Quantitative evaluation of 10 tractography algorithms on a realistic diffusion MR phantom.

International audienceAs it provides the only method for mapping white matter fibers in vivo, diffusion MRI tractography is gaining importance in clinical and neuroscience research. However, despite the increasing availability of different diffusion models and tractography algorithms, it remains unclear how to select the optimal fiber reconstruction method, given certain imaging parameters. Consequently, it is of utmost importance to have a quantitative comparison of these models and algorithms and a deeper understanding of the corresponding strengths and weaknesses. In this work, we use a common dataset with known ground truth and a reproducible methodology to quantitatively evaluate the performance of various diffusion models and tractography algorithms. To examine a wide range of methods, the dataset, but not the ground truth, was released to the public for evaluation in a contest, the "Fiber Cup". 10 fiber reconstruction methods were evaluated. The results provide evidence that: 1. For high SNR datasets, diffusion models such as (fiber) orientation distribution functions correctly model the underlying fiber distribution and can be used in conjunction with streamline tractography, and 2. For medium or low SNR datasets, a prior on the spatial smoothness of either the diffusion model or the fibers is recommended for correct modelling of the fiber distribution and proper tractography results. The phantom dataset, the ground truth fibers, the evaluation methodology and the results obtained so far will remain publicly available on: http://www.lnao.fr/spip.php?rubrique79 to serve as a comparison basis for existing or new tractography methods. New results can be submitted to [email protected] and updates will be published on the webpage

THE LEFT HEMISPHERE’S STRUCTURAL CONNECTIVITY FOR THE INFERIOR FRONTAL GYRUS, STRIATUM, AND THALAMUS, AND INTRA-THALAMIC TOPOGRAPHY

The neuroanatomy of language cognition has an extensive history of scientific interest and inquiry. Over a century of behavioral lesion studies and decades of functional neuroimaging research have established the left hemisphere’s inferior frontal gyrus (IFG) as a critical region for speech and language processing. This region’s subcortical projections are thought to be instrumental for supporting and integrating the cognitive functions of the language network. However, only a subset of these projections have been shown to exist in humans, and structural evidence of pars orbitalis’ subcortical circuitry has been limited to non-human primates. This thesis demonstrates direct, intra-structural connectivity of each of the left IFG’s gyral regions with the thalamus and the putamen in humans, using high-angular, deterministic tractography. Novel processing and analysis methods elucidated evidence of predominantly segregated cortical circuits within the thalamus, and suggested the presence of parallel circuits for motor/language integration along the length of the putamen

Reconstruction et description des fonctions de distribution d'orientation en imagerie de diffusion à haute résolution angulaire

