The Swedish BioFINDER 2 Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 2,950
- 试验地点
- 4
- 主要终点
- Clinical diagnosis
研究概览
简要总结
The Swedish BioFINDER 2 study is a new study that will launch in 2017 and extends the previous cohorts of BioFINDER 1 study (www.biofinder.se). BioFINDER 1 is used e.g. to characterize the role of beta-amyloid pathology in early diagnosis of Alzheimer's disease (AD) using amyloid-PET (18F-Flutemetamol) and Aβ analysis in cerebrospinal fluid samples. The BioFINDER 1 study has resulted in more than 40 publications during the last three years, many in high impact journals, and some the of the results have already had important implications for the diagnostic work-up patients with AD in the clinical routine practice.
The original BioFINDER 1 cohort started to include participants in 2008. Since then there has been a rapid development of biochemical and neuroimaging technologies which enable novel ways to the study biological processes involved in Alzheimer's disease in living people. There has also been a growing interest in the earliest stages of AD and other neurodegenerative diseases. With the advent of new tau-PET tracers there is now an opportunity to elucidate the role of tau pathology in the pathogenesis of AD and other tauopathies. The Swedish BioFINDER 2 study has been designed to complement the BioFINDER 1 study and to e.g. address issues regarding the role of tau pathology in different dementias and in preclinical stages of different dementia diseases. Further, the clinical assessments and MRI methods have been further optimized compared to BioFINDER 1. Detailed assessments of motor aspects and dual task performance, which is part of a sub-study named Motor-ACT: "Motor aspects and activities in relation to cognitive decline and brain pathologies, has been added to further optimize assessment of motor function.
详细描述
GENERAL AIMS:
- Develop methods for early and accurate diagnosis of different dementia disorders. This is important not only for the clinical diagnostic work-up, but also for selection of patients to clinical trials. Because dementia is very common among the elderly, but often misdiagnosed, we need to develop minimally invasive, reliable and affordable biomarkers for use in a primary care setting. This could include blood-based biomarkers which could be used to identify patients at high risk for a neurodegenerative disease. We also aim to develop new diagnostic algorithms using advanced imaging techniques and cerebrospinal fluid (CSF) biomarkers to diagnose patients prior to overt symptoms (when brain dysfunction is still limited and potentially reversible) in order to identify individuals more likely to respond to new disease-modifying therapies.
- Develop biomarkers and imaging techniques to monitor early effects of new disease-modifying therapies. Methods are needed that can reliably detect relevant changes in the turnover of Aβ, tau and α-synuclein. In the present study one focus will be to study the annual change in the retention of Tau PET ligands during both the prodromal and dementia stages of AD. Further, we need biomarkers that detect the intensity of ongoing synaptic/neuronal degeneration. Imaging methods revealing the functional and structural integrity of different brain networks might also be relevant.
- Investigate the heterogeneity of dementia and parkinsonian disorders to assist in the development of a new pathology-based disease classification. Current diagnostic work-up is based on symptomatology. However, the diseases (e.g. Alzheimer's and Parkinson's diseases) are heterogeneous with respect to clinical features and underlying pathologies. Moreover, there is also significant overlap between the diseases. Hence, today's symptom-based clinical diagnostic criteria are likely too crude to provide an etiologically meaningful classification of patients. We will therefore work towards a pathology-based disease classification, using in vivo biomarkers that reflect the underlying brain pathologies, e.g. Aβ or tau. This will be especially useful for the development of new disease-modifying therapies, which are aimed at specific brain pathologies.
- Define the temporal evolution of pathologies in the predementia phases of Alzheimer's disease. One of the last decade's paradigm shifts in neuroscience has been the realization that AD, and likely also other neurodegenerative diseases, starts with a prolonged predementia phase. AD even starts with an asymptomatic phase, when brain pathology is present in the absence of clinical symptoms. It has become clear that we need to better understand the temporal sequence of pathologic events in these disorders to be able to select the optimal disease stages for interventions in clinical trials with different disease-modifying therapies directed at specific pathologies.
