Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education (NCIRE), San Francisco, California, USA.
Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA.
Alzheimers Dement. 2024 Jan;20(1):652-694. doi: 10.1002/alz.13449. Epub 2023 Sep 12.
The Alzheimer's Disease Neuroimaging Initiative (ADNI) aims to improve Alzheimer's disease (AD) clinical trials. Since 2006, ADNI has shared clinical, neuroimaging, and cognitive data, and biofluid samples. We used conventional search methods to identify 1459 publications from 2021 to 2022 using ADNI data/samples and reviewed 291 impactful studies. This review details how ADNI studies improved disease progression understanding and clinical trial efficiency. Advances in subject selection, detection of treatment effects, harmonization, and modeling improved clinical trials and plasma biomarkers like phosphorylated tau showed promise for clinical use. Biomarkers of amyloid beta, tau, neurodegeneration, inflammation, and others were prognostic with individualized prediction algorithms available online. Studies supported the amyloid cascade, emphasized the importance of neuroinflammation, and detailed widespread heterogeneity in disease, linked to genetic and vascular risk, co-pathologies, sex, and resilience. Biological subtypes were consistently observed. Generalizability of ADNI results is limited by lack of cohort diversity, an issue ADNI-4 aims to address by enrolling a diverse cohort.
阿尔茨海默病神经影像学倡议 (ADNI) 旨在改善阿尔茨海默病 (AD) 的临床试验。自 2006 年以来,ADNI 已经共享了临床、神经影像学和认知数据以及生物流体样本。我们使用常规搜索方法,从 2021 年到 2022 年,利用 ADNI 数据/样本确定了 1459 篇出版物,并回顾了 291 项有影响力的研究。这篇综述详细介绍了 ADNI 研究如何改善疾病进展的理解和临床试验的效率。在受试者选择、治疗效果检测、协调和建模方面的进展提高了临床试验的水平,而磷酸化 tau 等血浆生物标志物显示出临床应用的前景。淀粉样蛋白 β、tau、神经退行性变、炎症和其他标志物具有预后价值,可通过在线提供的个体化预测算法获得。研究支持淀粉样蛋白级联假说,强调神经炎症的重要性,并详细描述了疾病的广泛异质性,与遗传和血管风险、共病、性别和韧性有关。生物亚型也得到了一致的观察。ADNI 结果的推广性受到队列多样性不足的限制,ADNI-4 旨在通过招募多样化的队列来解决这一问题。