@article {pmid41686995, year = {2026}, author = {Bacsu, JD and Mero, K and O'Connell, ME and Funk, M and Ménard, A and Norman, M and Blackstock, S and Mann, J and Hulko, W and D'Souza, MS and Fraser, S}, title = {Mapping the Landscape, Knowledge Gaps, and Areas for Innovation in Brain Health and Dementia Research in Canada: Protocol for a Scoping Review of Reviews.}, journal = {JMIR research protocols}, volume = {15}, number = {}, pages = {e79020}, doi = {10.2196/79020}, pmid = {41686995}, issn = {1929-0748}, mesh = {Humans ; Scoping Reviews as Topic ; *Dementia ; Canada ; *Brain ; *Biomedical Research ; Research Design ; }, abstract = {BACKGROUND: Dementia is one of Canada's most pressing public health challenges, with rates expected to surge in response to the country's aging population. Given the rapidly growing issue of dementia, understanding national research efforts is critical to prioritizing and advancing strategic directions in brain health and dementia research. Recently, the Canadian Institutes of Health Research awarded a 1-year funding grant from the Brain Health and Cognitive Impairment in Aging Research Initiative to map the scope of brain health and dementia research in Canada.
OBJECTIVE: This scoping review of reviews protocol aims to address this call by outlining the methodology that will be used for mapping the research landscape, documenting the knowledge gaps, and identifying areas of innovation to advance brain health and dementia research in Canada.
METHODS: Given the large volume of literature, a scoping review of Canadian-led reviews was selected as the most appropriate method because it would allow for a robust synthesis of nationally relevant research while mapping knowledge gaps and innovation. Our scoping review of reviews will follow the framework by Arksey and O'Malley along with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search will focus on peer-reviewed literature reviews published between January 1, 2020, and January 1, 2025, to capture the current state of knowledge since the national dementia strategy's publication in 2019. This search will be conducted using 5 electronic databases: CINAHL, PubMed, PsycInfo, Scopus, and Web of Science. Our data extraction table will include the following categories: author, province, and year; aim; review timeline; method; theme; knowledge gaps; innovations; and findings. The data will be analyzed using a combination of deductive and inductive thematic analysis.
RESULTS: This protocol was registered on June 5, 2025, with the Open Science Framework. This study was funded by the Canadian Institutes of Health Research from November 2024 to November 2025. The anticipated timeline for the publication of the full scoping review of reviews is May 2026. The findings from this review will be shared through targeted knowledge mobilization activities such as presentations at national funding agency meetings, academic conferences, and community workshops.
CONCLUSIONS: Our scoping review of reviews will provide a robust synthesis of the brain health and dementia research landscape, helping document critical knowledge gaps and identify areas for innovation. The results of this research will provide critical data to help inform strategic funding initiatives and future research directions. The findings from our scoping review will have implications for research funders, policymakers, community organizations, and researchers that are working to accelerate brain health and dementia research across Canada.}, }
@article {pmid41686674, year = {2026}, author = {Luo, Y and Wen, H and Li, W and Wang, X and Zheng, X and Ge, H and Yin, Y and Chen, L and Wu, X and Hou, W}, title = {Acute deep brain stimulation induces sustained changes in theta and gamma oscillations in Alzheimer's disease model mice.}, journal = {IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society}, volume = {PP}, number = {}, pages = {}, doi = {10.1109/TNSRE.2026.3664396}, pmid = {41686674}, issn = {1558-0210}, abstract = {Hippocampal theta and gamma oscillations degenerate early in Alzheimer's disease (AD), and may be a critical pathogenic factor and therapeutic target for AD. Deep brain stimulation (DBS) improves abnormal theta and gamma oscillations in AD; however, how these oscillations dynamically change after stimulation remains unclear. Exploring the prolonged neuroregulatory effects of DBS is essential for optimizing parameters and treatment strategies. Therefore, we investigated the sustained changes in the theta and gamma oscillations of the hippocampal cornu ammonis 1 region induced by acute DBS of the entorhinal cortex in APP/PS1 model mice and explored the underlying mechanisms. The results showed that the theta (4-8 Hz), low gamma (30-50 Hz) and high gamma (50-100 Hz) power of DBS-treated APP/PS1 mice exhibited a dynamic increase-decrease-increase trend, and the modulation index of theta and high gamma increased significantly and persisted for three weeks after DBS. Compared with the pre-DBS state, the firing rates of interneurons in APP/PS1 mice decreased significantly, while those of pyramidal neurons increased significantly, and the mean vector lengths of pyramidal neurons and interneurons with theta and gamma oscillations decreased significantly. Furthermore, the expression of CaMKII-α and GAD67 increased significantly. These findings suggest that acute DBS targeting the entorhinal cortex induces compensatory changes in the power of theta and gamma oscillations in APP/PS1 mice potentially by regulating the neuronal excitatory/inhibitory balance, thereby improving neuronal information transmission.}, }
@article {pmid41686334, year = {2026}, author = {Bautista, JLC and Abellanosa, EAM and Jardiolin, JG and Calpo, RAA and Noriega, CNC and Devanadera, MKP and Lopez, SMM and Guevarra, LA}, title = {Web of Potentials: Neuroactive Components of Spider Venom and Their Emerging Pharmacologic Applications in Neurologic Diseases.}, journal = {BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy}, volume = {}, number = {}, pages = {}, pmid = {41686334}, issn = {1179-190X}, abstract = {Spider venom has emerged as a promising source of neuroactive compounds with potential applications in the treatment of complex neurological disorders. With over 53,000 described species and more yet to be studied, spiders possess one of the most chemically diverse venoms in the animal kingdom. This diversity has evolved through ecological adaptation, enabling spiders to paralyze and manipulate the nervous systems of a wide range of prey. These same mechanisms, which target ion channels, neurotransmitter receptors, and signaling enzymes, coincide with pathways implicated in human neurologic diseases. By examining the structure-function relationships of spider venom components, this review highlights how venom compounds can modulate neuronal excitability, synaptic transmission, inflammation, and neurodegeneration. Evidence of therapeutic relevance is found in diseases such as Alzheimer's disease, Parkinson's disease, epilepsy, stroke, erectile dysfunction, and anxiety, where specific spider-derived components have demonstrated potential disease-modifying effects. Furthermore, by integrating molecular action with disease relevance and ecological context, this review proposes a shift in how spider venom is viewed-not simply as a source of isolated toxins, but as a platform for next-generation therapeutics. This integration of ecological, molecular, and therapeutic dimensions not only synthesizes current knowledge but also charts a path for future interdisciplinary research by revealing critical translational gaps and offering strategies to bridge them toward effective neurotherapeutics.}, }
@article {pmid41685967, year = {2026}, author = {Ramesh, M and Padmaja, P and Ugale, V and Shirkhedkar, A and Pawara, R and Lokwani, D and Manda, S and Reddy, PN}, title = {Structural Exploration of Pyrazine-1,2,3-Triazole Hybrids as Selective Acetylcholinesterase Inhibitors for the Treatment of Alzheimer's Disease.}, journal = {Drug development research}, volume = {87}, number = {2}, pages = {e70249}, doi = {10.1002/ddr.70249}, pmid = {41685967}, issn = {1098-2299}, mesh = {*Cholinesterase Inhibitors/pharmacology/chemistry/chemical synthesis ; *Alzheimer Disease/drug therapy ; *Triazoles/chemistry/pharmacology ; Molecular Docking Simulation ; Acetylcholinesterase/metabolism/chemistry ; Animals ; Structure-Activity Relationship ; *Pyrazines/chemistry/pharmacology ; Humans ; Butyrylcholinesterase/metabolism ; Mice ; Cell Line ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder that leads to gradual deterioration of cognitive functions. Cholinesterase enzymes play a critical role in regulating acetylcholine levels in the brain, and their dysfunction leads to impaired cholinergic neurotransmission, which is a primary hallmark of AD and contributes significantly to the cognitive decline and dementia. Here, a series of pyrazine-1,2,3-triazole molecular hybrids incorporating a trifluoromethyl (-CF3) group were synthesized (8a-o). Synthesized compounds were then evaluated in vitro for cytotoxicity and cholinesterase inhibitory activities. All synthesized compounds were found to be nontoxic toward BV-2 cells in the cytotoxicity screening. The in vitro inhibition assays revealed that these derivatives exhibited greater inhibitory potency against acetylcholinesterase (AChE) than butyrylcholinesterase (BuChE). Among them, compound 8h demonstrated the most potent AChE inhibition compared to BuChE (AChE, IC50 = 5.43 µM; BuChE, IC50 = 127.12 µM). The most active compound 8h was further subjected to molecular docking and dynamic simulation (100 ns) to investigate its binding affinity, thermodynamic behavior, and stability within the active site of cholinesterase enzymes. Overall, the findings suggested that the synthesized compounds represent promising drug candidates as selective acetylcholinesterase inhibitors for the treatment of AD.}, }
@article {pmid41685837, year = {2026}, author = {Jia, X and Guan, Y and Cao, W and Zhang, X and Duan, H and Guo, H and Chen, H and Wang, B and Li, T and Liao, J}, title = {NIR-responsive upconversion nanoplatforms: an anionic drug carrier for ROS amplification induced by β-amyloid fibrils.}, journal = {Dalton transactions (Cambridge, England : 2003)}, volume = {}, number = {}, pages = {}, doi = {10.1039/d5dt03121d}, pmid = {41685837}, issn = {1477-9234}, abstract = {Alzheimer's disease (AD), marked by the misfolding/aggregation of β-amyloid (Aβ), is a major global health challenge. Polyoxometalates (POMs), as anionic therapeutic agents, exhibit potential in depolymerizing Aβ fibrils, inhibiting Aβ fibrillation, and acting as a photocatalyst. To achieve targeted reactive oxygen species (ROS) amplification, we developed a chitosan-modified near-infrared (NIR)-responsive upconversion nanoplatform, UCNPs(Tm/Er)@SiO2@GPS@CH, as a targeted carrier for POMs. The nanoplatform was constructed by sequentially modifying upconversion nanoparticles (UCNPs) with a silica layer, 3-glycidoxypropyltrimethoxysilane (GPS, as a linker), and chitosan (CH, a cationic biomacromolecule). The cationic CH layer enabled efficient loading of anionic POMs through electrostatic interactions with an optimal POM loading capacity of 415.41 μg mg[-1] that positively correlated with CH modification levels. Under NIR irradiation, the nanoplatform triggered a photodynamic effect with abundant ROS. Notably, compared with the control group and Aβ monomer group, the ROS generation in the Aβ fibril group was approximately doubled, which further enhanced the targeted therapeutic efficacy of the system. By integrating NIR responsiveness, cationic chitosan, targeted ROS generation, and low systemic toxicity, the nanoplatform provides a novel strategy for the photooxidative treatment of AD and offers insights into the design of chitosan-modified upconversion nanoparticle-based drug carrier systems.}, }
@article {pmid41685608, year = {2026}, author = {Clark, HP and Horsley, D and Serpell-Stevens, A and Horton, T and Larsson, AI and Oluwabusola, ET and Ebel, R and De Clippele, LH and Jaspars, M}, title = {New Compounds From the Deep-sea Sponge Mycale lingua.}, journal = {Chemistry & biodiversity}, volume = {23}, number = {2}, pages = {e03519}, doi = {10.1002/cbdv.202503519}, pmid = {41685608}, issn = {1612-1880}, support = {BB/M010996/1/BB_/Biotechnology and Biological Sciences Research Council/United Kingdom ; 730984//ASSEMBLE Plus AmpLOPHELIA project/ ; GCBC//Department for Environment, Food and Rural Affairs, UK Government/ ; DEEPEND//Department for Environment, Food and Rural Affairs, UK Government/ ; }, mesh = {*Porifera/chemistry ; Animals ; Molecular Structure ; tau Proteins/metabolism/antagonists & inhibitors ; Humans ; Magnetic Resonance Spectroscopy ; }, abstract = {Three compatible solutes and one compound of unknown ecological function were isolated and characterized from the deep-sea sponge Mycale lingua (Bowerbank, 1866), collected from Tisler reef in Norway. These included the first isolation of asterubine and sulcatin from M. lingua as well as two new sulcatin analogues, sulcatin B and sulcatin C, which have not previously been reported from natural sources. Compound structures were elucidated through high-resolution liquid chromatography-mass spectrometry, and one- and two-dimensional nuclear magnetic resonance spectroscopic methods. All four compounds were tested in tau-tau aggregation assays to determine if they had potential for the treatment of Alzheimer's disease. No activity was displayed in either the cell-free or cell-based tau aggregation assays for any of the compounds.}, }
@article {pmid41685542, year = {2026}, author = {Kumar, GA and Pravallika, P and Thirumalai, V and Bukke, SPN and Rao, PBB and Thalluri, C and Chettupalli, AK and Onohuean, H}, title = {Persicaria hydropiper attenuates oxidative stress and reactive oxygen species, and inhibits amyloid-β/tau in SH-SY5Y cell lines via multiple pathways of Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261418555}, doi = {10.1177/13872877261418555}, pmid = {41685542}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) is a neurodegenerative disorder with progression leading to a decline in cognition. Despite the extensive research, conventional therapies have limited activity and often cause side effects. This demands the need for novel, safer, and effective treatment of AD.ObjectiveThe objective of this study was to determine the phytochemical constituents and determine the anti-Alzheimer's activity of Persicaria hydropiper.MethodsThe total phenol and flavonoid content of the Persicaria (MP) methanol extract was determined, and active principles were identified using GC-MS. The neuroprotective activity was investigated using biochemical assays against Aβ1-42-induced neurodegeneration in SH-SY5Y neuroblastoma cell lines.ResultsPhytochemical analysis revealed the presence of phenols (258.33 mg GAE) and flavonoids (48.31 mg QE). GC-MS identified the anti-inflammatory and antioxidant bioactive compounds. MP exhibited strong ABTS and DPPH radical-scavenging activities and inhibited AChE and BACE1 enzymes. In SHSY5Y cells, MP prevented Aβ1-42 aggregation, restored cell morphology, reduced reactive oxygen species levels, and preserved mitochondrial membrane potential. It suppressed Aβ and tau fibrillation, downregulated Bax and Caspase, upregulated Bcl2, Beclin-1, LC3B-II, and LAMP1, and reduced IL-6, TNF-α, and GSK3β expression, indicating potent neuroprotective, antioxidant, and anti-inflammatory effects.ConclusionsOverall, the results imply that Persicaria hydropiper exhibits protective activity on neuroblastoma cell lines by mitigating oxidative stress, Aβ/tau fibrils, cell death, and inflammation while also inducing autophagy induced by Aβ1-42. Further in vivo studies are needed to validate the findings to establish the plant as a potential source of anti-Alzheimer's drug.}, }
@article {pmid41685429, year = {2026}, author = {Doring, TH}, title = {TropMol: a cloud-based web tool for virtual screening and early-stage prediction of acetylcholinesterase inhibitors using machine learning.}, journal = {Organic & biomolecular chemistry}, volume = {}, number = {}, pages = {}, doi = {10.1039/d6ob00094k}, pmid = {41685429}, issn = {1477-0539}, abstract = {Alzheimer's disease (AD) is the most common type of dementia, accounting for at least two-thirds of dementia cases in people aged 65 and older. Numerous approaches have been studied for the treatment of this disease, including the cholinergic hypothesis. Acetylcholinesterase (AChE) is the most promising target studied within the cholinergic hypothesis for the treatment of AD. Therefore, it is necessary to develop predictive models for the identification of AChE inhibitors. Thus, general drug design models can assist chemical synthesis groups and biochemical testing laboratories by enabling virtual screening and drug design. In this work, the objective is to build a generic molecular screening prediction model for public, online and free use based on pIC50, using a random forest model (RF). For this, a dataset with approximately 16 000 compounds and 134 classes of descriptors was used, resulting in more than 2 000 000 calculated descriptors. Other algorithms were studied, such as gradient boosting, XGBoost, LightGBM, and RF with descriptors from principal component analysis (PCA), but none demonstrated significantly superior results compared to the RF model. The final model studied obtained an R[2] = 0.76 with a 15% test set and obtained an R[2] = 0.73 with a 30% test set, with rigorous Y-scrambling confirming the absence of chance correlation. External validation performed on an independent test set comprising 10% of the data yielded an R[2] of 0.77 and an RMSE of 0.67, statistically confirming that the model retains high predictive accuracy for novel chemical scaffolds and is free from overfitting. It is suggested that compounds containing oxime groups (RR'C = NOH) and those with high structural branching (higher Balaban index) tend to be less potent AChE inhibitors (negative correlation). In addition, some descriptors indicate that electronic charge distribution, molecular surface area, and hydrophobicity play important roles in correlating with the inhibitory activity (pIC50) of the compounds. The presence of linear alkane chains also seems relevant to activity (positive correlation and greater importance). The data and models are available at the following link: (https://colab.research.google.com/drive/1gMcuXAsrqTIBMNnsCEWG9xfkK7aaZAbn?usp=sharing).}, }
@article {pmid41684077, year = {2026}, author = {Sioufi, MC and Heroiu, I and Wong, S and Le, GH and Dri, CE and Zheng, YJ and Rhee, TG and Lo, HKY and Guillen-Burgos, HF and Teopiz, KM and McIntyre, RS}, title = {The Effect of GLP-1 Receptor Agonists on Autophagy: Insights Gathered from Research Evaluating Neurodegenerative Disorders With These Agents.}, journal = {Acta neuropsychiatrica}, volume = {}, number = {}, pages = {1-36}, doi = {10.1017/neu.2026.10060}, pmid = {41684077}, issn = {1601-5215}, abstract = {OBJECTIVE: Impaired autophagy has been implicated in the pathophysiology of neurodegenerative disorders, such as Alzheimer's Disease (AD) and Parkinson's Disease (PD). Consistent and replicated evidence indicate that Glucagon-like Peptide-1 Receptor Agonists (GLP-1RAs) exert treatment and preventative effects across disparate neurologic and mental disorders, potentially through mechanisms involving autophagy. This systematic review examined the effects of GLP-1RAs on autophagy in cell and animal models of AD and PD, as a proof of concept, to determine if these agents can be repurposed for the prevention and treatment of neurodegenerative and other mental disorders.
METHODS: A systematic search on PubMed, Web of Science, and OVID (Medline, Embase, and APA PsycInfo databases) was conducted from inception to June 17, 2025. Screening was performed independently by two reviewers (MCS and IH) using predefined inclusion and exclusion criteria. Subsequently, a quality assessment was conducted.
RESULTS: The search yielded 142 studies, of which 14 were included. Across studies, GLP-1RAs (e.g., liraglutide, semaglutide, and exendin-4) autophagy-specific markers, including beclin-1, LC3-II/LC3-I, ATG7, ATG3, and LAMP1, while normalizing p62 levels.
DISCUSSION: In addition to promoting neurogenesis, neuroplasticity, and reducing inflammation, GLP-1RAs appear to modulate molecular and cellular systems contributing to autophagy, potentially mediating their broad therapeutic effects. Collectively, these studies present promising findings of GLP-1RAs for neurodegenerative and mental disorders; however, further studies are required to establish their translatability to human populations.}, }
@article {pmid41684018, year = {2026}, author = {Zhao, Z and Yang, L and Zhang, Z and Song, J and Zhang, C and Duan, X}, title = {3,4-Dihydroxybenzaldehyde Exerts Anti-Alzheimer's Effects by Inhibiting Aβ Protofibril Assembly and Activating Antioxidant Defense Mechanisms.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, doi = {10.3390/ijms27031599}, pmid = {41684018}, issn = {1422-0067}, support = {82560897//National Natural Science Foundation of China/ ; XDYCQNRC-2022-0284//Xingdian Talent Support Program-Special for Young Talent/ ; 2023-05-007//High-level Talents Projects of Yunnan University of Chinese Medicine-Fifth Level Talents/ ; Zyyzdxk-2023193//National Administration of Traditional Chinese Medicine High-level Key Discipline Construction Project 'Dai Medicine'/ ; }, mesh = {Animals ; *Amyloid beta-Peptides/metabolism/chemistry ; Caenorhabditis elegans/metabolism/drug effects ; *Alzheimer Disease/drug therapy/metabolism ; *Antioxidants/pharmacology/metabolism ; *Benzaldehydes/pharmacology/chemistry ; Caenorhabditis elegans Proteins/metabolism ; Molecular Dynamics Simulation ; Signal Transduction/drug effects ; Forkhead Transcription Factors/metabolism ; Disease Models, Animal ; DNA-Binding Proteins ; Transcription Factors ; }, abstract = {3,4-Dihydroxybenzaldehyde (DBD) is a polyphenolic active constituent derived from Gastrodia elata. Its characteristic phenolic structure is associated with diverse bioactivities, such as anti-inflammatory, antioxidant, and cardioprotective effects. However, its role and underlying mechanisms in combating Alzheimer's disease (AD) remain inadequately elucidated. In this study, we employed computational and experimental approaches to investigate the anti-AD effects of DBD. Molecular dynamics simulations revealed that DBD binds to Aβ fibrils via π-π stacking, hydrophobic interactions, and hydrogen bonds, suggesting its potential to disrupt Aβ fibril stability and thereby inhibit aggregation. In vivo experiments in an AD C. elegans model demonstrated that 2 mM DBD treatment significantly delayed paralysis and extended lifespan. It also improved locomotor activity and pharyngeal pumping rates, while reducing lipofuscin accumulation. These results collectively suggest that DBD promotes healthspan-associated phenotypes. Broad-targeted metabolomics analysis indicated that DBD significantly altered the metabolic profile of the worms. Further mechanistic investigations suggested that the protective effects of DBD are associated with the activation of the DAF-16/FOXO and SKN-1/Nrf2 signaling pathways, accompanied by enhanced resistance to oxidative and thermal stress in nematodes. These findings suggest that DBD exhibits anti-AD potential through multimodal mechanisms, which involve interference with Aβ toxicity and reinforcement of cellular defense. This study supports DBD as a candidate compound and provides a rationale for its further investigation.}, }
@article {pmid41683895, year = {2026}, author = {Fernández-Ceballos, MLÁ and Vidal-Nogueira, L and Fernández-Pereira, C and Fortes-González, P and Salgado-Barreira, Á and Ledo-Matos, E and Santana-Muriel, E and Rivera-Baltanás, T and Olivares, JM and Veiga, C and Prieto-González, JM and Agís-Balboa, RC}, title = {Reduced Plasma Aβ Peptides but Stable NfL and GFAP in Major Depressive Disorder.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, doi = {10.3390/ijms27031474}, pmid = {41683895}, issn = {1422-0067}, support = {PI18/01311//Instituto de Salud Carlos III-ISCIII/ ; PID2022-138936OB-C31//Ministerio de Ciencia e Innovación/ ; PTA2023-023499-I,//Agencia Estatal de Investigación/ ; IN606A-2024/016//Agencia Gallega de Innovación/ ; }, mesh = {Humans ; *Amyloid beta-Peptides/blood ; *Glial Fibrillary Acidic Protein/blood ; *Major Depressive Disorder/blood ; Male ; Female ; *Neurofilament Proteins/blood ; Middle Aged ; Biomarkers/blood ; Adult ; Cross-Sectional Studies ; *Peptide Fragments/blood ; Aged ; Case-Control Studies ; }, abstract = {Major depressive disorder (MDD) has been associated with an increased risk of cognitive decline and neurodegenerative disorders like Alzheimer's disease (AD), prompting interest in peripheral biomarkers related to amyloid metabolism as well as neuroaxonal and astroglial injury. However, evidence regarding circulating markers in MDD remains inconsistent. In this cross-sectional study, we simultaneously assessed plasma levels of amyloid-β peptides (Aβ40 and Aβ42), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) in MDD patients and healthy controls (HC) using ultrasensitive single-molecule array (SIMOA) technology. Associations with clinical and cognitive scales were examined. Plasma concentrations of Aβ40 and Aβ42 were significantly lower in MDD patients, whereas no group differences were observed for NfL and GFAP, after correcting for age and sex. However, both Aβ peptides were not significantly associated with depressive symptom severity, whereas the Aβ42/Aβ40 ratio was negatively associated with anhedonia. NfL and GFAP levels were primarily influenced by age. In the absence of a reduced Aβ42/Aβ40 ratio, these findings suggest that reduced plasma Aβ levels in MDD may reflect systemic or metabolic factors associated with MDD, including lifestyle or treatment-related effects. Therefore, these findings should be interpreted with caution and further examined in longitudinal studies to prevent potential confounding factors.}, }
@article {pmid41683679, year = {2026}, author = {Zhang, L and Lu, T and Hua, Z and Peng, S and Du, H and Zhai, X and Cai, Z and Hua, J and Ma, X}, title = {Recent Advances in Polyoxometalates Targeting Proteins Associated with Alzheimer's Disease: From Molecular Mechanisms to Therapeutic Applications.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, doi = {10.3390/ijms27031257}, pmid = {41683679}, issn = {1422-0067}, support = {202303021211194//Shanxi Province Science Foundation/ ; 2025JG175//Research Project on Educational Reform of Postgraduate Education in Shanxi Province/ ; }, mesh = {*Alzheimer Disease/metabolism/drug therapy ; Humans ; *Tungsten Compounds/chemistry/therapeutic use/pharmacology ; Amyloid beta-Peptides/metabolism ; Animals ; Reactive Oxygen Species/metabolism ; Polyoxometalates ; }, abstract = {Polyoxometalates (POMs) exhibit significant potential for application in Alzheimer's disease (AD) therapeutics owing to their inherent chemical and physical properties and structural tunability. Through transition metal substitution, functional modification, and the construction of POMs-based nanocomposites, POMs can precisely recognize and effectively modulate various key pathogenic proteins involved in Alzheimer's disease. They can also intervene in disease progression through multiple mechanisms, including inhibition of Aβ aggregation, disaggregation of amyloid-β (Aβ), scavenging of reactive oxygen species (ROS), hydrolytic activity, and modulation of enzyme function. In addition, due to their outstanding physicochemical properties, the application of POMs in phototherapy has emerged as a significant direction in AD treatment research. This review systematically summarizes recent advances from 2011 to 2025 in POMs targeting key pathogenic proteins in AD, comprehensively analyzes their specific mechanisms of action across different therapeutic contexts, highlights their significant advantages and broad potential in AD treatment, and provides new insights for the future structural design, functional optimization, and clinical translation of POMs.}, }
@article {pmid41683566, year = {2026}, author = {Jha, D and Ancona, M and Oplt, F and Farmer, SL and Vagenknecht, M and Vazquez-Otero, A and Prazdnyk, I and Soukup, J and Mathew, RS and Peterson, V and Bitton, DA}, title = {InCytokine, an Open-Source Software, Reveals a TREM2 Variant-Specific Cytokine Signature.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, doi = {10.3390/ijms27031137}, pmid = {41683566}, issn = {1422-0067}, mesh = {*Receptors, Immunologic/genetics/metabolism ; *Membrane Glycoproteins/genetics/metabolism ; Humans ; *Cytokines/metabolism/genetics ; Microglia/metabolism/drug effects ; *Software ; Alzheimer Disease/genetics/metabolism ; Animals ; Lipopolysaccharides/pharmacology ; Mice ; Protein Array Analysis ; }, abstract = {Cytokine and chemokine profiling is central to understanding inflammatory processes and the mechanisms driving diverse diseases. We introduce InCytokine, an open-source tool for semiquantitative analysis of cytokine and chemokine data generated by protein array technologies. InCytokine features robust and modular image-processing workflows, including automated spot detection, template alignment, normalization, quality control measures, and quantitative intensity summarization to deliver consistent and reliable readouts from profiling assays. We evaluated InCytokine by profiling wild-type microglia, TREM2 knockout, and Alzheimer's disease-associated TREM2 R47H variant cells in response to lipopolysaccharide and sulfatide exposure. Differential expression analysis revealed unique sulfatide-specific and genotype-specific cytokine signatures in TREM2 variants. We also report an intriguing modulation of DPP4 and a divergent expression pattern of ENA-78 in TREM2 variants in response to lipopolysaccharide and sulfatide treatment. Such distinct expression signatures raise the possibility that TREM2 variants may play a role in modulating inflammatory signaling relevant to cardio-metabolic and Alzheimer's disease. These signatures were corroborated using transcriptional profiling of the same microglia cells, revealing also a good concordance between protein array and RNA sequencing technologies. Taken together, InCytokine is an interactive, user-friendly web application for rapid, reproducible, and scalable analysis of protein array data, proven to generate meaningful insights for drug and biomarker discovery campaigns in pharmaceutical settings.}, }
@article {pmid41683261, year = {2026}, author = {Marțiș, GS and Ungur, RA and Pop, A and Bordean, EM and Pașca, C and Borda, IM}, title = {Neuroprotective Herbs Associated with Parkinson's and Alzheimer's Disease.}, journal = {Nutrients}, volume = {18}, number = {3}, pages = {}, doi = {10.3390/nu18030439}, pmid = {41683261}, issn = {2072-6643}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; *Parkinson Disease/drug therapy ; *Neuroprotective Agents/pharmacology/therapeutic use ; Antioxidants/pharmacology/therapeutic use ; Phytochemicals/pharmacology/therapeutic use ; Animals ; *Phytotherapy ; *Plants, Medicinal/chemistry ; Polyphenols/pharmacology ; Flavonoids ; Plant Extracts/pharmacology/therapeutic use ; }, abstract = {There is currently no treatment for Parkinson's (PD) and Alzheimer's (AD) diseases, and medications that target the blockage of amyloid plaque cascades appear to be the most promising for preventing these diseases. However, it is believed that consuming natural antioxidants, particularly phytochemicals such as phenolic compounds, may help the treatment process for neurodegenerative illnesses. Phenolic substances such as phenolic acids, polyphenols, and flavonoids have been shown to have antioxidant properties in plants and are thought to have a similar impact in humans. This review provides an analysis of the current landscape of PD and AD pathophysiology, paying particular attention to phytochemical-based therapeutic, preventive, and management strategies using disclosed herb candidates in in vivo/vitro studies. We also highlight the herb-derived components that have recently been identified for their effects in the treatment of PD/AD to provide a review and perspectives for the development of the next generation of drugs and preparations for the treatment of PD/AD.}, }
@article {pmid41683016, year = {2026}, author = {Liu, J and Ren, G and Niu, S and Liu, Y and Zhao, Y and Sun, Z and Zhu, Q and Zhang, J and Mao, Y and Liu, Z and Guo, Q and Liu, H}, title = {Probiotics Lactobacillus acidophilus LA4 and Lacticaseibacillus paracasei F5 Alleviate Cognitive Dysfunction in Alzheimer's Disease Models: A Dual-Screening Study in Drosophila and Mice.}, journal = {Foods (Basel, Switzerland)}, volume = {15}, number = {3}, pages = {}, doi = {10.3390/foods15030429}, pmid = {41683016}, issn = {2304-8158}, support = {25YDTPJC00750//Tianjin Science and Technology Plan Project/ ; 25JCQNJC00840//Tianjin Science and Technology Plan Project/ ; }, abstract = {Identifying probiotics that modulate the gut-brain axis is vital for non-pharmacological Alzheimer's disease (AD) therapy. Through a staged screening from transgenic Drosophila to a D-galactose/AlCl3-induced murine model, Lactobacillus acidophilus LA4 and Lacticaseibacillus paracasei F5 were prioritized for their ability to improve climbing indices and reduce Aβ deposition and AChE activity. In AD mice, LA4 and F5 significantly ameliorated cognitive deficits and anxiety-like behaviors. Mechanistically, both strains reduced hippocampal Aβ1-42 and p-Tau levels, inhibited AChE, suppressed pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), and enhanced antioxidant enzymes (SOD, GSH-Px). 16S rRNA analysis revealed restored Firmicutes/Bacteroidetes ratios and enrichment of SCFA-producers (Muribaculaceae, Dubosiella). Metabolomics highlighted remodeled purine and arginine pathways, with strain-specific effects on primary bile acid biosynthesis/sphingolipid metabolism (LA4) and butanoate metabolism/nicotinate and nicotinamide metabolism (F5). Consequently, LA4 and F5 alleviate AD pathology by restructuring microbial and metabolic profiles, thereby mitigating neuroinflammation and oxidative stress. These findings confirm the potential of specific probiotics as functional food ingredients for the prevention and adjuvant treatment of neurodegenerative diseases.}, }
@article {pmid41682879, year = {2026}, author = {Jang, YJ and Chang, JH and Moon, DU and Jeon, HJ}, title = {Cognitive Impairment, Dementia and Depression in Older Adults.}, journal = {Journal of clinical medicine}, volume = {15}, number = {3}, pages = {}, doi = {10.3390/jcm15031198}, pmid = {41682879}, issn = {2077-0383}, support = {HR21C0885//Ministry of Health & Welfare, Republic of Korea/ ; }, abstract = {This narrative review integrates longitudinal cohort studies, neuroimaging and biomarker research, and major clinical trials to examine how depression and cognitive decline interact across the dementia continuum. Depression and cognitive impairment frequently co-occur in late life and exhibit substantial clinical and biological overlap. Meta-analytic and large population-based cohort studies consistently show that late-life depression increases the risk of mild cognitive impairment and dementia, with stronger associations observed for vascular dementia than for Alzheimer's disease. Neurobiological studies implicate cerebrovascular pathology, neuroinflammation, hypothalamic-pituitary-adrenal axis dysregulation, and fronto-subcortical circuit dysfunction as key mechanisms linking depressive symptoms to later cognitive decline. In a subset of older adults, new-onset depression-particularly when accompanied by executive dysfunction, subjective cognitive decline, or high white-matter hyperintensity burden-are associated with an increased likelihood of near-term cognitive decline and dementia, although evidence for a definitive prodromal state remains limited. Depression is also highly prevalent as part of the behavioral and psychological symptoms of dementia, occurring in 30-50% of individuals with Alzheimer's disease and even higher proportions in dementia with Lewy bodies or frontotemporal dementia. Comorbid depression in dementia accelerates cognitive and functional decline, increases neuropsychiatric burden, and worsens quality of life for patients and caregivers. Therapeutically, antidepressant treatment may confer modest benefits on mood and selected cognitive domains (e.g., processing speed and executive function) in non-demented older adults, whereas in established dementia, antidepressant efficacy is limited. In contrast, cholinesterase inhibitors, memantine, and multimodal non-pharmacological interventions yield small but measurable improvements in depressive or apathy-related symptoms. Emerging disease-modifying therapies for Alzheimer's disease have demonstrated cognitive benefits, but current trial data provide insufficient evidence regarding effects on depressive symptoms, highlighting an important gap for future research. These findings underscore the need for stage-specific, integrative strategies to address the intertwined trajectories of mood and cognition in aging.}, }
@article {pmid41681111, year = {2026}, author = {Liu, G and Xie, X and Niu, Y and Li, Y and Zhang, J and Jiao, X and Dou, X and Tang, Y and Wang, X and Tang, B}, title = {Aβ-Targeted Theranostic Agent for NIR Fluorescence Imaging Guided Type-I and Type-II Dual Photodynamic Therapy of Alzheimer's Disease.}, journal = {Analytical chemistry}, volume = {}, number = {}, pages = {}, doi = {10.1021/acs.analchem.5c07740}, pmid = {41681111}, issn = {1520-6882}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by the pathological aggregation of β-amyloid (Aβ), a key contributor to its pathogenesis. Current diagnostic and therapeutic strategies are hindered by limitations such as low sensitivity, high costs, limited efficacy, and severe side effects. In this study, we rationally designed a series of novel theranostic agents integrating Aβ-targeted fluorescence imaging and photodynamic therapy (PDT). Following theoretical calculations and experimental validation, we identified TA-2 as a promising candidate with superior binding affinity, excellent specificity, and a significant NIR fluorescence response to Aβ conformers. Upon NIR light activation, TA-2 generated both O2[•-] and [1]O2 via Type I and II dual mechanisms. This dual ROS generation profile is particularly beneficial for addressing the hypoxic conditions often encountered in Alzheimer's disease (AD) pathology. The photoinduced ROS specifically oxidized critical Aβ residues, disrupting Aβ aggregation and disassembling preformed Aβ fibrils. In vitro, TA-2 demonstrated neuroprotection against Aβ-induced cytotoxicity by alleviating neuronal apoptosis. Following systemic administration, TA-2 easily crossed the blood-brain barrier, bound specifically to Aβ plaques, and enabled real-time monitoring of AD progression and therapeutic efficacy via NIR fluorescence imaging. Meanwhile, PDT with TA-2 resulted in a reduction of cerebral Aβ burden, leading to improved cognitive function in AD mice. These findings position TA-2 as a promising Aβ-targeted theranostic agent, combining both fluorescence imaging and spatiotemporally controlled PDT for AD diagnosis and treatment. This work demonstrates a new paradigm of NIR fluorescence imaging guided PDT for precise AD intervention.}, }
@article {pmid41680984, year = {2026}, author = {Li, R and Huang, X and Lv, D and Wang, H and Qiao, S and Tan, L and Shi, X and Ren, Y and Wang, H}, title = {Mechanisms and clinical applications of transcranial alternating current stimulation in the treatment of neuropsychiatric disorders: Current evidence and future directions.}, journal = {Chinese medical journal}, volume = {}, number = {}, pages = {}, pmid = {41680984}, issn = {2542-5641}, abstract = {As a noninvasive brain stimulation technique, transcranial alternating current stimulation (tACS) can stimulate cortical neurons with sinusoidal and biphasic alternating current, which is expected to become an innovative neuromodulatory intervention for brain-related diseases. tACS primarily modulates the synchronization and desynchronization of neuronal electrical activity through low-intensity alternating current at specific frequencies, which regulates cortical excitability, alters endogenous cortical rhythms, and subsequently influences brain function. In recent years, tACS technology has been applied in clinical studies targeting various psychiatric and neurological disorders, demonstrating preliminary progress. However, the current research has focused mainly on feasibility studies and case analyses, while the effectiveness and safety of tACS modulation strategies require rigorous scientific validation. In the future, it will be necessary to conduct more high-quality, multicenter, large-sample randomized controlled double-blind trials targeting the different dysfunctions of patients with neuropsychiatric disorders and screen for optimal treatment parameters and stimulation sites to achieve the best neuromodulation effect. This article reviews the potential mechanisms, research progress, and factors influencing the therapeutic efficacy of tACS in the treatment of neuropsychiatric disorders. Furthermore, we discuss the existing challenges and future development trends in this field, aiming to provide novel insights and strategies for the clinical treatment and scientific investigation of neuropsychiatric disorders.}, }
@article {pmid41680609, year = {2026}, author = {Pourhossein, S and Mianrood, IB and Khatami, SH and Ehtiati, S and Ghasemian, M and Mokhtari, F and Ahmadzade, R and Goudarzi, M and Hamed, N and Namvarjah, F and Karima, S}, title = {Acetyl-11-keto-β-boswellic acid attenuates tau oligomer-induced neurotoxicity in neuroblastoma cell model.}, journal = {BMC neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12868-026-00996-6}, pmid = {41680609}, issn = {1471-2202}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by microtubule destabilization, neuroinflammation, and tau pathology. Among the proposed therapeutic approaches, acetyl-11-keto-β-boswellic acid (AKBA), a bioactive triterpene from Boswellia serrata, has gained attention due to its multiple neuroprotective mechanisms, including microtubule stabilization, anti-inflammatory activity, antioxidant effects, and promotion of neurogenesis. In this study, we aimed to investigate the neuroprotective effect of AKBA against tau oligomer-induced cytotoxicity in SH-SY5Y neuroblastoma cells.
RESULTS: Recombinant human tau protein was expressed, purified, and oligomerized, and the formation of oligomers was confirmed by thioflavin T fluorescence and dynamic light scattering (DLS). SH-SY5Y cells were then treated with AKBA and exposed to tau oligomers. Cell viability was assessed via MTT assay, and apoptosis was evaluated by flow cytometry. The morphology of tau aggregates was visualized using transmission electron microscopy.
CONCLUSIONS: Our findings demonstrated that AKBA significantly reduced tau oligomer-induced cytotoxicity and enhanced cell viability. These results suggest that AKBA, through its multifaceted protective mechanisms, holds promise as a potential therapeutic agent for the treatment of tauopathies such as Alzheimer's disease.
CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41680597, year = {2026}, author = {Roh, HW and Chang, YY and Kim, KY and Jeon, SY and Wang, SM and Kim, E and Bae, JN and Ryu, SH}, title = {Evolving Alzheimer's Disease Clinical Practice: Updated Diagnostic Criteria, Fluid Biomarkers, and Special Considerations for Anti-Amyloid Therapies.}, journal = {Psychiatry investigation}, volume = {23}, number = {2}, pages = {183-200}, doi = {10.30773/pi.2025.0400}, pmid = {41680597}, issn = {1738-3684}, support = {//Korean Association for Geriatric Psychiatry/ ; RS-2024-00450828//National Research Foundation of Korea/ ; //Ministry of Science and ICT/ ; }, abstract = {OBJECTIVE: This review overviewed the recent paradigm shifts in the diagnosis and management of Alzheimer's disease (AD), emphasizing the 2024 Alzheimer's Association (AA) revised criteria, advances in cerebrospinal fluid (CSF) and blood-based biomarkers (BBMs), and practical considerations for anti-amyloid monoclonal antibody therapy.
METHODS: We conducted a narrative appraisal of consensus frameworks (2018 National Institute on Aging-Alzheimer's Association [NIA-AA] amyloid, tau, and neurodegeneration [AT(N)] and the 2024 AA criteria), clinical practice guidance from AA released in 2025, regulatory status of CSF and BBMs. Intended-use settings (triage vs. confirmatory) of BBMs and implementation of anti-amyloid anti-body treatments (lecanemab or donanemab) in real-world practice in Korea were also reviewed.
RESULTS: The 2024 AA criteria define AD biologically and designate A and T as core biomarkers; Core 1 biomarkers can establish AD irrespective of symptoms, whereas Core 2 biomarkers refine staging. A two-cutoff BBM strategy (positive/intermediate/negative) reduces misclassification and guides confirmatory CSF/positron emission tomography (PET) or retesting. BBMs now approach CSF/PET accuracy for amyloid detection, enable triage and, in selected settings, confirmation, and show utility for monitoring treatment response. Integration of clinical stages (1-6) with biological stages (A-D) clarifies syndrome-pathology discordance. Special scenarios-maintenance after induction, APOE ε4 homozygotes, Down syndrome, and serious mental illness-require individualized risk-benefit assessment. In South Korea, constrained access to tau PET and some BBMs necessitates Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision-anchored evaluation with selective biomarker testing.
CONCLUSION: Biomarker-oriented diagnosis and anti-amyloid therapies are reshaping AD care. Priorities include rigorous validation of BBMs across populations, equitable access to core biomarkers, safety strategies, and real-world evidence to implement maintenance and special-population care pathways.}, }
@article {pmid41618453, year = {2026}, author = {Swain, A and Soni, ND and Gaspar, RB and Davis, JG and Liu, F and Juul, H and Nanga, RPR and Baur, JA and Reddy, R}, title = {In vivo imaging of glutamate uncovers the neuroprotective effects of nicotinamide riboside on excitotoxicity in an Alzheimer's mouse model.}, journal = {Alzheimer's research & therapy}, volume = {18}, number = {1}, pages = {37}, pmid = {41618453}, issn = {1758-9193}, support = {R01 DK098656/DK/NIDDK NIH HHS/United States ; R01 AG063869/AG/NIA NIH HHS/United States ; P41 EB029460/EB/NIBIB NIH HHS/United States ; R01 DK098656/DK/NIDDK NIH HHS/United States ; R01 AG063869/AG/NIA NIH HHS/United States ; P41 EB029460/EB/NIBIB NIH HHS/United States ; }, abstract = {BACKGROUND: Nicotinamide adenine dinucleotide (NAD[+]) precursors, such as nicotinamide riboside (NR), have gained interest as potential therapeutics for alleviating Alzheimer’s disease (AD) pathology. Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) can provide insights into the effects of NR on AD by virtue of its sensitivity to monitoring the metabolic status of tissue in vivo.
METHODS: This study used glutamate-weighted CEST (GluCEST) MRI to monitor glutamate-associated metabolic changes following NR treatment in the 5xFAD mouse model of AD. Drinking water was supplemented with NR or provided as is to animals over the course of expected disease progression prior to imaging experiments. Following imaging, an immunohistochemical assay to monitor the expression of glial fibrillary acidic protein (GFAP) and ionized calcium-binding adaptor molecule 1 (Iba1) was performed to assess the extent of neuroinflammatory glial responses. A two-way ANCOVA with interaction was performed for statistical analysis of both CEST and IHC data.
RESULTS: Results from GluCEST revealed significantly higher glutamate levels in the hippocampal dentate gyrus of AD mice compared to WT, with a significant reduction following treatment. GFAP staining mirrored this trend, implicating reactive astrogliosis as a mechanism for elevated glutamate. Similar patterns were observed in the cerebral peduncles, a white matter bundle, in which GFAP and Iba1 supported GluCEST findings and suggested neuroinflammation in axonal tracts. Our findings are in concordance with studies reporting elevated glutamate associated with reactive gliosis and morphological changes disrupting glutamate imbalance. Interestingly, NR restores glutamate homeostasis and alleviates neuroinflammatory processes, thus rescuing tissue from excitotoxic insults.
CONCLUSION: Overall, this study demonstrates the potential of NR to mitigate glutamate-driven excitotoxicity in AD pathology, and highlights GluCEST as a sensitive in vivo, clinically translatable biomarker for neuroinflammation and excitotoxicity.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13195-026-01958-0.}, }
@article {pmid41678018, year = {2026}, author = {Arbaciauskaite, S and Silvestri, S and Luo, P and Krüger, C and Mossmann, ZJ and Allelein, S and Scholz, A and Loeffler, D and Fiorenza, S and Menale, A and Torino, E and Kuhlmeier, D and Peters, O and Lehnardt, S}, title = {Microglia-Derived Extracellular Vesicles from Alzheimer's Disease Patients Carry miRNAs Driving a Neuroinflammatory Response.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {435}, pmid = {41678018}, issn = {1559-1182}, support = {LE 2420/7-1, SFB-TRR167/B03//Deutsche Forschungsgemeinschaft/ ; }, mesh = {*Microglia/metabolism/pathology ; *Alzheimer Disease/genetics/cerebrospinal fluid/pathology/metabolism ; *Extracellular Vesicles/metabolism ; Humans ; *MicroRNAs/metabolism/genetics ; Animals ; Mice ; *Neuroinflammatory Diseases/genetics/pathology/metabolism ; Aged ; Male ; Female ; HEK293 Cells ; Aged, 80 and over ; }, abstract = {Alzheimer's disease (AD) represents the most common cause of dementia and urgently requires sensitive biomarkers and effective therapies. Extracellular vesicles represent membranous nano-sized particles secreted from cells, which serve as intercellular messengers participating in central nervous system (CNS) homeostasis, but also are implicated in AD pathogenesis. In addition, EVs containing disease-specific signatures, such as microRNAs (miRNAs), are considered as potent tools for the diagnosis and treatment of AD and other brain disorders. In this study, we used TMEM119 antibody to immunocapture microglia-derived EVs from cerebrospinal fluid (CSF) of AD patients and control subjects. EVs harvested from these CSF samples contained distinct disease-specific miRNA profiles, as assessed by small RNA sequencing. Using a HEK TLR reporter cell system, we found that these miRNA are potent activators of human TLR8, an established RNA sensor. Out of the miRNAs present in AD-associated EVs, selected oligonucleotides were synthesized and loaded into BV2 microglia-derived EVs. Exposure of primary murine microglia to these miRNA-loaded EVs led to TNF release from these cells, thereby driving a neuroinflammatory response. Taken together, putatively microglia-derived EVs from the CSF of AD patients contain miRNAs, which are capable of activating hTLR8 and inducing an inflammatory response from microglia.}, }
@article {pmid41677765, year = {2026}, author = {Kim, H and Hong, JY and Yeo, C and Kim, H and Jeon, WJ and Lee, J and Lee, YJ and Ha, IH}, title = {Neuroprotective Effects of Herbal Formula Yookgong-Dan on Oxidative Stress-Induced Tau Hyperphosphorylation in Rat Primary Hippocampal Neurons.}, journal = {Biology}, volume = {15}, number = {3}, pages = {}, doi = {10.3390/biology15030294}, pmid = {41677765}, issn = {2079-7737}, abstract = {This study sought to evaluate the neuroprotective effects of YGD in an oxidative stress-induced Alzheimer's disease (AD)-like cellular model and to elucidate the underlying molecular pathways, with a focus on tau phosphorylation, Aβ accumulation, and antioxidant defense mechanisms. Rat primary hippocampal neurons were exposed to hydrogen peroxide to induce oxidative stress. The effects of YGD on neuronal viability, neurite outgrowth, and synaptic integrity were assessed using the immunodetection of microtubule-associated protein 2 (MAP2), postsynaptic density protein 95 (PSD-95), and synapsin-1. Levels of phosphorylated tau and Aβ were quantified, and the involvement of extracellular signal-regulated kinase (ERK), glycogen synthase kinase 3β (GSK3β), and nuclear factor-erythroid 2-related factor-2 (Nrf2) pathways was examined. Additionally, in silico molecular docking studies targeting the ATP-binding site of GSK3β were conducted to screen major phytochemicals from the ten medicinal herbs constituting YGD. YGD markedly enhanced neuronal viability under oxidative stress, promoted neurite extension, and increased synaptic marker expression (MAP2, PSD-95, and synapsin-1). Treatment reduced phosphorylated tau by suppressing ERK and GSK3β activation and significantly decreased Aβ accumulation. YGD also upregulated antioxidant defenses via the activation of the Nrf2 pathway. Docking simulations identified oleanolic acid (from Cornus officinalis) as the most potent GSK3β binder (-9.86 ± 0.40 kcal/mol), forming stable interactions with ARG96, ASN95, and GLU97. Additional compounds, including alisol C, drypemolundein B, and friedelin, demonstrated favorable binding energies and engaged key ATP-binding site residues. YGD confers neuroprotection through the integrated modulation of tau phosphorylation, Aβ pathology, and oxidative stress, partly via the multi-target engagement of GSK3β by its constituent phytochemicals. These findings support that YGD attenuates oxidative stress-induced AD-like cellular alterations.}, }
@article {pmid41677657, year = {2026}, author = {Dagla, I and Gkikas, F and Gikas, E and Tsarbopoulos, A}, title = {Targeting Amyloid Beta Aggregation and Neuroinflammation in Alzheimer's Disease: Advances and Future Directions.}, journal = {Cells}, volume = {15}, number = {3}, pages = {}, doi = {10.3390/cells15030295}, pmid = {41677657}, issn = {2073-4409}, mesh = {Humans ; *Alzheimer Disease/drug therapy/metabolism/pathology ; *Amyloid beta-Peptides/metabolism ; Animals ; *Neuroinflammatory Diseases/drug therapy ; Blood-Brain Barrier/metabolism ; Drug Delivery Systems ; *Protein Aggregation, Pathological/drug therapy ; Neuroprotective Agents/therapeutic use/pharmacology ; *Protein Aggregates/drug effects ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia in the elderly. Among the diverse pathological features of AD, amyloid beta (Aβ) aggregation and neuroinflammation are recognized as central and interlinked mechanisms driving disease progression. This review focuses specifically on these two processes and highlights current pharmacological limitations in modifying disease pathology. Natural products such as curcumin, resveratrol, Ginkgo biloba, epigallocatechin gallate (EGCG), crocin, ashwagandha, and cannabidiol (CBD) have shown promising activity in modulating Aβ aggregation and neuroinflammatory pathways, offering multi-target neuroprotective effects in preclinical studies. However, their therapeutic application remains hindered by poor solubility, instability, rapid metabolism, and limited blood-brain barrier (BBB) permeability. To overcome these barriers, nanotechnology-based drug delivery systems-including polymeric nanoparticles, niosomes, solid lipid nanoparticles, and chitosan-based carriers-have emerged as effective strategies to enhance brain targeting, bioavailability, and pharmacological efficacy. We summarize the mechanistic insights and nanomedicine approaches related to these bioactives and discuss their potential in developing future disease-modifying therapies. By focusing on Aβ aggregation and neuroinflammation, this review provides a targeted perspective on the evolving role of natural compounds and nanocarriers in AD treatment.}, }
@article {pmid41677635, year = {2026}, author = {Acquarone, E and Roy, SM and Staniszewski, A and Watterson, DM and Arancio, O}, title = {The Highly Selective 5-HT2B Receptor Antagonist MW073 Mitigates Aggressive Behavior in an Alzheimer's Disease Mouse Model.}, journal = {Cells}, volume = {15}, number = {3}, pages = {}, doi = {10.3390/cells15030273}, pmid = {41677635}, issn = {2073-4409}, support = {AG066722/GF/NIH HHS/United States ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy ; *Aggression/drug effects ; Disease Models, Animal ; Mice ; *Serotonin 5-HT2 Receptor Antagonists/pharmacology/therapeutic use ; Male ; Mice, Transgenic ; *Receptor, Serotonin, 5-HT2B/metabolism ; *Behavior, Animal/drug effects ; *Fluorobenzenes/pharmacology/therapeutic use ; Humans ; Mice, Inbred C57BL ; }, abstract = {Background: Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder and the leading cause of dementia worldwide. Progressive synaptic dysfunction underlies declines in cognition, daily functioning, and the development of neuropsychiatric syndromes. Neuropsychiatric syndromes that include agitation and aggression affect 40-60% of patients and represent a major source of caregiver burden. Serotonin 5-HT2B receptor levels are increased in the AD patient brain, and thus, treatment of AD animal models with the selective 5-HT2B receptor antagonist MW073 in prevention or disease stage paradigms attenuates Aβ- or tau-induced dysfunction. Methods: We investigated the effects of MW073 treatment on the aggressive behavior of Tg2576 mice in a resident-intruder assay. Results: MW073 treatment significantly reduced aggressive behavior in male Tg2576 mice. Conclusions: MW073 efficacy in treating aggression in Tg2576 mice implicates 5-HT2B receptor-mediated signaling in AD neuropsychiatric symptoms as well as cognitive and behavioral dysfunction.}, }
@article {pmid41677117, year = {2026}, author = {Li, Y and Cheng, Q and Tian, S and Li, X and Chen, Y and Guo, Y and Jiang, Y and Tao, Y and Niu, X and Hu, H and Liu, Y and Li, S}, title = {Oridonin Ameliorates Alzheimer's Disease-Like Pathology in Male Mice Through Inhibition of Receptor-Interacting Protein Kinase 1.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70185}, pmid = {41677117}, issn = {1099-1573}, support = {82404605//National Natural Science Foundation of China/ ; U23A20510//National Natural Science Foundation of China/ ; U24A20806//National Natural Science Foundation of China/ ; 32300318//National Natural Science Foundation of China/ ; BX20220048//National Postdoctoral Program for Innovative Talents/ ; 2022MD723713//China Postdoctoral Science Foundation/ ; 2022NSFSC1362//Natural Science Foundation of Sichuan Province/ ; 2023ZYD0051//Natural Science Foundation of Sichuan Province/ ; 2024NSFSC1324//Natural Science Foundation of Sichuan Province/ ; }, abstract = {Oridonin (Ori) is a bioactive diterpenoid from Rabdosia rubescens that exhibits potent anti-inflammatory and neuroprotective properties. However, its potential role in Alzheimer's disease (AD), especially in modulating receptor-interacting protein kinase 1 (RIPK1)-mediated neuroinflammation and necroptosis, remains unclear. This study aimed to investigate Ori's therapeutic mechanism in AD by targeting RIPK1. We utilized cellular thermal shift assay (CETSA), drug affinity responsive target stability assay (DARTS), and bio-layer interferometry (BLI) to verify the binding of Ori to RIPK1. In vitro, inflammatory and necroptotic responses were assessed in BV2 microglial cells and HT22 neuronal cells using enzyme-linked immunosorbent assay (ELISA), reverse transcription quantitative polymerase chain reaction (RT-qPCR), Western blotting, immunofluorescence, and flow cytometry assays. In vivo, we evaluated Ori's therapeutic efficacy in 5× FAD transgenic mice, a well-established AD model, through behavioral analysis using the Morris water maze, along with histological and biochemical assessments of brain tissues. Ori demonstrated a robust interaction with RIPK1 (KD = 533 nM) and significantly increased its thermal and proteolytic stability. Treatment with Ori markedly suppressed the secretion of pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) in microglia by inhibiting the RIPK1-ERK1/2-NF-κB signaling pathway. In neurons, Ori effectively blocked the activation of the RIPK1-RIPK3-MLKL signaling cascade, prevented necrosome formation, and significantly reduced necroptotic cell death. Importantly, in the 5× FAD mouse model, Ori treatment substantially improved spatial learning and memory performance, decreased amyloid-beta (Aβ) plaque deposition, and attenuated inflammatory and necroptotic markers in both cortical and hippocampal regions. Ori as a natural small-molecule inhibitor of RIPK1, capable of concurrently mitigating neuroinflammation and necroptosis-two critical pathological processes underpinning AD. These findings strongly support Ori's potential as a disease-modifying therapeutic for AD.}, }
@article {pmid41676727, year = {2026}, author = {Tong, M and Mehfooz, F and Zhang, S and Wang, Y and Fang, S and Saykin, AJ and Wang, X and Yan, J and , }, title = {Learning a Continuous Progression Trajectory of Amyloid in Alzheimer's disease.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.02.03.703568}, pmid = {41676727}, issn = {2692-8205}, abstract = {BACKGROUND: Understanding of Alzheimer progression is critical for timely diagnosis and treatment evaluation, but traditional discrete diagnostic groups often lack sensitivity to subtle early-stage changes.
METHODS: We developed SLOPE, an unsupervised dimensionality reduction method that models the amyloid progression in AD on a continuous scale while preserving the temporal order of longitudinal follow-up visits. Applied to longitudinal amyloid PET data, SLOPE generated a two-dimensional trajectory capturing global amyloid accumulation across the AD continuum.
RESULTS: SLOPE-derived staging scores better preserved temporal progression across diagnostic groups and longitudinal follow-up visits and can be generalized to held-out subjects. The learned trajectory revealed biologically consistent amyloid spreading patterns and greater sensitivity to early progression than global amyloid SUVR.
DISCUSSION: SLOPE provides a continuous staging of amyloid pathology that complements global amyloid measures by capturing early localized progression. These properties highlight its potential in disease modeling and monitoring, particularly in early and preclinical stages of AD.}, }
@article {pmid41676487, year = {2026}, author = {Tagmazian, AA and Schwarz, C and Lange, C and Pitkänen, E and Vuoksimaa, E and , }, title = {petVAE: A Data-Driven Model for Identifying Amyloid PET Subgroups Across the Alzheimer's Disease Continuum.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.02.02.703218}, pmid = {41676487}, issn = {2692-8205}, abstract = {Amyloid-β (Aβ) PET imaging is a core biomarker and is considered sufficient for the biological diagnosis of Alzheimer's disease (AD). However, it is typically reduced to a binary Aβ™/Aβ+ classification. In this study, we aimed to identify subgroups along the continuum of Aβ accumulation including subgroups within Aβ- and Aβ+. We used a total of 3,110 of Aβ PET scans from Alzheimer's Disease Neuroimaging Initiative (ADNI) and Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) datasets to develop petVAE , a 2D variational autoencoder model. The model accurately reconstructed Aβ PET scans without prior labeling or pre-selection based on scanner type or region of interest. Latent representations of scans extracted from the petVAE (11,648 latent features per scan) were used to visualize, analyze, and cluster the AD continuum. We identified the latent features most representative of the continuum, and clustering of PET scans using these features produced four clusters. Post-hoc characterization revealed that two clusters (Aβ-, Aβ-+) were predominantly Aβ negative and two (Aβ+, Aβ++) were predominantly Aβ positive. All clusters differed significantly in standardized uptake value ratio (p < 1.64×10 [-8]) and cerebrospinal fluid (CSF) Aβ (p < 0.02), demonstrating petVAE's ability to assign scans along the Aβ continuum. The clusters at the extremes of the continuum (Aβ-, Aβ++) resembled to the conventional Aβ negative and Aβ positive groups and differed significantly in cognitive performance, Apolipoprotein E (APOE) ε4 prevalence, and Aβ, tau and phosphorylated tau CSF biomarkers (p < 3×10 [-6]). The two intermediate clusters (Aβ-+, Aβ+) showed significantly higher odds of carrying at least one APOE ε4 allele compared with the Aβ-cluster (p < 0.026). Participants in Aβ+ or Aβ++ clusters exhibited a significantly faster rate of progression to AD compared to Aβ-group (Hazard ratio = 2.42 and 9.43 for groups Aβ+ and Aβ++, respectively, p < 1.17×10 [-7]). Thus, petVAE was capable of reconstructing PET scans while also extracting latent features that effectively represented the AD continuum and defined biologically meaningful clusters. By capturing subtle Aβ-related changes in brain PET scans, petVAE -based classification enables the detection of preclinical AD stages and offers a new data-driven framework for studying disease progression.}, }
@article {pmid41676474, year = {2026}, author = {Rossitto, LM and Foo, J and Di Silvestri, JM and Lehmann, L and Brunelli, M and Nie, Y and Muñoz-Mayorga, D and Xiao, Q and Dai-Liu, AY and Jati, S and Rossi, M and Daneman, R and Kelly, JW and Newman, JC and Myers, SA and Chen, X}, title = {Ketone body β-hydroxybutyrate restores neuronal Tau proteostasis via ketolysis-independent mechanism.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.01.30.702936}, pmid = {41676474}, issn = {2692-8205}, abstract = {Metabolic interventions that induce ketosis, including ketogenic diets, caloric restriction, intermittent fasting, and exercise, show promise in the treatment of Alzheimer's disease (AD) and related tauopathies. β-hydroxybutyrate (βHB), the primary ketone body produced during ketosis, reproduces key features of these metabolic interventions, but the molecular mechanism underlying its neuroprotective properties is not fully understood. Here, we demonstrate that a βHB precursor diet is sufficient to ameliorate Tau pathophysiology in a tauopathy mouse model. Furthermore, across in vitro , ex vivo , and in vivo models, we find that βHB enhances neuronal Tau proteostasis and reduces Tau aggregation and secretion. Importantly, these effects are independent of βHB's oxidation for ATP production, as its ketolysis-resistant enantiomer reproduces these benefits, indicating that ketolysis is dispensable for these effects. Overall, these data position βHB as a novel therapeutic avenue for AD and tauopathy and elucidate a novel mechanism of action of metabolic interventions in neurodegenerative disease.}, }
@article {pmid41676156, year = {2026}, author = {Weng, Y and He, T and Li, M and Zhou, Q and Xie, J and Wei, L and Wang, X and Wang, JZ and Zhong, M and Li, S}, title = {Microglial histone H3K18 crotonylation promotes STAT1 expression and induces cognitive deficit in Alzheimer disease.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1744375}, pmid = {41676156}, issn = {1664-3224}, mesh = {Animals ; *Alzheimer Disease/metabolism/genetics ; *Histones/metabolism ; Mice ; *Microglia/metabolism ; *STAT1 Transcription Factor/metabolism/genetics ; *Cognitive Dysfunction/metabolism/etiology ; Disease Models, Animal ; Hippocampus/metabolism ; Male ; Protein Processing, Post-Translational ; Mice, Transgenic ; Amyloid beta-Peptides ; Humans ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder, yet the epigenetic mechanisms underlying its pathogenesis remain incompletely understood. Histone crotonylation, a novel post-translational modification, has been implicated in neuroinflammation. However, its role in AD-related cognitive impairment has not been elucidated.
METHODS: Histone crotonylation was examined in 5xFAD and Aβ42-injected mice. Crotonic acid was administered intracerebroventricular (ICV) to elevate hippocampal histone crotonylation in wild-type mice. Cognitive function was assessed using behavioral tests. Synaptic integrity was evaluated via western blotting and Golgi staining. Microglial activation and co-localization of H3K18cr were determined by immunofluorescence. Transcriptomic analysis identified differentially expressed genes and enriched pathways. The role of signal transducer and activator of transcription 1 (STAT1) was validated in BV2 microglial cells using the STAT1 inhibitor fludarabine.
RESULTS: Hippocampal pan-histone H3 crotonylation (H3Kcr) and H3K18cr were significantly upregulated in both 5xFAD and Aβ42-injected mice compared to controls. ICV injection of crotonic acid markedly elevated hippocampal H3Kcr and H3K18cr levels and induced significant cognitive deficits, shown by impaired novel object recognition and fear conditioning performance. Crotonic acid treatment resulted in synaptic dysfunction, including reduced synaptic markers (SYN1, SYT, GluA2, GluN2B) and decreased CA1 dendritic spine density. Crotonic acid also induced microgliosis with elevated Iba1 expression. H3K18cr was specifically upregulated in microglia, with no significant changes observed in neurons or astrocytes. Transcriptomic analysis identified 478 differentially expressed genes enriched predominantly in immune-related pathways, with STAT1 highlighted as a key upstream transcription factor. In BV2 cells, crotonic acid significantly increased total and phosphorylated STAT1 (Tyr701) levels via a JAK1-independent mechanism. Treatment with fludarabine effectively suppressed STAT1 expression and attenuated the production of pro-inflammatory cytokines, including TNF-α, IL-6, and IL-1β.
CONCLUSION: This study provides the first evidence that elevated microglial H3K18cr contributes to AD-related cognitive impairment by promoting STAT1 expression and subsequent neuroinflammation. These findings identify microglial histone crotonylation as a novel epigenetic mechanism in AD pathogenesis and suggest that targeting the H3K18cr-STAT1 axis may represent a potential therapeutic strategy for AD.}, }
@article {pmid41675725, year = {2026}, author = {Patel, T and Henna, F and Sharif, I and Javed, I and Mustafa, F and Sharif, H and Nasir, F and Javaid, M and Usman, SF and Hanani, C and Anand, N}, title = {A narrative review on the therapeutic potential of stem cells in neurodegenerative diseases: advances, insights, and challenges.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {2}, pages = {1441-1453}, pmid = {41675725}, issn = {2049-0801}, abstract = {BACKGROUND: Neurodegenerative diseases (NDs) such as Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Huntington's disease (HD) are set apart by progressive neuronal loss and concomitant functional decline. Traditional therapies are equipped with only symptomatic relief, devoid of neurorestorative properties. Stem-cell-based therapies have the potential to revolutionize neurological care by replenishing lost cells, mitigating inflammation, and fostering a neuroprotective environment.
OBJECTIVES: This narrative review aims to appraise the treatment potential of various stem cell types in managing NDs, highlighting their functional pathways, delivery methods, and current experimental validation.
METHODS: A comprehensive literature search was carried out based on data retrieved from PubMed, The Cochrane Library, and ClinicalTrials.gov. Thirty-one studies that fulfill PICO criteria and only English-language publications are incorporated in this review. No part of the study design, data collection, analysis, or interpretation was conducted using artificial intelligence.
RESULTS: Stem cells, including embryonic stem cells, mesenchymal stem cells (MSCs), induced pluripotent stem cells, and neural stem cells, possess distinctive regenerative properties. MSC-derived exosomes can traverse the blood-brain barrier and improve nerve cell longevity. Administration routes such as intravenous, intranasal, and direct brain transplantation are being studied. Neurodegenerative conditions such as PD, AD, HD, and ALS have been widely studied for therapeutic benefits.
CONCLUSION: Regardless of their potential, stem cell therapies raise health risks, including neoplastic growth and immunological incompatibility, alongside bioethical issues. Developments in genetic modification, nanotechnology, and preconditioning strategies are being analyzed to optimize outcomes. Long-term research, harmonization of protocols, and extended patient follow-up are essential for the safe and effective development of medical applications.}, }
@article {pmid41675591, year = {2026}, author = {Malliou, G and Reus, LM and Pijnenburg, YAL and van der Flier, WM and de Wit, NM and Chornyi, S and Kooij, G and de Vries, HE and Teunissen, CE and Visser, PJ and Ophoff, RA and Tijms, BM}, title = {Distinct CSF lipidomic profiles are associated with five proteomic subtypes in patients with Alzheimer's disease.}, journal = {Molecular neurodegeneration advances}, volume = {2}, number = {1}, pages = {11}, pmid = {41675591}, issn = {3059-4944}, abstract = {BACKGROUND: Alzheimer's disease (AD) is molecularly heterogeneous. In our previous cerebrospinal fluid (CSF) proteomic study in AD, we identified and validated five distinct molecular subtypes characterized by neuronal hyperplasticity (subtype 1), innate immune activation (subtype 2), RNA dysregulation (subtype 3), choroid plexus dysfunction (subtype 4) and blood-brain barrier impairment (subtype 5). These subtypes also differed in the CSF levels of proteins involved in lipid metabolism, suggesting that lipid dysregulation in AD might be subtype specific.
METHODS: We performed untargeted lipidomics on CSF samples from 601 individuals in the Amsterdam Dementia Cohort who were previously included in our proteomic study (n = 416 AD, 185 controls). Using the CSH-QTOF platform for complex lipids, 3,532 lipids were detected in CSF, 270 of which could be mapped to 13 different lipid classes. Lipid levels were compared between each AD subtype and controls using linear regression models adjusted for age and sex (R v4.2.1). Lipids with significantly different levels (p < 0.05) were included for pathway enrichment analysis with MetaboAnalyst6.0.
RESULTS: We observed alterations in the levels of 1,893 lipids, with the majority associated with a single AD subtype. Subtype 3 (RNA dysregulation) exhibited the most pronounced alterations, with altered CSF levels of 669 lipids, including triglycerides and fatty acids, which were reduced compared to controls. Subtype 4 (choroid plexus dysfunction) and subtype 5 (blood-brain barrier dysfunction) both had alterations in the same set of 150 lipids, but with changes occurring in opposite directions (i.e., decreased in subtype 4, and increased in subtype 5). These lipids were associated with sphingolipid metabolism and lipid transport. Subtype 1 (neuronal hyperplasticity) and subtype 2 (innate immune activation) had less pronounced differences compared to the other subtypes. Subtype 1 had increased levels of several phospholipids, indicating neuronal membrane remodeling, and subtype 2 decreased arachidonic acid levels, a precursor of immunoregulatory oxylipins.
CONCLUSION: Our findings reveal subtype-specific lipid metabolism alterations in AD. Currently, five lipid-targeting drugs are in phase 1 and 2 trials. Our results suggest that treatment efficacy may vary by subtype. Understanding these molecular differences can inform trial design and analysis, advancing the development of tailored therapies for AD.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s44477-026-00018-z.}, }
@article {pmid41673679, year = {2026}, author = {Liao, J and Mou, H and Luo, S and Shen, L and Jiao, B}, title = {Microbiota and Alzheimer's disease: mechanistic insights from a multi-organ perspective.}, journal = {Translational neurodegeneration}, volume = {15}, number = {1}, pages = {3}, pmid = {41673679}, issn = {2047-9158}, support = {82371434//National Natural Science Foundation of China/ ; 2024JJ2097//Outstanding Youth Fund of Hunan Provincial Natural Science Foundation/ ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder driven by multifactorial mechanisms. Increasing evidence suggests that dysbiosis, a term denoting an imbalance in the composition of the microbiota, may play a pivotal role in the pathogenesis of AD across multiple bodily sites, including the gut, oral cavity, nasal passages, lungs, and skin. Microbial imbalances may promote neuroinflammation, immune dysfunction, and metabolic disturbances through complex host-microbiota networks. This review synthesizes current advances in the understanding of microbiota-driven modulation of AD, introduces the "Multi-Axis Co-Regulation" concept, and evaluates microbial biomarkers for early diagnosis. Finally, the translational potential of microbiota-targeting interventions, including probiotics, dietary modulation, fecal microbiota transplantation, and oral microbiome-based therapies, are discussed, which represent novel strategies for precision prevention and treatment of AD.}, }
@article {pmid41673254, year = {2026}, author = {Nazli, D and Ipekgil, D and Poyraz, YK and Can, K and Okmen, I and Turhanlar-Sahin, E and Sert Serdar, B and Kocturk, S and Ozhan, G}, title = {Epigallocatechin Gallate and Punicalagin Combination Reduces Aβ Aggregation and Promotes Neurogenesis in Adult Zebrafish Brain.}, journal = {Journal of neuroscience research}, volume = {104}, number = {2}, pages = {e70119}, doi = {10.1002/jnr.70119}, pmid = {41673254}, issn = {1097-4547}, support = {2021.KB.SAG.018//Dokuz Eylül Üniversitesi/ ; 121Z900//Türkiye Bilimsel ve Teknolojik Araştırma Kurumu/ ; IG 3024//European Molecular Biology Organization/ ; }, mesh = {Animals ; Zebrafish ; *Catechin/analogs & derivatives/pharmacology/administration & dosage ; *Hydrolyzable Tannins/pharmacology/administration & dosage ; *Amyloid beta-Peptides/metabolism ; *Neurogenesis/drug effects ; *Brain/drug effects/metabolism ; *Neuroprotective Agents/pharmacology/administration & dosage ; Alzheimer Disease/metabolism/drug therapy ; Disease Models, Animal ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment, and behavioral alterations. The pathogenesis of AD involves the accumulation of amyloid-beta (Aβ) plaques and the hyperphosphorylated tau proteins, which disrupt neuronal function and trigger neuroinflammation. This study explores the therapeutic potential of epigallocatechin gallate (EGCG) and punicalagin (PU) in mitigating Aβ-induced toxicity using an adult zebrafish model of AD. Our results demonstrate that the EGCG + PU combination significantly reduces Aβ accumulation, protects against cellular damage, suppresses acetylcholinesterase (AChE) activity, and normalizes the expression of amyloidogenic and AD-related genes. Additionally, EGCG + PU treatment alleviates neuroinflammation by suppressing glial activation, including reductions in L-plastin and proinflammatory cytokine expression, while promoting neuronal recovery through mechanisms of neurogenesis and neuroprotection. Notably, the combination treatment restored neuronal density and improved behavioral outcomes by alleviating anxiety- and aggression-like behaviors associated with Aβ toxicity. These results underscore the synergistic neuroprotective effects of EGCG + PU, highlighting their potential as a novel therapeutic approach for mitigating the pathological, behavioral, and inflammatory aspects of AD.}, }
@article {pmid41672403, year = {2026}, author = {Fenton, L and Aslanyan, V and Jacobs, DM and Salmon, DP and Brewer, JB and Rissman, RA and Shadyab, AH and Harrison, TM and Evans, AC and LaCroix, AZ and Feldman, HH and Baker, LD and Pa, J}, title = {Relationships between fine memory discrimination and tau burden in two independent cohorts of older adults.}, journal = {Neuropsychologia}, volume = {}, number = {}, pages = {109393}, doi = {10.1016/j.neuropsychologia.2026.109393}, pmid = {41672403}, issn = {1873-3514}, abstract = {Cognitive assessments sensitive to the integrity of the medial temporal lobe, an area vulnerable to early tau deposition, may serve as low-cost adjunctive markers of underlying tau pathology in older adults. The Mnemonic Similarity Task (MST) is a fine memory discrimination task designed to assess hippocampal integrity. The current cross-sectional study utilized baseline data from two AD prevention trials (the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study and the Exercise in Adults with Mild Memory Problems (EXERT) trial) to examine relationships between MST performance, amyloid-beta, tau, and hippocampal volume. We additionally explored relationships between performance on a traditional memory test, Logical Memory, and AD-related brain measures. Poorer fine memory discrimination was associated with higher tau as assessed by PET in A4 (N=407, 59% female, mean age=71.66, age range=65-85) and CSF (p-tau181, total tau) in EXERT (N=41, 61% female, mean age=74.10, age range=65-89). Poorer fine memory discrimination was also associated with higher amyloid PET in A4 and smaller hippocampal volume in EXERT. Poorer delayed recall on Logical Memory was associated with higher tau and amyloid burden in A4 and with lower hippocampal volume in EXERT. Poorer retention on Logical Memory was associated with higher tau in Braak I and amyloid in A4 and with CSF tau and lower hippocampal volume in EXERT. These results support the potential of fine memory discrimination as measured by the MST as an adjunctive, accessible screening measure associated with higher tau in cognitively normal, amyloid positive older adults and older adults with amnestic MCI.}, }
@article {pmid41672382, year = {2026}, author = {Khan, S and Imam, A and Singh, S and Ahmed, A and Hassan, MI and Shahid, M and Athar, F and Islam, A}, title = {Exploring the intersection of Alzheimer's disease and comorbidities: a review of the interplay between multiple chronic conditions.}, journal = {Biochimica et biophysica acta. Molecular basis of disease}, volume = {}, number = {}, pages = {168190}, doi = {10.1016/j.bbadis.2026.168190}, pmid = {41672382}, issn = {1879-260X}, abstract = {Alzheimer's disease (AD) represents degenerative brain disorder that impairs both cognitive functions and daily living activities gradually. It is frequently linked with other disorders such as psychosis, cardiovascular disorders, diabetes, and depression, all of which may influence the disease's onset, trajectory, and treatment approaches. These comorbidities can affect the onset, progression, and management of AD. This review focuses to explore the interplay of AD and comorbidities, and to examine the interplay between multiple chronic conditions. The review found that AD and comorbidities have a complex and bidirectional relationship. Comorbidities can affect the onset, progression, and management of AD, and AD can also affect the management and outcomes of comorbidities. The review also found that comorbidities may have an impact on caregiver burden, healthcare utilization and mortality. The findings suggest that the management of AD should take into account the presence and management of comorbidities to improve the overall outcomes for patients with AD. The literature also suggests that the management of comorbidities should be integrated in the management of AD patients. Furthermore, the review highlights the critical role of timely detection and treatment of comorbidities in AD patients to delay onset and mitigate disease progression. Additionally, it is crucial to consider the influence of comorbidities when selecting treatment options and the management of side effects and adverse events in AD patients. The literature reviewed in this article suggests that a multidisciplinary approach is needed in managing AD patients with comorbidities, which includes regular screening, early detection, and management of comorbidities in addition to managing AD.}, }
@article {pmid41672293, year = {2026}, author = {Ge, Y and Weng, Y and Chen, Y}, title = {Elucidating the toxicological impact and mechanism of plasticizers exposure on Alzheimer's disease through network toxicology and molecular docking.}, journal = {Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association}, volume = {}, number = {}, pages = {116005}, doi = {10.1016/j.fct.2026.116005}, pmid = {41672293}, issn = {1873-6351}, abstract = {This study aimed to explore the underlying mechanisms and key targets of widely used plasticizers, including dimethyl phthalate (DMP), diethyl phthalate (DEP), and dioctyl phthalate (DOP), to the pathogenesis of Alzheimer's disease (AD). Network toxicology, molecular docking, and dynamics simulation screened candidate targets for plasticizer in increasing AD risk. Three machine learning algorithms and two microarray datasets identified key targets, whose immune relevance was assessed by CIBERSORT. An Aβ42-induced BV2 microglia model validated their role. We identified 83 plasticizer targets relevant to AD, which were enriched in KEGG pathways like apoptosis and neuroactive ligand-receptor interaction. CDK5, SLC2A1, and STAT3 were confirmed as key targets, showing consistent differential expression in two AD datasets. Their expression correlated with M1 macrophage infiltration. Molecular docking and dynamics simulations demonstrated that plasticizers stably bind these targets with high affinity. In Aβ42-induced BV2 microglia, phthalate treatment elevated inflammatory factors (TNF-α, IL-1β, IL-6) and STAT3 expression. This study demonstrated the possible mechanistic associations between plasticizers exposure and AD, and STAT3 might be key target of plasticizers.}, }
@article {pmid41672268, year = {2026}, author = {de Melo Silva, JG and de Medeiros Barros, W and Lopes, NMCP and Bellozi, PMQ}, title = {Alzheimer's disease: Current therapeutic strategies and emerging perspectives for multifactorial intervention.}, journal = {Progress in neuro-psychopharmacology & biological psychiatry}, volume = {}, number = {}, pages = {111640}, doi = {10.1016/j.pnpbp.2026.111640}, pmid = {41672268}, issn = {1878-4216}, abstract = {Alzheimer's Disease (AD) is a progressive, multifactorial neurodegenerative condition and the most common form of dementia, affecting millions globally. Its incidence increases with age and is characterized by cognitive decline, functional impairments, and behavioral disturbances. Although its etiology remains unclear, AD is believed to result from a complex interaction between genetic, environmental, and lifestyle factors. Several hypotheses have been proposed to explain its pathogenesis, including the amyloid cascade, tau neurofibrillary tangle formation, cholinergic and glutamatergic dysfunctions, and, more recently, lipid invasion. Current treatment strategies involve both pharmacological and non-pharmacological interventions. In Brazil, acetylcholinesterase inhibitors and memantine are widely used. Recently, efforts have focused on developing new therapies, such as monoclonal antibodies, with three representatives already approved by the FDA, in addition to innovative approaches such as the use of technology and virtual reality for cognitive therapies. However, there is still a need for research that enables early diagnosis, interventions with fewer adverse effects, and the development of therapies targeting multiple mechanisms. Therefore, the pursuit of more effective and personalized treatments is essential to mitigate the societal impacts of AD.}, }
@article {pmid41672134, year = {2026}, author = {Maneu, V and García, AG}, title = {P2X7 receptors as targets for neuroprotection.}, journal = {Neuropharmacology}, volume = {}, number = {}, pages = {110877}, doi = {10.1016/j.neuropharm.2026.110877}, pmid = {41672134}, issn = {1873-7064}, abstract = {In this review we explore the potential of P2X7 receptor blockers to elicit neuroprotection. This conjecture is based on a reasonably well-established role of this receptor in activating glial cells to maintain a chronic low-level neuroinflammatory state in the brain of patients suffering some neurodegenerative diseases (NDDs). In this context we briefly discuss evidence supporting the role of P2X7 receptors (P2X7) in the pathogenesis of Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, multiple sclerosis, and retinal degeneration. From a pathogenic point of view these diseases have specific features but all share a low level neuroinflammatory state with microglia activation and enhanced P2X7 expression. Next, we comment on available P2X7 blockers with central nervous system (CNS) target engagement. Then, we deal with the proof-of-concept concerning the potential of some blockers to mitigate the neuroinflammatory state in preclinical models of the target diseases above mentioned. We follow with a discussion of the scarce number of clinical trials done with some P2X7 blockers in inflammatory diseases. Finally, we discuss the current discrepancy between promising preclinical data and the limited number of clinical trials exploring P2X7 antagonists in NDDs. We provide some clues that may boost clinical trials with single P2X7 blockers but particularly, with their association with other medicines currently being used or that are intended to be prescribed in the treatment of NDDs.}, }
@article {pmid41671691, year = {2026}, author = {da Silva, AMP and de Deus, O and Januário Campos Cardoso, L and Virgilio Ribeiro, F and Froelich Meldola, P and Rodrigues Menezes, I and Lee Han, M and Quiroga, DG and James Almeida, K and Haddad Santos, D and Perry, G and Høilund-Carlsen, PF and de Souza Franco, E and de Sousa Maia, MB}, title = {Efficacy, safety, and ARIA risk of anti-β-amyloid antibodies in early Alzheimer's disease: a systematic review, meta-analysis, and meta-regression.}, journal = {Expert opinion on biological therapy}, volume = {}, number = {}, pages = {}, doi = {10.1080/14712598.2026.2631536}, pmid = {41671691}, issn = {1744-7682}, abstract = {BACKGROUND: Alzheimer's disease (AD) is the most prevalent cause of dementia and has been closely linked to β-amyloid accumulation. However, the efficacy and safety of anti-β-amyloid monoclonal antibodies remain debated.
METHODS: We systematically searched PubMed, Embase, and Cochrane databases for RCTs comparing anti-β-amyloid monoclonal antibodies with placebo in early-stage AD. Eligible trials enrolled participants with biomarker-supported AD and reported global, cognitive, or safety outcomes, including the CDR-SB, ADAS-Cog 13/14, ARIA, and brain volumetric measures.
RESULTS: Six RCTs including 7837 participants were analyzed. Mean age ranged from 69.8 to 75.4 years, and 57.4% were APOE ε4 carriers. Anti-β-amyloid therapy was associated with small differences in global and cognitive outcomes, best described as a modest slowing of decline on the CDR-SB and ADAS-Cog scales. Treatment was associated with increased risks of ARIA-E (RR, 9.40; 95% CI, 6.98-12.66) and ARIA-H (RR, 2.40; 95% CI, 2.08-2.78), as well as greater ventricular enlargement and hippocampal atrophy.
CONCLUSION: In early AD, anti-β-amyloid monoclonal antibodies are associated with modest slowing of decline accompanied by increased ARIA risk and unfavorable structural brain changes, limiting clinical applicability.
PROTOCOL REGISTRATION: http://www.crd.york.ac.uk/prospero identifier is CRD420251071393.}, }
@article {pmid41671614, year = {2026}, author = {Li, Z and Tan, B and Dong, K and Yu, X and Zhang, SW and Luo, L and Yao, W and Qin, Z and Wu, F}, title = {Cobrotoxin mitigates neuroinflammation and cognitive impairment by suppressing CD8[+] T cell-microglia interactions in male 5 × FAD mice.}, journal = {Biochemical pharmacology}, volume = {247}, number = {}, pages = {117779}, doi = {10.1016/j.bcp.2026.117779}, pmid = {41671614}, issn = {1873-2968}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline accompanied by chronic neuroinflammation. Emerging evidence implicates T-cell infiltration and microglial activation as key immune events that accelerate AD pathology, yet therapeutic approaches targeting this neuroimmune interface remain scarce. Cobrotoxin (CTX), a short-chain neurotoxin derived from Naja atra venom, exhibits potent anti-inflammatory and immunomodulatory properties and is clinically approved in China for the treatment of chronic pain syndromes. Here, we investigated whether CTX could alleviate neuroinflammation and cognitive deficits in 5 × FAD mice, a transgenic model of AD. Intranasal CTX administration for nine weeks enhanced spatial learning and memory in the Morris water maze without altering amyloid-β burden. Flow cytometry and immunofluorescence revealed that CTX markedly reduced brain-infiltrating CD8[+] T cells and downregulated chemokines implicated in T cell-microglia communication, including Cxcl9, Cxcl10, Cxcl16, and Ccl5. Consistent with this, CTX attenuated microglial activation and pro-inflammatory cytokine release while preserving plaque-associated microglia (disease-associated microglia, DAM). Morphological and electrophysiological analyses demonstrated that CTX restored dendritic complexity, spine density, and hippocampal long-term potentiation (LTP), indicating improved synaptic integrity. Collectively, these findings identify CTX as a potent modulator of neuroimmune signaling that mitigates neuroinflammation and synaptic dysfunction in AD, suggesting its potential for repurposing as an immunomodulatory therapy for neurodegenerative diseases.}, }
@article {pmid41670689, year = {2026}, author = {Abedi, A and Foroutan, T and Dargahi, L}, title = {Intranasal CM-hMSCs modulate brain gene expression linked to glucose metabolism and inflammation in male and female rats exposed to maternal and post-weaning high-fat diets.}, journal = {Naunyn-Schmiedeberg's archives of pharmacology}, volume = {}, number = {}, pages = {}, pmid = {41670689}, issn = {1432-1912}, support = {4001774//Iran National Science Foundation (INSF)/ ; 26822//Research Affairs of Shahid Beheshti University of Medical Sciences/ ; }, abstract = {Peripheral metabolic disorders, which drive brain insulin resistance, increase the risk of cognitive impairment, a key contributor to Alzheimer's disease. Conditioned media derived from human mesenchymal stem cells (CM-hMSCs) have shown potential for modulating neurological pathways. Male and female offspring exposed to maternal and post-weaning high-fat diet (HFD) were treated with CM-hMSCs. Spatial memory and anxiety-like behaviors were assessed along with hippocampal markers of glucose metabolism, inflammation, and Alzheimer's disease-related pathways. In male offspring, CM-hMSCs partially improved molecular pathways involved in brain glucose metabolism, as indicated by increased hippocampal mRNA expression of Glut1, Glut4, and IDE, and elevated BDNF levels. CM-hMSC treatment also modulated the inflammatory profile, with increased IL-10 and reduced IL-1β in the hippocampus. However, CM-hMSCs did not produce significant improvements in behavioral outcomes. CM-hMSCs exert early, region-specific molecular effects on hippocampal glucose metabolism and inflammatory responses in HFD-exposed male offspring.}, }
@article {pmid41670187, year = {2026}, author = {Bourgeat, P and Fripp, J and Lebrat, L and Xia, Y and Feizpour, A and Cox, T and Zisis, G and Gillman, A and Goyal, MS and Tosun, D and Benzinger, TL and LaMontagne, P and Breakspear, M and Lupton, MK and Short, C and Adam, R and Robertson, JS and Sperling, R and O'Bryant, SE and Johnson, SC and Jr, CRJ and Schwarz, CG and Barkhof, F and Farrar, G and Bollack, A and Collij, LE and Landau, S and Koeppe, R and , and , and , and , and , and , and , and , and , and , and , and Morris, JC and Weiner, MW and Villemagne, VL and Masters, CL and Rowe, CC and Dore, V}, title = {AI-enhanced Centiloid quantification of amyloid PET images.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71162}, doi = {10.1002/alz.71162}, pmid = {41670187}, issn = {1552-5279}, support = {GA16788//National Health and Medical Research Council/ ; R01-AG058676-01A1/NH/NIH HHS/United States ; }, mesh = {Humans ; *Positron-Emission Tomography/methods ; *Alzheimer Disease/diagnostic imaging/metabolism ; *Amyloid beta-Peptides/metabolism ; Male ; *Deep Learning ; Female ; Aged ; *Brain/diagnostic imaging/metabolism ; *Neuroimaging/methods ; Australia ; }, abstract = {INTRODUCTION: The Centiloid scale is the standard for amyloid (Aβ) PET quantification in research and clinical settings. However, variability between tracers and scanners remains a challenge.
METHODS: This study introduces DeepSUVR, a deep learning method to correct Centiloid quantification, by penalizing implausible longitudinal trajectories during training. The model was trained using data from 2,129 participants (7,149 Aβ positron emission tomography [PET] scans) in the Australian Imaging, Biomarkers and Lifestyle Study of ageing (AIBL)/Alzheimer's Disease Neuroimaging Initiative (ADNI) and validated using 15,807 Aβ PET scans from 10,543 participants across 10 external datasets.
RESULTS: DeepSUVR increased correlation between tracers, and reduced variability in the Aß-negatives. It showed significantly stronger association with cognition, visual reads, neuropathology, and increased longitudinal consistency between studies. DeepSUVR also increased the effect size for detecting small treatment related slowing of amyloid accumulation in the A4 study.
DISCUSSION: DeepSUVR substantially advances Aβ PET quantification, outperforming all standard approaches, which is particularly important for clinical decision making and to detect subtle or early changes in Aβ.
HIGHLIGHTS: Novel artificial intelligence (AI)-method that penalizes biologically implausible longitudinal trajectories, enabling the model to learn standardized uptake value ratios (SUVR) correction factors without requiring longitudinal data at inference time. Improves Centiloid consistency across tracers and studies, significantly enhancing cross-sectional and longitudinal amyloid positron emission tomography (PET) quantification. DeepSUVR-derived Centiloids show stronger associations with cognition, visual reads, and neuropathology. Longitudinal variability is reduced three- to five-fold, enabling more reliable tracking of amyloid accumulation and better detection of treatment effects. Novel reference and target masks derived from DeepSUVR replicate most of the model's performance, offering a practical alternative for integration into existing pipelines.}, }
@article {pmid41668753, year = {2026}, author = {Giff, AE and Wruble Clark, M and Bhattacharyya, S and Sage, PT and Madore, B and Guenette, JP and Miyawaki, EK}, title = {Deep cervical lymph node analysis in central nervous system inflammatory disease.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1747114}, pmid = {41668753}, issn = {1664-3224}, mesh = {Humans ; *Lymph Nodes/immunology/pathology ; Animals ; *Neuroinflammatory Diseases/immunology ; Glymphatic System/immunology ; }, abstract = {A previously espoused notion that the brain is an immune-privileged organ has been challenged by evidence of bidirectional communication between the central nervous system and the periphery. A well-described "glymphatic" system in the brain and the meningeal lymphatic system serve as conduits through which antigens, immune cells, and metabolic waste travel from the brain to the deep cervical lymph nodes. These nodes, which are more than passive drainage points, serve as locales where dendritic cells, T cells, and B cells interact with central nervous system-derived signals and modulate immune responses that can influence the brain itself. Disruption of clearance mechanisms to deep cervical nodes-due to intracranial vascular disease, aging, poor sleep, chronic inflammation, or other etiologies-may lead to immune dysregulation. Abnormalities in lymphatic drainage can also alter the presentation of antigens from the central nervous system, affect lymphocyte trafficking, and contribute to the aggregation of proteins like β-amyloid, tau, and α-synuclein. This review synthesizes current knowledge on glymphatic and meningeal lymphatic anatomy and function, highlights how impaired drainage contributes to disorders including multiple sclerosis, Alzheimer disease, and Parkinson disease, and discusses the emerging role of deep cervical lymph node imaging and immunophenotyping in assessing neuroinflammation. Finally, we consider how modulation of meningeal lymphatic and nodal function, through pharmacologic or physical interventions, may impair or restore drainage and alter the course of disease in various ways. The integration of advanced imaging with immunological analysis ultimately may enhance the diagnosis, monitoring, and treatment of neuroinflammatory and neurodegenerative diseases. We propose that deep cervical lymph nodes represent an understudied locale, and, potentially, a therapeutic target for peripheral interventions to influence brain disease trajectories.}, }
@article {pmid41668551, year = {2026}, author = {Gao, C and Li, Y and Zhou, B and Liu, Y and Hao, MQ and Sun, H and Jin, Z and Li, LL and Yang, XF and Guo, XL and Yin, Y}, title = {The application of exosomes derived by mesenchymal stem cell from different tissues in the management of Alzheimer's disease.}, journal = {Nanomedicine (London, England)}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/17435889.2026.2629030}, pmid = {41668551}, issn = {1748-6963}, abstract = {With the intensifying global trend of population aging, the treatment of Alzheimer's disease (AD) faces significant challenges. Current therapeutic approaches can only temporarily alleviate symptoms without halting or reversing disease progression. Numerous studies on mesenchymal stem cell-derived exosomes (MSC-Exos) suggest that, compared to stem cell therapy, MSC-Exos offer considerable advantages in the treatment of AD. This review examines the various mechanisms by which exosomes produced from MSCs function as therapeutic agents for AD. Additionally, it provides a concise overview of the research conducted on MSC-Exos for AD, categorized by tissue source. The text also provides an account of the ongoing clinical trials involving MSC-Exos and examines their benefits, drawbacks, and potential avenues for future research.}, }
@article {pmid41668547, year = {2026}, author = {Zhang, Y and Wang, J and Yuan, J and Li, S and Sun, Y}, title = {FA-2-b-β modulates HMGB1/NF-κB/NLRP3 signaling to alleviate neuroinflammation in Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261418300}, doi = {10.1177/13872877261418300}, pmid = {41668547}, issn = {1875-8908}, abstract = {BackgroundFA-2-b-β, an extract derived from traditional Chinese medicine (TCM), has been suggested as a potential neuroprotective agent.ObjectiveThis study aimed to elucidate its role in modulating HMGB1-mediated inflammation and pyroptosis in Alzheimer's disease (AD), with a particular emphasis on the interaction between FA-2-b-β and HMGB1.MethodsAD cell and animal models were used to examine the effect of FA-2-b-β on HMGB1/NF-κB/NLRP3 signaling pathway. Protein expression levels were detected by western blotting, and enzyme-linked immunosorbent assay (ELISA), respectively. Immunofluorescence staining was performed to determine the cellular localization of key proteins. The role of HMGB1 in amyloid-β (Aβ)-induced neuroinflammation and pyroptosis was examined through siRNA-mediated HMGB1 knockdown. Behavioral tests were conducted in AD animal models to evaluate cognitive improvements following FA-2-b-β treatment.ResultsIn cellular models, FA-2-b-β significantly suppressed Aβ-induced overexpression HMGB1 and inhibited the activation of NF-κB, which consequently led to a reduction in the formation of the NLRP3 inflammasome. This suppression resulted in decreased of activation caspase-1 and lower levels of IL-1β and IL-18, thereby alleviating pyroptosis and neuroinflammation. The knockdown of HMGB1 further corroborated its role in mediating Aβ-induced inflammatory responses. In AD animal models, treatment with FA-2-b-β attenuated neuroinflammation, preserved neuronal integrity, and enhanced cognitive function.ConclusionsFA-2-b-β exhibits a capacity to modulate the HMGB1/NF-κB/NLRP3 signaling pathway, thereby mitigating neuroinflammation and pyroptosis, highlighting its potential as a therapeutic intervention for AD.}, }
@article {pmid41668529, year = {2026}, author = {Wang, W and Chen, Y and Xiong, Z and Wang, Z and Ye, W and Li, X}, title = {Donepezil Research in Cognitive Impairment: A Bibliometric and Scientometric Analysis of Global Trends and Pharmacological Perspectives.}, journal = {Brain and behavior}, volume = {16}, number = {2}, pages = {e71251}, doi = {10.1002/brb3.71251}, pmid = {41668529}, issn = {2162-3279}, support = {//Neurosurgery First-class Discipline Funding Project of the Second Affiliated Hospital of Harbin Medical University/ ; }, mesh = {*Donepezil/therapeutic use/pharmacology ; Humans ; *Bibliometrics ; *Cognitive Dysfunction/drug therapy ; Alzheimer Disease/drug therapy ; Cholinesterase Inhibitors/therapeutic use/pharmacology ; *Nootropic Agents/therapeutic use/pharmacology ; Biomedical Research ; }, abstract = {BACKGROUND: Cognitive impairment (CI) greatly affects global health and quality of life. Donepezil, a widely used treatment for CI, particularly in Alzheimer's disease, has been extensively studied; however, a comprehensive bibliometric analysis summarizing global research trends remains limited.
METHODS: Relevant English-language articles and reviews published between 2000 and 2025 were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were employed to analyze publication trends, collaborative networks, journal distribution, co-citation patterns, and keyword co-occurrence.
RESULTS: A total of 1907 publications were identified. The United States led in both output and citation impact, with the University of Toronto emerging as the most influential institution. The U.S. Department of Health and Human Services provided the greatest funding support. The Journal of Alzheimer's Disease was the primary publishing outlet, and Etsuro Mori was the most prolific and influential author. Keyword analysis revealed "Donepezil," "Alzheimer's disease," and "Mild cognitive impairment" as dominant terms. Recent hotspots-such as "acetylcholinesterase," "oxidative stress," "neuroinflammation," "tau protein," and "mechanism"-reflect a shift toward mechanistic and preclinical research.