- Investigate the underlying disease mechanisms of dementia disorders in humans aiming at finding new relevant drug targets. Drug discovery using the currently available cell and animal models, has not translated to human research as indicated by failed phase II and III trials. There are several possible reasons for these failures. First, it is possible that previous trials may have focused on the wrong drug targets, since findings from cell and animal models of dementias may not have accurately captured essential aspects of the disease mechanisms in humans. BioFINDER2 will be a translational study where we will attempt to bridge the knowledge gap between cell/animal studies and studies in humans, by using biomarkers that reflect biological mechanisms that may be studied across model systems. Second, another reason of the failed trials may be that they included patients in too advanced disease stages for the treatments to be effective, or that they partly included patients with unspecific diseases, since they did not use biomarker-based methods for inclusion of participants. BioFINDER2 will inform on the design of future clinical trials by providing detailed data about cognitive and functional changes over time in people with well-defined biomarker-characterized brain pathologies.
STUDY PLAN To reach the objectives above, we include well-characterized and clinically relevant populations of patients with dementia and/or parkinsonian symptoms and healthy individuals. We apply several state of the art methodologies in order to develop new brain imaging techniques, new biomarkers in blood and CSF as well as novel methods of assessing important clinical symptoms.
COGNITIVE TESTING Attention and executive function will be assessed with the Trail Making Test A and B (TMT), Symbol Digit Modalities Test (SDMT), and A Quick Test of cognitive speed (AQT). Visuospatial ability will be measured by two subtests from the Visual Objects and Space Perception (VOSP) battery, incomplete letters and cube analysis. Memory will be assessed with the Free and Cued Selective Reminding Test (FCSRT) in cohorts A and B. It will be complemented with the 10-word delayed recall test from ADAS-cog, including a recognition part. Verbal ability will be evaluated with the animal and letter S fluency tests and the 15-item short version of the Boston Naming Test. Global cognition will be assessed with the Mini-Mental State Examination (MMSE). In cohort A and B, a computerized cognitive battery focusing on memory and attention will also be performed.
ASSESSMENTS OF SYMPTOMS, FUNCTIONAL ABILITIES AND GLOBAL FUNCTION Cognitive symptoms. All subjects will rate his or her memory and attention/executive function in relation to others of the same age according the Brief Anosognosia Scale (BAS). We have also added similar questions to cover the other cognitive domains. These questions have been validated against neuropsychological testing but there are data indicating that self-reported cognitive complaints are only valid in a lesser degree of cognitive impairment. To assess a broader range of cognitive complaints, the Subjective Cognitive Decline questionnaire (SCD-q) will be administered to the research subjects. Subjects from cohorts C, D and E will be assessed with cognitive impairment questionnaire (CIMP-QUEST; filled out by an informant).
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •COHORT A: Cognitively healthy younger individuals (40-65 years of age) INCLUSION CRITERIA
- •Age 40-65 years
- •Absence of cognitive symptoms as assessed by a physician with special interest in cognitive disorders.
- •MMSE score 27-30 at screening visit.
- •Do not fulfill the criteria for MCI or any dementia according to DSM-V.
- •Speaks and understands Swedish to the extent that an interpreter is not necessary for the patient to fully understand the study information and cognitive tests.
排除标准
- •Significant unstable systemic illness or organ failure, such as terminal cancer, that makes it difficult to participate in the study.
- •Current significant alcohol or substance misuse.
- •Significant neurological or psychiatric illness.
- •Refusing lumbar puncture, MRI or PET.
- •COHORT B: Cognitively healthy elderly individuals (66-100 years of age) INCLUSION CRITERIA
- •Age 66-100 years
- •Absence of cognitive symptoms as assessed by a physician with special interest in cognitive disorders.
- •MMSE score 26-30 at screening visit.
- •Do not fulfill the criteria for MCI or any dementia according to DSM-V.
- •Speaks and understands Swedish to the extent that an interpreter is not necessary for the patient to fully understand the study information and cognitive tests.
- •EXCLUSION CRITERIA
- •Significant unstable systemic illness or organ failure, such as terminal cancer, that makes it difficult to participate in the study.
