Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study
Introduction There is a need for early, non-invasive and inexpensive biomarkers for Alzheimer’s disease (AD), which could serve as a proxy measure in prevention and intervention trials that might eventually be suitable for mass screening. People with Down syndrome (DS) are the largest patient group...
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BMJ Publishing Group
2025-07-01
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| Online Access: | https://bmjopen.bmj.com/content/15/7/e098285.full |
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| author | Henrik Zetterberg Tunde Peto Imre Lengyel Kathryn Saunders Sarah Atkinson André Strydom Julie-Anne Little Elaine Murray Jamie Mitchell Aoife Mary Louise Hunter Lajos Csincsik |
| author_facet | Henrik Zetterberg Tunde Peto Imre Lengyel Kathryn Saunders Sarah Atkinson André Strydom Julie-Anne Little Elaine Murray Jamie Mitchell Aoife Mary Louise Hunter Lajos Csincsik |
| author_sort | Henrik Zetterberg |
| collection | DOAJ |
| description | Introduction There is a need for early, non-invasive and inexpensive biomarkers for Alzheimer’s disease (AD), which could serve as a proxy measure in prevention and intervention trials that might eventually be suitable for mass screening. People with Down syndrome (DS) are the largest patient group whose condition is associated with a genetically determined increased risk of AD. The REVEAL study aims to examine changes in the structure and function of the eye in individuals with DS compared with those with mild cognitive impairment (MCI) and cognitively healthy control (HC) individuals. REVEAL will also explore whether these changes are connected to inflammatory markers previously associated with AD.Methods and analysis The protocol describes a cross-sectional, non-interventional, single-centre study recruiting three cohorts, including (1) participants with DS (target n=50; age range, 6–60 years), (2) participants with MCI (target n=50; age range, 50–80 years) and (3) HC participants (target n=50; age range, 50–80 years). The primary research objective is to profile retinal, choroidal and lenticular status using a variety of eye imaging modalities and retinal functional testing to determine potential associations with cognitive status. The REVEAL study will also measure and compare established blood markers for AD and proteomic and transcriptomic marker profiles between DS, MCI and HC groups. Between-group differences will be assessed with an independent sample t-test and χ2 tests for normally distributed or binary measures, respectively. Multivariate regression analysis will be used to analyse parameters across all three cohorts. Data collection began in October 2023 and is expected to end in October 2025.Ethics and dissemination The study gained a favourable opinion from Health and Social Care Research Ethics Committee A (REC reference 22/NI/0158; approved on 2 December 2022; Amendment 22/0064 Amend 1, 5 April 2023; Amendment 22/0064 Amend 2; 23 May 2024; Amendment 22/0064 Amend 3; 25 June 2024; Amendment 22/0064 Amend 4; 16 January 2025; Amendment 22.0064 Amend 5; 9 May 2025; Amendment 22.0064 Amend 6; 9 June 2025). The study has also been reviewed and approved by the School of Biomedical Sciences Research Ethics Filter Committee within Ulster University. Findings from the REVEAL study will be presented to academic audiences at international conferences and peer-reviewed publications in targeted high-impact journals after data collection and analysis are complete. Dissemination activities will also include presentations at public events. |
| format | Article |
| id | doaj-art-453c4d050d0a48d9bc4b18f8715fbb85 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-453c4d050d0a48d9bc4b18f8715fbb852025-08-20T02:42:31ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-098285Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional studyHenrik Zetterberg0Tunde Peto1Imre Lengyel2Kathryn Saunders3Sarah Atkinson4André Strydom5Julie-Anne Little6Elaine Murray7Jamie Mitchell8Aoife Mary Louise Hunter9Lajos Csincsik10UCL Queen Square Institute of Neurology and UK Dementia Research Institute, University College London, London, UKCentre for Public Health, School of Medicine Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UKWellcome-Wolfson Institute for Experimental Medicine, QUB, Belfast, UKCentre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UKCentre for Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, UKInstitute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UKCentre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UKPersonalised Medical Centre, School of Medicine, Ulster University, Coleraine, UKThe Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UKCentre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UKCentre for Public Health, School of Medicine Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UKIntroduction There is a need for early, non-invasive and inexpensive biomarkers for Alzheimer’s disease (AD), which could serve as a proxy measure in prevention and intervention trials that might eventually be suitable for mass screening. People with Down syndrome (DS) are the largest patient group whose condition is associated with a genetically determined increased risk of AD. The REVEAL study aims to examine changes in the structure and function of the eye in individuals with DS compared with those with mild cognitive impairment (MCI) and cognitively healthy control (HC) individuals. REVEAL will also explore whether these changes are connected to inflammatory markers previously associated with AD.Methods and analysis The protocol describes a cross-sectional, non-interventional, single-centre study recruiting three cohorts, including (1) participants with DS (target n=50; age range, 6–60 years), (2) participants with MCI (target n=50; age range, 50–80 years) and (3) HC participants (target n=50; age range, 50–80 years). The primary research objective is to profile retinal, choroidal and lenticular status using a variety of eye imaging modalities and retinal functional testing to determine potential associations with cognitive status. The REVEAL study will also measure and compare established blood markers for AD and proteomic and transcriptomic marker profiles between DS, MCI and HC groups. Between-group differences will be assessed with an independent sample t-test and χ2 tests for normally distributed or binary measures, respectively. Multivariate regression analysis will be used to analyse parameters across all three cohorts. Data collection began in October 2023 and is expected to end in October 2025.Ethics and dissemination The study gained a favourable opinion from Health and Social Care Research Ethics Committee A (REC reference 22/NI/0158; approved on 2 December 2022; Amendment 22/0064 Amend 1, 5 April 2023; Amendment 22/0064 Amend 2; 23 May 2024; Amendment 22/0064 Amend 3; 25 June 2024; Amendment 22/0064 Amend 4; 16 January 2025; Amendment 22.0064 Amend 5; 9 May 2025; Amendment 22.0064 Amend 6; 9 June 2025). The study has also been reviewed and approved by the School of Biomedical Sciences Research Ethics Filter Committee within Ulster University. Findings from the REVEAL study will be presented to academic audiences at international conferences and peer-reviewed publications in targeted high-impact journals after data collection and analysis are complete. Dissemination activities will also include presentations at public events.https://bmjopen.bmj.com/content/15/7/e098285.full |
| spellingShingle | Henrik Zetterberg Tunde Peto Imre Lengyel Kathryn Saunders Sarah Atkinson André Strydom Julie-Anne Little Elaine Murray Jamie Mitchell Aoife Mary Louise Hunter Lajos Csincsik Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study BMJ Open |
| title | Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study |
| title_full | Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study |
| title_fullStr | Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study |
| title_full_unstemmed | Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study |
| title_short | Investigating the eye in Down syndrome as a window to Alzheimer’s disease: the REVEAL protocol – a clinical cross-sectional study |
| title_sort | investigating the eye in down syndrome as a window to alzheimer s disease the reveal protocol a clinical cross sectional study |
| url | https://bmjopen.bmj.com/content/15/7/e098285.full |
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