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RJR: Recommended Bibliography 01 Aug 2026 at 01:36 Created:
Alzheimer Disease — Current Literature
Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer's, symptoms first appear in their mid-60s. Alzheimer's is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. Scientists don't yet fully understand what causes Alzheimer's disease in most people. There is a genetic component to some cases of early-onset Alzheimer's disease. Late-onset Alzheimer's arises from a complex series of brain changes that occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer's may differ from person to person. This bibliography runs a generic query on "Alzheimer" and then restricts the results to papers published in or after 2017.
Created with PubMed® Query: 2024:2026[dp] AND ( alzheimer*[TIAB] ) NOT pmcbook NOT ispreviousversion
Citations The Papers (from PubMed®)
RevDate: 2026-07-30
Neutral Borate Buffer Activates Diazo for Rapid Protein Labeling.
Angewandte Chemie (International ed. in English) [Epub ahead of print].
Diazo, a carbene precursor, offers an effective chemistry for bioorthogonal labeling upon activation by acids, metals, and/or photo-illumination. Here, we report neutral borate buffer can trigger diazo compounds into carbene for protein labeling without the need for acid, metal, or light. We show that such boron-diazo-mediated covalent modification rapidly occurs within seconds under physiological conditions and preferentially targets carboxylate-containing amino acid residues. Towards applications of such boron-diazo protein chemistry, we exemplify the design of an affinity-based covalent inhibitor for dihydrofolate reductase by installing diazo on the non-covalent trimethoprim drug. When extended to stressed cells, we also capture cellular aggresomes using a diazo-Thioflavin T probe that selectively labels aggregated proteins. Finally, in Alzheimer's disease brain tissue, we employ this boron-diazo chemistry to label, enrich, and profile amyloid plaques, identifying proteins related to pathological deposition. Together, the boron-diazo chemistry reported herein provides a rapid and facile protein modification strategy under mild conditions.
Additional Links: PMID-42531136
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PubMed:
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@article {pmid42531136,
year = {2026},
author = {Shen, D and Jin, H and Feng, H and Gao, R and Sun, R and Xiao, Y and Wan, W and Ma, C and Liu, Y},
title = {Neutral Borate Buffer Activates Diazo for Rapid Protein Labeling.},
journal = {Angewandte Chemie (International ed. in English)},
volume = {},
number = {},
pages = {e1990347},
doi = {10.1002/anie.1990347},
pmid = {42531136},
issn = {1521-3773},
support = {22374148//National Natural Science Foundation of China/ ; 2024JH3/50100009//Liaoning Province Science Foundation for Distinguished Young Scholars/ ; 2022RJ04//Dalian Science Foundation for Distinguished Young Scholars/ ; 028GJHZ2023079FN//International Partnership Program of Chinese Academy of Sciences for Future Network/ ; 2023JJ12WZ037//Dalian Science and Technology Innovation Foundation/ ; 2024-MSBA-59//Natural Science Foundation of Liaoning Province/ ; DICP I202458//Innovation Program of Science and Research from the DICP, CAS/ ; DICP I202310//Innovation Program of Science and Research from the DICP, CAS/ ; DICP I202529//Innovation Program of Science and Research from the DICP, CAS/ ; },
abstract = {Diazo, a carbene precursor, offers an effective chemistry for bioorthogonal labeling upon activation by acids, metals, and/or photo-illumination. Here, we report neutral borate buffer can trigger diazo compounds into carbene for protein labeling without the need for acid, metal, or light. We show that such boron-diazo-mediated covalent modification rapidly occurs within seconds under physiological conditions and preferentially targets carboxylate-containing amino acid residues. Towards applications of such boron-diazo protein chemistry, we exemplify the design of an affinity-based covalent inhibitor for dihydrofolate reductase by installing diazo on the non-covalent trimethoprim drug. When extended to stressed cells, we also capture cellular aggresomes using a diazo-Thioflavin T probe that selectively labels aggregated proteins. Finally, in Alzheimer's disease brain tissue, we employ this boron-diazo chemistry to label, enrich, and profile amyloid plaques, identifying proteins related to pathological deposition. Together, the boron-diazo chemistry reported herein provides a rapid and facile protein modification strategy under mild conditions.},
}
RevDate: 2026-07-30
Diagnosed oral cavity and salivary gland disorders and the risk of incident Parkinson disease, Alzheimer disease, dementia and all-cause mortality: a retrospective cohort study.
Internal medicine journal [Epub ahead of print].
BACKGROUND: Oral diseases encompass a heterogeneous group of conditions affecting the oral cavity and associated structures. Certain chronic inflammatory oral diseases, particularly periodontitis, have been linked to systemic inflammation and may contribute to neurodegenerative processes. However, long-term evidence on their association with Parkinson's disease (PD), Alzheimer's disease (AD), dementia and mortality remains inconsistent. This study aims to investigate whether diagnosed oral cavity and salivary gland disorders are associated with long‑term risk of PD, AD, dementia and all-cause mortality in older adults.
AIMS: To investigate whether diagnosed oral cavity and salivary gland disorders are associated with long-term risk of Parkinson disease, Alzheimer disease, dementia, and all-cause mortality in older adults.
METHODS: This retrospective propensity score-matched cohort study utilised the TriNetX US Collaborative Network. Patients aged ≥60 years with a documented diagnosis of diseases of the oral cavity and salivary glands (ICD-10-CM K00-K14) were 1:1 matched with patients without oral diseases on demographics, comorbidities and medication use (n = 232 809 per group after matching). The index date was the first documented oral disease diagnosis (exposure cohort) or equivalent healthcare encounter (control cohort). New-onset PD, AD, any-type dementia and all-cause mortality were assessed at 5- and 13-year follow-up using risk ratios (RRs), hazard ratios (HRs) and Kaplan-Meier survival analysis.
RESULTS: At 5 years, diagnosis of oral cavity and salivary gland diseases was associated with significantly increased risk of new-onset PD (HR 1.212, 95% confidence interval (CI) 1.133-1.296), any dementia (HR 1.132, 95% CI 1.098-1.167) and all-cause mortality (HR 1.117, 95% CI 1.101-1.134). AD risk was modestly elevated (HR 1.100, 95% CI 1.033-1.171). At 13 years, the increased risk persisted for PD (HR 1.146), dementia (HR 1.060) and mortality (HR 1.113), but the association with AD was no longer significant (HR 0.998, 95% CI 0.959-1.038).
CONCLUSIONS: Diagnosed oral cavity and salivary gland diseases are independently associated with sustained long-term risk of PD, dementia and all-cause mortality, but the association with AD appears time-limited. These findings highlight oral health as a potentially modifiable factor in neurodegenerative disease prevention and support multidisciplinary approaches to oral care in older adults.
Additional Links: PMID-42531512
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PubMed:
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@article {pmid42531512,
year = {2026},
author = {Khawar, M and Nasir, MF and Qadeer, A and Khawar, MMH and Malik, MA and Mubarika, M and Iftikhar, Q and Shahid, A and Zahid, A and Awais, M and Dalil, L and Khaliq, M and Ali, SZ},
title = {Diagnosed oral cavity and salivary gland disorders and the risk of incident Parkinson disease, Alzheimer disease, dementia and all-cause mortality: a retrospective cohort study.},
journal = {Internal medicine journal},
volume = {},
number = {},
pages = {},
doi = {10.1111/imj.70577},
pmid = {42531512},
issn = {1445-5994},
abstract = {BACKGROUND: Oral diseases encompass a heterogeneous group of conditions affecting the oral cavity and associated structures. Certain chronic inflammatory oral diseases, particularly periodontitis, have been linked to systemic inflammation and may contribute to neurodegenerative processes. However, long-term evidence on their association with Parkinson's disease (PD), Alzheimer's disease (AD), dementia and mortality remains inconsistent. This study aims to investigate whether diagnosed oral cavity and salivary gland disorders are associated with long‑term risk of PD, AD, dementia and all-cause mortality in older adults.
AIMS: To investigate whether diagnosed oral cavity and salivary gland disorders are associated with long-term risk of Parkinson disease, Alzheimer disease, dementia, and all-cause mortality in older adults.
METHODS: This retrospective propensity score-matched cohort study utilised the TriNetX US Collaborative Network. Patients aged ≥60 years with a documented diagnosis of diseases of the oral cavity and salivary glands (ICD-10-CM K00-K14) were 1:1 matched with patients without oral diseases on demographics, comorbidities and medication use (n = 232 809 per group after matching). The index date was the first documented oral disease diagnosis (exposure cohort) or equivalent healthcare encounter (control cohort). New-onset PD, AD, any-type dementia and all-cause mortality were assessed at 5- and 13-year follow-up using risk ratios (RRs), hazard ratios (HRs) and Kaplan-Meier survival analysis.
RESULTS: At 5 years, diagnosis of oral cavity and salivary gland diseases was associated with significantly increased risk of new-onset PD (HR 1.212, 95% confidence interval (CI) 1.133-1.296), any dementia (HR 1.132, 95% CI 1.098-1.167) and all-cause mortality (HR 1.117, 95% CI 1.101-1.134). AD risk was modestly elevated (HR 1.100, 95% CI 1.033-1.171). At 13 years, the increased risk persisted for PD (HR 1.146), dementia (HR 1.060) and mortality (HR 1.113), but the association with AD was no longer significant (HR 0.998, 95% CI 0.959-1.038).
CONCLUSIONS: Diagnosed oral cavity and salivary gland diseases are independently associated with sustained long-term risk of PD, dementia and all-cause mortality, but the association with AD appears time-limited. These findings highlight oral health as a potentially modifiable factor in neurodegenerative disease prevention and support multidisciplinary approaches to oral care in older adults.},
}
RevDate: 2026-07-30
Comments on "Persistent Functional Impairment as an Early Indicator of Alzheimer Disease Pathology and Progression".
Additional Links: PMID-42531527
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@article {pmid42531527,
year = {2026},
author = {Kuran, İ and Eşme, M},
title = {Comments on "Persistent Functional Impairment as an Early Indicator of Alzheimer Disease Pathology and Progression".},
journal = {Journal of the American Geriatrics Society},
volume = {},
number = {},
pages = {},
doi = {10.1111/jgs.70614},
pmid = {42531527},
issn = {1532-5415},
}
RevDate: 2026-07-30
Autoimmune Neurologic Disorders and the Risk of Alzheimer, Vascular, and Other Dementias: A Comprehensive Systematic Review and Meta-Analysis (P2-13.006).
Neurology, 107(5):e218536.
Additional Links: PMID-42531533
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PubMed:
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@article {pmid42531533,
year = {2026},
author = {Mohamed, MI and Sameh, R and Farghaly, D and Ashraf, B and Kamel, B and Mahmoud, NH and Abdelall, NA and Nada, MAF},
title = {Autoimmune Neurologic Disorders and the Risk of Alzheimer, Vascular, and Other Dementias: A Comprehensive Systematic Review and Meta-Analysis (P2-13.006).},
journal = {Neurology},
volume = {107},
number = {5},
pages = {e218536},
doi = {10.1212/WNL.0000000000218536},
pmid = {42531533},
issn = {1526-632X},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Validation of the VasCog-2-WSO VCID Criteria in a Dementia-Free and Stroke-Free Community Cohort: Cardiovascular Risk and Mortality.
Neurology, 107(4):e218311.
BACKGROUND AND OBJECTIVES: Vascular cognitive impairment and dementia (VCID), a major contributor of dementia, remains underrecognized, owing to the absence of universally accepted diagnostic criteria. The VasCog Society and WSO recently released updated criteria (VasCog-2-WSO); however, their applicability is unknown yet. We aimed to evaluate these criteria in a dementia-free and stroke-free community cohort and determine their associations with vascular burden and long-term mortality.
METHODS: We conducted a community-based cohort study using data from the I-Lan Longitudinal Aging Study. Adults aged 50 years or older without prior stroke or dementia underwent standardized brain MRI and comprehensive neuropsychological assessment. VCID was classified according to the VasCog-2-WSO criteria using a neuroimaging-first approach. Participants were categorized as non-VCID, preclinical VCID (with or without objective cognitive impairment), or vascular mild cognitive impairment (vaMCI). Baseline 10-year Framingham cardiovascular disease risk was assessed. The primary outcome was all-cause mortality over a mean follow-up of 9.4 years, analyzed using multivariable Cox proportional hazards and Poisson regression models.
RESULTS: A total of 1,236 participants (62.7 ± 8.8 years; 52.9% female) were included. Neuroimaging evidence of cerebrovascular disease was present in 19.6% of participants; 19.2% met criteria for preclinical VCID and 0.4% for vaMCI. Compared with non-VCID participants, neuroimaging-positive groups had worse cognitive performance and higher 10-year cardiovascular risk. Mortality increased across the VCID spectrum (7.4 [95% CI 5.7-9.4], 24.9 [16.0-37.1], 27.4 [18.2-39.6], and 137.9 [37.6-353.2] per 1,000 person-years). In adjusted Cox models, preclinical VCID was associated with a 1.5-1.7-fold higher mortality risk, and vaMCI with a hazard ratio of 7.2 (95% CI 2.4-21.1), with a significant graded association across the spectrum (p for trend <0.001).
DISCUSSION: The VasCog-2-WSO criteria identify a spectrum of MRI-defined vascular cognitive vulnerability associated with increased cardiovascular risk and mortality, with excess mortality risk detectable at a neuroimaging-defined preclinical stage before overt cognitive impairment. These findings support their utility for early detection and risk stratification in community settings. A key limitation is the inability to assess mixed etiologies due to the absence of genetic data and Alzheimer disease biomarkers, which limits the ability to thoroughly evaluate the VasCog-2-WSO VCID diagnostic framework.
Additional Links: PMID-42531538
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PubMed:
Citation:
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@article {pmid42531538,
year = {2026},
author = {Lin, YR and Lee, WJ and Lee, PL and Lin, CP and Wang, PN and Chen, LK and Chung, CP},
title = {Validation of the VasCog-2-WSO VCID Criteria in a Dementia-Free and Stroke-Free Community Cohort: Cardiovascular Risk and Mortality.},
journal = {Neurology},
volume = {107},
number = {4},
pages = {e218311},
doi = {10.1212/WNL.0000000000218311},
pmid = {42531538},
issn = {1526-632X},
mesh = {Humans ; Female ; Male ; Aged ; *Dementia, Vascular/mortality/diagnosis/diagnostic imaging ; *Cardiovascular Diseases/mortality/epidemiology ; Middle Aged ; Longitudinal Studies ; *Cognitive Dysfunction/diagnosis/mortality ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Cohort Studies ; },
abstract = {BACKGROUND AND OBJECTIVES: Vascular cognitive impairment and dementia (VCID), a major contributor of dementia, remains underrecognized, owing to the absence of universally accepted diagnostic criteria. The VasCog Society and WSO recently released updated criteria (VasCog-2-WSO); however, their applicability is unknown yet. We aimed to evaluate these criteria in a dementia-free and stroke-free community cohort and determine their associations with vascular burden and long-term mortality.
METHODS: We conducted a community-based cohort study using data from the I-Lan Longitudinal Aging Study. Adults aged 50 years or older without prior stroke or dementia underwent standardized brain MRI and comprehensive neuropsychological assessment. VCID was classified according to the VasCog-2-WSO criteria using a neuroimaging-first approach. Participants were categorized as non-VCID, preclinical VCID (with or without objective cognitive impairment), or vascular mild cognitive impairment (vaMCI). Baseline 10-year Framingham cardiovascular disease risk was assessed. The primary outcome was all-cause mortality over a mean follow-up of 9.4 years, analyzed using multivariable Cox proportional hazards and Poisson regression models.
RESULTS: A total of 1,236 participants (62.7 ± 8.8 years; 52.9% female) were included. Neuroimaging evidence of cerebrovascular disease was present in 19.6% of participants; 19.2% met criteria for preclinical VCID and 0.4% for vaMCI. Compared with non-VCID participants, neuroimaging-positive groups had worse cognitive performance and higher 10-year cardiovascular risk. Mortality increased across the VCID spectrum (7.4 [95% CI 5.7-9.4], 24.9 [16.0-37.1], 27.4 [18.2-39.6], and 137.9 [37.6-353.2] per 1,000 person-years). In adjusted Cox models, preclinical VCID was associated with a 1.5-1.7-fold higher mortality risk, and vaMCI with a hazard ratio of 7.2 (95% CI 2.4-21.1), with a significant graded association across the spectrum (p for trend <0.001).
DISCUSSION: The VasCog-2-WSO criteria identify a spectrum of MRI-defined vascular cognitive vulnerability associated with increased cardiovascular risk and mortality, with excess mortality risk detectable at a neuroimaging-defined preclinical stage before overt cognitive impairment. These findings support their utility for early detection and risk stratification in community settings. A key limitation is the inability to assess mixed etiologies due to the absence of genetic data and Alzheimer disease biomarkers, which limits the ability to thoroughly evaluate the VasCog-2-WSO VCID diagnostic framework.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
Female
Male
Aged
*Dementia, Vascular/mortality/diagnosis/diagnostic imaging
*Cardiovascular Diseases/mortality/epidemiology
Middle Aged
Longitudinal Studies
*Cognitive Dysfunction/diagnosis/mortality
Magnetic Resonance Imaging
Neuropsychological Tests
Cohort Studies
RevDate: 2026-07-30
Lead optimization of rivastigmine-like hybrids: Impact of nitro group and halogen substitution on multi-target anti-Alzheimer's activity.
Bioorganic & medicinal chemistry, 141:118760 pii:S0968-0896(26)00216-6 [Epub ahead of print].
The multifactorial profile of Alzheimer's disease has led researchers to adopt a multi-target strategy for the design of new small molecules. In this context, starting from the structure of ROS151, a novel series of seventeen rivastigmine-like hybrids was developed. Structural modification involved the aryloxy-methylene portion, with the substitution of the nitro group with other groups and the variation of type and position of the halogen atom. The nitro group was confirmed to be essential for high anti-ChE activity, with compound 3 showing the most balanced profile, superior to that of the lead compound (IC50 = 0.827 ± 0.012 μM and 4.58 ± 0.01 μM against hAChE and eqBChE, respectively). Hybrid 2 showed inhibitory activity against hAChE close to that of donepezil (IC50 = 0.029 ± 0.005 μM), while 7 had better activity against eqBChE than the parent drug rivastigmine (IC50 = 0.45 ± 0.02 μM). In silico experiments were performed to corroborate these results. When the nitro group was reduced to amine, as for compound 10, relevant antioxidant activity (ABTS, IC50 = 25.2 ± 1.2 μM) and remarkable chelating properties toward Fe[3+] (pM = 15.6) and Cu[2+] (pM = 11.4), with a good selectivity over Zn[2+] (pM = 6.0) were observed. Inhibition of fatty acid amide hydrolase (hFAAH) resulted less relevant but still appreciable. Cyano-derivative 8 appears to be the only compound with preserved multi-enzymatic inhibitory potential, even without nitro-group in its structure and can be used as starting point for further series. Finally, many hybrids demonstrated interesting experimental pharmacokinetic properties, evaluated using bioanalytical methods.
Additional Links: PMID-42531673
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PubMed:
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@article {pmid42531673,
year = {2026},
author = {Leuci, R and Paparella, M and Cerini, M and Simic, S and Chaves, S and Carrieri, A and Tortorella, P and Loiodice, F and Laghezza, A and Santos, MA and Wackerlig-Damle, J and Piemontese, L},
title = {Lead optimization of rivastigmine-like hybrids: Impact of nitro group and halogen substitution on multi-target anti-Alzheimer's activity.},
journal = {Bioorganic & medicinal chemistry},
volume = {141},
number = {},
pages = {118760},
doi = {10.1016/j.bmc.2026.118760},
pmid = {42531673},
issn = {1464-3391},
abstract = {The multifactorial profile of Alzheimer's disease has led researchers to adopt a multi-target strategy for the design of new small molecules. In this context, starting from the structure of ROS151, a novel series of seventeen rivastigmine-like hybrids was developed. Structural modification involved the aryloxy-methylene portion, with the substitution of the nitro group with other groups and the variation of type and position of the halogen atom. The nitro group was confirmed to be essential for high anti-ChE activity, with compound 3 showing the most balanced profile, superior to that of the lead compound (IC50 = 0.827 ± 0.012 μM and 4.58 ± 0.01 μM against hAChE and eqBChE, respectively). Hybrid 2 showed inhibitory activity against hAChE close to that of donepezil (IC50 = 0.029 ± 0.005 μM), while 7 had better activity against eqBChE than the parent drug rivastigmine (IC50 = 0.45 ± 0.02 μM). In silico experiments were performed to corroborate these results. When the nitro group was reduced to amine, as for compound 10, relevant antioxidant activity (ABTS, IC50 = 25.2 ± 1.2 μM) and remarkable chelating properties toward Fe[3+] (pM = 15.6) and Cu[2+] (pM = 11.4), with a good selectivity over Zn[2+] (pM = 6.0) were observed. Inhibition of fatty acid amide hydrolase (hFAAH) resulted less relevant but still appreciable. Cyano-derivative 8 appears to be the only compound with preserved multi-enzymatic inhibitory potential, even without nitro-group in its structure and can be used as starting point for further series. Finally, many hybrids demonstrated interesting experimental pharmacokinetic properties, evaluated using bioanalytical methods.},
}
RevDate: 2026-07-30
Alzheimer's disease-related β-amyloid deposition prediction based on plasma biomarkers, ApoE4, and CDR with a machine learning approach.
Computer methods and programs in biomedicine, 286:109567 pii:S0169-2607(26)00316-0 [Epub ahead of print].
BACKGROUND: Alzheimer's disease (AD) is an irreversible, incurable neurodegenerative disorder that imposes a substantial economic and social burden. As current therapies can only slow disease progression, early detection is of critical importance. Among existing diagnostic tools, amyloid positron emission tomography (PET) remains the most accurate non-invasive method for detecting β-amyloid deposition; however, its high cost significantly limits its applicability for early screening. To address this challenge, this study investigates the use of plasma biomarkers as a low-cost alternative for predicting cerebral β-amyloid burden.
METHODS: The predictive performance of three machine learning models-Classification and Regression Trees (CART), Support Vector Machines (SVM), and Logistic Regression (LR)-was systematically compared under varying feature subsets and thresholding strategies. Data were obtained from 276 participants in the ADNI database. The qualitative status of cerebral amyloid deposition, defined using threshold-based classification of Centiloid values, was set as the prediction target. Plasma biomarkers and other AD-related risk factors were employed as model features.
RESULTS: Cross-domain data integration enabled effective prediction of amyloid deposition status. The SVM model, combined with feature subset selection (FSS) and a threshold value of 25, achieved the best performance, yielding an area under the curve (AUC) of 0.80.
CONCLUSION: By applying the Centiloid quantification framework for amyloid-PET and employing plasma biomarkers along with established AD-related risk factors, this study demonstrates the feasibility of machine learning models as a low-risk, cost-effective approach for predicting amyloid-PET imaging outcomes. These findings highlight the potential to support clinical decision-making and reduce reliance on costly imaging techniques for early AD detection.
Additional Links: PMID-42531948
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PubMed:
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@article {pmid42531948,
year = {2026},
author = {Chang, CH and Chien, SC and Wang, CC and Chuang, CC and Chen, JC},
title = {Alzheimer's disease-related β-amyloid deposition prediction based on plasma biomarkers, ApoE4, and CDR with a machine learning approach.},
journal = {Computer methods and programs in biomedicine},
volume = {286},
number = {},
pages = {109567},
doi = {10.1016/j.cmpb.2026.109567},
pmid = {42531948},
issn = {1872-7565},
abstract = {BACKGROUND: Alzheimer's disease (AD) is an irreversible, incurable neurodegenerative disorder that imposes a substantial economic and social burden. As current therapies can only slow disease progression, early detection is of critical importance. Among existing diagnostic tools, amyloid positron emission tomography (PET) remains the most accurate non-invasive method for detecting β-amyloid deposition; however, its high cost significantly limits its applicability for early screening. To address this challenge, this study investigates the use of plasma biomarkers as a low-cost alternative for predicting cerebral β-amyloid burden.
METHODS: The predictive performance of three machine learning models-Classification and Regression Trees (CART), Support Vector Machines (SVM), and Logistic Regression (LR)-was systematically compared under varying feature subsets and thresholding strategies. Data were obtained from 276 participants in the ADNI database. The qualitative status of cerebral amyloid deposition, defined using threshold-based classification of Centiloid values, was set as the prediction target. Plasma biomarkers and other AD-related risk factors were employed as model features.
RESULTS: Cross-domain data integration enabled effective prediction of amyloid deposition status. The SVM model, combined with feature subset selection (FSS) and a threshold value of 25, achieved the best performance, yielding an area under the curve (AUC) of 0.80.
CONCLUSION: By applying the Centiloid quantification framework for amyloid-PET and employing plasma biomarkers along with established AD-related risk factors, this study demonstrates the feasibility of machine learning models as a low-risk, cost-effective approach for predicting amyloid-PET imaging outcomes. These findings highlight the potential to support clinical decision-making and reduce reliance on costly imaging techniques for early AD detection.},
}
RevDate: 2026-07-30
Ginkgo biloba Leaf Extracts in Global Dementia and Mild Cognitive Impairment Guidelines. A Review.
Planta medica [Epub ahead of print].
Age-related diseases like dementia are increasing globally, with limited treatments. Extracts of Ginkgo biloba are often used alongside synthetic drugs. The aim of this article was to identify clinical guidelines from countries around the world to assess recommendations on the use of Ginkgo biloba in dementia, mild cognitive impairment, and prevention. PubMed was systematically searched for guidelines on dementia and mild cognitive impairment on the 25th of April 2023. A search update was conducted on the 3rd of March 2026. Additional guidelines were identified via citation searching and organisations. Seventy-seven guideline documents were included: 47 on dementia (subtype not further defined), 25 on Alzheimer's disease, 19 on vascular dementia, 18 on mild cognitive impairment, and seven on prevention, with some guidelines including multiple mentions. The guidelines come from four continents and 28 countries, plus seven international guidelines. Regarding Ginkgo biloba, 52 give positive, 18 negative, and 26 neutral recommendations (double mentions possible); 27 do not mention it. Ginkgo biloba is referred to in guidelines worldwide, usually without reference to specific preparations. Preparation standardisation would be beneficial.
Additional Links: PMID-42532103
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PubMed:
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@article {pmid42532103,
year = {2026},
author = {Pfuhlmann, K and Koch, AK and Langhorst, J},
title = {Ginkgo biloba Leaf Extracts in Global Dementia and Mild Cognitive Impairment Guidelines. A Review.},
journal = {Planta medica},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2895-5345},
pmid = {42532103},
issn = {1439-0221},
abstract = {Age-related diseases like dementia are increasing globally, with limited treatments. Extracts of Ginkgo biloba are often used alongside synthetic drugs. The aim of this article was to identify clinical guidelines from countries around the world to assess recommendations on the use of Ginkgo biloba in dementia, mild cognitive impairment, and prevention. PubMed was systematically searched for guidelines on dementia and mild cognitive impairment on the 25th of April 2023. A search update was conducted on the 3rd of March 2026. Additional guidelines were identified via citation searching and organisations. Seventy-seven guideline documents were included: 47 on dementia (subtype not further defined), 25 on Alzheimer's disease, 19 on vascular dementia, 18 on mild cognitive impairment, and seven on prevention, with some guidelines including multiple mentions. The guidelines come from four continents and 28 countries, plus seven international guidelines. Regarding Ginkgo biloba, 52 give positive, 18 negative, and 26 neutral recommendations (double mentions possible); 27 do not mention it. Ginkgo biloba is referred to in guidelines worldwide, usually without reference to specific preparations. Preparation standardisation would be beneficial.},
}
RevDate: 2026-07-30
Neuromodulation in Alzheimer's disease: a review with illustrative pilot data using focused ultrasound.
Biological psychiatry pii:S0006-3223(26)01440-X [Epub ahead of print].
Alzheimer's disease (AD) is increasingly characterized as a disorder of large-scale brain networks driven by synaptic dysfunction, excitation-inhibition imbalance, and progressive breakdown of hippocampal-cortical communication. While recently developed disease-modifying therapies target molecular pathology, their clinical benefits remain modest, underscoring the need for interventions that target dysfunctional circuits. Neuromodulatory techniques such as transcranial magnetic stimulation, transcranial electrical stimulation, and deep brain stimulation demonstrate safety and act at network/system levels to engage target sites yet are limited by their ability to modulate deep anatomic structures and/or their invasiveness. Focused ultrasound (FUS) offers the distinct capability of modulating cortical and deep subcortical networks noninvasively and with anatomic precision. Preclinical studies demonstrate that FUS neuromodulation can influence mechanosensitive ion channels, synaptic plasticity, neurotrophic signaling, and oscillatory dynamics, with downstream effects on distributed memory networks. Early human investigations similarly suggest FUS neuromodulation can alter functional connectivity within default mode, frontoparietal, and limbic networks. Together, these findings support a framework in which FUS may help reshape pathological network states that emerge prior to irreversible neurodegeneration. Here, we present a narrative review of evidence across neuromodulation approaches to define principles of circuit engagement in AD and discuss a network-based rationale for ultrasound interventions. As an illustration of this framework, we also report preliminary findings from a Phase I pilot study of FUS neuromodulation in amyloid-positive mild cognitive impairment demonstrating safety, tolerability, and measurable modulation of hippocampal connectivity. We conclude mechanistic biomarkers of network response may accelerate translational development and guide future controlled trials.
Additional Links: PMID-42532278
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PubMed:
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@article {pmid42532278,
year = {2026},
author = {Haut, MW and Vieira Ligo Teixeira, C and Ranjan, M and Carpenter, J and Mehta, RI and Worhunsky, P and D'Haese, PF and Arsiwala, T and Everson, K and Suffridge, J and Keith, C and Phelps, HE and Ebbert, M and Finomore, V and Rezai, A},
title = {Neuromodulation in Alzheimer's disease: a review with illustrative pilot data using focused ultrasound.},
journal = {Biological psychiatry},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.biopsych.2026.07.019},
pmid = {42532278},
issn = {1873-2402},
abstract = {Alzheimer's disease (AD) is increasingly characterized as a disorder of large-scale brain networks driven by synaptic dysfunction, excitation-inhibition imbalance, and progressive breakdown of hippocampal-cortical communication. While recently developed disease-modifying therapies target molecular pathology, their clinical benefits remain modest, underscoring the need for interventions that target dysfunctional circuits. Neuromodulatory techniques such as transcranial magnetic stimulation, transcranial electrical stimulation, and deep brain stimulation demonstrate safety and act at network/system levels to engage target sites yet are limited by their ability to modulate deep anatomic structures and/or their invasiveness. Focused ultrasound (FUS) offers the distinct capability of modulating cortical and deep subcortical networks noninvasively and with anatomic precision. Preclinical studies demonstrate that FUS neuromodulation can influence mechanosensitive ion channels, synaptic plasticity, neurotrophic signaling, and oscillatory dynamics, with downstream effects on distributed memory networks. Early human investigations similarly suggest FUS neuromodulation can alter functional connectivity within default mode, frontoparietal, and limbic networks. Together, these findings support a framework in which FUS may help reshape pathological network states that emerge prior to irreversible neurodegeneration. Here, we present a narrative review of evidence across neuromodulation approaches to define principles of circuit engagement in AD and discuss a network-based rationale for ultrasound interventions. As an illustration of this framework, we also report preliminary findings from a Phase I pilot study of FUS neuromodulation in amyloid-positive mild cognitive impairment demonstrating safety, tolerability, and measurable modulation of hippocampal connectivity. We conclude mechanistic biomarkers of network response may accelerate translational development and guide future controlled trials.},
}
RevDate: 2026-07-30
Depression and amyloid-β across CSF, PET, and plasma biomarkers: a systematic review and meta-analysis.
Neuroscience pii:S0306-4522(26)00521-X [Epub ahead of print].
Alzheimer's disease is increasingly defined by biomarker evidence of amyloid-β and tau pathology, sharpening questions about whether late-life depression contributes to, or instead reflects, this pathology. We conducted a systematic review and meta-analysis of studies published between 2000 and 2025 that compared amyloid-β biomarkers in adults with and without depression, with depression defined by validated clinical diagnoses or symptom rating scales. Twenty-four studies were included, spanning three biomarker sources: cerebrospinal fluid, positron emission tomography imaging, and plasma. Across all sources, the pooled difference in amyloid-β burden between depressed and non-depressed individuals was small and clustered near zero, indicating only a weak, statistically non-significant tendency toward higher amyloid in depression. When the three sources were examined separately, each yielded a similar near-null result, although between-study heterogeneity was considerable for cerebrospinal fluid and plasma and moderate for imaging. Importantly, a prespecified subgroup analysis showed that imaging results diverged by quantification method: studies using the simpler standardized uptake value ratio clustered around zero, whereas the smaller group of studies using kinetic distribution volume ratio modelling showed a significant positive association, suggesting that methodological choices critically influence the observed relationship. Taken together, these findings indicate that depression is not consistently accompanied by greater amyloid-β burden across widely used biomarker platforms. The distribution volume ratio signal nonetheless raises the possibility of subtle associations that cruder methods may obscure, and suggests that depression may shape Alzheimer's disease trajectories more by modifying the clinical impact of amyloid than by altering its amount.
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@article {pmid42532327,
year = {2026},
author = {Tan, C},
title = {Depression and amyloid-β across CSF, PET, and plasma biomarkers: a systematic review and meta-analysis.},
journal = {Neuroscience},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.neuroscience.2026.07.065},
pmid = {42532327},
issn = {1873-7544},
abstract = {Alzheimer's disease is increasingly defined by biomarker evidence of amyloid-β and tau pathology, sharpening questions about whether late-life depression contributes to, or instead reflects, this pathology. We conducted a systematic review and meta-analysis of studies published between 2000 and 2025 that compared amyloid-β biomarkers in adults with and without depression, with depression defined by validated clinical diagnoses or symptom rating scales. Twenty-four studies were included, spanning three biomarker sources: cerebrospinal fluid, positron emission tomography imaging, and plasma. Across all sources, the pooled difference in amyloid-β burden between depressed and non-depressed individuals was small and clustered near zero, indicating only a weak, statistically non-significant tendency toward higher amyloid in depression. When the three sources were examined separately, each yielded a similar near-null result, although between-study heterogeneity was considerable for cerebrospinal fluid and plasma and moderate for imaging. Importantly, a prespecified subgroup analysis showed that imaging results diverged by quantification method: studies using the simpler standardized uptake value ratio clustered around zero, whereas the smaller group of studies using kinetic distribution volume ratio modelling showed a significant positive association, suggesting that methodological choices critically influence the observed relationship. Taken together, these findings indicate that depression is not consistently accompanied by greater amyloid-β burden across widely used biomarker platforms. The distribution volume ratio signal nonetheless raises the possibility of subtle associations that cruder methods may obscure, and suggests that depression may shape Alzheimer's disease trajectories more by modifying the clinical impact of amyloid than by altering its amount.},
}
RevDate: 2026-07-31
BACH1/HO-1 axis dysregulation links Down syndrome to Alzheimer-like neurodegeneration.
Neurochemistry international, 199:106232 pii:S0197-0186(26)00123-3 [Epub ahead of print].
Down syndrome (DS), caused by trisomy of chromosome 21, is characterized by early-onset oxidative stress, impaired neuronal development, and an increased risk of Alzheimer's disease (AD)-like neuropathology. Among chromosome 21 genes, the transcription factor BTB and CNC homology 1 (BACH1) has emerged as a critical regulator of redox homeostasis. Under physiological conditions, the balance between BACH1 and nuclear factor erythroid 2-related factor 2 (NRF2) warrants tight control of antioxidant defenses and heme metabolism. However, in DS, BACH1 overexpression disrupts this balance, impairing the induction of heme oxygenase-1 (HO-1) and of other cytoprotective pathways, thereby contributing to chronic oxidative stress, neuronal vulnerability, and pathological processes. The present review summarizes the molecular mechanisms that regulate the BACH1/HO-1 axis in the central nervous system. We recapitulate data from studies showing how dysregulation of this axis affects antioxidant defenses, iron homeostasis, ferroptosis, neuroinflammation, and mitochondrial function. We further provide evidence from the aging and AD literature, highlighting BACH1 as a convergent molecular node linking genetic and age-related neurodegeneration. Remarkably, we explore BACH1's contribution to the transition of DS to AD-like pathology. Finally, we evaluate emerging therapeutic strategies employing BACH1 inhibitors, NRF2 activators, and upstream signaling pathway modulators, and assess their applicability to the AD-like dementia context, concluding that targeting BACH1-dependent regulation of HO-1 represents a promising and unifying strategy to mitigate neurodegeneration in both DS and AD.
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@article {pmid42532345,
year = {2026},
author = {Di Domenico, F and Barone, E and Perluigi, M},
title = {BACH1/HO-1 axis dysregulation links Down syndrome to Alzheimer-like neurodegeneration.},
journal = {Neurochemistry international},
volume = {199},
number = {},
pages = {106232},
doi = {10.1016/j.neuint.2026.106232},
pmid = {42532345},
issn = {1872-9754},
abstract = {Down syndrome (DS), caused by trisomy of chromosome 21, is characterized by early-onset oxidative stress, impaired neuronal development, and an increased risk of Alzheimer's disease (AD)-like neuropathology. Among chromosome 21 genes, the transcription factor BTB and CNC homology 1 (BACH1) has emerged as a critical regulator of redox homeostasis. Under physiological conditions, the balance between BACH1 and nuclear factor erythroid 2-related factor 2 (NRF2) warrants tight control of antioxidant defenses and heme metabolism. However, in DS, BACH1 overexpression disrupts this balance, impairing the induction of heme oxygenase-1 (HO-1) and of other cytoprotective pathways, thereby contributing to chronic oxidative stress, neuronal vulnerability, and pathological processes. The present review summarizes the molecular mechanisms that regulate the BACH1/HO-1 axis in the central nervous system. We recapitulate data from studies showing how dysregulation of this axis affects antioxidant defenses, iron homeostasis, ferroptosis, neuroinflammation, and mitochondrial function. We further provide evidence from the aging and AD literature, highlighting BACH1 as a convergent molecular node linking genetic and age-related neurodegeneration. Remarkably, we explore BACH1's contribution to the transition of DS to AD-like pathology. Finally, we evaluate emerging therapeutic strategies employing BACH1 inhibitors, NRF2 activators, and upstream signaling pathway modulators, and assess their applicability to the AD-like dementia context, concluding that targeting BACH1-dependent regulation of HO-1 represents a promising and unifying strategy to mitigate neurodegeneration in both DS and AD.},
}
RevDate: 2026-07-30
The Microbiota-Gut-Brain Axis in Neuropsychiatric Disorders: Mechanisms, Advances, and Clinical Applications.
Brain research bulletin pii:S0361-9230(26)00349-7 [Epub ahead of print].
Neuropsychiatric disorders are increasingly recognized as systemic conditions arising from dynamic interactions within the gut-brain-immune network. The Microbiota-Gut-Brain Axis (MGBA) serves as a central regulatory system orchestrating neurodevelopment, neural homeostasis, and immune-metabolic balance. This review summarizes evidence across seven major neuropsychiatric disorders, Depression, Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, Alzheimer's disease, Schizophrenia, Anxiety and Obsessive Compulsive Disorder, demonstrating that dysregulation of the MGBA constitutes a shared pathological mechanism. On this common basis, we delineate disorder specific neurochemical and immunological features and highlight the clinical potential of microbiota-targeted interventions. Moreover, psychotropic medications profoundly alter microbial physiology, influencing bacterial growth and metabolism, thereby complicating interpretation of MGBA-disease relationships. Future research should define strain-specific therapeutic actions and integrate multi-omics approaches to unravel causal pathways, ultimately enabling precision microbiome modulation in neuropsychiatric medicine.
Additional Links: PMID-42532353
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@article {pmid42532353,
year = {2026},
author = {Li, T and Chang, Y and Tang, S and Chen, Y and Li, X and Wang, Y},
title = {The Microbiota-Gut-Brain Axis in Neuropsychiatric Disorders: Mechanisms, Advances, and Clinical Applications.},
journal = {Brain research bulletin},
volume = {},
number = {},
pages = {112062},
doi = {10.1016/j.brainresbull.2026.112062},
pmid = {42532353},
issn = {1873-2747},
abstract = {Neuropsychiatric disorders are increasingly recognized as systemic conditions arising from dynamic interactions within the gut-brain-immune network. The Microbiota-Gut-Brain Axis (MGBA) serves as a central regulatory system orchestrating neurodevelopment, neural homeostasis, and immune-metabolic balance. This review summarizes evidence across seven major neuropsychiatric disorders, Depression, Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, Alzheimer's disease, Schizophrenia, Anxiety and Obsessive Compulsive Disorder, demonstrating that dysregulation of the MGBA constitutes a shared pathological mechanism. On this common basis, we delineate disorder specific neurochemical and immunological features and highlight the clinical potential of microbiota-targeted interventions. Moreover, psychotropic medications profoundly alter microbial physiology, influencing bacterial growth and metabolism, thereby complicating interpretation of MGBA-disease relationships. Future research should define strain-specific therapeutic actions and integrate multi-omics approaches to unravel causal pathways, ultimately enabling precision microbiome modulation in neuropsychiatric medicine.},
}
RevDate: 2026-07-30
Naringin preserved cognitive function through modulation of cholinergic dysfunction, oxidative stress, and synaptic proteins in scopolamine-induced cognitive impairment.
Progress in neuro-psychopharmacology & biological psychiatry pii:S0278-5846(26)00266-6 [Epub ahead of print].
INTRODUCTION: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by memory loss and cognitive decline. The cholinergic hypothesis remains central to its framework, suggesting that the degeneration of cholinergic neurons and resulting neurotransmission disruption play a major role in cognitive impairment. Naringin, a potent polyphenolic compound abundant in citrus fruits, has gained attention for its antioxidant, anti-inflammatory, and neuroprotective properties. This study aims to investigate naringin's neuroprotective potential in a scopolamine-induced amnesia model, focusing on the BDNF/GAP-43 signaling pathway and markers of synaptic plasticity.
MATERIALS AND METHODS: A total of 42 male Wistar albino rats were divided into six groups: Saline, Scopolamine (Sco; 1 mg/kg/day), Sco + Naringin (50, 100, and 200 mg/kg), and Sco + Donepezil (3 mg/kg). Following a 21-day treatment period, cognitive and emotional behaviors were assessed using the Morris Water Maze (MWM) and Elevated Plus Maze (EPM) tests. Hippocampal tissues were analyzed for acetylcholinesterase (AChE) activity and oxidative/nitrosative stress markers (MDA, Peroxynitrite, NO, NOS). BDNF and GDNF mRNA expression was quantified by RT-qPCR, and the protein levels of BDNF, GAP-43, PSD-95, SYP, GFAP, SIRT1, KEAP1, Nrf2, and HO-1 were evaluated by Western blot. PSD-95, SYP, GFAP, and NeuN were further examined by confocal imaging.
RESULTS: Scopolamine administration induced significant impairments in spatial learning and memory, alongside anxiogenic-like behaviors. Biochemical analyses revealed a marked increase in AChE activity and oxidative/nitrosative stress in the Sco group. Additionally, scopolamine caused a profound reduction in BDNF, GDNF, GAP-43, PSD-95, and SYP levels, while increasing GFAP expression. Naringin treatment effectively attenuated these deficits by lowering AChE activity, reducing oxidative damage, and suppressing neuroinflammation. Notably, naringin preserved the expression of synaptic proteins, in association with upregulation of the BDNF/GAP-43 pathway and maintaining pre- and post-synaptic protein levels (SYP and PSD-95).
CONCLUSION: These findings demonstrate that naringin exerts significant neuroprotective effects against scopolamine-induced cholinergic amnesia. These findings are consistent with the possibility that naringin preserves synaptic plasticity, enhances neurotrophic support, and mitigates inflammatory responses, suggesting that it may represent a promising natural therapeutic candidate for Alzheimer-like neurodegeneration.
Additional Links: PMID-42532399
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@article {pmid42532399,
year = {2026},
author = {Yildirim, C and Bekerecioglu, S and Akyıldız, S and Bingol, B and Ulusal, H and Yilmaz, SG and Bal, R},
title = {Naringin preserved cognitive function through modulation of cholinergic dysfunction, oxidative stress, and synaptic proteins in scopolamine-induced cognitive impairment.},
journal = {Progress in neuro-psychopharmacology & biological psychiatry},
volume = {},
number = {},
pages = {111868},
doi = {10.1016/j.pnpbp.2026.111868},
pmid = {42532399},
issn = {1878-4216},
abstract = {INTRODUCTION: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by memory loss and cognitive decline. The cholinergic hypothesis remains central to its framework, suggesting that the degeneration of cholinergic neurons and resulting neurotransmission disruption play a major role in cognitive impairment. Naringin, a potent polyphenolic compound abundant in citrus fruits, has gained attention for its antioxidant, anti-inflammatory, and neuroprotective properties. This study aims to investigate naringin's neuroprotective potential in a scopolamine-induced amnesia model, focusing on the BDNF/GAP-43 signaling pathway and markers of synaptic plasticity.
MATERIALS AND METHODS: A total of 42 male Wistar albino rats were divided into six groups: Saline, Scopolamine (Sco; 1 mg/kg/day), Sco + Naringin (50, 100, and 200 mg/kg), and Sco + Donepezil (3 mg/kg). Following a 21-day treatment period, cognitive and emotional behaviors were assessed using the Morris Water Maze (MWM) and Elevated Plus Maze (EPM) tests. Hippocampal tissues were analyzed for acetylcholinesterase (AChE) activity and oxidative/nitrosative stress markers (MDA, Peroxynitrite, NO, NOS). BDNF and GDNF mRNA expression was quantified by RT-qPCR, and the protein levels of BDNF, GAP-43, PSD-95, SYP, GFAP, SIRT1, KEAP1, Nrf2, and HO-1 were evaluated by Western blot. PSD-95, SYP, GFAP, and NeuN were further examined by confocal imaging.
RESULTS: Scopolamine administration induced significant impairments in spatial learning and memory, alongside anxiogenic-like behaviors. Biochemical analyses revealed a marked increase in AChE activity and oxidative/nitrosative stress in the Sco group. Additionally, scopolamine caused a profound reduction in BDNF, GDNF, GAP-43, PSD-95, and SYP levels, while increasing GFAP expression. Naringin treatment effectively attenuated these deficits by lowering AChE activity, reducing oxidative damage, and suppressing neuroinflammation. Notably, naringin preserved the expression of synaptic proteins, in association with upregulation of the BDNF/GAP-43 pathway and maintaining pre- and post-synaptic protein levels (SYP and PSD-95).
CONCLUSION: These findings demonstrate that naringin exerts significant neuroprotective effects against scopolamine-induced cholinergic amnesia. These findings are consistent with the possibility that naringin preserves synaptic plasticity, enhances neurotrophic support, and mitigates inflammatory responses, suggesting that it may represent a promising natural therapeutic candidate for Alzheimer-like neurodegeneration.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Co-designing an Outpatient Clinical Decision Support Prototype for Managing Social Risks in Patients Living with Dementia.
Applied clinical informatics, 17(3):659-667.
BACKGROUND: Patients living with dementia (PLWD) require attention to social determinants of health (SDoH), but social information is often unavailable or incomplete during care encounters, and clinicians report uncertainty about how to act on this information.
OBJECTIVE: This study aimed to co-design the Intelligent Social Risk Management in Alzheimer's Disease and Alzheimer's Disease-Related Dementias Patients (iSMART) clinical decision support (CDS) prototype, which integrates an AI-driven individualized polysocial risk score (iPsRS) to identify PLWD at high social risk for hospitalization.
METHODS: We conducted a qualitative user-centered design study with nine outpatient providers and clinical staff who care for PLWD at a large academic health system. Participants completed semi-structured interviews to explore perceived social risks in dementia care, gather feedback on the iSMART prototype and its features, and identify implementation considerations. Interview transcripts were coded and analyzed via rapid qualitative and thematic analysis.
RESULTS: Nine participants (six providers, two nurses, and one social worker) were interviewed. Lack of caregiver or family support was identified as the most important social factor to consider for PLWD, followed by financial strain and transportation issues. Participants described the iSMART prototype as helpful for identifying social risks among PLWD, summarizing and prioritizing factors contributing to hospitalization risk, and connecting patients to relevant social resources. Participants suggested primary care providers and social workers should be the primary users. Recommended improvements included auto-populated (as opposed to manual entry) but editable SDoH fields for model input, incorporating caregiver presence as a model input, and providing clearer visual representations of risk.