- •Current significant alcohol or substance misuse.
- •Significant neurological or psychiatric illness.
- •Refusing lumbar puncture, MRI or PET.
- •COHORT C: Subjective cognitive decline and mild cognitive impairment INCLUSION CRITERIA
- •Age 40-100 years.
- •Referred to the memory clinics due to cognitive symptoms experienced by the patient and/or informant. These symptoms do not have to be memory complaints, but could also be executive, visuospatial, language, praxis, psychomotor or social cognitive complaints.
- •MMSE score of 24 - 30 points.
- •Do not fulfill the criteria for any dementia (major neurocognitive disorder) according to DSM-V.
- •The medical doctor (after clinical assessments, cognitive testing, CSF analyses and structural brain imaging) believes the cognitive complaints are caused by an incipient neurocognitive disorder of any sort. This is defined as any case fulfilling the criteria above (i.e. both SCD and MCI) with an abnormal CSF Aβ42/40 ratio, which is strongly associated with brain Aβ pathology and prodromal Alzheimer's disease. Further, cases with MCI (=minor neurocognitive impairment) due to either Parkinson's disease, Lewy body disease, vascular neurocognitive disorder or frontotemporal dementia (please see Appendix below for clinical criteria and references) can also be included.
- •Speaks and understands Swedish to the extent that an interpreter is not necessary for the patient to fully understand the study information and cognitive tests.
- •EXCLUSION CRITERIA
- •Significant unstable systemic illness or organ failure, such as terminal cancer, that makes it difficult to participate in the study.
- •Current significant alcohol or substance misuse.
- •Refusing lumbar puncture, MRI or PET.
- •COHORT D: Dementia due to Alzheimer's disease INCLUSION CRITERIA
- •Age 40-100 years.
- •Referred to the memory clinics due to cognitive symptoms experienced by the patient and/or informant. These symptoms do not have to be memory complaints, but could also be executive, visuospatial, language, praxis or psychomotor complaints.
- •MMSE score of 12-26 points.
- •Fulfill the criteria for dementia (major neurocognitive disorder) due to Alzheimer's disease (DSM-V).
- •Speaks and understands Swedish to the extent that an interpreter was not necessary for the patient to fully understand the study information and cognitive tests.
- •EXCLUSION CRITERIA
- •Significant unstable systemic illness or organ failure, such as terminal cancer, that makes it difficult to participate in the study.
- •Current significant alcohol or substance misuse.
- •Refusing lumbar puncture, MRI or PET.
- •COHORT E: Other dementias INCLUSION CRITERIA
- •Age 40-100 years.
- •Fulfill the criteria for dementia (major neurocognitive disorder) due to FTD, PDD, DLB or subcortical VaD alternatively the criteria for PD, PSP, MSA, CBS or ALS.
- •Speaks and understands Swedish to the extent that an interpreter was not necessary for the patient to fully understand the study information and cognitive tests.
- •EXCLUSION CRITERIA
- •Significant unstable systemic illness or organ failure, such as terminal cancer, that makes it difficult to participate in the study.
- •Current significant alcohol or substance misuse.
- •Refusing lumbar puncture, MRI or PET.
研究组 & 干预措施
COHORT A: Cognitively healthy younger individuals (40-65 y)
We will recruit 300 cognitively healthy individuals from the Malmö Offspring study, which is an epidemiological study. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline.
An auxiliary cohort (termed "Cohort A2") of 40 healthy individuals aged 20-40 years of age will also be included.
干预措施: Flutemetamol F18 Injection (Diagnostic Test)
COHORT A: Cognitively healthy younger individuals (40-65 y)
We will recruit 300 cognitively healthy individuals from the Malmö Offspring study, which is an epidemiological study. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline.
An auxiliary cohort (termed "Cohort A2") of 40 healthy individuals aged 20-40 years of age will also be included.
干预措施: [18F]-RO6958948 (Diagnostic Test)
COHORT A: Cognitively healthy younger individuals (40-65 y)
We will recruit 300 cognitively healthy individuals from the Malmö Offspring study, which is an epidemiological study. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline.