CONCLUSION: Research on donepezil for CI has shown consistent growth, evolving from clinical application toward mechanistic exploration and disease modification. Future studies are expected to focus on individualized therapy, combination strategies, and underexplored CI subtypes, aiming to enhance the therapeutic potential and clinical value of donepezil.}, }
@article {pmid41668484, year = {2026}, author = {Wang, Q}, title = {[Current status and future perspectives on age-related hearing loss and cognitive impairment].}, journal = {Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery}, volume = {40}, number = {3}, pages = {220-225}, doi = {10.13201/j.issn.2096-7993.2026.03.002}, pmid = {41668484}, issn = {2096-7993}, mesh = {Humans ; Aged ; *Presbycusis ; *Cognitive Dysfunction ; *Cognition Disorders ; *Hearing Loss ; Aging ; }, abstract = {Objective:Age-related hearing loss(ARHL) is one of the most common sensory degenerative disorders in the elderly, characterized by high prevalence, insidious onset, and progressive deterioration. Recent studies indicate that ARHL not only impairs communication and quality of life in older adults, but is also significantly associated with the development of cognitive impairment and Alzheimer's disease. However, its underlying pathogenesis remains incompletely understood, and the relationship between clinical phenotypes of ARHL and cognitive decline has yet to be clearly defined. ARHL occupies a pivotal position in geriatric health management and in the prevention of neurodegenerative diseases, yet it has not been systematically conceptualized or mechanistically examined. In this review, we summarize the current research progress on ARHL and cognitive impairment, analyze possible mechanisms linking the two conditions, evaluate the potential cognitive protective effects of hearing interventions, and propose priority directions for future research and clinical practice. With advances in multidisciplinary collaboration and technological innovation, the prevention and treatment of ARHL are expected to enter a new era of greater precision and efficiency, offering novel opportunities to reduce the risk of cognitive impairment and improve overall health in older populations.}, }
@article {pmid41669706, year = {2024}, author = {Hoang, B and Pang, Y and Dodge, H and Zhou, J}, title = {Translingual Language Markers for Cognitive Assessment from Spontaneous Speech.}, journal = {Interspeech}, volume = {2024}, number = {}, pages = {977-981}, pmid = {41669706}, issn = {2958-1796}, abstract = {Mild Cognitive Impairment (MCI) is considered a prodromal stage of dementia, including Alzheimer's disease. It is characterized by behavioral changes and decreased cognitive function, while individuals can still maintain their independence. Early detection of MCI is critical, as it allows for timely intervention, enrichment of clinical trial cohorts, and the development of therapeutic approaches. Recently, language markers have been shown to be a promising approach to identifying MCI in a non-intrusive, affordable, and accessible fashion. In the InterSpeech 2024 TAUKADIAL Challenge, we study language markers from spontaneous speech in English and Chinese and use the bilingual language markers to identify MCI cases and predict the Mini-Mental Status Examination (MMSE) scores. Our proposed framework combines the power from 1) feature extraction of a comprehensive set of bilingual acoustic features, and semantic and syntactic features from language models; 2) careful treatment of model complexity for small sample size; 3) consideration of imbalanced demographic structure, potential outlier removal, and a multi-task treatment that uses the prediction of clinical classification as prior for MMSE prediction. The proposed approach delivers an average of 78.2% Balanced Accuracy in MCI detection and an averaged RMSE of 2.705 in predicting MMSE. Our empirical evaluation shows that translingual language markers can improve the detection of MCI from spontaneous speech. Our codes are provided in https://github.com/illidanlab/translingual-language-markers.}, }
@article {pmid41667430, year = {2026}, author = {Rossini, PM and Pappalettera, C}, title = {Should all MCI with Alzheimer's biological diagnosis receive anti-amyloid therapy?.}, journal = {Cell death & disease}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41419-026-08456-z}, pmid = {41667430}, issn = {2041-4889}, abstract = {Our perspective addresses one of the most pressing and timely debates in contemporary neurology and health policy: whether the recent approval of anti-amyloid monoclonal antibodies for Alzheimer's disease should extend to all individuals with mild cognitive impairment (MCI; a large population of tens of millions of individuals worldwide mainly represented in Countries with aged population) who test positive for amyloid biomarkers, despite wide variability in prognosis and therapeutic response and the epidemiological demonstration that only about half of them manifest symptoms of dementia. The manuscript highlights three central themes. First, while epidemiological and meta-analytic data confirm that MCI significantly increases the risk of dementia, more than half of affected individuals-many of whom are biomarker-positive for amyloid/tau-do not progress to dementia even over long- term follow-up. Second, recently approved anti-amyloid therapies, although representing a landmark in disease-modifying treatments, carry high costs, non-negligible risks (particularly amyloid-related imaging abnormalities), and uncertain long-term real-world benefits. Third, indiscriminate prescription of these agents risks exposing large numbers of subjects to unnecessary harm while placing unsustainable burdens on healthcare systems. We argue that the field should urgently move to identify and validate accurate and sustainable instruments for risk-stratified treatment pathways, integrating genetic, clinical, neuropsychological, neuroimaging, and fluid biomarker data including risk and resilience factors to refine prognostication. In addition, we call on the scientific community, journals, and policymakers to foster dialog that bridges neurology, geriatrics, bioethics, health economics, and patient advocacy, so that clinical innovation is matched by ethical responsibility and equitable implementation.}, }
@article {pmid41667287, year = {2026}, author = {Casper, A and Bolin, J}, title = {Alzheimer Disease and the Utility of PET.}, journal = {Journal of nuclear medicine technology}, volume = {}, number = {}, pages = {}, doi = {10.2967/jnmt.125.271758}, pmid = {41667287}, issn = {1535-5675}, abstract = {Alzheimer disease (AD) is the most common cause of dementia and one of the leading causes of death in adults age 65 y or older in the United States. AD presents with symptoms of cognitive impairment that worsen with disease progression, ultimately affecting an individual's functional abilities, independence, and overall health. Historically, treatment has relied on the mitigation of the adverse effects of the disease; however, the recent development of antiamyloid monoclonal antibodies allows for the targeting of pathologic factors that drive the progression of disease. Nuclear medicine has established itself as a useful tool in the evaluation of AD through the use of PET tracers, which target pathologic biomarkers such as amyloid-β and tau proteins, as well as metabolic processes reflective of neurodegenerative damage. Amyloid-β PET imaging and quantification have recently gained interest for their ability to more effectively diagnose AD and identify patients eligible for treatment with new antiamyloid therapies.}, }
@article {pmid41667282, year = {2026}, author = {Grabher, BJ}, title = {Centiloids in Amyloid PET: A Practical Guide to Quantitation Interpretation.}, journal = {Journal of nuclear medicine technology}, volume = {}, number = {}, pages = {}, doi = {10.2967/jnmt.125.271823}, pmid = {41667282}, issn = {1535-5675}, abstract = {The approval of disease-modifying antiamyloid therapies has expanded the clinical role of amyloid PET beyond diagnostic confirmation to include baseline characterization and longitudinal monitoring of treatment response. Although visual interpretation remains the clinical standard for amyloid PET, it may be limited in borderline cases and when assessing subtle changes in amyloid burden over time. Quantitative amyloid PET provides objective measures that complement visual assessment, with z scores, SUV ratios, and Centiloid scaling offering increasing clinical utility. The Centiloid scale standardizes amyloid PET quantification across tracers, scanners, and institutions by anchoring measurements to biologically defined reference points, enabling consistent interpretation and comparison. This article describes the principles of amyloid PET quantification, explains the origin and interpretation of Centiloids, and discusses their role in therapy monitoring and clinical decision-making. Understanding quantitative amyloid PET and its limitations is essential for nuclear medicine professionals in the evolving landscape of Alzheimer disease imaging.}, }
@article {pmid41667280, year = {2026}, author = {Skyles, T and Bouchal, SM and Giarratana, A and Wengler, J and Hart, I and Greig, E and Singh, H and Huang, SS and Martinez, F and Nguyen, B and Shin, CH and Yang, M and Parent, E and Robb, WH and Franceschi, AM and Burkett, B and Johnson, D and Koran, ME}, title = {PET Imaging in Alzheimer Disease in the Era of Antiamyloid Therapy in the United States: Clinical Utility, Quantification, and Policy Landscape.}, journal = {Journal of nuclear medicine technology}, volume = {}, number = {}, pages = {}, doi = {10.2967/jnmt.125.271835}, pmid = {41667280}, issn = {1535-5675}, abstract = {Alzheimer disease (AD) is increasingly diagnosed using molecular imaging biomarkers. PET imaging provides the opportunity to visualize amyloid and tau aggregates and in vivo neurodegenerative changes. These techniques provide exciting new avenues toward diagnosis, disease staging, and therapeutic monitoring of AD. Methods: This review details recent advances in amyloid PET, tau PET, and [18]F-FDG PET as they relate to the diagnosis, staging, and treatment of AD. The increasing roles of PET in the biologically based diagnosis of AD and antiamyloid immunotherapy response monitoring are addressed. Results: Amyloid PET enables improved detection of amyloid-β plaques within the brain. Amyloid PET is increasingly vital for confirming AD diagnoses given the emergence of antiamyloid immunotherapies, which require biomarker-verified amyloid positivity to initiate treatment. Tau PET provides a direct measure of neurofibrillary tangle pathology and is useful for disease staging, the interpretation of atypical clinical presentations, and treatment decision-making. [18]F-FDG PET plays a vital role in distinguishing AD from other dementia subtypes. Expanded reimbursement policies for amyloid and tau PET have increased accessibility to these modalities. Finally, quantitative methods facilitate interscan reproducibility and permit therapeutic monitoring. Conclusion: Molecular neuroimaging is poised to play a central role in the biologic definition, diagnosis, staging, and management of AD. Integrating amyloid, tau, and FDG PET with clinical assessments and fluid biomarkers provides earlier and more accurate diagnoses, opening the door to personalized treatment.}, }
@article {pmid41666775, year = {2026}, author = {Chaudhari, S and Shinde, A and Salunke, M and Bairagi, S and Dhage, A and Patel, P and Rathod, V and Pathare, S and Altwaijry, N and Khan, MS}, title = {Investigating the anti-Alzheimer potential of biogenic compounds from Zinc15 database as NMDA antagonist: An in-silico approach.}, journal = {Journal of molecular graphics & modelling}, volume = {144}, number = {}, pages = {109277}, doi = {10.1016/j.jmgm.2026.109277}, pmid = {41666775}, issn = {1873-4243}, abstract = {Alzheimer's disease is an unavoidable neurological disorder in which the death of brain cells brings on memory loss, cognitive decline, and eventual dementia. There is no recognized treatment for Alzheimer's illness. By the year 2050, it is expected that the global population will witness approximately 100 million cases of Alzheimer's disease (AD). Despite recognizing AD as a formidable illness for over a century, no effective cure has been discovered thus far. Synaptic dysfunction could result from disturbed synaptic calcium handling caused by excessive activation of glutamate receptors, particularly the N-methyl-D-aspartate receptors (NMDARs). Glutamate serves as the brain's primary excitatory neurotransmitter, acting on ionotropic and metabotropic glutamate receptors. In recent years, several pharmacologically active substances derived from plants, animals, and microbes have shown promise in treating AD by focusing on various pathogenic processes. Initially, we used virtual screening to assess natural product-like compounds against NMDA receptors. In this research study, we have screened a natural compound database derived from zinc15. The best candidate was then validated through molecular dynamics simulation (MDS). The results revealed that out of 4221 compounds tested, only 165 showed superior binding interactions compared to native ligands, making them inhibitors for protein. Further analysis using ADMET indicates favorable drug-like properties, particularly for CNS drug-likeness. The MDS results, including RMSD, RMSF, Rg, and residue interactions, indicated a strong and stable association between top molecules and target protein. This confirms that top molecules can effectively remain within the binding pockets of the target proteins, forming stable protein-ligand complexes.}, }
@article {pmid41666521, year = {2026}, author = {Qin, Z and Wang, Z and Gao, C and Yong, X and Hua, Y and Zhou, Y and Xie, J}, title = {Ultrasound-mediated blood-brain barrier opening for targeted neurological drug delivery.}, journal = {Biomaterials advances}, volume = {183}, number = {}, pages = {214754}, doi = {10.1016/j.bioadv.2026.214754}, pmid = {41666521}, issn = {2772-9508}, abstract = {Neurological disorders represent a devastating global health crisis, and the blood-brain barrier (BBB) remains a major obstacle for their treatment. Conventional strategies for BBB opening, including direct intracranial injection, osmotic disruption, receptor-mediated transcytosis, and nanoparticle carriers, often suffers from surgical invasiveness, systemic toxicity, poor biodistribution, and off-target effects. Ultrasound-mediated drug delivery has emerged as a revolutionary non-invasive technology for transient and targeted BBB opening, enabling enhanced penetration of therapeutic agents into the central nervous system. This review comprehensively summarizes the mechanisms underlying ultrasound-based delivery with focus on current delivery platforms including microbubble (MB)-assisted, nanoparticle-based, and MB-nanoparticle composite strategies. Furthermore, we highlight recent advances in the application of focused ultrasound (FUS) combined with MBs for the treatment of Alzheimer's disease, Parkinson's disease, and glioma. Finally, we discuss emerging technologies such as sonodynamic therapy and ultrasound-controlled magnetic nanorobots, while also addressing current challenges in this field. This review underscores the transformative potential of ultrasound-mediated drug delivery as a versatile platform for precision neurology. It also prospects future directions for advancing multidisciplinary research and clinical translation.}, }
@article {pmid41666126, year = {2026}, author = {Yue, J and Jones, B and Tran, KH and Deen, M and Holicek, V and Cheng, WH and Michalik, M and Power, S and Wellington, CL and Watson, NV and Vocadlo, DJ}, title = {Pharmacological inhibition of O-GlcNAcase reduces pS129-α-synuclein positive aggregates in the substantia nigra of mThy1-hSNCA mice.}, journal = {Journal of Parkinson's disease}, volume = {}, number = {}, pages = {1877718X251410291}, doi = {10.1177/1877718X251410291}, pmid = {41666126}, issn = {1877-718X}, abstract = {BackgroundThe aggregation and spread of α-synuclein within brain are associated with the loss of dopaminergic neurons and the formation of Lewy bodies as seen in Parkinson's disease. Blocking the initiation of α-synuclein aggregation, or the spread of such aggregates, may offer disease-modifying approaches to slow disease progression. Previous studies have demonstrated that modification of aggregation prone proteins, including α-synuclein, with O-linked β-N-acetylglucosamine (O-GlcNAc) reduces their aggregation. Small molecule inhibitors of the enzyme O-GlcNAcase (OGA), which removes O-GlcNAc from proteins, confers neuroprotective benefits in various preclinical disease models of Alzheimer's and Parkinson's diseases.ObjectiveThis study investigates the effects of long-term pharmacological enhancement of O-GlcNAcylation in a transgenic mouse model of Parkinson's disease overexpressing human α-synuclein.MethodsThiamet-G was orally administered to mThy1-hSNCA and wild-type (WT) mice for ten months. Behavioral assessments were conducted to examine changes in locomotion and cognition. Histological analyses were performed to analyze α-synuclein aggregates and dopaminergic neurons in brain sections. Immunoblot and ELISA analyses were performed to analyze O-GlcNAc and soluble α-synuclein using brain lysates, respectively.ResultsThiamet-G increased the level of O-GlcNAc in the brain of both mThy1-hSNCA and WT mice. The levels of total α-synuclein in the brain were unaltered. However, Thiamet-G strongly attenuated the deposition of pS129-immunoreactive α-synuclein aggregates within the substantia nigra, prior to observable neurodegeneration. Thiamet-G also protected against locomotor decline.ConclusionsThese results support OGA inhibition as a therapeutic approach to block the pathological formation of toxic α-synuclein as a disease-modifying treatment against Parkinson's disease.}, }
@article {pmid41666058, year = {2026}, author = {Zhang, H and Wang, D and Yang, J and Zhao, Y and Liu, Y and Zhu, R and Wang, L and Song, R and Zhang, W}, title = {Unsupervised Disentanglement of Brain Heterogeneity for Identifying Subtypes of Alzheimer's Disease.}, journal = {IEEE transactions on bio-medical engineering}, volume = {PP}, number = {}, pages = {}, doi = {10.1109/TBME.2026.3663181}, pmid = {41666058}, issn = {1558-2531}, abstract = {Neuroanatomical heterogeneity in Alzheimer's disease (AD) hinders precision diagnosis and treatment, as distinct brain phenotypes may correspond to different disease subtypes. However, MRI-based subtype classifications are often confounded by co-occurring pathologies and non-AD factors, such as genetic predisposition and environmental influences, limiting their clinical interpretability. We propose 3D-DisAD, an unsupervised deep learning framework that disentangles AD-specific neuroanatomical variations from unrelated influences and clusters patients into subtypes with homogeneous brain phenotypes. The framework comprises two synergistic networks: (1) Contrastive Disentanglement Network, which separates AD-specific variations from those shared by AD patients and healthy controls; and (2) Transformation Generation Network, which refines these disease-specific variations by transforming healthy brain representations into realistic, pathology-consistent anatomies via diffusion-based generative modeling. Evaluated on four public datasets, 3D-DisAD reveals strong correlations between the disentangled AD-specific variations and diverse clinical and biological profiles, validating their relevance. Using these variations, we identify four AD subtypes with significant differences in biomarkers, cognitive trajectories, and genetic signatures, and uncover distinct longitudinal progression patterns that suggest potential windows for early intervention. By disentangling AD-specific variations, our method enables more precise patient stratification and personalized treatments, particularly in the early stage of AD. Code is available at: https://github.com/cnuzh/3D-DisAD.}, }
@article {pmid41665751, year = {2026}, author = {Voronova, AD and Karsuntseva, EK and Shishkina, VS and Chadin, AV and Fursa, GA and Gurin, PI and Kuznetsova, TV and Reshetov, IV and Shport, SV and Stepanova, OV and Chekhonin, VP}, title = {Clinical Trials of Cell Products for the Treatment of Alzheimer's Disease (Review).}, journal = {Bulletin of experimental biology and medicine}, volume = {}, number = {}, pages = {}, pmid = {41665751}, issn = {1573-8221}, abstract = {Existing approaches to the treatment of Alzheimer's disease are ineffective because they do not stop neurodegenerative processes in the brain and do not promote the regeneration of the nervous tissue. Cell therapy is a promising strategy for the treatment of this disease. This review discusses clinical studies of cell-based therapies for Alzheimer's disease, evaluates their therapeutic potential, and proposes strategies for developing safe, accessible, and effective cell products.}, }
@article {pmid41665706, year = {2026}, author = {Giacomini, PS and Voss, P and Devonshire, V and Schneider, R and Macaron, G and Hussein, S and Blanchette, F and de Villers-Sidani, É}, title = {Eye tracking as a digital biomarker in neurodegenerative diseases.}, journal = {Journal of neurology}, volume = {273}, number = {2}, pages = {133}, pmid = {41665706}, issn = {1432-1459}, mesh = {Humans ; *Neurodegenerative Diseases/diagnosis/physiopathology/complications ; Biomarkers ; *Eye-Tracking Technology ; *Eye Movements/physiology ; }, abstract = {Oculomotor abnormalities are a common finding in neurodegenerative diseases due to degeneration of neural pathways and brain regions involved in controlling eye movements. Pathological changes to the dorsolateral prefrontal cortex, basal ganglia, superior colliculus and cerebellum produce subtle changes in eye-movement metrics that may not be detected by clinical examination. The present review addresses the potential use of eye-movement biomarkers in neurodegenerative conditions such as multiple sclerosis, Parkinson's disease, Alzheimer's disease and other dementias, and amyotrophic lateral sclerosis. Eye-movement metrics such as saccades, anti-saccades, fixation and smooth pursuit are prognostic of disease progression, can differentiate pathologic subtypes as an aid to diagnosis, and enable clinicians to evaluate early worsening of motor and cognitive function. The cost of medical technologies limits their optimal use and accessibility in clinical practice. The shortage of subspecialist neurologists further limits access to care. New eye-tracking technologies incorporated into widely-accessible digital devices such as smart phones and tablets now permit detailed assessments with minimal equipment requirements, providing an important non-invasive and potentially cost-effective method for patient evaluation in routine clinical practice and as an aid to treatment decision-making. Digital biomarkers can be readily employed by healthcare professionals such as family physicians, nurses and pharmacists to bridge the care gaps, potentially providing them with powerful tools that can be broadly adopted to improve the delivery of care to patients with neurodegenerative conditions.}, }
@article {pmid41664707, year = {2026}, author = {Xiang, Q and Shi, RL and Huang, YX and Liu, LN and Tao, JS and Li, XH and Li, XD}, title = {Oligodendrocyte: Development, Plasticity, Biological Functions, Diseases, and Therapeutic Targets.}, journal = {MedComm}, volume = {7}, number = {2}, pages = {e70618}, pmid = {41664707}, issn = {2688-2663}, abstract = {In the past few years, the incidence rate of central nervous system (CNS) diseases is still growing. Meanwhile, the molecular mechanism on the pathogenesis of neurological diseases remains elusive. Oligodendrocyte progenitor cells (OPCs) are distributed in the whole CNS and represent a population of migrating and proliferating adult progenitor oligodendrocytes that can be differentiated into oligodendrocytes (OLs). The main function of OLs is to produce myelin, the membrane wrapping tightly around the axon, which are associated with the myelination and remyelination. During regeneration, the new OLs from OPCs can regenerate lost myelin, which prevents axonal degeneration and restores its plasticity and function. Considering these energy-consuming processes, the high metabolic turnover OLs are susceptible to neurotoxic factors and its excitatory toxicity. Thus, the pathogenesis of OPC and OL are proven in neurological diseases, such as multiple sclerosis, Alzheimer's disease, major psychiatric diseases, and epilepsy. The current study reviewed the development, plasticity as well as application of OPCs and OLs researches on CNS diseases. Additionally, the effective methods and bioengineering technologies as well as biomaterials relevant to regenerative medicine are also discussed, which could provide the novel insight into the therapeutic treatment of those diseases, exploring new pathological clues, identifying the key molecules and targets as well as the potential biomarkers.}, }
@article {pmid41664517, year = {2026}, author = {Silva Fernandes, A and Barbosa de Souza, Á and Benvindo de Souza, M and Madureira Almeida, L and Luiz Franco, O and Luiz Cardoso Bailão, EF and Borges, LL and Sérgio Nakao de Aguiar, A}, title = {DNA damage induced by fungicides triadimefon, triadimenol, and their mixture in human lymphocytes: cytogenotoxicity and computational analysis of metabolic pathways.}, journal = {Drug and chemical toxicology}, volume = {}, number = {}, pages = {1-9}, doi = {10.1080/01480545.2026.2626753}, pmid = {41664517}, issn = {1525-6014}, abstract = {Triadimefon (TF) and triadimenol (TN) are triazole fungicides widely used to prevent fungal infections in cereals, fruits, and other economically important crops. Their harmful effects on non-target organisms have been reported. This study investigated the cytogenotoxic effects of TF and TN, isolated and combined, at environmentally relevant concentrations (TF: 0.006, 0.012, and 0.024 mg/mL; TN: 1.5, 3.0, and 6.0 mg/mL; and 0.012 mg/mL TF + 3.0 mg/mL TN) on human lymphocytes using the trypan blue exclusion test and the comet assay. Additionally, in silico tools, BioTransformer and DIGEP-Pred, were employed to elucidate metabolic pathways more effectively for detoxifying these xenobiotics and to evaluate their putative effects on gene transcription, respectively. Exposure to TF and TN, either alone or in combination, did not affect lymphocyte viability at the tested concentrations. However, both compounds induced an increase in the percentage of DNA strand breaks after treatment. The in silico predictions suggested that the interaction with the cytochrome P450 isoforms (CYP1A2, CYP2A6, CYP2C9, and CYP2D6) differed for each compound analyzed. Gene expression prediction indicated that TF and TN may up-regulate genes involved with hormonal alterations, Alzheimer's disease risk, and cancer progression (SF1, SPON1, ADGRF5, and RORB). While they may down-regulate a gene involved with changes in heart rhythm and neurotoxicity (HCN1). In conclusion, our findings reinforced that the triazole fungicides TF and TN, while effective in agriculture, may pose risks to genomic stability in humans, highlighting the importance of biomonitoring studies in exposed populations.}, }
@article {pmid41664331, year = {2026}, author = {Siddiqui, S and Tufail, P and Khan, F and Khalid, MF and Khalid, F}, title = {Protocatechuic Acid Alleviates Neurodemyelination by Modulating PKCα-p38/MAPK Pathways in an LPC-Induced Model of Neurodegeneration.}, journal = {Current protein & peptide science}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113892037385148251207081917}, pmid = {41664331}, issn = {1875-5550}, abstract = {INTRODUCTION: Neuroinflammation, axonal damage, and alterations in extracellular matrix (ECM) protein expression are hallmarks of neurodegenerative diseases. Therapies that enhance recovery from brain injury are of significant clinical value. Therefore, this study investigated the antiinflammatory properties of protocatechuic acid (PCA).
METHODS: Neuroglial cocultures were prepared from P0-P1 rats. Demyelination was induced using LPC (0.003%). The effects of PCA (10 and 25 μg) on neurite outgrowth were assessed using morphometry software. Expression of COX-2, NF-κβ, PKC-α, and p38/MAPK was examined through immunostaining, SDS-PAGE, and Western blotting. Expression intensities were quantified using ImageJ software. Sustained repetitive neuronal firing was evaluated using the patch-clamp technique.
RESULTS: PCA increased neurite outgrowth in LPC-treated cultures after 72 hours in vitro. LPCinduced upregulation of ECM proteins TN-C, LN, and CSPGs was significantly reduced by PCA treatment compared with LPC controls. Similarly, PCA decreased the expression intensities of the pro-inflammatory markers NF-κβ and COX-2 relative to LPC controls. Furthermore, PCA reversed the sustained neuronal firing pattern observed in untreated LPC-exposed neurons.
DISCUSSION: Purified bioactive compounds commonly present in everyday foods show therapeutic potential for Parkinson's and Alzheimer's diseases due to their lower toxicity compared with conventional drugs. Artificial intelligence tools, such as AlphaFold and RoseTTAFold, further support drug development by predicting PCA binding modes with PKCα and P38/MAPK, thereby contributing to the design of personalized therapeutics and advancing neuroscience research.
CONCLUSION: PCA alleviated neuroinflammation by reducing phosphorylation of PKCα and p38/MAPK.}, }
@article {pmid41618017, year = {2026}, author = {Beccherle, M and Amato, S and Facci, E and Stefanescu, G and Bertagnoli, S and Francesco, VD and Fontana, G and Gambina, G and Moro, V}, title = {Patterns of cognitive and motor decline in Alzheimer's Disease (AD) and ageing in healthy populations.}, journal = {Aging clinical and experimental research}, volume = {38}, number = {1}, pages = {74}, pmid = {41618017}, issn = {1720-8319}, abstract = {BACKGROUND: Various patterns may apply to an individual’s health-span, with quality of life deriving from a balance between physical conditions, motor and cognitive abilities (i.e. psychomotor capabilities).
METHODS: In this study, the Italian version of the Éxamen Geronto-Psychomoteur was administered to a sample of Alzheimer’s Disease (AD) patients (n = 94) and a group of healthy older adults (n = 333) to compare the patterns of psychomotor decline in pathological and physiological ageing. Three domains were considered to integrate bodily and cognitive dimensions: cognitive functions, motor abilities, and muscular tone alterations (physical constraints). Potential correlations with general cognitive functioning, autonomy in daily life, mood and nutritional status were also investigated.
RESULTS: A correlation between cognitive, motor and physical dimensions is confirmed, and the results show that the patterns relating to healthy and pathological ageing are not only quantitatively but also qualitatively different. Besides the cognitive functions, the deterioration in AD also affects the physical components, precociously. Specifically, hypertonia may be present since the initial phases of illness. In healthy subjects, body representations decline early, while verbal memory, temporal and space representation resist over time. Malnutrition correlates with hypertonia in AD and with a reduction in daily life abilities in healthy people.
CONCLUSIONS: The results highlight the importance of adopting an integrated psychomotor approach in the screening, diagnosis and treatment of ageing and AD to investigate early motor and bodily indicators, which are often not fully considered in clinical practice.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-026-03327-1.}, }
@article {pmid41527082, year = {2026}, author = {Du, Y and Wu, L and Mao, Y and Chen, S and Gao, X}, title = {IL-27, a metabolic regulator secreted by astrocytes in response to GLP-1RA OHP2, modulates microglial reprogramming in Alzheimer's disease by regulating cGAS lactylation.}, journal = {Journal of neuroinflammation}, volume = {23}, number = {1}, pages = {58}, pmid = {41527082}, issn = {1742-2094}, support = {82473834//National Natural Science Foundation of China,China/ ; 82373780//National Natural Science Foundation of China,China/ ; CPU2022PZQ10//"Double First-Class" University Project/ ; }, abstract = {UNLABELLED: Microglia-mediated neuroinflammation, considered one of the most plausible pathogenic hypotheses underlying Alzheimer’s disease (AD), plays a pivotal role in the initiation and progression of this devastating condition. Recently, glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated promising neuroprotective effects in both preclinical and clinical studies. Previously, we developed an orally-administered GLP-1RA peptide called OHP2, which is capable of crossing the blood-brain barrier for the treatment of AD. OHP2 has been shown to effectively reduce brain inflammation in AD mouse models. In this study, we discovered that OHP2 treatment induced IL-27 secretion from astrocytes and modulated microglial reprogramming from the neurotoxic M1 phenotype to the neuroprotective M2 phenotype through glycolysis/cGAS lactylation clock/mTOR pathway, thereby alleviating excessive neuroinflammation. These findings provide a rationale for further pharmacological investigations into OHP2 and suggest that IL-27 may hold significant implications for AD therapy as a metabolic regulator.
GRAPHICAL ABSTRACT: [Image: see text]
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12974-025-03683-1.}, }
@article {pmid41663779, year = {2026}, author = {Roy, KK and Kumari, R and Upadhyay, AK and Mohanty, S}, title = {Tailoring treatments: pharmacogenomics in the management of neurodegenerative diseases.}, journal = {Acta neurologica Belgica}, volume = {}, number = {}, pages = {}, pmid = {41663779}, issn = {2240-2993}, abstract = {Neurodegenerative diseases like Alzheimer's, Parkinson's, Huntington's, and amyotrophic lateral sclerosis are growing more common worldwide, yet treatment is still poor. Conventional therapies can have unforeseen side effects, produce poor medication reactions, and take longer to work. This persistent treatment gap highlights the need for novel approaches to these disorders' complex distinctions. Pharmacogenomics, which examines how genetic differences affect drug response, is a promising new subject and an urgent solution. Pharmacogenomics tailors medicine selection and administration to each patient's genetic profile, addressing the main causes of poor treatment response and preventable side effects. This research has enabled precision medicine that can improve neurodegenerative disease therapy and reduce harm. In this in-depth research, we examine neurodegenerative disease management issues, pharmacogenomics breakthroughs, and how incorporating genetics to clinical practice can improve outcomes. We examine the latest evidence that genetics affect drug breakdown, efficacy, and toxicity. We also discuss the challenges and opportunities of applying this knowledge. Pharmacogenomic approaches must be widely applied to make medicines for these awful disorders safer, more effective, and really suited to patient needs, according to our compilation.}, }
@article {pmid41662806, year = {2026}, author = {Zhang, H and Zhang, H and Zhao, M and Luo, W and Chen, S and Wang, P and Liu, X and Xu, S}, title = {Da-Bu-Yin-Wan rescues cognitive deficits in aging and Alzheimer's disease models by Wnt/β-catenin-dependent restoration of lysosomal acidification.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {153}, number = {}, pages = {157916}, doi = {10.1016/j.phymed.2026.157916}, pmid = {41662806}, issn = {1618-095X}, abstract = {BACKGROUND: Lysosomal acidification deficits are increasingly recognized as a convergent pathological mechanism driving both age-related cognitive decline (ARCD) and early Alzheimer's disease (AD) progression, creating a self-reinforcing cycle of cellular aging and Aβ dyshomeostasis. Despite demonstrated neuroprotective effects of Da-Bu-Yin-Wan (DBYW) in Parkinson's disease models, its therapeutic potential for lysosomal dysfunction in ARCD and AD remains an uncharted area of investigation.
PURPOSE: This present work aimed to elucidate the mechanistic basis by which DBYW mitigates both ARCD and AD pathology through functionally rescuing impaired lysosomal acidification.
METHODS: Cell-based D-galactose and Aβ-induced in BV2 cells to study lysosomal acidification. Molecular analyses combined immunofluorescence localization studies with quantitative immunoblotting of lysosomal and Wnt signaling proteins. In vivo, DBYW treatment effects were systematically evaluated in both D-gal-induced and APP/PS1 transgenic models using cognitive behavioral followed by immunohistochemical and biochemical assessment of brain tissues lysosomal parameters and Wnt signaling activity.
RESULTS: DBYW attenuated the mechanistic basis of ARCD and AD pathology by functionally rescuing impaired lysosomal acidification. Overexpression of β-catenin could modulate D-galactose or Aβ-induced dysregulation of the Wnt/β-catenin pathway and restore lysosomes with abnormal acidification, while DBYW could regulate lysosomal function by promoting Wnt/β-catenin signaling. In addition, in D-gal-induced aging and AD model mice, DBYW treatment activated Wnt/β-catenin signaling to restore lysosomal acidification, while spatial memory deficits in ARCD and AD models were improved, and pathology in mouse attenuation and APP/PS1 mouse brain tissue was inhibited.
CONCLUSION: DBYW shows a potential dual efficacy in improving cognitive decline in ARCD and AD models. It makes DBYW a promising disease-modifying intervention targeting the shared lysosomal pathophysiology of aging-associated neurodegeneration.}, }
@article {pmid41662521, year = {2026}, author = {Boskovic, P and Shalita, R and Gao, W and Vernon, H and Deng, YL and Colonna, M and Majzner, RG and Amit, I and Kipnis, J}, title = {Engineering chimeric antigen receptor CD4 T cells for Alzheimer's disease.}, journal = {Proceedings of the National Academy of Sciences of the United States of America}, volume = {123}, number = {7}, pages = {e2530977123}, doi = {10.1073/pnas.2530977123}, pmid = {41662521}, issn = {1091-6490}, support = {R01AG078667//HHS | NIH | National Institute on Aging (NIA)/ ; R61AG090394//HHS | NIH | National Institute on Aging (NIA)/ ; no number//Carol and Gene Ludwig Family Foundation/ ; no number//Cure Alzheimer's Fund (CAF)/ ; no number//Fred and Ginger Haberle Charitable Fund at East Texas Communities Foundation/ ; }, mesh = {*Alzheimer Disease/therapy/immunology/pathology ; *CD4-Positive T-Lymphocytes/immunology/metabolism/transplantation ; Animals ; *Receptors, Chimeric Antigen/genetics/immunology/metabolism ; Mice ; Humans ; Amyloid beta-Peptides/metabolism/immunology ; *Immunotherapy, Adoptive/methods ; Disease Models, Animal ; Brain/pathology/immunology/metabolism ; }, abstract = {Alzheimer's disease (AD) is the prevailing cause of age-associated dementia worldwide. Current standard of care relies on antibody-based immunotherapy. However, antibody-based approaches carry risks for patients, and their effects on cognition are marginal. Increasing evidence suggests that T cells contribute to AD onset and progression. Unlike the cytotoxic effects of CD8[+] cells, CD4[+] T cells capable of regulating inflammation show promise in reducing pathology and improving cognitive outcomes in mouse models of AD and in aging. Here, we sought to exploit the beneficial properties of CD4[+] T cells while circumventing the need for TCR and peptide-MHC antigen discovery, thereby providing a potential universal therapeutic approach. To achieve this, we engineered CD4[+] T cells with chimeric antigen receptors (CARs) targeting fibrillar forms of aggregated amyloid-β. Our findings demonstrate that optimized CAR-T cells can alter amyloid deposition in the dura and reduce parenchymal pathology in the brain. Furthermore, we observed that CAR-T treatment promotes the expansion and recruitment of endogenous CD4[+] T cells into the brain parenchyma and leptomeninges. In summary, we established the feasibility of amyloid plaque-specific CAR-T cells as a potential therapeutic avenue for AD. These findings highlight the potential of CD4[+] CAR-T therapy not only to modify amyloid pathology but also to reshape the immune landscape of the CNS, paving the way for future development of cellular immunotherapies for neurodegenerative disease.}, }
@article {pmid41661364, year = {2026}, author = {Li, L and Kong, J and Fan, R and Yuan, Y and Zhu, L}, title = {Correction: Role of tRNA-Derived Fragments and Their Modifications in the Pathogenesis and Treatment of Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {429}, doi = {10.1007/s12035-026-05713-2}, pmid = {41661364}, issn = {1559-1182}, }
@article {pmid41660277, year = {2026}, author = {Fang, Y and Han, Z and Yang, S and Chen, J and Li, R and Zhang, Z and Song, J and Wang, D and Ban, Y}, title = {Ferroptosis and Alzheimer's disease: unraveling the molecular mechanisms and therapeutic opportunities.}, journal = {Frontiers in cell and developmental biology}, volume = {14}, number = {}, pages = {1758041}, pmid = {41660277}, issn = {2296-634X}, abstract = {Ferroptosis is a novel form of regulated cell death. Compared with other types of cell death, it shows great differences in structure and biochemistry. This type of cell death is receiving increasing attention. For example, studies have found that it plays a key role in the development of neurodegenerative diseases underlying brain atrophy, such as Alzheimer's disease (AD). AD is a chronic and worsening neurodegenerative disease. It poses a serious threat to the health and quality of life of the elderly. The pathology of AD is mainly the presence of extracellular beta-amyloid (Aβ) plaques and intracellular tau-based nerve fiber entanglement (NFTs). Although there are a large number of studies and interventions for AD, so far, no clinical drugs have been found that can stop the pathological progression of AD or cure it. Currently, treatment strategies for this disease only focus on alleviating clinical symptoms and do not achieve slowing disease progression or curing it. Ferroptosis is gradually considered to play a key role in the occurrence and development of AD. Research based on the AD model confirms that neuronal ferroptosis can be inhibited through pharmacology to reverse cognitive disorders. In this review, we first describe the key molecular mechanisms of ferroptosis, and then discuss how these mechanisms operate and develop in AD. Then, we give a detailed introduction to the latest treatments for AD, including iron chelators, antioxidants, and specific ferroptosis inhibitors. What is noteworthy is that this article emphasizes the analysis of the mechanisms of iron metabolism disorders, as well as the introduction of new drugs for the prevention, rather than the alleviation of AD.}, }
@article {pmid41659595, year = {2026}, author = {Chaggar, P and Vogel, JW and Thompson, TB and Aldea, R and Strandberg, O and Stomrud, E and Palqmvist, S and Ossenkoppele, R and Jbabdi, S and Magon, S and Klein, G and , and Mattson-Carlgren, N and Hansson, O and Goriely, A}, title = {Dynamical A β -Tau-Neurodegeneration Model Predicts Alzheimer's Disease Mechanisms and Biomarker Progression.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.01.27.701320}, pmid = {41659595}, issn = {2692-8205}, abstract = {UNLABELLED: Alzheimer's disease is characterised by the pathological interaction of two proteins, amyloid-beta (Aβ) and tau, which collectively drive neurodegeneration and cognitive decline. The progression of Aβ, tau, and neurodegeneration biomarkers is captured by the ATN framework, which is a powerful tool for disease classification. However, since the ATN framework is mainly descriptive, it cannot quantify or predict relationships between biomarkers over time. We address this limitation by introducing a dynamical ATN (dATN) model that mechanistically simulates the spatiotemporal progression of Aβ, tau, and neurodegeneration. The dATN model integrates mechanisms of prion-like protein aggregation of Aβ and tau, network-based tau propagation, Aβ-driven catalysis of tau progression, and tau-driven neurodegeneration. We calibrated the model using multimodal longitudinal imaging data from both the ADNI and BioFINDER-2 cohorts and show that it accurately fits longitudinal regional Aβ, tau, and neurodegeneration data. Using the dATN model, we show that Aβ-induced effects predict Braak-like cortical tau progression, that the spatial colocalisation of Aβ and tau is a crucial biomarker of disease acceleration, and that tau-driven atrophy strongly correlates with observed neurodegeneration. Furthermore, by integrating the disease progression model with pharmacokinetic-pharmacodynamic simulations, we present a powerful tool that facilitates regional evaluation of therapeutic strategies targeting Aβ, identification of critical intervention windows, and prediction of heterogeneous treatment effects across brain regions. This framework unifies mechanistic understanding with clinical imaging biomarkers, offering a quantitative approach for forecasting disease progression, testing mechanistic hypotheses, and optimising personalised treatment strategies in AD.
ONE SENTENCE SUMMARY: Colocalisation of A β and tau predicts regional tau progression and optimal A β -targeted intervention windows, while tau predicts neurodegeneration.}, }
@article {pmid41657474, year = {2026}, author = {Kim, GH and Pyun, JM and Kang, D and Kang, SH and Koh, SH and Kim, JS and Moon, SY and Moon, WJ and Park, YH and Shim, Y and Yang, DW and Youn, YC and Jung, YH and Cho, H and Choi, H and Lim, JS and Park, KH and Choi, SH}, title = {A Protocol of Korean JOint RegistrY for ALZheimer's Treatment and Diagnostics (JOY-ALZ).}, journal = {Dementia and neurocognitive disorders}, volume = {25}, number = {1}, pages = {25-41}, pmid = {41657474}, issn = {2384-0757}, abstract = {BACKGROUND AND PURPOSE: To assess the long-term effectiveness, safety, and economic viability of recently approved Alzheimer's disease (AD) therapies, as well as to evaluate the real-world application of novel diagnostics among AD patients with diverse comorbidities, comprehensive real-world data (RWD) analysis is essential. The Korean JOint RegistrY for ALZheimer's Treatment and Diagnostics (JOY-ALZ) endeavors to create a registry of RWD derived from clinical practice on new diagnostic methods and therapeutic agents for AD introduced in Korea since 2021.
METHODS: Participants must fulfill all the following: 1) be at least 19 years old; 2) be actively receiving, scheduled to initiate, or undergoing evaluation for any AD disease-modifying treatment; 3) have completed amyloid positron emission tomography or cerebrospinal fluid AD immunoassay (a positive result is not essential for participation); 4) have a clinical classification of cognitively unimpaired, mild cognitive impairment, or probable AD dementia. Data generated during routine care is segmented into a minimum dataset, extended dataset, and research-only dataset requiring extra consent. Assessments encompass clinical, cognitive, functional, neurobehavioral, neuroimaging, and biomarker evaluations, in addition to systematic monitoring of new AD treatments and their safety. Data are collected and monitored at baseline, at semiannual intervals during the initial 2 years, and then annually up to 2034. To date, 46 medical centers will participate in JOY-ALZ.
CONCLUSIONS: JOY-ALZ is expected to promote understanding of the long-term clinical outcomes, safety, and cost-effectiveness of recently introduced diagnostics and treatments for AD, thereby supporting the progress of precision medicine in AD care and diagnosis.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06889818.}, }
@article {pmid41657418, year = {2026}, author = {Geiger, PC and Pennington, JS and Kueck, PJ and John, CS and Mayfield, HD and Kemna, RE and Burns, J and Vidoni, E and Honea, R and Li, Y and Mahnken, J and Morris, JK}, title = {Heat therapy in individuals at risk for Alzheimer's disease-methods for a randomized controlled trial.}, journal = {Frontiers in neurology}, volume = {17}, number = {}, pages = {1736108}, pmid = {41657418}, issn = {1664-2295}, abstract = {UNLABELLED: Heat therapy (HT) has been shown to improve peripheral blood glucose regulation in some populations, yet its effects on brain glucose metabolism remain largely unexplored. The chronic benefits of HT may arise in part from upregulation of heat-shock proteins (HSPs). These proteins play a crucial role in the stress response and modulate diverse processes such as proteostasis and cell signaling pathways, including that of insulin signaling. Understanding the impact of HT on both peripheral and central glucose metabolism, including the effects of varying temperatures, is essential for elucidating potential mechanisms underlying its brain benefits. The Feasibility of Improving Glycemia to prevent Alzheimer's Disease (FIGHT-AD) study is a randomized controlled trial that aims to investigate changes in blood and brain glucose regulation following 10 weeks of HT. Specifically, we will examine the peripheral biomarker responses to warm and hot HT and assess how these responses relate to brain metabolic changes in both treatment groups. This trial will be the first to quantify the effect of HT on cerebral glucose metabolism in individuals at metabolic risk for Alzheimer's Disease (AD). The FIGHT-AD trial will provide critical data to inform the design of future clinical trials targeting metabolic and brain health through HT.
CLINICAL TRIAL REGISTRATION: clinicaltrials.gov, identifier NCT06023407.}, }
@article {pmid41661788, year = {2024}, author = {McCormick, L and Bodla, AP and Rubin, RT}, title = {Very early onset dementias: Importance of differentiating from schizophrenia spectrum disorders.}, journal = {PLOS mental health}, volume = {1}, number = {3}, pages = {e0000107}, doi = {10.1371/journal.pmen.0000107}, pmid = {41661788}, issn = {2837-8156}, abstract = {Very early onset dementias and other neurodegenerative diseases often present with prominent behavioral disturbances and can be initially misdiagnosed as schizophrenia spectrum disorders. Differentiating a primary psychiatric condition from a neurodegenerative cause is important, because there are considerable differences in prognosis, treatment, and the services required for effective management. To illustrate the implications of misdiagnosis, we provide case examples of very early onset dementias, most of which were initially diagnosed as schizophrenia or other psychotic disorder, owing to their unusually young age of onset and initial behavioral presentations. We suggest how a clinician can differentiate schizophrenia from rarer, early onset neurodegenerative causes of altered behavior and mentation, including behavioral variant frontotemporal dementia (bvFTD), Wilson's disease, adult metachromatic leukodystrophy (MLD), Creuzfeldt-Jakob disease (CJD), and very early-onset Alzheimer's disease. Schizophrenia with prominent obsessive-compulsive (OC) symptoms is briefly discussed, given that OC symptoms can be a major feature of dementias with prominent behavioral components.}, }
@article {pmid41656099, year = {2026}, author = {Ma, YN and Huang, X and Xia, Y and Song, P and Hu, X}, title = {Protein persulfidation: The missing link in Alzheimer's disease defense mechanisms.}, journal = {Drug discoveries & therapeutics}, volume = {}, number = {}, pages = {}, doi = {10.5582/ddt.2026.01004}, pmid = {41656099}, issn = {1881-784X}, abstract = {Despite decades of research dominated by the amyloid-beta hypothesis, clinical treatment of Alzheimer's disease (AD) has yet to achieve a decisive breakthrough. This editorial advances an alternative pathological paradigm: the collapse of endogenous hydrogen sulfide (H2S) signaling represents a central failure point in the brain's intrinsic defense mechanisms against AD. We dissect the molecular cascade triggered by cystathionine γ-lyase (CSE) deficiency, focusing on how reduced persulfidation of glycogen synthase kinase 3β (GSK3β) directly promotes Tau hyperphosphorylation and subsequent neuronal injury. A critical message of this commentary is the need to dispel the oversimplified notion that sulfide supplementation alone can confer neuroprotection. Because H2S works within a narrow therapeutic window and has complex hormetic effects, untargeted dietary or environmental exposure cannot match the spatiotemporal precision of endogenous signaling. Instead, it may increase the risk of toxicity. By integrating analyses of transsulfuration metabolism, mitochondrial function, and nutritional status, we propose a precision medicine framework centered on brain-targeted delivery technologies and metabolic correction strategies to selectively restore compromised H2S signaling networks. This conceptual shift marks a new direction in AD research, shifting the focus from clearing toxic protein aggregates to restoring endogenous neuronal resilience.}, }
@article {pmid41654970, year = {2026}, author = {Lu, W and Kawatani, K and Ren, Y and Nambara, T and Jia, L and Jeevaratnam, S and Lee, E and Martinez, PR and Izhar, T and Wang, N and Raulin, AC and Wszolek, ZK and Bu, G and Kanekiyo, T and Li, Y}, title = {CI-994 is a dual modulator of class I HDACs and Wnt/β-catenin signaling for the treatment of Alzheimer's disease.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-026-01982-0}, pmid = {41654970}, issn = {1758-9193}, support = {R21AG065653, R01AG078615, 24A07//NIH, Florida Department of Health Ed and Ethel Moore Alzheimer's Disease Research Program/ ; }, }
@article {pmid41654149, year = {2026}, author = {Yuan, J and Zhang, S and Dong, X and Han, D}, title = {Agrin at the Crossroads of Aging: A Pleiotropic Regulator in Age-Related Diseases.}, journal = {Pharmacological research}, volume = {}, number = {}, pages = {108131}, doi = {10.1016/j.phrs.2026.108131}, pmid = {41654149}, issn = {1096-1186}, abstract = {Aging is a significant risk factor for numerous age-related diseases, and elucidating its key molecular mechanisms is crucial for disease prevention and treatment. Agrin, initially identified for its role in neuromuscular junction development, is an extracellular matrix protein. Recent studies have revealed its broad functions in maintaining tissue homeostasis and facilitating cellular signal transduction. During aging, alterations in the expression and function of Agrin may participate in the regulation of tissue repair, inflammatory responses, and intercellular communication, thereby influencing the onset and progression of various age-related diseases. This review systematically examines the central role of Agrin in age-related diseases such as Alzheimer's disease, ischemic stroke, myocardial infarction, osteoarthritis, and type 2 diabetes. Accumulating evidence indicates that Agrin exhibits a distinct ''double-edged sword'' characteristic across different disease stages or tissue contexts-exerting protective effects in some scenarios while promoting pathological progression in others. We summarize current findings on the involvement of Agrin in disease mechanisms, including the regulation of amyloid deposition, blood-brain barrier integrity, synaptic function, inflammatory responses, and tissue repair. Furthermore, we discuss potential Agrin-targeted therapeutic strategies. We propose that Agrin represents a critical molecular node linking aging mechanisms with multiple age-related diseases. A deeper understanding of its context-dependent functional switching and the development of precise targeting approaches hold substantial promise for the prevention and treatment of age-related pathologies.}, }
@article {pmid41653883, year = {2026}, author = {Vanderlip, CR and Gillen, DL and Grill, JD and Stark, CEL}, title = {Digital memory assessments and plasma pTau217 enable efficient preclinical Alzheimer's trials.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {4}, pages = {100503}, doi = {10.1016/j.tjpad.2026.100503}, pmid = {41653883}, issn = {2426-0266}, abstract = {BACKGROUND: Preclinical Alzheimer's disease (AD) trials enroll cognitively unimpaired, amyloid-positive older adults; however, most remain clinically stable over typical trial durations. Limited near-term decline reduces statistical power and drives large sample sizes and high costs. Scalable enrichment strategies capable of identifying individuals most likely to decline are critically needed.
OBJECTIVES: To determine whether a brief digital memory assessment (DMA) and plasma phosphorylated tau 217 (pTau217), individually or combined, identify preclinical AD participants at elevated risk for cognitive and biological progression, and whether such enrichment reduces clinical trial sample-size requirements.
DESIGN: Analysis of data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) Study, a multicenter randomized clinical trial with 240 weeks of follow-up.
SETTING: Secondary-prevention trial conducted across sites in the United States, Canada, Australia, and Japan.
PARTICIPANTS: A total of 1,169 cognitively unimpaired adults aged 65-85 years who were amyloid-positive and completed both a baseline DMA and plasma pTau217 measurement.
MEASUREMENTS: Primary outcome was change in the Preclinical Alzheimer Cognitive Composite (PACC) over 240 weeks. Secondary outcomes included Clinical Dementia Rating-Sum of Boxes, Mini-Mental State Examination, Cognitive Function Instrument, and annualized change in amyloid PET, plasma pTau217, and tau PET.
RESULTS: Participants with both elevated pTau217 and low DMA exhibited the greatest cognitive decline and reached the 240-week PACC decline of the overall cohort 83 weeks earlier. Participants with neither marker showed minimal decline. Dual enrichment reduced sample-size estimates for a clinical trial from 3,252 to 818 participants per arm (75 % reduction). These individuals also demonstrated faster increases in plasma pTau217 and neocortical tau PET.
CONCLUSIONS: A brief DMA combined with plasma pTau217 identifies a subset of cognitively unimpaired, amyloid-positive older adults at highest risk for cognitive and biomarker progression. This dual-marker enrichment strategy enables smaller, shorter, and more cost-efficient preclinical AD trials and supports more targeted evaluation of preventive therapies.}, }
@article {pmid41653511, year = {2026}, author = {Nie, RZ and Luo, HM and Wang, H and Yang, YR and Wang, YZ and Zhang, SZ and Feng, K and Li, YL and Chen, FY and Duan, CX and Chen, JY and Ma, T and Li, PF}, title = {The inhibitory mechanisms of PGG, a natural polyphenol enriched with gallate moieties, against Aβ42 amyloid aggregation: A unified experimental and molecular dynamics simulation study.}, journal = {Bioorganic & medicinal chemistry}, volume = {136}, number = {}, pages = {118584}, doi = {10.1016/j.bmc.2026.118584}, pmid = {41653511}, issn = {1464-3391}, abstract = {Alzheimer's disease currently affects over 44 million individuals worldwide. Inhibiting Aβ aggregation and preventing the formation of toxic Aβ oligomers were regarded as promising therapeutic approaches. Experimental studies demonstrated that 1,2,3,4,6-Penta-O-galloyl-β-d-glucopyranose (PGG), a natural polyphenol enriched with gallate moieties, significantly inhibited Aβ42 oligomerization and amyloid formation both in vitro and in vivo, underscoring its potential as a promising lead compound for AD therapy. Nevertheless, the detailed molecular mechanisms remained mostly unknown. Herein, we employed relevant biophysical methods to investigate the inhibitory effects of PGG and its analogs on Aβ42 amyloid aggregation, particularly on oligomer formation, providing direct evidence for the influence of gallate moiety number on its inhibitory activity against Aβ42 amyloid aggregation. Moreover, we further conducted 1500 ns all-atom MD simulations to explore how PGG inhibited Aβ amyloid aggregation. The simulations revealed that PGG promoted the adoption of a more loosely packed conformation of the Aβ42 dimer, and completely prevented the helix-to-β-sheet conformational change. Moreover, the binding of PGG molecules to the Aβ42 dimer resulted in the disruption of the inter-peptide interactions, and dramatically weakened the intra-peptide contacts. We observed that, apart from the usual hydrogen bonds and hydrophobic interactions, both π-π and cation-π interactions were also detected between specific residues of the Aβ42 dimer and the gallate moieties of PGG. We believed that these results might provide novel insights into the mechanisms underlying the inhibitory effects of PGG on Aβ42 amyloid aggregation and further support its potential for AD prevention and treatment.}, }
@article {pmid41652334, year = {2026}, author = {Allison, GO and McCage, S and Brandt, S and Presciutti, M and Walker, K and Cornelius, T and Parker, RA and Dams-O'Connor, K and Dickerson, B and Ritchie, C and Vranceanu, AM and Bannon, SM}, title = {"We can do this. That I learned.": A nonrandomized open pilot of Resilient Together for Dementia, a post-diagnosis dyadic intervention.}, journal = {BMC geriatrics}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12877-026-07059-9}, pmid = {41652334}, issn = {1471-2318}, support = {R01NR019982-01/NR/NINR NIH HHS/United States ; 1K24AT011760-01/AT/NCCIH NIH HHS/United States ; 1K23AG075188-01A1/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND AND OBJECTIVES: Alzheimer's disease and related dementias (ADRDs) are prevalent conditions that are stressful and elevate emotional distress in couples after diagnosis. Without treatment, emotional distress may become chronic and negatively affect couples' quality of life. We report results from an NIH Stage 1A open pilot of Resilient Together for Dementia (RT-ADRD), a novel, dyadic, skills-based intervention aimed at preventing chronic emotional distress in couples early after diagnosis. We describe results from our mixed-methods single arm feasibility study, including preliminary feasibility and acceptability of the intervention, and qualitative feedback from exit interviews. We also present exploratory analyses for change in outcomes and mechanisms of action.
METHODS: Six couples (N = 12 individuals) were recruited within six months of ADRD diagnosis by their diagnosing providers. Participants completed baseline assessments, participated in weekly RT-ADRD sessions together, then completed post-intervention assessments and one 60-min exit interview together.
RESULTS: RT-ADRD exceeded all a-priori feasibility and acceptability benchmarks (> 70%). Feedback from exit interviews suggested that participants had favorable impressions of the program and found the skills useful and relevant. Participants also offered perspectives on barriers and facilitators of engagement and program enhancement. In exploratory analyses, persons living with dementia exhibited significant reductions in perceived stress at post-intervention (p < .05; Cohens d > 0.8). Both persons living with dementia and their care partners exhibited statistically significant improvements in positive dyadic interactions measured by the Dyadic Relationship Scale (ps < .05); Cohens ds > 0.8).
CONCLUSIONS: RT-ADRD shows promise as a feasible and acceptable dyadic intervention delivered early after diagnosis. Results support a future NIH Stage 1B trial of RT-ADRD to establish definitive feasibility markers of both intervention and control before formal efficacy testing.
TRIAL REGISTRATION: This open pilot was registered on ClinicalTrials.gov (NCT06421545) on 05/20/2024.}, }
@article {pmid41651379, year = {2026}, author = {Huang, X and Sun, YY and Qin, YR and Chen, H and Pan, TT and Zhao, SS and Cai, Q and Zhang, XS and Nie, XD and Feng, L and Hu, H and Tang, Y and Zhang, PZ and Zhong, ZY and Li, J and Lu, L and Meng, FH and Ma, QH}, title = {ApoE-directed CpG nano-immunoadjuvant ameliorates Alzheimer's-like pathology in mice.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {}, number = {}, pages = {114687}, doi = {10.1016/j.jconrel.2026.114687}, pmid = {41651379}, issn = {1873-4995}, abstract = {Toll-like receptor 9 (TLR9), expressed in both microglia and neurons of the CNS, represents a promising therapeutic target for Alzheimer's disease (AD). While either microglial or neuronal TLR9 activation exerts neuroprotective effects that ameliorate AD pathology and preserve cognitive function, CpG oligodeoxynucleotides (ODNs), the synthetic agonists, cannot cross the blood-brain barrier (BBB). To overcome this, we developed tNCpG, an apolipoprotein E (ApoE)-functionalized polymersome nanocarrier for brain-targeted delivery of CpG ODNs. APP/PS1 transgenic mice, which overexpress human mutant APP/PS1 and are widely used in AD mouse models for preclinical studies, were administered tNCpG intravenously biweekly for 3 months, starting at 4 months of age. tNCpG achieved efficient brain delivery while specifically targeting microglia and neurons. tNCpG treatment enhanced microglial recruitment to and phagocytosis of Aβ plaques, suppressed Aβ production while promoting its degradation, and improved BBB integrity and Aβ efflux. Collectively, these effects significantly reduced cerebral Aβ burden, neuroinflammation, and neurodegeneration, leading to the rescue of cognitive deficits. Our study establishes targeted TLR9 activation via tNCpG as a disease-modifying therapeutic strategy for AD.}, }
@article {pmid41651301, year = {2026}, author = {Zeying, W and Houyu, L and Zhongbin, Y and Yu, T and Qi, H and Kun, H and Qihang, H and Yingnan, Z and Zhi, L and Xiaojing, L and Xueming, Z and Qiang, M and Jingye, Z and Caixia, S and Liran, H and Jing, J and Yan, S}, title = {D-Ribose-Induced Cytotoxicity in K562 Cells: RBKS-Dependent Disruption of Copper Homeostasis and Mitochondrial Function.}, journal = {Free radical biology & medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.freeradbiomed.2026.01.062}, pmid = {41651301}, issn = {1873-4596}, abstract = {BACKGROUND: D-ribose, a highly reducing pentose sugar, can be phosphorylated by ribokinase (RBKS) to form ribose-5-phosphate (R-5-P). Elevated urinary D-ribose levels have been reported in patients with type 2 diabetes mellitus (T2DM) and Alzheimer's disease, implicating its potential role in disease pathogenesis. Previous investigations into D-ribose cytotoxicity have primarily focused on its non-enzymatic glycation activity, while alternative mechanisms remain underexplored. Since hemoglobin is a major in vivo target of glycation, this study utilized K562 cells-which retain inducible hemoglobin expression-to examine additional cytotoxic mechanisms of D-ribose.
METHODS AND RESULTS: CCK-8 assays demonstrated that D-ribose inhibited K562 cell proliferation in a concentration- and time-dependent manner, and this inhibitory effect was significantly enhanced in hemin-induced differentiated K562 cells. Conversely, RBKS overexpression promoted proliferation and alleviated oxidative stress in K562 cells. Transcriptomic analysis revealed that differentially expressed genes in D-ribose-treated cells were enriched in mineral absorption and oxidative phosphorylation pathways (KEGG), as well as in biological processes related to copper ion homeostasis (GO). RT-qPCR confirmed that both D-ribose treatment and RBKS knockout downregulated key copper homeostasis genes (e.g., SLC31A1, MT1F, ATOX1) and mitochondrial respiratory chain genes (e.g., COX17, COX11, MTATP8, MTND6), and were accompanied by a significant reduction in intracellular free copper levels.
CONCLUSIONS: These findings reveal a novel cytotoxic mechanism mediated by the RBKS-copper-oxidative phosphorylation axis in D-ribose-treated K562 cells, providing key insights into the intracellular role of D-ribose.}, }
@article {pmid41650025, year = {2026}, author = {Hou, XH and Zhang, W and Kang, K and Jin, Y and Ren, P and Wang, L and Li, Z and Li, Y and You, J and Zhang, B and Ma, Q and , and Xie, F and Yu, JT and Feng, JF and Cheng, W}, title = {Proteomics reveals three molecular subtypes of Alzheimer's disease with distinct progression patterns.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71106}, doi = {10.1002/alz.71106}, pmid = {41650025}, issn = {1552-5279}, support = {2023YFC3605400//National Key R&D Program of China/ ; 2018YFC1312904//National Key R&D Program of China/ ; 2019YFA0709502//National Key R&D Program of China/ ; 2025ZD0546300//Noncommunicable Chronic Diseases-National Science and Technology Major Project/ ; 82472055//National Natural Science Foundation of China/ ; 62433008//National Natural Science Foundation of China/ ; 82071201//National Natural Science Foundation of China/ ; 81971032//National Natural Science Foundation of China/ ; 92249305//National Natural Science Foundation of China/ ; 25TQ010//Shanghai Pilot Program for Basic Research-Fudan University 21TQ1400100/ ; 23JS1410100//Shanghai Science and Technology Commission Program/ ; 2022ZD0211600//Science and Technology Innovation 2030 Major Projects/ ; 2022QD002//Research Start-Up Fund of Huashan Hospital/ ; 3030277001//Excellence 2025 Talent Cultivation Program at Fudan University/ ; 2019074//Shanghai Talent Development Funding for the Project/ ; 2018SHZDZX01//Shanghai Municipal Science and Technology Major Project/ ; B18015//111 Project/ ; }, mesh = {Humans ; *Alzheimer Disease/cerebrospinal fluid/classification/pathology ; Disease Progression ; *Proteomics ; Male ; Female ; Aged ; tau Proteins/cerebrospinal fluid ; Biomarkers/cerebrospinal fluid ; Cognitive Dysfunction/cerebrospinal fluid/pathology ; Longitudinal Studies ; Atrophy/pathology ; Machine Learning ; Aged, 80 and over ; }, abstract = {INTRODUCTION: Alzheimer's disease (AD) shows marked molecular heterogeneity. Defining biological subtypes may refine diagnosis and treatment.
METHODS: We analyzed cerebrospinal fluid (CSF) proteomics and longitudinal data from 550 participants in the Alzheimer's Disease Neuroimaging Initiative with up to 16.5 years of follow-up. We profiled 6361 proteins, applied machine learning to identify biological subtypes, and validated them in three independent cohorts.
RESULTS: Three AD subtypes were identified. Subtype 1, enriched in RNA metabolism pathways, showed the mildest atrophy and slowest cognitive decline. Subtype 2, characterized by axonogenesis-related pathways, exhibited the greatest CSF tau elevations, moderate atrophy, and intermediate decline. Subtype 3, associated with catabolic processes, showed the most severe atrophy and fastest progression. These patterns were consistently replicated across validation cohorts.
DISCUSSION: These findings demonstrate robust, biologically distinct AD subtypes linked to divergent molecular pathways, clinical features, and progression rates. Such refined stratification supports precision diagnostics and targeted therapeutic strategies.}, }
@article {pmid41648425, year = {2026}, author = {Nada, H and Yuan, S and Gaamouch, FE and Cho, S and Gabr, MT}, title = {Small Molecule Agonists of TREM2 Reprogram Microglia and Protect Synapses in Human Alzheimer's Models.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.01.19.700278}, pmid = {41648425}, issn = {2692-8205}, abstract = {Triggering receptor expressed on myeloid cells-2 (TREM2) is a key immune receptor in the central nervous system that regulates microglial phagocytosis, survival, and neuroinflammatory responses. TRME2 variants have been established as genetic risk factors for Alzheimer's disease (AD). However, the therapeutic development of TREM2 modulators has been limited to antibody-based approaches that face limitations in blood-brain barrier penetration and manufacturing scalability. Furthermore, there are no FDA approved TREM2 therapeutics available to date marking an unmet therapeutic gap. Herein, we report the identification of the first TREM2 small molecule submicromolar binders as a result of optimizing compound 4a to yield S9 with TREM2 binding affinity of 0.95 µM. S9 demonstrated robust TREM2 agonism in cellular assays where it induced proximal Syk phosphorylation, activated downstream NFAT transcriptional signaling, enhanced APOE internalization and microglial phagocytic capacity. Pharmacokinetic profiling of the optimized hits revealed S9 to exhibit improved drug-likeness compared to 4a with 7-fold enhanced aqueous solubility, superior metabolic stability, reduced intrinsic clearance and a 9-fold improved hERG safety margin. Functional validation in human iPSC-derived microglia confirmed that S9 suppresses amyloid-beta (Aβ)-induced IL-1β secretion through a TREM2-dependent mechanism. In human neuron-microglia co-culture models exposed to amyloid stress, S9 treatment preserved synaptic integrity as measured by PSD95 expression that indicates promising neuroprotective activity. Together, these findings establish S9 as a first-TREM2 submicromolar small molecule TREM2 agonist which is orally bioavailable with favorable pharmacokinetic properties and promising therapeutic potential for the treatment of Alzheimer's disease.}, }
@article {pmid41648171, year = {2026}, author = {Kumar, V and Sanchez Franco, VM and Ferry, FS and Xie, Y and Hutson, AN and Zhang, YJ and Daniels, SD and Nguyen, DL and Spera, LK and Snyder, EM and Knauss, A and Sudhakar, SL and Duan, GY and Paul, EM and Tabuchi, M}, title = {Neuronal microscale biophysical instability mediates macroscale network dynamics shaping pathological manifestations.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2026.01.20.697254}, pmid = {41648171}, issn = {2692-8205}, abstract = {UNLABELLED: Microscale biophysical alterations in neuronal dynamics can have profound implications for macroscale pathological outcomes in the brain. Despite the critical need to link neuronal perturbations to large-scale disease manifestations, few studies successfully bridge these hierarchical scales. Here, we bridge microscale biophysical variability within neuronal dynamics to macroscale disease-related phenotypes. We find that Drosophila models expressing tauopathy- and epilepsy-associated molecular mutations exhibit increased dynamic instability in the timing of action potential initiation, and microscale biophysical changes are manifested at the level of the macroscale global brain state. We show that variability in voltage-gated sodium channel currents during non-stationary channel inactivation may act as a microscale biophysical contributor to the increased dynamic instability observed in action potential timing. We also find that treatment with antiepileptic drugs stabilizes neuronal dynamics by modulating this variability in voltage-gated sodium channel currents. Finally, we show that neurons derived from human induced pluripotent stem cells (iPSCs) from patients with Alzheimer's disease and epilepsy exhibit analogous dynamic instability, which is reversible by administration of antiepileptic medications. Our results highlight how subtle microscale neuronal instabilities propagate and are amplified to produce macroscopic pathological phenotypes, providing new biophysical insights into neurological disorders and potential strategies for therapeutic intervention.
SIGNIFICANCE STATEMENT: Linking microscale neuronal changes to macroscale disease phenotypes remains a key challenge in neuroscience biophysics. Here, we show that subtle biophysical instability, such as variability in action potential timing and increased noise in voltage-gated sodium channel activity, can destabilize neuronal network integrity and cause systemic pathology. Stabilizing neuronal dynamics with antiepileptic drugs reverses tau-induced instabilities in a Drosophila disease model. Similar neuronal instabilities occur in fly neurons expressing epilepsy-linked sodium channel mutations and in human iPSC-derived neurons from Alzheimer's and epilepsy patients, revealing a shared cellular mechanism. These findings highlight that targeting microscale instabilities may offer a unifying therapeutic approach for complex neurological disorders.}, }
@article {pmid41645816, year = {2026}, author = {Liu, W and Rao, X and Sun, W and Chen, X and Yu, L and Zhang, J}, title = {Radiofrequency electromagnetic fields in Alzheimer's therapy: emerging evidence and future prospects.}, journal = {Electromagnetic biology and medicine}, volume = {}, number = {}, pages = {1-18}, doi = {10.1080/15368378.2026.2627962}, pmid = {41645816}, issn = {1536-8386}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder and the most common cause of dementia in humans. The accumulation of abnormal protein aggregates, including extracellular amyloid plaques and intracellular neurofibrillary tangles, is considered a key pathological hallmark of AD. Currently, the primary approach for treating AD is pharmacological treatment, which is only symptomatic and unable to cure or reverse the progression of AD. Increasing evidence suggests that radiofrequency electromagnetic fields (RF-EMFs) may attenuate the progression of AD and improve memory function. This article reviews the studies related to the application of RF-EMFs in the field of AD, including investigations at the cellular and molecular levels, in animal models, and in clinical applications. The therapeutic potential of RF-EMFs as an intervention for AD is discussed in the present review, along with current challenges and future research directions.}, }
@article {pmid41645766, year = {2026}, author = {Li, W and Guo, Y and Wang, X and Yang, C and Zhu, J and Cao, Z}, title = {Design, synthesis and biological evaluation of donepezil-safinamide hybrids as dual AChE and MAO-B inhibitor for Alzheimer's disease treatment.}, journal = {Journal of enzyme inhibition and medicinal chemistry}, volume = {41}, number = {1}, pages = {2622769}, doi = {10.1080/14756366.2026.2622769}, pmid = {41645766}, issn = {1475-6374}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; *Cholinesterase Inhibitors/pharmacology/chemistry/chemical synthesis ; *Donepezil/pharmacology/chemistry/chemical synthesis ; *Monoamine Oxidase Inhibitors/pharmacology/chemistry/chemical synthesis ; *Drug Design ; *Acetylcholinesterase/metabolism ; Animals ; Structure-Activity Relationship ; Mice ; *Monoamine Oxidase/metabolism ; Molecular Structure ; Dose-Response Relationship, Drug ; *Alanine/analogs & derivatives/chemistry/pharmacology/chemical synthesis ; Molecular Docking Simulation ; Humans ; *Neuroprotective Agents/pharmacology/chemical synthesis/chemistry ; Male ; Blood-Brain Barrier/metabolism ; Benzylamines ; }, abstract = {Alzheimer's disease (AD) still lacks therapies that definitively halt its progression. Dual AChE/MAO-B inhibitors offer a promising strategy to address both symptoms and pathology. Here, we designed and synthesised a series of donepezil-safinamide hybrids. The optimised compound 28c was identified as a potent inhibitor of AChE (IC50 = 1.70 μM) and MAO-B (IC50 = 0.18 μM). Mechanistic studies indicated that 28c acts as a reversible mixed-type inhibitor of AChE and a competitive reversible inhibitor of MAO-B. Molecular docking and molecular dynamic simulations revealed that 28c could strongly and stably bind to MAO-B and AChE mainly through van der Waals interactions. Moreover, compound 28c demonstrated effective blood-brain barrier penetration, exhibited suitable stability in mouse plasma and brain homogenate, and showed a favourable safety profile both in vitro and in vivo. Furthermore, 28c could attenuate AD-related symptoms and exert hippocampal neuroprotection effect in vivo, highlighting its promise as an anti-AD candidate.}, }
@article {pmid41645728, year = {2026}, author = {Lodhi, MS and Maisam, M and Khan, MT and Bibi, A and Wei, D and Mou, K}, title = {Targeted Nanodelivery of WGX50 and Curcumin via Gold Nanoparticles for Alzheimer's Therapy.}, journal = {Journal of cellular and molecular medicine}, volume = {30}, number = {3}, pages = {e71045}, doi = {10.1111/jcmm.71045}, pmid = {41645728}, issn = {1582-4934}, mesh = {*Curcumin/chemistry/pharmacology/administration & dosage ; *Alzheimer Disease/drug therapy/pathology/metabolism ; *Gold/chemistry ; Animals ; *Metal Nanoparticles/chemistry ; Rats ; Male ; Disease Models, Animal ; Drug Delivery Systems ; Humans ; Blood-Brain Barrier/drug effects/metabolism ; Amyloid beta-Peptides/metabolism ; Rats, Sprague-Dawley ; Nanoconjugates/chemistry ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder, posing a global health challenge. It affects millions of people, causing cognitive decline and a heavy burden on healthcare systems. Neuroinflammation is a key pathological feature of AD, often associated with the dysregulation of microRNAs such as hsa-miR-146a-5p. WGX50 (N-[2-(3,4-Dimethoxy-phenyl)-ethyl]-3-phenyl-acrylamide), a small molecule derived from Zanthoxylum bungeanum Maxim, has antioxidant and anti-inflammatory activities. While WGX50 demonstrates potent inhibition of neuroinflammation, its poor blood-brain barrier permeability may be improved using targeted delivery strategies. The current study aimed to design a novel nanoconjugate of WGX50 and curcumin with gold nanoparticles (AuNPs) to observe its therapeutic effects in a rat model. All nanoconjugates were synthesised as targeted (Cys-capped AuNPs with WGX50-insulin and curcumin-insulin) and non-targeted (without insulin). Immunohistochemical analysis revealed that both non-targeted (WGX50-NT) and targeted (WGX50-T) therapies have a significant effect in the rat model, with WGX50-T showing a more pronounced effect. The histopathology results of WGX50 and WGX50-T showed an approximate 80%-90% reduction in Aβ plaque deposition. The treatment with both curcumins targeted (C-T) and non-targeted (C-NT) formulations led to a significant reduction in Aβ levels in AD rats. Fluorescence microscopy confirmed that targeted delivery was more effective, potentially leading to better therapeutic outcomes. The expression levels of hsa-miR-146a-5p showed differential expression levels with targeted treatments correlating with lower expression levels, suggesting a role in modulating neuroinflammation and immune responses. Overall, these findings highlight the potential of targeted drug delivery systems in enhancing the efficacy of AD treatments.}, }
@article {pmid41645578, year = {2026}, author = {İlhan, A and Güneş, F and Ertürk, A and Anıl, B and Gülçin, İ and Koca, M}, title = {Acetylcholinesterase and Carbonic Anhydrase Inhibition Profiles of New 5-HMF Chalcones and Their Ester Derivatives.}, journal = {Archiv der Pharmazie}, volume = {359}, number = {2}, pages = {e70198}, doi = {10.1002/ardp.70198}, pmid = {41645578}, issn = {1521-4184}, support = {TBTK-0097-8209//Türkiye Bilimsel ve Teknolojik Araştırma Kurumu/ ; }, mesh = {*Carbonic Anhydrase Inhibitors/pharmacology/chemical synthesis/chemistry ; *Cholinesterase Inhibitors/pharmacology/chemical synthesis/chemistry ; Molecular Docking Simulation ; *Chalcones/pharmacology/chemistry/chemical synthesis ; *Acetylcholinesterase/metabolism ; Structure-Activity Relationship ; Esters/pharmacology/chemistry/chemical synthesis ; Molecular Structure ; Dose-Response Relationship, Drug ; Carbonic Anhydrase I/antagonists & inhibitors/metabolism ; Carbonic Anhydrase II/antagonists & inhibitors/metabolism ; Humans ; Animals ; }, abstract = {Acetylcholinesterase (AChE) is one of the most important therapeutic targets in the treatment of neurological disorders such as Alzheimer's disease. In recent years, studies on the use of carbonic anhydrase (CA) inhibitors in the treatment of Alzheimer's disease have attracted considerable attention. In this study, novel benzene/5-HMF-chalcone hybrids and their benzoate esters were synthesized. Furthermore, the AChE, carbonic anhydrases I and II (CA I and II) inhibition potentials of the compounds were evaluated through in vitro enzyme inhibition assays and molecular docking studies to identify new potential drug candidate molecules. According to the inhibition results, the Ki values of the synthesized compounds were found to be in the range of 1.51-2.91 nM against AChE, 26.15-68.66 nM against CA I, and 27.91-107.04 nM against CA II. Molecular docking studies revealed that the compounds bind to both the catalytic active site (CAS) and the peripheral anionic site (PAS) of AChE, with Glide scores ranging from -5.76 to -8.50 kcal/mol. In contrast, the molecules interacted with the active site of CA I/II by coordinating with the catalytic Zn[2+] ion. All compounds complied with Lipinski's Rule of Five, indicating favorable drug-like properties. These results suggest that 5-HMF-chalcone hybrids and their benzoate derivatives could serve as promising scaffolds for the development of new anti-Alzheimer's agents. These findings suggest that 5-HMF-chalcone hybrids and their benzoate derivatives may be useful in establishing the structural basis of new anti-Alzheimer's agents.}, }
@article {pmid41645328, year = {2026}, author = {Xiao, J and Liu, Y and Peng, M and Ma, J and Lei, S and Chen, Y and Liu, S and Zhao, X and Lu, D and Sun, Q}, title = {ISX9 activates the Wnt/β-catenin signaling pathway and exerts neuroprotective effects in Alzheimer's disease.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-026-01961-5}, pmid = {41645328}, issn = {1758-9193}, support = {82470591//National Natural Science Foundation of China/ ; 82273485//National Natural Science Foundation of China/ ; JCYJ20240813142838050//Shenzhen Basic Research Program/ ; 2022A1515010598 and 2024A1515012466//Natural Science Foundation of Guangdong Province/ ; }, abstract = {BACKGROUND: Defective Wnt/β-catenin signaling is closely associated with the pathogenesis of Alzheimer's disease (AD), thus validating this pathway as a therapeutic target for AD. ISX9 is a potent agonist of the Wnt/β-catenin pathway. However, it remains unknown whether ISX9 exerts anti-AD effects by enhancing the Wnt/β-catenin signaling pathway. We therefore explored the neuroprotective potential of ISX9 using both hippocampal neuron-derived HT22 cells and 5×FAD transgenic mouse model of AD.
METHODS: In HT22 cells, we employed the SuperTOPFlash reporter gene, Co-IP and Western blot assays to investigate the mechanism by which ISX9 activates the Wnt signaling pathway. The effects of ISX9 on the biological behavior of HT22 cells were further evaluated through MTT, BrdU and IF staining. To study the therapeutic effect of ISX9 on AD, six-month-old 5×FAD transgenic mice were randomly divided into four groups: WT, WT/ISX9, AD and AD/ISX9. The mice were intraperitoneally injected with ISX9 or vehicle at an interval of one day for 2 months. Behavioral tests were conducted to evaluate the cognitive and learning abilities of mice, while the expression levels of Aβ peptides, Tau-related proteins, neuroinflammatory factors, blood-brain barrier (BBB)-related proteins and the components of Wnt/β-catenin signaling were investigated.
RESULTS: Our results demonstrated that ISX9 potently activated Wnt/β-catenin signaling by promoting the association of LRP6 with AXIN1, and increased the viability and proliferation of hippocampal cells. At the behavioral level, ISX9 improved learning and memory abilities in 5×FAD mice, and ameliorated hippocampal neuronal damage. Furthermore, ISX9 treatment effectively reduced the expression of Aβ peptides, total Tau, and phosphorylated Tau (S404) proteins in the AD mice. Mechanistically, ISX9 exhibited its neuroprotective effects, activating the Wnt/β-catenin signaling pathway via potentiating the interaction of LRP6 with AXIN1, upregulating the expression of BBB-related proteins and downregulating neuroinflammatory factors in AD mice.
CONCLUSION: Our findings indicate that ISX9 potently activates the Wnt/β-catenin signaling pathway and confers cognitive protection in hippocampal cells and AD mice. This compound may serve as a promising therapeutic agent for the treatment of AD.}, }
@article {pmid41636955, year = {2026}, author = {Hu, F and Tang, NLS and Wang, H and Zheng, H}, title = {Resolving Heterogeneity in the Diagnosis of Alzheimer's Disease and its Progression Using Multimodal Data.}, journal = {Journal of molecular neuroscience : MN}, volume = {76}, number = {1}, pages = {24}, pmid = {41636955}, issn = {1559-1166}, support = {No.2018SHZDZX01//Shanghai Municipal Science and Technology Major Project/ ; }, abstract = {UNLABELLED: Alzheimer’s disease (AD) is a complex and diverse illness that makes early detection extremely difficult. Most existing research utilizes data to identify biomarkers and more homogeneous subgroups to improve the detection, prediction of progression, and prognosis of AD. However, AD still suffers from a lack of appropriate biomarkers for early symptom detection and blurred boundaries between different subgroups. Here, an unsupervised clustering method known as similarity network fusion (SNF) was employed to analyze multimodal data from 972 subjects, including 370 with cognitively normal (CN), 565 with mild cognitive impairment (MCI), and 37 patients with AD. First, we constructed a similarity network for subjects using cognitive scores, genetics, and magnetic resonance imaging (MRI) related data, respectively. Then the SNF fusion method was employed to integrate the data, and spectral clustering was used to find subgroups sharing similarities across modalities. Our results indicated that the approach accurately diagnosed both current and prospective AD (~ 90%). Notably, we successfully identified two MCI subtypes with biological and clinical significance, validated by longitudinal studies of cognitive, clinical, fluid biomarkers and MRI-related features, dementia diagnosis, and pseudo-trajectory analysis. We also observed many dysregulated processes and signaling pathways between MCI subtypes, such as the GnRH signaling pathway, VEGF signaling pathway, and insulin signaling pathway. Overall, our research offers a distinctive viewpoint on the diversity of AD, and the more specific subtypes of MCI help create customized treatment plans.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12031-026-02474-4.}, }
@article {pmid41643605, year = {2026}, author = {Kim, WS and Choi, J and Kim, SS and Kim, JH and Han, YE and Kwak, MJ and Oh, SJ and Lee, B and Cho, IH and Choi, CW and Hong, GS and Kim, MS}, title = {Vitisin B, extracted from Vitis vinifera, enhances memory function and neuroprotective effects in scopolamine-induced memory-impaired mice.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {196}, number = {}, pages = {119019}, doi = {10.1016/j.biopha.2026.119019}, pmid = {41643605}, issn = {1950-6007}, abstract = {Alzheimer's disease (AD) is characterized by progressive cognitive decline and memory dysfunction, with prominent roles in cholinergic deficits and synaptic plasticity impairments. Vitisin B, a resveratrol tetramer derived from Vitis vinifera, exhibits potent antioxidant and neuroprotective properties. However, its potential to influence cognitive function in AD models remains inadequately explored. In this study, we first tested vitisin B in an in vitro model using SH-SY5Y cells exposed to scopolamine-induced cytotoxicity, where vitisin B significantly enhanced cell viability and promoted cell survival. We evaluated its therapeutic potential in vivo using both systemic administration and direct delivery into the third ventricle of the brain in a scopolamine-induced AD mouse model. Across both administration routes, vitisin B exerted a broad pro-cognitive effect, restoring multiple domains of learning and memory disrupted by scopolamine. Vitisin B recovered spatial working memory in the Y-maze, normalized exploratory activity in the open field, improved recognition memory in the novel object recognition (NOR) test, and enhanced long-term memory retention in the passive avoidance assay. This treatment restored cognitive function, alleviated cholinergic deficits, increased hippocampal brain-derived neurotrophic factor (BDNF) levels, and enhanced synaptic plasticity. These results suggest that vitisin B exerts reliable cognitive and neuroprotective effects through both systemic and cerebral administration, highlighting its potential as a promising therapeutic compound for restoring cholinergic function and enhancing hippocampal synaptic plasticity in AD.}, }
@article {pmid41642798, year = {2026}, author = {Justo-Henriques, SI and Silva, RCG and Carvalho, JO and Pérez-Sáez, E and de São João, RMV and Ribeiro, O}, title = {Differential response to cognitive stimulation in moderate versus moderately severe Alzheimer's disease.}, journal = {Canadian journal of experimental psychology = Revue canadienne de psychologie experimentale}, volume = {}, number = {}, pages = {}, doi = {10.1037/cep0000395}, pmid = {41642798}, issn = {1878-7290}, abstract = {Alzheimer's disease (AD) is characterized by impairments across several neurocognitive domains, particularly memory and executive function. The study explored the effectiveness of an individual cognitive stimulation (iCS) program on cognitive outcomes in older adults with moderate to moderately severe AD. A multicentre randomized controlled trial was conducted with 80 Portuguese older adults (Mage: 83.0 ± 7.1 years) with AD. Participants were randomly assigned to either iCS (n = 39; 49%) or treatment as usual (n = 41; 51%). Alzheimer's Disease Severity (ADS) categorized two groups based on Mini-Mental State Examination score: 10-14 in the ADS moderately severe group and 15-20 in the ADS moderate group. In participants with moderate AD, iCS led to significant improvements in memory-related outcomes (particularly Memory Assessment Test) and a trend toward improvement in global cognition. In contrast, no significant effects were observed in participants with moderately severe AD. Meta-analytic comparisons and meta-regression confirmed a significant difference in intervention effectiveness between severity levels. iCS was significantly more effective in individuals with moderate AD than in those with moderately severe AD. This difference in responsiveness between severity levels was statistically confirmed (Q = 11.29, p < .001). iCS was effective in enhancing memory in individuals with moderate AD, with additional indications of global cognitive benefit. However, no meaningful effects were observed in participants with moderately severe impairment, suggesting diminished responsiveness to iCS as disease severity increases. (PsycInfo Database Record (c) 2026 APA, all rights reserved).}, }
@article {pmid41642483, year = {2026}, author = {Alhajeri, MM and Abukhaled, Y and Alkhanjari, RR and Bassiouni, W and Al-Ali, H and Baig, A and Sembaij, SH and Al Muhairi, FA and Dimassi, Z and Hamdan, H and Abd-Elrahman, KS}, title = {Neuroglial Function and Hormonal Modulation in Neurodegenerative Diseases: The Influence of Sex Hormones.}, journal = {Cellular and molecular neurobiology}, volume = {}, number = {}, pages = {}, doi = {10.1007/s10571-026-01674-1}, pmid = {41642483}, issn = {1573-6830}, abstract = {Astrocytes, microglia, and oligodendrocytes, key neuroglial cell types, are essential for central nervous system (CNS) homeostasis, immune regulation, and neuronal support. In neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS), glial dysfunction contributes to pathogenesis via chronic inflammation, synaptic disruption, oxidative stress, and impaired myelination. Growing evidence highlights the regulatory influence of sex hormones on glial function. These hormones modulate inflammatory tone, synaptic remodeling, and remyelination, potentially contributing to sex-based differences in disease incidence, progression, and treatment response. This review synthesizes current understanding of glial involvement in neurodegeneration and examines how gonadal hormones interact with astrocytes, microglia, and oligodendrocytes. By integrating glial biology with neuroendocrinology, we propose that hormone-glia interactions represent promising, personalized targets for sex-informed therapies in CNS disorders.}, }
@article {pmid41642425, year = {2026}, author = {Li, Z and Wang, X and Li, M and Zhang, G and Zhang, Y and Wang, X and Zhang, C}, title = {Exploring the relationship between Alzheimer's disease and colorectal/breast cancers using SEER database, Mendelian randomization, and transcriptomic data.}, journal = {Discover oncology}, volume = {}, number = {}, pages = {}, doi = {10.1007/s12672-025-04136-0}, pmid = {41642425}, issn = {2730-6011}, support = {2024JH2/102600293//Liaoning province livelihood science and technology joint plan/ ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) and cancer are among the most prevalent age-related diseases. Despite previous research into their potential relationship, the nature of their association remains poorly understood. This study aims to examine the clinical characteristics of AD and various cancers using data from the Surveillance, Epidemiology, and End Results (SEER) database, investigate the causal relationship between AD and cancers through Mendelian randomization (MR) analysis, and identify potential shared underlying mechanisms through transcriptomic profiling.
METHODS: Clinical data from AD patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database, and survival analysis was conducted using Kaplan-Meier curves. For the two-sample Mendelian randomization (MR) analysis, data were obtained from genome-wide association study (GWAS) databases. Multiple MR approaches, including inverse-variance weighted, MR-Egger, and weighted median methods, were applied, along with assessments of heterogeneity and sensitivity to ensure the robustness and reliability of the results. Transcriptomic data for AD, colorectal cancer (CRC), and breast cancer (BC) were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified through differential expression analysis, followed by functional enrichment analysis using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis.
RESULTS: A total of 42,768 cancer patients who died from AD were included from the SEER database. Survival analysis revealed a more favorable prognosis (p < 0.01) in patients younger than 65 years. Asian or Pacific Islander patients exhibited better survival outcomes compared with White patients. Regarding tumor sites, patients with uterine corpus cancer had the best prognosis, while lung cancer patients had the poorest outcomes. Patients who received surgery, radiotherapy, or chemotherapy showed significantly improved survival compared to those who received no cancer treatment. Higher household income and being married were also associated with better prognosis, although no significant difference was observed by gender. MR analysis demonstrated a significant positive causal relationship between AD and CRC, and a weak inverse relationship between AD and BC, suggesting that increased genetic susceptibility to AD is associated with elevated CRC risk and reduced BC risk. Intersection analysis of DEGs revealed that shared DEGs between AD and BC were enriched in GO terms related to amino acid transport regulation, organic acid transport regulation, positive regulation of vesicle docking, and myo-inositol transmembrane import. Shared DEGs between AD and CRC were enriched in presynaptic actin cytoskeleton organization, proteasome ubiquitin-independent protein catabolic process, negative regulation of cellular amide metabolic process, and adenylate cyclase binding. KEGG enrichment analysis indicated that AD and BC may share the synaptic vesicle cycle pathway.
CONCLUSION: Our study reveals significant subgroup heterogeneity among cancer patients who died from AD. MR analysis demonstrates that AD increases the risk of CRC while showing weak evidence for a decreased risk of BC. These associations may be mediated by mechanisms involving amino acid transport regulation, myo-inositol transmembrane import, and synaptic vesicle cycling. These findings offer new perspectives on the AD-cancer relationship and may guide future investigations into shared mechanisms.}, }
@article {pmid41641965, year = {2026}, author = {Brenowitz, WD and Ehrlich, JR and Deal, JA and Yaffe, K}, title = {Introduction to Supplemental Issue: Sensory loss in Alzheimer's disease and related dementias.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261418685}, doi = {10.1177/13872877261418685}, pmid = {41641965}, issn = {1875-8908}, abstract = {Sensory impairments (e.g., decreased function in hearing, vision, olfaction, and other senses) may be risk factors for or early markers of Alzheimer's disease (AD) and related dementias (ADRD). Sensory impairments are common and have a large impact on wellbeing. Furthermore, they are clinically detectable and, often, treatable, and could be leveraged to identify and prevent AD/ADRD. This Supplemental Issue brings together original research articles, reviews, and thought papers regarding the links between sensory impairments and cognitive health. Together, this work highlights the significant opportunities to use sensory information and remediation for earlier diagnosis, treatment, and prevention of dementia.}, }
@article {pmid41641880, year = {2026}, author = {Wieland, LS and Ludeman, E and Chi, Y and Feinberg, TM and Chen, IH and Chen, KH and Zhu, Y and Wolverson, E and Amri, H}, title = {Ginkgo biloba for cognitive impairment and dementia.}, journal = {The Cochrane database of systematic reviews}, volume = {2}, number = {}, pages = {CD013661}, pmid = {41641880}, issn = {1469-493X}, mesh = {Humans ; *Ginkgo biloba ; Randomized Controlled Trials as Topic ; *Cognitive Dysfunction/drug therapy ; *Dementia/drug therapy ; *Plant Extracts/therapeutic use/adverse effects ; *Phytotherapy/methods/adverse effects ; Bias ; Aged ; Cognition/drug effects ; Placebos/therapeutic use ; Activities of Daily Living ; Ginkgo Extract ; }, abstract = {BACKGROUND: Dementia is a neurocognitive disorder that interferes with cognition and independent functioning. Common dementia subtypes include Alzheimer's disease, vascular dementia, and mixed type. Mild cognitive impairment (MCI) is a risk factor for dementia, and subjective cognitive complaints may be the earliest manifestation. Although cholinesterase inhibitors may help reduce some cognitive and behavioral symptoms, there is no established treatment that cures or slows dementia progression. Ginkgo biloba (ginkgo) is a popular herbal preparation that is used to improve brain and circulatory health, and neuroprotective effects are biologically plausible.
OBJECTIVES: To assess the benefits and harms of Ginkgo biloba for the treatment of people with cognitive impairment or dementia.
SEARCH METHODS: We searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE, Embase, four other databases, and two trials registries on 8 December 2022. The search was updated in MEDLINE, Embase, CENTRAL, and the trials registers on 18 November 2024.
SELECTION CRITERIA: We included randomized controlled trials (RCTs) comparing ginkgo with placebo, usual treatment, or other treatments for cognitive problems in people with cognitive complaints or diagnoses of MCI or dementia.
DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, extracted data, and assessed studies for risk of bias. Key outcomes were global clinical status, global cognitive function, activities of daily living (ADLs), adverse events (AEs), and serious adverse events (SAEs) at six months. When clinically appropriate, we pooled data using a random-effects model and expressed treatment effects as mean differences (MDs), standardized mean differences (SMDs), or risk ratios (RRs), each with its 95% confidence interval (CI). We used GRADE methods to assess the certainty of the evidence for each estimate.
MAIN RESULTS: We included 82 studies with 10,613 participants; 72 studies with 9783 participants provided extractable data. Four studies were at low risk of bias in all domains. Below we present data for the comparison of ginkgo versus placebo in people with different clinical conditions. Subjective cognitive impairment Three studies (597 participants) compared ginkgo with placebo for people with subjective cognitive complaints. Based on one study that lasted six months, it is uncertain whether ginkgo has any effect on global clinical status measured on a five-point Likert scale (MD 0.00, 95% CI -0.33 to 0.33; P = 1.00; 1 study, 197 participants; very low-certainty evidence). There were no data on cognition or ADLs. One study reported no difference in minor side effects between treatment groups and did not mention SAEs. A larger study lasting three months found that the risk of AEs may be higher with ginkgo versus placebo. It provided very uncertain evidence on the risk of SAEs. Multiple sclerosis and cognitive impairment Two studies (164 participants) tested ginkgo versus placebo over three months in people with multiple sclerosis and cognitive problems. Ginkgo probably has little or no effect on cognition measured on the Perceived Deficits Questionnaire (MD -0.09, 95% CI -0.41 to 0.22; P = 0.55, I² = 0%; 2 studies, 152 participants; moderate-certainty evidence). There were no data on global clinical status or ADLs. The studies suggested no important difference in numbers of AEs between groups, and there was no indication of SAEs due to ginkgo. Mild cognitive impairment Twelve studies (1913 participants) tested ginkgo against placebo in people with MCI. At six months, moderate-certainty evidence suggests that ginkgo probably has little to no effect on global clinical status measured on the Clinical Dementia Rating Scale (MD -0.03, 95% CI -0.06 to 0.01; 3 studies, 631 participants; I² = 0%), cognition measured on the Alzheimer's Disease Assessment Scale - cognition (MD -0.07, 95% CI -0.67 to 0.51; I² = 0%; 2 studies, 508 participants), and ADLs measured on the Instrumental ADL scale (MD -0.05, 95% CI -0.29 to 0.19; 1 study, 350 participants). There may be little or no difference between ginkgo and placebo at up to 12 months in the risk of AEs (RR 0.98, 95% CI 0.77 to 1.24; I² = 58%; 7 studies, 991 participants, 379 events; low-certainty evidence), and there is little or no difference in the risk of SAEs (RR 0.95, 95% CI 0.82 to 1.09; I² = 0%; 3 studies, 714 participants, 327 events; high-certainty evidence). Dementia Thirteen studies (3288 participants) compared ginkgo with placebo for dementia. At six months, low-certainty evidence suggests that people taking ginkgo may have better global clinical status on a six-point Likert scale (lower is better; MD -0.06, 95% CI -1.00 to -0.20; I² = 88%; 5 studies, 1359 participants), better cognition measured by decreases on a short cognitive performance test (Syndrom-Kurztest; MD -1.86, 95% CI -3.48 to -0.24; I² = 96%; 9 studies, 2801 participants), and slightly better ADLs measured on the ADL International Scale (MD -0.19, 95% CI -0.35 to -0.03; I² = 91%; 8 studies, 2571 participants). There is probably little or no difference between ginkgo and placebo in the risk of AEs at up to 12 months (RR 0.95, 95% CI 0.90 to 1.00; I² = 0%; 9 studies, 2746 participants, 1480 events; moderate-certainty evidence). There may be little or no difference in risk of SAEs at six months (RR 0.88, 95% CI 0.58 to 1.33; I² = 0%; 6 studies, 2463 participants, 89 events; low-certainty evidence).
AUTHORS' CONCLUSIONS: In people with cognitive complaints, we are unsure whether ginkgo improves global clinical status at six months, and it may be associated with an increased risk of AEs at three months. Ginkgo probably has no benefit at three months for cognition in multiple sclerosis; numeric data on AEs were unavailable, but studies did not suggest concerns. In people with MCI, ginkgo probably has little or no effect at six months on global status, cognition, or ADLS. There may be little or no difference in AEs, and there is little or no difference in SAEs, at up to 12 months. In people with dementia, there may be small to moderate benefits at six months for global status, cognition, and ADLs. There is probably little or no difference in AEs at up to 12 months, and there may be no difference in SAEs.}, }
@article {pmid41641771, year = {2026}, author = {Ruan, Q and Zhang, C and Wu, P and Huang, K and Xiong, X and Qiu, Z and Song, X and Wu, H and Guo, J}, title = {Restoration of intracellular osmotic pressure balance induced by protein nanoparticles: A potential target for developing Alzheimer's disease treatment strategies.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00763}, pmid = {41641771}, issn = {1673-5374}, abstract = {The progressive accumulation of amyloid-β and glutamate in synapses is a characteristic feature of early-stage Alzheimer's disease. This study investigated the influence of transmembrane osmotic pressure on Alzheimer's disease pathogenesis using a fluorescence resonance energy transfer-based optical probe for intermediate filament tension. Cotreatment with amyloid-β and glutamate at predicted cerebrospinal fluid levels induced Alzheimer's disease-like neuronal injury. Probe-transfected cells were used to monitor intermediate filament tension, whereas cytoplasmic osmolality was measured using a freezing point osmometer under individual and combined treatment with amyloid-β and glutamate. The results showed that the combined treatment of 50 nM amyloid-β and 0.3 mM glutamate significantly elevated intermediate filament tension and osmotic pressure. Cellular experiments indicated that this increase resulted from the formation of intracellular protein nanoparticles through nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome formation and cytoskeletal depolymerization. Oligomers of 50 nm amyloid-β induced an outward membrane current, whereas 0.3 mM glutamate increased both amyloid-β-induced current and calcium signals. The increase in protein nanoparticle levels and Ca2+ signals promoted voltage-dependent nonselective cation and anion influx, resulting in upregulated osmotic pressure, which was closely associated with the sensitization of ion channels elicited by calmodulin and protein kinase C activation. The attenuation of intracellular protein nanoparticles and desensitization of ion channels by drug combinations effectively alleviated transmembrane osmotic pressure and Alzheimer's disease-like neuronal injury. Behavioral assays performed using Caenorhabditis elegans Alzheimer's disease models further confirmed the efficacy of drug combinations. Therefore, protein nanoparticle-induced osmotic pressure plays a pivotal role in Alzheimer's disease pathogenesis, particularly in response to amyloid-β and glutamate cotreatment. Restoring intracellular osmotic pressure seems to be a potential target for developing new effective therapeutic strategies for Alzheimer's disease.}, }
@article {pmid41641469, year = {2026}, author = {Ye, Q and Gao, W and Feng, J and Li, X and Li, J and Yang, F and Li, L and Zi, M and Wu, X and Gao, H and Li, H}, title = {Spatial heterogeneity in microglia-complement crosstalk: Implications for synaptic pruning in Alzheimer's disease.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71185}, doi = {10.1002/alz.71185}, pmid = {41641469}, issn = {1552-5279}, support = {82105035//National Natural Science Foundation of China/ ; LH2023H064//Nature Science Foundation of Heilongjiang Province/ ; 2024065//Research Project of the Health Commission of Jiangsu Province/ ; HABZ202325//Huai'an Basic Research Project/ ; HABL202222//Huai'an Science and Technology Bureau/ ; ZHY2024-304//Research Project of the Traditional Chinese Medicine Administration of Heilongjiang Province/ ; }, mesh = {*Alzheimer Disease/immunology/pathology/metabolism ; *Microglia/metabolism/immunology ; Humans ; *Complement System Proteins/metabolism/immunology ; *Brain/pathology/immunology ; *Neuronal Plasticity/physiology ; *Synapses ; Animals ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by synaptic loss, as a key pathological feature in its early stages. Recent studies have highlighted the central role of microglia-complement interactions in synaptic pruning. This interaction exhibits significant spatial heterogeneity in AD, with activation patterns and functional manifestations varying across different brain regions and stages of disease. Therefore, this article systematically reviews the synergistic mechanisms of microglia and the complement system in physiological synaptic pruning. Additionally, the dynamic evolution of the complement-immune network during disease progression is analyzed, and the amplifying effect of genetic factors on the spatial heterogeneity of synaptic pruning is explored. Furthermore, current treatment strategies from both Western medicine and traditional Chinese medicine are discussed, emphasizing the potential value of combining these approaches for intervening in synaptic loss in AD.}, }
@article {pmid41641384, year = {2026}, author = {Lai, X}, title = {Intrinsic mechanical vibrations as a missing dimension in amyloid-β clearance: a mechanochemical hypothesis for Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {18}, number = {}, pages = {1749562}, pmid = {41641384}, issn = {1663-4365}, abstract = {Alzheimer's disease is widely viewed as a disorder of disturbed amyloid-β (Aβ) homeostasis, yet it remains unclear why Aβ shifts from routine turnover to progressive retention and plaque growth in mid-life. This article advances a mechanochemical hypothesis: that age-related reductions in low-intensity mechanical vibrations in the head and neck-arising from everyday self-vocalization (speech, singing, humming) and physiological, non-hypoxic upper-airway motion during stable sleep-contribute to a gradual narrowing of the Aβ clearance bottleneck. Gentle vibrations transmitted through bone and soft tissue could, in principle, enhance interstitial mixing, reduce local supersaturation and nucleation, increase encounter rates at blood-brain barrier and meningeal-lymphatic interfaces, and augment perivascular and glymphatic transport. A sustained decline in this "intrinsic mechanical vibration" (IMV) dose in mid-life might therefore favor Aβ retention without any change in production. We bring together indirect lines of evidence that are compatible with this view, including sleep and glymphatic studies, neuromodulatory stimulation paradigms, music and singing interventions, and hearing-loss epidemiology, and we discuss domains that at first appear inconsistent, such as voice-heavy occupations and obstructive sleep apnea. We then outline a testable cascade that links behavioral and sleep changes in mid-life to reduced mechanical drive and impaired clearance, and we propose concrete experiments spanning human laboratory studies, clinical trials, animal models, and prospective cohorts. Whether ultimately supported or refuted, this IMV-clearance framework highlights mechanical forces as a potentially modifiable dimension of Alzheimer's disease risk and treatment response, alongside sleep, vascular health, and cognitive engagement.}, }
@article {pmid41641155, year = {2025}, author = {Sánchez-Juan, P and Baz, P and Arrieta, E and Novick, D and Díaz-Cerezo, S and Cotton, S and Walker, C and Trueba Saiz, Á and Núñez, M}, title = {The diagnostic pathway of Alzheimer's disease in real-world clinical practice in Spain: results from the Adelphi Dementia Disease Specific Programme™.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1702805}, pmid = {41641155}, issn = {1664-2295}, abstract = {INTRODUCTION: There are challenges associated with the timely diagnosis of people with mild cognitive impairment (MCI) and Alzheimer's disease (AD), especially with the future introduction of amyloid-targeting therapies. This study evaluates the current diagnostic journey for MCI and dementia due to AD in Spain.
METHODS: This study used data from the Adelphi Real World Dementia Disease Specific Programme (DSP[TM]), a cross-sectional survey with retrospective data collection. The survey involved primary care physicians (PCPs) and hospital specialists with experience in managing and treating AD, along with their consulting patients, between January and July 2023 in Spain. Analyses were descriptive.
RESULTS: Physicians (N = 94; 44.7% PCPs, 38.3% neurologists) reported data for 723 patients. Most patients (78.9%) first consulted a PCP. The median (inter-quartile range) time since symptom onset to first consultation was 21.6 (6.1-48.2) weeks and, in those patients who were not diagnosed immediately, the time from first consultation to diagnosis was 13.0 (6.0-21.9) weeks if diagnosed by a PCP, or 28.9 (17.1-52.1) weeks if diagnosed by a specialist. The diagnosing physician was a specialist or a PCP for 83.2% and 16.8% of patients, respectively. In addition, the most used advanced diagnostic techniques were computed tomography scans and magnetic resonance imaging (57.2% and 43.3% of patients, respectively). CSF determination of AD biomarkers was conducted in 12.4% of patients and AD-specific blood biomarkers in 2.9%. Treatment was mostly initiated by neurologists.
CONCLUSION: The diagnostic process for people with MCI and AD could be accelerated by increased awareness of the disease, shorter referral times, and better access to specialized diagnostic services. This study shows limited use of AD-specific biomarker testing in Spain.}, }
@article {pmid41641094, year = {2026}, author = {Wang, J and Braunstein, JB and Wolz, R and Harper, L and Locascio, T and McPherson, HE and Mohs, R and Pontecorvo, MJ and Burnham, SC}, title = {Interchangeability of blood-based biomarkers and PET to identify Alzheimer's disease pathology.}, journal = {Alzheimer's & dementia (Amsterdam, Netherlands)}, volume = {18}, number = {1}, pages = {e70196}, pmid = {41641094}, issn = {2352-8729}, abstract = {INTRODUCTION: Establishing interchangeability between blood biomarkers and amyloid-positron emission tomography (PET) could help identify patients who would benefit from novel amyloid-targeting therapies for Alzheimer's disease.
METHODS: Adult participants from the Global Alzheimer's Platform Foundation's Bio-Hermes study with clinical diagnosis of mild cognitive impairment/mild dementia and available amyloid-PET evaluations and Aβ42/40-based PrecivityAD[®] (by C2N Diagnostics) and/or phosphorylated tau at threonine 217 (p-Tau217 (research use Meso Scale Discovery, Lilly) were included. Interchangeability between plasma-based tests (per pre-established thresholds) and amyloid-PET stratifications was evaluated.
RESULTS: PrecivityAD (N = 537) and p-Tau217 (N = 531) plasma-based tests had high agreement with florbetapir-PET (overall percent agreement: 80.7% and 90.1%, respectively) and accurately selected patients identified as florbetapir-PET-positive (positive predictive value: 86.0% and 88.0%, respectively). Further, they were non-inferior to quantitative florbetapir-PET (at 37 Centiloids) for identifying positive florbetapir-PET visual reads.
DISCUSSION: Results support the hypothesis that blood biomarkers may be interchangeable with amyloid-PET criteria for selecting patients who may benefit from treatment with novel amyloid-targeting therapies.
HIGHLIGHTS: Interchangeability of plasma-based tests and amyloid-PET stratifications was demonstrated.Non-inferiority of plasma-based biomarkers to amyloid-PET for identifying patients with AD pathology was observed.High agreement between plasma-based test stratification and florbetapir-PET expert visual read was observed.}, }
@article {pmid41641000, year = {2025}, author = {Khan, SA and Raza, K and Tiwari, P and El-Tanani, M and Rabbani, SA and Parvez, S}, title = {Mechanisms to medicines: navigating drug repurposing strategies in Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1676065}, pmid = {41641000}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD) represents a continuously advancing neurodegenerative condition distinguished by the unremitting deterioration of cognitive abilities and memory impairment, which significantly hampers daily functioning of life. In the absence of disease modifying treatments, it continues to pose a significant global challenge. Though symptomatic treatment exists, the inherent complexity involved with AD pathogenesis related to Aβ plaques, neurofibrillary tangles, neuroinflammation, oxidative stress, etc. poses a tremendous challenge to developing drugs. With the incidence of AD increasing yearly globally, research into already existing pharmacological agents has the potential to uncover a brighter future for breakthroughs in treatment strategy. A primary strategy to accelerate the development of AD therapies is drug repurposing: determining a new use for an existing known medication. Following innovative approaches like high-throughput screening, AI-based techniques, a number of classes of drugs originally designed for other diseases are now being tested to modulate the complex pathology mechanisms in AD. This review focuses on the therapeutic promise of drug repurposing as adjunctive to the much-needed renaissance in AD therapies. The review continues to focus on some promising repurposed drug candidates, methodologies applied, and the evaluation of the present status of drugs in the clinic. Apart from the information regarding mechanisms involved in AD, this review also complements case studies, challenges, and limitations along with the various drug repurposing strategies for AD. By understanding and harnessing the potential of existing pharmacological agents, we can expand therapeutic options and improve patient outcomes.}, }
@article {pmid41640998, year = {2025}, author = {Kawabata, S}, title = {Therapeutic and preventive strategies based on the maladaptive plasticity hypothesis for Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1726144}, pmid = {41640998}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD), the most common form of dementia, is characterized by two hallmark pathologies, amyloid plaques (APs) and neurofibrillary tangles (NFTs). Amyloid-β and tau, key components of APs and NFTs, respectively, are widely considered primary drivers of neurodegeneration in AD. In contrast, an alternative view proposes that network failure, arising from amyloid-β precursor protein-driven excessive/aberrant and maladaptive synaptic plasticity, underlies AD pathophysiology. Synaptic plasticity is indispensable for cognitive functions such as learning and memory; however, when dysregulated, it may lead to cognitive decline and accelerate the trajectory toward AD. This paper, based on this hypothesis, examines strategies to mitigate maladaptive plasticity while preserving adaptive plasticity, and proposes the potential of novel approaches for the prevention and treatment of mild cognitive impairment and AD, encompassing both activity-based interventions and pharmacological treatments. This hypothesis-driven framework offers a coherent perspective linking molecular, circuit, and cognitive levels of dysfunction in AD, and may guide more integrative, multi-level approaches to future preventive and therapeutic strategies, a direction increasingly emphasized in current experimental and clinical AD research.}, }
@article {pmid41640856, year = {2026}, author = {Badalova, A and Stott, J and Leff, AP}, title = {Proper name anomia in people with Alzheimer's disease: implications for diagnosis and treatment-a systematic review.}, journal = {NPJ dementia}, volume = {2}, number = {1}, pages = {11}, pmid = {41640856}, issn = {3005-1940}, abstract = {Proper name anomia (PNA) is a common experience that can become unpleasantly amplified in people with Alzheimer's disease (AD). In this systematic review, we discuss the key cognitive stages where naming can fail: facial recognition, person-specific semantics, and proper-name retrieval. We examine claims that PNA is an early indicator of AD and review studies that have attempted to treat PNA in individuals with AD. Twenty-two eligible studies were included. The main findings are that individuals with AD frequently experience difficulties in recalling proper names at any point in the disease process, with the distribution of functional breakdown between the three key cognitive stages involved in successful naming being: facial recognition (19%), person-specific semantics (30%), and proper-name retrieval (40%). PNA can be an early manifestation of AD. Effective behavioural treatments are available for those whose naming difficulties occur at the retrieval stage, including trial-by-trial practice using vanishing cues and spaced retrieval. We also provide clinical recommendations regarding the diagnosis and treatment of PNA.}, }
@article {pmid41640724, year = {2026}, author = {Hayashi, M and Morimoto, Y and Mikuzuki, L}, title = {Comparison of electroencephalogram waveforms in older patients with/without dementia after administration of midazolam: a prospective, observational comparative study.}, journal = {Journal of dental anesthesia and pain medicine}, volume = {26}, number = {1}, pages = {41-51}, pmid = {41640724}, issn = {2383-9309}, abstract = {BACKGROUND: Sedation with midazolam in older patients with severe dementia can cause reactions that differ from those encountered in healthy individuals. We hypothesized that one reason for this is that electroencephalogram (EEG) responses to midazolam in patients with severe dementia may differ from those encountered in healthy individuals. In this study, we aimed to examine the effects of midazolam on EEG findings in older patients with severe dementia and compare them with those observed in older adults without dementia.