This thesis concerns the reconstruction and description of orientation distribution functions (ODFs) in high angular resolution diffusion imaging (HARDI) such as q-ball imaging (QBI). QBI is used to analyze more accurately fiber structures (crossing, bending, fanning, etc.) in a voxel. In this field, the ODF reconstructed from QBI is widely used for resolving complex intravoxel fiber configuration problem. However, until now, the assessment of the characteristics or quality of ODFs remains mainly visual and qualitative, although the use of a few objective quality metrics is also reported that are directly borrowed from classical signal and image processing theory. At the same time, although some metrics such as generalized anisotropy (GA) and generalized fractional anisotropy (GFA) have been proposed for classifying intravoxel fiber configurations, the classification of the latters is still a problem. On the other hand, QBI often needs an important number of acquisitions (usually more than 60 directions) to compute accurately ODFs. So, reducing the quantity of QBI data (i.e. shortening acquisition time) while maintaining ODF quality is a real challenge. In this context, we have addressed the problems of how to reconstruct high-quality ODFs and assess their characteristics. We have proposed a new paradigm allowing describing the characteristics of ODFs more quantitatively. It consists of regarding an ODF as a general three-dimensional (3D) point cloud, projecting a 3D point cloud onto an angle-distance map (ADM), constructing an angle-distance matrix (ADMAT), and calculating morphological characteristics of the ODF such as length ratio, separability and uncertainty. In particular, a new metric, called PEAM (PEAnut Metric), which is based on computing the deviation of ODFs from a single fiber ODF represented by a peanut, was proposed and used to classify intravoxel fiber configurations. Several ODF reconstruction methods have also been compared using the proposed metrics. The results showed that the characteristics of 3D point clouds can be well assessed in a relatively complete and quantitative manner. Concerning the reconstruction of high-quality ODFs with reduced data, we have proposed two methods. The first method is based on interpolation by Delaunay triangulation and imposing constraints in both q-space and spatial space. The second method combines random gradient diffusion direction sampling, compressed sensing, resampling density increasing, and missing diffusion signal recovering. The results showed that the proposed missing diffusion signal recovering approaches enable us to obtain accurate ODFs with relatively fewer number of diffusion signals.Ce travail de thèse porte sur la reconstruction et la description des fonctions de distribution d'orientation (ODF) en imagerie de diffusion à haute résolution angulaire (HARDI) telle que l’imagerie par q-ball (QBI). Dans ce domaine, la fonction de distribution d’orientation (ODF) en QBI est largement utilisée pour étudier le problème de configuration complexe des fibres. Toutefois, jusqu’à présent, l’évaluation des caractéristiques ou de la qualité des ODFs reste essentiellement visuelle et qualitative, bien que l’utilisation de quelques mesures objectives de qualité ait également été reportée dans la littérature, qui sont directement empruntées de la théorie classique de traitement du signal et de l’image. En même temps, l’utilisation appropriée de ces mesures pour la classification des configurations des fibres reste toujours un problème. D'autre part, le QBI a souvent besoin d'un nombre important d’acquisitions pour calculer avec précision les ODFs. Ainsi, la réduction du temps d’acquisition des données QBI est un véritable défi. Dans ce contexte, nous avons abordé les problèmes de comment reconstruire des ODFs de haute qualité et évaluer leurs caractéristiques. Nous avons proposé un nouveau paradigme permettant de décrire les caractéristiques des ODFs de manière plus quantitative. Il consiste à regarder un ODF comme un nuage général de points tridimensionnels (3D), projeter ce nuage de points 3D sur un plan angle-distance (ADM), construire une matrice angle-distance (ADMAT), et calculer des caractéristiques morphologiques de l'ODF telles que le rapport de longueurs, la séparabilité et l'incertitude. En particulier, une nouvelle métrique, appelé PEAM (PEAnut Metric) et qui est basée sur le calcul de l'écart des ODFs par rapport à l’ODF (représenté par une forme arachide) d’une seule fibre, a été proposée et utilisée pour classifier des configurations intravoxel des fibres. Plusieurs méthodes de reconstruction des ODFs ont également été comparées en utilisant les paramètres proposés. Les résultats ont montré que les caractéristiques du nuage de points 3D peuvent être évaluées d'une manière relativement complète et quantitative. En ce qui concerne la reconstruction de l'ODF de haute qualité avec des données réduites, nous avons proposé deux méthodes. La première est basée sur une interpolation par triangulation de Delaunay et sur des contraintes imposées à la fois dans l’espace-q et dans l'espace spatial. La deuxième méthode combine l’échantillonnage aléatoire des directions de gradient de diffusion, le compressed sensing, l’augmentation de la densité de ré-échantillonnage, et la reconstruction des signaux de diffusion manquants. Les résultats ont montré que les approches de reconstruction des signaux de diffusion manquants proposées nous permettent d'obtenir des ODFs précis à partir d’un nombre relativement faible de signaux de diffusion

Spatially Regularized Reconstruction of Fibre Orientation Distributions in the Presence of Isotropic Diffusion