CONCLUSION: Outpatient providers and staff viewed the iSMART prototype as a promising approach to support social risk screening, resource connection, and referral support in dementia care. These findings inform practical strategies for integrating iPsRS-informed CDS tools into routine workflows in dementia clinics.
Additional Links: PMID-42532494
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@article {pmid42532494,
year = {2026},
author = {Alfaqih, MA and Haessner, P and LeLaurin, JH and Guo, J and Hammer, NC and Ike-Okpe, O and Pappa, MJ and He, X and Salloum, RG and Bian, J and Gregory, ME},
title = {Co-designing an Outpatient Clinical Decision Support Prototype for Managing Social Risks in Patients Living with Dementia.},
journal = {Applied clinical informatics},
volume = {17},
number = {3},
pages = {659-667},
doi = {10.1055/a-2917-6503},
pmid = {42532494},
issn = {1869-0327},
support = {R01AG089445/NH/NIH HHS/United States ; },
mesh = {Humans ; *Dementia ; *Decision Support Systems, Clinical ; *Outpatients ; Female ; *Risk Management ; },
abstract = {BACKGROUND: Patients living with dementia (PLWD) require attention to social determinants of health (SDoH), but social information is often unavailable or incomplete during care encounters, and clinicians report uncertainty about how to act on this information.
OBJECTIVE: This study aimed to co-design the Intelligent Social Risk Management in Alzheimer's Disease and Alzheimer's Disease-Related Dementias Patients (iSMART) clinical decision support (CDS) prototype, which integrates an AI-driven individualized polysocial risk score (iPsRS) to identify PLWD at high social risk for hospitalization.
METHODS: We conducted a qualitative user-centered design study with nine outpatient providers and clinical staff who care for PLWD at a large academic health system. Participants completed semi-structured interviews to explore perceived social risks in dementia care, gather feedback on the iSMART prototype and its features, and identify implementation considerations. Interview transcripts were coded and analyzed via rapid qualitative and thematic analysis.
RESULTS: Nine participants (six providers, two nurses, and one social worker) were interviewed. Lack of caregiver or family support was identified as the most important social factor to consider for PLWD, followed by financial strain and transportation issues. Participants described the iSMART prototype as helpful for identifying social risks among PLWD, summarizing and prioritizing factors contributing to hospitalization risk, and connecting patients to relevant social resources. Participants suggested primary care providers and social workers should be the primary users. Recommended improvements included auto-populated (as opposed to manual entry) but editable SDoH fields for model input, incorporating caregiver presence as a model input, and providing clearer visual representations of risk.
CONCLUSION: Outpatient providers and staff viewed the iSMART prototype as a promising approach to support social risk screening, resource connection, and referral support in dementia care. These findings inform practical strategies for integrating iPsRS-informed CDS tools into routine workflows in dementia clinics.},
}
MeSH Terms:
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Humans
*Dementia
*Decision Support Systems, Clinical
*Outpatients
Female
*Risk Management
RevDate: 2026-07-30
The impact of a 12-month randomized exercise intervention on cognitive function and brain volume in adults with down syndrome.
Disability and health journal pii:S1936-6574(26)00111-1 [Epub ahead of print].
BACKGROUND: Adults with Down syndrome (DS) have a high risk for Alzheimer's disease (AD). While exercise improves cognition and brain health in the general population, few long-term studies have evaluated its effects in DS.
OBJECTIVE: We examined the impact of a 12-month remotely delivered exercise program on cognitive function and brain volume in adults with DS.
METHODS: 81 adults with DS (mean age = 27 years) were randomized to high-frequency remote exercise (3 sessions/week, RH), low-frequency remote exercise (1 session/week, RL), or a support and education control (SE). Cognitive function was assessed using the DS-adapted Cambridge Neuropsychological Test Automated Battery (CANTAB), and brain volumes were measured via MRI at baseline and 12 months.
RESULTS: There were no significant changes in any group in executive function or episodic memory (all p > 0.05), but the RH arm significantly improved processing speed across the 12-month intervention (EMM change: 0.17; p = 0.04). No between-group differences were observed for changes in overall cognitive scores. The RL group showed a decrease in total grey matter volume (EMM change -0.82; p = 0.02) and the RH group had no change (EMM change: 0.08; p = 0.72), yielding a significant group effect across time (EMM: 0.90; p = 0.04). Additionally, the RH arm had an increase in right hippocampal volume over 12 months (EMM change: 0.004; p = 0.04).
CONCLUSION: The improvements in reaction time, right hippocampal volume, and grey matter preservation suggest that structured exercise may influence cognition and brain health in adults with DS.
CLINICAL TRIALS REGISTRATION: NCT04048759.
Additional Links: PMID-42532804
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@article {pmid42532804,
year = {2026},
author = {Ptomey, LT and Aschenbrenner, AJ and Helsel, B and Bodde, A and Clina, JG and Danon, JC and Lepping, R and Martin, LE and Brucks, M and Sherman, JR and Forsha, DE and Washburn, RA and Donnelly, JE},
title = {The impact of a 12-month randomized exercise intervention on cognitive function and brain volume in adults with down syndrome.},
journal = {Disability and health journal},
volume = {},
number = {},
pages = {102134},
doi = {10.1016/j.dhjo.2026.102134},
pmid = {42532804},
issn = {1876-7583},
abstract = {BACKGROUND: Adults with Down syndrome (DS) have a high risk for Alzheimer's disease (AD). While exercise improves cognition and brain health in the general population, few long-term studies have evaluated its effects in DS.
OBJECTIVE: We examined the impact of a 12-month remotely delivered exercise program on cognitive function and brain volume in adults with DS.
METHODS: 81 adults with DS (mean age = 27 years) were randomized to high-frequency remote exercise (3 sessions/week, RH), low-frequency remote exercise (1 session/week, RL), or a support and education control (SE). Cognitive function was assessed using the DS-adapted Cambridge Neuropsychological Test Automated Battery (CANTAB), and brain volumes were measured via MRI at baseline and 12 months.
RESULTS: There were no significant changes in any group in executive function or episodic memory (all p > 0.05), but the RH arm significantly improved processing speed across the 12-month intervention (EMM change: 0.17; p = 0.04). No between-group differences were observed for changes in overall cognitive scores. The RL group showed a decrease in total grey matter volume (EMM change -0.82; p = 0.02) and the RH group had no change (EMM change: 0.08; p = 0.72), yielding a significant group effect across time (EMM: 0.90; p = 0.04). Additionally, the RH arm had an increase in right hippocampal volume over 12 months (EMM change: 0.004; p = 0.04).
CONCLUSION: The improvements in reaction time, right hippocampal volume, and grey matter preservation suggest that structured exercise may influence cognition and brain health in adults with DS.
CLINICAL TRIALS REGISTRATION: NCT04048759.},
}
RevDate: 2026-07-30
Neuroinflammatory markers sTREM2 and YKL-40 in association with Alzheimer's disease pathology: a systematic review and meta-analysis.
Molecular psychiatry [Epub ahead of print].
BACKGROUND/OBJECTIVES: Neuroinflammation is increasingly recognised as a key feature of Alzheimer's Disease (AD) pathophysiology. Markers of glial reactivity, sTREM2 and YKL-40, are elevated in mild cognitive impairment (MCI) and AD, but their associations with core pathology across these stages have not yet been systematically investigated. This systematic review and meta-analysis examined their cross-sectional and longitudinal associations with core pathological biomarkers of AD, and examine how these relationships may evolve dynamically across the disease continuum.
METHODS: A systematic literature search conducted across Medline, Embase, PsycINFO, PubMed and Scopus (PROSPERO: CRD420250653864) identified 42 studies for sTREM2 and 44 for YKL-40 that were included in this study.
RESULTS: Meta-analyses revealed that both markers showed robust positive associations with pTau181, tTau and NfL (pooled r = 0.31-0.55), including in covariate-adjusted correlations. In contrast, associations with Aβ pathology (CSF Aβ42/40, Aβ-PET) were weaker and not significant in covariate-adjusted estimates. Meta-regression analyses revealed that glial-tau associations were strongest in cognitively unimpaired (CU) individuals, and progressively weakened in MCI and AD, independent of age effects. Longitudinal data were limited and summarised descriptively; glial reactivity predicts increases in soluble CSF hyperphosphorylated tau pathology, yet is concurrently associated with slower accumulation of insoluble PET-detectable amyloid and tau aggregates.
CONCLUSIONS: Our findings indicate that sTREM2 and YKL-40 preferentially associate with tauopathy and neurodegeneration over pathological Aβ accumulation. The progressive attenuation of glial-pathology coupling may reflect glial saturation or "exhaustion" with disease progression, offering new insights into how impaired glial responses may be involved in AD pathophysiology.
Additional Links: PMID-42533036
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@article {pmid42533036,
year = {2026},
author = {Yu, R and Suraev, A and Vidal, V and Kong, S and Zachariae, R and Piccio, L and Heneka, MT and Naismith, SL and Michaelian, JC},
title = {Neuroinflammatory markers sTREM2 and YKL-40 in association with Alzheimer's disease pathology: a systematic review and meta-analysis.},
journal = {Molecular psychiatry},
volume = {},
number = {},
pages = {},
pmid = {42533036},
issn = {1476-5578},
abstract = {BACKGROUND/OBJECTIVES: Neuroinflammation is increasingly recognised as a key feature of Alzheimer's Disease (AD) pathophysiology. Markers of glial reactivity, sTREM2 and YKL-40, are elevated in mild cognitive impairment (MCI) and AD, but their associations with core pathology across these stages have not yet been systematically investigated. This systematic review and meta-analysis examined their cross-sectional and longitudinal associations with core pathological biomarkers of AD, and examine how these relationships may evolve dynamically across the disease continuum.
METHODS: A systematic literature search conducted across Medline, Embase, PsycINFO, PubMed and Scopus (PROSPERO: CRD420250653864) identified 42 studies for sTREM2 and 44 for YKL-40 that were included in this study.
RESULTS: Meta-analyses revealed that both markers showed robust positive associations with pTau181, tTau and NfL (pooled r = 0.31-0.55), including in covariate-adjusted correlations. In contrast, associations with Aβ pathology (CSF Aβ42/40, Aβ-PET) were weaker and not significant in covariate-adjusted estimates. Meta-regression analyses revealed that glial-tau associations were strongest in cognitively unimpaired (CU) individuals, and progressively weakened in MCI and AD, independent of age effects. Longitudinal data were limited and summarised descriptively; glial reactivity predicts increases in soluble CSF hyperphosphorylated tau pathology, yet is concurrently associated with slower accumulation of insoluble PET-detectable amyloid and tau aggregates.
CONCLUSIONS: Our findings indicate that sTREM2 and YKL-40 preferentially associate with tauopathy and neurodegeneration over pathological Aβ accumulation. The progressive attenuation of glial-pathology coupling may reflect glial saturation or "exhaustion" with disease progression, offering new insights into how impaired glial responses may be involved in AD pathophysiology.},
}
RevDate: 2026-07-30
Agentic AI for scaling diagnosis and care in neurodegenerative disease.
Nature aging [Epub ahead of print].
US healthcare systems are struggling to meet the growing demand for neurological care, particularly in Alzheimer's disease and related dementias. Generative artificial intelligence (AI) built on large language models now enables agentic AI systems that can streamline clinical workflows, integrate multimodal data and learn from practicing specialists. We envision an agentic AI system that scales specialist-level care to nonspecialist clinical settings through a continuously learning healthcare system. We describe this destination and outline a phased roadmap for responsible design and integration into care of Alzheimer's disease and related dementias: (1) high-quality standardized data collection across modalities; (2) decision support; (3) clinical integration enhancing workflows; (4) rigorous validation and monitoring protocols; (5) continuous learning through clinical feedback; and (6) robust ethics and risk management frameworks. This human-centered approach optimizes clinicians' capabilities in comprehensive data collection, interpretation of complex clinical information and timely application of relevant medical knowledge while prioritizing patient safety, healthcare equity and transparency.
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@article {pmid42533108,
year = {2026},
author = {Breithaupt, AG and Weiner, M and Tang, A and Possin, KL and Sirota, M and Lah, J and Levey, AI and Van Hentenryck, P and Zandehshahvar, R and Gorno-Tempini, ML and Giorgio, J and Wang, J and Rauschecker, AM and Rosen, HJ and Nosheny, RL and Miller, BL and Pinheiro-Chagas, P},
title = {Agentic AI for scaling diagnosis and care in neurodegenerative disease.},
journal = {Nature aging},
volume = {},
number = {},
pages = {},
pmid = {42533108},
issn = {2662-8465},
support = {NA/ALZ/Alzheimer's Association/United States ; NA//Eisai/ ; NA//American Brain Foundation (ABF)/ ; 2112533//National Science Foundation (NSF)/ ; 2112533//National Science Foundation (NSF)/ ; },
abstract = {US healthcare systems are struggling to meet the growing demand for neurological care, particularly in Alzheimer's disease and related dementias. Generative artificial intelligence (AI) built on large language models now enables agentic AI systems that can streamline clinical workflows, integrate multimodal data and learn from practicing specialists. We envision an agentic AI system that scales specialist-level care to nonspecialist clinical settings through a continuously learning healthcare system. We describe this destination and outline a phased roadmap for responsible design and integration into care of Alzheimer's disease and related dementias: (1) high-quality standardized data collection across modalities; (2) decision support; (3) clinical integration enhancing workflows; (4) rigorous validation and monitoring protocols; (5) continuous learning through clinical feedback; and (6) robust ethics and risk management frameworks. This human-centered approach optimizes clinicians' capabilities in comprehensive data collection, interpretation of complex clinical information and timely application of relevant medical knowledge while prioritizing patient safety, healthcare equity and transparency.},
}
RevDate: 2026-07-30
The cross-site reproducibility of MRI morphometric phenotypes in psychiatric disorders.
Nature neuroscience [Epub ahead of print].
Decades of structural magnetic resonance imaging (MRI) studies have documented alterations of gray matter morphometry in psychiatric disorders, but the field has failed to identify any consensus disease phenotypes. Here we examine whether current approaches will ever converge on such phenotypes by evaluating the consistency of brain-wide maps of gray matter volume and cortical thickness differences obtained for each of 59 study sites of five psychiatric disorders (schizophrenia, schizoaffective disorder, autism spectrum disorder, major depressive disorder and bipolar disorder), totaling 2,437 patients and 2,065 controls. We find that cross-site consistency is low (median r ≤ 0.16); markedly reduced compared to Alzheimer's disease (r = 0.54); unexplained by demographic, clinical or scanner differences; and robust to analytic choices. Using bootstrapping, we observe that consistency may improve for sample sizes ≥200 per group for schizophrenia but that other disorders may require much larger samples. Our findings indicate that current widespread practices in structural MRI are unlikely to identify robust morphometric phenotypes for psychiatric disorders.
Additional Links: PMID-42533130
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@article {pmid42533130,
year = {2026},
author = {Cao, T and Pang, JC and Gajwani, M and Segal, A and Holmes, A and Wiley, JF and Chopra, S and Zhou, JH and Chen, CLH and Ji, F and Harrison, BJ and Davey, CG and Constable, T and Tiego, J and Hartshorn, B and Kwee, J and Bellgrove, MA and Fornito, A},
title = {The cross-site reproducibility of MRI morphometric phenotypes in psychiatric disorders.},
journal = {Nature neuroscience},
volume = {},
number = {},
pages = {},
pmid = {42533130},
issn = {1546-1726},
support = {2034000//Department of Health | National Health and Medical Research Council (NHMRC)/ ; 2033976//Department of Health | National Health and Medical Research Council (NHMRC)/ ; 1146292, 1197431//Department of Health | National Health and Medical Research Council (NHMRC)/ ; DP200103509, FL220100184//Department of Education and Training | Australian Research Council (ARC)/ ; },
abstract = {Decades of structural magnetic resonance imaging (MRI) studies have documented alterations of gray matter morphometry in psychiatric disorders, but the field has failed to identify any consensus disease phenotypes. Here we examine whether current approaches will ever converge on such phenotypes by evaluating the consistency of brain-wide maps of gray matter volume and cortical thickness differences obtained for each of 59 study sites of five psychiatric disorders (schizophrenia, schizoaffective disorder, autism spectrum disorder, major depressive disorder and bipolar disorder), totaling 2,437 patients and 2,065 controls. We find that cross-site consistency is low (median r ≤ 0.16); markedly reduced compared to Alzheimer's disease (r = 0.54); unexplained by demographic, clinical or scanner differences; and robust to analytic choices. Using bootstrapping, we observe that consistency may improve for sample sizes ≥200 per group for schizophrenia but that other disorders may require much larger samples. Our findings indicate that current widespread practices in structural MRI are unlikely to identify robust morphometric phenotypes for psychiatric disorders.},
}
RevDate: 2026-07-31
Protecting the Aging Brain in Diabetes: Mechanism, Biomarkers, and Emerging Therapeutic Frontiers in Cognitive Impairment-A Comprehensive Review.
Cardiology in review pii:00045415-990000000-00956 [Epub ahead of print].
Diabetes, which impacts over 500 million individuals globally, has been identified as a significant risk factor for accelerated cognitive aging, mild cognitive impairment, and various forms of dementia, including Alzheimer's disease and vascular dementia. Despite its clinical relevance, cognitive decline remains an underrecognized complication within diabetes management. This comprehensive review aims to synthesize evidence across the mechanisms, biomarkers, and therapeutic approaches pertinent to diabetes-associated cognitive impairment, with a particular emphasis on the aging brain. The primary literature search was conducted across the decade 2015-2025; however, earlier landmark studies and foundational scientific contributions have been selectively included where necessary to contextualize contemporary findings within the broader historical trajectory of the field. A systematic literature search was executed across PubMed, MEDLINE, Embase, and PsycINFO utilizing MeSH terms such as "type 2 diabetes mellitus," "cognitive decline," "dementia," "insulin resistance," "neuroinflammation," and "neuroprotection." Diabetes contributes to accelerated brain aging via several convergent pathways, including insulin resistance, chronic neuroinflammation, oxidative stress, blood-brain barrier dysfunction, and cerebrovascular damage. These mechanisms facilitate amyloid-beta accumulation and tau hyperphosphorylation, thereby linking diabetes to the Alzheimer's disease spectrum. Promising biomarkers for early detection include plasma p-tau 217, neurofilament light chain, and various neuroimaging markers.
Additional Links: PMID-42533301
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@article {pmid42533301,
year = {2026},
author = {Singh, AK and Dunde, V and Maurya, MH and Vora, N and Maheta, D and Frishman, WH and Aronow, WS},
title = {Protecting the Aging Brain in Diabetes: Mechanism, Biomarkers, and Emerging Therapeutic Frontiers in Cognitive Impairment-A Comprehensive Review.},
journal = {Cardiology in review},
volume = {},
number = {},
pages = {},
doi = {10.1097/CRD.0000000000001405},
pmid = {42533301},
issn = {1538-4683},
abstract = {Diabetes, which impacts over 500 million individuals globally, has been identified as a significant risk factor for accelerated cognitive aging, mild cognitive impairment, and various forms of dementia, including Alzheimer's disease and vascular dementia. Despite its clinical relevance, cognitive decline remains an underrecognized complication within diabetes management. This comprehensive review aims to synthesize evidence across the mechanisms, biomarkers, and therapeutic approaches pertinent to diabetes-associated cognitive impairment, with a particular emphasis on the aging brain. The primary literature search was conducted across the decade 2015-2025; however, earlier landmark studies and foundational scientific contributions have been selectively included where necessary to contextualize contemporary findings within the broader historical trajectory of the field. A systematic literature search was executed across PubMed, MEDLINE, Embase, and PsycINFO utilizing MeSH terms such as "type 2 diabetes mellitus," "cognitive decline," "dementia," "insulin resistance," "neuroinflammation," and "neuroprotection." Diabetes contributes to accelerated brain aging via several convergent pathways, including insulin resistance, chronic neuroinflammation, oxidative stress, blood-brain barrier dysfunction, and cerebrovascular damage. These mechanisms facilitate amyloid-beta accumulation and tau hyperphosphorylation, thereby linking diabetes to the Alzheimer's disease spectrum. Promising biomarkers for early detection include plasma p-tau 217, neurofilament light chain, and various neuroimaging markers.},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Associations of Inherited Chromosomally-Integrated Human Herpesvirus 6 With Dementia Incidence, Inflammation, and Other Dementia Risk Factors in the UK Biobank.
Journal of medical virology, 98(8):e71085.
The infection theory of dementia states that viral infections and chronic inflammation play a role in its pathogenesis. We aimed to test whether testing positive for inherited chromosomally-integrated human herpesvirus 6 (iciHHV-6) is associated with an increased dementia incidence, inflammation, and other dementia risk factors. We included n = 247,731 participants of the UK Biobank in the analysis, of whom n = 3388 (1.4%) tested positive for iciHHV-6. Linear and logistic regression models were performed to assess the associations between iciHHV-6 with HHV-6 antigens, blood-based biomarkers of inflammation, and other dementia risk factors. Cox proportional hazards regression models were applied to assess the associations of iciHHV-6 with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD). Subjects with iciHHV-6 exhibited statistically significantly higher antibody responses to the HHV-6 antigens IE1A (p = 0.002) and IE1B (p < 0.001). IciHHV-6 positivity was significantly more frequent among subjects with European or Chinese ethnicity, with lower education, higher alcohol consumption, current smoking, and longer telomere length. Interestingly, iciHHV-6 positive subjects had lower C-reactive protein (CRP) levels (p = 0.029). All other inflammatory biomarkers did not differ according to iciHHV-6 status. Overall, 6615 participants were diagnosed with all-cause dementia during a median of 13.6 years, including 3340 with AD and 1708 with VD. There was no significant association between iciHHV-6 positivity and the risk of any dementia outcome. IciHHV-6 positivity was not a risk factor for dementia outcomes or increased inflammation in this large study, but was associated with higher antibody responses against HHV-6 antigens, ethnicity, telomere length, and lifestyle factors.
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@article {pmid42533535,
year = {2026},
author = {Qiya, Z and Mandic, M and Waterboer, T and Ruijie, X and Brenner, H and Schöttker, B},
title = {Associations of Inherited Chromosomally-Integrated Human Herpesvirus 6 With Dementia Incidence, Inflammation, and Other Dementia Risk Factors in the UK Biobank.},
journal = {Journal of medical virology},
volume = {98},
number = {8},
pages = {e71085},
doi = {10.1002/jmv.71085},
pmid = {42533535},
issn = {1096-9071},
support = {//China Scholarship Council/ ; /WT_/Wellcome Trust/United Kingdom ; /MRC_/Medical Research Council/United Kingdom ; //Department of Health, Scottish government/ ; //Northwest Regional Development Agency/ ; //Welsh Assembly Government/ ; //British Heart Foundation./ ; },
mesh = {Humans ; *Herpesvirus 6, Human/genetics/immunology ; Female ; Male ; Risk Factors ; United Kingdom/epidemiology ; Aged ; *Inflammation/epidemiology/virology ; *Dementia/epidemiology/virology ; Incidence ; Middle Aged ; *Roseolovirus Infections/epidemiology/virology/complications ; Antibodies, Viral/blood ; Biological Specimen Banks ; Aged, 80 and over ; UK Biobank ; Alzheimer Disease/epidemiology/virology ; Biomarkers/blood ; },
abstract = {The infection theory of dementia states that viral infections and chronic inflammation play a role in its pathogenesis. We aimed to test whether testing positive for inherited chromosomally-integrated human herpesvirus 6 (iciHHV-6) is associated with an increased dementia incidence, inflammation, and other dementia risk factors. We included n = 247,731 participants of the UK Biobank in the analysis, of whom n = 3388 (1.4%) tested positive for iciHHV-6. Linear and logistic regression models were performed to assess the associations between iciHHV-6 with HHV-6 antigens, blood-based biomarkers of inflammation, and other dementia risk factors. Cox proportional hazards regression models were applied to assess the associations of iciHHV-6 with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD). Subjects with iciHHV-6 exhibited statistically significantly higher antibody responses to the HHV-6 antigens IE1A (p = 0.002) and IE1B (p < 0.001). IciHHV-6 positivity was significantly more frequent among subjects with European or Chinese ethnicity, with lower education, higher alcohol consumption, current smoking, and longer telomere length. Interestingly, iciHHV-6 positive subjects had lower C-reactive protein (CRP) levels (p = 0.029). All other inflammatory biomarkers did not differ according to iciHHV-6 status. Overall, 6615 participants were diagnosed with all-cause dementia during a median of 13.6 years, including 3340 with AD and 1708 with VD. There was no significant association between iciHHV-6 positivity and the risk of any dementia outcome. IciHHV-6 positivity was not a risk factor for dementia outcomes or increased inflammation in this large study, but was associated with higher antibody responses against HHV-6 antigens, ethnicity, telomere length, and lifestyle factors.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Herpesvirus 6, Human/genetics/immunology
Female
Male
Risk Factors
United Kingdom/epidemiology
Aged
*Inflammation/epidemiology/virology
*Dementia/epidemiology/virology
Incidence
Middle Aged
*Roseolovirus Infections/epidemiology/virology/complications
Antibodies, Viral/blood
Biological Specimen Banks
Aged, 80 and over
UK Biobank
Alzheimer Disease/epidemiology/virology
Biomarkers/blood
RevDate: 2026-07-31
CmpDate: 2026-07-31
DNAJB6a deficiency induces tau pathology through IRE1α-Xbp1-induced mitochondria dysfunction.
Zoological research, 47(4):1319-1331.
Endoplasmic reticulum (ER) stress and mitophagy have been indicated in the early stage of Alzheimer's disease (AD), in which tau hyperphosphorylation is one major pathological alteration. However, the precise mechanism remains unclear. Herein, the study identifies a crucial protein, the DnaJ (Hsp40) homolog, subfamily B, member 6a (DNAJB6a), and elucidates its potential pathogenic role in AD. The DNAJB6 gene is systematically screened using bioinformatics methods, confirming its decreased expression in AD patients' brains. And decreased DNAJB6a was found in the brains of the APP/PS1 mice compared to the control mice. DNAJB6a [-/-] mice exhibited cognitive impairment, synaptic loss and the pathological phenotypes of AD. Depletion of DNAJB6a led to activated ER stress depending on the downregulation of heat shock 70kDa protein 5 (HSPA5). Furthermore, DNAJB6a deficiency induced and accelerated AD-like phenotypes through activating IRE1α-XBP1 induced mitochondria dysfunction. These findings highlight DNAJB6a as a potential key target for preventing AD pathology.
Additional Links: PMID-42533583
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@article {pmid42533583,
year = {2026},
author = {Chen, X and Qian, FY and Zhao, N and Liu, XT and Wang, YJ and Geng, F and Zhu, MM and Zhang, ZJ and Ren, QG},
title = {DNAJB6a deficiency induces tau pathology through IRE1α-Xbp1-induced mitochondria dysfunction.},
journal = {Zoological research},
volume = {47},
number = {4},
pages = {1319-1331},
doi = {10.24272/j.issn.2095-8137.2025.348},
pmid = {42533583},
issn = {2095-8137},
mesh = {Animals ; *HSP40 Heat-Shock Proteins/genetics/metabolism/deficiency ; *Protein Serine-Threonine Kinases/metabolism/genetics ; *Mitochondria/metabolism ; Humans ; *tau Proteins/metabolism/genetics ; *X-Box Binding Protein 1/metabolism/genetics ; *Alzheimer Disease/genetics/metabolism/pathology ; *Molecular Chaperones/genetics/metabolism ; *Endoribonucleases/metabolism/genetics ; Mice ; *Nerve Tissue Proteins/genetics/metabolism ; Gene Expression Regulation ; Brain/metabolism ; Mice, Knockout ; },
abstract = {Endoplasmic reticulum (ER) stress and mitophagy have been indicated in the early stage of Alzheimer's disease (AD), in which tau hyperphosphorylation is one major pathological alteration. However, the precise mechanism remains unclear. Herein, the study identifies a crucial protein, the DnaJ (Hsp40) homolog, subfamily B, member 6a (DNAJB6a), and elucidates its potential pathogenic role in AD. The DNAJB6 gene is systematically screened using bioinformatics methods, confirming its decreased expression in AD patients' brains. And decreased DNAJB6a was found in the brains of the APP/PS1 mice compared to the control mice. DNAJB6a [-/-] mice exhibited cognitive impairment, synaptic loss and the pathological phenotypes of AD. Depletion of DNAJB6a led to activated ER stress depending on the downregulation of heat shock 70kDa protein 5 (HSPA5). Furthermore, DNAJB6a deficiency induced and accelerated AD-like phenotypes through activating IRE1α-XBP1 induced mitochondria dysfunction. These findings highlight DNAJB6a as a potential key target for preventing AD pathology.},
}
MeSH Terms:
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Animals
*HSP40 Heat-Shock Proteins/genetics/metabolism/deficiency
*Protein Serine-Threonine Kinases/metabolism/genetics
*Mitochondria/metabolism
Humans
*tau Proteins/metabolism/genetics
*X-Box Binding Protein 1/metabolism/genetics
*Alzheimer Disease/genetics/metabolism/pathology
*Molecular Chaperones/genetics/metabolism
*Endoribonucleases/metabolism/genetics
Mice
*Nerve Tissue Proteins/genetics/metabolism
Gene Expression Regulation
Brain/metabolism
Mice, Knockout
RevDate: 2026-07-31
CmpDate: 2026-07-31
Classification of tau status with machine learning models in amyloid-positive cohorts.
Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71683.
INTRODUCTION: Although tau positron emission tomography (PET) imaging is effective for staging tau pathology, it is limited clinically by cost and availability. Machine learning models based on magnetic resonance imaging (MRI)- and amyloid PET-derived features may serve as useful screening tools for tau pathology.
METHODS: Multiple machine learning models were developed to classify tau positivity in the Braak III/IV region using structural MRI, amyloid PET, and demographic features. Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 410) data were used for model training. Open Access Series of Imaging Studies (OASIS-3; n = 143) and the Standardized Centralized Alzheimer's Disease Neuroimaging (SCAN; n = 154) data were used for external validation.
RESULTS: Logistic regression achieved the best performance with areas under the curve (AUCs) of 0.92 for both internal and external validation. Combined external validation yielded accuracy/sensitivity/specificity of 85%/83%/85%. Subjects with mild cognitive impairment and predicted tau positivity progressed to AD at a significantly faster pace (p < 10[-6]).
DISCUSSION: Our model demonstrates the feasibility of classifying tau burden in amyloid-positive cohorts with MRI- and amyloid PET-derived features and may serve as a surrogate biomarker.
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@article {pmid42533677,
year = {2026},
author = {Lin, YC and Chiu, SC and Massey, R and Fang, YD and , },
title = {Classification of tau status with machine learning models in amyloid-positive cohorts.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
volume = {22},
number = {8},
pages = {e71683},
doi = {10.1002/alz.71683},
pmid = {42533677},
issn = {1552-5279},
support = {P30AG086401/NH/NIH HHS/United States ; },
mesh = {Humans ; *Machine Learning ; *tau Proteins/metabolism ; Positron-Emission Tomography ; *Alzheimer Disease/diagnostic imaging/pathology/metabolism ; Magnetic Resonance Imaging ; Female ; Aged ; Cognitive Dysfunction/diagnostic imaging/pathology ; Predictive Learning Models ; Classification Algorithms ; Brain/diagnostic imaging/pathology ; Aged, 80 and over ; Neuroimaging ; },
abstract = {INTRODUCTION: Although tau positron emission tomography (PET) imaging is effective for staging tau pathology, it is limited clinically by cost and availability. Machine learning models based on magnetic resonance imaging (MRI)- and amyloid PET-derived features may serve as useful screening tools for tau pathology.
METHODS: Multiple machine learning models were developed to classify tau positivity in the Braak III/IV region using structural MRI, amyloid PET, and demographic features. Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 410) data were used for model training. Open Access Series of Imaging Studies (OASIS-3; n = 143) and the Standardized Centralized Alzheimer's Disease Neuroimaging (SCAN; n = 154) data were used for external validation.
RESULTS: Logistic regression achieved the best performance with areas under the curve (AUCs) of 0.92 for both internal and external validation. Combined external validation yielded accuracy/sensitivity/specificity of 85%/83%/85%. Subjects with mild cognitive impairment and predicted tau positivity progressed to AD at a significantly faster pace (p < 10[-6]).
DISCUSSION: Our model demonstrates the feasibility of classifying tau burden in amyloid-positive cohorts with MRI- and amyloid PET-derived features and may serve as a surrogate biomarker.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Machine Learning
*tau Proteins/metabolism
Positron-Emission Tomography
*Alzheimer Disease/diagnostic imaging/pathology/metabolism
Magnetic Resonance Imaging
Female
Aged
Cognitive Dysfunction/diagnostic imaging/pathology
Predictive Learning Models
Classification Algorithms
Brain/diagnostic imaging/pathology
Aged, 80 and over
Neuroimaging
RevDate: 2026-07-31
CmpDate: 2026-07-31
Therapeutic Time Window of Disease-Modifying Therapy for Early Alzheimer's Disease in Japanese Individuals: Analysis Based on J-ADNI Study.
Geriatrics & gerontology international, 26(8):e70698.
BACKGROUND: Lecanemab and donanemab are recently approved disease-modifying therapies (DMTs) for early Alzheimer's disease (AD), indicating amyloid positivity, with Mini-Mental State Examination (MMSE) requirements. Prior analyses using North American population data suggested that baseline Clinical Dementia Rating-Global Score (CDR-GS) and MMSE may define the "therapeutic time window," but generalizability to Asian populations remains uncertain.
OBJECTIVE: To investigate the duration and predictors of the therapeutic time window, defined as the period until patients with early AD no longer meet eligibility criteria in Japanese patients.
METHODS: We retrospectively analyzed amyloid-positive participants from Japanese Alzheimer's Disease Neuroimaging Initiative, classified as lecanemab-eligible (MMSE 22-30, n = 129) or donanemab-eligible (MMSE 20-28, n = 143). Kaplan-Meier survival was estimated over 24 months, and Cox proportional-hazards models included age, sex, MMSE, CDR-GS, and baseline diagnosis. Education years, apolipoprotein-E ε4 (APOE-ε4), and CDR-Sum of Boxes (CDR-SB) were tested individually.
RESULTS: At 12 and 24 months, survival probabilities for remaining eligible were 82% and 69% (MCI) versus 51% and 38% (AD) in the lecanemab group, and 92% and 81% (MCI) versus 69% and 52% (AD) in the donanemab group. Baseline CDR-GS of 1 versus 0.5 predicted shorter eligibility for donanemab (HR = 2.50, 95% CI: 1.20-5.21), but not for lecanemab (HR = 0.48, 95% CI: 0.18-1.29). Each one-point increase in MMSE above threshold was protective (HR = 0.67-0.68).
CONCLUSIONS: Baseline CDR-GS and MMSE strongly predict the therapeutic time window in Japanese patients, supporting cross-population generalizability and contributing to the management of AD DMTs under resource constraints.
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@article {pmid42533763,
year = {2026},
author = {Nakashima, S and Sato, K and Niimi, Y and Ihara, R and Suzuki, K and Iwata, A and Satake, W and Iwatsubo, T and , },
title = {Therapeutic Time Window of Disease-Modifying Therapy for Early Alzheimer's Disease in Japanese Individuals: Analysis Based on J-ADNI Study.},
journal = {Geriatrics & gerontology international},
volume = {26},
number = {8},
pages = {e70698},
doi = {10.1111/ggi.70698},
pmid = {42533763},
issn = {1447-0594},
support = {24dk0207068//Japan Agency for Medical Research and Development/ ; 25dk0207075//Japan Agency for Medical Research and Development/ ; JP24K10653//Japan Society for the Promotion of Science/ ; JP25K19014//Japan Society for the Promotion of Science/ ; },
mesh = {Humans ; *Alzheimer Disease/drug therapy/diagnosis ; Female ; Japan/epidemiology ; Retrospective Studies ; Male ; Aged ; Time Factors ; Aged, 80 and over ; Mental Status and Dementia Tests ; *Antibodies, Monoclonal, Humanized/therapeutic use ; East Asian People ; },
abstract = {BACKGROUND: Lecanemab and donanemab are recently approved disease-modifying therapies (DMTs) for early Alzheimer's disease (AD), indicating amyloid positivity, with Mini-Mental State Examination (MMSE) requirements. Prior analyses using North American population data suggested that baseline Clinical Dementia Rating-Global Score (CDR-GS) and MMSE may define the "therapeutic time window," but generalizability to Asian populations remains uncertain.
OBJECTIVE: To investigate the duration and predictors of the therapeutic time window, defined as the period until patients with early AD no longer meet eligibility criteria in Japanese patients.
METHODS: We retrospectively analyzed amyloid-positive participants from Japanese Alzheimer's Disease Neuroimaging Initiative, classified as lecanemab-eligible (MMSE 22-30, n = 129) or donanemab-eligible (MMSE 20-28, n = 143). Kaplan-Meier survival was estimated over 24 months, and Cox proportional-hazards models included age, sex, MMSE, CDR-GS, and baseline diagnosis. Education years, apolipoprotein-E ε4 (APOE-ε4), and CDR-Sum of Boxes (CDR-SB) were tested individually.
RESULTS: At 12 and 24 months, survival probabilities for remaining eligible were 82% and 69% (MCI) versus 51% and 38% (AD) in the lecanemab group, and 92% and 81% (MCI) versus 69% and 52% (AD) in the donanemab group. Baseline CDR-GS of 1 versus 0.5 predicted shorter eligibility for donanemab (HR = 2.50, 95% CI: 1.20-5.21), but not for lecanemab (HR = 0.48, 95% CI: 0.18-1.29). Each one-point increase in MMSE above threshold was protective (HR = 0.67-0.68).
CONCLUSIONS: Baseline CDR-GS and MMSE strongly predict the therapeutic time window in Japanese patients, supporting cross-population generalizability and contributing to the management of AD DMTs under resource constraints.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/drug therapy/diagnosis
Female
Japan/epidemiology
Retrospective Studies
Male
Aged
Time Factors
Aged, 80 and over
Mental Status and Dementia Tests
*Antibodies, Monoclonal, Humanized/therapeutic use
East Asian People
RevDate: 2026-07-31
CmpDate: 2026-07-31
Correction: OATP1A2 mediates Aβ1-42 transport and may be a novel target for the treatment of Alzheimer's disease.
Frontiers in pharmacology, 17:1903977 pii:1903977.
[This corrects the article DOI: 10.3389/fphar.2024.1443789.].
Additional Links: PMID-42534606
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@article {pmid42534606,
year = {2026},
author = {Wen, J and Zhao, M and Xiao, Y and Li, S and Hu, W},
title = {Correction: OATP1A2 mediates Aβ1-42 transport and may be a novel target for the treatment of Alzheimer's disease.},
journal = {Frontiers in pharmacology},
volume = {17},
number = {},
pages = {1903977},
doi = {10.3389/fphar.2026.1903977},
pmid = {42534606},
issn = {1663-9812},
abstract = {[This corrects the article DOI: 10.3389/fphar.2024.1443789.].},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Polyphenols and microglial dynamics in neurodegenerative diseases: mechanistic advances and therapeutic perspectives.
PeerJ, 14:e21359.
Neuroinflammation plays a central role in multiple neurological and neurodegenerative disorders, including ischemic brain injury, Alzheimer's disease (AD), and Parkinson's disease (PD). Microglia, the principal immune cells with in the central nervous system (CNS) are pivotal mediators of neuroinflammatory responses via their dynamic transition across a spectrum of polarization states, broadly delineated by pro-inflammatory M1-like and anti-inflammatory M2-like phenotypic profiles. A pathological skew towards pro-inflammatory microglial activation drives and exacerbates disease progression, thereby rendering the modulation of microglial polarization states a promising therapeutic target for neuroprotective intervention. Natural polyphenols have garnered increasing interest owing to their capacity to traverse the blood-brain barrier (BBB), confer neuroprotective effects, and mitigate neuroinflammation. Despite challenges in clinical translation stemming from poor bioavailability and rapid in vivo metabolism, innovative delivery systems are being developed to address these limitations. This review consolidates current evidence regarding the mechanisms by which polyphenols modulate microglial phenotypic balance and polarization states and examines advanced delivery strategies designed to enhance their therapeutic efficacy in neuroinflammatory disorders. By synthesizing these perspectives, we offer novel insights into the potential application of polyphenols in neuroprotective therapies targeting pathological neuroinflammation.
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@article {pmid42534730,
year = {2026},
author = {Liu, L and Xiao, H and Zhou, J and Zhang, M and Duan, J},
title = {Polyphenols and microglial dynamics in neurodegenerative diseases: mechanistic advances and therapeutic perspectives.},
journal = {PeerJ},
volume = {14},
number = {},
pages = {e21359},
pmid = {42534730},
issn = {2167-8359},
mesh = {*Polyphenols/pharmacology/therapeutic use ; *Microglia/drug effects/metabolism ; Humans ; *Neurodegenerative Diseases/drug therapy ; Animals ; *Neuroprotective Agents/pharmacology/therapeutic use ; Blood-Brain Barrier/metabolism ; Neuroinflammatory Diseases/drug therapy ; },
abstract = {Neuroinflammation plays a central role in multiple neurological and neurodegenerative disorders, including ischemic brain injury, Alzheimer's disease (AD), and Parkinson's disease (PD). Microglia, the principal immune cells with in the central nervous system (CNS) are pivotal mediators of neuroinflammatory responses via their dynamic transition across a spectrum of polarization states, broadly delineated by pro-inflammatory M1-like and anti-inflammatory M2-like phenotypic profiles. A pathological skew towards pro-inflammatory microglial activation drives and exacerbates disease progression, thereby rendering the modulation of microglial polarization states a promising therapeutic target for neuroprotective intervention. Natural polyphenols have garnered increasing interest owing to their capacity to traverse the blood-brain barrier (BBB), confer neuroprotective effects, and mitigate neuroinflammation. Despite challenges in clinical translation stemming from poor bioavailability and rapid in vivo metabolism, innovative delivery systems are being developed to address these limitations. This review consolidates current evidence regarding the mechanisms by which polyphenols modulate microglial phenotypic balance and polarization states and examines advanced delivery strategies designed to enhance their therapeutic efficacy in neuroinflammatory disorders. By synthesizing these perspectives, we offer novel insights into the potential application of polyphenols in neuroprotective therapies targeting pathological neuroinflammation.},
}
MeSH Terms:
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*Polyphenols/pharmacology/therapeutic use
*Microglia/drug effects/metabolism
Humans
*Neurodegenerative Diseases/drug therapy
Animals
*Neuroprotective Agents/pharmacology/therapeutic use
Blood-Brain Barrier/metabolism
Neuroinflammatory Diseases/drug therapy
RevDate: 2026-07-31
CmpDate: 2026-07-31
A 10-state investigation of AD/ADRD-capable assisted living regulations using a comprehensive dementia care model.
Frontiers in dementia, 5:1789887.
INTRODUCTION: State regulation is central in shaping dementia care practices in assisted living facilities. Yet, there is limited systematic evidence examining how regulatory requirements vary and affect residents across states. Additionally, regulatory frameworks governing the training requirements and staff presence of ALFs play a vital role in shaping ALFs' dementia care capacity.
METHODS: This article reports the results of a legal mapping study that evaluated the variation of assisted living facility (ALF) memory care regulations across 10 states. We compared the regulations of these 10 selected states to the "gold standard" Dementia Care Practice Recommendations, a comprehensive memory care model compiled by the Alzheimer's Association (Fazio et al., 2018).
RESULTS: Of the care model's nine recommendations, regulations aligned most to the following: 1. Supportive and Therapeutic Environment (84% average alignment across 10 states), 2. Information Education and Support (74% average), and 3. Ongoing Care (70% average). States with regulation in highest alignment to the care model included California, Missouri, and Minnesota. Regulations were least aligned with the following recommendations: 7. Person-Centered Care (55% average), 8. Detection and Diagnosis (51% average), and 9. Medical Management (50%). States with regulation in lowest alignment to the care model included Texas, Georgia, and Connecticut.
DISCUSSION: Overall, inconsistencies in state alignment to the Care Model also underscore the absence of a standardized enforcement mechanism across assisted living systems. Additional evidence is needed to link regulatory standards to actual measured changes in state-level care coordination practice in the ALF setting. Target areas for regulation change may also exist outside of mechanisms that govern the staff and services directly provided by ALFs. Methods of this study are building blocks from which researchers may systematically collect and analyze regulations data for future across-state LTSS studies.
Additional Links: PMID-42534796
PubMed:
Citation:
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@article {pmid42534796,
year = {2026},
author = {Manchester, M and Boughrum, A and Helmly, V and Olupitan, O and Arias, J},
title = {A 10-state investigation of AD/ADRD-capable assisted living regulations using a comprehensive dementia care model.},
journal = {Frontiers in dementia},
volume = {5},
number = {},
pages = {1789887},
pmid = {42534796},
issn = {2813-3919},
abstract = {INTRODUCTION: State regulation is central in shaping dementia care practices in assisted living facilities. Yet, there is limited systematic evidence examining how regulatory requirements vary and affect residents across states. Additionally, regulatory frameworks governing the training requirements and staff presence of ALFs play a vital role in shaping ALFs' dementia care capacity.
METHODS: This article reports the results of a legal mapping study that evaluated the variation of assisted living facility (ALF) memory care regulations across 10 states. We compared the regulations of these 10 selected states to the "gold standard" Dementia Care Practice Recommendations, a comprehensive memory care model compiled by the Alzheimer's Association (Fazio et al., 2018).
RESULTS: Of the care model's nine recommendations, regulations aligned most to the following: 1. Supportive and Therapeutic Environment (84% average alignment across 10 states), 2. Information Education and Support (74% average), and 3. Ongoing Care (70% average). States with regulation in highest alignment to the care model included California, Missouri, and Minnesota. Regulations were least aligned with the following recommendations: 7. Person-Centered Care (55% average), 8. Detection and Diagnosis (51% average), and 9. Medical Management (50%). States with regulation in lowest alignment to the care model included Texas, Georgia, and Connecticut.
DISCUSSION: Overall, inconsistencies in state alignment to the Care Model also underscore the absence of a standardized enforcement mechanism across assisted living systems. Additional evidence is needed to link regulatory standards to actual measured changes in state-level care coordination practice in the ALF setting. Target areas for regulation change may also exist outside of mechanisms that govern the staff and services directly provided by ALFs. Methods of this study are building blocks from which researchers may systematically collect and analyze regulations data for future across-state LTSS studies.},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Anemia, iron deficiency, and blood biomarkers for Alzheimer disease: clinical interpretation and dementia risk stratification.
Frontiers in nutrition, 13:1897378.
Anemia and iron deficiency are common in older adults, yet their relevance to blood biomarkers for Alzheimer disease (AD) remains underappreciated. As these biomarkers move into clinical pathways, their interpretation depends not only on assay performance but also on comorbidity, kidney function, inflammation, and nutritional status. Against this backdrop, anemia, absolute iron deficiency, and functional iron deficiency are better viewed as distinct hematopoietic nutritional phenotypes than as background covariates, with important implications for interpreting the amyloid-β42/40 ratio, phosphorylated tau 217 (p-tau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Current human data link anemia and iron-restricted states to higher dementia risk and to variation in plasma p-tau217, GFAP, and NfL; kidney function, body mass index (BMI), inflammation, and multimorbidity further shift biomarker distributions and cutoff interpretation. Among available analytes, p-tau217 is closest to routine clinical use within validated intended-use diagnostic pathways; however, its interpretation remains assay- and cutoff-specific and depends on pretest probability, gray-zone handling, kidney function, BMI, hemoglobin, ferritin, and transferrin saturation. Mechanistic work supports plausible links involving impaired oxygen delivery, disrupted iron-mitochondrial bioenergetics, hepcidin-mediated functional iron restriction, and glial, myelin, and blood-brain barrier vulnerability, although a complete human causal chain has not been established. Current evidence therefore favors phenotype-aware interpretation over hemoglobin-only screening or biomarker-only reading. In memory clinics and geriatric practice, complete blood count and iron studies may provide useful interpretive context in selected patients, particularly when multimorbidity, chronic kidney disease (CKD), inflammation, nutritional vulnerability, fatigue, or low or low-normal hemoglobin could affect biomarker interpretation or downstream decisions. Future studies should test whether, and in whom, correcting iron-related phenotypes changes biomarker-guided risk stratification, biomarker trajectories, or clinical decisions.
