Jody Corey-Bloom - US grants

Psychosis is a common behavioral complication of dementia in the elderly, and of Alzheimer's disease (AD) in particular. Although certain limbic structures have been implicated in the cognitive and emotional abnormalities of chronic idiopathic psychosis, little is known about the neuropathological and neuroradiological correlates of psychoses of later onset, including those associated with neurodegenerative disorders. MRI provides the anatomical resolution necessary for in vivo detection of structural abnormalities and has the advantage over neuropathologic data in that results may be correlated with concurrent clinical assessments. The aim of the present study is to use computer-analyzed MR to estimate volumes of specific cerebral structures in AD patients with and without psychosis in an attempt to identify a possible anatomical substrate of late-onset psychosis. Analysis is proposed on four groups of patients (AD with psychosis, AD without psychosis, Lewy body variant, controls). It is our hypothesis that AD subjects with psychosis will demonstrate similar structural abnormalities with regard to their psychosis, especially involving lenticular, frontal and mesial temporal lobe structures. In the Lewy body variant of AD, where extrapyramidal features are characteristic of the clinical presentation, involvement of basal ganglia structures would be expected to be significantly more prominent. If patients die and have autopsies during the time-frame of the study, neuropathological findings will be correlated with quantitative MR analysis.

The Education and Information Transfer Core provides both training in basic science and clinical aspects of Alzheimer's disease, and information transfer within the ADRC, to health professional in the community, to caregivers and individuals affected by the disease, and to the general public. This includes providing cutting edge research training, professional staff enrichment, fostering interest in AD especially in under-represented groups, and providing information about our ADRC and its clinical research programs. We will also reach out to caregivers and individuals affected by AD to provide them with information, support groups, access to community resources, and opportunities to participate in research. Four specific aims will accomplish these goals: 1) Support the development of scientists, physicians, and other professional staff to improve research and clinical skills. This will be done at the basic science level through affiliated graduate programs, seminar series, and our pilot research program. At the clinical level, it will be accomplished through our biweekly clinical meetings, the mini-residency program, courses/lectures taught by our faculty, and dementia and geriatric fellowships. 2) Enhance the knowledge about AD diagnosis, care, and research in community healthcare providers. Activities include our annual CME conference, the mini-residency program, and numerous seminars and in-service training about research advances, diagnosis and management of AD.3) Enhance recruitment of under-represented groups into AD research and care through the development of culturally sensitive recruitment strategies and patient care program for Hispanics. A special attempt is made to educate the Hispanic community, including both healthcare professionals and the general public regarding diagnosis, care and the management of AD. We also strive to increase participation in research. 4) Increase public knowledge of AD, including information for caregivers, and promote recruitment into AD clinical research programs. We work closely with the San Diego Chapter of the Alzheimer's Association and other groups in San Diego to sponsor educational activities like our Young Caregiver and Patient Support groups. We also host an ADRC website with current information on the disease, produce a newsletter, and host an annual Fall Open House for participants and their families.

musculoskeletal disorder therapy; nervous system disorder therapy; psychomotor function; multiple sclerosis; Cannabis; neuromuscular disorder; human therapy evaluation; therapy adverse effect; alternative medicine; neuropsychological tests; smoking; outcomes research; clinical research; human subject;

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Determine the safety and tolerability of orally administered Dimebon during dosage escalation in subjects with mild to moderate Huntington's disease.

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Collect prospective data from individuals who are part of an HD family, relating phenotypes between individuals and families with each other and genetic factors, in order to learn more about HD, develop potential treatments for the disease, and plan for future research studies of experimental drugs aimed at slowing or postponing the onset of progression of HD.

Acids; CRISP; Chorea; Choreic Movement; Choreiform Movement; Clinical; Clinical Trials; Clinical Trials, Unspecified; Computer Retrieval of Information on Scientific Projects Database; Fatty Acids; Funding; Grant; Huntington Chorea; Huntington Disease; Huntington's; Huntington's Disease; Huntington's Disease Pathway; Huntingtons Disease; Institution; Investigators; Motor; NIH; National Institutes of Health; National Institutes of Health (U.S.); Placebo Effect; Progressive Chorea, Hereditary, Chronic (Huntington); Rate; Research; Research Personnel; Research Resources; Researchers; Resources; Score; Source; United States National Institutes of Health; clinical investigation; expectancy effect; expectation effect; impression; nocebo; placebo response

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. To evaluate the effectiveness of ACR16 as a symptomatic treatment for Huntington disease (HD) and to investigate the dose-response relationship of ACR16. The primary objective is to assess the effects of ACR16 on voluntary motor function in HD subjects. Secondary objectives are to assess the effects of ACR16 on clinical global impression of change (CGI-C), cognitive function, behavior, and symptoms of depression and anxiety at 12 weeks of treatment;in addition to assessing its safety and tolerability.

