PROVIDENCE, R.I. (WPRI) — A study out of Rhode Island Hospital aims to use saliva as a way to help researchers identify early brain changes indicative of Alzheimer’s disease.

Rhode Island Hospital’s Alzheimer’s Disease and Memory Disorders Center is actively recruiting participants for its ExosomeAD study.

The center has been recruiting since last fall, but still needs more qualified candidates to enroll, according to Associate Director Dr. Jonathan Drake.

The study is a multi-year collaboration between researchers at Rhode Island Hospital and Brown University and is funded by a grant from Drs. Jill Kreiling and Peter Quesenberry from the National Institutes on Aging. Kreiling and Quesenberry conducted an initial study on traumatic brain injuries.

“When they were analyzing these exosomes and what it seemed that the brain was doing in the face of a traumatic brain injury, was, they noticed, that certain genes that we would ordinarily associate with Alzheimer’s disease seemed to be lighting up. It seemed to be active,” Drake said. “That gave them the idea that this test might be something that would be useful for Alzheimer’s, so they reached out to us about that.”

Drake said a small sample of people with normal cognitive functioning, mild cognitive impairment, and mild dementia due to Alzheimer’s were recruited.

“We found a pretty intriguing early signal that this test could tell the difference between those three groups of people,” he said.

From there, researchers applied for and were awarded a National Institutes of Health grant to conduct a larger study on this test.

“This is literally just collecting saliva, so it is about as non-invasive as it gets, compared to lumbar puncture or spinal tap that we need to typically, more historically, assess for Alzheimer’s changes in the brain, or expensive PET imaging,” Drake said.

Researchers said clues about the progression of Alzheimer’s could be measured in bodily fluids like saliva or blood.

“This is a novel use of this in the saliva,” Drake explained. “There’s a higher concentration of these exosomes coming from the brain in the saliva, and so we’re hoping to pick up a pretty strong signal.”

Several open and closed studies being conducted at Butler Hospital already utilize donations of blood or spinal fluids as part of their research on the disease.

Drake said testing will look for what the brain is responding to in real-time. He described exosomes as “packets of information” that can be intercepted from blood and saliva.

“What’s really powerful about that is you can potentially tell if the brain is responding to Alzheimer’s changes or other kinds of disease changes, even other neurodegenerative disorders,” he said. “So we have an opportunity, potentially, to get a general sense of the state of the brain and you know, beyond Alzheimer’s, even.”

Drake said this kind of testing could open a new door to diagnosing Alzheimer’s disease earlier in life.

“It’s tremendously difficult to actually diagnose Alzheimer’s disease,” he said. “It requires typically many years of following people clinically to see how their symptoms progress.”

Drake said for the most part, watching symptoms progress, along with cognitive testing and structural brain imaging, are the only ways to diagnose the disease.

“But those things really don’t get at the core of what matters most when diagnosing Alzheimer’s,” he added. “Are there specific changes happening in the brain?”

The center is seeking participants who are age 65 years or older. Healthy people both with and without memory and thinking challenges can participate in the study.

Participants will meet with research staff at Rhode Island Hospital one time per year for up to five years. During each annual visit, participants will be given cognitive tests and be asked to donate saliva and blood samples.

Drake said each annual visit involving cognitive testing and lab work is expected to last a few hours.

The study will enroll 150 people who have normal cognitive functioning, 50 people with mild cognitive impairment likely due to Alzheimer’s, and 35 people who have dementia due to Alzheimer’s, Lewy Body disease, Frontotemporal dementia, Parkinson’s disease, dementia or ALS, according to Drake.

Only participants with normal to mild cognitive functioning will be followed for the full five years. Drake said others will provide a one-time sample of saliva and blood.

“None of this stuff can be figured out if people don’t very graciously dedicate their time and their effort to participating in these studies,” he said. “It’s a huge deal to do that and there’s literally no way to figure any of this out if people don’t participate.”

To learn more about the ExosomeAD study, or if you are interested in enrolling, contact the the center by calling (401) 444-0085.