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Review
. 2025 Sep;21(9):e70654.
doi: 10.1002/alz.70654.

Boston University Alzheimer's Disease Research Center Clinical Core: Infrastructure to facilitate research on post-traumatic Alzheimer's disease and related dementias

Michael L Alosco  1   2   3   4 , Madeline Morrison  1 , Rhoda Au  1   3   4   5   6   7 , Eric G Steinberg  1 , Jane Mwicigi  1 , Monica Ly  1   2   3 , Caroline Altaras  1   2   3 , Steve Lenio  1   2   3 , Myriam Abdennadher  1   2   3 , Maureen K O'Connor  1   8 , Yorghos Tripodis  1   9 , Joseph Palmisano  1   10 , Diane Dixon  1   10 , Brett Martin  1   10 , Greta Schneider  1   10 , Jenna R Groh  1 , Andrew Ellison  1 , Dean Sheppard  1 , Chad W Farris  1   11 , Christopher Nowinski  1   12 , Robert C Cantu  1 , Katherine W Turk  1   13 , Lindsay Farrer  1   3   5   6   7   14 , Gyungah Jun  7 , Lee E Goldstein  1   14   15 , Wei Qiao Qiu  1   16   17 , Thor D Stein  1   8   13   18 , Andrew E Budson  1   3   13 , Ann C McKee  1   3   8   13   18 , Jesse Mez  1   2   3   5
Affiliations
Review

Boston University Alzheimer's Disease Research Center Clinical Core: Infrastructure to facilitate research on post-traumatic Alzheimer's disease and related dementias

Michael L Alosco et al. Alzheimers Dement. 2025 Sep.

Abstract

We describe the rationale, methodology, and design of the Boston University Alzheimer's Disease Research Center (BU ADRC) Clinical Core (CC). The CC characterizes a longitudinal cohort of participants with/without brain trauma to characterize the clinical presentation, biomarker profiles, and risk factors of post-traumatic Alzheimer's disease (AD) and AD-related dementias (ADRD), including chronic traumatic encephalopathy (CTE). Participants complete assessments of traumatic brain injury (TBI) and repetitive head impacts (RHIs); annual Uniform Data Set (UDS) and supplementary evaluations; digital phenotyping; annual blood draw; magnetic resonance imaging (MRI) and lumbar puncture every 3 years; electroencephalogram (EEG); and amyloid and/or tau positron emission tomography (PET) on a subset. As of 3/2025, the CC consists of 467 participants (mean age: 65.6, 50.1% female), including 163 RHI and 302 TBI who completed a UDS 3.0 baseline visit. Common sources of RHI included football (n = 95), soccer (n = 26), ice hockey (n = 17), and military service (n = 46). Most TBIs were mild (97.7%). Eighty-nine percent agreed to brain donation. The BU ADRC CC will facilitate research, education, and training on post-traumatic AD/ADRD. HIGHLIGHTS: The Boston University Alzheimer's Disease Research Center (ADRC) Clinical Core facilitates unique research, education, and training on Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) with a focus on post-traumatic AD/ADRD, including chronic traumatic encephalopathy (CTE). We summarize the rationale, mission, study design, and recent updates for the Clinical Core. As of March 2025, the Clinical Core includes a longitudinal cohort of 467 participants enriched for repetitive head impacts (∼1/3) and traumatic brain injury (∼1/3) exposure who span the cognitive continuum, with most having available fluid and neuroimaging biomarker data and agreeing to brain donation (89%).

Keywords: Alzheimer's disease; chronic traumatic encephalopathy; cognitive function; concussion; football; head trauma; national football league; repetitive head impacts; traumatic brain injury.

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Conflict of interest statement

M.L.A.: Received honorarium from the Michael J Fox Foundation Inc as well as research support from Life Molecular Imaging Inc. M.M., E.G.S., J.M., M.L., C.A., S.L., M.A., M.K.O., Y.T., J.P., D.D., B.M., G.S., J.R.G., A.E., D.S., C.W.F., R.C.C., K.W.T., L.F., G.J., L.E.G., W.Q.Q., T.D.S., A.E.B., J.M.: None to report. R.A.: A scientific advisor to Signant Health and NovoNordisk. C.J.N.: A volunteer member of the Mackey‐White Committee of the National Football League Players Association, for which he receives travel support; an advisor and options‐holder with Oxeia Biopharmaceuticals, LLC, and StataDx; and has received travel support from the NFL, NFL Players Association, World Rugby, WWE, and AEW for lectures or conferences. C.J.N. has served as an expert witness in cases related to concussion and CTE and is compensated for speaking appearances and serving on the Players Advocacy Committee for the NFL Concussion Settlement. CJN is employed by the Concussion Legacy Foundation, a 501(c)(3) non‐profit which receives charitable donations. A.C.M.: A member of the Mackey‐White Health and Safety Committee of the National Football League Players Association and reported receiving grants from the National Institutes of Health and Department of Veteran Affairs, and other funding from the Buoniconti Foundation and MacParkman Foundation during the conduct of the study. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
BU ADRC infrastructure overview. Cores are highly interactive and synergistic while maintaining specific aims and responsibilities. Each core collaborates uniquely with the REC to accomplish REC goals. BU ADRC, Boston University Alzheimer's Disease Research Center; DMS, data management and statistics; GMP, genetics and molecular profiling; ORE, outreach, recruitment and engagement; REC, research education component.
FIGURE 2
FIGURE 2
Overview of clinical core recruitment and enrollment. BMC, Boston Medical Center; CLF, Concussion Legacy Foundation; GCRU, General Clinical Research Unit; VA, Veterans Affairs.
FIGURE 3
FIGURE 3
Dynamic study flow and data collection: Integration of multidisciplinary clinical cores. NACC, National Alzheimer's Coordinating Center; NCRAD, The National Centralized Repository for Alzheimer's Disease and Related Dementias; SCAN, Standardized Centralized Alzheimer's & Related Dementias Neuroimaging.
See this image and copyright information in PMC

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