Additional Links: PMID-42534839
PubMed:
Citation:
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@article {pmid42534839,
year = {2026},
author = {Li, Z and Ming, Q and Fu, L and Yang, J and Lv, Y and Chen, B and Qiu, X and Lu, Z},
title = {Anemia, iron deficiency, and blood biomarkers for Alzheimer disease: clinical interpretation and dementia risk stratification.},
journal = {Frontiers in nutrition},
volume = {13},
number = {},
pages = {1897378},
pmid = {42534839},
issn = {2296-861X},
abstract = {Anemia and iron deficiency are common in older adults, yet their relevance to blood biomarkers for Alzheimer disease (AD) remains underappreciated. As these biomarkers move into clinical pathways, their interpretation depends not only on assay performance but also on comorbidity, kidney function, inflammation, and nutritional status. Against this backdrop, anemia, absolute iron deficiency, and functional iron deficiency are better viewed as distinct hematopoietic nutritional phenotypes than as background covariates, with important implications for interpreting the amyloid-β42/40 ratio, phosphorylated tau 217 (p-tau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Current human data link anemia and iron-restricted states to higher dementia risk and to variation in plasma p-tau217, GFAP, and NfL; kidney function, body mass index (BMI), inflammation, and multimorbidity further shift biomarker distributions and cutoff interpretation. Among available analytes, p-tau217 is closest to routine clinical use within validated intended-use diagnostic pathways; however, its interpretation remains assay- and cutoff-specific and depends on pretest probability, gray-zone handling, kidney function, BMI, hemoglobin, ferritin, and transferrin saturation. Mechanistic work supports plausible links involving impaired oxygen delivery, disrupted iron-mitochondrial bioenergetics, hepcidin-mediated functional iron restriction, and glial, myelin, and blood-brain barrier vulnerability, although a complete human causal chain has not been established. Current evidence therefore favors phenotype-aware interpretation over hemoglobin-only screening or biomarker-only reading. In memory clinics and geriatric practice, complete blood count and iron studies may provide useful interpretive context in selected patients, particularly when multimorbidity, chronic kidney disease (CKD), inflammation, nutritional vulnerability, fatigue, or low or low-normal hemoglobin could affect biomarker interpretation or downstream decisions. Future studies should test whether, and in whom, correcting iron-related phenotypes changes biomarker-guided risk stratification, biomarker trajectories, or clinical decisions.},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Global research trends and hotspots of short-chain fatty acids in cognitive impairment: a bibliometric analysis based on two databases.
Frontiers in medicine, 13:1857769.
OBJECTIVE: Short-chain fatty acids (SCFAs) have been widely investigated in research related to cognitive impairment, yet systematic bibliometric analyses focusing on their correlation remain relatively scarce. This study employed bibliometric analysis to objectively review relevant literature, identify key research contributors, and uncover emerging frontiers in the field.
METHODS: Relevant literature published from 2009 to 2025 was retrieved from the Web of Science Core Collection (WoSCC) and Scopus databases. Bibliometric analyses were performed using the Bibliometrix R package, VOSviewer, and CiteSpace software to evaluate research outputs and generate visualizations.
RESULTS: A total of 425 eligible articles from WoSCC and 514 from Scopus were included. Annual publications on SCFAs and cognitive impairment showed a continuous upward trend from 2009 to 2025. China contributed the largest number of publications in this field, and an international collaboration network has been established, with Wenzhou Medical University (China) serving as the core collaboration hub. International Journal of Molecular Sciences was identified as a major publication platform, and Zhang, Xin was recognized as a core author in SCFA-cognitive impairment research. High-frequency keywords included "gut microbiota," "Alzheimer's disease," "neuroinflammation," and "gut-brain axis." In addition, recent research frontiers encompassed "drug therapy," "microbiology," and "chemistry," revealing the core themes and trends of SCFA and cognitive impairment studies.
CONCLUSION: This study conducted a comprehensive bibliometric analysis of the association between SCFAs and cognitive impairment, clarified the evolutionary trajectory of research themes, and identified potential future research directions. It revealed a developmental pattern whereby research in this field has gradually advanced from exploring basic correlations between diet and gut microbiota to in-depth investigations of pathological mechanisms, precise targeted interventions, and clinical translational applications. By systematically depicting the current research landscape, this study aims to provide guidance for subsequent investigations and fill critical knowledge gaps.
Additional Links: PMID-42534861
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Citation:
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@article {pmid42534861,
year = {2026},
author = {Wu, X and Yu, T and Hu, S and Zhang, T},
title = {Global research trends and hotspots of short-chain fatty acids in cognitive impairment: a bibliometric analysis based on two databases.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1857769},
pmid = {42534861},
issn = {2296-858X},
abstract = {OBJECTIVE: Short-chain fatty acids (SCFAs) have been widely investigated in research related to cognitive impairment, yet systematic bibliometric analyses focusing on their correlation remain relatively scarce. This study employed bibliometric analysis to objectively review relevant literature, identify key research contributors, and uncover emerging frontiers in the field.
METHODS: Relevant literature published from 2009 to 2025 was retrieved from the Web of Science Core Collection (WoSCC) and Scopus databases. Bibliometric analyses were performed using the Bibliometrix R package, VOSviewer, and CiteSpace software to evaluate research outputs and generate visualizations.
RESULTS: A total of 425 eligible articles from WoSCC and 514 from Scopus were included. Annual publications on SCFAs and cognitive impairment showed a continuous upward trend from 2009 to 2025. China contributed the largest number of publications in this field, and an international collaboration network has been established, with Wenzhou Medical University (China) serving as the core collaboration hub. International Journal of Molecular Sciences was identified as a major publication platform, and Zhang, Xin was recognized as a core author in SCFA-cognitive impairment research. High-frequency keywords included "gut microbiota," "Alzheimer's disease," "neuroinflammation," and "gut-brain axis." In addition, recent research frontiers encompassed "drug therapy," "microbiology," and "chemistry," revealing the core themes and trends of SCFA and cognitive impairment studies.
CONCLUSION: This study conducted a comprehensive bibliometric analysis of the association between SCFAs and cognitive impairment, clarified the evolutionary trajectory of research themes, and identified potential future research directions. It revealed a developmental pattern whereby research in this field has gradually advanced from exploring basic correlations between diet and gut microbiota to in-depth investigations of pathological mechanisms, precise targeted interventions, and clinical translational applications. By systematically depicting the current research landscape, this study aims to provide guidance for subsequent investigations and fill critical knowledge gaps.},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Mapping Alzheimer's disease heterogeneity through exploratory unsupervised learning.
Frontiers in aging neuroscience, 18:1869804.
INTRODUCTION: Alzheimer's disease (AD) is becoming one of the most pressing health challenges of the century, affecting circa 55 million people worldwide and expected to triple this number by 2050. Besides the growing prevalence, AD remains difficult to diagnose due to its long preclinical phase and substantial symptomatic heterogeneity. Despite the existence of international guidelines for AD diagnosis emphasizing the use of biomarkers (such as neuroimaging and cerebrospinal molecular biomarkers), most research studies are still using data disregarding their diagnostic quality, blurring the overall statistical outcomes. Aiming to circumvent this effect, biomarker confirmed samples from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were used, which integrate genetic and neuroimaging data for all participants.
METHODS: Unsupervised machine learning clustering methods were tested to explore whether curated genetic markers can reveal underlying substructure within sporadic AD (sAD). Here two specific sets of single nucleotide polymorphisms (SNPs) were selected: (i) candidate SNPs highlighted in previous studies that identified the existence of different subtypes in sAD and (ii) SNPs found associated with sAD in genome wide association studies (GWAS) that used at least 50% of samples with biomarker-confirmed diagnosis.
RESULTS: This strategy minimized background noise and enabled the construction of high quality SNP sets for analysis. Different clustering algorithms were evaluated with agglomerative hierarchical clustering consistently yielding the most robust performance. Across SNP sets, most trials revealed a reproducible binary structure within sAD samples, suggesting the presence of genetically distinguishable subgroups.
DISCUSSION: These findings align with emerging multimodal evidence supporting biological heterogeneity in AD. Overall, this work demonstrates that curated SNP panels combined with unsupervised learning can uncover meaningful substructure in sAD, reinforcing the value of integrating high quality genetic data into subtype research.
Additional Links: PMID-42534986
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@article {pmid42534986,
year = {2026},
author = {Xavier, C and Correia, AP and Lopes, J and Fernandes, J and Laranjinha, I and Pinto, N},
title = {Mapping Alzheimer's disease heterogeneity through exploratory unsupervised learning.},
journal = {Frontiers in aging neuroscience},
volume = {18},
number = {},
pages = {1869804},
pmid = {42534986},
issn = {1663-4365},
abstract = {INTRODUCTION: Alzheimer's disease (AD) is becoming one of the most pressing health challenges of the century, affecting circa 55 million people worldwide and expected to triple this number by 2050. Besides the growing prevalence, AD remains difficult to diagnose due to its long preclinical phase and substantial symptomatic heterogeneity. Despite the existence of international guidelines for AD diagnosis emphasizing the use of biomarkers (such as neuroimaging and cerebrospinal molecular biomarkers), most research studies are still using data disregarding their diagnostic quality, blurring the overall statistical outcomes. Aiming to circumvent this effect, biomarker confirmed samples from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were used, which integrate genetic and neuroimaging data for all participants.
METHODS: Unsupervised machine learning clustering methods were tested to explore whether curated genetic markers can reveal underlying substructure within sporadic AD (sAD). Here two specific sets of single nucleotide polymorphisms (SNPs) were selected: (i) candidate SNPs highlighted in previous studies that identified the existence of different subtypes in sAD and (ii) SNPs found associated with sAD in genome wide association studies (GWAS) that used at least 50% of samples with biomarker-confirmed diagnosis.
RESULTS: This strategy minimized background noise and enabled the construction of high quality SNP sets for analysis. Different clustering algorithms were evaluated with agglomerative hierarchical clustering consistently yielding the most robust performance. Across SNP sets, most trials revealed a reproducible binary structure within sAD samples, suggesting the presence of genetically distinguishable subgroups.
DISCUSSION: These findings align with emerging multimodal evidence supporting biological heterogeneity in AD. Overall, this work demonstrates that curated SNP panels combined with unsupervised learning can uncover meaningful substructure in sAD, reinforcing the value of integrating high quality genetic data into subtype research.},
}
RevDate: 2026-07-31
CmpDate: 2026-07-31
Exploring longitudinal relationships among Alzheimer's disease biomarkers.
Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71711.
INTRODUCTION: While most studies of Alzheimer's disease (AD) examine cross-sectional relationships among biomarkers, longitudinal relationships are also highly relevant.
METHODS: This study in the Alzheimer's Disease Neuroimaging Initiative cohort (n = 373) used non-parametric Spearman correlations to explore the relationships of baseline values and rates of change in plasma biomarkers and rates of change in key AD outcomes.
RESULTS: Compared to rates of change of plasma biomarkers, baseline values of plasma biomarkers were more strongly associated with rates of change in key AD outcomes. Change in amyloid positron emission tomography (PET) was most strongly associated with baseline values of amyloid beta (Aβ)42/Aβ40 and phosphorylated tau (p-tau)217, especially in amyloid PET--negative individuals. Changes in cortical thickness and measures of cognition were most strongly associated with baseline p-tau217, especially in amyloid PET-positive individuals.
DISCUSSION: Baseline p-tau217 is associated with rates of change of amyloid pathology and cognition. Visualization tools were developed to enable researchers to explore AD biomarker relationships.
Additional Links: PMID-42535261
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Citation:
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@article {pmid42535261,
year = {2026},
author = {Saef, B and Petersen, KK and Volluz, K and Li, Y and Tosun, D and Mila-Aloma, M and Shaw, LM and Zetterberg, H and Dage, JL and Rubel, CE and Ferber, K and Du-Cuny, L and Coomaraswamy, J and Baratta, M and Mordashova, Y and Saad, ZS and Triana-Baltzer, G and Ashton, NJ and Meyers, EA and Rosenbaugh, EG and Sabandal, JM and Bannon, AW and Potter, WZ and , and , and Schindler, SE},
title = {Exploring longitudinal relationships among Alzheimer's disease biomarkers.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
volume = {22},
number = {8},
pages = {e71711},
doi = {10.1002/alz.71711},
pmid = {42535261},
issn = {1552-5279},
support = {//the Foundation for the National Institutes of Health (FNIH)/ ; R01AG070941 (S.E.S.)/AG/NIA NIH HHS/United States ; //AbbVie Inc., Alzheimer's Association, Diagnostics Accelerator at the Alzheimer's Drug Discovery Foundation, Biogen, Janssen Research & Development, LLC, and Takeda Pharmaceutical Company Limited/ ; //Foundation for the National Institutes of Health/ ; },
mesh = {Humans ; *Alzheimer Disease/diagnostic imaging/blood/pathology ; *Biomarkers/blood ; Positron-Emission Tomography ; *tau Proteins/blood ; *Amyloid beta-Peptides/blood ; Longitudinal Studies ; Female ; Male ; Aged ; Peptide Fragments/blood ; Brain/diagnostic imaging/pathology ; },
abstract = {INTRODUCTION: While most studies of Alzheimer's disease (AD) examine cross-sectional relationships among biomarkers, longitudinal relationships are also highly relevant.
METHODS: This study in the Alzheimer's Disease Neuroimaging Initiative cohort (n = 373) used non-parametric Spearman correlations to explore the relationships of baseline values and rates of change in plasma biomarkers and rates of change in key AD outcomes.
RESULTS: Compared to rates of change of plasma biomarkers, baseline values of plasma biomarkers were more strongly associated with rates of change in key AD outcomes. Change in amyloid positron emission tomography (PET) was most strongly associated with baseline values of amyloid beta (Aβ)42/Aβ40 and phosphorylated tau (p-tau)217, especially in amyloid PET--negative individuals. Changes in cortical thickness and measures of cognition were most strongly associated with baseline p-tau217, especially in amyloid PET-positive individuals.
DISCUSSION: Baseline p-tau217 is associated with rates of change of amyloid pathology and cognition. Visualization tools were developed to enable researchers to explore AD biomarker relationships.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/diagnostic imaging/blood/pathology
*Biomarkers/blood
Positron-Emission Tomography
*tau Proteins/blood
*Amyloid beta-Peptides/blood
Longitudinal Studies
Female
Male
Aged
Peptide Fragments/blood
Brain/diagnostic imaging/pathology
RevDate: 2026-07-31
CmpDate: 2026-07-31
Evaluating digital cognitive tests for clinical use in Alzheimer's disease: A novel framework and scoping review.
Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71559.
Mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), remains undiagnosed in > 90% of individuals, delaying access to timely evaluation and interventions. Self-administered digital cognitive assessments (SA-DCAs) offer scalable approaches for early detection, yet their real-world validation and clinical readiness remain uncertain. We developed a use-case-specific framework to evaluate SA-DCAs intended for community and primary-care MCI screening and applied it to a comprehensive scoping review of published evidence (2012-2025). Among 79 identified SA-DCAs, only four tools met predefined framework criteria across nine eligible studies. Common limitations included restricted population representativeness, inconsistent diagnostic performance reporting, limited biomarker anchoring, and reliance on prefiltered cohorts. Overall, the current evidence base is methodologically heterogeneous and incomplete for clinical deployment. The proposed framework characterizes requirements including anchoring strength, prevalence-adjusted performance reporting, and representative sampling establishing a foundation for advancing robust real-world evidence needed to translate SA-DCAs from research to clinical practice.
Additional Links: PMID-42535268
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@article {pmid42535268,
year = {2026},
author = {Hampel, H and Nakamura, Y and Bell, J and Hendrix, S and Derchansky, M and Montezano, BB and Stoeckel, LE and Teipel, S and Willis, DR and Cummings, JL and Cobb, BR},
title = {Evaluating digital cognitive tests for clinical use in Alzheimer's disease: A novel framework and scoping review.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
volume = {22},
number = {8},
pages = {e71559},
doi = {10.1002/alz.71559},
pmid = {42535268},
issn = {1552-5279},
support = {//Eisai Incorporated/ ; },
mesh = {Humans ; *Alzheimer Disease/diagnosis ; *Cognitive Dysfunction/diagnosis ; Digital Health ; *Neuropsychological Tests ; Early Diagnosis ; Prodromal Symptoms ; Digital Media ; },
abstract = {Mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), remains undiagnosed in > 90% of individuals, delaying access to timely evaluation and interventions. Self-administered digital cognitive assessments (SA-DCAs) offer scalable approaches for early detection, yet their real-world validation and clinical readiness remain uncertain. We developed a use-case-specific framework to evaluate SA-DCAs intended for community and primary-care MCI screening and applied it to a comprehensive scoping review of published evidence (2012-2025). Among 79 identified SA-DCAs, only four tools met predefined framework criteria across nine eligible studies. Common limitations included restricted population representativeness, inconsistent diagnostic performance reporting, limited biomarker anchoring, and reliance on prefiltered cohorts. Overall, the current evidence base is methodologically heterogeneous and incomplete for clinical deployment. The proposed framework characterizes requirements including anchoring strength, prevalence-adjusted performance reporting, and representative sampling establishing a foundation for advancing robust real-world evidence needed to translate SA-DCAs from research to clinical practice.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/diagnosis
*Cognitive Dysfunction/diagnosis
Digital Health
*Neuropsychological Tests
Early Diagnosis
Prodromal Symptoms
Digital Media
RevDate: 2026-07-31
CmpDate: 2026-07-31
Heterogeneity in plasma p-tau217 response and its association with cognitive trajectories under lecanemab treatment.
Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71705.
INTRODUCTION: Plasma phosphorylated tau 217 (p-tau217) is a promising biomarker for monitoring treatment response in Alzheimer's disease (AD), but its longitudinal dynamics and clinical relevance remain unclear.
METHODS: In this prospective real-world study, 153 patients with early AD receiving lecanemab were analyzed. Longitudinal changes in plasma p-tau217 were assessed, and trajectory patterns were identified using clustering and slope-based approaches. Associations with baseline factors and cognitive outcomes were evaluated.
RESULTS: Plasma p-tau217 levels decreased significantly from 3 months, with the greatest decline between 3 and 6 months, followed by a plateau. Two distinct trajectory groups were identified. Patients in the greater reduction group showed more favorable cognitive trajectories, particularly slower progression in Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. Hypertension was associated with a diminished biomarker response.
DISCUSSION: These findings support plasma p-tau217 as an early pharmacodynamic biomarker and highlight its potential role in guiding individualized treatment strategies in routine clinical practice.
Additional Links: PMID-42535277
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PubMed:
Citation:
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@article {pmid42535277,
year = {2026},
author = {Kang, SH and Park, YJ and Lee, S and Kang, J and Lee, S and Lee, ES and Jung, HN and Ryoo, I and Hwang, H and Choi, K and Eo, JS and Suh, SI and Oh, K and Koh, SB},
title = {Heterogeneity in plasma p-tau217 response and its association with cognitive trajectories under lecanemab treatment.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
volume = {22},
number = {8},
pages = {e71705},
doi = {10.1002/alz.71705},
pmid = {42535277},
issn = {1552-5279},
support = {RS-2025-16066879//National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT)/ ; K2615351//Korea University Guro Hospital (Korea Research-Driven Hospital) and grant funded by Korea University Medicine/ ; RS-2023-00273685//Starting Growth Technological R&D Program (TIPS Program) funded by the Ministry of SMEs and Startups, Korea/ ; BT240027//Seoul R&BD Program through the Seoul Business Agency funded by the Seoul Metropolitan Government/ ; },
mesh = {Humans ; *tau Proteins/blood ; *Alzheimer Disease/drug therapy/blood ; Female ; Biomarkers/blood ; Male ; Aged ; Disease Progression ; Phosphorylation ; Prospective Studies ; Longitudinal Studies ; Treatment Effect Heterogeneity ; Aged, 80 and over ; *Cognition/drug effects ; },
abstract = {INTRODUCTION: Plasma phosphorylated tau 217 (p-tau217) is a promising biomarker for monitoring treatment response in Alzheimer's disease (AD), but its longitudinal dynamics and clinical relevance remain unclear.
METHODS: In this prospective real-world study, 153 patients with early AD receiving lecanemab were analyzed. Longitudinal changes in plasma p-tau217 were assessed, and trajectory patterns were identified using clustering and slope-based approaches. Associations with baseline factors and cognitive outcomes were evaluated.
RESULTS: Plasma p-tau217 levels decreased significantly from 3 months, with the greatest decline between 3 and 6 months, followed by a plateau. Two distinct trajectory groups were identified. Patients in the greater reduction group showed more favorable cognitive trajectories, particularly slower progression in Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. Hypertension was associated with a diminished biomarker response.
DISCUSSION: These findings support plasma p-tau217 as an early pharmacodynamic biomarker and highlight its potential role in guiding individualized treatment strategies in routine clinical practice.},
}
MeSH Terms:
show MeSH Terms
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Humans
*tau Proteins/blood
*Alzheimer Disease/drug therapy/blood
Female
Biomarkers/blood
Male
Aged
Disease Progression
Phosphorylation
Prospective Studies
Longitudinal Studies
Treatment Effect Heterogeneity
Aged, 80 and over
*Cognition/drug effects
RevDate: 2026-07-31
CmpDate: 2026-07-31
Coping Styles Predict Timing of Dementia Diagnosis: Evidence From DETERMIND.
International journal of geriatric psychiatry, 41(8):e70246.
OBJECTIVES: Early diagnosis underpins global policy directives aimed at supporting people to live well with dementia. While people encounter numerous barriers when seeking early dementia diagnosis, previous research has primarily focussed on non-modifiable, socio-demographic determinants of diagnostic timing. This study examined whether individuals' coping style could provide further insight into diagnostic delay.
METHODS: Coping was assessed via the dispositional Brief COPE in 935 individuals recently diagnosed with dementia and 697 carers from the DETERMIND cohort. Through principal component analysis, we identified three distinct coping styles. Hierarchical regression assessed the association of participant demographics and coping factors with diagnostic timing, operationalised via symptom severity and time between first symptoms and diagnosis.
RESULTS: Coping predicted diagnostic timing in terms of both symptom severity and temporal delay. Increased symptom severity at diagnosis was predicted by individuals with dementia using more avoidant coping and less approach coping. Longer temporal delays were associated with individuals with dementia using less support seeking coping and carers using less avoidant coping.
CONCLUSIONS: Our findings suggest diagnostic timing is related to the coping strategies employed by individuals with dementia and their carers, over and above demographic influences. These results identify coping as a modifiable factor that could help understand who is most at risk and inform interventions to promote early diagnosis, aligning with global policy directives.
Additional Links: PMID-42535660
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@article {pmid42535660,
year = {2026},
author = {Duncan-Cross, I and Miles, E and Hicks, B},
title = {Coping Styles Predict Timing of Dementia Diagnosis: Evidence From DETERMIND.},
journal = {International journal of geriatric psychiatry},
volume = {41},
number = {8},
pages = {e70246},
doi = {10.1002/gps.70246},
pmid = {42535660},
issn = {1099-1166},
support = {ES/S010351/1//Economic and Social Research Council/ ; },
mesh = {Humans ; *Adaptation, Psychological ; *Dementia/diagnosis/psychology ; Female ; *Coping Skills ; Male ; Aged ; Caregivers/psychology ; Aged, 80 and over ; *Delayed Diagnosis/psychology ; Early Diagnosis ; Middle Aged ; Treatment Delay ; },
abstract = {OBJECTIVES: Early diagnosis underpins global policy directives aimed at supporting people to live well with dementia. While people encounter numerous barriers when seeking early dementia diagnosis, previous research has primarily focussed on non-modifiable, socio-demographic determinants of diagnostic timing. This study examined whether individuals' coping style could provide further insight into diagnostic delay.
METHODS: Coping was assessed via the dispositional Brief COPE in 935 individuals recently diagnosed with dementia and 697 carers from the DETERMIND cohort. Through principal component analysis, we identified three distinct coping styles. Hierarchical regression assessed the association of participant demographics and coping factors with diagnostic timing, operationalised via symptom severity and time between first symptoms and diagnosis.
RESULTS: Coping predicted diagnostic timing in terms of both symptom severity and temporal delay. Increased symptom severity at diagnosis was predicted by individuals with dementia using more avoidant coping and less approach coping. Longer temporal delays were associated with individuals with dementia using less support seeking coping and carers using less avoidant coping.
CONCLUSIONS: Our findings suggest diagnostic timing is related to the coping strategies employed by individuals with dementia and their carers, over and above demographic influences. These results identify coping as a modifiable factor that could help understand who is most at risk and inform interventions to promote early diagnosis, aligning with global policy directives.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Adaptation, Psychological
*Dementia/diagnosis/psychology
Female
*Coping Skills
Male
Aged
Caregivers/psychology
Aged, 80 and over
*Delayed Diagnosis/psychology
Early Diagnosis
Middle Aged
Treatment Delay
RevDate: 2026-07-29
Perfusion as a biomarker of brain dysfunction in dementia (AD, DLB, FTD/PPA, PDD): comparison of CT, MRI (ASL/DSC/DCE), SPECT, and PET with interpretive pitfalls - a narrative review.
Acta neurologica Belgica [Epub ahead of print].
The term 'brain perfusion' is applied in clinical practice to a family of neuroimaging techniques that measure, in reality, quite different physiological quantities in the brain circulation. CT perfusion (CTP) and DSC-MRI track a contrast bolus to derive semi-quantitative haemodynamic parameters. ASL-MRI estimates cerebral blood flow (CBF) without contrast, but the result is sensitive to arterial transit time, haematocrit, and the patient's haemodynamic state on the day of the scan. DCE-MRI quantifies blood-brain barrier (BBB) permeability, a property of the neurovascular unit rather than a flow measurement. Perfusion SPECT provides a relative, normalisation-dependent CBF map that is distorted by cortical atrophy. [[18]F]FDG-PET reflects synaptic glucose metabolism, but not blood flow. Because these techniques answer different physiological questions, their results are not interchangeable, and applying a threshold or pattern derived from one modality to interpret another is methodologically unsound - yet this conflation occurs with regularity in clinical practice. This narrative review synthesises the clinical applications, diagnostic performance, and interpretive pitfalls of each technique in Alzheimer's disease (AD)/mild cognitive impairment (MCI-AD), dementia with Lewy bodies (DLB)/Parkinson's disease dementia (PDD), frontotemporal dementia (FTD)/primary progressive aphasia (PPA), and mixed dementia with vascular pathology. Recognised limitations include the narrative study design and the small number of head-to-head multi-modal studies in pathologically confirmed cohorts. A comparative table and practical minimum reporting elements are provided.
Additional Links: PMID-42525357
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@article {pmid42525357,
year = {2026},
author = {Sklinda, K and Bocianski, J and Budlewski, T and Kobylecka, M and Dorobek, M and Gorecki, A and Mruk, B and Błaszczak, M and Walecki, J},
title = {Perfusion as a biomarker of brain dysfunction in dementia (AD, DLB, FTD/PPA, PDD): comparison of CT, MRI (ASL/DSC/DCE), SPECT, and PET with interpretive pitfalls - a narrative review.},
journal = {Acta neurologica Belgica},
volume = {},
number = {},
pages = {},
pmid = {42525357},
issn = {2240-2993},
abstract = {The term 'brain perfusion' is applied in clinical practice to a family of neuroimaging techniques that measure, in reality, quite different physiological quantities in the brain circulation. CT perfusion (CTP) and DSC-MRI track a contrast bolus to derive semi-quantitative haemodynamic parameters. ASL-MRI estimates cerebral blood flow (CBF) without contrast, but the result is sensitive to arterial transit time, haematocrit, and the patient's haemodynamic state on the day of the scan. DCE-MRI quantifies blood-brain barrier (BBB) permeability, a property of the neurovascular unit rather than a flow measurement. Perfusion SPECT provides a relative, normalisation-dependent CBF map that is distorted by cortical atrophy. [[18]F]FDG-PET reflects synaptic glucose metabolism, but not blood flow. Because these techniques answer different physiological questions, their results are not interchangeable, and applying a threshold or pattern derived from one modality to interpret another is methodologically unsound - yet this conflation occurs with regularity in clinical practice. This narrative review synthesises the clinical applications, diagnostic performance, and interpretive pitfalls of each technique in Alzheimer's disease (AD)/mild cognitive impairment (MCI-AD), dementia with Lewy bodies (DLB)/Parkinson's disease dementia (PDD), frontotemporal dementia (FTD)/primary progressive aphasia (PPA), and mixed dementia with vascular pathology. Recognised limitations include the narrative study design and the small number of head-to-head multi-modal studies in pathologically confirmed cohorts. A comparative table and practical minimum reporting elements are provided.},
}
RevDate: 2026-07-29
CmpDate: 2026-07-29
Association of Sugar Restriction in Utero Through Age 2 Years on Dementia Risk Later in Life.
Neurology, 107(4):e218313.
BACKGROUND AND OBJECTIVES: Excess sugar intake in early life may affect long-term brain health, but evidence for dementia is limited. We used the abrupt end of UK sugar rationing in September 1953 as a natural experiment to test whether exposure to sugar rationing during different windows within the first 1,000 days from conception was associated with adult risk of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD).
METHODS: We analyzed UK Biobank participants born around the end of UK sugar rationing. Exposure was classified as rationing in utero only, in utero plus the first year of life, in utero plus 1-2 years of life, or no exposure. Incident dementia was identified from linked ICD-10 records. MRI of the brain and cognitive function were assessed in the imaging subcohort. Adjusted Cox and Gompertz models estimated HRs and 95% CIs, Fine-Gray models accounted for competing risk, and mediation analyses evaluated type 2 diabetes and hypertension.
RESULTS: Among 64,737 participants included in the analysis, the mean age at recruitment was 54.6 years, and 56.4% were women; 40,963 were exposed to sugar rationing during fetal and/or early-childhood life, and 23,774 were unexposed. Compared with unexposed individuals, sugar rationing in utero plus the first year of life was associated with lower hazards of all-cause dementia (HR, 0.79; 95% CI 0.66-0.94) and AD (HR, 0.77; 95% CI 0.59-1.00). Similar or slightly stronger associations were observed for exposure in utero plus 1-2 years (all-cause dementia: HR, 0.77; 95% CI 0.63-0.95; AD: HR, 0.72; 95% CI 0.53-0.98). Exposure in utero plus 1-2 years was associated with delayed onset of all-cause dementia by 2.55 years, AD by 2.87 years, and VaD by 2.49 years. Early-life sugar rationing was also associated with higher total gray matter volume (β, 3.27; 95% CI 0.46-6.07), lower white matter hyperintensity volume (β, -0.64; 95% CI -0.97 to -0.31), and better performance in processing speed and reasoning. Incident type 2 diabetes and hypertension jointly mediated 25.5% of the association.
DISCUSSION: Sugar restriction in the first 1,000 days was associated with lower dementia hazards, delayed onset, and more favorable brain-health profiles. These results support early-life sugar reduction as a potential strategy for dementia prevention.
Additional Links: PMID-42525901
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@article {pmid42525901,
year = {2026},
author = {Zheng, J and Lip, GYH and Zhang, Z and Lee, SWR},
title = {Association of Sugar Restriction in Utero Through Age 2 Years on Dementia Risk Later in Life.},
journal = {Neurology},
volume = {107},
number = {4},
pages = {e218313},
doi = {10.1212/WNL.0000000000218313},
pmid = {42525901},
issn = {1526-632X},
mesh = {Humans ; Female ; *Dementia/epidemiology/etiology/diagnostic imaging ; *Prenatal Exposure Delayed Effects/epidemiology ; Pregnancy ; Male ; Middle Aged ; United Kingdom/epidemiology ; Developmental Origins of Health and Disease ; Risk Factors ; Dementia, Vascular/epidemiology ; Magnetic Resonance Imaging ; Alzheimer Disease/epidemiology ; Brain/diagnostic imaging ; Aged ; Adult ; Infant ; },
abstract = {BACKGROUND AND OBJECTIVES: Excess sugar intake in early life may affect long-term brain health, but evidence for dementia is limited. We used the abrupt end of UK sugar rationing in September 1953 as a natural experiment to test whether exposure to sugar rationing during different windows within the first 1,000 days from conception was associated with adult risk of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD).
METHODS: We analyzed UK Biobank participants born around the end of UK sugar rationing. Exposure was classified as rationing in utero only, in utero plus the first year of life, in utero plus 1-2 years of life, or no exposure. Incident dementia was identified from linked ICD-10 records. MRI of the brain and cognitive function were assessed in the imaging subcohort. Adjusted Cox and Gompertz models estimated HRs and 95% CIs, Fine-Gray models accounted for competing risk, and mediation analyses evaluated type 2 diabetes and hypertension.
RESULTS: Among 64,737 participants included in the analysis, the mean age at recruitment was 54.6 years, and 56.4% were women; 40,963 were exposed to sugar rationing during fetal and/or early-childhood life, and 23,774 were unexposed. Compared with unexposed individuals, sugar rationing in utero plus the first year of life was associated with lower hazards of all-cause dementia (HR, 0.79; 95% CI 0.66-0.94) and AD (HR, 0.77; 95% CI 0.59-1.00). Similar or slightly stronger associations were observed for exposure in utero plus 1-2 years (all-cause dementia: HR, 0.77; 95% CI 0.63-0.95; AD: HR, 0.72; 95% CI 0.53-0.98). Exposure in utero plus 1-2 years was associated with delayed onset of all-cause dementia by 2.55 years, AD by 2.87 years, and VaD by 2.49 years. Early-life sugar rationing was also associated with higher total gray matter volume (β, 3.27; 95% CI 0.46-6.07), lower white matter hyperintensity volume (β, -0.64; 95% CI -0.97 to -0.31), and better performance in processing speed and reasoning. Incident type 2 diabetes and hypertension jointly mediated 25.5% of the association.
DISCUSSION: Sugar restriction in the first 1,000 days was associated with lower dementia hazards, delayed onset, and more favorable brain-health profiles. These results support early-life sugar reduction as a potential strategy for dementia prevention.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
Female
*Dementia/epidemiology/etiology/diagnostic imaging
*Prenatal Exposure Delayed Effects/epidemiology
Pregnancy
Male
Middle Aged
United Kingdom/epidemiology
Developmental Origins of Health and Disease
Risk Factors
Dementia, Vascular/epidemiology
Magnetic Resonance Imaging
Alzheimer Disease/epidemiology
Brain/diagnostic imaging
Aged
Adult
Infant
RevDate: 2026-07-29
Interpreting plasma p-tau217 discordance in real-world memory clinics.
Additional Links: PMID-42526376
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@article {pmid42526376,
year = {2026},
author = {Hu, H},
title = {Interpreting plasma p-tau217 discordance in real-world memory clinics.},
journal = {Journal of the neurological sciences},
volume = {489},
number = {},
pages = {126117},
doi = {10.1016/j.jns.2026.126117},
pmid = {42526376},
issn = {1878-5883},
}
RevDate: 2026-07-29
Fluorescence imaging-based investigation of tau-mediated promotion of U1 small nuclear ribonucleoprotein 70 kDa co-phase separation.
International journal of biological macromolecules pii:S0141-8130(26)03764-5 [Epub ahead of print].
Neurofibrillary tangles formed by Tau protein are a core pathological hallmark of Alzheimer's disease (AD). Although liquid-liquid phase separation (LLPS) of Tau is thought to induce its aggregation, and the basic-acidic dipeptide (BAD) domain-containing protein U1 small nuclear ribonucleoprotein 70 kDa (U1-70K) abnormally co-localizes with Tau tangles in AD brains, the molecular mechanism underlying their co-aggregation remains unclear. In this study, we found that Tau co-phase separates with two low-complexity domains (LC1/LC2). Both LC1 and LC2 promote the gelation of Tau droplets and the formation of pathological Tau aggregates under the conditions tested. Furthermore, under cellular stress, Tau and U1-70K exhibit aberrant cytoplasmic co-localization, suggesting a functional link between them under pathological conditions and providing new insights into the molecular basis of Tau pathology in AD.
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@article {pmid42526554,
year = {2026},
author = {Peng, B and Zou, S and Shi, Y and Zhu, X and Liu, M and Li, H and Zhang, Y},
title = {Fluorescence imaging-based investigation of tau-mediated promotion of U1 small nuclear ribonucleoprotein 70 kDa co-phase separation.},
journal = {International journal of biological macromolecules},
volume = {},
number = {},
pages = {153818},
doi = {10.1016/j.ijbiomac.2026.153818},
pmid = {42526554},
issn = {1879-0003},
abstract = {Neurofibrillary tangles formed by Tau protein are a core pathological hallmark of Alzheimer's disease (AD). Although liquid-liquid phase separation (LLPS) of Tau is thought to induce its aggregation, and the basic-acidic dipeptide (BAD) domain-containing protein U1 small nuclear ribonucleoprotein 70 kDa (U1-70K) abnormally co-localizes with Tau tangles in AD brains, the molecular mechanism underlying their co-aggregation remains unclear. In this study, we found that Tau co-phase separates with two low-complexity domains (LC1/LC2). Both LC1 and LC2 promote the gelation of Tau droplets and the formation of pathological Tau aggregates under the conditions tested. Furthermore, under cellular stress, Tau and U1-70K exhibit aberrant cytoplasmic co-localization, suggesting a functional link between them under pathological conditions and providing new insights into the molecular basis of Tau pathology in AD.},
}
RevDate: 2026-07-29
Intranasal drug delivery to the brain for neurodegenerative diseases: Current efforts and challenges in delivery platforms and modeling.
Advanced drug delivery reviews pii:S0169-409X(26)00172-9 [Epub ahead of print].
Neurodegenerative diseases, such as Parkinson's disease (PD) and Alzheimer's disease (AD), globally pose a significant challenge with an aging population. Despite the presence of various therapeutic agents, AD and PD treatments with small molecules currently only address the symptoms; certain biologic agents for AD have been approved for their disease-modifying effects, but the risk of intracerebral hemorrhage severely limits their use. Moreover, the bioavailability of orally administered agents in the brain is challenged by the blood-brain barrier, complicating brain-targeted drug development. Extensive efforts are currently underway to develop intranasal platforms with nanoparticles for direct nose-to-brain drug delivery. Additionally, various in vitro designs involving brain organoids, and in vivo models, such as rodents and zebrafish, have been explored to improve the efficiency and accuracy of preclinical models. Efforts to develop sophisticated computational modeling of intranasal drug delivery, including computational fluid dynamics (CFD) deposition and physiologically based pharmacokinetics (PBPK) modeling, also continue to advance the intranasal drug delivery research and potentially improve the feasibility of developing clinically relevant intranasal platforms for neurodegenerative disease.
Additional Links: PMID-42526715
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Citation:
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@article {pmid42526715,
year = {2026},
author = {Bang, KY and Walenga, R and Chopski, S and Luke, MC and Blinova, K and Zhao, L and Guo, S},
title = {Intranasal drug delivery to the brain for neurodegenerative diseases: Current efforts and challenges in delivery platforms and modeling.},
journal = {Advanced drug delivery reviews},
volume = {},
number = {},
pages = {115938},
doi = {10.1016/j.addr.2026.115938},
pmid = {42526715},
issn = {1872-8294},
abstract = {Neurodegenerative diseases, such as Parkinson's disease (PD) and Alzheimer's disease (AD), globally pose a significant challenge with an aging population. Despite the presence of various therapeutic agents, AD and PD treatments with small molecules currently only address the symptoms; certain biologic agents for AD have been approved for their disease-modifying effects, but the risk of intracerebral hemorrhage severely limits their use. Moreover, the bioavailability of orally administered agents in the brain is challenged by the blood-brain barrier, complicating brain-targeted drug development. Extensive efforts are currently underway to develop intranasal platforms with nanoparticles for direct nose-to-brain drug delivery. Additionally, various in vitro designs involving brain organoids, and in vivo models, such as rodents and zebrafish, have been explored to improve the efficiency and accuracy of preclinical models. Efforts to develop sophisticated computational modeling of intranasal drug delivery, including computational fluid dynamics (CFD) deposition and physiologically based pharmacokinetics (PBPK) modeling, also continue to advance the intranasal drug delivery research and potentially improve the feasibility of developing clinically relevant intranasal platforms for neurodegenerative disease.},
}
RevDate: 2026-07-29
Global Perspectives on Social Relationships and Cognitive Decline in Older Adults: Insights From Cohort Studies in the U.S., Mexico, England, and China.
Journal of applied gerontology : the official journal of the Southern Gerontological Society [Epub ahead of print].
BackgroundThis research aimed to explore associations between social relationships and annual cognitive decline in older adults globally.MethodsHarmonized data from 4 longitudinal aging cohorts across the U.S., Mexico, England, and China were included. Participants (aged ≥55) with social relationship data and repeated cognitive assessments were analyzed, excluding dementia cases. Linear mixed models assessed associations between social relationship markers and annual rate of cognitive decline, with effects pooled via two-stage random-effects meta-analysis.ResultsAmong 29,805 participants, living with others was associated with slower decline in episodic memory (b = 0.086, 95%CI: 0.013 to 0.158) and global cognition (b = 0.025, 95%CI: 0.013 to 0.038). Felt loneliness was associated with faster decline in episodic memory (b = -0.087, 95%CI: -0.140 to -0.034) and global cognition (b = -0.023, 95%CI: -0.040 to -0.006).ConclusionsGood social relationships were associated with slower cognitive decline, while poor social relationships with faster decline.
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@article {pmid42527124,
year = {2026},
author = {Li, J and Wang, Y and Shi, L and Zheng, Z and Wu, Y and Jiang, N},
title = {Global Perspectives on Social Relationships and Cognitive Decline in Older Adults: Insights From Cohort Studies in the U.S., Mexico, England, and China.},
journal = {Journal of applied gerontology : the official journal of the Southern Gerontological Society},
volume = {},
number = {},
pages = {7334648261470866},
doi = {10.1177/07334648261470866},
pmid = {42527124},
issn = {1552-4523},
abstract = {BackgroundThis research aimed to explore associations between social relationships and annual cognitive decline in older adults globally.MethodsHarmonized data from 4 longitudinal aging cohorts across the U.S., Mexico, England, and China were included. Participants (aged ≥55) with social relationship data and repeated cognitive assessments were analyzed, excluding dementia cases. Linear mixed models assessed associations between social relationship markers and annual rate of cognitive decline, with effects pooled via two-stage random-effects meta-analysis.ResultsAmong 29,805 participants, living with others was associated with slower decline in episodic memory (b = 0.086, 95%CI: 0.013 to 0.158) and global cognition (b = 0.025, 95%CI: 0.013 to 0.038). Felt loneliness was associated with faster decline in episodic memory (b = -0.087, 95%CI: -0.140 to -0.034) and global cognition (b = -0.023, 95%CI: -0.040 to -0.006).ConclusionsGood social relationships were associated with slower cognitive decline, while poor social relationships with faster decline.},
}
RevDate: 2026-07-29
Demographic, gender and ethnic disparities in COPD associated mortality trends among older adults (>55 years) with Alzheimer's disease in the United States, 1999-2020: a 20 year retrospective analysis using CDC WONDER database.
Journal of the National Medical Association pii:S0027-9684(26)00122-7 [Epub ahead of print].
BACKGROUND: Alzheimer's disease (AD) is the 3rd leading cause of global deaths. COPD and AD have a bi-directional positive relationship, increasing the interrelated mortality.
OBJECTIVES: To analyze the mortality trends associated with COPD in Alzheimer's disease among older adults (>55 years of age) in the United States, using CDC WONDER data from 1999 to 2020.
METHODS: A retrospective analysis using the CDC WONDER database was conducted to analyse the mortality trends due to COPD in Alzheimer's disease patients, stratified by sex, race/ethnicity, census region, states and urbanization status.
RESULTS: A total of 58,495 deaths due to COPD-associated Alzheimer's disease occurred among older adults (aged >55 years). Overall mortality increased from an AAMR of 2.04 per 100,000 in 1999 to 5.19 per 100,000 in 2020 (AAPC=4.31%, p < 0.05). Men exhibited higher mortality than women (AAMR 4.00 vs. 3.58 per 100,000). Non-Hispanic Whites had the highest mortality (AAMR 4.04), followed by Hispanics (AAMR; 2.58) and Non-Hispanic Blacks (AAMR; 2.39). The mortality was highest in the Western region (AAMR; 4.3), followed by Southern region (AAMR; 4.14), Midwestern region (AAMR; 3.94) and least in Northeastern region (AAMR; 2.26). Non-Metropolitan areas exhibit higher AAMR (4.62) than Metropolitan areas (AAMR; 3.52). Tennessee, Kentucky, and Washington were the top 3 states with the highest mortality. Significant increases in mortality were observed across most demographic groups (p < 0.05).
CONCLUSION: These findings highlight the increasing COPD-related mortality among Alzheimer's patients and reveal significant disparities by sex, race, and urbanization status. Systemic inflammation, oxidative stress, and COPD-induced hypoxia may contribute to cognitive impairment and dementia. These results underscore the urgent need for targeted healthcare strategies and further research to address these disparities.
Additional Links: PMID-42527215
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PubMed:
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@article {pmid42527215,
year = {2026},
author = {Ahmad, M and Irshad, A and Ahmed, MA and Ahmed, FK and Noor, S and Irshad, H},
title = {Demographic, gender and ethnic disparities in COPD associated mortality trends among older adults (>55 years) with Alzheimer's disease in the United States, 1999-2020: a 20 year retrospective analysis using CDC WONDER database.},
journal = {Journal of the National Medical Association},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jnma.2026.06.021},
pmid = {42527215},
issn = {1943-4693},
abstract = {BACKGROUND: Alzheimer's disease (AD) is the 3rd leading cause of global deaths. COPD and AD have a bi-directional positive relationship, increasing the interrelated mortality.
OBJECTIVES: To analyze the mortality trends associated with COPD in Alzheimer's disease among older adults (>55 years of age) in the United States, using CDC WONDER data from 1999 to 2020.
METHODS: A retrospective analysis using the CDC WONDER database was conducted to analyse the mortality trends due to COPD in Alzheimer's disease patients, stratified by sex, race/ethnicity, census region, states and urbanization status.
RESULTS: A total of 58,495 deaths due to COPD-associated Alzheimer's disease occurred among older adults (aged >55 years). Overall mortality increased from an AAMR of 2.04 per 100,000 in 1999 to 5.19 per 100,000 in 2020 (AAPC=4.31%, p < 0.05). Men exhibited higher mortality than women (AAMR 4.00 vs. 3.58 per 100,000). Non-Hispanic Whites had the highest mortality (AAMR 4.04), followed by Hispanics (AAMR; 2.58) and Non-Hispanic Blacks (AAMR; 2.39). The mortality was highest in the Western region (AAMR; 4.3), followed by Southern region (AAMR; 4.14), Midwestern region (AAMR; 3.94) and least in Northeastern region (AAMR; 2.26). Non-Metropolitan areas exhibit higher AAMR (4.62) than Metropolitan areas (AAMR; 3.52). Tennessee, Kentucky, and Washington were the top 3 states with the highest mortality. Significant increases in mortality were observed across most demographic groups (p < 0.05).
CONCLUSION: These findings highlight the increasing COPD-related mortality among Alzheimer's patients and reveal significant disparities by sex, race, and urbanization status. Systemic inflammation, oxidative stress, and COPD-induced hypoxia may contribute to cognitive impairment and dementia. These results underscore the urgent need for targeted healthcare strategies and further research to address these disparities.},
}
RevDate: 2026-07-29
Connectome-guided personalization of optimal tDCS intervention selection in Alzheimer's disease: A modeling study.
eNeuro pii:ENEURO.0407-25.2026 [Epub ahead of print].
