表征和验证早发性阿尔茨海默病12个月可靠的认知变化用于临床试验

IF 4.3 Q2 BUSINESS
Dustin B Hammers, Jane Musema, Ani Eloyan, Maryanne Thangarajah, Alexander Taurone, Renaud La Joie, Alexandra Touroutoglou, Prashanthi Vemuri, Joel Kramer, Paul Aisen, Jeffrey L Dage, Kelly N Nudelman, Kala Kirby, Alireza Atri, David Clark, Gregory S Day, Ranjan Duara, Neill R Graff-Radford, Ian Grant, Lawrence S Honig, Erik C B Johnson, David T Jones, Joseph C Masdeu, Mario F Mendez, Kyle Womack, Erik Musiek, Chiadi U Onyike, Meghan Riddle, Emily Rogalski, Steven Salloway, Sharon J Sha, Raymond Scott Turner, Thomas S Wingo, David A Wolk, Maria C Carrillo, Gil D Rabinovici, Bradford C Dickerson, Liana G Apostolova
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引用次数: 0

摘要

背景:由于文献表明早发性阿尔茨海默病(EOAD)和晚发性阿尔茨海默病(late-onset AD)可能在许多重要方面存在差异,因此有必要针对早发性阿尔茨海默病(EOAD)进行随机临床试验。准确可靠地测量EOAD患者个体的认知变化对这些试验具有重要价值。目的:目前的研究旨在描述和验证纵向早发性阿尔茨海默病研究(LEADS)神经心理电池12个月的可靠变化。设计:基于标准化回归(SRB)的预测方程从年龄匹配的认知完整的参与者中建立,并应用于临床受损的参与者。环境:参与者从门诊学术医疗中心招募。参与者:参与者被纳入LEADS并被诊断为淀粉样蛋白阳性的EOAD (n = 189)和淀粉样蛋白阴性的与AD无关的早发性认知障碍(EOnonAD;N = 43)。测量:12个月的可靠变化(z分数)在认知领域复合材料组之间进行比较,并检查个体参与者轨迹的分布。还考虑了常用AD生物标志物对z分数的预测。结果:与基于SRB方程的预测相比,EOAD和EOnonAD的12个月随访评分均显著降低,其中EOAD在多个领域的下降更为明显。脑β-淀粉样蛋白、tau和eoad特异性萎缩的AD生物标志物可预测12个月的变化评分。结论:目前的结果支持将EOAD患者纳入纵向临床试验,并为在EOAD队列(如LEADS)的临床试验中使用12个月可靠的认知变化作为临床结果指标提供了验证证据。这样做将提高EOAD试验的成功率,并使人们能够更好地了解个体对治疗的反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing and validating 12-month reliable cognitive change in Early-Onset Alzheimer's Disease for use in clinical trials.

Background: As literature suggests that Early-Onset Alzheimer's Disease (EOAD) and late-onset AD may differ in important ways, need exists for randomized clinical trials for treatments tailored to EOAD. Accurately measuring reliable cognitive change in individual patients with EOAD will have great value for these trials.

Objectives: The current study sought to characterize and validate 12-month reliable change from the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) neuropsychological battery.

Design: Standardized regression-based (SRB) prediction equations were developed from age-matched cognitively intact participants within LEADS, and applied to clinically impaired participants from LEADS.

Setting: Participants were recruited from outpatient academic medical centers.

Participants: Participants were enrolled in LEADS and diagnosed with amyloid-positive EOAD (n = 189) and amyloid-negative early-onset cognitive impairment not related to AD (EOnonAD; n = 43).

Measurement: 12-month reliable change (Z-scores) was compared between groups across cognitive domain composites, and distributions of individual participant trajectories were examined. Prediction of Z-scores by common AD biomarkers was also considered.

Results: Both EOAD and EOnonAD displayed significantly lower 12-month follow-up scores than were predicted based on SRB equations, with declines more pronounced for EOAD across several domains. AD biomarkers of cerebral β-amyloid, tau, and EOAD-specific atrophy were predictive of 12-month change scores.

Conclusions: The current results support including EOAD patients in longitudinal clinical trials, and generate evidence of validation for using 12-month reliable cognitive change as a clinical outcome metric in clinical trials in EOAD cohorts like LEADS. Doing so will enhance the success of EOAD trials and permit a better understanding of individual responses to treatment.

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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
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0
期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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