Alzheimer's Disease Neuroimaging Initiative: Assessing Disease Progression

The Alzheimer’s Disease Neuroimaging Initiative (ADNI) is a public-private research partnership organized by the National Institute on Aging/National Institutes of Health.  This study observes and tracks longitudinal changes in neuropsychological/clinical measures, neuroimaging (MRI, FDG-PET, amyloid-imaging PET) measures, and fluid (blood, urine, CSF) biomarkers in cognitively normal older individuals, in people with MCI (mild cognitive impairment), a condition which often precedes Alzheimer’s disease, and in people with mild Alzheimer’s disease.  ADNI was developed out of the need for biological measures that would be able to track disease progression in the brain from mild to moderate Alzheimer’s disease (AD) and from MCI to AD.  It is generally acknowledged that the clinical and neuropsychological measures currently in use are not able to distinguish a symptomatic effect from a disease modifying one, whereas validated imaging and fluid biomarkers may be able to do so. The major goal of ADNI is to identify the best biomarkers or combinations of biomarkers for following disease progression and monitoring treatment response in clinical trials.  This will hopefully provide a means to evaluate therapies for their potential disease modifying effects. ADNI will also provide information about the earliest changes in the brain which eventually lead to MCI and AD and the timing of these changes. Finally, ADNI is determining the optimum methods for acquiring, processing, and distributing images and biomarkers in conjunction with clinical and neuropsychological data in a multi-site context.  All of the ADNI data are available on a public database.  Thus, ADNI is expected to improve the understanding of disease progression as assessed by various combinations of these measures and consequently provide validated biomarkers and eventually surrogate markers to allow faster and more efficient evaluation of potential therapies in clinical trials for Alzheimer’s disease.  This presentation will involve the following aspects: description of the ADNI study; ADNI as a public/private partnership and role of the various partners; update on progress in ADNI; and an understanding of how ADNI will help facilitate clinical trials for Alzheimer’s disease.