The connectivity and structural integrity of the white matter of the brain is known to be implicated in a wide range of brain-related diseases and injuries. However, it is only since the advent of diffusion magnetic resonance imaging (dMRI) that researchers have been able to probe the miscrostructure of white matter in vivo. Presently, among a range of methods of dMRI, high angular resolution diffusion imaging (HARDI) is known to excel in its ability to provide reliable information about the local orientations of neural fasciculi (aka fibre tracts). It preserves the high angular resolution property of diffusion spectrum imaging (DSI) but requires less measurements. Meanwhile, as opposed to the more traditional diffusion tensor imaging (DTI), HARDI is capable of distinguishing the orientations of multiple fibres passing through a given spatial voxel. Unfortunately, the ability of HARDI to discriminate neural fibres that cross each other at acute angles is always limited. The limitation becomes the motivation to develop numerous post-processing tools, aiming at the improvement of the angular resolution of HARDI. Among such methods, spherical deconvolution (SD) is the one which attracts the most attentions. Due to its ill-posed nature, however, standard SD relies on a number of a priori assumptions needed to render its results unique and stable. In the present thesis, we introduce a novel approach to the problem of non-blind SD of HARDI signals, which does not only consider the existence of anisotropic diffusion component of HARDI signal but also explicitly take the isotropic diffusion component into account. As a result of that, in addition to reconstruction of fODFs, our algorithm can also yield a useful estimation of its related IDM, which quantifies a relative contribution of the isotropic diffusion component as well as its spatial pattern. Moreover, one of the principal contributions is to demonstrate the effectiveness of exploiting different prior models for regularization of the spatial-domain behaviours of the reconstructed fODFs and IDMs. Specifically, the fibre continuity model has been used to force the local maxima of the fODFs to vary consistently throughout the brain, whereas the bounded variation model has helped us to achieve piecewise smooth reconstruction of the IDMs. The proposed algorithm is formulated as a convex minimization problem, which admits a unique and stable minimizer. Moreover, using ADMM, we have been able to find the optimal solution via a sequence of simpler optimization problems, which are both computationally efficient and amenable to parallel computations. In a series of both in silico and in vivo experiments, we demonstrate how the proposed solution can be used to successfully overcome the effect of partial voluming, while preserving the spatial coherency of cerebral diffusion at moderate to severe noise levels. The performance of the proposed method is compared with that of several available alternatives, with the comparative results clearly supporting the viability and usefulness of our approach. Moreover, the results illustrate the power of applied spatial regularization terms

Data augmentation in Rician noise model and Bayesian Diffusion Tensor Imaging

Mapping white matter tracts is an essential step towards understanding brain function. Diffusion Magnetic Resonance Imaging (dMRI) is the only noninvasive technique which can detect in vivo anisotropies in the 3-dimensional diffusion of water molecules, which correspond to nervous fibers in the living brain. In this process, spectral data from the displacement distribution of water molecules is collected by a magnetic resonance scanner. From the statistical point of view, inverting the Fourier transform from such sparse and noisy spectral measurements leads to a non-linear regression problem. Diffusion tensor imaging (DTI) is the simplest modeling approach postulating a Gaussian displacement distribution at each volume element (voxel). Typically the inference is based on a linearized log-normal regression model that can fit the spectral data at low frequencies. However such approximation fails to fit the high frequency measurements which contain information about the details of the displacement distribution but have a low signal to noise ratio. In this paper, we directly work with the Rice noise model and cover the full range of $b$-values. Using data augmentation to represent the likelihood, we reduce the non-linear regression problem to the framework of generalized linear models. Then we construct a Bayesian hierarchical model in order to perform simultaneously estimation and regularization of the tensor field. Finally the Bayesian paradigm is implemented by using Markov chain Monte Carlo.Comment: 37 pages, 3 figure