Transcranial direct current stimulation (tDCS) could reduce the neurophysiological effects in Alzheimer's disease (AD), but progress is hampered by variable outcomes across studies, likely related to both methodological and individual differences. We recently described a virtual brain network simulation method for optimizing tDCS interventions and now propose a method for further personalizing this approach. We now personalized the model for 6 female and 4 male biomarker-confirmed AD patients based on their brain structure and functional connectivity, by using individual structural magnetic resonance imaging (MRI) data and amplitude envelope correlation (AEC)-based connectivity matrices extracted from magnetoencephalography (MEG) scans, respectively. We then assessed a set of previously established stimulation strategies based on their ability to improve relevant neurophysiological outcome parameters in each personalized model, while undergoing AD damage. Personalized tDCS strategies were able to delay neurophysiological deterioration, but while the general model favored posterior anodal stimulation targeting the precuneus region, the personalized models favored frontal anodal stimulation targeting the dorsolateral prefrontal cortex (dlPFC) region in 90% of the cases. This may be explained by higher connectivity levels of frontal regions in the personalized connectivity matrices, as anodal stimulation of highly connected regions produced more beneficial effects. In this methodological study we propose several ways to improve personalized computational tDCS stimulation prediction modeling. We conclude that connectome-guided personalization of tDCS effects lead to different strategies with potentially better intervention outcomes. For external validation of this model-guided tDCS approach, model predictions are being tested in an ongoing clinical tDCS-MEG trial in AD patients.Significance statement Our aim is to improve the efficacy of transcranial direct current stimulation (tDCS) in Alzheimer's disease (AD) through the use of a personalized modeling approach. This is beneficial since results of tDCS remain variable across groups, and therefore a systematic approach to choosing the stimulation parameters such as placement of electrodes is required. Modeling of tDCS allows us to do this while assessing multiple possible approaches without necessitating a considerable burden on patients across multiple trials. Furthermore, personalizing the model can enable more accurate selection of target regions for stimulation, for example by locating highly connected brain regions without too much damage in each patient, thus increasing the potential for recovery.
Additional Links: PMID-42527300
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@article {pmid42527300,
year = {2026},
author = {Luppi, JJ and Koomen, AP and Stam, CJ and Scheltens, P and de Haan, W},
title = {Connectome-guided personalization of optimal tDCS intervention selection in Alzheimer's disease: A modeling study.},
journal = {eNeuro},
volume = {},
number = {},
pages = {},
doi = {10.1523/ENEURO.0407-25.2026},
pmid = {42527300},
issn = {2373-2822},
abstract = {Transcranial direct current stimulation (tDCS) could reduce the neurophysiological effects in Alzheimer's disease (AD), but progress is hampered by variable outcomes across studies, likely related to both methodological and individual differences. We recently described a virtual brain network simulation method for optimizing tDCS interventions and now propose a method for further personalizing this approach. We now personalized the model for 6 female and 4 male biomarker-confirmed AD patients based on their brain structure and functional connectivity, by using individual structural magnetic resonance imaging (MRI) data and amplitude envelope correlation (AEC)-based connectivity matrices extracted from magnetoencephalography (MEG) scans, respectively. We then assessed a set of previously established stimulation strategies based on their ability to improve relevant neurophysiological outcome parameters in each personalized model, while undergoing AD damage. Personalized tDCS strategies were able to delay neurophysiological deterioration, but while the general model favored posterior anodal stimulation targeting the precuneus region, the personalized models favored frontal anodal stimulation targeting the dorsolateral prefrontal cortex (dlPFC) region in 90% of the cases. This may be explained by higher connectivity levels of frontal regions in the personalized connectivity matrices, as anodal stimulation of highly connected regions produced more beneficial effects. In this methodological study we propose several ways to improve personalized computational tDCS stimulation prediction modeling. We conclude that connectome-guided personalization of tDCS effects lead to different strategies with potentially better intervention outcomes. For external validation of this model-guided tDCS approach, model predictions are being tested in an ongoing clinical tDCS-MEG trial in AD patients.Significance statement Our aim is to improve the efficacy of transcranial direct current stimulation (tDCS) in Alzheimer's disease (AD) through the use of a personalized modeling approach. This is beneficial since results of tDCS remain variable across groups, and therefore a systematic approach to choosing the stimulation parameters such as placement of electrodes is required. Modeling of tDCS allows us to do this while assessing multiple possible approaches without necessitating a considerable burden on patients across multiple trials. Furthermore, personalizing the model can enable more accurate selection of target regions for stimulation, for example by locating highly connected brain regions without too much damage in each patient, thus increasing the potential for recovery.},
}
RevDate: 2026-07-29
CmpDate: 2026-07-29
Mind Matters: South Dakota's Public Health Response to Dementia.
South Dakota medicine : the journal of the South Dakota State Medical Association, 79(6):262-264.
Alzheimer's disease and related dementias pose a growing health and societal challenge in South Dakota, where dementia ranks as the fourth leading cause of death. The burden extends beyond patients to families and caregivers, many of whom report significant emotional, financial, and physical strain. In response, the South Dakota Department of Health introduced the South Dakota Healthy Brain Initiative. This statewide effort aims to improve brain health across the lifespan, promote earlier detection, strengthen caregiver support, and prepare the state's workforce to better respond to the needs of people living with dementia. The initiative promotes routine cognitive assessment, distributes clinical toolkits to assist with diagnosis and care planning, and expands access to community-based services. A core focus of the initiative is health equity, particularly for rural, tribal, and underserved communities that face significant barriers to care. Through strengthened partnerships among public health, healthcare systems, and aging services, the Healthy Brain Initiative seeks to reduce disparities, support caregivers, and improve outcomes for individuals and families affected by dementia across South Dakota.
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@article {pmid42527361,
year = {2026},
author = {Persson, J and Geffre, G},
title = {Mind Matters: South Dakota's Public Health Response to Dementia.},
journal = {South Dakota medicine : the journal of the South Dakota State Medical Association},
volume = {79},
number = {6},
pages = {262-264},
pmid = {42527361},
issn = {0038-3317},
mesh = {Humans ; South Dakota/epidemiology ; *Dementia/diagnosis/therapy/epidemiology ; *Public Health ; Caregivers ; },
abstract = {Alzheimer's disease and related dementias pose a growing health and societal challenge in South Dakota, where dementia ranks as the fourth leading cause of death. The burden extends beyond patients to families and caregivers, many of whom report significant emotional, financial, and physical strain. In response, the South Dakota Department of Health introduced the South Dakota Healthy Brain Initiative. This statewide effort aims to improve brain health across the lifespan, promote earlier detection, strengthen caregiver support, and prepare the state's workforce to better respond to the needs of people living with dementia. The initiative promotes routine cognitive assessment, distributes clinical toolkits to assist with diagnosis and care planning, and expands access to community-based services. A core focus of the initiative is health equity, particularly for rural, tribal, and underserved communities that face significant barriers to care. Through strengthened partnerships among public health, healthcare systems, and aging services, the Healthy Brain Initiative seeks to reduce disparities, support caregivers, and improve outcomes for individuals and families affected by dementia across South Dakota.},
}
MeSH Terms:
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Humans
South Dakota/epidemiology
*Dementia/diagnosis/therapy/epidemiology
*Public Health
Caregivers
RevDate: 2026-07-29
Amyloid Co-Pathology and Clinical Heterogeneity of Parkinson's Disease.
Additional Links: PMID-42527385
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PubMed:
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@article {pmid42527385,
year = {2026},
author = {Postuma, RB},
title = {Amyloid Co-Pathology and Clinical Heterogeneity of Parkinson's Disease.},
journal = {Movement disorders : official journal of the Movement Disorder Society},
volume = {},
number = {},
pages = {},
doi = {10.1002/mds.70459},
pmid = {42527385},
issn = {1531-8257},
}
RevDate: 2026-07-29
Mitochondrial accumulation and lysosomal dysfunction result in mitochondrial plaques in Alzheimer's disease.
Nature neuroscience [Epub ahead of print].
Dysfunctional mitophagy is proposed as a key component of Alzheimer's disease (AD) pathology, yet direct in vivo evidence and mechanistic insights are still lacking. Here we show that AD model mice expressing a mitophagy reporter (APP/PSEN1/mt-Keima) develop large accumulation of acidic and neutral mitochondria within neuronal processes that form a previously unrecognized pathological structure termed mitochondrial plaques (MPs). The development of MPs is driven by abnormal mitochondrial buildup and lysosomal recruitment occurs as a delayed response to promote mitochondrial degradation. However, degradation through mitophagy is incomplete due to impaired lysosomal functions, resulting in accumulation of both neutral and acidic mitochondria. MPs frequently codevelop with amyloid to form mixed plaques but can also emerge independently at early stages of disease. Notably, MPs were also identified in the 5xFAD AD mouse model and postmortem human AD brains. These findings establish MPs as a new pathological entity in AD.
Additional Links: PMID-42527552
PubMed:
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@article {pmid42527552,
year = {2026},
author = {Dan, X and Croteau, DL and Liu, W and Chu, X and McDevitt, RA and Robbins, PD and Bohr, VA},
title = {Mitochondrial accumulation and lysosomal dysfunction result in mitochondrial plaques in Alzheimer's disease.},
journal = {Nature neuroscience},
volume = {},
number = {},
pages = {},
pmid = {42527552},
issn = {1546-1726},
support = {U19 AG056278 and U54 AG079754//U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging)/ ; },
abstract = {Dysfunctional mitophagy is proposed as a key component of Alzheimer's disease (AD) pathology, yet direct in vivo evidence and mechanistic insights are still lacking. Here we show that AD model mice expressing a mitophagy reporter (APP/PSEN1/mt-Keima) develop large accumulation of acidic and neutral mitochondria within neuronal processes that form a previously unrecognized pathological structure termed mitochondrial plaques (MPs). The development of MPs is driven by abnormal mitochondrial buildup and lysosomal recruitment occurs as a delayed response to promote mitochondrial degradation. However, degradation through mitophagy is incomplete due to impaired lysosomal functions, resulting in accumulation of both neutral and acidic mitochondria. MPs frequently codevelop with amyloid to form mixed plaques but can also emerge independently at early stages of disease. Notably, MPs were also identified in the 5xFAD AD mouse model and postmortem human AD brains. These findings establish MPs as a new pathological entity in AD.},
}
RevDate: 2026-07-29
Metabolomics atlas of Alzheimer's disease models.
Lab animal, 55(8):283.
Additional Links: PMID-42527710
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PubMed:
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@article {pmid42527710,
year = {2026},
author = {Le Bras, A},
title = {Metabolomics atlas of Alzheimer's disease models.},
journal = {Lab animal},
volume = {55},
number = {8},
pages = {283},
doi = {10.1038/s41684-026-01782-x},
pmid = {42527710},
issn = {1548-4475},
}
RevDate: 2026-07-29
CmpDate: 2026-07-29
LncRNA DLX6-AS1 Regulates the Pathological Process Related to Alzheimer's Disease via miR-204-5p.
Neuromolecular medicine, 28(1):.
Alzheimer's disease (AD) is a neurodegenerative disorder causing progressive neuronal damage. Incidence rises with age, and early diagnosis is difficult. This study examined DLX6-AS1 clinical relevance and regulatory mechanism in AD, and its interaction with miR-204-5p in AD pathology. It offers new insights into early diagnosis and treatment. A total of 133 AD patients and 105 healthy controls were selected. Their serum levels of DLX6-AS1 and miR-204-5p were analyzed using quantitative polymerase chain reaction. β-amyloid (Aβ)1-42-induced SH-SY5Y neuronal injury and okadaic acid (OA)-induced Neuro-2a tau abnormal phosphorylation models were constructed. The role/function of DLX6-AS1/miR-204-5p axis was then investigated using cell counting kit-8, flow cytometry, western blotting, enzyme-linked immunosorbent assay and a dual-luciferase reporter gene assay. AD patients had higher serum DLX6-AS1 and lower miR-204-5p levels. DLX6-AS1 showed an AUC of 0.838 for AD diagnosis. DLX6-AS1 levels were negatively associated with cognitive function, brain structural integrity, and benign pathology-and positively associated with disease severity, functional impairment, and pathological markers. In AD cell models, DLX6-AS1 was upregulated. Silencing it promoted cell proliferation, reduced apoptosis and oxidative stress, improved mitochondrial and synaptic function, decreased tau phosphorylation, and enhanced microtubule stability and axonal transport. Dual-luciferase assays confirmed direct binding between DLX6-AS1 and miR-204-5p. Co-inhibition reversed the protective effects of DLX6-AS1 silencing. Serum DLX6-AS1 is a potential biomarker for early diagnosis and assessment of AD. It regulates Aβ-induced neuronal damage and tau phosphorylation by targeting miR-204-5p, offering a new mechanism target for AD molecular therapy.
Additional Links: PMID-42527713
PubMed:
Citation:
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@article {pmid42527713,
year = {2026},
author = {Jiang, M and Lin, Y and Wang, L and Ou, K},
title = {LncRNA DLX6-AS1 Regulates the Pathological Process Related to Alzheimer's Disease via miR-204-5p.},
journal = {Neuromolecular medicine},
volume = {28},
number = {1},
pages = {},
pmid = {42527713},
issn = {1559-1174},
mesh = {Humans ; *Alzheimer Disease/pathology/genetics/blood/metabolism ; *MicroRNAs/physiology/genetics/biosynthesis/blood ; tau Proteins/metabolism ; Female ; Male ; Amyloid beta-Peptides/pharmacology/toxicity ; Phosphorylation ; *RNA, Long Noncoding/physiology/blood/genetics ; Cell Line, Tumor ; Aged ; Animals ; *Homeodomain Proteins/physiology/genetics ; Peptide Fragments/pharmacology/toxicity ; Aged, 80 and over ; Mice ; Brain/pathology ; },
abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder causing progressive neuronal damage. Incidence rises with age, and early diagnosis is difficult. This study examined DLX6-AS1 clinical relevance and regulatory mechanism in AD, and its interaction with miR-204-5p in AD pathology. It offers new insights into early diagnosis and treatment. A total of 133 AD patients and 105 healthy controls were selected. Their serum levels of DLX6-AS1 and miR-204-5p were analyzed using quantitative polymerase chain reaction. β-amyloid (Aβ)1-42-induced SH-SY5Y neuronal injury and okadaic acid (OA)-induced Neuro-2a tau abnormal phosphorylation models were constructed. The role/function of DLX6-AS1/miR-204-5p axis was then investigated using cell counting kit-8, flow cytometry, western blotting, enzyme-linked immunosorbent assay and a dual-luciferase reporter gene assay. AD patients had higher serum DLX6-AS1 and lower miR-204-5p levels. DLX6-AS1 showed an AUC of 0.838 for AD diagnosis. DLX6-AS1 levels were negatively associated with cognitive function, brain structural integrity, and benign pathology-and positively associated with disease severity, functional impairment, and pathological markers. In AD cell models, DLX6-AS1 was upregulated. Silencing it promoted cell proliferation, reduced apoptosis and oxidative stress, improved mitochondrial and synaptic function, decreased tau phosphorylation, and enhanced microtubule stability and axonal transport. Dual-luciferase assays confirmed direct binding between DLX6-AS1 and miR-204-5p. Co-inhibition reversed the protective effects of DLX6-AS1 silencing. Serum DLX6-AS1 is a potential biomarker for early diagnosis and assessment of AD. It regulates Aβ-induced neuronal damage and tau phosphorylation by targeting miR-204-5p, offering a new mechanism target for AD molecular therapy.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/pathology/genetics/blood/metabolism
*MicroRNAs/physiology/genetics/biosynthesis/blood
tau Proteins/metabolism
Female
Male
Amyloid beta-Peptides/pharmacology/toxicity
Phosphorylation
*RNA, Long Noncoding/physiology/blood/genetics
Cell Line, Tumor
Aged
Animals
*Homeodomain Proteins/physiology/genetics
Peptide Fragments/pharmacology/toxicity
Aged, 80 and over
Mice
Brain/pathology
RevDate: 2026-07-29
Advancing the FAIRness of Multimodal Imaging Research Through the OMOP MI-CDM Framework: A Case Replication Study in Alzheimer's Disease.
Journal of imaging informatics in medicine [Epub ahead of print].
The objective of this study is to demonstrate an end-to-end approach for operationalizing the Findable, Accessible, Interoperable, and Reusable (FAIR) principles in multimodal medical imaging research using standardized data models and reproducible computational workflows, illustrated by reproducing the design and directional findings of a published Alzheimer's disease (AD) imaging study. Clinical and imaging data from the Alzheimer's Disease Neuroimaging Initiative (ADNI-4) were harmonized within the Observational Medical Outcomes Partnership Common Data Model and its Medical Imaging extension (OMOP MI-CDM). MRI acquisition metadata (DICOM) were extracted and mapped to standardized concepts, while clinical variables were integrated via reproducible extract-transform-load processes. Interoperable phenotypes were defined using OHDSI tools. Hippocampal volumes were derived from T1-weighted MRI using a fully automated machine learning segmentation pipeline (OpenMap-T1). Imaging attributes and derived measurements were stored as structured, provenance-preserving records in OMOP MI-CDM. We replicated a reference study evaluating hippocampal volume differences across AD, mild cognitive impairment (MCI), and cognitively normal controls, stratified by age and sex. We included 289 participants and 545 MRI studies. Across age- and sex-stratified cohorts, mean hippocampal volumes showed consistent directional reductions in AD compared with controls, with intermediate values in MCI, matching trends reported in the replication study. FAIR principles can be operationalized across the full imaging research pipeline using OMOP MI-CDM and automated analysis workflows. This framework enables transparent cohort definition, reproducible image processing, and interoperable reuse of machine learning-derived imaging features to support scalable validation and reproducible multimodal imaging research.
Additional Links: PMID-42527781
PubMed:
Citation:
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@article {pmid42527781,
year = {2026},
author = {Salvador, GLO and Park, JW and Schmidt, TS and Park, Y and Jeon, K and You, SC and Nagy, P and Dewey, B and , },
title = {Advancing the FAIRness of Multimodal Imaging Research Through the OMOP MI-CDM Framework: A Case Replication Study in Alzheimer's Disease.},
journal = {Journal of imaging informatics in medicine},
volume = {},
number = {},
pages = {},
pmid = {42527781},
issn = {2948-2933},
abstract = {The objective of this study is to demonstrate an end-to-end approach for operationalizing the Findable, Accessible, Interoperable, and Reusable (FAIR) principles in multimodal medical imaging research using standardized data models and reproducible computational workflows, illustrated by reproducing the design and directional findings of a published Alzheimer's disease (AD) imaging study. Clinical and imaging data from the Alzheimer's Disease Neuroimaging Initiative (ADNI-4) were harmonized within the Observational Medical Outcomes Partnership Common Data Model and its Medical Imaging extension (OMOP MI-CDM). MRI acquisition metadata (DICOM) were extracted and mapped to standardized concepts, while clinical variables were integrated via reproducible extract-transform-load processes. Interoperable phenotypes were defined using OHDSI tools. Hippocampal volumes were derived from T1-weighted MRI using a fully automated machine learning segmentation pipeline (OpenMap-T1). Imaging attributes and derived measurements were stored as structured, provenance-preserving records in OMOP MI-CDM. We replicated a reference study evaluating hippocampal volume differences across AD, mild cognitive impairment (MCI), and cognitively normal controls, stratified by age and sex. We included 289 participants and 545 MRI studies. Across age- and sex-stratified cohorts, mean hippocampal volumes showed consistent directional reductions in AD compared with controls, with intermediate values in MCI, matching trends reported in the replication study. FAIR principles can be operationalized across the full imaging research pipeline using OMOP MI-CDM and automated analysis workflows. This framework enables transparent cohort definition, reproducible image processing, and interoperable reuse of machine learning-derived imaging features to support scalable validation and reproducible multimodal imaging research.},
}
RevDate: 2026-07-29
A Novel Video-Based Method to Estimate American Football Helmet Pad Deformation During Impact Testing.
Annals of biomedical engineering [Epub ahead of print].
PURPOSE: American football is among the sports with the highest incidence of mild traumatic brain injuries (mTBI), associated with long-term neurological consequences including cognitive impairment, chronic traumatic encephalopathy, and Alzheimer's disease. Despite recent rule changes and stricter National Football League (NFL) safety guidelines, mTBI remains common, underscoring the need for improved helmet design and evaluation. Current helmet testing protocols, such as the NFL's, measure head kinematics to derive performance scores but do not characterize helmet component behavior during impact. This study proposes a novel approach through the Pad Deformation Index (PDI)-a quantitative metric estimating compressive deformation of helmet pads during impact.
METHODS: Standard helmet impact tests were conducted at the Side Upper location, at three velocities (5.5, 7.4, and 9.3 m/s). Complementary mechanical tests on isolated pads using a drop tower at equivalent velocities linked helmet-level outcomes with localized pad response. High-speed videos enabled frame-by-frame reconstruction of the headform-impactor interaction and calculation of the minimum distance between the two rigid bodies, from which PDI was derived.
RESULTS: Higher PDI values generally coincided with reduced peak linear acceleration (PLA), Head Injury Criterion (HIC), DAMAGE, HARM, and partial Helmet Performance Score (HPS), supporting the use of PDI as an indicator connecting impact performance metric to pad deformation. Furthermore, pads exhibiting later densification within high-PDI range produced the lowest performance scores, underscoring the critical role of delayed densification.
CONCLUSION: PDI offers a practical tool for identifying absorption mechanisms and guiding helmet design.
Additional Links: PMID-42527810
PubMed:
Citation:
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@article {pmid42527810,
year = {2026},
author = {Marois, B and Leger, P and Petit, Y and Le Vot, R and Le Naveaux, F and Benoit, D and Aumeras, R and Wagnac, E},
title = {A Novel Video-Based Method to Estimate American Football Helmet Pad Deformation During Impact Testing.},
journal = {Annals of biomedical engineering},
volume = {},
number = {},
pages = {},
pmid = {42527810},
issn = {1573-9686},
support = {ETS-124//Axelys/ ; },
abstract = {PURPOSE: American football is among the sports with the highest incidence of mild traumatic brain injuries (mTBI), associated with long-term neurological consequences including cognitive impairment, chronic traumatic encephalopathy, and Alzheimer's disease. Despite recent rule changes and stricter National Football League (NFL) safety guidelines, mTBI remains common, underscoring the need for improved helmet design and evaluation. Current helmet testing protocols, such as the NFL's, measure head kinematics to derive performance scores but do not characterize helmet component behavior during impact. This study proposes a novel approach through the Pad Deformation Index (PDI)-a quantitative metric estimating compressive deformation of helmet pads during impact.
METHODS: Standard helmet impact tests were conducted at the Side Upper location, at three velocities (5.5, 7.4, and 9.3 m/s). Complementary mechanical tests on isolated pads using a drop tower at equivalent velocities linked helmet-level outcomes with localized pad response. High-speed videos enabled frame-by-frame reconstruction of the headform-impactor interaction and calculation of the minimum distance between the two rigid bodies, from which PDI was derived.
RESULTS: Higher PDI values generally coincided with reduced peak linear acceleration (PLA), Head Injury Criterion (HIC), DAMAGE, HARM, and partial Helmet Performance Score (HPS), supporting the use of PDI as an indicator connecting impact performance metric to pad deformation. Furthermore, pads exhibiting later densification within high-PDI range produced the lowest performance scores, underscoring the critical role of delayed densification.
CONCLUSION: PDI offers a practical tool for identifying absorption mechanisms and guiding helmet design.},
}
RevDate: 2026-07-29
Home-Based Tailored Light Therapy for Sleep, Mood, and Cognitive Outcomes in Mild Cognitive Impairment: A Randomized Trial.
Journal of applied gerontology : the official journal of the Southern Gerontological Society [Epub ahead of print].
BackgroundLight offers a promising approach to sleep and circadian disturbances in mild cognitive impairment (MCI).ObjectiveTest a home-based lighting intervention in people living with MCI.MethodsIn a randomized, placebo-controlled trial, 61 participants received active or placebo light for 24 weeks, with assessments for cognition, sleep, depression, and quality of life at baseline, week 13, 25, and, post-intervention, at week 37. Light exposure was measured as area under the curve (AUC) for morning circadian stimulus (CS).ResultsActive light participants (mean age 69.7 years; 52% male; mean MoCA 21.4) showed greater improvement in ADAS-Cog memory scores than placebo (p = 0.035), higher morning CS AUC by week 25 (0.021 vs -0.030; p = 0.025), and better sleep percent (-0.21 vs -1.29; p = 0.042), wake percent (-0.10 vs 1.19; p = 0.023), and wake after sleep onset (2.19 vs 8.23 min; p = 0.031).
Additional Links: PMID-42527889
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PubMed:
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@article {pmid42527889,
year = {2026},
author = {Li, W and Suarez-Farinas, M and Shuster, A and Mednick, S and Figueiro, MG},
title = {Home-Based Tailored Light Therapy for Sleep, Mood, and Cognitive Outcomes in Mild Cognitive Impairment: A Randomized Trial.},
journal = {Journal of applied gerontology : the official journal of the Southern Gerontological Society},
volume = {},
number = {},
pages = {7334648261474211},
doi = {10.1177/07334648261474211},
pmid = {42527889},
issn = {1552-4523},
abstract = {BackgroundLight offers a promising approach to sleep and circadian disturbances in mild cognitive impairment (MCI).ObjectiveTest a home-based lighting intervention in people living with MCI.MethodsIn a randomized, placebo-controlled trial, 61 participants received active or placebo light for 24 weeks, with assessments for cognition, sleep, depression, and quality of life at baseline, week 13, 25, and, post-intervention, at week 37. Light exposure was measured as area under the curve (AUC) for morning circadian stimulus (CS).ResultsActive light participants (mean age 69.7 years; 52% male; mean MoCA 21.4) showed greater improvement in ADAS-Cog memory scores than placebo (p = 0.035), higher morning CS AUC by week 25 (0.021 vs -0.030; p = 0.025), and better sleep percent (-0.21 vs -1.29; p = 0.042), wake percent (-0.10 vs 1.19; p = 0.023), and wake after sleep onset (2.19 vs 8.23 min; p = 0.031).},
}
RevDate: 2026-07-29
CmpDate: 2026-07-30
Transaldolase 1 contributes to pentose phosphate pathway disruption and synaptic dysfunction in Alzheimer's disease.
Translational neurodegeneration, 15(1):.
BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and synaptic dysfunction. Increasing evidence suggests that impaired glucose utilization is a major contributor to AD pathogenesis. Neurons preferentially use glucose through the pentose phosphate pathway (PPP). In AD, the flux through the PPP is significantly reduced; however, the underlying mechanism is still elusive. This study was aimed to elucidate how PPP was affected in AD and its contribution to the AD pathogenesis.
METHODS: Proteomic analyses of temporal cortex synaptosomes from AD patients and controls were conducted to identify dysregulated pathways and significantly affected proteins. Functional analysis was performed by knockdown or restoration of protein expression in primary cultured neurons, as well as in wild-type and 5 × FAD mice. Pseudotargeted metabolomics and biochemical, molecular, electrophysiological and behavioral assessments were performed to evaluate metabolic characteristics, redox status, mitochondrial function, synaptic plasticity and cognition.
RESULTS: Proteomic analysis of synaptic compartments identified glucose metabolism as the most significantly dysregulated functional network in AD. Further, transaldolase 1 (TALDO1), a rate-limiting enzyme in the PPP, was identified as a key enzyme affected in AD. TALDO1 was markedly downregulated at the early stage of AD. Downregulation of TALDO1 reduced glucose metabolism by inhibiting the PPP, TCA cycle and oxidative phosphorylation, causing broad metabolic collapse. Further, downregulation of TALDO1 depleted the nicotinamide adenine dinucleotide phosphate and glutathione pools, weakening antioxidant defense, thus resulting in mitochondria impairment and reduced energy supply. These collectively drive synaptic dysfunction and cognitive decline. Conversely, restoring TALDO1 expression in 5 × FAD mice improved glucose uptake, mitigated oxidative stress, restored metabolic homeostasis, and rescued neuronal and cognitive functions.
CONCLUSION: These findings identify TALDO1 as a key regulator of the impaired PPP in AD and may represent a promising therapeutic target for restoring neuronal metabolic homeostasis and function.
Additional Links: PMID-42527927
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Citation:
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@article {pmid42527927,
year = {2026},
author = {Hu, X and Yu, Y and Luo, H and Li, J and Zhang, X and Wang, G and Li, J and Li, J and Chen, H and Qiu, Y},
title = {Transaldolase 1 contributes to pentose phosphate pathway disruption and synaptic dysfunction in Alzheimer's disease.},
journal = {Translational neurodegeneration},
volume = {15},
number = {1},
pages = {},
pmid = {42527927},
issn = {2047-9158},
support = {82373844//National Natural Science Foundation of China/ ; ZXY25001//Shanghai Jiao Tong University School of Medicine High level Local University Construction of Integrated Traditional Chinese and Western Medicine Research Platform Construction Project/ ; },
mesh = {*Alzheimer Disease/metabolism/pathology ; *Pentose Phosphate Pathway/physiology ; Animals ; Humans ; Mice ; *Transaldolase/metabolism/genetics ; Male ; *Synapses/metabolism/pathology ; Glucose/metabolism ; Neurons/metabolism ; Female ; Proteomics ; Mice, Transgenic ; },
abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and synaptic dysfunction. Increasing evidence suggests that impaired glucose utilization is a major contributor to AD pathogenesis. Neurons preferentially use glucose through the pentose phosphate pathway (PPP). In AD, the flux through the PPP is significantly reduced; however, the underlying mechanism is still elusive. This study was aimed to elucidate how PPP was affected in AD and its contribution to the AD pathogenesis.
METHODS: Proteomic analyses of temporal cortex synaptosomes from AD patients and controls were conducted to identify dysregulated pathways and significantly affected proteins. Functional analysis was performed by knockdown or restoration of protein expression in primary cultured neurons, as well as in wild-type and 5 × FAD mice. Pseudotargeted metabolomics and biochemical, molecular, electrophysiological and behavioral assessments were performed to evaluate metabolic characteristics, redox status, mitochondrial function, synaptic plasticity and cognition.
RESULTS: Proteomic analysis of synaptic compartments identified glucose metabolism as the most significantly dysregulated functional network in AD. Further, transaldolase 1 (TALDO1), a rate-limiting enzyme in the PPP, was identified as a key enzyme affected in AD. TALDO1 was markedly downregulated at the early stage of AD. Downregulation of TALDO1 reduced glucose metabolism by inhibiting the PPP, TCA cycle and oxidative phosphorylation, causing broad metabolic collapse. Further, downregulation of TALDO1 depleted the nicotinamide adenine dinucleotide phosphate and glutathione pools, weakening antioxidant defense, thus resulting in mitochondria impairment and reduced energy supply. These collectively drive synaptic dysfunction and cognitive decline. Conversely, restoring TALDO1 expression in 5 × FAD mice improved glucose uptake, mitigated oxidative stress, restored metabolic homeostasis, and rescued neuronal and cognitive functions.
CONCLUSION: These findings identify TALDO1 as a key regulator of the impaired PPP in AD and may represent a promising therapeutic target for restoring neuronal metabolic homeostasis and function.},
}
MeSH Terms:
show MeSH Terms
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*Alzheimer Disease/metabolism/pathology
*Pentose Phosphate Pathway/physiology
Animals
Humans
Mice
*Transaldolase/metabolism/genetics
Male
*Synapses/metabolism/pathology
Glucose/metabolism
Neurons/metabolism
Female
Proteomics
Mice, Transgenic
RevDate: 2026-07-30
Multi-case review of posterior cortical atrophy in a neuropsychology clinic.
Neurocase [Epub ahead of print].
Posterior Cortical Atrophy (PCA) is a neurodegenerative syndrome defined by occipital atrophy that results in visuospatial deficits, often caused by Alzheimer's disease (AD) pathology. Patients with PCA are younger than typical AD patients and can present with anxiety. A rare and atypical variant of AD, the variable presentation of PCA has left it understudied, misdiagnosed, and with few in-depth examinations of cognitive profiles. This project reviews three patients referred for neuropsychological evaluation who were determined to have probable PCA. A comprehensive neuropsychological battery examined learning and memory, executive function, language, attention and processing speed, and visuospatial ability. Cases were examined based on cognitive complaints, daily functioning based on informant report, neuropsychological test performance, and neurodiagnostic work-up. Striking visuospatial deficits were observed in visuospatial construction tests (all patients scored < 1 percentile), and performance was impaired on most tests with visual components. Memory scores were impaired on some tests, but scores were slightly better on a contextualized verbal task compared to a word list. Patients had trouble functioning related to vision (e.g. object finding, reading) and tested positive for AD biomarkers. These cases highlight key aspects of the neuropsychological work-up for suspected PCA, including visuospatial deficits, AD biomarkers, and cognitive complaints.
Additional Links: PMID-42528450
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PubMed:
Citation:
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@article {pmid42528450,
year = {2026},
author = {Dewhurst, HE and Jorda, L and Aranda, A and Chunduri, B and Lopez, OL and Patira, R and Gogniat, MA},
title = {Multi-case review of posterior cortical atrophy in a neuropsychology clinic.},
journal = {Neurocase},
volume = {},
number = {},
pages = {1-11},
doi = {10.1080/13554794.2026.2710636},
pmid = {42528450},
issn = {1465-3656},
abstract = {Posterior Cortical Atrophy (PCA) is a neurodegenerative syndrome defined by occipital atrophy that results in visuospatial deficits, often caused by Alzheimer's disease (AD) pathology. Patients with PCA are younger than typical AD patients and can present with anxiety. A rare and atypical variant of AD, the variable presentation of PCA has left it understudied, misdiagnosed, and with few in-depth examinations of cognitive profiles. This project reviews three patients referred for neuropsychological evaluation who were determined to have probable PCA. A comprehensive neuropsychological battery examined learning and memory, executive function, language, attention and processing speed, and visuospatial ability. Cases were examined based on cognitive complaints, daily functioning based on informant report, neuropsychological test performance, and neurodiagnostic work-up. Striking visuospatial deficits were observed in visuospatial construction tests (all patients scored < 1 percentile), and performance was impaired on most tests with visual components. Memory scores were impaired on some tests, but scores were slightly better on a contextualized verbal task compared to a word list. Patients had trouble functioning related to vision (e.g. object finding, reading) and tested positive for AD biomarkers. These cases highlight key aspects of the neuropsychological work-up for suspected PCA, including visuospatial deficits, AD biomarkers, and cognitive complaints.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Epigenetic Clock Trajectories and Brain Health in Midlife.
medRxiv : the preprint server for health sciences pii:2026.07.16.26358251.
BACKGROUND: Accelerated biological aging can be assessed with DNA methylation (DNAm)-based epigenetic clocks. Research suggests that greater DNAm is associated with faster cognitive decline and risk of Alzheimer disease (AD) and other dementias. However, most studies have relied on single-time-point measurements of clocks, rather than evaluating dynamic changes over time. We examined the association between 15-year epigenetic aging trajectories and brain health outcomes in midlife.
METHODS: We analyzed 2,833 middle-aged adults (mean baseline age 40 years, 59% female and 44% Black) with ≥ 3 DunedinPACE (a recently developed epigenetic clock) measurements, collected over 15 years. Using mixed-effects modeling, we derived individual-specific slopes of epigenetic aging trajectories and categorized participants as Fast Agers (slopes > 1 SD above the mean), Slow Agers (slopes < 1 SD below the mean), or Typical Agers (within ±1 SD of the mean). We examined associations between trajectory group and cognition on five cognitive domains as well as on plasma AD biomarkers (NfL, p-tau217, Aβ42/Aβ40), all assessed 15-20 years post-baseline. Models were adjusted for demographics, education, physical activity and APOE *ε4 carrier status (with additional adjustments for eGFRcr for biomarker outcomes).
RESULTS: Epigenetic aging trajectories were associated with multiple domains of cognition and AD biomarkers (Figure 1). Compared to Typical Agers, Fast Agers showed worse processing speed, memory, executive function, and global cognition (all p<0.05), with no difference in verbal fluency. Slow Agers had better performance on memory and global cognition (both p < 0.05). Fast Agers also exhibited significantly lower Aβ42/Aβ40 levels (p = 0.011) compared to Typical agers; no significant associations with p-tau217 or NfL were observed in either group.
CONCLUSION: Middle-aged adults with faster 15-year epigenetic aging trajectories demonstrated worse cognitive performance, whereas those with slower biological aging trajectories exhibited cognitive resilience and more favorable AD biomarker profiles. By examining long-term trajectories rather than single timepoints, these findings identify individuals at differential risk for brain health outcomes.
Additional Links: PMID-42528496
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@article {pmid42528496,
year = {2026},
author = {Boeriu, AI and Andrews, SJ and Hoang, T and Bae, S and Yaffe, K},
title = {Epigenetic Clock Trajectories and Brain Health in Midlife.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.07.16.26358251},
pmid = {42528496},
abstract = {BACKGROUND: Accelerated biological aging can be assessed with DNA methylation (DNAm)-based epigenetic clocks. Research suggests that greater DNAm is associated with faster cognitive decline and risk of Alzheimer disease (AD) and other dementias. However, most studies have relied on single-time-point measurements of clocks, rather than evaluating dynamic changes over time. We examined the association between 15-year epigenetic aging trajectories and brain health outcomes in midlife.
METHODS: We analyzed 2,833 middle-aged adults (mean baseline age 40 years, 59% female and 44% Black) with ≥ 3 DunedinPACE (a recently developed epigenetic clock) measurements, collected over 15 years. Using mixed-effects modeling, we derived individual-specific slopes of epigenetic aging trajectories and categorized participants as Fast Agers (slopes > 1 SD above the mean), Slow Agers (slopes < 1 SD below the mean), or Typical Agers (within ±1 SD of the mean). We examined associations between trajectory group and cognition on five cognitive domains as well as on plasma AD biomarkers (NfL, p-tau217, Aβ42/Aβ40), all assessed 15-20 years post-baseline. Models were adjusted for demographics, education, physical activity and APOE *ε4 carrier status (with additional adjustments for eGFRcr for biomarker outcomes).
RESULTS: Epigenetic aging trajectories were associated with multiple domains of cognition and AD biomarkers (Figure 1). Compared to Typical Agers, Fast Agers showed worse processing speed, memory, executive function, and global cognition (all p<0.05), with no difference in verbal fluency. Slow Agers had better performance on memory and global cognition (both p < 0.05). Fast Agers also exhibited significantly lower Aβ42/Aβ40 levels (p = 0.011) compared to Typical agers; no significant associations with p-tau217 or NfL were observed in either group.
CONCLUSION: Middle-aged adults with faster 15-year epigenetic aging trajectories demonstrated worse cognitive performance, whereas those with slower biological aging trajectories exhibited cognitive resilience and more favorable AD biomarker profiles. By examining long-term trajectories rather than single timepoints, these findings identify individuals at differential risk for brain health outcomes.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Elevated BrainAGE precedes cognitive impairment and improves prediction of future cognitive decline.
medRxiv : the preprint server for health sciences.
Magnetic Resonance Imaging (MRI) derived brain age varies substantially between individuals, but it remains unclear whether early deviations from normal brain ageing precede future cognitive decline and whether they provide predictive value beyond conventional MRI measures. Here, we investigated whether MRI-derived brain age gap estimation (BrainAGE) identifies early structural brain ageing differences among cognitively normal individuals who later develop mild cognitive impairment (MCI) or dementia. We analysed longitudinal structural MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and replicated the main findings in the population-based Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE). Individuals who later converted to MCI or dementia had higher BrainAGE values several years before diagnosis and, in ADNI, showed steeper longitudinal increases than stable individuals. Elevated BrainAGE values were also associated with increased risk of future conversion to MCI in cognitively healthy individuals and faster subsequent memory decline. Cross-sectional differences and the association between BrainAGE and risk of future conversion were replicated in OSTPRE. Importantly, adding BrainAGE to models including demographic, APOE4, cognitive, and MRI-derived measures consistently improved prediction of future cognitive outcomes, with the greatest benefit observed for individuals who converted after longer follow-up. These findings show that structural brain ageing begins to diverge years before the onset of MCI. BrainAGE captures this early divergence, providing complementary information beyond conventional structural MRI measures that may improve the early identification of cognitively normal individuals at increased risk of future cognitive decline when integrated with other biomarkers.
Additional Links: PMID-42528498
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@article {pmid42528498,
year = {2026},
author = {Moradi, E and Dahnke, R and Gaser, C and Rikkonen, T and Kröger, H and Väänänen, S and Solomon, A and Sund, R and Tohka, J and , },
title = {Elevated BrainAGE precedes cognitive impairment and improves prediction of future cognitive decline.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
pmid = {42528498},
abstract = {Magnetic Resonance Imaging (MRI) derived brain age varies substantially between individuals, but it remains unclear whether early deviations from normal brain ageing precede future cognitive decline and whether they provide predictive value beyond conventional MRI measures. Here, we investigated whether MRI-derived brain age gap estimation (BrainAGE) identifies early structural brain ageing differences among cognitively normal individuals who later develop mild cognitive impairment (MCI) or dementia. We analysed longitudinal structural MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and replicated the main findings in the population-based Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE). Individuals who later converted to MCI or dementia had higher BrainAGE values several years before diagnosis and, in ADNI, showed steeper longitudinal increases than stable individuals. Elevated BrainAGE values were also associated with increased risk of future conversion to MCI in cognitively healthy individuals and faster subsequent memory decline. Cross-sectional differences and the association between BrainAGE and risk of future conversion were replicated in OSTPRE. Importantly, adding BrainAGE to models including demographic, APOE4, cognitive, and MRI-derived measures consistently improved prediction of future cognitive outcomes, with the greatest benefit observed for individuals who converted after longer follow-up. These findings show that structural brain ageing begins to diverge years before the onset of MCI. BrainAGE captures this early divergence, providing complementary information beyond conventional structural MRI measures that may improve the early identification of cognitively normal individuals at increased risk of future cognitive decline when integrated with other biomarkers.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Implementation of a standardized Video-based Asynchronous Neurological Examination (VANE) in a multi-center observational study of Alzheimer's disease (AD) and AD related dementias.
medRxiv : the preprint server for health sciences.
INTRODUCTION: The Diabetes Prevention Program Outcomes Study (DPPOS) is an established cohort of aging persons with pre-diabetes and type 2 diabetes with 25 years of median follow-up. In 2022 DPPOS added Alzheimer's disease (AD), and AD related dementias (ADRD) phenotyping using the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDSv3), which included a standardized neurological examination across 25 clinical sites, administered by clinical staff and interpreted centrally by clinicians.
METHODS: A DPPOS video-based asynchronous neurological examination (DPPOS-VANE) was developed iteratively through consensus from research clinicians and staff feedback to harmonize with UDSv3 to identify common neurological diagnoses aside from dementia including diabetic cranial neuropathies, stroke and parkinsonism. DPPOS-VANE was designed to be conducted without direct participant contact by the examiner, reproducible, and independent of clinical skills of PCs. An iPad™ camera recorded the video exam, comprised of assessments of extraocular and facial movements, visual fields, speech, gross motor strength, pronator drift, praxis and parkinsonism. A 10-minute training video demonstrated the examination step-by-step with scripts and instructions in English and Spanish. Site-specific performance review, feedback, and staff certification preceded central reading of video recordings by physicians.After two years of implementation, 1286 DPPOS-VANEs led to 1284 examination reviews. Of these, 1204 (93%) were completed by having the examiner follow the standard script. Overall, 1237 examinations (96%) were delivered as planned, 41 (3%) had minor errors but were still usable, and 6 (0.4%) had major deviations in exam technique; two additional recorded evaluations were not usable as recorded videos were inaccessible due to technical errors. Each examination was completed within 10-15 minutes. Each site on average completed 51.4 examinations (range 14-92).
DISCUSSION: Engaging 55 research staff across 25 sites and 3 physician-reviewers, this study is the first to demonstrate feasibility of a VANE as an efficient neurological examination model enabled by commonly used devices. Such a multisite standardized VANE represents a novel paradigm for large epidemiological studies.
Additional Links: PMID-42528526
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@article {pmid42528526,
year = {2026},
author = {Noble, JM and Nadkarni, NK and Martinez, D and Temprosa, M and Bowers, A and Carmichael, O and Doherty, L and Febres, GJ and Sanchez, D and Goldberg, TE and Sherif, H and Shah, V and Luchsinger, JA and , },
title = {Implementation of a standardized Video-based Asynchronous Neurological Examination (VANE) in a multi-center observational study of Alzheimer's disease (AD) and AD related dementias.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
pmid = {42528526},
abstract = {INTRODUCTION: The Diabetes Prevention Program Outcomes Study (DPPOS) is an established cohort of aging persons with pre-diabetes and type 2 diabetes with 25 years of median follow-up. In 2022 DPPOS added Alzheimer's disease (AD), and AD related dementias (ADRD) phenotyping using the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDSv3), which included a standardized neurological examination across 25 clinical sites, administered by clinical staff and interpreted centrally by clinicians.
METHODS: A DPPOS video-based asynchronous neurological examination (DPPOS-VANE) was developed iteratively through consensus from research clinicians and staff feedback to harmonize with UDSv3 to identify common neurological diagnoses aside from dementia including diabetic cranial neuropathies, stroke and parkinsonism. DPPOS-VANE was designed to be conducted without direct participant contact by the examiner, reproducible, and independent of clinical skills of PCs. An iPad™ camera recorded the video exam, comprised of assessments of extraocular and facial movements, visual fields, speech, gross motor strength, pronator drift, praxis and parkinsonism. A 10-minute training video demonstrated the examination step-by-step with scripts and instructions in English and Spanish. Site-specific performance review, feedback, and staff certification preceded central reading of video recordings by physicians.After two years of implementation, 1286 DPPOS-VANEs led to 1284 examination reviews. Of these, 1204 (93%) were completed by having the examiner follow the standard script. Overall, 1237 examinations (96%) were delivered as planned, 41 (3%) had minor errors but were still usable, and 6 (0.4%) had major deviations in exam technique; two additional recorded evaluations were not usable as recorded videos were inaccessible due to technical errors. Each examination was completed within 10-15 minutes. Each site on average completed 51.4 examinations (range 14-92).
DISCUSSION: Engaging 55 research staff across 25 sites and 3 physician-reviewers, this study is the first to demonstrate feasibility of a VANE as an efficient neurological examination model enabled by commonly used devices. Such a multisite standardized VANE represents a novel paradigm for large epidemiological studies.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Orthogonal Contributions of Genetic, Clinical, and Social Determinants of Health Risk Burdens on Alzheimer's Disease Pathophysiology.
medRxiv : the preprint server for health sciences pii:2026.07.07.26357509.
IMPORTANCE: Alzheimer's disease (AD) arises from complex interactions among genetic, clinical, and social determinants of health (SDoH) risk factors, yet their independent contributions to underlying AD pathophysiology remain elusive.
OBJECTIVE: To quantify the effects of risk factors across amyloid (Aβ)/tau, neurodegeneration, and cognition.
DESIGN: Cross-sectional analysis using structural equation modeling (SEM).
SETTING: Health and Aging Brain Study-Health Disparities (HABS-HD), a community-based cohort study.
PARTICIPANTS: A total of 2,276 participants with demographics, genetic, clinical, and biomarker data from the baseline visit.
EXPOSURES: APOE ε4 carrier status, AD polygenic risk score (AD-PRS), clinical risk score (CogDRisk), and a social determinants of health (SDoH) latent score derived using factor analysis.
MAIN OUTCOMES AND MEASURES: Latent variables representing Aβ/tau pathology (plasma pTau 181 , plasma pTau 217 /Aβ 42 , amyloid PET positivity, and global standardized uptake value ratio), neurodegeneration (plasma neurofilament light, cortical thickness, hippocampal volume), and cognition (memory, executive, and language tests) were modeled and regressed on AD latent variables using SEM adjusted for age, sex, genetic principal components, and spoken language.
RESULTS: The total analytic sample included 2,276 participants (mean age: 65.3 ± 8.7; non-Hispanic White: 43.0%, non-Hispanic Black: 16.2%, and Latinx/Hispanic adults: 40.8%). APOE ε4 was strongly associated with worse Aβ/tau latent variable (β=0.31; p<0.001), with smaller but significant associations with neurodegeneration (β=0.085; p<0.001) and cognition (β=0.083; p<0.001). Higher AD-PRS was modestly associated with worse Aβ/tau (β=0.075; p<0.01) but was not associated with neurodegeneration or cognition. A higher clinical risk score was significantly associated with worse neurodegeneration (β=0.16; p<0.001) but not with Aβ/tau or cognition. Adverse SDoH was associated with worse neurodegeneration (β=0.071; p<0.05) and strongly associated with worse cognition (β=0.22; p<0.001), with no associations with Aβ/tau.
CONCLUSION AND RELEVANCE: Genetic risks were primarily associated with Aβ and tau pathology, clinical risks with neurodegeneration, and SDoH risks with cognition, suggesting that risk factors exert differential effects on AD pathophysiology. Future studies investigating additional risk factors and their longitudinal associations with AD pathophysiological changes are warranted.
