Research drives scientific progress. At Johns Hopkins and at institutions across the nation, dedicated scientists are uncovering knowledge and insights that lead to critical and lifesaving treatments and technologies. In the series “Research Matters,” we highlight groundbreaking research and the committed scientists making it happen at Johns Hopkins Biomedical Engineering.
Many brain disorders are nearly impossible to diagnose until symptoms become apparent, making early intervention a challenge. But groundbreaking research funded by the National Institutes of Health and led by Michael I. Miller, director of the Johns Hopkins Department of Biomedical Engineering, is ushering in a new era for diagnosing and treating these debilitating conditions years before symptoms surface.
Throughout his trailblazing career, Miller has transformed our understanding of neurological diseases that impact millions of Americans and their families, including Alzheimer’s, Huntington’s, dementia, schizophrenia, and epilepsy.
Miller’s current work focuses on early diagnostic and therapeutic approaches (theranostics) using computational methods to link precise diagnostic techniques with targeted therapies in the temporal lobe regions of the brain involved in Alzheimer’s disease. Researchers in his lab use an enhanced form of magnetic resonance imaging (MRI) and molecular markers to map how the brain’s structure and function change over the course of disease progression. They look at how these changes relate to known hallmarks of Alzheimer’s disease, such as amyloid plaques and Tau tangles in the brain.
To conduct his work, Miller uses real patient data from the NIH-funded BIOCARD project, one of the largest Alzheimer’s studies in the world led by Marilyn Albert, a professor of neurology at Johns Hopkins School of Medicine. More recently, and in collaboration with Meaghan Morris, a Johns Hopkins assistant professor of pathology and neuropathology, Miller is using such patient data to investigate changes in gene expression associated with Alzheimer’s. Their discoveries are setting the stage for early detection, disease monitoring, and personalized treatment.
“We are finding more and more evidence that Alzheimer’s is possible to detect early, during a window when treatments may be more effective,” Miller says. “We believe that such insights will guide the development of preventive treatments that target these subtle brain changes rather than merely addressing the symptoms.”
Miller’s work contributed to shaping the NIH’s 2011 diagnostic criteria for Alzheimer’s disease and demonstrated MRI’s potential as a powerful and noninvasive tool for early detection. In a landmark 2014 NIH study, Miller and collaborators were the first to prove that MRI scans can detect changes in the brain—specifically in the medial temporal lobe—that are linked to Alzheimer’s. They showed that these changes can be seen more than 10 years before people start showing symptoms.