Mild Cognitive Impairment (MCI)ADNI2NCT01231971
Alzheimer's Disease Neuroimaging Initiative 2
An observational study of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), run by University of Southern California at 58 sites in 2 countries.
Trial summary
The purpose of this study is to build upon the information obtained in the original Alzheimer's Disease Neuroimaging Initiative (ADNI1) and ADNI-GO (Grand Opportunity; a study funded through an NIH grant under the American Recovery and Reinvestment Act), to examine how brain imaging technology can be used with other… Read more about this study
- Who is it for?
- Ages 55 to 90 yearsHealthy volunteers can take part
- Conditions the study is for
- Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), Significant Memory Concern (SMC)
- What is being tested?
- Florbetapir and Flortaucipir
- Type of treatment
- Injection or infusion
- How many people
- 1,182 participants
- Where
- 58 sitesin 2 countries
- Study dates
- 14 Feb 2011to 29 Nov 2017
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 55 to 90 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: Community Sample
Who may be able to join
- Participants will be classified as either normal controls, SMC, EMCI, LMCI or AD participants. General Inclusion Criteria will apply to all groups, with specific criteria for each group as described below:
- General (applies to each category):
- Geriatric Depression Scale less than 6.
- Age between *55-90 (inclusive). *For normal controls and SMC participants, age must be between 65-90.
- Study partner is available who has frequent contact with the participant (e.g. an average of 10 hours per week or more), and can accompany the participant to all clinic visits for the duration of the protocol.
- Visual and auditory acuity adequate for neuropsychological testing.
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- Good general health with no diseases expected to interfere with the study.
- Participant is not pregnant, lactating, or of childbearing potential (i.e. women must be two years post-menopausal or surgically sterile).
- Willing and able to participate in a longitudinal imaging study.
- Hachinski less than or equal to 4.
- Completed six grades of education or has a good work history (sufficient to exclude mental retardation).
- Must speak English or Spanish fluently.
- Willing to undergo repeated MRIs (3Tesla) and at least two PET scans (one FDG and one Amyloid imaging) and no medical contraindications to MRI.
- Agrees to collection of blood for Genome Wide Association Studies (GWAS), APOE testing and DNA and RNA banking.
- Agrees to collection of blood for biomarker testing.
- Agrees to at least one lumbar puncture for the collection of CSF.
- Specific Inclusion Criteria for normal controls:
- Participant must be free of memory complaints, verified by a study partner.
- Normal memory function score on Wechsler Memory Scale (adjusted for education)
- Mini-Mental State Exam (MMSE) score between 24 and 30 (inclusive)
- Clinical Dementia Rating (CDR) = 0; Memory Box score must be 0
- Cognitively normal, based on an absence of significant impairment in cognitive functions or activities of daily living
- Stability of Permitted Medications for 4 weeks. In particular, participants may take:
- Antidepressants lacking significant anticholinergic side effects
- Estrogen replacement therapy is permissible
- Gingko biloba is permissible, but discouraged
- Washout from psychoactive medication (e.g., excluded antidepressants, neuroleptics, chronic anxiolytics or sedative hypnotics, etc.) for at least 4 weeks prior to screening
- Specific Inclusion Criteria for SMC participants:
- Subjects that are "self-referrals" that have a significant subjective memory concern
- Significant memory concern confirmed by a Cognitive Change Index score of more than or equal to 16
- Normal memory function score on Wechsler Memory Scale (adjusted for education)
- Mini-Mental State Exam (MMSE) score between 24 and 30 (inclusive)
- Clinical Dementia Rating (CDR) = 0; Memory Box score must be 0
- Cognitively normal, based on the absence of significant memory impairment in cognitive function or activities of daily living
- Stability of Permitted Medications for 4 weeks. In particular, subjects may take:
- Antidepressants lacking significant anticholinergic side effects
- Estrogen replacement therapy is permissible
- Gingko biloba is permissible, but discouraged
- Washout from psychoactive medication (e.g., excluded antidepressants, neuroleptics, chronic anxiolytics or sedative hypnotics, etc.) for at least 4 weeks prior to screening
- Specific Inclusion Criteria for EMCI and LMCI participants:
- Participant must have a subjective memory concern as reported by participant, study partner, or clinician
- Abnormal memory function score on Wechsler Memory Scale (adjusted for education)
- Mini-Mental State Exam (MMSE) score between 24 and 30 (inclusive)
- Clinical Dementia Rating (CDR) = 0.5; Memory Box score must be at least 0.5
- General cognition and functional performance sufficiently preserved such that a diagnosis of AD cannot be made by the site physician at the time of the screening visit
