The 14th Cognitive Neuroscience and 4th Neurotechnology Congress was held with the theme 'A Multidisciplinary Approach to the Early Diagnosis of Dementia'.
At the 14th Cognitive Neuroscience and 4th Neurotechnology Congress, themed 'A Multidisciplinary Approach to the Early Diagnosis of Dementia', the latest developments playing a role in early diagnosis were discussed. Leading experts in neuroscience such as Prof. Oğuz Tanrıdağ, Prof. Sultan Tarlacı, and Prof. Barış Metin gave presentations throughout the day.
Psychiatrist Prof. Nevzat Tarhan, emphasizing the rapid development of brain imaging methods, said, “Those who miss out on neuroscience will historically fall behind. If someone interested in human behavior misses these developments, they will be left out of this rapid transformation.” Tarhan stated that confirming diagnosis in diseases with 90% accuracy has become possible by reading brain waves with artificial intelligence.
Organized by Üsküdar University this year with the main theme of 'A Multidisciplinary Approach to the Early Diagnosis of Dementia', the 14th Cognitive Neuroscience and 4th Neurotechnology Congress was held at Üsküdar University NP Health Campus Ibn-i Sina Auditorium. The congress, which discussed new discoveries revealing early signs of dementia and the latest developments in early diagnosis, brought together experts in the field.
Psychiatrist Prof. Nevzat Tarhan: “The way psychiatric illnesses are defined will fundamentally change in the coming years”
President of Üsküdar University, Chairman of the Board of NPİSTANBUL, and Psychiatrist Prof. Nevzat Tarhan stated that we are currently experiencing an artificial intelligence and digital revolution. Emphasizing that the industrial revolution led to a slower change, but the digital revolution brought about a much faster transformation, Prof. Tarhan said, “This rapid change also affects clinical areas and medical illnesses. Many neuropsychiatric diseases are being redefined.”
Reminding that the systems used to define diseases until now were mostly anatomically based, Prof. Tarhan said, “Diagnoses such as schizophrenia and dementia were largely approached through anatomical information. However, now not only anatomical connections but also functional connections have become measurable. Biomarkers have emerged, epigenetic effects can be measured, and changes in gene expression can be monitored. All these will fundamentally change the way psychiatric diseases are defined in the coming years. For example, instead of saying ‘schizophrenia,’ definitions can be made through connection disorders between the brain's amygdala and prefrontal region or between different regions.”
Prof. Tarhan: “Those who miss out on neuroscience will historically fall behind”
Noting that electromagnetic tomography stands out as a new brain imaging method today, Prof. Nevzat Tarhan said, “First X-ray-based tomography, then magnetic resonance imaging techniques developed. Now, electromagnetic tomography reveals electrical mappings in the brain. Thus, we have become able to measure the relationships between diseases and the brain's functional connections.”
Stating that all this indicates a serious paradigm shift in medicine, especially in psychiatry, Prof. Tarhan continued:
“Those who miss out on neuroscience will historically fall behind. If someone interested in human behavior misses these developments, they will be left out of this rapid transformation. One of the striking topics in psychiatry in recent years is the ‘Default Mode Network’. We also call this the ‘meaning network’; it is related to self-perception. Within this network, the structure called precuneus, located in the medial region of the parietal lobe, particularly stands out. The precuneus is seen to be directly related to self-perception. This is a very important and new piece of information.”
Tarhan: “We developed software that detects with nearly 90% accuracy”
Tarhan, stating that studies on consciousness also support this field, said, “When anesthesia is applied, the activity of this region is suppressed, and consciousness is lost. Therefore, it is understood that this region is directly related to consciousness. All these developments pave the way for new approaches in diagnosis and treatment processes. The ‘NP model’ we developed and patented is particularly important in this regard. We can evaluate diseases using the brain's electrical functions, electromagnetic waves, and artificial intelligence. For example, we have developed software that can detect obsessive-compulsive disorder (OCD) with nearly 90% accuracy by comparing it with the normal population, without even seeing the patient. Now, confirming diagnosis in diseases with 90% accuracy has become possible by reading brain waves with artificial intelligence. These studies are still ongoing. For this reason, we believe that everyone should learn and understand artificial intelligence.”
Prof. Tarhan: “Although artificial intelligence has become popular today, we started these studies years ago”
Noting that the importance given to this subject is not new, Prof. Nevzat Tarhan said, “We focused on this field starting from the 2008s. In 2017, we wanted to establish a laboratory for deep learning. We prepared a project within this scope. Initially, it received great interest; however, as the process progressed, it unexpectedly stopped. Later, a center named NÖROM was established in Ankara. Its content largely coincided with the project we prepared. Of course, it is gratifying that our state established such a center; but I would also like to state that the project idea belonged to us.”
