Purpose

The Longitudinal Early-onset Alzheimer's Disease Study (LEADS) is a non-randomized, natural history, non-treatment study designed to look at disease progression in individuals with early onset cognitive impairment. Clinical, cognitive, imaging, biomarker, and genetic characteristics will be assessed across three cohorts: (1) early onset Alzheimer's Disease (EOAD) participants, (2) early onset non-Alzheimer's Disease (EOnonAD) participants, and (3) cognitively normal (CN) control participants.

Conditions

Eligibility

Eligible Ages
Between 40 Years and 64 Years
Eligible Genders
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

(Cognitively Impaired (EOAD and EOnonAD) Cohorts Only): 1. Meets NIA-AA criteria for MCI due to AD or probable AD dementia 2. Have a global CDR score ≤ 1.0 3. Have capacity to provide informed consent (IC) or has a legal authorized representative or guardian who provides IC 4. Age between 40-64 years (inclusive) at the time of consent 5. Must have a study partner (informant) who spends a minimum average of at least 10 hours per week with the participant (e.g., family member, significant other, friend, caregiver) who is generally aware of the participants' daily activities and can provide information about the participant's cognitive and functional performance. If the participant does not have a study partner who spends 10 face-to-face hours per week, other arrangements for identifying a viable study partner will be granted on a case-by-case basis by the Site PI 6. Willing and able to complete longitudinal study procedures aside from LP which is an optional procedure 7. Not pregnant or lactating. Women must be two years post-menopausal, be surgically sterile, or have a negative pregnancy test prior to each PET scan 8. Fluent in English Inclusion Criteria (Cognitively Normal (CN) Cohort Only): 1. Meets criteria for cognitively normal, based on an absence of significant impairment in cognitive functions or activities of daily living 2. Have a global CDR score = 0 3. Have capacity to provide informed consent 4. Have a Mini-Mental State Exam score between 26-30 (inclusive). Exceptions may be made for participant with less than 8 years of education at the discretion of the Site PI 5. Age between 40-64 years (inclusive) at the time of consent 6. Must have a study partner (informant) who spends a minimum average of 10 hours per week with the participant (e.g., family member, significant other, friend, caregiver) who is generally aware of the participants' daily activities and can provide information about the participant's cognitive and functional performance. If the participant does not have a study partner who spends 10 face-to-face hours per week, other arrangements for identifying a viable study partner will be granted on a case-by-case basis by the Site PI 7. Willing and able to complete longitudinal study procedures aside from LP which is an optional procedure 8. Not pregnant or lactating. Women must be two years post-menopausal, be surgically sterile, or have a negative pregnancy test prior to each PET scan 9. Fluent in English

Exclusion Criteria

(All (EOAD, EOnonAD and CN) Cohorts): 1. Meets core clinical criteria for non-AD dementia 2. Two or more first degree relatives with a history of early-onset dementia suggestive of autosomal dominant transmission, unless known pathogenic mutations in APP, PSEN1, PSEN2 have been excluded 3. Known CLIA certified mutation in an ADAD gene (APP, PSEN1, PSEN2) or other autosomal dominant genes associated with other neurodegenerative disorders 4. Contraindications to 3T MRI (e.g., claustrophobia, pacemaker, select aneurismal clip, artificial heart valve, select ear implants, select stents incompatible with 3T MRI, metal fragments or foreign objects in the eyes, skin or body, etc.) 5. Lifetime medical history of a brain disorder other than the disorder causing dementia except for headache (exceptions are allowed at the discretion of the Site PI - e.g., seizure disorder thought to be due to EOAD). 6. MRI scan with evidence of infection or focal lesions, cortical strokes, multiple lacunes (single lacune is allowable unless it meets criteria for strategic lacune affecting cognition) 7. Any significant systemic illness or unstable medical condition, which could lead to difficulty complying with the protocol (at the discretion of the Site PI) 8. Medical radiation exposure will be assessed by the study physician. If the candidate participant has had more than one nuclear medicine study in the prior 12 months, study inclusion will require approval from the PET Core 9. Investigational agents are prohibited 30 days prior to entry 10. Previous enrollment in a therapeutic trial targeting amyloid or tau 11. Participation in other clinical studies with neuropsychological measures, with the exception of participants who are co-enrolled in the NACC Uniform Data Set (UDS) protocol (Note: This criterion is intended to reduce repeat measures effects during neuropsychological testing. Exceptions are allowed at the discretion of the Site PI) 12. Lifetime history of schizophrenia spectrum disorders (DSM-5 criteria) 13. Current history (in previous 12 months) of DSM-5 diagnosis of mania, bipolar disorder with or without psychotic features 14. Current history (in previous 6 months) of moderate or severe substance abuse (nicotine or caffeine is allowed) 15. Suicidal behaviors in the past 12 months or active suicidal ideations 16. Residing in a 24-hour care skilled nursing facility (at the time of screening) 17. (For optional lumbar puncture procedure only): a. Clinical laboratory values must be within normal limits or, if abnormal, must be judged to be not clinically significant by the Site PI i. Platelet count <100,000/µl ii. INR>1.2 iii. Abnormal PT or PTT at screening b. Contraindications to the procedure, including but not limited to severe degenerative joint disease, deformity of the spine, history of a bleeding disorder c. Suspected elevated intracranial pressure, Arnold Chiari malformation or mass lesion d. Use of the anticoagulant medications such as but not limited to warfarin, rivaroxaban, dabigatran 18. Deemed ineligible by the Site PI for any other reason