- Stability of Permitted Medications for 4 weeks. In particular, participants may take:
- Antidepressants lacking significant anticholinergic side effects
- Estrogen replacement therapy
- Gingko biloba is permissible, but discouraged
- Washout from psychoactive medication (e.g., excluded antidepressants, neuroleptics, chronic anxiolytics or sedative hypnotics, etc.) for at least 4 weeks prior to screening
- Cholinesterase inhibitors and memantine are allowable if stable for 12 weeks prior to screening
- Specific Inclusion Criteria for AD participants:
- Participant must have a subjective memory concern as reported by participant, study partner, or clinician
- Abnormal memory function score on Wechsler Memory Scale (adjusted for education)
- Mini-Mental State Exam (MMSE) score between 20 and 26 (inclusive)
- Clinical Dementia Rating (CDR) = 0.5 or 1.0
- National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) criteria for probable AD
- Stability of Permitted Medications for 4 weeks. In particular, participants may take:
- Antidepressants lacking significant anticholinergic side effects
- Estrogen replacement therapy
- Gingko biloba is permissible, but discouraged
- Washout from psychoactive medication (e.g., excluded antidepressants, neuroleptics, chronic anxiolytics or sedative hypnotics, etc.) for at least 4 weeks prior to screening
- Cholinesterase inhibitors and memantine are allowable if stable for 12 weeks prior to screening
- Specific Inclusion Criteria for follow-up participants from ADNI1 and ADNI GO:
- Must have been enrolled and followed in ADNI1 for at least one year or enrolled in ADNI-GO with original diagnosis of Cognitively Normal (CN), Mild Cognitive Impairment (MCI), or Early Mild Cognitive Impairment (EMCI) regardless of whether a diagnostic conversion has occurred since initial enrollment in ADNI.
- Willing and able to continue to participate in an ongoing longitudinal study. A reduced battery of tests is allowable if the participant is not able/willing to complete the full battery.
- Study partner is available who has frequent contact with the participant (e.g. an average of 10 hours per week or more), and can accompany the participant to all clinic visits for the duration of the protocol.
Who cannot join
- General (applies to each category):
- Screening/baseline MRI scan with evidence of infection, infarction, or other focal lesions; Participants with multiple lacunes or lacunes in a critical memory structure are excluded
- Presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments or foreign objects in the eyes, skin or body
- Major depression, bipolar disorder as described in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) within the past 1 year
- Currently treated with medication for obsessive-compulsive disorder or attention deficit disorder
- History of schizophrenia
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- History of alcohol or substance abuse or dependence within the past 2 years
- Any significant systemic illness or unstable medical condition which could lead to difficulty complying with the protocol
- Clinically significant abnormalities in B12, or TFTs that might interfere with the study
- Residence in skilled nursing facility
- Current use of specific psychoactive medications (e.g.,certain antidepressants, neuroleptics, chronic anxiolytics or sedative hypnotics, etc.); Current use of warfarin or dabigatran (exclusionary for lumbar puncture).
- Use of investigational agents one month prior to entry and for the duration of the trial
- Participation in clinical studies involving neuropsychological measures being collected more than one time per year
- Exclusion for FDG PET scan and amyloid imaging with Florbetapir F 18: Current or recent participation in any procedures involving radioactive agents such that the total radiation dose exposure to the participant in any given year would exceed the limits of annual and total dose commitment set forth in the US Code of Federal Regulations (CFR) Title 21 Section 361.1.
- Exceptions to these guidelines may be considered on a case-by-case basis at the discretion of the protocol director
- Specific Exclusion Criteria for normal controls and SMC participants:
- Any significant neurologic disease, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities
- Specific Exclusion Criteria for EMCI and LMCI participants:
- Any significant neurologic disease other than suspected incipient Alzheimer's disease, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities.
- Specific Exclusion Criteria for AD participants:
- Any significant neurologic disease other than Alzheimer's disease, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities.
- Specific Exclusion Criteria for follow-up participants from ADNI1 and ADNI GO:
- Participants will not be able to participate in FDG PET scan and amyloid imaging with Florbetapir F 18 if the following is true: Current or recent participation in any procedures involving radioactive agents such that the total radiation dose exposure to the participant in any given year would exceed the limits of annual and total dose commitment set forth in the US Code of Federal Regulations (CFR) Title 21 Section 361.1.
Trial locations and contacts
58 sites in 2 countries.