NOVEL PHANTOMS AND POST-PROCESSING FOR DIFFUSION SPECTRUM IMAGING

High Angular Resolution Diffusion Imaging (HARDI) techniques, including Diffusion Spectrum Imaging (DSI), have been proposed to resolve crossing and other complex fiber architecture in the human brain white matter. In these methods, directional information of diffusion is inferred from the peaks in the orientation distribution function (ODF). Extensive studies using histology on macaque brain, cat cerebellum, rat hippocampus and optic tracts, and bovine tongue are qualitatively in agreement with the DSI-derived ODFs and tractography. However, there are only two studies in the literature which validated the DSI results using physical phantoms and both these studies were not performed on a clinical MRI scanner. Also, the limited studies which optimized DSI in a clinical setting, did not involve a comparison against physical phantoms. Finally, there is lack of consensus on the necessary pre- and post-processing steps in DSI; and ground truth diffusion fiber phantoms are not yet standardized. Therefore, the aims of this dissertation were to design and construct novel diffusion phantoms, employ post-processing techniques in order to systematically validate and optimize (DSI)-derived fiber ODFs in the crossing regions on a clinical 3T MR scanner, and develop user-friendly software for DSI data reconstruction and analysis. Phantoms with a fixed crossing fiber configuration of two crossing fibers at 90° and 45° respectively along with a phantom with three crossing fibers at 60°, using novel hollow plastic capillaries and novel placeholders, were constructed. T2-weighted MRI results on these phantoms demonstrated high SNR, homogeneous signal, and absence of air bubbles. Also, a technique to deconvolve the response function of an individual peak from the overall ODF was implemented, in addition to other DSI post-processing steps. This technique greatly improved the angular resolution of the otherwise unresolvable peaks in a crossing fiber ODF. The effects of DSI acquisition parameters and SNR on the resultant angular accuracy of DSI on the clinical scanner were studied and quantified using the developed phantoms. With a high angular direction sampling and reasonable levels of SNR, quantification of a crossing region in the 90°, 45° and 60° phantoms resulted in a successful detection of angular information with mean ± SD of 86.93°±2.65°, 44.61°±1.6° and 60.03°±2.21° respectively, while simultaneously enhancing the ODFs in regions containing single fibers. For the applicability of these validated methodologies in DSI, improvement in ODFs and fiber tracking from known crossing fiber regions in normal human subjects were demonstrated; and an in-house software package in MATLAB which streamlines the data reconstruction and post-processing for DSI, with easy to use graphical user interface was developed. In conclusion, the phantoms developed in this dissertation offer a means of providing ground truth for validation of reconstruction and tractography algorithms of various diffusion models (including DSI). Also, the deconvolution methodology (when applied as an additional DSI post-processing step) significantly improved the angular accuracy of the ODFs obtained from DSI, and should be applicable to ODFs obtained from the other high angular resolution diffusion imaging techniques

Double Dissociation of Auditory Attention and Visual Scanning in Long Term Survivors of Childhood Cerebellar Tumor: A Deterministic Tractography and Volumetric Study of the Cerebellar-Frontal and the Superior Longitudinal Fasciculus Pathways

Background. Right cerebellar-left frontal (RC-LF) white matter integrity (WMI) has been associated with working memory. Right Superior Longitudinal Fasciculus II (SLF II) WMI has been associated with visual attention. These relationships have held true for neurotypical controls and brain tumor survivors. The current study examined the relationships between RC-LF WMI and processing speed, attention, and working memory. SLF II WMI and visual attention were included as a control tract and task to demonstrate a correlational double dissociation. This study also examined the relationship between the volume of brain regions within the RC-LF network and RC-LF WMI. Methods. Adult survivors of childhood brain tumors (n= 29, age: M=22 years (SD= 5), 45% female) were treated with neurosurgery, and combinations of radiation therapy and chemotherapy. Age- and gender-matched controls (n=29) were also included. Tests of auditory attention span, working memory, visual attention, and processing speed served as cognitive measures. Participants completed a 3T MRI diffusion imaging scan. WMI (FA, RD) and volume served as neuroimaging measures. In the survivor group, partial correlations between WMI and cognitive scores included controlling for type of treatment. Results. A correlational double dissociation was found. RC-LF WMI was associated with auditory attention span (FA: r=.42, p=.03; RD: r=-.50, p=.01), and was not associated with visual attention (FA: r=-.11, p=.59; RD: r=-.11, p=.57). SLF II FA WMI was associated with visual attention (FA: r=.44, p=.02; RD: r=-.17, p=.40), and was not associated with auditory attention span (FA: r=.24, p=.22; RD: r=-.10, p=.62). The relationship between RC-LF WMI and auditory attention span robustly dissociated from working memory and visual attention. In the radiation group, thalamic-frontal segment of RC-LF WMI associated with the volumetric measures of each structure of the RC-LF pathway, whereas in the no radiation group cerebellar-rubral segment of RC-LF WMI associated with the volumetric measures. Conclusions. The current study advances the understanding of structural brain changes following cerebellar tumor resection and treatment because the results show that RC-LF WMI is associated with auditory attention span rather that working memory, provide evidence for a correlational double dissociation, and suggest distinct relationships between WMI and volume based on treatment

Accurate Bayesian segmentation of thalamic nuclei using diffusion MRI and an improved histological atlas