Seeinstructions): The Education and Information Core provides both training in basic science and clinical aspects of Alzheimer's disease (AD), and information transfer within the ADRC, to health professional in the community, to caregivers and individuals affected by the disease, and to the general public. This includes providing cutting edge research training, professional staff enrichment, fostering interest in AD especially in under- represented groups, and providing information about our ADRC and its clinical research programs. We will also reach out to caregivers and individuals affected by AD to provide them with information, support groups, access to community resources, and opportunities to participate in research. This Core, along with the Clinical Core, shares the primary responsibility for recruitment for our studies. Five specific aims will accomplish these goals: 1) Provide professional training in clinical and research skills to academic and professional staff at UCSD and other universities in San Diego including physicians, researchers, graduate students, postdoctoral fellows, neuropsychologists, nurses, and social workers. 2) Maintain outreach programs to community healthcare professionals and families to enhance knowledge about AD diagnosis, care, and research and,in turn, enhance recruitment for ADRC-related research studies. Develop new programs and outreach as needed to ensure enrollment of special populations, such as patients with Dementia with Lewy bodies or Mild Cognitive Impairment. 3) Develop culturally sensitive strategies and programs for Hispanic elderly and healthcare professionals who serve the Hispanic community. Educate them regarding AD and related disorders and encourage participation in all aspects of clinical research. 4) Provide innovative social and educational support programs for persons with dementia and their caregivers. 5) Evaluate the success of all outreach, recruitment, and educational programs. Use the data from these evaluations to develop an annual needs assessment in conjunction with the Clinical Core, Project, and Pilot Principal Investigators. RELEVANCE (See instructions): AD affects millions of Americans with its risk growing exponentially with age. The AD Centers Program fosters research related to AD and non-AD dementias. The ADRC will enhance the performance of innovative research on AD and related topics, including research that may lead to potential disease modifying therapies or behavioral treatments. It will provide an environment and core resources to enhance research, foster professional and community training, and coordinate interdisciplinary research.

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. To use functional and structural MRI to examine brain changes in subjects at risk for HD prior to significant cell loss by scanning at risk HD subjects and controls at two time-points to: 1) evaluate the hypothesis that functional activation of fronto-striatal circuits is abnormal in subjects at risk for HD compared to controls even while subjects are many years away from manifest disease onset. This will be achieved by comparing at risk HD subjects to controls at timepoint 1. 2) evaluate the hypothesis that alterations in frontostriatal function in HD subjects are detectable over a comparatively short interval (approx. 12 months) by scanning each at risk HD subject and control at two time-points.

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. To evaluate the effectiveness of ACR16 as a symptomatic treatment for Huntington disease (HD) and to investigate the dose-response relationship of ACR16. The primary objective is to assess the effects of ACR16 on voluntary motor function in HD subjects. Secondary objectives are to assess the effects of ACR16 on clinical global impression of change (CGI-C), cognitive function, behavior, and symptoms of depression and anxiety at 12 weeks of treatment;in addition to assessing its safety and tolerability.

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Determine the effect of Dimebon as compared to placebo on cognition as measured by the Mini-Mental State Examination (MMSE);and determine the effect of Dimebon as compared to placebo on the primary measure of global function, the Clinician's Interview-Based Impression of Change, plus caregiver input (CIBIC-plus).

CORE E: OUTREACH, RECRUITMENT AND EDUCATION - ABSTRACT The Outreach, Recruitment and Education (ORE) Core provides a liaison between the ADRC and its research subjects, their caregivers and the professional and lay community. It also works in tandem with the Administrative Core, Clinical Core and the Hispanic Satellite Core to develop and execute recruitment strategies, which evolve with the needs of the Center and its affiliated research projects. ORE develops tools and programs to support its mission, such as the Recruitment Registry database and Quality of Life programs. ORE faculty and staff are involved in research projects that benefit the community, local healthcare professionals, and the Center's mission. Eight specific aims will accomplish these goals: 1) Achieve recruitment goals for the ADRC and related research studies, including Alzheimer's Disease Cooperative Study (ADCS) trials. Develop new programs and outreach approaches both to inform the community and to ensure enrollment of special populations. Promote acceptance of research procedures and retention of recruited subjects. 2) Provide professional training in clinical and research skills to academic and professional staff at UCSD and other San Diego (SD) universities. Provide education targeting research and clinical care to healthcare professionals through our regional CME courses. 3) Work with the Hispanic satellite to develop culturally sensitive recruitment strategies and programs for Hispanic elderly as well as healthcare professionals. 4) Provide innovative social and educational support programs for persons with dementia and their caregivers. 5) Conduct developmental research aimed at refining assessment instruments to facilitate the initial screening and recruitment process, including recruitment of at-risk normal elders. Develop tools appropriate for cognitive screening and referral strategies in community settings. 6) Continue to develop and refine a recruitment registry database to systematically track participant enrollment in all ADRC and affiliated investigator protocols, and to assess the effectiveness of various outreach strategies. 7) Evaluate the success of all outreach, recruitment, and educational programs. 8) Disseminate information about the ADRC and its available resources to the UCSD/VA community and to the SD research community.