58 sites in 2 countries
United States53 sites
Albany Medical College
Albany, New York, 12208
Dent Neurologic Institute
Amherst, New York, 14226
University of Michigan, Ann Arbor
Ann Arbor, Michigan, 48109
Emory University
Atlanta, Georgia, 30329
Johns Hopkins University
Baltimore, Maryland, 21205
Case Western Reserve University
Beachwood, Ohio, 44122
University of Alabama, Birmingham
Birmingham, Alabama, 35294
Brigham and Women's Hospital
Boston, Massachusetts, 02115
Boston University
Boston, Massachusetts, 02118
Northwestern University
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
Ohio State University
Columbus, Ohio, 43210
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
Duke University Medical Center
Durham, North Carolina, 27710
Baylor College of Medicine
Houston, Texas, 77030
Indiana University
Indianapolis, Indiana, 46202
University of Iowa
Iowa City, Iowa, 52242
University of California, Irvine
Irvine, California, 92697
Mayo Clinic, Jacksonville
Jacksonville, Florida, 32224
University of Kansas
Kansas City, Kansas, 66160
University of California, San Diego
La Jolla, California, 92037
Cleveland Clinic Lou Ruvo Center for Brain Health
Las Vegas, Nevada, 89106
Dartmouth Medical Center
Lebanon, New Hampshire, 03756
University of Kentucky
Lexington, Kentucky, 40536
University of Southern California
Los Angeles, California, 90033
University of California, Los Angeles
Los Angeles, California, 90095
University of Wisconsin
Madison, Wisconsin, 53705
University of California, Davis
Martinez, California, 94553
Wien Center for Clinical Research
Miami Beach, Florida, 33140
Yale University School of Medicine
New Haven, Connecticut, 06510
New York University Medical Center
New York, New York, 10016
Columbia University
New York, New York, 10032
Mount Sinai School of Medicine
New York, New York, 10032
Roper St. Francis Healthcare
North Charleston, South Carolina, 29406
University of California, Irvine (Brain Imaging Center)
Orange, California, 92868
Nathan S. Kline Institute for Psychiatric Research
Orangeburg, New York, 10962
Stanford University / PAIRE
Palo Alto, California, 94304
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Banner Alzheimer's Institute
Phoenix, Arizona, 85006
University of Pittsburgh
Pittsburgh, Pennsylvania, 15213
Oregon Health and Science University
Portland, Oregon, 97239
Rhode Island Hospital
Providence, Rhode Island, 02903
Butler Hospital Memory and Aging Program
Providence, Rhode Island, 02906
Mayo Clinic, Rochester
Rochester, Minnesota, 55901
University of Rochester Medical Center
Rochester, New York, 14620
University of California, San Francisco
San Francisco, California, 94158
Washington University, St. Louis
St Louis, Missouri, 63108
Banner Sun Health Research Institute
Sun City, Arizona, 85351
USF Health Byrd Alzheimer's Institute
Tampa, Florida, 33613
Georgetown University
Washington D.C., District of Columbia, 20057
Howard University
Washington D.C., District of Columbia, 20060
Premiere Research Institute
West Palm Beach, Florida, 33407
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Canada5 sites
Parkwood Institute
London, Ontario, N6C 5J1
St. Joseph's Health Center - Cognitive Neurology
London, Ontario, N6C 5J1
McGill University / Jewish General Hospital Memory Clinic
Montreal, Quebec, H3T 1E2
Sunnybrook Health Sciences Centre
Toronto, Ontario, M4N 3M5
University of British Columbia, Clinic for Alzheimer's Disease and Related Disorders Program
Vancouver, British Columbia, V6T 2B5
About this study
The purpose of this study is to build upon the information obtained in the original Alzheimer's Disease Neuroimaging Initiative (ADNI1) and ADNI-GO (Grand Opportunity; a study funded through an NIH grant under the American Recovery and Reinvestment Act), to examine how brain imaging technology can be used with other tests to measure the progression of mild cognitive impairment (MCI) and early Alzheimer's disease (AD). ADNI2 seeks to inform the neuroscience of AD. This information will aid in the early detection of AD, and in measuring the effectiveness of treatments in future clinical trials.
Read the detailed description
The Alzheimer's Disease Neuroimaging Initiative (ADNI) began in October 2004 as a landmark study with a public-private partnership that gathered and analyzed thousands of brain scans, genetic profiles and biomarkers in blood and cerebrospinal fluid (CSF). Although the original goal was to define biomarkers for use in clinical trials to determine the best way to measure treatment effects of Alzheimer's disease (AD), the goal has been expanded to using biomarkers to identify AD at a pre-dementia stage. ADNI1 involves scientists at 59 research centers, 54 in the U.S. and five in Canada. Originally 800 participants were enrolled. This group was comprised of 200 participants with AD, 400 with mild cognitive impairment (MCI) and 200 with normal cognition. In ADNI-GO, an estimated 200 participants with early amnestic MCI (EMCI) were enrolled to understand and characterize the mildest symptomatic phase of AD. An additional 650 participants will be enrolled under ADNI2.