METHODS: We included 25 patients aged ≥ 60 years, and allocated them to either the dementia (13 patients) or non-dementia (12 patients) group. Participants with a Mini-Mental State Examination score of ≤ 23, Functional Assessment Staging of Alzheimer's disease stage 6 or 7, and/or Clinical Dementia Rating of being "severe" were considered to have severe dementia. EEG electrodes were attached to patients' frontal pole (Fp2). Midazolam was administered until a modified Observer's Assessment of Alertness/Sedation (OAA/S) score of 2 was attained. Chi-square test, Mann-Whitney U test, and Wilcoxon signed-rank test were performed to assess between-group differences. Differences were considered statistically significant at P < 0.05.
RESULTS: The power of the delta wave at baseline and immediately before treatment was higher in patients with dementia than that in the patients without dementia. Conversely, the power of the alpha wave was lower in the dementia group in the sedated state of the OAA/S 2. Regarding the changes within each group, the theta and beta waves in the dementia group decreased after midazolam administration.
CONCLUSION: Regarding EEG waveforms in the frontal pole, administration of midazolam significantly decreased the power of the fast wave (alpha wave) and increased the power of the slow wave (delta wave) in older patients with severe dementia compared with that in older patients without cognitive decline.}, }
@article {pmid41572662, year = {2026}, author = {Martino-Adami, PV and Jessen, F and Brosseron, F and Bewernick, B and Domschke, K and Luppa, M and Wagner, M and Peters, O and Frölich, L and Riedel-Heller, S and Schramm, E and Ramirez, A and Dafsari, FS}, title = {Exploring blood-based biomarkers in late-life depression: Correlates of psychotherapeutic treatment outcomes.}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {69}, number = {1}, pages = {e18}, doi = {10.1192/j.eurpsy.2026.10153}, pmid = {41572662}, issn = {1778-3585}, support = {01KG1716//Bundesministerium für Bildung und Forschung/ ; 01ED2007A//Bundesministerium für Bildung und Forschung/ ; 2030-390661388//Deutsche Forschungsgemeinschaft/ ; }, mesh = {Humans ; Biomarkers/blood ; Aged ; Male ; Female ; *Major Depressive Disorder/therapy/blood ; Middle Aged ; *Cognitive Behavioral Therapy ; Aged, 80 and over ; }, abstract = {BACKGROUND: Major depressive disorder is a prevalent and debilitating mental health condition contributing to a growing global burden. Late-life depression (LLD), affecting individuals over 60 years of age, is further associated with elevated risks for cardiovascular diseases, cognitive decline, and dementia. Treatment responses vary widely, potentially due to underlying neurodegeneration and cellular senescence. We aimed to explore blood-based biomarkers related to Alzheimer's disease and senescence-associated secretory phenotype (SASP) proteins, seeking to identify biological underpinnings of LLD and their association with response to psychotherapy.
METHODS: We performed a secondary analysis of the Cognitive Behavioral Therapy for Late-Life Depression (CBTlate) trial in 228 participants aged 60 years and older with a diagnosis of LLD. Depression trajectories were compared using clustering. In participants with available plasma samples, biomarker data were generated post hoc. We assessed associations between biomarkers and depression trajectories, biomarker dynamics, and their ability to predict treatment response.
RESULTS: Two depression trajectories were identified: persistently high stable Geriatric Depression Scale (GDS) scores (hsGDS) and decreasing scores over time (dGDS). The hsGDS group had more severe baseline depression (p = 2.88 × 10[-6]), anxiety (p = 4.39 × 10[-4]), and sleep disorders (p = 1.09 × 10[-3]), and was more likely to have a history of major depression (p = 0.01) and mild cognitive impairment (p = 0.01). Biomarker analysis revealed elevated baseline plasma neurofilament light chain (NfL, p = 2.51 × 10[-2]) and reduced C-X-C Motif Chemokine Ligand 5 (CXCL5, p = 2.83 × 10[-2]) in the hsGDS group. Including CXCL5 in predictive models improved trajectory differentiation (p = 3.94 × 10[-3]).
CONCLUSIONS: Cellular aging biomarkers like CXCL5 may improve understanding of LLD and guide personalized therapeutic interventions.}, }
@article {pmid41639713, year = {2026}, author = {You, C and Wu, S and Zhang, Y and Li, Q and Cui, Y and Wu, Y}, title = {Exploration of borneol essential oil function in the treatment of Alzheimer's disease based on network pharmacology and experimental validation.}, journal = {BMC complementary medicine and therapies}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12906-026-05280-y}, pmid = {41639713}, issn = {2662-7671}, }
@article {pmid41639575, year = {2026}, author = {Zetterberg, H and Bendlin, BB}, title = {Biofluid biomarkers in Alzheimer's disease and other neurodegenerative dementias.}, journal = {Nature}, volume = {650}, number = {8100}, pages = {49-59}, pmid = {41639575}, issn = {1476-4687}, abstract = {Biofluid-based biomarkers have transformed neurodegenerative disease research and care, providing insights into the molecular underpinnings of Alzheimer's disease (AD) and other neurodegenerative dementias. This Review provides an update on recent developments in biofluid-based biomarkers for amyloid-β (Aβ) pathology, tau pathology, neurodegeneration, glial reactivity, α-synuclein pathology, TAR DNA-binding protein 43 (TDP-43) pathology, synaptic pathophysiology and cerebrovascular disease-pathologies and processes that are all relevant to neurodegenerative dementias. Complementing longstanding cerebrospinal assays, improved technologies now facilitate the detection of molecules linked to neurodegenerative brain changes at very low concentrations in the blood. This promises to complement the clinical evaluation of suspected neurodegenerative disease in healthcare with molecular phenotyping biomarkers that will help to link the clinical symptoms to ongoing pathophysiological processes in the brain and improve how patients are referred to specialty clinics for initiation and monitoring of molecularly targeted treatments. Clinically relevant breakthroughs such as the use of anti-Aβ monoclonal antibodies to address Aβ pathology in AD serve as important proof-of-concept examples of how the field is advancing toward molecularly informed prevention and treatment. This Review provides an overview of the most established biofluid-based biomarkers currently in use and offers practical guidance on their interpretation and implementation in clinical settings.}, }
@article {pmid41639293, year = {2026}, author = {Amr, Y and Gad, W and Leiva, V and Martin-Barreiro, C and Abdelkader, T}, title = {Comparative analysis of supervised and ensemble models with unsupervised exploration for alzheimer's disease prediction.}, journal = {Scientific reports}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41598-026-37122-9}, pmid = {41639293}, issn = {2045-2322}, abstract = {Alzheimer's disease is a progressive neurodegenerative disorder characterized by memory loss and cognitive decline, with no known cure. Early detection of dementia, a primary manifestation of Alzheimer's disease, is critical to enable timely intervention and treatment planning. This study introduces ensemble learning models for predicting Alzheimer's disease and presents a comparative analysis between traditional machine learning and advanced ensemble models. The evaluation is conducted using the "Open Access Series of Imaging Studies" 2 (OASIS-2) dataset. Traditional models, including logistic regression, decision tree, support vector machine, and random forest, are benchmarked against ensemble models such as adaptive boosting, extreme gradient boosting, and a hyperparameter-tuned majority voting ensemble models. Performance is assessed using accuracy, precision, and the area under the receiver operating characteristic curve. Results show that ensemble models, particularly the optimized majority voting classifier, consistently outperform traditional methods. To complement the supervised comparison, exploratory unsupervised methods were applied using multiple correspondence analysis and k-means clustering to uncover latent structures in the dataset. By categorizing all variables, these unsupervised methods highlight patterns of clinical and demographic similarity. Unlike prior studies that focus solely on predictive accuracy, this work integrates supervised classification, ensemble learning, and unsupervised exploratory analysis within a unified framework. This combined approach enables both robust performance comparison and deeper insights into latent data structures relevant to Alzheimer's disease. All computational experiments were conducted using the Python programming language.}, }
@article {pmid41639038, year = {2026}, author = {Haskell, AK and Kulas, JA and Carter, WE and Javens-Wolfe, J and Hinkel, RD and Moussaif, M and Smiley, JS and Lazaro, O and Robertson, S and Palkowitz, AD and Lamb, BT and Richardson, TI and Dage, JL and Chu, S and Johnson, T and Stancato, LF and Syed, AQ}, title = {Generation and characterization of iPSC-derived microglia for in vitro modeling of stimuli-specific neuroimmune responses.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71117}, doi = {10.1002/alz.71117}, pmid = {41639038}, issn = {1552-5279}, support = {//Center for Medical Genomics at Indiana University School of Medicine/ ; //Indiana University Grand Challenges Precision Health Initiative/ ; U01AG088021/AG/NIA NIH HHS/United States ; U54AG065181/AG/NIA NIH HHS/United States ; U54AG090792/AG/NIA NIH HHS/United States ; }, mesh = {*Microglia/immunology/metabolism ; *Induced Pluripotent Stem Cells/cytology ; Humans ; Cell Differentiation ; Receptors, Immunologic/immunology/metabolism ; Membrane Glycoproteins/immunology/metabolism ; Phagocytosis ; Cells, Cultured ; }, abstract = {INTRODUCTION: Microglia are macrophage-like brain resident immune cells known to express numerous Alzheimer's disease risk genes. Here we generated a human induced pluripotent stem cell (iPSC) derived microglia cell culture model for use in neuroimmune modeling and therapeutic testing.
METHODS: We generated iPSC lines using episomal reprogramming for subsequent stepwise differentiation of iPSC-derived microglia (iMG) without commercial kits. We characterized the responses of this model to immunogenic stimuli and recombinant TREM2 antibodies.
RESULTS: The iMG expressed several key microglia signature genes and are morphologically and transcriptionally dynamic. iMG rapidly phagocytosed myelin debris and strongly changed expression of lipid homeostasis genes. iMG expressed TREM2 and increased TREM2 levels in response to IL-4. Recombinant TREM2 antibody treatment impaired iMG myelin phagocytosis and upregulated chemokines.
DISCUSSION: We validated our iMG model system for the evaluation of biological responses of human microglia-like cells to stimuli and pharmacological agents for their transcriptional and functional impacts.}, }
@article {pmid41635250, year = {2026}, author = {Xu, Z and Xu, W and He, J and Qian, J and Wang, H and Li, C and Zhou, X}, title = {β-Asarone Attenuates Neuroinflammation of Alzheimer's Disease by Activating Autophagy and Suppressing NLRP3 Inflammasome Assembly.}, journal = {CNS neuroscience & therapeutics}, volume = {32}, number = {2}, pages = {e70771}, doi = {10.1002/cns.70771}, pmid = {41635250}, issn = {1755-5949}, support = {LJHSQY26H280002//Central Zhejiang Science and Technology Innovation CorridorJoint Fund of Zhejiang Provincial Natural Science Foundation of China/ ; 2025CC02//Inhua Traditional Chinese medicine science and technology project/ ; 2025ZL061//Zhejiang Province Traditional Chinese medicine science and technology project/ ; 2024-3-094//Jinhua major key science and technology plan project/ ; }, mesh = {Animals ; *Allylbenzene Derivatives/pharmacology ; *Alzheimer Disease/drug therapy/metabolism/pathology ; *Autophagy/drug effects/physiology ; *Anisoles/pharmacology/therapeutic use ; *NLR Family, Pyrin Domain-Containing 3 Protein/metabolism/antagonists & inhibitors ; Mice ; *Inflammasomes/metabolism/drug effects ; *Neuroinflammatory Diseases/drug therapy/metabolism/pathology ; Mice, Transgenic ; Male ; Amyloid beta-Peptides/metabolism ; Mice, Inbred C57BL ; Microglia/drug effects ; }, abstract = {AIM: Alzheimer's Disease (AD) is a neurodegenerative condition with poorly understood mechanisms and few effective treatments. β-asarone has shown potential in AD management, though its molecular actions require further clarification. This study investigates the mechanisms through which β-asarone exerts its effects using both animal and cellular models.
METHODS: In vivo, the 3×Tg-AD mice were administered β-asarone for 8 weeks. Learning and memory abilities were assessed via the Morris water maze and step-down tests. Histomorphological examination, immunofluorescence, immunohistochemistry, ELISA, transmission electron microscopy, and Western blotting were employed to detect pathological changes, neuroinflammation, and protein expression of relevant signaling pathway molecules. In vitro, Aβ was used to culture BV-2 cells to mimic the brain microenvironment in Alzheimer's disease; changes in neuroinflammation, autophagy, and NLRP3 inflammasome-related proteins were observed after treatment with β-asarone.
RESULTS: The administration of β-asarone resulted in enhanced cognitive performance in 3×Tg-AD mice, alongside a reduction in microglial apoptosis induced by Aβ. Additionally, β-asarone diminished the accumulation of Aβ and phosphorylated Tau, ultimately supporting neuronal survival. In both the hippocampal tissue and BV-2 cell models, treatment with β-asarone led to a downregulation of neuroinflammatory markers and modulation of autophagy-related proteins (Beclin-1, P62, ATG5, LC3-II/I), while concurrently suppressing components of the NLRP3 inflammasome (NLRP3, ASC, Caspase-1, cleaved Caspase-1). Notably, the autophagy inhibitor 3-MA counteracted the inhibitory effects of β-asarone on NLRP3 activation.
CONCLUSION: β-Asarone attenuates AD-related neuroinflammation by activating autophagy to inhibit NLRP3 inflammasome assembly.}, }
@article {pmid41635245, year = {2026}, author = {Wiatrak, B and Szeląg, A}, title = {Alzheimer's disease: Time to reassess research and clinical priorities.}, journal = {Advances in clinical and experimental medicine : official organ Wroclaw Medical University}, volume = {}, number = {}, pages = {}, doi = {10.17219/acem/217199}, pmid = {41635245}, issn = {1899-5276}, abstract = {Alzheimer's disease (AD) remains one of the most pressing challenges in contemporary neurology, with growing evidence highlighting the limitations of the amyloid hypothesis and monomodal therapies. This editorial advocates for a shift toward multidimensional research and therapeutic frameworks that integrate molecular, electrophysiological, neuroimaging, and behavioral data. Emphasis is placed on the potential of microRNA-based biomarkers, electroencephalography (EEG) analysis, and non-invasive methods to improve early diagnosis. Emerging multimodal treatment strategies - including immunotherapy, neurostimulation, and nutraceuticals - are discussed alongside ethical and regulatory challenges in implementing novel interventions. The authors propose an integrated, patient-centered model that combines precision medicine with preventive approaches rooted in lifestyle, digital biomarkers, and AI-powered personalization. A paradigm shift toward systemic, translational, and ethically grounded strategies is urgently needed to meet the growing burden of AD.}, }
@article {pmid41634843, year = {2026}, author = {Bellelli, F and Delrieu, J and van Kan, GA and Peluso, A and Soriano, G and Vellas, B and Angioni, D and Sourdet, S}, title = {Are pre-frail and frail amyloid positive individuals eligible to Lecanemab? A cross-sectional analysis from the Cogfrail real-world cohort.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-026-01966-0}, pmid = {41634843}, issn = {1758-9193}, abstract = {BACKGROUND: Following the positive outcomes of the Clarity-AD trial, Lecanemab received marketing authorization from the European Medicines Agency (EMA) and is expected to become available across Europe. However, the trial did not specifically evaluate frailty, making it difficult to estimate the potential effects of Lecanemab among frail individuals. This study aimed to apply Lecanemab eligibility criteria-based on both the Clarity-AD trial and the Appropriate Use Recommendations (AUR) from the United States and France-to a real-world population of pre-frail and frail older adults with confirmed positive amyloid status, and to evaluate differences in frailty status between eligible and non-eligible patients.
METHODS: Eligibility criteria from the Clarity-AD trial, the American and the French AUR, were applied to all participants with confirmed amyloid positivity (n = 120), assessed through amyloid-PET (visual reading) or cerebrospinal fluid (CSF) analysis (Aβ42 levels or Aβ42/Aβ40 ratio). Frailty was defined using the Fried phenotype.
RESULTS: The median age of the sample was 82.0 years (IQR: 79-85); 65% (n = 78) were women, and 36.7% (n = 44) were frail. Overall, 20.0% (n = 24) met the Clarity-AD eligibility criteria, while 50.8% (n = 61) and 47.5% (n = 57) were potentially eligible according to the American and French AURs, respectively. Only 9.1% (n = 4) of frail individuals met the Clarity-AD criteria, compared to 26.3% (n = 20) of pre-frail participants (p = 0.042). In contrast, 50.0% (n = 22) and 45.5% (n = 20) of frail individuals were potentially eligible according to the American and French AURs, respectively.
CONCLUSION: Although less than one in five participants would have been eligible for the Clarity-AD trial, approximately half the cohort would be potentially treatable with Lecanemab under real-world recommendations. While a considerable proportion of frail patients may have access to Lecanemab treatment in real-life, the low proportion of potentially eligible frail individuals for Clarity-AD in our cohort indirectly suggests that frailty may have been underrepresented in the trial, raising concerns about the generalizability of its findings to this population. Caution is warranted when targeting amyloid burden without previously addressing the underlying frailty.
TRIAL REGISTRATION: NCT03129269.}, }
@article {pmid41634017, year = {2026}, author = {Li, Y and Wang, H and Zhang, D and Wang, S and Li, Z and Li, J and Tai, S and Tong, D and Wang, B and Lu, D and Yuan, S and Sun, W and Yang, B and Bai, C and Wang, Q and Ding, J and Wang, Z and Gao, Y and Yu, H and Cui, K and Liu, C and Mao, J and Yao, Y and Liu, F and Wan, Y and Yuan, J and Liu, X and Zheng, J}, title = {Gut microbiota-dependent 24-hydroxycholesterol metabolism contributes to capsaicin-induced amelioration of Alzheimer's disease-like pathology in mice.}, journal = {Nature communications}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41467-026-68937-9}, pmid = {41634017}, issn = {2041-1723}, support = {82160558//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, abstract = {Dietary capsaicin intake appears to affect the pathogenesis of Alzheimer's disease (AD), while the underlying mechanisms remain unclear. Here, we found in human cohorts that moderate-to-high level of dietary capsaicin intake was associated with improved cognitive performance. Similarly, long-term oral capsaicin administration in male 5×FAD mice ameliorated AD-like pathologies and reshaped gut microbial composition. Gut microbiota transfer from capsaicin-treated mice produced similar effects of capsaicin intake. Moreover, capsaicin elevated the level of host 24(S)-hydroxycholesterol (24-HC), relating to the increase of gut Oscillibacter genus abundance. The 24-HC elevation enhanced microglial phagocytic activity in the brain, and inhibited proinflammatory factors production via liver x receptor β (LXRβ)-mediated transcriptional regulation. Finally, we observed elevation of 24-HC in plasma in AD patients with higher level of dietary capsaicin intake, which correlated with cognitive scores and plasma Aβ and p-tau biomarkers. These findings suggest the potential of capsaicin or capsaicin-rich diets in the prevention or treatment of AD and related diseases.}, }
@article {pmid41633894, year = {2026}, author = {Kim, DH and Jo, HY and Oh, YJ and Lim, JR and Chae, CW and Jung, YH and Han, HJ and Lee, HJ}, title = {Folate receptor 1 activation suppresses high glucose-induced amyloidogenesis in neurons via STAT3/Nrf2 pathway-dependent mitigation of mitochondrial oxidative stress.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {}, number = {}, pages = {119074}, doi = {10.1016/j.biopha.2026.119074}, pmid = {41633894}, issn = {1950-6007}, abstract = {Diabetes is a major risk factor for diabetic encephalopathy (DE), which is closely associated with sporadic Alzheimer's disease. Folic acid (FA) receptor signaling can suppress generation of neuropathogenic amyloid-beta (Aβ) induced by high extracellular glucose, suggesting that enhanced activation of this pathway could be a therapeutic strategy against DE-associated dementia, but the precise molecular signaling mechanisms are unclear. We report that high glucose levels increased the expression of amyloid precursor protein (APP) and β-secretase (BACE1) in cultured neurons and concomitantly induced amyloidogenesis, while FA treatment suppressed high glucose-stimulated expression of APP and BACE1, Aβ release, and accumulation of mitochondrial reactive oxygen species. Expression of nuclear factor erythroid 2-related factor 2 (Nrf2) was minimal under high glucose conditions, but was significantly upregulated together with downstream antioxidant enzymes following FA co-treatment. High glucose stimulation also increased folate receptor 1 (FOLR1) mRNA expression, suggesting a compensatory protective response. While treatment with 5-methyltetrahydrofolate (5-MTHF), the activated form of folate, did not significantly alter high glucose-induced upregulation of APP and BACE1, knockdown of FOLR1 mRNA reduced high glucose-stimulated Nrf2 expression and further augmented APP and BACE1 expression under high glucose conditions. Treatment with the STAT3 inhibitor 5'15-DPP also abolished high glucose-stimulated Nrf2 expression and increased APP and BACE1 expression levels. These findings indicate that FA/FOLR1 activation suppresses high glucose-induced amyloidogenesis by mitigating mitochondrial oxidative stress via STAT3/Nrf2 pathway signaling. In conclusion, present study suggests that the FA/FOLR1/STAT3/Nrf2 pathway is an effective therapeutic target for DE.}, }
@article {pmid41484627, year = {2026}, author = {Jia, H and Ma, L and Liu, J and Gao, M and Liang, X and Zhang, F and Gao, Y and Liu, M and Jiang, W and Wei, M and Zhong, X}, title = {Organelle stress in NLRP3 inflammasome: a central mediator of neurodegenerative diseases.}, journal = {Molecular neurodegeneration}, volume = {21}, number = {1}, pages = {8}, pmid = {41484627}, issn = {1750-1326}, abstract = {UNLABELLED: Organelle stress and NLRP3 inflammasome activation have been established as pivotal contributors to inflammatory responses and play a significant role in the pathogenesis of neurodegenerative diseases (NDDs), including Alzheimer’s disease (AD) and Parkinson’s disease (PD). However, the involvement of multiple organelles and their interorganellar signaling in NLRP3 inflammasome activation has not yet been systematically elucidated. The causal mechanisms by which these organelles promote NLRP3 activation and subsequently drive the progression of NDDs remain unclear. Furthermore, therapeutic interventions targeting this pathway require urgent and comprehensive investigation. This article comprehensively reviews the mechanisms by which organelle-derived stress signals, such as mitochondrial reactive oxygen species (mtROS), cathepsin B (CTSB), and calcium ions (Ca[2+]), induce NLRP3 inflammasome activation. It further examines the pivotal role of organelle-specific NLRP3 localization and post-translational modifications in the activation of the NLRP3 inflammasome. Finally, we outline NLRP3-mediated inflammatory processes in NDDs, focusing on events directly induced by organelle stress and interactions. These processes are not merely consequences of NDD progression but also critical factors accelerating disease deterioration. Potential therapeutic strategies targeting the organelle-NLRP3 axis are proposed, which may provide novel theoretical foundations and promising avenues for the prevention and treatment of NDDs.
GRAPHICAL ABSTRACT: [Image: see text]}, }
@article {pmid41631871, year = {2026}, author = {Sun, M and Lin, J and Li, S}, title = {Extracellular tau oligomers exert neurocytotoxicity by triggering mitochondrial dysfunction.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251414979}, doi = {10.1177/13872877251414979}, pmid = {41631871}, issn = {1875-8908}, abstract = {BackgroundAbnormal tau aggregation is implicated in the development of neurodegenerative diseases such as Alzheimer's disease (AD). The presence of tau in the extracellular space and the spread of tau between nerve cells is associated with its toxicity. At present, researchers are trying to treat AD by limiting, blocking or removing extracellular tau.ObjectiveTo investigate the molecular mechanism underlying the cytotoxicity of extracellular tau oligomers.MethodsThe morphology of tau oligomers was observed by transmission electron microscopy. The neurocytotoxicity of tau oligomers was examined using CCK-8 assay. The localization of tau oligomers in cells was observed by laser confocal microscopy. The influence of tau oligomers on apoptosis was detected by Hoechst 33342/PI double-staining, Annexin V/PI double-staining and flow cytometry. JC-1 staining, DCFH-DA staining and Fluo-4 AM staining were used to evaluate the effect of tau oligomers on mitochondria. Western blot analysis was used to investigate the mechanism underlying the effects of tau oligomers on apoptosis and autophagy.ResultsAfter treatment with tau oligomers, the viability of SH-SY5Y cells decreased, and a typical apoptotic morphology was observed. Tau oligomers can enter cells, decrease the mitochondrial membrane potential, increase reactive oxygen species levels and drive calcium levels up to disrupt calcium homeostasis. The cytotoxicity of tau oligomers is closely related to the induction of mitochondrial apoptosis and blockade of mitophagy.ConclusionsThis study provides a molecular mechanism for understanding the cytotoxicity of extracellular tau oligomers and provides a therapeutic target for the development of effective treatment strategies for tau-related diseases.}, }
@article {pmid41630792, year = {2026}, author = {Sato, K and Niimi, Y and Kurihara, M and Ihara, R and Iwata, A and Iwatsubo, T}, title = {Utility of APOE testing for reducing ARIA under probabilistic stopping rates to treat with anti-amyloid therapy for ε4-homozygote patients: A simulation study.}, journal = {JAR life}, volume = {15}, number = {}, pages = {100059}, pmid = {41630792}, issn = {2534-773X}, abstract = {BACKGROUND: APOE ε4/ε4 genotype increases the risk of Amyloid-Related Imaging Abnormalities (ARIA) from anti-amyloid antibody treatment (AAT). While guidelines recommend testing, its practical utility depends on the resulting probability (p) that treatment is actually withheld for ε4-homozygotes, which varies significantly across clinical settings.
OBJECTIVES: To quantify the Number Needed to Test (NNT) to prevent one ARIA event as a function of p of withholding AAT in ε4/ε4 patients.
DESIGN: A Bayesian simulation study using a Beta-Binomial model to analyze genotype-stratified contingency tables.
SETTING: Data were derived from two published, phase 3 clinical trials: Clarity-AD (lecanemab) and TRAILBLAZER-ALZ 2 (donanemab).
PARTICIPANTS: Aggregate data from source trials.
INTERVENTION: Simulation of varying treatment discontinuation probability p from 0 (none) to 1 (universal for ε4-homozygotes).
MEASUREMENTS: NNT to prevent one ARIA event (any ARIA-E, any ARIA-H, and symptomatic ARIA-E) and the fractional reduction in total ARIA events as a function of p.
RESULTS: NNTs increased (worsened) significantly as p decreased. Under the most conservative policy (p = 1), the median NNT to prevent one any ARIA-E event was 20-30 (lecanemab) and 15-25 (donanemab), yet this only reduced total ARIA events by 10-30%. The NNT to prevent one symptomatic ARIA-E (lecanemab) was substantially higher, at 70-90 (at p = 1).
CONCLUSIONS: The direct safety impact of APOE testing for ARIA mitigation is limited, even under universal discontinuation policies. Its primary value lies in supporting shared decision-making and operational planning rather than as a standalone safety lever.}, }
@article {pmid41630733, year = {2025}, author = {Aliffia, D and Wihadmadyatami, H and Raihan, MZZ and Kustiati, U and Sanjaya, WBT and Aviana, AP and Nugrahaningsih, DAA and Widayati, WT and Karnati, S and Kusindarta, DL}, title = {C3H mouse model of Alzheimer's disease: Blood markers, proteomic biomarkers, cognitive ability, and histopathology.}, journal = {Open veterinary journal}, volume = {15}, number = {11}, pages = {5718-5726}, pmid = {41630733}, issn = {2218-6050}, mesh = {Animals ; *Alzheimer Disease/pathology/chemically induced/blood ; *Disease Models, Animal ; Male ; Mice ; Biomarkers/blood ; Mice, Inbred C3H ; *Cognition ; Proteomics ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative condition, and the number of cases of AD is projected to increase each year. Developing an AD animal model has a major impact on studying the pathology of the disease and on developing therapies and treatments.
AIM: This study aimed to create an AD animal model using C3H mice by administering trimethyltin (TMT) via intraperitoneal injection. Hematological analysis, pathology, protein biomarkers, and behavioral assessments supported the findings.
METHODS: In this experiment, two groups were included: a non-treated group (normal mouse) and a treatment group (AD animal model). Each group consisted of four male C3H mice aged 8 weeks. The treatment group was intraperitoneally injected with 2.5 mg/kg of body weight TMT. Hematological analyses were conducted to assess the blood routine, while pathological changes in brain structure, particularly in the hippocampus, were examined using hematoxylin and eosin staining as well as Nissl staining. Additionally, proteomic profiling was used to analyze protein biomarkers associated with AD via liquid chromatography-high-resolution mass spectrometry. Behavioral analysis was conducted using the radial arm maze.
RESULTS: Hematological analysis revealed an increase in hematocrit, mean corpuscular volume, leucocytes, and neutrophil levels, whereas other parameters remained within the normal range. Histopathological analysis revealed neuronal loss and structural alterations in the pyramidal cell layers of the CA1 and CA3, the presence of inflammation, and neurofibrillary tangles. Proteomic analysis identified several protein biomarkers related to AD in the AD animal model, including amyloid beta, tau protein, apolipoprotein E, and Triggering Receptor Expressed on Myeloid cells. Behavioral analysis demonstrated significant cognitive and memory declines in AD animal models compared with non-treated animals.
CONCLUSION: The intraperitoneal administration of TMT in C3H mice effectively induces pathological changes in the brain that are related to AD. The observed pathological and behavioral changes in this AD animal model resemble those found in human cases of the disease. This model can serve as a valuable platform for studying the etiology, pathogenesis, and pathophysiology of AD, as well as testing new therapies.}, }
@article {pmid41628899, year = {2026}, author = {Huan, T and Intrator, O and Simning, A and Boockvar, K and Grabowski, DC and Cai, S}, title = {Psychotherapy and Problematic Behavior Reduction in Long-Stay Nursing Home Residents With Alzheimer's Disease and Related Dementias.}, journal = {Journal of the American Medical Directors Association}, volume = {}, number = {}, pages = {106106}, doi = {10.1016/j.jamda.2025.106106}, pmid = {41628899}, issn = {1538-9375}, abstract = {OBJECTIVES: To examine the association between receipt of psychotherapy and behavior reduction among long-stay nursing home residents with Alzheimer's disease and related dementias (ADRD).
DESIGN: Retrospective cohort study using Minimum Data Set assessments linked to Medicare: Master Beneficiary Summary File, Part B Carrier, and Part D Event file (2017-2018).
SETTING AND PARTICIPANTS: All US Medicare- or Medicaid-certified nursing homes. Traditional Medicare beneficiaries enrolled in Medicare Parts B and D, aged ≥65 with ADRD and any problematic behaviors (physical, verbal, or other), stratified to residents with both ADRD and co-occurring psychiatric disorders, and ADRD only.
METHODS: The unit of analysis was 2 consecutive quarters with indication of a problematic behavior in the first. Outcomes were reductions in any, physical, verbal, or other behaviors. The treatment was receipt of psychotherapy in both quarters vs neither. Covariates included predisposing, enabling, and need factors. Propensity score weighting balanced resident characteristics, and generalized estimating equation logistic models were applied.
RESULTS: The cohort included 175,165 resident-quarter observations from 99,584 unique long-stay residents with ADRD and problematic behaviors. Psychotherapy was received in 9% of observations, most often in short (73%), quarterly (59%), or monthly (35%) sessions delivered by psychologists (56%) or social workers (34%). After weighting, psychotherapy was associated with greater likelihood of behavior reduction (ADRD + psychiatric disorders: 17%, P < .01; ADRD only: 33%, P < .05). In ADRD-only residents, psychotherapy was associated with 36% reduction in physical behaviors and 28% in verbal behaviors. In those with ADRD + psychiatric disorders, reductions were seen in physical (31%) and other behaviors (18%).
CONCLUSIONS AND IMPLICATIONS: Fewer than 10% of nursing home residents with ADRD and problematic behaviors received psychotherapy, yet its receipt was significantly associated with behavior reduction. Findings underscore the need to expand access to psychotherapy in nursing homes and to further investigate the psychotherapy characteristics that contribute to effectiveness.}, }
@article {pmid41628871, year = {2026}, author = {Wei, M and Zhang, Q and Zhao, Z and Chen, L and Tan, R}, title = {Saffron (Crocus sativus L.): A Multi-Target Phytochemical with Potential Therapeutic Relevance for Autism Spectrum Disorder - A Review of Pharmacological Mechanisms and Future Perspectives.}, journal = {Journal of ethnopharmacology}, volume = {}, number = {}, pages = {121299}, doi = {10.1016/j.jep.2026.121299}, pmid = {41628871}, issn = {1872-7573}, abstract = {Saffron (Crocus sativus L.) has a long history of use in traditional medicine practices across Persia/the Middle East, India, and the Mediterranean region. Traditionally, it has been regarded for its potential to regulate mood, support cognition, and promote sleep. This paper explores saffron's potential applications and mechanisms of action in autism spectrum disorder (ASD) and related comorbidities (such as anxiety, sleep disorders, and cognitive impairments) from an ethnopharmacological perspective. It integrates pharmacological evidence from saffron's primary constituents-crocins, crocetin, picrocrocin, and safranal-emphasizing the convergence of traditional medicinal knowledge with modern scientific evidence.
AIM OF THE STUDY: This review aims to systematically evaluate the therapeutic potential of saffron (Crocus sativus L.) and its bioactive constituents (crocins, crocetin, picrocrocin, safranal) in ASD, its comorbid conditions, and related neurodegenerative diseases. The goal is to synthesize current evidence on saffron's mechanisms of action and translational prospects for ASD management.
MATERIALS AND METHODS: A comprehensive literature search was conducted across PubMed, Web of Science and Science Direct databases up to May 2025. Search terms included combinations of keywords such as "saffron," "crocetin," "autism," "anxiety," "depression," "Alzheimer's disease," and "Parkinson's," to identify relevant preclinical and clinical studies on saffron's neuroprotective effects and therapeutic applications.
RESULTS: Saffron exhibits pleiotropic neuroprotective effects by modulating multiple key pathways involved in ASD and neurodegeneration, including inhibition of neuroinflammatory signaling pathways such as NF-κB/NLRP3, activation of antioxidant responses via the Nrf2/ARE pathway, and restoring balance between GABAergic and glutamatergic neurotransmission. These mechanisms support saffron's potential to reestablish neurodevelopmental homeostasis and alleviate core ASD symptoms, along with associated comorbidities such as anxiety and cognitive impairments.
CONCLUSION: Saffron is a promising natural multi-target agent with significant translational potential for ASD and related disorders. Its ability to modulate neuroinflammatory, oxidative, and neurotransmission pathways underscores its potential as an adjunctive or alternative therapy. Future research should focus on elucidating precise mechanisms, conducting rigorous clinical validations, and optimizing formulations to facilitate evidence-based integration of saffron into ASD treatment strategies.}, }
@article {pmid41628818, year = {2026}, author = {Munir, S and Chaudhary, Z and Khan, IA and Ahmad, M and Khurshid, M and Ashfaq, UA}, title = {Discovery of a novel IMS48 as a dual inhibitor of acetylcholinesterase and butyrylcholinesterase: In vitro and in vivo study for Alzheimer Therapy.}, journal = {Neuropharmacology}, volume = {}, number = {}, pages = {110856}, doi = {10.1016/j.neuropharm.2026.110856}, pmid = {41628818}, issn = {1873-7064}, abstract = {Current medications for Alzheimer's disease (AD) provide symptomatic relief only and fail to prevent neurodegeneration, necessitating the development of new therapeutic agents. This study aimed to evaluate benzimidazole (BIM) analogues as potential inhibitors for AD. In vitro screening identified 1-benzyl-3-(2-((3-chlorophenyl)amino)-2-oxoethyl)-1H-benzo[d]imidazol-3-ium chloride (IMS48) as a potent inhibitor of both acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), with IC50 values of 0.31 ± 0.04 μM and 1.85 ± 0.05 μM, respectively, outperforming the standard drug donepezil. In the in vivo study, rats were administered D-gal (300 mg/kg) and AlCl3 (150 mg/kg) orally for three weeks to induce AD-like symptoms. Concurrently, IMS48 was administered at doses of 0.75 mg/kg and 1.5 mg/kg for 21 days. Donepezil (DON) was used as a positive control to evaluate the therapeutic efficacy of the IMS8 compound. IMS48 treatment significantly reversed behavioural alterations and improved learning ability. Histopathological analysis demonstrated that IMS48 effectively inhibited neuronal death and neurofibrillary tangles in the brain tissue. Furthermore, IMS48 restored the altered antioxidant enzyme levels (p<0.001), reducing malondialdehyde (MDA) concentration and enhancing superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT) concentrations. IMS48 also downregulated the gene expression of AChE (1.56 ± 0.10-fold and 1.71 ± 1.76-fold), APP (1.96 ± 0.17-fold and 3.39 ± 0.139-fold), BACE1 (1.92 ± 0.10-fold and 2.59 ± 0.04-fold), TNFα (2.16 ± 0.21-fold and 3.35 ± 0.17-fold), IL-1α (1.86 ± 0.236-fold and 2.56 ± 0.15-fold), and IL-1β (1.58 ± 1.82-fold and 2.32 ± 0.13-fold), associated with AD pathology and neuroinflammation. Overall, these findings highlight the neuroprotective potential of IMS48 in enhancing cognitive function and mitigating neurodegeneration in AD.}, }
@article {pmid41627667, year = {2026}, author = {Jia, YJ and Ge, YJ and Li, B and Yang, Y and Chen, H and Liu, J and Guo, JH and Yu, JT and Ye, KQ and Wang, JZ and Song, W and Wang, YJ}, title = {Advances in Alzheimer's disease: mechanistic insights and therapeutic targets.}, journal = {Science China. Life sciences}, volume = {}, number = {}, pages = {}, pmid = {41627667}, issn = {1869-1889}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by cognitive decline, memory loss, and behavioral disturbances, eventually leading to dementia and severely diminishing quality of life. With the global population aging, AD has become an unprecedented challenge for society and families. Recent advances in the development of amyloid-beta (Aβ)-targeting monoclonal anti-bodies, like lecanemab and donanemab, provided hope for slowing or even halting disease progression. However, these treatments have not yet achieved the ultimate goal of reversing cognitive deterioration and restoring normal function. The complexity of AD stems from multiple contributing factors, with Aβ deposition and tau protein tangles being central to its pathology, while genetic predispositions, aging, and systemic factors further drive disease progression. Addressing AD by targeting a single factor has proven insufficient, highlighting the need for a comprehensive understanding of its multifaceted mechanisms. This review explores the latest advances in AD mechanistic research and therapeutic development, focusing on key areas such as amyloid precursor protein (APP) metabolism, Aβ dynamics, Aβ antibody immunotherapy, tau protein dysfunction, genetic influences, aging mechanisms, and systemic factors. By critically examining these aspects, we aim to provide insights that support more holistic approaches to AD diagnosis and treatment, ultimately laying the groundwork for innovative strategies to combat this debilitating disease.}, }
@article {pmid41627306, year = {2026}, author = {Cronin, M and Jennings, AA and Caufield, U and Coonan, I and Cornally, N and Daly, B and Dockeray, L and Hartigan, I and Lawlor, B and McCarthy, G and Ni Chorcorain, AM and O'Dowd, S and Nolan-Palmer, J and Perry, M and Quinlan, D and Timmons, S and Foley, T}, title = {Co-designing a structured referral template to enhance dementia diagnosis: a modified e-Delphi study.}, journal = {Age and ageing}, volume = {55}, number = {2}, pages = {}, doi = {10.1093/ageing/afag008}, pmid = {41627306}, issn = {1468-2834}, support = {APA-2022-027//Applied Partnership Award from the Health Research Board/ ; }, mesh = {Humans ; *Referral and Consultation/organization & administration/standards ; *Dementia/diagnosis/psychology/therapy ; Delphi Technique ; Consensus ; Aged ; Female ; Male ; Predictive Value of Tests ; Cognition ; }, abstract = {BACKGROUND: Dementia care is a health and social care priority, with rising prevalence driven by ageing populations worldwide. Timely and accurate diagnosis improves quality of life, enables access to support and is becoming even more critical due to the emergence of disease-modifying therapies for Alzheimer's disease. Complex referral pathways can contribute to diagnostic delays and under-diagnosis. A structured, evidence-based referral template could enhance diagnostic efficiency and care quality.
METHODS: This study was conducted in two phases. First, a two-round e-Delphi survey was used to achieve consensus on items for inclusion in a dementia referral template. In the second phase, a modified Nominal Group Technique was employed with a multidisciplinary panel and Public and Patient Involvement (PPI) contributors to discuss, refine and prioritise items, ensuring clinical relevance and practical applicability.
RESULTS: The consensus process refined and prioritised 76 potential referral items into a final set of 11 essential components. The resulting concise template balances clinical relevance with usability, potentially supporting more efficient referral and triage. Items achieving the highest consensus included cognitive screening scores, rapid deterioration, problems with daily activities and patient safety concerns.
CONCLUSION: The findings demonstrate the value of structured consensus methods in developing a practical, evidence-based referral template, tailored to optimise dementia diagnostic pathways. This is particularly important in the current evolving therapeutic landscape, to ensure that people with suspected dementia receive timely diagnosis and access to appropriate care and treatment options.}, }
@article {pmid41626944, year = {2026}, author = {Zhou, S and Xu, L and Dong, J and Zhang, X and Gao, W and Luo, H and Fang, X}, title = {Advances in Immune Cell Interactions and Natural Compounds Therapeutic Strategies in Alzheimer's Disease.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70249}, pmid = {41626944}, issn = {1099-1573}, support = {82304913//National Natural Science Foundation of China/ ; 82204785//National Natural Science Foundation of China/ ; 82474141//National Natural Science Foundation of China/ ; YDZJ202501ZYTS803//Department of Science and Technology of Jilin Province/ ; YDZJ202401110ZYTS//Department of Science and Technology of Jilin Province/ ; 20240601005RC//Department of Science and Technology of Jilin Province/ ; 20230401074YY//Department of Science and Technology of Jilin Province/ ; YDZJ202401442ZYTS//Department of Science and Technology of Jilin Province/ ; 202104011055YY//Department of Science and Technology of Jilin Province/ ; 20220204001YY//Department of Science and Technology of Jilin Province/ ; }, abstract = {As the global population ages, the incidence of Alzheimer's disease (AD) increases, burdening patients, families, and society. In recent years, microglia have been shown to interact with T cells, astrocytes, and other immune cells to form a complex immune microenvironment, which plays a damaging or protective role on neurons during the pathological process of AD. Herein, we review the interactions between microglia and other immune cells in the pathogenesis of AD and explore the potential of natural compounds as multi-targeted therapeutic strategies: (1) Balancing glial cell polarization status and ameliorating neuroinflammation by inhibiting core neuroinflammatory pathways such as NF-κB (nuclear factor kappa-B), MAPK, and NLRP3 inflammasome; (2) modulating the gut flora-brain axis function to inhibit central inflammation indirectly; (3) multi-targeted interventions for core AD pathology, including amyloid-beta (Aβ) clearance, tau phosphorylation, and synaptic plasticity. However, natural compounds still face clinical translation bottlenecks such as low bioavailability and poor blood-brain barrier permeability. Current studies have shown that nanocarrier systems and combination therapy strategies hold promise for addressing existing bottlenecks. However, systematic validation is still required for their clinical translation. This review systematically summarizes progress in the treatment of AD by regulating microglia and other immune cell interactions using natural compounds.}, }
@article {pmid41626761, year = {2026}, author = {Chen, H and Zhang, H and Yang, M and Xie, Q and Zhu, L}, title = {Association between apolipoprotein E gene polymorphisms and serum lipid indicators and Alzheimer's disease risk.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261416064}, doi = {10.1177/13872877261416064}, pmid = {41626761}, issn = {1875-8908}, abstract = {BackgroundApolipoprotein E (APOE) polymorphisms, particularly the APOE4 genotype, are established genetic risk factors for Alzheimer's disease (AD). However, the clinical utility of combining APOE genotypes with serum lipids and blood-based AD biomarkers remains incompletely defined.ObjectiveTo investigate the association between APOE gene polymorphisms, serological indicators, and the occurrence of AD.MethodsBlood samples of 109 patients with AD and 85 non-AD participants were used to detect APOE genotypes. Serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), amyloid-β 1-42 (Aβ1-42), and p-tau-181 were measured. Receiver operating characteristic analysis was performed in an independent validation set of 82 cases.ResultsThe frequency of the APOE4 genotype was significantly higher in the AD group compared with the non-AD group, whereas APOE2 and APOE3 genotypes showed no significant differences. TC, HDL-C, and LDL-C levels were significantly elevated in the AD group compared with the non-AD group, while TG, Aβ1-42, and p-tau-181 levels did not differ significantly. Among patients with AD carrying the APOE4 genotype, TC and LDL-C levels were significantly higher than those in non-AD APOE4 carriers. Further, within the AD group, APOE4 carriers had a significantly higher proportion of elevated TC and LDL-C levels than non-APOE4 carriers. Validation experiments revealed that the combination of APOE4 genotype with elevated TC and LDL-C demonstrated greater diagnostic efficacy for AD.ConclusionsAPOE4 genotype combined with elevated TC and LDL-C levels strongly correlate with AD onset and may be valuable auxiliary biomarkers for AD diagnosis and treatment.}, }
@article {pmid41626292, year = {2026}, author = {Ashford, MT and Tank, R and Kabeto, MU and Nosheny, RL and Weiner, MW and Weir, DR and Langa, KM}, title = {Exclusions affect representativeness of Alzheimer's disease trial participants.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {12}, number = {1}, pages = {e70191}, pmid = {41626292}, issn = {2352-8737}, abstract = {BACKGROUND: This study assessed how medical exclusion criteria of a prevention Alzheimer's disease trial impact potential eligibility and sample characteristics.
METHODS: Medical exclusion criteria from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial were applied to N = 3695 participants from the population-based Health Retirement Study (HRS) with linked Medicare data. We determined the proportion of hypothetical eligibility. Multivariate Poisson regression was used to estimate associations between sociodemographic characteristics and eligibility.
RESULTS: Of the participants, 74.2% (N = 2742) were deemed ineligible. Accounting for all sociodemographic characteristics, older age, female gender, fewer years of education, lower net worth, and body mass index of 30+ was associated with a higher odds of being deemed ineligible. Ethnocultural identity and living arrangement were not associated with eligibility.
CONCLUSIONS: Our results suggest that certain sociodemographic factors may limit eligibility for a prevention Alzheimer's disease trial due to the presence of exclusionary medical conditions. This highlights the need to make trials more inclusive.
HIGHLIGHTS: A total of 2742 participants (74.2%) were deemed ineligible for the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial based on the medical exclusion criteria.The most common medical exclusion in this sample was for cardiovascular conditions.Ineligibility was associated with age, education, net worth, and body mass index.}, }
@article {pmid41625339, year = {2025}, author = {Knudsen, E and Tadje, J and Coggins, C and Venketaraman, V}, title = {Glutathione and neurodegenerative diseases: immunopharmacological implications.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1737199}, pmid = {41625339}, issn = {1663-9812}, abstract = {Neurodegenerative diseases are characterized by progressive neuronal dysfunction, often accompanied by chronic inflammatory states and redox imbalance within the central nervous system (CNS). Glutathione (GSH), a key regulator of oxidative stress and cellular immunity, has a critical role in modulating the functional states of CNS-resident and infiltrating immune cell subsets. This review aims to synthesize emerging evidence on how GSH depletion contributes to impaired immune and antioxidant activity in neurodegenerative diseases, such as Parkinson's Disease (PD), Alzheimer's Disease (AD), and multiple sclerosis (MS). By exploring how redox signaling via GSH influences inflammatory immune phenotypes across different disease states, we will isolate possible therapeutic interventions for treatment of these conditions. By characterizing GSH's function and designating it as a special regulator of immune cell behavior, this review highlights its potential as both a therapeutic agent and biomarker for patients with neurodegenerative conditions.}, }
@article {pmid41624730, year = {2026}, author = {Qiao, F and Guo, Y and Dong, Y and Song, K and Yan, B and Zhou, J}, title = {Unlocking a Novel Therapeutic Modality: Low-Intensity Transcranial Ultrasound as a Key to CNS Treatment - A Bibliometric and Systematic Review.}, journal = {Journal of central nervous system disease}, volume = {18}, number = {}, pages = {11795735261415705}, pmid = {41624730}, issn = {1179-5735}, abstract = {OBJECTIVES: Over the past decade, low-intensity transcranial ultrasound stimulation (LITUS) has emerged as a promising non-invasive neuromodulation technique for central nervous system (CNS) disorders. This study aims to chart the current research landscape, uncover key trends and challenges, and offer a reference for future investigations.
METHODS: Following PRISMA guidelines, we sourced data from 3 databases and included 454 literature. We conducted bibliometric analyses using R, VOSviewer, and CiteSpace to explore publication trends, journal/region contributions, keyword co-occurrence networks, research clusters, and emerging frontiers.
RESULTS: The United States, China, and South Korea were the most influential countries in the field, while Brain Stimulation was the leading journal. Keyword analysis revealed 7 research clusters, and burst-detection highlighted frontiers such as safety, thalamic stimulation, and frequency. The literature review shows that LITUS is an emerging field with therapeutic promise, but faces challenges in areas like safety and ultrasound parameter standardization.
CONCLUSION: As the first comprehensive bibliometric and systematic review of LITUS in CNS disorders treatment, this work presents a global picture of publication trends, hotspots, and obstacles-providing valuable guidance for future research and clinical translation of LITUS.}, }
@article {pmid41624205, year = {2025}, author = {Wang, Y and Liu, C and Zheng, X and Wang, Z and Wang, Y and Geng, Y and Yang, J and Wei, K and Chen, X}, title = {Modified Sanjia Powder ameliorates cognitive impairment and exerts neuroprotective effects in 5 × FAD mice: insights from quantitative proteomics.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1699142}, pmid = {41624205}, issn = {2296-861X}, abstract = {BACKGROUND: Modified Sanjia Powder (MSP) is a traditional Chinese herbal formulation with potential use as a dietary supplement, which has shown neuroprotective properties against Alzheimer's disease (AD). However, its mechanisms of action, particularly those related to metabolic pathways, remain poorly understood. Given the emerging role of lipid metabolism and associated oxidative stress in AD pathogenesis, this study aimed to investigate the therapeutic effects of MSP on cognitive impairment and explore its molecular mechanisms, with emphasis on nutritionally relevant pathways, in the 5 × FAD mouse model of AD using quantitative proteomics.
METHODS: Cognitive, pathological, and molecular functions were evaluated following MSP treatment. Cognitive performance was assessed using behavioral tests including the Y-maze, novel object recognition (NOR), and Morris Water Maze. Brain tissues from control, 5 × FAD, and MSP-treated mice were analyzed by data-independent acquisition mass spectrometry to identify differentially expressed proteins (DEPs). Key findings were validated using Western blotting, immunohistochemistry, and cytokine assays.
RESULTS: MSP treatment significantly improved cognitive function in 5 × FAD mice across multiple behavioral tests. It reduced Aβ plaque deposition, attenuated tau hyperphosphorylation, inhibited microglial activation, and decreased levels of pro-inflammatory cytokines (IL-1β, TNF-α, and IL-6). Proteomic analysis identified 460 DEPs, with significant enrichment in pathways related to fatty acid biosynthesis, lipid metabolism, and oxidative stress. Notably, among these DEPs, ACSL4-a key regulator of lipid metabolism and oxidative stress-was upregulated in 5 × FAD mice but markedly downregulated after MSP treatment. Importantly, MSP's modulation of lipid metabolism appeared selective for the ACSL4 pathway, without broadly affecting other lipid metabolic pathways that influence cytokine release. MSP also reduced levels of reactive oxygen species (ROS) and lipid peroxidation markers (MDA and 4-HNE).
CONCLUSION: MSP confers neuroprotection in AD by modulating ACSL4-mediated lipid metabolism and oxidative stress, leading to improved cognitive function and reduced neuroinflammation in the 5 × FAD mouse model. These results position MSP as a promising therapeutic candidate for AD and demonstrate the value of quantitative proteomics in elucidating the mechanisms of traditional Chinese medicines.}, }
@article {pmid41623423, year = {2025}, author = {Tang, B and Tao, M}, title = {Research progress on 40 Hz sensory stimulation for the treatment of Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1710041}, pmid = {41623423}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD) is a prevalent neurodegenerative disorder characterized by β-amyloid (Aβ) deposition, tau protein hyperphosphorylation, and synaptic dysfunction. In recent years, 40 Hz sensory stimulation-including visual, auditory, and multimodal modalities-has emerged as a novel, non-invasive intervention demonstrating potential efficacy in both animal models and preliminary clinical studies. Preclinical evidence indicates that such stimulation can markedly reduce cerebral Aβ burden (by approximately 37%-53%), inhibit tau protein phosphorylation, enhance neuronal network synchrony and synaptic plasticity, and improve learning and memory performance. Limited human trials suggest that 40 Hz sensory stimulation is safe and well tolerated in patients with mild cognitive impairment (MCI) and early-stage AD, with a slowing trend in cognitive scale score decline following intervention. This review summarizes the mechanisms of action, experimental evidence from animal models, and advances in clinical application of 40 Hz sensory stimulation in AD prevention and treatment. It further explores the potential for multimodal combination therapies integrating sensory stimulation with cognitive training, pharmacological interventions, and lifestyle modifications, and addresses challenges such as optimal timing of intervention and the influence of ambient electromagnetic fields in real-world settings. Current evidence supports 40 Hz sensory stimulation as a feasible, multi-target, and safe adjunctive intervention; however, its efficacy and applicability must be verified through multicenter, randomized controlled trials with long-term follow-up.}, }
@article {pmid41622480, year = {2026}, author = {Martinez, B and Peplow, PV}, title = {Treatment of animal models of Alzheimer's disease with extracellular vesicles or exosomes and involvement of microRNAs.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-01116}, pmid = {41622480}, issn = {1673-5374}, abstract = {Alzheimer's disease is a complex and devastating neurodegenerative disorder that accounts for roughly 80% of all dementia cases. It is primarily marked by the accumulation of senile amyloid-β plaques and neurofibrillary tangles composed of hyperphosphorylated tau protein. These pathological features are accompanied by chronic neuroinflammation and glial cell dysfunction, which collectively contribute to the progressive loss of synapses and neurons. As a result, individuals with Alzheimer's disease experience gradual memory loss and cognitive decline. Currently, the global patient population is nearing 50 million, a number expected to increase dramatically over the coming decades. Conventional treatments focus on symptom management through acetylcholinesterase inhibitors, such as donepezil, galantamine, and rivastigmine, and the N-methyl-D-aspartate receptor antagonist memantine. However, the past few years have seen the approval of newer agents such as sodium oligomannate, aducanumab, and lecanemab, which show some promise in slowing disease progression. Unfortunately, most patients are not diagnosed until moderate or advanced stages when irreversible brain damage has occurred. This highlights an urgent need for early diagnosis and biomarkers together with therapeutic strategies aimed at early-stage intervention and identifying novel drug targets that address prodromal and established forms of the disease. This article is a literature review of extracellular vesicles/exosomes treatment in animal models of Alzheimer's disease involving microRNAs. In the in vivo animal studies of Alzheimer's disease reviewed, extracellular vesicles and exosomes from various sources improved memory and cognitive decline, lowered inflammation and amyloid deposition, and increased neuron survival in the brain. Loading extracellular vesicles and exosomes with microRNA mimics (e.g., miR-22, -29b, -124, -132, -138-5p, -342-5p, -711, and -7670-3p) or antagomirs (e.g., miR-206-antagomir) improved outcomes in animal models of Alzheimer's disease. Supporting results were found in the in vitro cell studies reviewed.}, }
@article {pmid41622475, year = {2026}, author = {Guo, J and Lu, X and Qiu, L and Xue, W and Fu, H and Wang, K and Wang, Y}, title = {Analysis of the dual role of amyloid-beta in Alzheimer's disease through multi-omics integration.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00872}, pmid = {41622475}, issn = {1673-5374}, abstract = {Accumulation of amyloid-beta is highly important in the development of Alzheimer's disease. Given the limitations of the amyloid cascade hypothesis and the repeated clinical failures of anti-amyloid-beta therapies, researchers are increasingly exploring the infection hypothesis. This review explores the dual behaviors of amyloid-beta in Alzheimer's disease, with a particular focus on its protective role against infection by microorganisms and its complicated connections with innate immune system. This new opinion holds that amyloid-beta can play an antimicrobial peptide role. During microbial invasion, its original role is to protect neural tissue, but prolonged accumulation leads to chronic deposition and involvement in pathological processes. Evidence from in vitro experiments, animal models, and clinical studies indicates that amyloid-beta may possess antiviral and antibacterial properties, particularly against infections such as (herps simplex virus) HSV, (human immunodeficiency virus) HIV, and Porphyromonas gingivalis. However, excessive accumulation of amyloid beta triggers a neuroinflammatory cascade that impairs neuronal regeneration and cognitive function. Despite substantial research into Alzheimer's disease, current treatments have not yielded significant clinical benefits. Although monoclonal antibodies such as Aducanumab, Lecanemab, and Donanemab have been approved for marketing, their strict indications and high costs pose challenges for widespread promotion. The infection hypothesis of amyloid-beta has spurred clinical trials investigating vaccines targeting specific pathogens to assess their potential in preventing or treating Alzheimer's disease. This highlights the need for further exploring the multifaceted role of amyloid-beta in Alzheimer's disease. In addition, microbial infections can also trigger or regulate genetic and epigenetic factors, accelerating amyloid beta deposition. Among them, the apolipoprotein E epsilon 4 allele is the strongest genetic risk factor for Alzheimer's disease, as it exacerbates the accumulation of amyloid beta and promotes neuroinflammation. Strategies targeting epigenetic regulation may provide novel approaches to inhibit Alzheimer's disease pathology. This review also integrates various technologies such as genomics, proteomics, and metabolomics. This provides a broader system-level understanding of the risk gene loci, protein interaction networks, and metabolic changes associated with amyloid beta under the influence of microbial infections. Such techniques may lead to the identification of new molecular targets, the development of individualized treatment strategies, and the creation of early biomarkers for use in clinical research. In conclusion, this review suggests that amyloid-beta is not merely a pathological by-product but an environmentally responsive molecule with dual functions. A deeper understanding of the dynamic regulation of amyloid-beta, considering infection status and disease stage, can provide new directions for treatment strategies aimed at the prevention and treatment of Alzheimer's disease.}, }
@article {pmid41622474, year = {2026}, author = {Cui, Z and Li, G and Wei, S and Cheng, Q and Yu, Q and Zong, S and Zhang, P and Chen, H and Yu, S and Wu, S and Li, M and Lu, Z}, title = {Blood-based biomarkers and early diagnosis of Alzheimer's disease.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00759}, pmid = {41622474}, issn = {1673-5374}, abstract = {Alzheimer's disease is a common neurodegenerative disease characterized by progressive memory loss, cognitive decline, and behavioral changes. Blood-based biomarkers have recently gained significant attention due to their accessibility and cost-effectiveness. This review highlights the latest progress in multiple key areas of bloodbased biomarkers for Alzheimer's disease. For early diagnosis, blood-based biomarkers such as amyloid-β and phosphorylated tau can identify Alzheimer's disease even before clinical symptoms emerge. Dynamic changes in blood-based biomarkers, including p-tau217 and neurofilament light chain, reflect disease progression and correlate with cognitive decline, enabling continuous monitoring of Alzheimer's disease progression. Additionally, bloodbased biomarkers such as p-tau181 and glial fibrillary acidic protein aid in differential diagnosis by distinguishing Alzheimer's disease from other dementias such as frontotemporal dementia. Blood-based biomarkers related to nerve repair have opened up new avenues for tracking nerve regeneration and therapeutic response, especially brain-derived neurotrophic factor. Furthermore, advanced detection technologies such as single-molecule array and immunoprecipitation-mass spectrometry have significantly improved the sensitivity and specificity of bloodbased biomarkers, facilitating their clinical translation. In summary, blood-based biomarkers hold strong potential to improve early diagnosis, monitor progression, differential diagnosis, and evaluate therapies in Alzheimer's disease. This review provides a comprehensive and updated evaluation of the translational potential of bloodbased biomarkers, emphasizing their practical utility in clinical settings and offering insights into future directions for large-scale application. This review emphasizes the need to prioritize the allocation of scientific resources, expedite the transition of blood-based biomarkers to clinical implementation, and ultimately achieve precise treatment of Alzheimer's disease using these biomarkers.}, }
@article {pmid41622469, year = {2026}, author = {Xu, X and Khan, A and Xia, X and Zahid, A and Forsberg, E and Lu, W and Jiang, C and Cheng, X}, title = {Photonic biosensing and optogenetic technologies: Emerging therapeutic strategies in neurodegenerative diseases.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00711}, pmid = {41622469}, issn = {1673-5374}, abstract = {The rising burden of neurodegenerative diseases has exposed critical gaps in the development of diagnostic and therapeutic tools, particularly regarding their limited sensitivity, poor spatiotemporal resolution, and lack of treatment specificity. These shortcomings highlight the need for technologies that enable early disease detection, real-time monitoring of regenerative processes, and precise therapeutic interventions. This review focuses on recent advances in photonic biosensing and optogenetics, examining how these technologies are reshaping neural regeneration research and assessing their potential for clinical translation. Photonic biosensing platforms, including chemiluminescence, plasmonics, and fluorescencebased methods, now achieve ultrasensitive, multiplexed biomarker detection. These technologies can identify pathological biomarkers such as amyloid-beta, tau, and alphasynuclein at sub-picomolar concentrations, revealing molecular signatures years before symptom onset. Optogenetics provides unprecedented control over neural activity through light-sensitive proteins, offering millisecond temporal precision and cell-type specificity. Studies demonstrate that targeted optogenetic modulation can enhance synaptic plasticity, promote axonal regeneration, and restore functional connectivity. Preclinical models show memory restoration in Alzheimer's disease through hippocampal circuit reactivation, motor recovery in Parkinson's disease via basal ganglia stimulation, and movement restoration after spinal cord injury. Most notably, optogenetic therapy has achieved partial vision restoration in a blind patient with retinitis pigmentosa, marking a significant clinical milestone in humans. Three fundamental paradigm shifts characterize current progress in neural regeneration research. First, the field is transitioning from single-biomarker detection strategies to integrated multiparameter sensing platforms capable of simultaneously quantifying diverse molecular signatures, enabling a comprehensive assessment of disease states and regenerative processes. Second, static endpoint measurements are evolving toward dynamic real-time monitoring capabilities that capture temporal changes in cellular and molecular events during neural repair. Third, broad-spectrum pharmacological interventions are giving way to cell-type-specific neuromodulation strategies that selectively target distinct neuronal populations within affected circuits. Clinical translation faces substantial challenges that require systematic resolution. Biomarker standardization across diverse patient populations and validation through multicenter studies remain incomplete. Device miniaturization and optimization for chronic biocompatibility are essential for long-term implantation. Long-term safety assessments of optogenetic constructs, particularly regarding immune responses and potential genotoxicity, require rigorous clinical evaluation. Regulatory frameworks for these novel therapeutic modalities need further development. Despite these hurdles, continued technological innovation and interdisciplinary collaboration position photonic biosensing and optogenetics to deliver more precise diagnostic and therapeutic solutions for neurodegenerative diseases, potentially improving patient neurological outcomes and quality of life in the coming decade.}, }
@article {pmid41621577, year = {2026}, author = {Guo, H and Peng, X and Zhang, X and Ruganzu, JB and Wu, X and Zhao, M and Yang, P and Ji, S and Yang, W}, title = {Insulin-like growth factor-1 enhances β-amyloid protein clearance in HMC3 microglia via low-density lipoprotein receptor-related protein 1-mediated pathway.}, journal = {Experimental cell research}, volume = {}, number = {}, pages = {114920}, doi = {10.1016/j.yexcr.2026.114920}, pmid = {41621577}, issn = {1090-2422}, abstract = {β-amyloid protein (Aβ) deposition occurs years before cognitive symptoms appear and is considered one of the main causes underlying the pathogenic events that occur in Alzheimer's disease (AD). Mounting evidence suggests that the imbalance of Aβ production and clearance leads to the accumulation of Aβ and the subsequent formation of toxic Aβ aggregates. Aβ is internalized by microglia and transported to lysosomes for degradation, which is one of the main ways by which Aβ may be cleared from the brain. Insulin-like growth factor-1 (IGF-1) promotes clearance of Aβ in the brain by enhancing Aβ carrier proteins. Our previous study demonstrated that low-density lipoprotein receptor-related protein 1 (LRP1) mediates the internalization of Aβ1-42 and lysosomal trafficking in primary cortical neurons. However, whether IGF-1 enhances the clearance of Aβ in microglia through the LRP1-mediated pathway and its underlying mechanisms is incompletely understood. Here, we reported that knockdown of LRP1 expression significantly decreased the internalization of Aβ1-42 in HMC3 cells. Furthermore, pretreatment with IGF-1 significantly increased intracellular Aβ1-42, indicating IGF-1 enhances HMC3 cells uptake of extracellular Aβ1-42. Interestingly, the intracellular Aβ1-42 in LRP1-knockdown HMC3 cells was reduced after preincubation with IGF-1. Thus, it was indicated that LRP1 is essential for IGF-1-enhanced internalization of Aβ1-42 in HMC3 cells. Moreover, IGF-1 significantly inhibited the downregulation of PI3K, phospho-PI3K, Akt, and phospho-Akt induced by Aβ1-42. Importantly, treatment with LY294002, a PI3K inhibitor, significantly reduced the intracellular Aβ1-42 levels and decreased the expression of LRP1. These findings indicated that IGF-1 enhances the internalization of Aβ in a LRP1-dependent manner by activating the PI3K/Akt signaling pathway. Finally, we identified that IGF-1 promotes lysosomal proteolysis of Aβ1-42 by increasing cathepsin B (CTSB) and cathepsin D (CTSD) expression. Consequently, these results demonstrated that IGF-1 promotes the internalization and lysosomal degradation of Aβ by microglia, which is an effective approach to lowering brain Aβ levels, and it might be a promising therapeutic target for AD.}, }
@article {pmid41621469, year = {2026}, author = {Miller, D and Jordan, L and Lambert, S and Goodwin, AM and Sinvani, L and Perrin, A and Cheung, YK and Davidson, KW and Butler, MJ}, title = {Protocol for a single-arm, multi-component behavior change technique (BCT) intervention to develop a walking habit among caregivers for persons with Alzheimer's disease and related dementias (ADRD).}, journal = {Contemporary clinical trials}, volume = {}, number = {}, pages = {108248}, doi = {10.1016/j.cct.2026.108248}, pmid = {41621469}, issn = {1559-2030}, abstract = {Even low to moderate physical activity is critical in improving and maintaining physical health and well-being. Caregivers of people living with Alzheimer's disease and related dementias (ADRD) are a burdened population and, as such, can experience challenges with managing even modest increases in physical activity while caring for others. While some interventions have been proposed to increase physical activity, many fail to consider the unique needs of caregivers of people with ADRD. The purpose of this 12-week decentralized behavioral trial is to test the efficacy of a multi-component, personalized text-message delivered BCT intervention to encourage the formation of a daily walking habit among caregivers of persons with ADRD assessed by Fitbit activity trackers via the key mechanism of behavior change (MoBC) of behavioral automaticity. Formation of a daily walking habit will be defined as attainment of walking 1000 or more additional steps during the same one-hour period on 7 consecutive days as set up in a personalized walking plan. We will also evaluate the association of habit formation attainment with changes in behavioral automaticity, association between longitudinal behavioral automaticity and habit formation attainment over time, and the heterogeneity of treatment effects between participants. Results will advance science about behavioral habit formation among caregivers for persons with ADRD and determine whether behavioral automaticity acts as the primary MoBC for the effect on this BCT intervention on daily habitual walking. This trial is registered on www.ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT06803797); NCT #: NCT06803797.}, }
@article {pmid41621181, year = {2026}, author = {Spinelli, R and Sanchis, I and de Orellana, M and Humpola, MV and Rietmann, Á and Siano, ÁS}, title = {A nature-inspired peptide from the Boana cordobae frog as a potent and reversible AChE inhibitor with anti-amyloid and neuroprotective activities.}, journal = {Bioorganic chemistry}, volume = {171}, number = {}, pages = {109566}, doi = {10.1016/j.bioorg.2026.109566}, pmid = {41621181}, issn = {1090-2120}, abstract = {Alzheimer's disease (AD) is a multifactorial and progressive neurodegenerative disorder for which no effective treatment currently exists. The development of multitarget-directed ligands (MTDLs) capable of simultaneously modulating several pathological pathways represents a rational strategy to address its complex etiology. In this study, we report the isolation, chemical synthesis, and functional characterization of BcI-4, a short cationic peptide identified from the skin secretion of the Argentinean frog Boana cordobae. The peptide exhibited potent and reversible inhibitory activity against acetylcholinesterase (AChE), with IC50 values of 1.10 and 0.9 μM for recombinant human and Electrophorus electricus AChE, respectively, acting through a non-competitive mechanism involving the peripheral anionic site (PAS). BcI-4 also inhibited AChE-induced β-amyloid (Aβ) aggregation, showed modest monoamine oxidase B (MAO-B) inhibition, and displayed both antioxidant and metal-chelating activities, including inhibition of lipid peroxidation. The peptide retained the multifuctional pharmacological profile previously observed for the crude extract of B. cordobae, with significantly enhanced potency and selectivity toward AChE. Moreover, BcI-4 was non-toxic in vitro (hemolysis and HeLa cell assays) and in vivo (Artemia salina test) even at the highest concentrations tested. Altogether, these findings position BcI-4 as a nature-inspired multitarget peptide with neuroprotective potential, combining reversible AChE inhibition, anti-amyloid, antioxidant, and MAO-B modulatory activities. BcI-4 represents a promising lead compound for the development of peptide-based therapeutics against AD.}, }
@article {pmid41620439, year = {2026}, author = {Gong, Q and Fu, X and Feng, D and Rao, S and Pütz, B and Müller-Myhsok, B and Wei, L and Shen, C and Zhang, Y and Xu, L and Chen, W and Yang, K and Chen, D and Lv, X and Yan, Z and Luo, D and Wei, P and Jiang, H and Chen, W}, title = {Randomized, double-blind, sham-controlled pilot trial of theta-band transcranial alternating current stimulation during cognitive training in mild Alzheimer's disease.}, journal = {Translational psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41398-026-03822-z}, pmid = {41620439}, issn = {2158-3188}, support = {82071181//National Natural Science Foundation of China (National Science Foundation of China)/ ; 82101581//National Natural Science Foundation of China (National Science Foundation of China)/ ; 82371453//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, abstract = {Cognitive deficits are a hallmark of Alzheimer's disease (AD), and effective treatments remain elusive. Transcranial alternating current stimulation (tACS), a non-invasive technique, has shown potential in improving cognitive function across various populations, but further research is needed to investigate its efficacy in AD. In a randomized, double-blind, sham-controlled pilot trial, 36 mild AD patients received active or sham theta-tACS (8 Hz, 1.6 mA, 20-min daily) during n-back task for two weeks, followed by a 10-week follow-up. Cognitive assessments and resting-state EEG were analyzed at baseline, after-treatment, and follow-up. The results showed that the active group demonstrated significant cognitive improvements after treatment (MMSE: t (15) =-3.273, p = 0.005, Cohen's d = 0.82), particularly in short-term memory (MMSE-recall: Z = -2.11, p = 0.035, r = 0.53), with maintained benefits after 10 weeks. In contrast, the sham group exhibited long-term cognitive decline (MMSE: t (4) = 3.586, p = 0.023, Cohen's d = -1.60). EEG analysis revealed reduced gamma power (t (23) = 2.689, p = 0.013, Cohen's d = 1.077) and theta connectivity in active group, particularly in the frontotemporal regions (F4/F7: t (23) = 2.467, p = 0.021, Cohen's d = 0.988; F4/T3: t (23) = 2.465, p = 0.022, Cohen's d = 0.987), which was correlated with cognitive improvements (R = -0.57, p = 0.043). In conclusion, tACS combining cognitive training may offer cognitive benefits in mild AD by modulating neural activity, though further studies are needed to clarify its mechanisms.}, }
@article {pmid41620006, year = {2026}, author = {Ma, S and Wang, Q and Yang, W and Zhang, S and Liu, F and Guan, F and Liu, H and Li, D}, title = {4,4'-dimethoxychalcone exerts neuroprotective effects in Alzheimer's disease mice by activating the Keap1/Nrf2 signaling pathway.}, journal = {European journal of pharmacology}, volume = {}, number = {}, pages = {178617}, doi = {10.1016/j.ejphar.2026.178617}, pmid = {41620006}, issn = {1879-0712}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disease with no effective therapies. 4,4'-Dimethoxychalcone (DMC) is a natural chalcone extracted from Angelica keiskei (Miq.) Koidz and Angelica sinensis (Oliv.) Diels, which could promote autophagy and prolong lifespan. However, the neuroprotective effects and mechanisms of DMC on AD mice have not been reported. In this study, we proved that DMC treatment significantly mitigated cognitive impairment and depressive behavior, ameliorated blood-brain barrier permeability and amyloid β pathology, and inhibited p-Tau expression in 5×FAD mice. Also, DMC suppressed glial cell activation, enhanced neurogenesis, and decreased oxidative stress in vivo and in vitro by activating the Kelch-like ECH-associated protein1 (Keap1)/nuclear factor-erythrocyte 2-associated factor 2 (Nrf2) signaling pathway. However, Brusatol, an inhibitor of the Keap1/Nrf2 signalling, partly attenuated the neuroprotective effects of DMC on lipopolysaccharide-induced HT22 cells injury and 5×FAD mice. In conclusion, DMC exhibited neuroprotective effects on 5×FAD mice via the activation of Keap1/Nrf2 signalling pathway. Thus, DMC may be a promising therapeutic drug for AD by activating the Keap1/Nrf2 signalling pathway.}, }
@article {pmid41619409, year = {2026}, author = {Vogelgsang, J and Beck, C and Patrick, R and Vahia, I and Weisenbach, S}, title = {Preclinical amyloid pathology is associated with anxiety but not depression in cognitively normal older adults: Evidence for differential neuropsychiatric pathways.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {4}, pages = {100497}, doi = {10.1016/j.tjpad.2026.100497}, pmid = {41619409}, issn = {2426-0266}, abstract = {INTRODUCTION: Neuropsychiatric symptoms may represent early Alzheimer's disease (AD) manifestations, but their relationship with amyloid pathology in cognitively unimpaired individuals remains unclear.
METHODS: We analyzed 4,492 cognitively unimpaired adults (aged 65-85) from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Study. Participants completed amyloid-PET imaging and assessments of anxiety, depression, memory complaints, and AD concerns.
RESULTS: 1,231 participants (27.4%) were amyloid-positive. While anxiety and depression scores remained within normal ranges, amyloid-positive participants reported higher memory complaints (p = 0.008) and AD concerns (p < 0.001) before status disclosure. Regression analyses showed amyloid burden associated with anxiety (β = 0.04, standardized, p = 0.003) but not depression (p = 0.68). Mediation analyses revealed anxiety was directly associated with amyloid, while depression was mediated through subjective cognitive concerns.
DISCUSSION: Preclinical amyloid pathology directly associates with subclinical anxiety but only indirectly with depression through subjective stress, suggesting distinct neuropsychiatric pathways in early AD that could inform detection strategies.}, }
@article {pmid41619339, year = {2026}, author = {Shaaban, D and Seerley, A and Crew, L and Kaylor, C and McElroy, S and Guter, E and Pounder, J and Panter, AG}, title = {The impact of formic acid treatment on brain tissues for prion inactivation.}, journal = {Acta histochemica}, volume = {128}, number = {2}, pages = {152324}, doi = {10.1016/j.acthis.2026.152324}, pmid = {41619339}, issn = {1618-0372}, abstract = {There are significant risks in clinical, diagnostic, and research settings to those who investigate prion diseases, due to the difficult nature of inactivating prion proteins with standard decontamination methods. Formic acid treatment has been shown to be effective for decontaminating infectious prions and commonly used in biosafety practice to prevent occupational exposure. However, the impact of formic acid protocols on the morphology of tissue samples has not been adequately documented. The goal of this study is to examine morphologic effects of formic acid treatment on central nervous system tissue, using mouse model brain hemisphere tissues that exhibit varying degrees of neurodegeneration as a model. This study included normal, non-diseased wild-type tissues and a 5xFAD model, which recapitulates aspects of Alzheimer's Disease (AD). A model exhibiting Chronic Wasting Disease (CWD), a prion disease of deer and elk, was also used to analyze the effects of formic acid on tissues with spongiform changes. Tissues from both formic acid and untreated control treatment groups were embedded in paraffin, sectioned, stained, and imaged microscopically. Anatomical regions were analyzed and evaluated quantitatively to determine the width, area, and structural integrity of the tissue between treatment groups. Our findings demonstrated that while formic acid has been previously reported to effectively inactivate prions, it compromised the morphology of mouse brain tissues. Furthermore, the effects of formic acid were not distributed equally between regions of the brain. Age did not play a role in the morphologic changes seen in the formic acid treatment group. Interestingly, the presence of neurodegeneration in the tissues did not appear to exacerbate the effects of morphological changes post-formic acid treatment. These results emphasize the need to explore alternative prion inactivation methods that ensure the safety and reliability of handling prion-infected tissues without compromising the integrity of tissues.}, }
@article {pmid41618768, year = {2026}, author = {Golden, JC and Murphy, KS and Tampi, RR}, title = {From schizophrenia to dementia: Is Cobenfy a potential treatment for behavioral and psychological symptoms of dementia?.}, journal = {The Journal of international medical research}, volume = {54}, number = {1}, pages = {3000605261417092}, doi = {10.1177/03000605261417092}, pmid = {41618768}, issn = {1473-2300}, mesh = {Humans ; *Schizophrenia/drug therapy ; *Dementia/drug therapy/psychology ; *Nortropanes/therapeutic use ; *Antipsychotic Agents/therapeutic use ; Drug Combinations ; *Melatonin/therapeutic use/analogs & derivatives ; }, abstract = {Behavioral and psychological symptoms of dementia significantly impact patient outcomes, caregiver burden, and healthcare costs. Current pharmacologic treatments are limited by efficacy and safety concerns. Cobenfy, a novel combination of xanomeline and trospium chloride, has shown efficacy in schizophrenia and presents a promising alternative for treating behavioral and psychological symptoms of dementia. This editorial explores the potential role of Cobenfy in the management of behavioral and psychological symptoms of dementia. To date, no trials of Cobenfy for behavioral and psychological symptoms of dementia have been completed; however, multiple trials are underway to investigate this medication for psychosis and agitation in Alzheimer's disease. Cobenfy may offer a safer pharmacologic option for behavioral and psychological symptoms of dementia compared with existing treatments. Further research in older adult populations is warranted.}, }
@article {pmid41618467, year = {2026}, author = {Ziaei, A and Kargar, M and Shirvani-Farsani, Z and MehrabMohseni, M}, title = {Emerging roles of circular RNAs and enhancer RNAs: new insights into the development and management of neurodegenerative disorders.}, journal = {Biomarker research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40364-025-00886-9}, pmid = {41618467}, issn = {2050-7771}, abstract = {Neurodegenerative disorders involve the gradual breakdown of neurons, leading to problems with thinking, movement, and mental health. More evidence is emerging about the important roles of non-coding RNAs (ncRNAs). CircRNAs are a type of ncRNA formed through back-splicing and are widely present in the mammalian brain. They play crucial roles in brain development and mainly regulate gene expression and post-transcriptional processes by acting as molecular sponges for miRNAs and RBPs. eRNAs are another class of ncRNAs. They are produced from enhancer regions of the genome and act as vital regulatory elements in gene expression. There is increasing evidence that abnormal levels of circRNAs and eRNAs can be found in many human diseases, including neurodegenerative conditions. This suggests they could have important clinical uses in these illnesses. The unique stability and disease-specific expression patterns of circRNAs and eRNAs in biofluids like blood and cerebrospinal fluid make them strong candidates for noninvasive biomarkers in neurodegenerative disorders, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and multiple sclerosis. Additionally, their roles in crucial pathological pathways open new opportunities for treatment. This includes strategies that target RNA, such as antisense oligonucleotides or miRNA sponges, to influence gene expression networks. This review gathers recent findings to propose that circRNAs and eRNAs might introduce a new layer of regulation in neurodegeneration, providing exciting possibilities for real-world applications.}, }
@article {pmid41617942, year = {2026}, author = {Ran, Z and Yang, LL and Zhou, LY and Wen, T and Wang, WJ and Chen, L}, title = {Research trends and hotspots of nanomaterials in Alzheimer's disease: bibliometric analysis.}, journal = {Discover nano}, volume = {21}, number = {1}, pages = {20}, pmid = {41617942}, issn = {2731-9229}, support = {82204761//National Natural Science Foundation of China/ ; 2024SZY120//the Deyang Science and Technology Bureau/ ; }, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a progressive neurodegenerative disorder with limited clinical treatment options. Nanoparticle technology offers promising new strategies for innovative diagnosis and therapy of AD. However, the rapid development of this field has not been accompanied by a systematic bibliometric analysis. This study applies bibliometric methods to comprehensively evaluate the development trends and prospects of nanoparticle applications in AD research.
MATERIALS AND METHODS: Publications related to nanomaterials in AD were retrieved from the Web of Science Core Collection. Visualization and analysis were conducted using VOSviewer, CiteSpace, and the Bibliometrix package in R to identify research hotspots in the field.
RESULTS: A total of 2837 publications were included, involving 92 countries/regions, 2953 institutions, and 13,294 authors. China, the Chinese Academy of Sciences, and Xiao-Gang Qu were the most productive country, institution, and author, respectively. The Journal of Controlled Release was the most influential. Among them, Saraiva et al. (J Control Release 235:34-47, 2016) ranked first with 1069 citations, and their research highlights the great potential of nanoparticle drug delivery technology to cross the blood-brain barrier. Emerging keyword trends indicate a shift in research focus toward nasal delivery, extracellular vesicles, graphene quantum dots for diagnostics, and nanostructured lipid carriers for therapy.
CONCLUSION: Nanomaterial-based AD research is expanding rapidly. Current focus involves developing targeted nanoparticle systems to overcome the blood-brain barrier, mitigate Aβ pathology, and enable early diagnosis. Future work should prioritize mechanistic studies and clinical trials to translate potential into practical applications.}, }
@article {pmid41616952, year = {2026}, author = {Denver, P and Duffy, A and Kennedy, RT and Gault, VA and McClean, PL}, title = {Therapeutic efficacy of synthetic analogues of gut hormones in a mouse model of Alzheimer's disease.}, journal = {Neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.neuroscience.2026.01.038}, pmid = {41616952}, issn = {1873-7544}, abstract = {Alzheimer's disease (AD) is a neurodegenerative condition characterised by amyloid-β pathology, neuroinflammation, synaptic dysfunction and cognitive decline. Few pharmacological interventions are available, offering only symptomatic relief, and approval for a number of anti-amyloid biologics is limited, with concerns about safety, cost and efficacy. Here we investigated the effects of 8-10 weeks treatment with liraglutide, NAcGIP[Lys(37)PAL] and Xenin-25[Lys(13)PAL], long-lasting analogues of gut hormones glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and xenin-25, respectively, in the APP/PS1 mouse model of AD. Cognitive function was measured in novel object recognition (NOR) and Morris water maze (MWM) tasks and amyloid burden, gliosis, synapse density and neurogenesis were assessed in brains of APP/PS1 and wild-type mice. AD-associated gene expression analysis was performed to identify potential pathways targeted by treatment. Liraglutide and NAcGIP[Lys(37)PAL] improved cognitive performance in APP/PS1 mice and, along with Xenin-25[Lys(13)PAL], reduced amyloid-β burden in the brain. Liraglutide ameliorated gliosis and all three treatments restored synaptophysin levels. Additionally, Xenin-25[Lys(13)PAL] increased neurogenesis in the dentate gyrus. Numerous AD-associated genes were altered in the brain following treatments. Notably, Serpina3c was upregulated in brains of APP/PS1 mice treated with liraglutide, NAcGIP[Lys(37)PAL] and Xenin-25[Lys(13)PAL], while Map2, Adam9, Lrp8, Casp3, Abca1 and App were downregulated. These results underscore the neuroprotective effects of liraglutide and suggest that NAcGIP[Lys(37)PAL] and Xenin-25[Lys(13)PAL] possess neuroprotective properties. Further investigation of the precise nature of these effects may support development of multi-target therapeutics based on combinations of gut hormone analogues.}, }
@article {pmid41616931, year = {2026}, author = {Licciardo, D and Matti, C and Benelli, A and Isella, V and Appollonio, I and Santarnecchi, E}, title = {Gray matter atrophy and structural connectivity in Posterior Cortical Atrophy: a voxel-based meta-analysis.}, journal = {Neuroscience and biobehavioral reviews}, volume = {}, number = {}, pages = {106554}, doi = {10.1016/j.neubiorev.2026.106554}, pmid = {41616931}, issn = {1873-7528}, abstract = {Posterior Cortical Atrophy (PCA) is a neurodegenerative syndrome most commonly associated with Alzheimer's disease, characterized by progressive visuospatial and visuoperceptual decline. Although voxel-based morphometry studies have described gray matter loss in PCA, a comprehensive and updated coordinate-based meta-analysis is still missing, and associated structural connectivity alterations remain unclear. We conducted a systematic review and meta-analysis of whole-brain voxel-based morphometry studies comparing patients with PCA and healthy controls (PROSPERO ID: CRD420251010673). Analyses were performed using Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) with family-wise error correction, and meta-regressions assessed the impact of demographic and clinical variables. To investigate structural connectivity, deterministic tractography was carried out on a normative diffusion MRI template, using meta-analytic gray matter clusters as seeds. Eighteen studies were included (339 PCA; 577 healthy controls). The meta-analysis revealed consistent bilateral gray matter atrophy in the lateral occipital cortex, inferior parietal lobule, precuneus, and ventral occipitotemporal regions. Meta-regression highlighted an interaction between age and disease duration, associated with atrophy in the left superior temporal gyrus and right thalamus. Tractography demonstrated that affected clusters were embedded within major long-range pathways, including the superior and inferior longitudinal fasciculi, vertical occipital fasciculi, and parietal aslant tract. Regression-derived clusters additionally mapped onto the arcuate fasciculus, frontal aslant tract, and superior thalamic radiations. This is the first systematic review and voxel-based meta-analysis of PCA conducted after the establishment of consensus diagnostic criteria, providing a statistically robust characterization of gray and white matter alterations and identifying potential imaging biomarkers for diagnosis and treatment.}, }
@article {pmid41616387, year = {2026}, author = {Upadhayay, S}, title = {Unrevealing role of TLRs/NLRP receptors in halting Alzheimer's neuroinflammation: Current progress and existing therapies.}, journal = {International immunopharmacology}, volume = {173}, number = {}, pages = {116285}, doi = {10.1016/j.intimp.2026.116285}, pmid = {41616387}, issn = {1878-1705}, abstract = {Alzheimer's disease (AD) is a multifactorial condition caused by genetic, environmental, metabolic, and immunological factors. These pathological alterations trigger oxidative stress, excitotoxicity, and neuroinflammation, leading to the degeneration of cholinergic neurons in the brain. Several studies have found that persistent neuroinflammation plays a key role in AD progression; still, no curative medicine is available to halt the disease progression. For this reason, exploring new target-based therapy is necessary for AD treatment. The current review aims to understand the inflammatory processes associated with the activation of toll-like receptors (TLRs) and Inflammasomes (NLRPs) in AD progression. Additionally, the impact of TLR and NLRP inhibitors on improving the condition of AD patients. As multiple studies have confirmed, TLR/NLRP activation stimulates the infiltration of inflammatory cytokines, which enhances AD severity. Similarly, various studies have shown that inhibition of the TLR/NLRP signaling axis reduces oxidative stress, inflammatory cytokines, and apoptosis, thereby demonstrating a neuroprotective effect. This review examines the roles of TLR and NLRP pathways in AD progression, focusing on preclinical and clinical evidence supporting the neuroprotective benefits of targeting these pathways in AD. This review extensively examined the molecular mechanisms of TLR/NLRP inhibitors, highlighting recent discoveries that could be used to initiate clinical trials in patients with Alzheimer's.}, }
@article {pmid41615932, year = {2026}, author = {Hedaya, RJ}, title = {Iterative Dual-AI Consultation for Error Detection in Clinical Medicine: A Case Study Demonstrating Convergent Validity Through Cross-Validation of Large Language Models.}, journal = {Alternative therapies in health and medicine}, volume = {32}, number = {1}, pages = {}, pmid = {41615932}, issn = {1078-6791}, mesh = {Humans ; Female ; Middle Aged ; Magnetic Resonance Imaging ; *Artificial Intelligence ; Reproducibility of Results ; *Alzheimer Disease/diagnostic imaging/therapy ; *Neuroimaging/methods ; Brain/diagnostic imaging ; Large Language Models ; }, abstract = {BACKGROUND: Large language models have demonstrated remarkable promise in medical data analysis, but serious concerns about reliability and error propagation persist. This study reports a novel approach of using iterative consultation between two independent AI systems to analyze complex clinical neuroimaging data.
METHODS: A 63-year-old woman with a family history of Alzheimer's disease and Parkinsonism underwent brain MRI volumetry showing apparent 10-13% increases in gray matter volume following intensive multimodal interventions (Functional Medicine and HYLANE™ treatment). Despite clinical improvement, objective cognitive testing declined during the same period. Two AI systems (Claude and Perplexity) independently analyzed neuroimaging reports, cognitive testing, and clinical data over 5-7 iterative cycles, systematically challenging each other's interpretations.
RESULTS: Initial analyses diverged substantially (45-60 percentage-point difference in probability estimates). Through autonomous error detection and cross-validation, systems converged to a consensus (<10 percentage-point difference). Critical autonomous discoveries included: (1) 3.5% increase in total intracranial volume (physiologically impossible, indicating measurement artifact), (2) 11-month temporal gap between cognitive testing and MRI, and (3) literature review revealing hyperbaric oxygen therapy produces maximum 1-2% volumetric changes. Final consensus: modest real improvements (2-4%) embedded within measurement artifact (3-5%).
CONCLUSIONS: Dual-AI iterative consultation achieved autonomous error detection, literature integration, and convergent validity without requiring human identification of critical flaws. This approach may enhance reliability in complex clinical decision-making while maintaining appropriate physician oversight.
KEYWORDS: artificial intelligence, clinical decision support, neuroimaging, automated volumetry, large language models, convergent validity, error detection.}, }
@article {pmid41614916, year = {2026}, author = {Zhao, X and Yin, J and Du, B and Fan, W and Chen, Y and Yang, Y and Fang, F and Guan, J}, title = {Behavioral, Histopathological, and Biochemical Implications of Aloe Emodin in Copper-Aβ-Induced Alzheimer's Disease-like Model Rats.}, journal = {Current issues in molecular biology}, volume = {48}, number = {1}, pages = {}, doi = {10.3390/cimb48010086}, pmid = {41614916}, issn = {1467-3045}, support = {82074001//National Natural Science Foundation of China/ ; zyyzdxk-2023265//the State Administration of Traditional Chinese Medicine High-level TCM key discipline Con-struction Project/ ; }, abstract = {Simultaneously inhibiting beta-amyloid protein (Aβ) aggregation and reducing metal ion overload in the brain is a promising strategy for treating Alzheimer's disease (AD). Aloe emodin (AE) is one of the major components of the traditional Chinese medicine rhubarb. Based on its reported pharmacological effects and its structural affinity for metal ions, this study aims to explore the potential of AE in improving AD pathology. Through the injection of Aβ or copper-Aβ complex in the bilateral hippocampus of rats, we constructed two kinds of nontransgenic animal models. Behavioral tests were used to evaluate cognitive impairment, and the effects of AE on neuronal damage and Aβ deposition were measured via Nissl staining and immunohistochemistry. Furthermore, we detected copper content in the serum and brain tissues as well as some biochemical indexes of Aβ cascade pathology in the brain tissues of model rats to explore the mechanism of action. AE treatment decreased copper accumulation and regulated Aβ metabolism in the brain of model rats, thereby improving Aβ deposition, memory impairment, hippocampal nerve cell damage, and related biochemical indicators. AE ameliorated the AD pathology of the model rats by targeting copper-induced Aβ toxicity, revealing a mechanism of action by which AE may exhibit good clinical efficacy in treating AD.}, }
@article {pmid41614554, year = {2026}, author = {Büyükgök, D and Ince Guliyev, E and Bilgiç, B}, title = {Apathy in dementia: pharmacological and nonpharmacological treatment strategies.}, journal = {Current opinion in psychiatry}, volume = {39}, number = {2}, pages = {160-167}, doi = {10.1097/YCO.0000000000001054}, pmid = {41614554}, issn = {1473-6578}, mesh = {Humans ; *Apathy/drug effects ; *Dementia/therapy/drug therapy/psychology ; Methylphenidate/therapeutic use ; Alzheimer Disease/therapy/psychology ; Central Nervous System Stimulants/therapeutic use ; Cholinesterase Inhibitors/therapeutic use ; }, abstract = {PURPOSE OF REVIEW: Apathy is one of the most prevalent and disabling symptoms of neurodegenerative disorders, yet targeted treatments remain poorly defined. In recent years, growing interest in its conceptualization and management has led to an increasing number of randomized controlled trials (RCTs) and meta-analyses addressing both pharmacological and nonpharmacological interventions.
RECENT FINDINGS: Among pharmacological approaches, methylphenidate presented with early reductions in apathy with an acceptable safety profile in multiple RCTs, including a large 6-month trial. However, the sustainability of effect has not been fully achieved. Other stimulants, bupropion, and conventional Alzheimer's medications such as cholinesterase inhibitors and memantine show inconsistent or limited effects. Antidepressants and antipsychotics are not recommended for apathy, although selected agents may benefit comorbid conditions. As for the nonpharmacological interventions, evidence supports the benefits of physical exercise and the emerging promise of neuromodulation. Technology-based interventions are feasible but show variable efficacy.
SUMMARY: Methylphenidate currently represents the most studied pharmacological agent for apathy in Alzheimer's disease (AD). However, optimal management is likely to combine pharmacological and psychosocial strategies tailored to the patient context. Future studies should include pragmatic trials with apathy as a primary endpoint, long-term follow-up, and expansion beyond AD.}, }
@article {pmid41613766, year = {2026}, author = {McMackin, R and Price, S and Slator, GR and Hardiman, O and Kelly, JA}, title = {JAK4D, a first-in-class thyrotropin-releasing hormone analogue, reverses scopolamine-induced memory deficits.}, journal = {Brain communications}, volume = {8}, number = {1}, pages = {fcag006}, pmid = {41613766}, issn = {2632-1297}, abstract = {There is a pressing unmet clinical and health economic need for effective drugs to treat cognitive impairment that occurs in neurodegenerative diseases. JAK4D is a first-in-class thyrotropin releasing hormone (TRH) analogue that overcomes the pharmacological limitations of thyrotropin releasing hormone and enables delivery of the long-recognized multifactorial neurotherapeutic actions of thyrotropin releasing hormone without inducing endocrine side effects. JAK4D is demonstrated to be neuroprotective and significantly reduce excitotoxic-induced hippocampal-dependent memory deficits in rat. In the present study, we used the scopolamine challenge test coupled with the novel object recognition test to evaluate the effect of JAK4D on scopolamine-induced recognition memory deficits in the male, Lister-Hooded rat. Scopolamine administration has been shown by others to mimic cholinergic and brain network disruption in neurodegenerative diseases. Although the scopolamine challenge test does not fully replicate the pathophysiology of neurodegenerative disease, such as Alzheimer's disease, it is a well-recognized acute pharmacological model for assessing the ability of pharmacological interventions to counteract memory deficits relevant to neurodegenerative diseases. In this model of cholinergic dysfunction, we also assessed the effects of thyrotropin releasing hormone, taltirelin (a degradation-stabilized thyrotropin releasing hormone analogue) and the acetylcholinesterase inhibitor, donepezil, as a positive reference compound. The discrimination (d2) index was used as the primary measure to assess the effect of treatment on scopolamine-induced performance deficit in the novel object recognition test. d2 is a standard well-recognized measure of discrimination between a novel and familiar object in the novel object recognition test, which advantageously takes into account individual differences in exploration levels. Across all investigations, JAK4D (1 mg/kg i.p.) significantly reversed scopolamine-induced recognition memory impairment (P = 0.0274, P = 0.0002, P < 0.0001). The degree of reversal of scopolamine-induced memory deficits by JAK4D (1 mg/kg i.p.) was indistinguishable from that observed for donepezil (0.1 mg/kg p.o.) (P = 0.026). Subcutaneously administered JAK4D (0.3-10.0 mg/kg) also significantly reversed this deficit (P = 0.0432-0.0021). Furthermore, similar pro-cognitive effects were exerted by thyrotropin releasing hormone (5 mg/kg i.p., P = 0.0055) and taltirelin (10 mg/kg p.o., P = 0.0002). Together, these results underscore the relevance of the central thyrotropin releasing hormone signalling system for the treatment of memory impairment. Data from the current study provide further evidence in support of the potential of JAK4D as a novel therapeutic for cognitive deficits in neurodegenerative diseases.}, }
@article {pmid41613657, year = {2025}, author = {Arai, H and Yamamoto, H and Akiba, Y and Aiba, S and Arai, R}, title = {Amyloid Positron Emission Tomography Imaging at the Onset of Amyloid-Related Abnormalities With Edema in an Alzheimer's Disease Patient.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e100276}, pmid = {41613657}, issn = {2168-8184}, abstract = {Amyloid-related imaging abnormalities with edema (ARIA-E) are known adverse events of anti-amyloid monoclonal antibody therapy for Alzheimer's disease (AD), but to our knowledge, amyloid positron emission tomography (PET) captured exactly at the moment of ARIA-E onset has not previously been reported. We report an 85-year-old woman with AD who received anti-amyloid antibody therapy for approximately one year. As part of routine post-treatment evaluation, a second amyloid PET scan obtained 16 days after her final infusion unexpectedly revealed asymptomatic ARIA-E when followed immediately by magnetic resonance imaging (MRI). Compared with the baseline, the follow-up PET showed a marked overall reduction in cortical amyloid burden, including near-complete loss of tracer uptake in the region corresponding to ARIA-E, while the adjacent white matter exhibited reduced, non-specific uptake likely related to edema. This unique, same-day PET-MRI pairing at the moment of ARIA-E detection highlights dynamic regional changes in amyloid signal during treatment and emphasizes the value of continued neuroimaging surveillance even in asymptomatic patients.}, }
@article {pmid41612173, year = {2026}, author = {Yu, L and Zhao, M and Zhang, W and Lv, Z and Zhao, K and Li, H and Qi, Y and Peng, X and Zheng, Z and Zhang, W}, title = {Precise Aβ clearance and antioxidant therapy in Alzheimer's disease via photoacoustic imaging-guided palladium hydride nanosheet-mediated photothermal treatment.}, journal = {BMC neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12868-025-00994-0}, pmid = {41612173}, issn = {1471-2202}, }
@article {pmid41611638, year = {2026}, author = {Tang, C and Yang, J and Lei, X and Zhang, M and Chen, Y and Peng, X and He, D}, title = {Association between brain volume and depression in Alzheimer's disease: Neuroimaging insights.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71120}, doi = {10.1002/alz.71120}, pmid = {41611638}, issn = {1552-5279}, support = {U24AG072122//National Institute on Aging and National Institutes of Health/ ; P30AG062429/AG/NIA NIH HHS/United States ; P30AG066468/AG/NIA NIH HHS/United States ; P30AG062421/AG/NIA NIH HHS/United States ; P30AG066509/AG/NIA NIH HHS/United States ; P30AG066514/AG/NIA NIH HHS/United States ; P30AG066530/AG/NIA NIH HHS/United States ; P30AG066507/AG/NIA NIH HHS/United States ; P30AG066444/AG/NIA NIH HHS/United States ; P30AG066518/AG/NIA NIH HHS/United States ; P30AG066512/AG/NIA NIH HHS/United States ; P30AG066462/AG/NIA NIH HHS/United States ; P30AG072979/AG/NIA NIH HHS/United States ; P30AG072972/AG/NIA NIH HHS/United States ; P30AG072976/AG/NIA NIH HHS/United States ; P30AG072975/AG/NIA NIH HHS/United States ; P30AG072978/AG/NIA NIH HHS/United States ; P30AG072977/AG/NIA NIH HHS/United States ; P30AG066519/AG/NIA NIH HHS/United States ; P30AG062677/AG/NIA NIH HHS/United States ; P30AG079280/AG/NIA NIH HHS/United States ; P30AG062422/AG/NIA NIH HHS/United States ; P30AG066511/AG/NIA NIH HHS/United States ; P30AG072946/AG/NIA NIH HHS/United States ; P30AG062715/AG/NIA NIH HHS/United States ; P30AG072973/AG/NIA NIH HHS/United States ; P30AG066506/AG/NIA NIH HHS/United States ; P30AG066508/AG/NIA NIH HHS/United States ; P30AG066515/AG/NIA NIH HHS/United States ; P30AG072947/AG/NIA NIH HHS/United States ; P30AG072931/AG/NIA NIH HHS/United States ; P30AG066546/AG/NIA NIH HHS/United States ; P20AG068024/AG/NIA NIH HHS/United States ; P20AG068053/AG/NIA NIH HHS/United States ; P20AG068077/AG/NIA NIH HHS/United States ; P20AG068082/AG/NIA NIH HHS/United States ; P30AG072958/AG/NIA NIH HHS/United States ; P30AG072959/AG/NIA NIH HHS/United States ; P30AG072980//Arizona Alzheimer's Center/ ; R01AG069453//Arizona Alzheimer's Center/ ; P30AG019610//Arizona Alzheimer's Center/ ; //and the State of Arizona which provided additional funding supporting our center/ ; P30AG013846//Boston University/ ; P30AG062428//Clevel and ADRC/ ; //Clevel and Clinic/ ; P20AG068053//Las Vegas/ ; P50AG008702//Columbia/ ; P30AG072958//Duke/UNCADRC/ ; P30AG066511//Emory University/ ; R01AG19771//Indiana University/ ; P30AG10133//Indiana University/ ; P30AG072976//Indiana University/ ; R01AG061788//Indiana University/ ; R01AG053993//Indiana University/ ; U01AG057195//Indiana University/ ; U19AG063911//Indiana University/ ; //and the Indiana University Department of Radiology and Imaging Sciences/ ; P30AG066507//Johns Hopkins/ ; P50AG016574//Mayo Clinic/ ; P30AG066514//Mount Sinai/ ; R01AG054110//Mount Sinai/ ; R01AG053509//Mount Sinai/ ; P30AG066512-01S2//New York University/ ; R01AG056031//New York University/ ; R01AG056531//New York University/ ; P30AG013854//North western University/ ; R01AG045571//North western University/ ; R56AG045571//North western University/ ; R01AG067781//North western University/ ; U19AG073153//North western University/ ; R01DC008552//North western University/ ; R01AG077444//North western University/ ; R01NS075075//North western University/ ; R01AG056258//North western University/ ; P30AG008017//Oregon Health and Science University/ ; R56AG074321//Oregon Health and Science University/ ; P30AG010161//Rush University/ ; P30AG066515//Stanford/ ; P50AG047366//Stanford/ ; P20//University of Alabama, Birmingham/ ; P30AG10129//University of California, Davis/ ; P30AG072972//University of California, Davis/ ; P50AG016573//University of California, Irvine/ ; P30AG062429//University of California, San Diego/ ; P30AG062422//University of California, San Francisco/ ; P30AG035982//University of Kansas/ ; P30AG028283-15S1//University of Kentucky/ ; P30AG053760//University of Michigan ADRC/ ; P30AG072931//University of Michigan ADRC/ ; 200775//Cure Alzheimer's Fund/ ; U19NS120384//Cure Alzheimer's Fund/ ; R01AG068338//Cure Alzheimer's Fund/ ; S10OD026738-01//Cure Alzheimer's Fund/ ; R01AG058724//Cure Alzheimer's Fund/ ; R35AG072262//Cure Alzheimer's Fund/ ; W81XWH2110743//Cure Alzheimer's Fund/ ; R01AG073235//Cure Alzheimer's Fund/ ; 1I01RX001534//Cure Alzheimer's Fund/ ; IRX001381//Cure Alzheimer's Fund/ ; P20AG068077//University of New Mexico/ ; 2019NF4100087335//University of Pennsylvania-State of PA project/ ; R01AG055005//Rooney Family Research Fund/ ; P50AG005133//University of Pittsburgh/ ; P50AG005142//University of Southern California/ ; P50AG005136//University of Washington/ ; P50AG033514//University of Wisconsin/ ; P20AG068082//Vanderbilt University/ ; P30AG072947//WakeForest/ ; P01AG03991//Washington University, St.Louis/ ; P01AG026276//Washington University, St.Louis/ ; P20MH071616//Washington University, St.Louis/ ; P30AG066444//Washington University, St.Louis/ ; P30NS098577//Washington University, St.Louis/ ; R01AG021910//Washington University, St.Louis/ ; R01AG043434//Washington University, St.Louis/ ; R01EB009352//Washington University, St.Louis/ ; UL1TR000448//Washington University, St.Louis/ ; U24RR021382//Washington University, St.Louis/ ; //Avid Radiopharmaceuticals/Eli Lilly/ ; P50AG047270//Yale/ ; R01AG052560//Yale/ ; R01AG062276//Yale/ ; P30AG066506-03//1Florida/ ; P50AG047266//1Florida/ ; //Key and Dominant Discipline Construction Project of the Health Commission of Guizhou Province in 2023, China/ ; 2021ZD0201801//STI2023-Major Projects/ ; }, mesh = {Humans ; *Alzheimer Disease/diagnostic imaging/pathology/complications/psychology ; Male ; Female ; Aged ; *Depression/diagnostic imaging/pathology/etiology ; *Brain/pathology/diagnostic imaging ; Neuroimaging ; Magnetic Resonance Imaging ; Atrophy/pathology ; Aged, 80 and over ; Organ Size ; Hippocampus/pathology/diagnostic imaging ; Neuropsychological Tests ; }, abstract = {INTRODUCTION: Alzheimer's disease (AD) often co-occurs with depression, affecting cognitive function and quality of life. Understanding the neurobiological links between brain abnormalities and depressive symptoms is essential for effective treatment.
