Clinical Core

1.总结(临床核心) 为了支持国家阿尔茨海默氏症项目法案的目标，斯坦福ADRC将专注于 阿尔茨海默病(AD)谱和神经退行性认知的路易体(LB)谱 减损。认识到当调查人员深入调查时，关键的答案将更容易浮出水面 在多个级别的参与者数据内和跨多个级别的参与者数据，我们采用了深度表型分析策略。史丹福 ADRC参与者的特点是密集的，并随着时间的推移而跟踪。AD谱包括认知方面的 阿尔茨海默病和轻度认知障碍的AD患者以及临床前AD的推断 从生物标志物数据中。LB谱包括路易体痴呆和帕金森氏病 痴呆症和帕金森病合并轻度认知障碍患者。健康的成年人没有认知能力或 运动障碍可以作为与年龄相当的比较人群，作为无症状的高危人群 作为一个潜在的临床前人群，认知老化和临床前的机制 可以研究过渡。在LB谱内，无认知障碍的帕金森病患者 作为与年龄相当的比较对象和处于发展中的高危过渡性人群-- 谱性认知障碍。斯坦福ADRC资源将使这些AD和LB的并行研究成为可能 谱系障碍。为调查人员提供比较和对比的机会可以提供独特的见解 发病机制、抵抗力和复原力以及治疗方法。临床核心将负责 参与者登记以及临床、认知和行为评估。为了支持一项战略， 强调个人参与者的深层表型，临床核心也负责 Biospecimen采购、成像转介和脑捐赠同意。它对参与者负责 保留和纵向随访。斯坦福ADRC的大多数新参与者将被要求提供 在脑脊液中测量的疾病定义生物标志物，通过淀粉样蛋白-PET/MRI成像，或两者兼而有之；同意 纵向随访；并同意通过神经病理核心进行脑捐赠。临床核心意志 与其他ADRC核心合作实现四个目标，重点是AD频谱和LB谱 神经退行性认知损伤：(1)纳入受试者参加 斯坦福ADRC；描述他们的神经、认知和行为状态；提供共识 诊断；纵向跟踪参与者；并促进遵守；(2)支持其他ADRC的努力 核心；(3)支持ADRC发展项目赠款和符合条件的外部资助的研究需求 可受益于核心资源的研究人员；以及(4)通过以下方式支持研究教育部分 为医学和研究生、住院医师、研究员和初级教员提供丰富的培训环境。

1. SUMMARY (Clinical Core) In support of the goals of the National Alzheimer's Project Act, the Stanford ADRC will focus on the Alzheimer's disease (AD) spectrum and the Lewy body (LB) spectrum of neurodegenerative cognitive impairment. Recognizing that critical answers will emerge more readily when investigators can delve deeply within and across multiple levels of participant data, we have adopted a strategy of deep phenotyping. Stanford ADRC participants are characterized intensively and followed over time. The AD spectrum includes cognitively impaired patients with AD dementia and mild cognitive impairment due to AD, as well as preclinical AD inferred from biomarker data. The LB spectrum encompasses dementia with Lewy bodies and Parkinson's disease dementia and Parkinson's disease patients with mild cognitive impairment. Healthy adults without cognitive or motor impairment can serve as an age-equivalent comparison population, as an asymptomatic at-risk population, and as a potential preclinical population in which mechanisms of cognitive aging and preclinical transition can be studied. Within the LB spectrum, Parkinson's disease patients without cognitive impairment serve as age-equivalent comparators and as an at-risk transitional population for the development of LB- spectrum cognitive impairment. Stanford ADRC resources will enable the parallel study of these AD and LB spectrum disorders. Opportunities for investigators to compare and contrast can provide unique insights into pathogenesis, resistance and resilience, and therapeutic approaches. The Clinical Core will be responsible for participant enrollment and for clinical, cognitive, and behavioral assessments. In support of a strategy that emphasizes the deep phenotyping of individual participants, the Clinical Core is also responsible for biospecimen procurement, imaging referral, and brain donation consent. It is responsible for participant retention and for longitudinal follow-up. Most new participants in the Stanford ADRC will be asked to provide disease-defining biomarkers measured in CSF, imaged by amyloid-PET/MRI, or both; to consent to longitudinal follow-up; and to agree to brain donation through the Neuropathology Core. The Clinical Core will work with other ADRC Cores to accomplish four aims focused on the AD spectrum and the LB spectrum of neurodegenerative cognitive impairment: (1) Enroll participants into longitudinal research protocols of the Stanford ADRC; characterize their neurological, cognitive, and behavioral status; provide consensus diagnoses; follow participants longitudinally; and promote adherence; (2) support the efforts of other ADRC Cores; (3) support ADRC development project grants and research needs of qualified externally funded investigators who could benefit from Core resources; and (4) support the Research Education Component by providing a rich training environment for medical and graduate students, residents, fellows, and junior faculty.