Some of the leading-edge technologies under study are brain-imaging techniques, such as positron emission tomography (PET), including FDG-PET (which measures glucose metabolism in the brain); PET using a radioactive compound (Florbetapir F 18) that measures brain beta-amyloid; and structural MRI. Brain scans are showing scientists how the brain's structure and function change as AD starts and progresses. Biomarkers in cerebrospinal fluid are revealing other changes that could identify which patients with MCI will develop Alzheimer's. Scientists are looking at levels of beta-amyloid and tau in cerebrospinal fluid. (Abnormal amounts of the amyloid and tau proteins in the brain are hallmarks of Alzheimer's disease.)
ADNI2 extends the work of ADNI1 and ADNI GO to understand the progression of AD. The overall goal is to determine the relationships among the clinical, cognitive, imaging, genetic and biochemical biomarker characteristics of the entire spectrum of AD, as the pathology evolves from normal aging through very mild symptoms, to MCI, to dementia.
The overall impact of this study will be increased knowledge concerning the sequence and timing of events leading to MCI and AD, development of better clinical and imaging/fluid biomarker methods for early detection and for monitoring the progression of these conditions, and facilitation of clinical trials to slow disease progression, ultimately contributing to the prevention of AD.
- Conditions
- Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), Significant Memory Concern (SMC), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI)
- Being tested
- Florbetapir, Flortaucipir
- Keywords
- amyloid, plaques, neuroimaging, biomarkers, cognition disorder, early detection, Amnestic MCI, pre-dementia, dementia, Alzheimer's disease, tau
- Medical subject headings
- Cognitive Dysfunction, Alzheimer Disease, Plaque, Amyloid, Cognition Disorders, Dementia, Pick Disease of the Brain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FlorbetapirDrug
Also called 18F-AV-45, LY3078786
Participants will receive a single bolus intravenous injection of 10 mCi (370 MBq) (+/- 10%) florbetapir F18. At approximately 50-minutes post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed.
FlortaucipirDrug
Also called 18F-AV-1451 (also known as [F-18]T807 or LY3191748)
Participants will receive a single bolus intravenous injection of 10 mCi (370 MBq) flortaucipir injection followed by a saline flush. At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
| Study group | Role | What they receive |
|---|---|---|
| Cognitively Normal (CN) | 150 newly enrolled participants with no apparent memory problems, and CN participants followed from the ADNI1 study Receives: Drug: Florbetapir; Drug: Flortaucipir | |
| Early Mild Cognitive Impairment (EMCI) | 100 newly enrolled early amnestic MCI participants, and approximately 200 EMCI participants will be followed from the ADNI-GO study Receives: Drug: Florbetapir; Drug: Flortaucipir | |
| Late Mild Cognitive Impairment (LMCI) | 150 newly enrolled late MCI participants, and LMCI participants followed from the ADNI1 study Receives: Drug: Florbetapir; Drug: Flortaucipir | |
| Alzheimer's Disease (AD) | 150 newly enrolled mild AD participants Receives: Drug: Florbetapir; Drug: Flortaucipir | |
| Significant Memory Concern (SMC) | 100 newly enrolled participants with Significant Memory Concern (SMC) Receives: Drug: Florbetapir; Drug: Flortaucipir |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of volume change of whole brain, hippocampus and other structural MRI measures
Measured: 5 Years
Secondary outcomes (10)
Rate of Decline as measured by: Cognitive Tests, Activities of Daily Living, and CDR Sum of Boxes
Measured: 5 Years
Rate of conversion will be evaluated among all five groups
Measured: 5 Years
Rates of change on each specified biochemical biomarker
Measured: 5 Years
Rates of change of glucose metabolism (FDG-PET)
Measured: 5 Years
Extent of amyloid deposition as measured by Florbetapir F 18
Measured: 4 Years
Group differences for each imaging and biomarker measurement
Measured: 5 Years
Correlations among biomarkers and biomarker change
Measured: 4 Years
APOE genotype, low CSF Aβ42, positive amyloid imaging with florbetapir F 18 (AV-45)
Measured: 5 Years
Rate of change of tau and extent of tau deposition as measured by flortaucipir (18F-AV-1451)
Measured: 1 Year
Rate of cognitive decline using computer based testing as measured by Cogstate Brief Battery (CBB)
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Nov 2010 (estimated)
- Study start14 Feb 2011
- Primary completion29 Nov 2017
- Study completion29 Nov 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Mild Cognitive Impairment (MCI)Studies of the same condition, open and under way.
