Section: Application Domains

Biomarkers for diagnosis, prognosis and clinical trials

Currently, the routine diagnosis of neurological disorders is mainly based on clinical examinations. This is also true for clinical trials, aiming to assess the efficacy of new treatments. However, clinical diagnoses only partially overlap with pathological processes. For instance, the sensitivity and specificity of clinical diagnosis of Alzheimer’s disease (AD) based on established consensus criteria are of only about 70-80% compared to histopathological confirmation. Furthermore, the pathological processes often begin years before the clinical symptoms. Finally, clinical measures embed subjective aspects and have a limited reproducibility and are thus not ideal to track disease progression. It is thus crucial to supplement clinical examinations with biomarkers that can detect and track the progression of pathological processes in the living patient. This has potentially very important implications for the development of new treatments as it would help: i) identifying patients with a given pathology at the earliest stage of the disease, for inclusion in clinical trials; ii) providing measures to monitor the efficacy of treatments.

The derivation of biomarkers from image analysis approaches requires large-scale validation in well-characterized clinical populations. The ARAMIS team is strongly engaged in such efforts, in particular in the field of neurodegenerative disorders. To that purpose, we collaborate to several national studies (see section Partnerships) that involve multicenter and longitudinal acquisitions. Moreover, ARAMIS is strongly involved in the CATI which manages over 15 multicenter studies, including the national cohort MEMENTO (2000 patients).