Rochester to Take Part in National Alzheimer’s Imaging Initiative

Community Leads Nation in Number of Residents Who Have Taken Part in Search for Better Treatments

October 20, 2004

"We have nothing short of an epidemic on our hands."

            The University of Rochester will take part in one of the largest Alzheimer’s studies to date, a $60 million effort led by the National Institute on Aging (NIA) to test whether new imaging techniques and other technology can be better used to assess and treat patients with memory loss and dementia.

            Pierre Tariot, M.D., a psychiatrist at the University, helped design the five-year Alzheimer’s Disease Neuroimaging Initiative, which will begin in April 2005 and will include 800 participants at 50 sites around the nation and Canada, including at least 20 people in the Rochester area.

            The community’s participation should come as no surprise: The University was recently recognized by the NIA as the lead site for the nationwide Alzheimer’s Disease Cooperative Study, enrolling more patients than any other place in the country. Through Tariot’s research efforts, more than 1,200 patients from the Rochester area have taken part in Alzheimer’s studies since 1998; Rochester is the only Upstate New York community taking part in the new initiative.

            “Rochester has achieved nationwide attention as a community of citizens concerned about Alzheimer’s, dedicated to helping to find answers. All of us, patients and possible future patients alike, are grateful for this support,” says Tariot.

            The new study will fill a gap in our knowledge about how Alzheimer’s disease progresses, giving researchers a clearer picture, literally, of memory loss at its earliest stages. Doctors and nurses will use sophisticated imaging technology and other tests to watch what happens in the brain when an older person who has normal memory gaps develops more serious cognitive problems or even Alzheimer’s disease.

            Physicians are recognizing that patients suffering from “mild cognitive impairment” – a condition that describes the in-between ground between normal memory problems and full-blown dementia – are at especially high risk of developing Alzheimer’s, with nearly half developing dementia. The study will include adults from ages 55 to 90 who are either healthy, have some impairment, or have Alzheimer’s disease.

            “This will help us focus on those people at highest risk for the disease,” Tariot says. “We have nothing short of an epidemic on our hands: Currently there are approximately 4.5 million Americans with dementia, and that number is expected to triple over the next four decades.”

            In the study doctors and nurses will use repeated magnetic resonance imaging (MRI) scans to measure the brain size of participants as they age. Such scans are used in limited fashion now by doctors to help diagnose the disease, but not to chart their progress. While our brains normally shrink as we age, they shrink more rapidly in patients with Alzheimer’s, especially the parts that focus on memory, such as the hippocampus (so named because it is shaped like a sea horse). Physicians hope to develop a map of sorts so doctors know what to expect at various stages of the disease, helping them evaluate disease-altering effects a new medication might have.

            Scientists will also take repeated positron emission tomography (PET) scans to track the activity in the brains of some of the participants, watching closely how the activity changes or lessens. They’ll also track a number of “biomarkers” from a patient’s blood, urine, and even cerebrospinal fluid in some cases, in an effort to develop new ways to track the progression of the disease. Such markers will help doctors assess the safety of future treatments and evaluate their potential to stop the disease.

            In Rochester the study will include extensive participation from physicians and other researchers in the Division of Diagnostic and Interventional Neuroradiology of the Department of Radiology at Strong Memorial Hospital, where the PET and MRI scans will be conducted. The local portion of the study will be led by Tariot, who is professor of Psychiatry, Medicine, and Neurology, and a member of the Center for Aging and Developmental Biology. Study participants will be seen at the University’s Geriatric Neurology and Psychiatry Clinic, where physicians treat several thousand patients a year from throughout New York State and parts of Ohio and Pennsylvania.

            In addition to the National Institute on Aging, other partners include the National Institute of Biomedical Imaging and Bioengineering, the Food and Drug Administration, Pfizer Inc, Wyeth Research, Eli Lilly and Company, Merck & Co., Inc., GlaxoSmithKline, AstraZeneca AB, Novartis Pharmaceuticals Corp., Eisai Global Clinical Development, Elan Corp., the Institute for the Study of Aging (ISOA), and the Alzheimer’s Association. About two-thirds of the funding is expected to come from the Federal government while private partners are expected to pick up the rest of the cost.

            “This is an extraordinary pooling of talent and resources toward a common goal –delaying or preventing Alzheimer’s disease,” says Richard J. Hodes, M.D., director of the NIA. “The initiative should become a landmark study in the development of neuroimaging and other biomarkers, helping us to find biological changes early so that we can identify the people at highest risk of the disease and test the effectiveness of new therapies more quickly and efficiently.”

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