KEY POINTS: Questions: Do Alzheimer's disease (AD) risk factors differentially influence underlying AD pathophysiological processes, and do these associations vary across demographic subgroups?Findings: Genetic and genomic risk burdens demonstrated the strongest associations with amyloid and tau pathology; clinical risk burden with neurodegeneration; and adverse social determinants of health with cognition.Meaning: Because of the differential effects of risk factors on the underlying AD pathophysiology, a one-size-fits-all approach to AD risk prediction and prevention is insufficient. AD risk assessment should leverage multidomain frameworks incorporating genomic, clinical, and social determinants of health information to better inform disease development and progression.
Additional Links: PMID-42528531
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@article {pmid42528531,
year = {2026},
author = {Okorie, M and Jiang, X and Tolosa-Tort, P and Sharma, RU and Clark, AL and Yaffe, K and Yokoyama, JS and Andrews, S and , },
title = {Orthogonal Contributions of Genetic, Clinical, and Social Determinants of Health Risk Burdens on Alzheimer's Disease Pathophysiology.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.07.07.26357509},
pmid = {42528531},
abstract = {IMPORTANCE: Alzheimer's disease (AD) arises from complex interactions among genetic, clinical, and social determinants of health (SDoH) risk factors, yet their independent contributions to underlying AD pathophysiology remain elusive.
OBJECTIVE: To quantify the effects of risk factors across amyloid (Aβ)/tau, neurodegeneration, and cognition.
DESIGN: Cross-sectional analysis using structural equation modeling (SEM).
SETTING: Health and Aging Brain Study-Health Disparities (HABS-HD), a community-based cohort study.
PARTICIPANTS: A total of 2,276 participants with demographics, genetic, clinical, and biomarker data from the baseline visit.
EXPOSURES: APOE ε4 carrier status, AD polygenic risk score (AD-PRS), clinical risk score (CogDRisk), and a social determinants of health (SDoH) latent score derived using factor analysis.
MAIN OUTCOMES AND MEASURES: Latent variables representing Aβ/tau pathology (plasma pTau 181 , plasma pTau 217 /Aβ 42 , amyloid PET positivity, and global standardized uptake value ratio), neurodegeneration (plasma neurofilament light, cortical thickness, hippocampal volume), and cognition (memory, executive, and language tests) were modeled and regressed on AD latent variables using SEM adjusted for age, sex, genetic principal components, and spoken language.
RESULTS: The total analytic sample included 2,276 participants (mean age: 65.3 ± 8.7; non-Hispanic White: 43.0%, non-Hispanic Black: 16.2%, and Latinx/Hispanic adults: 40.8%). APOE ε4 was strongly associated with worse Aβ/tau latent variable (β=0.31; p<0.001), with smaller but significant associations with neurodegeneration (β=0.085; p<0.001) and cognition (β=0.083; p<0.001). Higher AD-PRS was modestly associated with worse Aβ/tau (β=0.075; p<0.01) but was not associated with neurodegeneration or cognition. A higher clinical risk score was significantly associated with worse neurodegeneration (β=0.16; p<0.001) but not with Aβ/tau or cognition. Adverse SDoH was associated with worse neurodegeneration (β=0.071; p<0.05) and strongly associated with worse cognition (β=0.22; p<0.001), with no associations with Aβ/tau.
CONCLUSION AND RELEVANCE: Genetic risks were primarily associated with Aβ and tau pathology, clinical risks with neurodegeneration, and SDoH risks with cognition, suggesting that risk factors exert differential effects on AD pathophysiology. Future studies investigating additional risk factors and their longitudinal associations with AD pathophysiological changes are warranted.
KEY POINTS: Questions: Do Alzheimer's disease (AD) risk factors differentially influence underlying AD pathophysiological processes, and do these associations vary across demographic subgroups?Findings: Genetic and genomic risk burdens demonstrated the strongest associations with amyloid and tau pathology; clinical risk burden with neurodegeneration; and adverse social determinants of health with cognition.Meaning: Because of the differential effects of risk factors on the underlying AD pathophysiology, a one-size-fits-all approach to AD risk prediction and prevention is insufficient. AD risk assessment should leverage multidomain frameworks incorporating genomic, clinical, and social determinants of health information to better inform disease development and progression.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Explainable Machine Learning Models for Alzheimer's Diagnosis Using Routine and Low-Cost Clinical Data.
medRxiv : the preprint server for health sciences pii:2026.07.10.26357720.
Emerging as a significant global health challenge, Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that causes memory loss and cognitive decline. Despite the ever-increasing waiting time for a specialist diagnosis, the need for a cost-effective and fast diagnostic technique is evident. This study explores the development of an explainable deep learning model to diagnose AD using only routine and low-cost clinical data, including demographic information, patient history, and results of neuropsychological tests (limited to those that can be automatically acquired). The analysis was carried out using a dataset provided by the National Alzheimer's Coordinating Center, comprising 167,364 observations and 1,024 features. The findings demonstrate diagnostic performance comparable, and slightly superior, to that of clinicians when evaluated under similar informative constraints. This study introduces two classification models to discriminate whether the presumptive etiological cause of cognitive impairment is Alzheimer's disease. The deep neural network achieved an accuracy of 90% with an area under the receiver operating characteristic curve (ROC-AUC) of 0.96, whereas the Light Gradient Boosting Machine reached the same accuracy with a ROC-AUC of 0.97.
Additional Links: PMID-42528554
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@article {pmid42528554,
year = {2026},
author = {De Carli, D and Sudati, A and Dercole, F},
title = {Explainable Machine Learning Models for Alzheimer's Diagnosis Using Routine and Low-Cost Clinical Data.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.07.10.26357720},
pmid = {42528554},
abstract = {Emerging as a significant global health challenge, Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that causes memory loss and cognitive decline. Despite the ever-increasing waiting time for a specialist diagnosis, the need for a cost-effective and fast diagnostic technique is evident. This study explores the development of an explainable deep learning model to diagnose AD using only routine and low-cost clinical data, including demographic information, patient history, and results of neuropsychological tests (limited to those that can be automatically acquired). The analysis was carried out using a dataset provided by the National Alzheimer's Coordinating Center, comprising 167,364 observations and 1,024 features. The findings demonstrate diagnostic performance comparable, and slightly superior, to that of clinicians when evaluated under similar informative constraints. This study introduces two classification models to discriminate whether the presumptive etiological cause of cognitive impairment is Alzheimer's disease. The deep neural network achieved an accuracy of 90% with an area under the receiver operating characteristic curve (ROC-AUC) of 0.96, whereas the Light Gradient Boosting Machine reached the same accuracy with a ROC-AUC of 0.97.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Curation of Mini Mental State Examination (MMSE) Scores in the VA Million Veteran Program (MVP): Applications for Cognitive Aging Research.
medRxiv : the preprint server for health sciences pii:2026.07.14.26358064.
BACKGROUND: Electronic health record (EHR)-linked biorepositories provide opportunities to advance epidemiological research in Alzheimer's disease (AD) and related dementias.
OBJECTIVE: Evaluate the extraction, curation, and associative validity of Mini Mental State Examination (MMSE) scores from the VA EHR for participants in the VA Million Veteran Program (MVP).
METHODS: The sample (N = 49,555; 7.4% women) included a multiethnic cohort (European [68.3%], African [20.4%], Hispanic [9.0%]) with EHR-extracted MMSE scores; 30.7% were apolipoprotein E (APOE) ε4 carriers, and 25.8% had multiple scores. Linear regressions examined cross-sectional associations between ε4 dosage (0, 1, 2) and first and lowest MMSE scores. MMSE scores were also evaluated against MVP dementia diagnostic algorithms in participants aged ≥65 years.
RESULTS: Among participants of European ancestry, there was a significant ε4 dose-response relationship (p s < .001) with MMSE scores. Homozygote carriers scored lower than heterozygote carriers (M diff : first = -0.5; lowest = -0.9), who scored lower than non-carriers (M diff : first = -0.4; lowest = -0.6). Among Veterans of African and Hispanic ancestry, no dose-response relationship was observed, although ε4 carriers had lower scores than non-carriers (p s ≤ .04). MMSE scores corresponded strongly with dementia case/control status across phenotypes: mild impairment on the MMSE was strongly associated with AD (odds ratio [OR] = 11.48), with more severe MMSE impairment showing stronger associations (moderate OR = 17.95; severe OR = 27.83).
CONCLUSION: This study demonstrated MMSE scores can be systematically extracted and curated from the VA EHR. Findings offer a scalable framework for future studies on risk stratification, highlighting the potential for harnessing MVP to explore genetic and clinical factors contributing to cognitive and dementia outcomes in diverse samples.
Additional Links: PMID-42528566
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@article {pmid42528566,
year = {2026},
author = {Lopez, FV and Gillis, M and Lee, S and Sakamoto, MS and Zhang, R and , and Sherva, R and Logue, MW and Merritt, VC},
title = {Curation of Mini Mental State Examination (MMSE) Scores in the VA Million Veteran Program (MVP): Applications for Cognitive Aging Research.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.07.14.26358064},
pmid = {42528566},
abstract = {BACKGROUND: Electronic health record (EHR)-linked biorepositories provide opportunities to advance epidemiological research in Alzheimer's disease (AD) and related dementias.
OBJECTIVE: Evaluate the extraction, curation, and associative validity of Mini Mental State Examination (MMSE) scores from the VA EHR for participants in the VA Million Veteran Program (MVP).
METHODS: The sample (N = 49,555; 7.4% women) included a multiethnic cohort (European [68.3%], African [20.4%], Hispanic [9.0%]) with EHR-extracted MMSE scores; 30.7% were apolipoprotein E (APOE) ε4 carriers, and 25.8% had multiple scores. Linear regressions examined cross-sectional associations between ε4 dosage (0, 1, 2) and first and lowest MMSE scores. MMSE scores were also evaluated against MVP dementia diagnostic algorithms in participants aged ≥65 years.
RESULTS: Among participants of European ancestry, there was a significant ε4 dose-response relationship (p s < .001) with MMSE scores. Homozygote carriers scored lower than heterozygote carriers (M diff : first = -0.5; lowest = -0.9), who scored lower than non-carriers (M diff : first = -0.4; lowest = -0.6). Among Veterans of African and Hispanic ancestry, no dose-response relationship was observed, although ε4 carriers had lower scores than non-carriers (p s ≤ .04). MMSE scores corresponded strongly with dementia case/control status across phenotypes: mild impairment on the MMSE was strongly associated with AD (odds ratio [OR] = 11.48), with more severe MMSE impairment showing stronger associations (moderate OR = 17.95; severe OR = 27.83).
CONCLUSION: This study demonstrated MMSE scores can be systematically extracted and curated from the VA EHR. Findings offer a scalable framework for future studies on risk stratification, highlighting the potential for harnessing MVP to explore genetic and clinical factors contributing to cognitive and dementia outcomes in diverse samples.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Characterizing the impact of plasma protein levels on human brain structure and disorders leveraging integrative multi-omics analysis.
medRxiv : the preprint server for health sciences pii:2026.07.13.26358006.
With recent advances in high-throughput proteomic technologies, population-scale plasma proteomics datasets, often linked to extensive genetic and phenotypic information, have become increasingly accessible. Yet the relationships between circulating protein levels, brain imaging phenotypes, and risk for neurological and psychiatric disorders remain largely unexplored. Proteome-wide association studies offer a promising approach for elucidating biological mechanisms that connect genetic variation to complex brain-related traits and diseases. In this study, we integrated protein quantitative trait loci (pQTLs) from the two largest plasma proteomic resources (the UK Biobank Pharma Proteomics Project [UKB-PPP] and Ferkingstad et al. [deCODE]) with genome-wide association studies of brain imaging-derived phenotypes in UK Biobank using Mendelian randomization and colocalization analyses. We identified 120 cis and 20 trans associations between plasma proteins and imaging phenotypes and validated these findings using brain tissue-derived proteomic and transcriptomic datasets. Multivariable Mendelian randomization revealed eleven plasma proteins (coding genes APOE, ARL3, MICB, NSF, RHOC, RSPO3, ENPP2, BTN2A1, EIF2AK3, MRVI1, and OPLAH) with significant direct effects on the risk of Alzheimer's disease, Parkinson's disease, multiple sclerosis, bipolar disorder, and schizophrenia. Single-cell expression and pathway enrichment analyses further revealed cell-type-specific effects and distinct biological processes underlying these protein- disease associations. Together, these findings demonstrate robust links between plasma protein variation and brain structure, delineate protein-disease pathways, and highlight the cellular and molecular mechanisms that contribute to neurobiological diversity and pathology.
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@article {pmid42528609,
year = {2026},
author = {Ayubcha, C and Dennis, E and Bhattacharyya, U and John, J and Lam, M and Lencz, T and Ge, T and Chen, CY},
title = {Characterizing the impact of plasma protein levels on human brain structure and disorders leveraging integrative multi-omics analysis.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.07.13.26358006},
pmid = {42528609},
abstract = {With recent advances in high-throughput proteomic technologies, population-scale plasma proteomics datasets, often linked to extensive genetic and phenotypic information, have become increasingly accessible. Yet the relationships between circulating protein levels, brain imaging phenotypes, and risk for neurological and psychiatric disorders remain largely unexplored. Proteome-wide association studies offer a promising approach for elucidating biological mechanisms that connect genetic variation to complex brain-related traits and diseases. In this study, we integrated protein quantitative trait loci (pQTLs) from the two largest plasma proteomic resources (the UK Biobank Pharma Proteomics Project [UKB-PPP] and Ferkingstad et al. [deCODE]) with genome-wide association studies of brain imaging-derived phenotypes in UK Biobank using Mendelian randomization and colocalization analyses. We identified 120 cis and 20 trans associations between plasma proteins and imaging phenotypes and validated these findings using brain tissue-derived proteomic and transcriptomic datasets. Multivariable Mendelian randomization revealed eleven plasma proteins (coding genes APOE, ARL3, MICB, NSF, RHOC, RSPO3, ENPP2, BTN2A1, EIF2AK3, MRVI1, and OPLAH) with significant direct effects on the risk of Alzheimer's disease, Parkinson's disease, multiple sclerosis, bipolar disorder, and schizophrenia. Single-cell expression and pathway enrichment analyses further revealed cell-type-specific effects and distinct biological processes underlying these protein- disease associations. Together, these findings demonstrate robust links between plasma protein variation and brain structure, delineate protein-disease pathways, and highlight the cellular and molecular mechanisms that contribute to neurobiological diversity and pathology.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
The dual pathological roles and targeted therapy of PGE2: from receptor signaling networks to disease microenvironment modulation.
Frontiers in pharmacology, 17:1810417.
Prostaglandin E2 (PGE2) is a pleiotropic lipid mediator that exerts context-dependent effects via four G protein-coupled receptors (EP1-EP4), playing a pivotal role in the pathogenesis of diverse disorders, including neurodegenerative, cardiovascular, neoplastic, and chronic inflammatory diseases. In this review, we systematically delineate the dualistic functions and mechanisms of PGE2 across these diseases. In neurodegenerative conditions such as Alzheimer's and Parkinson's diseases, PGE2 exacerbates neuroinflammation and neuronal injury in part through EP1 and EP2 in specific cell types, whereas EP4 signaling can confer neuroprotection in certain disease-stage and cellular contexts. Within the tumor microenvironment, PGE2 can drive immunosuppression, angiogenesis, and tumor progression via the EP2/EP4 axis, particularly in colorectal carcinoma, lung adenocarcinoma, and melanoma where this axis is best characterized. In cardiovascular and metabolic diseases, PGE2 exhibits both protective (EP4-mediated) and detrimental (EP3-mediated) effects. Building on this mechanistic framework, we highlight emerging therapeutic strategies designed to overcome the limitations of conventional non-steroidal anti-inflammatory drugs (NSAIDs). These include modulating key enzymes involved in PGE2 synthesis and degradation, developing subtype-selective EP receptor modulators for context-specific intervention, and synergistically targeting downstream pathogenic signaling pathways (e.g., PI3K/Akt/mTOR). By integrating mechanistic and translational perspectives, this review aims to advance next-generation therapies targeting the PGE2 signaling network.
Additional Links: PMID-42528719
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@article {pmid42528719,
year = {2026},
author = {Yang, M and Gao, Z and Zhao, Z and Niu, X and Xue, F and Zhang, J and Sun, H and Shen, Y and Liu, G},
title = {The dual pathological roles and targeted therapy of PGE2: from receptor signaling networks to disease microenvironment modulation.},
journal = {Frontiers in pharmacology},
volume = {17},
number = {},
pages = {1810417},
pmid = {42528719},
issn = {1663-9812},
abstract = {Prostaglandin E2 (PGE2) is a pleiotropic lipid mediator that exerts context-dependent effects via four G protein-coupled receptors (EP1-EP4), playing a pivotal role in the pathogenesis of diverse disorders, including neurodegenerative, cardiovascular, neoplastic, and chronic inflammatory diseases. In this review, we systematically delineate the dualistic functions and mechanisms of PGE2 across these diseases. In neurodegenerative conditions such as Alzheimer's and Parkinson's diseases, PGE2 exacerbates neuroinflammation and neuronal injury in part through EP1 and EP2 in specific cell types, whereas EP4 signaling can confer neuroprotection in certain disease-stage and cellular contexts. Within the tumor microenvironment, PGE2 can drive immunosuppression, angiogenesis, and tumor progression via the EP2/EP4 axis, particularly in colorectal carcinoma, lung adenocarcinoma, and melanoma where this axis is best characterized. In cardiovascular and metabolic diseases, PGE2 exhibits both protective (EP4-mediated) and detrimental (EP3-mediated) effects. Building on this mechanistic framework, we highlight emerging therapeutic strategies designed to overcome the limitations of conventional non-steroidal anti-inflammatory drugs (NSAIDs). These include modulating key enzymes involved in PGE2 synthesis and degradation, developing subtype-selective EP receptor modulators for context-specific intervention, and synergistically targeting downstream pathogenic signaling pathways (e.g., PI3K/Akt/mTOR). By integrating mechanistic and translational perspectives, this review aims to advance next-generation therapies targeting the PGE2 signaling network.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Pre-plaque glutamatergic hyperexcitability, mitochondrial dysfunction, and dendritic remodeling in the hippocampus of one-month-old 5xFAD mice.
Frontiers in aging neuroscience, 18:1804332.
Alzheimer's disease (AD) is characterized by progressive cognitive decline and stereotyped neuropathology, yet the earliest cellular events that precede overt plaque burden and measurable behavioral impairment remain incompletely defined. Here, we tested the hypothesis that synaptic hyperexcitability and subcellular metabolic dysfunction emerge early in the 5xFAD mouse model and contribute to region-specific neuronal vulnerability before substantial amyloid plaque deposition. Using the 5xFAD heterozygous mouse, we first established the onset of transgene expression and the timing of plaque accumulation. Robust transgene expression was detected by postnatal day 15 and statistically significant plaque accumulation in the CA1 stratum radiatum by 4 months of age. Hippocampal slice electrophysiology revealed an early hyperexcitable phenotype at 1 month of age, including both increased AMPA receptor-mediated transmission and N-methyl-D-aspartate receptor signaling associated with the GluN2B subunit. Given the tight coupling between glutamatergic hyperactivity, oxidative stress, calcium dysregulation, and mitochondrial health, we assessed mitochondrial structure and function at this pre-plaque stage. Mitochondrial abnormalities consistent with impaired bioenergetic homeostasis were evident within hippocampal synaptic processes. Morphological analyses demonstrated that these early changes were associated with altered dendritic architecture in the CA1 and dentate gyrus regions, revealing hippocampal subregional susceptibility. Finally, spatial transcriptomics identified regionally enriched molecular signatures consistent with differential vulnerability. The CA1 subregion exhibited pronounced downregulation of mitochondria-related transcripts, and single-cell deconvolution resolved this transcriptomic suppression specifically to CA1 pyramidal neurons (CA1.ProS); CA3 and dentate gyrus did not show equivalent mitochondrial pathway suppression. Together, these findings define a pre-plaque window in 5xFAD mice marked by GluN2B-linked glutamatergic hyperexcitability, early mitochondrial disruption, and selective dendritic and transcriptional vulnerability. Mitochondrial transcriptomic suppression was anatomically restricted to CA1 pyramidal neurons, establishing a cell-type-specific bioenergetic signature at 1 month of age, well before overt amyloid pathology. While the observations herein are descriptive in nature and detailed mechanisms have yet to be established, nevertheless, the integrated timeline suggests that synaptic and metabolic dysfunctions arise before substantial plaque deposition and may represent tractable early targets for intervention in AD.
Additional Links: PMID-42528726
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@article {pmid42528726,
year = {2026},
author = {Kelley, AR and Sackinger, E and Frischman, M and Thomas, N and Kim, K and Scuderi, G and Labut, EM and MacMurchy, D and Ikea-Mario, T and Rauenhorst, J and Neitzel, E and Vu, T and Liko, L and Hoff, A and Hoff, A and Wallace, O and Harry, WKE and Hagen, B and Bihun, AZ and Abou-Seada, IA and Lee, K and Butler, J and Nigussie, F and Ebrahimi, A and Lee, PY and Marney, LC and Maier, CS and Magnusson, KR and Hagen, TM},
title = {Pre-plaque glutamatergic hyperexcitability, mitochondrial dysfunction, and dendritic remodeling in the hippocampus of one-month-old 5xFAD mice.},
journal = {Frontiers in aging neuroscience},
volume = {18},
number = {},
pages = {1804332},
pmid = {42528726},
issn = {1663-4365},
abstract = {Alzheimer's disease (AD) is characterized by progressive cognitive decline and stereotyped neuropathology, yet the earliest cellular events that precede overt plaque burden and measurable behavioral impairment remain incompletely defined. Here, we tested the hypothesis that synaptic hyperexcitability and subcellular metabolic dysfunction emerge early in the 5xFAD mouse model and contribute to region-specific neuronal vulnerability before substantial amyloid plaque deposition. Using the 5xFAD heterozygous mouse, we first established the onset of transgene expression and the timing of plaque accumulation. Robust transgene expression was detected by postnatal day 15 and statistically significant plaque accumulation in the CA1 stratum radiatum by 4 months of age. Hippocampal slice electrophysiology revealed an early hyperexcitable phenotype at 1 month of age, including both increased AMPA receptor-mediated transmission and N-methyl-D-aspartate receptor signaling associated with the GluN2B subunit. Given the tight coupling between glutamatergic hyperactivity, oxidative stress, calcium dysregulation, and mitochondrial health, we assessed mitochondrial structure and function at this pre-plaque stage. Mitochondrial abnormalities consistent with impaired bioenergetic homeostasis were evident within hippocampal synaptic processes. Morphological analyses demonstrated that these early changes were associated with altered dendritic architecture in the CA1 and dentate gyrus regions, revealing hippocampal subregional susceptibility. Finally, spatial transcriptomics identified regionally enriched molecular signatures consistent with differential vulnerability. The CA1 subregion exhibited pronounced downregulation of mitochondria-related transcripts, and single-cell deconvolution resolved this transcriptomic suppression specifically to CA1 pyramidal neurons (CA1.ProS); CA3 and dentate gyrus did not show equivalent mitochondrial pathway suppression. Together, these findings define a pre-plaque window in 5xFAD mice marked by GluN2B-linked glutamatergic hyperexcitability, early mitochondrial disruption, and selective dendritic and transcriptional vulnerability. Mitochondrial transcriptomic suppression was anatomically restricted to CA1 pyramidal neurons, establishing a cell-type-specific bioenergetic signature at 1 month of age, well before overt amyloid pathology. While the observations herein are descriptive in nature and detailed mechanisms have yet to be established, nevertheless, the integrated timeline suggests that synaptic and metabolic dysfunctions arise before substantial plaque deposition and may represent tractable early targets for intervention in AD.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Stage-dependent effects of cognitive reserve on memory and brain structural integrity across the spectrum from healthy aging to Alzheimer's disease.
Frontiers in human neuroscience, 20:1830181.
INTRODUCTION: Cognitive reserve (CR) has been proposed as a key factor explaining inter-individual variability in cognitive performance despite comparable neuropathology. However, its role across the Alzheimer's disease (AD) continuum remains unclear. This study investigates stage-dependent effects of CR on the relationship between memory performance and brain structural network integrity across healthy subjects (HS), individuals with subjective cognitive decline (SCD), and patients with amnestic mild cognitive impairment (a-MCI), and AD dementia.
MATERIALS AND METHODS: A total of 209 participants underwent a comprehensive neuropsychological assessment and 3T MRI. Source-based morphometry identified three grey matter structural covariance networks, involving orbitofrontal-temporal-insular regions (OTIN), precuneus-posterior cingulate cortex (PreCiN), and cingulate-hippocampal regions (CHiN). A composite memory score was derived using factor analysis. Regression and moderation models examined the predictive and moderating effects of CR (operationalized as years of education) and network integrity on cognitive performance within each group.
RESULTS: OTIN and PreCiN showed progressive structural vulnerability along the AD continuum, whereas CHiN showed no significant between-group differences. Across the sample, OTIN and PreCiN integrity significantly predicted cognitive performance. In HS, CR was positively associated with memory performance independently of structural network integrity, suggesting an additive protective role of cognitive reserve in healthy aging. In the SCD group, CR was not directly associated with memory, and only limited effects emerged, indicating early alterations in reserve-related processes. In a-MCI patients, the significant interaction between CR and OTIN integrity suggested patterns consistent with compensatory mechanisms, with higher reserve supporting memory despite structural decline. In AD patients, CR and its interaction with structural networks no longer predicted cognitive outcomes, suggesting a possible exhaustion of reserve capacity.
CONCLUSION: These findings support a stage-dependent model of CR, characterized by an additive protective role in healthy aging, patterns consistent with compensatory recruitment in early cognitive decline, and a possible loss of reserve effectiveness beyond a critical neuropathological threshold. Distinct network vulnerabilities and stage-specific CR effects highlight potential windows for reserve-enhancing interventions across the AD continuum.
Additional Links: PMID-42528828
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@article {pmid42528828,
year = {2026},
author = {Serra, L and Bonarota, S and Caruso, G and Mancini, M and Sperati, S and Di Domenico, C and Tamigi, FM and Di Lorenzo, F and Ricci, F and Caltagirone, C and Koch, G and Giove, F and Bozzali, M and Petrosini, L},
title = {Stage-dependent effects of cognitive reserve on memory and brain structural integrity across the spectrum from healthy aging to Alzheimer's disease.},
journal = {Frontiers in human neuroscience},
volume = {20},
number = {},
pages = {1830181},
pmid = {42528828},
issn = {1662-5161},
abstract = {INTRODUCTION: Cognitive reserve (CR) has been proposed as a key factor explaining inter-individual variability in cognitive performance despite comparable neuropathology. However, its role across the Alzheimer's disease (AD) continuum remains unclear. This study investigates stage-dependent effects of CR on the relationship between memory performance and brain structural network integrity across healthy subjects (HS), individuals with subjective cognitive decline (SCD), and patients with amnestic mild cognitive impairment (a-MCI), and AD dementia.
MATERIALS AND METHODS: A total of 209 participants underwent a comprehensive neuropsychological assessment and 3T MRI. Source-based morphometry identified three grey matter structural covariance networks, involving orbitofrontal-temporal-insular regions (OTIN), precuneus-posterior cingulate cortex (PreCiN), and cingulate-hippocampal regions (CHiN). A composite memory score was derived using factor analysis. Regression and moderation models examined the predictive and moderating effects of CR (operationalized as years of education) and network integrity on cognitive performance within each group.
RESULTS: OTIN and PreCiN showed progressive structural vulnerability along the AD continuum, whereas CHiN showed no significant between-group differences. Across the sample, OTIN and PreCiN integrity significantly predicted cognitive performance. In HS, CR was positively associated with memory performance independently of structural network integrity, suggesting an additive protective role of cognitive reserve in healthy aging. In the SCD group, CR was not directly associated with memory, and only limited effects emerged, indicating early alterations in reserve-related processes. In a-MCI patients, the significant interaction between CR and OTIN integrity suggested patterns consistent with compensatory mechanisms, with higher reserve supporting memory despite structural decline. In AD patients, CR and its interaction with structural networks no longer predicted cognitive outcomes, suggesting a possible exhaustion of reserve capacity.
CONCLUSION: These findings support a stage-dependent model of CR, characterized by an additive protective role in healthy aging, patterns consistent with compensatory recruitment in early cognitive decline, and a possible loss of reserve effectiveness beyond a critical neuropathological threshold. Distinct network vulnerabilities and stage-specific CR effects highlight potential windows for reserve-enhancing interventions across the AD continuum.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Dual decline in gait and cognition as a high-risk clinical phenotype: differential associations with cerebral amyloid-β deposition and the apolipoprotein E ε4 allele and implications for integrated assessment.
Frontiers in aging neuroscience, 18:1845747.
BACKGROUND: Gait slowing and cognitive impairment often coexist in older adults, yet their relationship with core Alzheimer's disease (AD) biomarkers remains incompletely understood.
OBJECTIVE: To investigate the associations of isolated and combined slow gait (SG) and cognitive impairment subtypes with cerebral amyloid-β (Aβ) deposition and the apolipoprotein E ε4 (APOE ε4) allele in Chinese older adults.
METHODS: This cross-sectional study included 1,753 participants (mean age 65.9 years). Based on gait speed and cognitive status, participants were classified into six groups: normal, slow gait alone (SG-A), subjective cognitive decline alone (SCD-A), mild cognitive impairment alone (MCI-A), SCD with slow gait (SCD-SG), and MCI with slow gait (MCI-SG). 687 individuals underwent 18F-florbetapir positron emission tomography (PET) scans, 654 participants were examined for Apolipoprotein E (APOE) genotyping, and 618 participants had all relevant information recorded.
RESULTS: The MCI-SG group exhibited the most pronounced physical decline (slowest gait speed and weakest handgrip strength) and the highest burden of AD pathology, with a significantly higher prevalence of Aβ positivity (38%) and APOE ε4 carriage (32%) compared with other groups. While overall Aβ positivity rates across the six groups were not significantly different, logistic regression analyses revealed specific, strong associations. Aβ positivity was significantly associated with both SCD-SG (OR = 1.78, 95% CI: 1.03-3.08) and MCI-SG (OR = 1.85, 95% CI: 1.07-3.21) compared with the normal group. In contrast, APOE ε4 carriage was specifically and more strongly linked to MCI-SG (OR = 3.21, 95% CI: 1.41-7.31) compared with the SCD-A group. These combined gait-cognitive impairment phenotypes showed consistently stronger associations with AD biomarkers than isolated impairments across multiple reference groups. The risk was greatest for MCI-SG in individuals who were both Aβ positive and APOE ε4 carriers (OR = 2.27, 95% CI: 1.19-5.15).
CONCLUSION: The co-occurrence of slow gait and mild cognitive impairment (MCI-SG) represents a distinct high-risk clinical phenotype strongly linked to AD pathology. Aβ and APOE ε4 show differential associations across the gait-cognitive spectrum. Integrated assessment of gait and cognition improves risk stratification in older adults and may guide early intervention strategies.
Additional Links: PMID-42528992
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@article {pmid42528992,
year = {2026},
author = {Ren, C and Zhu, J and Huang, L and Hu, T and Guan, Y and Xie, F and Jin, J and Guo, Q},
title = {Dual decline in gait and cognition as a high-risk clinical phenotype: differential associations with cerebral amyloid-β deposition and the apolipoprotein E ε4 allele and implications for integrated assessment.},
journal = {Frontiers in aging neuroscience},
volume = {18},
number = {},
pages = {1845747},
pmid = {42528992},
issn = {1663-4365},
abstract = {BACKGROUND: Gait slowing and cognitive impairment often coexist in older adults, yet their relationship with core Alzheimer's disease (AD) biomarkers remains incompletely understood.
OBJECTIVE: To investigate the associations of isolated and combined slow gait (SG) and cognitive impairment subtypes with cerebral amyloid-β (Aβ) deposition and the apolipoprotein E ε4 (APOE ε4) allele in Chinese older adults.
METHODS: This cross-sectional study included 1,753 participants (mean age 65.9 years). Based on gait speed and cognitive status, participants were classified into six groups: normal, slow gait alone (SG-A), subjective cognitive decline alone (SCD-A), mild cognitive impairment alone (MCI-A), SCD with slow gait (SCD-SG), and MCI with slow gait (MCI-SG). 687 individuals underwent 18F-florbetapir positron emission tomography (PET) scans, 654 participants were examined for Apolipoprotein E (APOE) genotyping, and 618 participants had all relevant information recorded.
RESULTS: The MCI-SG group exhibited the most pronounced physical decline (slowest gait speed and weakest handgrip strength) and the highest burden of AD pathology, with a significantly higher prevalence of Aβ positivity (38%) and APOE ε4 carriage (32%) compared with other groups. While overall Aβ positivity rates across the six groups were not significantly different, logistic regression analyses revealed specific, strong associations. Aβ positivity was significantly associated with both SCD-SG (OR = 1.78, 95% CI: 1.03-3.08) and MCI-SG (OR = 1.85, 95% CI: 1.07-3.21) compared with the normal group. In contrast, APOE ε4 carriage was specifically and more strongly linked to MCI-SG (OR = 3.21, 95% CI: 1.41-7.31) compared with the SCD-A group. These combined gait-cognitive impairment phenotypes showed consistently stronger associations with AD biomarkers than isolated impairments across multiple reference groups. The risk was greatest for MCI-SG in individuals who were both Aβ positive and APOE ε4 carriers (OR = 2.27, 95% CI: 1.19-5.15).
CONCLUSION: The co-occurrence of slow gait and mild cognitive impairment (MCI-SG) represents a distinct high-risk clinical phenotype strongly linked to AD pathology. Aβ and APOE ε4 show differential associations across the gait-cognitive spectrum. Integrated assessment of gait and cognition improves risk stratification in older adults and may guide early intervention strategies.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Wearable monitoring during music-based interventions in dementia: physiological and behavioral observations from a pilot study.
Frontiers in human neuroscience, 20:1854021.
INTRODUCTION: Music-based interventions (MBIs) are widely used in dementia care, but objective methods for characterizing participant responses during intervention sessions remain limited. Synchronized datasets combining wearable physiological signals and behavioral observations are particularly scarce.
METHODS: We conducted a pilot feasibility study involving five individuals with Alzheimer's disease and related dementias (ADRD) who participated in 13 formal MBI sessions. Physiological signals, including photoplethysmography (PPG), electrodermal activity (EDA), skin temperature (TEMP), and accelerometry (ACC), were collected using a wrist-worn wearable sensor and synchronized with intervention playlists and time-stamped behavioral observations. Exploratory analyses examined physiological responses across intervention phases, participant-specific response patterns, time-of-day effects, and music-preference effects.
RESULTS: The dataset contains 13 intervention sessions, 99 music segments, and 248 behavioral observations. PPG, ACC, TEMP, and behavioral observations were available for all sessions, while EDA quality varied because of sensor-contact challenges. Behavioral responses were highly heterogeneous across participants, with engagement and calm behaviors observed most frequently. Physiological responses also showed substantial inter-individual variability, and case studies demonstrated that physiological and behavioral responses were not always concordant.
CONCLUSION: This study demonstrates the feasibility of collecting synchronized physiological, behavioral, and intervention-context data during MBIs in people living with dementia. The resulting publicly available multimodal dataset provides a foundation for future investigations of participant-specific responses and adaptive music-based interventions.
Additional Links: PMID-42529009
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@article {pmid42529009,
year = {2026},
author = {Zhou, H and Jiang, N and Bernheim, S and Paik, P and Zhou, Q and Kurabayashi, K and Ray, K},
title = {Wearable monitoring during music-based interventions in dementia: physiological and behavioral observations from a pilot study.},
journal = {Frontiers in human neuroscience},
volume = {20},
number = {},
pages = {1854021},
pmid = {42529009},
issn = {1662-5161},
abstract = {INTRODUCTION: Music-based interventions (MBIs) are widely used in dementia care, but objective methods for characterizing participant responses during intervention sessions remain limited. Synchronized datasets combining wearable physiological signals and behavioral observations are particularly scarce.
METHODS: We conducted a pilot feasibility study involving five individuals with Alzheimer's disease and related dementias (ADRD) who participated in 13 formal MBI sessions. Physiological signals, including photoplethysmography (PPG), electrodermal activity (EDA), skin temperature (TEMP), and accelerometry (ACC), were collected using a wrist-worn wearable sensor and synchronized with intervention playlists and time-stamped behavioral observations. Exploratory analyses examined physiological responses across intervention phases, participant-specific response patterns, time-of-day effects, and music-preference effects.
RESULTS: The dataset contains 13 intervention sessions, 99 music segments, and 248 behavioral observations. PPG, ACC, TEMP, and behavioral observations were available for all sessions, while EDA quality varied because of sensor-contact challenges. Behavioral responses were highly heterogeneous across participants, with engagement and calm behaviors observed most frequently. Physiological responses also showed substantial inter-individual variability, and case studies demonstrated that physiological and behavioral responses were not always concordant.
CONCLUSION: This study demonstrates the feasibility of collecting synchronized physiological, behavioral, and intervention-context data during MBIs in people living with dementia. The resulting publicly available multimodal dataset provides a foundation for future investigations of participant-specific responses and adaptive music-based interventions.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Peripheral and central inflammation associated with progressive cognitive decline in dementia with Lewy bodies.
Brain communications, 8(4):fcag274.
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, pathologically defined by the presence of Lewy bodies. Peripheral and central inflammation are increasingly recognized in DLB in clinical, post-mortem and animal studies. Finding clinically relevant biomarkers of inflammation in DLB will support the identification of novel pathways for disease-modifying therapies or use in clinical trials of immunomodulatory agents. Whilst there are cross-sectional studies of inflammation markers in DLB, there is limited evidence on the association between these markers and cognitive decline over time. Twenty participants with DLB underwent blood sampling for serum inflammatory markers, paired with PET imaging of the translocator protein (TSPO) and up to 4 years of longitudinal cognitive testing. Thirty participants with Alzheimer's disease-comprising both Alzheimer's dementia and/or mild cognitive impairment with biomarker evidence of amyloid pathology (AD/MCI+)-and 28 controls were also recruited for group comparisons. Data from 42 baseline cytokine immunoassays and TSPO PET were used as predictors of longitudinal cognitive scores in linear mixed-effects models. Partial least squares regression was used to test the association between peripheral and central inflammation. Using peripheral inflammatory markers as single predictors, we identified 14 associated with either a slower or faster rate of cognitive decline in DLB, whilst no single marker was predictive of decline in AD/MCI+. As many inflammatory markers were highly correlated, we used principal component analysis to identify a cytokine component associated with reduced cognitive decline in both DLB and AD/MCI+, that overlapped with the single markers identified in the previous analysis. A separate component was associated with cognitive decline in AD/MCI+ or DLB with Alzheimer's dementia co-pathology (ascertained by amyloid PET). Widespread TSPO binding was associated with reduced cognitive decline in DLB, whilst a fronto-temporal pattern was associated with more rapid cognitive decline in both DLB and AD/MCI+. There were associations between peripheral cytokines and TSPO PET in AD/MCI+, but these were not significant in DLB. Overall, peripheral and central inflammation predicted cognitive decline in DLB. Specific patterns associated with both faster and slower rates of decline were identified. These profiles had both overlapping and contrasting associations when compared to AD/MCI+. Collectively, these data add to a body of evidence suggesting clinically relevant levels of inflammation in DLB. Future studies in larger, multi-site cohorts with multiple biomarker sampling points are required to understand the impact and dynamics of inflammation across all stages of the disease.
Additional Links: PMID-42529064
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@article {pmid42529064,
year = {2026},
author = {Swann, P and Malpetti, M and Chouliaras, L and White, SR and Mak, E and Surendranathan, A and Jones, PS and Su, L and Savulich, G and Kigar, S and McKeever, A and Fryer, T and Hong, YT and Aigbirhio, FI and Rowe, JB and O'Brien, JT},
title = {Peripheral and central inflammation associated with progressive cognitive decline in dementia with Lewy bodies.},
journal = {Brain communications},
volume = {8},
number = {4},
pages = {fcag274},
pmid = {42529064},
issn = {2632-1297},
abstract = {Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, pathologically defined by the presence of Lewy bodies. Peripheral and central inflammation are increasingly recognized in DLB in clinical, post-mortem and animal studies. Finding clinically relevant biomarkers of inflammation in DLB will support the identification of novel pathways for disease-modifying therapies or use in clinical trials of immunomodulatory agents. Whilst there are cross-sectional studies of inflammation markers in DLB, there is limited evidence on the association between these markers and cognitive decline over time. Twenty participants with DLB underwent blood sampling for serum inflammatory markers, paired with PET imaging of the translocator protein (TSPO) and up to 4 years of longitudinal cognitive testing. Thirty participants with Alzheimer's disease-comprising both Alzheimer's dementia and/or mild cognitive impairment with biomarker evidence of amyloid pathology (AD/MCI+)-and 28 controls were also recruited for group comparisons. Data from 42 baseline cytokine immunoassays and TSPO PET were used as predictors of longitudinal cognitive scores in linear mixed-effects models. Partial least squares regression was used to test the association between peripheral and central inflammation. Using peripheral inflammatory markers as single predictors, we identified 14 associated with either a slower or faster rate of cognitive decline in DLB, whilst no single marker was predictive of decline in AD/MCI+. As many inflammatory markers were highly correlated, we used principal component analysis to identify a cytokine component associated with reduced cognitive decline in both DLB and AD/MCI+, that overlapped with the single markers identified in the previous analysis. A separate component was associated with cognitive decline in AD/MCI+ or DLB with Alzheimer's dementia co-pathology (ascertained by amyloid PET). Widespread TSPO binding was associated with reduced cognitive decline in DLB, whilst a fronto-temporal pattern was associated with more rapid cognitive decline in both DLB and AD/MCI+. There were associations between peripheral cytokines and TSPO PET in AD/MCI+, but these were not significant in DLB. Overall, peripheral and central inflammation predicted cognitive decline in DLB. Specific patterns associated with both faster and slower rates of decline were identified. These profiles had both overlapping and contrasting associations when compared to AD/MCI+. Collectively, these data add to a body of evidence suggesting clinically relevant levels of inflammation in DLB. Future studies in larger, multi-site cohorts with multiple biomarker sampling points are required to understand the impact and dynamics of inflammation across all stages of the disease.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Plaque-associated microglial polarization in visual brain regions of the 5xFAD mouse model.
Frontiers in aging neuroscience, 18:1824891.
INTRODUCTION: Alzheimer's disease (AD), a neurodegenerative disorder associated with amyloid beta (Aβ) plaque deposition, leads to cognitive decline in affected individuals. Vision changes are among the reported symptoms in AD with studies showing both decline in functions performed by the visual system as well as associations between vision loss and cognitive impairment in AD patients. Due to the increasing number of individuals diagnosed with AD and its early impact on vision, we sought to provide an in-depth analysis of how Aβ, a primary pathology typically preceding many other AD-associated pathologies, affects visual regions of the brain and how microglia, key immune regulators of the brain's environment, respond to this AD-like pathology.
METHODS: Amyloid pathology was examined in histological sections containing the dorsolateral geniculate nucleus (dLGN), and the primary visual cortex (V1), suprachiasmatic nucleus (SCN), and superior colliculus (SC) of 5xFAD mice using thioflavin-S and anti-amyloid staining. Microglia morphology was analyzed in Iba1 antibody-stained sections and phagocytic activity was evaluated with CD68 co-staining.
RESULTS: We found that in the pathway for image-forming vision, including the dLGN and V1, there was significant Aβ pathology, shifts in microglial morphology to an amoeboid state, localization of microglia around plaques, and increased Iba1/CD68 co-labeling. However, in non-image-forming visual brain regions such as the SC and SCN, there was minimal Aβ pathology, ramified microglial morphology, and minimal phagocytic activity.
CONCLUSION: Overall, Aβ plaque deposition was related to brain-region-specific differences in microglial responses, indicating that visual brain regions are differentially affected by AD pathology in the 5xFAD mouse model of amyloidosis.
Additional Links: PMID-42529168
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@article {pmid42529168,
year = {2026},
author = {McCool, S and Jain, A and Smith, JC and Van Hook, MJ},
title = {Plaque-associated microglial polarization in visual brain regions of the 5xFAD mouse model.},
journal = {Frontiers in aging neuroscience},
volume = {18},
number = {},
pages = {1824891},
pmid = {42529168},
issn = {1663-4365},
abstract = {INTRODUCTION: Alzheimer's disease (AD), a neurodegenerative disorder associated with amyloid beta (Aβ) plaque deposition, leads to cognitive decline in affected individuals. Vision changes are among the reported symptoms in AD with studies showing both decline in functions performed by the visual system as well as associations between vision loss and cognitive impairment in AD patients. Due to the increasing number of individuals diagnosed with AD and its early impact on vision, we sought to provide an in-depth analysis of how Aβ, a primary pathology typically preceding many other AD-associated pathologies, affects visual regions of the brain and how microglia, key immune regulators of the brain's environment, respond to this AD-like pathology.
METHODS: Amyloid pathology was examined in histological sections containing the dorsolateral geniculate nucleus (dLGN), and the primary visual cortex (V1), suprachiasmatic nucleus (SCN), and superior colliculus (SC) of 5xFAD mice using thioflavin-S and anti-amyloid staining. Microglia morphology was analyzed in Iba1 antibody-stained sections and phagocytic activity was evaluated with CD68 co-staining.
RESULTS: We found that in the pathway for image-forming vision, including the dLGN and V1, there was significant Aβ pathology, shifts in microglial morphology to an amoeboid state, localization of microglia around plaques, and increased Iba1/CD68 co-labeling. However, in non-image-forming visual brain regions such as the SC and SCN, there was minimal Aβ pathology, ramified microglial morphology, and minimal phagocytic activity.
CONCLUSION: Overall, Aβ plaque deposition was related to brain-region-specific differences in microglial responses, indicating that visual brain regions are differentially affected by AD pathology in the 5xFAD mouse model of amyloidosis.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Blood transcriptomic signatures link β-amyloid deposition to molecular pathways across SCD, MCI, and dementia.
Frontiers in aging neuroscience, 18:1816733.
INTRODUCTION: Brain β-amyloid (Aβ) accumulation is a hallmark of Alzheimer's disease, but noninvasive detection remains challenging. Blood transcriptomics may provide accessible biomarkers associated with Aβ pathology.
METHODS: We integrated peripheral blood transcriptomic profiling and MRI-derived structural metrics from 48 individuals across the cognitive continuum, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, stratified by Aβ-PET status. Predictive models were constructed using leave-one-out cross-validation (LOOCV), and selected genes were validated by qRT-PCR.
RESULTS: Cross-stage analysis identified RUNX1T1 and COL14A1 as consistently downregulated in Aβ-positive individuals regardless of clinical stage. A predictive model incorporating these two genes demonstrated moderate discrimination of Aβ-PET status in internal leave-one-out cross-validation (LOOCV) evaluation (AUC = 0.81). In addition, COL14A1 expression was associated with cortical thickness and hippocampal volume, whereas RUNX1T1 was primarily associated with hippocampal structure. Among individuals with MCI or dementia, HCN1 and NRG3 were upregulated, whereas KCNMB2 was downregulated in Aβ-positive subjects. A three-gene model based on these markers achieved an LOOCV AUC of 0.79.
DISCUSSION: These findings indicate that peripheral blood transcriptomic alterations are associated with Aβ pathology across clinical groups. RUNX1T1 and COL14A1 represent candidate peripheral biomarkers associated with Aβ pathology, while the observed molecular signatures and their associations with brain structural measures provide a basis for further validation in larger, longitudinal cohorts and mechanistic studies.
Additional Links: PMID-42529199
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@article {pmid42529199,
year = {2026},
author = {Lin, Y and Cheng, L and Zhang, Z and Cui, L and Li, W and Guo, Q and Miao, Y},
title = {Blood transcriptomic signatures link β-amyloid deposition to molecular pathways across SCD, MCI, and dementia.},
journal = {Frontiers in aging neuroscience},
volume = {18},
number = {},
pages = {1816733},
pmid = {42529199},
issn = {1663-4365},
abstract = {INTRODUCTION: Brain β-amyloid (Aβ) accumulation is a hallmark of Alzheimer's disease, but noninvasive detection remains challenging. Blood transcriptomics may provide accessible biomarkers associated with Aβ pathology.
METHODS: We integrated peripheral blood transcriptomic profiling and MRI-derived structural metrics from 48 individuals across the cognitive continuum, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, stratified by Aβ-PET status. Predictive models were constructed using leave-one-out cross-validation (LOOCV), and selected genes were validated by qRT-PCR.
