Secondary prevention of Alzheimer's dementia: neuroimaging contributions

Mara ten Kate, Silvia Ingala, Adam J. Schwarz, Nick C. Fox, Gaël Chételat, Bart N. M. van Berckel, Michael Ewers, Christopher Foley, Juan Domingo Gispert, Derek Hill, Michael C. Irizarry, Adriaan A. Lammertsma (+9 others)
2018 Alzheimer's Research & Therapy  
In Alzheimer's disease (AD), pathological changes may arise up to 20 years before the onset of dementia. This pre-dementia window provides a unique opportunity for secondary prevention. However, exposing non-demented subjects to putative therapies requires reliable biomarkers for subject selection, stratification, and monitoring of treatment. Neuroimaging allows the detection of early pathological changes, and longitudinal imaging can assess the effect of interventions on markers of molecular
more » ... thology and rates of neurodegeneration. This is of particular importance in pre-dementia AD trials, where clinical outcomes have a limited ability to detect treatment effects within the typical time frame of a clinical trial. We review available evidence for the use of neuroimaging in clinical trials in pre-dementia AD. We appraise currently available imaging markers for subject selection, stratification, outcome measures, and safety in the context of such populations.
doi:10.1186/s13195-018-0438-z pmid:30376881 pmcid:PMC6208183 fatcat:rbbvlm6jajb2hnke62sxe576iy