The Alzheimer's Disease Neuroimaging Initiative

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Alzheimer's disease: the way to an effective treatment

With increasing life expectancy in developed countries, diseases typically associated with old age are becoming more frequent and, thus, increasingly gain in socioeconomic importance. Age is a major risk factor for almost all neurodegenerative diseases, in particular dementia. Currently, more than 4 million people in the United States suffer from dementia, the majority of them from Alzheimer's disease (AD). The cost of dementia to the United States economy is now well over $100 billion per

Assessment of treatment efficacy in Alzheimer's disease trials

Currently, treatment trials in AD use neuropsychologic measures (eg, the Alzheimer's Disease Assessment Scale–cognitive subscale [ADAS Cog]) [16] as the primary outcome measure. Measures of cognitive impairment and disability unquestionably reflect meaningful aspects of AD but they also suffer from several limitations. One major problem is their poor test-retest reliability (intraclass correlation coefficients approximately 0.5–0.8). This probably reflects the influence on performance of

Neuroimaging outcome measures for Alzheimer's disease and mild cognitive impairment trials

The use of structural MR imaging and [18F]-2-fluoro-2-deoxy-d-glucose (FDG) positron emmission tomography (PET) in trials for AD and MCI can complement the information gained from clinical measures in several important aspects. First, neuroimaging has a higher test-retest reliability than cognitive measures (eg, interclass correlation coefficient [ICC] greater than 0.95 for hippocampal volume [17]) and, thus, greatly increases the power to detect longitudinal change and treatment effects.

Biomarkers as outcome measures for Alzheimer's disease and mild cognitive impairment trials

Over the past years, several biomarkers in blood and CSF associated with an increased risk for AD have been identified (eg, the 42 amino acid form of β-amyloid proteins [reduced in AD], phosphorylated tau proteins [increased in AD], cytokines and glial fibrillary acidic proteins [markers of inflammation, increased in AD], isoprostanes and 3-nitrotyrosine [markers of oxidative stress, increased in AD], and sulfatides [marker for disordered lipid metabolism, decreased in AD]). Although some of

Conclusions

With increasing age, the incidence and, thus, socioeconomic impact of AD are growing. Increasing knowledge about the pathophysiologic mechanisms leading to AD has led to the development of promising AD treatments. The translation of these new drugs into clinical treatment advances only slowly, however, because the clinical trials necessary to assess the efficacy of these treatments require large patient samples and lengthy observation times. There is growing evidence that neuroimaging measures

Alzheimer' Disease Neuroimaging Initiative

The ADNI is funded by the National Institute on Aging and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH), several pharmaceutical companies (Pfizer, Wyeth, Eli Lilly, Merck, GlaxoSmithKline, AstraZeneca, Novartis, Eisai, Elan, Forest Laboratories, Bristol Meyers Squibb), and foundations (Alzheimers Association, Institute for Study of Aging) in conjunction with the NIH Foundation (Fig. 1). This initiative encompasses clinical

Current state of the Alzheimer' Disease Neuroimaging Initiative

At the time of writing this article (April 2005), the ADNI-CC has recruited a network of more than 50 clinical study sites (Fig. 4). The majority of these also participate in Alzheimer's Disease Cooperative Study treatment trials and many were involved in a recent treatment study of MCI. The final clinical protocol is established and the informed consent form distributed for approval by the local IRBs. The final decision on the MR imaging sequences to be used in the ADNI will be made in May

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    This article was supported by grant ADNI UO1 AG024904-01.

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