METHODS: We analyzed 2,722 participants from the National Alzheimer's Coordinating Center, including 886 AD patients and 1,836 cognitively normal controls. Neuroimaging assessed brain volumes, while depressive symptoms were measured using the Geriatric Depression Scale. Multiple linear regression and mediation analyses evaluated associations between brain structure, cognitive function, and depression.
RESULTS: AD patients had significantly higher rates of depressive symptoms (35.3% vs. 14.7%; p < 0.001) and cognitive impairments (mean Mini-Mental State Examination [MMSE]: 23.1 vs. 28.9; p < 0.001). Hippocampal atrophy mediated the relationship between depression and AD (indirect effect = -0.107; p < 0.001).
CONCLUSION: Hippocampal atrophy significantly mediates the relationship between depression and AD, suggesting targeted interventions may enhance patient outcomes.}, }
@article {pmid41611624, year = {2026}, author = {Donohue, MC and Hussen, K and Langford, O and Gallardo, R and Jimenez-Maggiora, G and Aisen, PS and , }, title = {Alzheimer's clinical research data via R packages: The alzverse.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {2}, pages = {e71152}, doi = {10.1002/alz.71152}, pmid = {41611624}, issn = {1552-5279}, support = {//Alzheimer's Disease Neuroimaging Initiative/ ; /AG/NIA NIH HHS/United States ; /NH/NIH HHS/United States ; //Northern California Institute for Research and Education/ ; //ADNI/ ; /EB/NIBIB NIH HHS/United States ; /CAPMC/CIHR/Canada ; //Foundation for the National Institutes of Health/ ; //AbbVie/ ; //Alzheimer's Association; Alzheimer's Drug Discovery Foundation/ ; //Araclon Biotech/ ; //BioClinica, Inc./ ; //Biogen/ ; //BristolMyers Squibb Company/ ; //CereSpir, Inc./ ; //Eisai Inc./ ; //Elan Pharmaceuticals, Inc./ ; //Eli Lilly and Company/ ; //Genentech, Inc./ ; //Fujirebio/ ; //GE Healthcare/ ; //IXICO Ltd./ ; //Johnson & Johnson Pharmaceutical Research & Development LLC./ ; //Lumosity/ ; //Lundbeck/ ; //Merck & Co., Inc./ ; //Meso Scale Diagnostics, LLC./ ; //NeuroRx Research/ ; //Neurotrack Technologies/ ; //Novartis Pharmaceuticals Corporation/ ; //Pfizer Inc./ ; //Piramal Imaging/ ; //Servier/ ; //Takeda Pharmaceutical Company/ ; //Transition Therapeutics/ ; //NIA/ ; U19AG024904/GF/NIH HHS/United States ; U24AG057437/GF/NIH HHS/United States ; /NH/NIH HHS/United States ; //GHR Foundation/ ; //Davis Alzheimer Prevention Program/ ; //Yugilbar Foundation/ ; //Women's Hospital/ ; //Avid Radiopharmaceuticals/ ; //Cogstate/ ; //Albert Einstein College of Medicine and the Foundation for Neurologic Diseases/ ; //SCELC/ ; //Statewide California Electronic Library Consortium/ ; //Epstein Family Foundation/ ; }, mesh = {Humans ; *Alzheimer Disease/diagnostic imaging ; Reproducibility of Results ; *Biomedical Research ; Neuroimaging ; *Information Dissemination/methods ; Biomarkers ; }, abstract = {INTRODUCTION: Sharing clinical research data is essential for advancing Alzheimer's disease (AD) research, yet challenges in accessibility, standardization, documentation, usability, and reproducibility persist.
METHODS: We developed R data packages to streamline access to curated datasets from key AD studies. A4LEARN includes data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) randomized trial and its companion observational study, the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN). ADNIMERGE2 contains curated data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), a longitudinal biomarker and imaging study.
RESULTS: These packages bundle data, documentation, and reproducible analysis vignettes into portable, analysis-ready formats that can be installed and used within R. We also introduce the alzverse package, which applies a common data standard to integrate study-specific packages and facilitate meta-analyses.
DISCUSSION: By promoting collaboration, transparency, and reproducibility, R data packages provide a scalable framework to accelerate AD clinical research.
HIGHLIGHTS: R packages enable access to curated Alzheimer's clinical study datasets. A4LEARN and ADNIMERGE2 provide portable, analysis-ready data resources. R packages integrate data, documentation, and reproducible analysis vignettes. alzverse unifies study packages via common standards to support meta-analyses. Tools promote transparency, collaboration, and reproducibility in Alzheimer's disease (AD) research.}, }
@article {pmid41611033, year = {2026}, author = {Zeng, X and Peng, D and Shen, Y and Tang, L and Ran, T and Pan, Z and Liu, H}, title = {Bletilla striata polysaccharide alleviates Alzheimer's disease in Caenorhabditis elegans by modulating autophagy via the insulin/AMPK pathway.}, journal = {Free radical biology & medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.freeradbiomed.2026.01.051}, pmid = {41611033}, issn = {1873-4596}, abstract = {Alzheimer's disease (AD) is a common neurodegenerative disorder characterized by the abnormal aggregation of amyloid-β (Aβ). Bletilla striata polysaccharide (BSP), the primary active component of the traditional Chinese medicine Bletilla striata, exhibits various pharmacological effects including hemostatic, antioxidant, anti-inflammatory, and immunomodulatory activities. This study aimed to systematically investigate the protective effects and molecular mechanisms of BSP in Caenorhabditis elegans AD model. We found that BSP effectively alleviated the paralysis phenotype in AD worms, with optimal efficacy observed at a concentration of 100 μg/mL. Furthermore, BSP significantly extended the lifespan of both wild type and AD worms, reduced lipofuscin deposition and egg-laying capacity, improved neuromuscular function, learning ability, and stress resistance, and lowered the level of oxidative stress in vivo. Additionally, BSP treatment markedly suppressed Aβ aggregation in AD worms.Transcriptomic analysis revealed that BSP significantly regulates the autophagy pathway. In combination with genetic experiments, we further elucidated that BSP coordinates the insulin and AMPK signaling pathways to modulate autophagy, thereby reducing abnormal autophagosome accumulation and restoring autophagic homeostasis. Notably, the neuroprotective effects of BSP were completely abolished in mutants of key insulin signaling pathway genes (daf-2, age-1, akt-1, akt-2, daf-16) and the AMPK homologous gene aak-2, indicating that its efficacy is associated with the insulin/AMPK-autophagy regulatory axis. This study reveals the mechanism by which BSP ameliorates AD pathology through multi-target and multi-pathway regulation of autophagy, providing a new theoretical basis for its development as a candidate therapeutic agent for AD and further highlighting the potential medical value of Bletilla striata in combating AD.}, }
@article {pmid41610646, year = {2026}, author = {Kumar, S and Srivastava, S and Tan, CS and Abohashrh, M and Malviya, R}, title = {Correlation between oral disease and neurodegenerative disorders: Role of biological proteins for the modulation of oral-brain axis and gut-brain axis.}, journal = {Colloids and surfaces. B, Biointerfaces}, volume = {262}, number = {}, pages = {115480}, doi = {10.1016/j.colsurfb.2026.115480}, pmid = {41610646}, issn = {1873-4367}, abstract = {Biological proteins play a crucial role at the intersection of oral health and neuroscience, offering promising opportunities for improved diagnosis, prevention, and treatment. This review highlights the molecular, inflammatory, and biochemical pathways linking oral diseases, particularly periodontal disease and microbial dysbiosis, with neurodegenerative disorders such as Alzheimer's and Parkinson's disease. Key inflammatory, neuroprotective, and tissue-repair proteins play a crucial role in maintaining both oral integrity and neural function. Advances in proteomics and molecular imaging have clarified how protein misfolding, aggregation, and immune responses drive neuroinflammation and cognitive decline. Emerging therapies include protein-based biomaterials, such as hydrogels, nanocarriers, and protein-polymer hybrids, for delivering neuroprotective and regenerative agents through oral and nasal routes. Early diagnosis is being transformed by salivary proteomics and transcriptomics, enabling non-invasive detection of neurodegenerative biomarkers. Host-defense peptides and antimicrobial proteins also show promise in controlling oral infections that may exacerbate brain inflammation. Integrating oral biology, biomaterials science, and neuroscience is accelerating clinical translation through the development of innovative scaffolds and smart delivery systems. Despite challenges in biomarker validation and clinical application, advances in artificial intelligence, bioinformatics, and protein engineering are driving the future of personalized regenerative and preventive medicine. Overall, biological proteins provide a critical molecular link between oral and neural health, paving the way for novel non-invasive diagnostic and therapeutic strategies.}, }
@article {pmid41613446, year = {2025}, author = {Sun, Y and Sun, J and Feng, Y and Zhang, Y and Li, J and Wang, F and Loznik, M and Tian, Y and Zhang, H and Herrmann, A and Liu, K and Zhang, C}, title = {Significant downregulation of Alzheimer's amyloid-β levels enabled by engineered DNA nanomaterials.}, journal = {Fundamental research}, volume = {5}, number = {5}, pages = {2241-2247}, pmid = {41613446}, issn = {2667-3258}, abstract = {Although there are no effective therapies to block or reverse Alzheimer's disease (AD) progression at present, a promising therapeutic strategy is to reduce levels of amyloid-β (Aβ) proteins, which drive the formation of amyloid plaque, a primary hallmark in AD brains. Herein, we report that amphiphilic lipid-DNA molecules (LD) were designed by incorporating a long alkyl chain into the nucleotide base. It significantly down-regulated Alzheimer's Aβ levels in vivo and in vitro. In contrast to small-molecule chemical drugs and antibody therapies, the assembled DNA nanoparticles allowed them to effectively cross the blood-brain barrier (BBB) and accumulate in the brain, increasing the therapeutic effects. Notably, lipid-DNA downregulated the levels of Aβ peptides significantly in vitro. AD mice model experiments demonstrated that the LD-treated groups exhibited a rapid cognition behavioral improvement, which was associated with brain engagement of LD and reduced Aβ levels. Thus, the molecularly engineered DNA nanomaterials effectively regulated Aβ peptides. This work might provide a promising DNA engineering strategy for AD treatment.}, }
@article {pmid41609875, year = {2026}, author = {Shahabinejad, E and Shakoeizadeh, A and Karimabad, MN and Asadi, F and Heydari, M and Salandari-Rabori, M}, title = {Utilizing nanotechnology to diagnose and treat central nervous system disorders.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {47}, number = {2}, pages = {209}, pmid = {41609875}, issn = {1590-3478}, mesh = {Humans ; *Central Nervous System Diseases/diagnosis/therapy/drug therapy ; *Nanotechnology/methods ; Animals ; *Drug Delivery Systems/methods ; Blood-Brain Barrier ; }, abstract = {The CNS presents a unique challenge to therapeutic intervention due to its sophisticated organization, the protective blood-brain barrier (BBB), and the low regenerative potential of neural tissue. Over the last few decades, nanotechnology has emerged as a revolutionary technology capable of transforming the diagnosis and treatment of CNS diseases, thereby offering new hope to patients with previously incurable neurodegenerative diseases. This review highlights the therapeutic and diagnostic potential of newer types of nanomaterials-i.e., nanoliposomes (NLs), metallic nanoparticles (MNPs), and carbon nanotubes (CNTs)-which have been found to cross the blood-brain barrier (BBB) and deliver drugs with enhanced specificity and efficacy. Nanoparticle-based therapies have revolutionized drug delivery, gene therapy, in vivo imaging, and molecular profiling for CNS diseases. However, despite such advancements, hurdles remain, particularly in terms of biocompatibility, long-term safety, and site-specific activity within complex biological systems. Herein, we summarize recent advances in the construction of smart nanocarriers and multi-functional platforms for overcoming physiological and pharmacological challenges in CNS therapy. Finally, we emphasize the urgent need for interdisciplinary studies to unlock the full clinical potential of nanotechnology in neurology and answer outstanding questions regarding toxicity, immune responses, and scalability for human application.}, }
@article {pmid41609790, year = {2026}, author = {Haußmann, A}, title = {[New treatments for Alzheimer disease : A challenge for radiology].}, journal = {Radiologie (Heidelberg, Germany)}, volume = {}, number = {}, pages = {}, pmid = {41609790}, issn = {2731-7056}, abstract = {Alzheimer's disease is one of the most common causes of dementia in older adults. Since 2024, monoclonal antibody therapy has been available, which can slow disease progression at certain stages. During therapy, magnetic resonance imaging changes called amyloid-related imaging abnormalities (ARIA)-edema (ARIA-E) and hemorrhage (ARIA-H)-must be monitored at specific points during treatment; depending on severity, therapy may need to be paused. Cerebral amyloid angiopathy (CAA) and its inflammatory form (CAA-I) should be considered in the differential diagnosis.}, }
@article {pmid41609117, year = {2026}, author = {Wu, CK and Dailey, JM and Donahue, JE}, title = {Behavioral Variant in Alzheimer's Disease.}, journal = {Acta neurologica Taiwanica}, volume = {35}, number = {1}, pages = {14-24}, doi = {10.4103/ant.ANT-D-25-00098}, pmid = {41609117}, issn = {1028-768X}, mesh = {Humans ; *Alzheimer Disease/psychology/diagnosis/complications ; Aged ; Male ; Female ; }, abstract = {In this review, the authors report on the development and discovery of atypical variants in Alzheimer's disease (AD). The behavioral variant of AD is emphasized and described in detail, in addition to its comparison with other variants. Furthermore, the newly developed diagnostic criteria and diagnostic approach are explained and applied for clinical practice in neurology. Principles of management and treatment for behavioral variants are highlighted. Three cases are reported to illustrate different courses of pathophysiology in behavioral variants in AD.}, }
@article {pmid41609034, year = {2026}, author = {Gashtrodkhani, AA and Shirkouhi, SG and Khatami, SS and Kamari, F and Ghaedi, S and Blaabjerg, M and Andalib, S}, title = {Neuroplasticity and Alzheimer's Disease.}, journal = {Journal of integrative neuroscience}, volume = {25}, number = {1}, pages = {48051}, doi = {10.31083/JIN48051}, pmid = {41609034}, issn = {0219-6352}, mesh = {Humans ; *Neuronal Plasticity/physiology ; *Alzheimer Disease/physiopathology/therapy ; Animals ; *Brain/physiopathology ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disease that leads to a decline in cognitive function, including memory. The exact causes of AD are not fully understood, and to date no treatments are available that can stop the progression of this neurocognitive disorder. AD is associated with progressive loss of neurons, synaptic connectivity, and disruption of neuroplasticity in the brain. Neuroplasticity is the nervous system's ability to adapt and recover in response to experiences, injuries, or a pathological change. Synaptic dysfunction and impairment of neuroplasticity are important elements of AD progression and cognitive decline. Studies have demonstrated that enhancement of neuroplasticity effectively improves cognition and memory, preventing the progression of AD. In this narrative review, we discuss the role of various pathophysiological explanations regarding the impairment of neuroplasticity in the pathogenesis of AD. We also highlight neuromodulation approaches, such as exercise, neurotrophic factor mimetics, pharmacological drugs, light therapy, and diet therapy that can promote neuroplasticity and have the potential for use in the prevention and treatment of AD.}, }
@article {pmid41608511, year = {2025}, author = {Xu, Y and Gao, J and Wang, M and Zhang, H}, title = {Exercise-mimicking effects of betaine in chronic disease prevention and management.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1762908}, pmid = {41608511}, issn = {2296-861X}, abstract = {Betaine, a natural compound found in beets, wheat germ, shellfish, and mammalian tissues, plays a crucial role in preventing and treating various chronic diseases. As the global population ages, chronic diseases are posing the primary threat to the health of the elderly, significantly increasing the medical pressure on families and society. Chronic diseases associated with aging involve complex molecular mechanisms and, therefore, developing multipronged interventions is crucial for their prevention and treatment. Although exercise is a primary intervention for preventing and treating chronic diseases, many elderly individuals have motor disabilities. Therefore, researchers are exploring natural products that mimic the therapeutic effects of exercise in individuals who are unable to exercise. Betaine has exhibited significant preventive and therapeutic effects in studies on chronic diseases and is known as an exercise mimetic. A deeper understanding of betaine may help elucidate crucial molecular mechanisms underlying its effects and offer theoretical insights for developing exercise-mimicking foods, supplements, and drugs, which are expected to benefit the human health.}, }
@article {pmid41607671, year = {2025}, author = {Tommet, D and Foldi, NS and Lamar, M and Wang, C and Rabin, L and Grandoit, E and Choi, SE and Jutten, RJ and Lee, M and Nakano, C and Gibbons, LE and Scollard, P and Mungas, D and Jones, RN and , and Crane, PK}, title = {Six month repeat cognitive testing to identify people with MCI at greatest AD dementia risk.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.30.25343228}, pmid = {41607671}, abstract = {INTRODUCTION: People with mild cognitive impairment (MCI) are candidates for early intervention, but not all progress to Alzheimer's disease (AD) dementia. Identifying a subgroup at highest risk may improve treatment targeting.
METHODS: We analyzed data from participants with MCI enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive domains included memory, executive functioning, language, and visuospatial abilities. We evaluated baseline performance and 6-month change scores, using proportional hazards models to estimate associations with time to conversion to AD dementia.
RESULTS: The strength of association varied by domain, but in general both baseline performance and 6-month change were associated with conversion. The strongest effects observed for memory and language. Observed associations were largely independent of established risk biomarkers, including APOE genotype, structural MRI measures, and CSF biomarkers.
DISCUSSION: 6-month change scores on cognitive tests may help identify a high-risk subgroup of persons with MCI likely to progress to AD dementia.
RESEARCH IN CONTEXT: Systematic review. The authors reviewed the literature using traditional (e.g. PubMed) sources. There is a modest literature on change scores in the context of the AD clinical spectrum, but few investigations have evaluated whether short-term changes may be able to identify a high-risk subgroup of people with MCI. The authors have published a systematic review of this literature (Jutten et al. 2020) and appropriately refer to relevant citations here.Interpretation: Our findings suggest that short-term changes in cognition may be useful as part of a strategy to identify subsets of people with MCI who are at highest risk of conversion. Findings were clearest for memory and language. Domain-specific changes appeared to be independent from other biomarkers used to identify people at highest risk. Domain-specific changes did not appear to be better than changes in global cognition as measured by the MMSE or the CDR-sum of boxes.Future directions: Short-term changes in cognition may be useful to help identify a subgroup of people with MCI at highest risk of conversion to AD dementia. Future work could consider time frames shorter than the 6-month data we had available, better characterizing changes with more than 2 time points, or developing strategies that combine changes in cognition with other biomarkers to identify a subgroup of people with MCI to target for treatment.}, }
@article {pmid41607407, year = {2025}, author = {Reading, CL and Yan, J and Testa, MA and Simonson, DC and Javaid, H and Schmunk, L and Martin-Herranz, DE and Brooke, R and Gordevicius, J and Zhang, J and Yuan, H and Ahlem, C and Wang, L and Markham, P and Osman, N and O'Quinn, S and Palumbo, J}, title = {Correction: An exploratory analysis of bezisterim treatment associated with decreased biological age acceleration, and improved clinical measure and biomarker changes in mild-to-moderate probable Alzheimer's disease.}, journal = {Frontiers in neuroscience}, volume = {19}, number = {}, pages = {1758523}, doi = {10.3389/fnins.2025.1758523}, pmid = {41607407}, issn = {1662-4548}, abstract = {[This corrects the article DOI: 10.3389/fnins.2025.1516746.].}, }
@article {pmid41607405, year = {2025}, author = {Crivelli, SM and Quadri, Z and van Kruining, D and Martinez-Martinez, P and Bieberich, E and Chatton, JY}, title = {Editorial: The role of glial cells in the pathophysiology and treatment of Alzheimer's disease.}, journal = {Frontiers in neuroscience}, volume = {19}, number = {}, pages = {1749170}, doi = {10.3389/fnins.2025.1749170}, pmid = {41607405}, issn = {1662-4548}, }
@article {pmid41605825, year = {2026}, author = {Rodriguez, AD and DuBose, JR and Rozga, A and Zimring, CM and Mynatt, ED and Clifford, GD and Vickers, KL and Goldstein, FC and Giannotto, EL and Thelin, J and Levey, AI}, title = {Rationale and design of a multidomain lifestyle program for mild cognitive impairment.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71068}, doi = {10.1002/alz.71068}, pmid = {41605825}, issn = {1552-5279}, support = {//The James M. Cox Foundation/ ; //Cox Enterprises, Inc./ ; }, mesh = {*Cognitive Dysfunction/therapy/psychology ; Humans ; *Life Style ; Quality of Life ; }, abstract = {The development of non-pharmacological treatment approaches is supported by evidence that addressing key modifiable risk factors may prevent or delay up to 45% of dementia cases. The Charlie and Harriet Shaffer Cognitive Empowerment Program (CEP) was developed to address current gaps in access to, and evidence for, interventions that reduce lifestyle risk factors and improve quality of life in individuals with mild cognitive impairment (MCI). Co-designed with patients and families, clinicians, researchers, and industry professionals, the CEP is situated in a conceptual framework that guides assessments and interventions/supports to holistically address the experience of living with MCI. CEP comprises four cores (Therapeutic Programs, Technology, Built Environment, and Innovation Accelerator) that map to the conceptual framework. We contend that our approach provides an opportunity to contribute to the evidence base for multidomain lifestyle programs and gain a deeper understanding of MCI and how individuals can be empowered to manage it. HIGHLIGHTS: The cognitive empowerment program (CEP) is a multidomain lifestyle program that was developed using a co-design process and a conceptual framework that holistically addresses the experience of living with mild cognitive impairment (MCI). CEP provides comprehensive assessment and intervention/support through four cores that map to the conceptual framework: therapeutic programs, technology, built environment and research innovation. CEP's unique approach provides an opportunity to build the evidence base for multidomain lifestyle interventions and to develop and refine lifestyle biomarkers that can be used for early detection of MCI, tracking of disease progression, and objective measurement of the impact of lifestyle interventions.}, }
@article {pmid41605321, year = {2026}, author = {Zhang, H and Xu, Q and Ye, M and Wu, X and Ren, Z and Qin, L and Tang, Z and Wang, G and Xiang, Q and Liu, L}, title = {Inclisiran Attenuates Alzheimer's Disease-like Changes by Suppressing Microvascular Endothelial Ferroptosis to Preserve Blood-Brain Barrier Integrity.}, journal = {Free radical biology & medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.freeradbiomed.2026.01.045}, pmid = {41605321}, issn = {1873-4596}, abstract = {The integrity of blood-brain barrier (BBB) plays a pivotal role in the pathogenesis of Alzheimer's disease (AD) by regulating Aβ clearance and neurotoxic compound exclusion. Hyperlipidemia exacerbates AD by impairing the BBB function. Inclisiran, a PCSK9-targeting siRNA, reduces cholesterol levels; however, its neuroprotective effects remain unclear. Here, we report the novel discovery that Inclisiran attenuates AD-like changes through the PCSK9-ferroptosis axis in brain microvascular endothelial cells (BMECs). First, integrated bioinformatics analysis and experimental validation of cortical tissues from patients with AD and healthy controls revealed a coordinated upregulation of PCSK9 and β-amyloid (Aβ), accompanied by increased iron deposition and significant activation of the ferroptosis pathway. Interestingly, these changes are located in the BMECs of the blood-brain barrier rather than in the brain parenchyma. Second, in hyperlipidemic ApoE-/- mouse models, integrated application of cerebral microvessel isolation, molecular biology techniques, immunofluorescence co-localization analysis, and behavioral tests demonstrated that Inclisiran significantly reduced AD-like changes by attenuating BBB dysfunction based on the suppression of PCSK9-mediated ferroptosis in BMECs. Third, in vitro studies employing the HCMEC/D3 BBB model with integrated assessments of lipid peroxidation, mitochondrial function, and transwell-based barrier integrity demonstrated that Inclisiran significantly reduced ferroptosis and restored BBB integrity via PCSK9 suppression. Our findings not only establish a novel PCSK9-ferroptosis-BBB regulatory axis in AD pathogenesis but also posit the clinically approved lipid-lowering drug, Inclisiran, as a promising therapeutic candidate for AD, providing new targets and mechanisms for the prevention and treatment of AD.}, }
@article {pmid41604898, year = {2026}, author = {Ni, H and Xiong, Y and Liu, M and Liu, J and Liu, M and Zhang, L and Zhao, Y and Yi, L and Zhou, R and He, Q and Li, Y and Du, Q and Liu, L and Huang, Y and Ning, W and Zhou, H and Dong, Y}, title = {Sinomenine inhibits oxidative stress to attenuate Alzheimer's disease pathology via α7 nicotinic acetylcholine receptor.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {152}, number = {}, pages = {157779}, doi = {10.1016/j.phymed.2026.157779}, pmid = {41604898}, issn = {1618-095X}, abstract = {BACKGROUND: The pathological mechanism of Alzheimer's disease (AD) is complex. The binding of Aβ to α7 nicotinic acetylcholine receptor (α7nAChR) contributes to neuronal damage. Sinomenine (SIN) is an alkaloid extracted from the traditional Chinese medicine Qingfengteng (Sinomenium acutum). The anti-inflammatory, antioxidant, and immunomodulatory effects of SIN were confirmed to be closely associated with the α7nAChR.
PURPOSE: This study aimed to investigate whether α7nAChR serves as a pharmacological target of SIN against AD, and to evaluate the neuroprotective effects of SIN both in vivo and in vitro, focusing on the α7nAChR/Nrf2/Keap1 signaling pathway.
METHODS: In this study, the effects of SIN in both APP/PS1 transgenic mice and SH-SY5Y cells subjected to Aβ1-42-induced injury were assessed. The selective antagonist α-bungarotoxin (α-BTX), the agonist nicotine (Nic) of α7nAChR, and α7nAChR siRNA were employed. The cognitive function, Aβ deposition, synaptic plasticity markers, the tau protein phosphorylation, mitochondrial membrane potential, oxidative stress and the α7nAChR/Nrf2/Keap1 signaling pathway were analyzed in vivo and/or in vitro.
RESULTS: SIN significantly enhanced learning and memory abilities in APP/PS1 mice, reduced Aβ plaque deposition and synaptic dysfunction, and inhibited hyperphosphorylation of tau protein and oxidative stress in the brain. In Aβ1-42-induced neuronal injury model, SIN alleviated apoptosis, increased BDNF and ACh levels, inhibited mitochondrial damage, stabilized calcium homeostasis, and suppressed oxidative stress. Meanwhile, SIN disrupted Nrf2-Keap1 binding to promote the Nrf2/HO-1 signaling pathway. Nevertheless, SIN effects above were inhibited by α-BTX. The knockdown of α7nAChR in vitro significantly promoted Nrf2/HO-1 pathway and BDNF expression.
CONCLUSION: SIN exerts neuroprotective effect in APP/PS1 transgenic mice and Aβ1-42-induced neuronal injury by inhibiting oxidative stress via α7nAChR/Nrf2/Keap1 pathway. This study provides evidence for α7nAChR as a new target and the clinical application potential of SIN in AD treatment.}, }
@article {pmid41582778, year = {2026}, author = {Mumtaz, and Unnithan, D and Hosseini, H and Ali, J and Khan, MA}, title = {Chitosan nanoparticles for brain targeted nose-to-brain drug delivery in neurodegenerative disease: a comprehensive exploration of advances, limitations and future prospects.}, journal = {Expert opinion on drug delivery}, volume = {}, number = {}, pages = {1-19}, doi = {10.1080/17425247.2026.2619090}, pmid = {41582778}, issn = {1744-7593}, abstract = {INTRODUCTION: Neurodegenerative diseases (NDDs), such as Alzheimer's and Parkinson's and epilepsy, cause irreversible nerve cell degradation, resulting in cognitive and motor decline. The blood-brain barrier (BBB) complicates treatment, limiting drug access and causing low bioavailability. Chitosan nanoparticles (CH-NPs) offer a promising solution for improving drug delivery to the brain due to their biocompatibility and ability to enhance intranasal delivery, potentially increasing therapeutic efficacy.
AREAS OF COVERAGE: The review discusses advancements in chitosan-based nanoparticle drug delivery systems for NDDs, highlighting literature from 2015 to 2025. It indicates that chitosan can improve drug uptake in the brain by up to ten times and emphasizes its potential for targeted central nervous system (CNS) delivery due to its unique properties. Additionally, intranasal delivery is a non-invasive method to bypass the BBB and enhance therapeutic precision.
EXPERT OPINION: CH-NPs effectively deliver therapeutics to the CNS, leveraging their mucoadhesive properties and biocompatibility to cross the BBB via intranasal delivery. This platform enhances drug uptake and retention in the brain, addressing challenges faced by traditional therapies for NDDs. Optimizing nanoparticle biomaterial properties and delivery methods could improve therapeutic precision and clinical outcomes.}, }
@article {pmid41603883, year = {2026}, author = {Burn, O and Molloy, K and Kanekiyo, M and Parker, C and Rothwell, S and Pan, JJ and Trueman, D and Ritchie, C}, title = {Estimating the long-term health outcomes of treatment with lecanemab in early Alzheimer's disease: a modelling study.}, journal = {Journal of medical economics}, volume = {29}, number = {1}, pages = {250-262}, doi = {10.1080/13696998.2025.2600875}, pmid = {41603883}, issn = {1941-837X}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; Markov Chains ; Aged ; Male ; Female ; Severity of Illness Index ; Cognitive Dysfunction/drug therapy ; Aged, 80 and over ; Standard of Care ; Disease Progression ; Quality-Adjusted Life Years ; }, abstract = {AIMS: To assess the long-term effects of lecanemab plus standard of care (SoC) compared with SoC alone in a cohort of patients with early Alzheimer's disease (AD; mild cognitive impairment [MCI] due to AD, or mild AD dementia) using different modeling approaches and data from Clarity AD (NCT0388745538).
METHODS: A Markov model was employed using health states based on disease severity, long-term institutionalization, and death, with disease severity defined using the Clinical Dementia Rating - Sum of Boxes (CDR-SB) classification for MCI due to AD, and Mild, Moderate, and Severe AD. State transitions during the first 18 months of treatment were estimated using either patient count data (Approach 1) or multistate survival analysis (Approach 2). Transition probabilities beyond 18 months for the lifetime of the cohort were informed by longitudinal natural history data for the SoC arm with a hazard ratio for time-to-worsening health state applied to estimate outcomes in the lecanemab arm.
RESULTS: Over a lifetime horizon, the model predicted a delayed time to Mild, Moderate, and Severe AD for patients treated with lecanemab compared to SoC by 1.31, 1.85, and 2.04 years, respectively when using Approach 1. Patients treated with lecanemab experienced a survival benefit of 1.36 years, comprised of an additional 1.85 years in early AD and 0.49 years less in moderate and severe AD, compared to patients treated with SoC alone. The model also predicted that compared to SoC, lecanemab increased the time in community care and reduced time spent in institutional care. Results were similar when using Approach 2.
LIMITATIONS: Long-term disease progression was informed by constant annual transition probabilities derived from the published literature.
CONCLUSIONS: Patients treated with lecanemab experience delayed progression to Moderate and Severe AD, resulting in additional life-years (LYs) and reduced time in institutional care.}, }
@article {pmid41603392, year = {2026}, author = {Prevot, E and Shand, C and , and Oxtoby, N}, title = {How reproducible are data-driven subtypes of Alzheimer's disease atrophy?.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251415019}, doi = {10.1177/13872877251415019}, pmid = {41603392}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) exhibits substantial clinical and biological heterogeneity, complicating efforts in treatment and intervention development. While new computational methods offer insights into AD subtyping and disease staging, the reproducibility of these subtypes across datasets remains understudied, particularly concerning the robustness of subtype definitions when validated on diverse databases.ObjectiveThis study evaluates the robustness of the AD progression subtypes identified by the Subtype and Stage Inference (SuStaIn) algorithm on a larger and more diverse cohort.MethodsWe extracted T1-weighted MRI data for 5444 subjects from ANMerge, OASIS, and ADNI datasets, forming four independent cohorts. Each cohort was analyzed with SuStaIn under two conditions: one using the full cohort, including cognitively normal controls, and another excluding controls to test subtype robustness.ResultsResults confirm the three primary atrophy subtypes identified in earlier studies: Typical, Cortical, and Subcortical, as well as the emergence of rare and atypical AD variants such as posterior cortical atrophy. Notably, each subtype displayed varying robustness to the inclusion of controls, with certain subtypes, like the Subcortical subtype, more influenced by cohort composition.ConclusionsThis investigation underscores SuStaIn's reliability for defining stable AD subtypes and suggests its utility in clinical stratification for trials and diagnosis. However, our findings also highlight the need for improved dataset ethnic and demographic diversity, particularly in terms of ethnic representation, to enhance generalizability and support broader clinical application.}, }
@article {pmid41603342, year = {2026}, author = {Sha, L and Wu, M and Sun, S and Xie, Y and Liu, Y and Li, Z and Liu, R and Guo, W and Yan, S and Xu, B and Kang, L}, title = {Subcutaneous transplantation of mesenchymal stem cell spheroids ameliorates cognitive deficits in Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261418164}, doi = {10.1177/13872877261418164}, pmid = {41603342}, issn = {1875-8908}, abstract = {BackgroundMesenchymal stem cell (MSC)-based therapy has emerged as a promising alternative treatment for Alzheimer's disease (AD) but is limited by low cell survival rates and complex handling.ObjectiveThe present study explored the therapeutic potential of subcutaneous transplantation of MSC spheroids in a mouse AD model.MethodsWe prepared uniform size MSC spheroids with good stemness properties, and performed three consecutive subcutaneous treatments with MSC spheroids on early-stage AD APP/PS1 mice (6 months old), with each injection administered one month apart. Following treatment, behavioral experiments were conducted to evaluate learning and cognitive functions. Additionally, positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) were utilized to assess cerebral glucose metabolism and neuronal functional connectivity. Subsequently, brain tissue sections were prepared and stained to evaluate amyloid plaque deposition, levels of inflammation, and other pathological changes.ResultsAPP/PS1 mice treated with MSC spheroids demonstrated better performance in cognitive behavioral tests compared to the AD model group. Imaging studies showed that brain glucose metabolism was higher in the MSC spheroids-treated group than in the AD model group, with enhanced functional brain connectivity. Moreover, pathological analysis revealed that MSC spheroids treatment resulted in a reduced amyloid-β plaque burden and attenuated inflammatory phenotypes in AD mice. MSC spheroids also protected neurons from apoptosis and restored synaptic plasticity.ConclusionsOur study suggests that subcutaneous transplantation of MSC spheroids reduced key pathological changes in AD by improving brain glucose metabolism and alleviating inflammation.}, }
@article {pmid41603338, year = {2026}, author = {Ho, BL and Liu, CF and Huang, YB and Huang, LC and Yang, YH}, title = {Treatment persistence with acetylcholinesterase inhibitors in Alzheimer's disease: Real-world evidence from a retrospective cohort study.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251415021}, doi = {10.1177/13872877251415021}, pmid = {41603338}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) is the leading cause of dementia worldwide, yet long-term persistence with acetylcholinesterase inhibitors remains suboptimal in routine practice.ObjectiveTo compare real-world treatment persistence among patients with mild to moderate AD receiving oral donepezil, rivastigmine capsules, or transdermal rivastigmine patches, and to identify factors influencing discontinuation.MethodsIn this retrospective cohort study, 1062 patients aged ≥65 years with newly diagnosed AD were identified from a hospital registry between 2015 and 2019 and followed through 2021. Treatment persistence was evaluated by duration and 1-year continuation rates. Discontinuation was defined as a prescription gap exceeding 90 days. Multivariable Cox proportional hazards models were used to identify predictors of discontinuation.ResultsPatients receiving donepezil had significantly longer mean treatment duration (3.03 years) and higher 1-year continuation rates (66.2%) than those receiving rivastigmine capsules (1.81 years, 39.9%) or patches (1.43 years, 45.5%). Both rivastigmine formulations were independently associated with greater discontinuation risk (adjusted hazard ratio [aHR] 1.44 and 1.76, respectively; p < 0.001). Participation in a national dementia care program was the strongest protective factor, associated with a 69% lower discontinuation risk (aHR 0.31; p < 0.001). Higher baseline CASI scores, younger age, and milder cognitive impairment predicted greater persistence, whereas adverse events markedly increased discontinuation.ConclusionsDonepezil demonstrated superior real-world persistence compared with rivastigmine. Structured dementia care programs substantially enhanced treatment continuity, underscoring the importance of both pharmacologic choice and system-level support in sustaining long-term therapy in AD.}, }
@article {pmid41603335, year = {2026}, author = {Byeon, JH and Lee, D and Shin, EJ and Park, EM and Yoon, EJ and Kim, H and Ham, H and Yeo, J and Yoo, H and Youn, JH and Kang, SH and Lee, JY}, title = {Validation of a web-based cognitive test for early detection of Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261415925}, doi = {10.1177/13872877261415925}, pmid = {41603335}, issn = {1875-8908}, abstract = {BackgroundEarly detection of Alzheimer's disease (AD) is critical for effective disease management and treatment. Web-based assessment tools offer advantages by enabling broader accessibility and reducing reliance on specialized clinical infrastructure.ObjectiveThis study aimed to validate a self-administered, web-based cognitive assessment tool for AD screening.MethodsA total of 106 older adults aged 55 to 84 years were recruited and clinically classified as cognitively unimpaired (CU, n = 35), amnestic mild cognitive impairment (aMCI, n = 37), or AD (n = 34). Participants completed Cogscreen, a 10-min web-based cognitive test comprising verbal cued memory and digit symbol substitution tasks.ResultsBoth the verbal cued memory and digit symbol substitution tasks showed significant score differences among CU, aMCI, and AD (p < 0.001). The Cogscreen composite score yielded area under the curve (AUC) values of 0.876 for aMCI (cut-off = 0.64, sensitivity = 0.865, specificity = 0.657) and 0.994 for AD (cut-off = -0.59, sensitivity = 0.971, specificity = 0.971), and outperformed the Mini-Mental State Examination (MMSE) in diagnosing aMCI (AUC = 0.638, p = 0.001). The composite score significantly correlated with the Consortium to Establish a Registry for Alzheimer's Disease assessment packet total score (r = 0.765, p < 0.001) and MMSE score (r = 0.722, p < 0.001).ConclusionsCogscreen is a rapid, self-administered cognitive screening tool for detecting aMCI and AD. It outperforms the MMSE in identifying early cognitive decline and holds potential for detecting even subtler cognitive changes in the future.}, }
@article {pmid41602207, year = {2025}, author = {Tarnanas, I and Seixas, A and Wyss, M and Vlamos, P and Çöltekin, A}, title = {Merging multimodal digital biomarkers into "Digital Neuro Fingerprints" for precision neurology in dementias: the promise of the right treatment for the right patient at the right time in the age of AI.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1727707}, pmid = {41602207}, issn = {2673-253X}, abstract = {Digital biomarkers are revolutionizing medicine in ways that were unimaginable a few years ago. Consequently, precision medicine approaches now realistically can promise personalization, i.e., the right treatments for the right patients at the right time, including earlier, targeted interventions which lead to a major paradigm shift in how medicine is practiced from reactive to preventive action. Although the scientific evidence is clear on the power of digital biomarkers, there is an unmet need for translating these findings into actionable insights in clinical practice. In this paper, we focus on Alzheimer's disease and related dementias (ADRD), and how digital biomarkers could empower clinical decision making in its preclinical stages. We argue that a new all-encompassing score is needed, akin to a BrainHealth Index linked to the established and validated risk stratifications frameworks and is directed at the prevention of ADRD. Specifically, we propose the new concept "Digital Neuro Fingerprint (DNF)", built with simultaneous collection of multimodal digital biomarkers (speech, gait, eye movements etc.) from smartphone based augmented reality or virtual reality while an individual is immersed in activities of daily living. Fusing the captured multimodal digital biomarkers, data is automatically analyzed with custom combinations of machine- and deep-learning approaches and enhanced with explainable artificial intelligence (XAI) and uncertainty quantifications. We argue that DNF is useful for capturing ADRD progression and should supersede the biomarkers that are invasive and expensive to obtain, offering a sensitive and highly specific score that measures meaningful aspects of health for the patients in high-frequency intervals.}, }
@article {pmid41602161, year = {2025}, author = {Greco, D and Čočková, Z and Das, D and Mali, AS and Novotný, J and Olsen, MJ and Telenský, P}, title = {Small molecule FTO inhibitor MO-I-500 protects differentiated SH-SY5Y neuronal cells from oxidative stress.}, journal = {Frontiers in molecular neuroscience}, volume = {18}, number = {}, pages = {1736173}, pmid = {41602161}, issn = {1662-5099}, abstract = {INTRODUCTION: Oxidative stress is a central driver of brain aging, impairing cellular function and increasing susceptibility to neurodegenerative diseases. Recent studies suggest that the RNA demethylase FTO regulates N6-methyladenosine (m6A) RNA modification, a key pathway in modulating oxidative stress in the brain. However, the precise mechanisms underlying FTO's role remain unclear. This study examines the neuroprotective potential of MO-I-500, a small-molecule FTO inhibitor, against oxidative stress induced by tert-butyl hydroperoxide (TBHP) in neuron-like SH-SY5Y cells differentiated with retinoic acid and BDNF (dSH-SY5Y).
METHODS: dSH-SY5Y cells were treated with MO-I-500 alone for 72 h or with TBHP alone for 24 h. Alternatively, cells were pretreated with 1 μM MO-I-500 for 48 h, followed by co-treatment with MO-I-500 and 25 or 50 μM TBHP for an additional 24 h, for a total treatment duration of 72 h. Cellular metabolism was assessed using a Seahorse XF MitoStress assay, and oxidative stress markers, including ROS and superoxide levels, were quantified with DCFDA and MitoSOX probes. ATP content was measured using a bioluminescence assay.
RESULTS: FTO inhibition by MO-I-500 induced a metabolic shift toward an energy-efficient state, enhancing cellular resilience to oxidative stress. Pretreatment significantly reduced TBHP-induced oxidative damage, lowering intracellular ROS levels and preserving ATP content.
CONCLUSION: Together with our previous findings demonstrating the protective effects of MO-I-500 in astrocytes and recent studies supporting the importance of astrocyte function in neurodegeneration, these results suggest a dual protective role of MO-I-500 in neurons and astrocytes. This dual action positions MO-I-500 as a promising therapeutic strategy to mitigate oxidative damage and reduce the risk of neurodegenerative diseases, including Alzheimer's disease.}, }
@article {pmid41601969, year = {2025}, author = {Ntsapi, C and Weyers, M and Chinheya, R and Jim, T and Matsabisa, M}, title = {Exploring cannabinoid modulation on autophagy mechanisms in Alzheimer's disease: a review.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1748368}, pmid = {41601969}, issn = {1663-9812}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the accumulation of toxic protein aggregates in the brain, leading to brain cell death and cognitive impairment. Central to AD pathogenesis is the autophagy pathway, a crucial cellular self-digestion process. Cannabinoids, the fundamental phytochemical compounds derived from the Cannabis sativa plant, have been demonstrated to exhibit neuroprotective qualities when used as a treatment at microdoses. However, the impact of multi-cannabinoid treatments on autophagy induction and subsequent cell survival in AD in vitro models remains uncertain. This review seeks to explore the potential of a multi-cannabinoid treatment strategy in enhancing neuronal cell survival through autophagy activation within an AD in vitro model. The proposed approach involves a combination of cannabinoids in their potential to upregulate autophagy mechanisms, potentially supporting neuronal cell resilience. By unravelling the mechanistic link between autophagy, cannabinoid treatment, and neuronal viability, this review aims to elucidate how cannabinoids influence neuronal function and survival at a cellular and molecular level. By offering insights into the exploitation of the endocannabinoid system, this review contributes to the development of novel cannabinoid-based treatment avenues for AD. This pursuit aligns with the broader objective of addressing the debilitating effects of AD on the quality of life for those affected.}, }
@article {pmid41601601, year = {2025}, author = {Yang, E and Al-Ghraiybah, NF and Alkhalifa, AE and Woodie, LN and Swinford, SP and King, J and Greene, MW and Kaddoumi, A}, title = {Dose-dependent evaluation of chronic oleocanthal on metabolic phenotypes and organ toxicity in 5xFAD mice.}, journal = {Pharmacological research. Natural products}, volume = {8}, number = {}, pages = {}, pmid = {41601601}, issn = {2950-1997}, abstract = {In Alzheimer's disease (AD), alterations in the basal metabolic rate (BMR) and energy expenditure, known as metabolic phenotyping, are present early in the disease, which progresses as the disease advances. The Mediterranean diet, including extra-virgin olive oil (EVOO), has been known to reduce AD risk. Oleocanthal (OC) is a major phenolic compound in EVOO. Previous research showed that OC reduced brain amyloid-β, tau hyperphosphorylation, neuroinflammation, and improved blood-brain barrier and memory functions in AD mouse models. In this work, we aimed to investigate the dose-dependent impact of chronic oral OC treatment on modulating metabolic phenotypes affected by AD and its toxicity in 5xFAD mice, an AD mouse model. 5xFAD mice were treated with OC for 3 months, starting at the ages of one (prevention mode, before the pathology hallmarks appear) and 6 months (treatment mode, after the pathology hallmarks appear). Findings demonstrated OC altered metabolic phenotypes in the 5-20 mg/kg dose range in both groups. Furthermore, OC proved not toxic except at 20 mg/kg, where hepatic toxicity is observed. In conclusion, these findings highlight the OC effect in rectifying metabolic phenotypes in AD. However, it limits the dose range in mice to 5 and 10 mg/kg despite exhibiting a favorable response in metabolic parameters due to observed hepatotoxicity with the 20 mg/kg.}, }
@article {pmid41601569, year = {2025}, author = {Gan, Y and Sun, J and Yang, D and Fang, C and Zhou, Z and Yin, J}, title = {Exploration and validation of biomarkers for Alzheimer's disease based on GEO database.}, journal = {IBRO neuroscience reports}, volume = {19}, number = {}, pages = {1157-1165}, pmid = {41601569}, issn = {2667-2421}, abstract = {OBJECTIVES: The purpose of this study is to leverage bioinformatics techniques to identify differentially expressed genes in Alzheimer's disease (AD), explore potential biomarkers for its early diagnosis, and provide new insights for the early diagnosis and treatment of AD.
METHODS: Two Alzheimer's disease-associated datasets, GSE66351 and GSE153712, were obtained from the Gene Expression Omnibus (GEO) database. Differential methylation analysis was conducted on the raw data utilizing the R programming language. Key genes were discerned by integrating LASSO regression, Pearson correlation analysis, and protein-protein interaction network analysis (PPI). Furthermore, the functional roles of these genes were investigated via Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) enrichment analyses. To assess their causal association with AD, a Mendelian randomization analysis was performed.
RESULTS: In two AD datasets, we identified a total of 387 overlapping differential methylation sites, which mapped to 297 genes. The GO enrichment analysis indicated that these genes are involved in a range of biological processes, such as signal transduction, cell cycle regulation, as well as the function of neuronal cell bodies and synapses. Furthermore, KEGG pathway analysis uncovered that these genes play crucial roles in the PI3K-Akt and TGF-beta signaling pathways. By utilizing a combination of LASSO, Pearson correlation analysis, and PPI network interaction analysis, we have identified five pivotal genes: EBF1, IGF1, EGR2, PRDM16, and RBL2. Finally, Mendelian randomization analysis demonstrated that the IVW analysis for cg00000029 (RBL2) yielded statistically significant results with an odds ratio (OR) of 1.201, and a 95 % confidence interval (CI) ranging from 1.089 to 1.325, corresponding to a p -value of 0.000249.
CONCLUSIONS: This study not only confirmed the known genes linked to AD but, more significantly, revealed the potential connection between the RBL2 gene and AD. Furthermore, it verified a causal link between RBL2 and the risk of AD onset. This finding suggests that the RBL2 gene could serve as a promising biomarker for the early diagnosis of AD, thereby offering novel avenues for future research and clinical interventions.}, }
@article {pmid41599763, year = {2026}, author = {Md Roslan, AH and Tengku Muhazan Shah, TMH and Mohd Saffian, S and John, LJ and Che Ramli, MD and Nassir, CMNCM and Mahadi, MK and Hein, ZM}, title = {Neuroprotective Potential of SGLT2 Inhibitors in Animal Models of Alzheimer's Disease and Type 2 Diabetes Mellitus: A Systematic Review.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {19}, number = {1}, pages = {}, doi = {10.3390/ph19010166}, pmid = {41599763}, issn = {1424-8247}, support = {GUP-2024-100//National University of Malaysia/ ; }, abstract = {Background: Alzheimer's disease (AD) features progressive cognitive decline and amyloid-beta (Aβ) accumulation. Insulin resistance in type 2 diabetes mellitus (T2DM) is increasingly recognised as a mechanistic link between metabolic dysfunction and neurodegeneration. Although sodium-glucose cotransporter-2 inhibitors (SGLT2is) have established glycaemic and cardioprotective benefits, their neuroprotective role remains less well defined. Objectives: This systematic review examines animal studies on the neuroprotective effects of SGLT2i in T2DM and AD models. Methods: A literature search was conducted across the Web of Science, Scopus, and PubMed databases, covering January 2014 to November 2024. Heterogeneity was assessed with I[2], and data were pooled using fixed-effects models, reported as standardised mean differences with 95% confidence intervals. We focus on spatial memory performance as measured by the Morris Water Maze (MWM) test, including escape latency and time spent in the target quadrant, as the primary endpoints. The secondary endpoints of Aβ accumulation, oxidative stress, and inflammatory markers were also analysed and summarised. Results: Twelve studies met the inclusion criteria for this review. A meta-analysis showed that SGLT2i treatment significantly improved spatial memory by reducing the escape latency in both T2DM and AD models. In addition, SGLT2i yielded a significant improvement in spatial memory, as indicated by an increased target quadrant time for both T2DM and AD. Furthermore, SGLT2i reduced Aβ accumulation in the hippocampus and cortex, which met the secondary endpoint; the treatment also lessened oxidative stress and inflammatory markers in animal brains. Conclusions: Our findings indicate that SGLT2is confer consistent neuroprotective benefits in experimental T2DM and AD models.}, }
@article {pmid41599761, year = {2026}, author = {Yang, L and Yin, Y and Liu, X and Guo, B}, title = {Aptamer-Based Delivery of Genes and Drugs Across the Blood-Brain Barrier.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {19}, number = {1}, pages = {}, doi = {10.3390/ph19010164}, pmid = {41599761}, issn = {1424-8247}, support = {1R01CA293945-01/NH/NIH HHS/United States ; RP260101//Cancer Prevention and Research Institute of Texas/ ; }, abstract = {The blood-brain barrier (BBB) restricts therapeutic delivery to the central nervous system (CNS), hindering the treatment of neurological disorders, such as Alzheimer's disease, Parkinson's disease, brain cancers, and stroke. Aptamers, short single-stranded DNA or RNA oligonucleotides that can fold into unique 3D shapes and bind to specific target molecules, offer high affinity and specificity, low immunogenicity, and promising BBB penetration via receptor-mediated transcytosis targeting receptors such as the transferrin receptor (TfR) and low-density lipoprotein receptor-related protein 1 (LRP1). This review examines aptamer design through the Systematic Evolution of Ligands by Exponential Enrichment (SELEX) and its variants, mechanisms of BBB crossing, and applications in CNS disorders. Recent advances, including in silico optimization, in vivo SELEX, BBB chip-based MPS-SELEX, and nanoparticle-aptamer hybrids, have identified brain-penetrating aptamers and enhanced the brain delivery efficiency. This review highlights the potential of aptamers to transform CNS-targeted therapies.}, }
@article {pmid41599628, year = {2025}, author = {Titze-de-Almeida, R and Oliveira Gomes, GM and Santos, TCD and Titze-de-Almeida, SS}, title = {C16-siRNAs in Focus: Development of ALN-APP, a Promising RNAi-Based Therapeutic for Alzheimer's Disease.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {19}, number = {1}, pages = {}, doi = {10.3390/ph19010026}, pmid = {41599628}, issn = {1424-8247}, abstract = {This review examines a small interfering RNA (siRNA) designed for intrathecal (IT) injection, which reduces the formation of amyloid beta precursor protein (APP), a critical factor in the pathology of Alzheimer's disease (AD). The siRNA, designated ALN-APP, incorporates a 16-carbon chain (C16-siRNA) to enhance its delivery to the central nervous system (CNS) while leveraging advancements in specificity and duration of action based on previously approved drugs by the Food and Drug Administration. The development of ALN-APP involved a comprehensive analysis of the optimal carbon chain length and its conjugation position to the siRNA. Preclinical studies conducted on male Sprague Dawley rats, mice, and non-human primates (NHPs) demonstrated the efficacy of ALN-APP. In rats, an IT injection of C16-siRNAs at a concentration of 30 mg/mL, delivering a dose of 0.9 mg, resulted in cranial distribution via cerebrospinal fluid and led to a 75% reduction in copper-zinc superoxide dismutase 1 (SOD1) mRNA levels. These effects were dose-dependent and persisted for three months across multiple brain regions. Furthermore, studies in NHPs indicated that soluble APP levels were reduced to below 25%, sustained for two months. In the cerebrovascular amyloid Nos2[-/-] (CVN) mouse model of AD, administration of 120 µg of siRNA via the intracerebroventricular route produced reductions in APP expression, with mRNA levels remaining suppressed for 60 days in the ventral cortex. Indeed, ALN-APP controlled neuropathology in 5xFAD mice by significantly reducing amyloid levels and brain neuroinflammation, with improved behaviors in the elevated plus maze. Following these promising results in animal models, ALN-APP advanced to a Phase 1 trial, designated ALN-APP-001, which assessed its safety and efficacy in 12 participants with early-onset Alzheimer's disease (EOAD). Initial findings revealed a 55% reduction in soluble APPα and a 69% reduction in APPβ by day 15. These exploratory findings require further validation with larger cohorts and proper statistical analysis. In a subsequent cohort of 36 patients, administration of the 75 mg dose via IT injection led to mean reductions of 61.3% in soluble APPα (sAPPα) and 73.5% in soluble APPβ (sAPPβ) after one month. These silencing effects persisted for six months and were associated with important decreases in Aβ42 and Aβ40 levels. These results highlight the potential of ALN-APPs to address Alzheimer's pathology while maintaining a favorable safety profile. Whether ALN-APP succeeds in further clinical trials, key challenges include ensuring accessibility and affordability due to treatment costs, the need for specialized intrathecal administration, and establishing infrastructure for large-scale production of siRNAs. In conclusion, advancements in ALN-APP represent a promising strategy to reduce beta-amyloid formation in AD, with substantial biomarker reductions suggesting potential disease-modifying effects. Continued development may pave the way for innovative treatments for neurodegenerative diseases.}, }
@article {pmid41599308, year = {2026}, author = {Ptak, A and Warchoł, M and Morańska, E and Laurain-Mattar, D and Spina, R and Dupire, F and Waligórski, P and Simlat, M}, title = {Amaryllidaceae Alkaloids and Phenolic Acids Identification in Leucojum aestivum L. Plant Cultures Exposed to Different Temperature Conditions.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {2}, pages = {}, doi = {10.3390/molecules31020258}, pmid = {41599308}, issn = {1420-3049}, support = {00078.DDD.6509.00124.2022.06//Agency for Restructuring and Modernization of Agriculture/ ; }, mesh = {*Amaryllidaceae Alkaloids/chemistry/metabolism ; Temperature ; *Hydroxybenzoates/metabolism/chemistry/analysis ; *Amaryllidaceae/chemistry/metabolism ; *Liliaceae/chemistry/metabolism ; }, abstract = {Amaryllidaceae alkaloids are of notable pharmacological relevance. For instance, galanthamine is used in the treatment of Alzheimer's disease, while other alkaloids (lycorine, crinine, etc.) derived from Amaryllidaceae plants are also of great interest because they exhibit antitumour, antiviral, antibacterial, antifungal, antimalarial, analgesic and cytotoxic properties. Phenolic acids comprise a group of natural bioactive substances that have commercial value in the cosmetic, food and medicinal industries due to their antioxidant, anticancer, anti-inflammatory and cardioprotective potential. In the present study, the effect of temperature (15, 20, 25 and 30 °C) on Amaryllidaceae alkaloid and phenolic acid biosynthesis in Leucojum aestivum in vitro plant cultures was investigated. The highest diversity of alkaloids (i.e., galanthamine, crinan-3-ol, demethylmaritidine, crinine, 11-hydroxyvitattine, lycorine, epiisohaemanthamine, chlidanthine) was noted in plants cultured at 30 °C. By contrast, ismine and tazettine were only present in plants cultured at 15 °C. Temperatures of 20 °C and 30 °C were found to stimulate galanthamine accumulation. The highest lycorine content was noted in plants grown at temperatures of 15 and 30 °C, and it was negatively correlated with the expression of the gene that encodes the cytochrome P450 96T (CYP96T) enzyme which catalyses a key step in the biosynthesis of different types of Amaryllidaceae alkaloids. This observation may reflect temperature-induced shifts in metabolic flux among different branches of Amaryllidaceae alkaloid biosynthesis. The observed stimulating effect of a 15 °C temperature on the chlorogenic, caffeic, p-coumaric, sinapic, ferulic and isoferulic acid content was in line with the highest expression of a gene that encodes the tyrosine decarboxylase (TYDC) enzyme, which is involved in plant stress response mechanisms. At 30 °C, however, the highest content of the caffeic, vanillic, p-coumaric and isoferulic acids was noted.}, }
@article {pmid41599225, year = {2026}, author = {Bernatoniene, J and Kopustinskiene, DM and Casale, R and Medoro, A and Davinelli, S and Saso, L and Petrikonis, K}, title = {Nrf2 Modulation by Natural Compounds in Aging, Neurodegeneration, and Neuropathic Pain.}, journal = {Pharmaceutics}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/pharmaceutics18010118}, pmid = {41599225}, issn = {1999-4923}, support = {S-A-UEI-23-7//Research Council of Lithuania (LMTLT)/ ; }, abstract = {This review summarizes the role of nuclear factor erythroid 2-related factor 2 (Nrf2) as a common link between aging, neurodegeneration, and neuropathic pain. Aging is characterized by oxidative stress and constant inflammation, which coincides with reduced Nrf2 activity and weaker antioxidant responses, increasing vulnerability to diseases. In neurodegenerative disorders-including Alzheimer's, Parkinson's, Huntington's disease, and amyotrophic lateral sclerosis-evidence indicates that impaired Nrf2 signaling contributes to oxidative damage, neuroinflammation, and mitochondrial dysfunction. Furthermore, in neuropathic pain, similar mechanisms are involved, and Nrf2 could play a role as a potential analgesic target because of its role in regulating cellular defense pathways. We also review natural Nrf2 modulators (e.g., flavonoids, other polyphenols, terpenoids, alkaloids), discussing their benefits alongside common translational limitations such as poor solubility, low oral bioavailability, rapid metabolism, and potential safety issues, including possible pro-oxidant effects and chemoresistance. We also outline future directions that should prioritize improving delivery systems, addressing NRF2/KEAP1 gene variations, evaluating combinations with standard therapies, exploring preventive applications, and defining dosing, treatment duration, and long-term safety. Overall, current evidence indicates that Nrf2 modulation is a practical, cross-cutting approach relevant to healthy aging and disease management.}, }
@article {pmid41599190, year = {2026}, author = {El-Dakroury, WA and Salim, SA and Said, AR and Asaad, GF and Abdelhameed, MF and Shabana, ME and Ibrahim, MM and Abualmajd, SG and Mosaad, HH and Salama, AA and Asran, SE and Amer, ML and Doghish, AS and El-Tokhy, FS}, title = {Novel Repurposing of Empagliflozin-Loaded Buccal Composite (Chitosan/Silk Fibroin/Poly(lactic acid)) Nanofibers for Alzheimer's Disease Management via Modulation of Aβ-AGER-p-tau Pathway.}, journal = {Pharmaceutics}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/pharmaceutics18010083}, pmid = {41599190}, issn = {1999-4923}, abstract = {Background/Objectives: Empagliflozin (EMPA) was repurposed for Alzheimer's disease (AD) treatment via buccal delivery, exploiting novel nanofibers (NFs) integrating chitosan (Cs), silk fibroin (Fb), and poly(lactic acid) (PLA). Methods: EMPA-loaded Cs/Fb/PLA NFs were electrospun in different formulations to optimize the formulation parameters. The optimized formulation was then investigated for its enhanced in vivo effect. Results: Optimized nanofiber diameters ranged from 459 ± 173 to 668 ± 148 nm, possessing bead-free morphology confirmed by SEM and satisfactory mechanical properties. EMPA was successfully well-dispersed in the polymer matrix as evidenced by FTIR, XRD, and drug content. The optimized NFs displayed a hydrophilic surface (contact angle < 90°), and biphasic drug release with sustained EMPA liberation (84.98% over 24 h). In vivo, buccal EMPA-Cs/Fb/PLA NFs in an AlCl3-induced AD rat model significantly reduced brain-amyloid-β, phosphorylated tau, IL-1β, and AGER expression by 2.88-, 2.64-, 2.87-, and 2.50-fold, respectively, compared to positive controls, and improved locomotor activity (1.86-fold) and cognitive performance (T-maze) (4.17-fold). Compared to pure EMPA, the nanofiber formulation achieved further reductions in amyloid-β (1.78-fold), p-tau (1.42-fold), IL-1β (1.89-fold), and AGER (1.38-fold), with efficacy comparable to memantine. Histopathological examination revealed preservation of the hippocampal neuronal structure. Conclusions: The findings suggest EMPA-loaded Cs/Fb/PLA NFs as a promising non-invasive, sustained-release buccal delivery platform for AD therapy, offering multimodal neuroprotection through modulation of the Aβ-AGER-p-tau axis.}, }
@article {pmid41599177, year = {2026}, author = {Li, F and Wu, L and Feng, X and Li, Y and Fan, H}, title = {Extracellular Vesicles in Alzheimer's Disease: Dual Roles in Pathogenesis, Promising Avenues for Diagnosis and Therapy.}, journal = {Pharmaceutics}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/pharmaceutics18010070}, pmid = {41599177}, issn = {1999-4923}, support = {LQ24H160003//Zhejiang Provincial Natural Science Foundation/ ; 2023KY299//Medical Scientific Research Foundation of Zhejiang Province/ ; 2024KY351//Medical Scientific Research Foundation of Zhejiang Province/ ; 2023J365//Ningbo Natural science foundation/ ; 2021A-012-G//Young Innovative Talent Project of Yongjiang Talent Introduction Programme of Ningbo Municipal Government/ ; 2023RC004//Bei'An Talent Programme of Jiangbei District of Ningbo/ ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by the accumulation of amyloid-β (Aβ) plaques, neurofibrillary tau tangles, chronic neuroinflammation, and synaptic loss, leading to cognitive decline. Extracellular vesicles (EVs)-lipid bilayer nanoparticles secreted by nearly all cell types-have emerged as critical mediators of intercellular communication, playing a complex dual role in both the pathogenesis and potential treatment of AD. This review generally delineates two opposite roles of EVs in pathogenesis and potential treatment of AD. On one hand, EVs derived from neurons, astrocytes, microglia and oligodendrocytes can propagate toxic proteins (Aβ, tau) and inflammatory signals, thereby accelerating disease progression. On the other hand, EVs-especially those from mesenchymal stem cells (MSCs)-exert neuroprotective effects by facilitating toxic protein clearance, modulating immune responses, preserving synaptic integrity, and alleviating oxidative stress. The cargo-carrying function of EVs gives them considerable diagnostic value. The associated cargos such as proteins and microRNAs (miRNAs) in the EVs may serve as minimally invasive biomarkers for early detection and monitoring of AD. Therapeutically, engineered EVs, including those incorporating CRISPR/Cas9-based genetic modification, are being developed as sophisticated delivery platforms for targeting core AD pathologies. Furthermore, this review highlights emerging technologies such as microfluidic chips and focused ultrasound (FUS), discussing their potential to enhance the translational prospects of EV-based early diagnostic and treatment for AD.}, }
@article {pmid41599176, year = {2026}, author = {Santos, P and Sá Filho, AS and Aprigliano, V and Duarte, AG and Ribeiro, NA and Lombardo, KM and Fajemiroye, JO and Buchholz, AP and Vaz, VR and Chiappa, GR}, title = {Liraglutide and Exenatide in Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Cognitive Outcomes.}, journal = {Pharmaceutics}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/pharmaceutics18010069}, pmid = {41599176}, issn = {1999-4923}, abstract = {Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exhibit neuroprotective properties in preclinical models of Alzheimer's disease (AD), reducing amyloid accumulation, neuroinflammation, and insulin resistance within the brain. However, clinical evidence regarding their cognitive effects in AD and mild cognitive impairment (MCI) remains inconclusive. To evaluate the effects of GLP-1 RAs on cognitive outcomes in patients with AD or MCI due to AD. Methods: A systematic review was conducted according to PRISMA 2020 and registered in PROSPERO (CRD420251143171). Although the original registry was broad, the identification of a small set of homogeneous randomized controlled trials (RCTs) during screening, prior to data extraction, allowed for a random-effects meta-analysis of cognitive outcomes. RCTs enrolling adults with clinically or biomarker-confirmed AD or MCI were included. Interventions comprised liraglutide or exenatide compared with placebo. Standardized mean differences (SMD) in global cognitive scores were pooled using a random-effects model (restricted maximum likelihood [REML] estimator with Hartung-Knapp adjustment). Results: Three randomized trials (n = 278 participants; 51% women; mean age 68 ± 7 years) met inclusion criteria. Treatment duration ranged from 26 weeks to 18 months. Pooled analysis revealed no significant effect of GLP-1 RAs on global cognition compared with placebo -0.21 (95% CI -0.81 to 0.38; I[2] = 47%; τ[2] = 3.77). Sensitivity analyses restricted to liraglutide or studies ≥ 12 months yielded similar results. Conclusions: Current randomized evidence does not support cognitive improvement with GLP-1 RAs in AD or MCI.}, }
@article {pmid41598278, year = {2026}, author = {Burgos-Puentes, S and Avendaño-Estrada, A and Sablón-Carrazana, M and Ramírez-Hernández, E and Granados-Juárez, A and Ramírez-Rodríguez, GB and Meraz-Ríos, M and Martínez-Coria, H and Ávila-Rodríguez, MA}, title = {Animal Models of Alzheimer's Disease Evaluated with [[11]C]Pittsburg Compound B.}, journal = {Life (Basel, Switzerland)}, volume = {16}, number = {1}, pages = {}, doi = {10.3390/life16010123}, pmid = {41598278}, issn = {2075-1729}, support = {PRONACES 322512//CONAHCYT/ ; PAPPIT-IT201623//DGAPA-UNAM/ ; }, abstract = {Several animal models of Alzheimer's disease have been developed and tested for diagnostic and treatment purposes. [[11]C]PIB is the gold-standard radiotracer for the detection of Aβ plaque deposits, a hallmark of the disease. This study aimed to evaluate the in vivo detection of Aβ plaques using [[11]C]PIB microPET imaging across different animal models of Alzheimer's disease. The study included 3xTg-AD transgenic mice, TgF344-AD transgenic rats and Aβ injection-based rat model. The results showed an age-related increase in [[11]C]PIB uptake in 3xTg-AD mice, particularly in the midbrain and thalamus. In TgF344-AD rats, differences were also observed compared to WT controls, with the highest values observed in the hippocampus and cortex. In the injection-based model, inoculated rats showed greater uptake in the injection site than SHAM animals. Across all microPET studies, [[11]C]PIB uptake was consistently higher in females than in their male counterparts. These findings support the value of transgenic and Aβ injection-based models in preclinical research on Aβ plaque deposition and highlight the importance of considering species, model type, sex, and age in experimental design.}, }
@article {pmid41597254, year = {2026}, author = {Brustovetsky, T and Khanna, R and Brustovetsky, N}, title = {Collapsin Response Mediator Protein 2 (CRMP2) Modulates Induction of the Mitochondrial Permeability Transition Pore in a Knock-In Mouse Model of Alzheimer's Disease.}, journal = {Cells}, volume = {15}, number = {2}, pages = {}, doi = {10.3390/cells15020179}, pmid = {41597254}, issn = {2073-4409}, support = {R01 NS098772/GF/NIH HHS/United States ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/pathology/genetics ; Disease Models, Animal ; Mitochondria/metabolism ; *Mitochondrial Permeability Transition Pore/metabolism ; Mice ; *Nerve Tissue Proteins/metabolism/genetics ; Phosphorylation ; *Intercellular Signaling Peptides and Proteins/metabolism ; Gene Knock-In Techniques ; Neurons/metabolism ; *Mitochondrial Membrane Transport Proteins/metabolism ; Mice, Transgenic ; Humans ; }, abstract = {Hyperphosphorylated collapsin response mediator protein 2 (CRMP2) is elevated in the cerebral cortex of an APP-SAA knock-in mouse model of Alzheimer's disease and binds the adenine nucleotide translocase (ANT) in a phosphorylation-dependent manner. We propose that, in Alzheimer's disease (AD) mitochondria, dissociation of hyperphosphorylated CRMP2 from ANT promotes opening of the permeability transition pore (PTP). We showed that purified ANT, when reconstituted into giant liposomes, forms large calcium-dependent channels resembling the PTP, which are effectively blocked by recombinant, unphosphorylated CRMP2. In synaptic mitochondria isolated from the cortices of APP-SAA knock-in mice and control B6J hAbeta mice, we observed an increased susceptibility to permeability transition pore (PTP) induction in AD mitochondria, accompanied by reduced viability of cultured cortical neurons. Pre-treatment of AD mice with the CRMP2-binding small molecule (S)-lacosamide ((S)-LCM), which prevents CRMP2 hyperphosphorylation and restores its interaction with ANT, attenuated PTP induction and improved neuronal viability. Interestingly, direct application of (S)-LCM to isolated mitochondria failed to suppress PTP induction, indicating that its protective effect requires upstream cellular mechanisms. These findings support a phosphorylation-dependent role for CRMP2 in regulating PTP induction in AD mitochondria and highlight (S)-LCM as a promising therapeutic candidate for mitigating mitochondrial dysfunction and enhancing neuronal viability in AD.}, }
@article {pmid41596702, year = {2026}, author = {Shaikh, A and Ahmad, F and Murthy, J and Teoh, SL and Yahaya, MF}, title = {Early Molecular Biomarkers in an Amyloid-β-Induced Rat Model of Alzheimer's Disease: Effects of Kelulut Honey.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, doi = {10.3390/ijms27021059}, pmid = {41596702}, issn = {1422-0067}, support = {GUP-2021-038//UKM Research University Grant/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/chemically induced/pathology/blood ; *Amyloid beta-Peptides/metabolism/toxicity ; *Biomarkers/metabolism/blood ; Rats ; Disease Models, Animal ; *Honey ; Chemokine CCL2/metabolism/blood ; Hippocampus/metabolism/pathology ; Male ; Peptide Fragments/metabolism ; tau Proteins/metabolism ; Superoxide Dismutase-1/metabolism/blood ; Phosphorylation ; Humans ; Transcription Factor RelA/metabolism ; }, abstract = {Alzheimer's disease (AD) is the leading cause of dementia worldwide, characterized by progressive neurodegeneration and cognitive decline. Early diagnosis remains critical for enabling timely intervention. However, detecting the earliest pathological changes is challenging due to the limited availability of reliable biomarkers that reflect early disease pathology in experimental models. This study evaluated molecular markers associated with AD-related processes in a rat model inoculated with human amyloid β (Aβ)1-42 peptides. We assessed the levels of biomarkers: Aβ1-42, Aβ42, phosphorylated tau, monocyte chemoattractant protein-1 (MCP-1), nuclear factor kappa B (NF-κB p65) and superoxide dismutase 1 (SOD1) in hippocampal tissue and serum using enzyme-linked immunosorbent assay. A treatment group receiving Kelulut honey was included to evaluate biomarker responsiveness. Results showed significant elevation in hippocampal Aβ1-42 and phosphorylated tau in diseased rats, with changes in inflammatory markers MCP-1 and NF-κB p65, whereas no significant change was observed in oxidative stress marker SOD1. Serum levels of Aβ1-42 and MCP-1 did not differ significantly between groups, indicating limited peripheral sensitivity after a month of disease induction. These findings suggest that amyloid-, tau-, and inflammation-related markers in hippocampal tissue may be informative for early pathological changes in this acute model, while serum markers showed limited sensitivity.}, }
@article {pmid41596649, year = {2026}, author = {Al-Ghraiybah, NF and Alkhalifa, AE and Itokazu, Y and Farr, TO and Perez, NC and Ali, H and Kaddoumi, A}, title = {Apolipoprotein E4 in Alzheimer's Disease: Role in Pathology, Lipid Metabolism, and Drug Treatment.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, doi = {10.3390/ijms27021004}, pmid = {41596649}, issn = {1422-0067}, mesh = {Humans ; *Alzheimer Disease/metabolism/drug therapy/pathology/genetics ; *Apolipoprotein E4/metabolism/genetics ; *Lipid Metabolism ; Animals ; Blood-Brain Barrier/metabolism/pathology ; }, abstract = {Alzheimer's Disease (AD) is a neurodegenerative disorder characterized by cognitive decline and memory loss. Among the genetic risk factors linked to AD, the Apolipoprotein E4 (ApoE4) remains the strongest. It is well known that carrying the ApoE4 isoform is associated with advanced AD pathology, blood-brain barrier (BBB) disruption, and changes in lipid metabolism. In this review, we provide an overview of the role of centrally and peripherally produced ApoE in AD. After this introduction, we focus on new findings regarding ApoE4's effects on AD pathology and BBB function. We then discuss ApoE's role in lipid metabolism in AD, highlighting examples of lipid changes caused by carrying the ApoE4 isoform. Next, the review explores the implications of ApoE4 isoforms for current treatments-whether they involve anti-amyloid therapy or other pharmacological agents used for AD-emphasizing the importance of personalized medicine approaches for patients with this high-risk allele. This review aims to provide an updated overview of ApoE4's effects on AD pathology and treatment. By integrating recent discoveries, it underscores the critical need to consider ApoE4 status in both research and clinical settings to enhance therapeutic strategies and outcomes for individuals with AD.}, }
@article {pmid41596530, year = {2026}, author = {Higgins, M and Wasef, V and Kwakowsky, A}, title = {FDA-Approved Passive Immunization Treatments Against Aβ in Alzheimer's Disease: Where Are We Now?.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, doi = {10.3390/ijms27020883}, pmid = {41596530}, issn = {1422-0067}, mesh = {*Alzheimer Disease/therapy/immunology/metabolism ; Humans ; *Amyloid beta-Peptides/immunology/metabolism/antagonists & inhibitors ; *Immunization, Passive/methods ; United States ; Apolipoprotein E4/genetics ; Blood-Brain Barrier/metabolism ; United States Food and Drug Administration ; Animals ; Antibodies, Monoclonal/therapeutic use ; Biomarkers ; Antibodies, Monoclonal, Humanized ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by decreased amyloid-beta (Aβ) clearance, enhanced Aβ aggregation, an increased risk of amyloid-related imaging abnormalities (ARIA), and blood-brain barrier (BBB) dysfunction. The APOE4 allele, being the leading genetic risk factor for AD, contributes strongly to these symptoms. This review covers the relationship between APOE4 status and the efficacy of FDA-approved monoclonal antibody (mAb) therapies, namely aducanumab, lecanemab, and donanemab. Across several clinical trials, APOE4 carriers exhibited higher rates of ARIA-E and ARIA-H compared to non-carriers. While the therapies did often meet biomarker endpoints (i.e., reduced amyloid), benefits were only observed in early and mild AD, and cognitive benefits were often marginal. Going forward, experimental apoE4-targeted immunotherapies may ease the burden of APOE4-related pathology. The field is shifting towards a more integrated approach, focusing on earlier interventions, biomarker-driven precision treatment, and improved drug delivery systems, such as subcutaneous injections, receptor-mediated transport, and antibodies with enhanced BBB penetration. As it stands, high treatment costs, limited accessibility, and strict eligibility criteria all stand as barriers to treatment. By integrating the APOE4 genotype into treatment planning and focusing on disease-stage-specific approaches, a safer and more effective means of treating AD could be achieved.}, }
@article {pmid41596255, year = {2026}, author = {Wang, Z and Ba, S and Li, M and Wei, Y and Wang, Y and Mao, J and Xiang, Y and Qin, D and Zeng, C}, title = {Targeting the Gut Microbiota: Mechanistic Investigation of Polyphenol Modulation of the Gut-Brain Axis in Alzheimer's Disease.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, doi = {10.3390/ijms27020604}, pmid = {41596255}, issn = {1422-0067}, support = {82560898//National Natural Science Foundation of China/ ; 82060831//National Natural Science Foundation of China/ ; }, mesh = {*Alzheimer Disease/drug therapy/microbiology/metabolism ; Humans ; *Gastrointestinal Microbiome/drug effects ; *Polyphenols/pharmacology/therapeutic use ; *Brain/drug effects/metabolism ; Animals ; }, abstract = {Alzheimer's disease (AD) represents an increasingly severe global health challenge. Recently, the role of the gut-brain axis in AD pathogenesis has garnered significant attention. Dysbiosis of the gut microbiota can exacerbate core pathologies such as neuroinflammation, amyloid beta (Aβ) deposition, and tau hyperphosphorylation through neural, endocrine, and immune pathways. Polyphenolic compounds have emerged as a focal point in neuroprotective research owing to their pronounced anti-inflammatory and antioxidant properties. Notably, polyphenols exert effects not only by directly influencing the central nervous system (CNS) but also through indirectly modulating the composition and function of the gut microbiota, thereby impacting bidirectional gut-brain communication. This dual mechanism offers a potential avenue for their application in the prevention and treatment of AD. This review aims to compile recent research on the relationship between polyphenols and the gut microbiota. We assessed the literature from PubMed, Google Scholar, and Web of Science databases, published from the establishment of the database to 24 November 2025. The keywords used include "Polyphenols", "Gut-brain axis", "Gut microbiota", "Alzheimer's disease", "Epigallocatechin gallate", "Quercetin", "Curcumin", "Ferulic acid", "Resveratrol", "Anthocyanin", "Myricetin", "Chlorogenic acid", etc. This review discusses the various mechanisms by which polyphenols influence AD through modulating the gut microbiota. Polyphenols and gut microbiota exhibit critical bidirectional interactions. On one hand, the bioavailability and activity of polyphenols are highly dependent on metabolic conversion by gut microbiota. On the other hand, polyphenols selectively promote the proliferation of beneficial bacteria such as bifidobacteria and lactobacilli like prebiotics, while inhibiting the growth of pathogenic bacteria. This reshapes the intestinal microecology, enhances barrier function, and regulates beneficial metabolites. Utilizing a nanotechnology-based drug delivery system, the pharmacokinetic stability and brain targeting efficacy of polyphenols can be significantly enhanced, providing innovative opportunities for the targeted prevention and management of AD.}, }
@article {pmid41595595, year = {2025}, author = {Beretti, F and Malenchini, M and Gatti, M and Maraldi, T}, title = {Oxidative Stress as a Central Mechanistic Bridge Between Alzheimer's and Vascular Pathologies in Mixed Dementia: Emerging Evidence and Therapeutic Perspectives.}, journal = {Biomedicines}, volume = {14}, number = {1}, pages = {}, doi = {10.3390/biomedicines14010059}, pmid = {41595595}, issn = {2227-9059}, abstract = {Mixed dementia (MD), characterized by overlapping features of Alzheimer's disease (AD) and vascular dementia (VaD), represents the most prevalent form of late-life cognitive decline. Increasing evidence identifies oxidative stress as a unifying molecular mechanism driving both neurodegenerative and vascular pathologies in MD. Reactive oxygen species (ROS) contribute to amyloid-β aggregation, tau hyperphosphorylation, endothelial dysfunction, and blood-brain barrier disruption, creating a self-perpetuating cycle of neuronal and vascular injury. Mechanistic models demonstrate how chronic hypoperfusion and mitochondrial dysfunction exacerbate ROS generation and neuroinflammation, while impaired Nrf2-mediated antioxidant defense further amplifies damage. Therapeutically, classical antioxidants show inconsistent efficacy, shifting focus toward mitochondrial protection, Nrf2 activation, and lifestyle-based oxidative load reduction. Therefore, we sought to outline therapeutic approaches capable of broadly targeting these mechanisms, through focused narrative analysis of recent studies employing delivery systems for antioxidant proteins and/or redox-regulating miRNAs. In particular, experimental interventions using mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) demonstrate neuroprotective and anti-inflammatory effects via the Nrf2 pathway, suggesting promising avenues for multimodal treatment. Integrating oxidative, vascular, and neurodegenerative paradigms is essential for advancing diagnostic precision and developing targeted interventions capable of addressing the complex pathophysiology of mixed dementia.}, }
@article {pmid41595571, year = {2025}, author = {Lee, MS and Son, SJ and Kim, J and Go, S and Hong, CH and Roh, HW and Chang, J}, title = {Exploratory Analysis of Autophagy-Lysosomal Pathway Proteins in Dermal Fibroblasts as Potential Peripheral Biomarkers for Alzheimer's Disease: A Pilot Study.}, journal = {Biomedicines}, volume = {14}, number = {1}, pages = {}, doi = {10.3390/biomedicines14010034}, pmid = {41595571}, issn = {2227-9059}, support = {RS-2024-00338983//National Research Foundation of Korea/ ; RS-2019-NR040055//National Research Foundation of Korea/ ; }, abstract = {Background/Objectives: Alzheimer's disease (AD) is characterized by accumulation of abnormal intracellular substances and autophagy-lysosomal pathway (ALP) dysfunction. While current diagnostic methods rely on cerebrospinal fluid biomarkers and neuroimaging, minimally invasive peripheral biomarkers are needed. Dermal fibroblasts could serve as accessible reporters of AD-related molecular changes. This exploratory pilot study investigated whether ALP-associated proteins in patient-derived fibroblasts could serve as potential peripheral biomarkers for AD diagnosis. Methods: We analyzed dermal fibroblasts from 9 AD patients (amyloid Positron emission tomography (PET)-positive) and 9 age-matched controls (amyloid PET-negative). Comprehensive immunoblot analysis assessed expression profiles of 16 AD- and ALP-associated proteins. Autophagic flux and lysosomal function were evaluated using bafilomycin A1 treatment and LysoTracker staining. Diagnostic performance was assessed through receiver operating characteristic (ROC) curve analysis and multivariable logistic regression. Results: AD fibroblasts showed significantly reduced Beta-site APP cleaving enzyme 1 (BACE1) (p = 0.022) and elevated Tax1-binding protein 1 (TAX1BP1) (p = 0.035) expression. BCL2-associated athanogene proteins 2 (BAG2) and OPTN demonstrated consistent directional changes across patients. Preliminary ROC analysis showed promising performance for protein combinations, with BAG2 + OPTN achieving Area under the curve (AUC) = 0.963 (sensitivity 77.8%, specificity 88.9%). Integration with Apolipoprotein E4 (APOE4) status further enhanced diagnostic accuracy (APOE4 + BACE1: AUC = 0.914). Notably, baseline autophagic flux and lysosomal acidification were preserved, suggesting pathway-specific rather than systemic ALP dysfunction. Conclusions: This exploratory study provides preliminary evidence that dermal fibroblast-derived ALP proteins show disease-associated alterations in AD and may represent potential peripheral biomarkers. However, given the small sample size (n = 18) and lack of independent validation, these findings require confirmation in larger multi-center cohorts before clinical translation.}, }
@article {pmid41594924, year = {2026}, author = {Bao, Y and Miao, G and He, N and Bao, X and Shi, Z and Hu, C and Liu, X and Wang, B and Sun, C}, title = {Melatonin as a Guardian of Mitochondria: Mechanisms and Therapeutic Potential in Neurodegenerative Diseases.}, journal = {Biology}, volume = {15}, number = {2}, pages = {}, doi = {10.3390/biology15020189}, pmid = {41594924}, issn = {2079-7737}, abstract = {Mitochondrial dysfunction is a key early pathological process in neurodegenerative diseases (NDs), leading to oxidative stress, impaired energy metabolism, and neuronal apoptosis prior to the onset of clinical symptoms. Although mitochondria represent important therapeutic targets, effective interventions targeting mitochondrial function remain limited. This review summarizes current evidence regarding the mechanisms by which melatonin protects mitochondria and evaluates its therapeutic relevance, with a primary focus on Alzheimer's disease, Parkinson's disease, and Huntington's disease-the major protagonists of NDs-while briefly covering other NDs such as amyotrophic lateral sclerosis, multiple sclerosis, and prion diseases. Melatonin selectively accumulates in neuronal mitochondria and exerts neuroprotection through multiple pathways: (1) direct scavenging of reactive oxygen species (ROS); (2) transcriptional activation of antioxidant defenses via the SIRT3 and Nrf2 pathways; (3) regulation of mitochondrial dynamics through DRP1 and OPA1; and (4) promotion of PINK1- and Parkin-mediated mitophagy. Additionally, melatonin exhibits context-dependent pleiotropy: under conditions of mild mitochondrial stress, it restores mitochondrial homeostasis; under conditions of severe mitochondrial damage, it promotes pro-survival autophagy by inhibiting the PI3K/AKT/mTOR pathway, thereby conferring stage-specific therapeutic advantages. Overall, melatonin offers a sophisticated mitochondria-targeting strategy for the treatment of NDs. However, successful clinical translation requires clarification of receptor-dependent signaling pathways, development of standardized dosing strategies, and validation in large-scale randomized controlled trials.}, }
@article {pmid41594819, year = {2026}, author = {Motoi, Y and Sanjo, N}, title = {Switching from Oral Cholinesterase Inhibitors to a Transdermal Donepezil Patch Attenuated Gastrointestinal Symptoms and Allowed Treatment Continuation in Three Patients with Alzheimer's Disease in Clinical Settings.}, journal = {Brain sciences}, volume = {16}, number = {1}, pages = {}, doi = {10.3390/brainsci16010098}, pmid = {41594819}, issn = {2076-3425}, abstract = {Background: Cholinesterase inhibitors (ChEIs) are commonly prescribed for the treatment of Alzheimer's disease (AD) and achieve long-term benefits for cognition and survival in real-world settings. However, the discontinuation rate is high due to their side effects, with gastrointestinal (GI) symptoms hampering long-term prescriptions. The risk of side effects associated with rivastigmine was previously shown to be lower with transdermal delivery than with oral capsules; however, this has yet to be examined in detail for donepezil, the most widely used ChEI. The daily application of a donepezil transdermal patch was officially approved in Japan in 2023. The incidence of side effects was lower with the donepezil transdermal patch than with oral donepezil in healthy volunteers, but has not yet been assessed in clinical settings. Results: We herein report three AD patients in two different memory clinics who developed GI symptoms with oral ChEIs that were attenuated by switching to the donepezil transdermal patch. Conclusions: The donepezil transdermal patch may improve tolerability and adherence in patients who develop gastrointestinal adverse effects with oral donepezil.}, }
@article {pmid41594643, year = {2026}, author = {Pawar, Y and Kopranovic, A and C S, R and Meyer-Almes, FJ}, title = {Epigenetic Dysregulation in Neurodegeneration: The Role of Histone Deacetylases and Emerging Inhibitor Strategies.}, journal = {Biomolecules}, volume = {16}, number = {1}, pages = {}, doi = {10.3390/biom16010103}, pmid = {41594643}, issn = {2218-273X}, support = {none//Darmstadt University of Applied Sciences/ ; }, mesh = {Humans ; *Histone Deacetylase Inhibitors/pharmacology/therapeutic use/chemistry ; *Histone Deacetylases/metabolism/genetics ; *Epigenesis, Genetic/drug effects ; *Neurodegenerative Diseases/genetics/drug therapy/metabolism ; Animals ; }, abstract = {Neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD) are characterized by complex pathologies with progressive neurodegeneration, protein misfolding, oxidative stress, and persistent inflammation. Recent findings indicate the pivotal involvement of epigenetic disruption, particularly aberrant histone deacetylase (HDAC) activity, in disease initiation and progression. In the current review, we systematically discuss the mechanistic function of HDACs across all classes (I, IIa, IIb, III, and IV) in neurodegenerative disease mechanisms, such as their involvement in the modulation of gene expression, mitochondrial function, proteostasis, and neuronal survival. We discuss the therapeutic potential, as well as limitations, of HDAC inhibitors (HDACis), such as pan-inhibitors and isoenzyme-selective inhibitors, and new multi-target-directed ligands with HDAC inhibition combined with acetylcholinesterase modulation, PDE modulation, MAO-B inhibition, or NMDAR modulation. Particular emphasis is placed on the development of HDAC6-selective inhibitors with enhanced brain permeability and reduced toxicity, which have shown promising preclinical efficacy in ameliorating hallmark pathologies of AD, PD, and HD. In addition, s-triazine-based scaffolds have recently emerged as promising chemotypes in HDAC inhibitor design, offering favorable pharmacokinetic profiles, metabolic stability, and the potential for dual-target modulation relevant to neurodegeneration. The review also explores the future of HDAC-targeted therapies, including PROTAC degraders, dual-inhibitor scaffolds, and sustainable, BBB-penetrant molecules. Collectively, this review underscores the importance of HDAC modulation as a multifaceted strategy in the treatment of neurodegenerative diseases and highlights the need for continued innovation in epigenetic drug design.}, }
@article {pmid41594629, year = {2026}, author = {Zedde, M and Losa, M and Grisafi, E and Lucia, DD and Gandoglia, I and Del Sette, M and Pardini, M and Roccatagliata, L and Pascarella, R and Piazza, F}, title = {Spontaneous and Drug-Induced Amyloid-Related Imaging Abnormalities: Overlaps, Divergences, and Clinical Implications Across a Continuum Between Alzheimer's Disease and Cerebral Amyloid Angiopathy.}, journal = {Biomolecules}, volume = {16}, number = {1}, pages = {}, doi = {10.3390/biom16010089}, pmid = {41594629}, issn = {2218-273X}, mesh = {Humans ; *Cerebral Amyloid Angiopathy/diagnostic imaging/metabolism/pathology ; *Alzheimer Disease/diagnostic imaging/metabolism/pathology ; *Amyloid/metabolism ; }, abstract = {BACKGROUND: Amyloid-related imaging abnormalities (ARIA) have gained significance in the context of anti-amyloid therapies (AATs), exhibiting clinical and radiological manifestations that overlap with Cerebral Amyloid Angiopathy-related inflammation (CAA-ri). This review aims to elucidate the similarities and differences between spontaneous (sARIA) and drug-induced ARIA (dARIA).
METHODS: We conducted a narrative review comparing sARIA and dARIA, focusing on their underlying mechanisms, clinical presentations, and implications for diagnosis and treatment.
RESULTS: Both sARIA and dARIA are characterized by similar pathophysiological mechanisms involving amyloid deposits and neuroinflammation. Notably, ARIA can manifest as ARIA-E (edema) or ARIA-H (hemorrhage), with varying incidence rates in clinical trials. The review highlights that while sARIA occurs independently from treatment, dARIA is associated with AAT and can lead to significant symptomatic presentations.
CONCLUSIONS: Understanding the continuum between sARIA and dARIA is crucial for improving diagnostic criteria, risk stratification, and therapeutic approaches. The proposed unified framework emphasizes the need for consensus in managing these conditions and advancing future research in amyloid-related diseases.}, }
@article {pmid41593839, year = {2026}, author = {Grese, Z and Naidu, A and Silverglate, BD and Grossberg, GT}, title = {The impact of the ketogenic diet on Alzheimer's disease progression.}, journal = {Expert review of neurotherapeutics}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/14737175.2026.2621502}, pmid = {41593839}, issn = {1744-8360}, abstract = {INTRODUCTION: The ketogenic diet as a potential treatment for Alzheimer's disease (AD) has been investigated in several controlled trials. This topic is significant because of the limited nature of current interventions for AD, and the increasing recognition that lifestyle interventions may be important for reducing the risk of AD. The ketogenic diet is one of the few lifestyle interventions that has the potential to be beneficial after diagnosis.
AREAS COVERED: In this narrative review, the authors discuss the biological plausibility of how a ketogenic diet may improve amyloid burden and reduce neuroinflammation by providing an alternative energy source. They review relevant meta-analyses, systematic reviews, and controlled trials to investigate this diet in people diagnosed with AD. To this end, the authors used PubMed to search for appropriate systematic reviews and human trials, and closely examined the bibliographies of these papers to find trials potentially missed in their initial search.
EXPERT OPINION: More research is needed before a ketogenic diet could be broadly recommended in patients diagnosed with AD. However, to the extent a treatment effect has been demonstrated, it is comparable to some pharmaceutical interventions in AD. Challenges that remain include demonstrating improvement in quality of life, improving adherence, and standardizing ketogenic therapies.}, }
@article {pmid41593813, year = {2026}, author = {Beusink, M and de Rijke, TJ and Schaaij-Visser, TBM and Berkhout, M and Kroon, L and Smeitink, M and van der Landen, SM and Kaijser, KKM and Saaltink, DJ and van der Rhee, E and Rebers, S and de Boer, C and Rhodius-Meester, HFM and van der Flier, WM and Visser, LNC}, title = {Evaluation and lessons learned regarding Public Involvement: a panel advising on an Alzheimer's disease and related dementia cohort study.}, journal = {Research involvement and engagement}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40900-026-00844-1}, pmid = {41593813}, issn = {2056-7529}, support = {ZonMw projectnumber 10510022110004//the Memorabel Dementia Fellowship 2021/ ; }, }
@article {pmid41593242, year = {2026}, author = {Hobson, R and Levy, SHS and Singal, CMS and Flaherty, D and Xiao, H and Ciener, B and Reddy, H and Zabinyakov, N and Kim, CY and Teich, AF and Shneider, NA and Bradshaw, EM and Elyaman, W}, title = {Clonal CD8[+] T cells populate the leptomeninges and coordinate with immune cells in human degenerative brain diseases.}, journal = {Nature immunology}, volume = {}, number = {}, pages = {}, pmid = {41593242}, issn = {1529-2916}, support = {PF-IMP-870699//Parkinson's Foundation (Parkinson's Foundation, Inc.)/ ; }, abstract = {Meningeal immune cells monitor the central nervous system (CNS) and influence neuroinflammation in mice, but the human leptomeningeal immune landscape and the changes that occur in this immunological niche in neurodegeneration remain underexplored. Here we performed single-cell RNA and T cell receptor (TCR) sequencing of 99,625 high-quality immune cells from 57 leptomeninges and brain samples from donors with Alzheimer's disease (AD), amyotrophic lateral sclerosis and Parkinson's disease and found that although the leptomeninges are home to highly clonally expanded CD8 tissue-resident memory (TRM) T cells, the maximal level of clonal expansion was decreased in AD in comparison to non-neurodegenerative controls. Intra-patient paired tissue analysis further revealed that brain and leptomeningeal TCR repertoires share significant similarities, but tissue-specific clones emerge in AD. Finally, in AD, the degree of CD8 TRM clonal expansion was positively correlated with microglial TGFB2, suggesting that brain and leptomeningeal immune cells coordinate their activities in AD. In addition to identifying key inflammatory dynamics in the human degenerating CNS, this study establishes a foundational resource for future studies that could inform treatment for AD and other neuroinflammatory diseases.}, }
@article {pmid41593034, year = {2026}, author = {Fulop, T and Cohen, AA and Frost, EH and Lévesque, S and Khalil, A and Rodrigues, S and Desroches, M and Alami, M and Berrougui, H and Ramassamy, C and Hirokawa, K and Witkowski, JM and Laurent, B}, title = {Unmasking the hidden catalyst: How infections trigger Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251415571}, doi = {10.1177/13872877251415571}, pmid = {41593034}, issn = {1875-8908}, abstract = {For years, the understanding of Alzheimer's disease (AD) has been shaped by the amyloid hypothesis, which suggests that pathological markers like amyloid-β (Aβ) and phosphorylated tau are the primary drivers of the disease. This hypothesis has guided the development of major treatment strategies, including monoclonal antibodies targeting Aβ. However, most of these treatments have failed to produce clinically significant results, highlighting the urgent need for a new therapeutic approach. It is now evident that AD is a complex, multifactorial disease that develops over decades, ultimately leading to Aβ and tau accumulation. Therefore, addressing the underlying causes of these depositions is crucial. One well-supported yet underrecognized theory is the infection hypothesis, which links infections to AD pathology. Despite substantial scientific evidence, this perspective has faced significant resistance. In this review, we describe how chronic infections contribute to AD by triggering neuroinflammation and Aβ accumulation. We also explore the barriers to accepting the infection hypothesis and the steps necessary for its integration into drug development and early-stage treatment strategies. Persisting with an amyloid-centric approach will only exacerbate the societal burden. Embracing the infection hypothesis could transform AD research, diagnosis, and treatment, bringing new hope to millions.}, }
@article {pmid41592930, year = {2026}, author = {Fu, Z and Yang, Y and Chung, MK and Cheng, F}, title = {Artificial Intelligence to Guide Repurposing of Drugs.}, journal = {Annual review of medicine}, volume = {77}, number = {1}, pages = {381-398}, doi = {10.1146/annurev-med-050224-122802}, pmid = {41592930}, issn = {1545-326X}, mesh = {*Drug Repositioning/methods ; Humans ; *Artificial Intelligence ; Machine Learning ; Precision Medicine ; }, abstract = {With the pharmacokinetics, dosing, safety, and manufacturing of approved or investigational drugs already well-characterized, drug repurposing and repositioning offer emerging strategies to rapidly develop effective treatments for various challenging diseases. However, the growing mass of genetic and multiomics data has not been effectively explored by the drug repurposing community due to a lack of accurate approaches. This review aims to be an authoritative, critical, and accessible review and discussion of general interest to the drug repurposing community concerning the use of artificial intelligence (AI) and machine learning (ML) tools. Emerging questions include what is achievable with AI in this domain and what its impact will be, what AI and ML embrace, and how we, as geneticists, pharmacologists, and computational scientists, can contribute to the discovery of new, inexpensive, and affordable repurposable medicines. The fast growth of genetics and multiomics data (genomics, transcriptomics, proteomics, metabolomics, and radiomics) and electronic health records in diverse populations contributes to answering questions, including how to rapidly identify effective repurposable medicines, what a clinically meaningful effect size in trials is, and what the potential implications for precision medicine are. This review discusses AI and ML for drug repurposing in the context of genetics, multiomics, real-world data collection, and crowdsourcing of knowledge. We conclude by considering questions on how AI and ML methodologies can unite the diverse aspects of translational medicine for emerging treatment development in human-challenging diseases.}, }
@article {pmid41592521, year = {2026}, author = {Wang, J and Su, O and Meng, Z and Lu, L and Qi, Y and Zhang, Z and Li, Z and Dong, X and Lian, H and Mu, Y}, title = {Layered double hydroxide-induced modulation of oxidative stress in disease therapy.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {195}, number = {}, pages = {119063}, doi = {10.1016/j.biopha.2026.119063}, pmid = {41592521}, issn = {1950-6007}, abstract = {Oxidative stress plays a crucial role in the development of various diseases, including diabetes, cardiovascular diseases, cancer, and rheumatic disorders. It disrupts the redox balance and initiates a series of pathological changes. As two-dimensional inorganic solids with an open structure and anion-exchange properties, layered double hydroxides (LDHs) offer significant advantages in the biomedical field, such as drug carriers, antioxidant catalysts. This article outlines application of LDHs in the treatment of cancer, rheumatic diseases, bone disorders, diabetes, Alzheimer's disease, and other conditions. More importantly, this paper elaborates on the challenges faced by the application of LDHs, including the biological activity to be explored, the performance to be optimized, and their in vivo functions and molecular mechanisms to be clarified. The solution strategies have also been discussed, which pointed out the direction for promoting the clinical transformation and application of LDHs in the future.}, }
@article {pmid41592400, year = {2026}, author = {Gönüllü, S and Aydın, Ş and Çelik, H and Çelik, O and Küçükler, S and Topal, A and Akay, R and Yıldız, MO and Alım, B and Çulha, MH and Özdemir, S}, title = {In vitro investigation of miR-206-3p-loaded extracellular vesicles as modulators of Aβ-induced neurodegeneration.}, journal = {Biochemical and biophysical research communications}, volume = {802}, number = {}, pages = {153306}, doi = {10.1016/j.bbrc.2026.153306}, pmid = {41592400}, issn = {1090-2104}, abstract = {In this study, we investigated the therapeutic potential of miR-206-3p delivered via small extracellular vesicles (sEVs) in an in vitro Alzheimer's disease model using SH-SY5Y human neuroblastoma cells treated with amyloid beta (Aβ). The sEV-miR-206-3p complexes were successfully loaded with miR-206-3p (∼0.001 copies per particle) without disrupting vesicle integrity or inducing cytotoxicity at the optimized concentration of 5 μg/mL. Aβ treatment significantly increased oxidative stress markers (ROS, MDA, LDH) and decreased antioxidant enzyme activity (SOD), while GPX1 showed an opposite trend. Furthermore, Aβ elevated proinflammatory gene expression (ICAM1, TNF-α) and reduced neuroprotective BDNF levels, induced mitochondrial dysfunction (increased Cyt-c, PINK1, DNM1L; decreased TFAM), impaired synaptic proteins (CPLX2, ROR1), and promoted tau phosphorylation and Aβ accumulation. Treatment with sEV-miR-206-3p effectively mitigated these alterations, reducing oxidative stress, suppressing neuroinflammatory responses, restoring mitochondrial function and synaptic protein levels, and attenuating tau and Aβ pathology. These findings demonstrate that miR-206-3p-loaded sEVs protect neuroblastoma cells from Aβ-induced neurodegenerative processes, highlighting their potential as a novel drug delivery system for neuroprotection.}, }
@article {pmid41591746, year = {2026}, author = {Cummings, JL and Chumki, SR and Chang, D and Zhang, Z and Brubaker, M and Hefting, N and Such, P and Wang, D and Grossberg, GT}, title = {Efficacy of Brexpiprazole in Participants with Agitation Associated with Dementia Due to Alzheimer's Disease: Pooled Analysis of Randomized Controlled Trials.}, journal = {Clinical drug investigation}, volume = {}, number = {}, pages = {}, pmid = {41591746}, issn = {1179-1918}, abstract = {OBJECTIVE: This analysis aimed to evaluate the efficacy of brexpiprazole 2 or 3 mg/day for the treatment of agitation associated with dementia due to Alzheimer's disease, on the basis of pooled clinical trial data.
METHODS: Data were pooled from two similarly designed, phase 3, 12-week, multicenter, randomized, double-blind, placebo-controlled trials of fixed-dose brexpiprazole in participants in care facilities or community-based settings who had agitation associated with dementia due to Alzheimer's disease. Efficacy outcomes included Cohen-Mansfield Agitation Inventory (CMAI) total score (which measures the frequency of 29 different agitation symptoms), Clinical Global Impression-Severity of illness (CGI-S) score, CMAI factor scores (aggressive behaviors, physically nonaggressive behaviors, and verbally agitated behaviors), and response rates. A sensitivity analysis included a third trial with flexible dosing.
RESULTS: In total, 621 participants were randomized (brexpiprazole, 368; placebo, 253), and completion rates were 320/368 (87.0%) and 225/253 (88.9%), respectively. Mean (SD) baseline CMAI total scores were: brexpiprazole 76.9 (17.2) points and placebo 75.5 (18.0) points. Over 12 weeks, CMAI total scores improved by least squares mean (SE) - 22.8 (0.8) points for brexpiprazole and - 18.3 (1.0) points for placebo, with a least squares mean difference between treatment arms of - 4.50 points (95% CI - 6.90 to - 2.10; p < 0.001; Cohen's d 0.30). CGI-S, CMAI factor, and response analyses also showed greater improvement with brexpiprazole versus placebo. The sensitivity analysis was supportive.
CONCLUSIONS: Brexpiprazole 2 or 3 mg/day reduced agitation symptoms compared with placebo over 12 weeks in this large, pooled sample of participants with dementia due to Alzheimer's disease.
STUDY REGISTRATION: ClinicalTrials.gov identifiers: NCT01862640, NCT03548584, and NCT01922258.}, }
@article {pmid41591137, year = {2025}, author = {Khalid, MZ and Iqbal, N and Ali, B and Rahman, JSU and Iqbal, S and Almudaimeegh, L and Hamd, ZY and Gareeballah, A}, title = {Detection and Classification of Alzheimer's Disease Using Deep and Machine Learning.}, journal = {Tomography (Ann Arbor, Mich.)}, volume = {12}, number = {1}, pages = {}, doi = {10.3390/tomography12010004}, pmid = {41591137}, issn = {2379-139X}, support = {RSP 25850//Princess Nourah bint Abdulrahman University/ ; }, mesh = {Humans ; *Alzheimer Disease/diagnostic imaging/classification/diagnosis ; *Magnetic Resonance Imaging/methods ; *Deep Learning ; Male ; Aged ; Female ; *Machine Learning ; Brain/diagnostic imaging/pathology ; Support Vector Machine ; Aged, 80 and over ; Image Interpretation, Computer-Assisted/methods ; }, abstract = {BACKGROUND/OBJECTIVES: Alzheimer's disease is the leading cause of dementia, marked by progressive cognitive decline and a severe socioeconomic burden. Early and accurate diagnosis is crucial to enhancing patient outcomes, yet traditional clinical and imaging assessments are often limited in sensitivity, particularly at early stages. This study presents a dual-modal framework that integrates symptom-based clinical data with magnetic resonance imaging (MRI) using machine learning (ML) and deep learning (DL) models, enhanced by explainable AI (XAI).
