Researchers from Nanyang Technological University, Singapore, have identified a subtle but potentially powerful early warning sign of Alzheimer’s disease: clogged brain “drains” that can be detected on routine MRI scans. These structures, known as enlarged perivascular spaces, are part of the brain’s waste-removal system. When they become blocked, toxic proteins linked to Alzheimer’s – such as beta amyloid and tau – are less efficiently cleared.
In a study of nearly 1,000 participants in Singapore, including individuals with normal cognition and those with mild cognitive impairment (MCI), the team found that enlarged perivascular spaces were significantly more common in people with early cognitive decline. Importantly, these clogged drainage pathways showed strong associations with Alzheimer’s-related blood biomarkers, in some cases even stronger than traditional MRI markers like white matter damage. The findings are notable because the study focused on Asian populations, which have been underrepresented in Alzheimer’s research. Genetic risk profiles and disease patterns can differ across ethnic groups, meaning results from Western cohorts may not always translate globally. By examining a diverse Asian cohort, the study strengthens the relevance of these markers for broader clinical use.
Because enlarged perivascular spaces are already visible on standard MRI scans, they could complement existing diagnostic approaches without requiring costly new tests. Detecting Alzheimer’s risk earlier could give clinicians a crucial window to intervene before irreversible brain damage occurs. The researchers plan to follow participants over time to see whether these MRI findings reliably predict progression to Alzheimer’s dementia. If confirmed, clogged brain drains may become a routine, accessible tool for spotting the disease at its earliest stages – before symptoms fully take hold.
Research article: A hidden brain problem may be an early warning for Alzheimer’s
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