Study Design

Phase
Study Type
Observational
Observational Model
Cohort
Time Perspective
Prospective

Arm Groups

ArmDescriptionAssigned Intervention
Early Onset Alzheimer's Disease (EOAD) Diagnosis of NIA-AA criteria of MCI due to AD or probable AD dementia Amyloid positive status (florbetaben PET scan with evidence of elevated amyloid as determined by a central read) CDR score ≤ 1.0 flortaucipir (18F-AV-1451) PET scanning
  • Drug: Flortaucipir
    All participants will receive a single bolus intravenous injection of approximately 10 mCi (+/- 10%, 20μg mass dose) of flortaucipir (18F-AV-1451). At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
    Other names:
    • 18F-AV-1451 (also known as [F-18]T807 or LY3191748)
  • Drug: Florbetaben
    All participants will receive a single bolus intravenous injection of approximately 8 mCi +/- .8mCi of florbetaben (AV-45). At approximately 90-minutes (+/- 10 minutes) post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed.
    Other names:
    • AV-45, Neuraceq
Cognitively Normal (CN) Controls Meets criteria for cognitively normal, based on an absence of significant impairment in cognitive functions and activities of daily living Mini-Mental State Exam score between 26-30 CDR score = 0 flortaucipir (18F-AV-1451) PET scanning
  • Drug: Flortaucipir
    All participants will receive a single bolus intravenous injection of approximately 10 mCi (+/- 10%, 20μg mass dose) of flortaucipir (18F-AV-1451). At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
    Other names:
    • 18F-AV-1451 (also known as [F-18]T807 or LY3191748)
  • Drug: Florbetaben
    All participants will receive a single bolus intravenous injection of approximately 8 mCi +/- .8mCi of florbetaben (AV-45). At approximately 90-minutes (+/- 10 minutes) post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed.
    Other names:
    • AV-45, Neuraceq
  • Drug: Fluorodeoxyglucose
    All participants will receive a single bolus intravenous injection of approximately 5 mCi (+/- 10%, 0.5 mCi) of fluorodeoxyglucose. At approximately 30 minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
    Other names:
    • FDG
Early Onset non-Alzheimer's Disease (EOnonAD) Diagnosis of NIA-AA criteria of MCI due to AD or probable AD dementia Amyloid negative status (florbetaben PET scan with no evidence of elevated amyloid as determined by a central read) CDR score ≤ 1.0 flortaucipir (18F-AV-1451) PET scanning
  • Drug: Flortaucipir
    All participants will receive a single bolus intravenous injection of approximately 10 mCi (+/- 10%, 20μg mass dose) of flortaucipir (18F-AV-1451). At approximately 75-minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
    Other names:
    • 18F-AV-1451 (also known as [F-18]T807 or LY3191748)
  • Drug: Florbetaben
    All participants will receive a single bolus intravenous injection of approximately 8 mCi +/- .8mCi of florbetaben (AV-45). At approximately 90-minutes (+/- 10 minutes) post dose, scanning will begin. An approximately 20-minute image acquisition scan will be performed.
    Other names:
    • AV-45, Neuraceq
  • Drug: Fluorodeoxyglucose
    All participants will receive a single bolus intravenous injection of approximately 5 mCi (+/- 10%, 0.5 mCi) of fluorodeoxyglucose. At approximately 30 minutes post dose, scanning will begin. An approximately 30-minute image acquisition scan will be performed.
    Other names:
    • FDG

Recruiting Locations

Georgetown University
Washington, District of Columbia 20057
Contact:
Kelly McCann
202-687-0413
keb53@georgetown.edu

More Details

Status
Recruiting
Sponsor
Liana Apostolova

Study Contact

IU LEADS Team
317-963-7436
iuLEADS@iupui.edu

Detailed Description

The LEADS study is a non-randomized, natural history, non-treatment study. Enrolled participants must be 40 - 64 (inclusive) years of age, with MCI due to AD or probable AD dementia (cognitively impaired participants) or have no significant memory impairment (cognitively normal [CN] participants). Approximately 600 participants with cognitive impairment (400 with early onset Alzheimer's Disease [EOAD] and 200 with early onset non-Alzheimer's Disease [EOnonAD]) and 100 CN participants will be enrolled at approximately 20 sites in the United States. Cognitively impaired participants will take part in the study for 48+ months; CN participants will take part in the study for 24+ months. Participants will undergo longitudinal clinical and cognitive assessments, computerized cognitive tests, biomarker and genetic tests, PET (FDG, amyloid and tau) and MRI brain scans, and optional cerebrospinal fluid (CSF) collection. Participants will be invited to consider autopsy brain donation The primary objectives of the LEADS study are to: - collect longitudinal assessments and biomarker data in individuals with early onset cognitive impairment (EOAD / EOnonAD) and cognitively normal (CN) controls; - to compare baseline and longitudinal cognitive and functional characteristics, between EOAD and CN, and EOAD and Late Onset Alzheimer's Disease (LOAD) from the Alzheimer's Disease Neuroimaging Initiative (ADNI); and - to study the associations of longitudinal clinical and cognitive assessments with multimodal imaging and biofluid markers that capture different elements of the AD pathophysiological cascade

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.