An auxiliary cohort (termed "Cohort A2") of 40 healthy individuals aged 20-40 years of age will also be included.
干预措施: Elecsys (Roche) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT A: Cognitively healthy younger individuals (40-65 y)
We will recruit 300 cognitively healthy individuals from the Malmö Offspring study, which is an epidemiological study. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline.
An auxiliary cohort (termed "Cohort A2") of 40 healthy individuals aged 20-40 years of age will also be included.
干预措施: Lumipulse (Fujirebio) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT B: Cognitively healthy elderly individuals (66-100 y)
We will recruit 300 cognitively healthy individuals from the Malmö/Lund region, where we will aim to include as many individuals as possible that did participate in the Malmö Diet and Cancer study during the early 1990's. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE 4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline. Motor assessments (Motor-ACT) are performed at baseline and afte
干预措施: Flutemetamol F18 Injection (Diagnostic Test)
COHORT B: Cognitively healthy elderly individuals (66-100 y)
We will recruit 300 cognitively healthy individuals from the Malmö/Lund region, where we will aim to include as many individuals as possible that did participate in the Malmö Diet and Cancer study during the early 1990's. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE 4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline. Motor assessments (Motor-ACT) are performed at baseline and afte
干预措施: [18F]-RO6958948 (Diagnostic Test)
COHORT B: Cognitively healthy elderly individuals (66-100 y)
We will recruit 300 cognitively healthy individuals from the Malmö/Lund region, where we will aim to include as many individuals as possible that did participate in the Malmö Diet and Cancer study during the early 1990's. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE 4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline. Motor assessments (Motor-ACT) are performed at baseline and afte
干预措施: Elecsys (Roche) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT B: Cognitively healthy elderly individuals (66-100 y)
We will recruit 300 cognitively healthy individuals from the Malmö/Lund region, where we will aim to include as many individuals as possible that did participate in the Malmö Diet and Cancer study during the early 1990's. The participants will be stratified according to a) family history of dementia in first degree relatives (with onset before 80 years of age) and b) APOE 4 genotype; i.e. 25% will have no family history and no APOE 4 allele, 25% will have a family history and no APOE 4 allele, 25% will have no family history and at least one APOE 4 allele, 25% will have a family history and at least one APOE 4 allele.
FOLLOW-UP FOR 8 YEARS Every 2 years new clinical, cognitive, neurological, and psychiatric assessments will be performed as well as CSF/blood sampling.
MRI, Tau PET and Amyloid PET will be done every 4 years in all cases, and Tau PET and MRI every two years if the subject is amyloid positive at baseline. Motor assessments (Motor-ACT) are performed at baseline and afte
干预措施: Lumipulse (Fujirebio) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT C: SCD and MCI
>750 patients with either subjective cognitive decline (SCD) or mild cognitive impairment (MCI) will be recruited in a consecutive fashion from the Skåne University Hospital and Ängelholm Hospital. We will only include cases where the medical doctor believes that the cognitive symptoms are caused by an incipient neurocognitive disorder. For example, cases with evidence of brain amyloid pathology (i.e. an abnormal CSF Aβ42/40 ratio).
FOLLOW-UP FOR 6 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET, Amyloid PET and MRI will be done every 2 years. Motor assessment (Motor-ACT) at year 1, year 3 and year 5.
A auxiliary cohort ("Cohort C2") >150 cases with SCD/MCI where the doctor does not suspect incipient neurocognitive disorder, will undergo the same baseline investigations, but they will be followed up clinically only after 2, 4 and 8 y.
In total, 1000 patients with SCD or MCI will be included.
干预措施: Flutemetamol F18 Injection (Diagnostic Test)
COHORT C: SCD and MCI
>750 patients with either subjective cognitive decline (SCD) or mild cognitive impairment (MCI) will be recruited in a consecutive fashion from the Skåne University Hospital and Ängelholm Hospital. We will only include cases where the medical doctor believes that the cognitive symptoms are caused by an incipient neurocognitive disorder. For example, cases with evidence of brain amyloid pathology (i.e. an abnormal CSF Aβ42/40 ratio).
