The Alzheimer's Disease Neuroimaging Initiative in the era of Alzheimer's disease treatment: A review of ADNI studies from 2021 to 2022

Alzheimers Dement. 2024 Jan;20(1):652-694. doi: 10.1002/alz.13449. Epub 2023 Sep 12.

Abstract

The Alzheimer's Disease Neuroimaging Initiative (ADNI) aims to improve Alzheimer's disease (AD) clinical trials. Since 2006, ADNI has shared clinical, neuroimaging, and cognitive data, and biofluid samples. We used conventional search methods to identify 1459 publications from 2021 to 2022 using ADNI data/samples and reviewed 291 impactful studies. This review details how ADNI studies improved disease progression understanding and clinical trial efficiency. Advances in subject selection, detection of treatment effects, harmonization, and modeling improved clinical trials and plasma biomarkers like phosphorylated tau showed promise for clinical use. Biomarkers of amyloid beta, tau, neurodegeneration, inflammation, and others were prognostic with individualized prediction algorithms available online. Studies supported the amyloid cascade, emphasized the importance of neuroinflammation, and detailed widespread heterogeneity in disease, linked to genetic and vascular risk, co-pathologies, sex, and resilience. Biological subtypes were consistently observed. Generalizability of ADNI results is limited by lack of cohort diversity, an issue ADNI-4 aims to address by enrolling a diverse cohort.

Keywords: Alzheimer's Disease Neuroimaging Initiative; Alzheimer's disease clinical trials; Alzheimer's disease subtypes; amyloid; cerebrovascular disease; co-pathologies; diagnosis; disease progression; generalizability; neurodegeneration; neuroinflammation; plasma biomarkers; prediction; resilience; tau.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / therapy
  • Amyloid beta-Peptides
  • Biomarkers
  • Cognitive Dysfunction* / diagnostic imaging
  • Disease Progression
  • Humans
  • Neuroimaging / methods
  • tau Proteins

Substances

  • Amyloid beta-Peptides
  • Biomarkers
  • tau Proteins