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Articles
by
Arthur W. Toga |
Total Records (
3 ) for
Arthur W. Toga |
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John Q. Trojanowski
,
Hugo Vandeerstichele
,
Magdalena Korecka
,
Christopher M. Clark
,
Paul S. Aisen
,
Ronald C. Petersen
,
Kaj Blennow
,
Holly Soares
,
Adam Simon
,
Piotr Lewczuk
,
Robert Dean
,
Eric Siemers
,
William Z. Potter
,
Michael W. Weiner
,
Clifford R. Jack Jr.
,
William Jagust
,
Arthur W. Toga
,
Virginia M.-Y. Lee
and
Leslie M. Shaw
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Here, we review progress by the Penn Biomarker Core in the Alzheimer's Disease Neuroimaging Initiative (ADNI) toward developing a pathological cerebrospinal fluid (CSF) and plasma biomarker signature for mild Alzheimer's disease (AD) as well as a biomarker profile that predicts conversion of mild cognitive impairment (MCI) and/or normal control subjects to AD. The Penn Biomarker Core also collaborated with other ADNI Cores to integrate data across ADNI to temporally order changes in clinical measures, imaging data, and chemical biomarkers that serve as mileposts and predictors of the conversion of normal control to MCI as well as MCI to AD, and the progression of AD. Initial CSF studies by the ADNI Biomarker Core revealed a pathological CSF biomarker signature of AD defined by the combination of Aβ1-42 and total tau (T-tau) that effectively delineates mild AD in the large multisite prospective clinical investigation conducted in ADNI. This signature appears to predict conversion from MCI to AD. Data fusion efforts across ADNI Cores generated a model for the temporal ordering of AD biomarkers which suggests that Aβ amyloid biomarkers become abnormal first, followed by changes in neurodegenerative biomarkers (CSF tau, F-18 fluorodeoxyglucose-positron emission tomography, magnetic resonance imaging) with the onset of clinical symptoms. The timing of these changes varies in individual patients due to genetic and environmental factors that increase or decrease an individual's resilience in response to progressive accumulations of AD pathologies. Further studies in ADNI will refine this model and render the biomarkers studied in ADNI more applicable to routine diagnosis and to clinical trials of disease modifying therapies. |
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Paul S. Aisen
,
Ronald C. Petersen
,
Michael C. Donohue
,
Anthony Gamst
,
Rema Raman
,
Ronald G. Thomas
,
Sarah Walter
,
John Q. Trojanowski
,
Leslie M. Shaw
,
Laurel A. Beckett
,
Clifford R. Jack Jr.
,
William Jagust
,
Arthur W. Toga
,
Andrew J. Saykin
,
John C. Morris
,
Robert C. Green
and
Michael W. Weiner
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The Clinical Core of the Alzheimers Disease Neuroimaging Initiative (ADNI) has provided clinical, operational, and data management support to ADNI since its inception. This article reviews the activities and accomplishments of the core in support of ADNI aims. These include the enrollment and follow-up of more than 800 subjects in the three original cohorts: healthy controls, amnestic mild cognitive impairment (now referred to as late MCI, or LMCI), and mild Alzheimers disease (AD) in the first phase of ADNI (ADNI 1), with baseline longitudinal, clinical, and cognitive assessments. These data, when combined with genetic, neuroimaging, and cerebrospinal fluid measures, have provided important insights into the neurobiology of the AD spectrum. Furthermore, these data have facilitated the development of novel clinical trial designs. ADNI has recently been extended with funding from an NIH Grand Opportunities (GO) award, and the new ADNI GO phase has been launched; this includes the enrollment of a new cohort, called early MCI, with milder episodic memory impairment than the LMCI group. An application for a further 5 years of ADNI funding (ADNI 2) was recently submitted. This funding would support ongoing follow-up of the original ADNI 1 and ADNI GO cohorts, as well as additional recruitment into all categories. The resulting data would provide valuable data on the earliest stages of AD, and support the development of interventions in these critically important populations. |
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Arthur W. Toga
and
Karen L. Crawford
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The Alzheimers Diseases Neuroimaging Initiative project has brought together geographically distributed investigators, each collecting data on the progression of Alzheimers disease. The quantity and diversity of the imaging, clinical, cognitive, biochemical, and genetic data acquired and generated throughout the study necessitated sophisticated informatics systems to organize, manage, and disseminate data and results. We describe, here, a successful and comprehensive system that provides powerful mechanisms for processing, integrating, and disseminating these data not only to support the research needs of the investigators who make up the Alzheimers Diseases Neuroimaging Initiative cores, but also to provide widespread data access to the greater scientific community for the study of Alzheimers Disease. |
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