This project aims to make one of the most promising platforms for biomarkers of developing dementia widely accessible by making it affordable to services and acceptable to patients. A biomarker is a measure of a bodily function that can be used to make useful predictions about the body. The biomarker we are interested in is the **activity in brain networks**. We can "see" brain activity by measuring how much blood is going to an area. There are constant changes in activity happening across several areas of the brain at the same time. **In dementia, we see this healthy pattern shift to dementia patterns**. Such changes have been shown to predict the onset of dementia and get worse as dementia progresses, making it a **useful measurement when trying new drugs or treatments** to delay or slow down dementia progression. Measuring the activity of the brain has traditionally been done using a special type of magnetic resonance imaging (MRI), a medical scan that requires the patient to lie still for about 20 minutes in a tight, noisy, uncomfortable space - If the patient moves, the scan will be wasted. This is very difficult for patients with dementia. The scanners are also very expensive to buy and run, costing more than £1 million and requiring university graduate operators. These scans can harm patients with pacemakers. This means these scans have not been widely accessible. To make them more accessible, we will take another technology that can see brain activity called near-infrared spectroscopy (NIRS). It uses harmless infrared light, and can be done at home wearing a special headcap costing about £10,000, and operators can be trained much quicker than on MRI. We are already building a scanner that will have many features that are important for dementia, such as very high spatial resolution and it will be built to the standards to make it a medical device. But NIRS scanners need a good fit with the head, and a good fit can be uncomfortable or finicky to set up, squandering the comfort advantage NIRS could have over MRI. As we are still designing it, we can use this opportunity to speak to those who live with dementia, their carers and the professionals helping them to learn their needs to ensure it works reliably, comfortably and efficiently, and work together to build the headgear so it is dementia-suitable out of the box.

Suspected brain diseases are common, but challenging for ambulances. While most patients can go to standard hospitals, some need specialist surgery available at only 1 in 6 A&Es. Delayed treatment results in disability and death. The most common emergencies are stroke and head injuries. Finding those most at risk without scans is essentially impossible. Scans can only be done in hospitals using scanners the size of a car and the cost of a house. Patients who need specialist treatment are often transferred to the nearest non-specialist hospital first, then scanned, and then transferred to the specialist centre later, losing precious hours when minutes matter. A small, cheap and "smart" brain scanner would bring imaging into ambulances and save lives. We have developed a **scanner the size and cost of a defibrillator**, meaning it would be suitable as **standard ambulance equipment**. Our scanner can be small because it uses harmless (near-infrared) light. We believe our scanner will help paramedics to help stroke patients by diagnosing them at the roadside, and taking them straight to the right hospital, saving lives. In this project, we will develop our device further to detect strokes. We will: 1. Ensure our electronics are fine-tuned for 'seeing' stroke 2. Build the diagnostic artificial intelligence needed to enable the device to be used by people who are not trained to interpret medical imaging 3. Get data from healthy volunteers with as many different skin/hair colours as possible. This will help train our diagnostic artificial intelligence, and it will prevent the different light absorption of different skin/hair tones causing problems - meaning it works well for everyone Following this project, we will use this prototype to run a study with real patients. If successful, the scanner could start saving lives in the real world: stroke affects 100,000 patients a year in the UK alone. The impact is enormous: between 1 and 3 out of 4 working-age stroke survivors are unable to return to work, stroke results in relationship trouble in two thirds of survivors, and three quarters of stroke carers put the survivor's needs over their own. The total cost of stroke is around £27 billion per year in the UK alone. Our technology could allow more people to return to living a normal life after stroke.

Traumatic brain injury (TBI) is the most common cause of death and disability among children and young adults. Brain imaging is a prerequisite for effective and timely treatment of traumatic brain injury; however, current imaging equipment is expensive and non-portable and therefore is only available in hospitals. Furthermore, neurosurgical and neurocritical care services are centralised in specialist centres often far from the local hospital. This leads to delays in diagnosis, causing delays in definitive treatment, and ultimately increasing fatality and disability rates for patients. Cortirio will develop inexpensive, portable brain imaging to be used at the scene of the injury to enable faster treatment and triage, thereby reducing disability burdens and saving lives.