- More trials run by University of Southern CaliforniaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,182 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Southern California
- Sponsor type
- University, hospital or other
- Collaborators
- Northern California Institute of Research and Education, National Institute on Aging (NIA), Alzheimer's Therapeutic Research Institute
- Responsible party
- Principal investigator, Paul S. Aisen, University of Southern California
- Investigators
- Ronald Petersen, MD, PhD, Principal investigator, Mayo ClinicMichael W. Weiner, MD, Principal investigator, University of California, San FranciscoPaul S. Aisen, MD, Principal investigator, University of Southern California
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01231971
- Sponsor's protocol ID
- ADC-039-ADNI2
- Other IDs
- U01AG024904
- Acronym
- ADNI2
- Status last verified
- Nov 2024
- First submitted
- 27 Oct 2010
- Last updated
- 21 Nov 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Shen L, Kim S, Risacher SL, Nho K, Swaminathan S, West JD, Foroud T, Pankratz N, Moore JH, Sloan CD, Huentelman MJ, Craig DW, Dechairo BM, Potkin SG, Jack CR Jr, Weiner MW, Saykin AJ; Alzheimer's Disease Neuroimaging Initiative. Whole genome association study of brain-wide imaging phenotypes for identifying quantitative trait loci in MCI and AD: A study of the ADNI cohort. Neuroimage. 2010 Nov 15;53(3):1051-63. doi: 10.1016/j.neuroimage.2010.01.042. Epub 2010 Jan 25.
PubMed 20100581Risacher SL, Saykin AJ, West JD, Shen L, Firpi HA, McDonald BC; Alzheimer's Disease Neuroimaging Initiative (ADNI). Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort. Curr Alzheimer Res. 2009 Aug;6(4):347-61. doi: 10.2174/156720509788929273.
PubMed 19689234Petersen RC, Aisen PS, Beckett LA, Donohue MC, Gamst AC, Harvey DJ, Jack CR Jr, Jagust WJ, Shaw LM, Toga AW, Trojanowski JQ, Weiner MW. Alzheimer's Disease Neuroimaging Initiative (ADNI): clinical characterization. Neurology. 2010 Jan 19;74(3):201-9. doi: 10.1212/WNL.0b013e3181cb3e25. Epub 2009 Dec 30.
PubMed 20042704Misra C, Fan Y, Davatzikos C. Baseline and longitudinal patterns of brain atrophy in MCI patients, and their use in prediction of short-term conversion to AD: results from ADNI. Neuroimage. 2009 Feb 15;44(4):1415-22. doi: 10.1016/j.neuroimage.2008.10.031. Epub 2008 Nov 5.
PubMed 19027862Howe MD, Zide BS, Hayes K, Ross D, Barker MS, Kunicki ZJ, Rudolph J, Huey E. Symptom-Guided Blood Biomarker Testing for Alzheimer's Disease. Dement Geriatr Cogn Disord. 2026 Oct 12:1. doi: 10.1159/dem/aciag010. Online ahead of print.
PubMed 42862762Miller AA, Sharp ES, Wang S, Zhao Y, Mecca AP, van Dyck CH, O'Dell RS; Alzheimer's Disease Neuroimaging Initiative (ADNI). Self-reported hearing loss is associated with faster cognitive and functional decline but not diagnostic conversion in the ADNI cohort. Alzheimers Dement. 2024 Nov;20(11):7847-7858. doi: 10.1002/alz.14252. Epub 2024 Sep 26.
PubMed 39324520Howe MD, Caruso MR, Manoochehri M, Kunicki ZJ, Emrani S, Rudolph JL, Huey ED, Salloway SP, Oh H; Alzheimer's Disease Neuroimaging Initiative. Utility of cerebrovascular imaging biomarkers to detect cerebral amyloidosis. Alzheimers Dement. 2024 Oct;20(10):7220-7231. doi: 10.1002/alz.14207. Epub 2024 Sep 1.
PubMed 39219209Howe MD, Caruso MR, Manoochehri M, Kunicki ZJ, Emrani S, Rudolph JL, Huey ED, Salloway SP, Oh H; Alzheimer's Disease Neuroimaging Initiative. Utility of cerebrovascular imaging biomarkers to detect cerebral amyloidosis. medRxiv [Preprint]. 2024 May 28:2024.05.28.24308056. doi: 10.1101/2024.05.28.24308056.
