Core B: Clinical Core

波士顿大学阿尔茨海默病研究中心临床核心(BU ADRC CC)促进和 对AD和AD相关痴呆(ADRD)进行尖端研究，包括慢性创伤 脑病(CTE)。CC参与者，以及他们参与所产生的生物量和数据，支持 地方努力、跨ADRC合作和国家研究倡议。CC调查人员正在从事 AD/ADRD针对几个国家阿尔茨海默氏症项目法(NAPA)目标的研究，包括人口研究， 精确医学、健康差异、生物标志物、诊断、机制、翻译和临床 研究。该中心与北卡罗来纳大学的弗雷明翰心脏研究密切结合并相互配合。研究 CC调查人员对接触造成的重复性头部撞击(RHI)的作用有了基本的见解 运动参与、服兵役和身体暴力在AD/ADRD发病机制中的作用，包括CTE。 然而，由于临床表现不明确且缺乏确认性，CTE不能在生前诊断。 生物标志物。研究一直受到对前美国精英男性的小样本的横断面研究的限制 足球运动员和对回溯性线人报告的依赖。为了解决这些知识差距，我们扩大了 我们的CC在2018年将参与者与RHI(男性和女性，不同类型的运动)的接触相结合 和比赛的级别)。这一整合与研究RHI后期影响的中心主题高度一致 并将AD、CTE和其他ADRD与临床表现、生物标记物特征、遗传和其他方面进行比较 风险因素和临床-病理相关性。在目标1中，我们将维持、增强和描述 已建立的CC队列(CCC)的临床表型和轨迹。CCC由400名成员组成 参赛者年龄50岁，人口结构多样，代表大波士顿，跨越 认知光谱。我们将与外联、征聘和参与核心部门合作，继续 招募传统的CC参与者，并扩大接触RHI的人数。我们将描述 使用传统和新型的神经学、神经心理学、神经精神病学和诊断简档 表型鉴定方法，包括数字表型鉴定。我们将获得CC参与者的脑捐赠同意 并与神经病理核心中心合作，促进大脑捐赠。在目标2中，我们将获得大脑成像， 来自CCC的生物标记物和新型生物标记物，并与数据管理和统计、生物标记物、 以及基因组学和分子图谱分析核心，以集成生物标记物收集、分析、银行和 分发。在目标3中，我们将分享数据，并为当地和 关于AD和ADRD的国家研究，包括CTE。在目标4中，我们将教育学员发展 新一代AD/ADRD临床研究人员。总而言之，协调委员会通过以下方式在BU ADRC中发挥核心作用 吸引研究参与者参与并推动反映中心总体主题的活动，以及 推进国家适应行动方案建议中确定的优先事项。

The Boston University Alzheimer’s Disease Research Center Clinical Core (BU ADRC CC) facilitates and conducts cutting-edge research on AD and AD related dementias (ADRDs), including chronic traumatic encephalopathy (CTE). CC participants, and biospecimens and data generated from their participation, support local efforts, cross-ADRC collaborations and national research initiatives. CC investigators are engaged in AD/ADRD research towards several National Alzheimer’s Project Act (NAPA) goals, including population studies, precision medicine, health disparities, biomarkers, diagnosis, mechanisms, and translational and clinical research. The Center is closely integrated and synergistic with the Framingham Heart Study at BU. Research by CC investigators has led to fundamental insights into the role of repetitive head impacts (RHI) from contact sport participation, military service and physical violence in the pathogenesis of AD/ADRD, including CTE. However, CTE cannot be diagnosed during life due to an ill-defined clinical presentation and lack of validated biomarkers. Research has been limited by cross-sectional studies of small samples of male former elite American football players and reliance on retrospective informant reports. To address these knowledge gaps, we expanded our CC in 2018 to integrate participants with exposure to RHI (men and women, across different types of sports and levels of play). This integration is highly aligned with the Center-wide theme to study the late effects of RHI and compare AD, CTE and other ADRDs, vis-à-vis clinical presentation, biomarker profile, genetic and other risks factors, and clinical-pathological correlations. In Aim 1, we will sustain, augment, and characterize the clinical phenotypes and trajectories of an established CC Cohort (CCC). The CCC is comprised of 400 participants, that are >50 years, demographically diverse, representative of Greater Boston and that span the cognitive spectrum. We will collaborate with the Outreach, Recruitment and Engagement Core to continue recruitment of traditional CC participants and expand the number with RHI exposure. We will characterize the neurological, neuropsychological, neuropsychiatric and diagnostic profiles using traditional and novel phenotyping approaches, including digital phenotyping. We will obtain brain donation consent of CC participants and work with the Neuropathology Core to facilitate brain donation. In Aim 2, we will obtain brain imaging, biospecimens and novel biomarkers from the CCC and work with the Data Management & Statistics, Biomarker, and Genomics and Molecular Profiling Cores to integrate biomarker collection, analysis, banking, and distribution. In Aim 3, we will share data and provide a source of well-characterized participants for local and national research studies on AD and ADRD, including CTE. In Aim 4, we will educate trainees to develop the next generation of AD/ADRD clinical investigators. In conclusion, the CC plays a central role in the BU ADRC by engaging research participants and driving activities that reflect the Center’s overall themes, as well as advancing the priorities identified in NAPA recommendations.