Strong position in neurotechnology
Prof. Tarhan, also referring to the study prepared in 2019 under the title 'Computational Psychiatry', said, “We presented the study at the American Psychiatric Association Congress in 2020. The presentation was accepted and received great interest. It was even chosen as the presentation of the year. In 2021, this presentation was re-published online worldwide. Consider that even though artificial intelligence has become popular today, we started these studies years ago. At the point we have reached today, we have a strong position in the field of neurotechnology. Because the founding theme of our university is based on this: the convergence of neuroscience, genetics, health, engineering, and computer sciences. The Science and Idea Festival, which we started in 2013, was also part of this vision. At that time, there was no science festival in Turkey. We set out asking 'Why is there no science festival?' and started this event. This year, the 11th will be organized. Hundreds of high school students participate every year. The purpose of this festival was to support future scientists and potential Nobel candidates. Research shows that the human brain learns better in a fun and disciplined environment. We wanted to make science fun, and this approach received great interest.”
Prof. Tarhan: “Everything is now progressing computationally and mathematically based”
Prof. Nevzat Tarhan, emphasizing that the studies in this field will shape the medicine, neuroscience, and psychiatry of the future, said, “Everything is now progressing computationally and mathematically based. If the combination of mathematics and logic gave birth to the computer, the combination of mathematics and psychiatry gave birth to artificial intelligence.”
Noting that those working in this field were previously called ‘too imaginative’, Prof. Tarhan said, “However, today this perspective has largely changed. Those interested in neuroscience will better grasp the future. Therefore, I see everyone participating in this meeting as visionaries. I thank all participants who combined neurotechnology with cognitive neuroscience and everyone who contributed. Now, neurology is also questioning its classic approaches and transforming.”
Prof. Oğuz Tanrıdağ: “Early diagnosis in dementia is delayed diagnosis”
Prof. Oğuz Tanrıdağ, Head of the Neuroscience Department at Üsküdar University and Neurologist at NPİSTANBUL Hastanesi, who gave the first presentation of the congress on ‘The Concept of Early Diagnosis in Dementia’, said, “Early diagnosis in dementia is delayed diagnosis,” and stated that this concept is the product of experience and also a message.
Prof. Oğuz Tanrıdağ, emphasizing the need to first ask ‘why?’, continued:
“Dementia is generally a syndrome formed on a chronic basis. What is essential in a medical sense is the diagnosis of risk factors and pre-dementia disease stages. When we look at the common inner surface of the concept of dementia, it is seen to be a chronically progressive syndrome with four main characteristics: consciousness is preserved, there is cognitive impairment, there are personality and behavioral abnormalities, and there is impairment in daily living functions.
There is no such concept as acute dementia. If you encounter an acute syndrome resembling dementia, the first thing that should come to mind is delirium. Delirium comes up in psychiatry along with dementia and is a treatable and successful syndrome.
Factors determining the onset of dementia include: the duration factor, risk factors, neurodegeneration factors, and diseases with dementia potential. Every dementia has a formation period, specific risk factors, stages of neurodegeneration, and disease factors.
If we briefly review the factors we rely on when saying ‘early diagnosis in dementia is delayed diagnosis’: while usual risk factors include advanced age, stroke, trauma, infection, systemic diseases, and psychiatric factors, genetic factors have taken the top spot among risks in the last 30-40 years.”
Prof. Barış Metin: “Quantitative EEG in early diagnosis can reveal subtle changes not visible to the naked eye”
Prof. Barış Metin, Neurologist at Üsküdar University NPİSTANBUL Hastanesi, who gave a presentation within the scope of the congress, shared information on ‘EEG Biomarkers in the Early Diagnosis of Dementia’.
Prof. Barış Metin, reminding that EEG is actually a very old examination, said, “In recent years, EEG biomarkers for the early diagnosis of dementia have rapidly increased, especially with the strengthening of computational applications, computational neuroscience, and signal processing science, in parallel with the use of artificial intelligence and deep learning.”
Explaining why EEG is a good examination in dementia, Prof. Metin said:
“EEG is an easy-to-apply, non-invasive, and inexpensive examination. It also provides information about brain functions and can be repeated frequently without posing any risk. When the quantitative EEG method is used, brain oscillations are converted into numerical data, and statistical inferences, such as increased or decreased, can be made by comparing a person's oscillations or EEG indices with the normative values of the population. This method also significantly helps in solving concrete practical problems such as distinguishing dementia from depression.
In early diagnosis, quantitative EEG can reveal subtle changes not visible to the naked eye. Although EEG is usually analyzed visually, the quantitative method allows us to detect early differences. Since it is inexpensive and easy to apply, it can be applied to large populations as a screening test. Many EEG recordings can be made during patient follow-up. Thus, dementia-specific findings and the progression of the initial state can be monitored.
