Clinical Core

1.总结（临床核心） 为了支持国家阿尔茨海默病项目法案的目标，斯坦福大学ADRC将重点关注 阿尔茨海默病（AD）谱和路易体（LB）谱的神经退行性认知障碍 损伤认识到当调查人员能够深入研究时， 在参与者数据的多个层次内和跨多个层次，我们采用了深度表型分析的策略。斯坦福大学 ADRC参与者的特点集中，并随着时间的推移。AD谱包括认知性 患有AD痴呆和AD所致轻度认知障碍的受损患者，以及推断的临床前AD 生物标记数据。LB谱包括路易体痴呆和帕金森病 痴呆和帕金森病患者的轻度认知功能障碍。健康的成年人没有认知或 运动障碍可以作为年龄相当的比较人群，作为无症状的高危人群， 人群，并作为潜在的临床前人群，其中认知老化和临床前 可以研究转型。在LB范围内，没有认知障碍的帕金森病患者 作为年龄相当的比较者，并作为发展LB的风险过渡人群- 频谱认知障碍斯坦福大学ADRC资源将使这些AD和LB的平行研究成为可能 谱系障碍调查人员进行比较和对比的机会可以提供独特的见解， 发病机理、抵抗力和恢复力以及治疗方法。临床中心将负责 参与者登记和临床，认知和行为评估。为了支持一项战略， 强调个体参与者的深层表型，临床核心还负责 生物标本获取、影像学转诊和大脑捐赠同意书。它负责参与者 保持和纵向随访。斯坦福大学ADRC的大多数新参与者将被要求提供 在CSF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;同意 纵向随访;并同意通过神经病理学核心捐赠大脑。临床核心将 与其他ADRC核心合作，实现四个目标，重点是AD频谱和LB频谱， 神经退行性认知障碍：（1）将参与者纳入纵向研究方案 斯坦福大学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发展项目赠款和合格外部资助的研究需求 研究人员谁可以受益于核心资源;（4）支持研究教育部分， 为医学和研究生、住院医生、研究员和初级教师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.