PubMed 38853879Xu B, Ling Y, Liu L, Liu Y, Lin Y, Lyu J, Zhang Y. Potential prognostic value of CSF-targeted proteomics across the Alzheimer's disease continuum. BMC Geriatr. 2024 Jun 6;24(1):501. doi: 10.1186/s12877-024-05104-z.
PubMed 38844858Rauchmann BS, Schneider-Axmann T, Perneczky R; Alzheimer's Disease Neuroimaging Initiative (ADNI). Associations of longitudinal plasma p-tau181 and NfL with tau-PET, Abeta-PET and cognition. J Neurol Neurosurg Psychiatry. 2021 Dec;92(12):1289-1295. doi: 10.1136/jnnp-2020-325537. Epub 2021 Jun 29.
PubMed 34187867
Study at a glance
From the registry record, last updated by the sponsor on 21 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Alzheimer's Disease Neuroimaging Initiative 2
- ClinicalTrials.gov ID
- NCT01231971
- Acronym / sponsor ID
- ADNI2 / ADC-039-ADNI2
- Conditions
- Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), Significant Memory Concern (SMC), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI)
- Keywords
- amyloid, plaques, neuroimaging, biomarkers, cognition disorder, early detection, Amnestic MCI, pre-dementia
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,182 participants (actual)
- Lead sponsor
- University of Southern CaliforniaUniversity, hospital or other
- Collaborators
- Northern California Institute of Research and Education, National Institute on Aging (NIA), Alzheimer's Therapeutic Research Institute
- Study start
- 14 Feb 2011 (actual)
- Primary completion
- 29 Nov 2017 (actual)
- Study completion
- 29 Nov 2017 (actual)
- First posted
- 1 Nov 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to build upon the information obtained in the original Alzheimer's Disease Neuroimaging Initiative (ADNI1) and ADNI-GO (Grand Opportunity; a study funded through an NIH grant under the American Recovery and Reinvestment Act), to examine how brain imaging technology can be used with other tests to measure the progression of mild cognitive impairment (MCI) and early Alzheimer's disease (AD). ADNI2 seeks to inform the neuroscience of AD. This information will aid in the early detection of AD, and in measuring the effectiveness of treatments in future clinical trials.
Detailed description
The Alzheimer's Disease Neuroimaging Initiative (ADNI) began in October 2004 as a landmark study with a public-private partnership that gathered and analyzed thousands of brain scans, genetic profiles and biomarkers in blood and cerebrospinal fluid (CSF). Although the original goal was to define biomarkers for use in clinical trials to determine the best way to measure treatment effects of Alzheimer's disease (AD), the goal has been expanded to using biomarkers to identify AD at a pre-dementia stage. ADNI1 involves scientists at 59 research centers, 54 in the U.S. and five in Canada. Originally 800 participants were enrolled. This group was comprised of 200 participants with AD, 400 with mild cognitive impairment (MCI) and 200 with normal cognition. In ADNI-GO, an estimated 200 participants with early amnestic MCI (EMCI) were enrolled to understand and characterize the mildest symptomatic phase of AD. An additional 650 participants will be enrolled under ADNI2.
Some of the leading-edge technologies under study are brain-imaging techniques, such as positron emission tomography (PET), including FDG-PET (which measures glucose metabolism in the brain); PET using a radioactive compound (Florbetapir F 18) that measures brain beta-amyloid; and structural MRI. Brain scans are showing scientists how the brain's structure and function change as AD starts and progresses. Biomarkers in cerebrospinal fluid are revealing other changes that could identify which patients with MCI will develop Alzheimer's. Scientists are looking at levels of beta-amyloid and tau in cerebrospinal fluid. (Abnormal amounts of the amyloid and tau proteins in the brain are hallmarks of Alzheimer's disease.)
ADNI2 extends the work of ADNI1 and ADNI GO to understand the progression of AD. The overall goal is to determine the relationships among the clinical, cognitive, imaging, genetic and biochemical biomarker characteristics of the entire spectrum of AD, as the pathology evolves from normal aging through very mild symptoms, to MCI, to dementia.