RESULTS: Cross-stage analysis identified RUNX1T1 and COL14A1 as consistently downregulated in Aβ-positive individuals regardless of clinical stage. A predictive model incorporating these two genes demonstrated moderate discrimination of Aβ-PET status in internal leave-one-out cross-validation (LOOCV) evaluation (AUC = 0.81). In addition, COL14A1 expression was associated with cortical thickness and hippocampal volume, whereas RUNX1T1 was primarily associated with hippocampal structure. Among individuals with MCI or dementia, HCN1 and NRG3 were upregulated, whereas KCNMB2 was downregulated in Aβ-positive subjects. A three-gene model based on these markers achieved an LOOCV AUC of 0.79.
DISCUSSION: These findings indicate that peripheral blood transcriptomic alterations are associated with Aβ pathology across clinical groups. RUNX1T1 and COL14A1 represent candidate peripheral biomarkers associated with Aβ pathology, while the observed molecular signatures and their associations with brain structural measures provide a basis for further validation in larger, longitudinal cohorts and mechanistic studies.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Spatially Resolved Free Fatty Acid Profiling Reveals Region- and Age-Dependent Remodeling of Alzheimer's Disease Plaques.
JACS Au, 6(7):4153-4165.
Free fatty acids (FFAs) are bioactive mediators of inflammation, energy metabolism, and membrane remodeling, yet their spatial organization within the Alzheimer's disease (AD) brain and at individual amyloid-β (Aβ) plaques has remained inaccessible. We developed a novel, chemically tailored MALDI workflow that enables simultaneous, spatially resolved detection of nearly 30 FFAs alongside over 100 complex lipid species within the same tissue section. Applying this approach to a transgenic AD mouse model across brain regions and disease stages, and combining it with single-plaque microenvironment analysis (SPMA) that treats each plaque as an individual analytical object, we uncover two previously inaccessible dimensions of plaque-associated lipid biology. FFA distributions form highly structured spatial compartments reflecting regional cytoarchitecture, with distinct enrichment of saturated, monounsaturated, and polyunsaturated species across cortical layers. Within Aβ plaques, nearly 75% of detected FFAs are significantly remodeled, with reciprocal enrichment of short saturated and highly unsaturated species alongside depletion of long-chain monounsaturated FFAs. This pattern is consistent with concurrent disruption of ELOVL-mediated elongation and FADS-mediated desaturation, including opposing enrichment of pro-inflammatory arachidonic acid and pro-resolving docosahexaenoic acid. Machine learning of single-plaque profiles reveals that FFA composition alone classifies plaque age with high accuracy, demonstrating that lipid remodeling continues after Aβ peptide composition has stabilized. Together, these findings establish spatial FFA profiling as a new analytical dimension in neurodegeneration research, revealing that Aβ plaques are dynamic lipid-metabolic microenvironments that continue to remodel long after Aβ deposition has stabilized.
Additional Links: PMID-42529446
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@article {pmid42529446,
year = {2026},
author = {Hakhverdyan, S and Hansson, S and Kadej, P and Orlovsky, SB and Hladkou, S and Viirman, B and Nilsson, A and Lord, M and Cologna, SM and Mohr, JT and Syvänen, S and Andrén, PE and Michno, W},
title = {Spatially Resolved Free Fatty Acid Profiling Reveals Region- and Age-Dependent Remodeling of Alzheimer's Disease Plaques.},
journal = {JACS Au},
volume = {6},
number = {7},
pages = {4153-4165},
pmid = {42529446},
issn = {2691-3704},
abstract = {Free fatty acids (FFAs) are bioactive mediators of inflammation, energy metabolism, and membrane remodeling, yet their spatial organization within the Alzheimer's disease (AD) brain and at individual amyloid-β (Aβ) plaques has remained inaccessible. We developed a novel, chemically tailored MALDI workflow that enables simultaneous, spatially resolved detection of nearly 30 FFAs alongside over 100 complex lipid species within the same tissue section. Applying this approach to a transgenic AD mouse model across brain regions and disease stages, and combining it with single-plaque microenvironment analysis (SPMA) that treats each plaque as an individual analytical object, we uncover two previously inaccessible dimensions of plaque-associated lipid biology. FFA distributions form highly structured spatial compartments reflecting regional cytoarchitecture, with distinct enrichment of saturated, monounsaturated, and polyunsaturated species across cortical layers. Within Aβ plaques, nearly 75% of detected FFAs are significantly remodeled, with reciprocal enrichment of short saturated and highly unsaturated species alongside depletion of long-chain monounsaturated FFAs. This pattern is consistent with concurrent disruption of ELOVL-mediated elongation and FADS-mediated desaturation, including opposing enrichment of pro-inflammatory arachidonic acid and pro-resolving docosahexaenoic acid. Machine learning of single-plaque profiles reveals that FFA composition alone classifies plaque age with high accuracy, demonstrating that lipid remodeling continues after Aβ peptide composition has stabilized. Together, these findings establish spatial FFA profiling as a new analytical dimension in neurodegeneration research, revealing that Aβ plaques are dynamic lipid-metabolic microenvironments that continue to remodel long after Aβ deposition has stabilized.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
APLG-Net: an anatomy-guided local-global hybrid network with progression-aware supervision for structural MRI-based NC/MCI/AD classification.
Frontiers in neurology, 17:1885491.
INTRODUCTION: Structural MRI-based Alzheimer's disease classification remains challenging due to subtle anatomical variations and the intermediate nature of mild cognitive impairment (MCI).
METHODS: We propose APLG-Net, an anatomy-guided local-global hybrid network with progression-aware supervision for NC/MCI/AD classification. The model integrates a global whole-brain encoder and a local ROI-based encoder, followed by cross-attention fusion and vector-gated integration. An ordinal supervision strategy is introduced to model disease progression.
RESULTS: On the ADNI dataset, APLG-Net achieves 87.1% accuracy, 86.4% balanced accuracy, 86.8% Macro-F1, and 85.6% MCI F1, outperforming CNN-based, Transformer-based, and hybrid baselines.
DISCUSSION: The results demonstrate that incorporating anatomical priors, local-global feature interaction, and ordinal supervision significantly improves MCI discrimination and overall classification robustness.
Additional Links: PMID-42529466
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@article {pmid42529466,
year = {2026},
author = {Shi, B and Wang, Z and Lian, J and Yang, Z and Zuo, X},
title = {APLG-Net: an anatomy-guided local-global hybrid network with progression-aware supervision for structural MRI-based NC/MCI/AD classification.},
journal = {Frontiers in neurology},
volume = {17},
number = {},
pages = {1885491},
pmid = {42529466},
issn = {1664-2295},
abstract = {INTRODUCTION: Structural MRI-based Alzheimer's disease classification remains challenging due to subtle anatomical variations and the intermediate nature of mild cognitive impairment (MCI).
METHODS: We propose APLG-Net, an anatomy-guided local-global hybrid network with progression-aware supervision for NC/MCI/AD classification. The model integrates a global whole-brain encoder and a local ROI-based encoder, followed by cross-attention fusion and vector-gated integration. An ordinal supervision strategy is introduced to model disease progression.
RESULTS: On the ADNI dataset, APLG-Net achieves 87.1% accuracy, 86.4% balanced accuracy, 86.8% Macro-F1, and 85.6% MCI F1, outperforming CNN-based, Transformer-based, and hybrid baselines.
DISCUSSION: The results demonstrate that incorporating anatomical priors, local-global feature interaction, and ordinal supervision significantly improves MCI discrimination and overall classification robustness.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Antiamyloid Antibody Effects on Aβ-42 Protein Aggregates Profiled Using Nanospectroscopy.
Chemical & biomedical imaging, 4(7):1379-1389.
Anti-amyloid-β (Aβ) monoclonal antibodies are designed to selectively target protein biomarkers and promote amyloid clearance in Alzheimer's disease. Yet the effects of antibodies on individual Aβ protein aggregates remain to be fully clarified. The work presented here employs nanospectroscopy (atomic force microscopy combined with infrared spectroscopy) to resolve morphological and secondary structural changes in Aβ-42 protein aggregates upon treatment with aducanumab and lecanemab antibodies (biosimilars). The treatment of Aβ-42 peptides with aducanumab resulted in reduction of oligomer prevalence and formation of larger-diameter fibril bundles confirmed from the AFM height maps and infrared spectral readouts recorded at nanometer-scale spatial resolution. Conversely, lecanemab treatment of Aβ-42 peptides did not suppress oligomer generation but was observed to preferentially bind along the full length of the nodular-shaped protofibril surface. Importantly, neither aducanumab nor lecanemab was observed to induce any surface adsorption-driven disassembly of Aβ-42 protofibrils or elongated mature fibrils. Thus, nanospectroscopy enables direct characterization of antibody-amyloid interfacial interactions and provides insights into the distinct modes of action of emerging anti-Aβ therapeutics through label-free chemical imaging.
Additional Links: PMID-42529533
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@article {pmid42529533,
year = {2026},
author = {Kummer, N and Cihova, M and Nirmalraj, PN},
title = {Antiamyloid Antibody Effects on Aβ-42 Protein Aggregates Profiled Using Nanospectroscopy.},
journal = {Chemical & biomedical imaging},
volume = {4},
number = {7},
pages = {1379-1389},
pmid = {42529533},
issn = {2832-3637},
abstract = {Anti-amyloid-β (Aβ) monoclonal antibodies are designed to selectively target protein biomarkers and promote amyloid clearance in Alzheimer's disease. Yet the effects of antibodies on individual Aβ protein aggregates remain to be fully clarified. The work presented here employs nanospectroscopy (atomic force microscopy combined with infrared spectroscopy) to resolve morphological and secondary structural changes in Aβ-42 protein aggregates upon treatment with aducanumab and lecanemab antibodies (biosimilars). The treatment of Aβ-42 peptides with aducanumab resulted in reduction of oligomer prevalence and formation of larger-diameter fibril bundles confirmed from the AFM height maps and infrared spectral readouts recorded at nanometer-scale spatial resolution. Conversely, lecanemab treatment of Aβ-42 peptides did not suppress oligomer generation but was observed to preferentially bind along the full length of the nodular-shaped protofibril surface. Importantly, neither aducanumab nor lecanemab was observed to induce any surface adsorption-driven disassembly of Aβ-42 protofibrils or elongated mature fibrils. Thus, nanospectroscopy enables direct characterization of antibody-amyloid interfacial interactions and provides insights into the distinct modes of action of emerging anti-Aβ therapeutics through label-free chemical imaging.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Trauma-Informed Support in a Dementia Helpline: Retrospective Mixed Methods Study.
JMIR formative research, 10:e71746 pii:v10i1e71746.
BACKGROUND: People with dementia and their caregivers experience significant psychological distress, which may increase their vulnerability to trauma across the dementia diagnostic and caregiving trajectory. Specialist dementia helplines offer immediate emotional support, information, and signposting; however, little empirical evidence exists about how call handlers account for potential trauma in their responses.
OBJECTIVE: This study aimed to examine the extent to which call handlers' responses on the United Kingdom's only 24-hour dementia helpline reflected trauma-informed (TI) principles of safety, trust, choice, collaboration, and empowerment and to describe caller characteristics and reasons for contact during the COVID-19 pandemic.
METHODS: No participants were actively recruited. Instead, the study analyzed 198 anonymized, routinely collected helpline call logs (out of 200 randomly selected) drawn from 7357 calls received by Alzheimer Scotland's 24-hour helpline between April 2020 and April 2021. A retrospective deductive framework analysis mapped narrative summaries to 5 TI principles (safety, trustworthiness and transparency, choice, collaboration, and empowerment). Double‑coding and calibration were undertaken in line with established guidance on intercoder reliability for qualitative research. Descriptive statistics summarized caller characteristics and theme frequencies; no inferential testing was conducted due to the exploratory nature of the analysis, sample properties, and the subjective nature of theme ratings.
RESULTS: Most calls were made during daytime hours (159/198, 79.5%) and were made by carers, family members, or friends (n=179, 89.5%). Emotional support was the most frequently recorded reason for contact (91 instances), followed by carer stress (66 instances) and information on caring (51 instances). Across call handlers' responses, collaboration (126/179, 70.4%) and empowerment (108/179, 60.3%) were the most frequently observed TI principles, followed by safety (105/179, 58.7%), choice (66/179, 37.4%), and trust (56/179, 31.3%). Safety-focused responses were more prevalent in nighttime calls than daytime calls (76.9% vs 56%). Illustrative call log excerpts demonstrated empathetic listening, validation, shared problem-solving, and signposting practices aligned with TI principles.
CONCLUSIONS: In this exploratory retrospective evaluation, responses from a national dementia helpline commonly reflected TI principles, despite call handlers receiving primarily awareness-level TI content within their wider role preparation. Findings should be interpreted as descriptive and hypothesis-generating because they are based on call log summaries rather than recorded interactions and were obtained within the unique context of the COVID-19 pandemic. The results suggest that TI principles may be feasible and relevant in dementia helpline services and highlight the potential value of more structured approaches to TI workforce development. Future prospective research incorporating richer data sources such as recorded calls and call-reported outcomes is warranted to support service development and evaluation.
Additional Links: PMID-42529812
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PubMed:
Citation:
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@article {pmid42529812,
year = {2026},
author = {Harkess-Murphy, E and Macrae, R and Brown, M and Hall, J},
title = {Trauma-Informed Support in a Dementia Helpline: Retrospective Mixed Methods Study.},
journal = {JMIR formative research},
volume = {10},
number = {},
pages = {e71746},
doi = {10.2196/71746},
pmid = {42529812},
issn = {2561-326X},
mesh = {Humans ; *Dementia/psychology ; Retrospective Studies ; *Hotlines/statistics & numerical data ; *Caregivers/psychology ; Male ; Female ; *COVID-19/psychology/epidemiology ; United Kingdom ; Qualitative Research ; Aged ; },
abstract = {BACKGROUND: People with dementia and their caregivers experience significant psychological distress, which may increase their vulnerability to trauma across the dementia diagnostic and caregiving trajectory. Specialist dementia helplines offer immediate emotional support, information, and signposting; however, little empirical evidence exists about how call handlers account for potential trauma in their responses.
OBJECTIVE: This study aimed to examine the extent to which call handlers' responses on the United Kingdom's only 24-hour dementia helpline reflected trauma-informed (TI) principles of safety, trust, choice, collaboration, and empowerment and to describe caller characteristics and reasons for contact during the COVID-19 pandemic.
METHODS: No participants were actively recruited. Instead, the study analyzed 198 anonymized, routinely collected helpline call logs (out of 200 randomly selected) drawn from 7357 calls received by Alzheimer Scotland's 24-hour helpline between April 2020 and April 2021. A retrospective deductive framework analysis mapped narrative summaries to 5 TI principles (safety, trustworthiness and transparency, choice, collaboration, and empowerment). Double‑coding and calibration were undertaken in line with established guidance on intercoder reliability for qualitative research. Descriptive statistics summarized caller characteristics and theme frequencies; no inferential testing was conducted due to the exploratory nature of the analysis, sample properties, and the subjective nature of theme ratings.
RESULTS: Most calls were made during daytime hours (159/198, 79.5%) and were made by carers, family members, or friends (n=179, 89.5%). Emotional support was the most frequently recorded reason for contact (91 instances), followed by carer stress (66 instances) and information on caring (51 instances). Across call handlers' responses, collaboration (126/179, 70.4%) and empowerment (108/179, 60.3%) were the most frequently observed TI principles, followed by safety (105/179, 58.7%), choice (66/179, 37.4%), and trust (56/179, 31.3%). Safety-focused responses were more prevalent in nighttime calls than daytime calls (76.9% vs 56%). Illustrative call log excerpts demonstrated empathetic listening, validation, shared problem-solving, and signposting practices aligned with TI principles.
CONCLUSIONS: In this exploratory retrospective evaluation, responses from a national dementia helpline commonly reflected TI principles, despite call handlers receiving primarily awareness-level TI content within their wider role preparation. Findings should be interpreted as descriptive and hypothesis-generating because they are based on call log summaries rather than recorded interactions and were obtained within the unique context of the COVID-19 pandemic. The results suggest that TI principles may be feasible and relevant in dementia helpline services and highlight the potential value of more structured approaches to TI workforce development. Future prospective research incorporating richer data sources such as recorded calls and call-reported outcomes is warranted to support service development and evaluation.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Dementia/psychology
Retrospective Studies
*Hotlines/statistics & numerical data
*Caregivers/psychology
Male
Female
*COVID-19/psychology/epidemiology
United Kingdom
Qualitative Research
Aged
RevDate: 2026-07-30
CmpDate: 2026-07-30
Advances in biomarkers for Parkinson's disease: from molecular pathology to precision diagnostics.
Journal of Zhejiang University. Science. B, 27(7):736-760.
Parkinson's disease (PD) is the second most common neurodegenerative disorder, and continues to present significant challenges in early diagnosis, precise subtyping, and prognosis assessment. In recent years, the field of biomarker research has undergone a profound paradigm shift from static concentration measurements to functional activity detection. The most revolutionary breakthrough is the α-synuclein seed amplification assay (α-Syn-SAA), which enables ultrasensitive and specific detection of pathological α-Syn in both clinical and prodromal stages, thus providing an unprecedented window for early intervention. Substantial progress has also been made in the development of biomarkers such as neurofilament light chain (NfL), Alzheimer's disease-related biomarkers, and genetic biomarkers, as well as in detection technologies based on peripheral samples. The integrated application of cutting-edge technologies, such as real-time quaking-induced conversion (RT-QuIC), high-resolution mass spectrometry, and high-field magnetic resonance imaging (MRI), is advancing the field into a new stage characterized by a focus on pathological activity, multi-omics integration, and non- or minimally invasive approaches. In this review, we explore recent advances in PD biomarkers, focusing on core pathophysiological markers. We examine the potential of multi-omics and artificial intelligence (AI) to enhance diagnostic, subtyping, and prognostic accuracy, while also outlining the pivotal role and future directions of biomarkers in advancing precision medicine for PD.
Additional Links: PMID-42529883
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@article {pmid42529883,
year = {2026},
author = {Li, X and Chen, H and Wang, X and Hu, Y and Yang, Z and Wei, M},
title = {Advances in biomarkers for Parkinson's disease: from molecular pathology to precision diagnostics.},
journal = {Journal of Zhejiang University. Science. B},
volume = {27},
number = {7},
pages = {736-760},
pmid = {42529883},
issn = {1862-1783},
support = {82101513//the National Basic Research Program of China/ ; 2019-ZD-0943//the Natural Science Foundation of Liaoning Province/ ; },
mesh = {Humans ; *Parkinson Disease/diagnosis/pathology/genetics ; *Biomarkers/analysis ; alpha-Synuclein ; *Precision Medicine ; Pathology, Molecular ; },
abstract = {Parkinson's disease (PD) is the second most common neurodegenerative disorder, and continues to present significant challenges in early diagnosis, precise subtyping, and prognosis assessment. In recent years, the field of biomarker research has undergone a profound paradigm shift from static concentration measurements to functional activity detection. The most revolutionary breakthrough is the α-synuclein seed amplification assay (α-Syn-SAA), which enables ultrasensitive and specific detection of pathological α-Syn in both clinical and prodromal stages, thus providing an unprecedented window for early intervention. Substantial progress has also been made in the development of biomarkers such as neurofilament light chain (NfL), Alzheimer's disease-related biomarkers, and genetic biomarkers, as well as in detection technologies based on peripheral samples. The integrated application of cutting-edge technologies, such as real-time quaking-induced conversion (RT-QuIC), high-resolution mass spectrometry, and high-field magnetic resonance imaging (MRI), is advancing the field into a new stage characterized by a focus on pathological activity, multi-omics integration, and non- or minimally invasive approaches. In this review, we explore recent advances in PD biomarkers, focusing on core pathophysiological markers. We examine the potential of multi-omics and artificial intelligence (AI) to enhance diagnostic, subtyping, and prognostic accuracy, while also outlining the pivotal role and future directions of biomarkers in advancing precision medicine for PD.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Parkinson Disease/diagnosis/pathology/genetics
*Biomarkers/analysis
alpha-Synuclein
*Precision Medicine
Pathology, Molecular
RevDate: 2026-07-30
Alzheimer disease in the computational era: from a deterministic disease to a multifaceted disorder.
Brain : a journal of neurology pii:8747345 [Epub ahead of print].
The definition of Alzheimer disease (AD) keeps changing over the years, which is critical for studying it, understanding it, and developing treatments. Here we first review the different definitions proposed for AD from its original characterization by Kraepelin in 1908, to the recent Alzheimer's Association revised criteria in 2024. We describe these definitions in parallel to the new knowledge gained, demonstrating how they vacillate between restricted and circumscribed clinicopathological characterizations and wider clinical and pathological ones. Then, we describe AD multifaceted clinical presentations, including very early subtle cognitive and behavioural changes, alongside its pathological multifactorial variability of core-pathologies, co-pathologies and risk factors, encompassing changes in various cortical and subcortical brain regions, and its genetic complex landscape. We suggest that all potential factors among the different levels should be considered to provide a patient-tailored clinical profile. To address the richness and complexity of the data, we outline a metamodeling-based computational framework that allows diverse sources of evidence to be integrated without forcing them into a single monolithic model. Specifically, different data subsets are first used to construct partial models, each addressing selected domains and factors; these models are then converted into probabilistic surrogate models with shared variables and parameters; finally, the latent variables inferred from the surrogate models are related via a probabilistic coupling layer to create predictions of individual patients' trajectories and intervention effects, staging, clinical stratification and attribution maps. Taken together, the computational and data revolutions may enable us to expose the complexity of AD through large-scale patients' data, computational metamodeling, and hypothesis-free analyses, leading to reconceptualization of AD from a monolithic diagnostic category into a stratified, mechanistically interpretable nosology, with practical implications at the individual patient level.
Additional Links: PMID-42530031
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PubMed:
Citation:
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@article {pmid42530031,
year = {2026},
author = {Benbaji, M and Raveh, B and Bassal, L and Elias, U and Gazit, L and Allali, G and Marshall, GA and Arzy, S},
title = {Alzheimer disease in the computational era: from a deterministic disease to a multifaceted disorder.},
journal = {Brain : a journal of neurology},
volume = {},
number = {},
pages = {},
doi = {10.1093/brain/awag248},
pmid = {42530031},
issn = {1460-2156},
abstract = {The definition of Alzheimer disease (AD) keeps changing over the years, which is critical for studying it, understanding it, and developing treatments. Here we first review the different definitions proposed for AD from its original characterization by Kraepelin in 1908, to the recent Alzheimer's Association revised criteria in 2024. We describe these definitions in parallel to the new knowledge gained, demonstrating how they vacillate between restricted and circumscribed clinicopathological characterizations and wider clinical and pathological ones. Then, we describe AD multifaceted clinical presentations, including very early subtle cognitive and behavioural changes, alongside its pathological multifactorial variability of core-pathologies, co-pathologies and risk factors, encompassing changes in various cortical and subcortical brain regions, and its genetic complex landscape. We suggest that all potential factors among the different levels should be considered to provide a patient-tailored clinical profile. To address the richness and complexity of the data, we outline a metamodeling-based computational framework that allows diverse sources of evidence to be integrated without forcing them into a single monolithic model. Specifically, different data subsets are first used to construct partial models, each addressing selected domains and factors; these models are then converted into probabilistic surrogate models with shared variables and parameters; finally, the latent variables inferred from the surrogate models are related via a probabilistic coupling layer to create predictions of individual patients' trajectories and intervention effects, staging, clinical stratification and attribution maps. Taken together, the computational and data revolutions may enable us to expose the complexity of AD through large-scale patients' data, computational metamodeling, and hypothesis-free analyses, leading to reconceptualization of AD from a monolithic diagnostic category into a stratified, mechanistically interpretable nosology, with practical implications at the individual patient level.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Anticholinergic Burden and Cognitive Function, Depressive Symptoms, and Functional Performance in Individuals With Neurocognitive Disorders: Real-World Evidence.
Journal of integrative neuroscience, 25(7):51135.
BACKGROUND: Despite their negative effects on cognitive function and cognitive decline risk, drugs with anticholinergic properties are commonly prescribed, particularly in older individuals. In this observational study we aimed to shed light on the relationships between anticholinergic burden (ACB) and depressive symptoms and cognitive and functional performance in a real-world clinical setting.
METHODS: The study included individuals seeking care at the old-age psychiatry outpatient clinic of Patras University Mental Health Services. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale; cognitive function was tapped using the Cognitive Telephone Screening Instrument, the Montreal Cognitive Assessment, and the Mini-Mental State Examination; and functional performance was assessed using the Bristol Activities of Daily Living Scale. Differences in demographic and clinical variables across the four diagnostic groups were analyzed. Regression analyses were performed to examine the associations between ACB, cognitive and non-cognitive symptoms, and demographic variables. In addition, clustering analyses were conducted to identify distinct, naturally occurring examinee subgroups and to assess if ACB differed across them.
RESULTS: The study sample consisted of individuals without cognitive impairment (N = 301), people with mild neurocognitive disorder (MiND, N = 264), major neurocognitive disorder caused by Alzheimer's disease (ADMaND, N = 114), or other diseases (nonADMaND, N = 63). Significant associations were detected between ACB and depressive symptoms (0.72, p < 0.001), short-term memory (-0.11, p = 0.017), long-term memory (-0.24, p < 0.001), working memory (-0.24, p = 0.001), attention/concentration (-0.13, p = 0.004), verbal fluency (-0.57, p = 0.003), inductive reasoning (-0.17, p = 0.002), basic activities of daily living (0.29, p = 0.001), and instrumental activities of daily living (0.58, p < 0.001). The clustering analyses indicated that in the cluster including individuals with more advanced cognitive decline, poorer functional status, and more severe depressive symptoms, ACB was higher compared with the second group identified by the analyses (p < 0.001).
CONCLUSIONS: ACB is related to different aspects of the clinical phenotype of cognitive decline. Despite the lack of solid evidence regarding causal relationships and need for further research, minimizing ACB in clinical settings may embody a potential pragmatic strategy in managing cognitive decline in ageing.
Additional Links: PMID-42530037
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PubMed:
Citation:
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@article {pmid42530037,
year = {2026},
author = {Skondra, M and Papadopoulos, L and Kougioumtzoglou, T and Kandilakis, CL and Konidari, E and Papalexiou, V and Marouli, I and Malagkoniari, LM and Kostakiotis, A and Veskoukis, T and Peritogiannis, V and Economou, P and Felemegkas, P and Alexopoulos, P},
title = {Anticholinergic Burden and Cognitive Function, Depressive Symptoms, and Functional Performance in Individuals With Neurocognitive Disorders: Real-World Evidence.},
journal = {Journal of integrative neuroscience},
volume = {25},
number = {7},
pages = {51135},
doi = {10.31083/JIN51135},
pmid = {42530037},
issn = {0219-6352},
mesh = {Humans ; Female ; Male ; Aged ; *Depression/chemically induced/physiopathology ; Aged, 80 and over ; *Activities of Daily Living ; *Cholinergic Antagonists/adverse effects ; *Neurocognitive Disorders/physiopathology ; *Cognition/drug effects ; *Cognitive Dysfunction/physiopathology/chemically induced ; *Functional Status ; },
abstract = {BACKGROUND: Despite their negative effects on cognitive function and cognitive decline risk, drugs with anticholinergic properties are commonly prescribed, particularly in older individuals. In this observational study we aimed to shed light on the relationships between anticholinergic burden (ACB) and depressive symptoms and cognitive and functional performance in a real-world clinical setting.
METHODS: The study included individuals seeking care at the old-age psychiatry outpatient clinic of Patras University Mental Health Services. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale; cognitive function was tapped using the Cognitive Telephone Screening Instrument, the Montreal Cognitive Assessment, and the Mini-Mental State Examination; and functional performance was assessed using the Bristol Activities of Daily Living Scale. Differences in demographic and clinical variables across the four diagnostic groups were analyzed. Regression analyses were performed to examine the associations between ACB, cognitive and non-cognitive symptoms, and demographic variables. In addition, clustering analyses were conducted to identify distinct, naturally occurring examinee subgroups and to assess if ACB differed across them.
RESULTS: The study sample consisted of individuals without cognitive impairment (N = 301), people with mild neurocognitive disorder (MiND, N = 264), major neurocognitive disorder caused by Alzheimer's disease (ADMaND, N = 114), or other diseases (nonADMaND, N = 63). Significant associations were detected between ACB and depressive symptoms (0.72, p < 0.001), short-term memory (-0.11, p = 0.017), long-term memory (-0.24, p < 0.001), working memory (-0.24, p = 0.001), attention/concentration (-0.13, p = 0.004), verbal fluency (-0.57, p = 0.003), inductive reasoning (-0.17, p = 0.002), basic activities of daily living (0.29, p = 0.001), and instrumental activities of daily living (0.58, p < 0.001). The clustering analyses indicated that in the cluster including individuals with more advanced cognitive decline, poorer functional status, and more severe depressive symptoms, ACB was higher compared with the second group identified by the analyses (p < 0.001).
CONCLUSIONS: ACB is related to different aspects of the clinical phenotype of cognitive decline. Despite the lack of solid evidence regarding causal relationships and need for further research, minimizing ACB in clinical settings may embody a potential pragmatic strategy in managing cognitive decline in ageing.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
Female
Male
Aged
*Depression/chemically induced/physiopathology
Aged, 80 and over
*Activities of Daily Living
*Cholinergic Antagonists/adverse effects
*Neurocognitive Disorders/physiopathology
*Cognition/drug effects
*Cognitive Dysfunction/physiopathology/chemically induced
*Functional Status
RevDate: 2026-07-30
CmpDate: 2026-07-30
Sevoflurane and Aβ1-42 Oligomers Synergistically Induce Morphological Changes of Astrocytes in the Hippocampus of Male Mice.
Journal of integrative neuroscience, 25(7):50442.
BACKGROUND: Reactive gliosis serves as a characteristic feature of the pathophysiology of Alzheimer's disease (AD). Nevertheless, the influence of anesthetics on the morphological dynamics of astrocytes remains ambiguous.
METHODS: Employing ex vivo hippocampal slices, in this study, we explored the impacts of sevoflurane and Amyloid-β peptide 1-42 (Aβ1-42) oligomers on astrocytic morphology. The primary outcomes encompassed the fluorescence intensity of glial fibrillary acidic protein (GFAP), the levels of a 38-kDa GFAP breakdown product (a marker of astroglial injury), and quantitative morphometric analyses (cell volume, surface area, branch complexity, and Sholl intersections).
RESULTS: Co-exposure to sevoflurane and Aβ1-42 led to an elevation of the 38-kDa GFAP breakdown product and a significant reduction in the mean fluorescence intensity of GFAP. Moreover, it resulted in a decrease in astrocytic volume, surface area, branch complexity, and Sholl intersections. These synergistic alterations were not observed when either treatment was administered alone.
CONCLUSIONS: These findings imply that sevoflurane aggravates Aβ1-42-induced astrocytic dysfunction, which has implications for perioperative management in patients with AD or those at risk of developing AD.
Additional Links: PMID-42530040
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PubMed:
Citation:
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@article {pmid42530040,
year = {2026},
author = {Shi, Q and Pradhan, AK and Dong, S and Rammes, G and Wang, X},
title = {Sevoflurane and Aβ1-42 Oligomers Synergistically Induce Morphological Changes of Astrocytes in the Hippocampus of Male Mice.},
journal = {Journal of integrative neuroscience},
volume = {25},
number = {7},
pages = {50442},
doi = {10.31083/JIN50442},
pmid = {42530040},
issn = {0219-6352},
support = {2024MZFS003//Open Fund Program of the Key Laboratory of Anesthesiology and Resuscitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China/ ; },
mesh = {Animals ; *Amyloid beta-Peptides/pharmacology ; *Sevoflurane/pharmacology ; *Peptide Fragments/pharmacology/administration & dosage ; *Astrocytes/drug effects/pathology/metabolism ; Male ; *Hippocampus/drug effects/pathology/metabolism ; Glial Fibrillary Acidic Protein/metabolism/drug effects ; *Anesthetics, Inhalation/pharmacology/administration & dosage ; Mice ; },
abstract = {BACKGROUND: Reactive gliosis serves as a characteristic feature of the pathophysiology of Alzheimer's disease (AD). Nevertheless, the influence of anesthetics on the morphological dynamics of astrocytes remains ambiguous.
METHODS: Employing ex vivo hippocampal slices, in this study, we explored the impacts of sevoflurane and Amyloid-β peptide 1-42 (Aβ1-42) oligomers on astrocytic morphology. The primary outcomes encompassed the fluorescence intensity of glial fibrillary acidic protein (GFAP), the levels of a 38-kDa GFAP breakdown product (a marker of astroglial injury), and quantitative morphometric analyses (cell volume, surface area, branch complexity, and Sholl intersections).
RESULTS: Co-exposure to sevoflurane and Aβ1-42 led to an elevation of the 38-kDa GFAP breakdown product and a significant reduction in the mean fluorescence intensity of GFAP. Moreover, it resulted in a decrease in astrocytic volume, surface area, branch complexity, and Sholl intersections. These synergistic alterations were not observed when either treatment was administered alone.
CONCLUSIONS: These findings imply that sevoflurane aggravates Aβ1-42-induced astrocytic dysfunction, which has implications for perioperative management in patients with AD or those at risk of developing AD.},
}
MeSH Terms:
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Animals
*Amyloid beta-Peptides/pharmacology
*Sevoflurane/pharmacology
*Peptide Fragments/pharmacology/administration & dosage
*Astrocytes/drug effects/pathology/metabolism
Male
*Hippocampus/drug effects/pathology/metabolism
Glial Fibrillary Acidic Protein/metabolism/drug effects
*Anesthetics, Inhalation/pharmacology/administration & dosage
Mice
RevDate: 2026-07-30
CmpDate: 2026-07-30
A Multi-Frequency Self-Supervised Fusion Model for EEG-Based Dementia Classification.
Journal of integrative neuroscience, 25(7):50737.
BACKGROUND: Brain source localization technology enables precise characterization of the spatial distribution of neural activity, serving as a crucial tool for exploring the pathological mechanisms underlying dementia. However, effectively integrating complementary diagnostic information from source localization features across multiple frequency bands remains a major challenge to enhancing classification performance and model interpretability.
METHODS: An attention-based multi-frequency self-supervised fusion model (AM-SSF) is proposed to address this issue. Independent contrastive self-supervised encoders are trained for the θ (4-8 Hz), α (8-13 Hz), β (13-30 Hz), and γ (30-48 Hz) frequency bands to learn band-specific latent representations. Then, an attention-guided adaptive fusion module is introduced to dynamically allocate band weights through cross-entropy-based supervised optimization, thereby achieving effective cross-band information integration. Finally, a random forest classifier is employed to evaluate the model's performance in distinguishing Alzheimer's disease (AD) from frontotemporal dementia (FTD).
RESULTS: Experimental results show that the proposed framework achieves a classification accuracy of 93.1% under five-fold cross-validation, significantly outperforming baseline methods such as single-band self-supervised learning (SSL) and average pooling fusion. Further analysis of the attention weight distributions revealed that the θ and β bands contributed most to model decision-making, providing interpretability regarding frequency-specific effects.
CONCLUSIONS: In summary, the proposed AM-SSF model enhances AD and FTD classification performance while offering valuable insights into the discriminative roles of frequency band features.
Additional Links: PMID-42530050
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PubMed:
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@article {pmid42530050,
year = {2026},
author = {Sheng, J and Lin, J and Zhang, Q and Gong, Z and Zhang, R and Wu, M and Cheng, Y and Zhu, X and Sun, Z},
title = {A Multi-Frequency Self-Supervised Fusion Model for EEG-Based Dementia Classification.},
journal = {Journal of integrative neuroscience},
volume = {25},
number = {7},
pages = {50737},
doi = {10.31083/JIN50737},
pmid = {42530050},
issn = {0219-6352},
support = {LZ24F010007//Key Program of Natural Science Foundation of Zhejiang Province/ ; 62271177//National Natural Science Foundation of China/ ; },
mesh = {Humans ; *Alzheimer Disease/physiopathology/diagnosis/classification ; *Electroencephalography/methods ; *Frontotemporal Dementia/diagnosis/physiopathology/classification ; *Supervised Machine Learning ; *Brain Waves/physiology ; Classification Algorithms ; },
abstract = {BACKGROUND: Brain source localization technology enables precise characterization of the spatial distribution of neural activity, serving as a crucial tool for exploring the pathological mechanisms underlying dementia. However, effectively integrating complementary diagnostic information from source localization features across multiple frequency bands remains a major challenge to enhancing classification performance and model interpretability.
METHODS: An attention-based multi-frequency self-supervised fusion model (AM-SSF) is proposed to address this issue. Independent contrastive self-supervised encoders are trained for the θ (4-8 Hz), α (8-13 Hz), β (13-30 Hz), and γ (30-48 Hz) frequency bands to learn band-specific latent representations. Then, an attention-guided adaptive fusion module is introduced to dynamically allocate band weights through cross-entropy-based supervised optimization, thereby achieving effective cross-band information integration. Finally, a random forest classifier is employed to evaluate the model's performance in distinguishing Alzheimer's disease (AD) from frontotemporal dementia (FTD).
RESULTS: Experimental results show that the proposed framework achieves a classification accuracy of 93.1% under five-fold cross-validation, significantly outperforming baseline methods such as single-band self-supervised learning (SSL) and average pooling fusion. Further analysis of the attention weight distributions revealed that the θ and β bands contributed most to model decision-making, providing interpretability regarding frequency-specific effects.
CONCLUSIONS: In summary, the proposed AM-SSF model enhances AD and FTD classification performance while offering valuable insights into the discriminative roles of frequency band features.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/physiopathology/diagnosis/classification
*Electroencephalography/methods
*Frontotemporal Dementia/diagnosis/physiopathology/classification
*Supervised Machine Learning
*Brain Waves/physiology
Classification Algorithms
RevDate: 2026-07-30
CmpDate: 2026-07-30
Neurotrophic Factors in Stroke, Traumatic Brain Injury, and Neurodegeneration: A Convergent Pathophysiological and Translational Perspective.
Journal of integrative neuroscience, 25(7):51543.
Neurotrophic factors (NTFs), including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), glial cell line-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF), and vascular endothelial growth factor (VEGF), play a central role in neuronal survival, plasticity, and regeneration. Despite their distinct etiologies and temporal profiles, stroke (both ischemic and hemorrhagic), traumatic brain injury (TBI), and neurodegenerative diseases (NDDs), including Alzheimer's disease (AD) and Parkinson's disease (PD), converge on a common pathophysiological phenotype characterized by excitotoxicity, oxidative stress, mitochondrial dysfunction, neuroinflammation, blood-brain barrier (BBB) disruption, and neuronal apoptosis. Neurotrophic factors modulate these pathological cascades through tropomyosin receptor kinase (Trk) receptors, p75 neurotrophin receptor (p75NTR), and related signaling pathways, thereby supporting neuroprotection, neurogenesis, and synaptogenesis. Experimental evidence from preclinical models demonstrates robust beneficial effects of neurotrophin-based interventions in stroke, TBI, AD, and PD across protein, gene, and cell-based strategies. However, clinical translation remains severely limited. Early-phase clinical trials of adeno-associated virus (AAV)-mediated GDNF and neurturin gene therapy for PD, ex vivo NGF gene therapy for AD, and BDNF gene therapy for AD have confirmed acceptable safety profiles but yielded modest or inconsistent efficacy, largely due to constraints in brain delivery, the need for invasive neurosurgical procedures, restricted target coverage, suboptimal control of expression, and marked patient heterogeneity. Consequently, the principal barrier to clinical success is not biological validity, but the lack of safe, effective and scalable delivery platforms capable of bypassing or functionally modulating the BBB. In this review we synthesize shared pathophysiological mechanisms linking stroke, TBI and NDDs; examine the biology, receptor systems, and signaling pathways of key neurotrophic factors; summarize preclinical evidence for their therapeutic potential; and critically evaluate current delivery strategies, including viral vectors, lipid nanoparticles, exosomes, cell-based therapies, small-molecule mimetics, and intranasal administration. We conclude that overcoming delivery barriers through development of improved viral and non-viral platforms, minimally invasive administration routes, controllable expression systems, and rational patient stratification based on disease stage and biomarkers will be essential to fully realize the neuroprotective and neuroregenerative potential of neurotrophin-based therapies for acute and chronic brain disorders.
Additional Links: PMID-42530052
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PubMed:
Citation:
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@article {pmid42530052,
year = {2026},
author = {Shcheblykina, OV and Kostina, DA and Pokrovskii, MV and Korokin, MV},
title = {Neurotrophic Factors in Stroke, Traumatic Brain Injury, and Neurodegeneration: A Convergent Pathophysiological and Translational Perspective.},
journal = {Journal of integrative neuroscience},
volume = {25},
number = {7},
pages = {51543},
doi = {10.31083/JIN51543},
pmid = {42530052},
issn = {0219-6352},
support = {FZWG-2026-0003//Ministry of Science and Higher Education of the Russian Federation/ ; },
mesh = {Humans ; *Brain Injuries, Traumatic/metabolism/therapy/physiopathology ; Animals ; *Stroke/metabolism/therapy/physiopathology ; *Nerve Growth Factors/metabolism ; *Neurodegenerative Diseases/metabolism/therapy/physiopathology ; },
abstract = {Neurotrophic factors (NTFs), including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), glial cell line-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF), and vascular endothelial growth factor (VEGF), play a central role in neuronal survival, plasticity, and regeneration. Despite their distinct etiologies and temporal profiles, stroke (both ischemic and hemorrhagic), traumatic brain injury (TBI), and neurodegenerative diseases (NDDs), including Alzheimer's disease (AD) and Parkinson's disease (PD), converge on a common pathophysiological phenotype characterized by excitotoxicity, oxidative stress, mitochondrial dysfunction, neuroinflammation, blood-brain barrier (BBB) disruption, and neuronal apoptosis. Neurotrophic factors modulate these pathological cascades through tropomyosin receptor kinase (Trk) receptors, p75 neurotrophin receptor (p75NTR), and related signaling pathways, thereby supporting neuroprotection, neurogenesis, and synaptogenesis. Experimental evidence from preclinical models demonstrates robust beneficial effects of neurotrophin-based interventions in stroke, TBI, AD, and PD across protein, gene, and cell-based strategies. However, clinical translation remains severely limited. Early-phase clinical trials of adeno-associated virus (AAV)-mediated GDNF and neurturin gene therapy for PD, ex vivo NGF gene therapy for AD, and BDNF gene therapy for AD have confirmed acceptable safety profiles but yielded modest or inconsistent efficacy, largely due to constraints in brain delivery, the need for invasive neurosurgical procedures, restricted target coverage, suboptimal control of expression, and marked patient heterogeneity. Consequently, the principal barrier to clinical success is not biological validity, but the lack of safe, effective and scalable delivery platforms capable of bypassing or functionally modulating the BBB. In this review we synthesize shared pathophysiological mechanisms linking stroke, TBI and NDDs; examine the biology, receptor systems, and signaling pathways of key neurotrophic factors; summarize preclinical evidence for their therapeutic potential; and critically evaluate current delivery strategies, including viral vectors, lipid nanoparticles, exosomes, cell-based therapies, small-molecule mimetics, and intranasal administration. We conclude that overcoming delivery barriers through development of improved viral and non-viral platforms, minimally invasive administration routes, controllable expression systems, and rational patient stratification based on disease stage and biomarkers will be essential to fully realize the neuroprotective and neuroregenerative potential of neurotrophin-based therapies for acute and chronic brain disorders.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Brain Injuries, Traumatic/metabolism/therapy/physiopathology
Animals
*Stroke/metabolism/therapy/physiopathology
*Nerve Growth Factors/metabolism
*Neurodegenerative Diseases/metabolism/therapy/physiopathology
RevDate: 2026-07-30
CmpDate: 2026-07-30
Investigating the Therapeutic Mechanism of Ginkgo Biloba Extract in Alzheimer's Disease via Integrated Network Pharmacology and Molecular Docking.
Die Pharmazie, 81(7):51748.
OBJECTIVE: This study aimed to investigate the mechanisms through which ginkgolides in Ginkgo biloba extract (GBE) may protect against Alzheimer's disease (AD).
METHODS: Candidate ginkgolide constituents and their putative targets were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction. AD-associated genes were retrieved from OMIM and GeneCards. Overlapping targets were used to construct component-target-disease and protein-protein interaction (PPI) networks for hub target screening. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using DAVID. AutoDock Vina was used for molecular docking, and molecular dynamics simulations were conducted to evaluate ligand-target stability. The predicted mechanisms were further examined in APP/PS1 mice and Aβ1-42-treated HT22 cells.
RESULTS: A total of 27 active ginkgolide-related constituents and 336 intersecting targets were identified. Ginkgolides B and M were identified as the major active compounds, whereas MAPK3, HIF-1α, and AKT1 emerged as important targets. Enrichment analysis indicated a close association with the PI3K-Akt pathway. Docking analysis showed that ginkgolides B and M bound strongly to MAPK3 and HIF-1α with binding energies ranging from -9.34 to -8.41 kcal/mol. Molecular dynamics simulations supported the stable formation of these complexes. In vivo and in vitro experiments showed that ginkgolides B and M alleviated synaptic protein damage, decreased HIF-1α expression, and improved cognitive deficits.
CONCLUSIONS: Ginkgolides B and M may contribute to anti-AD effects in experimental models, partly through modulation of HIF-1α-related stress responses and PI3K-Akt-associated survival pathways.
Additional Links: PMID-42530076
Publisher:
PubMed:
Citation:
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@article {pmid42530076,
year = {2026},
author = {Li, Y and Gong, J and Yang, L and Jin, L and Peng, R and Wang, F and Wang, L},
title = {Investigating the Therapeutic Mechanism of Ginkgo Biloba Extract in Alzheimer's Disease via Integrated Network Pharmacology and Molecular Docking.},
journal = {Die Pharmazie},
volume = {81},
number = {7},
pages = {51748},
doi = {10.31083/Pharmazie51748},
pmid = {42530076},
issn = {3053-691X},
support = {232102311152//Scientific and Technological Project in Henan Province/ ; },
mesh = {Animals ; Molecular Docking Simulation ; *Ginkgolides/pharmacology ; *Ginkgo biloba/chemistry ; *Alzheimer Disease/drug therapy/genetics ; *Plant Extracts/pharmacology/chemistry ; Mice ; Ginkgo Extract ; Molecular Dynamics Simulation ; Network Pharmacology ; Humans ; Amyloid beta-Peptides ; Protein Interaction Maps/drug effects ; Cell Line ; Disease Models, Animal ; },
abstract = {OBJECTIVE: This study aimed to investigate the mechanisms through which ginkgolides in Ginkgo biloba extract (GBE) may protect against Alzheimer's disease (AD).
METHODS: Candidate ginkgolide constituents and their putative targets were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction. AD-associated genes were retrieved from OMIM and GeneCards. Overlapping targets were used to construct component-target-disease and protein-protein interaction (PPI) networks for hub target screening. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using DAVID. AutoDock Vina was used for molecular docking, and molecular dynamics simulations were conducted to evaluate ligand-target stability. The predicted mechanisms were further examined in APP/PS1 mice and Aβ1-42-treated HT22 cells.
RESULTS: A total of 27 active ginkgolide-related constituents and 336 intersecting targets were identified. Ginkgolides B and M were identified as the major active compounds, whereas MAPK3, HIF-1α, and AKT1 emerged as important targets. Enrichment analysis indicated a close association with the PI3K-Akt pathway. Docking analysis showed that ginkgolides B and M bound strongly to MAPK3 and HIF-1α with binding energies ranging from -9.34 to -8.41 kcal/mol. Molecular dynamics simulations supported the stable formation of these complexes. In vivo and in vitro experiments showed that ginkgolides B and M alleviated synaptic protein damage, decreased HIF-1α expression, and improved cognitive deficits.
CONCLUSIONS: Ginkgolides B and M may contribute to anti-AD effects in experimental models, partly through modulation of HIF-1α-related stress responses and PI3K-Akt-associated survival pathways.},
}
MeSH Terms:
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Animals
Molecular Docking Simulation
*Ginkgolides/pharmacology
*Ginkgo biloba/chemistry
*Alzheimer Disease/drug therapy/genetics
*Plant Extracts/pharmacology/chemistry
Mice
Ginkgo Extract
Molecular Dynamics Simulation
Network Pharmacology
Humans
Amyloid beta-Peptides
Protein Interaction Maps/drug effects
Cell Line
Disease Models, Animal
RevDate: 2026-07-30
CmpDate: 2026-07-30
Validation of Plasma p-tau217 as a Biomarker of Prodromal Alzheimer's Disease.
