Structural Brain Magnetic Resonance Imaging to Rule Out Comorbid Pathology in the Assessment of Alzheimer’s Disease Dementia: Findings from the Ontario Neurodegenerative Disease Research Initiative (ONDRI) Study and Clinical Trials Over the Past 10 Years
| Autor: | Sara Mitchell, Fuqiang Gao, Tarek K. Rajji, Michael Borrie, Robert Bartha, Morris Freedman, Christopher J.M. Scott, Joel Ramirez, Sean P. Symons, Maria Carmela Tartaglia, Ondri Investigators, Corinne E. Fischer, Bruce G. Pollock, Michael Uri Wolf, Miracle Ozzoude, David F. Tang-Wai, Sanjeev Kumar, Richard H. Swartz, Dallas Seitz, Stephen H. Pasternak, Sandra E. Black, Gary Naglie, Nathan Herrmann, Elizabeth Finger, Andrew Frank, Arunima Kapoor, Jennifer Mandzia, William E. Reichman, Mario Masellis, Nicolaas Paul L.G. Verhoeff |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male Pathology medicine.medical_specialty Neuroimaging Disease Comorbidity Cohort Studies Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Alzheimer Disease Medicine Dementia Humans Brain magnetic resonance imaging Cognitive Dysfunction Aged Aged 80 and over Ontario Clinical Trials as Topic business.industry General Neuroscience Incidence (epidemiology) Dementia Vascular Incidence Brain Neurodegenerative Diseases General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Clinical trial Psychiatry and Mental health Clinical Psychology 030104 developmental biology Cohort Medical Biophysics Observational study Female Geriatrics and Gerontology business Tomography X-Ray Computed 030217 neurology & neurosurgery Research Article |
| Zdroj: | Journal of Alzheimer's Disease Medical Biophysics Publications |
| ISSN: | 1875-8908 1387-2877 |
| Popis: | Background/Objective: Structural brain magnetic resonance imaging (MRI) is not mandatory in Alzheimer's disease (AD) research or clinical guidelines. We aimed to explore the use of structural brain MRI in AD/mild cognitive impairment (MCI) trials over the past 10 years and determine the frequency with which inclusion of standardized structural MRI acquisitions detects comorbid vascular and non-vascular pathologies. Methods: We systematically searched ClinicalTrials.gov for AD clinical trials to determine their neuroimaging criteria and then used data from an AD/MCI cohort who underwent standardized MRI protocols, to determine type and incidence of clinically relevant comorbid pathologies. Results: Of 210 AD clinical trials, 105 (50%) included structural brain imaging in their eligibility criteria. Only 58 (27.6%) required MRI. 16,479 of 53,755 (30.7%) AD participants were in trials requiring MRI. In the observational AD/MCI cohort, 141 patients met clinical criteria; 22 (15.6%) had relevant MRI findings, of which 15 (10.6%) were exclusionary for the study. Discussion: In AD clinical trials over the last 10 years, over two-thirds of participants could have been enrolled without brain MRI and half without even a brain CT. In a study sample, relevant comorbid pathology was found in 15% of participants, despite careful screening. Standardized structural MRI should be incorporated into NIA-AA diagnostic guidelines (when available) and research frameworks routinely to reduce diagnostic heterogeneity. |
| Databáze: | OpenAIRE |
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