Alzheimer Research Forum releases overview of Alzheimer’s Disease
The Alzheimer Research Forum (Alzforum), an authoritative Web
resource, is releasing a six-part series on the Alzheimer’s Disease
Neuroimaging Initiative (ADNI), the largest study ever to fill a central
knowledge gap in the Alzheimer disease field.
Announced in October 2004 and set to run until 2010, the ADNI is a
public-private consortium that has engaged 58 research centers in the US
and Canada in a massive effort to follow 819 research volunteers for
three years. Beginning this week, the Alzforum reports on the first
waves of much-awaited data generated by the study, and also takes
readers behind the scenes for a look at the challenges that had to be
overcome in getting so many groups to work together effectively.
ADNI set out to identify biological markers that can reliably
foretell whether a still-healthy person is on the way to developing
full-blown Alzheimer disease. Such markers are essential in order to
test — and some day prescribe — treatments to slow down or prevent the
Objective and quantitative ways to measure how quickly a person
progresses with AD will enable future drug trials to be smaller and
faster, and thereby attract investors who now shy away from AD drug
development because its trials have a reputation of being costly and
prone to failure.
The need for such markers is so universally acknowledged across
academia and industry and at the FDA that both academic and industry
leaders have set aside their usual competition around this goal.
Funded to the tune of US$64 million — $40 million from the National
Institute on Aging, and $24 million to date from a consortium of
pharmaceutical companies and private foundations — ADNI is a massive and
complex five-year study.
The 58 participating research centers all conduct the same long list
of tests in 819 people in exactly the same way, and upload all the
information into a database that is freely accessible to qualified
scientists around the world for analysis.
All academics studying neurodegeneration and every company developing
AD drugs around the world can use the integrated database of ADNI
results for their purposes. At this level, ADNI data are not subject to
embargoes, journal subscription, or even peer review. Those factors
apply later, as investigators from within and outside ADNI publish their
own analyses of ADNI data in scientific journals.
For their part, the research volunteers made a big commitment. They
undergo a range of tests over the course of several days at each 6-month
visit — extensive clinical, neuropsychological tests, different kinds of
brain imaging, blood test and even a spinal tap to look for telltale
signs of impending AD in the cerebrospinal fluid.
The key to the success or failure of this huge, shared effort is
standardization. Only if all research centers do things in exactly the
same ways will they produce a large dataset that can speak with
This is critical because at present, at least a dozen highly regarded
labs have promising results on potential AD imaging and biochemical
markers. However, each study, even if well performed within its scope
and institution, has used small groups of different patients and done
their work differently enough to make it impossible to compare the
results and decide which candidate markers are indeed the best.
One of ADNI’s express goals is to vet candidate markers and imaging
methods side by side so the best may ‘win’ and go on to modernize
clinical drug trials. In essence, ADNI aims to speak with a loud voice
over the cacophony of present-day research studies, and in this way to
facilitate a consensus on biomarkers among scientists and federal
ADNI represents the latest example in a movement to standardize and
to unify that has been gradually building in US Alzheimer science in the
past decade (Other such examples are the NACC and the ADCS). It also has
inspired similar studies in Japan, Europe, China, and Australia.
In its six-part report, the Alzforum describes how ADNI evolved from
its origins in 2004 and is beginning to produce results. The Alzforum
series delves into how well the standardization and co-ordination among
all the participating groups has gone, and what the actual scientific
The series is available at:
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