The human thalamus is a highly connected brain structure, which is key for the control of numerous functions and is involved in several neurological disorders. Recently, neuroimaging studies have increasingly focused on the volume and connectivity of the specific nuclei comprising this structure, rather than looking at the thalamus as a whole. However, accurate identification of cytoarchitectonically designed histological nuclei on standard in vivo structural MRI is hampered by the lack of image contrast that can be used to distinguish nuclei from each other and from surrounding white matter tracts. While diffusion MRI may offer such contrast, it has lower resolution and lacks some boundaries visible in structural imaging. In this work, we present a Bayesian segmentation algorithm for the thalamus. This algorithm combines prior information from a probabilistic atlas with likelihood models for both structural and diffusion MRI, allowing segmentation of 25 thalamic labels per hemisphere informed by both modalities. We present an improved probabilistic atlas, incorporating thalamic nuclei identified from histology and 45 white matter tracts surrounding the thalamus identified in ultra-high gradient strength diffusion imaging. We present a family of likelihood models for diffusion tensor imaging, ensuring compatibility with the vast majority of neuroimaging datasets that include diffusion MRI data. The use of these diffusion likelihood models greatly improves identification of nuclear groups versus segmentation based solely on structural MRI. Dice comparison of 5 manually identifiable groups of nuclei to ground truth segmentations show improvements of up to 10 percentage points. Additionally, our chosen model shows a high degree of reliability, with median test-retest Dice scores above 0.85 for four out of five nuclei groups, whilst also offering improved detection of differential thalamic involvement in Alzheimer’s disease (AUROC 81.98%). The probabilistic atlas and segmentation tool will be made publicly available as part of the neuroimaging package FreeSurfer

Tractographie par IRM de diffusion : algorithmes, validation, reproductibilité et applications

La tractographie gagne de plus en plus en importance dans les études cliniques car elle est l'unique modalité d'imagerie en mesure de caractériser in vivo l'architecture et l'intégrité des fibres de la substance blanche. Toutefois, la disponibilité croissante de modèles de diffusion et d'algorithmes de tractographie rend le choix d'une méthode de reconstruction de fibres difficile. Plus important encore, les performances et la reproductibilité de chaque méthode peuvent varier. Cette dernière considération souligne la difficulté de validation des méthodes de tractographie étant donné qu'aucune réalité terrain n'est disponible. Dans ce travail de thèse, nous avons dans un premier temps implémenté et intégré quatre différents algorithmes de tractographie par Imagerie de Tenseur de Diffusion à un logiciel de neuroimagerie. Trois déterministes et un autre probabiliste. Ensuite, nous avons étudié la validation de ces algorithmes sur des données fantôme qui simule une réalité terrain, offrant différentes configurations complexes de fibres. La reproductibilité des algorithmes implémentés a été étudiée sur des données réelles, chez 12 sujets sains en variant la résolution angulaire et en prenant comme faisceau test, le faisceau corticospinal. Les résultats obtenus ont montré une meilleure reproductibilité de l'algorithme probabiliste en conjonction avec une haute résolution angulaire. Enfin, sachant que dans certaines maladies, l'asymétrie entre les faisceaux concernés devrait être différente de celle des sujets sains, nous avons utilisé l'algorithme le plus reproductible pour examiner chez des sujets sains les degrés d'asymétries macro et microstructurale du faisceau corticospinal.Tractography is gaining increasing importance in clinical studies because it is the only imaging modality able to characterize in vivo the architecture and integrity of white matter fibers. However, the increasing availability of diffusion models and tractography algorithms makes the choice of a fiber reconstruction method difficult. More important, the performance and reproducibility of each method can vary. This last observation underscores the difficulty of validating tractography methods since no ground truth is available. In this work, we initially implemented and integrated four different Diffusion Tensor Imaging tractography algorithms in neuroimaging software. Three deterministic and one probabilistic. Next, we studied the validation of these algorithms on phantom data which simulates a given ground truth, offering various complex configurations of fibers. The reproducibility of the implemented algorithms has been studied on real data, in 12 healthy subjects by varying the angular resolution and taking as tractus test, the corticospinal tract. The results showed a better reproducibility of the probabilistic algorithm in conjunction with high angular resolution. Finally, in some diseases, the asymmetry between the tractus involved should be different from that of healthy subjects, we used the most reproducible algorithm to investigate in healthy subjects the levels of macro and microstructural asymmetries in the corticospinal tract

Accurate Bayesian segmentation of thalamic nuclei using diffusion MRI and an improved histological atlas

