Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA.
Alzheimers Dement. 2010 May;6(3):274-9. doi: 10.1016/j.jalz.2010.03.012.
Our objectives are to facilitate autopsy consent, brain collection, and perform standardized neuropathologic assessments of all Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who come to autopsy at the 58 ADNI sites in the USA and Canada.
Building on the expertise and resources of the existing Alzheimer's Disease Research Center (ADRC) at Washington University School of Medicine, St. Louis, MO, a Neuropathology Core (NPC) to serve ADNI was established with one new highly motivated research coordinator. The ADNI-NPC coordinator provides training materials and protocols to assist clinicians at ADNI sites in obtaining voluntary consent for brain autopsy in ADNI participants. Secondly, the ADNI-NPC maintains a central laboratory to provide uniform neuropathologic assessments using the operational criteria for the classification of AD and other pathologies defined by the National Alzheimer Coordinating Center (NACC). Thirdly, the ADNI-NPC maintains a state-of-the-art brain bank of ADNI-derived brain tissue to promote biomarker and multi-disciplinary clinicopathologic studies.
During the initial year of funding of the ADNI Neuropathology Core, there was notable improvement in the autopsy rate to 44.4%. In the most recent year of funding (September 1(st), 2008 to August 31(st) 2009), our autopsy rate improved to 71.5%. Although the overall numbers to date are small, these data demonstrate that the Neuropathology Core has established the administrative organization with the participating sites to harvest brains from ADNI participants who come to autopsy.
Within two years of operation, the Neuropathology Core has: (1) implemented a protocol to solicit permission for brain autopsy in ADNI participants at all 58 sites who die and (2) to send appropriate brain tissue from the decedents to the Neuropathology Core for a standardized, uniform, and state-of-the-art neuropathologic assessment. The benefit to ADNI of the implementation of the NPC is very clear. Prior to the establishment of the NPC in September 2007, there were 6 deaths but no autopsies in ADNI participants. Subsequent to the establishment of the Core there have been 17 deaths of ADNI participants and 10 autopsies. Hence, the autopsy rate has gone from 0% to 59%. The third major accomplishment is the detection of co-existent pathologies with AD in the autopsied cases. It is possible that these co-morbidities may contribute to any variance in ADNI data.
我们的目标是促进尸检同意、脑采集，并对所有来到美国和加拿大 58 个 ADNI 地点进行尸检的阿尔茨海默病神经影像学倡议（ADNI）参与者进行标准化神经病理学评估。
利用密苏里州圣路易斯华盛顿大学医学院现有的阿尔茨海默病研究中心（ADRC）的专业知识和资源，成立了一个新的神经病理学核心（NPC），为 ADNI 服务，该核心有一名新的积极性很高的研究协调员。ADNI-NPC 协调员提供培训材料和协议，以协助 ADNI 地点的临床医生获得 ADNI 参与者自愿同意进行脑尸检。其次，ADNI-NPC 维持一个中央实验室，使用国家阿尔茨海默病协调中心（NACC）定义的 AD 和其他病理学的分类操作标准进行统一的神经病理学评估。第三，ADNI-NPC 维持一个 ADNI 衍生脑组织的最先进的脑库，以促进生物标志物和多学科临床病理研究。
在 ADNI 神经病理学核心资助的初始一年中，尸检率显著提高到 44.4%。在最近一年的资助期间（2008 年 9 月 1 日至 2009 年 8 月 31 日），我们的尸检率提高到 71.5%。尽管迄今为止的总体数字很小，但这些数据表明，神经病理学核心已经与参与地点建立了行政组织，以从进行尸检的 ADNI 参与者中采集大脑。
在运营两年内，神经病理学核心已经：（1）在所有 58 个地点实施了一项协议，以征求 ADNI 参与者死后进行脑尸检的许可；（2）将适当的脑组织从死者送往神经病理学核心进行标准化、统一和最先进的神经病理学评估。NPC 的实施对 ADNI 非常有益。在 2007 年 9 月 NPC 成立之前，有 6 名 ADNI 参与者死亡但没有进行尸检。核心成立后，有 17 名 ADNI 参与者死亡，进行了 10 次尸检。因此，尸检率从 0%上升到 59%。第三个主要成就是在尸检病例中发现与 AD 共存的病理学。这些合并症可能会导致 ADNI 数据的任何差异。