Revista de neurologia, 81(7):50619.
BACKGROUND: Plasma phosphorylated tau 217 protein (p-tau217p) has recently been proposed as a useful biomarker for the early diagnosis of Alzheimer's disease (AD). However, local validation is recommended because of the potential influence of clinical, analytical, and preanalytical factors on assay performance.
METHODS: Between 2021 and 2024, we evaluated patients with amnestic mild cognitive impairment (aMCI) through clinical history, neurological and neuropsychological examination, blood sampling for biobanking, brain imaging, and lumbar puncture, among other diagnostic tests. In September 2025, p-tau217p levels were measured simultaneously using the LUMIPULSE immunoassay (Fujirebio). The diagnostic validity, reproducibility, receiver operating characteristic (ROC) curve performance, correlation with cerebrospinal fluid (CSF) biomarkers, and influence of clinical and analytical variables were evaluated in this study.
RESULTS: Among the 108 aMCI patients included, 66 met the criteria for clinic-biological AD, while the remainder had alternative clinical diagnoses. Using a two-threshold approach, p-tau217p levels ≥0.19 yielded a sensitivity of 88% and a positive predictive value of 83% for identifying AD. Levels ≥0.39 showed a specificity of 91% and a positive predictive value of 90% for the same purpose. Intermediate values (0.20-0.38) achieved a specificity of 83%. The intraclass correlation coefficient for the assay reproducibility was 0.97. The ROC curve for p-tau217p demonstrated an area under the curve of 0.86 for diagnosing AD. P-tau217p correlated more strongly with CSF p-tau181 (ρ = 0.63; p < 0.01) than with CSF Aβ1-42 (ρ = -0.40; p < 0.01). Finally, a reduced glomerular filtration rate was associated with a significant increase in p-tau217p levels (p < 0.006).
CONCLUSIONS: In our setting, p-tau217p measurement showed a high validity for the diagnosis of prodromal AD, which is consistent with the recent neurological literature. The assay showed high reproducibility, although results may be influenced by renal function. P-tau217p correlated more strongly with CSF p-tau181 than with CSF Aβ1-42.
Additional Links: PMID-42530129
Publisher:
PubMed:
Citation:
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@article {pmid42530129,
year = {2026},
author = {Monge-García, V and Lorenzo-García, S and Bernal-Soriano, MC and Torrella-Esteban, P and Monge-García, S and Sánchez-Payá, J and Monge-Argilés, JA},
title = {Validation of Plasma p-tau217 as a Biomarker of Prodromal Alzheimer's Disease.},
journal = {Revista de neurologia},
volume = {81},
number = {7},
pages = {50619},
doi = {10.31083/RN50619},
pmid = {42530129},
issn = {1576-6578},
mesh = {Humans ; *Alzheimer Disease/blood/diagnosis/cerebrospinal fluid ; *tau Proteins/blood/cerebrospinal fluid ; Biomarkers/blood/cerebrospinal fluid ; Female ; Male ; Aged ; Cognitive Dysfunction/blood/cerebrospinal fluid/diagnosis ; Reproducibility of Results ; Prodromal Symptoms ; Middle Aged ; Sensitivity and Specificity ; },
abstract = {BACKGROUND: Plasma phosphorylated tau 217 protein (p-tau217p) has recently been proposed as a useful biomarker for the early diagnosis of Alzheimer's disease (AD). However, local validation is recommended because of the potential influence of clinical, analytical, and preanalytical factors on assay performance.
METHODS: Between 2021 and 2024, we evaluated patients with amnestic mild cognitive impairment (aMCI) through clinical history, neurological and neuropsychological examination, blood sampling for biobanking, brain imaging, and lumbar puncture, among other diagnostic tests. In September 2025, p-tau217p levels were measured simultaneously using the LUMIPULSE immunoassay (Fujirebio). The diagnostic validity, reproducibility, receiver operating characteristic (ROC) curve performance, correlation with cerebrospinal fluid (CSF) biomarkers, and influence of clinical and analytical variables were evaluated in this study.
RESULTS: Among the 108 aMCI patients included, 66 met the criteria for clinic-biological AD, while the remainder had alternative clinical diagnoses. Using a two-threshold approach, p-tau217p levels ≥0.19 yielded a sensitivity of 88% and a positive predictive value of 83% for identifying AD. Levels ≥0.39 showed a specificity of 91% and a positive predictive value of 90% for the same purpose. Intermediate values (0.20-0.38) achieved a specificity of 83%. The intraclass correlation coefficient for the assay reproducibility was 0.97. The ROC curve for p-tau217p demonstrated an area under the curve of 0.86 for diagnosing AD. P-tau217p correlated more strongly with CSF p-tau181 (ρ = 0.63; p < 0.01) than with CSF Aβ1-42 (ρ = -0.40; p < 0.01). Finally, a reduced glomerular filtration rate was associated with a significant increase in p-tau217p levels (p < 0.006).
CONCLUSIONS: In our setting, p-tau217p measurement showed a high validity for the diagnosis of prodromal AD, which is consistent with the recent neurological literature. The assay showed high reproducibility, although results may be influenced by renal function. P-tau217p correlated more strongly with CSF p-tau181 than with CSF Aβ1-42.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/blood/diagnosis/cerebrospinal fluid
*tau Proteins/blood/cerebrospinal fluid
Biomarkers/blood/cerebrospinal fluid
Female
Male
Aged
Cognitive Dysfunction/blood/cerebrospinal fluid/diagnosis
Reproducibility of Results
Prodromal Symptoms
Middle Aged
Sensitivity and Specificity
RevDate: 2026-07-30
CmpDate: 2026-07-30
AI-Enabled Modeling for Alzheimer's Disease Risk Prediction and Validation.
Revista de neurologia, 81(7):49220.
BACKGROUND: To investigate the multimodal clinical influencing factors of Alzheimer's disease (AD) onset, and to establish and test a risk prediction tool derived from these determinants and additional clinical measures, thus facilitating early intervention and risk classification in individuals at high risk for AD.
METHODS: A retrospective cohort of 502 high-risk individuals for AD (exhibiting cognitive decline or family history) who visited our hospital was included. A total of 502 participants were randomly split into a training cohort (n = 350) and a validation cohort (n = 152) in a 7:3 proportion. Demographic characteristics, clinical indicators, biomarkers, and genetic markers were collected. In the training set, univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were first applied for variable screening, followed by multivariate logistic regression to pinpoint independent influencing factors. Random forest (RF), XGBoost, and deep learning models were constructed using Python, with performance evaluated using area under the curve (AUC). The optimal model was selected, and feature importance was analyzed.
RESULTS: Between the training and validation sets, no statistically significant baseline characteristic differences were found (p > 0.05). Multivariate logistic regression identified the apolipoprotein E epsilon 4 allele (APOE ε4) genotype, cerebrospinal fluid (CSF) p-tau181/amyloid-beta 42 (Aβ42) ratio, and diabetes as independent risk factors for AD (p < 0.05), while serum folate levels, Mini-Mental State Examination (MMSE) scores, and Montreal Cognitive Assessment (MoCA) scores served as independent protective factors (p < 0.05). In the validation set, the RF model achieved the highest AUC (0.879), followed by XGBoost (0.869) and deep learning (0.844), with the CSF p-tau181/Aβ42 ratio identified as the most predictive feature.
CONCLUSION: The RF model, based on integrated multimodal clinical influencing factors and clinical indicators, demonstrates potential for AD risk stratification in high-risk populations when evaluated on a validation cohort.
Additional Links: PMID-42530130
Publisher:
PubMed:
Citation:
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@article {pmid42530130,
year = {2026},
author = {Li, P and Wang, Y},
title = {AI-Enabled Modeling for Alzheimer's Disease Risk Prediction and Validation.},
journal = {Revista de neurologia},
volume = {81},
number = {7},
pages = {49220},
doi = {10.31083/RN49220},
pmid = {42530130},
issn = {1576-6578},
mesh = {Humans ; *Alzheimer Disease/diagnosis/genetics/cerebrospinal fluid ; Female ; Retrospective Studies ; Risk Assessment/methods ; Male ; Aged ; Random Forest ; Boosting Machine Learning Algorithms ; Predictive Learning Models ; Risk Factors ; Prediction Algorithms ; *Artificial Intelligence ; Amyloid beta-Peptides/cerebrospinal fluid ; Apolipoprotein E4/genetics ; Biomarkers/cerebrospinal fluid ; },
abstract = {BACKGROUND: To investigate the multimodal clinical influencing factors of Alzheimer's disease (AD) onset, and to establish and test a risk prediction tool derived from these determinants and additional clinical measures, thus facilitating early intervention and risk classification in individuals at high risk for AD.
METHODS: A retrospective cohort of 502 high-risk individuals for AD (exhibiting cognitive decline or family history) who visited our hospital was included. A total of 502 participants were randomly split into a training cohort (n = 350) and a validation cohort (n = 152) in a 7:3 proportion. Demographic characteristics, clinical indicators, biomarkers, and genetic markers were collected. In the training set, univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were first applied for variable screening, followed by multivariate logistic regression to pinpoint independent influencing factors. Random forest (RF), XGBoost, and deep learning models were constructed using Python, with performance evaluated using area under the curve (AUC). The optimal model was selected, and feature importance was analyzed.
RESULTS: Between the training and validation sets, no statistically significant baseline characteristic differences were found (p > 0.05). Multivariate logistic regression identified the apolipoprotein E epsilon 4 allele (APOE ε4) genotype, cerebrospinal fluid (CSF) p-tau181/amyloid-beta 42 (Aβ42) ratio, and diabetes as independent risk factors for AD (p < 0.05), while serum folate levels, Mini-Mental State Examination (MMSE) scores, and Montreal Cognitive Assessment (MoCA) scores served as independent protective factors (p < 0.05). In the validation set, the RF model achieved the highest AUC (0.879), followed by XGBoost (0.869) and deep learning (0.844), with the CSF p-tau181/Aβ42 ratio identified as the most predictive feature.
CONCLUSION: The RF model, based on integrated multimodal clinical influencing factors and clinical indicators, demonstrates potential for AD risk stratification in high-risk populations when evaluated on a validation cohort.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Alzheimer Disease/diagnosis/genetics/cerebrospinal fluid
Female
Retrospective Studies
Risk Assessment/methods
Male
Aged
Random Forest
Boosting Machine Learning Algorithms
Predictive Learning Models
Risk Factors
Prediction Algorithms
*Artificial Intelligence
Amyloid beta-Peptides/cerebrospinal fluid
Apolipoprotein E4/genetics
Biomarkers/cerebrospinal fluid
RevDate: 2026-07-30
CmpDate: 2026-07-30
Peripheral Administration of isoD7-Aβ Exacerbates Motor Deficits and Tau Pathology in P301S Mice.
Frontiers in bioscience (Landmark edition), 31(7):53279.
BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder leading to dementia, disability, and premature death. Beta-amyloid (Aβ) and tau pathology are considered key components of its pathogenesis; however, the role of peripheral amyloid load in modulating pre-existing tau pathology remains understudied. We hypothesized that peripheral amyloid load could exacerbate tau pathology through mechanisms potentially linked to the disruption of the Akt/glycogen synthase kinase-3β-associated signaling pathway, which could lead to increased behavioral deficits and progression of neurodegenerative changes.
OBJECTIVE: To evaluate the effect of double peripheral (retro-orbital) administration of the Aβ isoform D7 on the behavioral phenotype, morphological signs of tau pathology, and the expression of genes related to Akt/GSK-3β-associated signaling, neuroinflammation, and apoptosis in the brains of P301S transgenic mice.
MATERIALS AND METHODS: The study included 12-week-old male P301S transgenic mice (Tg(Thy1-MAPT*P301S)2541Godt) (n = 20, biological duplication) and wild-type C57Black6/J mice (n = 10). P301S mice received two retro-orbital injections of isoD7-Aβ into the venous sinus at a dose of 100 µg (n = 10) with a 1-month interval; control P301S mice received an equivalent volume of water for injection (n = 10). Behavioral testing ("open field", "novel object recognition", "vertical pole", "inverted screen") was performed at 16 and 20 weeks of age. Tau pathology was assessed immunohistochemically using AT-8 (pSer202/pThr205) antibodies in the frontal cortex and brainstem, and amyloid deposits were assessed histologically using Congo red staining in the entorhinal cortex and hippocampus. The expression of Akt1, Gfap, Mapt, Cdk5, Casp3, Bax, and Bcl2 genes in brain tissue was analyzed by quantitative real-time PCR.
RESULTS: Two peripheral administrations of isoD7-Aβ were not associated with further deterioration of performance in the "open field" and "novel object recognition" tests compared to the control P301S group, which likely reflects the already established deficit characteristic of this transgenic line. In contrast, in motor coordination tests ("vertical pole", "inverted screen"), motor impairments in the P301S+Aβ group emerged by week 16, whereas in P301S mice without amyloid load, they appeared only by week 20. Immunohistochemical analysis revealed an increase in AT-8-positive staining in the brainstem, whereas no statistically significant differences were found between groups in the frontal cortex. Histological analysis did not reveal amyloid plaques in the entorhinal cortex and hippocampus of P301S+Aβ mice and control P301S mice. At the molecular level, the P301S+Aβ group showed decreased Akt1 expression, increased Gfap and Bax expression, and decreased Bcl2 expression, with no significant changes in Mapt, Casp3, and Cdk5. This pattern is consistent with dysregulation of Akt/GSK-3β-associated signaling, enhanced glial activation, and a pro-apoptotic shift.
CONCLUSIONS: Two peripheral administrations of isoD7-Aβ to P301S mice were associated with earlier development of motor impairments, increased tau protein phosphorylation, and changes in gene expression consistent with a disrupted Akt/GSK-3β-associated signaling pathway. These findings support the hypothesis that peripheral amyloid load can exacerbate tauopathy manifestations, and the observed transcriptional changes are consistent with the possible involvement of the Akt/GSK-3β-associated signaling pathway, which may represent a potential therapeutic target in AD.
Additional Links: PMID-42530254
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@article {pmid42530254,
year = {2026},
author = {Stepenko, Y and Shcheblykina, O and Zhunusov, N and Shmigerova, V and Kozin, S and Mitkevich, V and Radchenko, A and Kuzubova, E and Khalzov, L and Korokin, M},
title = {Peripheral Administration of isoD7-Aβ Exacerbates Motor Deficits and Tau Pathology in P301S Mice.},
journal = {Frontiers in bioscience (Landmark edition)},
volume = {31},
number = {7},
pages = {53279},
doi = {10.31083/FBL53279},
pmid = {42530254},
issn = {2768-6698},
support = {FZWG-2026-0003//Program of Fundamental Research in the Russian Federation/ ; 124031800075-1//Program of Fundamental Research in the Russian Federation/ ; },
mesh = {Animals ; *tau Proteins/metabolism/genetics ; Mice ; *Amyloid beta-Peptides/administration & dosage ; Mice, Transgenic ; Male ; *Alzheimer Disease/pathology/metabolism ; Brain/metabolism/pathology ; Proto-Oncogene Proteins c-akt/metabolism ; Mice, Inbred C57BL ; Signal Transduction ; Disease Models, Animal ; Glycogen Synthase Kinase 3 beta/metabolism ; Apoptosis ; },
abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder leading to dementia, disability, and premature death. Beta-amyloid (Aβ) and tau pathology are considered key components of its pathogenesis; however, the role of peripheral amyloid load in modulating pre-existing tau pathology remains understudied. We hypothesized that peripheral amyloid load could exacerbate tau pathology through mechanisms potentially linked to the disruption of the Akt/glycogen synthase kinase-3β-associated signaling pathway, which could lead to increased behavioral deficits and progression of neurodegenerative changes.
OBJECTIVE: To evaluate the effect of double peripheral (retro-orbital) administration of the Aβ isoform D7 on the behavioral phenotype, morphological signs of tau pathology, and the expression of genes related to Akt/GSK-3β-associated signaling, neuroinflammation, and apoptosis in the brains of P301S transgenic mice.
MATERIALS AND METHODS: The study included 12-week-old male P301S transgenic mice (Tg(Thy1-MAPT*P301S)2541Godt) (n = 20, biological duplication) and wild-type C57Black6/J mice (n = 10). P301S mice received two retro-orbital injections of isoD7-Aβ into the venous sinus at a dose of 100 µg (n = 10) with a 1-month interval; control P301S mice received an equivalent volume of water for injection (n = 10). Behavioral testing ("open field", "novel object recognition", "vertical pole", "inverted screen") was performed at 16 and 20 weeks of age. Tau pathology was assessed immunohistochemically using AT-8 (pSer202/pThr205) antibodies in the frontal cortex and brainstem, and amyloid deposits were assessed histologically using Congo red staining in the entorhinal cortex and hippocampus. The expression of Akt1, Gfap, Mapt, Cdk5, Casp3, Bax, and Bcl2 genes in brain tissue was analyzed by quantitative real-time PCR.
RESULTS: Two peripheral administrations of isoD7-Aβ were not associated with further deterioration of performance in the "open field" and "novel object recognition" tests compared to the control P301S group, which likely reflects the already established deficit characteristic of this transgenic line. In contrast, in motor coordination tests ("vertical pole", "inverted screen"), motor impairments in the P301S+Aβ group emerged by week 16, whereas in P301S mice without amyloid load, they appeared only by week 20. Immunohistochemical analysis revealed an increase in AT-8-positive staining in the brainstem, whereas no statistically significant differences were found between groups in the frontal cortex. Histological analysis did not reveal amyloid plaques in the entorhinal cortex and hippocampus of P301S+Aβ mice and control P301S mice. At the molecular level, the P301S+Aβ group showed decreased Akt1 expression, increased Gfap and Bax expression, and decreased Bcl2 expression, with no significant changes in Mapt, Casp3, and Cdk5. This pattern is consistent with dysregulation of Akt/GSK-3β-associated signaling, enhanced glial activation, and a pro-apoptotic shift.
CONCLUSIONS: Two peripheral administrations of isoD7-Aβ to P301S mice were associated with earlier development of motor impairments, increased tau protein phosphorylation, and changes in gene expression consistent with a disrupted Akt/GSK-3β-associated signaling pathway. These findings support the hypothesis that peripheral amyloid load can exacerbate tauopathy manifestations, and the observed transcriptional changes are consistent with the possible involvement of the Akt/GSK-3β-associated signaling pathway, which may represent a potential therapeutic target in AD.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Animals
*tau Proteins/metabolism/genetics
Mice
*Amyloid beta-Peptides/administration & dosage
Mice, Transgenic
Male
*Alzheimer Disease/pathology/metabolism
Brain/metabolism/pathology
Proto-Oncogene Proteins c-akt/metabolism
Mice, Inbred C57BL
Signal Transduction
Disease Models, Animal
Glycogen Synthase Kinase 3 beta/metabolism
Apoptosis
RevDate: 2026-07-30
CmpDate: 2026-07-30
Neuroprotective Properties and Molecular Mechanisms of Action of 4H-Pyran-Based Acids.
Frontiers in bioscience (Landmark edition), 31(7):48552.
The development of effective neuroprotective agents remains one of the most urgent and complex challenges in modern medical and biological research, given the increasing prevalence of neurodegenerative diseases and the limited efficacy of existing therapeutic options. In recent years, compounds belonging to the 4H-pyran chemical class have attracted significant attention due to their pronounced antioxidant, anti-inflammatory, and cytoprotective properties. These molecules exhibit structural versatility, enabling modulation of multiple molecular targets involved in neuronal survival, redox homeostasis, and mitochondrial function. This review provides a comprehensive analysis of the pharmacological activity and molecular mechanisms of action of five 4H-pyran-based compounds-maltol, kojic acid, chelidonic acid, comenic acid, and meconic acid. Special attention is paid to their effects on signaling pathways that play a central role in maintaining neuronal integrity and resistance to stress factors. In particular, the review examines how these compounds regulate key intracellular cascades such as nuclear factor erythroid 2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1)/antioxidant response element (ARE), Nrf2/PTEN-induced putative kinase 1 (PINK1)/Parkin, nuclear factor-kappa B (NF-κB), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR), which are critically involved in controlling oxidative stress, mitochondrial autophagy, inflammation, and neuronal plasticity. The integrated evaluation of these mechanisms demonstrates that 4H-pyran-based acids can act as multitarget neuroprotective agents capable of influencing both primary metabolic processes and secondary signaling responses to neurotoxic stimuli. Their pleiotropic action highlights the promise of these compounds as molecular scaffolds for the development of novel drugs aimed at preventing or delaying the progression of neurodegenerative disorders such as Alzheimer's and Parkinson's diseases.
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@article {pmid42530260,
year = {2026},
author = {Kravtsov, A and Kozin, S and Kondratenko, R and Lyasota, O and Dorohova, A and Leontyeva, O and Hernandez-Caceres, JL and Dzhimak, S},
title = {Neuroprotective Properties and Molecular Mechanisms of Action of 4H-Pyran-Based Acids.},
journal = {Frontiers in bioscience (Landmark edition)},
volume = {31},
number = {7},
pages = {48552},
doi = {10.31083/FBL48552},
pmid = {42530260},
issn = {2768-6698},
support = {075-15-2025-283//Ministry of Science and Higher Education of the Russian Federation/ ; },
mesh = {Humans ; *Neuroprotective Agents/pharmacology/chemistry ; Animals ; Signal Transduction/drug effects ; *Neurodegenerative Diseases/drug therapy/metabolism ; *Pyrans/pharmacology/chemistry ; Pyrones/pharmacology/chemistry ; Antioxidants/pharmacology ; },
abstract = {The development of effective neuroprotective agents remains one of the most urgent and complex challenges in modern medical and biological research, given the increasing prevalence of neurodegenerative diseases and the limited efficacy of existing therapeutic options. In recent years, compounds belonging to the 4H-pyran chemical class have attracted significant attention due to their pronounced antioxidant, anti-inflammatory, and cytoprotective properties. These molecules exhibit structural versatility, enabling modulation of multiple molecular targets involved in neuronal survival, redox homeostasis, and mitochondrial function. This review provides a comprehensive analysis of the pharmacological activity and molecular mechanisms of action of five 4H-pyran-based compounds-maltol, kojic acid, chelidonic acid, comenic acid, and meconic acid. Special attention is paid to their effects on signaling pathways that play a central role in maintaining neuronal integrity and resistance to stress factors. In particular, the review examines how these compounds regulate key intracellular cascades such as nuclear factor erythroid 2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1)/antioxidant response element (ARE), Nrf2/PTEN-induced putative kinase 1 (PINK1)/Parkin, nuclear factor-kappa B (NF-κB), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR), which are critically involved in controlling oxidative stress, mitochondrial autophagy, inflammation, and neuronal plasticity. The integrated evaluation of these mechanisms demonstrates that 4H-pyran-based acids can act as multitarget neuroprotective agents capable of influencing both primary metabolic processes and secondary signaling responses to neurotoxic stimuli. Their pleiotropic action highlights the promise of these compounds as molecular scaffolds for the development of novel drugs aimed at preventing or delaying the progression of neurodegenerative disorders such as Alzheimer's and Parkinson's diseases.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Neuroprotective Agents/pharmacology/chemistry
Animals
Signal Transduction/drug effects
*Neurodegenerative Diseases/drug therapy/metabolism
*Pyrans/pharmacology/chemistry
Pyrones/pharmacology/chemistry
Antioxidants/pharmacology
RevDate: 2026-07-30
Sex and racial/ethnic patterns in subjective cognitive concerns-related functional difficulties among middle-aged and older adults: A multi-year cross-sectional analysis of a population-based U.S. adult sample in 2015-2022.
Journal of Alzheimer's disease : JAD [Epub ahead of print].
BackgroundExperiencing subjective cognitive concerns (SCC) marks a potential risk stage for Alzheimer's disease.ObjectiveThis study examined sex and racial/ethnic patterns in the prevalence of functional difficulties among U.S. adults with SCC.MethodsData for 32,105 adults aged ≥45 years who experienced SCC in the past year were sourced from the Behavioral Risk Factor Surveillance System in 2015-2022. Individuals reporting SCC-related functional difficulties in daily or social life activities always/usually/sometimes (versus rarely/never) in the past year were considered having each of the functional difficulties. Weighted binomial logistic regression analyses were conducted to examine the association of sex (male or female) and race/ethnicity (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic, or non-Hispanic Other [NHO]) with SCC-related daily and social life difficulties, adjusting for all covariates.ResultsOverall, a decreasing trend in SCC-related functional difficulties was observed in both sexes, while female adults had higher prevalence. Trends in these functional difficulties varied by race/ethnicity, with NHW adults exhibiting the most stable and lowest prevalence. Female adults had significantly higher odds of experiencing SCC-related daily life (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.15, 1.41) and social life difficulties (AOR = 1.12, 95% CI = 1.01, 1.24) than male adults. NHB, Hispanic, and NHO groups had higher odds of experiencing SCC-related daily and social life difficulties compared to NHW participants.ConclusionsFemale and racial/ethnic minority individuals experienced higher levels of SCC-related functional difficulties. Public health interventions are warranted to alleviate such challenges for vulnerable populations.
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@article {pmid42530543,
year = {2026},
author = {Pan, Y and Cho, B and Stallings-Smith, S},
title = {Sex and racial/ethnic patterns in subjective cognitive concerns-related functional difficulties among middle-aged and older adults: A multi-year cross-sectional analysis of a population-based U.S. adult sample in 2015-2022.},
journal = {Journal of Alzheimer's disease : JAD},
volume = {},
number = {},
pages = {13872877261472887},
doi = {10.1177/13872877261472887},
pmid = {42530543},
issn = {1875-8908},
abstract = {BackgroundExperiencing subjective cognitive concerns (SCC) marks a potential risk stage for Alzheimer's disease.ObjectiveThis study examined sex and racial/ethnic patterns in the prevalence of functional difficulties among U.S. adults with SCC.MethodsData for 32,105 adults aged ≥45 years who experienced SCC in the past year were sourced from the Behavioral Risk Factor Surveillance System in 2015-2022. Individuals reporting SCC-related functional difficulties in daily or social life activities always/usually/sometimes (versus rarely/never) in the past year were considered having each of the functional difficulties. Weighted binomial logistic regression analyses were conducted to examine the association of sex (male or female) and race/ethnicity (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic, or non-Hispanic Other [NHO]) with SCC-related daily and social life difficulties, adjusting for all covariates.ResultsOverall, a decreasing trend in SCC-related functional difficulties was observed in both sexes, while female adults had higher prevalence. Trends in these functional difficulties varied by race/ethnicity, with NHW adults exhibiting the most stable and lowest prevalence. Female adults had significantly higher odds of experiencing SCC-related daily life (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.15, 1.41) and social life difficulties (AOR = 1.12, 95% CI = 1.01, 1.24) than male adults. NHB, Hispanic, and NHO groups had higher odds of experiencing SCC-related daily and social life difficulties compared to NHW participants.ConclusionsFemale and racial/ethnic minority individuals experienced higher levels of SCC-related functional difficulties. Public health interventions are warranted to alleviate such challenges for vulnerable populations.},
}
RevDate: 2026-07-30
Cognitive-enhancing drugs in Phase II clinical trials for Alzheimer's disease: emerging therapeutic candidates.
Expert opinion on investigational drugs [Epub ahead of print].
INTRODUCTION: Alzheimer's disease (AD) is biologically defined by amyloid-β (Aβ) and tau pathology but clinically manifests as progressive synaptic dysfunction and cognitive decline. Although anti-amyloid and anti-tau therapies modestly slow disease progression, they do not directly restore cognition or synaptic function.
AREAS COVERED: Phase II trials of cognition‑enhancing therapies in AD and prodromal AD were reviewed to identify factors behind success or failure. Trials from ClinicalTrials.gov and the EU Clinical Trials Register with cognitive endpoints were assessed by mechanism, design, population, and outcomes. Strategies included synaptic, inflammatory, metabolic, vascular, and regenerative approaches.Most therapies showed limited or inconsistent cognitive effects, and many trials did not demonstrate clear efficacy.
EXPERT OPINION: Phase II cognition‑enhancing trials in AD show biological plausibility but remain methodologically limited. Cognitive signal detection depends on the fit between mechanism, disease stage, and trial design, and on the statistical approach used to capture subtle change. Outcome variability highlights the need for sensitive cognitive measures and adequate power. Progress will require precision‑enriched designs, with biomarker‑defined populations, cognitive‑trajectory modeling, and integrated cognitive and functional endpoints.
Additional Links: PMID-42530559
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PubMed:
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@article {pmid42530559,
year = {2026},
author = {Manzine, PR and Carrasco, M and Antonia Alves Fernandes, T and Santos Alves, S and Guzman, L and Driouech, L and Millet, M and Garcia Cairasco, N and Olloquequi, J and Juan, ME and Ettcheto, M and Cominetti, MR and Camins, A},
title = {Cognitive-enhancing drugs in Phase II clinical trials for Alzheimer's disease: emerging therapeutic candidates.},
journal = {Expert opinion on investigational drugs},
volume = {},
number = {},
pages = {},
doi = {10.1080/13543784.2026.2710112},
pmid = {42530559},
issn = {1744-7658},
abstract = {INTRODUCTION: Alzheimer's disease (AD) is biologically defined by amyloid-β (Aβ) and tau pathology but clinically manifests as progressive synaptic dysfunction and cognitive decline. Although anti-amyloid and anti-tau therapies modestly slow disease progression, they do not directly restore cognition or synaptic function.
AREAS COVERED: Phase II trials of cognition‑enhancing therapies in AD and prodromal AD were reviewed to identify factors behind success or failure. Trials from ClinicalTrials.gov and the EU Clinical Trials Register with cognitive endpoints were assessed by mechanism, design, population, and outcomes. Strategies included synaptic, inflammatory, metabolic, vascular, and regenerative approaches.Most therapies showed limited or inconsistent cognitive effects, and many trials did not demonstrate clear efficacy.
EXPERT OPINION: Phase II cognition‑enhancing trials in AD show biological plausibility but remain methodologically limited. Cognitive signal detection depends on the fit between mechanism, disease stage, and trial design, and on the statistical approach used to capture subtle change. Outcome variability highlights the need for sensitive cognitive measures and adequate power. Progress will require precision‑enriched designs, with biomarker‑defined populations, cognitive‑trajectory modeling, and integrated cognitive and functional endpoints.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
Maternal Traumatic Brain Injury Increases Fetal Brain Cis p-tau Levels: Evidence for Potential Transplacental Effects in a Murine Model.
Journal of molecular neuroscience : MN, 76(3):.
Traumatic brain injury (TBI) is a well-established risk factor for Alzheimer's disease-related tauopathy. However, whether maternal TBI can lead to transgenerational transmission of pathogenic tau to offspring remains unknown. This study examines whether maternal Traumatic brain injury (TBI) induces pathogenic tau transfer to offspring, impairing fetal brain development. TBI was induced in pregnant Balb/C mice prior to pregnancy using a weight-drop model, while the sham group underwent anesthesia without injury, and the fetal brains were analyzed for cis p-tau using immunofluorescence (IF) and Western blotting (WB). Maternal anxiety post-TBI was assessed via the Elevated Plus Maze (EPM). Compared with the sham group, maternal TBI resulted in 4.25 and 5.81-fold increase in cis p-tau aggregation in embryonic and fetal brains, respectively (F(2,12) = 68.45, p < 0.001; F(2,12) = 102.34, p < 0.0001), and protein levels showed 3.13- and 6.79-fold increases (F(2,12) = 45.12, p < 0.001; F(2,12) = 89.67, p < 0.0001). This was accompanied by a significant increase in apparent transfer efficiency of p-tau to fetal brains (t(8) = 12.50, p < 0.0001). EPM assessment revealed that TBI-induced dams spent significantly more time in the open arms compared with sham (t(8) = 2.65, p = 0.029), suggesting reduced anxiety-like behavior or increased risk-taking. Maternal serum p-tau181 and fetal cis p-tau showed a positive but non-significant correlation (r(3) = 0.78, p = 0.120). These changes were associated with IL-6 and TNF increased by 2.8-fold (t(8) = 4.22, p = 0.003) and 1.8-fold (t(8) = 2.45, p = 0.040), respectively. These findings demonstrate a significant increase in apparent p-tau transfer efficiency from maternal serum to fetal brain following maternal TBI, although the correlation between maternal serum p-tau181 and fetal brain cis p-tau did not reach statistical significance.
Additional Links: PMID-42530714
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@article {pmid42530714,
year = {2026},
author = {Asgari, M and Mousavi, SE and Zaeifi, D and Ehsani, E},
title = {Maternal Traumatic Brain Injury Increases Fetal Brain Cis p-tau Levels: Evidence for Potential Transplacental Effects in a Murine Model.},
journal = {Journal of molecular neuroscience : MN},
volume = {76},
number = {3},
pages = {},
pmid = {42530714},
issn = {1559-1166},
support = {1402-2-209-67616//Experimental Medicine Research Center, Tehran University of Medical Sciences/ ; },
mesh = {Animals ; Female ; Pregnancy ; *tau Proteins/metabolism/genetics ; *Brain Injuries, Traumatic/metabolism ; Mice ; *Brain/metabolism/embryology ; Mice, Inbred BALB C ; *Maternal-Fetal Exchange ; },
abstract = {Traumatic brain injury (TBI) is a well-established risk factor for Alzheimer's disease-related tauopathy. However, whether maternal TBI can lead to transgenerational transmission of pathogenic tau to offspring remains unknown. This study examines whether maternal Traumatic brain injury (TBI) induces pathogenic tau transfer to offspring, impairing fetal brain development. TBI was induced in pregnant Balb/C mice prior to pregnancy using a weight-drop model, while the sham group underwent anesthesia without injury, and the fetal brains were analyzed for cis p-tau using immunofluorescence (IF) and Western blotting (WB). Maternal anxiety post-TBI was assessed via the Elevated Plus Maze (EPM). Compared with the sham group, maternal TBI resulted in 4.25 and 5.81-fold increase in cis p-tau aggregation in embryonic and fetal brains, respectively (F(2,12) = 68.45, p < 0.001; F(2,12) = 102.34, p < 0.0001), and protein levels showed 3.13- and 6.79-fold increases (F(2,12) = 45.12, p < 0.001; F(2,12) = 89.67, p < 0.0001). This was accompanied by a significant increase in apparent transfer efficiency of p-tau to fetal brains (t(8) = 12.50, p < 0.0001). EPM assessment revealed that TBI-induced dams spent significantly more time in the open arms compared with sham (t(8) = 2.65, p = 0.029), suggesting reduced anxiety-like behavior or increased risk-taking. Maternal serum p-tau181 and fetal cis p-tau showed a positive but non-significant correlation (r(3) = 0.78, p = 0.120). These changes were associated with IL-6 and TNF increased by 2.8-fold (t(8) = 4.22, p = 0.003) and 1.8-fold (t(8) = 2.45, p = 0.040), respectively. These findings demonstrate a significant increase in apparent p-tau transfer efficiency from maternal serum to fetal brain following maternal TBI, although the correlation between maternal serum p-tau181 and fetal brain cis p-tau did not reach statistical significance.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Animals
Female
Pregnancy
*tau Proteins/metabolism/genetics
*Brain Injuries, Traumatic/metabolism
Mice
*Brain/metabolism/embryology
Mice, Inbred BALB C
*Maternal-Fetal Exchange
RevDate: 2026-07-30
RETRACTION: The Preventive Effects of Edible Folic Acid on Cardiomyocyte Apoptosis and Survival in Early Onset Triple-transgenic Alzheimer's Disease Model Mice.
Environmental toxicology [Epub ahead of print].
K. Lin, C. Chiu, W. Kuo, D. Ju, C. Shen, R. Chen, C. Lin, V. P. Viswanadha, J. Liu, R. S. Huang, and C. Huang, "The Preventive Effects of Edible Folic Acid on Cardiomyocyte Apoptosis and Survival in Early Onset Triple-transgenic Alzheimer's Disease Model Mice," Environmental Toxicology 33, no. 1 (2017): 83-92, https://doi.org/10.1002/tox.22498. The above article, published online on 25 October 2017 in Wiley Online Library (https://wileyonlinelibrary.com), has been retracted by agreement between the journal's Editor-in-Chief, April Rodd, and Wiley Periodicals LLC. A third party reported on PubPeer [1] that bands in Figures 2, 3, and 4 appeared to have been duplicated in other articles and preprints [Chiang et al. 2016 (https://doi.org/10.3402/fnr.v60.31417); Bai et al. 2019 (https://doi.org/10.1101/823088); and Asokan et al. 2019 (https://doi.org/10.1186/s12906-019-2700-8)]. Each article describes these bands as different samples and many show additional blots that were not included in this article. Additionally, the GAPDH control bands in Figures 2 and 3 in this article also appear to have been duplicated. The retraction has been agreed to because the evidence of data duplication and manipulation fundamentally compromises the editors' confidence in the results presented in this article. The authors were informed of the retraction. Reference [1] René Aquarius, Comments on "The preventive effects of edible folic acid on cardiomyocyte apoptosis and survival in early onset triple-transgenic Alzheimer's disease model mice," PubPeer, April 2026. https://pubpeer.com/publications/76A62C91CAA2ABA60C4A9E31783C55.
Additional Links: PMID-42530851
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PubMed:
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@article {pmid42530851,
year = {2026},
author = {},
title = {RETRACTION: The Preventive Effects of Edible Folic Acid on Cardiomyocyte Apoptosis and Survival in Early Onset Triple-transgenic Alzheimer's Disease Model Mice.},
journal = {Environmental toxicology},
volume = {},
number = {},
pages = {},
doi = {10.1002/tox.70167},
pmid = {42530851},
issn = {1522-7278},
abstract = {K. Lin, C. Chiu, W. Kuo, D. Ju, C. Shen, R. Chen, C. Lin, V. P. Viswanadha, J. Liu, R. S. Huang, and C. Huang, "The Preventive Effects of Edible Folic Acid on Cardiomyocyte Apoptosis and Survival in Early Onset Triple-transgenic Alzheimer's Disease Model Mice," Environmental Toxicology 33, no. 1 (2017): 83-92, https://doi.org/10.1002/tox.22498. The above article, published online on 25 October 2017 in Wiley Online Library (https://wileyonlinelibrary.com), has been retracted by agreement between the journal's Editor-in-Chief, April Rodd, and Wiley Periodicals LLC. A third party reported on PubPeer [1] that bands in Figures 2, 3, and 4 appeared to have been duplicated in other articles and preprints [Chiang et al. 2016 (https://doi.org/10.3402/fnr.v60.31417); Bai et al. 2019 (https://doi.org/10.1101/823088); and Asokan et al. 2019 (https://doi.org/10.1186/s12906-019-2700-8)]. Each article describes these bands as different samples and many show additional blots that were not included in this article. Additionally, the GAPDH control bands in Figures 2 and 3 in this article also appear to have been duplicated. The retraction has been agreed to because the evidence of data duplication and manipulation fundamentally compromises the editors' confidence in the results presented in this article. The authors were informed of the retraction. Reference [1] René Aquarius, Comments on "The preventive effects of edible folic acid on cardiomyocyte apoptosis and survival in early onset triple-transgenic Alzheimer's disease model mice," PubPeer, April 2026. https://pubpeer.com/publications/76A62C91CAA2ABA60C4A9E31783C55.},
}
RevDate: 2026-07-30
Opposing effects of uric acid and triglycerides on cognitive decline cancel within a metabolic oxidative composite: Longitudinal evidence from CHARLS and cross-sectional replication in NHANES.
Journal of Alzheimer's disease : JAD [Epub ahead of print].
BackgroundComposite metabolic-oxidative scores have shown inconsistent associations with cognitive outcomes, yet whether their components move in the same direction remains unexamined.ObjectiveTo test whether Metabolic Oxidative Risk Score (MORS) tracks cognitive change, and to decompose MORS to assess whether component effects on cognitive slope are concordant or opposing.MethodsWe constructed a four-component MORS (uric acid, triglycerides, fasting glucose, reverse-scored HDL; range 4-20) and examined its association with cognitive change across four waves (2011-2018) in CHARLS (N = 7,300, age ≥ 45 years) using linear mixed models. Equivalence testing distinguished null findings from insufficient power. Components were decomposed individually and simultaneously. Cross-sectional triangulation used NHANES 2011-2014 (N = 1,340, age ≥ 60 years).ResultsThe adjusted MORS × time interaction was β = -0.00046 SD/year (95% CI -0.00185 to 0.00093; p = 0.516); equivalence testing rejected any clinically meaningful effect (p = 0.0002). Component decomposition revealed opposing effects: higher uric acid predicted steeper decline (β = -0.0055; p = 0.003) while higher triglycerides predicted attenuated decline (β = + 0.0042; p = 0.045), with near-perfect cancellation at the composite level. In NHANES, the MORS-cognition association reversed sign after socioeconomic adjustment and showed a significant non-linear association (p = 6 × 10[-4]); leave-one-out analysis identified uric acid as the dominant signal carrier.ConclusionsAn equal-weight metabolic-oxidative composite does not track cognitive decline because its components exert opposing effects that cancel. Uric acid emerges as an independent, potentially modifiable risk factor with implications for Alzheimer's disease prevention research.
Additional Links: PMID-42530901
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@article {pmid42530901,
year = {2026},
author = {Li, TY and Yu, ZM},
title = {Opposing effects of uric acid and triglycerides on cognitive decline cancel within a metabolic oxidative composite: Longitudinal evidence from CHARLS and cross-sectional replication in NHANES.},
journal = {Journal of Alzheimer's disease : JAD},
volume = {},
number = {},
pages = {13872877261471903},
doi = {10.1177/13872877261471903},
pmid = {42530901},
issn = {1875-8908},
abstract = {BackgroundComposite metabolic-oxidative scores have shown inconsistent associations with cognitive outcomes, yet whether their components move in the same direction remains unexamined.ObjectiveTo test whether Metabolic Oxidative Risk Score (MORS) tracks cognitive change, and to decompose MORS to assess whether component effects on cognitive slope are concordant or opposing.MethodsWe constructed a four-component MORS (uric acid, triglycerides, fasting glucose, reverse-scored HDL; range 4-20) and examined its association with cognitive change across four waves (2011-2018) in CHARLS (N = 7,300, age ≥ 45 years) using linear mixed models. Equivalence testing distinguished null findings from insufficient power. Components were decomposed individually and simultaneously. Cross-sectional triangulation used NHANES 2011-2014 (N = 1,340, age ≥ 60 years).ResultsThe adjusted MORS × time interaction was β = -0.00046 SD/year (95% CI -0.00185 to 0.00093; p = 0.516); equivalence testing rejected any clinically meaningful effect (p = 0.0002). Component decomposition revealed opposing effects: higher uric acid predicted steeper decline (β = -0.0055; p = 0.003) while higher triglycerides predicted attenuated decline (β = + 0.0042; p = 0.045), with near-perfect cancellation at the composite level. In NHANES, the MORS-cognition association reversed sign after socioeconomic adjustment and showed a significant non-linear association (p = 6 × 10[-4]); leave-one-out analysis identified uric acid as the dominant signal carrier.ConclusionsAn equal-weight metabolic-oxidative composite does not track cognitive decline because its components exert opposing effects that cancel. Uric acid emerges as an independent, potentially modifiable risk factor with implications for Alzheimer's disease prevention research.},
}
RevDate: 2026-07-30
Evaluation of the Addenbrooke's Cognitive Examination-Revised in a routine cognitive outpatient clinic.
Journal of Alzheimer's disease : JAD [Epub ahead of print].
BackgroundThe Addenbrooke's Cognitive Examination-Revised (ACE-R) is a widely used multidomain cognitive screening instrument. However, its performance in routine cognitive outpatient clinics with heterogeneous, diagnostically unselected populations remains insufficiently characterized.ObjectiveTo evaluate the diagnostic accuracy and clinical utility of ACE-R across the spectrum of cognitive impairment in a real-world cognitive outpatient setting.MethodsThis retrospective observational study included 348 consecutive patients attending a cognitive outpatient clinic. Diagnostic accuracy was assessed using binary and multiclass classification, and longitudinal cognitive trajectories were analysed using multilevel modelling.ResultsACE-R reliably differentiated dementia from non-dementia and distinguished Alzheimer's disease from mild cognitive impairment. Discrimination between subjective cognitive impairment and normal cognition was limited, consistent with the absence of objective cognitive deficits in subjective cognitive impairment. The instrument demonstrated greater sensitivity for cortical dementias than for subcortical conditions. Longitudinal analyses showed significant cognitive decline in Alzheimer's disease.ConclusionsACE-R is a practical and clinically useful screening tool for routine outpatient settings, particularly for dementia detection. However, limited sensitivity in early-stage impairment and restricted ability to differentiate dementia subtypes support its use within a multimodal diagnostic framework rather than as a standalone instrument.
Additional Links: PMID-42530906
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@article {pmid42530906,
year = {2026},
author = {Novotný, JS and Thatcher, A and Shatti, D and Mofardin, S and Rakuša, M and Kolenc, M and Zupan, M and Frol, S and Popović, KŠ and Oblak, JP and Bossert, I and Kuruvilla, T and Lyburn, I and Trifiro, G and Stokin, GB},
title = {Evaluation of the Addenbrooke's Cognitive Examination-Revised in a routine cognitive outpatient clinic.},
journal = {Journal of Alzheimer's disease : JAD},
volume = {},
number = {},
pages = {13872877261471428},
doi = {10.1177/13872877261471428},
pmid = {42530906},
issn = {1875-8908},
abstract = {BackgroundThe Addenbrooke's Cognitive Examination-Revised (ACE-R) is a widely used multidomain cognitive screening instrument. However, its performance in routine cognitive outpatient clinics with heterogeneous, diagnostically unselected populations remains insufficiently characterized.ObjectiveTo evaluate the diagnostic accuracy and clinical utility of ACE-R across the spectrum of cognitive impairment in a real-world cognitive outpatient setting.MethodsThis retrospective observational study included 348 consecutive patients attending a cognitive outpatient clinic. Diagnostic accuracy was assessed using binary and multiclass classification, and longitudinal cognitive trajectories were analysed using multilevel modelling.ResultsACE-R reliably differentiated dementia from non-dementia and distinguished Alzheimer's disease from mild cognitive impairment. Discrimination between subjective cognitive impairment and normal cognition was limited, consistent with the absence of objective cognitive deficits in subjective cognitive impairment. The instrument demonstrated greater sensitivity for cortical dementias than for subcortical conditions. Longitudinal analyses showed significant cognitive decline in Alzheimer's disease.ConclusionsACE-R is a practical and clinically useful screening tool for routine outpatient settings, particularly for dementia detection. However, limited sensitivity in early-stage impairment and restricted ability to differentiate dementia subtypes support its use within a multimodal diagnostic framework rather than as a standalone instrument.},
}
RevDate: 2026-07-30
Abnormal eye movements reflect early cortical and volumetric brain changes in apparently healthy, PM2.5-exposed urban youth.
Journal of Alzheimer's disease : JAD [Epub ahead of print].
BackgroundEye movement dysfunction plays an important role in understanding the pathology of neurodegenerative disorders. Fine particulate matter (PM2.5) exposures are associated with hallmark proteins diagnostic of Alzheimer's and Parkinson's diseases in Metropolitan Mexico City (MMC) ≤ 40-year-old residents.ObjectiveTo assess oculomotor function with neuroanatomical correlates using magnetic resonance imaging (MRI) region of interest analysis in young urbanites.MethodsVideo-based eye-tracking was used to explore oculomotor dysfunction and structural brain MRI changes in two highly exposed PM2.5 cohorts. We assessed fixation stability, smooth pursuit, pro-saccades, and anti-saccades using the Eyelink 1000-plus eye-tracker, in 80 volunteers' age 33 ± 11 years from MMC and Cuernavaca. Forty-five MMC subjects age 31.2 ± 14.7 years with oculomotor assessment had brain MRIs. Measurements of saccadic accuracy, latency, and smooth pursuit gain and square wave jerk frequency were collected.ResultsOculomotor variables did not reach statistically significant differences in MMC versusCuernavaca. Abnormal antisaccades, low gain pursuit, and square wave jerks were documented more often in MMC residents. Correlational analysis between oculomotor function and structural MRI data revealed statistical cortical and subcortical changes at frontal-temporal-parietal regions, hippocampus, thalamus, caudate, amygdala, habenula, nucleus accumbens, and cerebellum. Involved regions potentially reveal the location and severity of neurodegeneration processes via altered saccade parameters.ConclusionsOur findings suggest that simple oculomotor test batteries may provide a useful tool to monitor and/or measure the impact of pollution on neurodevelopment and early neurodegeneration. The integration of ocular movement parameters into the Continuum model of neurodegeneration offers a promising approach for neuroprotection decision-making and rigorous emissions control in polluted settings.