METHODS: Four ML classifiers-K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Decision Tree (DT), and Random Forest (RF)-were trained on demographic and clinical features. For stage-wise classification, five DL models-CNN, EfficientNetB3, DenseNet-121, ResNet-50, and MobileNetV2-were applied to MRI scans. Interpretability was incorporated through SHAP and Grad-CAM visualizations.
RESULTS: Random Forest achieves the highest accuracy of 97% on clinical data, while CNN achieves the best overall performance of 94% in MRI-based staging. SHAP and Grad-CAM were used to find clinically relevant characteristics and brain areas, including hippocampal atrophy and ventricular enlargement.
CONCLUSIONS: Integrating clinical and imaging data and interpretable AI improves the accuracy and reliability of AD staging. The proposed model offers a valid and clear diagnostic route, which can assist clinicians in making timely diagnoses and adjusting individual treatment.}, }
@article {pmid41591092, year = {2026}, author = {Angelopoulou, E and Papageorgiou, S and Papatriantafyllou, J}, title = {Reframing Dementia Prevention Strategies Aligned with the WHO Global Action Plan: A Structured Narrative Review Focusing on Mild Behavioral Impairment.}, journal = {Neurology international}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/neurolint18010018}, pmid = {41591092}, issn = {2035-8385}, abstract = {Background/Objectives: Dementia represents a growing public health challenge. The WHO Global Action Plan on the Public Health Response to Dementia emphasizes early detection, risk reduction, and innovation as key priorities. Mild Behavioral Impairment (MBI), defined as the emergence of persistent neuropsychiatric symptoms in older individuals, represents a potential marker of early neurodegeneration and possible window for early intervention. This review explores the role of MBI in dementia prevention, mapping current evidence within the WHO Global Action Plan framework. Methods: A comprehensive search was performed in PubMed, Scopus, and the official WHO website, during 1 September 2025-10 November 2025, without time restrictions. Eligible sources included original clinical studies, reviews, and policy documents addressing MBI, dementia prevention, and public health. Data were thematically synthesized according to the seven objectives of WHO: (1) dementia as a public health priority, (2) dementia awareness and friendliness, (3) dementia risk reduction, (4) dementia diagnosis, treatment, care and support, (5) support for dementia carers, (6) information systems for dementia, and (7) dementia research and innovation. Results: Accumulating evidence indicates that MBI assessment can capture early behavioral manifestations of neurodegenerative and other forms of dementia, correlating with fluid, neuroimaging and genetic biomarkers. Integrating MBI screening through the easy-to-administer MBI Checklist (MBI-C) into clinical and community-based care, including telemedicine pathways and research, may enhance early identification and personalized interventions, enrich the pool for clinical trials, and facilitate research in biomarker and therapy. MBI-related research further supports its integration in remote digital monitoring and population-based prevention. Conclusions: Embedding MBI-informed screening and interventions into national dementia strategies aligns with WHO objectives for early, equitable and scalable prevention and brain health.}, }
@article {pmid41590318, year = {2026}, author = {Rajkumar, M and Tian, F and Javed, B and Prajapati, BG and Deepak, P and Girigoswami, K and Karmegam, N}, title = {Smart Biosensing Nanomaterials for Alzheimer's Disease: Advances in Design and Drug Delivery Strategies to Overcome the Blood-Brain Barrier.}, journal = {Biosensors}, volume = {16}, number = {1}, pages = {}, doi = {10.3390/bios16010066}, pmid = {41590318}, issn = {2079-6374}, mesh = {*Alzheimer Disease/drug therapy ; *Blood-Brain Barrier ; Humans ; *Drug Delivery Systems ; *Biosensing Techniques ; *Nanostructures/chemistry ; Animals ; Nanoparticles ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by persistent memory impairment and complex molecular and cellular pathological changes in the brain. Current treatments, including acetylcholinesterase inhibitors and memantine, only help with symptoms for a short time and do not stop the disease from getting worse. This is mainly because these drugs do not reach the brain well and are quickly removed from the body. The blood-brain barrier (BBB) restricts the entry of most drugs into the central nervous system; therefore, new methods of drug delivery are needed. Nanotechnology-based drug delivery systems (NTDDS) are widely studied as a potential approach to address existing therapeutic limitations. Smart biosensing nanoparticles composed of polymers, lipids, and metals can be engineered to enhance drug stability, improve drug availability, and target specific brain regions. These smart nanoparticles can cross the BBB via receptor-mediated transcytosis and other transport routes, making them a promising option for treating AD. Additionally, multifunctional nanocarriers enable controlled drug release and offer theranostic capabilities, supporting real-time tracking of AD treatment responses to facilitate more precise and personalized interventions. Despite these advantages, challenges related to long-term safety, manufacturing scalability, and regulatory approval remain. This review discusses current AD therapies, drug-delivery strategies, recent advances in nanoparticle platforms, and prospects for translating nanomedicine into effective, disease-modifying treatments for AD.}, }
@article {pmid41589495, year = {2026}, author = {Dewangan, A and Nandy, SK and Das, AK and Sharma, A and Sharma, L}, title = {Enzymatic Biomarkers for Early Diagnosis of Alzheimer's Disease: Uncovering Key Targets and Mechanisms.}, journal = {CNS & neurological disorders drug targets}, volume = {}, number = {}, pages = {}, doi = {10.2174/0118715273418918251112112429}, pmid = {41589495}, issn = {1996-3181}, abstract = {Alzheimer's Disease (AD) is a neuronal illness that disrupts behavior, cognitive, and functional abilities. The development of AD is progressive, continuous, and irreversible, from preclinical illness to mild cognitive or even behavioral disturbance to dementia (a medical brain condition) triggered by AD. Worldwide accepted hypotheses of AD are called the amyloid-cascade and hyperphosphorylated tau-cascade hypotheses, and enzymes are implicated in the pathophysiology of AD directly or indirectly. There is an implication of enzymes in the pathophysiology of AD. Enzymes include proteases (e.g., neprilysin), kinases (e.g., glycogen synthase kinase-3), cholinergic enzymes (e.g., acetylcholinesterase), metalloproteinases (e.g., matrix metalloproteinases), and oxidative stress-related enzymes (e.g., superoxide dismutase). However, during abnormal or early Alzheimer's Disease (AD) conditions, the activity and expression of these enzymes are altered in biological samples such as blood, urine, and cerebrospinal fluid (CSF) in patients with early AD when examined. These alterations in enzyme activity in early AD demonstrate the potential of these enzymes as biomarkers. Early detection of AD in its early stages is crucial for effective control and treatment of the disease. Existing diagnostic techniques rely mainly on neuroimaging and medical evaluation. Through this technique, we can only diagnose the advanced or late stage of AD. Therefore, there is a crucial need to establish valid biomarkers that might assist in the early detection of AD. Enzymatic targets have come to light as a promising alternative for the development of selective and sensitive diagnostic assays. This review aims to investigate the potential of enzymes as an enzymatic target for early AD diagnosis, emphasizing their diagnostic use and fundamental mechanisms. Here, we summarize the role or implication of 25 enzymes in the pathophysiology of AD in the early stage.}, }
@article {pmid41589493, year = {2026}, author = {Almawashee, HS and Khalaj-Kondori, M and Hosseinpour Feizi, MA and Safaralizadeh, R}, title = {Correlation of miR-214, miR-204, miR-25, miR-15a Expression with IL-33 and Malondialdehyde in Blood Samples from Patients with Alzheimer's Disease.}, journal = {MicroRNA (Shariqah, United Arab Emirates)}, volume = {}, number = {}, pages = {}, doi = {10.2174/0122115366411857251025004952}, pmid = {41589493}, issn = {2211-5374}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a late-onset neurodegenerative disease that affects older people. Deregulations of miRNAs play essential roles in AD pathogenesis; as a re-sult, they might be potential biomarkers for AD development, diagnosis, and treatment. This case-control study aimed to assess the expression of miR-214, miR-204, miR-15a, miR-25, and inves-tigate their correlations with the expression of IL-33, plasma level of Malondialdehyde (MDA), and Mini-Mental State Examination (MMSE) score of the AD patients.
METHODS: Blood samples were obtained from 125 participants, including 75 AD patients and 50 healthy controls. Plasma MDA level was assessed using the ZellBio ELISA kit. Total RNA was extracted from blood lymphocytes using RiboExTM (GeneAll), and expression levels of miRNAs and IL-33 were evaluated by qRT-PCR.
RESULTS: Results showed that miR-15a and miR-25, and IL-33 were downregulated in the pa-tients' group, but miR-214 and miR-204 were upregulated. Besides, the plasma level of MDA was significantly higher in the AD patients. A statistically significant negative correlation was observed between miR-15a and IL-33 expression. The MDA level showed a negative correlation with MMSE and a positive correlation with IL-33. Correlations between the miRNAs and MDA or MMSE scores were all non-significant. However, ROC curve analysis revealed that expres-sions of the studied miRNAs, IL-33, and the plasma level of MDA effectively differentiate AD patients from healthy controls.
DISCUSSION: Results showed that expression levels of miR-214, miR-204, miR-25, miR-15a, and IL-33 and MDA plasma levels are deregulated in AD patients, highlighting their potential relation with AD pathogenesis.
CONCLUSION: Expression levels of the studied miRNAs and IL33, and plasma level of MDA might be considered as potential biomarkers for AD development and diagnosis.}, }
@article {pmid41589492, year = {2026}, author = {Liu, A and Li, J and Gao, W and Li, X and Song, J and Xing, L and Li, H}, title = {Research Progress on Targeted Inhibition of Ferroptosis and Alzheimer's Disease Treatment.}, journal = {Mini reviews in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113895575411431251125115235}, pmid = {41589492}, issn = {1875-5607}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by the formation of senile plaques and neurofibrillary fiber tangles. Studies have shown that increased regional iron loading in the brain, dysregulation of iron homeostasis in the body, oxidative stress, and protein and lipid oxidation are all involved in the pathogenesis of AD. Ferroptosis, an irondependent, lipid peroxidation-driven form of regulated cell death, is increasingly implicated in the pathological process of AD, and some new compounds targeting ferroptosis demonstrate therapeutic efficacy in both cellular and animal models of AD. Therefore, this article systematically summarizes recent advances in the role of ferroptosis in AD pathogenesis and highlights progress in targeting ferroptosis for AD treatment, providing insights for future therapeutic and preventive strategies.}, }
@article {pmid41588889, year = {2026}, author = {Thakur, A and Chowdhury, KR and Kumar, A and Sharma, VV and Bhatia, R}, title = {Targeting Non-coding RNAs in Neurodegeneration: Advances in Therapeutic RNA Modalities and Next-Gen Delivery Technologies.}, journal = {Current Alzheimer research}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115672050421604251108045622}, pmid = {41588889}, issn = {1875-5828}, abstract = {Non-coding RNA (ncRNA)-based therapies represent an emerging and transformative approach in the treatment of neurodegenerative diseases (NDs), such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS)/Motor Neuron Disease (MND). This review explored the potential for targeting microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and exosomal RNAs, reinforced by promising results from clinical trials demonstrating their capacity to modulate disease pathways. The incorporation of cutting-edge computational methodologies, including RNA structure prediction and gene regulatory network analysis, has been at the forefront in enhancing the efficacy of ncRNA-based treatments. Moreover, chemical methods have improved RNA molecules' stability, accuracy, and directed delivery, enhancing their therapeutic effects. Moreover, cutting-edge RNA editing technologies like Clustered Regularly Interspaced Short Palindromic Repeats/CRISPRassociated protein 13 (CRISPR/Cas13) are advancing our ability to directly manipulate ncRNA expression, offering a powerful avenue for addressing the molecular origins of neurodegeneration. Despite these advances, challenges persist, particularly in ensuring the specificity, delivery efficiency, and long-term efficacy of these treatments. Nanotechnology provides innovative solutions to these obstacles, facilitating more efficient and precise RNA delivery, especially to neuronal tissue. In conclusion, ncRNA-based therapies, while still in nascent stages, represent a hopeful frontier in the fight against NDs. With ongoing research and technological advancements, these therapies could not only halt disease progression but also redefine the future of ND treatment, offering new avenues for patients' care and clinical success.}, }
@article {pmid41588888, year = {2026}, author = {Sahu, A and Khileshwari, and Patle, K and Jain, P and Ajazuddin, }, title = {Advances in Nose-to-Brain Delivery Systems for Effective Alzheimer's Disease Management.}, journal = {Current Alzheimer research}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115672050395356251106100427}, pmid = {41588888}, issn = {1875-5828}, abstract = {Neurodegenerative diseases comprise a heterogeneous group of disorders characterized by the progressive structural and functional deterioration of neurons in the central nervous system. Among them, Alzheimer's disease is the most prevalent worldwide. Despite their distinct clinical manifestations, many neurodegenerative disorders share convergent pathophysiological mechanisms such as protein misfolding and aggregation, oxidative stress, mitochondrial dysfunction, and neuroinflammation, which ultimately drive neuronal loss. These processes lead to profound impairments in cognitive performance, motor coordination, and overall functional capacity, making such diseases exceptionally difficult to diagnose early and manage effectively. Traditional treatment approaches administered orally or parenterally face limitations, including high hepatic metabolism, poor penetration across the blood-brain barrier (BBB), and systemic side effects. This review highlights the potential of the nose-to-brain (N2B) delivery system as an emerging and promising therapeutic strategy. N2B delivery utilizes the olfactory and trigeminal nerve pathways in the nasal cavity to rapidly and precisely deliver drugs to the central nervous system without crossing the blood-brain barrier. Because the system is non-invasive, it offers high bioavailability, reduced systemic exposure, and improved patient compliance. The use of lipid nanocarriers, nanoparticles, dendrimers, and nanogels to enhance the stability of drugs, facilitating efficient targeting and controlled release, is a crucial factor in optimizing N2B drug delivery systems. Various attributes influence drug transport, which are physiological, physicochemical and formulation-dependent characteristics. The main challenges faced by the N2B delivery system are enzymatic degradation and mucociliary clearance. Emerging technologies, such as AI, 3D Printing, and personalized medicine, all hold promise for future inventions in this area. Preclinical and clinical trials demonstrate the efficacy of delivering N2B in treating neurodegenerative diseases; however, its full potential remains to be seen due to regulatory, safety, and scalability concerns. Hence, this review emphasizes the research required to pursue interdisciplinary collaboration and unlock the full potential of N2B delivery, as well as a new approach to transforming neurodegenerative conditions.}, }
@article {pmid41588887, year = {2026}, author = {Edelbach, B and Huang, L and Boling, W}, title = {Vagus Nerve Stimulation in the Management of Neurodegenerative Diseases: A Systematic Review of Advances in Animal Research and Clinical Applications.}, journal = {Current Alzheimer research}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115672050373772251103053036}, pmid = {41588887}, issn = {1875-5828}, abstract = {INTRODUCTION: Vagus Nerve Stimulation (VNS) has been approved by the FDA as a treatment for epilepsy, depression, post-ischemic stroke rehabilitation, and migraine in patients. It is emerging as a potential treatment for neurodegenerative diseases. Herein, we summarize the research on VNS and its application in common neurodegenerative diseases.
METHODS: A literature search was completed in PubMed, ScienceDirect, and Google Scholar using the terms: "neurodegeneration," "neuromodulation," "Vagus Nerve Stimulation," "Parkinson's Disease (PD)," "Alzheimer's Disease (AD)," "dementia," "neuroinflammation," and "cognitive dysfunction." Animal and clinical studies using VNS as a primary intervention in neurodegenerative diseases were included.
RESULTS: The studies of VNS application in Parkinson's and Alzheimer's models were reviewed. In animal studies, VNS was associated with increased locomotion and balance, as well as reduced cognitive impairments. The underlying neuroprotective mechanisms included: increased dopaminergic neurons, reduced α-synuclein concentration in the brain, preservation of the nigrostriatal dopaminergic pathway, increased α7nAChR expression, reduced apoptotic markers, reduced neuroinflammation, and significant reductions in microglial and astrocytic densities. In clinical studies with small patient populations of PD or AD/mild cognitive impairment, VNS was associated with improved gait parameters and enhanced performance in memory-based tasks.
DISCUSSION: Vagus Nerve Stimulation (VNS) shows neuroprotective and anti-inflammatory effects in animal models of Alzheimer's and Parkinson's disease, but clinical results remain inconsistent due to variability in treatment duration, outcome measures, and reliance on subjective assessments. Emerging physiologic biomarkers such as VSEP, EEG, and magnetoencephalography may provide more objective measures of therapeutic response.
CONCLUSIONS: The systematic review highlights the potential of VNS as a therapeutic approach for managing neurodegenerative diseases. The efficacy of VNS in animal models of Parkinson's and Alzheimer's diseases involves both neuroprotection and anti-neuroinflammation, while additional protective mechanisms require further exploration.}, }
@article {pmid41588609, year = {2026}, author = {Zhou, S and Hassan, H and Guo, J and Xu, Y and Zhang, P and Yuan, L and Zhou, T and Chen, R}, title = {From gut to brain: formulation and transporter-guided approaches to maximise rutin central nervous system delivery.}, journal = {Nutritional neuroscience}, volume = {}, number = {}, pages = {1-27}, doi = {10.1080/1028415X.2026.2617363}, pmid = {41588609}, issn = {1476-8305}, abstract = {Neurological disorders, including Alzheimer's and Parkinson's disease, are characterised by high morbidity and disability, representing a major global health challenge. A central obstacle in their treatment is the blood-brain barrier, a highly selective interface that limits drug delivery to the central nervous system. Rutin, a naturally occurring flavonoid, exhibits potent antioxidant, anti-inflammatory, and neuroprotective activities, yet its clinical utility remains constrained by poor solubility, low oral bioavailability, and restricted blood-brain barrier permeability. Recent advances in drug delivery and formulation science offer promising solutions. Nanoparticle encapsulation, peptide conjugation, intranasal delivery, and co-administration with absorption enhancers have been shown to improve rutin's solubility, metabolic stability, and central nervous system penetration in preclinical models. Mechanistic studies further reveal that rutin can modulate efflux transporters, regulate tight-junction proteins, and influence microglial activity and cellular metabolism, collectively contributing to enhanced neuroprotection. Experimental evidence highlights its potential to mitigate key neurodegenerative processes, particularly in Alzheimer's disease. This review synthesises current knowledge on rutin's pharmacological effects, limitations in bioavailability, and innovative strategies to improve blood-brain barrier penetration. By integrating mechanistic insights with advances in delivery technologies, this review underscores rutin's translational potential. Priority next steps include optimising delivery systems, establishing long-term safety, and conducting well-designed clinical trials to define efficacy and dosing.}, }
@article {pmid41588589, year = {2026}, author = {Justin, S and Ali, SA and Masood, M and Abbasi, SW and Farhat, SM and Shakeel, R and Khalid, A and Mahboob, A and Zafar, S and Zahid, S and Ahmed, T}, title = {Evaluation of the Combined Therapeutic Potential of Turmeric and Donepezil on the Cholinergic System in a Mouse Model of AD-like Pathology.}, journal = {Current drug targets}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113894501433829251216060839}, pmid = {41588589}, issn = {1873-5592}, abstract = {INTRODUCTION: The multifactorial pathogenesis of Alzheimer's Disease (AD) makes effective prevention and treatment challenging. Integrative medicine presents a promising approach by complementing conventional treatments with neuroprotective nutraceuticals. This study investigates the individual and combinatorial effects of turmeric, a neuroprotective herb, and donepezil, an acetylcholinesterase (AChE) inhibitor, on cognitive functions in a scopolamine-induced amnesic mouse model.
METHODS: Molecular interactions of curcuminoids and donepezil with AChE were analyzed using AutoDock Vina and AMBER22. In animal model studies, amnesia was induced in BALB/c mice via subcutaneous injections of scopolamine (1mg/kg/day) for a duration of 25 days. From the 11th day onwards, the turmeric rhizome powder (20mg/kg/day) and donepezil (0.5mg/kg/day) were orally administered as monotherapies or in combination. Cognitive functions were assessed through behavior tests.
RESULTS: Molecular docking and dynamics simulations revealed that curcuminoids (curcumin, bisdemethoxycurcumin, and desmethoxycurcumin) inhibited AChE more effectively than donepezil. Animal studies demonstrated significant enhancements in spatial, reference, recognition, and contextual fear memories, with both turmeric and donepezil monotherapies, and their combination therapy. No significant differences were observed between monotherapies, and no additive effect was evident in the combination therapy.
DISCUSSION: Co-administration of turmeric and donepezil did not yield a significant additive effect on cognitive improvement in scopolamine-induced amnesic mice. Turmeric monotherapy showed cognitive improvements comparable to those of donepezil monotherapy, highlighting its potential as a candidate therapy for donepezil-resistant AD.
CONCLUSION: Turmeric monotherapy improved cognitive performance similarly to donepezil monotherapy in scopolamine-induced amnesic mice. These preliminary findings require further research, including dose optimization and clinical trials, to establish their clinical relevance.}, }
@article {pmid41588303, year = {2026}, author = {Zuo, CT and Lu, JY}, title = {[AI-driven PET-MRI multimodal fusion: paradigm shift and clinical translation challenges in precision diagnosis and treatment of neurodegenerative diseases].}, journal = {Zhonghua yi xue za zhi}, volume = {106}, number = {4}, pages = {289-293}, doi = {10.3760/cma.j.cn112137-20250730-01894}, pmid = {41588303}, issn = {0376-2491}, support = {82394434, 82272039, 82021002//National Natural Science Foundation of China/ ; 2022ZD0211606//Science and Technology Innovation 2030-Major Project/ ; }, mesh = {Humans ; *Neurodegenerative Diseases/diagnosis/therapy/diagnostic imaging ; *Magnetic Resonance Imaging ; *Positron-Emission Tomography ; *Multimodal Imaging ; Precision Medicine ; *Artificial Intelligence ; }, abstract = {Individualized precision diagnosis and treatment of neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, etc.) faces challenges due to overlapping early symptoms and clinical/pathological heterogeneity. PET-MRI multimodal imaging, integrating in vivo molecular pathological information from PET with brain structural/functional information revealed by MRI, has become a crucial cornerstone for precision diagnosis and treatment of neurodegenerative diseases. However, its clinical translation is limited by practical bottlenecks, such as complexities in data integration, and uneven distribution of resources. AI, with its unique strengths in multimodal data fusion, automated quantitative analysis, and cross-modal image synthesis, is gradually reshaping the paradigm of diagnostic and therapeutic landscape of neurodegenerative diseases. This article systematically explores the pivotal role of AI in PET-MRI, covering its contributions to improving diagnostic objectivity, deciphering disease heterogeneity, enabling stratified care pathways. It also critically addresses the multiple challenges hindering the clinical implementation of AI and proposes that future efforts should focus on the development of interpretable AI models, the construction of embedded clinical systems, and the exploitation of inclusive technological solutions to promote the deep integration of AI and PET-MRI, ultimately driving the transformation of neurodegenerative diseases towards a precision medicine paradigm of early prevention, early diagnosis, and early treatment.}, }
@article {pmid41588024, year = {2026}, author = {Khodaei, F and Namavar, MR and Soutodeh, N and Hadipour, A and Asadi, F and Khoshnoud, MJ and Rashedinia, M}, title = {Mitochondrial protective effects of ellagic acid in a rat model of sporadic Alzheimer's disease induced by STZ.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {3498}, pmid = {41588024}, issn = {2045-2322}, support = {9958//Shiraz University of Medical Sciences/ ; }, mesh = {Animals ; *Ellagic Acid/pharmacology ; *Alzheimer Disease/chemically induced/drug therapy/metabolism/pathology ; *Mitochondria/drug effects/metabolism ; Streptozocin/toxicity ; Rats ; Disease Models, Animal ; Oxidative Stress/drug effects ; Male ; *Neuroprotective Agents/pharmacology ; Hippocampus/drug effects/metabolism/pathology ; Maze Learning/drug effects ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder primarily affecting the elderly, characterized by mitochondrial dysfunction. Mitochondria play a dual role in AD, serving both as the main source of reactive oxygen species (ROS) generation and as a major target of oxidative damage. This study aimed to investigate the protective mechanisms of ellagic acid (EA) a natural dietary polyphenol on mitochondrial function in an intracerebroventricular (ICV) streptozotocin (STZ)-injected rat model of AD. Rats were randomly assigned to six groups: Control, Sham, STZ (1.5 mg/kg on days 1 and 3), STZ + EA 5 mg/kg, STZ + EA 50 mg/kg, and STZ + EA 100 mg/kg. On day 14, behavioral tests (Shuttle box and Step-down), histopathological evaluations, oxidative stress markers, and mitochondrial indices were assessed in brain tissue. Treatment with EA (100 mg/kg) significantly improved spatial memory, as evidenced by increased latency time in the Morris water maze test (p < 0.001). Furthermore, EA treatment mitigated hippocampal neurodegeneration, increasing neuronal density in the CA1 subfield (p < 0.001) and restoring total hippocampal volume (p < 0.01). At the biochemical level, EA markedly reduced oxidative stress levels (p < 0.001) and enhanced mitochondrial function, restoring cortical ATP levels (p < 0.001) and cytochrome c oxidase activity (p < 0.01) compared to the STZ- group. In conclusion, these findings suggest that EA may have therapeutic potential in mitigating mitochondrial dysfunction and oxidative stress in AD, offering a promising approach for addressing neurodegeneration and energy deficits associated with the disease.}, }
@article {pmid41585699, year = {2026}, author = {Ferreira, LAP and Caruso, L and Nadur, NF and Franco, DP and Sousa, GLS and Lacerda, RB and Kümmerle, AE}, title = {Imidazo[1,2‑a]pyridines in Medicinal Chemistry: Recent Advances in Synthesis and Biological Activities.}, journal = {ACS omega}, volume = {11}, number = {2}, pages = {2348-2383}, pmid = {41585699}, issn = {2470-1343}, abstract = {Imidazo-[1,2-a]-pyridines are widely recognized scaffolds present in several marketed drugs, including the anxiolytics alpidem, saripidem, necopidem, and zolpidem, which are some of the most prescribed medications for insomnia. In this review, we analyze publication trends, which reveal exponential growth in research involving this scaffold. We highlight recent synthetic strategies (2017-2025) for the preparation of imidazo-[1,2-a]-pyridine derivatives, such as condensation, multicomponent and tandem reactions, intramolecular cyclizations, and oxidative couplings under green conditions. In addition, we discuss innovative Medicinal Chemistry studies exploring their applications in the treatment of cancer, Alzheimer's disease, tuberculosis, and neglected tropical diseases. Significant advances have been made in identifying derivatives with potent activity against specific biological targets, including kinases, tubulin, HDACs, the cytochrome bc1 complex of Mycobacterium tuberculosis, and key enzymes involved in the pathogenesis of Alzheimer's disease, such as cholinesterases and secretases. Altogether, this review consolidates the vast therapeutic potential of the imidazo-[1,2-a]-pyridine core, emphasizing its synthetic versatility and broad spectrum of biological activities, which firmly establish it as a privileged scaffold for drug discovery.}, }
@article {pmid41585467, year = {2026}, author = {Yue, J and Wang, X and Ringman, J and Shi, Y}, title = {Graphical modeling of cortical tau pathology topography for its subtyping in Alzheimer's disease.}, journal = {Imaging neuroscience (Cambridge, Mass.)}, volume = {4}, number = {}, pages = {}, pmid = {41585467}, issn = {2837-6056}, abstract = {Hyperphosphorylated tau tangles are essential hallmarks of Alzheimer's disease (AD) and their propagation across brain regions was often considered to follow the classic Braak stages. Recent post-mortem and in vivo tau positron emission tomography (PET) studies, however, revealed the frequent presence of tau pathology heterogeneity. Clustering or event-based methods were proposed previously for the subtyping to tau pathology in AD, but they often lack robustness to varying distributions of disease severity across cohorts. To robustly discover and model tau pathology subtypes in AD, we propose in this work a novel graphical modeling framework that can disentangle the phenotypical differences of tau PET imaging due to disease heterogeneity from the spatiotemporal variations of disease stages. First, we propose a novel Reeb graph representation at the individual level to characterize the topographic patterns of salient tau pathology on cortical surfaces. Next, we use only cross-sectional tau PET data to develop a graphical model at the population level to encode the inter-subject spatiotemporal relationships, which enables us to robustly derive subtypes based on the topographic patterns of tau pathology and hence achieve increased generalization power to new samples with distinct tau pathology severity from the training data. Using synthetic and large-scale tau PET imaging data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) studies, we compare with the state-of-the-art SuStaIn method and demonstrate the improved generalization performance of the proposed method. In addition, we validate both methods on a cohort of autosomal dominant Alzheimer's disease (ADAD) patients with known tau pathology patterns to show that our method has more robust performance in testing data with large deviations from training data. Furthermore, for preclinical patients of the A4 cohort, we demonstrate more significant differences in clinical cognitive measures can be observed across subtypes discovered by our method.}, }
@article {pmid41585268, year = {2025}, author = {Srivastav, J and Sharma, S}, title = {Viral and non-viral cellular therapies for neurodegeneration.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1718669}, pmid = {41585268}, issn = {2296-858X}, abstract = {Neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS) are characterized by progressive loss of neurons and still lack curative treatment options. In this review, we describe current and developing therapeutic strategies that include viral vector-based gene delivery, antisense oligonucleotide (ASO) and RNA interference methods, stem cell transplantation, and genome editing technologies. Adeno-associated viruses (AAVs) and lentiviruses have been used for gene delivery in preclinical and clinical studies, while ASOs are under development to reduce expression of pathogenic proteins such as tau, α-synuclein, and mutant huntingtin. Cellular therapies, including mesenchymal stem cell (MSC)-based paracrine support and transplantation of neurons derived from induced pluripotent stem cells (iPSCs), are being evaluated, particularly in PD and AD. We also discuss important gene targets such as APOE4, GBA1, SCNA, and MAPT, and how treatment strategies may differ between monogenic and polygenic forms of these disorders. Lastly, we highlight recent efforts focused on genes like TREM2, PINK1, and progranulin, and examine their role in the future development of gene- and cell-based interventions.}, }
@article {pmid41585084, year = {2025}, author = {Matsuzaka, Y and Iyoda, M}, title = {Applications, image analysis, and interpretation of computer vision in medical imaging.}, journal = {Frontiers in radiology}, volume = {5}, number = {}, pages = {1733003}, pmid = {41585084}, issn = {2673-8740}, abstract = {This review summarizes the current advances, applications, and research prospects of computer vision in advancing medical imaging. Computer vision in healthcare has revolutionized medical practice by increasing diagnostic accuracy, improving patient care, and increasing operational efficiency. Likewise, deep learning algorithms have advanced medical image analysis, significantly improved healthcare outcomes and transforming diagnostic processes. Specifically, convolutional neural networks are crucial for modern medical image segmentation, enabling the accurate, efficient analysis of various imaging modalities and helping enhance computer-aided diagnosis and treatment planning. Computer vision algorithms have demonstrated remarkable capabilities in detecting various diseases. Artificial intelligence (AI) systems can identify lung nodules in chest computed tomography scans at a sensitivity comparable to that of experienced radiologists. Computer vision can analyze brain scans to detect problems such as aneurysms and tumors or areas affected by diseases such as Alzheimer's. In summary, computer vision in medical imaging is significantly improving diagnostic accuracy, efficiency, and patient outcomes across a range of medical specialties.}, }
@article {pmid41584821, year = {2026}, author = {Ali, F and Babour, A and Asiry, O and Alghamdi, W and Masmoudi, A and Rajkhan, NW}, title = {Advancing neurological disease treatment: a computational approach for fibroblast growth factor detection.}, journal = {Biomedical engineering letters}, volume = {16}, number = {1}, pages = {167-176}, pmid = {41584821}, issn = {2093-985X}, abstract = {Fibroblast Growth Factor plays a crucial role in neurological health, contributing to neuron protection, injury recovery, and angiogenesis. It is also significantly involved in the onset and progression of neurodegenerative disorders such as Huntington's, Alzheimer's, Parkinson's disease, and stroke, making FGF a vital target for therapeutic interventions. Despite its importance, no computational tool has been developed to predict FGF proteins. In this study, we present the first novel deep learning-based computational approach designed for the prediction of FGF proteins. We constructed two novel, high-quality datasets curated from the UniProt database for training and evaluation. Sequences were transformed into numerical representations using three complementary feature encoding methods including Dipeptide Composition, Dipeptide Deviation from Expected Mean, and Grouped Amino Acid Composition. These features capture both local and global sequence information. Multiple deep learning models were explored, including Convolutional Neural Network, Bidirectional Long Short-Term Memory, Generative Adversarial Network, and Gated Recurrent Unit. Among these, our proposed Convolutional Neural Network-based model outperformed all others, achieving an accuracy of 83.50%, sensitivity of 84.30%, specificity of 82.67%, F1 score of 83.42%, and a Matthews Correlation Coefficient of 0.671. The proposed approach has the potential to advance therapeutic discovery by enabling accurate identification of Fibroblast Growth Factor and improving our understanding of their role in neurological health and disease.}, }
@article {pmid41583320, year = {2025}, author = {Miura, K}, title = {Hematuria as a Diagnostic Clue to Non-cirrhotic Hyperammonemia Due to Corynebacterium urealyticum Urinary Tract Infection: A Case Report.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e100082}, pmid = {41583320}, issn = {2168-8184}, abstract = {Hyperammonemia is an important cause of altered mental status in older adults; however, non-cirrhotic hyperammonemia in the absence of underlying liver dysfunction is easily overlooked. Hyperammonemia secondary to urinary tract infection (UTI) caused by urease-producing bacteria is relatively rare, and reliable clinical clues for early diagnosis have not been fully established. We report the case of a 95-year-old woman with Alzheimer's disease residing in a nursing facility. She had macroscopic hematuria for two days without any change in consciousness. On the day of admission, she was found unresponsive at breakfast and was transported to the emergency department with impaired consciousness. On arrival, she had renal dysfunction and marked hyperammonemia (168 µg/dL) but normal liver function tests. Her urine was alkaline, turbid, and purulent with gross hematuria, and her mental status improved rapidly after bladder catheterization and fluid resuscitation. Urine culture yielded Corynebacterium urealyticum, and she was diagnosed with non-cirrhotic hyperammonemia secondary to a UTI caused by this urease-producing organism. Including the present case, a review of 33 English- and Japanese-language reports identified gross hematuria in 15 cases, microscopic hematuria alone in 11, and no hematuria in seven; thus, 78.8% of patients demonstrated some degree of hematuria. These findings suggest that, in older patients with preserved liver function who present with impaired consciousness, the presence of hematuria is an important clue to hyperammonemia secondary to a UTI due to urease-producing bacteria. When hematuria is observed, clinicians should consider this entity in the differential diagnosis and promptly assess urine pH, urinary retention, and indwelling urinary catheters to identify ammonia-producing sources and perform timely drainage to prevent delays in diagnosis and treatment.}, }
@article {pmid41583006, year = {2025}, author = {Eyamu, J and Ku, B and Kim, K and Lee, KH and Kim, JU}, title = {Aperiodic EEG signatures: unveiling the interplay between APOE ε4 and mild cognitive impairment subtypes.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1675330}, pmid = {41583006}, issn = {1663-4365}, abstract = {BACKGROUND: Mild cognitive impairment (MCI) is a cognitive decline syndrome in the elderly, often a precursor to dementia. It is a heterogeneous condition that can signal degenerative disorders like Alzheimer's or non-degenerative conditions such as vascular issues, depression, or poorly managed diabetes. Early detection of MCI is crucial for timely intervention, and differentiating its phenotypes helps in understanding its causes, progression, and treatment. EEG, which records brain electrical activity, consists of rhythmic and arrhythmic components. Examining these inherently overlapping EEG components calls for quantification, ensuring that an appropriate physiological mechanism is attributed to a given neural response. This study explores the interaction between APOE ε4 (APOE4) and cognitive impairment on non-oscillatory EEG activity.
METHODS: We examined aperiodic EEG activity using a parameterized spectral estimation approach in a sample comprising 751, 142, and 279 cognitively normal (CN), non-amnestic (naMCI), and amnestic (aMCI) MCI patients, respectively. The 5-min EEG was recorded using a prefrontal two-channel EEG device in a resting state, eyes closed. Cognitive decline was assessed using the Seoul Neuropsychological Screening Battery (SNSB) and the Mini-Mental State Examination (MMSE). The analyses were performed using various statistical methods, including independent t-tests and generalized linear models (GLM) with an identity link function. These analyses investigated the main and interaction effects of the APOE4 status and participants' cognitive states.
RESULTS: We found interactions between APOE4 and cognitive states in the aperiodic EEG exponent and the spectral power ratio (SPR). Distinct patterns were observed in the exponent, offset, and SPR between APOE4 non-carriers and carriers across the CN, naMCI, and aMCI. Among the APOE4 carriers, the aMCI individuals exhibited heightened aperiodic activity and a reduced SPR than the naMCI. Furthermore, the CN had a lower SPR compared to the naMCI. However, no differences in the aperiodic component and SPR were observed in the APOE4 non-carriers across the cognitive states.
DISCUSSION: The higher aperiodic component and a reduced SPR observed in aMCI relative to naMCI in APOE4 carriers may indicate an interplay between genetic predisposition, neuropathological changes, and cognitive decline. These aperiodic components, combined with APOE4 status, represent promising neurophysiological markers that may help identify individuals at elevated risk for cognitive decline or progression toward AD.}, }
@article {pmid41582996, year = {2025}, author = {Deng, Y and Yin, H and Lu, Z and Lan, H and Liu, W and Zuo, C and Pan, N and Tian, X and Gong, Q}, title = {LRP1 at the crossroads of Aβ clearance and therapeutic targeting in Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1669405}, pmid = {41582996}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD), characterized by progressive cognitive decline, memory impairment and behavioral disturbances, is the most common form of dementia, and no disease-modifying treatments are available to halt or slow its progression. Amyloid-beta (Aβ) is suggested to play a pivotal role in the pathogenesis of AD, and enhancing the clearance of Aβ from the brain has emerged as a major research direction. As the primary receptor for Aβ clearance at the blood-brain barrier (BBB), low-density lipoprotein receptor-related protein 1 (LRP1) plays a crucial role in regulating Aβ transport and metabolism. Understanding the mechanisms through which LRP1 functions, as well as the factors that influence its activity is essential for enhancing Aβ clearance from the brain and developing targeted therapeutic strategies for Alzheimer's disease. In this review, we introduce the transport of Aβ across the BBB, followed by a discussion of the basic structure and function of LRP1 and its role in AD progression. Then, we summarize factors affecting LRP1 function and current advances in LRP1-targeted therapies. Finally, we explore the potential of LRP1 as a therapeutic target for AD. So, LRP1 may be a central modulator of Aβ dynamics and a clinically actionable target for treatment of Alzheimer's disease.}, }
@article {pmid41437270, year = {2025}, author = {Hu, WT and Butts, B and Misiura, M and Verble, DD and Swatson, E and Park, C and Watson, J and Hammerschlag, BL and Nayyar, A and Korrapati, N and Trotti, LM and Benameur, K and Scorr, LM and Zetterberg, H and Mielke, MM and Wharton, W}, title = {CSF estrogens' relationships to neuroinflammatory markers and brain networks in middle-aged and older black and white women.}, journal = {Journal of neuroinflammation}, volume = {23}, number = {1}, pages = {31}, pmid = {41437270}, issn = {1742-2094}, support = {AG066203/AG/NIA NIH HHS/United States ; AG054046/AG/NIA NIH HHS/United States ; AG066203/AG/NIA NIH HHS/United States ; AG054046/AG/NIA NIH HHS/United States ; }, abstract = {UNLABELLED: Neuroprotective properties of estrogen have poorly translated to reduced neurodegeneration in clinical trials of systemic estrogen replacement therapy. To more directly assess biological processes associated with brain estrogen (estrone, estradiol) levels, we recruited 81 women (42 non-white) and 28 men (13 non-white) for cerebrospinal fluid (CSF) hormone, targeted proteomic, and volumetric brain analysis. In the mostly post-menopausal women, we found CSF estrogen levels to only modestly correlate with their corresponding plasma levels, and were additionally influenced by body mass index or age. CSF estrone was also correlated with a marker of Alzheimer’s disease (AD) neuropathologic change (CSF Aβ42/Aβ40), but this was not the case for the more biologically active CSF estradiol. Aptamer-based proteomic analysis of 1,075 CSF markers for inflammation, proteolysis, signaling, and DNA/RNA regulation revealed CSF estrogen levels to associate with alternative complement pathway proteins, and shifts observed in AD (apoE, RAGE). Parallel MRI analysis correlated higher CSF estrogen with smaller volumes of the brain somatosensory and posterior-medial networks without influence from cognition or neurodegeneration. Analysis using plasma estrogens only partially reproduced CSF estrogens’ biochemical correlates but provided inconclusive relationships with brain volume correlates. These findings highlight the association between CSF levels of the more biologically active estradiol and CSF inflammatory pathways involving AD risk genes as potential mechanisms linking hormone status to AD risks, and suggest caution in using CSF estrone or plasma estrogens when interpreting treatment or preventive studies.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12974-025-03657-3.}, }
@article {pmid41582466, year = {2026}, author = {Kim, H and Lee, KH and Han, C and Patkar, AA and Masand, PS and Bahk, WM and Pae, CU}, title = {Brexpiprazole for the Treatment of Agitation Associated with Dementia due to Alzheimer's Disease: Clinical Perspectives.}, journal = {Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology}, volume = {24}, number = {1}, pages = {15-29}, doi = {10.9758/cpn.24.1252}, pmid = {41582466}, issn = {1738-1088}, abstract = {Dementia is a neuropsychiatric disorder that primarily affects the elderly, leading to a widespread decline in cognitive function and significant impairment of occupational, social, and personal functioning. In addition to cognitive deficits, dementia is frequently comorbid with behavioral and psychological symptoms of dementia (BPSD), such as agitation. When present, these secondary symptoms can exacerbate the clinical course of the disease, reduced treatment responsiveness, increased rates of admission to long-term care facilities, extended hospitalization, higher risk of personal injury and a substantial socioeconomic burden. Given these consequences, early management of BPSD-particularly agitation-is critical to mitigating these risks. Although antipsychotics are commonly prescribed to manage agitation, risperidone remains the only agent approved by regulatory authorities for this indication. Recently, however, brexpiprazole, a medication with a pharmacological profile distinct from that of risperidone, received U.S. FDA approval (on May 11, 2023) for the treatment of agitation associated with Alzheimer's disease. Agitation is among the most prevalent BPSD manifestations, with symptoms ranging from verbal to physical aggression. Given its recent approval and unique pharmacodynamic properties, brexpiprazole may have strong potential as a therapeutic option for this population. This paper aims to review the pharmacological mechanisms, clinical evidence, and future perspectives of brexpiprazole as a novel therapeutic option for managing agitation in patients with Alzheimer's disease.}, }
@article {pmid41581519, year = {2026}, author = {Vossel, K and Johnson, EL and Cretin, B and Matsumoto, R}, title = {Epileptic activity in Alzheimer's disease: emerging insights and therapeutic implications.}, journal = {The Lancet. Neurology}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1474-4422(25)00425-9}, pmid = {41581519}, issn = {1474-4465}, abstract = {An estimated 60% of patients with Alzheimer's disease develop epilepsy or subclinical epileptiform activity over the course of the disease. New-onset seizures in cognitively healthy adults also increase the risk of developing dementia. Epileptic activity, including both seizures and subclinical epileptiform discharges, can hasten the onset of Alzheimer's disease and accelerate cognitive decline. Studies are investigating whether antiseizure medications could improve cognitive outcomes, particularly in patients with Alzheimer's disease with epileptic activity. Detection of epileptic activity in people with Alzheimer's disease requires high clinical vigilance and neurophysiological monitoring. Evaluation and treatment of late-onset epilepsy or Alzheimer's disease-associated epileptic activity should be informed by clinical advances. Epilepsy management is especially important in patients receiving anti-amyloid monoclonal antibodies, which can increase seizure risk. Recent insights support the concept of an epileptic subtype of Alzheimer's disease, position epileptic activity as a modifiable risk factor in Alzheimer's disease, highlight innovations for earlier identification of epileptic activity, and provide evidence supporting the need for early detection and targeted treatment across the stages of Alzheimer's disease.}, }
@article {pmid41580393, year = {2026}, author = {Feiten, AF and Dahm, K and Schlepckow, K and van Lengerich, B and Suh, JH and Reifschneider, A and Wefers, B and Bartos, LM and Wind-Mark, K and de Weerd, L and Ulas, T and De-Domenico, E and Grundschöttel, P and Paulusch, S and Tast, B and Honda, T and Müller, SA and Becker, M and Khalin, I and Ricci, A and Liesz, A and Brunner, B and Krenner, C and Buschmann, K and Nuscher, B and Spieth, L and Junker, N and Berghoff, SA and Davis, SS and Neher, JJ and Wurst, W and Plesnila, N and Lewcock, JW and Simons, M and Lichtenthaler, SF and Di Paolo, G and Brendel, M and Capell, A and Monroe, KM and Schultze, JL and Haass, C}, title = {TREM2 expression level is critical for microglial state, metabolic capacity and efficacy of TREM2 agonism.}, journal = {Nature communications}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41467-026-68706-8}, pmid = {41580393}, issn = {2041-1723}, support = {HA1737/16-1//Deutsche Forschungsgemeinschaft (German Research Foundation)/ ; }, abstract = {Triggering receptor expressed on myeloid cells 2 (TREM2) is a central regulator of microglial activity and loss-of-function coding variants are major risk factors for late onset Alzheimer's disease (LOAD). To better understand the molecular and functional changes associated with TREM2 signalling in microglia, we generated a TREM2 reporter mouse. In APP transgenic animals, bulk RNA-sequencing of isolated microglia sorted based on reporter expression highlighted TREM2 level-related changes in major immunometabolic pathways, and enrichment of genes in oxidative phosphorylation and cholesterol metabolism in microglia with increased TREM2 expression. Metabolic and lipidomic profiling of sorted microglia showed that, independent of Aβ pathology, TREM2 expression correlated with signatures consistent with increased cellular redox, energetics, and cholesterol homoeostasis. In accordance, metabolic activity correlated with phagocytic capacity. Finally, we performed chronic treatment with a TREM2 agonist antibody and identified a window of TREM2 expression where microglia are most responsive, thereby informing clinical applications of TREM2 agonists.}, }
@article {pmid41579987, year = {2026}, author = {Jeon, YN and Baek, JS}, title = {TPGS-coated zein nanoparticles encapsulating Haematococcus pluvialis extract for Alzheimer's disease: An in vitro evaluation towards brain-targeted delivery.}, journal = {International journal of biological macromolecules}, volume = {}, number = {}, pages = {150378}, doi = {10.1016/j.ijbiomac.2026.150378}, pmid = {41579987}, issn = {1879-0003}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by β-amyloid (Aβ) aggregation and limited treatment efficacy due to the restrictive nature of the blood-brain barrier (BBB). To address this, we developed d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS)-coated Zein nanoparticles (Hp-Zein-TPGS NPs) encapsulating Haematococcus pluvialis (Hp) extract as a brain-targeted drug delivery system. Hp-Zein-TPGS NPs exhibited high physical stability over 14 days, sustained astaxanthin release, and potent antioxidant activity. The NPs also demonstrated excellent biocompatibility, showing minimal cytotoxicity in both bEnd.3 and SH-SY5Y cells, along with enhanced cellular uptake in vitro. Based on the reported effects of TPGS on P-glycoprotein (P-gp) inhibition and membrane fluidity, a delivery strategy was designed to facilitate BBB transport. In an in vitro BBB model, Hp-Zein-TPGS NPs exhibited increased transport, and Rhodamine 123 (Rh123) accumulation analysis indicated properties associated with the regulation of P-gp mediated efflux. In addition, Thioflavin T (ThT) fluorescence and morphological analyses confirmed that Hp-Zein-TPGS NPs effectively inhibited Aβ1-42 aggregation and fibril formation, while WST and Annexin V-FITC/PI assays demonstrated that Hp-Zein-TPGS NPs significantly attenuated Aβ1-42-induced neuronal toxicity, indicating their neuroprotective effects. Taken together, these findings suggest that Hp-Zein-TPGS NPs possess favorable stability, biocompatibility, BBB transport potential, and neuroprotective effects, highlighting their promise as a nanocarrier system for brain-targeted therapeutic delivery in AD.}, }
@article {pmid41579901, year = {2026}, author = {Tariot, PN and Lopera, FS and Ríos-Romenets, S and Sink, KM and Giraldo-Chica, M and Acosta-Baena, N and Villegas, G and Espinosa, A and Castaño, ML and Muñoz, C and Ospina, P and Bocanegra, Y and Tirado, V and Henao, E and Cardona, E and Luna, E and Lopez, H and Sánchez, G and Collazos, MM and Alvarez, S and Aguillón, D and Hu, N and Clayton, D and Bittner, T and Schneider, A and Dolton, M and Poon, V and Nguyen, J and Thomas, RG and Schneider, LS and Chen, K and Su, Y and Alexander, RC and Quiroz, YT and Cai, Y and Xu, YR and Ostaszewski, B and Selkoe, DJ and Ashton, NJ and Denkinger, MN and Jakimovich, LJ and Doody, RS and Langbaum, JB and Reiman, EM}, title = {Safety and efficacy of crenezumab in cognitively unimpaired carriers of the PSEN1[Glu280Ala] mutation at risk for autosomal-dominant Alzheimer's disease in Colombia (API ADAD Colombia Trial): a phase 2, randomised, double-blind, placebo-controlled trial.}, journal = {The Lancet. Neurology}, volume = {25}, number = {2}, pages = {147-159}, doi = {10.1016/S1474-4422(25)00426-0}, pmid = {41579901}, issn = {1474-4465}, mesh = {Humans ; *Alzheimer Disease/genetics/drug therapy ; Double-Blind Method ; Male ; *Presenilin-1/genetics ; Female ; Middle Aged ; *Antibodies, Monoclonal, Humanized/therapeutic use/adverse effects ; Colombia ; Adult ; Mutation/genetics ; Heterozygote ; Treatment Outcome ; }, abstract = {BACKGROUND: To have maximal benefit, Alzheimer's disease-modifying treatments might need to be started before the onset of clinical symptoms. Mutations of the PSEN1 gene are inherited as fully penetrant, autosomal-dominant traits, which almost always result in the clinical onset of Alzheimer's disease before the age of 65 years. We aimed to evaluate the efficacy, including possible delayed emergence of cognitive impairment, and safety of crenezumab, an anti-amyloid monoclonal antibody, in cognitively unimpaired carriers of the PSEN1[Glu280Ala] mutation at high imminent risk of developing symptoms due to Alzheimer's disease.
METHODS: This 5-8-year common-close, double-blind, placebo-controlled, single-centre trial screened kindred members aged 30-60 years from the main health-care site in Medellín, Colombia. Participants who were cognitively unimpaired and carried the PSEN1[Glu280Ala] autosomal-dominant mutation were randomly assigned 1:1 to receive placebo or subcutaneous crenezumab (investigators and participants were masked to treatment allocation), with an initial 300 mg dose every 2 weeks that increased to 720 mg every 2 weeks, and a later optional increase to 60 mg/kg intravenously every 4 weeks. Randomisation was stratified by age, education, APOE ɛ4 carrier status, and baseline Clinical Dementia Rating. Mutation non-carriers received placebo and were included in a 1:2 ratio of non-carriers to carriers to maintain genotype masking and include a genetic kindred control. Dual primary outcomes were the annualised rates of change in the Alzheimer's Prevention Initiative (API) preclinical autosomal-dominant Alzheimer's disease (ADAD) composite test total score and Free and Cued Selective Reminding Test-Cueing Index (FCSRT-CI) assessed in randomised participants who received at least one dose of the study drug, according to treatment assignment. Primary endpoints were assessed with a random coefficient regression model with a missing-at-random assumption adjusting for randomisation factors. Safety endpoints for mutation carriers were assessed in randomised participants who received at least one dose of the study drug. This trial is registered with ClinicalTrials.gov (NCT01998841) and is completed.
FINDINGS: 619 Colombian API registrants were prescreened, 315 were assessed for eligibility, and 252 were enrolled (crenezumab-carrier, n=85; placebo-carrier, n=84; placebo-non-carrier, n=83; 160 [63%] women and 92 [37%] men) between Dec 20, 2013, and Feb 27, 2017. 237 (94%) completed the trial, with final data collection on March 22, 2022. The annualised rate of change in the API ADAD composite was -1·10 (SE 0·29) in the crenezumab group and -1·43 (0·29) in the placebo group (between-group difference 0·33 [95% CI -0·48 to 1·13]; p=0·43). The annualised rate of change in FCSRT-CI was -0·03 (0·00) in the crenezumab group and -0·04 (0·00) in the placebo group (between-group difference 0·01 [0·00 to 0·02]; p=0·16). All participants had at least one adverse event; serious adverse events occurred in 23 (27%) of 84 in the crenezumab group and 21 (25%) of 84 in the placebo group. No fatalities occurred.
INTERPRETATION: Crenezumab therapy administered for 5-8 years did not result in significant benefits on our primary clinical outcomes in cognitively unimpaired participants predisposed to developing ADAD dementia; secondary and exploratory outcomes also showed no significant effect on removal of amyloid plaques or other clinical or biomarker outcomes. Together with the results of other anti-amyloid β trials, robust fibrillar amyloid removal appears necessary for clinical efficacy in people with elevated brain amyloid. This study will further inform the biomarker, cognitive, and clinical trajectory of preclinical ADAD, the risk of clinical progression in amyloid-positive and amyloid-negative mutation carriers, and the size and design of future secondary and primary prevention trials.
FUNDING: US National Institute on Aging (NIA), Banner Alzheimer's Institute, Genentech, F Hoffmann-La Roche.}, }
@article {pmid41576501, year = {2026}, author = {Jayaswamy, PK and Ambrish, T and Sangamesh, VC and Kabekkodu, SP and Kellarai, A and Shetty, J and Shetty, P}, title = {EGFR-Annexin A2 signaling-mediated tauopathy in amyloid-β and aluminum chloride-induced Alzheimer's disease and its modulation by the HDAC inhibitor butyrate.}, journal = {Ecotoxicology and environmental safety}, volume = {310}, number = {}, pages = {119775}, doi = {10.1016/j.ecoenv.2026.119775}, pmid = {41576501}, issn = {1090-2414}, abstract = {Alzheimer's disease (AD) is typified by amyloid-β (Aβ) accumulation and tauopathy, culminating in synaptic destabilization, dendritic atrophy, and widespread neurodegeneration. Epidermal growth factor receptor (EGFR), prominently expressed during neurodevelopment, is largely quiescent in adulthood but undergoes pathological reactivation in AD, with its mechanistic contribution remaining elusive. Here, we delineate the EGFR-Annexin A2 (AnxA2) signaling nexus as a pivotal mediator of tau hyperphosphorylation in Aβ1-42-challenged SH-SY5Y and PC12 neuronal cultures and in aluminum chloride (AlCl3)/D-galactose (D-gal)-induced AD rat models. In vitro, Aβ1-42 orchestrated synergistic EGFR-AnxA2 activation, triggering site-specific tau phosphorylation (Thr231/Ser396), synaptic protein depletion, apoptotic cascades, neuroinflammatory signaling, and plasminogen activator inhibitor-1 (PAI-1)-driven fibrinolytic deficits. In vivo, AlCl3/D-gal rats displayed hippocampal EGFR-AnxA2 upregulation, region-specific tauopathy, cognitive impairments in Open Field and Novel Object Recognition paradigms, oxidative perturbations, and elevated TNF-α. Butyrate intervention abrogated EGFR-AnxA2 hyperactivity, attenuated tau pathology, restored PAI-1/tissue plasminogen activator homeostasis, and mitigated oxidative stress and neuroinflammation. Moreover, butyrate preserved synaptic and dendritic architecture, modulated apoptotic effectors by upregulating Bcl-2 and suppressing Bad, and enhanced neuronal viability. In vivo pre-and post-treatment paradigms improved behavioral and molecular outcomes, with prophylactic administration exhibiting superior efficacy. Collectively, these findings establish EGFR-AnxA2 as a central driver of tauopathy and identify prophylactic butyrate as a mechanistically grounded, diet-derived neuroprotective strategy capable of attenuating tau hyperphosphorylation, synaptic loss, and neuroinflammation in AD.}, }
@article {pmid41575675, year = {2026}, author = {Kopalli, SR and Wankhede, N and Rahangdale, SR and Sammeta, S and Aglawe, M and Koppula, S and Taksande, B and Upaganlawar, A and Umekar, M and Kale, M}, title = {Age-driven dysbiosis: gut microbiota in the pathogenesis and treatment of aging disorders.}, journal = {Biogerontology}, volume = {27}, number = {1}, pages = {42}, pmid = {41575675}, issn = {1573-6768}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Dysbiosis/therapy/microbiology ; *Aging/physiology ; Animals ; Probiotics/therapeutic use ; }, abstract = {Aging, a complex physiological and molecular process, has undergone significant changes, of which gut microbiome composition has surfaced as an important key in the maintenance of neurological health. Recent studies have revealed the significant impact of age-related gut dysbiosis in the induction of neuroinflammation, metabolic syndrome, disruptions in gut-brain axis, and age-related neurological decline. Although significant studies have revealed the impact of the microbiome-gut-brain axis in individual neurological diseases, an aging-focused holistic synthesis has not yet been adequately developed. This review provides a critical assessment of the involvement of age-related dysbiosis of gut microbiota in the development and progression of neurological disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, and cognitive aging of the elderly, and to focus on age-related microbial patterns and mechanisms of dysbiosis related to neurological aging, including inflammation and immune system dysregulation, metabolic changes, oxidative stress, barrier dysfunction, and gut-brain communication through enteroendocrine, enteric neural, and vagal mechanisms, and to emphasize disease-specific and common microbial patterns of dysbiosis and beneficial and harmful microbial roles in aging diseases. This review assesses some of the latest promising therapies aimed at the microbiota, such as probiotics, prebiotics, dietary therapies, fecal microbiota transplantation, as well as pharmacological therapies, and critically discusses their limitations in terms of interindividual variability and their generalisation and applicability. Focusing on mechanistic, comparative, and translation aspects, this review offers a comprehensive approach to neurological aging due to gut microbiota and identifies gaps for future precision microbiome-based interventions.}, }
@article {pmid41575410, year = {2026}, author = {Neth, BJ and Graff-Radford, J and Cogswell, PM and Johnson, DR and Botha, H and McCarter, SJ and Jones, DT and Conkins, MM and Hardin, DB and Spence, JJ and Rhegness, CL and Allen, LA and Coburn, RP and Pounders, JD and Burkett, BJ and Pillai, JJ and Day, GS and Graff-Radford, NR and Lachner, C and Messina, SA and Jain, MK and Stricker, NH and Machulda, MM and Fields, JA and Boots, EA and Aduen, PA and Barnard, LR and Remold, MA and Anderlik, AM and Asleson, KM and Martin, LL and Klaassen, JA and Larsen, JJ and Algeciras-Schimnich, A and Bornhorst, JA and Rumilla, AM and Jack, CR and Boeve, BF and Knopman, DS and Petersen, RC and Ramanan, VK}, title = {Establishing an Alzheimer Disease Therapeutics Clinic: Experience From a Year of Evaluations.}, journal = {Mayo Clinic proceedings}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.mayocp.2025.09.019}, pmid = {41575410}, issn = {1942-5546}, abstract = {OBJECTIVE: To describe the establishment and initial experience of a multidisciplinary Alzheimer disease treatment clinic (ADTC), focusing on the evaluation of eligibility for novel disease-modifying therapies, as well as the treatment and monitoring of qualifying patients.
PATIENTS AND METHODS: We completed a retrospective review of cases seen through the Mayo Clinic ADTC between October 2, 2023, and December 31, 2024. Typical evaluations occurred over 4 to 5 days and included multimodal testing, office visits, and a weekly case conference modeled on tumor board meetings.
RESULTS: Patients evaluated in the ADTC (N=232) ranged from 52 to 85 years of age (mean age, 71.2 years). Most patients had mild cognitive impairment (128 of 232 [55%]) or mild dementia (72 of 232 [31%]) syndromes. Overall, 121 patients (52%) were judged eligible for antiamyloid therapy. Eligibility rates were higher among internal (from our institution) referrals compared with external referrals (63% [146 of 232] vs 37% [86 of 232). Reasons for treatment ineligibility were typically multiple but commonly included magnetic resonance imaging features, too severe cognitive/functional impairment, and general health conditions believed likely to increase therapeutic risks. In some cases, the ADTC evaluation uniquely identified treatment risk factors, such as cerebral amyloid angiopathy, that had not been previously discussed with patients. Through shared decision making, approximately 30% of eligible patients (25 of 81) ultimately deferred antiamyloid therapy. In addition, approximately 10% of patients evaluated in the ADTC were amyloid-negative by positron emission tomography, suggesting non-Alzheimer disease diagnoses for their presentations.
CONCLUSION: The ADTC facilitated systematic implementation of antiamyloid therapies for early Alzheimer disease and provided a scalable foundation for integrating future approved treatment options.}, }
@article {pmid41574617, year = {2026}, author = {Sharma, P and Goyal, R}, title = {Mitigation of Circadian Disruption-Induced Amyloid Pathology, Neuroinflammation, and Cognitive Disability in C57BL/6J Mice Using Estradiol.}, journal = {ACS chemical neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1021/acschemneuro.5c00650}, pmid = {41574617}, issn = {1948-7193}, abstract = {Circadian rhythms (CRs) are intrinsic 24 h cycles that regulate critical physiological processes, including sleep-wake behavior, hormonal signaling, and cognition. Disruption of CRs, often caused by chronic aberrant light exposure, has been linked to neurodegenerative diseases such as Alzheimer's disease (AD), through altered expression of core clock genes and neurotransmitter imbalances. Estrogen is a known neuromodulator that influences both circadian timing and cognitive function, yet the mechanistic interplay between estrogen and circadian dysregulation in neurodegeneration remains underexplored. In this study, we investigated whether estradiol could mitigate neuropathological and circadian disturbances induced by chronic, constant light (LL) exposure in female C57BL/6J mice. Mice were exposed to LL for 6 or 10 weeks (LL6, LL10) to model progressive CR disruption. LL10 significantly delayed locomotor rhythms (p < 0.0001), elevated hippocampal amyloid-β (Aβ) levels (p = 0.0018), and reduced SCN GABA and glutamate levels (p < 0.01), compared to LL6 and light-dark (LD) controls. Both LL6 and LL10 also showed decreased hippocampal nitric oxide and glutathione levels (p < 0.05), indicating oxidative stress. Estradiol treatment (1.5 or 3 μg/kg) restored activity rhythms, reduced Aβ accumulation (p = 0.0019), and normalized SCN neurotransmitter levels (GABA; p = 0.0046; glutamate: p = 0.0003). These effects were abrogated by tamoxifen, suggesting estrogen receptor-mediated signaling. Histological analysis further showed that estradiol attenuated hippocampal inflammation and neuronal damage in LL10-exposed animals. These results demonstrate that estrogen protects against circadian disruption-induced neuropathology and supports its potential as a therapeutic agent in mitigating cognitive decline via ER-dependent pathways.}, }
@article {pmid41573517, year = {2025}, author = {Ham, HJ and Park, SS and Lee, YS and Kim, TH and Son, DJ and Kim, JH and Lim, KH and Park, H and Lee, HJ and Yun, J and Han, SB and Choi, MK and Hong, JT}, title = {CHI3L1 monoclonal antibody therapy mitigates cognitive impairment by inhibiting neuroinflammation through ERK and NF-κB pathway in Tg2576 mice.}, journal = {Frontiers in molecular neuroscience}, volume = {18}, number = {}, pages = {1728279}, pmid = {41573517}, issn = {1662-5099}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is neurodegenerative disorder characterized by chronic inflammation in the brain. Chitinase-3-like 1 (CHI3L1), a secreted glycoprotein that is upregulated in a variety of diseases with chronic inflammation, represents a promising target for AD. Here, we studied the inhibitory effect of a novel CHI3L1 monoclonal antibody (H1) on memory impairment and neuroinflammation in Tg2576 transgenic mice.
METHODS AND RESULTS: H1 was shown to cross the blood-brain barrier selectively, as confirmed by fluorescence imaging. Tg2576 mice were administered H1 (2 mg/kg, i.v., weekly for 1 month), and cognitive functions were assessed through behavioral tests. H1 treatment alleviated memory impairment and reduced amyloid deposition and neuroinflammation both in Tg2576 mice and Aβ-induced BV-2 microglial cells. Mechanistically, H1 inhibited the ERK and NF-κB signaling pathways and suppressed M1 microglial marker expression. Global proteomic analysis and gene expression profiling in BV-2 cells and Tg2576 mouse brains revealed a strong association between CHI3L1 and HAX1 expression. H1 therapy significantly reduced HAX1 levels in both in vivo and in vitro models. Moreover, HAX1 induction by Aβ or CHI3L1 was blocked by an NF-κB inhibitor.
DISCUSSION: These findings suggest that CHI3L1 monoclonal antibody therapy may attenuate cognitive decline in AD by modulating neuroinflamma.}, }
@article {pmid41573383, year = {2025}, author = {Liu, B and Chen, C and Cai, P and Zhang, J and Yang, L and Chen, X and Ma, X and Jiang, X and Zhang, A and Song, L and Jiang, L}, title = {The alterations in brain network functional gradients and dynamic functional connectivity in Alzheimer's disease: a resting-state fMRI study.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1716076}, pmid = {41573383}, issn = {1663-4365}, abstract = {BACKGROUND AND PURPOSE: Alzheimer's disease (AD), the most common form of dementia worldwide, is characterized by progressive cognitive decline. Extensive evidence from dynamic functional connectivity (dFC) studies has demonstrated unstable functional states, reduced network flexibility, and impaired transitions between large-scale neurocognitive networks across the AD continuum. However, how these temporal abnormalities are embedded within the hierarchical spatial organization of brain networks, as captured by functional gradients (FG), and whether combined FG-dFC metrics can provide mechanistically interpretable and potentially sensitive imaging biomarkers, remain to be elucidated.
METHODS: This study enrolled 46 AD patients who were diagnosed according to the Amyloid/Tau/Neurodegeneration (ATN) biological diagnostic framework and 37 age- and sex-matched healthy controls (HC). All participants underwent resting-state fMRI. Functional gradients were derived using connectivity similarity matrices and diffusion embedding (aligned and standardized), while dFC was estimated with a sliding window approach and clustered into four recurrent states. Group differences were assessed with two-sample t-tests with Gaussian Random Field (GRF) correction. Correlation analyses included ATN biomarkers and cognitive scores. A linear support vector machine (SVM) with leave-one-out cross-validation evaluated classification performance based on significant FG features.
RESULTS: Compared to the healthy controls, AD patients exhibited widespread FG alterations between regions of the Default Mode Network (DMN) and the Sensorimotor Network (SMN). In the first gradient DMN, the left precuneus showed reduced gradient scores, whereas the right medial superior frontal gyrus and bilateral angular gyri were increased. In the first gradient of the SMN, the right supplementary motor area increased while bilateral superior temporal gyri decreased. Second-gradient reductions were confined to two regions: the left postcentral gyrus (SMN) and left middle occipital gyrus (visual network, VIS). The right medial superior frontal gyrus first-gradient score correlated negatively with T-Tau (r = -0.50, P = 0.006) and age (r = -0.36, P = 0.02); the right angular gyrus correlated negatively with age (r = -0.29, P = 0.04); the left precuneus correlated positively with age (r = 0.38, P = 0.009). dFC revealed four recurrent states (27.59, 17.67, 28.27, 26.47% of total occurrences). Relative to HC, AD showed higher FT and MDT in states 1-2 and lower scores in state 3, with NT unchanged, alongside state-dependent bidirectional connectivity changes (fronto-insular-sensorimotor increases; DMN-temporal and visuo-auditory decreases). The SVM achieved an AUC of 0.776, sensitivity 78.26%, specificity 67.57%, and accuracy 73.49%, with the right superior temporal gyrus within SMN first-gradient contributing most.
CONCLUSION: AD is characterized by macro-scale hierarchical disorganization centered on the principal functional gradient, accompanied by reduced cross-state flexibility and state-dependent connectivity abnormalities. The combined functional gradient-dynamic functional connectivity (FG-dFC) analysis provides complementary spatiotemporal insights and reveals imaging features associated with T-Tau levels and age, offering new perspectives on the neuropathological mechanisms of AD and potential imaging biomarkers. Moreover, these network topology and dynamic connectivity metrics may prove useful for monitoring disease progression, evaluating treatment effects, and stratifying patients in future clinical and interventional studies.}, }
@article {pmid41573059, year = {2025}, author = {Ayla, S and Saygi, HI and Sahin, M and Ciftkaya, E and Kilic, A and Pence, S and Bahadori, F and Dolanbay, EG and Elibol, B}, title = {Urtica dioica can regulate autophagy pathway in the rat hippocampal tissue after STZ-induced neurodegeneration.}, journal = {Northern clinics of Istanbul}, volume = {12}, number = {5}, pages = {531-539}, pmid = {41573059}, issn = {2536-4553}, abstract = {OBJECTIVE: Autophagy plays a crucial role in neuroprotection by helping to clear toxic substances, like misfolded proteins. In neurodegeneration, autophagy is impaired leading to the accumulation of harmful proteins that disrupt neuronal function, promote inflammation, and contribute to the degeneration of brain cells. Therefore, because of its anti-inflammatory and anti-oxidative actions, the effects of Urtica dioica (UD) on the proteins of autophagy signaling pathways was studied in the hippocampus of rats with streptozotocin-(STZ) induced neurodegeneration.
METHODS: Neurodegeneration model of rats was induced by intracerebroventricular injection of STZ (3 mg/kg) to observe both cognitive deficits and autophagic dysfunction. Then, the rats in the treatment group were consumed UD at the dose of 50 mg/kg/day for 4 weeks. At the end of 4 weeks, passive avoidance test was applied for cognitive functions and hippocampal tissue of rats were investigated to determine the changes in the proteins related to autophagy by western blotting and immunofluoresecence.
RESULTS: UD treatment slightly attenuated the STZ-induced memory deficiencies in the rats. In addition, an increase in the autophagy was noted by increasing the expression of Beclin, ATG5, and LC3β proteins in the STZ-UD group compared to the STZ group.
CONCLUSION: In summary, UD may be a candidate molecule as a therapeutic strategy to protect neurons in neurodegeneration through increasing autophagy to reduce toxic protein accumulation.}, }
@article {pmid41572310, year = {2026}, author = {Kashem, M and Haldenby, O and Ahmad, JF and Muhammad, AA and Mostert, CM and Ali, S}, title = {Are diagnostic technologies for alzheimer's disease and dementia cost-effective? A systematic review of economic evaluations.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-025-01933-1}, pmid = {41572310}, issn = {1758-9193}, abstract = {BACKGROUND: Alzheimer's disease (AD) and dementia pose a significant clinical and economic burden globally. Early diagnosis and intervention can potentially delay disease progression. Current diagnostic guidelines recommend considering imaging and biomarker analysis in conjunction with clinical evaluation. Given limited healthcare resources, evidence on the cost-effectiveness of diagnostic technologies is critical to guide allocation of resources.
OBJECTIVE: To systematically review the economic evaluation studies of neuroimaging, biomarkers, and other diagnostic or screening strategies for diagnosing and/or tracking the progression of AD or dementia.
METHODS: A comprehensive search was conducted across Medline, Embase, PsycINFO, CINAHL and EconLit, and to identify relevant studies, with no restrictions on country, language, or publication period. Quality of the studies was evaluated using the Consensus on Health Economic Criteria-Extended (CHEC-Extended) checklist.
RESULTS: Out of 6,804 records, 21 studies met the eligibility criteria. These included evaluations of neuroimaging technologies such as Positron Emission Tomography, Single Photon Emission Computed Tomography, Computed Tomography, and Magnetic Resonance Imaging (n = 10), cerebrospinal fluid and blood biomarkers (n = 7), and alternative diagnostic strategies including screening programs, machine learning-based models, and multidisciplinary care approaches (n = 4). Among the studies evaluating imaging technologies, most (n = 6) did not find them to be cost-effective. In contrast, CSF and blood biomarker studies found these technologies to be cost-effective, with some variability in results. Methodological quality score ranged between 15% and 95%, indicating a mix of low- to high-quality studies. Due to heterogeneity in study designs and reported outcomes, direct comparisons were not feasible.
CONCLUSIONS: While many studies were of high quality, heterogeneity in study objectives, design, and outcomes restricted evidence synthesis. Future research should ensure methodological consistency, transparent cost reporting, and integration of new treatment frameworks to improve the policy relevance and reliability of economic evidence for AD diagnostics.}, }
@article {pmid41571954, year = {2026}, author = {Ahn, NH and Hong, SC and Hong, CR and Lee, EH and Lee, JH and Choi, SB and Jung, J and Kim, Y and Kim, JS and Park, K and Kim, YK and Kim, Y and Yang, SH}, title = {Fucoxanthin Extracted from the Microalgae Phaeodactylum tricornutum Ameliorates Alzheimer's Pathologies with the Reduction of Aβ-Induced NLRP3 Inflammasome Activation in APP/PS1 Mice.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {385}, pmid = {41571954}, issn = {1559-1182}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism ; *NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; *Xanthophylls/pharmacology/therapeutic use/isolation & purification ; *Amyloid beta-Peptides/metabolism ; Mice, Transgenic ; *Inflammasomes/metabolism ; Mice ; *Microalgae/chemistry ; Microglia/drug effects/metabolism ; Mice, Inbred C57BL ; Astrocytes/drug effects/metabolism/pathology ; tau Proteins/metabolism ; *Presenilin-1/metabolism ; Male ; *Amyloid beta-Protein Precursor/metabolism ; Brain/pathology/drug effects/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder, one of the most common types of dementia, accompanying severe learning and memory dysfunctions. In AD brains, the misfolded aggregation and deposits of amyloid-β (Aβ) and tau are frequently observed before the cognitive symptom onset; thus, trials for alleviation of these lesions are considered commensurate strategies with AD treatment. Additionally, increasing evidence suggests that misfolded and aggregated proteins induce the activation of microglia and astrocytes by the release of the inflammatory mediators via the activation of the inflammatory signaling cascade, which consequently contributes to AD pathogenesis. Here, we investigated the therapeutic potential of fucoxanthin, a compound derived from the microalgae Phaeodactylum tricornutum, in mitigating AD pathologies. Fucoxanthin was shown to inhibit the aggregation of Aβ and tau, converting their aggregates to monomeric forms. In the brain of APP/PS1 transgenic mice, fucoxanthin administration significantly reduced the levels of Aβ plaques and hyperphosphorylated tau and further ameliorated cognitive impairments by inhibiting the activation of microglia and astrocytes. Notably, fucoxanthin effectively regulated Aβ-induced NLRP3 inflammasome activation in astrocytes, reducing neuroinflammation associated with AD. Thus, our findings showing the multifaceted therapeutic mode of action of fucoxanthin against AD provide that fucoxanthin would have promising roles in the strategies of AD treatment.}, }
@article {pmid41571775, year = {2026}, author = {Sathish, R and Muthukumar, R and Kumaran, KM and Murugan, SP}, title = {Intelligent decision-making systems for early detection of alzheimer's disease using wearable technologies and deep learning.}, journal = {Scientific reports}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41598-026-36895-3}, pmid = {41571775}, issn = {2045-2322}, abstract = {Intelligent decision-making systems using wearable electronics and deep learning (DL) might identify Alzheimer's disease (AD) early for treatment. These technologies can continually monitor vital signs and behavioral characteristics to identify early cognitive deterioration in patients. Clinical examinations, neuroimaging, and cognitive testing are the main ways to identify Alzheimer's, but they are difficult, expensive, and frequently miss the illness early on. Such approaches lack the sensitivity and real-time monitoring essential for early intervention. Through wearable technology and sophisticated DL approaches, Early Detection using Deep Learning Algorithm (ED-DLA) tackles these constraints. In real time, wearable sensors capture data on heart rate, sleep habits, and physical activity. DL algorithms evaluate this data to identify early Alzheimer's. Continuous and non-invasive monitoring improves detection sensitivity and accuracy. To evaluate sequential wearable device data, the suggested technique uses an RNN-based image classification model. Temporal patterns are essential for understanding AD development, and the RNN does so well. The slight changes in cognitive and physical activities may indicate early-stage dementia. The suggested AD diagnosis and management system improves early detection accuracy and real-time monitoring, making it more dependable and scalable.}, }
@article {pmid41571077, year = {2026}, author = {Abdel-Aal, RA and Meligy, FY and Kamel, G and Ashry, IEM}, title = {Cognitive Enhancing Effect of Canagliflozin in Aluminum-Induced Rat Model of Alzheimer's-Like Disease: Cross Talk Between Amyloid-Β and BDNF/GSK-3β Signaling.}, journal = {European journal of pharmacology}, volume = {}, number = {}, pages = {178581}, doi = {10.1016/j.ejphar.2026.178581}, pmid = {41571077}, issn = {1879-0712}, abstract = {The strong relationship between Alzheimer's Disease (AD) and diabetes mellitus (DM) is described by the term "type 3 diabetes". Canagliflozin (CAN), a sodium-glucose co-transporter 2 inhibitor (SGLT2i), is an antidiabetic agent under investigation as a potential new treatment for AD due to its acetylcholinesterase (AChE) inhibitory properties. We aimed to examine the effect of CAN on the efficacy of the anti-acetylcholinesterase, rivastigmine (RIV), against aluminum chloride (AlCl3)-induced AD rat model. The efficacy of CAN, RIV, and CAN plus RIV against abnormal behavioral, biochemical, and histological changes in AlCl3-induced AD in rats was examined. Three weeks of treatment with CAN partially reversed the AlCl3-induced behavioral dysfunction, along with significantly elevated levels of brain-derived neurotrophic factor (BDNF) and decreased levels of AChE, glycogen synthase kinase-3β (GSK3β), amyloid beta (Aβ) deposits, and inducible nitric oxide synthase (iNOS) expression. Histological examination revealed that CAN administration significantly increased RIV's efficacy by protecting neurons in rats' hippocampal tissues from AlCl3-induced damage. Interestingly, the RIV+CAN combination exhibited a more pronounced inhibitory effect on Aβ plaque formation, iNOS activity, and neurodegeneration compared to either RIV or CAN alone. However, this combination did not show any additive benefits for behavior, AChE activity, BDNF, or GSK3β concentrations compared with RIV alone. Our research indicates that CAN has potential benefits for AD, as evidenced by improvements in cognitive abilities, cholinergic activity, and neurogenesis in rats with AD. This is attributed to the upregulation of BDNF/GSK3β signaling, reduced neuroinflammation, and Aβ deposition.}, }
@article {pmid41570950, year = {2026}, author = {Guo, J and Shi, C and Yu, C and Wang, Y and He, M}, title = {Protein S-Sulfhydration: Mechanisms and Therapeutic Implications in Alzheimer's Disease and Parkinson's Disease.}, journal = {Free radical biology & medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.freeradbiomed.2026.01.033}, pmid = {41570950}, issn = {1873-4596}, abstract = {BACKGROUND: Alzheimer's disease (AD), Parkinson's disease (PD) and other neurodegenerative diseases have complex pathogenic mechanisms. Traditional theories (e.g., free radical damage/oxidative stress, inflammatory responses) have laid a foundation for understanding these pathological processes. However, single mechanisms cannot fully explain their complexity. In recent years, post-translational modifications (PTMs)-especially redox-related types such as S-sulfhydration-have emerged as key complementary regulators of nervous system homeostasis and disease progression. It is mediated by the endogenous gas signaling molecule hydrogen sulfide (H2S) and has unique regulatory effects.
AIM OF REVIEW: This review systematically summarizes the molecular mechanisms and therapeutic targets of S-sulfhydration in AD and PD. It discusses the potential of S-sulfhydration in disease intervention and treatment. It also looks into H2S-based therapeutic strategies and their clinical application prospects. This review aims to provide a theoretical basis for understanding the role of PTMs in neurological diseases.
This review summarizes clearly: in AD and PD, S-sulfhydration interacts with protein modifications like phosphorylation, S-nitrosylation and succinylation. It regulates key pathogenic proteins such as Tau, Aβ and Parkin. It also takes part in regulating energy metabolism, resisting oxidative stress and inhibiting inflammatory responses. These effects influence neuronal survival and functional homeostasis. This indicates that S-sulfhydration plays an important regulatory role in AD and PD progression. It is part of the complex network of pathological mechanisms. Its modification mechanisms and interaction pathways offer promising complementary molecular targets and intervention strategies for treating AD, PD, and other potential neurodegenerative diseases.}, }
@article {pmid41570699, year = {2026}, author = {Razzaq, R and Ahmed, T and Butt, AM and Jabeen, Z and Khalid, A and Shahid, I and Alzahrani, AR and Rehman, S}, title = {Betanin-encapsulated nanoparticles mitigate neurotoxicity against AlCl3-induced Alzheimer's disease via modulation of AChE/TNF-α/IL-1β expression.}, journal = {Biochemical and biophysical research communications}, volume = {801}, number = {}, pages = {153293}, doi = {10.1016/j.bbrc.2026.153293}, pmid = {41570699}, issn = {1090-2104}, abstract = {Alzheimer's disease (AD), the most common health problem, is significantly characterized by oxidative stress, neuroinflammation, and cholinergic dysfunction, provoking growing interest in natural antioxidants with improved bioavailability. This study is intended to evaluate the neuroprotective impact and the probable mechanism of betanin and formulated betanin-encapsulated nanoparticles (ChBetNPs) in an AlCl3 and D-galactose-induced rat model Alzheimer's-like neurotoxicity. The rats were treated daily with AlCl3 and D-galactose for 21 days to induce neurotoxicity, followed by two weeks of treatment with low and high doses of betanin and ChBetNPs. After treatment, cognitive performance, oxidative stress markers, acetylcholinesterase (AChE) activity, and hippocampal inflammatory gene expression were assessed. Both low and high doses of ChBetNPs (40 mg/kg/day and 80 mg/kg/day respectively) significantly improved learning and memory performance in AlCl3 + D-galactose-treated rats. Treatment with ChBetNPs also markedly restored antioxidant defenses, as evidenced by increased activities of CAT (∗∗P < 0.01), elevated reduced GSH, and reduced levels of the lipid peroxidation marker MDA. The higher dose of ChBetNPs produced a pronounced protective effect on cholinergic function, reflected by a robust reduction in brain AChE activity (∗∗∗∗P < 0.0001). In addition, both free betanin and ChBetNPs at low and high doses significantly (∗∗P < 0.01) downregulated the hippocampal mRNA expression of AChE, α-synuclein, TNF-α, and IL-1β in hippocampal region of brain as compared with untreated group, indicating attenuation of neuroinflammatory and protein-aggregation-related pathways. In summary, our findings demonstrate that ChBetNPs enhanced learning, memory, and cholinergic neurotransmission, likely by mitigating oxidative stress and the associated NF-κB-mediated inflammatory responses.}, }
@article {pmid41570392, year = {2026}, author = {Wischik, CM and Stefanacci, R and Bentham, P and Gauthier, S and Zetterberg, H and Wilcock, GK and Froelich, L and Burns, A and MacSweeney, E and Ballard, C and Yu, JT and Choon, TS and Asvatourian, V and Muehlemann, N and Priel, J and Kook, K and Sullivan, T and Downie, D and Miller, S and Pringle, C and Storey, JMD and Baddeley, T and Harrington, CR and Penny, LK and Arastoo, M and Staff, R and Sandu, AL and Shiells, H and Lo, S and Nazlee, N and Evans, E and Hull, C and Schelter, BO}, title = {Clinical, imaging and blood biomarker outcomes in a Phase 3 clinical trial of tau aggregation inhibitor hydromethylthionine mesylate in mild cognitive impairment and mild to moderate dementia due to Alzheimer's disease.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {3}, pages = {100480}, doi = {10.1016/j.tjpad.2026.100480}, pmid = {41570392}, issn = {2426-0266}, abstract = {BACKGROUND: Hydromethylthionine mesylate (HMTM) targets tau pathology and has tau-independent symptomatic activity.
OBJECTIVES: To evaluate the safety and efficacy of HMTM in participants with mild cognitive impairment (MCI) and mild to moderate dementia due to Alzheimer's disease (AD).
SETTING: 82 centres in Canada, European Union, United Kingdom and United States of America.
PARTICIPANTS: A total of 598 amyloid β-PET positive participants were included; 44% (263) met clinical criteria for MCI due to Alzheimer's disease and 56% (335) were diagnosed with mild to moderate dementia due to AD.
INTERVENTION: HMTM 16 mg/day and 8 mg/day were compared with methylthioninium chloride (MTC) 4 mg twice weekly, intended as an inactive urinary colourant to preserve blinding with respect to possible urinary discolouration caused by HMTM.
MEASUREMENTS: HMTM and MTC were compared on cognitive and functional endpoints for the first 52 weeks followed by all receiving HMTM 16 mg/day to 104 weeks in a modified delayed-start trial design. Biomarker outcomes included change in plasma levels of neurofilament light chain (NfL), pTau217 and MRI measures of grey matter atrophy.
RESULTS: It was not possible to demonstrate significant differences on the co-primary clinical endpoints (ADAS-cog11 and ADCS-ADL23) at 52 weeks due to symptomatic activity in the control arm. In participants with MCI, statistically significant differences in cognitive decline (ADAS-cog13) emerged at 78 weeks (p = 0·0291) and 104 weeks (p = 0·0308) between early- and delayed-start HMTM 16 mg/day in analyses specified prior to the 24-month database lock. Statistically significant cognitive improvement over baseline score was sustained for 78 weeks in the early start MCI group, with no significant cognitive or functional decline to 104 weeks. There was a significant reduction in progression of neurodegeneration measured by NfL change (p = 0·0291) at 52 weeks in the whole population, consistent with significant reductions in progression of grey matter atrophy at 52 and 104 weeks, and a reduction in progression of tau pathology (pTau217, p = 0·0165) in MCI. Headache (1·5%) and diarrhoea (1·2%) were the most frequent adverse effects.
CONCLUSIONS: Although HMTM 16 mg/day arrested progression of neurodegeneration and reduced grey matter atrophy at 52 weeks, symptomatic activity in the control arm precluded separation of treatment arms at 52 weeks on primary clinical endpoints. In participants with MCI, significant clinical separation was seen only at 78 and 104 weeks. This effect has been confirmed in a further study. HMTM was well tolerated and has the potential to offer an accessible oral treatment option with a benign safety profile which could be delivered with minimal patient/physician burden.}, }
@article {pmid41569280, year = {2026}, author = {Huynh, ALH and Wang, S and Lee, K and Amadoru, S and Wrigley, S and Zisis, G and Ernstrom, K and Raman, R and Aisen, P and Sperling, RA and Masters, CL and Ward, D and Yates, PA}, title = {Prevalence of frailty and its association with cognition in preclinical Alzheimer's disease: a cross-sectional analysis of baseline data from the A4 study.}, journal = {Age and ageing}, volume = {55}, number = {1}, pages = {}, doi = {10.1093/ageing/afaf378}, pmid = {41569280}, issn = {1468-2834}, mesh = {Humans ; Aged ; Female ; Cross-Sectional Studies ; Male ; *Alzheimer Disease/epidemiology/diagnosis/psychology ; *Frailty/epidemiology/diagnosis/psychology ; Prevalence ; *Cognition ; Amyloid beta-Peptides/metabolism ; Aged, 80 and over ; *Frail Elderly ; Geriatric Assessment ; Risk Factors ; Prodromal Symptoms ; }, abstract = {BACKGROUND: The prevalence and role of frailty in preclinical Alzheimer's disease (AD) is unclear.
METHODS: Cross-sectional analyses of pre-randomization data from the Anti-Amyloid Treatment in Asymptomatic AD (A4) study were analysed to derive two models of a frailty index (FI)-full [FI-Full] and cognitive variables removed [FI-CVR]. The prevalence of frailty (FI > 0.25) according to amyloid status (Aβ+/-), and the association of frailty and cognition (determined by the Preclinical Alzheimer Cognitive Composite (PACC) score) and whether frailty moderates the relationship between amyloid status and cognition was assessed, adjusting for age, sex and education.
RESULTS: Four thousand four hundred eighty-six participants were included (mean age 71.3 ± 4.7 years, 30% participants Aβ+, 59% female). The prevalence of frailty in preclinical AD was 22% (or 44% when cognitive variables were removed from the FI). Using either FI model, in adjusted analyses, Aβ+ participants were more likely to be frail compared to Aβ- [FI-Full-Odds ratio (OR) 1.43 95% confidence interval (CI) 1.20-1.71, P < .001; FI-CVR-OR 1.21 95% CI 1.05-1.40, P < .008]. Frail participants had lower PACC scores compared to non-frail participants, on average (FI-Full-PACC score -0.58 95% CI -0.76 to -0.40, P < .001; FI-CVR-PACC score -0.26 95% CI -0.40 to -0.12, P < .001). Frailty did not influence the relationship between Aβ status and cognition.
CONCLUSIONS: In a cohort screened for a preclinical AD trial, elevated Aβ levels were associated with frailty and frailty was associated with reduced cognitive performance independent of elevated Aβ levels. These associations, and whether or not frailty is associated with longitudinal cognitive decline independent of Aβ status, warrant further study.}, }
@article {pmid41569242, year = {2026}, author = {Zuliani, G and Boscolo Bragadin, F and Romagnoli, T and Polastri, M and Cervellati, C and Dario, FDP and Brombo, G and Zuin, M}, title = {Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia.}, journal = {International journal of geriatric psychiatry}, volume = {41}, number = {1}, pages = {e70195}, doi = {10.1002/gps.70195}, pmid = {41569242}, issn = {1099-1166}, mesh = {Humans ; *Cholinesterase Inhibitors/therapeutic use ; Aged ; Male ; Female ; *Dementia/drug therapy/psychology ; Aged, 80 and over ; Severity of Illness Index ; Behavioral Symptoms/drug therapy ; }, abstract = {OBJECTIVE: Behavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based first on a non-pharmacological and subsequently on a pharmacological approach. We explored the potential effect of long-term treatment with acetylcholinesterase inhibitors (AChEI) on BPSD severity over time.
METHODS: The initial sample included 4032 older patients with mild-moderate dementia (Alzhemier's disease - AD, Lewy body dementia - LBD, or vascular dementias - VaD) from the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS). After propensity score matching, a cohort of 1408 patients (704 treated with AChEI = AChEI+ and 704 not treated = AChEI-) was generated. The mean age was 73.2 years (females: 50.4%). The mean follow-up duration was 4.3 ± 1.6 years (range: 2.2-8.3 years). Patients were evaluated at baseline, T1 (2 years), T2 (4 years), T3 (6.2 years), and T4 (8.1 years). BPSD severity was assessed by Neuropsychiatric Inventory (NPI-Q).
RESULTS: The baseline mean NPI-Q severity score was 1.33. At T4, the score increased to 1.41 in AChEI- patients (+6% from baseline), while it decreased to 1.26 in AChEI+ (-6%) (all p < 0.01 from T1 to T4). As regards the NPI-Q sub-items, six of them (hallucinations, agitation/aggression, depression/dysphoria, anxiety, disinhibition and irritability/lability) exhibited significant differences over time (all p < 0.01) in favor of the AChEI + group (stabilization or improvement). Similar trends were observed when LOAD, LBD and VaD were considered separately. In contrast, for five domains (delusions, elation/euphoria, motor disturbances, night-time behaviors, and appetite/eating changes) no differences were observed.
CONCLUSIONS: Our study supports the potential role for AChEI in BPSD management, demonstrating a trend toward symptoms stabilization or improvement in patients with mild-moderate dementia. Although the effects were not uniform across all NPI-Q domains, and the limitations of the study, our results reinforces the relevance of AChEI in the comprehensive treatment of dementia.}, }
@article {pmid41568736, year = {2025}, author = {Liu, W and Li, Y and Qin, W and Wang, X and Li, W and Li, Y and , and Jia, J}, title = {The impact of cholinesterase inhibitors on cognitive trajectories in mild cognitive impairment patients based on amyloid beta status.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {5}, pages = {e70193}, doi = {10.1002/alz.70193}, pmid = {41568736}, issn = {1552-5279}, support = {CX23YZ15//Chinese Institutes for Medical Research/ ; U20A20354//Key Project of the National Natural Science Foundation of China/ ; 81530036//Key Project of the National Natural Science Foundation of China/ ; 7244355//Beijing Municipal Natural Science Foundation/ ; 31627803//National Key Scientific Instrument and Equipment Development Project/ ; No.2021ZD0201802//STI2030-Major Projects/ ; Z201100005520016//Beijing Brain Initiative from Beijing Municipal Science & Technology Commission/ ; Z201100005520017//Beijing Brain Initiative from Beijing Municipal Science & Technology Commission/ ; 82401404//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Cognitive Dysfunction/drug therapy/metabolism ; Male ; Female ; Disease Progression ; *Cholinesterase Inhibitors/therapeutic use/adverse effects ; *Amyloid beta-Peptides/metabolism ; Aged ; *Alzheimer Disease ; Aged, 80 and over ; *Cognition/drug effects ; Neuropsychological Tests ; }, abstract = {INTRODUCTION: This study examines whether cholinesterase inhibitors (ChEIs) influence the progression to Alzheimer's disease (AD) dementia and cognitive trajectories in amnestic mild cognitive impairment (MCI) patients, considering their amyloid beta (Aβ) status.
METHODS: Kaplan-Meier and time-varying Cox models evaluated ChEI use and different Aβ status on MCI-to-AD progression. Linear mixed-effects models assessed cognitive trajectories. Locally estimated scatterplot smoothing regression analyzed cognitive changes before and after ChEI initiation.
RESULTS: Among 558 amnestic MCI participants (168 ChEI users), ChEI users exhibited higher risk of progression to AD dementia (hazard ratio = 1.77, 95% confidence interval: 1.15 to 2.73, p = 0.001). Both ChEI use and Aβ burden independently accelerated MCI progression and cognitive decline. Cognitive trajectories demonstrated decline before ChEI initiation and continued to decline after treatment began.
DISCUSSION: The association between ChEI treatment and accelerated progression to AD dementia and cognitive decline, independent of Aβ status, emphasized the need to reconsider optimal timing for ChEI initiation in MCI.
HIGHLIGHTS: ChEI use in MCI was associated with increased risk of progression to AD dementia. ChEI use in MCI was associated with accelerated longitudinal cognitive decline. Cognitive decline persisted after ChEI initiation rather than reversing. ChEI effects on MCI progression to AD dementia were independent of Aβ status.}, }
@article {pmid41568664, year = {2026}, author = {Jootar, T and Hongeng, S and Chiangjong, W}, title = {Engineering nanobodies for drug delivery systems in Alzheimer's disease.}, journal = {Artificial cells, nanomedicine, and biotechnology}, volume = {54}, number = {1}, pages = {104-118}, doi = {10.1080/21691401.2026.2617707}, pmid = {41568664}, issn = {2169-141X}, mesh = {*Alzheimer Disease/drug therapy/metabolism/immunology/pathology ; *Single-Domain Antibodies/therapeutic use/chemistry/immunology ; Humans ; Animals ; *Drug Delivery Systems ; *Protein Engineering ; Blood-Brain Barrier/metabolism ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) remains a major global health challenge, with current therapies offering only symptomatic relief. A significant constraint in the development of effective treatments is the blood-brain barrier (BBB), as it greatly limits the access of therapeutic drugs targeting amyloid-β (Aβ) aggregation, tau hyperphosphorylation and neuroinflammation. Nanobodies, single-domain antibody fragments derived from camelids, have emerged as versatile tools with unique properties such as small size, high stability and the ability to penetrate the BBB. Engineered formats allow for specific targeting of Aβ and tau, receptor-mediated transcytosis, and conjugation with therapeutic or diagnostic substances. Preclinical studies show that nanobody-based strategies can reduce pathological burden, attenuate neuroinflammation and improve cognitive outcomes in AD models. Manufacturing scale-up, long-term safety and regulatory validation are among the remaining challenges, yet nanobody engineering represents a viable path to disease-modifying medicines. Innovative approaches, including artificial intelligence-driven design, i.e. 4-1BB agonist nanobodies, and clustered regularly interspaced short palindromic repeat-facilitated diversification of nanobody libraries - such as targeted complementarity-determining region 3 mutagenesis followed by functional screening against disease-relevant tau or Aβ conformers - alongside half-life extension strategies, are commencing to surmount these obstacles and enhance the potential of nanobody platforms to develop into clinically viable disease-modifying therapies.}, }
@article {pmid41567052, year = {2026}, author = {Tziakouri, A and Loser, V and Vicino, A and Baumgartner, T and Di Liberto, G and Pantazou, V and Bernard-Valnet, R and Theaudin, M and Pot, C and Castro-Jimenez, M and Hübsch, CA and Bally, J and Strambo, D and Hirt, L and Caranzano, L and Rouaud, O and Allali, G and Salvioni, P and Sokolov, AA and Pignat, JM and Ryvlin, P and Perrenoud, MP and Rossetti, AO and Novy, J and Beuchat, I and Du Pasquier, R and Michel, P}, title = {[Neurology : what's new in 2025].}, journal = {Revue medicale suisse}, volume = {22}, number = {946}, pages = {161-164}, doi = {10.53738/REVMED.2026.22.946.48114}, pmid = {41567052}, issn = {1660-9379}, mesh = {Humans ; *Neurology/trends ; Female ; Pregnancy ; *Nervous System Diseases/therapy/diagnosis ; Multiple Sclerosis/therapy/drug therapy ; }, abstract = {In 2025, several major advances have marked the field of neurology. Anti-FcRN and anti-C5 antibodies have confirmed their long-term efficacy in the treatment of myasthenia gravis. Bruton tyrosine kinase inhibitors have expanded the therapeutic arsenal for multiple sclerosis. An antibody targeting α-synuclein appears to slow motor decline in early-stage Parkinson's disease. The efficacy of late thrombolysis in strokes with radiological mismatch has been confirmed. A blood biomarker facilitates early detection of Alzheimer's disease, and Swiss guidelines specify the modality for the use of anti-amyloid therapies in this disease. Finally, in pregnant women with epilepsy, the recommended dose of folic acid has been reduced.}, }
@article {pmid41566034, year = {2026}, author = {Peng, Y and Wang, SS and Lai, KD and Ye, JR and He, WB and Yan, X and Zhang, Z and Chu, SF and Chen, NH}, title = {Protopanaxatriol restores cognitive function in okadaic acid-treated mice via direct inhibition of pathological CDK5 activity.}, journal = {Acta pharmacologica Sinica}, volume = {}, number = {}, pages = {}, pmid = {41566034}, issn = {1745-7254}, abstract = {Alzheimer's disease (AD), a prevalent neurodegenerative dementia, presents therapeutic challenges due to safety concerns about amyloid-targeting strategies. Traditional Chinese medicine (TCM) may offer alternative avenues for exploration. Ginsenoside Rg1, a key bioactive component of ginseng, has shown neuroprotective potential in okadaic acid (OKA)-induced rat model, its limited brain bioavailability suggests that its metabolite protopanaxatriol (Ppt) may exert these effects. In this study, we investigated the therapeutic effects of Ppt on OKA-induced mice model and the underlying mechanisms. Cultured hippocampal neurons were treated with OKA (0.5 nM) with or without Ppt co-treatment for 24 h. We showed that Ppt (1.25-40 nM) exerted dose-dependent neuroprotection against OKA-induced cytotoxicity, with the maximal protection observed at 10 nM. The suppressed tau aggregation by Ppt was confirmed using a Venus-tau bimolecular fluorescence complementation (BiFC) system. Molecular dynamics simulations and microscale thermophoresis (MST) revealed that Ppt bound to the catalytic domain of CDK5 at Cys83, destabilizing the CDK5/p25 complex. Co-immunoprecipitation (Co-IP) assays with CDK5 mutants (S159T, C83A, F80A and D86A) validated this interaction. In vivo mice were treated with Ppt (10 mg/kg, i.g.) for 25 days. On D8 and D9, the mice were bilaterally microinjected with OKA into the cerebral ventricles. We showed that Ppt administration improved spatial memory deficits in Novel Object Recognition and Barnes Maze tests; these effects were abolished in mice expressing a lentivirus-mediated CDK5[C83A] mutant. Hippocampal transcriptomic profiling in OKA-challenged mice following Ppt intervention revealed that Ppt modulated Drp1-mediated mitochondrial fission/fusion dynamics, mitigating OKA-induced mitochondrial homeostasis disruption. Collectively, these results demonstrate that Ppt attenuates tau pathology by selectively targeting CDK5 at Cys83, thereby reducing pathological kinase activity, rebalancing mitochondrial function, and improving cognitive outcomes in an OKA-induced mice neurodegeneration model. The study underscores the therapeutic potential of Ppt in AD treatment and supports CDK5 modulation as a strategic approach for addressing tau-related neurodegeneration.}, }
@article {pmid41565079, year = {2026}, author = {Doshi, PP and Desale, SH and Khutale, AA and Sabarathinam, S and Suresh, S}, title = {Evaluating Senescence-Targeted Approaches in Alzheimer's Disease: What We Know and What Lies Ahead.}, journal = {Ageing research reviews}, volume = {}, number = {}, pages = {103029}, doi = {10.1016/j.arr.2026.103029}, pmid = {41565079}, issn = {1872-9649}, abstract = {Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease, which represents the most prevalent dementia worldwide. Although amyloid-β (Aβ) and tau pathology have been the classic focus of treatment, accumulating evidence indicates that ageing-associated cellular senescence plays a central role in AD pathogenesis. Senescent neurons, astrocytes, microglia and endothelial cells accumulate in the ageing and Alzheimer's brain and adopt a senescence-associated secretory phenotype characterized by sustained release of pro-inflammatory and neurotoxic factors. This chronic inflammatory milieu promotes neurodegeneration, disrupts the synaptic activity and is involved in cognitive deficit. Senolytics, which selectively eliminate senescent cells, have demonstrated benefit in multiple preclinical models of AD, including decreased neuroinflammation, improvement in neuronal function and cognitive performance. Several senolytic agents, such as dasatinib, quercetin, fisetin and navitoclax, hit anti-apoptotic modalities that support the survival of senescent cells. Early-phase human studies suggest the feasibility of senescence-targeted interventions and indicate that senescence-associated molecular changes may compromise blood-brain barrier integrity. Consistently, preclinical studies demonstrate partial restoration of barrier function following senolytic therapy; however, clinical translation remains limited and at an early stage. Major challenges include the identification of senolytic agents with effective central nervous system penetration, the determination of optimal dosing regimens and treatment schedules, generation of robust long-term safety profile in human population, and the development of predictive biomarkers to guide patient selection and clinical study design. As senolytics and senomorphic strategies continue to evolve, they hold promise as complementary approaches to existing anti-amyloid and anti-tau therapies by offering a multi-mechanistic approach toward AD modification. This review synthesizes current evidence on cellular senescence in AD, outlines the mechanistic rationale for senescence-targeted therapies, summarizes available clinical data, while providing future directions for integrating senolytics into AD management.}, }
@article {pmid41565030, year = {2026}, author = {Zhang, X and Ding, W and Guo, C and Chen, X and Chen, B}, title = {Choline serves as the primary active compound of anti-aging tablets and targets PTGS2 to alleviate neuronal damage in Alzheimer's disease by modulating ferroptosis and apoptosis in nerve cells.}, journal = {Behavioural brain research}, volume = {}, number = {}, pages = {116040}, doi = {10.1016/j.bbr.2026.116040}, pmid = {41565030}, issn = {1872-7549}, abstract = {BACKGROUND: Alzheimer's disease (AD), a neurodegenerative disorder characterized by progressive cognitive impairment, involves pathological mechanisms including β-amyloid protein deposition, hyperphosphorylation of Tau proteins, and neuronal damage mediated by ferroptosis. As a traditional Chinese medicine, anti-aging tablets have potential neuroprotective effects, but their active ingredients and mechanisms have not been fully elucidated.
METHODS: We screened active ingredients and AD-related targets in anti-aging tablets using liquid chromatography-mass spectrometry combined with network pharmacology analysis. A protein-protein interaction network was established, and GO/KEGG enrichment analyses were performed. The binding of choline to PTGS2 was verified through molecular thermal shift assay. qPCR was utilized to detect PTGS2 expression. An AD model was constructed, with cellular injury levels evaluated through CCK-8, LDH assays, and WB detection by examining the expression of apoptosis-related biomarkers. The expression of ferroptosis-related proteins (FSP1, SLC7A11, GPX4) was examined through Western blot analysis. MDA and GSH/GSSG analyses determined lipid peroxidation and antioxidant capacity. DCFH-DA detected ROS levels.
RESULTS: The combined use of UPLC-MS/MS with network pharmacology led to the identification and characterization of choline as the key active ingredient in anti-aging tablets. PTGS2 was determined as its primary target. The direct binding of choline to PTGS2 was verified through molecular thermal shift assay. In vitro experiments revealed that choline significantly repressed cell damage in the AD model, as indicated by enhanced cell viability, reduced release of LDH, lowered levels of reactive oxygen species (ROS), and downregulated expression of caspase-3 and Bax. Additional studies uncovered that overexpression of PTGS2 exacerbated ferroptosis-related parameters (upregulation of MDA, decrease in GSH/GSSG ratio, downregulation of FSP1, SLC7A11, and GPX4 expression), whereas Fer-1 treatment reversed these changes.
CONCLUSION: This study revealed that choline targets PTGS2 to depress ferroptosis, thus alleviating AD-related neuronal injury. This study provides a theoretical basis for the pharmacodynamic effects of anti-aging tablets as well as new therapeutic strategies for AD.}, }
@article {pmid41564814, year = {2026}, author = {Harris, K and Shyer, M and Wang, D and He, E and Cattani, M and Zhang, C and Farrell, CM and Jiang, X and Kim, Y and Schulz, PE}, title = {The influence of bapineuzumab and semagacestat on rapid progressors: A retrospective cohort study.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {3}, pages = {100483}, doi = {10.1016/j.tjpad.2026.100483}, pmid = {41564814}, issn = {2426-0266}, abstract = {BACKGROUND: A subset of Alzheimer's disease patients progresses much more rapidly than average. These rapid progressors exhibit accelerated cognitive and functional decline. Potential differences in Alzheimer's biomarkers for rapid progressors and their responses to disease-modifying treatments remain poorly understood, with previous clinical trials and studies producing limited biomarker data and inconsistent results.