The overall impact of this study will be increased knowledge concerning the sequence and timing of events leading to MCI and AD, development of better clinical and imaging/fluid biomarker methods for early detection and for monitoring the progression of these conditions, and facilitation of clinical trials to slow disease progression, ultimately contributing to the prevention of AD.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 5
| Arm | Type | Receives |
|---|---|---|
| Cognitively Normal (CN) | – | Drug: Florbetapir, Drug: Flortaucipir150 newly enrolled participants with no apparent memory problems, and CN participants followed from the ADNI1 study |
| Early Mild Cognitive Impairment (EMCI) | – | Drug: Florbetapir, Drug: Flortaucipir100 newly enrolled early amnestic MCI participants, and approximately 200 EMCI participants will be followed from the ADNI-GO study |
| Late Mild Cognitive Impairment (LMCI) | – | Drug: Florbetapir, Drug: Flortaucipir150 newly enrolled late MCI participants, and LMCI participants followed from the ADNI1 study |
| Alzheimer's Disease (AD) | – | Drug: Florbetapir, Drug: Flortaucipir150 newly enrolled mild AD participants |
| Significant Memory Concern (SMC) | – | Drug: Florbetapir, Drug: Flortaucipir100 newly enrolled participants with Significant Memory Concern (SMC) |
Who may qualify
- Ages
- 55 to 90 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Community Sample
Key inclusion criteria (67 listed)
- Participants will be classified as either normal controls, SMC, EMCI, LMCI or AD participants. General Inclusion Criteria will apply to all groups, with specific criteria for each group as described below:
- Geriatric Depression Scale less than 6.
- Age between *55-90 (inclusive). *For normal controls and SMC participants, age must be between 65-90.
- Study partner is available who has frequent contact with the participant (e.g. an average of 10 hours per week or more), and can accompany the participant to all clinic visits for the duration of the protocol.
- Visual and auditory acuity adequate for neuropsychological testing.
Key exclusion criteria (23 listed)
- Screening/baseline MRI scan with evidence of infection, infarction, or other focal lesions; Participants with multiple lacunes or lacunes in a critical memory structure are excluded
- Presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments or foreign objects in the eyes, skin or body
- Major depression, bipolar disorder as described in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) within the past 1 year
- Currently treated with medication for obsessive-compulsive disorder or attention deficit disorder
- History of schizophrenia
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FlorbetapirAlso: 18F-AV-45, LY3078786Participants will receive a single bolus intravenous injection of 10 mCi (370 MBq) (+/- 10%) florbetapir F18. At approximately 50-minutes post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed. | Drug | Alzheimer's Disease (AD), Cognitively Normal (CN), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI), Significant Memory Concern (SMC) |
| FlortaucipirAlso: 18F-AV-1451 (also known as [F-18]T807 or LY3191748)Participants will receive a single bolus intravenous injection of 10 mCi (370 MBq) flortaucipir injection followed by a saline flush. At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed. | Drug | Alzheimer's Disease (AD), Cognitively Normal (CN), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI), Significant Memory Concern (SMC) |
Primary outcome
Rate of volume change of whole brain, hippocampus and other structural MRI measures
Time frame: 5 Years
10 secondary outcomes
Rate of Decline as measured by: Cognitive Tests, Activities of Daily Living, and CDR Sum of Boxes
Time frame: 5 Years
Rate of conversion will be evaluated among all five groups
Time frame: 5 Years
Rates of change on each specified biochemical biomarker
Time frame: 5 Years
Rates of change of glucose metabolism (FDG-PET)
Time frame: 5 Years
Extent of amyloid deposition as measured by Florbetapir F 18
Time frame: 4 Years
Group differences for each imaging and biomarker measurement
Time frame: 5 Years
Correlations among biomarkers and biomarker change
Time frame: 4 Years
APOE genotype, low CSF Aβ42, positive amyloid imaging with florbetapir F 18 (AV-45)
Time frame: 5 Years
Rate of change of tau and extent of tau deposition as measured by flortaucipir (18F-AV-1451)
Time frame: 1 Year
Rate of cognitive decline using computer based testing as measured by Cogstate Brief Battery (CBB)
Time frame: 1 year
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Nov 2024.
- Background: PubMed 20100581Shen L, Kim S, Risacher SL, Nho K, Swaminathan S, West JD, Foroud T, Pankratz N, Moore JH, Sloan CD, Huentelman MJ, Craig DW, Dechairo BM, Potkin SG, Jack CR Jr, Weiner MW, Saykin AJ; Alzheimer's Disease Neuroimaging Initiative. Whole genome association study of brain-wide imaging phenotypes for identifying quantitative trait loci in MCI and AD: A study of the ADNI cohort. Neuroimage. 2010 Nov 15;53(3):1051-63. doi: 10.1016/j.neuroimage.2010.01.042. Epub 2010 Jan 25.
