Project Details
Description
PROJECT SUMMARY / ABSTRACT
Mild Cognitive Impairment (MCI) with core clinical features of dementia with Lewy bodies (DLB) is recognized
as the prodromal stage of DLB (MCI-LB). Patients with MCI-LB frequently progress to DLB, but a subset may
have a range of additional AD pathology. Rapid advances in the development of protein-specific disease-
modifying therapies highlight a critical need for biomarkers in MCI-LB, because clinical trials will need to be
sufficiently powered to detect changes in disease progression during the prodromal phase, when the disease-
modifying therapies would be most effective. During the initial cycle of this project, we determined the cross-
sectional and longitudinal imaging biomarkers of DLB with pathologic confirmation. The current cycle of the
U01 project is designed to identify cross-sectional and longitudinal multi-modal biomarkers of prodromal DLB in
MCI-LB, and prepare for protein-specific disease-modifying clinical trials that will need these biomarkers for
selection of participants and to track outcomes in MCI-LB. The rationale for a multi-modal biomarker approach
stems from the multi-factorial and co-existing LBD and AD pathology in DLB and similarly in MCI-LB. We will
determine the cross-sectional and longitudinal PET, SPECT, MRI, and polysomnogram (PSG) biomarkers of
MCI-LB compared to cognitively unimpaired controls. We will also determine whether age, sex as a biological
variable, APOE ε4 status, and cerebrovascular disease lesions on MRI modulate these differences. In a pilot
analysis, we will compare protein misfolding cyclic amplification (PMCA) and real-time quaking-induced
conversion (RT-QuIC) assays for α-synuclein in CSF for differentiating MCI-LB from controls. Finally, we will
correlate our findings with pathologic outcomes. Inclusion of MCI-LB patients in the current cycle will be based
on the presence of one or more core clinical features of DLB and not on biomarker findings. This will provide
the opportunity to validate the use of proposed and novel biomarkers in the diagnosis of MCI-LB and to
determine which biomarkers predict progression from MCI-LB to DLB. All samples, clinical, imaging, and
autopsy data from MCI-LB cases and controls will be collected and shared according to the Parkinson's
Disease Biomarkers Program guidelines.
Status | Active |
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Effective start/end date | 9/25/17 → 8/31/24 |
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