OBJECTIVES: Examine differences in rapid progressor versus non-rapid progressor outcomes in two AD treatment trials (bapineuzumab and semagacestat) and investigate cognitive and biomarker progression in the placebo groups.
DESIGN: Retrospective cohort study.
SETTING: Four randomized, double-blind, phase 3 clinical trials from the Center for Global Clinical Research Data (Semagacestat) and the Yale University Open Data Access Project (Bapineuzumab).
PARTICIPANTS: 4,902 patients (2,355 in bapineuzumab trials, 2,647 in semagacestat trials). Rapid progressors were operationally defined as the 10% of patients with the largest changes in cognitive scores from baseline to trial end.
INTERVENTION: Bapineuzumab (monoclonal antibody) and Semagacestat (γ-secretase inhibitor).
MEASUREMENTS: Cognitive assessments (CDR-SB, MMSE, ADAS-Cog, ADCS-ADL) and biological markers (CSF and plasma levels, MRI, FDG PET Scan, and Amyloid PET Scan) at baseline and endpoint.
RESULTS: Rapid progressors showed distinct baseline characteristics in both the bapineuzumab and semagacestat trials: younger age (61.27 vs 63.14 years, p=0.008; and, 72.64 v. 73.64 years, p=0.046), a higher proportion of APOE4 carriers (87.6% vs 41.4%, p<0.001; and, 85.2% vs 49.3%, p = 0.022), and greater cognitive impairment across all measures (p<0.001). Both progression groups demonstrated improvement in specific biomarkers with treatment, though with different patterns. With bapineuzumab according to Conditional Average Treatment Effect analysis, rapid progressors showed biomarker improvement in amyloid CSF, p-Tau CSF, and amyloid PET scan, while non-rapid progressors demonstrated biomarker improvements in p-Tau CSF, amyloid PET, and MRI. With semagacestat, rapid progressors showed improvements in amyloid CSF and plasma while non-rapid progressors showed improvements in amyloid CSF, FDG PET, and MRI.
CONCLUSIONS: This study provides crucial insights for clinical practice and trial design. The distinct response patterns between progression groups suggest that early identification and balancing of RPs between groups could improve clinical trial efficiency. The findings support the development of personalized treatment approaches for rapid progressors, who have aggressive disease progression. These results may significantly modify clinical trial design and patient care in Alzheimer's disease.}, }
@article {pmid41564595, year = {2026}, author = {Muzurović, E and Katsiki, N and Volčanšek, Š and Plescia, F and Rizzo, M and Mantzoros, CS}, title = {Emerging incretin- and multi-agonist-based treatments - the continued refinement and continuous expansion of a potent therapeutic armamentarium for cardio-kidney-liver-metabolic diseases and beyond.}, journal = {Metabolism: clinical and experimental}, volume = {177}, number = {}, pages = {156494}, doi = {10.1016/j.metabol.2026.156494}, pmid = {41564595}, issn = {1532-8600}, abstract = {While the use of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) has achieved a central position in our therapeutic armamentarium, new and innovative incretin- and multi-agonist-based treatment strategies hold further promise as potential game-changers for obesity and cardio-kidney-liver-metabolic diseases. Molecular pathways of GLP-1, glucose-dependent insulinotropic polypeptide (GIP), amylin, glucagon and peptide YY have been consistently involved in improved outcomes associated with obesity and related disorders. Single, dual, and even triple drug combinations are being researched throughout all phases of clinical trials. The similarities in GLP-1, GIP, and glucagon peptide sequences enable the development of unimolecular multi-receptor activating agonists and/or antagonists. Furthermore, subcutaneously administered peptides are being supplemented with oral analogs currently in development. Both well-designed clinical trials and real-world evidence are fuelling the development of incretin and multi-agonist-based therapies, thereby holding the promise to deliver an increasing double-digit percent weight loss in addition to addressing many obesity-related comorbidities and complications. It is increasingly evident that early initiation of incretin-based therapy across a broad spectrum of cardio-kidney-metabolic disorders improves body weight, dysglycemia, and cardiovascular risk factor management and consequently is expected to reduce cardio-kidney-liver-metabolic and vascular morbidity and mortality and soon most probably those from obesity-related malignancies, Alzheimer's, and other neurocognitive diseases. This review explores new incretin- and multi-agonist-based therapies undergoing clinical trials for chronic weight management, type 2 diabetes mellitus with its complications, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease and obstructive sleep apnea; it also highlights areas of uncertainty regarding the potency, safety, tolerability, and sustainability of incretin-based approaches for obesity and cardio-kidney-liver-metabolic disorders and finally, we discuss future directions.}, }
@article {pmid41564288, year = {2026}, author = {Chen, ZH and Li, R and Jiang, YH and He, JK and Yan, SS and Zong, GH and Yi, ZX and Ren, XY and Jia, BH}, title = {Predictive Model of Acupuncture Adherence in Alzheimer Disease: Secondary Analysis of Randomized Controlled Trials.}, journal = {JMIR aging}, volume = {9}, number = {}, pages = {e82787}, doi = {10.2196/82787}, pmid = {41564288}, issn = {2561-7605}, mesh = {Humans ; *Alzheimer Disease/therapy/psychology ; Male ; Aged ; Female ; *Acupuncture Therapy/statistics & numerical data ; Middle Aged ; Aged, 80 and over ; Randomized Controlled Trials as Topic ; China ; }, abstract = {BACKGROUND: The therapeutic efficacy of acupuncture in treating Alzheimer disease (AD) largely depends on consistent treatment adherence. Therefore, identifying key factors influencing adherence and developing targeted interventions are crucial for enhancing clinical outcomes.
OBJECTIVE: This study aims to develop and validate a predictive model for identifying patients with AD who are likely to maintain good adherence to acupuncture treatment.
METHODS: This secondary analysis included 108 patients with probable AD, aged 50 to 85 years, from 2 independent randomized controlled trials conducted at Guang'anmen Hospital, China Academy of Chinese Medical Sciences. Of all, 66 patients were assigned to the development cohort and 42 to the external validation cohort. Acupuncture adherence was defined as the proportion of completed sessions relative to scheduled sessions, with good adherence defined as ≥80% completion. Baseline data included demographic, clinical, cognitive, functional, psychological, and caregiving variables. Multivariable logistic regression with backward stepwise selection was used to identify significant predictors, and a nomogram was constructed based on the final model. Model performance was assessed using receiver operating characteristic curves, calibration plots, and decision curve analysis, with external validation performed by receiver operating characteristic analysis. Sensitivity analysis was performed using alternative adherence thresholds of 70% and 90%.
RESULTS: A higher number of treatments during the first month was associated with a significant increase in the odds of good adherence (odds ratio [OR] 3.06, 95% CI 1.68-7.01; P=.002), while longer disease duration (OR 0.97, 95% CI 0.94-1.00; P=.049) and receiving care from a part-time caregiver (OR 0.19, 95% CI 0.04-0.72; P=.022) were associated with lower odds of adherence. Sensitivity analyses further supported the stability and reliability of the model.
CONCLUSIONS: This study is the first to develop and validate a predictive model for acupuncture adherence in patients with AD. In clinical research, it can facilitate participant stratification and help identify individuals who may need additional adherence support, thereby reducing bias and enhancing trial quality. In clinical practice, the nomogram enables proactive adherence management by prospectively identifying high-risk patients and guiding targeted strategies to improve adherence and optimize therapeutic outcomes.}, }
@article {pmid41563682, year = {2026}, author = {Paul, R and Firdous, SM}, title = {Unraveling the molecular mechanisms of aluminium chloride-induced Alzheimer's disease.}, journal = {Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine}, volume = {}, number = {}, pages = {}, pmid = {41563682}, issn = {1572-8773}, abstract = {The most prevalent neurodegenerative illness is Alzheimer's disease (AD). Aluminium chloride (AlCl3) is a heavy metals that produces several neurodegenerative diseases, commonly AD. AlCl3 easily goes through the blood-brain barrier and reaches to brain. In this study, we reviewed literature, highlighting the various molecular mechanisms targeting AlCl3-induced neurodegenerative disorders like AD in numerous in vivo and in vitro models. AlCl3 can cause conformational changes in the beta-sheet of amyloid beta (Aβ) peptide that lead to the aggregation of Aβ in the brain's neuronal cells. AlCl3 can also decrease the expression of protein phosphatase 2A (PP2A), which is essential for evading tau aggregation and neurofibrillary tangles (NFTs) formation. It can increase acetylcholinesterase (AChE) levels in the brain, which can produce cognitive impairment. AlCl3 also produces calcium (Ca[2+]) and iron dyshomeostasis in neuronal cells. It activates various inflammatory mediators such as interleukin-6 (IL-6), interleukin-1β (IL-1β), plasminogen activator inhibitor-1 (PAI-1), and tumour necrosis factor-α (TNF-α). In addition, AlCl3 can increase the production of reactive oxygen species (ROS), which induce telomere degradation, may initiate telomere dysfunction that can initiate neuroinflammation, and induce cellular senescence. AlCl3 may increase the expression of glycogen synthase kinase-3 beta (GSK3β), which produces various cognitive impairments, leading to AD. Various therapeutic techniques like chelation, antioxidant, and drug therapy are used to treat AD, but a better-targeted approach and a deeper understanding of the molecular basis of Alzheimer's due to AlCl3 intoxication are crucial. AlCl3-induced neurotoxicity involves mitochondrial disruption, oxidative stress, neuroinflammation, and DNA impairment, necessitating further research for treatment against aluminium (Al)-induced AD. AlCl3 can cause neurodegenerative diseases like AD, but understanding its molecular mechanisms is challenging due to its interaction with biological systems.}, }
@article {pmid41563466, year = {2026}, author = {Ueffing, M and Lange, C and Schlunck, G and Wolf, J}, title = {[Liquid biopsy proteomics in ophthalmology : A clinical and scientific perspective].}, journal = {Die Ophthalmologie}, volume = {}, number = {}, pages = {}, pmid = {41563466}, issn = {2731-7218}, abstract = {BACKGROUND: For many patients with age-related macular degeneration, diabetic retinopathy and other partially monogenetic retinal diseases as well as for tumors of the eye that are relatively rare but are usually associated with profound consequences for affected patients, there is still no effective treatment available. Metastatic melanoma, for example, remains poorly predictable with respect to disease progression, response to treatment and outcome. This illustrates the urgent need for a deeper molecular understanding of the disease with the goal to develop novel therapeutic strategies. Liquid biopsies of the aqueous humor represent a promising possibility for molecular analyses in the eyes of patients.
OBJECTIVE: A clinical and scientific perspective with respect to potential fields of applications of liquid biopsy proteomics in ophthalmology is presented.
MATERIAL AND METHODS: A systematic literature search was carried out in PubMed and the personal experiences of the authors are presented.
RESULTS AND CONCLUSION: Aqueous humor proteomics offer a plethora of potential applications in ophthalmology and could become a key factor in personalized ophthalmology. Potential areas of application include the selection of treatment based on the activated biological signalling pathways, the selection of patients for clinical trials as well as the diagnostics, prognosis estimation and monitoring of the response to treatment. In addition, it can be a valuable component of multimodal diagnostics and enable insights into neurodegenerative diseases, such as Alzheimer's or Parkinson's disease.}, }
@article {pmid41562905, year = {2025}, author = {Fedotcheva, TA and Shimanovsky, NL}, title = {Current State of the Neurotrophin-Based Pharmaceutics in the Treatment of Neurodegenerative Diseases and Neuroinflammation.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, doi = {10.3390/medsci14010015}, pmid = {41562905}, issn = {2076-3271}, support = {124020900031-0//Ministry of Health of the Russian Federation/ ; }, mesh = {Humans ; *Nerve Growth Factors/therapeutic use ; *Neurodegenerative Diseases/drug therapy ; *Neuroinflammatory Diseases/drug therapy ; Animals ; }, abstract = {BACKGROUND: The regulation of the synthesis of the nerve growth factor and other neurotrophins is one of the dynamically developing areas of pharmacotherapy of neurological and mental disorders. Despite a large number of studies of various ligands of neurotrophin receptors, only a few have reached clinical application and only for ocular diseases. The aim of this narrative review was to systematize the main progress on neurotrophin-based pharmaceutics; to perform a comparative critical analysis of various therapeutic strategies, elucidate the underlying causes of clinical trial failures, and identify the most promising avenues for future development.
METHODS: The literature search was conducted in PubMed, Google Scholar, Medline, and EBSCO, and the ClinicalTrials.gov database was used to track current clinical studies, along with the official websites of pharmaceutical companies. The search covered original studies published up to October 2025, with inclusion restricted to articles published in English. Articles describing specific pharmacological compounds that had reached the clinical trial stage were selected. Foundational biological research was referenced to contextually explain the mechanisms of action of the drugs and their therapeutic implications.
RESULTS: Recombinant neurotrophins and synthetic molecules, the agonists and antagonists of their receptors, and cell-based gene therapy are promising means for the prevention and rehabilitation of ischemic conditions, as well as the treatment of neuropathic pain and neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Some of these have undergone clinical trials, yet only neurotrophins for ocular diseases have been implemented in clinical practice: recombinant NGF-cenegermin and recombinant CNTF-Revakinagene taroretcel. The success of these eye drugs is likely attributable to their local administration, improved bioavailability, and low ocular immunoresistance.
CONCLUSIONS: The study identified limitations and future prospects for neurotrophin-based pharmaceuticals. For future clinical trials, attention should be paid to the pharmacogenetic profiles of the patients and the evaluation of the inflammatory status of the disease. Novel plasma biomarkers of the effectiveness are needed as well as TSPO-PET imaging. Drug delivery systems remain insufficient; therefore, efforts should focus on inducing endogenous neurotrophin production and developing highly selective agonists and antagonists of neurotrophin receptors. It is crucial to establish a favorable premorbid background before neurotrophin therapy to minimize immunoresistance.}, }
@article {pmid41562838, year = {2026}, author = {Wozniczka, CM and Weaver, DF}, title = {β-Alanine Is an Unexploited Neurotransmitter in the Pathogenesis and Treatment of Alzheimer's Disease.}, journal = {NeuroSci}, volume = {7}, number = {1}, pages = {}, doi = {10.3390/neurosci7010013}, pmid = {41562838}, issn = {2673-4087}, support = {KF-2023-1//Krembli Foundation/ ; ASC-2024//Alzheimer's Society Canada/ ; }, abstract = {Alzheimer's disease (AD) remains an unmet medical challenge, as there are no effective therapies that alter the disease's progression. While approaches have targeted molecules like acetylcholine (ACh) and glutamate, these strategies have provided only limited benefits and do not address the complex molecular mechanisms underlying AD development. This review suggests that β-alanine (3-aminopropanoic acid) is an underexplored neurotransmitter that could serve as a potential AD drug target. Existing evidence indicates that β-alanine modulates GABAergic and glutamatergic neurotransmission, thereby affecting neuronal hyperexcitability. Additionally, studies suggest that β-alanine has antioxidant effects, reducing oxidative stress caused by reactive oxygen species (ROS). We propose that β-alanine might bind to Aβ/tau proteins, possibly targeting the six-amino acid sequences EVHHQK/DDKKAK, which are involved in protein aggregation. β-Alanine may also influence the release of pro-inflammatory cytokines from microglia, potentially reducing neuroinflammation. We also hypothesize that β-alanine may help regulate metal dyshomeostasis, which leads to ROS production. Taurine, structurally like β-alanine, appears to influence comparable mechanisms. Although structural similarity doesn't ensure therapeutic effectiveness, this evidence supports considering β-alanine as a treatment for AD. Furthermore, β-alanine and its analogues face challenges, including crossing the blood-brain barrier (BBB) and optimizing structure-activity relationships (SAR). This review includes articles through September 2025, sourced from four databases.}, }
@article {pmid41561733, year = {2026}, author = {Curd, BC and Zubrick, C and Brown, CJC and Sorweid, MK and Dehoney, SB and Anzai, Y and Minoshima, S and Parks, AL and Frost, NA}, title = {Real-world experience with lecanemab therapy for Alzheimer's disease in the Intermountain West.}, journal = {Alzheimer's & dementia (Amsterdam, Netherlands)}, volume = {18}, number = {1}, pages = {e70251}, pmid = {41561733}, issn = {2352-8729}, abstract = {INTRODUCTION: Lecanemab is a monoclonal antibody targeting amyloid plaques that has been approved for the treatment of early symptomatic Alzheimer's disease. Here, we report on the clinical history and outcomes of the first 70 patients at the University of Utah to receive amyloid-removal therapy.
METHODS: This is a retrospective analysis of patients treated with lecanemab over a 26-month period. We extracted patient data from charts and analyzed demographics, health history, and clinical details with outcomes on lecanemab treatment.
RESULTS: In total, we observed 14 cases (20%) of amyloid-related imaging abnormalities (ARIAs), which was significantly associated with apolipoprotein E ε4 homozygosity. Zero cases of ARIAs were symptomatic, and there was no association between distance from clinic and adverse effects.
DISCUSSION: Our study examined the safety and tolerability of centrally managed lecanemab administration across a widely distributed region and suggests that use of distributed infusion sites increases access to disease-modifying treatment without significant increase in risk.
HIGHLIGHTS: Lecanemab therapy can be safely administered to patients across a broadly distributed area through a single clinical center.In our first 70 treated patients, 14 developed amyloid-related imaging abnormalities (ARIAs)-a rate of 20%, which is consistent with clinical trials of lecanemab.No patients experienced symptomatic ARIAs.ARIA incidence was significantly associated with apolipoprotein E genotype, but not other demographic factors, comorbid conditions, or baseline clinical details.}, }
@article {pmid41560836, year = {2026}, author = {Zhang, Y and Yin, C and Tian, Y and Li, X and Wang, H and Han, S and Chen, H and Hou, H}, title = {Intranasal delivery of Odorranalectin-modified lipid nanoparticles for multi-targeted therapy of Alzheimer's disease.}, journal = {Materials today. Bio}, volume = {36}, number = {}, pages = {102764}, pmid = {41560836}, issn = {2590-0064}, abstract = {Oxidative stress, neuroinflammation, and β-amyloid (Aβ) deposition act synergistically to drive Alzheimer's disease (AD) progression. Effective treatment, therefore, requires multi-targeted strategies capable of addressing these interconnected pathological mechanisms. Here, an Odorranalectin (OL)-conjugated lipid nanoparticle (siB/QU@L-OL) was engineered for efficient intranasal delivery of β-site APP cleaving enzyme 1 (BACE1) siRNA (siB) and quercetin (QU). siB/QU@L-OL prepared via microfluidics exhibited uniform size distribution, high encapsulation efficiency, and robust stability. Following intranasal administration, OL surface modification enabled binding to L-fucose residues expressed on the olfactory epithelium, reducing mucociliary clearance and facilitating brain transport. In vitro, siB silenced BACE1 expression and inhibited Aβ generation, while QU alleviated Aβ-induced oxidative stress and neuroinflammation, thereby suppressing neuronal apoptosis. In APP/PS1 mice, siB/QU@L-OL restored Aβ homeostasis and redox balance, attenuated neuroinflammation and neuronal loss, and consequently improved cognitive performance. Collectively, this brain-targeted nanoplatform demonstrates strong potential for synergistic intervention in AD.}, }
@article {pmid41560713, year = {2026}, author = {Barnwal, M and Baksh, S and Ismail, Z and Shade, DM and Moghekar, A and Ho, SG and Rosenberg, PB and Porsteinsson, AP and Lyketsos, CG and , }, title = {Blood biomarkers for Alzheimer's disease are correlated with measures of agitation and cognition in a randomized trial assessing the effects of escitalopram on agitation.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {12}, number = {1}, pages = {e70203}, pmid = {41560713}, issn = {2352-8737}, abstract = {INTRODUCTION: Escitalopram for Agitation in Alzheimer's Disease (S-CitAD) is a National Institutes of Health-funded randomized controlled trial that randomized 173 participants with clinically diagnosed Alzheimer's disease (AD) and agitation to escitalopram or placebo for 12 weeks, assessing efficacy and safety. There was no advantage for escitalopram in treating agitation, potentially attributed to including participants at various stages of AD brain pathology, reflected in levels of blood biomarkers. Here, we (1) estimated the fraction of participants meeting blood biomarker criteria for AD pathology, (2) examined associations between baseline blood biomarkers and agitation severity or cognitive functioning, and (3) evaluated whether baseline blood biomarkers predicted treatment response.
METHODS: Eighty-two randomized participants provided blood for biomarker measurement prior to randomization. Plasma amyloid beta (Aβ)42, Aβ40, glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and phosphorylated tau (p-tau)217 were measured using standard methods. We examined associations of baseline blood biomarkers and clinical measures at baseline and follow-up with (1) agitation severity (Neuropsychiatric Inventory Clinical Rating of the agitation and aggression domains [NPI-C-A+A]), (2) cognitive status (Mini-Mental State Examination [MMSE]), and (3) escitalopram treatment.
RESULTS: Seventy-seven out of 82 (94%) scored above threshold for p-tau217, supporting the clinical diagnosis of AD. Baseline higher p-tau217 predicted higher NPI-C-A+A scores at weeks 6 (beta = 3.26, p < 0.001) and 12 (beta = 2.86, p = 0.01) after randomization. Baseline higher levels of GFAP (beta = -0.02, p = 0.0002) and p-tau217 (beta = -2.68, p = 0.003) were associated with lower baseline MMSE scores. After adjusting for treatment, higher baseline p-tau217 was associated with greater odds of worsening NPI-C-A+A scores at weeks 6 (odds ratio [OR] = 2.79, p = 0.02) and 12 (OR = 2.55, p = 0.02).
DISCUSSION: In this clinical trial cohort, elevated plasma p-tau217 confirmed AD pathology in 94% of participants and forecast greater agitation severity and worse cognitive functioning, underscoring its practical value for stratifying and monitoring patients in neuropsychiatric intervention studies.
HIGHLIGHTS: We examined whether Alzheimer's disease (AD) blood biomarkers predicted severity of agitation and cognitive impairment and/or treatment response in the 12-week Escitalopram for Agitation in Alzheimer's Disease (S-CitAD) randomized controlled trial.Blood phosphorylated tau (p-tau)217 confirmed the presence of significant AD brain amyloid pathology in 94% of these clinically diagnosed participants.Independent of treatment assignment, higher baseline p-tau217 predicted lower baseline and future Mini-Mental State Examination (MMSE) scores and worse agitation overtime.Independent of treatment assignment, higher baseline levels of glial fibrillary acidic protein were associated with lower baseline and follow-up MMSE scores.}, }
@article {pmid41560694, year = {2026}, author = {Wan, Z and Feng, X and Chou, J and Zhou, X and Ma, T and Zhang, T}, title = {Sex- and brain region-specific gene expression in Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251413797}, doi = {10.1177/13872877251413797}, pmid = {41560694}, issn = {1875-8908}, abstract = {BackgroundWomen with Alzheimer's disease (AD) have higher prevalence and more severe dementia syndrome than men with AD, and the brain regions are also affected differently. However, the underlying mechanisms are poorly understood.ObjectiveTo characterize the sex-dependent and region-specific gene expression in AD brain.MethodsA previously published large scale bulk tissue gene expression dataset from postmortem brain samples across 19 cortical regions of normal control and individuals diagnosed with dementia and neuropathology of AD was used for differential gene expression analysis. Functional enrichment analysis was used to identify enriched biological functions or pathways related to selected genes. Protein expression level of a selected gene was validated by western blot.ResultsWe identified 113 dysregulated genes in 11 AD brain regions (9 in men, 7 in women, and 5 shared between men and women). Notably, more dysregulated genes were found in women AD brain (77 genes) than in men (49 genes), and 13 dysregulated genes across these 11 brain regions were shared between women and men. Functional analysis further revealed the distinctive enrichment in categories of cellular component, biological process, and/or molecular function in these dysregulated genes. GPR34 gene expression was upregulated in the men AD brain across three different regions and a significant elevation of GPR34 protein level was confirmed in men AD brain.ConclusionsThese findings provide insight into sex- and brain region-specific gene expression dysregulation, which may indicate novel mechanisms underlying AD pathogenesis and will facilitate the development of personalized diagnosis and treatment strategies for AD.}, }
@article {pmid41560693, year = {2026}, author = {Custodio, B and Montesinos, R and Bayona, W and Rojas Benites, MJ and Camargo, I and Ibañez, M and Huilca, J and Noriega de la Colina, A and Matias-Guiu, JA and Custodio, N}, title = {Perceptions of Peruvian neurologists toward the implementation of anti-amyloid drugs for early Alzheimer's disease in the departments of neurology.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251410959}, doi = {10.1177/13872877251410959}, pmid = {41560693}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) is a neurodegenerative disease affecting millions globally, with particular severity in low- and middle-income countries due to barriers in timely diagnosis and treatment. To date, two monoclonal anti-amyloids have shown positive results in phase III clinical trials. However, their administration is complex, requiring specialized infrastructure, highly trained professionals, and regular follow-ups, posing major challenges for healthcare systems.ObjectiveThis study explores Peruvian neurologists' perceptions of changes needed to implement monoclonal antibodies in line with clinical guidelines.MethodsA cross-sectional study was conducted in Peru using the key informant (KI) methodology. KI were neurologists from multiple regions across the country. A comprehensive list of tertiary-level hospitals (public healthcare system, social security, and police and armed forces) was compiled, and at least one neurologist from each institution was contacted. The instrument used was adapted from a study conducted in Spain, which included questions focusing on changes in diagnosis, patient care, diagnostic and therapeutic techniques, public and family impact, neurology resources, and dementia research. Data analysis was employed using Stata18, using descriptive statistics and frequency distributions.ResultsTwenty-eight neurologists completed the survey. There was consensus on the significant impact monoclonal antibodies would have on neurology services. Over 85% agreed that more neurologists and nurses would be needed. Additionally, 93% supported using brief diagnostic scales in primary care and increasing follow-up visit frequency.ConclusionsThe introduction of monoclonal antibodies for AD in Peru requires modifications to healthcare institutions, highlighting the urgent need for strategic healthcare planning.}, }
@article {pmid41559471, year = {2026}, author = {Liu, T and Chen, D and Liu, F and Sun, Y}, title = {ZFP36-mediated ZBP1 degradation inhibits microglia pro-inflammatory and NLRP3 inflammasome activation in Alzheimer's disease.}, journal = {Cell biology and toxicology}, volume = {}, number = {}, pages = {}, doi = {10.1007/s10565-026-10139-6}, pmid = {41559471}, issn = {1573-6822}, abstract = {Alzheimer's disease (AD) is a heterogeneous disease with limited treatment efficacy. Identifying novel molecular targets and mechanisms is therefore crucial for developing therapeutic strategies. Zinc finger protein 36 (ZFP36) has not been reported in AD. This study found that the hippocampus of APP/PS1 mice showed ZFP36 upregulation. Using recombinant adeno-associated virus to overexpress ZFP36 improved the cognitive function of APP/PS1 mice, as assessed by Morris maze and Y maze tests. Furthermore, ZFP36 overexpression reduced Aβ deposition, expression of pro-inflammatory markers, and inhibited NLRP3 inflammasome activation in the hippocampus. These inhibitory effects of ZFP36 overexpression on the aforementioned proteins were also observed in Aβ1-42-treated BV-2 cells. mRNA sequencing identified Z-DNA Binding Protein 1 (ZBP1) as a target of ZFP36. After ZFP36 overexpression, ZBP1 was downregulated in the hippocampus and Aβ1-42-treated BV-2 cells. The interaction between ZFP36 and ZBP1 RNA was verified by RIP-PCR, and ZFP36 was shown to promote the degradation of ZBP1 mRNA. The inhibitory effects of ZFP36 on the NLRP3 inflammasome activation and microglial pro-inflammatory activation was reversed by ZBP1 overexpression. In summary, ZFP36 inhibits microglia pro-inflammatory and NLRP3 inflammasome activation through promoting the degradation of ZBP1 mRNA, thereby ameliorating cognitive deficits of APP/PS1 mice.}, }
@article {pmid41558720, year = {2026}, author = {Zhou, R and Li, J and Liu, W and Zheng, R and Han, J and Liao, Z and Ning, W and Tang, C}, title = {[Systematic review and mechanistic exploration of "intelligence three-needling" in treatment of Alzheimer's disease].}, journal = {Zhongguo zhen jiu = Chinese acupuncture & moxibustion}, volume = {46}, number = {1}, pages = {153-160}, doi = {10.13703/j.0255-2930.20250723-k0001}, pmid = {41558720}, issn = {0255-2930}, mesh = {*Alzheimer Disease/therapy/metabolism/genetics ; Humans ; Animals ; *Acupuncture Therapy ; Acupuncture Points ; Brain/metabolism ; }, abstract = {The "intelligence three-needling" therapy, developed by Professor JIN Rui, the eminent acupuncture- moxibustion master in the south of Five Ridges, is effective on cognitive dysfunction in practice. The paper reviews the animal experiment researches of Alzheimer's disease (AD) treated with this therapy, aiming to explain its core mechanism and effect characteristics for AD. The results showed that the "intelligence three-needling" therapy exerts its effect through multiple targets and diverse pathways. It improves cholinergic system function, enhances glucose metabolism in brain regions, reduces oxidative stress damage, suppresses neuroinflammation, regulates the Wnt/β-catenin signaling pathway, promotes autophagy-lysosomal clearance of pathological proteins, activates the transmembrane receptor protein (Notch) pathway to strengthen synaptic plasticity, demonstrates neuroprotective and anti-apoptotic effects, and modulates gut microbiota. In experiments, this therapy demonstrated specific effect in brain regions of 5xFAD mouse models. Compared with the single application at "Benshen" (GB13) or "Shenting" (GV24), the acupoint combination in this therapy displayed the synergistic advantages, regulating more comprehensively adenosine monophosphate activated protein kinase (AMPK)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) kinase network. This review provides the theoretical basis for optimizing the protocol of acupuncture and moxibustion for AD, and is conducive to promoting the deep integration of traditional acupuncture-moxibustion therapy with modern neuroscience.}, }
@article {pmid41557600, year = {2026}, author = {Fisher, DW and Borisovskaya, A and Lindley, E and Domoto-Reilly, K}, title = {Somatic Symptom Disorder as a Prodrome of Alzheimer Disease and Successful Treatment of Pain and Agitation With Electroconvulsive Therapy: A Case Report.}, journal = {The journal of ECT}, volume = {}, number = {}, pages = {}, doi = {10.1097/YCT.0000000000001229}, pmid = {41557600}, issn = {1533-4112}, support = {T32AG052354//National Institute of Aging/ ; }, abstract = {Neuropsychiatric symptoms in dementia can be heterogeneous and hard to treat, though electroconvulsive therapy (ECT) is becoming more widely accepted as a viable treatment option. Here, we describe a patient with Alzheimer disease (AD) who developed Somatic Symptom Disorder as a prodrome to cognitive and functional decline, though atypical, primary affective disorder in AD was also on the differential. This patient further developed debilitating anxiety and agitation that was refractory to multiple behavioral and pharmacological interventions. ECT was able to treat the patient's neuropsychiatric symptoms, resulting in sustained, full remission with minimal transient, cognitive side effects. This case depicts a rare presentation of AD and further adds to the growing body of literature that suggests ECT is safe and effective for treating neuropsychiatric symptoms in dementia.}, }
@article {pmid41555828, year = {2026}, author = {Merten, N and Dawes, P and Munro, KJ and Brenowitz, WD}, title = {Hearing impairment and cognitive decline: Alternative explanations to causality.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251410502}, doi = {10.1177/13872877251410502}, pmid = {41555828}, issn = {1875-8908}, abstract = {Despite growing interest in hearing impairment as a potentially modifiable risk factor for dementia, the association is poorly understood. This has implications for whether treating hearing impairment can prevent or delay onset of dementia, as causation is not the only explanation for the association. In this editorial, we highlight how biases in research studies might account for the reported associations. We suggest future research using different study designs and novel biomarkers to help us overcome methodological limitations. This may allow us to determine the strength of the causal pathways linking hearing impairment to dementia, ultimately informing prevention and treatment strategies.}, }
@article {pmid41555825, year = {2026}, author = {Wang, EJ and Oğuztüzün, Ç and Xu, R and Gao, Z}, title = {Comparative evaluation of large language models in retrieving known and predicting novel drug combinations.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877261415635}, doi = {10.1177/13872877261415635}, pmid = {41555825}, issn = {1875-8908}, abstract = {BackgroundLarge language models (LLMs) are increasingly used in the biomedical field for information retrieval, information extraction and knowledge discovery. However, their potential in retrieving and discovering drug combinations for diseases remains underexplored.ObjectiveThis study aims to evaluate the effectiveness of LLMs in retrieving known drug combinations and to identify novel drug combinations for treating Alzheimer's disease (AD).MethodsWe developed a series of prompts to guide LLMs in retrieving drug combinations. Their performance was evaluated using both FDA-approved combinations and combinations identified through PubMed literature mining. We then assessed the feasibility of identifying novel drug combination candidates for AD. In collaboration with domain experts, we performed pathway enrichment analyses to evaluate their potential mechanisms of action within the context of AD.ResultsIn a comparative evaluation of multiple LLMs, GPT-5 demonstrated the strongest overall performance, achieving an accuracy of 0.95 and a balanced F1 score of 0.95 in identifying FDA-approved drug combinations. Among the top 10 drug-combination candidates for AD treatment suggested by GPT-5, the combination of donepezil and memantine is already FDA-approved. Three other combinations have been tested in AD clinical trials, and three have supporting evidence in the literature. We also identified 10 off-label drug combinations, with pathway enrichment analyses indicating that several target key AD-related biological pathways.ConclusionsLLMs is effective in retrieving drug combinations for a given disease and the performance varies among different language models with best performance for GPT-5. However, the suggestions from LLM models require further validation to be considered reliable.}, }
@article {pmid41555820, year = {2026}, author = {Smith, PJ and Blumenthal, JA and Ingle, K and Watkins, LL and Avorgbedor, F and Mabe, SK and Kraus, W and Tyson, C and Hinderliter, A and Sherwood, A}, title = {Lifestyle, sleep quality, and cognitive function in resistant hypertension: One-year follow-up from the TRIUMPH trial.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251409716}, doi = {10.1177/13872877251409716}, pmid = {41555820}, issn = {1875-8908}, abstract = {BackgroundTreatment resistant hypertension (TRH) is associated with increased risk of cognitive decline, which may be reduced by healthy lifestyle changes.ObjectiveTo examine the effects of a comprehensive, rehabilitation-based lifestyle hprogram on cognitive function during a one-year follow-up of participants from the TRIUMPH clinical trial.MethodsAmong the 140 TRIUMPH participants originally randomized, 91 (65%) were available for one-year assessments prior to the COVID-19 lockdown. Participants were originally randomized to a Cardiac rehabilitation-based LIFEstyle program (C-LIFE) or to a Standardized Education and Physician Advice (SEPA) condition for 4-months. During their one-year follow-up, participants underwent assessments of sleep quality, body mass index, actigraphy-assessed physical activity levels, and cerebrovascular reactivity using functional near infrared spectroscopy (fNIRS). Cognitive function was assessed using a 45-min test battery incorporating tests of Executive Function/Learning, Memory, and Processing Speed. Regression-based models incorporating reliable change indices were used to assess cognitive change.ResultsParticipants included 91 individuals (mean age = 63.6 [SD = 8.6]), evenly distributed in biological sex and race/ethnicity, and tended to be college-educated. The C-LIFE group had more preserved cognitive functioning compared to SEPA (C-LIFE: z = -0.26 [-0.40, -0.12] versus SEPA: -0.60 [-0.81, -0.39]; d = 0.44, p = 0.008), with reduced PSQI sleep symptoms associating with more preserved cognitive function (B = -0.18, p = 0.050 per 3-points). Treatment did not improve fNIRS markers, although changes in weight and physical activity associated with fNIRS outcomes.ConclusionsLifestyle modification may help preserve cognitive functioning among individuals with resistant hypertension.}, }
@article {pmid41408289, year = {2025}, author = {Kantor, AB and Rickert, M and Cheng, H and Flanagan, K and Salgotra, V and Suppahia, A and Ryu, JK and Widboom, PF and Warfield, JR and Akassoglou, K and Stavenhagen, JB}, title = {Development of a humanized anti-fibrin monoclonal antibody for the treatment of neuroinflammatory and retinal diseases.}, journal = {Journal of neuroinflammation}, volume = {23}, number = {1}, pages = {19}, pmid = {41408289}, issn = {1742-2094}, abstract = {UNLABELLED: Vascular dysfunction and subsequent innate immune activation are key players of neurodegenerative, retinal, and inflammatory diseases, including Alzheimer's disease (AD), multiple sclerosis (MS), diabetic retinopathy (DR), and age-related macular degeneration (AMD). At sites of vascular damage, conversion of the blood coagulation protein fibrinogen to fibrin exposes a cryptic inflammatory epitope, γ377–395, which can bind CD11b/CD18 and CD11c/CD18 complement receptors on microglia, macrophages, and dendritic cells. Genetic targeting of the fibrin γ377–395 epitope or its pharmacologic inhibition with the mouse monoclonal antibody 5B8 protects from inflammation and neurodegeneration in AD and MS mouse models. Here, we present the development of THN391, a first-in-class humanized antibody, to neutralize fibrin toxicity without adverse anticoagulant effects for the treatment of neurodegenerative, retinal, and inflammatory diseases. THN391 was affinity matured with 100-fold greater affinity than 5B8, engineered to lack Fc effector function, and have improved developability properties for clinical use. THN391 blocks the interaction of fibrin with CD11b/c and does not bind fibrinogen nor interfere with coagulation, consistent with the crystal structure of its binding interface to the γ377–395 epitope. THN391 and its Fc wild-type counterpart THN313 showed preclinical efficacy in experimental autoimmune encephalomyelitis (EAE) mouse models of MS and in a rodent model of retinal disease. Both THN391 and THN313 reduced demyelination, inflammatory foci, and clinical scores in EAE, demonstrating that anti-fibrin γ377-395 antibodies function as pure antagonists, blocking fibrin from activating CD11b/c complement receptors. THN391 was as effective as the standard of care vascular endothelial growth factor (VEGF) antagonists in reducing laser-induced neovascular lesions in a rat model of neovascular macular degeneration. Taken together, these results support the clinical development of THN391 for neurological diseases and ophthalmic indications.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12974-025-03650-w.}, }
@article {pmid41554303, year = {2026}, author = {Çelik, H and Çelik, O and Aydın, Ş and Küçükler, S and Çomaklı, S and Topal, A and Akay, R and Gönüllü, S and Yıldız, MO and Alım, B and Özdemir, S}, title = {Small extracellular vesicles carrying miRNA34 in Alzheimer's disease: effects on oxidative stress, neuroinflammation, cognitive function, and mitochondrial/ferroptosis-related protein regulation.}, journal = {Gene}, volume = {}, number = {}, pages = {150014}, doi = {10.1016/j.gene.2026.150014}, pmid = {41554303}, issn = {1879-0038}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, oxidative stress, and persistent neuroinflammation. Recent studies have increasingly focused on the regulatory role of microRNAs in AD pathogenesis. In this study, we investigated the therapeutic potential of small extracellular vesicles (sEV) enriched with microRNA34 (miRNA34) to target key pathogenic mechanisms of AD. We hypothesized that miRNA34-loaded sEV could alleviate oxidative damage, inhibit neuroinflammatory responses and ferroptosis, reduce mitochondrial impairment, and ultimately improve cognitive function. We evaluated the effects of miRNA34 administration on oxidative stress markers, pro-inflammatory cytokines, synaptic plasticity indicators, and behavioral outcomes in an in vivo Aβ-induced mouse model of AD. The experimental design included five groups, each consisting of seven mice. The findings demonstrated that miRNA34-loaded sEV treatment significantly reduced oxidative stress and neuroinflammation while enhancing memory and learning performance. Overall, our results indicate that miRNA34-enriched sEV represent a promising and minimally invasive therapeutic strategy capable of modulating AD pathogenesis. This research provides a novel perspective on the potential clinical application of miRNA34 and sEVin neurodegenerative disorders.}, }
@article {pmid41553693, year = {2026}, author = {Brandt, PJ and Pototska, O and Stys, PK}, title = {Fluorescence from dual molecular rotors allows sensitive detection of widespread brain pathology in a mouse model of Alzheimer's disease.}, journal = {Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology}, volume = {}, number = {}, pages = {}, pmid = {41553693}, issn = {1474-9092}, abstract = {Amyloid fibrils formed by the misfolding and aggregation of proteins are a pathological hallmark of many neurodegenerative conditions including Alzheimer's disease (AD). Although recent studies have shown that pre-fibrillar species including low molecular-weight oligomers are more toxic in vitro than mature fibrils, and correlate better with cognitive decline in AD patients, techniques to study this subtle pathology remain limited. Here, we describe the use of the dye pair 9-(dicyanovinyl)julolidine (DCVJ) and crystal violet (CV), two fluorescent molecular rotors, to detect widespread pathology in the 5xFAD mouse model of AD via fluorescence spectroscopy. DCVJ and CV individually displayed a limited ability to detect spectral differences between WT and non-plaque areas of 5xFAD brain samples. However, when used in combination, the two probes discerned subtle but significant differences in a much higher proportion of tissue compared to either dye alone. These spectral differences were eliminated after treatment to disaggregate macromolecular protein assemblies, providing evidence that the dye pair was able to detect subtle pathology present in the parenchyma of the 5xFAD mouse brain. These findings demonstrate that the combined use of DCVJ and CV could be a valuable addition to the tools currently available to study the early stages of protein misfolding, which is essential for advancing therapeutics and diagnostic technologies in many neurodegenerative diseases.}, }
@article {pmid41552820, year = {2025}, author = {Fakhri, S and Gravandi, MM and Majnooni, MB and Farzaei, MH and Abbaszadeh, F and Rashidi, K and Echeverría, J}, title = {Ferula ammoniacum gum aqueous extract exerts anti-inflammatory and antioxidant mechanisms to combat aluminum chloride-induced Alzheimer's disease in rats: possible involvement of opioid pathways.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1708643}, pmid = {41552820}, issn = {1663-9812}, abstract = {BACKGROUND: Alzheimer's disease (AD), the most common form of dementia, significantly affects memory and behavior due to dysregulated pathways involving oxidative stress, inflammation, and opioidergic systems. Currently, no effective treatments are available, underscoring the need for novel alternatives. Ferula ammoniacum (D.Don) Spalik, M. Panahi, Piwczyński, and Puchałka [Apiaceae] (FA), an Iranian medicinal plant, is known for its anti-seizure, anti-inflammatory, and analgesic properties, with its gum utilized as a nerve tonic.
PURPOSE: This study investigates the anti-AD effects of F. ammoniacum gum aqueous extract (FAGAE) using an aluminum chloride (AlCl3)-induced Wistar rat model of AD.
MATERIALS AND METHODS: The aqueous extract, prepared by macerating powdered gum in distilled water for 48 h at ambient temperature, was subjected to phytochemical analysis using ultraviolet, infrared, and nuclear magnetic resonance spectroscopy. Thirty rats were assigned to five different groups: one receiving saline, one receiving AlCl3 (100 mg/kg, i.p.), two receiving AlCl3 followed by oral treatment with FAGAE at doses of 50 or 100 mg/kg, and one receiving naloxone (an opioid receptor antagonist) along with AlCl3 and the effective dose of FAGAE. Behavioral changes were evaluated using the open-field, passive avoidance, and elevated plus maze tests. Furthermore, biochemical analyses were conducted to measure the serum nitrite levels, changes in weight, matrix metalloproteinase (MMP) activity, and histopathological changes in brain tissue.
RESULTS AND DISCUSSION: The phytochemical analysis of FAGAE revealed the presence of polysaccharide compounds with tentative arabinogalactan structures. FAGAE decreased step-through latency in the passive avoidance test and modified AlCl3-induced weight changes. FAGAE also significantly increased mobility, grooming, and crossing in the open-field test. Naloxone reversed the anti-AD effects of FAGAE, suggesting a possible role for opioidergic pathways in its therapeutic effects. Zymography results showed that FAGAE reduced MMP-9 activity while increasing MMP-2 activity. Histopathological analysis revealed a preserved number of intact neurons in the hippocampus, whereas reduced serum nitrite levels were observed after FAGAE administration in rats with AD.
CONCLUSION: Behavioral, biochemical, and histopathological impairments induced by AlCl3 were significantly attenuated by FAGAE, possibly through the opioidergic pathway, which combats inflammation and oxidative stress and supports neuronal survival.}, }
@article {pmid41551731, year = {2025}, author = {Lim, S and Lee, HW and Yoon, S and Han, JW and Chung, JY and Yoon, S}, title = {Sex differences in efficacy/safety of anti-amyloid-beta monoclonal antibodies for the treatment of Alzheimer's disease.}, journal = {Translational and clinical pharmacology}, volume = {33}, number = {4}, pages = {212-223}, pmid = {41551731}, issn = {2289-0882}, abstract = {Alzheimer's disease (AD) is the most common cause of dementia. AD exhibits notable sex-related disparities in prevalence, progression, and treatment response. With the recent approval of anti-amyloid-beta monoclonal antibodies-aducanumab, lecanemab, and donanemab-understanding sex differences in their clinical effects has become increasingly relevant. This review article investigates sex differences in the pharmacokinetics, efficacy, and safety of aducanumab, lecanemab, and donanemab and discusses the possible mechanism underlying the observed differences. Although sex-specific analyses were largely underreported in clinical trials, population pharmacokinetic models identified sex as a covariate affecting clearance and volume of distribution for aducanumab and lecanemab and higher exposure to lecanemab was predicted for females. Subgroup analyses of phase 3 trials revealed that males tended to experience greater benefit from aducanumab and lecanemab, whereas females showed better response to donanemab. The overall incidence of adverse events, including amyloid-related imaging abnormalities, did not show significant differences between sexes. Potential mechanisms underlying these differences include sex-related variations in blood-brain barrier permeability, apolipoprotein E4-associated neuroinflammatory responses, and baseline disease characteristics. These findings underscore the need for future AD clinical trials to incorporate sex-based analyses and to consider sex as a key factor in optimizing treatment strategies.}, }
@article {pmid41550978, year = {2026}, author = {Moien, MAS and Saghravanian, SJ and Fereidoni, M}, title = {Evaluating the impact of intracerebroventricular norepinephrine on spatial memory in rats: Insights into sporadic Alzheimer's pathogenesis.}, journal = {IBRO neuroscience reports}, volume = {20}, number = {}, pages = {84-93}, pmid = {41550978}, issn = {2667-2421}, abstract = {One consequence of stress is the increased release of norepinephrine (NE) in the central nervous system, primarily driven by activation of the sympathetic nervous system. Given the importance of chronic stress in the development and progression of Alzheimer's disease (AD), clarifying the specific contributions of stress-related pathways, including the sympathetic axis and the hypothalamic-pituitary-adrenal (HPA) axis, is critical. In this study, we examined the effects of repeated central NE administration, as a potential contributor to stress-related cognitive impairment, on spatial memory in rats, alone or in combination with a low-dose streptozotocin (STZ) model of sporadic AD. Forty-nine rats were assigned to seven groups: control (no treatment), sham (saline; i.c.v.), low-dose streptozotocin (0.5 mg/kg, i.c.v.), norepinephrine administration at either 1 (adolescent) or 3 (adult) months of age (30 or 50 μg, respectively; i.c.v.), and co-administration of norepinephrine with streptozotocin at 1 or 3 months of age. Spatial memory was assessed using the Morris Water Maze test. Norepinephrine administration during adolescence and adulthood impaired spatial memory similar to streptozotocin in different parameters of the MWM, with adult rats showing the most significant vulnerability (p < 0.001). However, co-administration of both substances did not exacerbate the impairment caused by each alone. The results suggest that norepinephrine may impair cognition through mechanisms distinct from those of STZ-induced deficits. Additionally, they raise questions about the contribution of the sympathetic axis of chronic stress to the progression of sporadic AD.}, }
@article {pmid41550956, year = {2025}, author = {Piccolino, I and Iannuzzi, F and Lionetti, L and Mazzonello, B and Barreca, V and Banaj, N and Arezzini, V and Piras, F and Bossù, P}, title = {The immunomodulating effect of palmitoylethanolamide on human myeloid dendritic cells and its possible impact on Alzheimer's disease.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1664164}, pmid = {41550956}, issn = {1664-3224}, mesh = {Humans ; *Alzheimer Disease/immunology/drug therapy/metabolism ; *Palmitic Acids/pharmacology ; *Dendritic Cells/immunology/drug effects/metabolism ; *Ethanolamines/pharmacology ; *Amides/pharmacology ; *Myeloid Cells/immunology/drug effects/metabolism ; Cells, Cultured ; *Immunomodulation/drug effects ; *Immunologic Factors/pharmacology ; }, abstract = {Palmitoylethanolamide (PEA) is an endogenous fatty acid amide that has emerged as a promising therapeutic candidate for neurodegenerative disorders, particularly Alzheimer's disease (AD). Recognized for its inherent anti-inflammatory, analgesic, immunomodulatory, and neuroprotective properties, PEA possesses a good potential as a novel treatment addressing neuroinflammation associated with neurodegeneration, even though its precise mechanisms of action remain to be fully understood. Dendritic cells (DCs) are specialized migratory innate immune cells that play a crucial role in initiating and regulating immune responses and inflammation in both the body and the brain. In AD, DCs display a dysfunctional, pro-inflammatory profile, suggesting their involvement in disease pathology and progression. To explore the therapeutic potential of PEA, this study investigated its effects in vitro on human monocyte-derived DCs under both normal and AD-like conditions. The results show that PEA exerts significant immunomodulatory effects, promoting the maturation of DCs in both healthy and disease states. Notably, PEA treatment appears to correct the dysregulated state of DCs observed in AD conditions. This study reveals a novel mechanism by which PEA modulates immune activity through its action on DCs. By restoring normal DC function in neurodegenerative settings, PEA may help reduce inflammation, highlighting its potential as a therapeutic agent for Alzheimer's disease.}, }
@article {pmid41550591, year = {2026}, author = {Madhi, I and Kim, JH and Shin, HS and So, YH and Jung, EM and Kim, Y}, title = {Ginsenoside Re mitigates Aβ1-42-induced neurotoxicity by promoting autophagy and suppressing NLRP3 inflammasome.}, journal = {Journal of ginseng research}, volume = {50}, number = {1}, pages = {100911}, pmid = {41550591}, issn = {1226-8453}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by β-amyloid (Aβ) accumulation and neuroinflammation. Activation of NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome in microglia significantly contributes to AD-associated neuroinflammation and neuronal damage. Ginsenoside Re (G-Re), a major bioactive constituent of Panax ginseng, exhibits anti-inflammatory properties, but its role in modulating inflammasome activation in AD remains unclear.
METHODS: This study evaluated the therapeutic potential of G-Re in mice intracerebroventricularly injected with Aβ1-42 and delineated its molecular mechanisms in complementary cell-based models. We employed behavioral testing, immunohistochemistry, Western blotting, enzyme-linked immunosorbent assays, Annexin V apoptosis assays, and mitochondrial functional assays.
RESULTS: Intraperitoneal administration of G-Re significantly improved cognitive performance, as evidenced by enhanced outcomes in the T-maze and novel object recognition tests. G-Re treatment reduced microglial activation and interleukin-1β (IL-1β) levels in the cortex and hippocampus. In vitro, G-Re protected neurons from conditioned medium derived from Aβ1-42-stimulated microglia, showing neuroprotection comparable to anti-IL-1β treatment. G-Re also inhibited Aβ1-42-induced activation of the NLRP3 inflammasome, as indicated by diminished levels of NLRP3, cleaved caspase-1, cleaved gasdermin D (GSDMD), IL-1β, and IL-18 in brain tissues and cultured microglia. Mechanistically, G-Re reduced mitochondrial reactive oxygen species (mtROS), preserved mitochondrial membrane potential, and activated autophagy via SIRT1/AMPK/mTOR signaling, thereby suppressing inflammasome activation.
CONCLUSION: G-Re ameliorates Aβ1-42-induced neuroinflammation and cognitive impairment by restoring mitochondrial homeostasis, enhancing autophagy, and suppressing NLRP3 inflammasome activation. These findings suggest G-Re as a potential therapeutic intervention for neurodegenerative disorders including AD.}, }
@article {pmid41550486, year = {2026}, author = {Gao, H and Yang, S and Zhaorong, O and Wang, Y and Tang, J and Hou, Q and Fang, Z and Shao, N and Cai, B}, title = {Aloe-emodin attenuates Aβ25-35-induced HT22 cell pyroptosis via inhibiting NLRP3 inflammasome pathway.}, journal = {3 Biotech}, volume = {16}, number = {2}, pages = {71}, pmid = {41550486}, issn = {2190-572X}, abstract = {Neuronal death in Alzheimer's disease (AD) is closely associated with NLRP3 inflammasome-mediated pyroptosis. This study aimed to investigate the protective effects of Aloe-emodin (AE) in an AD cellular model and to explore the underlying mechanisms involving the NLRP3 inflammasome pathway. Molecular docking simulations predicted strong binding affinities between AE and key pyroptosis-related proteins (NLRP3, ASC, Caspase-1, GSDMD), with the highest affinity observed for NLRP3. In an Aβ25-35-induced AD cellular model, AE (6 µM) significantly enhanced cell viability and alleviated pyroptotic morphological changes, including cellular swelling and rupture. EdU staining and immunofluorescence analysis further revealed that AE promoted HT22 cell proliferation and reduced Aβ deposition. Moreover, assessments of plasma and mitochondrial membrane integrity, via Hoechst 33,342/PI staining and mitochondrial permeability transition pore (MPTP) assay, respectively, revealed that AE treatment reduced the population of PI-positive cells and suppressed MPTP opening. Western blot, immunofluorescence, and ELISA analyses consistently demonstrated that AE downregulated the expression of pyroptosis-related proteins (NLRP3, ASC, Caspase-1, GSDMD, GSDMD-N) and suppressed the release of inflammatory cytokines (IL-1β, IL-18, IL-6, TNF-α). The inhibitory effect of AE on the pyroptosis pathway was comparable to that of the specific NLRP3 inhibitor MCC950. These results suggest that AE exerts neuroprotective effects in the AD cellular model by inhibiting NLRP3 inflammasome activation, thereby blocking Caspase-1 and GSDMD-N activation, attenuating neuronal pyroptosis, reducing inflammatory responses, and mitigating Aβ-induced pathological damage. Collectively, these findings identify AE as a promising therapeutic candidate for AD.}, }
@article {pmid41549413, year = {2026}, author = {Burns, JM and Alford, S and Coppinger, J and Jiménez-Mausbach, M and Ray, S and Pandey, H and Laird, R}, title = {Early Alzheimer's diagnosis: U.S. primary care physicians and use of blood biomarkers.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e70986}, doi = {10.1002/alz.70986}, pmid = {41549413}, issn = {1552-5279}, support = {//Novo Nordisk Inc./ ; }, mesh = {Humans ; *Alzheimer Disease/diagnosis/blood ; *Biomarkers/blood ; *Physicians, Primary Care/psychology ; United States ; Male ; Female ; *Attitude of Health Personnel ; Early Diagnosis ; Middle Aged ; }, abstract = {INTRODUCTION: We aimed to explore primary care physicians' (PCP) attitudes, perceptions, and barriers toward Alzheimer's disease (AD) diagnosis and incorporating blood biomarker (BBM) tests into the diagnostic workflow.
METHODS: Remote 60-min interviews with 20 PCPs were conducted (May 2023). Participants included generalists and geriatricians representing urban, suburban, and rural U.S. practices. Interviews encompassed early AD diagnosis, PCP role, and BBM test implementation.
RESULTS: Most PCPs view investigating cognitive decline as an important part of their role and are somewhat confident in diagnosing AD. Barriers include the complexity and inefficiency of current diagnostic workflows, lack of effective treatments, and stigma. PCPs consider BBM tests accurate and cost-effective but have concerns about reimbursement and diagnostic pathway placement.
DISCUSSION: PCPs are interested in AD diagnosis and receptive toward BBM testing. Education on BBM test use and AD diagnosis may benefit PCPs in the care of individuals with cognitive decline.
HIGHLIGHTS: Early Alzheimer's disease (AD) diagnosis is crucial for initiating treatment Primary care physicians (PCPs) find investigation of cognitive decline important PCPs consider blood biomarker (BBM) tests accurate and cost-effective PCPs seek clarity on reimbursement of BBM tests and their context of use Education on BBM test interpretation and AD diagnosis may benefit primary care.}, }
@article {pmid41549381, year = {2026}, author = {Lee, S and Lee, J and Jeon, J and Lee, H and Choi, B and Hong, J and Lee, SJ}, title = {PLGA Nanoparticle-based Anti-TLR2 scFv Gene Delivery for the Treatment of Alzheimer's Disease.}, journal = {Experimental neurobiology}, volume = {}, number = {}, pages = {}, doi = {10.5607/en25047}, pmid = {41549381}, issn = {1226-2560}, abstract = {In Alzheimer's disease (AD), persistent microglial neuroinflammation and the poor brain exposure and durability of current therapies underscore the need for new, long-acting treatments. We developed a non-viral gene therapy that suppresses microglial Toll-like receptor 2 (TLR2) signaling using poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with a plasmid encoding the anti-TLR2 single-chain variable fragment (scFv33). Following intra-cisterna magna delivery, PLGA NPs exhibited microglia-biased uptake and enabled brain-wide transgene expression in mice. In 5xFAD mice, a single administration of scFv33 NPs improved recognition memory in the novel object recognition (NOR) assay, outperforming 8 weeks of weekly recombinant scFv33-Fc dosing. Histology showed selective reduction of small hippocampal Aβ plaques and a shift toward a ramified microglial morphology, indicative of reduced activation. In primary neuron-microglia co-culture, scFv33 reduced microglial hypertrophy, restored process complexity, and enhanced Aβ phagocytosis. Together, these data indicate that sustained, local expression of an anti-TLR2 scFv via a clinically translatable PLGA platform recalibrates microglial state and preferentially limits early-stage plaque accumulation, yielding cognitive benefit after a single dose.}, }
@article {pmid41550171, year = {2024}, author = {Kamaljeet, and Singh, S and Gupta, GD and Aran, KR}, title = {Emerging role of antioxidants in Alzheimer's disease: Insight into physiological, pathological mechanisms and management.}, journal = {Pharmaceutical science advances}, volume = {2}, number = {}, pages = {100021}, pmid = {41550171}, issn = {2773-2169}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory loss, cognitive decline, impairment in activities of daily living, and loss of independent function. Cognitive decline and brain shrinkage, particularly hippocampal atrophy, are associated with the accumulation of tau proteins. They cause inflammation, amyloid plaque deposition, neuronal loss, temporofrontal cortex atrophy, aberrant protein fragment clusters, and twisted fiber bundles. Given the significant role of oxidative processes in neurodegeneration, it is logical to consider the potential of antioxidants in the treatment of AD. Several antioxidants, including glutathione, astaxanthin, ascorbyl palmitate, catalase, and molecular hydrogen, play important roles in AD. Antioxidants interact with free radicals to neutralize them. Several studies have suggested that oxidative stress or damage is involved in the development of AD via different mechanisms and pathways. Thus, new approaches are needed to reduce the extent of oxidative damage that may be therapeutically effective against AD. Although certain antioxidants have exhibited notable benefits in animal models, their efficacy in human clinical trials has been limited, casting doubt regarding the efficacy of antioxidant treatments for AD. Therefore, a more focused and precise strategy that incorporates antioxidants is essential for slowing or stopping AD progression. The integrated role of antioxidants in reducing inflammation must be considered, because the link between inflammation and AD is undeniable. Therefore, the present study aimed to elucidate the role of antioxidants in AD, with the goal of aiding researchers in developing effective and potentially enhanced antioxidant-based therapeutic strategies.}, }
@article {pmid41552781, year = {2022}, author = {Iddi, S and Donohue, MC}, title = {Power and Sample Size for Longitudinal Models in R - The longpower Package and Shiny App.}, journal = {The R journal}, volume = {14}, number = {1}, pages = {264-281}, pmid = {41552781}, issn = {2073-4859}, abstract = {Longitudinal studies are ubiquitous in medical and clinical research. Sample size computations are critical to ensure that these studies are sufficiently powered to provide reliable and valid inferences. There are several methodologies for calculating sample sizes for longitudinal studies that depend on many considerations including the study design features, outcome type and distribution, and proposed analytical methods. We briefly review the literature and describe sample size formulas for continuous longitudinal data. We then apply the methods using example studies comparing treatment versus control groups in randomized trials assessing treatment effect on clinical outcomes. We also introduce a Shiny app that we developed to assist researchers with obtaining required sample sizes for longitudinal studies by allowing users to enter required pilot estimates. For Alzheimer's studies, the app can estimate required pilot parameters using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Illustrative examples are used to demonstrate how the package and app can be used to generate sample size and power curves. The package and app are designed to help researchers easily assess the operating characteristics of study designs for Alzheimer's clinical trials and other research studies with longitudinal continuous outcomes. Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu).}, }
@article {pmid41548934, year = {2026}, author = {Neghabi, M and Nategh, P and Stauffer, AM and Hahn, MK and Blakely, RD and Ranji, M}, title = {Elesclomol Diminishes Redox Imbalance in Peripheral Tissues of Mblac1 Knockout Mice.}, journal = {Journal of biophotonics}, volume = {19}, number = {1}, pages = {e70224}, doi = {10.1002/jbio.70224}, pmid = {41548934}, issn = {1864-0648}, support = {EY031533/NH/NIH HHS/United States ; 2154267//National Science Foundation/ ; //Florida Atlantic University I-SENSE Seed Funding to MR/ ; //Florida Department of Health award to RDB/ ; }, mesh = {Animals ; Oxidation-Reduction/drug effects ; Mice ; Mice, Knockout ; Male ; Female ; Liver/metabolism/drug effects ; Kidney/metabolism/drug effects ; Mitochondria/metabolism/drug effects ; Copper/metabolism ; *Hydrazines/pharmacology ; Organ Specificity/drug effects ; }, abstract = {OBJECTIVE: To determine whether loss of Mblac1, a gene implicated in copper metabolism and Alzheimer's disease, causes systemic mitochondrial redox imbalance and whether treatment with the copper chaperone elesclomol (ES) can restore this balance.
METHODS: We employed 3D cryoimaging to quantify redox ratio (RR) in kidneys and livers of Mblac1 knockout (KO) mice and their wildtype (WT) littermates. Mice of both sexes were administered either vehicle control (C) or ES (10 mg/kg, i.p.).
RESULTS: KO tissues exhibited reduced RR, indicating an oxidized metabolic state. ES treatment recovered 77% of the RR deficit in kidneys and 48% in livers, restoring RR to WT levels.
CONCLUSION: Mblac1 deletion disrupts mitochondrial redox homeostasis in peripheral tissues, while ES partially reverses this imbalance by restoring Cu(I)-dependent metabolism.
SIGNIFICANCE: Optical metabolic imaging reveals Mblac1 as a key regulator of systemic redox balance and supports ES as a potential therapy for Cu-linked metabolic dysfunctions.}, }
@article {pmid41548855, year = {2026}, author = {Jiang, A and Ma, Y and Bao, S and Shahbazi, MA and Reis, RL and Kundu, SC and Xiao, B and Shi, X}, title = {Metal-directed nanomedicines for imaging-guided disease treatment.}, journal = {Acta biomaterialia}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.actbio.2026.01.032}, pmid = {41548855}, issn = {1878-7568}, abstract = {Metal-directed self-assembly, driven by metal-ligand coordination, represents a highly versatile and efficient strategy for constructing drug delivery systems with precisely tunable properties, inherent imaging capabilities, and broad biomedical applications. Stimuli-responsive metal-directed drug delivery systems (MDDSs), guided by advanced imaging techniques, enable precise control over their size and spatial architecture while facilitating site-specific drug release. Moreover, certain metal ions play a dual role, not only orchestrating the self-assembly process but also serving as therapeutic agents and regulatory components for the treatment of various diseases, including cancer, microbial infections, and Alzheimer's disease. This review provides a comprehensive overview of the self-assembly mechanisms underlying diverse MDDSs and their applications in image-guided therapy. Furthermore, we critically examine existing challenges in the field and propose strategic directions to propel the advancement of metal-directed self-assembly in drug delivery. Given the profound implications of this research, further exploration of the critical roles of metal coordination in self-assembly is imperative for the development of next-generation drug delivery platforms. STATEMENT OF SIGNIFICANCE: This review systematically summarize the self-assembly mechanisms of metal-directed drug delivery systems, outlines their applications in image-guided therapy and discusses the current challenges that remain. Furthermore, it elucidates the unique regulatory roles of metal ions in precise drug release and multimodal therapy, providing valuable insights and broad appeal for the development and clinical translation of next-generation smart nanomedicine platforms.}, }
@article {pmid41548697, year = {2026}, author = {Takeda, A and Takeuchi, T and Minakawa, EN and Tanaka, N and Mochizuki, H and Nagai, Y}, title = {Blood extracellular vesicles contribute to the exercise-mediated suppression of brain Aβ pathology in the App[NL-G-F] knockin mouse model of Alzheimer's disease.}, journal = {Neurochemistry international}, volume = {}, number = {}, pages = {106120}, doi = {10.1016/j.neuint.2026.106120}, pmid = {41548697}, issn = {1872-9754}, abstract = {Epidemiological, clinical, and experimental evidence suggest that physical exercise suppresses the deposition of amyloid β (Aβ) plaques in the brain and reduces the risk of Alzheimer's disease (AD). However, how exercise provides such beneficial effects on AD remains largely unclear. In this study, we show that the exercise-mediated suppression of Aβ deposition requires blood extracellular vesicles (EVs) that are upregulated by exercise. We demonstrated that treadmill exercise induces a transient increase in the secretion of blood EVs in both wild-type mice and the App[NL-G-F] knockin mouse model of AD. Comprehensive analysis of protein contents of the exercise-induced blood EVs demonstrated that molecular chaperones, such as heat shock proteins and cochaperones, are substantially increased, together with substantial changes in proteomic profiles after exercise. Importantly, long-term exercise led to the suppression of Aβ plaque deposition in App[NL-G-F] knockin mice, but this suppressive effect was almost completely diminished by the pharmacological inhibition of EV secretion. These results indicate that the secretion of blood EVs is increased by exercise, which contributes to the suppression of Aβ pathology in the brain. Our study identifies blood EVs as a key mediator of the benefits of exercise throughout the body including the brain, highlighting the therapeutic potential of exercise-induced EVs for the treatment of AD pathology.}, }
@article {pmid41548619, year = {2026}, author = {Shao, S and Zu, R and Lu, H and Yuan, Y and Chen, Y and Wu, C and Yang, Y and Shao, S and Ma, H and Zhang, Z and Sun, Y}, title = {Kai-Xin-San alleviates Alzheimer's disease by targeting the DHFR-mediated folate-mitochondrial axis.}, journal = {Journal of ethnopharmacology}, volume = {}, number = {}, pages = {121230}, doi = {10.1016/j.jep.2026.121230}, pmid = {41548619}, issn = {1872-7573}, abstract = {Kai-Xin-San (KXS) is a classical herbal formula first recorded in the Tang Dynasty and has been used for more than 1,000 years for cognitive impairment and dementia.
AIM OF THE STUDY: To investigate whether KXS granules (KXSG) alleviate mitochondrial dysfunction in AD by engaging dihydrofolate reductase (DHFR) -linked folate metabolism.
MATERIALS AND METHODS: The pharmacodynamic effects of KXSG were evaluated in APP/PS1 transgenic mice using behavioral testing, neuropathological assessment, and ultrastructural examination of mitochondria. Pathways and candidate targets were first prioritized by brain-tissue DIA proteomics, and were further supported by a network pharmacology analysis based on putative brain-penetrant constituents. Mechanistic validation was performed both in vivo using APP/PS1 transgenic mice and in vitro using an APP-overexpressing HT22 cell model. Mitochondrial function, folate-cycle-related indices, and target protein expression were assessed in both systems, and pharmacological inhibition of DHFR with methotrexate was employed to probe causality.
RESULTS: KXSG treatment improved learning and memory performance, preserved hippocampal neuronal integrity, and reduced Aβ burden in APP/PS1 mice. Proteomic profiling showed that proteins reversed by KXSG were enriched for mitochondrial localization and were closely linked to folate metabolism. DHFR emerged as a key candidate within this network. In cellular assays, KXSG mitigated AD-related mitochondrial impairment while partially normalizing folate-cycle-associated markers and DHFR expression. Notably, methotrexate, a DHFR inhibitor, attenuated the mitochondrial benefits conferred by KXSG.
CONCLUSION: These data support DHFR-associated folate metabolism as an important mechanistic axis through which KXSG promotes mitochondrial function in AD, providing experimental evidence for a folate-mitochondria link underlying its neuroprotective effects.}, }
@article {pmid41548526, year = {2026}, author = {Moon, SY and Chen, TF and Lee, BC and Moon, WJ and Kandiah, N and Kumar, S and Park, YH and Inaba, K and Dash, A}, title = {A regional framework for the detection and management of ARIA with anti-amyloid therapies in early Alzheimer's disease in Asia.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {3}, pages = {100477}, doi = {10.1016/j.tjpad.2026.100477}, pmid = {41548526}, issn = {2426-0266}, abstract = {Alzheimer's disease (AD) is a growing public health concern in Asia, with an increasing prevalence driven by demographic shifts and rising life expectancy. The introduction of anti-amyloid monoclonal antibodies such as lecanemab and donanemab marks a pivotal transition from symptomatic management of AD to disease-modifying approaches, but their clinical use requires careful monitoring for amyloid-related imaging abnormalities (ARIA), a key safety consideration that presents either as vasogenic edema or as microhemorrhages and superficial siderosis. ARIA has been observed in varying frequencies across global and Asian clinical trial populations, underscoring the need for region-specific guidance. With our early clinical experiences in South Korea, Taiwan and Singapore serving as archetypes in Asia, we outline a framework for the detection and management of ARIA in Asian healthcare settings, accounting for disparities in imaging infrastructure, genetic factors, and clinician experience. Pre-treatment risk stratification, standardized imaging protocols, and severity-based treatment modifications are central to the framework, highlighting the critical role of multidisciplinary collaboration involving neurologists, geriatricians, psychiatrists, and radiologists in ensuring accurate detection and management of ARIA. Additionally, the paper highlights the role of pharmacovigilance, real-world evidence generation, physician education, and healthcare system preparedness in optimizing the safety and efficacy of anti-amyloid therapies in Asia. The proposed framework aims to ensure safe and effective use of anti-amyloid therapies while mitigating ARIA-related risks, thereby optimizing therapeutic outcomes for early AD in diverse healthcare settings across Asia.}, }
@article {pmid41548335, year = {2026}, author = {Dong, W and Yuan, Q and Wu, B and Gao, S and Zhang, Y and Pan, Y and Zhou, K and Jiang, H}, title = {Age at type 2 diabetes onset and risk of dementia: The modifying role of genetic susceptibility and mitochondrial function.}, journal = {The journal of nutrition, health & aging}, volume = {30}, number = {3}, pages = {100780}, doi = {10.1016/j.jnha.2026.100780}, pmid = {41548335}, issn = {1760-4788}, abstract = {OBJECTIVES: To assess dementia risk after incident type 2 diabetes (T2D) by age at diagnosis and evaluate modification by treatment, genetic susceptibility, and mitochondrial function.
DESIGN: Prospective 1:1 age- and sex-matched cohort study using inverse-probability-weighted Cox models.
SETTING: Kunshan Aging Research with E-health (KARE) cohort in China (2018-2024).
PARTICIPANTS: 42,514 adults without diabetes or dementia at baseline, including 21,257 incident T2D cases and 21,257 non-diabetic controls.
MEASUREMENTS: Outcomes were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) from linked medical records and annual examinations. T2D onset age was grouped as 45-54 years, 55-64 years, and persons 65 years and older. In genotyped participants (n = 14,455), a T2D polygenic risk score (PRS) and blood mitochondrial DNA copy number (mtDNA-CN) were examined.
RESULTS: Over a median 3.67 years, incident T2D was associated with higher risks of all-cause dementia (adjusted hazard ratio [AHR] 1.95, 95% CI 1.71-2.21), AD (2.21, 1.88-2.59), and VaD (1.57, 1.20-2.07). Glucose-lowering treatment was associated with lower dementia risk versus no treatment. Among patients aged 55-64 years, the low-PRS/low-mtDNA-CN subgroup had the highest AD risk (AHR 2.41, 95% CI 1.12-5.19).
CONCLUSION: Age at T2D onset was associated with variation in dementia risk. Earlier diagnosis and treatment were associated with lower observed cognitive risk, while genetic susceptibility and mitochondrial function may inform individualised risk stratification.}, }
@article {pmid41547241, year = {2025}, author = {Reichau, K and Crouzier, L and Gehrig, T and Flake, A and Schaller, E and Meunier, J and Bertrand-Gaday, C and Chatonnet, A and Zvejniece, L and Sotriffer, C and Maurice, T and Decker, M}, title = {Targeting neuroinflammation by activation of the sigma-1 receptor (S1R) and inhibition of butyrylcholinesterase (hBChE) leads to highly potent anti-amnesic compounds in an Alzheimer's disease mouse model.}, journal = {European journal of medicinal chemistry}, volume = {305}, number = {}, pages = {118486}, doi = {10.1016/j.ejmech.2025.118486}, pmid = {41547241}, issn = {1768-3254}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder for which no effective preventative or curative treatment has yet been identified. Due to the multifactorial nature and complex pathophysiology of the disease, we developed a multi-target ligand that both inhibits human butyrylcholinesterase (hBChE), a key enzyme linked to β-amyloid plaque formation, and activates the sigma-1 receptor (S1R), which modulates neuroinflammatory and protective pathways. To this end, a series of isoindolines were designed and synthesized, and their biological activities were evaluated. The most promising compound, 7c, exhibited significant dual activity, achieving nanomolar IC50 values against hBChE and potent S1R activation. Subsequent in vivo studies in an Aβ25-35 mouse model revealed a remarkable improvement in cognitive deficits in both short- and long-term memory at an effective dose of 0.01 mg/kg in WT Swiss-OF1 mice. This dose is 10-fold lower compared to single-target compounds 7a and 7b of this isoindoline series. The lack of neuroprotective effects in BChE knock-out (KO) mice confirmed the involvement of BChE inhibition in the pharmacological effects of compound 7c in WT mice. Further combinatorial studies employing a two-drug combination demonstrated synergy in the neuroprotective effect of addressing the two targets.}, }
@article {pmid41546910, year = {2026}, author = {Elyasi, L and Wężyk, M}, title = {Exosome-derived microRNAs from stem cells from human exfoliated deciduous teeth (SHED): Emerging therapeutics for neurodegenerative disorders.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {195}, number = {}, pages = {119001}, doi = {10.1016/j.biopha.2026.119001}, pmid = {41546910}, issn = {1950-6007}, abstract = {Neurodegenerative diseases (NDDs) cause progressive damage of brain structures, resulting in a loss of function and, eventually, the patient's death. Current therapeutic strategies are limited to late stages of the disease, culminating in palliative care, while tackling the underlying causes of neurodegeneration could halt or at least slow down the disease at an early stage. In this vein, stem cell transplantation therapies are emerging as a promising alternative, as such as cells can penetrate the central nervous system, engraft, differentiate, and secrete neurotrophic, neuro-regenerative, and neuroprotective factors. Stem cells derived from human exfoliated deciduous teeth (SHED) have demonstrated significant regenerative potential in various biological systems and pathological conditions, showing high proliferative capacity and multipotency to differentiate into neuronal cells both in vivo and in vitro, apparently functioning through exosome-derived microRNAs (exos-miRs). Here, we summarize recent reports on specific miRs from SHED's exosomes, which exert diverse regulatory functions counteracting oxidative stress, and provide immunomodulatory and neurotrophic benefits contributing to the treatment of neurodegeneration in NDDs. We discuss clinical and preclinical evidence supporting the potential of SHED cells in the treatment of NDDs, including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), spinal cord injury, focal cerebral ischemia, and peripheral nerve damage. We also highlight that the use of SHED in NDDs treatment remains largely underexplored, opening a wide field for further research. We suggest deeper studies on the role of SHED-exos-miRs in NDDs, including their proneurotrophic activity, reduction of genotoxic neuronal stress, and disruption of proinflammatory signaling pathways.}, }
@article {pmid41546373, year = {2026}, author = {Massoumzadeh, P and Tiemann-Powles, S and Naghashzadeh, M and Rizzo, J and Hu, J and Yaeger, LH and Alkelani, H and Wang, Q and Chen, G and Dolatshahi, M and Joseph-Mathurin, N and Benzinger, TLS}, title = {Sex Differences in Alzheimer's Disease: A Systematic Review of Two Decades of Neuroimaging Research.}, journal = {The British journal of radiology}, volume = {}, number = {}, pages = {}, doi = {10.1093/bjr/tqag011}, pmid = {41546373}, issn = {1748-880X}, abstract = {OBJECTIVES: Given the heterogeneous nature of Alzheimer's Disease (AD) and its higher prevalence in females, it is crucial to understand sex-related differences in AD presentation and changes in the brain.
METHODS: : This systematic review investigates sex differences in AD and summarizes key findings from neuroimaging studies over the past two decades to examine how genetics, hormones, and lifestyle factors influence neuroimaging biomarkers and their correlation with cognitive decline and AD progression. A comprehensive literature search was conducted across several databases for human studies from 2004 to 2024 related to AD, biological sex differences, and neuroimaging.
RESULTS: : After a three-step review process, the final extraction included 120 peer-reviewed studies using various neuroimaging modalities, such as Magnetic Resonance Imaging (MRI), amyloid-beta Positron Emission Tomography (PET), tau-PET, and Fluorodeoxyglucose (FDG) PET, to investigate sex as a biological predictor variable in adults with or at risk for AD. Over 90% of the reviewed studies identified clear sex-specific patterns of imaging biomarkers related to cognitive reserve, hormonal changes, APOE-ɛ4 genotype, inflammation, vascular health, and lifestyle factors. Machine learning studies increasingly incorporate sex as a key variable, revealing sex-specific biomarkers and improving model performance in predicting disease status and progression.
CONCLUSIONS: Considering biological sex in AD research is essential for improving diagnostic accuracy, tailoring interventions, and health outcomes.
ADVANCES IN KNOWLEDGE: This systematic review identifies sex-specific patterns in neuroimaging biomarkers of Alzheimer's Disease, influenced by cognitive reserve, hormones, APOE-ɛ4 genotype, inflammation, vascular health, and lifestyle. Recognizing these differences is crucial for understanding, diagnosis, and treatment efficacy.}, }
@article {pmid41544372, year = {2026}, author = {Rosenberg, A and Solomon, A and Bonnard, A and Daniilidou, M and Hagman, G and Hall, A and Matton, A and Öhlund-Wistbacka, U and Westman, E and Kivipelto, M}, title = {Preparing for the implementation of anti-amyloid therapies in Europe: Assessing real-world eligibility for lecanemab and donanemab in a Swedish memory clinic.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {13}, number = {3}, pages = {100476}, doi = {10.1016/j.tjpad.2025.100476}, pmid = {41544372}, issn = {2426-0266}, abstract = {Lecanemab and donanemab are the first anti-Aβ treatments to receive approval in Europe. Eligibility criteria are strict, eg., APOE ε4/4 carriers are excluded. Successful implementation in public healthcare hinges on accurate estimates of eligibility rates in settings which will be the first to roll out the treatments (specialized memory clinics with early disease stages). We applied the appropriate use recommendations (AUR) to assess treatment eligibility in a Swedish tertiary memory clinic where Aβ and APOE assessments are routinely performed. Of the full cohort (N = 410), 26 and 25 patients met the AUR criteria for lecanemab and donanemab, respectively (6 %; partial overlap between the groups). After excluding APOE ε4/4 carriers in line with the European guidelines, only 14 and 13 patients remained eligible (3 %). In clinics with younger populations, a significant percentage of potentially eligible patients are likely to have the APOE ε4/4 genotype. These findings are important to inform the implementation of anti-Aβ treatments.}, }
@article {pmid41543510, year = {2026}, author = {Dumoulin, D and Ghrayeb, M and Côté, S and Garneau, D and Chai, L and Frost, EH and Fülöp, T and Beauregard, PB}, title = {Bidirectional relationship between the biofilm of Porphyromonas gingivalis and the amyloid-beta peptide.}, journal = {Microbiology spectrum}, volume = {}, number = {}, pages = {e0198125}, doi = {10.1128/spectrum.01981-25}, pmid = {41543510}, issn = {2165-0497}, abstract = {UNLABELLED: Periodontitis and Porphyromonas gingivalis infections are significant risk factors for the onset of Alzheimer's disease (AD). Despite the reliance of P. gingivalis on its biofilm for its survival and virulence, the impact of the extracellular matrix on AD's neuropathological hallmarks has never been examined. In this study, we report a bidirectional relationship between the amyloid-beta (Aβ) peptide, which plays a central role in AD, and the biofilm of P. gingivalis. Using multiple fluorescent markers for biofilm components, we observed that Aβ1-40 inhibited biofilm formation while Aβ1-42 increased extracellular matrix production. Also, using thioflavin T staining and atomic force microscopy, we observed co-aggregation of the biofilm and monomeric Aβ1-40, resulting in faster aggregation and significant changes in aggregate structure. Our findings propose mechanistic explanations for the role of P. gingivalis as a risk factor for AD and offer potential mechanisms for microbial involvement in AD etiology.
IMPORTANCE: While the etiology of Alzheimer's disease has been studied extensively for the past 50 years, its exact causes remain unknown. Our current understanding is that the accumulation of multiple genetic and environmental risk factors would lead to the onset of the disease. Porphyromonas gingivalis is a bacterium that produces biofilm and elicits periodontitis, a chronic infection of the gums that constitutes a risk factor for Alzheimer's disease. While studies have looked at the effects of P. gingivalis in triggering Alzheimer's symptoms in animal models, none have explored the impact of the biofilm, which is essential in this bacterium. Our study seeks to bridge that gap by demonstrating a bidirectional relationship between P. gingivalis biofilm and amyloid beta, one of the brain lesions involved in Alzheimer's disease. By understanding the risk factors involved in Alzheimer's disease and their impact, we aim to provide valuable insights on prevention and treatment.}, }
@article {pmid41543367, year = {2026}, author = {Bhagunde, P and Penner, N and Willis, BA and Bell, R and Charil, A and Irizarry, MC and Hersch, S and Reyderman, L}, title = {Brain Amyloid Plaque Levels Affect Clinical Progression in Alzheimer Disease: Assessment of Amyloid PET and Change in CDR-SB Utilizing Semi-Mechanistic Model.}, journal = {CPT: pharmacometrics & systems pharmacology}, volume = {15}, number = {2}, pages = {e70173}, doi = {10.1002/psp4.70173}, pmid = {41543367}, issn = {2163-8306}, mesh = {Humans ; *Alzheimer Disease/drug therapy/diagnostic imaging/metabolism ; Positron-Emission Tomography ; Disease Progression ; *Antibodies, Monoclonal, Humanized/therapeutic use/administration & dosage/pharmacology ; *Plaque, Amyloid/drug therapy/diagnostic imaging/metabolism ; Amyloid beta-Peptides/metabolism ; *Brain/metabolism/diagnostic imaging/drug effects ; Male ; Aged ; Female ; Double-Blind Method ; Models, Biological ; }, abstract = {Lecanemab is a humanized IgG1 monoclonal antibody binding with high affinity to protofibrils of amyloid-beta (Aβ) protein. In clinical studies, lecanemab has been shown to reduce amyloid markers in early symptomatic Alzheimer's disease and slow decline on clinical endpoints of cognition and function. Nonlinear mixed-effects modeling assessed the correlation between amyloid PET and change in CDR-SB using data from lecanemab phase 2 study (Study 201) and phase 3 study (Study 301; Clarity AD). Data from placebo-treated subjects were used to establish a disease-progression model; the effect of amyloid reduction on disease progression was defined using data from lecanemab-treated subjects. CDR-SB scores were used with beta regression to fit a Richard's function parameterized in terms of baseline CDR-SB, intrinsic rate of disease progression, shape, and precision of the beta distribution. Simulations were conducted to evaluate the impact of lecanemab treatment over 4 years. Baseline CDR-SB was predicted by diagnosis and baseline mini-mental state examination (BMMSE) score. Intrinsic rate of disease progression was predicted by amyloid PET and BMMSE. Amyloid PET was a better predictor of drug effect than lecanemab exposure, demonstrating amyloid reduction as a surrogate marker of efficacy. Simulations projected the difference in CDR-SB between lecanemab and placebo treated subjects continued increasing over 4 years. Patients with low baseline amyloid and less severe disease were projected to have slower disease progression and better outcomes with lecanemab treatment.}, }
@article {pmid41541199, year = {2026}, author = {Salah, RS and El-Sayed, NF and El-Hussieny, M and Mansour, ST and Othman, M and Fouad, MA and Rashdan, HRM and Ewies, EF and Gharib, HSA and Elsayed, GH}, title = {Design and synthesis of new phosphazine and triazole derivatives for treatment of Alzheimer's disease: modulating ROS/JNK and Wnt/β-catenin signaling pathways.}, journal = {RSC advances}, volume = {16}, number = {4}, pages = {3077-3100}, pmid = {41541199}, issn = {2046-2069}, abstract = {Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder characterized by progressive cognitive impairment and the accumulation of amyloid-β (Aβ) peptides. In this study, a novel series of triazole and phosphazine derivatives were synthesized and evaluated for neuroprotective activity in an aluminum chloride (AlCl3)-induced rat model of AD. Among the synthesized compounds, 3a, 6a, and 6c were structurally characterized and selected for in vivo biological evaluation. Behavioral, biochemical, molecular, and histopathological assessments were conducted to determine their efficacy, with Rivastigmine used as a reference drug. Compounds 3a and 6c significantly improved cognitive and memory performance, decreased Aβ1-42 production, and reduced reactive oxygen species (ROS) generation. Furthermore, both compounds inhibited the activation of JNK and Puma, promoted Beclin-1 expression, and activated Wnt/β-catenin signaling, as evidenced by increased expression levels of Wnt7a, β-catenin, LRP6, and FZD4, alongside decreased expression levels of GSK-3β and BACE1. Molecular docking studies supported these findings, revealing strong binding affinities of the active compounds, particularly 3a, to the JNK3 active site. Molecular dynamic simulations were performed on the best docking pose of the most potent compound 3a to confirm the formation of a stable complex with JNK3. Compounds 3a, 6a, and 6c demonstrated favorable pharmacokinetic profiles, with predicted good oral bioavailability, blood-brain barrier permeability, and non-substrate behavior toward P-glycoprotein. They are expected to maintain therapeutic availability in systemic circulation, as indicated by the predicted plasma protein binding below 90%, moderate to high steady-state volume of distribution, and lack of substrate affinity for cytochrome P450 enzymes CYP2C9 and CYP2D6. These results suggest that compounds 3a and 6c may serve as promising multi-target therapeutic candidates for AD by modulating oxidative stress, apoptosis, autophagy, and Wnt/β-catenin signaling pathways.}, }
@article {pmid41540764, year = {2026}, author = {Kanwal, A and Azeem, B and Nasir, H and Mumtaz, F and Ashraf, N and Amin, MHJ and Kanwal, W and Khan, BW}, title = {Exploring Adjunctive Novel Therapeutic Approach of KarXT (Xanomeline-Trospium Chloride) for Managing Psychotic Symptoms in Patients With Schizophrenia and Alzheimer's Disease.}, journal = {Brain and behavior}, volume = {16}, number = {1}, pages = {e71182}, pmid = {41540764}, issn = {2162-3279}, mesh = {Humans ; *Alzheimer Disease/drug therapy/complications ; *Schizophrenia/drug therapy/complications ; *Psychotic Disorders/drug therapy ; *Antipsychotic Agents/pharmacology/therapeutic use ; Quality of Life ; }, abstract = {BACKGROUND: Acute psychotic symptoms like delusions and hallucinations are of major concern while treating patients with schizophrenia and alzheimer's psychosis, primarily impacting their daily life functioning and quality of life. The traditional antipsychotic medications, commonly prescribed to manage these symptoms, cause significant side effects with limited efficacy, requiring novel therapeutic agents that can overcome this challenge. While there is no definitive cure, symptomatic treatment can help relieve some of the symptoms and improve the quality of life of people with alzheimer's disease (AD).
METHOD: A comprehensive literature search of PubMed, scopus, google scholar, and ClinicalTrials.gov was conducted to identify studies on xanomeline-trospium chloride (KarXT) in schizophrenia and AD psychosis. After screening 802 unique records, 39 studies-including preclinical, clinical, and observational investigations-were included in this narrative review. Only English-language publications up to February 2025 were considered.
RESULT: KarXT, with its dual action on the M1 and M4 receptors and mAChR antagonism, greatly helps reduce the severity of the positive and negative symptoms, as it resulted in an 8.4-point greater reduction on the PANSS scale. Side effects were minimal and did not account for the discontinuation of treatment.
CONCLUSION: Psychosis is a common feature of schizophrenia and AD, most often caused by high concentrations of dopamine in the brain, characterized by hallucinations, delusions, and disorganized thinking, resulting in markedly reduced quality of life for the patient and associated caregiver. Conventional treatments targeting dopamine receptors produce extrapyramidal symptoms and metabolic side effects, leading to noncompliance with medication. KarXT, with its dual action on M1 and M4 receptors and mAChR antagonism, greatly helps reduce the severity of the positive and negative symptoms. The side effects experienced were minimal and did not account for the discontinuation of treatment.An overview of the mechanism of action, clinical trials, and classical findings of KarXT for the management of psychotic symptoms in patients with schizophrenia and alzheimer's disease.}, }
@article {pmid41540706, year = {2026}, author = {Zhang, S and Huang, T and Yang, C and Chen, J and Lü, T and Zhang, J}, title = {[Sulforaphane reduces reactive astrocyte-mediated neuron apoptosis in vitro by inhibiting the MAPK/NF-κB signaling pathway in Aβ42 oligomer-activated astrocytes].}, journal = {Nan fang yi ke da xue xue bao = Journal of Southern Medical University}, volume = {46}, number = {1}, pages = {191-199}, pmid = {41540706}, issn = {1673-4254}, mesh = {*Isothiocyanates/pharmacology ; *Astrocytes/cytology/drug effects/metabolism ; Sulfoxides ; *Apoptosis/drug effects ; *Amyloid beta-Peptides/pharmacology ; *Neurons/cytology/drug effects/metabolism ; Signal Transduction/drug effects ; Humans ; Animals ; NF-kappa B/metabolism ; Mice ; Coculture Techniques ; Peptide Fragments/pharmacology ; Tumor Necrosis Factor-alpha/metabolism ; Cell Line, Tumor ; Interleukin-6/metabolism ; }, abstract = {OBJECTIVES: To explore the effects of sulforaphane (SFN) on Aβ42-activated U87 astrocyte-mediated apoptosis of SH-SY5Y neurons in vitro.
METHODS: U87 cells treated with different concentrations of Aβ42, SFN or both were examined for changes in cell activity, IL-6 and TNF-α mRNA expression, release of IL-6 and TNF-α proteins, and expressions of p-p38, p-p65 and GFAP using CCK-8 assay, RT-qPCR, ELISA and Western blotting. SH-SY5Y neurons were co-cultured with U87 astrocytes treated with Aβ42 alone or in combination with SFN or SB203580 for 24 h, and the changes in Bax protein expression levels and viability of SH-SY5Y cells were examined. The effects of Aβ42, SFN, and their combination were also observed in astrocytes isolated from mouse brain tissues, and the indirect effects of astrocyte treatmentt on viability of the co-cultured primary neurons were assessed.
RESULTS: The viability of U87 astrocytes increased significantly following treatment with 1.25 μmol/L Aβ42 but decreased after Aβ42 treatment above 5 μmol/L. SFN treatments for 24 h below 5 μmol/L did not significantly affect U87 cell viability. Aβ42 treatment significantly increased protein expressions of p-p38, p-p65 and GFAP, mRNA expression levels of IL-6 and TNF-α, and IL-6 and TNF-α levels in culture supernatant of U87 cells. SH-SY5Y cells co-cultured with Aβ42-treated U87 cells showed significantly increased protein expressions of Bax, and exhibited lowered viability following co-culture with 5 μmol/L Aβ42-treated U87 cells. The isolated mouse astrocytes showed lowered viability following Aβ42 treatment above 10 μmol/L, but SFN treatment below 5 μmol/L for 24 did not obviously affect the cell viability. The primary neurons co-cultured with Aβ42-treated mouse astrocytes showed significantly lower cell viability than those co-cultured with the astrocytes treated with Aβ+SFN or Aβ+SB203580.
CONCLUSIONS: SFN attenuates astrocyte-mediated neuron apoptosis by inhibiting the MAPK/NF-κB signaling pathway in Aβ42 oligomer-activated astrocytes.}, }
@article {pmid41540543, year = {2026}, author = {Singh, NK and Kumar, Y and Chandra, M and PadmaPriya, G and Sharma, Y and Mishra, S}, title = {Betanin: A Natural Phytomolecule for the Intervention of Neurological Disorders.}, journal = {Current topics in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115680266398457251014040532}, pmid = {41540543}, issn = {1873-4294}, abstract = {Betanin is widely consumed around the globe either as beetroot directly or as one of the key ingredients in food and pharmaceutical preparations. The health benefits of Betanin, including the treatment of numerous neurological diseases and brain cancer, have been reported extensively. Betanin has gained global attention due to notable anti-inflammatory, antioxidant, and anti-cancer activities. Recently, there has been growing attention on the usage of Betanin to prevent or delay the onset of neurodegenerative disorders. This review recapitulates available information from various recent pre-clinical studies on Betanin in several neurological diseases, such as Parkinson's disease, Alzheimer's disease, aging, brain stroke, anxiety, and neuropathic pain. Betanin exhibits remarkable neuroprotective effects via activation of the Nrf2 signaling pathway, inhibition of the production and expression of pro-inflammatory mediators and reactive oxygen species, along with suppression of the NF-κB signaling pathway. Taking betanin as part of a healthy diet may aid in the management of various brain-related disorders. This review focuses on the neurological conditions for which betanin has shown therapeutic potential, highlighting its beneficial properties, cellular and molecular mechanisms of action, and its relevance in light of current research. Based on the available evidence, betanin could be considered a promising candidate and lead compound in the drug development process for the prevention, treatment, and management of several neurological disorders in the future.}, }
@article {pmid41540503, year = {2026}, author = {Song, C and Wu, PY and Huffman, WJ and David-Bercholz, J and Bedolla, A and Velagapudi, R and Njoroge, A and Rodriguiz, RM and Wetsel, WC and Rendina, D and Bilbo, SD and Chiang, W and Ogu, JC and Gelbard, HA and Yang, T and Grill, WM and Terrando, N}, title = {Electrical stimulation of the vagus nerve improves amyloid pathology in delirium superimposed on dementia.}, journal = {Bioelectronic medicine}, volume = {12}, number = {1}, pages = {2}, pmid = {41540503}, issn = {2332-8886}, support = {AARF-24-1313412/ALZ/Alzheimer's Association/United States ; 2019-AARG-643070/ALZ/Alzheimer's Association/United States ; R01-AG057525, R01-AG083979A1, RF1-AG079138, R21-AG055877/NH/NIH HHS/United States ; }, abstract = {BACKGROUND: Delirium and delirium superimposed on dementia (DSD) are common complications affecting patients suffering from ongoing neurodegenerative pathologies. Peripheral surgical trauma can trigger neuroinflammation and ensuing DSD via mechanisms that remain poorly understood. Given the multifactorial therapeutic effects of neuromodulation, including vagal nerve stimulation, we have tested a minimally invasive approach to combat DSD following orthopedic surgery.
METHODS: We performed orthopedic surgery on 5xFAD and CVN-AD mice and tested the efficacy of minimally invasive percutaneous vagus nerve stimulation (pVNS). We applied immunohistochemical, biochemical, and behavioral assays to evaluate the impact of surgery on postoperative delirium on DSD pathology in Alzheimer’s disease-like mice. To confirm the role of systemic factors in neuroinflammation and amyloid-β dyshomeostasis, we conducted experiments using interleukin-6 (IL-6), a cytokine commonly upregulated in postoperative delirium and in vitro co-culture assays for validation.
RESULTS: In AD-like mice surgery induced acute changes in amyloid-β; perioperative treatment with pVNS effectively reduced amyloid-β load, plaque sphericity, and neuronal loss. The rescue of these pathological hallmarks led to improved delirium-like behavior, as demonstrated by the 5-choice serial reaction time task on postoperative days 1 and 2. pVNS improved microglial morphology, particularly near amyloid-β plaques. Acute isolation of microglial cells from 5xFAD mice after surgery indicated that pVNS partially enhanced key Disease-Associated Microglia (DAM) markers. The contribution of pro-inflammatory cytokines to amyloid-β aggregation was validated using an in vitro transwell culture model following Cytomix exposure, which also caused endothelial barrier disruption. Finally, we isolated IL-6 as a well-established biomarker of postoperative delirium and described its role in DSD pathology following systemic administration.
CONCLUSION: These findings establish a role for neuromodulation after pVNS in regulating perioperative immunity and advance a new paradigm for perioperative interventions in patients at risk for DSD.
GRAPHICAL ABSTRACT: [Image: see text]
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42234-025-00194-5.}, }
@article {pmid41540481, year = {2026}, author = {Si, X and Tian, S and Chen, Y and Li, X and Wu, G and Yao, Y and Wang, M}, title = {Investigating the molecular mechanisms of glutamine metabolism and mitochondria-related biomarkers in Alzheimer's disease through transcriptomics and experimental validation.}, journal = {European journal of medical research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40001-025-03747-1}, pmid = {41540481}, issn = {2047-783X}, support = {22JR5RA994//Natural Science Foundation of Gansu Province, China/ ; CY2022-MS-A07//Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital, China/ ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a prevalent neurodegenerative disorder. This study aims to identify biomarkers associated with glutamine metabolism-related genes (GRGs) and mitochondria-related genes (MRGs) in AD through bioinformatics analysis, offering insights for prevention and treatment strategies.
METHODS: Candidate genes were first picked out through differential gene expression profiling, construction of weighted gene co-expression network analysis (WGCNA), and interaction network analysis. Biomarkers were then filtered using machine learning algorithms. For these biomarkers, expression verification and receiver operating characteristic (ROC) curve analysis were carried out. These biomarkers underwent GeneMANIA analysis, subcellular and chromosomal localization, enrichment analysis, along with immune infiltration assessment, establishment of a multi-layered molecular regulatory network, and prediction of potential therapeutic agents by leveraging drug-gene interaction databases. Finally, the consistency was validated by reverse transcription quantitative polymerase chain reaction (RT-qPCR).
RESULTS: Initially, 10 candidate genes were identified through bioinformatics analysis. Machine learning, expression validation, and ROC analysis pinpointed SNCA and PPP2R1A as biomarkers (AUC > 0.7). These biomarkers were associated with 20 functionally similar genes and were active in the nucleus and cytoplasm. SNCA was located on chromosome 4, and PPP2R1A on chromosome 19. Enrichment analysis unveiled their involvement in pathways such as olfactory transduction. Additionally, these biomarkers influenced immune cells; for instance, there was a positive correlation between PPP2R1A and type 2 T helper cells (cor = 0.66, P = 1.03 × 10[-5]). A molecular regulatory network demonstrated that these biomarkers were regulated by 134 miRNAs, and 72 potential drugs targeting these biomarkers were identified. RT-qPCR confirmed the expression consistency with bioinformatics results.
CONCLUSION: This study ultimately identified SNCA and PPP2R1A as biomarkers for AD, providing a theoretical foundation and potential targets for the diagnosis and treatment of AD.}, }
@article {pmid41540476, year = {2026}, author = {Zhang, Y and Zhang, F and Yin, H and Sun, Y and Wang, Y and Ren, Z and Jiang, J and Zeng, L}, title = {hUC-MSC-derived exosomes ameliorate Alzheimer's disease pathology through lncRNA-9969-mediated multi-target protection involving neuronal autophagy and microglial modulation.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-026-01954-4}, pmid = {41540476}, issn = {1758-9193}, support = {YDZJ202301ZYTS536//the Science and Technology Department of Jilin Province/ ; }, abstract = {BACKGROUND: Alzheimer's disease is characterized by intertwined pathologies including neuroinflammation, driven by microglial dysfunction, and metabolic disturbances such as lipid dyshomeostasis. Mesenchymal stem cell-derived exosomes (MSC-Exos) hold therapeutic promise, Still, it is unknown whether they can simultaneously address these co-occurring impairments via specific molecular cargos, such as long non-coding RNAs (lncRNAs).
METHODS: Transcriptome sequencing of exosomes derived from human umbilical cord mesenchymal stem cells (hUC-MSCs) revealed high expression of the long noncoding RNA ENST00000629969 (hereinafter referred to as lncRNA-9969). We isolated exosomes from hUC-MSCs (WT-Exo) and established human umbilical cord blood mesenchymal stem cells stably knocked down for lncRNA-9969 via siRNA, from which corresponding exosomes (KD-Exo) were isolated. Cross-species analysis identified the mouse homolog of lncRNA-9969 as ENSMUST00000200021 (hereinafter referred to as lncRNA-0021). Cellular experiments employed an Aβ₂₅₋₃₅-induced SH-SY5Y cell model to evaluate the protective effects of exosomes. In animal experiments, 6-month-old APP/PS1 mice received biweekly tail vein injections of WT-Exo or KD-Exo for 4 weeks. Phenotypic and mechanistic analyses were subsequently conducted using the Morris water maze, Western blot, immunofluorescence, qPCR, and transmission electron microscopy.
RESULTS: In Aβ-injured SH-SY5Y cells, WT-Exo significantly attenuated cellular damage and promoted Aβ clearance, whereas the protective effect of KD-Exo was markedly reduced. In APP/PS1 mice, WT-Exo treatment significantly improved spatial memory deficits and upregulated hippocampal expression of synaptic proteins synaptophysin (Syn) and brain-derived neurotrophic factor (BDNF). Molecular mechanism studies demonstrated that lncRNA-0021 directly binds mmu-miR-6361. Through this ceRNA mechanism, exosome-delivered lncRNA activated the mTOR/p70S6K autophagy pathway, regulated lipid metabolism-related genes, promoted microglial polarization toward the protective M2 phenotype, and suppressed pyroptosis. These beneficial changes were not observed in the KD-Exo-treated group.