FOLLOW-UP FOR 6 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET, Amyloid PET and MRI will be done every 2 years. Motor assessment (Motor-ACT) at year 1, year 3 and year 5.
A auxiliary cohort ("Cohort C2") >150 cases with SCD/MCI where the doctor does not suspect incipient neurocognitive disorder, will undergo the same baseline investigations, but they will be followed up clinically only after 2, 4 and 8 y.
In total, 1000 patients with SCD or MCI will be included.
干预措施: [18F]-RO6958948 (Diagnostic Test)
COHORT C: SCD and MCI
>750 patients with either subjective cognitive decline (SCD) or mild cognitive impairment (MCI) will be recruited in a consecutive fashion from the Skåne University Hospital and Ängelholm Hospital. We will only include cases where the medical doctor believes that the cognitive symptoms are caused by an incipient neurocognitive disorder. For example, cases with evidence of brain amyloid pathology (i.e. an abnormal CSF Aβ42/40 ratio).
FOLLOW-UP FOR 6 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET, Amyloid PET and MRI will be done every 2 years. Motor assessment (Motor-ACT) at year 1, year 3 and year 5.
A auxiliary cohort ("Cohort C2") >150 cases with SCD/MCI where the doctor does not suspect incipient neurocognitive disorder, will undergo the same baseline investigations, but they will be followed up clinically only after 2, 4 and 8 y.
In total, 1000 patients with SCD or MCI will be included.
干预措施: Elecsys (Roche) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT C: SCD and MCI
>750 patients with either subjective cognitive decline (SCD) or mild cognitive impairment (MCI) will be recruited in a consecutive fashion from the Skåne University Hospital and Ängelholm Hospital. We will only include cases where the medical doctor believes that the cognitive symptoms are caused by an incipient neurocognitive disorder. For example, cases with evidence of brain amyloid pathology (i.e. an abnormal CSF Aβ42/40 ratio).
FOLLOW-UP FOR 6 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET, Amyloid PET and MRI will be done every 2 years. Motor assessment (Motor-ACT) at year 1, year 3 and year 5.
A auxiliary cohort ("Cohort C2") >150 cases with SCD/MCI where the doctor does not suspect incipient neurocognitive disorder, will undergo the same baseline investigations, but they will be followed up clinically only after 2, 4 and 8 y.
In total, 1000 patients with SCD or MCI will be included.
干预措施: Lumipulse (Fujirebio) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT D: Dementia due to Alzheimer's disease
400 patients with mild to moderate dementia due to Alzheimer's disease (AD) will be recruited from the Skåne University Hospital and Ängelholm Hospital in southern Sweden. We will include at least 50 cases aged 40-65 years of age, at least 200 cases aged 66-79 years of age and at least 50 cases aged 80-100 years of age.
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET and MRI will be done at baseline and after 2 years. Amyloid PET is performed at baseline for a subset of this group.
干预措施: [18F]-RO6958948 (Diagnostic Test)
COHORT D: Dementia due to Alzheimer's disease
400 patients with mild to moderate dementia due to Alzheimer's disease (AD) will be recruited from the Skåne University Hospital and Ängelholm Hospital in southern Sweden. We will include at least 50 cases aged 40-65 years of age, at least 200 cases aged 66-79 years of age and at least 50 cases aged 80-100 years of age.
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET and MRI will be done at baseline and after 2 years. Amyloid PET is performed at baseline for a subset of this group.
干预措施: Elecsys (Roche) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT D: Dementia due to Alzheimer's disease
400 patients with mild to moderate dementia due to Alzheimer's disease (AD) will be recruited from the Skåne University Hospital and Ängelholm Hospital in southern Sweden. We will include at least 50 cases aged 40-65 years of age, at least 200 cases aged 66-79 years of age and at least 50 cases aged 80-100 years of age.
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET and MRI will be done at baseline and after 2 years. Amyloid PET is performed at baseline for a subset of this group.
