A neuropsychologist with Warren roots is on the cusp of a potentially world-changing diagnostic test for people at risk of developing Alzheimer’s Disease, the incurable, degenerative brain disease that impacts more than 3 million Americans annually.

Dr. James Arruda, professor of psychology at the University of West Florida and a graduate of URI and Brown Medical School, remembers clearly the moment he hypothesized about a new way to test for possible biomarkers of Alzheimer’s.

“I was with my youngest son, Ethan, and we were having him tested for seafood allergies,” he recalled. “It dawned on me as I was there — this concept of challenging the body to see how it reacts, which is what they do with allergies. I kind of took that and ran with it and converted it into something that could be used to challenge the human visual luminance channel, which is what we measure.”

The test — developed by Arruda in partnership with California-based BIOPAC Systems Inc. — utilizes existing electroencephalography (EEG) technology to measure brain activity through electrodes placed on a patient’s head. A flash of light is administered to the area of the brain that processes visual stimuli, and the physician administering the test is then able to measure the amount of time it takes the brain to react to that stimuli. A second flash, administered shortly after the first, compounds the efficacy of this test.

If a person displays a significant delay in reacting to the light stimuli, the theory is that this may represent a sign that the person is at risk of developing dementia-related illnesses, such as Alzheimer’s.

Diagnosing Alzheimer’s earlier could change everything
The science at the root of the new test lies in the chemical acetylcholine, a neurotransmitter which is utilized by the central nervous system to activate muscles throughout the body. In patients with dementia and Alzheimer’s, the cells that produce acetylcholine begin to wither and die. Without ample acetylcholine production in the brain, its reaction to all different manner of stimuli — such as light — become slower and slower, resulting in the cognitive decline that Alzheimer’s is notorious for.

There is currently no cure for Alzheimer’s. Arruda said that although some clinical trials that have shown promise fighting the illness in animals, they have resulted in tragic results in human trials, including the death of some clinical patients.

“There are a number of different treatments that have been tried that haven’t really succeeded,” he said. “Some of that may be due to the fact that we’re actually getting to people quite late.”

Current tests for Alzheimer’s include the use of radioactive tracing materials to map the brain, or invasive spinal taps to test the cerebrospinal fluid, both of which are prohibitively expensive. Arruda’s test, however, could potentially be administered during the course of a normal doctor’s visit for people who want to be screened for possible warning signs of dementia as they age.

“You can’t just routinely puncture someone’s spinal canal or routinely give them radioactive tracers,” he said. “[This test] is cheaper, it’s less invasive, it’s readily accessible or will be readily accessible to more people. It would be used as kind of a screen or assessment in conjunction with other assessments to help out with differential diagnoses, but it could also be used annually or bi-annually to kind of keep an eye on someone because it is inexpensive, because it would be easy to administer and it wouldn’t pose any sort of health risks to the individual.”

Arruda believes that a non-invasive, quick (a test could take as few as five minutes) and inexpensive diagnostic test such as this would be a game changer in the neuropsychology world — whereas currently, Alzheimer’s is most often not caught until it is far too late to do anything but try to manage deteriorating symptoms.

“Early detection might even demonstrate to us that things as simple as exercising or modifications of behavior at critical periods might actually account for some variance [in outcomes among patients]. We just don’t know,” Arruda said. “The only thing we do know is the earlier we catch it…it’s got to be a better time to mitigate. It just has to be. That’s what we’re shooting for now.”

Clinical trials starting soon
The promise of Arruda’s test has resulted in an upcoming trial being conducted at Rhode Island Hospital through the Brown University Medical School’s Department of Psychology, where Arruda did post-doctorate work following receipt of his PhD from the University of Rhode Island.

The study will focus on 25 individuals who have been diagnosed with mild cognitive impairment, a middle ground between normal cognitive function and more developed stages of dementia. Another 25 healthy individuals will be utilized as a control group. Alzheimer’s patients will not be included in the study, as the goal is to assess the viability of the test on individuals whose cognitive function has not degraded to such a serious degree.

The study should commence by this June, and should be wrapped up by the end of the summer. Arruda said that, by then, they should be compiling data and assessing whether or not they have the answer they’re hoping to have. The next step, if that materializes, is to go for FDA approval of the test.

“If we ever got FDA approval, then it would just take off from there,” Arruda said.

Prior to his graduation from the University of Rhode Island, Arruda (son of the late Joseph and Shirley Arruda) spent the first 32 years of his life in Warren, where he attended Warren public schools and graduated from Warren High School.