CONCLUSIONS: hUC-MSC-derived exosomes exert neuroprotective effects by delivering functional lncRNA-9969. Its highly conserved homolog in mice, lncRNA-0021, achieves coordinated multi-target regulation of neuroinflammation, pyroptosis, and metabolic disturbances by sequestering miR-6361 and activating downstream signaling pathways. This study elucidates the central role of exosomal lncRNAs in AD pathology and provides new insights for developing RNA-based multi-target therapeutic strategies.}, }
@article {pmid41540303, year = {2026}, author = {Abd El-Fattah, MA}, title = {Challenges and Opportunities of Drug Delivery for Treatment of Alzheimer's Disease.}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {78}, pmid = {41540303}, issn = {1530-9932}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Humans ; *Drug Delivery Systems/methods ; Blood-Brain Barrier/metabolism/drug effects ; Animals ; Nanoparticles/chemistry ; Brain/metabolism/drug effects ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive deterioration in cognitive functions. It represents a global health concern with increasing prevalence and devastating outcomes for the quality of life that could ultimately lead to death. AD is associated with deposition of β-amyloid (Aβ) plaques and intracellular buildup of tau proteins forming neurofibrillary tangles (NFTs), which are the main characteristics for AD brain tissues. Approved AD therapy is based mainly on symptomatic relief, and conventional medicaments often fail due to either low bioavailability, limited solubility, or failure to cross blood-brain barrier (BBB). The complexity in AD pathophysiology opens windows for many therapeutic options. So, lecanemab was recently approved by FDA as the first disease-modifying therapy. However, drug delivery to the brain remains challenging due to the nature of BBB. Hence, more extensive research is essential to develop disease-modifying therapies and also to find drug delivery strategies to ensure simplified administration and successful brain delivery. This review article summarizes AD pathogenesis with the corresponding treatment targets. It emphasizes innovative drug delivery strategies and novel formulation approaches to deliver medicines across BBB. The use of recent advancements in drug delivery to deliver medicaments across BBB are highlighted, with focus given to novel drug delivery systems and formulation of nanoparticles for brain targeting. The use of nutraceuticals, gene therapy, and stem cell therapy are is covered.}, }
@article {pmid41539386, year = {2026}, author = {Hector, A and Leduc, T and Caiado, MJDC and Delignat-Lavaud, B and Dufort-Gervais, J and Daneault, C and Des Rosiers, C and Bourguignon, C and Lina, JM and Fernandes, K and Brouillette, J and Mongrain, V}, title = {Electrocorticographic, Astrocytic and Transcriptomic Signatures in the Triple Transgenic Mouse Model of Alzheimer's Disease submitted to Stearoyl-CoA Desaturase Inhibition.}, journal = {Neuropharmacology}, volume = {}, number = {}, pages = {110835}, doi = {10.1016/j.neuropharm.2026.110835}, pmid = {41539386}, issn = {1873-7064}, abstract = {Alzheimer's disease (AD) is associated with cognitive deficits and sleep disturbances. Research suggests the involvement of dysfunctions in lipid metabolism in the brain of AD patients and animal models. The inhibition of stearoyl-CoA desaturase (SCD), a lipid-converting enzyme, was shown to restore memory in triple transgenic (3xTg)-AD mice. In the brain, astrocytes regulate the synthesis of specific lipids. This project tested whether the inhibition of SCD restores sleep in 3xTg-AD mice, and whether this associates with modifications in lipids, astrocytic function and the transcriptome. Wild-type (WT) and 3xTg-AD female mice received a SCD inhibitor (SCDi) or vehicle, which was followed by an electrocorticographic (ECoG) recording. Brain slices were stained for lipid droplets, astrocytic markers or processed for spatial transcriptomics. The reduced time spent awake (increased time spent in slow wave sleep) in 3xTg-AD mice was not restored by SCDi treatment. Rhythmic and scale-free ECoG activities were markedly altered in 3xTg-AD mice for all wake/sleep states, and SCDi changed these ECoG signatures differently in mutant in comparison to WT mice. GFAP-positive cell density and lipid droplet count were elevated in hippocampal CA1, and rescued by SCDi. The treatment also rescued the expression of several genes in a manner mainly overlapping between brain regions. The findings suggest that the multiple wake/sleep alterations in 3xTg-AD mice are not mitigated by SCD inhibition, but that this treatment can revert changes in hippocampal astrocytes, lipids and in the brain transcriptome. This work will benefit the understanding of the AD pathophysiology and associated sleep disturbances.}, }
@article {pmid41537771, year = {2026}, author = {Wang, N and Sun, Z and Chen, F and Tian, X and Li, J and He, X}, title = {Mangiferin Alleviates Formaldehyde-Induced Tau Hyperphosphorylation and Cognitive Impairment in Mice via the PI3K/AKT/GSK3β Pathway: Insights From Network Pharmacology and Experimental Validation.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {40}, number = {2}, pages = {e71346}, doi = {10.1096/fj.202503159R}, pmid = {41537771}, issn = {1530-6860}, support = {202401AT070082//Yunnan Fundamental Research Projects/ ; 202301BA070001-032//Yunnan Fundamental Research Projects/ ; }, mesh = {Animals ; *Glycogen Synthase Kinase 3 beta/metabolism ; Mice ; *tau Proteins/metabolism ; *Proto-Oncogene Proteins c-akt/metabolism ; *Cognitive Dysfunction/chemically induced/metabolism/drug therapy ; *Phosphatidylinositol 3-Kinases/metabolism ; *Xanthones/pharmacology ; Phosphorylation/drug effects ; Male ; Network Pharmacology/methods ; *Formaldehyde/toxicity ; Molecular Docking Simulation ; Signal Transduction/drug effects ; Mice, Inbred C57BL ; Hippocampus/metabolism/drug effects ; }, abstract = {Studies have demonstrated that accumulation of formaldehyde (FA) in the body can result in Alzheimer's disease (AD) like changes including cognitive impairment, Aβ deposition, and Tau hyperphosphorylation. Mangiferin (MGF), a natural flavonoid compound, has been suggested in previous reports to have potential in the treatment of AD. This study integrated network pharmacology and in vivo experiments to elucidate the therapeutic potential and mechanisms of MGF in mitigating FA-induced neurotoxicity. Potential overlapping targets between MGF and AD were identified using jvenn. Functional enrichment analysis of these targets was performed with DAVID. A protein-protein interaction (PPI) network was constructed using STRING and visualized in Cytoscape to identify hub genes. Molecular docking simulations with AutoDock were then employed to assess binding affinity. Subsequently, for experimental validation, a mouse model of FA-induced neurotoxicity was established. Spatial memory and cognitive function in mice were evaluated using the Y-maze and novel object recognition tests. The expression levels of key pathway-related proteins in the cortex and hippocampus were analyzed via immunohistochemistry (IHC) and Western blotting (WB). Network analysis identified AKT1 and GSK3β as key targets, and molecular docking confirmed strong binding affinity between MGF and these proteins. Experimental validation demonstrated that MGF dose-dependently improved spatial memory and cognitive performance in FA-exposed mice, reduced neuronal apoptosis, and suppressed Tau hyperphosphorylation at Thr181, Ser396, and Ser404. Mechanistically, MGF activated the PI3K/AKT pathway, leading to GSK3β inactivation through Ser9 phosphorylation. These findings highlight MGF as a promising therapeutic candidate for AD by targeting the PI3K/AKT/GSK3β axis.}, }
@article {pmid41538772, year = {2026}, author = {Liao, YS and Wai, T and Liao, TY and Chang, HL and Chang, YL and Fu, LC}, title = {Mild Cognitive Impairment Detection System Based on Unstructured Spontaneous Speech: Longitudinal Dual-Modal Framework.}, journal = {JMIR medical informatics}, volume = {14}, number = {}, pages = {e80883}, pmid = {41538772}, issn = {2291-9694}, mesh = {Humans ; *Cognitive Dysfunction/diagnosis ; Aged ; Male ; Female ; Longitudinal Studies ; *Speech ; Aged, 80 and over ; Memory, Episodic ; China ; }, abstract = {BACKGROUND: In recent years, the incidence of cognitive diseases has also risen with the significant increase in population aging. Among these diseases, Alzheimer disease constitutes a substantial proportion, placing a high-cost burden on health care systems. To give early treatment and slow the progression of patient deterioration, it is crucial to diagnose mild cognitive impairment (MCI), a transitional stage.
OBJECTIVE: In this study, we use autobiographical memory (AM) test speech data to establish a dual-modal longitudinal cognitive detection system for MCI. The AM test is a psychological assessment method that evaluates the cognitive status of subjects as they freely narrate important life experiences.
METHODS: Identifying hidden disease-related information in unstructured, spontaneous speech is more difficult than in structured speech. To improve this process, we use both speech and text data, which provide more clues about a person's cognitive state. In addition, to track how cognition changes over time in spontaneous speech, we introduce an aging trajectory module. This module uses local and global alignment loss functions to better learn time-related features by aligning cognitive changes across different time points.
RESULTS: In our experiments on the Chinese dataset, the longitudinal model incorporating the aging trajectory module achieved area under the receiver operating characteristic curve of 0.85 and 0.89 on 2 datasets, respectively, showing significant improvement over cross-sectional, single time point models. We also conducted ablation studies to verify the necessity of the proposed aging trajectory module. To confirm that the model not only applies to AM test data, we used part of the model to evaluate the performance on the ADReSSo dataset, a single time point semistructured data for validation, with results showing an accuracy exceeding 0.88.
CONCLUSIONS: This study presents a noninvasive and scalable approach for early MCI detection by leveraging AM speech data across multiple time points. Through dual-modal analysis and the introduction of an aging trajectory module, our system effectively captures cognitive decline trends over time. Experimental results demonstrate the method's robustness and generalizability, highlighting its potential for real-world, long-term cognitive monitoring.}, }
@article {pmid41537461, year = {2026}, author = {Choi, KY and Kang, S and Cook, S and Li, D and Choi, YY and Seo, EH and Han, X and Park, JE and Lee, S and Lee, S and Chung, JY and Chong, A and Choi, SM and Ha, JM and Song, MK and Lee, JS and Choo, IH and Kim, JH and Song, HC and Kim, BC and Kim, H and Farrer, LA and Gim, J and Jun, GR and Lee, KH}, title = {The Gwangju Alzheimer's & Related Dementias (GARD) cohort: Over a decade of Asia's largest longitudinal multimodal study.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e70981}, pmid = {41537461}, issn = {1552-5279}, support = {25-BR-03-05//the KBRI Basic Research Program through the Korea Brain Research Institute, funded by the Ministry of Science and ICT/ ; NRF-2014M3C7A1046041//the Original Technology Research Program for Brain Science of the National Research Foundation funded by the Korean government, MSIT/ ; RS-2024-00407198//Brain Pool program funded by the Ministry of Science and ICT through the National Research Foundation of Korea/ ; 2023-ER1007-01//Korea National Institute of Health research project/ ; //by the Technology Innovation Program (20022810, Development and Demonstration of a Digital System for the evaluation of geriatric Cognitive impairment) funded By the Ministry of Trade, Industry & Energy (MOTIE, Korea)/ ; RS-2024-00433283//the Technology Innovation Program funded by the Ministry of Trade, Industry & Energy, Republic of Korea/ ; HR22C141105//Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea/ ; }, mesh = {Humans ; Longitudinal Studies ; Male ; *Alzheimer Disease/epidemiology/diagnostic imaging/genetics/diagnosis ; Female ; Aged ; *Cognitive Dysfunction/epidemiology/diagnostic imaging ; Disease Progression ; Republic of Korea/epidemiology ; Cohort Studies ; Middle Aged ; Biomarkers ; Magnetic Resonance Imaging ; Aged, 80 and over ; Neuroimaging ; Proteomics ; Genomics ; }, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a major public health concern in Korea, with a high prevalence among older adults. A community-based longitudinal study is essential for tracking disease progression, identifying biomarkers, and developing targeted prevention and treatment strategies. The Gwangju Alzheimer's & Related Dementias (GARD) cohort was established to address these needs through a multimodal approach.
METHODS: Participants aged ≥60 years undergo comprehensive clinical evaluations, neuroimaging, and biospecimen collection for multi-omics analyses (genomics, transcriptomics, proteomics, and metagenomics) at baseline and systematic follow-up visits.
RESULTS: From over 17,000 screened individuals, 12,877 were enrolled. Baseline diagnoses include 5,123 cognitively unimpaired (CU), 3,250 mild cognitive impairment (MCI), and 2,125 AD dementia. The resource includes magnetic resonance imaging scans (n = 10,843) and extensive multi-omics data: genomic (n = 10,775), proteomic (n = 116), and microbiome (n = 595).
DISCUSSION: The integrated GARD dataset provides a powerful and scalable resource for identifying novel biomarkers, understanding disease heterogeneity, and advancing precision medicine for AD.
HIGHLIGHTS: Gwangju Alzheimer's & Related Dementias (GARD) is a large-scale, longitudinal, community-based cohort study in South Korea. The study focuses on early detection and monitoring of dementia progression. GARD includes cognitive testing, imaging, biospecimens, and multi-omics data. We aim to identify Korean-specific biomarkers predictive of cognitive decline. Supports East Asian insights and fills gaps in global Alzheimer's research.}, }
@article {pmid41536422, year = {2025}, author = {Thaliath, A and Pillai, JA}, title = {Non-Cognitive Symptoms in Alzheimer's Disease and Their Likely Impact on Patient Outcomes. A Scoping Review.}, journal = {Current treatment options in neurology}, volume = {27}, number = {}, pages = {}, pmid = {41536422}, issn = {1092-8480}, support = {P30 AG072959/AG/NIA NIH HHS/United States ; }, abstract = {PURPOSE OF REVIEW: Increased understanding of the pathophysiology of Alzheimer's disease (AD) has led to development of disease modifying therapies. The therapies primarily target measures of cognitive decline since AD has been thought of as a cognitive disorder. However, the non-cognitive symptoms seen in AD contribute to overall quality-of-life. This scoping review was undertaken to further our understanding of the non-cognitive features of AD.
RECENT FINDINGS: The non-cognitive symptoms in AD range from changes in sensory perception, systemic changes, and neuropsychiatric manifestations. We targeted the following non-cognitive domains: vision, olfaction, GI, muscle, sleep, circadian rhythm, immune and behavioral symptoms as it relates to AD for this review. Non-cognitive features impact the ability of individuals to perform their activities of daily living, have safety implications and lead to increased caregiver burden. The review explores non-pharmacological and pharmacological measures targeted at the non-cognitive changes in AD.
SUMMARY: Non-cognitive symptoms contribute to significant disease burden in Alzheimer's disease. It is important to screen for and provide supportive care for these symptoms to help improve clinical care. Incorporation of non-cognitive features of AD in clinical trials will help ascertain the true societal and economic impact of AD and that of potential therapeutics.
OPINION STATEMENT: Alzheimer's disease (AD) is primarily recognized as a disorder of cognition; however, non-cognitive symptoms significantly contribute to disease burden and clinical presentation. These manifestations particularly behavioral symptoms and systemic changes beyond the central nervous system impact patients' quality of life and increase caregiver stress. Often, such symptoms necessitate a transition from home-based care to more intensive settings, such as memory care facilities. As AD prevalence rises alongside an aging population, the shortage of dedicated memory care providers in community settings challenges access and quality of care. Improved awareness and early recognition of non-cognitive features among healthcare professionals can aid identification of modifiable systemic issues and allow timely behavioral management during clinical encounters. Treatment of these symptoms requires a multifaceted approach, incorporating pharmacological and non-pharmacological strategies. Non-pharmacological interventions, including tailored behavioral approaches and environmental modifications, can enhance quality of life for individuals with AD and reduce caregiver burden especially where specialized medical resources are limited.}, }
@article {pmid41536056, year = {2026}, author = {Dong, J and Xu, L and Xu, X and Shi, B and Wang, Q and Xu, J and Xu, C and Kuang, H and Qu, A}, title = {Chiral Spindle-like Nanorods Reprogram Neuroinflammation by Catalyzing α-Ketoglutarate Biosynthesis.}, journal = {Journal of the American Chemical Society}, volume = {}, number = {}, pages = {}, doi = {10.1021/jacs.5c19753}, pmid = {41536056}, issn = {1520-5126}, abstract = {Alzheimer's disease (AD) is the most prevalent cause of dementia worldwide, and breakthroughs in effective intervention strategies are urgently needed. Here, we report that chiral spindle-like Fe7Se8 nanorods (NRs) promote α-ketoglutarate (AKG) biosynthesis, providing a new potential route for AD intervention through modulation of neuroimmune homeostasis. Oral administration of L-NRs significantly restored intestinal microbiota homeostasis in 3 × Tg AD model mice, markedly enriched Lactobacillus johnsonii, and enhanced biosynthesis of the metabolite AKG, which reversed cognitive impairment and neuronal degeneration in 5 × FAD mice. Moreover, AKG levels in the clinical serum and cerebrospinal fluids were found to be significantly lower in patients with AD than in healthy controls. Mechanistic studies revealed that L-NRs efficiently promoted AKG biosynthesis through scavenging reactive oxygen species (ROS) to restore the activities of three enzymes in the biosynthesis pathway. Crucially, these NRs are broken down by gastric juice into smaller nanoparticles and subsequently into ions in the intestines. Further studies explored that AKG crossed the blood-brain barrier via cooperatively mediated transport proteins, targeted microglial phenotypic switching, reprogrammed the neuroinflammatory microenvironment, and ultimately ameliorated cognitive deficits and neuronal pathological alterations. Our findings suggest that AKG might serve as a therapeutic drug for the precise treatment of neurodegenerative diseases.}, }
@article {pmid41535708, year = {2026}, author = {Yu, MJ and Xiong, RQ and Wu, JW and Li, YC and Xie, JX and Zhou, HP and Ye, GY and Chang, Y and Huang, KB and Pan, SY}, title = {β-Hydroxybutyrate improves glymphatic system function and alleviates cerebral edema in mice after ischemic stroke.}, journal = {Acta pharmacologica Sinica}, volume = {}, number = {}, pages = {}, pmid = {41535708}, issn = {1745-7254}, abstract = {Cerebral edema is a severe complication following ischemic stroke. Recent studies have highlighted the crucial role of the glymphatic system (GS) in the clearance of water and macromolecules. GS dysfunction involving the disorders of AQP4 polarization may be crucial in the pathophysiology of cerebral edema. β-Hydroxybutyrate (BHB), the main component of the ketone body, has been shown to alleviate neurological deficits by restoring GS function in subarachnoid hemorrhage models and to reduce Aβ deposition in Alzheimer's disease models. In this study we investigated the effects of BHB on cerebral edema following ischemic stroke and its mechanisms. The mice were fed a ketogenic diet (KD) or a normal diet for 4 weeks before transient middle cerebral artery occlusion (MCAO). Alternatively, the mice received BHB (5 g·kg[-1]·d[-1]) or vehicle post-MCAO. By using brain section analysis, transcranial macroimaging, two-photon in vivo imaging and MRI, we demonstrated that both KD and BHB treatment significantly enhanced GS function under normal and MCAO conditions. BHB reduced cerebral edema and infarct volume post-MCAO. Notably, delayed BHB treatment initiated 10 h post-MCAO still improved GS function, but did not influence infarct volume. Furthermore, we revealed that BHB increased α1-syntrophin expression and H3K27ac levels in α1-syntrophin (Snta1) enhancer, restoring AQP4 polarization. In addition, BHB also reduced HDAC3 expression and elevated p300 expression. These results suggest that a KD and BHB treatment enhance GS function in mice and that BHB also mitigates brain edema after MCAO. The potentiation of GS function by BHB is likely mediated by the inhibition of HDAC3 activity and the increase in p300 activity, which upregulate α1-syntrophin expression and restore AQP4 polarization.}, }
@article {pmid41535445, year = {2026}, author = {Schnieder, M and von Arnim, CAF}, title = {[Polypharmacy in patients with neuropsychiatric symptoms].}, journal = {Innere Medizin (Heidelberg, Germany)}, volume = {}, number = {}, pages = {}, pmid = {41535445}, issn = {2731-7099}, abstract = {Dementia, delirium, and depression are the main geriatric psychiatric syndromes, and their prevalence is increasing significantly due to demographic aging. At the same time, multimorbidity and polypharmacy lead to increased interaction rates and a higher frequency of side effects, as well as reduced adherence. In Germany, the number of dementia cases is projected to rise from the current 1.8 million to 2.8 million by 2050. The most common etiologies are Alzheimer's disease and vascular dementia. Progressive cognitive and motor function loss often results in apraxia and dysphagia, which complicate pharmacotherapy. Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine are used therapeutically. Newly approved amyloid antibodies (lecanemab, donanemab) show efficacy in the early stages of Alzheimer's disease, but carry the risk of amyloid-associated imaging abnormalities (ARIA). Dementia is considered a predisposing risk factor for delirium, which is characterized by fluctuations in attention and consciousness. Delirogenic factors include polypharmacy as well as other medications such as opioids and benzodiazepines. Due to the increased risk of mortality and stroke, neuroleptics should only be administered to geriatric patients when strictly indicated, in minimal doses, and for a limited duration. Non-pharmacological interventions take precedence. Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatment for depressive disorders in older adults, while tricyclic antidepressants should be avoided. Regular medication reviews, reduction of anticholinergic burden, and technical aids to facilitate medication intake are essential for optimizing treatment adherence.}, }
@article {pmid41533472, year = {2026}, author = {Shah, A and Kalu, U and Chen, D and Slomkowski, M and Hobart, M and Such, P and Grossberg, GT}, title = {Brexpiprazole side-effect profile in people with agitation in Alzheimer's dementia: a plain language summary.}, journal = {Current medical research and opinion}, volume = {}, number = {}, pages = {1-3}, doi = {10.1080/03007995.2025.2608578}, pmid = {41533472}, issn = {1473-4877}, }
@article {pmid41533031, year = {2026}, author = {Tan, FHP and Najimudin, N and Azzam, G and Zainuddin, A and Shamsuddin, S and Mohd Kasihmuddin, MS}, title = {Geroprotective effects of Salvianolic acid A through redox and detoxification pathway activation in an aging Drosophila Alzheimer's model.}, journal = {Biogerontology}, volume = {27}, number = {1}, pages = {39}, pmid = {41533031}, issn = {1573-6768}, mesh = {Animals ; *Alzheimer Disease/metabolism/drug therapy/genetics ; Drosophila melanogaster ; Disease Models, Animal ; *Aging/drug effects/metabolism ; Oxidation-Reduction ; Animals, Genetically Modified ; Oxidative Stress/drug effects ; Amyloid beta-Peptides/metabolism/genetics ; *Caffeic Acids/pharmacology ; *Lactates/pharmacology ; Humans ; *Neuroprotective Agents/pharmacology ; Longevity/drug effects ; Peptide Fragments ; }, abstract = {Alzheimer's disease (AD) is characterized by the accumulation of amyloid-β42 (Aβ42) neurotoxic peptides that cause oxidative stress and neurodegeneration. The current study examined the neuroprotective properties of salvianolic acid A (SalA), an antioxidant polyphenol, in a Drosophila melanogaster model of AD. Transgenic flies expressing human Aβ42 were assayed for eye morphology, life span, and locomotor function after SalA diet supplementation. RNA-seq and RT-qPCR were used to quantify transcriptional regulation with SalA treatment. Aβ42 expression resulted in classic AD phenotypes, including retinal degeneration, shortened lifespan, and compromised climbing ability. Partial rescue of the rough-eye phenotype, significant prolongation of lifespan, and improved locomotor function in aging flies were induced by SalA treatment. Transcriptome profiling showed the upregulation of glutathione metabolism-associated, cytochrome P450 activity-associated, and antioxidant defence-associated genes, while muscle development-associated, cell adhesion-associated, and apoptosis-associated genes were downregulated. Network analysis identified a SalA-responsive gene module enriched in detoxification and immune pathways that was conducive to enhanced cellular resistance to Aβ42 toxicity. These findings identify a redox-regulated aging mechanism whereby SalA maintains neuronal and systemic homeostasis during aging. SalA inhibits Aβ42-induced neurotoxicity in Drosophila via promoting redox equilibrium and detoxification. These findings present SalA as a potential multi-target lead drug for AD and other age-related neurodegenerative diseases.}, }
@article {pmid41531988, year = {2025}, author = {Benin, BM and Hillyer, T and Csubak, BA and Aguirre, N and Dengler-Crish, CM and Kang, C and Shin, WS}, title = {Investigation of Three Flavonoids as Potent Tau Aggregation Inhibitors and In vivo Demonstration of Myricetin.}, journal = {Pharmacological research. Natural products}, volume = {9}, number = {}, pages = {}, pmid = {41531988}, issn = {2950-1997}, support = {R01 AG076699/AG/NIA NIH HHS/United States ; R03 NS135326/NS/NINDS NIH HHS/United States ; }, abstract = {Neurodegenerative disorders, including Alzheimer's disease (AD), are characterized by the formation and propagation of neurotoxic tau aggregates, which arise from the misfolding and subsequent aggregation of tau proteins into fibrillary structures. While tau-targeting agents represent a promising therapeutic strategy for the prevention and treatment of various neurodegenerative diseases, they currently constitute a limited subset of the treatments undergoing clinical trials. In this study, we report the potent anti-aggregation and filament disassembly effects of three flavonols: myricetin, quercetagetin, gossypetin. We observed remarkable nanomolar-to-low-micromolar 50% inhibitory concentrations (0.57-1.21μM) and low 50% disassembly concentrations (7.5-14μM) using tau seeds derived from AD mouse model brains. Furthermore, we validated that myricetin treatment was associated with a reduction in overall phosphorylated tau (p-Tau) burden in vivo in the 3xTg AD mouse model. Notably, these reductions were associated with enhanced performance in Y-maze assessments of spatial learning and memory, supporting further preclinical evaluation, including direct brain pharmacokinetic studies and mechanism-driven investigations relevant to tauopathy therapy.}, }
@article {pmid41531938, year = {2026}, author = {Mandloi, U and Giri, N and Kumar, S and Modi, G}, title = {Theranostic advances in Alzheimer's disease: structure-guided design of near-infrared fluorescent probes targeting amyloid-β and cholinergic dysfunction.}, journal = {RSC medicinal chemistry}, volume = {}, number = {}, pages = {}, pmid = {41531938}, issn = {2632-8682}, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disorder, with unmet clinical challenges due to the lack of early diagnosis and an efficient treatment. Theranostics, an integrated approach that combines diagnosis and therapy, has emerged as a viable option, particularly with the use of near-infrared fluorescence probes (NIRFPs), which allow real-time in vivo imaging and therapeutic monitoring. This review article discusses recent breakthroughs in the rational design of alkene-bridged donor-π-acceptor (D-π-A) NIRFPs that target AD hallmarks such as amyloid-β (Aβ) aggregation and cholinergic dysfunction. We specifically focused on multifunctional probes like THK-565 (fluorescent compound), and a dihydrotetramethyl-indocyanine theranostic near-infrared probe (DTNP), which exhibit high blood-brain barrier (BBB) permeability, target selectivity, and dual imaging/therapeutic capabilities. Furthermore, emerging probes can distinguish between Aβ and cholinesterase (ChEs) with high resolution and low toxicity. Together, these molecular imaging technologies provide a game-changing platform for detection of early-stage AD and multiple intervention approaches. We explore structure-activity connections, molecular processes, and future directions for the clinical translation of NIRFP-based theranostic agents in AD.}, }
@article {pmid41531926, year = {2025}, author = {Jerath, R and Malani, V}, title = {The fading self in space-disruption of default spatial representation across neurological disorders.}, journal = {Frontiers in systems neuroscience}, volume = {19}, number = {}, pages = {1655500}, pmid = {41531926}, issn = {1662-5137}, abstract = {Neurological disorders stem from an intermingled change to self-in-space. While many of these disorders present as spatial deficits-contralateral neglect syndrome, for example-they manifest from the same etiology: disruption to the brain's "default spatial representation" (DSR). DSR is a basic internally generated representation of space that delineates where the self is located in space-without attentional focus from an external drive. We review how pathologic disintegration of DSR is associated with anomalous activation and connectivity within distinct large-scale brain networks (e.g., the default mode network and a comprehensive attention-networked system), leading to a heterogeneous presentation of clinically assessed outcomes. The outcomes include psychogenic paralysis of limbs, left-side neglect, rectified sense of other locations, disorders of consciousness, symptoms related to autism spectrum disorder, Alzheimer's disease, schizophrenia, and depersonalization/derealization disorder. By consolidating evidence from neuroimaging, lesion-symptom mapping, and computational assessment, we aim to reconceptualize these disorders not as separate and independent maladies, but as manifestations of a deeper, shared etiology, supporting a network-based assessment strategy for diagnosis and treatment that seeks to restore self-in-space.}, }
@article {pmid41531784, year = {2025}, author = {Zhang, Y and Ren, Y and Zhu, X and Liu, T and Han, R and Fang, Y and Zhao, Z and Mao, F and Wang, Y and Li, X and Li, X}, title = {Research Progress on Idebenone in Neurodegenerative Diseases.}, journal = {Aging medicine (Milton (N.S.W))}, volume = {8}, number = {6}, pages = {624-633}, pmid = {41531784}, issn = {2475-0360}, abstract = {In recent years, significant progress has been made in understanding the therapeutic potential of idebenone (IDE), a synthetic analogue of Coenzyme Q10, in neurodegenerative diseases (NDs). This review comprehensively examines the pharmacological properties of IDE and its emerging applications in various NDs, with particular emphasis on Alzheimer's disease, Parkinson's disease, Friedreich's ataxia, and Huntington's disease. We elucidate IDE's multifaceted neuroprotective mechanisms, including its potent antioxidant activity that reduces reactive oxygen species production, its ability to enhance mitochondrial bioenergetics, and its regulatory effects on cellular metabolism. Additionally, we critically evaluate current clinical research findings and discuss the translational potential of IDE in ND therapeutics. The accumulated evidence strongly supports IDE as a promising mitochondrial-targeted agent capable of mitigating disease symptoms and modifying disease progression in multiple neurodegenerative disorders. This review highlights both the current achievements and future directions for IDE-based interventions in ND treatment.}, }
@article {pmid41531459, year = {2025}, author = {Fischer, BL and Van Hulle, CA and Norton, DL and Wyman, MF and Ennis, G and Lambrou, NH and Bouges, S and Gooding, DC and Gleason, CE}, title = {Mild Behavioral Impairment is Associated With Incident Cognitive Decline Among Dementia-Free, Racially Diverse Older Adults: Data From the African Americans Fighting Alzheimer's in Midlife (AA-FAIM) Study.}, journal = {The American journal of geriatric psychiatry. Open science, education, and practice}, volume = {8}, number = {}, pages = {43-53}, pmid = {41531459}, issn = {2950-3868}, support = {R01 AG074231/AG/NIA NIH HHS/United States ; R01 AG062307/AG/NIA NIH HHS/United States ; R56 AG062307/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; R01 AG054059/AG/NIA NIH HHS/United States ; }, abstract = {OBJECTIVES: To determine whether MBI associates with worse cognitive performance over time and with incident cognitive decline in an older, racially/ethnically diverse cohort at early stages of cognitive change.
DESIGN: This observational cohort study followed participants from the Wisconsin Alzheimer's Disease Research Center Clinical Core (WADRC) for up to 13 visits.
SETTING: An urban university research center.
PARTICIPANTS: Participants from the WADRC Clinical Core were included in this convenience sample if they were without dementia, had undergone at least 1 cognitive assessment, and completed measures of cognitive, clinical and affective function.
MEASUREMENTS: MBI was assessed using the Neuropsychiatric Inventory. Linear mixed effects models (LME) were fit to cognitive outcomes Trailmaking Tests A and B (TMT-A, B) and Wechsler Logical Memory (LM). Cox proportional hazard models assessed whether MBI was related to risk for incident global Clinical Dementia Rating Scale (CDR >0).
RESULTS: N = 584 participants with mean age 64.6 years, range 46-92.6 years, 59.4% female and 17% African American. LME results indicated participants with MBI exhibited worse age-associated decline on TMT-B, compared to those without MBI (beta=0.008, p = 0.01, CI: 0.002, 0.01, t(337) = 2.4, p = 0.01). MBI at baseline was associated with a significant hazard ratio (HR) indicating an increased risk of decline on the CDR (HR: 2.84; HR 95% CI: 1.68 - 4.81; p = 0.0001).
CONCLUSIONS: MBI associated with worse cognitive performance and incident cognitive decline in a racially diverse, older adult sample at early stages of cognitive change. Increased awareness of the late life emergence of neuropsychiatric symptoms is warranted to assist in identification and improve prognostication and treatment of neurodegenerative disease.}, }
@article {pmid41531227, year = {2026}, author = {Samudra, N and Vemuri, M and Weitlauf, J}, title = {Menopause, cognition, and Alzheimer's disease risk.}, journal = {Current opinion in obstetrics & gynecology}, volume = {}, number = {}, pages = {}, doi = {10.1097/GCO.0000000000001087}, pmid = {41531227}, issn = {1473-656X}, abstract = {PURPOSE OF REVIEW: Cognitive symptoms are common throughout the menopause transition. This review outlines a comprehensive clinical approach, grounded in recent findings, to guide clinicians in addressing menopause-related cognitive concerns and neurodegenerative disease risk for midlife women.
RECENT FINDINGS: Research highlights the benefits of lifestyle and psychosocial interventions for cognitive symptoms during the menopause transition. Addressing underlying medical and mental health conditions, as well as difficulties with sleep, chronic stress, and vasomotor symptoms, can ameliorate symptoms and reduce risk for future dementia. Cognitive changes during the menopause transition do not typically indicate dementia. A subset of women, including apolipoprotein ε4 (APOE ε4) carriers and those who experience early menopause, face heightened risk. Alzheimer's disease biomarkers are clinically available and may change in some women during the menopause transition, particularly in APOE ε4 carriers, but our understanding of these changes, as well as their relationship to menopause hormone therapy, is evolving. There is presently insufficient evidence for the role of menopause hormone therapy for the treatment of menopause-related cognitive symptoms or neurodegenerative disease prevention.
SUMMARY: While typically transient, cognitive symptoms in menopause can benefit from addressing comorbid medical and psychosocial conditions. Research into dementia risk related to changes in the menopause transition is ongoing.}, }
@article {pmid41530949, year = {2026}, author = {Chen, Y and Liu, Y}, title = {Eosinophils: Pathological Mechanisms and Novel Targeted Therapeutic Strategies Across Multiple Disease Spectrums.}, journal = {Journal of leukocyte biology}, volume = {}, number = {}, pages = {}, doi = {10.1093/jleuko/qiag009}, pmid = {41530949}, issn = {1938-3673}, abstract = {Eosinophils are a type of white blood cell belonging to the granulocyte family. Their cytoplasm contains eosinophilic granules that hold various biologically active substances. They perform diverse functions, participating in inflammatory responses, immune defense, and tissue repair. Eosinophils are implicated in the pathogenesis of multiple diseases, including infectious diseases, allergic disorders, and hematological conditions. Moreover, increasing research in recent years has revealed significant associations between eosinophils and autoimmune diseases, solid tumors, coronary atherosclerotic heart disease, and even Alzheimer's disease. They participate in disease onset and progression through the release of toxic proteins, cytokines, and chemokines, as well as through interactions with other cells. Focusing on the biological characteristics and functions of eosinophils facilitates the elucidation of disease mechanisms associated with related disorders. This, in turn, provides further direction for eosinophil-targeted research and therapeutic strategies, including the research and development of drugs that modulate their function, targeted therapies, immunotherapies, and cell therapies. This paper provides a comprehensive review of the structure, function, and role of eosinophils in related diseases, along with potential future therapeutic strategies. It aims to deepen the understanding of researchers and clinicians, thereby facilitating their application in further research, as well as in clinical disease diagnosis and treatment analysis.}, }
@article {pmid41530554, year = {2026}, author = {Taylor, WD and Gerlach, AR and Szymkowicz, SM and Gujral, S and Andreescu, C}, title = {Remission is insufficient: predictors and mechanistic models of recurrence in late-life depression.}, journal = {Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41530554}, issn = {1740-634X}, support = {R01 MH121620/MH/NIMH NIH HHS/United States ; R01 MH123662/MH/NIMH NIH HHS/United States ; R33 MH122464/MH/NIMH NIH HHS/United States ; K01 MH133913/MH/NIMH NIH HHS/United States ; K23 MH125074/MH/NIMH NIH HHS/United States ; R01 MH108509/MH/NIMH NIH HHS/United States ; R01 MH121619/MH/NIMH NIH HHS/United States ; }, abstract = {While achieving remission is the goal of acute antidepressant treatment, recurrence of new depressive episodes following remission is unfortunately common in clinical populations with Major Depressive Disorder, including older adults with Late-Life Depression (LLD). The neurobiological factors underlying this risk are poorly understood, limiting our ability to identify potential preventive mechanistic targets. Beyond the limited prognostic utility achieved from individual psychiatric history, it remains challenging to clinically stratify individual risk. This review examines factors influencing the recurrence of depressive episodes following remission in LLD, focusing on cognitive, behavioral, social, and environmental aspects. It additionally considers neuroimaging-based biomarkers related to recurrence risk as well as discussing evidence for and limits of maintenance treatment to prevent recurrence. The paper proposes possible mechanisms contributing to recurrence, including physiological and behavioral responses to stressors, the influence of Alzheimer's disease neuropathology, and conceptualizing repeat depressive episodes within the accelerated aging hypothesis of LLD. A dynamical landscape model of depression recurrence is proposed to elucidate the interplay between different mood states, resilience, and treatment response. This synthesis then highlights avenues for future research, focusing on areas of potential significance ranging from risk stratification to tertiary prevention efforts that may improve both long-term affective and cognitive symptoms.}, }
@article {pmid41530008, year = {2026}, author = {Feldman, OJ and Herrmann, N and Ruthirakuhan, M and Gallagher, D and L G Verhoeff, NP and Kiss, A and Black, SE and Lanctôt, KL}, title = {Assessment of clinical factors that predict response to nabilone for agitation in Alzheimer's disease: A post hoc analysis of a randomized placebo-controlled trial.}, journal = {International psychogeriatrics}, volume = {}, number = {}, pages = {100183}, doi = {10.1016/j.inpsyc.2026.100183}, pmid = {41530008}, issn = {1741-203X}, abstract = {INTRODUCTION: Previously, nabilone showed a medium effect size for treating agitation in moderate-to-severe Alzheimer's disease (AD), but response varied. These post hoc analyses aimed to identify a group of clinical characteristics that predicted treatment response.
METHODS: Data from a double-blind, placebo-controlled crossover trial in AD agitation were used. Nineteen clinical characteristics were categorized (presence/absence) and evaluated for relation to agitation response (change on Cohen-Mansfield Agitation Inventory (CMAI)). Characteristics with a ≥ 8 point response difference between categories were included in a multivariable analysis model to calculate individual predicted response. Linear mixed-effects models with Satterthwaite's approximation evaluated the impact of treatment on the relationship between predicted and observed responses.
RESULTS: Thirty-nine participants (77 % male, mean [SD] age 87 [10.2], standardized Mini-Mental State Exam (sMMSE) 6.5 [6.8]) were enrolled. Variable selection identified five characteristics related to greater nabilone efficacy: higher pain (Pain Assessment in Advanced Dementia score ≥3) (difference [SE] in CMAI response = -18.8 [3.2]), greater appetite and eating disorders (-16.4 [5.5]), greater apathy (-14.0 [5.5]), less cognitive impairment (sMMSE greater than 10) (-16.5 [4.2]) and no concomitant cholinesterase inhibitors (-13.9 [4.4]). For those with a predicted response in the top tertile based on those five characteristics, 82 % responded, compared with 40 % in the lowest tertile. A treatment-by-tertile interaction (F(2,29) = 8.48, p = 0.001) indicated observed treatment response varied across tertiles.
CONCLUSION: A reliable clinical profile of persons with AD related agitation likely to respond to nabilone may be established with additional research.}, }
@article {pmid41528665, year = {2026}, author = {Kumar, A and Rakshit, D and Saharia, N and Tiwari, P and Mugale, MN and Mishra, A}, title = {Dietary Isoflavone Biochanin A Attenuates Aluminium Chloride-Induced Sporadic Alzheimer's Disease and Associated Neurobehavioral Alterations Through NRF2-HO1 Pathway Activation and NLRP3 Inflammasome Suppression.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {359}, pmid = {41528665}, issn = {1559-1182}, mesh = {Animals ; *Genistein/pharmacology/therapeutic use/administration & dosage ; Aluminum Chloride ; *Alzheimer Disease/chemically induced/metabolism/drug therapy/pathology ; *NF-E2-Related Factor 2/metabolism ; *NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; *Inflammasomes/metabolism/drug effects ; Male ; Signal Transduction/drug effects ; Mice ; Oxidative Stress/drug effects ; *Behavior, Animal/drug effects ; *Heme Oxygenase-1/metabolism ; Amyloid beta-Peptides/metabolism ; Neuroprotective Agents/pharmacology ; Mice, Inbred C57BL ; }, abstract = {Alzheimer's disease (AD), a debilitating neurodegenerative disorder, currently lacks effective curative treatments. Growing evidence implicates aluminium, a widely prevalent environmental metal, in the pathogenesis of AD due to its ability to induce oxidative stress, neuroinflammation, cholinergic dysfunction, and amyloid-beta (Aβ) deposition, ultimately leading to cognitive decline. Biochanin A (BCA), a naturally occurring isoflavone, exhibits well-documented antioxidant, anti-inflammatory, and neuroprotective activities, including acetylcholinesterase (AChE) inhibition. However, its specific therapeutic potential in AD models has remained largely unexplored. This study evaluates the protective effects of BCA against aluminium chloride (AlCl3)-induced AD-like pathology in mice. Animals received daily oral administration of AlCl3 (100 mg/kg) for 6 weeks, with or without concurrent BCA treatment (5, 10, and 20 mg/kg). During the final week, comprehensive neurobehavioral assessments were conducted. Thereafter, hippocampal tissues were analyzed for biochemical, molecular, and elemental analyses, and intact brains were examined histologically. AlCl3 exposure significantly impaired neurobehavioral performance, elevated oxidative stress, disrupted cholinergic function, intensified neuroinflammation, promoted amyloid aggregation, and induced neurodegeneration. Notably, BCA supplementation dose-dependently ameliorated these pathological alterations. BCA treatment improved neurobehavioral deficits (P < 0.05), reduced oxidative markers (P < 0.01), restored cholinergic function by lowering AChE activity (P < 0.01), attenuated inflammatory mediators (P < 0.01), reduced amyloid and aluminium deposition (P < 0.001), and alleviated AlCl3-induced neurodegeneration. Overall, our findings indicate that BCA confers neuroprotection primarily through activation of the NRF2-HO-1 signaling pathway and through suppression of the NLRP3 inflammasome, highlighting its promise as a potential therapeutic candidate for AD.}, }
@article {pmid41527747, year = {2026}, author = {Heo, RJ and Negida, A and Barrett, MJ and Chrenka, EA and Bayram, E and Kane, JPM and Werner, AM and Rossom, RC and Wyman-Chick, KA}, title = {Cholinesterase inhibitors for patients with dementia: Patterns of prescribing and disparities in treatment.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251411418}, doi = {10.1177/13872877251411418}, pmid = {41527747}, issn = {1875-8908}, abstract = {BackgroundCholinesterase inhibitors (ChEIs) are cornerstones of the symptomatic treatment of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) and are also prescribed for vascular dementia (VaD). Despite their widespread use, patterns of ChEI prescribing are unclear.ObjectiveOur objective was to examine the prevalence, timing, and types of ChEI prescriptions before and after dementia diagnosis.MethodsWe analyzed electronic health record and claims data for patients diagnosed with AD, DLB, or VaD between October 2015 and August 2022 from a large U.S. healthcare system. ChEI claims (donepezil, rivastigmine, galantamine) were identified in the ±3 years surrounding dementia diagnosis. Repeated measures logistic regression was used to estimate the likelihood of ChEI fills by time-period, dementia type, and time x dementia type interaction to determine if change in prescription patterns significantly differed by diagnosis.ResultsAmong 3166 eligible patients, DLB had the highest prevalence of ChEIs both pre-and post-diagnosis compared to patients with AD and VaD. Post-diagnosis, donepezil was the most common, while galantamine use was sparse. After adjusting for demographics, patients with VaD had lower rates of ChEIs relative to AD (OR: 0.34, 95% CI 0.26-0.45). In the fully adjusted model, females (OR: 0.81, 95% CI: 0.71-0.91) and patients from ethnoracially minoritized populations (OR: 0.74, 95% CI: 0.62-0.88) were less likely to fill ChEI prescriptions.ConclusionsDonepezil was the most frequently filled ChEI across dementias. Patients with DLB had the highest prevalence of ChEIs pre- and post-diagnosis. The potential disparities in treatment we identified should be investigated further.}, }
@article {pmid41527739, year = {2026}, author = {Le, J and Hu, X and Jiang, Y and Wang, Q and Ma, Q and Cui, W}, title = {Insights into phosphoproteomic studies and prospects of phosphoproteins as biomarkers for brain disorders.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251411546}, doi = {10.1177/13872877251411546}, pmid = {41527739}, issn = {1875-8908}, abstract = {The dysregulation of phosphorylation networks plays a critical role in the pathogenesis of a wide spectrum of brain disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, traumatic brain injury, ischemic stroke, drug abuse, major depressive disorder, and schizophrenia. Notably, phosphorylated isoforms of microtubule-associated protein tau and neurofilament heavy polypeptide are already utilized in clinical diagnostics, highlighting the promise of protein phosphorylation signatures as biomarkers for prediction, diagnosis, prognosis, and treatment monitoring. Recent advances in deep phosphoproteomic technologies now facilitate the comprehensive mapping of phosphorylation alterations across diverse biological samples and disease stages. This review summarizes current phosphoproteomic studies aimed at identifying biomarkers for brain disorders and elaborates on the promising application of phosphorylated proteins in this context.}, }
@article {pmid41527682, year = {2026}, author = {Zohud, O and Lone, IM and Midlej, K and Iraqi, FA}, title = {The complexity of dementia development and its comorbidities: The collaborative cross-mouse population for multivarious tasks approach.}, journal = {Animal models and experimental medicine}, volume = {}, number = {}, pages = {}, doi = {10.1002/ame2.70131}, pmid = {41527682}, issn = {2576-2095}, support = {//A core fund from Tel Aviv University/ ; }, abstract = {The rising incidence of dementia and associated neurodegenerative disorders poses a growing public health challenge. These conditions have traditionally been studied as isolated central nervous system disorders; however, emerging evidence suggests that broader systemic factors, including chronic inflammation, immune dysregulation, metabolic dysfunction, and genetic susceptibility, may also play a role. This review examines the interconnection between autoimmune diseases and metabolic syndromes in the pathogenesis and exacerbation of neurodegeneration. Conditions such as rheumatoid arthritis, systemic lupus erythematosus, and type 1 diabetes mellitus have been associated with a heightened risk of developing dementia through chronic immune activation, blood-brain barrier disruption, and neuroinflammatory signaling. Similarly, metabolic disorders such as diabesity promote insulin resistance and oxidative stress, accelerating cognitive decline. The review also discusses glaucoma as a neurodegenerative condition with autoimmune features, underscoring the need for expanded classification and treatment strategies. A key focus is the utilization of the Collaborative Cross (CC) mouse model, which enables the study of gene-environment interactions across genetically diverse backgrounds. Findings from CC mice reveal strain-dependent susceptibility to inflammation, cognitive impairment, and gut-brain axis dysfunction, providing a translational bridge to human variability. This review highlights the importance of integrating precision-based approaches to dementia research that consider systemic influences. Advancing our understanding of these multiorgan interactions holds potential for designing precision-based therapeutic approaches to postpone the onset or reduce the incidence of neurodegenerative conditions.}, }
@article {pmid41527663, year = {2025}, author = {Barbati, SA and Carota, G and Partsinevelos, K and Di Pietro, L and Privitera, A and Cardaci, V and Graziani, A and Mangione, R and Lazzarino, G and Tavazzi, B and Di Pietro, V and Maiani, E and Bellia, F and Amorini, AM and Lazzarino, G and Baba, SP and Caruso, G}, title = {Preclinical evidence and therapeutic perspectives on carnosine for the treatment of neurodegenerative disorders.}, journal = {AIMS neuroscience}, volume = {12}, number = {4}, pages = {444-513}, pmid = {41527663}, issn = {2373-7972}, abstract = {Carnosine (β-alanyl-L-histidine) is an endogenous dipeptide widely distributed in mammalian tissues, especially skeletal and cardiac muscle cells, and, to a lesser extent, in the brain. While early interest in carnosine was given because of its role in muscle cell metabolism and athletic performance, it has more recently gained attention for its potential application in several chronic diseases. Specifically, brain aging and neurodegenerative disorders have received particular attention, as a marked reduction in carnosine levels has been described in these conditions. Carnosine exerts a wide range of biological activities, including antioxidant, anti-inflammatory, anti-glycation, metal-chelating, and neuroprotective properties. Mechanistically, it acts by inhibiting the production of advanced glycation end products (AGEs), buffering cellular pH, and regulating intracellular nitric oxide signaling and mitochondrial function. Its safety profile, the lack of toxicity, and significant side effects support its application for long-term therapeutic use. In this review, we aim to recapitulate and discuss the effects, dosages, and administration routes of carnosine in preclinical in vivo models, with a particular focus on neurodegenerative disorders where it has been shown to reduce oxidative stress, suppress neuroinflammation, modulate protein aggregation, and preserve cognitive function, all key features of neurodegeneration. Despite promising findings, there are gaps in the knowledge on how carnosine affects synaptic plasticity, neuronal remodeling, and other processes that play a central role in the pathophysiology of neurodegenerative disorders. Additionally, clinical translation remains challenging due to inconsistencies across in vivo studies in terms of dosage, treatment duration, routes of administration, and disease models, which affect reproducibility and cross-study comparability. Therefore, while carnosine emerges as a multifunctional and well-tolerated molecule, further research is needed to clarify its therapeutic relevance in human diseases. In this review, we also address future perspectives and key methodological challenges that must be overcome to effectively translate carnosine's biological potential into clinical practice.}, }
@article {pmid41527522, year = {2026}, author = {Richardson, TI and Klein, RC and Huang, K and Zhang, J and Mesecar, AD and Dage, JL and Clayton, B and Lamb, BT and Palkowitz, AD}, title = {Next-generation Alzheimer's therapeutics: target assessment and enablement at the Indiana University School of Medicine-Purdue University TREAT-AD Center.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e70964}, pmid = {41527522}, issn = {1552-5279}, support = {U54AG065181/AG/NIA NIH HHS/United States ; }, mesh = {*Alzheimer Disease/drug therapy ; Humans ; *Drug Discovery/methods ; Indiana ; United States ; National Institute on Aging (U.S.) ; Schools, Medical ; }, abstract = {The incidence of Alzheimer's disease (AD) continues to increase, despite decades of effort to develop disease-modifying therapies. In response, the National Institute on Aging (NIA) established the TaRget Enablement to Accelerate Therapy Development for Alzheimer's Disease (TREAT-AD) centers to address the gap between basic research and translational drug discovery. Situated within a robust AD research environment, the Indiana University School of Medicine (IUSM)-Purdue University TREAT-AD Center is one of two National Institutes of Health (NIH)-supported centers funded to accomplish this mission. With a focus on novel biological targets beyond amyloid and tau, our center has assembled the necessary components of a drug discovery engine: project and data management, bioinformatics and computational science, structural biology and biochemistry, assay development and pharmacology, and molecular design and synthesis of small molecules, antibodies, and oligonucleotides. Our objective is to deliver Target Enabling Packages (TEPs) within an open science framework, making data, methods, and research tools broadly accessible through the AD Knowledge Portal. HIGHLIGHTS: The Indiana University School of Medicine (IUSM)-Purdue TREAT-AD Center develops Target Enabling Packages (TEPs) to advance novel targets for the treatment of Alzheimer's disease (AD). The center is overseen by an administrative core and operates through four technical cores - bioinformatics, structural biology, assay development, and medicinal chemistry - within a milestone-driven and open science framework. Multi-omics, systems biology, and machine learning (ML) approaches guide the nomination of high-priority targets beyond amyloid and tau. Cross-core workflows provide structural insights into novel biological targets, validated assays, biomarkers, and molecular probes that enable lead optimization. All data, methods, and tools are openly shared through the AD Knowledge Portal to accelerate global efforts in AD drug discovery.}, }
@article {pmid41527496, year = {2026}, author = {Kalita, T and Shakya, A and Ghosh, SK and Singh, UP and Bhat, HR}, title = {Microwave-Assisted Synthesis and In Vitro Anti-Alzheimer Evaluation of Novel 1,3,5-Triazine-Nicotinic Hydrazide Derivatives as Acetylcholinesterase and Butyrylcholinesterase Inhibitors.}, journal = {Journal of biochemical and molecular toxicology}, volume = {40}, number = {1}, pages = {e70685}, doi = {10.1002/jbt.70685}, pmid = {41527496}, issn = {1099-0461}, mesh = {*Cholinesterase Inhibitors/pharmacology/chemical synthesis/chemistry ; *Butyrylcholinesterase/metabolism/chemistry ; *Alzheimer Disease/drug therapy/enzymology ; *Acetylcholinesterase/metabolism/chemistry ; Animals ; Humans ; *Triazines/chemistry/pharmacology/chemical synthesis ; *Microwaves ; Cell Line, Tumor ; Molecular Docking Simulation ; Male ; *Hydrazines/chemistry/pharmacology/chemical synthesis ; Rats ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder posing major global health challenges due to its complex pathophysiology and increasing prevalence among the elderly. In the present work, the molecular hybridization technique was utilized to design and synthesize nicotinic hydrazide-1,3,5-triazine hybrids. Accordingly, this study aimed to design, perform in silico screening, synthesize, and evaluate the in vitro and in vivo anti-AD potential of the proposed compounds. Docking studies revealed that the compounds displayed key interactions with catalytic site and peripheral anionic site residues. Based on binding affinity, ten compounds were synthesized and characterized using different spectroscopic techniques. In vitro AChE and BChE inhibitory assays revealed that the compound 4A36 showed the highest inhibitory ability with log IC50 values of 5.97 μM against AChE and 4.57 μM against BChE. In addition, cytotoxicity screening revealed that 4A36 was non-toxic in SH-SY5Y neuroblastoma cells in the concentration range of 15.625-250 µg/mL. Acute oral toxicity evaluation of the compound revealed no adverse effects up to 175 mg/kg b.w. Further, in vivo studies using the scopolamine-induced model further validated the therapeutic promise of the compound. At a dose of 30 mg/kg b.w., the compound demonstrated significant improvements in learning and memory, reduced MDA levels with concurrent elevation of antioxidant enzymes SOD and Catalase, and reduced AChE activity in hippocampal tissue. Histopathological observations revealed that treatment groups, especially at higher dose (30 mg/kg b.w.), preserved the granular layer of the dentate gyrus and improved neuronal integrity compared to the disease control. These findings indicate that 4A36 at a dose of 30 mg/kg b.w. may be considered as a promising lead compound in AD.}, }
@article {pmid41527161, year = {2026}, author = {Cheng, CM and Tsai, MJ and Tseng, CC and Lin, YS and Lin, YS and Chen, LY and Liu, MN and Fuh, JL}, title = {Pharmacological management of agitation in dementia: An evidence-based review with expert consensus.}, journal = {Journal of the Chinese Medical Association : JCMA}, volume = {}, number = {}, pages = {}, doi = {10.1097/JCMA.0000000000001342}, pmid = {41527161}, issn = {1728-7731}, abstract = {Agitation is a frequently occurring and challenging neuropsychiatric symptom of Alzheimer's disease (AD) that substantially affects quality of life, caregiver burden, and healthcare utilization. Non-pharmacological interventions, especially trigger identification, environmental adjustments, and supportive activities, remain the first-line approach for treating agitation. Pharmacological treatment should be considered only when non-drug measures are insufficient or when agitation causes severe distress or safety risks. This consensus integrates evidence up to June 2025, the Taiwan Ministry of Health and Welfare approvals, and Taipei Veterans General Hospital expert opinion. Among the approved agents, brexpiprazole demonstrated the strongest evidence and most favorable safety profile. Risperidone and aripiprazole are effective, but require careful monitoring for cerebrovascular and extrapyramidal risks. Selected antidepressants, particularly citalopram and agomelatine, should be considered when safety is prioritized. Anticonvulsants, acetylcholinesterase inhibitors, and memantine have limited efficacy and should be reserved for refractory cases. Long-term or routine pharmacological use is not supported by current evidence. Future research should focus on identifying responsive patient subgroups, optimizing dosing strategies, and integrating medications into individualized, multidisciplinary care plans.}, }
@article {pmid41526725, year = {2026}, author = {Li, R and Berlowitz, D and Mez, J and Silver, B and Wang, X and Hu, W and Goodwin, R and Keating, H and Liu, W and Lin, H and Yu, H}, title = {Early prediction of Alzheimer's disease using longitudinal electronic health records of US military veterans.}, journal = {Communications medicine}, volume = {6}, number = {1}, pages = {23}, pmid = {41526725}, issn = {2730-664X}, support = {I01 HX003711/HX/HSRD VA/United States ; I01 HX003969/HX/HSRD VA/United States ; R01 AG080670/AG/NIA NIH HHS/United States ; R01 DA056470/DA/NIDA NIH HHS/United States ; }, abstract = {BACKGROUND: Early prediction of Alzheimer's disease is important for timely intervention and treatment. We examine whether machine learning on longitudinal electronic health record notes can improve early prediction of Alzheimer's disease.
METHODS: From Veterans Health Administration records (2000 to 2022), we studied 61,537 individuals diagnosed with Alzheimer's disease and 234,105 without, aged 45-103 years, 98.4% were male. From clinical notes, we quantified the frequency of subjective cognitive decline and Alzheimer's disease-related keywords, and applied statistical machine learning models to assess their ability to predict future diagnosis.
RESULTS: Here we show that Alzheimer's-related keywords (e.g., "concentration," "speaking"), occur more often in notes of individuals who later develop Alzheimer's disease than in controls. In the 15 years preceding diagnosis, cases demonstrate an exponential increase in keyword mentions (from 9.4 to 57.7 per year), whereas controls show a slower, linear increase (8.2 to 20.3). These trends are consistent across demographic subgroups. Random forest models using these keywords for prediction achieve an area under receiver operating characteristic curve from 0.577 at ten years before diagnosis to 0.861 one day before diagnosis, consistently outperforming models using only structured data.
CONCLUSIONS: Signs and symptoms of early Alzheimer's disease are reported in clinical notes many years before a clinical diagnosis is made and the frequency of these signs and symptoms, approximated by keywords, increases the closer one is to the diagnosis. A simple keyword-based approach can capture these signals and can help identify individuals at high risk of future Alzheimer's disease.}, }
@article {pmid41524953, year = {2026}, author = {O'Mara, A and Mody, BP and Mammi, M and Simjian, T and Ghattas, K and Kaliki, S and Le, NPM and Liew, A and Migliore, M and Mekary, RA}, title = {The effect of GLP-1 receptor agonists on cognition in nondiabetic patients with mild cognitive impairment or alzheimer's disease: a meta-analysis of randomized controlled trials.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {47}, number = {1}, pages = {149}, pmid = {41524953}, issn = {1590-3478}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; *Cognitive Dysfunction/drug therapy ; *Glucagon-Like Peptide-1 Receptor Agonists ; Randomized Controlled Trials as Topic ; *Cognition/drug effects ; }, abstract = {BACKGROUND: Currently, the cognitive impact of Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) remains unclear in non-diabetic patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI), despite their widespread use for type 2 diabetes. This meta-analysis summarized cognitive outcomes from randomized controlled trials (RCTs) of GLP-1 RAs in non-diabetic patients with AD or MCI.
METHODS: PubMed, Cochrane Library, and Embase were searched for studies through October 27, 2024. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using random-effects models. Sensitivity analyses addressed variations in cognitive assessment methodologies. Between-study heterogeneity was evaluated using the I² index.
RESULTS: Four RCTs comprising 112 patients (61 placebo, 51 treatment) were included. For cognitive tests where higher scores indicate better outcomes, no significant difference was observed between GLP-1 RA and placebo groups (pooled SMD: -0.10, 95% CI: -0.53, 0.34; I² = 23.9%). Sensitivity analyses yielded consistent results. Analysis of the Alzheimer's Disease Assessment Scale-Cognitive subscale from two studies, where lower scores indicate better outcomes, similarly showed no significant treatment effect (SMD: 0.07, 95% CI: -0.47, 0.62; I² = 0%).
CONCLUSION: There was no evidence that GLP-1 RAs improved cognitive outcomes compared to placebo in non-diabetic patients with AD or MCI. Further research is needed to clarify their neuroprotective potential and explore alternative therapeutic strategies for cognitive decline.}, }
@article {pmid41524814, year = {2026}, author = {Tripathi, P and Shah, J}, title = {Valacyclovir Mitigates Amyloid Plaque Deposition, P-Tau Aggregation, and Neuroinflammation in Streptozotocin induced Alzheimer's Disease Rat Model.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {356}, pmid = {41524814}, issn = {1559-1182}, support = {GSBTM/MD/PROJECTS/SSA/4887/2016-17//Gujarat State Biotechnology Mission, Government of Gujarat, India./ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/chemically induced/metabolism/pathology ; *tau Proteins/metabolism ; Streptozocin ; Male ; *Valacyclovir/pharmacology/therapeutic use ; Disease Models, Animal ; *Plaque, Amyloid/drug therapy/metabolism/pathology ; *Neuroinflammatory Diseases/drug therapy/metabolism/pathology ; Rats ; Amyloid beta-Peptides/metabolism ; Rats, Wistar ; *Protein Aggregates/drug effects ; Neuroprotective Agents/pharmacology/therapeutic use ; Oxidative Stress/drug effects ; }, abstract = {Alzheimer's Disease (AD), a leading cause of dementia, is a known neurodegenerative disorder. Affecting millions of people worldwide, AD pathogenesis involves diverse risk factors such as lifestyle, environmental, and metabolic conditions that accelerate sporadic AD. Very recently, backed with substantial evidence, herpes simplex virus-1 (HSV-1) has been recognized as a potential causative factor that may play a pivotal role in sporadic AD. Latent virus is estimated to activate key underlying pathways, preferably Aβ and p-tau, to cause AD. Additionally, Antivirals such as Valacyclovir have emerged to impart a potential neuroprotective role in AD. Present research aimed to explore the neuroprotective role and mechanism of Valacyclovir in the streptozotocin-induced Alzheimer's disease model in rats. A single dose of 3 mg/kg ICV (intracerebroventricular) Streptozotocin (STZ) was administered to induce AD in rats. Two doses of Valacyclovir, i.e., 100 mg/kg and 150 mg/kg were evaluated with Donepezil 5 mg/kg as standard. Post 21 days of treatment, Valacyclovir demonstrated dose-dependent improvement in neurobehavioral parameters. Further, AD-specific parameters i.e. Aβ1-40 and Aβ1-42, p-tau, and BACE-1 were significantly (p < 0.001) reduced with parallel reduction in inflammatory (p < 0.001) and oxidative stress markers. Additionally, Valacyclovir also increased the levels of amyloid clearance enzymes i.e., neprilysin (NEP) (p < 0.001) and insulin-degrading enzyme (IDE) (p < 0.001). Results suggest promising neuroprotective action of valacyclovir via reducing Aβ-amyloid protein, p-Tau, BACE-1, as well as demonstrating anti-inflammatory and antioxidant activity.}, }
@article {pmid41524585, year = {2026}, author = {Hu, G and Li, W and Lei, X and Yao, Y and Ye, S}, title = {Aloe-emodin attenuated Aβ-induced tau phosphorylation by autophagy-NLRP3 inflammasome pathway.}, journal = {Neuroreport}, volume = {}, number = {}, pages = {}, doi = {10.1097/WNR.0000000000002246}, pmid = {41524585}, issn = {1473-558X}, support = {82205235//the National Natural Science Foundation of China/ ; 2022AH050502//The Key Project Foundation of Natural Science Research of Anhui University of Chinese Medicine/ ; 2022rcyb028//The Talent Support Program of Anhui University of Traditional Chinese Medicine/ ; YQYB2024028//Anhui Province 2024 Action Project for Training Young and Middle aged Teachers in Universities/ ; }, abstract = {OBJECTIVE: Anthraquinone derivative aloe-emodin, extracted from Chinese herbs has been confirmed with various pharmacological effects, including anti-inflammatory and neuroprotective properties, particularly in Alzheimer's disease, but the exact mechanism of action remains unclear.
METHODS: In this study, the PC12 cells were induced by amyloid β-protein (Aβ) to establish an in vitro model of Alzheimer's disease. The 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide, 5-ethynyl-2'-deoxyuridine staining, transmission electron microscopy, real-time quantitative PCR, western blot, ELISA, coimmunoprecipitation (Co-IP), and immunofluorescence were employed to evaluate effect of aloe-emodin on the survival and expression of related genes and proteins in PC12 cells induced by Aβ.
RESULTS: We found that 5 μM aloe-emodin significantly enhanced cell survival and proliferation. It also increased the mRNA and protein expression of Beclin-1 and LC3II, while decreasing the mRNA expression of P62, PI3K, AKT, mechanistic target of rapamycin (mTOR), NOD-like receptor protein 3 (NLRP3), and caspase-1, as well as the protein expression of P62, NLRP3, cleaved-caspase-1, p-PI3K, p-AKT, p-mTOR, interleukin-18 (IL-18), and IL-1β. Additionally, aloe-emodin reduced the intensity of p-tau fluorescence. The Co-IP results demonstrated a direct interaction between NLRP3 and LC3. Interestingly, aloe-emodin exhibited effects comparable to those of RAPA, an mTOR inhibitor.
CONCLUSION: These findings demonstrate that aloe-emodin offers neuroprotective benefits by reducing NLRP3-mediated inflammation and promoting autophagy, thereby providing a novel perspective on the treatment of Alzheimer's disease.}, }
@article {pmid41524357, year = {2025}, author = {Guzanova, EV and Zorkova, AV and Sorokina, TA and Goncharov, VV and Voronina, DS and Beschastnova, IA}, title = {[Frequency of nutritional deficiency in patients with Alzheimer's disease and Parkinson's disease].}, journal = {Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova}, volume = {125}, number = {12}, pages = {113-119}, doi = {10.17116/jnevro2025125121113}, pmid = {41524357}, issn = {1997-7298}, mesh = {Humans ; Aged ; *Parkinson Disease/complications ; *Alzheimer Disease/complications ; Male ; Female ; Middle Aged ; Aged, 80 and over ; *Malnutrition/epidemiology/etiology/diagnosis/diet therapy ; Nutritional Status ; Nutrition Assessment ; Incidence ; Body Mass Index ; }, abstract = {OBJECTIVE: To determine the incidence of nutritional deficiencies in patients with Alzheimer's disease (AD) and Parkinson's disease (PD) and, if identified, to correct them.
MATERIAL AND METHODS: 111 patients with neurodegenerative diseases AD and PD aged 50 to 89 years) were examined. Patients were examined twice: at the initial visit and 2 months later. During the first visit, a neurological examination and neuropsychological assessment were performed, and anxiety and depression levels were determined. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire, and body mass index (BMI) was calculated. For laboratory confirmation of malnutrition, hemoglobin, albumin, lipid profile, urea, and creatinine levels were assessed. All patients at risk of malnutrition were given dietary recommendations. The patient's family discussed adherence to a dietary regimen and maintaining a nutritious diet. To treat malnutrition, patients were also recommended to receive enteral nutrition supplements at a rate of 30-35 kcal/kg of body weight for outpatients (a total of at least 400 kcal/day) and 1 g of protein/kg of body weight/day. For this purpose, Fresubin protein was used, individually adjusted from 2 to 6 measuring spoons (12-36 g of protein). In the presence of dysphagia, depending on the severity of the swallowing disorder, a diet with a modified consistency was prescribed: Fresubin Cream 2 kcal, Fresubin Yogurt, Fresubin Condensed Level 2, and Fresubin Condensed Level 1. At the second visit (2 months later), treatment effectiveness was assessed.
RESULTS: Among the examined patients, AD was diagnosed in 66 (59.5%) patients, and PD in 45. (40.5%). malnutrition/risk of malnutrition was detected in 31 (28%) patients. In the group of patients with AD who had malnutrition/risk of malnutrition, 15 (62.5%) patients had malnutrition, 9 (37.5%) had the risk of malnutrition. Among patients with PD, 3 (42.9%) patients were diagnosed with malnutrition, 4 (57.1%) had the risk of malnutrition. Patients with AD who had moderate and severe dementia had significantly more often malnutrition and risk of malnutrition (p<0.05). Patients with PD at a more severe stage of the disease and, accordingly, with more pronounced movement disorders, had significantly more often malnutrition and the risk of malnutrition (p<0.05). A moderate correlation was obtained between dysphagia, oral apraxia, tooth loss, chewing disorder and malnutrition and the risk of malnutrition in patients with AD and PD (r=0.3, p<0.001). The value of laboratory parameters, such as increased creatinine, decreased albumin and hemoglobin, statistically significantly correlated with malnutrition and the risk of malnutrition (p<0.05). The study found a statistically significant association between depression, affective disorders, and malnutrition and the risk of malnutrition in patients with AD and PD (p<0.05). When examining patients malnutrition and the risk of malnutrition at the second visit, BMI increased in all patients.
CONCLUSION: Malnutrition and the risk of malnutrition occur in more than a quarter of patients with AD and PD. The risk of malnutrition increases in moderate and severe stages of the disease. Malnutrition is more common in AD compared to PD. Malnutrition and the risk of malnutrition were significantly associated with the presence of depression, affective disorders, as well as with chewing disorders, tooth loss, dysphagia, and oral apraxia. Early recognition of the risks of malnutrition is important for the timely correction of modifiable factors for the development of malnutrition, including the organization of adequate nutrition for the patient, dental prosthetics, Adjustment of the treatment regimen for the underlying disease, treatment of depressive episodes, and affective disorders. If a diagnosis of malnutrition is made, it is necessary to calculate and replenish the patient's energy and fluid needs, including the inclusion of additional enteral nutrition in the comprehensive treatment strategy.}, }
@article {pmid41524345, year = {2025}, author = {Yusupov, FA and Abdykadyrov, MS}, title = {[Neurogenesis in neurodegeneration: multifactorial regulation, mechanisms of impairment, and therapeutic strategies].}, journal = {Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova}, volume = {125}, number = {12}, pages = {14-21}, doi = {10.17116/jnevro202512512114}, pmid = {41524345}, issn = {1997-7298}, mesh = {Humans ; *Neurogenesis/physiology ; *Alzheimer Disease/physiopathology/metabolism/therapy ; *Neurodegenerative Diseases/physiopathology/therapy ; *Parkinson Disease/physiopathology/therapy/metabolism ; Animals ; }, abstract = {OBJECTIVE: To systematize current data on neurogenesis and its role in the pathogenesis of neurodegenerative conditions, such as Alzheimer's disease and Parkinson's disease, with a focus on molecular mechanisms of regulation, the nature of disorders in neurodegeneration, and the evaluation of therapeutic approaches aimed at stimulating neurogenesis.
MATERIAL AND METHODS: Research papers published in scientific databases, mainly Scopus, PubMed, and Google Scholar, over the past 5 years were used for this review. Special attention was paid to studies on neurogenesis and its role in the pathogenesis of neurodegenerative diseases. The review included studies that met the following criteria: publications from the past five years reporting current neurogenesis data, using clearly identified experimental and clinical techniques, published in peer-reviewed international journals with a high impact factor, and providing reliable statistics to support the results.
UNLABELLED: Studies with a limited sample size and insufficient statistical significance, those lacking a transparent methodology or exhibiting a low level of data reproducibility, reviews without a clear focus on neurogenesis or its connection to neurodegenerative diseases, and studies providing insufficient information on the applied technologies and analysis methods were excluded.
RESULTS: Modern research has significantly expanded the understanding of neurogenesis and its role in neurodegenerative diseases. Neurogenesis has been confirmed to occur in specific areas of the adult brain, including the hippocampus, where it is involved in cognitive processes such as learning, memory consolidation, spatial adaptation, cognitive flexibility, and regulation of affective behavior. However, the extent and functional significance of neurogenesis in different brain regions remain a matter of debate. The effect of neurodegenerative diseases on neurogenesis varies: in Alzheimer's disease, studies in animal models demonstrate its impairment; however, data on humans are inconsistent: a decrease in neurogenesis is observed in the early stages of the disease, but in some cases, its increase is reported, likely as a compensatory mechanism. Factors influencing neurogenesis in Alzheimer's disease include β-amyloid and tau protein accumulation, neuroinflammation, mitochondrial dysfunction, and oxidative stress. Parkinson's disease is associated with a decrease in neurogenesis in the subventricular zone and hippocampus due to the degeneration of dopaminergic neurons and the accumulation of α-synuclein; however, deep brain stimulation is able to enhance neuronal proliferation. Therapeutic strategies include pharmacological approaches aimed at stimulating neurogenesis, such as the use of neurotrophic factors, acetylcholinesterase inhibitors, selective serotonin reuptake inhibitors, Wnt and EGFR signaling pathway modulators, uric acid, and MFG-E8, as well as non-pharmacological methods, including physical activity, enriched environment, cognitive training, electrical stimulation, and music therapy.
CONCLUSION: Neurodegenerative diseases are a significant problem in modern healthcare, requiring an in-depth study of the mechanisms of neurogenesis and its role in pathogenesis. Despite conflicting evidence on neurogenesis in adult humans, animal model studies and cellular technologies demonstrate prospects for its therapeutic stimulation. Pharmacological and non-pharmacological methods, including the use of neurotrophic factors, electrical stimulation, and cognitive training, as well as cellular and gene therapy, are the basis of new intervention strategies. However, the issues of controlling the differentiation and integration of new neurons, as well as the ethical aspects associated with the use of stem cells, remain unresolved. Further interdisciplinary research aimed at studying the regulatory mechanisms of neurogenesis and its therapeutic potential may lead to the development of effective treatment strategies that can slow or even reverse the progression of neurodegenerative diseases. It highlights the need to integrate advanced technologies and approaches in modern neuroscience and clinical practice.}, }
@article {pmid41523330, year = {2025}, author = {Raphael, DL}, title = {Neuropsychiatric symptoms in mild cognitive impairment and early Alzheimer's disease: Clinical pattern and diagnostic implications.}, journal = {AIMS neuroscience}, volume = {12}, number = {4}, pages = {676-705}, pmid = {41523330}, issn = {2373-7972}, abstract = {BACKGROUND: Alzheimer's disease (AD) and mild cognitive impairment (MCI) are widely recognized for their hallmark cognitive deficits, typically characterized by progressive cognitive deterioration. However, neuropsychiatric symptoms (NPS), including depression, apathy, anxiety, irritability, and sleep disturbances, are increasingly prevalent in the early stages of these conditions and significantly influence the disease trajectory and patient outcomes. Importantly, neuropsychiatric symptoms often precede overt memory loss by several years, with subtle mood and behavioral disturbances serving as early pre-diagnostic markers of an underlying Alzheimer's pathology. Their presence complicates the diagnosis, accelerates the disease progression, and intensifies the caregiver burden. However, distinguishing NPS arising from neurodegeneration and primary psychiatric disorders remains a profound diagnostic challenge, thus delaying timely intervention and obscuring early disease recognition.
OBJECTIVE: This structured narrative review examines the diagnostic complexities, clinical impact, and current management of NPS in early-stage Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI), alongside the biological underpinnings, clinical relevance, diagnostic challenges, and treatment perspectives. We argue that understanding and managing NPS is essential to improve the clinical outcomes, reduce the caregiver burden, and guide therapeutic innovation.
METHODS: A structured narrative review of peer-reviewed studies published between 2012 and 2025 was conducted using PubMed, MEDLINE, Scopus, PsycINFO, Google Scholar, and CINAHL. The included studies investigated NPS prevalence, neurobiological correlations, and management strategies in individuals with AD or MCI.
FINDINGS: NPS affects up to 80% of individuals with early AD or MCI, often preceding cognitive decline. The current management strategies heavily rely on non-pharmacological interventions such as caregiver support, behavioral activation, and structured routines, while pharmacological options remain limited by modest efficacy and safety concerns.
DISCUSSION: Advancing knowledge of NPS and their association with cognitive decline is critical to establish more precise diagnostic criteria and to inform personalized therapeutic approaches. Future research should emphasize biomarker-driven diagnostics and the development of novel, targeted interventions that simultaneously address cognitive and neuropsychiatric domains to optimize outcomes for patients and caregivers. This study contributes to the field by reframing NPS as potential early biomarkers in the trajectory of MCI and dementia progression.}, }
@article {pmid41522467, year = {2026}, author = {Williams, DM and Heikkinen, S and Hiltunen, M and , and Davies, NM and Anderson, EL}, title = {The proportion of Alzheimer's disease attributable to apolipoprotein E.}, journal = {NPJ dementia}, volume = {2}, number = {1}, pages = {1}, pmid = {41522467}, issn = {3005-1940}, abstract = {Variation in the APOE gene strongly affects Alzheimer's disease (AD) risk. However, the proportion of AD burden attributable to this variation requires clarification, which would help to elucidate the scope of strategies targeting apolipoprotein E (APOE) for AD prevention and treatment. We estimated the extents to which clinically diagnosed AD, AD neuropathology and all-cause dementia are attributable to the common APOE alleles in four large studies. First, we used data on 171,105 and 289,150 participants aged ≥60 years from UK Biobank (UKB) and FinnGen, respectively. AD and all-cause dementia were ascertained from linked electronic health records in these cohorts. Second, we examined amyloid-β positivity from amyloid positron emission tomography scans of 4415 participants of the A4 Study. Third, we analysed data from the Alzheimer's Disease Genetics Consortium (ADGC), where neuropathologically confirmed AD cases were compared to pathology-negative, cognitively intact controls (N = 5007). In each analysis, we estimated outcome risk among carriers of APOE risk alleles ε3 and ε4, relative to individuals with an ε2/ε2 genotype, and calculated attributable fractions to show the proportions of the outcomes due to ε3 and ε4. For AD, fractions ranged from 71.5% (95% confidence interval: 54.9%, 81.7%) in FinnGen to 92.7% in the ADGC (82.4, 96.5%). In A4, 85.4% (17.5, 94.5%) of cerebral amyloidosis was attributable to ε3 and ε4. The proportions of all-cause dementia attributable to ε3 and ε4 in UKB and Fin-Gen were 44.4% (95% CI: 18.2%, 62.2%) and 45.6% (30.6%, 56.9%), respectively. Without strong underlying risks from APOE ε3 and ε4, almost all AD and half of all dementia would not occur. Intervening on APOE should be prioritised to facilitate dementia prevention.}, }
@article {pmid41522370, year = {2026}, author = {Foley, KE and Weekman, EM and Wilcock, DM}, title = {Acute anti-Aβ antibody exposure induces microglial changes and significantly alters chemokine signaling.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {12}, number = {1}, pages = {e70201}, pmid = {41522370}, issn = {2352-8737}, abstract = {INTRODUCTION: While the anti-amyloid-lowering immunotherapies provide the first disease-targeting therapies for the treatment of Alzheimer's disease, there remain harmful adverse events causing hesitation among patients, families, physicians, and regulatory bodies. Though these drugs have been repeatedly proven to lower brain amyloid plaque burden, the specific cellular mechanisms and pathways by which the immunotherapy impacts the brain remain unclear.
METHODS: This study aimed to transcriptionally profile the brain's immediate immune response to anti-amyloid beta (anti-Aβ) antibodies. To evaluate acute cellular priorities, we intracranially injected anti-Aβ antibody (3D6) or an isotype-matched control immunoglobulin G (IgG) antibody and performed single-cell sequencing analysis after 3 days.
RESULTS: We found reduced numbers of a motile microglia cluster and homeostatic microglia in the 3D6 antibody-injected cortex compared to the IgG-injected cortex. It was also found that chemokine/cytokine signaling was enriched across homeostatic-proinflammatory microglia, interferon-responding microglia, and disease-associated microglia 2 (DAM2) following 3D6 antibody injection. We explored "CCL" signaling, which suggested a change in outgoing signaling coordinated by all microglia types targeting homeostatic microglia, surprisingly not targeting DAM1 or DAM2. We then analyzed enriched signaling pathways clustered by k-means river plots and identified pathways enriched and dampened with acute 3D6 treatment.
DISCUSSION: Together these data supply evidence for significant involvement of microglia in the anti-Aβ response in the brain after just 3 days. Most interestingly, there are changes in cytokine/chemokine signaling across microglia subtypes, specifically with communication in CCL pathways targeting homeostatic microglia and T cells. These acute signaling changes provide novel insights and generate unique hypotheses on the brain's immediate immune reaction to anti-Aβ antibody.
HIGHLIGHTS: Intracranially injected anti-amyloid beta (anti-Aβ) antibody promotes an immediate microglial response.3D6 exposure resulted in fewer homeostatic and motile microglia subtypes.Acute 3D6 enriches for chemokine/cytokine signaling pathways.}, }
@article {pmid41522368, year = {2026}, author = {Scheltens, P and Atri, A and Feldman, HH and Zetterberg, H and Sano, M and Johannsen, P and Colombo, TL and Bardtrum, L and Jeppesen, R and Hansen, CT and Cummings, JL}, title = {Baseline characteristics from evoke and evoke+: Two phase 3 randomized placebo-controlled trials of semaglutide in participants with early-stage symptomatic Alzheimer's disease.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {12}, number = {1}, pages = {e70200}, pmid = {41522368}, issn = {2352-8737}, abstract = {INTRODUCTION: The glucagon-like peptide-1 receptor agonist semaglutide may impact neuroinflammation and reduce neurodegeneration. We present baseline characteristics of participants enrolled in the evoke (NCT04777396) and evoke+ (NCT04777409) trials, referred to as "evoke (+)" hereafter.
METHODS: Evoke (+) are two ongoing global, multicenter, randomized, double-blind, parallel-group, placebo-controlled phase 3 trials investigating semaglutide in participants with early-stage symptomatic Alzheimer's disease (AD) with confirmed amyloid positivity (by positron emission tomography or cerebrospinal fluid testing). Inclusion criteria are the same for both trials, except that by design, evoke+ also includes participants with significant small vessel pathology. Both trials include a 12-week screening phase before randomization (1:1) to receive oral semaglutide titrated to 14 mg or placebo for 156 weeks. Baseline data were summarized and analyzed descriptively. Additionally, data were pooled and assessed by five main geographical regions.
RESULTS: Evoke (+) recruited 9996 participants from 566 sites in 40 countries. The mean (standard deviation) age of participants was 71.8 (7.1) and 72.6 (7.1) years in evoke and evoke+, respectively; more participants were female than male (female: 53.0% and 51.9%, respectively) and most had a Clinical Dementia Rating (CDR) global score of 0.5 (72.8% and 71.4%; CDR global score of 1: 26.5% and 27.6%). Both trial populations had similar demographics, and clinical and cognitive baseline characteristics, except that 2.8% of participants in evoke+ had magnetic resonance imaging-documented significant small vessel pathology as per protocol inclusion criteria. Regional-level data demonstrated some differences in AD treatment characteristics, including cholinesterase inhibitor use of 41.7% in North America versus 61.6% in Asia.
DISCUSSION: Evoke (+) are the only large-scale, phase 3 trials investigating the longer-term efficacy and safety of semaglutide in early AD as a potential disease-modifying treatment. The baseline characteristics from evoke (+) reflect a varied, global population with early-stage symptomatic AD. Primary readouts are expected in the second half of 2025.
HIGHLIGHTS: evoke and evoke+ are the only large-scale randomized controlled trials (RCTs) investigating the longer-term efficacy and safety of semaglutide in early AD.Baseline characteristics reflect a varied, global population.The trials' primary readouts are expected in the second half of 2025.}, }
@article {pmid41521630, year = {2026}, author = {K, A and B, SK and Reddy, SG and Kugabalasooriar, S}, title = {Innovations in Nanobot and Microbot Propulsion for Targeted CNS Drug Delivery Across the Blood-Brain Barrier.}, journal = {Critical reviews in analytical chemistry}, volume = {}, number = {}, pages = {1-30}, doi = {10.1080/10408347.2025.2612631}, pmid = {41521630}, issn = {1547-6510}, abstract = {The transport of therapeutic molecules to the brain is one of the largest challenges of contemporary medicine because of the restrictive nature of the blood-brain barrier (BBB), which blocks the penetration of almost all biological therapeutics and most small-molecule drugs. This is a major limitation to the treatment of such neurological diseases as Parkinson's disease (PD), glioblastoma, and Alzheimer's disease. To beat these obstacles, there must be advanced delivery systems that can be precise, be released under control, and move without being invasive. Over the past decade, there have been innovations in micro and nanorobotic technologies, which provide a groundbreaking model that incorporates innovations in materials science, analytical chemistry, and biomedical engineering. Such engineered nanorobots are magnetically controlled, polymeric, or biologically derived nanorobots, which can be magnetically, acoustically, optically, or chemically controlled, and can cross the BBB with greater specificity. It has also been possible to follow the behavior of nanorobots at a direct visualization level in biological systems due to the development of analytical tools, especially imaging, real-time monitoring, and in situ sensing, which allows the behavior of nanorobots to be evaluated rigorously in terms of motions, shape transformation, and drug release profiles. The present review gives a detailed description of the propulsion-based nanorobotic drug delivery systems to the central nervous system (CNS), including structural components, modes of actuation, and protocols of analysis. The review explains that the combined effects of physicochemical features, external stimuli, and interactions between biointerfaces influence permeability via the BBB and accuracy of therapeutic response.}, }
@article {pmid41521126, year = {2026}, author = {Sankhe, K and Ruthirakuhan, M and Andreazza, AC and Brawman-Mintzer, O and Craft, S and Herrmann, N and Ismail, Z and Lerner, AJ and Levey, AI and Mintzer, J and Padala, PR and Perin, J and Porsteinsson, AP and Rosenberg, PB and Shade, D and Tumati, S and van Dyck, CH and Lanctôt, KL}, title = {Peripheral biomarkers associated with apathy and predicting response to methylphenidate: Secondary analysis of the Apathy in Dementia Methylphenidate Trial 2 (ADMET2) study.}, journal = {International psychogeriatrics}, volume = {}, number = {}, pages = {100181}, doi = {10.1016/j.inpsyc.2025.100181}, pmid = {41521126}, issn = {1741-203X}, abstract = {BACKGROUND: In Apathy in Dementia Methylphenidate Trial 2 (ADMET2), apathy in Alzheimer's disease improved with methylphenidate (MPH) in a randomized, placebo-controlled trial, though response varied. Here we evaluated serum biomarkers for their association with apathy and with treatment response.
METHODS: All ADMET2 participants with available blood samples were included. Markers of inflammation [interleukin (IL)-6, IL-10, Tumor Necrosis Factor (TNF)], oxidative stress [lipid hydroperoxide (LPH), 4-hydroxynonenal (4-HNE), 8-isoprostane (8-ISO)] and neuronal injury [neurofilament light (NfL), S100B] were assessed and values log-transformed. Neuropsychiatric Inventory-apathy (NPI-A) measured apathy. Least Absolute Shrinkage and Selection Operator (LASSO) regression was performed for feature selection of baseline markers predicting NPI-A at Month-6 (M6). Univariate analyses examined individual biomarker effects and multivariable models evaluated their combined effects. Treatment interactions, baseline and change in biomarker levels in treatment responders (≥4 change in NPI-A) and remitters (M6 NPI-A=0) were explored.
RESULTS: In the ADMET2 biomarker subset (n = 44, MPH:21, age:75 years, MMSE:20.2), higher baseline TNF was associated with higher M6 NPI-A [B(SE)= 6.86 (1.71), p = .0003], and multivariable models found lower baseline TNF [B(SE)= 8.28(1.61), p < .001] and higher baseline S100B [B(SE)= -6.41(1.95), p = .002] were associated with lower M6 NPI-A. Exploratory analyses suggested that higher baseline NfL significantly interacted with treatment to predict lower M6 NPI-A [B(SE)= -8.36(4.21), p = .05], only when adjusting for cognition. MPH remitters had lower baseline TNF [B(SE)= -0.27(0.10), p = .02], higher baseline NfL [B(SE)= 0.33(0.14), p = .03], and a greater decrease in IL-6 [B(SE)= -0.44 (0.17), p = .02].
CONCLUSIONS: Inflammatory and neuronal injury biomarkers may have prognostic value and may potentially inform treatment response and remission outcomes in apathy. Apathy in Dementia Methylphenidate Trial 2 (ADMET2), NCT02346201, https://clinicaltrials.gov/study/NCT02346201.}, }
@article {pmid41520868, year = {2026}, author = {Bajinka, O and Jallow, L and Ozdemir, G}, title = {A multi-target therapeutic framework for Alzheimer's disease: an integrative mechanistic review.}, journal = {Neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.neuroscience.2026.01.010}, pmid = {41520868}, issn = {1873-7544}, abstract = {BACKGROUND: Alzheimer's disease (AD) is increasingly recognized as a multifactorial network disorder in which amyloid and tau pathology interact with mitochondrial dysfunction, neuroinflammation, metabolic impairment, vascular dysregulation, and synaptic failure. This review provides an integrative, systems-level synthesis of these mechanisms with emphasis on diagnostic and therapeutic implications.
METHODS: A structured narrative review was conducted using PubMed, Scopus, Web of Science, and Embase (2010-2025). Eligible studies included clinical trials, biomarker validation studies, cohort analyses, and mechanistic investigations. Evidence was synthesized by mechanistic domain with focus on cross-system interactions and translational relevance.
FINDINGS: Convergent data indicate that soluble Aβ species, tau propagation, glial dysregulation, insulin resistance, mitochondrial bioenergetic failure, lipid imbalance, and BBB dysfunction form a self-reinforcing neurodegenerative network. Diagnostic advances-including plasma p-tau181/217, Aβ42/40 ratio, GFAP, sTREM2, neuronal exosomes, and multimodal machine-learning models-enable earlier staging and refinement of therapeutic selection. Therapeutic development is shifting from linear amyloid removal to multi-target strategies incorporating anti-tau agents, glial-modulating compounds, metabolic and microbiome interventions, medical nutrition, and multidomain lifestyle programs. Across trials, combined strategies targeting interacting mechanisms demonstrate stronger biomarker and cognitive effects than single-axis approaches.
CONCLUSIONS: AD management requires a systems-oriented therapeutic architecture in which interventions are selected based on mechanistic dominance, biomarker stage, and potential synergy. We outline a multi-target strategy integrating amyloid/tau modulation, neuroimmune regulation, metabolic-vascular stabilization, and synaptic support. Future work should prioritize biomarker-guided stratification, treatment sequencing, and prevention-oriented combination designs.}, }
@article {pmid41520543, year = {2025}, author = {Xue, R and Wang, F and Zhang, B and Wu, J and Zhang, N and Sun, C}, title = {Carrier-free nanoassembly with dual antioxidant and anti-inflammatory activities camouflaged by melanoma cell membrane for tau-targeted therapy of Alzheimer's disease.}, journal = {Biomaterials}, volume = {329}, number = {}, pages = {123970}, doi = {10.1016/j.biomaterials.2025.123970}, pmid = {41520543}, issn = {1878-5905}, abstract = {Targeting phosphorylated tau (p-tau) across the blood-brain barrier (BBB) represents a critical prerequisite for attenuating tau pathology and disease progression in Alzheimer's disease (AD) by alleviating oxidative stress and neuroinflammation. To address this challenge, we developed a novel carrier-free selenium-based nanoassembly stabilized by hydroxyl-rich fingolimod (FTY720), a sphingosine analogue. Following camouflaging with melanoma cell membranes and further functionalizing with T807, the resulting nanocomposite (FSMT) demonstrated robust capacity for BBB crossing and target p-tau both in vitro and in vivo. Additionally, FTY720 and nano-selenium exert remarkable antioxidant and anti-inflammatory effects by modulating the GSK-3β and NF-κB signaling pathways, respectively, thereby attenuating tau hyperphosphorylation and preventing neuronal cell death. In an okadaic acid-induced AD mouse model, the FSMT treatment not only significantly ameliorated oxidative stress and neuroinflammation, but also improved spatial learning and memory impairments. The reduction in abnormal tau aggregation following treatment was confirmed by PET-CT imaging. Overall, this p-tau-targeted biomimetic nanocomposite demonstrated excellent biocompatibility and therapeutic efficacy, presenting a translatable strategy for treating AD and other neurological disorders through analogous mechanisms.}, }
@article {pmid41520099, year = {2026}, author = {Mao, C and Wang, W and Huang, X and Wu, M and Wang, Y and Wang, T and Qiu, Y and Chu, S and Jin, W and Jiang, Y and Bao, J and You, Y and Li, Y and Dong, L and Feng, F and Huo, L and Qiu, L and Gao, J}, title = {Real world clinical practice of lecanemab at PUMCH dementia cohort: focus on dynamic imaging and biomarker evolution.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-025-01943-z}, pmid = {41520099}, issn = {1758-9193}, support = {2021-I2M-1-020//CAMS Innovation fund for medical sciences (CIFMS)/ ; 2022-PUMCH-A-254//National High Level Hospital Clinical Research Funding/ ; 2020YFA0804500, 2020YFA0804501//National Key Research and Development Program of China/ ; }, abstract = {BACKGROUND: Lecanemab is an anti-Aβ antibody approved in China for mild cognitive impairment (MCI) and mild dementia. Real-world application requires comprehensive assessment beyond MMSE scores, considering factors like ARIA risk. This single-center, real-world study aims to evaluate its efficacy in an expanded population, observe biomarker changes, and assess its safety profile in clinical practice.
METHODS: We recruited adults aged 40-90 with early AD from the PUMCH Dementia Cohort. A total of 42 patients received lecanemab treatment, of whom 29 completed the 6-month treatment evaluation. Participants had confirmed amyloid and tau pathology and met clinical criteria (CDR ≤ 1, CDR-SB ≤ 8and MMSE ≥ 18). Comprehensive assessments included neuropsychological testing, CSF and plasma biomarkers (Lumipulse G1200), multi-sequence 3T MRI (volumetric and ALPS index analysis), and amyloid/tau PET imaging (Centiloid quantification). All were monitored for adverse reactions. Matched control groups (matched for sex, age, APOE genotype, disease severity, and baseline therapy) were established for comparison of longitudinally changes in cognitive function, daily living ability and structure MRI.
RESULTS: Treatment was effective even for patients with lower MMSE scores but still classified as having mild dementia by CDR. A significant median Centiloid reduction of 30.9 was observed, with a 24.1% amyloid PET negativity rate after six months. While scores on cognitive and functional scales (CDR-SB, ADL) significantly worsened, indicating disease progression, the rate of progression was significantly slower compared to the control group. Structural MRI showed significant volume reduction in multiple brain regions and increased ventricular volume post-treatment, with no statistically significant change in the ALPS value. The rate of brain volume reduction is faster than that in the control group. Plasma biomarker dynamics (Aβ42, GFAP) indicated effective disease-modifying therapy. Greater Centiloid reduction was linked to more brain volume loss, higher baseline Centiloid levels, higher plasma Aβ42 increase and older age of onset. APOE ɛ4 homozygotes showed less Centiloid reduction. A favorable safety profile was observed, with a 7.1% incidence of asymptomatic, mild ARIA.
CONCLUSIONS: This study confirms the clinical efficacy, biomarker changes, and safety profile of lecanemab treatment over a 6-month period, demonstrating its positive therapeutic value and a favorable safety profile in the Chinese population with AD.}, }
@article {pmid41519279, year = {2026}, author = {Cai, M and Wang, S and Liu, M and Lai, B and Chen, C and Ding, J and Wang, X}, title = {Elevated FKBP5 expression associates with epilepsy-related molecular changes and promotes neuronal hyperexcitability.}, journal = {Brain research}, volume = {1874}, number = {}, pages = {150157}, doi = {10.1016/j.brainres.2026.150157}, pmid = {41519279}, issn = {1872-6240}, abstract = {OBJECTIVE: Epilepsy is one of the neurological disorders, characterized by recurrent, spontaneous seizures arising from neuronal hyperexcitability and hypersynchrony in the brain. The mechanisms of epilepsy are intricate and remain elusive. FKBP5 has emerged as a significant protein implicated in neurological disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD). This study aims to investigate the role of FKBP5 in a kainic acid (KA)-induced intrahippocampal epilepsy model and assessed how FKBP5 gain-of-function and FKBP51 inhibition influence neurotransmitter dynamics and neuronal excitability.
METHODS: We examined the expression of FKBP5 in the hippocampus of the kainic acid (KA)-induced epilepsy model. To explore the impact of FKBP5 on neuronal activity, we overexpressed FKBP5 in primary cortical neurons and astrocytes, assessing extracellular glutamate levels in neuron-astrocytes co-cultures with or without the FKBP51-selective inhibitor SAFit2 (250 nM). Intrinsic excitability, voltage-gated Na[+] currents, and network activity were evaluated using whole-cell patch-clamp recordings and high-density microelectrode arrays (HD-MEAs).
RESULTS: We observed an elevated level of FKBP5 in the hippocampus of a kainic acid (KA)-induced chronic epilepsy mouse model, whereas cortical FKBP5 did not show clear changes across the examined post-insult time points.. Moreover, FKBP5 overexpression induced a remarkable increase in the extracellular glutamate level in co-cultured primary cortical neurons and astrocytes. Intriguingly, FKBP5 overexpression modifies the electrophysiological properties of primary neurons, resulting in increased intrinsic excitability and enhanced Na[+] currents. Additionally, the network activity exhibits hyperexcitability with FKBP5 overexpression. Notably, SAFit2 treatment was also associated with elevated extracellular glutamate in the co-culture system, while intracellular FKBP5 and EAAT2 protein levels showed no significant group differences in the current dataset.