干预措施: Lumipulse (Fujirebio) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT E: Other dementias
Patients with primary neurodegenerative disorders other than Alzheimer's disease will be recruited:
- 160 cases with Frontotemporal dementia (FTD)-related disorders, including behavioral variant of FTD (bvFTD), Progressive nonfluent aphasia (PNFA), semantic dementia (SD), Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD).
- 50 cases with subcortical Vascular dementia (VaD).
- 200 cases with either Parkinson's disease (PD), Parkinson's disease with dementia (PDD), Dementia with Lewy Bodies (DLB), Multiple system atrophy (MSA).
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET (depends on further funding) and MRI will be done at baseline and after 2 years. No Amyloid PET in this group. Motor assessments (Motor-ACT) are performed at baseline and a 2-year follow-up since 7th Oct 2019.
干预措施: [18F]-RO6958948 (Diagnostic Test)
COHORT E: Other dementias
Patients with primary neurodegenerative disorders other than Alzheimer's disease will be recruited:
- 160 cases with Frontotemporal dementia (FTD)-related disorders, including behavioral variant of FTD (bvFTD), Progressive nonfluent aphasia (PNFA), semantic dementia (SD), Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD).
- 50 cases with subcortical Vascular dementia (VaD).
- 200 cases with either Parkinson's disease (PD), Parkinson's disease with dementia (PDD), Dementia with Lewy Bodies (DLB), Multiple system atrophy (MSA).
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET (depends on further funding) and MRI will be done at baseline and after 2 years. No Amyloid PET in this group. Motor assessments (Motor-ACT) are performed at baseline and a 2-year follow-up since 7th Oct 2019.
干预措施: Elecsys (Roche) Abeta42, Ttau and Ptau (Diagnostic Test)
COHORT E: Other dementias
Patients with primary neurodegenerative disorders other than Alzheimer's disease will be recruited:
- 160 cases with Frontotemporal dementia (FTD)-related disorders, including behavioral variant of FTD (bvFTD), Progressive nonfluent aphasia (PNFA), semantic dementia (SD), Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD).
- 50 cases with subcortical Vascular dementia (VaD).
- 200 cases with either Parkinson's disease (PD), Parkinson's disease with dementia (PDD), Dementia with Lewy Bodies (DLB), Multiple system atrophy (MSA).
FOLLOW-UP FOR 2 YEARS Every 12 months new clinical, cognitive, neurological, and psychiatric assessments will be performed.
CSF/blood sampling, Tau PET (depends on further funding) and MRI will be done at baseline and after 2 years. No Amyloid PET in this group. Motor assessments (Motor-ACT) are performed at baseline and a 2-year follow-up since 7th Oct 2019.
干预措施: Lumipulse (Fujirebio) Abeta42, Ttau and Ptau (Diagnostic Test)
结局指标
主要结局
Clinical diagnosis
时间窗: Clinical diagnosis at last 1 day visit
Clinical diagnosis according to consensus group decision blinded to the diagnostic test
Clinical Dementia Rating-Sum of Boxes (CDR-SB)
时间窗: Time zero equals the baseline visit. All subjects will subsequently attend follow-up visits every year for approximately 2-8 years after baseline.
Change in CDR-SB
次要结局
- Rate of cognitive decline as measured by MMSE.(Time zero equals the baseline visit. All subjects will subsequently attend follow-up visits every year for approximately 2-8 years after baseline.)
- Rate of cognitive decline as measured in ADL-function.(Time zero equals the baseline visit. All subjects will subsequently attend follow-up visits every year for approximately 2-8 years after baseline.)
- Rates of change on cerebrospinal fluid AD biomarkers(Time zero equals the baseline visit. All subjects will subsequently attend follow-up visits every year for approximately 2-8 years after baseline.)
- Rate of volume change of structural MRI measures and amyloid PET(Time zero equals the baseline visit. All subjects will subsequently attend follow-up visits every year for approximately 2-8 years after baseline.)
研究者
Erik Stomrud
M.D., PhD
Skane University Hospital