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Scalco R, Hamsafar Y, White CL, Schneider JA, Reichard RR, Prokop S, Perrin RJ, Nelson PT, Mooney S, Lieberman AP, Kukull WA, Kofler J, Keene CD, Kapasi A, Irwin DJ, Gutman DA, Flanagan ME, Crary JF, Chan KC, Murray ME, Dugger BN. The status of digital pathology and associated infrastructure within Alzheimer's Disease Centers. J Neuropathol Exp Neurol 2023; 82:202-211. [PMID: 36692179 PMCID: PMC9941826 DOI: 10.1093/jnen/nlac127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Digital pathology (DP) has transformative potential, especially for Alzheimer disease and related disorders. However, infrastructure barriers may limit adoption. To provide benchmarks and insights into implementation barriers, a survey was conducted in 2019 within National Institutes of Health's Alzheimer's Disease Centers (ADCs). Questions covered infrastructure, funding sources, and data management related to digital pathology. Of the 35 ADCs to which the survey was sent, 33 responded. Most respondents (81%) stated that their ADC had digital slide scanner access, with the most frequent brand being Aperio/Leica (62.9%). Approximately a third of respondents stated there were fees to utilize the scanner. For DP and machine learning (ML) resources, 41% of respondents stated none was supported by their ADC. For scanner purchasing and operations, 50% of respondents stated they received institutional support. Some were unsure of the file size of scanned digital images (37%) and total amount of storage space files occupied (50%). Most (76%) were aware of other departments at their institution working with ML; a similar (76%) percentage were unaware of multiuniversity or industry partnerships. These results demonstrate many ADCs have access to a digital slide scanner; additional investigations are needed to further understand hurdles to implement DP and ML workflows.
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Affiliation(s)
- Rebeca Scalco
- Department of Pathology and Laboratory Medicine, University of California-Davis, Sacramento, California, USA
| | - Yamah Hamsafar
- Department of Pathology and Laboratory Medicine, University of California-Davis, Sacramento, California, USA
| | - Charles L White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | - Stefan Prokop
- Department of Pathology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Richard J Perrin
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | | | - Sean Mooney
- Institute for Medical Data Science and Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Andrew P Lieberman
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Walter A Kukull
- Institute for Medical Data Science and Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Julia Kofler
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christopher Dirk Keene
- Department Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | | | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A Gutman
- Departments of Neurology, Psychiatry, and Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Margaret E Flanagan
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John F Crary
- Department of Pathology, Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neuroscience, Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kwun C Chan
- Institute for Medical Data Science and Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Brittany N Dugger
- Department of Pathology and Laboratory Medicine, University of California-Davis, Sacramento, California, USA
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Bollinger RM, Keleman A, Thompson R, Westerhaus E, Fagan AM, Benzinger TL, Schindler SE, Xiong C, Balota D, Morris JC, Ances BM, Stark SL. Falls: a marker of preclinical Alzheimer disease: a cohort study protocol. BMJ Open 2021; 11:e050820. [PMID: 34526343 PMCID: PMC8444237 DOI: 10.1136/bmjopen-2021-050820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Progression to symptomatic Alzheimer disease (AD) occurs slowly over a series of preclinical stages. Declining functional mobility may be an early indicator of loss of brain network integration and may lead to an increased risk of experiencing falls. It is unknown whether measures of functional mobility and falls are preclinical markers of AD. The purpose of this study is to examine (1) the relationship between falls and functional mobility with AD biomarkers to determine when falls occur within the temporal progression to symptomatic Alzheimer disease, and (2) the attentional compared with perceptual/motor systems that underlie falls and functional mobility changes seen with AD. METHODS AND ANALYSIS This longitudinal cohort study will be conducted at the Knight Alzheimer Disease Research Center. Approximately 350 cognitively normal participants (with and without preclinical AD) will complete an in-home visit every year for 4 years. During each yearly assessment, functional mobility will be assessed using the Performance Oriented Mobility Assessment, Timed Up and Go, and Timed Up and Go dual task. Data regarding falls (including number and severity) will be collected monthly by self-report and confirmed through interviews. This study will leverage ongoing neuropsychological assessments and neuroimaging (including molecular imaging using positron emission tomography and MRI) performed by the Knight Alzheimer Disease Research Center. Relationships between falls and biomarkers of amyloid, tau and neurodegeneration will be evaluated. ETHICS AND DISSEMINATION This study was approved by the Washington University in St. Louis Institutional Review Board (reference number 201807135). Written informed consent will be obtained in the home prior to the collection of any study data. Results will be published in peer-reviewed publications and presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT04949529; Pre-results.
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Affiliation(s)
- Rebecca M Bollinger
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Audrey Keleman
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Regina Thompson
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Elizabeth Westerhaus
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tammie Ls Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David Balota
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Beau M Ances
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Susan L Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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