Alzheimer’s disease with a goal to enrol a diverse patient population.

They will also work with Belfast-based commercial partners Cumulus Neuroscience Ltd to develop the technology into a product that can be rolled out wider across the NHS and beyond. It will use the existing Cumulus dry electrode 16-lead EEG headset that is UKCA marked and has FDA 510-K clearance.

Dr George Stothart, project co-lead and a cognitive neuroscientist based in the Department of Psychology at the University of Bath, said:

“Nearly all of us will know someone, or be caring for someone, with dementia. The costs to families, and to the NHS is enormous and is set to rise as our population ages. Yet, dementia is currently diagnosed too late – typically up to 20 years after the disease has first begun.

“Quicker, more accurate ways to diagnose dementia are greatly needed so that patients can get treatments earlier and families can plan better for the future, which is why we are so excited for the potential of Fastball EEG and the development of our work through this significant new funding and the collaborations it will enable.”

Dr Liz Coulthard, Associate Professor in Dementia Neurology at the University of Bristol and neurologist at North Bristol NHS Trust, added:

“Patients can wait a long time for diagnosis and some of our current tests can be inaccurate and sometimes stressful for them. A quick, easy-to-administer memory test, like Fastball, could transform a patient’s journey to diagnosis.

“As we adopt new treatments into clinical practice, we will need to scale-up our ability to diagnose people at an early stage of Alzheimer’s and avoid language barriers. Fastball offers the opportunity to improve Alzheimer’s diagnosis equitably.”