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Imaging the Aging Brain$
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William Jagust and Mark D'Esposito

Print publication date: 2009

Print ISBN-13: 9780195328875

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780195328875.001.0001

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Brain Imaging in the Evaluation of Putative Alzheimer’s Disease-Slowing, Risk-Reducing and Prevention Therapies

Brain Imaging in the Evaluation of Putative Alzheimer’s Disease-Slowing, Risk-Reducing and Prevention Therapies

Chapter:
(p.319) 20 Brain Imaging in the Evaluation of Putative Alzheimer’s Disease-Slowing, Risk-Reducing and Prevention Therapies
Source:
Imaging the Aging Brain
Author(s):

Eric M. Reiman

Jessica B. S. Langbaum

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195328875.003.0020

This chapter describes the emerging roles of brain imaging and other biomarker measurements of Alzheimer's disease (AD) progression and pathology in the evaluation of putative AD-slowing, risk—reducing, and prevention therapies. It discusses the advantages, disadvantages, and complementary roles of structural magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography (FDG PET), and fibrillar amyloid-β (Aβ) PET in clinical trials of AD patients, patients with mild cognitive impairment (MCI), and cognitively normal people at increased genetic risk for AD. It proposes strategies to optimize these methods’ statistical power, address potentially confounding treatment effects, and develop reasonably likely surrogate endpoints for the rapid and rigorous evaluation of promising pre-symptomatic treatments. Finally, it recommends scientific strategies and new public policies to accelerate the identification of demonstrably effective pre-symptomatic AD treatments without losing a generation.

Keywords:   brain imaging, magnetic resonance imaging, positron emission tomography, amyloid, biomarkers, surrogate endpoints, clinical trials, public policy, prevention

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