The most basic EEG findings of dementia are; an increase in slow waves (theta, delta) and a decrease in fast waves (alpha, beta). This is called spectral shift. This condition can also be observed in individuals at high risk, where dementia has not yet clinically appeared. With quantitative EEG, this picture is frequently seen; the spectral power of delta and theta waves is increased, and the spectral power of alpha and beta waves is decreased.”
Prof. Sultan Tarlacı: “LORETA converts the EEG signal into a three-dimensional brain structure, allowing the identification of the brain region from which the signal originates”
Prof. Sultan Tarlacı, Neurologist at Üsküdar University NPİSTANBUL Hastanesi, who delivered a presentation titled ‘Low Resolution Brain Electromagnetic Tomography (LORETA) in the Early Diagnosis of Alzheimer's Disease’, noted that although EEG has a history spanning over a century, the information we perceive increasingly grows as software develops and signal analysis methods advance.
Stating that low-resolution electromagnetic tomography is relatively new, Prof. Tarlacı said, “A classical EEG provides high temporal resolution. However, for many years, the primary source of the recorded electrical activity was unknown. EEG recordings capture the electrical activity of many pyramidal neurons in the cortex. By increasing the number of electrodes, it is possible to see the correspondence of specific brain lobes or regions; for example, insights can be gained about regions such as the anterior and posterior parts of the frontal lobe, the anterior and posterior parts of the temporal lobe, or the midline. But relating this signal to the deep structures and functional anatomy of the brain has been difficult for a long time.”
Prof. Tarlacı, stating that this problem was overcome with the LORETA method developed in 1996, touched upon the following points in his speech:
“LORETA functions like a low-resolution magnetic tomography using mathematical algorithms and advanced computations, enabling us to understand the electrical activity in the depths of the brain.
Under normal conditions, the EEG signal spreads over a flat brain surface. However, the skull and brain are not flat structures; they have an ellipsoidal, three-dimensional structure. The LORETA technique converts the signal from a two-dimensional structure to a three-dimensional brain structure. This allows for the identification of the anatomical region in the brain's depths from which the incoming signal originates, and the relevant brain area can be determined via alpha, beta, gamma, delta, and theta bands.
The main feature of LORETA is to place the electrical signal onto structural anatomy and derive function from it. It is a three-stage method.
The obtained information is also consistent with data from functional MRI. With LORETA, the source of the signal and which structure functions differently, as well as which functions are lost, can be understood. Since our topic is dementia, certain networks are directly related to dementia. For example, language networks, hippocampus, entorhinal cortex, and amygdaloid nucleus are related to memory and emotion. By combining the sources of the signal with structural anatomy, functional loss can be observed with LORETA.
The problem of early diagnosis is always important; it is necessary to catch the prodromal stage.”
Experts in the field gave presentations!
Later in the congress, NPİSTANBUL Hastanesi Clinical Neuropsychologist İnci Birincioğlu presented on “Neuropsychological Assessment Tests in the Early Diagnosis of Dementia”, NPİSTANBUL Hastanesi Radiology Specialist Dr. Necati Alp Tabak on “Early Radiological Findings in Dementia”, NPİSTANBUL Hastanesi Medical Genetics Specialist Assoc. Prof. Yeşim Özdemir on “On the Road from Forgetfulness to Dementia: Genetic and Mitochondrial Indicators in Early Diagnosis”, Prof. Erdinç Dursun on “Blood Biomarkers and Their Conditions of Use in Dementia”, Prof. Duygu Gezen Ak on “Cerebrospinal Fluid Biomarkers in Dementia”, Asst. Prof. Onur Erdem Şahin on “Nuclear Medicine in Dementia Diagnosis: Clinical Importance of Imaging with Fdg-Pet”, Assoc. Prof. Özgül Ekmekçioğlu on “Nuclear Medicine in Dementia Diagnosis: Other Molecular Imaging Methods”, Prof. Lütfü Hanoğlu on “Approach to Biological Early Diagnosis in Light of Newly Developing Disease-Modifying Treatments”, NPİSTANBUL Hastanesi Neurologist Dr. Celal Şalçini on “Neuromodulation Applications in Dementia”, Üsküdar University Organizing Committee Secretary Dr. Psych. Shams Farhad on “Functional Brain Connectivity in Amnestic Mild Cognitive Impairment (aMCI)” and Exp. Eng. Sahar Taghizadeh Makouei on “Artificial Intelligence Applications in the Early Diagnosis of Dementia”.
Group photo was taken
Certificates of appreciation were presented to the speakers who contributed to the congress with their presentations, and a group photo was taken.