- Background: PubMed 19689234Risacher SL, Saykin AJ, West JD, Shen L, Firpi HA, McDonald BC; Alzheimer's Disease Neuroimaging Initiative (ADNI). Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort. Curr Alzheimer Res. 2009 Aug;6(4):347-61. doi: 10.2174/156720509788929273.
- Background: PubMed 20042704Petersen RC, Aisen PS, Beckett LA, Donohue MC, Gamst AC, Harvey DJ, Jack CR Jr, Jagust WJ, Shaw LM, Toga AW, Trojanowski JQ, Weiner MW. Alzheimer's Disease Neuroimaging Initiative (ADNI): clinical characterization. Neurology. 2010 Jan 19;74(3):201-9. doi: 10.1212/WNL.0b013e3181cb3e25. Epub 2009 Dec 30.
- Background: PubMed 19027862Misra C, Fan Y, Davatzikos C. Baseline and longitudinal patterns of brain atrophy in MCI patients, and their use in prediction of short-term conversion to AD: results from ADNI. Neuroimage. 2009 Feb 15;44(4):1415-22. doi: 10.1016/j.neuroimage.2008.10.031. Epub 2008 Nov 5.
- Derived from this study: PubMed 42862762Howe MD, Zide BS, Hayes K, Ross D, Barker MS, Kunicki ZJ, Rudolph J, Huey E. Symptom-Guided Blood Biomarker Testing for Alzheimer's Disease. Dement Geriatr Cogn Disord. 2026 Oct 12:1. doi: 10.1159/dem/aciag010. Online ahead of print.
- Derived from this study: PubMed 39324520Miller AA, Sharp ES, Wang S, Zhao Y, Mecca AP, van Dyck CH, O'Dell RS; Alzheimer's Disease Neuroimaging Initiative (ADNI). Self-reported hearing loss is associated with faster cognitive and functional decline but not diagnostic conversion in the ADNI cohort. Alzheimers Dement. 2024 Nov;20(11):7847-7858. doi: 10.1002/alz.14252. Epub 2024 Sep 26.
- Derived from this study: PubMed 39219209Howe MD, Caruso MR, Manoochehri M, Kunicki ZJ, Emrani S, Rudolph JL, Huey ED, Salloway SP, Oh H; Alzheimer's Disease Neuroimaging Initiative. Utility of cerebrovascular imaging biomarkers to detect cerebral amyloidosis. Alzheimers Dement. 2024 Oct;20(10):7220-7231. doi: 10.1002/alz.14207. Epub 2024 Sep 1.
- Derived from this study: PubMed 38853879Howe MD, Caruso MR, Manoochehri M, Kunicki ZJ, Emrani S, Rudolph JL, Huey ED, Salloway SP, Oh H; Alzheimer's Disease Neuroimaging Initiative. Utility of cerebrovascular imaging biomarkers to detect cerebral amyloidosis. medRxiv [Preprint]. 2024 May 28:2024.05.28.24308056. doi: 10.1101/2024.05.28.24308056.
- Derived from this study: PubMed 38844858Xu B, Ling Y, Liu L, Liu Y, Lin Y, Lyu J, Zhang Y. Potential prognostic value of CSF-targeted proteomics across the Alzheimer's disease continuum. BMC Geriatr. 2024 Jun 6;24(1):501. doi: 10.1186/s12877-024-05104-z.
- Derived from this study: PubMed 34187867Rauchmann BS, Schneider-Axmann T, Perneczky R; Alzheimer's Disease Neuroimaging Initiative (ADNI). Associations of longitudinal plasma p-tau181 and NfL with tau-PET, Abeta-PET and cognition. J Neurol Neurosurg Psychiatry. 2021 Dec;92(12):1289-1295. doi: 10.1136/jnnp-2020-325537. Epub 2021 Jun 29.
- Alzheimer's Therapeutic Research InstituteLink provided by the sponsor.
- Laboratory of Neuroimaging: Alzheimer's Disease Neuroimaging InitiativeLink provided by the sponsor.
- Alzheimer's Disease Neuroimaging InitiativeLink provided by the sponsor.
- List of Alzheimer's Disease Neuroimaging Initiative PublicationsLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ronald Petersen, MD, PhD principal investigator
Mayo Clinic
Michael W. Weiner, MD principal investigator
University of California, San Francisco
Paul S. Aisen, MD principal investigator
University of Southern California
58 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), run by University of Southern California at 58 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 67 inclusion and 23 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 58 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rate of volume change of whole brain, hippocampus and other structural MRI measures (time frame: 5 Years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01231971, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2024.