Data availability: Data will be made available on request.Supplementary materials are available online at: https://www.sciencedirect.com/science/article/pii/S1053811923002744?via%3Dihub#sec0024 .Research data are available online at: https://www.sciencedirect.com/science/article/pii/S1053811923002744?via%3Dihub#ec-research-data .Copyright © 2023 The Author(s). The human thalamus is a highly connected brain structure, which is key for the control of numerous functions and is involved in several neurological disorders. Recently, neuroimaging studies have increasingly focused on the volume and connectivity of the specific nuclei comprising this structure, rather than looking at the thalamus as a whole. However, accurate identification of cytoarchitectonically designed histological nuclei on standard in vivo structural MRI is hampered by the lack of image contrast that can be used to distinguish nuclei from each other and from surrounding white matter tracts. While diffusion MRI may offer such contrast, it has lower resolution and lacks some boundaries visible in structural imaging. In this work, we present a Bayesian segmentation algorithm for the thalamus. This algorithm combines prior information from a probabilistic atlas with likelihood models for both structural and diffusion MRI, allowing segmentation of 25 thalamic labels per hemisphere informed by both modalities. We present an improved probabilistic atlas, incorporating thalamic nuclei identified from histology and 45 white matter tracts surrounding the thalamus identified in ultra-high gradient strength diffusion imaging. We present a family of likelihood models for diffusion tensor imaging, ensuring compatibility with the vast majority of neuroimaging datasets that include diffusion MRI data. The use of these diffusion likelihood models greatly improves identification of nuclear groups versus segmentation based solely on structural MRI. Dice comparison of 5 manually identifiable groups of nuclei to ground truth segmentations show improvements of up to 10 percentage points. Additionally, our chosen model shows a high degree of reliability, with median test-retest Dice scores above 0.85 for four out of five nuclei groups, whilst also offering improved detection of differential thalamic involvement in Alzheimer’s disease (AUROC 81.98%). The probabilistic atlas and segmentation tool will be made publicly available as part of the neuroimaging package FreeSurfer.This work was primarily funded by Alzheimers Research UK (ARUK-IRG2019A003). PGs work in this area was supported by NIH NIBIB NAC P41EB015902 AYs work in this area was supported by NIH grants R01 EB021265 and R56 MH121426. DCAs work in this area was supported by EPSRC grant EP/R006032/1 and Wellcome Trust award 221915/Z/20/Z. The Dementia Research Centre is supported by Alzheimer’s Research UK, Alzheimer’s Society, Brain Research UK, and The Wolfson Foundation. This work was supported by the National Institute for Health Research (NIHR) Queen Square Dementia Biomedical Research Unit and the University College London Hospitals Biomedical Research Centre, the Leonard Wolfson Experimental Neurology Centre (LWENC) Clinical Research Facility, and the UK Dementia Research Institute, which receives its funding from UK DRI Ltd, funded by the UK Medical Research Council, Alzheimer’s Society and Alzheimer’s Research UK. This project has received funding from the European Unions Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No. 765148, as well as from the National Institutes Of Health under project number R01NS112161. MB is supported by a Fellowship award from the Alzheimers Society, UK (AS-JF-19a-004-517). MBs work was also supported by the UK Dementia Research Institute which receives its funding from DRI Ltd, funded by the UK Medical Research Council, Alzheimers Society and Alzheimers Research UK. JDR is supported by the Miriam Marks Brain Research UK Senior Fellowship and has received funding from an MRC Clinician Scientist Fellowship (MR/M008525/1) and the NIHR Rare Disease Translational Research Collaboration (BRC149/NS/MH). JEI is supported by the European Research Council (Starting Grant 677697, project BUNGEE-TOOLS) and the NIH (1RF1MH123195-01 and 1R01AG070988-01). The collection and sharing of the ADNI data was funded by the Alzheimer’s Disease Neuroimaging Initiative (National Institutes of Health Grant U01 AG024904) and Department of Defence (W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and the following: Alzheimer’s Association; Alzheimer’s Drug Discovery Foundation; BioClinica, Inc.; Biogen Idec Inc.; Bristol-Myers Squibb Company; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; F. Hoffmann-La Roche Ltd and affiliated company Genentech, Inc.; GE Healthcare; Innogenetics, N.V.; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Medpace, Inc.; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Synarc Inc.; and Takeda Pharmaceutical Company. The Canadian Institutes of Health Research is providing funds for ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health. The grantee is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer’s Disease Cooperative Study at the University of California, San Diego. ADNI is disseminated by the Laboratory for Neuro Imaging at the University of Southern California