Additional Links: PMID-42530934
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PubMed:
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@article {pmid42530934,
year = {2026},
author = {Calderón-Garcidueñas, L and Stommel, EW and Hernández-Luna, J and Clouston, SAP and Muñoz, MJ and Loera-Barba, BA and Torres-Jardón, R and Nalbantoglu, OU},
title = {Abnormal eye movements reflect early cortical and volumetric brain changes in apparently healthy, PM2.5-exposed urban youth.},
journal = {Journal of Alzheimer's disease : JAD},
volume = {},
number = {},
pages = {13872877261471048},
doi = {10.1177/13872877261471048},
pmid = {42530934},
issn = {1875-8908},
abstract = {BackgroundEye movement dysfunction plays an important role in understanding the pathology of neurodegenerative disorders. Fine particulate matter (PM2.5) exposures are associated with hallmark proteins diagnostic of Alzheimer's and Parkinson's diseases in Metropolitan Mexico City (MMC) ≤ 40-year-old residents.ObjectiveTo assess oculomotor function with neuroanatomical correlates using magnetic resonance imaging (MRI) region of interest analysis in young urbanites.MethodsVideo-based eye-tracking was used to explore oculomotor dysfunction and structural brain MRI changes in two highly exposed PM2.5 cohorts. We assessed fixation stability, smooth pursuit, pro-saccades, and anti-saccades using the Eyelink 1000-plus eye-tracker, in 80 volunteers' age 33 ± 11 years from MMC and Cuernavaca. Forty-five MMC subjects age 31.2 ± 14.7 years with oculomotor assessment had brain MRIs. Measurements of saccadic accuracy, latency, and smooth pursuit gain and square wave jerk frequency were collected.ResultsOculomotor variables did not reach statistically significant differences in MMC versusCuernavaca. Abnormal antisaccades, low gain pursuit, and square wave jerks were documented more often in MMC residents. Correlational analysis between oculomotor function and structural MRI data revealed statistical cortical and subcortical changes at frontal-temporal-parietal regions, hippocampus, thalamus, caudate, amygdala, habenula, nucleus accumbens, and cerebellum. Involved regions potentially reveal the location and severity of neurodegeneration processes via altered saccade parameters.ConclusionsOur findings suggest that simple oculomotor test batteries may provide a useful tool to monitor and/or measure the impact of pollution on neurodevelopment and early neurodegeneration. The integration of ocular movement parameters into the Continuum model of neurodegeneration offers a promising approach for neuroprotection decision-making and rigorous emissions control in polluted settings.},
}
RevDate: 2026-07-30
Association between number of teeth and functional tooth units and prevalence of mild cognitive impairment in Japan: Baseline data from the Aidai Cohort Study.
Journal of Alzheimer's disease : JAD [Epub ahead of print].
BackgroundEpidemiological studies have suggested a possible association between tooth loss and dementia, yet evidence regarding mild cognitive impairment (MCI) remains limited.ObjectiveWe examined the association between the number of remaining teeth and functional tooth units (FTUs) and the prevalence of MCI.MethodsA total of 8697 adults aged 20-95 years (3786 men and 4911 women) were included. Dental status was assessed visually, excluding third molars. MCI was defined as a score of less than 26 on the Japanese version of the Montreal Cognitive Assessment. Participants were categorized into five groups based on the FTUs of natural teeth (n-FTUs) and total FTUs: n-FTUs ≥10; n-FTUs 6-9 and total FTUs ≥10; n-FTUs 6-9 and total FTUs <10; n-FTUs <6 and total FTUs ≥10; and n-FTUs <6 and total FTUs <10.ResultsThe prevalence of MCI was 35.5%. A reduced number of teeth was significantly associated with the higher prevalence of MCI (p for trend <0.0001). Compared with having n-FTUs ≥10, having n-FTUs <6 and total FTUs ≥10, and having n-FTUs <6 and total FTUs <10 were independently associated with a higher prevalence of MCI. There was no association between having 6-9 n-FTUs, regardless of total FTUs, and the prevalence of MCI.ConclusionsEven when occlusal function is maintained through prosthodontic restorations, a reduced number of natural teeth is independently associated with MCI, underscoring the importance of preserving natural dentition for maintaining cognitive health.
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@article {pmid42530937,
year = {2026},
author = {Tanaka, K and Ogawa, S and Suzuki, H and Fujiwara, Y and Nobuhara, T and Kato, H and Kawamoto, R and Kimura, E and Miyake, Y},
title = {Association between number of teeth and functional tooth units and prevalence of mild cognitive impairment in Japan: Baseline data from the Aidai Cohort Study.},
journal = {Journal of Alzheimer's disease : JAD},
volume = {},
number = {},
pages = {13872877261470790},
doi = {10.1177/13872877261470790},
pmid = {42530937},
issn = {1875-8908},
abstract = {BackgroundEpidemiological studies have suggested a possible association between tooth loss and dementia, yet evidence regarding mild cognitive impairment (MCI) remains limited.ObjectiveWe examined the association between the number of remaining teeth and functional tooth units (FTUs) and the prevalence of MCI.MethodsA total of 8697 adults aged 20-95 years (3786 men and 4911 women) were included. Dental status was assessed visually, excluding third molars. MCI was defined as a score of less than 26 on the Japanese version of the Montreal Cognitive Assessment. Participants were categorized into five groups based on the FTUs of natural teeth (n-FTUs) and total FTUs: n-FTUs ≥10; n-FTUs 6-9 and total FTUs ≥10; n-FTUs 6-9 and total FTUs <10; n-FTUs <6 and total FTUs ≥10; and n-FTUs <6 and total FTUs <10.ResultsThe prevalence of MCI was 35.5%. A reduced number of teeth was significantly associated with the higher prevalence of MCI (p for trend <0.0001). Compared with having n-FTUs ≥10, having n-FTUs <6 and total FTUs ≥10, and having n-FTUs <6 and total FTUs <10 were independently associated with a higher prevalence of MCI. There was no association between having 6-9 n-FTUs, regardless of total FTUs, and the prevalence of MCI.ConclusionsEven when occlusal function is maintained through prosthodontic restorations, a reduced number of natural teeth is independently associated with MCI, underscoring the importance of preserving natural dentition for maintaining cognitive health.},
}
RevDate: 2026-07-30
Burden trends of Alzheimer's disease and other dementias in China, 1990-2023: Sex, age, and risk-attributable patterns.
Annals of the Academy of Medicine, Singapore [Epub ahead of print].
INTRODUCTION: China's population has aged rapidly in recent decades, accompanied by a steady rise in Alzheimer's disease and other dementias (ADOD). Understanding long-term national trends is important for anticipating future healthcare needs.
METHOD: The authors analysed Global Burden of Disease (GBD) 2023 estimates for China from 1990 to 2023, following the Guidelines for Accurate and Transparent Health Estimates Reporting, with STROBE used as a secondary reporting reference. Deaths, disability-adjusted life years (DALYs), incidence, and prevalence were examined together with crude rates, age-standardised rates (ASRs), and average annual percentage changes. Results were evaluated and stratified by sex and broad age group. Modelled risk-attributable burden was assessed for selected GBD risk factors-ambient particulate matter pollution, high fasting plasma glucose, smoking, and household air pollution from solid fuels.
RESULTS: Over the study period, the number of people affected increased markedly. Deaths rose from 122,411 in 1990 to 586,002 in 2023, while DALYs and prevalent cases more than tripled. In contrast, ASR showed only modest upward changes. Women had higher ASRs in 2023, although mortality- and DALY-related rates increased more quickly among men. The burden remained concentrated in those aged 75 years and older. Among the selected exposures, ambient particulate matter pollution accounted for the largest attributable share in 2023, whereas household air pollution declined over time.
CONCLUSION: The marked increase in absolute ADOD burden, together with smaller changes in ASR, is consistent with demographic ageing being an important contributor to rising dementia-related service needs in China. The risk-attributable estimates suggest changing population-level patterns for selected environmental and metabolic exposures, but they should not be interpreted as individual-level causal effects.
Additional Links: PMID-42531044
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@article {pmid42531044,
year = {2026},
author = {Li, Y and Wang, S and Xie, K and Qian, S and Ma, M and Zhang, H},
title = {Burden trends of Alzheimer's disease and other dementias in China, 1990-2023: Sex, age, and risk-attributable patterns.},
journal = {Annals of the Academy of Medicine, Singapore},
volume = {},
number = {},
pages = {},
doi = {10.47102/annals-acadmedsg.2026146},
pmid = {42531044},
issn = {2972-4066},
abstract = {INTRODUCTION: China's population has aged rapidly in recent decades, accompanied by a steady rise in Alzheimer's disease and other dementias (ADOD). Understanding long-term national trends is important for anticipating future healthcare needs.
METHOD: The authors analysed Global Burden of Disease (GBD) 2023 estimates for China from 1990 to 2023, following the Guidelines for Accurate and Transparent Health Estimates Reporting, with STROBE used as a secondary reporting reference. Deaths, disability-adjusted life years (DALYs), incidence, and prevalence were examined together with crude rates, age-standardised rates (ASRs), and average annual percentage changes. Results were evaluated and stratified by sex and broad age group. Modelled risk-attributable burden was assessed for selected GBD risk factors-ambient particulate matter pollution, high fasting plasma glucose, smoking, and household air pollution from solid fuels.
RESULTS: Over the study period, the number of people affected increased markedly. Deaths rose from 122,411 in 1990 to 586,002 in 2023, while DALYs and prevalent cases more than tripled. In contrast, ASR showed only modest upward changes. Women had higher ASRs in 2023, although mortality- and DALY-related rates increased more quickly among men. The burden remained concentrated in those aged 75 years and older. Among the selected exposures, ambient particulate matter pollution accounted for the largest attributable share in 2023, whereas household air pollution declined over time.
CONCLUSION: The marked increase in absolute ADOD burden, together with smaller changes in ASR, is consistent with demographic ageing being an important contributor to rising dementia-related service needs in China. The risk-attributable estimates suggest changing population-level patterns for selected environmental and metabolic exposures, but they should not be interpreted as individual-level causal effects.},
}
RevDate: 2026-07-30
CmpDate: 2026-07-30
XYomics: detecting sex-dependent molecular mechanisms in omics data.
Nucleic acids research, 54(14):.
Understanding sex-dependent differences in disease risk, manifestation, and treatment response is essential for precision medicine. While funding agencies now mandate consideration of Sex as a Biological Variable (SABV), existing bioinformatics tools lack systematic approaches to characterize sex-related molecular mechanisms. Current practices frequently treat sex as a confounding variable, which may obscure important biological differences such as sex-specific alterations, sex-dimorphic changes (opposite effects between sexes), and sex-modulated changes (different effect magnitudes). We present XYomics, an open-source R package for systematic analysis of sex-dependent alterations in biomedical omics data. The software identifies sex-specific, sex-dimorphic, and sex-modulated changes at both individual feature and systems levels. XYomics implements dual analytical modes: sex-disease interaction term modeling for adequately powered datasets and sex-stratified analysis with robust non-significance filtering for smaller sample sizes. Using single-cell RNA sequencing data from Alzheimer's disease patients, we demonstrate how XYomics identifies sex-dimorphic genes largely undetected by standard sex-averaged analyses. By integrating statistical categorization with pathway enrichment and network analysis using a curated hormone signaling interactome, the software facilitates discovery of sex-specific biomarkers and disease mechanisms frequently obscured in sex-aggregated analyses.
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@article {pmid42531071,
year = {2026},
author = {Le Bars, S and Soudy, M and Glaab, E},
title = {XYomics: detecting sex-dependent molecular mechanisms in omics data.},
journal = {Nucleic acids research},
volume = {54},
number = {14},
pages = {},
doi = {10.1093/nar/gkag759},
pmid = {42531071},
issn = {1362-4962},
support = {//Luxembourg Fondation Wivine/ ; INTER/JPND23/17999421/AD-PLCG2//Luxembourg National Research Fund/ ; INTER/22/17104370/RECAST//Luxembourg National Research Fund/ ; INTER/EJP RD22/17027921/PreDYT//Luxembourg National Research Fund/ ; C24/BM/18865990/AsynIntact//Luxembourg National Research Fund/ ; },
mesh = {Humans ; *Software ; Male ; *Sex Characteristics ; *Alzheimer Disease/genetics/metabolism ; Female ; *Computational Biology/methods ; Genomics/methods ; Single-Cell Analysis ; },
abstract = {Understanding sex-dependent differences in disease risk, manifestation, and treatment response is essential for precision medicine. While funding agencies now mandate consideration of Sex as a Biological Variable (SABV), existing bioinformatics tools lack systematic approaches to characterize sex-related molecular mechanisms. Current practices frequently treat sex as a confounding variable, which may obscure important biological differences such as sex-specific alterations, sex-dimorphic changes (opposite effects between sexes), and sex-modulated changes (different effect magnitudes). We present XYomics, an open-source R package for systematic analysis of sex-dependent alterations in biomedical omics data. The software identifies sex-specific, sex-dimorphic, and sex-modulated changes at both individual feature and systems levels. XYomics implements dual analytical modes: sex-disease interaction term modeling for adequately powered datasets and sex-stratified analysis with robust non-significance filtering for smaller sample sizes. Using single-cell RNA sequencing data from Alzheimer's disease patients, we demonstrate how XYomics identifies sex-dimorphic genes largely undetected by standard sex-averaged analyses. By integrating statistical categorization with pathway enrichment and network analysis using a curated hormone signaling interactome, the software facilitates discovery of sex-specific biomarkers and disease mechanisms frequently obscured in sex-aggregated analyses.},
}
MeSH Terms:
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hide MeSH Terms
Humans
*Software
Male
*Sex Characteristics
*Alzheimer Disease/genetics/metabolism
Female
*Computational Biology/methods
Genomics/methods
Single-Cell Analysis
RevDate: 2026-07-28
The management of daily topics in conversations with individuals with Alzheimer's disease in Chinese residential care.
Social science & medicine (1982), 406:119617 pii:S0277-9536(26)00694-5 [Epub ahead of print].
BACKGROUND: Individuals with Alzheimer's Disease (AD) often experience difficulties managing topics in daily interactions, which can hinder their participation in interactions and affect their social engagement. There is a gap in exploring the interactional dynamics and the maintenance of personhood when interacting with individuals with AD in asymmetric institutional settings.
OBJECTIVES: This study aims to examine the interactional competence of individuals with AD and how their vulnerabilities are managed in daily-topic interactions within institutional healthcare settings.
METHODS: This study adopts Conversation Analysis (CA) to examine video-recorded conversations between a trained researcher and individuals with mild cognitive impairment due to AD residing in two residential care facilities in China.
FINDINGS: Individuals with mild AD demonstrate agency within asymmetric interactions by reshaping conversational frames, preserving face, and situating themselves within relational contexts to maintain their personhood. This agency emerges only when interlocutors actively engage, providing validation and recognition while accommodating temporary incoherence. These findings underscore the collaborative nature of sustaining identity in dementia care and highlight the particular significance of such interactional practices within the Chinese cultural context.
IMPLICATIONS: Conversation partners can support agency in individuals with AD by ratifying frame reconfigurations, sustaining topics, acknowledging repetitions, and responding flexibly to disengagement. Care facilities are also expected to create more opportunities for residents to engage in casual conversation.
Additional Links: PMID-42520619
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PubMed:
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@article {pmid42520619,
year = {2026},
author = {Zhao, H and Zhang, T and Liu, L and Zhang, S and Ma, W},
title = {The management of daily topics in conversations with individuals with Alzheimer's disease in Chinese residential care.},
journal = {Social science & medicine (1982)},
volume = {406},
number = {},
pages = {119617},
doi = {10.1016/j.socscimed.2026.119617},
pmid = {42520619},
issn = {1873-5347},
abstract = {BACKGROUND: Individuals with Alzheimer's Disease (AD) often experience difficulties managing topics in daily interactions, which can hinder their participation in interactions and affect their social engagement. There is a gap in exploring the interactional dynamics and the maintenance of personhood when interacting with individuals with AD in asymmetric institutional settings.
OBJECTIVES: This study aims to examine the interactional competence of individuals with AD and how their vulnerabilities are managed in daily-topic interactions within institutional healthcare settings.
METHODS: This study adopts Conversation Analysis (CA) to examine video-recorded conversations between a trained researcher and individuals with mild cognitive impairment due to AD residing in two residential care facilities in China.
FINDINGS: Individuals with mild AD demonstrate agency within asymmetric interactions by reshaping conversational frames, preserving face, and situating themselves within relational contexts to maintain their personhood. This agency emerges only when interlocutors actively engage, providing validation and recognition while accommodating temporary incoherence. These findings underscore the collaborative nature of sustaining identity in dementia care and highlight the particular significance of such interactional practices within the Chinese cultural context.
IMPLICATIONS: Conversation partners can support agency in individuals with AD by ratifying frame reconfigurations, sustaining topics, acknowledging repetitions, and responding flexibly to disengagement. Care facilities are also expected to create more opportunities for residents to engage in casual conversation.},
}
RevDate: 2026-07-28
Applications of quantum AI in brain disorder diagnosis: A systematic review.
Computer methods and programs in biomedicine, 286:109565 pii:S0169-2607(26)00314-7 [Epub ahead of print].
BACKGROUND AND OBJECTIVE: Brain disorder diagnosis and prediction remain challenging because neuroimaging, electrophysiological, behavioral, and multimodal data are high-dimensional, noisy, heterogeneous, and limited by small clinical cohorts. This systematic review synthesised applications of quantum artificial intelligence (QAI) for brain disorder diagnosis, prediction, detection, and monitoring.
METHODS: Following PRISMA guidelines, studies published from 2016 to 13 January 2026 were retrieved from Scopus, Web of Science, and IEEE Xplore. After screening, 36 studies met the eligibility criteria and were qualitatively analysed according to disorder category, data modality, QAI method, implementation setting, validation strategy, and performance.
RESULTS: At the broader disease-group level, neurodegenerative disorders were the most frequently investigated, followed by mental health and psychiatric disorders. At the individual level, Parkinson's disease and schizophrenia were the leading applications, followed by depression, anxiety, Alzheimer's disease, and stress-related tasks. MRI-based modalities were the most frequently used data source, followed by multimodal data and EEG. Methodologically, primary QAI approaches were dominated by quantum neural and QDL architectures, followed by quantum-inspired optimization or feature-selection methods and quantum-kernel/conventional QML classifiers. Qiskit/IBM Quantum and PennyLane were the most frequently reported quantum software frameworks. However, most studies relied on simulators, classical quantum-inspired implementations, or unclear implementation settings, with limited real-hardware evaluation.
CONCLUSIONS: QAI shows emerging potential for brain disorder analysis, particularly through hybrid quantum-classical learning, quantum neural architectures, quantum-kernel methods, and quantum-inspired optimization. Nevertheless, current evidence remains preliminary and requires larger datasets, subject-level and external validation, fair classical benchmarking, noise-resilient circuits, real quantum hardware evaluation, explainability, and clinical validation.
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@article {pmid42520739,
year = {2026},
author = {Jafari, M and Tang, Z and Acharya, UR and Li, Y},
title = {Applications of quantum AI in brain disorder diagnosis: A systematic review.},
journal = {Computer methods and programs in biomedicine},
volume = {286},
number = {},
pages = {109565},
doi = {10.1016/j.cmpb.2026.109565},
pmid = {42520739},
issn = {1872-7565},
abstract = {BACKGROUND AND OBJECTIVE: Brain disorder diagnosis and prediction remain challenging because neuroimaging, electrophysiological, behavioral, and multimodal data are high-dimensional, noisy, heterogeneous, and limited by small clinical cohorts. This systematic review synthesised applications of quantum artificial intelligence (QAI) for brain disorder diagnosis, prediction, detection, and monitoring.
METHODS: Following PRISMA guidelines, studies published from 2016 to 13 January 2026 were retrieved from Scopus, Web of Science, and IEEE Xplore. After screening, 36 studies met the eligibility criteria and were qualitatively analysed according to disorder category, data modality, QAI method, implementation setting, validation strategy, and performance.
RESULTS: At the broader disease-group level, neurodegenerative disorders were the most frequently investigated, followed by mental health and psychiatric disorders. At the individual level, Parkinson's disease and schizophrenia were the leading applications, followed by depression, anxiety, Alzheimer's disease, and stress-related tasks. MRI-based modalities were the most frequently used data source, followed by multimodal data and EEG. Methodologically, primary QAI approaches were dominated by quantum neural and QDL architectures, followed by quantum-inspired optimization or feature-selection methods and quantum-kernel/conventional QML classifiers. Qiskit/IBM Quantum and PennyLane were the most frequently reported quantum software frameworks. However, most studies relied on simulators, classical quantum-inspired implementations, or unclear implementation settings, with limited real-hardware evaluation.
CONCLUSIONS: QAI shows emerging potential for brain disorder analysis, particularly through hybrid quantum-classical learning, quantum neural architectures, quantum-kernel methods, and quantum-inspired optimization. Nevertheless, current evidence remains preliminary and requires larger datasets, subject-level and external validation, fair classical benchmarking, noise-resilient circuits, real quantum hardware evaluation, explainability, and clinical validation.},
}
RevDate: 2026-07-29
CmpDate: 2026-07-29
Anti-Amyloid Therapies for Early Alzheimer's Disease: Evidence-Based Recommendations.
South Dakota medicine : the journal of the South Dakota State Medical Association, 79(1):35-39.
BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia in older adults and represents a growing public health burden. Traditional therapies offer only symptomatic relief without modifying disease progression. Recently approved anti-amyloid monoclonal antibodies, donanemab and lecanemab, represent a shift toward disease-modifying treatment in patients with mild cognitive impairment (MCI) or mild AD with confirmed amyloid pathology.
METHODS: This review synthesizes current evidence from key clinical trials, real-world safety considerations, and expert-driven appropriate use recommendations (AURs) to guide the safe and effective use of donanemab and lecanemab.
RESULTS: Both agents demonstrate statistically significant and clinically meaningful slowing of cognitive and functional decline in early symptomatic AD. Key differences exist in their mechanisms of action, dosing schedules, and treatment duration. Safety monitoring, particularly for amyloid-related imaging abnormalities (ARIA) and apolipoprotein E (APOE) ε4 genotyping, is an essential component of care.
CONCLUSION: Anti-amyloid therapies offer a meaningful step forward in AD management, but their use requires careful patient selection, biomarker confirmation, and adherence to safety protocols. As long-term outcomes and comparative effectiveness remain uncertain, continued surveillance, patient education, and equitable access will be important in optimizing the clinical impact of anti-amyloid therapies.
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@article {pmid42520782,
year = {2026},
author = {Persson, J and Voss, G},
title = {Anti-Amyloid Therapies for Early Alzheimer's Disease: Evidence-Based Recommendations.},
journal = {South Dakota medicine : the journal of the South Dakota State Medical Association},
volume = {79},
number = {1},
pages = {35-39},
pmid = {42520782},
issn = {0038-3317},
mesh = {Humans ; *Alzheimer Disease/drug therapy ; *Antibodies, Monoclonal/therapeutic use ; Evidence-Based Medicine ; Cognitive Dysfunction/drug therapy ; },
abstract = {BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia in older adults and represents a growing public health burden. Traditional therapies offer only symptomatic relief without modifying disease progression. Recently approved anti-amyloid monoclonal antibodies, donanemab and lecanemab, represent a shift toward disease-modifying treatment in patients with mild cognitive impairment (MCI) or mild AD with confirmed amyloid pathology.
METHODS: This review synthesizes current evidence from key clinical trials, real-world safety considerations, and expert-driven appropriate use recommendations (AURs) to guide the safe and effective use of donanemab and lecanemab.
RESULTS: Both agents demonstrate statistically significant and clinically meaningful slowing of cognitive and functional decline in early symptomatic AD. Key differences exist in their mechanisms of action, dosing schedules, and treatment duration. Safety monitoring, particularly for amyloid-related imaging abnormalities (ARIA) and apolipoprotein E (APOE) ε4 genotyping, is an essential component of care.
CONCLUSION: Anti-amyloid therapies offer a meaningful step forward in AD management, but their use requires careful patient selection, biomarker confirmation, and adherence to safety protocols. As long-term outcomes and comparative effectiveness remain uncertain, continued surveillance, patient education, and equitable access will be important in optimizing the clinical impact of anti-amyloid therapies.},
}
MeSH Terms:
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Humans
*Alzheimer Disease/drug therapy
*Antibodies, Monoclonal/therapeutic use
Evidence-Based Medicine
Cognitive Dysfunction/drug therapy
RevDate: 2026-07-28
Parent-of-origin effects in Alzheimer's liability dissociate neurocognitive and cardiovascular traits in at-risk individuals.
Cell reports. Medicine pii:S2666-3791(26)00360-5 [Epub ahead of print].
Alzheimer's disease (AD) has a higher prevalence in women than men and is more frequently inherited from mothers than fathers. Yet, while neuroimaging and biomarker studies link maternal family history to stronger AD-related alterations, epidemiological studies suggest that paternal history confers comparable or even greater risk. Here, we leverage the deeply profiled PREVENT-AD cohort to derive three intermediate phenotypes of AD susceptibility. Drawing on nearly 1,000 individual study visits, we quantify how these intermediate phenotypes vary as a function of maternal versus paternal AD lineage. We show that lineage-specific differentiation, including both maternal and paternal biases, is reflected in the brain structure and phenome of adult children of AD patients. Cognitive and cardiovascular risk markers, together with associated genetic variants, show the strongest differentiation along the parental-lineage spectrum of disease susceptibility relative to other correlates of AD burden. Our cross-generational analysis ultimately delineates multidimensional parent-of-origin effects in AD genealogy.
Additional Links: PMID-42520805
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PubMed:
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@article {pmid42520805,
year = {2026},
author = {Savignac, C and St-Onge, F and Villeneuve, S and Badhwar, A and Gagliano Taliun, SA and Farhan, S and Geddes, M and Iturria Medina, Y and Poirier, J and Spreng, RN and Bzdok, D and , },
title = {Parent-of-origin effects in Alzheimer's liability dissociate neurocognitive and cardiovascular traits in at-risk individuals.},
journal = {Cell reports. Medicine},
volume = {},
number = {},
pages = {102943},
doi = {10.1016/j.xcrm.2026.102943},
pmid = {42520805},
issn = {2666-3791},
abstract = {Alzheimer's disease (AD) has a higher prevalence in women than men and is more frequently inherited from mothers than fathers. Yet, while neuroimaging and biomarker studies link maternal family history to stronger AD-related alterations, epidemiological studies suggest that paternal history confers comparable or even greater risk. Here, we leverage the deeply profiled PREVENT-AD cohort to derive three intermediate phenotypes of AD susceptibility. Drawing on nearly 1,000 individual study visits, we quantify how these intermediate phenotypes vary as a function of maternal versus paternal AD lineage. We show that lineage-specific differentiation, including both maternal and paternal biases, is reflected in the brain structure and phenome of adult children of AD patients. Cognitive and cardiovascular risk markers, together with associated genetic variants, show the strongest differentiation along the parental-lineage spectrum of disease susceptibility relative to other correlates of AD burden. Our cross-generational analysis ultimately delineates multidimensional parent-of-origin effects in AD genealogy.},
}
RevDate: 2026-07-28
Non-transgenic rodent models associated with Alzheimer's disease: applications, evaluation, and perspectives.
Neuroscience pii:S0306-4522(26)00507-5 [Epub ahead of print].
Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Familial AD accounts for less than 1% of cases, while sporadic AD (SAD) accounts for over 95%. Mild cognitive impairment (MCI) is the critical transition phase from normal aging to AD dementia. Understanding the pathological progression from MCI to AD and the mechanisms underlying SAD is essential. Rodent models, including transgenic and non-transgenic models, are vital tools for developing effective AD therapies. However, transgenic models primarily mimic familial AD and poorly replicate MCI and the complex pathological features of SAD. Non-transgenic models address these limitations by incorporating genetic, environmental, and aging factors, thereby better simulating SAD complexity. In addition, non-transgenic models are valuable for studying the compensatory mechanisms within neural networks that preserve cognitive function despite early pathology during MCI. In this review, we provide a comprehensive summary of non-transgenic rodent models used in AD and MCI research. First, we detail modeling strategies, including agents, administration routes, and dosages. Next, we discuss evaluation methods, such as behavioral and molecular assessments. We emphasize the importance of electrophysiological data, such as long-term potentiation, for evaluating cognition. Finally, we discuss the advantages and limitations of these non-transgenic models. This review may serve as a reference for selecting models to study the progression from MCI to AD and to develop related therapeutics. Combining non-transgenic and transgenic models more accurately replicates the complex, multifactorial pathology of the disease.
Additional Links: PMID-42520915
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PubMed:
Citation:
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@article {pmid42520915,
year = {2026},
author = {Xing, S and Ren, P and Chen, Z and Fu, Y},
title = {Non-transgenic rodent models associated with Alzheimer's disease: applications, evaluation, and perspectives.},
journal = {Neuroscience},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.neuroscience.2026.07.063},
pmid = {42520915},
issn = {1873-7544},
abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Familial AD accounts for less than 1% of cases, while sporadic AD (SAD) accounts for over 95%. Mild cognitive impairment (MCI) is the critical transition phase from normal aging to AD dementia. Understanding the pathological progression from MCI to AD and the mechanisms underlying SAD is essential. Rodent models, including transgenic and non-transgenic models, are vital tools for developing effective AD therapies. However, transgenic models primarily mimic familial AD and poorly replicate MCI and the complex pathological features of SAD. Non-transgenic models address these limitations by incorporating genetic, environmental, and aging factors, thereby better simulating SAD complexity. In addition, non-transgenic models are valuable for studying the compensatory mechanisms within neural networks that preserve cognitive function despite early pathology during MCI. In this review, we provide a comprehensive summary of non-transgenic rodent models used in AD and MCI research. First, we detail modeling strategies, including agents, administration routes, and dosages. Next, we discuss evaluation methods, such as behavioral and molecular assessments. We emphasize the importance of electrophysiological data, such as long-term potentiation, for evaluating cognition. Finally, we discuss the advantages and limitations of these non-transgenic models. This review may serve as a reference for selecting models to study the progression from MCI to AD and to develop related therapeutics. Combining non-transgenic and transgenic models more accurately replicates the complex, multifactorial pathology of the disease.},
}
RevDate: 2026-07-28
The Human Retina in Alzheimer's Disease: Pathology, Mechanisms, and Biomarkers.
Ageing research reviews pii:S1568-1637(26)00267-9 [Epub ahead of print].
Alzheimer's disease (AD) is characterized by progressive neurodegeneration and synaptic dysfunction that begins decades before clinical symptoms emerge. While AD research has traditionally focused on the brain, increasing evidence suggests that the retina undergoes pathological remodeling that shares features with cerebral changes. Advances in retinal imaging, including optical coherence tomography (OCT), OCT angiography, and hyperspectral approaches, have identified structural, vascular, and functional abnormalities in individuals with mild cognitive impairment (MCI) and early-stage AD. This supports the potential utility of the retina as a non-invasive biomarker for detecting neurodegenerative processes. Furthermore, postmortem studies have demonstrated accumulation of amyloid-β and phosphorylated tau, increased vulnerability of retinal ganglion cells (RGC), synaptic alterations in the inner plexiform layer (IPL), and significant activation of glial cells and complement-mediated inflammatory pathways. Melanopsin RGCs appear to be selectively affected, suggesting a mechanistic link between retinal pathology and the circadian or sleep disturbances commonly observed in AD. This review synthesizes human clinical data from imaging, histopathological, and proteomic studies supporting retinal involvement in AD, with emphasis on convergent mechanisms, including mitochondrial dysfunction, oxidative stress, microglial activation, and synaptic degeneration. Key limitations and sources of variation in current retinal biomarker studies, including cohort heterogeneity, comorbid ocular disease, and methodological variability, are discussed, and future directions are outlined to strengthen retinal diagnostics and therapeutic monitoring of visual system dysfunction in AD.
Additional Links: PMID-42521027
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PubMed:
Citation:
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@article {pmid42521027,
year = {2026},
author = {de Sevilla, LP and Majumdar, S and Recio, B},
title = {The Human Retina in Alzheimer's Disease: Pathology, Mechanisms, and Biomarkers.},
journal = {Ageing research reviews},
volume = {},
number = {},
pages = {103275},
doi = {10.1016/j.arr.2026.103275},
pmid = {42521027},
issn = {1872-9649},
abstract = {Alzheimer's disease (AD) is characterized by progressive neurodegeneration and synaptic dysfunction that begins decades before clinical symptoms emerge. While AD research has traditionally focused on the brain, increasing evidence suggests that the retina undergoes pathological remodeling that shares features with cerebral changes. Advances in retinal imaging, including optical coherence tomography (OCT), OCT angiography, and hyperspectral approaches, have identified structural, vascular, and functional abnormalities in individuals with mild cognitive impairment (MCI) and early-stage AD. This supports the potential utility of the retina as a non-invasive biomarker for detecting neurodegenerative processes. Furthermore, postmortem studies have demonstrated accumulation of amyloid-β and phosphorylated tau, increased vulnerability of retinal ganglion cells (RGC), synaptic alterations in the inner plexiform layer (IPL), and significant activation of glial cells and complement-mediated inflammatory pathways. Melanopsin RGCs appear to be selectively affected, suggesting a mechanistic link between retinal pathology and the circadian or sleep disturbances commonly observed in AD. This review synthesizes human clinical data from imaging, histopathological, and proteomic studies supporting retinal involvement in AD, with emphasis on convergent mechanisms, including mitochondrial dysfunction, oxidative stress, microglial activation, and synaptic degeneration. Key limitations and sources of variation in current retinal biomarker studies, including cohort heterogeneity, comorbid ocular disease, and methodological variability, are discussed, and future directions are outlined to strengthen retinal diagnostics and therapeutic monitoring of visual system dysfunction in AD.},
}
RevDate: 2026-07-28
Gating of Somatosensory Neural Oscillations Across the Lifespan: A Narrative Review.
Ageing research reviews pii:S1568-1637(26)00268-0 [Epub ahead of print].
Healthy and pathological aging are associated with progressive changes in cortical inhibition, yet the underlying neural mechanisms remain incompletely understood. Somatosensory gating (SG), the brain's suppression of redundant tactile input, provides a pre-attentive marker of inhibitory function. Paired-pulse paradigms concurrent with noninvasive magnetoencephalography (MEG) provide a millisecond portrayal of the neural dynamics underlying somatosensory processing and the gating of such responses with excellent spatial resolution. This narrative review synthesizes SG research focusing on neural oscillations, with a particular emphasis on gamma-band activity which is linked to GABAergic inhibitory processes. SG oscillatory metrics are sensitive to both healthy chronological aging and biological stressors such as allostatic load and epigenetic aging and offer insight beyond neural evoked responses. We also examine aberrant presentations of SG oscillatory metrics in age-related neuropathologies, including Alzheimer's disease and HIV-associated neurocognitive disorder, sensorimotor pathologies, and psychiatric conditions. Finally, we outline methodological considerations and propose future directions to refine SG oscillatory metrics as markers of inhibitory decline or potential compensatory mechanisms, situating the existing findings within prominent theories of neurocognitive aging. Collectively, this review underscores how an oscillatory perspective to brain function reveals frequency-specific somatosensory and inhibitory mechanisms, highlighting their differential sensitivity to healthy aging and pathology.
Additional Links: PMID-42521029
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PubMed:
Citation:
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@article {pmid42521029,
year = {2026},
author = {Virlley, M and Spooner, RK and Wilson, TW and Pruitt, T and Davenport, EM and Maldjian, JA and Proskovec, AL},
title = {Gating of Somatosensory Neural Oscillations Across the Lifespan: A Narrative Review.},
journal = {Ageing research reviews},
volume = {},
number = {},
pages = {103276},
doi = {10.1016/j.arr.2026.103276},
pmid = {42521029},
issn = {1872-9649},
abstract = {Healthy and pathological aging are associated with progressive changes in cortical inhibition, yet the underlying neural mechanisms remain incompletely understood. Somatosensory gating (SG), the brain's suppression of redundant tactile input, provides a pre-attentive marker of inhibitory function. Paired-pulse paradigms concurrent with noninvasive magnetoencephalography (MEG) provide a millisecond portrayal of the neural dynamics underlying somatosensory processing and the gating of such responses with excellent spatial resolution. This narrative review synthesizes SG research focusing on neural oscillations, with a particular emphasis on gamma-band activity which is linked to GABAergic inhibitory processes. SG oscillatory metrics are sensitive to both healthy chronological aging and biological stressors such as allostatic load and epigenetic aging and offer insight beyond neural evoked responses. We also examine aberrant presentations of SG oscillatory metrics in age-related neuropathologies, including Alzheimer's disease and HIV-associated neurocognitive disorder, sensorimotor pathologies, and psychiatric conditions. Finally, we outline methodological considerations and propose future directions to refine SG oscillatory metrics as markers of inhibitory decline or potential compensatory mechanisms, situating the existing findings within prominent theories of neurocognitive aging. Collectively, this review underscores how an oscillatory perspective to brain function reveals frequency-specific somatosensory and inhibitory mechanisms, highlighting their differential sensitivity to healthy aging and pathology.},
}
RevDate: 2026-07-28
Is amyloid beta peptide a driver of inflammaging?.
Ageing research reviews pii:S1568-1637(26)00272-2 [Epub ahead of print].
Inflammaging, the chronic subclinical systemic inflammation accompanying aging, represents a critical pathogenetic mechanism underlying age-related neurodegenerative diseases. While amyloid beta (Aβ) peptides are established contributors to neuroinflammation in Alzheimer's disease, their role in aging-related subclinical inflammation remains insufficiently elucidated. In humans, Aβ exhibits dual functions: it supports neuronal activity, survival, and protection against neurotrauma, while also promoting inflammation and central nervous system dysfunction. This review highlights the beneficial effects of Aβ, including its antioxidant and antipathogenic properties, and synthesizes current knowledge of the molecular mechanisms driving Aβ-associated inflammaging. We structure this analysis across distinct brain cell types - microglia, astrocytes, oligodendrocytes, neurons, pericytes, and endothelial cells - and consider additional factors influencing Aβ-related neuroinflammation. Finally, we examine strategies to counteract the detrimental effects of Aβ, focusing on Aβ physiological clearance via the blood-brain barrier and glymphatic system, as well as therapeutic interventions. Understanding Aβ-driven inflammaging mechanisms offers new therapeutic avenues for early intervention in age-related neurodegenerative diseases, particularly in genetically susceptible populations. Targeting Aβ-associated inflammaging reframes Aβ not solely as a pathological marker but also as a context-dependent contributor to inflammatory processes during brain aging.
Additional Links: PMID-42521030
Publisher:
PubMed:
Citation:
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@article {pmid42521030,
year = {2026},
author = {Kechko, OI and Moskalev, AA and Franceschi, C and Mitkevich, VA and Makarov, AA},
title = {Is amyloid beta peptide a driver of inflammaging?.},
journal = {Ageing research reviews},
volume = {},
number = {},
pages = {103280},
doi = {10.1016/j.arr.2026.103280},
pmid = {42521030},
issn = {1872-9649},
abstract = {Inflammaging, the chronic subclinical systemic inflammation accompanying aging, represents a critical pathogenetic mechanism underlying age-related neurodegenerative diseases. While amyloid beta (Aβ) peptides are established contributors to neuroinflammation in Alzheimer's disease, their role in aging-related subclinical inflammation remains insufficiently elucidated. In humans, Aβ exhibits dual functions: it supports neuronal activity, survival, and protection against neurotrauma, while also promoting inflammation and central nervous system dysfunction. This review highlights the beneficial effects of Aβ, including its antioxidant and antipathogenic properties, and synthesizes current knowledge of the molecular mechanisms driving Aβ-associated inflammaging. We structure this analysis across distinct brain cell types - microglia, astrocytes, oligodendrocytes, neurons, pericytes, and endothelial cells - and consider additional factors influencing Aβ-related neuroinflammation. Finally, we examine strategies to counteract the detrimental effects of Aβ, focusing on Aβ physiological clearance via the blood-brain barrier and glymphatic system, as well as therapeutic interventions. Understanding Aβ-driven inflammaging mechanisms offers new therapeutic avenues for early intervention in age-related neurodegenerative diseases, particularly in genetically susceptible populations. Targeting Aβ-associated inflammaging reframes Aβ not solely as a pathological marker but also as a context-dependent contributor to inflammatory processes during brain aging.},
}
RevDate: 2026-07-29
CmpDate: 2026-07-29
Protecting the brain from post-stroke cognitive impairment and dementia with multimodal exercise training: study protocol for a Bayesian adaptive trial (PROTECT).
BMJ open, 16(7):e123336 pii:bmjopen-2026-123336.
INTRODUCTION: Stroke triggers acute vascular and inflammatory mechanisms that predispose the brain to rapid neurodegeneration. Up to 52% of stroke survivors develop cognitive impairment within 6 months and 20% receive a clinical diagnosis of dementia within 5 years. The subacute phase (<6 months) represents a critical window in which the brain may be most responsive to neuroprotective interventions. Multimodal aerobic and resistance training improves cognition in chronic stroke, but whether it improves cognition, neuroimaging markers and blood biomarkers of dementia risk when delivered during this early window remains unknown. The PROTECT trial will compare the effects of 12 weeks of multimodal exercise (moderate-to-high-intensity resistance and aerobic training) versus a low-intensity exercise comparator on cognition, neuroimaging outcomes, blood biomarkers of cognitive decline and dementia risk in people with subacute stroke.
METHODS AND ANALYSIS: The PROTECT trial is a 12-week, Phase 3, assessor-blinded, multisite Bayesian adaptive randomised controlled trial (RCT) following a two-arm parallel group sequential design with 6-month and 12-month follow-up (NCT07445841). Participants will be randomised to multimodal training or the comparator using concealed allocation with permuted blocks of varying sizes. The primary outcome is cognition, measured using the 13-item Alzheimer's Disease Assessment Scale-Cognitive assessment (ADAS-Cog-13). Secondary outcomes include ADAS-Cog-Plus, structural and perfusion neuroimaging and blood biomarkers of inflammation and neurodegeneration. Tertiary outcomes include cardiorespiratory fitness, functional mobility, muscle strength, body composition, neuropsychological status, patient-reported cognition, quality of life, fatigue and healthcare utilisation. Outcomes will be assessed at baseline, post-intervention (primary endpoint) and at 6-month and 12-month follow-up. Sample size was estimated via 20 000 Monte Carlo simulations using an ADAS-Cog effect size of Cohen's d=0.63 from a previous exercise RCT. The target was ≥80% power to detect this treatment effect at a one-sided type I error rate of 2.5%, using a weakly informative prior centred at zero with a variance of 100. The minimum required was 45 completers per arm (N=90) and accounting for 25% attrition, up to 120 participants (60 per arm) will be enrolled. Pre-planned adaptive features include: (1) two interim analyses at 50% and 75% of completers; (2) early stopping for efficacy and futility; and (3) sample size re-estimation.
ETHICS AND DISSEMINATION: Ethical approval to conduct this study has been granted by the Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR MP-50-2025-2294) and Hamilton Integrated Research Board (HIREB 19222). Any protocol amendments will be submitted to the appropriate ethics boards. Written informed consent to participate in this study will be obtained from all participants by study coordinators or assistants. Study results will be published and reported in peer-reviewed journal following Adaptive Designs Consolidated Standards of Reporting Trials extension guidelines.
TRIAL REGISTRATION NUMBER: NCT07445841.
Additional Links: PMID-42521309
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PubMed:
Citation:
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@article {pmid42521309,
year = {2026},
author = {Moncion, K and Rodrigues, L and Bon, A and Sutoski, A and Sikorska, K and Allison, EY and Abreu, J and Golchi, S and Arbour, N and Gauthier, C and Paquette, C and Rosa-Neto, P and Leppert, I and Rowley, C and Tardiff, CL and Thiel, A and Al-Khazraji, B and Tang, A and Roig, M},
title = {Protecting the brain from post-stroke cognitive impairment and dementia with multimodal exercise training: study protocol for a Bayesian adaptive trial (PROTECT).},
journal = {BMJ open},
volume = {16},
number = {7},
pages = {e123336},
doi = {10.1136/bmjopen-2026-123336},
pmid = {42521309},
issn = {2044-6055},
mesh = {Humans ; *Stroke/complications ; *Stroke Rehabilitation/methods ; *Cognitive Dysfunction/prevention & control/etiology ; *Dementia/prevention & control/etiology ; Bayes Theorem ; *Exercise Therapy/methods ; Randomized Controlled Trials as Topic ; Clinical Trials, Phase III as Topic ; Resistance Training/methods ; Brain ; Multicenter Studies as Topic ; Biomarkers/blood ; Cognition ; Neuroimaging ; },
abstract = {INTRODUCTION: Stroke triggers acute vascular and inflammatory mechanisms that predispose the brain to rapid neurodegeneration. Up to 52% of stroke survivors develop cognitive impairment within 6 months and 20% receive a clinical diagnosis of dementia within 5 years. The subacute phase (<6 months) represents a critical window in which the brain may be most responsive to neuroprotective interventions. Multimodal aerobic and resistance training improves cognition in chronic stroke, but whether it improves cognition, neuroimaging markers and blood biomarkers of dementia risk when delivered during this early window remains unknown. The PROTECT trial will compare the effects of 12 weeks of multimodal exercise (moderate-to-high-intensity resistance and aerobic training) versus a low-intensity exercise comparator on cognition, neuroimaging outcomes, blood biomarkers of cognitive decline and dementia risk in people with subacute stroke.
METHODS AND ANALYSIS: The PROTECT trial is a 12-week, Phase 3, assessor-blinded, multisite Bayesian adaptive randomised controlled trial (RCT) following a two-arm parallel group sequential design with 6-month and 12-month follow-up (NCT07445841). Participants will be randomised to multimodal training or the comparator using concealed allocation with permuted blocks of varying sizes. The primary outcome is cognition, measured using the 13-item Alzheimer's Disease Assessment Scale-Cognitive assessment (ADAS-Cog-13). Secondary outcomes include ADAS-Cog-Plus, structural and perfusion neuroimaging and blood biomarkers of inflammation and neurodegeneration. Tertiary outcomes include cardiorespiratory fitness, functional mobility, muscle strength, body composition, neuropsychological status, patient-reported cognition, quality of life, fatigue and healthcare utilisation. Outcomes will be assessed at baseline, post-intervention (primary endpoint) and at 6-month and 12-month follow-up. Sample size was estimated via 20 000 Monte Carlo simulations using an ADAS-Cog effect size of Cohen's d=0.63 from a previous exercise RCT. The target was ≥80% power to detect this treatment effect at a one-sided type I error rate of 2.5%, using a weakly informative prior centred at zero with a variance of 100. The minimum required was 45 completers per arm (N=90) and accounting for 25% attrition, up to 120 participants (60 per arm) will be enrolled. Pre-planned adaptive features include: (1) two interim analyses at 50% and 75% of completers; (2) early stopping for efficacy and futility; and (3) sample size re-estimation.
ETHICS AND DISSEMINATION: Ethical approval to conduct this study has been granted by the Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR MP-50-2025-2294) and Hamilton Integrated Research Board (HIREB 19222). Any protocol amendments will be submitted to the appropriate ethics boards. Written informed consent to participate in this study will be obtained from all participants by study coordinators or assistants. Study results will be published and reported in peer-reviewed journal following Adaptive Designs Consolidated Standards of Reporting Trials extension guidelines.
TRIAL REGISTRATION NUMBER: NCT07445841.},
}
MeSH Terms:
show MeSH Terms
hide MeSH Terms
Humans
*Stroke/complications
*Stroke Rehabilitation/methods
*Cognitive Dysfunction/prevention & control/etiology
*Dementia/prevention & control/etiology
Bayes Theorem
*Exercise Therapy/methods
Randomized Controlled Trials as Topic
Clinical Trials, Phase III as Topic
Resistance Training/methods
Brain
Multicenter Studies as Topic
Biomarkers/blood
Cognition
Neuroimaging
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RJR Experience and Expertise
Researcher
Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.
Educator
Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.
Administrator
Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.
Technologist
Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.
Publisher
While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.
Speaker
Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.
Facilitator
Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.
Designer
Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.
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