Perspective from the Alzheimer's Association: Neuroimaging Professional Interest Area of ISTAART continues impact on the field

More than 5 million Americans [1] and 35 million people worldwide are estimated to be living with Alzheimer’s disease (AD) today, with the prevalence expected to quadruple by 2050 as the world’s population ages [2]. Although Dr. Alois Alzheimer first described AD more than a century ago [3,4], advances in therapy development have remained elusive. Today’s current therapies provide symptomatic relief, and there is no evidence that they stop or slow the progression of the underlying disease process. The search for disease-modifying therapies has been hampered by a lack of knowledge about the course of the disease process. Data from clinical, imaging, biomarker, genomic, and other omic studies combined with electronic health records, payer claims, and new technologies that track real-time data should inform a better understanding of the earliest neuropathological and behavioral events that herald the oncoming disease. The in vivo imaging biomarkers field for Alzheimer’s disease and related disorders is rapidly expanding, and neuroimaging has emerged as a critical research and diagnostic tool in the field of AD and other dementias. In 2004, researchers from the University of Pittsburgh, led by Drs. William Klunk and Chet Mathis, reported for the first time at the Alzheimer’s Association International Conference (AAIC; formerly the International Conference on Alzheimer’s Disease) on an imaging agent called Pittsburgh compound B (PiB), a major potential breakthrough in disease monitoring and early detection. PiB enters the brain through the bloodstream and attaches itself to beta-amyloid deposits, where it can be detected by positron emission tomography (PET). This set the stage for the next decade of research on betaamyloid imaging ligands. The Alzheimer’s Association provided significant support to initiatives to develop PiB and conduct preclinical testing in animal studies. Also in 2004, the Alzheimer’s Disease Neuroimaging Initiative (ADNI) launched as a model of private and public partnership to establish standards for obtaining and interpreting brain images across the nation. In 2005, the Alzheimer’s Association provided $2.4 million in funding for the ADNI PiB add-on study which was pivotal in our understanding about the accumulation of beta-amyloid in later life. Findings resulting from ADNI have influenced the field in dramatic