Monitoring disease pathophysiology longitudinally using multiparametric PET acquisitions: The McGill TRIAD cohort

Abstract

AbstractBackgroundThe Translational Biomarkers in Aging and Dementia (TRIAD) cohort aims at describing the biomarker trajectories and interactions between pathophysiological processes as drivers of dementia. While focusing on advanced personalized and preclinical dementia diagnosis, TRIAD’s main objectives include understanding the interactions between amyloid‐β and tau and their role in the progression of brain atrophy and cognitive decline; as well as the role of neuroinflammation, epigenetics and synaptic depletion as mediators of cognitive decline.MethodInclusion into the TRIAD cohort begins with a telephone screening ensuring the participant’s eligibility. Participants sign an ethically approved consent form where they agree to donate biofluids (blood, urine, saliva and cerebrospinal fluid) at the first on‐site visit. The second visit consists of an extensive neuropsychological battery, followed by PET and MRI visits. The PET scans completed are dependent on their diagnosis and the project in which they are enrolled. TRIAD cohort uses a variety of tracers in their different projects to detect the presence of different protein accumulation in the brain. These tracers include [18F]MK6240, [18F]AZD4694, [18F]AV1451, [18F]PI2620 and [18F]RO948, [11C]PBR28 or [18F]DPA, [18F]FEOBV [11C]MRT and [18F]SDM‐8. TRIAD participants complete intermediate telephone follow‐up calls at 6 and 18 months and return for follow‐up clinical and imagery visits 12 and 24 months after baseline, with a retention rate of 75%.ResultSince 2017, the TRIAD registry has recruited 1,285 people and enrolled 576 participants. Enrolled in the TRIAD studies are individuals without cognitive impairment (n=345), with mild cognitive impairment (n=75), sporadic and autosomal‐dominant Alzheimer’s disease (n=90), atypical dementia (n=27) and individuals under evaluation (n=39). The TRIAD cohort currently banks 495 baseline blood collections and 108 follow‐up collections with 85 participants having completed 12‐month follow‐up scans and neuropsychological evaluation.ConclusionWith a strong participant retention rate, TRIAD presents a striking opportunity to further understand the progression of Alzheimer’s disease with resources ready to uphold the use of affordable biomarkers, capable of diagnosing and measuring disease progression.