Biological heterogeneity in ADRD

摘要： 阿尔茨海默病和相关痴呆症(ADRD)与美国一样，是一场史诗般的医疗危机 人口继续老龄化。AD研究中心(ADRC)和神经生物库(NBB)，两者都得到了资助 由NIH代表两个独立的网络，都专注于促进和支持人脑研究， 前者专注于ADRD，在具有最深厚专业知识和 ADRD神经病理学基础设施，后者拥有最广泛的网络和完善的 协调中心、外展渠道以及数据和组织共享机制。2017年度香港艺术发展局 小组建议包括侧重于ADRD神经病理学的多项建议，包括 纳入人数不足群体的捐赠者和非痴呆(对照)捐赠者的机制， 增加与当地社区的接触和参与脑捐赠的机会，以及 加强ADRC和NBB网络之间的合作，以促进脑捐赠和脑研究 科学家对组织的利用侧重于ADRD。为此，成立了ADRC-NBB工作组，以 探索满足这一需求的机会，从而形成一个试验计划来测试其中的一些 解决办法。这项提议是为了支持威斯康星州大学网站进行这项试点研究，该研究有五个目标，当 成功完成，将开发、实施和测试整个ADRC和NBB的机制，以确定和 同意ADRD脑捐赠者，包括控制组，以协调的方式在全国范围内收集来自 同意的捐赠者，使用优化的程序进行研究，以最大限度地提高组织质量，进行 最先进的神经病理检查，通过以下方式使用关键捐赠者元数据补充此数据 有组织的家庭访谈和医疗记录审查，以在 网络和美国各地的研究人员，并满足这些捐赠者的数据和组织请求，基于 这一基础设施，以支持ADRD研究。当成功完成后，这项初步研究将会有所帮助 确定有效的机制/协议/管道，以支持人脑捐赠和研究 最终有助于推动ADRD研究朝着机械性知识、改进的诊断策略和 有效的治疗干预。

Abstract: Alzheimer's disease and related dementias (ADRD) represent a healthcare crisis of epic proportions as the US populations continues to age. The AD Research Centers (ADRC) and the NeuroBiobank (NBB), both funded by NIH, represent two separate networks both focused on promoting and supporting human brain research, the former focused on ADRD in well-characterized prospective cohorts with the deepest expertise and infrastructure for ADRD neuropathology, and the latter with the broadest network with well-established coordination across center, outreach pipelines, and data and tissue sharing mechanisms. The 2017 ADC Panel Recommendations included multiple focused on ADRD neuropathology, including developing mechanisms for inclusion of donors from underrepresented groups and non-demented (control) donors, increasing engagement with and opportunity for local communities to participate in brain donation, and enhancing collaborations across the ADRC and NBB networks to promote brain donation and research brain tissue utilization by scientists focused on ADRD. In response, an ADRC-NBB working group was established to explore opportunities to meet this need, resulting in formation of a pilot program to test some of these solutions. This proposal is for support of the UW site for this pilot study, which has five aims that, when successfully completed, will develop, implement, and test mechanisms across ADRC and NBB to identify and consent ADRD brain donors, including controls, in a coordinated manner nationally, to collect brains from consented donors who pass using procedures optimized for maximum tissue quality for research, to perform state-of-the-art neuropathological examination, to supplement this data with critical donor metadata through structured family interviews and medical records reviews, to share this deidentified information across the networks and with researchers across the US, and to fill data and tissue requests from these donors, based on this infrastructure, to support ADRD research. When successfully completed, this pilot study will have helped identify effective mechanisms/protocols/pipelines to support human brain donation and research that will ultimately help propel ADRD research toward mechanistic knowledge, improved diagnostic strategies, and effective therapeutic interventions.