Esther Bron: "Ultimately, this research will contribute to a medicine against Alzheimer's"

Dr. Esther Bron, researcher at the Medical Delta Diagnostics 3.0 scientific program and at Erasmus MC (Radiology and Nuclear Medicine), is one of the two nominees for the Young Outstanding Researcher Award from Alzheimer Nederland in the category "The patient of tomorrow". In June she will hear whether she receives the personal prize worth € 100,000. The award is a talent prize for the most promising researcher in the field of dementia in the Netherlands.

The winner of the Young Outstanding Researcher Award is determined by a jury (75%) and by public votes (25%). You can vote via this link.

Esther Bron is researching computer models that help doctors better diagnose dementia. It now takes a long time before the correct diagnosis is made. Previous research shows that computer models are accurate, but this has only been researched in a simplified setting. In practice, it is much more complex to determine a diagnosis, due to different forms of dementia. Esthers mission is to optimize the computer models for hospital use. Not only can this make it possible to estimate more accurately and earlier whether a person is at an increased risk of developing a disease such as Alzheimer's - ultimately, this is also expected to accelerate research into a drug against Alzheimer's. We spoke to Esther about her nomination and about her research.

Congratulations on your nomination. Can you tell us more about your research?

Within the Medical Delta Diagnostics 3.0 scientific program, we research how we can detect dementia at the earliest possible stage with the aid of imaging techniques, such as MRI scans. We link images and data from large population studies to AI techniques. It is one of the most promising technologies to improve diagnoses, prognoses and choices for treatments.

I am researching the use of new computer models to help doctors make better diagnoses. Those computer models improve as more data is collected. But although developments are moving fast, much is still unclear. The existing models are far from answering all questions from doctors to be able to make the correct diagnosis, because we do not yet have a good picture of the various syndromes. We therefore miss an important link to apply this way of working widely in the clinic. With my research I try to fill this gap.

Why is it so important to detect dementia at an early stage?

First of all, it is important for the patient and his family to get the diagnosis early so that they can adjust to it and take measures. But my research mainly focuses on the patient of tomorrow. There is no cure for Alzheimer's yet. This is partly because test projects with medicines have not yet reached the finish line. Test results are expected to be much clearer when patients are involved who have Alzheimer's disease in its early stages.

The diagnosis of dementia is made interdisciplinary, so research must also be interdisciplinary.For the search for a medicine, it is therefore important to be able to detect the symptoms of Alzheimer's disease much earlier. MRI scans in combination with smart computer models can play a key role in this. Together with a group of scientists, I recently organized an international competition in which researchers were challenged to predict Alzheimer's on the basis of MRI scans with computer models. The results were promising, there is a lot of potential in that area.

What will this research ultimately mean for the doctor who makes the diagnosis?

I want to give doctors the tools to make better diagnoses and to explain to the patient what the disease will mean. This requires analyzing as much information as possible in smart models. Computer models already provide better diagnoses than doctors for some standard questions. However, individual cases are never standard. At this time, there isn’t enough data for the exceptions. We must therefore work with doctors to determine which important questions need to be answered for diagnoses, to unlock these data and to make good models.

Currently, doctors diagnose partly on their interpretation of what they see on an MRI scan. There is currently a change going on by using software (from Quantib - a spin-off of the Medical Delta program, ed.) to measure how brain tissue is lost. It’s a first step and already has an impact. Ultimately, we want to combine many measurements with computer models. Measurements such as protein measurements, test results and imaging data.

What is it like to work with different scientific disciplines?

I have always been at the crossroads between clinic and technology. I studied medical science at the VU, a multidisciplinary course that combines medical and technical research. Even then I wanted to be close to the application of science. As a result, I understand both the language of clinical and technical researchers. The complexity and magic of how our brains work attract me enormously. This also applies to imaging research.

Within the scientific program of Medical Delta we work together with all kinds of disciplines, which makes it challenging and interesting. It is also essential for our research, as different expertise is required. In addition to imaging research, so-called "biomarkers" and neurological tests are also necessary to be able to make a good diagnosis. Scientists from Erasmus MC, TU Delft and LUMC work closely together on this. The diagnosis of dementia is made interdisciplinary, so research must also be interdisciplinary.

Do you already know what you want to spend the price money on if you win?

We would very much like to expand the research by bringing together different computer models. The international competition showed that there is a lot to be gained there. The next step that is necessary, is to test the computer models on the data of patients with various diseases that cause dementia. The price money gives me the opportunity to speed up the research. In this way we can achieve a faster diagnosis, better testing options for medicines and, ultimately, a future without dementia.