P4‐003: Neuropathologic assessment of ADNI participants: The essential role of the neuropathology core

Our objectives are to facilitate autopsy consent, brain collection, and perform standardized neuropathologic assessments of all Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who come to autopsy at the 58 ADNI sites in the USA and Canada. Building on the expertise and resources of the existing Knight Alzheimer's Disease Research Center (ADRC) at Washington University School of Medicine, St. Louis, MO, a Neuropathology Core (NPC) to serve ADNI was established. The ADNI-NPC coordinator provides training materials and protocols to assist clinicians at ADNI sites in obtaining voluntary consent for brain autopsy in ADNI participants. Secondly, the ADNI-NPC maintains a central laboratory to provide uniform neuropathologic assessments using the operational criteria for the classification of AD and other pathologies defined by the National Alzheimer Coordinating Center (NACC). Thirdly, the ADNI-NPC maintains a state-of-the-art brain bank of ADNI-derived brain tissue to promote biomarker and multi-disciplinary clinicopathological studies. During the initial year of funding of the ADNI-NPC, there was an improvement in the autopsy rate from 0 to 40%. In the most recent year of funding (September 1, 2010 to February1, 2011), the autopsy rate was 2/2 (100%). The overall autopsy rate is 12/23 (52.2%). Although the overall numbers to date are small, these data demonstrate that the Neuropathology Core has established the administrative organization with the participating sites to harvest brains from ADNI participants who come to autopsy. The Neuropathology Core has: (1) implemented a protocol to solicit permission or brain autopsy in ADNl participants at all 58 sites who die and (2) established procedures to send appropriate brain tissue from the decedents to the Neuropathology Core for a standardized, uniform, and state-of-the-art neuropathologic assessment. The benefit to ADNI of the implementation ofthe NPC is very clear. Prior to the establishment ofthe NPC in September 2007, there were 6 deaths but no autopsies in ADNI participants. Subsequent to the establishment ofthe Core there have been 23 deaths of ADNI participants and 12 autopsies. Hence, the autopsy rate has gone from 0% to 52.2%. The third major accomplishment is the detection ofco-existent pathologies, most frequently synucleinopathy, with AD in the cases. It is possible that these co-morbidities may contribute to any variance in ADNI data. Cairns NI, Taylor-Reinwald L, Morris Ie; Alzheimer's Disease Neuroimaging Initiative. Autopsy consent;brain collection, and standardized neuropathologic assessment of ADN1 participants: the essential role ofthe neuropathology core. Azheimers Dement. 2010;6:274-9.

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