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A Biomarker Combining Imaging and Neuropsychological Assessment for Tracking Early Alzheimer's Disease in Clinical Trials.
- Source :
-
Current Alzheimer research [Curr Alzheimer Res] 2018 Mar 14; Vol. 15 (5), pp. 429-442. - Publication Year :
- 2018
-
Abstract
- Background: Combining optimized cognitive (Alzheimer's Disease Assessment Scale- Cognitive subscale, ADAS-Cog) and atrophy markers of Alzheimer's disease for tracking progression in clinical trials may provide greater sensitivity than currently used methods, which have yielded negative results in multiple recent trials. Furthermore, it is critical to clarify the relationship among the subcomponents yielded by cognitive and imaging testing, to address the symptomatic and anatomical variability of Alzheimer's disease.<br />Method: Using latent variable analysis, we thoroughly investigated the relationship between cognitive impairment, as assessed on the ADAS-Cog, and cerebral atrophy. A biomarker was developed for Alzheimer's clinical trials that combines cognitive and atrophy markers.<br />Results: Atrophy within specific brain regions was found to be closely related with impairment in cognitive domains of memory, language, and praxis. The proposed biomarker showed significantly better sensitivity in tracking progression of cognitive impairment than the ADAS-Cog in simulated trials and a real world problem. The biomarker also improved the selection of MCI patients (78.8±4.9% specificity at 80% sensitivity) that will evolve to Alzheimer's disease for clinical trials.<br />Conclusion: The proposed biomarker provides a boost to the efficacy of clinical trials focused in the mild cognitive impairment (MCI) stage by significantly improving the sensitivity to detect treatment effects and improving the selection of MCI patients that will evolve to Alzheimer's disease.<br /> (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)
- Subjects :
- Aged, 80 and over
Alzheimer Disease physiopathology
Atrophy
Biomarkers
Brain pathology
Cognitive Dysfunction physiopathology
Computer Simulation
Disease Progression
Female
Humans
Image Interpretation, Computer-Assisted methods
Latent Class Analysis
Male
Neuropsychological Tests
Pattern Recognition, Automated
Sensitivity and Specificity
Alzheimer Disease diagnosis
Brain diagnostic imaging
Clinical Trials as Topic
Cognitive Dysfunction diagnosis
Magnetic Resonance Imaging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1875-5828
- Volume :
- 15
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Current Alzheimer research
- Publication Type :
- Academic Journal
- Accession number :
- 29110613
- Full Text :
- https://doi.org/10.2174/1567205014666171106150309