Evidence map›Paper›PMID 40450374›Full record

Observational studyAlzheimer's research & therapy2025

Digital twins and non-invasive recordings enable early diagnosis of Alzheimer's disease.

Lorenzo Gaetano Amato, Michael Lassi, Alberto Arturo Vergani, Jacopo Carpaneto, Salvatore Mazzeo, Valentina Moschini, Rachele Burali, Giovanni Salvestrini, Carlo Fabbiani, Giulia Giacomucci and 10 more

Registry-linked trialAbstract readMulticenter StudyObservational StudyNetwork Meta-Analysis
In one paragraph

Observational study in Alzheimer's research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05569083 (PRedicting the EVolution of SubjectIvE Cognitive Decline to Alzheimer's Disease With Machine Learning), which is not on this map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05569083 unknown statusnot on this map

PRedicting the EVolution of SubjectIvE Cognitive Decline to Alzheimer's Disease With Machine Learning

TypeobservationalSponsorAzienda Ospedaliero-Universitaria CareggiRan2020 to 2024Enrolled350ConditionsCognitive Decline, Mild Cognitive Impairment, Alzheimer DiseaseArmsGenetic analysis of APOE and BDNF genes., EEG recording, CSF collection and AD biomarker measurement, Neuropsychological evaluation, Assessment of cognitive reserve, depression, personality traits and leisure activities
3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Review
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  9. Mapping the future of medicine through digital twins.Frontiers in molecular medicine · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Lorenzo Gaetano AmatoThe BioRobotics Institute, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, 56127, Pisa, Italy.
Michael LassiThe BioRobotics Institute, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, 56127, Pisa, Italy.
Alberto Arturo VerganiThe BioRobotics Institute, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, 56127, Pisa, Italy.
Jacopo CarpanetoThe BioRobotics Institute, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, 56127, Pisa, Italy.
Salvatore MazzeoResearch and Innovation Center for Dementia-CRIDEM, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
Valentina MoschiniSkeletal Muscles and Sensory Organs Department, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
Rachele BuraliIRCSS Fondazione Don Carlo Gnocchi, Via Di Scandicci 269, 50143, Florence, Italy.
Giovanni SalvestriniUnit of Neurophysiology, Careggi University Hospital, Florence, Italy.
Carlo FabbianiIRCSS Fondazione Don Carlo Gnocchi, Via Di Scandicci 269, 50143, Florence, Italy.
Giulia GiacomucciDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Giulia GaldoDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Carmen MorinelliDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Filippo EmilianiDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Maenia ScarpinoDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Sonia PadiglioniDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Benedetta NacmiasIRCSS Fondazione Don Carlo Gnocchi, Via Di Scandicci 269, 50143, Florence, Italy.
Sandro SorbiIRCSS Fondazione Don Carlo Gnocchi, Via Di Scandicci 269, 50143, Florence, Italy.
Antonello GrippoUnit of Neurophysiology, Careggi University Hospital, Florence, Italy.
Valentina BessiDepartment of Neuroscience, Psychology, Drug Research and Child Health, Università Di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Alberto MazzoniThe BioRobotics Institute, Sant'Anna School of Advanced Studies, Piazza Martiri Della Libertà 33, 56127, Pisa, Italy. alberto.mazzoni@santannapisa.it.

Funding

Ministero dell'Istruzione, dell'Università e della Ricerca PE0000006Regione Toscana CUP.D18D20001300002
6 · The paper itself

Abstract

backgroundThe diagnosis of Alzheimer's disease (AD) in its preclinical stages, such as subjective cognitive decline (SCD), is crucial for a timely management of the condition. However, current early diagnostic methods are unsuitable for preclinical screenings due to limited availability and diagnostic reliability. Additionally, reliance on invasive and scarcely available methods exacerbates the underdiagnosis of AD in its preclinical forms.

methodsWe introduce an early diagnostic pipeline based on the Digital Alzheimer's Disease Diagnosis (DADD) digital twin model, which derives personalized AD biomarkers from non-invasive electroencephalographic (EEG) recordings. These biomarkers reconstruct patient-specific neurodegeneration, capturing synaptic and connectivity degeneration mechanisms. Digital biomarkers were used to predict cerebrospinal fluid (CSF) biomarker positivity for AD and clinical conversions at follow-up in 124 participants with varying degrees of cognitive decline, including a control group of 19 healthy subjects.

resultsDigital biomarkers derived from the DADD model: i) Robustly distinguished SCD from healthy participants, improving classification accuracy by 7% compared to standard EEG biomarkers; ii) Identified patients positive for CSF biomarkers of AD with 88% accuracy (significantly outperforming standard EEG biomarkers, which achieved 58% accuracy); iii) Predicted follow-up conversions to clinical cognitive decline with 87% accuracy (compared to 54% accuracy for standard EEG biomarkers).

conclusionsThe DADD model provided robust digital AD biomarkers with strong diagnostic and prognostic value for preclinical AD, enabling the prediction of CSF biomarkers and clinical conversions using only non-invasive EEG recordings. This is particularly important as preclinical patients, such as those with SCD, are often excluded from diagnostic procedures like lumbar puncture. Predicting CSF biomarkers by combining digital twins with non-invasive recordings could revolutionize AD diagnosis in its early stages, paving the way for the clinical application of digital twins in AD diagnostics.

trial registrationClinical Trial identifier: NCT05569083 (submitted 2022-08-24).

Indexed as

Alzheimer DiseaseCognitive DysfunctionElectroencephalographyAgedBiomarkersEarly DiagnosisFemaleHumansMaleMiddle AgedBiomarkersBiomarkersDiagnosisPrognosisSubjective Cognitive Decline

Identifiers

PMID40450374
PMCPMC12125947

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.