CONCLUSION: These findings suggested that FKBP5 played a significant role in regulating neuronal excitability and extracellular glutamate homeostasis. However, due to discrete sampling and the lack of continuous seizure monitoring, the present in vivo data do not establish a definitive causal contribution of FKBP5 to epileptogenesis, warranting future studies integrating longitudinal EEG and cell-type-specific manipulations.}, }
@article {pmid41519243, year = {2026}, author = {Sharma, K and Shahid, M and Patel, R and Islam, A}, title = {Insights into Mechanism of Ionic Liquids for Protein Stability: Future Implications for Neurodegeneration Treatment.}, journal = {Ageing research reviews}, volume = {}, number = {}, pages = {103024}, doi = {10.1016/j.arr.2026.103024}, pmid = {41519243}, issn = {1872-9649}, abstract = {Neurodegenerative diseases are characterized by a gradual loss of neurons, cellular dysfunction, loss of intricate synaptic networks and brain damage, which are going to be the second leading cause of death in future. These proteinopathies are marked by abnormal amyloid fibril deposition, aberrant aggregation of misfolded proteins via polymerization, where protein aggregates serve as key pathological hallmarks in Alzheimer's, Parkinson's, and multiple system atrophy disorders. These toxic aggregates accumulate in the brain and disrupt neuronal function targeting motor neurons, spinal cord, and ultimately leading to respiratory failure and death. As population age, the prevalence of these neuronal disorders rises significantly, emphasizing to approach effective treatment for risk reduction. In the pursuit of developing effective anti-amyloidogenesis therapeutic agents, ionic liquids (ILs) continue to receive least attention. ILs have emerged as promising substitute for conventional solvents, owing to their unique physicochemical properties that facilitate protein refolding, mitigate denaturation, amyloidogenesis, and prevent aggregation. This review critically addresses intricate IL-protein interactions, dictated by anions-cations composition of ILs, their polarity, hydrophobicity, kosmotropicity, chaotropicity, amphiphillicity, and network, which modulate protein behavior and support structural and functional integrity. This article also underscores the need for precision in IL selection, ensuring their properties align with the desired structural outcome. We showcase ILs as a promising therapeutic avenue for neurodegenerative diseases, demonstrating their potential to modulate pathological protein aggregation and enhance protein homeostasis. Lastly, this review of outstanding research works, account for current lacunae that will guide future perspectives for the rational designing of IL for protein stabilization and offers new strategies for addressing underlying mechanism of ageing disorders.}, }
@article {pmid41519166, year = {2026}, author = {Zhao, P and Cao, Z and Rozpędek-Kamińska, W}, title = {Receptor tyrosine kinases in Alzheimer's disease: Mechanistic insights and therapeutic implications.}, journal = {Neurochemistry international}, volume = {193}, number = {}, pages = {106117}, doi = {10.1016/j.neuint.2026.106117}, pmid = {41519166}, issn = {1872-9754}, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disorder whose pathogenesis remains incompletely understood. It is considered one of the most costly, fatal, and socially burdensome diseases of the twenty-first century. Previous studies have shown that receptor tyrosine kinases (RTKs) play an important role in the pathological progression of AD. RTKs regulate amyloid-beta (Aβ) deposition and Tau hyperphosphorylation, thereby influencing neuronal survival, synaptic plasticity, and spatial cognitive function in patients with AD. From a therapeutic perspective, RTK-targeted interventions offer new avenues for AD treatment. Inhibiting specific RTKs can reduce Aβ production and pathological Tau phosphorylation, thereby slowing disease progression. Conversely, activating selected neuroprotective RTKs can promote neuronal survival, restore synaptic function, and ameliorate cognitive impairment. Several small-molecule inhibitors and monoclonal antibodies targeting RTKs have already demonstrated promising therapeutic potential in preclinical studies. Overall, this review systematically summarizes the clinical features and mechanisms of AD, as well as the current applications and future challenges of RTK-based research in neurodegenerative diseases, providing theoretical guidance for the development and repurposing of novel multi-pathway RTK-directed therapies.}, }
@article {pmid41518900, year = {2025}, author = {Loraine, A and Farr, SA and Niehoff, ML and Larrea, IG and Ganev, Y and Samanta, J and Rahman, K and Crider, AM and Sandoval, K and Witt, KA}, title = {Dual sigma receptor 1 and 2 modulator improves memory behavior in mouse model of age-related cognitive decline.}, journal = {The Journal of pharmacology and experimental therapeutics}, volume = {393}, number = {2}, pages = {103795}, doi = {10.1016/j.jpet.2025.103795}, pmid = {41518900}, issn = {1521-0103}, abstract = {Sigma-1 (S1R) and sigma-2 (S2R) receptors are promising targets for treating Alzheimer disease (AD), playing important roles in cognitive function, with potential to mitigate neuropathology. The dual S1R/S2R receptor modulator (+/-)-cis-1-n-Butyl-8-methoxy-1,2,3a,4,5,9b-hexahydrobenz[e]indole hydrochloride (BBZI) was evaluated in the senescence-accelerated mouse prone 8 model of cognitive decline and AD as to behavior and hippocampal expression effects. Chronic BBZI treatment (0, 0.001, 0.01, 0.1, 1.0, or 10 mg/kg, i.p. daily, 27-days) was evaluated using a behavioral battery including open field activity (day-15), elevated plus maze (day-16), Y-maze (day-22), T-maze foot-shock avoidance (days 20 and 27), and novel object recognition (days 23 and 24). No changes were observed in open field, elevated plus maze, Y-maze, or novel object recognition tests at any dose of BBZI as compared with vehicle. BBZI enhanced T-maze foot-shock memory retention at 0.1 (P < .05, Bonferroni) and 1.0 mg/kg (P < .001, Bonferroni) compared with vehicle (day-27). In a separate cohort, a single-injection of BBZI (0, 0.001, 0.01, 0.1 & 1.0 μg, i.c.v.) with testing 7-days later showed a significant effect in the T-maze foot-shock test (P = .011) and enhanced memory retention behavior at 0.01 μg compared with vehicle (P < .05, Bonferroni). Poly(A) RNA sequencing evaluation of hippocampal tissue 24-hours after intracerebroventricular administered BBZI (1.0 μg/μL) versus vehicle showed unique gene expression changes, with notable effects relevant to mitochondrial energetics and synaptic function. Gene enrichment analysis identified affiliations with pathways involved in neurodegenerative disease. This data supports dual S1R/S2R receptor modulation as a promising strategy for AD treatment and identifies potential gene pathways involved. SIGNIFICANCE STATEMENT: Dual sigma receptor 1 and 2 modulator BBZI improved memory behavior in senescence-accelerated mouse prone 8 mice. Evaluation of senescence-accelerated mouse prone 8 hippocampal tissue 24 hours after BBZI (1.0 μg/μL i.c.v.) versus vehicle administration identified gene changes related to mitochondrial energetics and synaptic function. BBZI to mitigates cognitive decline behavior, impacting hippocampal genes critical for brain function.}, }
@article {pmid41518808, year = {2026}, author = {Qu, J and Jiang, X and Ma, Y and Sheng, X and Pi, C and Wang, Y and Xu, Q and Li, R and Wang, P and Qian, D and Wang, J and Yi, Z and Yi, J and Wen, L and Liu, S}, title = {Unveiling the gut-brain axis: How chronic exposure to arsenic-induced microglial pyroptosis drives Alzheimer's disease-like pathology.}, journal = {Journal of hazardous materials}, volume = {503}, number = {}, pages = {141087}, doi = {10.1016/j.jhazmat.2026.141087}, pmid = {41518808}, issn = {1873-3336}, abstract = {Arsenic, a pervasive environmental contaminant in groundwater, poses a severe global threat to public health. Chronic arsenic exposure has been linked to neurological impairment, however, its specific pathogenic mechanism and whether the gut-brain axis plays a key role remain unclear. This study investigated the role of gut microbiota and its metabolite indoxyl sulfate (IS) in mediating chronic exposure to arsenic-induced cognitive impairment and Alzheimer's disease (AD)-like pathology, with a specific focus on microglial pyroptosis. We found that chronic arsenic exposure induced cognitive dysfunction and intestinal barrier injury, disrupted gut microbiota composition, promoted IS accumulation in serum and brain, and activated the AhR/NF-κB/NLRP3 signaling pathway, triggering microglial pyroptosis and elevating AD-like pathological markers in mice. Meanwhile, fecal microbiota transplantation (FMT) from arsenic-exposed mice recapitulated cognitive impairment, elevated IS levels, and neuroinflammation in recipient mice. Furthermore, arsenic upregulated hepatic IS-synthesis genes (CYP2E1, Sult1d1) and downregulated renal IS-excretion gene (ABCG2). In vitro, arsenic and IS co-exposure promoted M1 polarization and enhanced pyroptosis by activating the AhR/NF-κB/NLRP3 signaling pathway, while suppressing phagocytosis-related proteins (TREM2, SYK and CD36). Furthermore, SiAhR treatment could alleviated microglial inflammatory injury and enhancing the microglia's phagocytic capacity induced by arsenic and IS co-exposure in BV2 cells through inhibiting the AhR/NF-κB/NLRP3-mediated pyroptosis signaling pathway. In conclusion, chronic arsenic exposure induced cognitive impairment and AD-like pathological via the gut microbiota-AhR-pyroptosis cascade, where in IS accumulation served a key mediator. These findings provide new insights into preventing arsenic-related cognitive damage.}, }
@article {pmid41518572, year = {2026}, author = {Zhang, Z and Zhang, M and Cao, Z and Zhao, H and Li, X and Luo, P}, title = {Fibrillarin: bridging ribosome biogenesis and apoptosis in cellular stress and disease.}, journal = {Apoptosis : an international journal on programmed cell death}, volume = {31}, number = {1}, pages = {11}, pmid = {41518572}, issn = {1573-675X}, support = {82171363//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Apoptosis/genetics ; *Ribosomes/metabolism/genetics ; *Neoplasms/genetics/metabolism/pathology ; *Stress, Physiological ; Animals ; Tumor Suppressor Protein p53/metabolism/genetics ; *Neurodegenerative Diseases/genetics/metabolism/pathology ; Cell Nucleolus/metabolism ; Signal Transduction ; Chromosomal Proteins, Non-Histone ; }, abstract = {Nucleolar stress has emerged as a critical regulatory mechanism linking ribosome biogenesis defects to apoptotic cell death in various pathological conditions. Fibrillarin (FBL), the catalytic component of box C/D small nucleolar ribonucleoproteins, participates in multiple forms of programmed cell death through both p53-dependent and p53-independent pathways across diverse disease contexts including cancer and neurodegeneration. In malignancies including breast cancer, colorectal cancer, and hepatocellular carcinoma, FBL overexpression promotes apoptosis resistance, whereas in Alzheimer's disease and ALS/FTD, FBL dysfunction contributes to pathological neuronal death. Dysregulation of FBL can lead to excessive apoptosis or apoptosis resistance depending on cellular context and disease state. Various cellular stressors trigger aberrant FBL function, disrupting rRNA processing and ribosome assembly, which then activates nucleolar stress responses that culminate in cell death through ribosomal protein-MDM2-p53 axis activation or selective translational control of survival factors in a context-dependent manner. Therefore, targeting FBL-mediated apoptotic pathways is considered an important avenue for the treatment of various cancers and neurodegenerative diseases. In this review, we summarize the major and recent findings focusing on the mechanisms of FBL-regulated apoptosis in disease pathogenesis and provide a systematic overview of current therapeutic strategies targeting nucleolar stress pathways, including RNA polymerase I inhibitors and precision medicine approaches based on p53 status, which may provide important therapeutic targets that merit further investigation.}, }
@article {pmid41518096, year = {2026}, author = {Mai, D and Li, Z and Cao, Z and Lin, P and Tan, J and Li, R and Ye, Q}, title = {Metabolomics-Driven Integration of Traditional Chinese Medicine for Neurological Disorders: From Precision Diagnosis to Therapeutic Innovation.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70182}, pmid = {41518096}, issn = {1099-1573}, support = {20251026//Guangdong Provincial Department of Traditional Chinese Medicine/ ; SEZYY2023A13//the Second Traditional Chinese Medicine Hospital of Guangdong Province/ ; }, abstract = {Neurological disorders are leading causes of disability and death worldwide, yet many patients still face delayed diagnosis, limited disease-modifying options and substantial treatment-related adverse effects. Traditional Chinese medicine (TCM) provides holistic, multi-target interventions through acupuncture, herbal formulas and adjunctive therapies, but its mechanisms remain insufficiently defined. Metabolomics, which enables system-wide profiling of small-molecule metabolites, offers an objective way to characterise disease-related metabolic networks and quantify the global effects of TCM. We systematically searched PubMed, Web of Science and China National Knowledge Infrastructure for studies published between January 2005 and June 2025 that evaluated TCM-related interventions for neurological disorders and reported metabolomic outcomes. Peer-reviewed animal and clinical studies were included, whereas reviews, conference abstracts, methodological-only papers and non-neurological studies were excluded. Across Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), ischaemic stroke (IS), epilepsy and high-altitude cerebral oedema (HACE), consistent alterations were identified in amino acid, lipid and energy-related pathways, such as nicotinamide and lysophosphatidylcholine species in AD, branched-chain amino acids in PD and phenylalanine and asymmetric dimethylarginine in MS. Metabolomics studies indicate that acupuncture and herbal formulas can jointly modulate neurotransmitter balance, cerebral energy metabolism, oxidative stress, neuroinflammation and blood-brain barrier integrity. Emerging spatial metabolomics based on mass spectrometry imaging links individual TCM components, including ginsenosides and Astragalus membranaceus-Carthamus tinctorius decoctions, to region-specific metabolic reprogramming in the cortex, hippocampus and thalamus. However, most metabolite-disease associations are correlative and are constrained by small sample sizes, heterogeneous designs and lack of technical standardisation. Metabolomics therefore provides a quantitative framework to dissect the multi-target mechanisms of TCM in neurology and to connect molecular changes with functional outcomes. Standardised workflows, larger multicentre clinical studies and integration of spatial metabolomics, multi-omics and artificial-intelligence-based analysis are required to translate these findings into TCM-informed precision diagnosis and personalised treatment for neurological disorders.}, }
@article {pmid41517979, year = {2026}, author = {Bachhav, SS and Florian, H and Boiser, J and Wang, Y and Shiller, DD and Graab, U and Lynch, SY and Graff, O and Xiong, H}, title = {Safety, Tolerability, and Pharmacokinetics of Single Doses of ABBV-916, an Anti-Amyloid Antibody, in Healthy Participants.}, journal = {Clinical and translational science}, volume = {19}, number = {1}, pages = {e70419}, pmid = {41517979}, issn = {1752-8062}, mesh = {Humans ; Male ; Female ; Double-Blind Method ; Healthy Volunteers ; Adult ; *Amyloid beta-Peptides/immunology/antagonists & inhibitors ; Middle Aged ; Dose-Response Relationship, Drug ; *Antibodies, Monoclonal, Humanized/administration & dosage/pharmacokinetics/adverse effects ; Infusions, Intravenous ; Alzheimer Disease/drug therapy ; Injections, Subcutaneous ; Young Adult ; }, abstract = {Amyloid-beta (Aβ) plaque brain clearance is one of the promising disease-modifying treatment approaches to slow cognitive decline in Alzheimer's disease (AD). ABBV-916, an anti-amyloid antibody, was being developed as an early AD disease-modifying treatment. A phase 1, randomized double-blind, placebo-controlled single ascending dose (SAD) study investigated the safety, tolerability, pharmacokinetics (PK), and immunogenicity of ABBV-916 in healthy participants. Five groups of participants were enrolled and randomized 6:2 to receive ABBV-916 (100, 300, 1000, or 3000 mg) or placebo by intravenous (IV) infusion or subcutaneous (SC) injection (300-mg dose only). After dosing, participants were followed for 20 weeks for assessments. Cerebrospinal fluid (CSF) samples were collected after dosing 1000 mg IV for determination of ABBV-916 levels in the CSF. ABBV-916 single doses up to 3000 mg were well tolerated in healthy participants. No clinically significant laboratory findings, amyloid-related imaging abnormalities, or serious adverse events were reported. The ABBV-916 PK profile exhibited dose-related increases in maximum concentration and area under the plasma concentration-time curve with terminal elimination half-life ranging from 29 to 40 days across the cohorts. The estimated absolute bioavailability after SC dosing was 51%. The average CSF-to-serum partition ratio was 0.12% (range 0.10%-0.21%). Positive anti-drug antibody was detected in < 7% of participants, which was transient, at low titer, and did not affect ABBV-916 PK. This study demonstrated desirable safety, tolerability, and PK profile of ABBV-916 after single-dose administration in healthy participants. The data supported further evaluation of ABBV-916 multiple IV and SC doses in patients with AD.}, }
@article {pmid41517961, year = {2026}, author = {Vilor-Tejedor, N and Danso, S and Albanus, RD and Billingsley, K and Evans, TE and Lee, LY and Wang, S and Jiang, J and Liu, H and Ross, J and Chilla, G}, title = {Advancing global dementia research through equity and inclusion.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71069}, pmid = {41517961}, issn = {1552-5279}, support = {//Alzheimer's Disease Data Initiative/ ; RYC2022-038136-I//Spanish Ministry of Science and Innovation-State Research Agency,/ ; PID2022-143106OA-I00//European Union FSE+/ ; 23S06083-001//European Union FEDER/ ; //Ajuntament de Barcelona/ ; //la Caixa Foundation/ ; VCID-UMD-26-1514428//AD Strategic Fund: Vascular Contributions to Cognitive Impairment and Dementia-Understanding Mechanisms of Dysfunction/ ; 25AARF-1377279 (2025-2029)//Alzheimer's Association Research postdoctoral fellowship/ ; WE.03-2024-07(2025-2027)//Alzheimer's Association Research postdoctoral fellowship/ ; //Intramural Research Programs of the National Institute on Aging (NIA)/ ; //National Institute of Neurological Disorders and Stroke (NINDS)/ ; Z01-AG000949//National Institutes of Health (NIH), Department of Health and Human Services/ ; 1ZIANS003154//National Institutes of Health (NIH), Department of Health and Human Services/ ; P30AG072976//National Institutes of Health (NIH), Department of Health and Human Services/ ; R01AG081693//National Institutes of Health (NIH), Department of Health and Human Services/ ; }, mesh = {Humans ; *Dementia ; *Biomedical Research ; Global Health ; }, abstract = {Despite the global burden of dementia, research remains dominated by high-income, Western populations, limiting the generalizability and equity of findings. In this Perspective, we highlight the importance of diversity and inclusion in dementia research, not only in study participants but also in the researchers, study design, and funding priorities. We describe how the lack of representation creates knowledge gaps and delays progress in prevention, diagnosis, and treatment. We also present examples of initiatives that are working to change this, including the Alzheimer's Disease Data Initiative and the William H. Gates Sr. Fellowship program, which supports open science, international collaboration, and early-career researchers from underrepresented regions. These efforts demonstrate that diversity is not only an ethical goal, but a scientific need. More inclusive and global research could lead to discoveries that are more generalizable, more globally applicable, and better able to inform strategies to address dementia across all communities. HIGHLIGHTS: Prioritize representation in datasets across ethnicity, geography, sex/gender, and socio-economic status. Support early-career researchers from underrepresented regions with long-term funding and mentorship. Standardize and adapt tools (cognitive, clinical, genomic) across cultural and linguistic contexts. Promote open science through equitable, federated data sharing platforms, and embed community engagement from research design to dissemination. Value diversity as a driver of discovery, not as a confounder.}, }
@article {pmid41517810, year = {2026}, author = {Lee, S and Chang, JW}, title = {From Ablation to Neuromodulation Platform: The Evolving Role of Magnetic Resonance-Guided Focused Ultrasound in Functional Neurosurgery.}, journal = {Journal of clinical neurology (Seoul, Korea)}, volume = {22}, number = {1}, pages = {17-41}, pmid = {41517810}, issn = {1738-6586}, support = {/HI/NHLBI NIH HHS/United States ; }, abstract = {Magnetic resonance-guided focused ultrasound (MRgFUS) has rapidly evolved from an experimental concept into a versatile platform in functional neurosurgery. Initially pioneered as a noninvasive thermal ablation modality for essential tremor, MRgFUS has since gained regulatory approval and demonstrated durable long-term efficacy. Its clinical applications have expanded to include Parkinson's disease, chronic pain, psychiatric disorders, and investigational use in dystonia, epilepsy, and brain tumors. Beyond lesioning, low-intensity focused ultrasound enables reversible neuromodulation and transient blood-brain barrier opening, facilitating drug and gene delivery in conditions such as Alzheimer's disease and glioblastoma. Comparative analyses highlight MRgFUS as an incisionless alternative to traditional modalities like deep brain stimulation, radiofrequency ablation, and radiosurgery, offering unique advantages in precision, safety, and patient acceptability while retaining certain limitations, including irreversibility and eligibility constraints due to skull properties. Emerging innovations-such as dual-target strategies, staged bilateral procedures, adaptive focusing technologies, and integration with immuno- or gene therapies-are expanding its therapeutic potential. Collectively, these advances position MRgFUS as not only an ablative tool but also a transformative neuromodulation platform with broad implications for the treatment of movement disorders, neuropsychiatric disease, and neurodegeneration.}, }
@article {pmid41517524, year = {2025}, author = {Abboud, I and Xu, E and Xu, S and Alhasany, A and Wang, Z and Wu, X and Astraea, N and Jiang, F and Hu, ZJ and Chan, JW}, title = {Emerging Oculomic Signatures: Linking Thickness of Entire Retinal Layers with Plasma Biomarkers in Preclinical Alzheimer's Disease.}, journal = {Journal of clinical medicine}, volume = {15}, number = {1}, pages = {}, pmid = {41517524}, issn = {2077-0383}, support = {UL1 TR001872/NH/NIH HHS/United States ; }, abstract = {Background/Objectives: Alzheimer's disease (AD) is the leading cause of dementia, which is an inevitable consequence of aging. Early detection of AD, or detection during the pre-AD stage, is beneficial, as it enables timely intervention to reduce modifiable risk factors, which may help prevent or delay the progression to dementia. On the one hand, plasma biomarkers have demonstrated great promise in predicting cognitive decline. On the other hand, in recent years, ocular imaging features, particularly the thickness of retinal layers measured by spectral-domain optical coherence tomography (SD-OCT), are emerging as possible non-invasive, non-contact surrogate markers for early detection and monitoring of neurodegeneration. This pilot study aims to identify retinal layer thickness changes across the entire retina linked to plasma AD biomarkers in cognitively healthy (CH) elderly individuals at risk for AD. Methods: Eleven CH individuals (20 eyes total) were classified in the pre-AD stage by plasma β-amyloid (Aβ)42/40 ratio < 0.10 and underwent SD-OCT. A deep-learning-derived automated algorithm was used to segment retinal layers on OCT (with manual correction when needed). Multiple layer thicknesses throughout the entire retina (including the inner retina, the outer retina, and the choroid) were measured in the inner ring (1-3 mm) and outer ring (3-6 mm) of the Early Treatment Diabetic Retinopathy Study (ETDRS). Relationships between retinal layers and plasma biomarkers were analyzed by ridge regression/bootstrapping. Results: Results showed that photoreceptor inner segment (PR-IS) thinning had the largest size effect with neurofilament light chain. Additional findings revealed thinning or thickening of the other retinal layers in association with increasing levels of glial fibrillary acidic protein and phosphorylated tau at threonine 181 and 217 (p-tau181 and p-tau217). Conclusions: This pilot study suggests that retinal layer-specific signatures exist, with PR-IS thinning as the largest effect, indicating neurodegeneration in pre-AD. Further research is needed to confirm the findings of this pilot study using larger longitudinal pre-AD cohorts and comparative analyses with healthy aging adults.}, }
@article {pmid41516328, year = {2026}, author = {Cipriano, GL and Floramo, A and Argento, V and Oddo, S and Artimagnella, O}, title = {Mutant Tau (P301L) Enhances Global Protein Translation in Differentiated SH-SY5Y Cells by Upregulating mTOR Signalling.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516328}, issn = {1422-0067}, support = {RRC-2025-23686388//Ministero della Salute/ ; }, mesh = {Humans ; *TOR Serine-Threonine Kinases/metabolism/genetics ; *tau Proteins/genetics/metabolism ; *Protein Biosynthesis ; *Signal Transduction ; Up-Regulation ; Cell Line, Tumor ; *Mutation ; Neurons/metabolism ; Sirolimus/pharmacology ; Cell Differentiation ; }, abstract = {Altered protein synthesis plays a key role in ageing and multiple neurodegenerative diseases. In Alzheimer's disease and other tauopathies, the intracellular accumulation of hyperphosphorylated Tau disrupts several cellular processes, including mRNA translation. Although Tau interacts with ribosomal proteins and modulates translational selectivity, its effects on global protein synthesis remain poorly understood. Studies report reduced translation in later disease stages but increased translation early in pathology. To clarify Tau's impact in human neurons, we used SH-SY5Y cells overexpressing the P301L mutant form of Tau and quantified global protein synthesis using the SUnSET (Surface Sensing of Translation) puromycin-incorporation assay. We found that Tau-P301L expression greatly increased global translation by upregulating mTOR/S6 pathway. These effects were abolished by rapamycin treatment, indicating that Tau-driven translational upregulation is mTOR-dependent. Given that impaired translational control can disrupt synaptic plasticity and memory, Tau-induced alterations in protein synthesis may contribute to tauopathy progression and identify mTOR signalling as a potential therapeutic target.}, }
@article {pmid41516246, year = {2025}, author = {Kvetnoy, I and Kheyfets, O and Safaniev, L and Kheifets, V and Mironova, E and Kvetnaia, T and Mazzoccoli, G and Prashchayeu, K and Gavrilova, A}, title = {Signaling Molecules and Diagnosis of Cognitive Disorders: Current State and Prospects.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516246}, issn = {1422-0067}, mesh = {Humans ; Biomarkers/metabolism ; *Signal Transduction ; *Alzheimer Disease/metabolism/diagnosis ; Dementia, Vascular/metabolism/diagnosis ; *Cognition Disorders/diagnosis/metabolism ; *Cognitive Dysfunction/diagnosis/metabolism ; }, abstract = {Cognitive disorders present significant medical and social challenges nowadays, due to their high prevalence, progressive course and a lack of effective methods for treatment of neurodegenerative diseases and comorbid pathologies. An important area of research is the identification of molecular biomarkers that reflect early pathophysiological changes and facilitate a more accurate biological characterization of cognitive impairment. This study provides an overview of the most relevant signaling molecules for diagnosing cognitive disorders. It presents data on the effectiveness of using comprehensive panels of molecular biomarkers in clinical practice, including β-amyloid, CD34, claudin, DRP1, endothelin-1, NF-kB, PINK1, RAGE, S100, α-synuclein, and tau protein, in patients with Alzheimer's disease (AD) and vascular dementia (VD). The study results demonstrate that cumulative changes in the expression of signaling molecules reflect various neurodegenerative and vascular-associated biological processes. The data obtained are comparative in nature and require further validation before potential clinical application.}, }
@article {pmid41515488, year = {2026}, author = {Huang, Y and Li, X and Dai, L and Cheng, M and Zhao, L and Shen, Y and Xie, J and Luo, X}, title = {Antioxidant, Anti-Inflammatory, and Chemical Composition Analysis of In Vitro Huperzia serrata Thallus and Wild Huperzia serrata.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {1}, pages = {}, pmid = {41515488}, issn = {1420-3049}, support = {20232ACB2050009//Natural Science Foundation of Jiangxi Province, China/ ; 32060074//National Natural Science Foundation of China/ ; 20204BCJ22024//Major Academic and Technical Leader Training Project of Jiangxi Province/ ; }, mesh = {*Antioxidants/pharmacology/chemistry ; *Anti-Inflammatory Agents/pharmacology/chemistry ; *Huperzia/chemistry ; Animals ; *Plant Extracts/chemistry/pharmacology ; Mice ; Sesquiterpenes/pharmacology/chemistry ; Alkaloids/pharmacology/chemistry ; RAW 264.7 Cells ; }, abstract = {Huperzine A is a preferred treatment option for Alzheimer's disease. Huperzia serrata (Thunb. ex Murray) Trev. (H. serrata) has garnered significant attention for its ability to produce Huperzine A (HupA). However, natural populations of wild H. serrata (WH) are rapidly declining. Fortunately, our group obtained two types of H. serrata thalli (OT and ST) capable of stably producing Huperzine A, which have the potential to serve as an alternative resource to WH. To evaluate the feasibility of this strategy, we conducted a comprehensive assessment of both WH and H. serrata thallus. The results indicated that compared to WH, ST and OT exhibited stronger anti-inflammatory and antioxidant activities, with lower cytotoxicity. Notably, ST demonstrated a strong radical scavenging activity, reaching 93.23% (DPPH at 0.2 μg/mL) and 99.87% (ABTS at 4 μg/mL), and reduced nitrite production from 10.29 μM to 6.51 μM at 50 µg/mL. GC-MS and widely targeted metabolomics analyses revealed that the higher antioxidant and anti-inflammatory activities for ST and OT were due to higher concentrations of phenolic acids and flavonoids compared to WH. In addition, the HupA content in ST reached 36.56% of that found in WH. KEGG enrichment analysis revealed that the flavonoid, phenylalanine, and phenylpropanoid biosynthesis pathways may be involved in regulating the antioxidant activity. P-coumaroyl quinic acid and caffeoyl quinic acid are the crucial metabolites for antioxidant activity. These findings suggested that the H. serrata thallus could serve as a sustainable alternative to WH.}, }
@article {pmid41514478, year = {2026}, author = {Noman, M and Qadir, H and Ahmed, S and Rehman, NU and Shah, FA and Riaz, M and Ahmad, N and Ul-Haq, Z and Irshad, N}, title = {Santonin Attenuates Alzheimer's-Like Pathology via Multitarget Modulation of the NLRP3 Inflammasome, BDNF Signaling, and Amyloidogenic Pathways: An Integrated Experimental and Computational Study.}, journal = {ACS chemical neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1021/acschemneuro.5c00957}, pmid = {41514478}, issn = {1948-7193}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder and the predominant cause of dementia, characterized by amyloid β (Aβ) plaques and tau tangles that disrupt neurons in memory-related brain regions. This study explores the therapeutic potential of santonin using integrated in silico, in vitro, and in vivo approaches. Molecular docking identified santonin as a promising acetylcholinesterase, NOD-like receptor family, pyrin domain-containing 3 (NLRP3), brain-derived neurotrophic factor (BDNF), and nuclear factor kappa B (NF-κB) ligand with significant binding affinities and supportive interaction scores supported by molecular dynamics simulations with significant multitarget therapeutic relevance. In vitro assays demonstrated that santonin has measurable inhibition of cholinesterase enzymes, showing significant effects on butyrylcholinesterase and acetylcholinesterase enzymes. Behavioral analysis revealed that santonin produced dose-dependent improvements in memory and exploratory behaviors, indicating significant neuroprotective effects against streptozotocin (STZ)-induced impairments. Histological analysis showed that santonin preserved neuronal architecture, enhanced neuronal density, and reduced Aβ deposition in STZ-treated brains using hematoxylin and eosin, Congo red, and Nissl analysis. These effects were evident in the cortical and hippocampal regions. Santonin exhibited strong antioxidant effects, mitigating induced enzyme depletion and oxidative marker elevation. Santonin effectively mitigated STZ-induced Aβ buildup and provided protective effects. Santonin modulated marker expression in STZ-treated brains by reducing the amyloid precursor protein, Tau, toll-like receptor 4, NLRP3, discs large MAGUK scaffold protein 4, and BDNF. Santonin reduces neuroinflammation and neurotrophic signaling in the early stages of AD, which suggests that it may be used as a treatment. However, more research is needed to confirm its effectiveness.}, }
@article {pmid41514416, year = {2026}, author = {Tian, Q and Liu, M and Zhong, F and Liu, X and Lü, Y}, title = {Lecanemab treatment for mild alzheimer's disease with high risk of cerebral hemorrhage: a case report.}, journal = {BMC neurology}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12883-025-04581-y}, pmid = {41514416}, issn = {1471-2377}, abstract = {BACKGROUND: Lecanemab has been approved for the treatment of mild cognitive impairment due to Alzheimer's disease (AD) and mild AD dementia based on the efficacy in slowing cognitive decline and preliminary safety data from the phase Ⅲ Clarity AD trial. However, this trial excluded patients with high risk of cerebral hemorrhage, such as individuals with intracranial aneurysms or > 4 microhemorrhages.
CASE PRESENTATION: A 70-year-old male with mild AD, intracranial aneurysm, microhemorrhages, and APOE ε3/ε4 genotype received lecanemab after multidisciplinary evaluation and informed consent. Over six months of intensive monitoring, cognitive function stabilized with no deterioration, daily activities were preserved, microhemorrhages remained stable (with one new small lesion noted at 3 months), and no aneurysm rupture or severe adverse events (including amyloid-related imaging abnormalities) occurred.
CONCLUSIONS: This case suggests that, despite hemorrhage risks, lecanemab may have a manageable risk-benefit profile in selected real-world AD patients under intensive monitoring and multidisciplinary care, with its application beyond clinical trial criteria requiring more nuanced and individualized consideration.}, }
@article {pmid41513640, year = {2026}, author = {Abdulkhaliq, AA and Kim, B and Almoghrabi, YM and Khan, J and Ajoolabady, A and Ren, J and Bahijri, S and Tuomilehto, J and Borai, A and Pratico, D}, title = {Amyloid-β and Tau in Alzheimer's disease: pathogenesis, mechanisms, and interplay.}, journal = {Cell death & disease}, volume = {17}, number = {1}, pages = {21}, pmid = {41513640}, issn = {2041-4889}, mesh = {Humans ; *Alzheimer Disease/metabolism/pathology ; *tau Proteins/metabolism ; *Amyloid beta-Peptides/metabolism ; Animals ; Brain/metabolism/pathology ; }, abstract = {Alzheimer's disease (AD) is a devastating neurodegenerative disease and the most prevalent type of dementia characterized by pathological deposition of amyloid-β plaques/deposits and tau tangles within the brain parenchyma. This progressive ailment is featured by irreversible cognitive impairment and memory loss, often misdiagnosed as the consequence of old age in elderlies. Pathologically, synaptic dysfunction occurs at the early stages and then progresses into neurodegeneration with neuronal cell death in later stages. In this review, we aimed to critically discuss and highlight recent advances in the pathological footprints of amyloid-β and tau in AD. Specifically, we focused our attention on the interplay and synergistic effects of amyloid-β and tau in the pathogenesis of AD. We hope that our paper will provide new insights and perspectives on these pathological features of AD and spark new ideas and directions in AD research and treatment.}, }
@article {pmid41513181, year = {2026}, author = {Vyas, J and Jamenis, AS and Kaku, K and Shah, Y and Miner, KM and Bhatia, TN and Kim, RE and Bai, R and Hamel, E and Leak, RK and Gangjee, A}, title = {Discovery of multitargeting single agents as a novel route to the potential treatment of neurodegenerative diseases.}, journal = {Bioorganic & medicinal chemistry letters}, volume = {133}, number = {}, pages = {130536}, doi = {10.1016/j.bmcl.2026.130536}, pmid = {41513181}, issn = {1464-3405}, abstract = {There are no cures for neurodegenerative diseases. The biggest hurdle to treating these disorders is that their clinical manifestation is rooted in multiple physiological processes. Therefore, efficacious pharmaceutical options will likely require two or more agents with different mechanisms of action. However, drug combinations have significant drawbacks, including overlapping toxicities and unique pharmacokinetic properties, particularly the rate and extent of central nervous system (CNS) penetration. A single agent with multiple mechanisms of action could overcome these drawbacks. We have recently discovered first-in-class novel single agents (compounds 1 and 2) that mildly inhibit clinically important kinases and subtly favor microtubule stability at concentrations that show no evidence of neuronal toxicity in primary neurons, while maintaining their ability to penetrate the CNS in vivo. It is important to note that the effects of these analogs are mild and are predicated on avoiding neurotoxicity. These multitargeting single agents provide a new structural modality with the potential to influence treatments for Parkinson's and Alzheimer's disease and serve as lead compounds for further optimization.}, }
@article {pmid41511604, year = {2026}, author = {Babaker, MA and Alazabi, NI and Yousef, EM and Haredy, SA and Algohary, AM and Mansour, DF and Ahmed-Farid, OA}, title = {Taurine Mitigates Spironolactone-Induced Hyperkalemia and Cognitive Dysfunction: A Biochemical and Histological Study in a Rat Model.}, journal = {Applied biochemistry and biotechnology}, volume = {}, number = {}, pages = {}, doi = {10.1007/s12010-025-05513-9}, pmid = {41511604}, issn = {1559-0291}, abstract = {Spironolactone (SPR), a widely used potassium-sparing diuretic, frequently causes hyperkalemia, leading to significant cardiovascular and neurological complications. Taurine, a semi-essential amino acid with known antioxidant and neuroprotective effects, was hypothesized to mitigate these adverse effects. This study investigated taurine's efficacy against SPR-induced hyperkalemia and associated cognitive dysfunction in a rat model. Adult male Sprague-Dawley rats were treated for four weeks with SPR, SPR + galantamine (an AChE inhibitor widely used in the treatment of Alzheimer's disease), or SPR + varying concentrations of taurine, followed by assessment of cognitive, biochemical, and histopathological alterations. SPR administration significantly increased serum potassium levels (~7.5 mEq/L), induced cognitive deficits, disrupted neurotransmitter balance (e.g., altered GABA and glutamate levels), and caused reactive astrocytic swelling in key brain regions. Taurine demonstrated a dose-dependent protective effect against SPR-induced neurotoxicity by mitigating hyperkalemia and associated cognitive impairments. Biochemically, taurine restored neurotransmitter balance by increasing GABA and reducing the excitotoxic glutamate levels. Histological analysis further confirmed taurine's neuroprotective effects, showing preserved cortical structures and reduced astrogliosis, especially at the highest concentration (5%). Our correlation analysis reveals complex regulatory mechanisms underlying neurotransmitter balance in the brain. These findings suggest taurine as a promising therapeutic agent for alleviating SPR-induced neurological side effects. Further studies are needed to explore taurine's long-term effects and clinical applications in managing hyperkalemia-related cognitive dysfunctions.}, }
@article {pmid41511339, year = {2025}, author = {Yu, H and Josi, RR and Khanna, A and Khismatullin, DB}, title = {Low-Density Lipoproteins Induce a Pro-Inflammatory, Chemotactic Mox-like Phenotype in THP-1-Derived Human Macrophages.}, journal = {Cells}, volume = {15}, number = {1}, pages = {}, pmid = {41511339}, issn = {2073-4409}, support = {R01 HL127092/HL/NHLBI NIH HHS/United States ; 1R01HL127092-01A1/NH/NIH HHS/United States ; }, mesh = {Humans ; *Lipoproteins, LDL/pharmacology ; *Macrophages/metabolism/drug effects ; *Chemotaxis/drug effects ; Phenotype ; THP-1 Cells ; *Inflammation/pathology/metabolism ; Mast Cells/metabolism/drug effects ; Interleukin-6/metabolism ; Cytokines/metabolism ; Cell Differentiation/drug effects ; }, abstract = {Murine macrophages exposed to oxidized low-density lipoprotein (oxLDL) polarize into a distinct Mox phenotype characterized by impaired phagocytic and chemotactic function. Although implicated in atherosclerosis, this phenotype has not been confirmed in human macrophages. Drawing parallels to human tumor-associated macrophages, and in contrast to the murine cell response, we hypothesize that LDL/oxLDL induces a hybrid Mox-like state in human macrophages, marked by the simultaneous secretion of pro-inflammatory cytokines and anti-inflammatory factors, potentially exacerbating vascular inflammation and atherogenesis. To test this, THP-1 human monocytes were differentiated into resting macrophages, then polarized into M1-like and M2-like phenotypes, followed by treatment with native LDL, oxLDL, IL-6, or their combinations. ELISA results showed that oxLDL or LDL with IL-6 polarized resting and M1-like macrophages into a Mox-like phenotype that secreted TNF-α and TGF-β1 at levels comparable to M1- and M2-like cells, respectively. The pro-inflammatory nature of Mox-like macrophages was supported by increased THP-1 adhesion to vascular endothelial cells exposed to the macrophage-conditioned media. In microfluidic assays, LUVA human mast cells migrated toward media from Mox-like macrophages, indicating enhanced chemotaxis. In summary, the pro-inflammatory Mox-like state is triggered in human macrophages by oxLDL or LDL combined with IL-6, a key regulator of the inflammatory acute-phase response. Unlike in murine cells, this state is marked by high chemotactic activity driven by TGF-β1 secretion, which promotes mast cell recruitment and contributes to atherosclerotic plaque development and Alzheimer's disease.}, }
@article {pmid41510854, year = {2026}, author = {Tyagi, S and Murali, N and Singh, SK and Babtiwale, SR and Padhi, BK and Lakshmi, NRA and Gandhi, AP}, title = {A Systematic Review to Evaluate the Effect of Neflamapimod on Cognitive Function and Progression of Dementia.}, journal = {Neurology India}, volume = {74}, number = {1}, pages = {12-19}, doi = {10.4103/neurol-india.Neurol-India-D-25-00227}, pmid = {41510854}, issn = {1998-4022}, mesh = {Humans ; *Cognition/drug effects ; Disease Progression ; *Dementia/drug therapy ; *Alzheimer Disease/drug therapy ; *Lewy Body Disease/drug therapy ; }, abstract = {Treatment options for dementia mainly comprise of symptomatic treatment, as no disease-modifying therapy currently exists that directly reduces the pathology. This systematic review assessed the effectiveness of neflamapimod (VX-745), a p38α kinase inhibitor, as a therapeutic agent for treating dementia, including Alzheimer's disease (AD) and Lewy Body Dementia (LBD). The systematic review evaluated the therapeutic effect of neflamapimod on dementia. Five electronic databases were included in the systematic review: PubMed, Embase, ProQuest, Cochrane Library, and Web of Science, which were searched until May 5, 2024. Two independent reviewers conducted title and abstract screening, followed by full-text review and data extraction, with disagreements resolved by a third reviewer. The risk of bias in the included studies was assessed using the ROB 2.0 tool. PROSPERO Registration ID: CRD42024542377. The review identified clinical results, biomarker effects, and mechanistic insights from two key trials. Due to the inclusion of only two eligible studies with varying methodologies and outcome measures, a meta-analysis could not be performed. While the primary cognitive outcomes, such as "neuropsychological test battery (NTB)" and "Hopkins Verbal Learning Test-Revised (HVLT-R)" were not statistically different, episodic memory, executive function, attention, gait dysfunction, and motor issues showed improvements, especially in patients with elevated plasma tau181, a marker for AD pathology. Biomarker analysis also indicated a statistically significant reduction in cerebrospinal fluid (CSF) tau and phosphorylated tau biomarkers, which are closely related to neuroinflammation and synaptic impairment in dementia. The findings of the current review suggested that while the cognitive effects of neflamapimod remain uncertain, its ability to influence disease-specific biomarkers makes it a potential drug to be used in dementia. This review connects biological and clinical outcomes, paving the way for future advancements in dementia treatment strategies.}, }
@article {pmid41510732, year = {2026}, author = {Adhikari, B and Venkatesh, DN and Puri, V and Sharma, A}, title = {Therapeutic Implications of Nutraceutical Nanotechnology for the Treatment of Chronic Diseases.}, journal = {Current drug metabolism}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113892002415344251122122358}, pmid = {41510732}, issn = {1875-5453}, abstract = {Nanotechnology possesses therapeutic value in managing chronic disease, but it has limitations like as solubility, stability, and targeted delivery in clinical applications. The review explores how nanotechnology-based delivery systems improve the efficacy, bioavailability, and targeted actions of nutraceutical compounds. Health benefits, sustainable nanotechnology, market size, and growth forecasts have shown positive results in this industry over the last two decades. The disease-like respiratory, diabetes, Alzheimer's and Parkinson's, and breast cancer top focused sectors for this nutraceuticals sector. Most literature has been collected from 2020-2025 using PubMed, Scopus, Google Scholar, and Web of Science. The different criteria included preclinical, clinical, and nanotechnology-integrated nutraceutical studies. The liposomes, dendrimers, nanoemulsions, and polymeric nanoparticles significantly enhance the stability and delivery of key bioactive as example like curcumin, resveratrol, and omega-3. Early-stage clinical trials show promise for diseases like Alzheimer's, diabetes, and cancer. Nanotechnology is the reshaping of nutraceutical therapy, through regulatory, toxicology, and large-scale validation gaps persist. Future work must focus on green synthesis, long-term safety, and harmonized approval pathways. Despite this, the industry still needs collaboration between academic researchers, scientists, and regulatory bodies to start the next generation of clinical trials and treatments that can reduce the risk of diseases and death in the future.}, }
@article {pmid41510728, year = {2026}, author = {González-Jiménez, KA and Herrera-Mayorga, EV and Paredes Sánchez, FA and Niño-García, N and Torres-Castillo, JA and Martínez-Padrón, HY and Sánchez-Sánchez, M}, title = {New Drug Therapies Against Targeting Neurodegenerative Diseases: A Comprehensive Review.}, journal = {Central nervous system agents in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0118715249397580251117044621}, pmid = {41510728}, issn = {1875-6166}, abstract = {Neurodegenerative diseases encompass well-characterized behavioral, cognitive, and movement disorders that affect older people, impacting all facets of daily life. In Alzheimer's disease, specific antibodies targeting the β-amyloid protein (aducanumab, lecanemab, and others) are gaining special interest due to the approval of the first particular drugs against this disease. In Parkinson's disease, most drugs were approved several decades ago; however, new Phase II clinical trials point to monoclonal antibodies as a promising approach, and the report of alkaloids also suggests various therapeutic targets against this disease. Pick's disease has a low prevalence; currently, no drugs are approved by government agencies. However, thanks to molecular tools, it has been possible to elucidate therapeutic targets implicated in the appearance of the disease. α-synuclein is the main therapeutic target in Lewy body disease; most of the reported molecules are in clinical Phases I and II. Additionally, drug repositioning may emerge as a viable option in the search for effective treatments against this disease. In amyotrophic lateral sclerosis, the appearance of newly approved drugs such as tofersen and edaravone, and some others in clinical Phase II (bosutinib), opens a new era in the understanding and treatment of this condition. Altered emotions and progressive damage in some brain regions characterize schizophrenia and vascular dementia. Combinations of tricyclic drugs are a trend that aims to increase the cognitive performance of patients with schizophrenia. In vascular dementia, numerous in vivo trials with molecules of different natures (flavonoids and lactones) have yielded positive results, delaying the progression of the disease. This review examines recent reports on molecules evaluated in vivo and in vitro models of the primary neurodegenerative diseases.}, }
@article {pmid41510718, year = {2026}, author = {Prabakaran, A and Sivaperuman, A and Natarajan, R and Nagarajan, NC and Solomon, VR}, title = {Innovative Approaches to Alzheimer's Treatment: Utilizing Tacrine Hybrids to Inhibit Amyloid Beta Aggregation as a Strategic Focus.}, journal = {Mini reviews in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113895575422492251116190843}, pmid = {41510718}, issn = {1875-5607}, abstract = {Alzheimer's disease (AD) is a complex and progressive brain disorder marked by memory loss, cognitive decline, and behavioral changes. One of its defining features is the build-up of amyloid plaques, clumps of β-amyloid (Aβ) peptides, in the brain, along with the formation of neurofibrillary tangles. These Aβ peptides are generated when the amyloid precursor protein (APP) is cleaved by enzymes, with β-secretase (BACE1) playing a key role in the first step of this process. Because BACE1 starts the cascade that leads to harmful Aβ build-up, it has become an important target in the search for effective Alzheimer's treatments. As Aβ accumulates in neurons, it disrupts communication between brain cells and triggers oxidative stress, which worsens damage and accelerates disease progression. This is often exacerbated by imbalances in metal ions, such as copper and iron. While tacrine, an early acetylcholinesterase inhibitor, has shown benefits in managing AD symptoms, its limitations have led researchers to explore improved versions. One promising direction is the development of tacrine-based hybrid molecules. By combining tacrine with other chemical groups that have anti-β-amyloid (Aβ) effects, antioxidant properties, and metal-chelating properties, scientists aim to create compounds that target multiple aspects of the disease simultaneously. This review examines the emerging potential of tacrine hybrids, particularly their capacity to inhibit BACE1 and prevent Aβ aggregation, providing new hope for more effective and disease-modifying therapies for Alzheimer's disease.}, }
@article {pmid41510716, year = {2026}, author = {Bano, A and Khan, AA and Kushwaha, SP and -, A and Zaidi, SMH and Misbahul Hasan, S and Fatima, A}, title = {Indole Scaffolds in Neurological Therapeutics: Synthesis, Structure-Activity Relationships and Drug-Receptor Interactions.}, journal = {Mini reviews in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113895575415521251021091530}, pmid = {41510716}, issn = {1875-5607}, abstract = {INTRODUCTION: Indole is a privileged heterocyclic scaffold that plays a crucial role in medicinal chemistry due to its strong ability to bind to various biological receptors and interact with diverse molecular targets. Indole exhibits both biological and chemical significance. Its structural versatility allows for precise chemical modifications, making it an essential framework in drug discovery. This review discusses the structure-activity relationships, synthesis, and interactions of indole derivatives, particularly in relation to targets within the central nervous system.
METHODS: A detailed literature survey was conducted using databases such as Google Scholar, Elsevier, PubMed, ACS, PubChem, ScienceDirect, and RSC to understand the structural modifications of indole derivatives and their therapeutic potential. Both research and review articles related to indole- based compounds were thoroughly studied to prepare this review article.
RESULTS: There are over 40 FDA-approved drugs containing an indole nucleus used to treat various diseases, underscoring its potential in neurotherapeutics. This review highlights innovative synthetic strategies, including green chemistry approaches, that improve the drug-likeness and bioavailability of indole derivatives. Indole continues to be an indispensable scaffold in the development of novel therapeutics aimed at addressing the growing burden of neurological disorders.
DISCUSSION: This review aims to provide a comprehensive analysis of the therapeutic potential of indole-based compounds for the treatment of neurological disorders. However, challenges like blood-brain barrier permeability and long-term safety must be addressed for clinical success. Nonetheless, this review will help in designing and developing newer indole-based molecules in the discovery of neurological drug development.
CONCLUSION: Due to its broad spectrum of biological activities and favorable pharmacokinetic properties, indole is an impressive scaffold for the treatment of various neurological disorders. Indole demonstrates remarkable therapeutic potential against a range of central nervous system-related conditions, including Alzheimer's disease, epilepsy, migraine, stroke, Parkinson's disease, prion disease, amyotrophic lateral sclerosis, and Huntington's disease.}, }
@article {pmid41510572, year = {2026}, author = {Tang, C and Han, K and Wen, X and Zhang, J and Sun, W and Yue, X and Shi, L and Liu, Z and Zhao, J and Yan, C and Liu, M and Yao, Z and Kong, Z and Liu, Y and Fu, Z and Zhao, X and Yang, Z and Han, M and Chen, C and Xing, Z and Zhou, X and Yang, F and Zhang, Y and Jiang, X}, title = {Synthetic Disaggregators Enhance Central-Peripheral Amyloid-β Clearance in Alzheimer's Disease.}, journal = {Advanced materials (Deerfield Beach, Fla.)}, volume = {}, number = {}, pages = {e20002}, doi = {10.1002/adma.202520002}, pmid = {41510572}, issn = {1521-4095}, support = {2024YFA0918400//National Key Research and Development Program of China/ ; 82350125//National Natural Science Foundation of China/ ; 82425056//National Natural Science Foundation of China/ ; 82173763//National Natural Science Foundation of China/ ; 82303810//National Natural Science Foundation of China/ ; ZR2022ZD18//Fundamental Research Funds of Shandong Province/ ; ZR2023QH224//Natural Science Foundation of Shandong Province/ ; 2022M721967//China Postdoctoral Science Foundation/ ; 2024T170524//China Postdoctoral Science Foundation/ ; SYS202202//Shandong Provincial Laboratory Project/ ; NO.tsqnz20221165//Taishan Scholar Foundation of Shandong Province/ ; 2025CXPT177//Key R&D Program of Shandong Province/ ; 2025CXPT177//Key R&D Program of Shandong Province/ ; }, abstract = {Pathogenic amyloid-β (Aβ) accumulation defines Alzheimer's disease (AD), directly inflicting neuronal damage and driving chronic neuroinflammation. While both central microglia and peripheral macrophages are critical for Aβ clearance, their functional impairment in AD inexorably leads to escalating Aβ burden and disease progression. We here report an in situ engineered synthetic Aβ disaggregator (SAD) delivered to macrophages via neuroprotective DHA-based lipid nanoparticles (DLNPs). This platform transcends current therapeutic limitations by not only potently dismantling neurotoxic Aβ aggregates but also by fundamentally reprogramming peripheral macrophages to enhance Aβ clearance. Specifically, our results demonstrate that DLNPs effectively reprogram peripheral macrophages to produce and secrete cerebral-penetrating SAD both in vitro and in vivo. The SAD can promote cerebral Aβ disaggregation, thereby inhibiting neuroinflammatory pathology progression. Moreover, the DLNPs efficiently reprogram the peripheral macrophages to enhance phagocytosis, further facilitating drainage of Aβ and reducing cerebral Aβ accumulation in mouse models. Collectively, these findings uncover a dual-action mechanism of SAD through the synergistic interplay of direct Aβ disaggregation and enhanced macrophage-mediated clearance. In sum, our findings establish that the central-peripheral targeting therapeutic strategy significantly reversed AD pathology, highlighting the therapeutic potential of mRNA-based in situ fusion protein in AD treatment.}, }
@article {pmid41510365, year = {2026}, author = {Wang, Y and Alexander, GC and Mehta, HB}, title = {Treatment of type 2 diabetes among medicare beneficiaries with and without alzheimer's disease: A retrospective cohort study.}, journal = {Journal of diabetes and metabolic disorders}, volume = {25}, number = {1}, pages = {25}, pmid = {41510365}, issn = {2251-6581}, abstract = {PURPOSE: While Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) commonly co-occur in older adults, little is known regarding whether and how the treatment of T2DM varies by AD status. This study aimed to compare and contrast T2DM treatment among individuals with and without AD.
METHODS: We conducted a retrospective cohort study using 20% Medicare Fee-for-Service claims data from 2016 to 2020. The primary outcome was initiation of any antidiabetic medication within one year of T2DM diagnosis, and we also examined initiation patterns across specific drug classes. We used multivariable logistic regression to estimate adjusted odds ratios for the association between AD and treatment initiation.
RESULTS: Among 388,359 beneficiaries newly diagnosed with T2DM, 9,584 had AD. Within one year, overall treatment initiation was lower for individuals with AD compared to those without. At initiation, individuals with AD were more likely to receive insulin and less likely to receive metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, or glucagon-like peptide-1 (GLP-1) receptor agonists. In adjusted models, AD was associated with lower odds of antidiabetic treatment initiation, and among those initiating treatment, lower odds of initiating newer agents such as GLP-1 receptor agonists and SGLT2 inhibitors.
CONCLUSION: Beneficiaries with AD were less likely to initiate antidiabetic therapy, particularly newer agents. Future work could explore the basis for these differences.}, }
@article {pmid41510304, year = {2025}, author = {Wang, Y and Zhou, M and Tang, Z and Xiong, C and Asken, B and Yang, B and Su, J and Zhou, X and Song, Q}, title = {CauReL: Dynamic Counterfactual Learning for Precision Drug Repurposing in Alzheimer's Disease.}, journal = {Research square}, volume = {}, number = {}, pages = {}, doi = {10.21203/rs.3.rs-8206648/v1}, pmid = {41510304}, issn = {2693-5015}, abstract = {Alzheimer's disease has few effective therapies, and decades of amyloid- and tau-focused trials have delivered only modest benefit with substantial toxicity. Drug repurposing using real-world data offers a faster and lower-risk route to new treatments, yet current approaches typically average effects across populations, model disease onset and progression separately, and provide little insight into which patients are most likely to benefit. We present CauReL, a dynamic counterfactual representation learning framework that enables transparent, patient specific estimation of treatment effects from large-scale electronic health records for precision drug repurposing in AD. CauReL first learns balanced latent representations of treated and untreated patients using Integral Probability Metric regularization, then jointly predicts two clinically linked outcomes, incident AD and time from mild cognitive impairment (MCI) to AD, to generate paired counterfactual outcomes for every individual. A counterfactual explanation module quantifies how clinical features shape benefit at the patient level, and uplift trees transform complex heterogeneity into simple, rule-based subgroups suitable for trial enrichment and clinical decision support.Using independent cohorts from OneFlorida + and All of Us, we screened outpatient prescriptions with at least 20 percent exposure among 28,605 individuals with mild cognitive impairment, of whom 4,990 progressed to Alzheimer's disease. CauReL substantially improved covariate balance and distributional overlap across drug cohorts and achieved strong predictive accuracy for both incidence (AUC greater than 0.90) and progression timing (C index 0.81 to 0.84; Spearman 0.80 to 0.86). Twenty drugs showed consistent protective associations, with four emerging as highly reproducible across both networks, the metabolic agents liraglutide and empagliflozin and the neuroactive agents entacapone and amantadine. These drugs were associated with meaningful absolute risk reductions and clinically significant delays in progression from mild cognitive impairment to Alzheimer's disease. Metabolic drugs produced the strongest benefits in individuals with diabetes, obesity, or cardiovascular disease, whereas neuroactive drugs provided broadly consistent protection across most subgroups.CauReL is available as an open source Python package with a companion web server for direct application to new cohorts or disease settings (https://caurel.site/). This work delivers a scalable and interpretable framework for prioritizing repurposable drugs and designing targeted clinical trials for the patients most likely to benefit.}, }
@article {pmid41510223, year = {2025}, author = {Jiang, L and Tucker, A and Sepehri, C and Patel, D and Wang, Q and Yuan, S and Sherman, E and Chen, Y and Beh, J and Downey, A and Goldberg, D and Gniadzik, W and Ma, X}, title = {Inhibition of N6-Methyladenosine Accumulation by Targeting METTL3 Mitigates Tau Pathology and Cognitive Decline in Alzheimer's Disease.}, journal = {Research square}, volume = {}, number = {}, pages = {}, doi = {10.21203/rs.3.rs-8379573/v1}, pmid = {41510223}, issn = {2693-5015}, abstract = {Dysregulation of N6-methyladenosine (m6A) modification of RNA has emerged as a novel feature of Alzheimer's disease (AD). Here, we investigate the relationship between m6A modification and AD pathology, and the therapeutic potential of modulating excessive m6A via its "writer" methyltransferase METTL3 in a humanized P301S tau transgenic mouse model of AD (PS19). We observed significantly elevated m6A levels in human post-mortem AD frontal cortex tissue compared to healthy controls, which positively correlated with hyperphosphorylated tau and amyloid-β (Aβ) deposition. These effects were recapitulated in the PS19 tau mice model of AD. Importantly, treatment of PS19 mice with the METTL3 inhibitor STM2457 reduced excessive m6A, alleviated tau pathology, and attenuated neurodegeneration. Behavioral assessments further demonstrated that STM2457-treated PS19 mice exhibited significantly improved learning and memory relative to untreated PS19 mice. Our results identify m6A as a critical contributor to AD pathogenesis and demonstrate that pharmacological inhibition of METTL3 represents a promising therapeutic strategy to improve cognition in AD.}, }
@article {pmid41509358, year = {2026}, author = {Jati, S and Kal, S and Munoz-Mayorga, D and Tang, K and Sahoo, D and Chen, X and Mahata, SK}, title = {Catestatin ameliorates tauopathy and amyloidogenesis via adrenergic inhibition.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41509358}, issn = {2692-8205}, support = {I21 RX004398/RX/RRD VA/United States ; P30 NS047101/NS/NINDS NIH HHS/United States ; R21 AG091126/AG/NIA NIH HHS/United States ; R01 AG074273/AG/NIA NIH HHS/United States ; R21 AG078635/AG/NIA NIH HHS/United States ; R01 AG078185/AG/NIA NIH HHS/United States ; R21 AG080246/AG/NIA NIH HHS/United States ; R01 GM138385/GM/NIGMS NIH HHS/United States ; UG3 TR003355/TR/NCATS NIH HHS/United States ; R01 AI155696/AI/NIAID NIH HHS/United States ; }, abstract = {Neurodegenerative disorders like Alzheimer's disease (AD), Corticobasal Degeneration (CBD), and Progressive Supranuclear Palsy (PSP) are characterized by Tau aggregation, synaptic dysfunction, neuroinflammation, and progressive cognitive decline. Although metabolic dysregulation and neuropeptide imbalance have been linked to these disorders, the functional consequences of such imbalance and its potential for therapeutic reversal remain poorly understood. Our previous work identified chromogranin A (CgA), which encodes a pro-hormone for several metabolic peptides, as a key regulator of Tau pathology. Here, we investigate Catestatin (CST), a CgA-derived peptide that is a potent inhibitor of catecholamine release and has been shown to increase insulin sensitivity and lower peripheral blood pressure. We report significant reductions in CST levels in the hippocampus and cortex of AD brains, as well as in the frontal cortex of CBD and the basal ganglia of PSP. Supplementing CST in cortical neuronal cultures and organotypic slice cultures (OTSC) decreased Tau phosphorylation and aggregation. In vivo, CST administration in PS19 Tauopathy mice reduced pathological Tau species, attenuated gliosis, and improved cognitive function. CST treatment also lowered amyloid plaque burden and neuroinflammation in 5xFAD mice. Mechanistically, CST decreased epinephrine (EPI) levels in both PS19 and 5xFAD mice and suppressed downstream protein kinase A (PKA) hyperactivation in PS19 and OTSC. These findings reveal a previously unrecognized neuropeptidergic mechanism linking CST deficiency to elevated adrenergic receptor (ADR)-EPI-PKA stress signaling and Tauopathy-driven neurodegeneration, suggesting CST replacement as a promising therapeutic approach.}, }
@article {pmid41509252, year = {2026}, author = {Jesudason, CD and Rangel-Barajas, C and Beach, CJ and Beck, DE and Caballero-Floran, IH and Clayton, WB and Da Silva, L and David, JC and Doolen, S and Faulkner, AN and Hamdani, AK and Huhe, H and Huynh, K and Imhoff, RD and Javens-Wolfe, J and Mason, ER and Moussaif, M and Singhal, K and Soni, DM and van Buuren-Milne, M and Williams, SP and Angus, SP and Chu, S and Dage, JL and Hipskind, PA and Johnson, TS and Kaddurah-Daouk, R and Lamb, BT and Meikle, PJ and Mesecar, AD and Palkowitz, AD and Quinney, SK and Sukoff Rizzo, SJ and Oblak, AL and Richardson, TI}, title = {Optimization and Characterization of SHIP1 Ligands for Cellular Target Engagement and Activity in Alzheimer's Disease Models.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41509252}, issn = {2692-8205}, support = {T32 AG071444/AG/NIA NIH HHS/United States ; U01 AG088021/AG/NIA NIH HHS/United States ; U54 AG065181/AG/NIA NIH HHS/United States ; T32 CA272370/CA/NCI NIH HHS/United States ; P30 CA082709/CA/NCI NIH HHS/United States ; R01 AG081322/AG/NIA NIH HHS/United States ; }, abstract = {Src homology 2 domain-containing inositol 5-phosphatase 1 (SHIP1), encoded by the gene INPP5D, is a lipid phosphatase that negatively regulates immune receptor signaling in hematopoietic cells and microglia. Here, we describe a pyridyl-pyrazole-piperidine scaffold and the lead compound 3-((2-chlorobenzyl)oxy)-5-(1-(piperidin-4-yl)-1H-pyrazol-4-yl)pyridine (32), which demonstrates SHIP1 target engagement, brain exposure, and evidence of a central pharmacodynamic response in vivo. Structure-activity relationship studies, guided by biochemical and cellular assays using multiple human and murine protein constructs and cells, identified SHIP1-active ligands. A thermal shift assay using full-length SHIP1 was used to assess compounds for cellular target engagement, while studies in IL-4 conditioned THP-1 cells was used to demonstrate changes in downstream AKT signaling. Targeted lipidomics revealed changes in the overall phosphoinositide pool consistent with SHIP1 target engagement and reduction of phospho-AKT levels. In a protein-lipid overlay assay, compound 32 induced changes in the relative association of SHIP1 with multiple phosphatidylinositols on a membrane surface. In high-content cellular imaging assays, compound 32 enhanced the uptake of myelin/membrane debris and fibrillar amyloid by primary murine microglia, phenocopying a genetic model with reduced SHIP1 expression. Finally, oral administration of compound 32 resulted in brain exposure sufficient to alter gene expression and reduce IL-1β levels as pharmacodynamic markers of microglial activation and neuroinflammation in an amyloidosis mouse model of Alzheimer's disease. Collectively, these results define a scaffold with SHIP1 target engagement, CNS exposure, and in vivo activity, providing a foundation for the optimization of brain-penetrant SHIP1 ligands suitable for further mechanistic studies and therapeutic development for the treatment of Alzheimer's disease.}, }
@article {pmid41509242, year = {2025}, author = {Kumari, R and Bowen, C and Srivastava, U and Brandelli, AD and Kumar, P and Kour, D and Malepati, S and Jang, WE and Bromwich, M and Zeng, H and Sing, A and Sloan, SA and Wulff, H and Rangaraju, S}, title = {Kv1.3 inhibition alleviates neuropathology via neuroinflammatory and resilience pathways in a mouse model of Aβ pathology.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.25.696456}, pmid = {41509242}, issn = {2692-8205}, abstract = {Inhibition of voltage-gated potassium channel Kv1.3 is a therapeutic strategy to curb microglia-mediated neuroinflammation in neurodegeneration, although the cellular and signaling mechanisms of disease-modification by Kv1.3 blockers are unclear. In this study, we delineate protective mechanisms of Kv1.3 blockade in a mouse model of Alzheimer's disease (AD) pathology using comprehensive transcriptomics and proteomics profiling of brain, corresponding with neuropathological effects of two translationally relevant Kv1.3 blockers, namely small molecule PAP-1 and peptide ShK-223. Following 3 months of treatment, both molecules reduced Ab plaque burden. Single nuclear RNA seq (snRNA seq) of brain nuclei showed that PAP-1 disproportionately impacted oligodendrocytes and microglia and increased crosstalk between neurons and astrocytes with endothelial cells. In contrast, ShK-223 had pronounced effects on glutamatergic neurons and astrocytes. Both blockers increased expression of myelination genes in oligodendrocytes and synaptic genes in neurons. Neuroprotective effects of PAP-1 were further confirmed by bulk brain transcriptomics and proteomics whereby PAP-1 increased levels of synaptic, cognitive resilience and mitochondrial proteins, while decreasing glial and immune pathways including STAT1/3 phosphorylation. Using proximity labeling and co-immunoprecipitation, we found that Kv1.3 interacts with STAT1/3 in microglia. Using microglial cell lines and primary microglia, we discovered a preferential functional coupling between Kv1.3 and type 2 but not type 1 IFN signaling. Brain-level disease modification by Kv1.3 blockade was reflected in the cerebrospinal fluid (CSF) via reduced levels of neurofilament-light (NEFL) and resilience protein RPH3A, both of which are increased in human AD CSF. Together, this study demonstrates functional links between Kv1.3 channels and type 2 IFN signaling and reveals distinct cellular effects of Kv1.3 blockers in AD pathology that correspond with reduced neuropathology and neuroinflammation, augmentation of resilience and neuro-vascular pathways, along with biomarkers of therapeutic effect.}, }
@article {pmid41508224, year = {2025}, author = {Ma, YJ and Deng, SX and Liao, ZH and Gao, MH and Ding, HX and Xu, ZQ and Lu, YT and Yang, C and Wang, Q}, title = {[Treatment of Alzheimer's disease from gut-brain interactions based on theory of "spleen deficiency leading to obstruction of nine orifices"].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {50}, number = {19}, pages = {5330-5339}, doi = {10.19540/j.cnki.cjcmm.20250618.501}, pmid = {41508224}, issn = {1001-5302}, mesh = {*Alzheimer Disease/drug therapy/physiopathology/metabolism ; Humans ; *Brain/physiopathology/drug effects/metabolism ; *Spleen/physiopathology/drug effects ; Animals ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/therapeutic use ; Gastrointestinal Microbiome ; }, abstract = {Alzheimer's disease(AD) is the most common form of dementia. The decline in sensory function is associated with pathological damage in specific brain regions during the early stages of AD. Such decline often precedes cognitive impairment, worsens as the pathology progresses, and constitutes a high-risk factor for the onset of AD. According to traditional Chinese medicine(TCM), all orifices are connected to the brain, and the brain governs all orifices. The mind originates from and depends on both the brain and orifices, with their physiological and pathological states being closely interconnected. In AD, dysfunction of the sensory orifices is closely linked to the later-stage manifestations of impaired mental clarity and consciousness. The theory that "spleen deficiency leading to obstruction of nine orifices" emphasizes that insufficiency of the spleen and stomach is the root cause of orifice dysfunction. Both internal and external pathogenic factors in AD can damage the spleen and stomach, leading to the abnormal movement of turbid substances generated by these organs, which may transform into turbid toxins. This, in turn, gradually impairs the orifices, brain, and mind, thereby exacerbating the progression of AD. The digestive, absorptive, and transport functions of the spleen and stomach are similar to those of the gut microbiota. Spleen deficiency is a core pathological factor in diseases associated with gut microbiota dysbiosis. Such dysbiosis can lead to dysfunction in the neural, metabolic, and immune pathways involved in gut-brain interactions, constituting the biological basis for the TCM concept that "spleen deficiency leading to obstruction of nine orifices". Under the guidance of this theory, employing spleen-strengthening and cognition-enhancing drugs alongside aromatic orifice-opening drugs to support spleen function, and using ingredients that promote dampness elimination, lubrication, and blood stasis resolution to dispel pathogenic factors from the orifices, can help restore the structural balance of the gut microbiota, regulate related metabolic and immune dysfunctions, and ultimately delay the progression of AD. This article explores the etiology, pathogenesis, and therapeutic strategies of AD based on the theory of "spleen deficiency leading to obstruction of nine orifices", and interprets its biological significance from the perspective of gut-brain interactions, aiming to provide new insights for the prevention and treatment of AD.}, }
@article {pmid41508200, year = {2025}, author = {Zhang, YX and Wang, J and Chen, QQ and Zhang, JL and Wang, Q and Long, YL and Zhou, SJ and Gong, ZP and Zheng, L and Huang, Y and Li, YT}, title = {[Study on quality markers of Pleione yunnanensis for "same treatment for different diseases" in liver inflammation and Alzheimer's disease based on UHPLC fingerprint and network pharmacology].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {50}, number = {20}, pages = {5684-5696}, doi = {10.19540/j.cnki.cjcmm.20250710.202}, pmid = {41508200}, issn = {1001-5302}, mesh = {Network Pharmacology ; *Drugs, Chinese Herbal/chemistry/therapeutic use ; *Alzheimer Disease/drug therapy/genetics/metabolism ; Chromatography, High Pressure Liquid/methods ; Humans ; Molecular Docking Simulation ; Biomarkers/analysis ; Quality Control ; }, abstract = {This study aims to screen quality markers(Q-markers) of Pleione yunnanensis for the treatment of liver inflammation and Alzheimer's disease(AD) based on the concept of "same treatment for different diseases" using ultra-high-performance liquid chromatography(UHPLC) fingerprinting combined with network pharmacology and molecular docking, and to perform quantitative analysis of the identified Q-markers. The UHPLC fingerprints of 15 batches of P. yunnanensis were established and subjected to similarity evaluation, cluster analysis(CA), principal component analysis(PCA), and orthogonal partial least squares discriminant analysis(OPLS-DA) to identify characteristic components responsible for quality variations. Network pharmacology and molecular docking were employed to explore the potential active components, related targets, and signaling pathways underlying the "same treatment for different diseases" mechanism for liver inflammation and AD. Based on the criteria of effectiveness, specificity, and measurability, Q-markers of P. yunnanensis were identified and quantified. Ten common peaks were identified in the UHPLC fingerprints of 15 batches, with eight components identified. Similarity scores ranged from 0.774 to 0.987. Chemical pattern recognition analysis identified that shancigusin H, militarine, and gymnoside Ⅴ were the major characteristic components contributing to quality differences among batches. RESULTS:: of network pharmacology and molecular docking revealed that dactylorhin A and militarine were the key active components exerting anti-inflammatory and neuroprotective effects. These components acted on 13 core targets, including SRC, CASP3, and CTNNB1, and regulated signaling pathways such as the PI3K-Akt signaling pathway and arachidonic acid metabolism. Based on the effectiveness, specificity, and measurability of Q-marker, dactylorhin A and militarine were selected as the Q-markers of P. yunnanensis. Quantitative analysis demonstrated that the content of dactylorhin A ranged from 0.527% to 2.21%, and militarine ranged from 0.731% to 2.58% across the 15 batches. The UHPLC fingerprint method and Q-marker-based quantification approach are robust and reliable, providing experimental evidence for quality control and standardization of P. yunnanensis.}, }
@article {pmid41508178, year = {2025}, author = {Hou, WX and Liu, YX and Miao, JR and Zhu, ZK and Yin, Y and Liu, JL and Zhao, DY}, title = {[Mechanism of Liuwei Dihuang Pills in enhancing GPNMB expression to regulate FcγRⅡB/c-Src pathway for prevention and treatment of Alzheimer's disease].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {50}, number = {21}, pages = {6062-6071}, doi = {10.19540/j.cnki.cjcmm.20250805.401}, pmid = {41508178}, issn = {1001-5302}, mesh = {Animals ; *Drugs, Chinese Herbal/administration & dosage ; *Alzheimer Disease/drug therapy/genetics/metabolism/prevention & control ; Male ; Mice ; *Membrane Glycoproteins/genetics/metabolism ; Humans ; Signal Transduction/drug effects ; *src-Family Kinases/metabolism/genetics ; Hippocampus/drug effects/metabolism ; Amyloid beta-Peptides/metabolism ; Memory/drug effects ; Eye Proteins ; }, abstract = {This study investigated the effect of Liuwei Dihuang Pills on the Fcγ receptor Ⅱ-b(FcγRⅡB)/c-Src tyrosine kinase(c-Src) pathway in senescence-accelerated mouse prone 8(SAMP8) by regulating the expression of the glycoprotein non-metastatic melanoma protein B(GPNMB) and explored the mechanism of the kidney-tonifying and essence-strengthening therapy in the treatment of Alzheimer's disease.(1) For the effects of Liuwei Dihuang Pills on the learning and memory ability, hippocampal β-amyloid protein(Aβ), GPNMB, and autophagy function in SAMP8 mice, eight seven-month-old male senescence-accelerated mouse resistant 1(SAMR1) mice were used as a control group, and 16 male SAMP8 mice of the same age were randomly divided into a model group and a Liuwei Dihuang Pills group. The Liuwei Dihuang Pills group was given 2.36 g·kg~(-1) concentrated Liuwei Dihuang Pills solution by gavage, while the control group and the model group were given the same volume of normal saline twice a day for four consecutive weeks. The learning and memory ability of mice in each group was detected by the Morris water maze experiment; the expression level of Aβ in the hippocampus of mice were detected by enzyme-linked immunosorbent assay(ELISA) and immunohistochemistry; the expression of GPNMB in the hippocampus of mice was detected by immunofluorescence and Western blot; the expression level of ubiquitin-binding protein p62 and microtubule-associated protein light chain 3(LC3) Ⅱ/LC3Ⅰ in the hippocampus of mice was measured by Western blot.(2) For the regulatory effect of GPNMB on the FcγRⅡB/c-Src pathway, eight seven-month-old male SAMR1 mice were used as a control group, and 24 male SAMP8 mice of the same age were randomly divided into a model group, an LV-Vector group, and an LV-GPNMB~(OE) group. The bilateral hippocampus of the LV-Vector group and LV-GPNMB~(OE) group was injected with LV-Vector and LV-GPNMB~(OE) of 2 μL/each side, respectively. Western blot was used to detect the expression level of p62, LC3Ⅱ/LC3Ⅰ, FcγRⅡB, Src homology 2 protein tyrosine phosphatase 1(SHP-1), and c-Src proteins in the hippocampus of mice.(3) For the effect of Liuwei Dihuang Pills in regulating the FcγRⅡB/c-Src pathway by increasing the GPNMB expression, 32 seven-month-old male SAMP8 mice were randomly divided into a model group, a Liuwei Dihuang Pills group, a Liuwei Dihuang Pills + LV-NC group, and a Liuwei Dihuang Pills + LV-shGPNMB group. The bilateral hippocampus of the Liuwei Dihuang Pills + LV-NC group and Liuwei Dihuang Pills + LV-shGPNMB group was injected with LV-NC and LV-shGPNMB, respectively, before the drug treatment. Western blot was used to detect the expression level of p62, LC3Ⅱ/LC3Ⅰ, FcγRⅡB, SHP-1, and c-Src proteins in the hippocampus of mice. The results showed that(1) compared with those of the control group, the escape latency of the model group was significantly increased, and the time spent in the target quadrant and the effective area was significantly decreased. The expression level of Aβ, GPNMB, and p62 in the hippocampus was significantly increased, and the level of LC3Ⅱ/LC3Ⅰ was significantly decreased. Compared with those of the model group, the escape latency of the Liuwei Dihuang Pills group was significantly shortened, and the time spent in the target quadrant and the effective area was significantly increased. The level of Aβ was significantly decreased, and the expression level of GPNMB was significantly increased. The expression level of p62 was significantly decreased, and the level of LC3Ⅱ/LC3Ⅰ was significantly increased.(2) Compared with those of the control group, the expression level of p62, FcγRⅡB, SHP-1, and c-Src proteins in the hippocampus of the model group was significantly increased, and the level of LC3Ⅱ/LC3Ⅰ was significantly decreased. Compared with those of the model group, the expression level of p62, FcγRⅡB, SHP-1, and c-Src in the LV-GPNMB~(OE) group was significantly decreased, and the level of LC3Ⅱ/LC3Ⅰ was significantly increased.(3) Compared with those of the model group, the expression level of p62, FcγRⅡB, SHP-1, and c-Src in the Liuwei Dihuang Pills group was significantly decreased, and the level of LC3Ⅱ/LC3Ⅰ was significantly increased. Compared with those of the Liuwei Dihuang Pills group, the expression level of p62, FcγRⅡB, SHP-1, and c-Src in the Liuwei Dihuang Pills + LV-shGPNMB group was significantly increased, and the level of LC3Ⅱ/LC3Ⅰ was significantly decreased. These results indicate that Liuwei Dihuang Pills can inhibit the FcγRⅡB/c-Src pathway by up-regulating the GPNMB expression, thereby increasing autophagy levels, enhancing neuroprotective ability, and alleviating Alzheimer's disease.}, }
@article {pmid41508060, year = {2025}, author = {Sun, CX and Han, XY and Xiao, YT and Liu, YX and Ye, TY}, title = {[Research progress on prevention and treatment of Alzheimer's disease with Danggui Shaoyao San].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {50}, number = {22}, pages = {6215-6226}, doi = {10.19540/j.cnki.cjcmm.20250626.601}, pmid = {41508060}, issn = {1001-5302}, mesh = {*Alzheimer Disease/drug therapy/prevention & control/metabolism ; *Drugs, Chinese Herbal/therapeutic use/administration & dosage ; Humans ; Animals ; }, abstract = {Alzheimer's disease is a neurodegenerative disorder associated with aging. In traditional Chinese medicine(TCM), it is classified as a syndrome of root deficiency and branch excess. Danggui Shaoyao San, a classic formula traditionally used to treat gynecological disorders, has the effects of promoting blood circulation, removing blood stasis, opening orifices, awakening the mind, strengthening the spleen, resolving phlegm, and tonifying Qi to nourish the spirit. Modern clinical studies have found that Danggui Shaoyao San can slow the progression of Alzheimer's disease and has great potential for clinical application. Recent studies indicate that Danggui Shaoyao San treats Alzheimer's disease through multi-target and multi-level mechanisms. These include clearing amyloid β(Aβ) plaques and abnormally phosphorylated tau protein, maintaining brain-gut homeostasis, reducing oxidative stress, and regulating autophagy. Its key components, paeoniflorin and ferulic acid, have also been reported to exert antioxidant, anti-inflammatory, and anti-apoptotic effects, eliminate pathological products, and regulate the cholinergic system in the brain. This paper traces the classic formula of Danggui Shaoyao San, conducts a theoretical integration of ancient and modern medical systems, and systematically summarizes and analyzes the research related to the treatment of Alzheimer's disease using Danggui Shaoyao San and its key components. It aims to provide a valuable reference for further research and modern application of Danggui Shaoyao San in the treatment of Alzheimer's disease.}, }
@article {pmid41507065, year = {2026}, author = {De Rui, M and Salerno Trapella, G and Ceolin, C and Ceccato, F and Antonelli, G and Ravelli, A and Andreuzza, R and Conti, E and Sarlo, M and Coin, A and Zanforlini, BM and Bertocco, A and Curreri, C and Tizianel, I and Mapelli, D and Sergi, G and Devita, M}, title = {Effect of cognitive training on cortisol levels in patients with neurocognitive disorders.}, journal = {The journals of gerontology. Series B, Psychological sciences and social sciences}, volume = {81}, number = {2}, pages = {}, pmid = {41507065}, issn = {1758-5368}, mesh = {Humans ; *Hydrocortisone/metabolism/analysis ; Male ; Female ; Aged ; Saliva/chemistry ; *Neurocognitive Disorders/therapy/metabolism ; Middle Aged ; Italy ; *Cognitive Behavioral Therapy/methods ; Hypothalamo-Hypophyseal System/metabolism ; Case-Control Studies ; Cognitive Training ; }, abstract = {OBJECTIVES: Elevated cortisol levels are linked to a greater risk and faster progression of neurocognitive disorders (NCDs). While interventions such as exercise and mindfulness have shown benefits in reducing cortisol, the impact of cognitive training (CT) on cortisol regulation remains unexplored. This study investigated whether CT affects cortisol levels and secretion patterns in individuals with minor or major NCD and compared its effects with those of pharmacological treatment.
METHODS: Sixty-two older adults with NCD and 43 healthy controls were recruited from the University Hospital of Padua in Italy. Among patients with NCD, 34 underwent CT (CT-NCD group), and 28 received pharmacological treatment (PH-NCD group). Salivary cortisol was measured at six points during the day, at baseline, and at 3 months (T1) and 6 months (T2) post-intervention.
RESULTS: Compared with pharmacological treatment (PH), CT showed a larger percentage decrease of daily cortisol exposure area under the curve (AUC) from baseline; however, the between-group difference did not remain statistically significant after covariate adjustment, and the only robust time-point effect was in the afternoon (F(1,47)=5.13; p = .028). Morning values decreased within groups, but between-group differences in the CAR were not significant; at bedtime, CT showed only a trend towards lower cortisol than PH (p = .071). Median morning values changed from 7.75 to 6.20 in CT and from 5.80 to 5.15 in PH.
DISCUSSION: Cognitive training may help lower cortisol levels and enhance cognitive function in NCD patients, suggesting its potential as a nonpharmacological tool to modulate hypothalamic-pituitary-adrenal axis activity. Larger randomized studies are needed to confirm and extend these findings.}, }
@article {pmid41506734, year = {2026}, author = {, and , }, title = {[Guidelines for the management of chronic insomnia comorbid with common neuropsychiatric disorders in adults (2025 edition)].}, journal = {Zhonghua nei ke za zhi}, volume = {65}, number = {1}, pages = {18-44}, doi = {10.3760/cma.j.cn112138-20250911-00539}, pmid = {41506734}, issn = {0578-1426}, support = {2021YFC2501400//National Key Research and Development Program of China/ ; }, mesh = {Humans ; *Sleep Initiation and Maintenance Disorders/therapy/epidemiology/complications ; *Mental Disorders/therapy/complications/epidemiology ; Comorbidity ; Adult ; Parkinson Disease ; }, abstract = {Chronic insomnia frequently co-occurs with common neuropsychiatric disorders, including migraine, stroke, Alzheimer's disease, Parkinson's disease, epilepsy, generalized anxiety disorder, depressive disorder, body distress disorder, post-traumatic stress disorder, and disorders due to use of alcohol. The prevalence of these neuropsychiatric disorders is hiher among patients with chronic insomnia than in the general population, and the conditions mutually exacerbate each other. Comorbidities not only exacerbate the severity and increases the relapse risk of each condition but also lead to a poorer prognosis, more severe impairment of social functioning, a higher all-cause mortality risk, and greater treatment challenges. Therefore, the Sleep Disorders Group, Chinese Society of Neurology and Sleep Medicine Group,China Neurologist Association have convened experts in relevant fields, based on current medical evidence, to establish guideline for the management of Chinese adults with chronic insomnia comorbid with the aforementioned 10 categories of common neuropsychiatric disorders. The aim is to standardize clinical practice and improve treatment effectiveness and cure rates.}, }
@article {pmid41506537, year = {2026}, author = {Liang, YZ and Jiang, MZ and Xu, XT and Zhu, T and Guo, H and Ding, L and Zhong, H and Bao, J and Qin, LQ and Li, YH}, title = {Ameliorating effect and mechanism of p-coumaric acid liposome on cognitive dysfunction and mitochondrial damage under intermittent hypoxia.}, journal = {Life sciences}, volume = {387}, number = {}, pages = {124197}, doi = {10.1016/j.lfs.2026.124197}, pmid = {41506537}, issn = {1879-0631}, abstract = {AIMS: Alzheimer's disease (AD) has become a global public health problem. Mitochondrial dysfunction contributes to AD pathogenesis, and adequate oxygen supply is essential to maintain mitochondrial homeostasis. P-coumaric Acid (CA) is a polyphenol with anti-hypoxia and anti-AD properties. In this study, CA was formulated into a biomimetic liposome (CA-Lip) to enhance its therapeutic efficacy, and the underlying mechanisms were studied.
MATERIALS AND METHODS: APP/PS1 mice were divided into four groups: AD group, hypoxia treatment group (AD-HY group), hypoxia + CA treatment group (CA group), hypoxia + CA-Lip treatment group (CA-Lip group). Age-matched wild-type littermates were used as controls. Mice in the hypoxia treatment groups were exposed to a hypoxia chamber for 6 h daily for 8 weeks. Cognitive performance and mitochondrial function were subsequently evaluated to determine the ameliorating effects and mechanisms of CA-Lip.
RESULTS: Cognitive impairment and mitochondrial dysfunction were more pronounced in the AD-HY group than in the AD group. CA-Lip produced greater neuroprotective effects than CA. Mechanistic analyses showed that CA-Lip reduced amyloid-β (Aβ) accumulation, enhanced mitochondrial biogenesis (upregulation of PGC-1α expression), maintained mitochondrial dynamics (upregulation of MFN2 expression, and downregulation of DRP1 expression), inhibited excessive mitophagy (downregulation of PINK1 and Parkin expression), enhanced cell autophagy (upregulation of ATG7 and LC3B expression and downregulation of mTOR and P62 expression), and reduced neuronal apoptosis.
CONCLUSIONS: CA-Lip effectively ameliorates hypoxic cognitive impairment by reducing Aβ generation and improving mitochondrial function.}, }
@article {pmid41505228, year = {2026}, author = {Head, E and Cohen, A and Fortea, J and McGlinchey, E}, title = {Novel insights into Alzheimer's disease through the study of individuals with Down syndrome.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71074}, pmid = {41505228}, issn = {1552-5279}, support = {U19AG068054//NIH/NIA/ ; U19AG068054//NIH/NIA/ ; P30AG066519//NIH/NIA/ ; RF1AG079519//NIH/NIA/ ; U19AG068054//NIH/NIA/ ; P30AG066519//NIH/NIA/ ; RF1AG079519//NIH/NIA/ ; R01AG056850//NIH/NIA/ ; R21AG056974//NIH/NIA/ ; R01AG061566//NIH/NIA/ ; 1R01AG081394//NIH/NIA/ ; R61AG066543//NIH/NIA/ ; //Fondo de Investigaciones Sanitario/ ; INT21/00073//Carlos III Health Institute/ ; PI20/01473//Carlos III Health Institute/ ; PI23/01786//Carlos III Health Institute/ ; //Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Program 1/ ; //Fondo Europeo de Desarrollo Regional/ ; SLT006/17/00119//Department de Salut de la Generalitat de Catalunya/ ; //Fundación/ ; IIBSP-DOW-2020-151//Tatiana Pérez de Guzmán el Bueno/ ; H2020-SC1-BHC-2018-2020//Horizon 2020-Research and Innovation Framework Programme/ ; HPE-ADRD 24HPE1284307//Alzheimer Association/ ; }, }
@article {pmid41505203, year = {2026}, author = {Lyketsos, CG and Peters, ME}, title = {Neuropsychiatric symptoms in Alzheimer's disease: Past, present, and future.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71077}, pmid = {41505203}, issn = {1552-5279}, support = {P30AG066507//Johns Hopkins Alzheimer's Disease Research Center/ ; }, mesh = {Humans ; *Alzheimer Disease/psychology/complications ; *Cognitive Dysfunction/psychology ; *Depression/etiology ; Disease Progression ; }, abstract = {Noncognitive neuropsychiatric symptoms (NPS; e.g., depression, agitation) are nearly universal throughout the course of Alzheimer's disease (AD), cause significant adverse impact to patients and caregivers, and are associated with more rapid progression to severe dementia. Although the importance and presence of NPS was recognized by Dr. Alois Alzheimer himself, it was a series of research roundtables in the 2010s that propelled the understanding and treatment of NPS in AD forward. The mild behavioral impairment (MBI) construct was developed as a complementary behavioral analogue to mild cognitive impairment, solidifying the importance of NPS prior to dementia onset. Neurobiological underpinnings of NPS are being studied and the NPS treatment pipeline includes novel therapeutics, repurposing of existing pharmaceuticals, and non-pharmacologic interventions. The Alzheimer's Disease Research Centers and The National Alzheimer's Coordinating Center, being recognized in this special issue, have played a pivotal role in the recognition and study of NPS in AD. HIGHLIGHTS: Noncognitive neuropsychiatric symptoms (NPS) are nearly universal throughout the course of Alzheimer's disease (AD), cause significant adverse impact to patients and caregivers, and are associated with more rapid progression to severe dementia. A series of research roundtables in the last decade and a half have propelled the understanding and treatment of NPS in AD forward. The mild behavioral impairment (MBI) construct was developed as a complementary behavioral analogue to mild cognitive impairment, solidifying the importance of NPS prior to dementia onset. Neurobiological underpinnings of NPS are being studied and the treatment pipeline includes novel therapeutics, repurposing of pharmaceuticals, and non-pharmacologic interventions. The Alzheimer's Disease Research Centers and The National Alzheimer's Coordinating Center have played a pivotal role in the recognition and study of NPS in AD.}, }
@article {pmid41502736, year = {2025}, author = {Biswal, B and Pattnaik, S and Satapathy, BS and Maharana, L}, title = {Luliconazole-Loaded Nanoliposomes as a Repurposing Strategy to Combat Memory Dysfunction in LPS-Induced Alzheimer's Rats.}, journal = {ACS omega}, volume = {10}, number = {48}, pages = {59655-59674}, pmid = {41502736}, issn = {2470-1343}, abstract = {Alzheimer's disease (AD) is a major neurodegenerative disorder with no definitive cure. Out of several proposed pathophysiology, microbial infection has recently been identified as one of the key pathogenic contributors for the development and progression of AD. In this context, the present study aims at a repurposing strategy through luliconazole (a potent imidazole derivative)-loaded optimized nanoliposomal carriers to treat AD. Optimized luliconazole-loaded nanoliposomes (LuNLs) were developed by the conventional thin-film hydration method followed by characterization in terms of FESEM, AFM, zeta potential, average size, loading %, and drug release (in vitro). The in vivo effectiveness of the LuNLs was investigated in LPS-induced AD rats. Molecular docking and simulation analysis demonstrated a favorable docking score between luliconazole and selected AD proteins. Spherical, nanosized (52.42 nm), negatively charged (-29.9 mV) LuNLs were reported showing a sustained drug release up to 24 h. An in vivo behavioral study depicted improved cognitive behavior in the LuNLs-treated group as compared to control groups. In vivo antioxidant activity in terms of SOD, MDA, and GSH inhibition by LuNLs was found comparable to that of standard formulation-treated groups, depicting the neuroprotective behavior of LuNLs. The histopathological observation of brain tissue in the LuNLs/control group further substantiated the in vivo behavioral study data. Based on the reports, luliconazole may be used as a viable, efficacious alternative for the treatment of AD, though further preclinical studies are highly warranted.}, }
@article {pmid41502722, year = {2025}, author = {Wu, H and Huang, N and Wang, K and Mi, J and Liu, Z and Wang, J and Sang, Z and Tan, Z}, title = {Development of Novel 3‑Phenylpropanamide Derivatives as BChE Inhibitors for the Treatment of Alzheimer's Disease.}, journal = {ACS omega}, volume = {10}, number = {48}, pages = {59522-59534}, pmid = {41502722}, issn = {2470-1343}, abstract = {Alzheimer's disease (AD) is a prevalent neurodegenerative degenerative disorder among the elderly, featured by progressive cognitive decline and memory impairment. Due to its complex pathogenesis, there is still no effective therapeutic drug to date. Recently, selective BChE inhibition has been regarded as a potent approach for treating AD. In this work, we conducted structural optimization and structure-activity relationship studies on the previously obtained lead compound EMC-4f, and obtained the potential selective BChE inhibitor 12a (eqBChE, IC50 = 1.3 μM; huBChE, IC50 = 0.95 μM). The in vitro results exhibited that 12a showed good BBB permeability. Moreover, 12a demonstrated significant neuroprotective effects on l-Glu/Aβ25-35-induced HT22 cells injury. Further, the in vivo tests suggested that 12a remarkably alleviated mice cognitive impairment induced by scopolamine. Therefore, these data present that 12a is a promising BChE inhibitor against AD.}, }
@article {pmid41502346, year = {2026}, author = {Chang, YY and Zheng, XH and Wang, MW and Zhang, QW and Gao, YT and Wang, YN and Sun, YT and Fan, HH and Li, X and Du, LD and Xie, XM and Pang, XB}, title = {Morroniside Modulates Microglia Polarization via the CX3CL1/CX3CR1/PU.1 Axis in ApoE4 Transgenic Mice.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70177}, pmid = {41502346}, issn = {1099-1573}, support = {251111313400//Key R&D Program of Henan Province/ ; 252300421379//Natural Science Foundation of Henan/ ; 25B350004//Key Scientific Research Projects of Henan Higher Education Institutions/ ; 82501727//Natural Science Foundation of China/ ; 22508091//Natural Science Foundation of China/ ; }, abstract = {Microglia monitor disease stimulation, neuronal apoptosis, and neural repair, and their overactivation-induced inflammation plays a key role in the pathogenesis of Alzheimer's disease (AD). Morroniside (Mor), an iridoid glycoside compound in Cornus officinalis, is one of the effective active components. The effects of Mor on antioxidant stress, antiapoptosis, and nerve repair function have been widely studied, but the mechanism of Mor in AD treatment remains unclear. To study the neuroprotective effects of Mor and elucidate the molecular mechanisms underlying its improvement of AD symptoms, we used ApoE4 transgenic mice and ApoE4-transfected BV2 cells as models of AD, focusing on microglia phenotype, function, and neuroinflammation. The 10-month-old mice were randomly divided into the ApoE3 control group (ApoE3 + Veh), the ApoE4 model group (ApoE4 + Veh), and the ApoE4 + Mor 10, 20, and 40 mg/kg groups as in vivo models. The in vitro BV2-ApoE model was constructed via lentiviral transfection. The effects of Mor on cognitive function of AD models were assessed through behavioral tests, western blot, immunofluorescence staining, and ELISA to measure changes of related pathological and inflammatory factors. Mor improved the cognitive function of ApoE4 transgenic mice by reducing Aβ plaques in the brain, improving the structural lesions of hippocampal neurons, and increasing synaptic plasticity in the brain of AD mice. In addition, Mor promoted the transformation of microglia from the M1 to the M2 phenotype, inhibited the activation of the CX3CR1/PU.1 signaling axis, and alleviated the dysfunction of microglia both in vitro and in vivo. CX3CR1 siRNA and PU.1 siRNA were used further to verify the regulatory effect of Mor on microglia phenotype. Our findings indicate that Mor can inhibit neuroinflammation, reduce Aβ accumulation, and improve synaptic damage in ApoE4 mice via the CX3CL1/CX3CR1/PU.1 pathway regulating the phenotype and function of microglia. This study provides a new therapeutic candidate for the prevention and treatment of AD.}, }
@article {pmid41502301, year = {2026}, author = {Abhyankar, SD and Xiao, Y and Mahajan, N and Luo, Q and Cummins, TR and Oblak, AL and Lamb, BT and Corson, TW and Bhatwadekar, AD}, title = {Müller Glial Kir4.1 Channel Dysfunction in APOE4-KI Model of Alzheimer's Disease.}, journal = {Glia}, volume = {74}, number = {3}, pages = {e70119}, pmid = {41502301}, issn = {1098-1136}, support = {R01EY027779-S1/EY/NEI NIH HHS/United States ; R01EY032080/EY/NEI NIH HHS/United States ; //Research to Prevent Blindness, Unrestricted Grant/ ; DK064466/DK/NIDDK NIH HHS/United States ; G20240315-8762//Sigma Xi Grants in Aid of Research/ ; //NIH T32, Peter J. Roach Award, Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine/ ; }, mesh = {Animals ; *Potassium Channels, Inwardly Rectifying/metabolism/genetics ; *Alzheimer Disease/metabolism/genetics/pathology ; *Ependymoglial Cells/metabolism/pathology/drug effects ; *Apolipoprotein E4/genetics/metabolism ; Kcnj10 Channel ; Disease Models, Animal ; Mice, Transgenic ; Rats ; Mice ; Mitochondria/metabolism ; Oxidative Stress/physiology ; Retina/metabolism/pathology ; Mice, Inbred C57BL ; }, abstract = {Alzheimer's disease (AD), particularly late-onset AD (LOAD), affects millions worldwide, with the apolipoprotein ε4 (APOE4) allele being a significant genetic risk factor. Retinal abnormalities are a hallmark of LOAD, and our recent study demonstrated significant age-related retinal impairments in APOE4-knock-in (KI) mice, highlighting that retinal impairments occur before the onset of cognitive decline in these mice. Müller cells (MCs), key retinal glia, are vital for retinal health, and their dysfunction may contribute to retinal impairments seen in AD. MCs maintain potassium balance via specialized inwardly rectifying K[+] channels 4.1 (Kir4.1). This study posits that Kir4.1 channels will be impaired in APOE4-KI, resulting in MC dysfunction. Additionally, we demonstrate that MC dysfunction in APOE4-KI stems from alterations in mitochondrial dynamics and oxidative stress. Kir4.1 expression and function were studied using immunofluorescence and through the whole-cell voltage clamp, respectively. In parallel, rat Müller cells (rMC-1) were used to create an in vitro model for further mechanistic studies. MitoQ was used to evaluate its potential to mitigate APOE4-induced deficits. APOE4 retinas and APOE4-transfected rMC-1 significantly reduced Kir4.1 expression, K+ buffering capacity, and increased mitochondrial damage. APOE4-transfected rMC-1 showed reduced mitochondrial membrane potential (ΔΨm) and increased mitochondrial reactive oxygen species (ROS). MitoQ treatment significantly reduced mitochondrial ROS and restored Kir4.1 expression in APOE4-expressing cells. Our results demonstrate that APOE4 causes mitochondrial dysfunction and MC impairment, which may contribute to retinal pathology in AD. MitoQ restored mitochondrial health and Kir4.1 expression in APOE4-expressing rMC-1, suggesting targeting mitochondria may offer a promising therapeutic strategy for AD.}, }
@article {pmid41501928, year = {2026}, author = {Li, E and Song, F and Coppola, Q and Yack, L and Le, M and Javed, S and Pandher, N and Prufer, I and Mayzel, O and Heuer, HH and Koestler, M and Miller, BL and Boxer, AL and Vandevrede, L and Grinberg, LT and Walsh, CM and Neylan, TC}, title = {Treatment of Disturbed Sleep in Progressive Supranuclear Palsy: a randomized, remote, double-blinded, 6-week cross-over design study protocol comparing zolpidem, suvorexant, and placebo.}, journal = {Trials}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13063-025-09382-9}, pmid = {41501928}, issn = {1745-6215}, support = {A130340//Rainwater Charitable Foundation/ ; }, abstract = {BACKGROUND: Prior research identified profound sleep disruption in progressive supranuclear palsy (PSP). The hypothalamus and brainstem, areas that help regulate sleep/wake patterns, are among the earliest affected brain regions in PSP disease progression. Comparing polysomnography and quantitative-neuropathology metrics, we identified relative sparing of wake-promoting nuclei in PSP compared to Alzheimer's disease, though PSP had more disrupted sleep. It led to the hypothesis that PSP patients have hyperinsomnia (or hyposomnia, little sleep) due to degeneration of sleep nuclei with a preservation of sleep neurons, causing a system unbalance. A higher neuronal count of wake-promoting nuclei was associated with greater nocturnal wake, regardless of disease. Specifically, orexinergic wake-promoting neurons in the lateral hypothalamus, previously described as the sleep-on/off switch, are relatively spared in PSP. Thus, we hypothesized that an orexinergic antagonist may be more effective in treating sleep/wake issues in PSP than other hypnotic medications. This study protocol was established to test the safety and efficacy of an orexinergic antagonist (suvorexant) targeting the wake-promoting system and contrasts it with a GABAergic receptor agonist (zolpidem) targeting sleep-promoting systems and placebo.
METHODS: This is a remote clinical trial, designed as a double-blind, cross-over, within-subject 6-week trial, with 3 one-week-long conditions, separated by 1-week washout periods. The order of the 3 regimens is randomized and counterbalanced: placebo (microcrystalline cellulose), 15 mg/day suvorexant, 5 mg/day zolpidem. Participants are recruited from doctor and study referrals, registries, and support groups. Once onboarded, the trial coordinator maintains communication with the participant/caregiver throughout the 6 weeks. Assessments include neurological interviews, cognitive testing, and subjective questionnaire packets. Sleep and circadian rhythms are assessed through ambulatory EEG and actigraphy monitoring devices worn by the participant throughout the trial.
DISCUSSION: The study design aims to reduce participant and caregiver burden, while improving accessibility to such a study. Administering a remote clinical trial for a rare disease, however, creates unique issues that would otherwise be absent from in-person studies. Particularly, a symptom rather than disease-modifying trial is challenging to recruit for when potential disease-modifying therapeutics are available. Needing to coordinate with non-associated medical offices to attain medical records or prescriptions can cause frustrations for the potential participant, medical office, and study team. In recruitment, onboarding, and trial maintenance, this study design relies on consistent communication to support participant enrollment and satisfaction.
TRIAL REGISTRATION: Treatment of Disturbed Sleep in Progressive Supranuclear Palsy (PSP); NCT04014389. Registered on June 2, 2019.}, }
@article {pmid41501420, year = {2026}, author = {Wang, XY and Zhou, WS and Gaur, U and Zhen, XC and Zheng, WH}, title = {Sigma-1 receptor positive allosteric modulator promotes neuronal survival and improves cognitive deficits in AD mice via sigma-1 receptor/ERK pathway.}, journal = {Acta pharmacologica Sinica}, volume = {}, number = {}, pages = {}, pmid = {41501420}, issn = {1745-7254}, abstract = {The sigma-1 receptor is an important new therapeutic drug target for Alzheimer's disease (AD). Here, we reported that SOMCL-668, a novel selective and potent sigma-1 receptor allosteric modulator, is neuroprotective in AD both in vitro and in vivo. SOMCL-668 promoted PC12 cells against Aβ-induced intracellular reactive oxygen species (ROS) accumulation, mitochondrial membrane potential hyperpolarization and neuronal apoptosis. Similar results were obtained in SH-SY5Y and primary cortical culture neurons. The mechanistic study showed that SOMCL-668 stimulated the phosphorylation of ERK and CREB, while pharmacological inhibition or knockout of ERK via CRISPR-Cas9 attenuated its protective effects. Further studies with the sigma-1 receptor agonists/antagonists and knockout of sigma-1 receptor via CRISPR-Cas9 indicated that the sigma-1 receptor is essential for the effect of SOMCL-668. In 3xTg-AD mice, SOMCL-668 improved the learning and memory deficits, inhibited neuronal apoptosis and oxidative stress, reduced Aβ deposition and tau protein phosphorylation via ERK/CREB pathway. Moreover, pretreatment with sigma-1 receptor antagonist BD1047 blocked the effect of SOMCL-668. These results demonstrated that SOMCL-668 provides neuroprotection in AD and its effect is mediated by the sigma-1 receptor/ERK/CREB pathway. Our findings support that SOMCL-668 can be utilized as a potential drug for the prevention and treatment of Alzheimer's disease.}, }
@article {pmid41499862, year = {2025}, author = {Nadais, A and Castro, C and Martins, I and Trigo, D and Nunes, C and Henriques, AG and de Lourdes Pereira, M and da Cruz E Silva, OAB}, title = {Nanoparticle-mediated Zn delivery impacts neural protein phosphatase activity.}, journal = {Biomaterials advances}, volume = {182}, number = {}, pages = {214675}, doi = {10.1016/j.bioadv.2025.214675}, pmid = {41499862}, issn = {2772-9508}, abstract = {In recent years, the use of nanoparticles (NPs) in diagnosis and treatment of different disorders has been a matter of intensive research. Due to their physical and chemical properties, zinc oxide nanoparticles (ZnO NP) have been explored in a range of biological applications, including cancer and neurological diseases. Regarding the latter, while some studies report protective effects of ZnO NP in cultured cells and animal models, others indicate that these NPs have a harmful impact on the brain, such as promoting oxidative stress and cell death. Previous results from our group have suggested beneficial effects for zinc (Zn) cations in both modulating protein aggregation and on Alzheimer's disease (AD) pathology. In this context, the effect of encapsulated Zn as a nanoparticle on protein aggregation and its influence on protein phosphorylation events associated with AD were explored. The results herein presented show that ZnO NP contributed to a decrease in protein aggregation in neuronal cells. However, these NPs were also found to decrease PP1 and PP2A activity, potentially contributing to increased phosphorylation of tau and APP, which are AD pathology hallmarks. In conclusion, while the use of NPs as a Zn delivery system may offer benefits by reducing aggregate formation, they also appear to induce undesired molecular changes, like those observed in AD. Therefore, a holistic approach should be incorporated as we move forward in this research line, as their effects on distinct cellular processes may be dual edged.}, }
@article {pmid41499318, year = {2026}, author = {Melrose, J}, title = {Roles for Electrochemical Proton Gradients in Mitochondrial Energy Production and Neurosensory Processes in Health and Disease.}, journal = {Developmental neurobiology}, volume = {86}, number = {1}, pages = {e70006}, doi = {10.1002/dneu.70006}, pmid = {41499318}, issn = {1932-846X}, support = {//Melrose Personal Research Fund/ ; }, mesh = {Humans ; Animals ; *Mitochondria/metabolism ; *Energy Metabolism/physiology ; *Protons ; *Proton-Motive Force/physiology ; *Nervous System Diseases/metabolism ; Oxidative Stress/physiology ; }, abstract = {This study reviews the roles of proton electrochemical gradients in ubiquitous mitochondrial energy production systems in cellular activation and functions in neurosensory signaling. Proton electrochemical gradients crucially shaped the evolution of life. The emergence of the proton-motive force in mitochondria was fundamental in energy production and central to the function of eukaryotic cells. Dysfunctional mitochondria, however, result in impaired formation of proton gradients and a wide spectrum of diseases. This is particularly prominent in tissues with high energetic demands, such as muscle and nervous tissues. Oxidant stress generated by dysfunctional proton conductance in the brain results in Alzheimer's and Parkinson's disease, muscular sclerosis, amyotrophic sclerosis, and Huntington's disease. In these disorders, oxidative stress, protein misfolding, and neuroinflammation lead to dysfunctional neuronal activity, neuronal damage, and death. Advancements in nanozyme-engineered synthetic enzymes offer a promising innovative approach to the treatment of these disorders. Nanozymes target proton conductance and the oxidant species they generate, scavenging oxygen free radicals and restoring redox balance, and offer neuronal protection and functional recovery of brain tissues. Neural injury and associated neurological diseases affect almost 1 billion people globally, so there is a clear need to develop effective methods that stimulate neural repair and regeneration. Glycosaminoglycans with proton capture and transport properties regulate intercellular signaling processes, synaptic functions, and cellular communication. Electroconductive hydrogels are showing impressive results in neural repair and regeneration. Glycosaminoglycans, particularly keratan sulfate, show useful electroconductive proton capture and transport properties, suggesting they may be worth evaluation in such procedures.}, }
@article {pmid41499301, year = {2026}, author = {Mohasel-Roodi, M and Nozari, M and Shamsara, A and Basiri, M and Mirzaie, V and Baghalishahi, M}, title = {Effects of Dexmedetomidine on the Behavioral Outcomes in Streptozotocin-Induced Alzheimer's Disease Rats.}, journal = {Brain and behavior}, volume = {16}, number = {1}, pages = {e71196}, pmid = {41499301}, issn = {2162-3279}, support = {402000357//Kerman Neuroscience Research Center, Kerman University of Medical Sciences/ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/chemically induced ; *Dexmedetomidine/pharmacology/administration & dosage ; Streptozocin/pharmacology ; Rats, Wistar ; Male ; Rats ; *Behavior, Animal/drug effects ; Anxiety/drug therapy ; Maze Learning/drug effects ; Disease Models, Animal ; Neuroprotective Agents/pharmacology ; *Adrenergic alpha-2 Receptor Agonists/pharmacology ; Cognitive Dysfunction/drug therapy ; }, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a progressive and prevalent neurodegenerative disorder characterized by progressive cognitive decline and memory impairment. Intracerebroventricular (ICV) administration of streptozotocin (STZ) in rodents recapitulates key features of sporadic AD, including brain insulin resistance and oxidative stress. Dexmedetomidine (Dex), a highly selective α2-adrenergic receptor agonist, has demonstrated neuroprotective and anti-inflammatory properties, suggesting its potential utility as a therapeutic approach for AD.
METHODS: Seventy adult male Wistar rats were randomly allocated to seven experimental groups: Control, Sham, STZ, Sham + Dex (25 µg/kg), and STZ + Dex (25, 50, 100 µg/kg). Cognitive performance and anxiety-like behaviors were evaluated using the open-field test (OFT), elevated plus maze (EPM), Y-maze test, and Morris water maze (MWM).
RESULTS: In the Y-maze, STZ-treated rats exhibited significant reductions in spontaneous alternation behavior (p = 0.002), which were significantly reversed by Dex (25 µg/kg, p = 0.002). In the MWM, the STZ administration resulted in prolonged escape latencies and increased path lengths compared with Control animals (p < 0.05). Treatment with Dex (25 µg/kg) significantly improved spatial learning and memory retention (p < 0.05). No significant differences were observed in locomotor activity and anxiety-related behaviors in the OFT or EPM.
CONCLUSIONS: These findings indicate that Dex at 25 µg/kg attenuates STZ-induced cognitive deficits, likely through neuroprotective and anti-inflammatory mechanisms. The results highlight Dex as a promising candidate for AD therapy, though further research is required to elucidate its underlying molecular pathways. The study supports the potential repurposing of Dex for neurodegenerative disorders.}, }
@article {pmid41498900, year = {2026}, author = {Lin, ZY and Cai, LL and Lin, JX and Zheng, GY}, title = {Tiaobu Xinshen Recipe Improves Cognitive Deficits by Alleviating Synaptic Ultrastructure Degradation and Reducing Amyloid β in Transgenic Mice of Alzheimer's Disease.}, journal = {Chinese journal of integrative medicine}, volume = {}, number = {}, pages = {}, pmid = {41498900}, issn = {1993-0402}, abstract = {OBJECTIVE: To investigate the effect of Tiaobu Xinshen Recipe (TXR) on cognitive function of 5xFAD transgenic mice and explore the potential mechanisms.
METHODS: Six-month-old male wild-type (WT) mice and 5xFAD transgenic mice were randomly divided into vehicle (0.9% NaCl), TXR (granules, 4.18 g/kg) and donepezil (0.625 mg/kg) groups using a random number table, respectively, which were given intragastric administration once a day for 60 d. Spatial learning and memory performance was tested with modified Morris water maze (MMWM) test. Synaptic ultrastructure in the hippocampal CA1 region was observed by transmission electron microscopy. The levels of amyloid β (Aβ), the major amyloid precursor protein (APP)-cleaving enzymes and Aβ-degrading enzymes including β-secretase, α-secretase, neprilysin (NEP) and insulin-degrading enzyme (IDE), were detected by immunohistochemistry staining and Western blot, respectively.
RESULTS: In MMWM test, when compared with the 5xFAD-vehicle group, 5xFAD-TXR group demonstrated a significantly shorter escape latency to the platform and increased number of platform crossings and time spent in target quadrant (P<0.05 or P<0.01). The ultrastructure of synapse in the hippocampal CA1 region of mice in the 5xFAD-TXR group was significantly changed, including increased numbers of mitochondria and synaptic vesicles, intact synaptic membrane, and thickened postsynaptic density. The Aβ load was markedly decreased in the cerebral cortex and hippocampus CA1 subregion of TXR-treated 5xFAD mice (P<0.05). TXR treatment decreased APP levels and increased IDE expression in brains of 5xFAD mice (P<0.01). However, TXR treatment had no effect on α- and β-secretase, and NEP in 5xFAD mice (P>0.05).
CONCLUSION: TXR improves cognitive dysfunction in 5xFAD mice by alleviating synaptic ultrastructure degradation and reducing Aβ.}, }
@article {pmid41498480, year = {2026}, author = {Goodall, LS and Lennon, MJ and Sachdev, PS and Gorelick, PB and Kovacic, JC and Samaras, K}, title = {Current and Emerging Therapeutic Approaches for Vascular Cognitive Impairment and Dementia.}, journal = {Journal of the American College of Cardiology}, volume = {87}, number = {1}, pages = {77-100}, doi = {10.1016/j.jacc.2025.09.1502}, pmid = {41498480}, issn = {1558-3597}, mesh = {Humans ; *Dementia, Vascular/therapy/prevention & control ; *Cognitive Dysfunction/therapy ; }, abstract = {Cardiovascular risk factors contribute to the majority of dementia cases, with about 20% directly attributable to vascular cognitive impairment and dementia (VCID). VCID treatment developments have been slow compared with Alzheimer's disease (AD), which now has several FDA-approved symptom- and disease-modifying agents. In the second part of this JACC Seminar Series, advances and new perspectives on the management and prevention of VCID are reviewed. There is reasonable evidence that cognitive enhancers (donepezil, galantamine, and memantine) modestly improve cognition in vascular dementia (VaD), the most severe form of VCID, especially if there is associated AD pathology. Antidepressants may benefit those with depression and stroke, but they have poor efficacy in those with depression and VaD alone. Behavioral, social, and environmental interventions are first-line therapies for managing VCID-associated agitation and psychosis. Second-line antipsychotics have not been trialed in those with VaD alone, but are beneficial where AD and VaD co-exist, with risperidone and quetiapine effective in reducing psychosis and agitation. Primary prevention of VCID includes identifying and managing cardiometabolic risk factors along with manifestations of covert cerebrovascular disease. Both primary and secondary VCID prevention involve management of cardiovascular risks, specifically hypertension, diabetes mellitus, smoking, atrial fibrillation, obesity, and sedentariness. Management of vascular risk factors may moderately reduce the risk of incident cognitive impairment. Novel interventions currently being evaluated in clinical trials are discussed. The discovery and utilization of VCID and AD biomarkers will enhance the specificity and effectiveness of interventions such that a precision-medicine approach to disease-specific medical therapy may be taken.}, }
@article {pmid41498479, year = {2026}, author = {Sachdev, PS and Bentvelzen, AC and Gustafson, D and Hansra, GK and Hosoki, S and Jiang, J and Lennon, MJ and Moro, MA and Saks, DG and Samaras, K and Kovacic, JC and Kalaria, R}, title = {Vascular Cognitive Impairment and Dementia: Clinical Features, Neuropathology, and Biomarkers.}, journal = {Journal of the American College of Cardiology}, volume = {87}, number = {1}, pages = {52-76}, doi = {10.1016/j.jacc.2025.11.008}, pmid = {41498479}, issn = {1558-3597}, mesh = {Humans ; Biomarkers/metabolism ; *Dementia, Vascular/diagnosis/pathology ; *Cognitive Dysfunction/diagnosis/etiology ; Risk Factors ; *Brain/pathology ; }, abstract = {Vascular cognitive impairment and dementia (VCID), ie, cognitive impairment secondary to cerebrovascular disease (CeVD), is the second most common form of dementia after Alzheimer's disease (AD), accounting for 15% to 20% of all cases. CeVD, in fact, contributes to dementia alongside other neuropathologies in up to 75% of dementia cases. CeVD and AD not only frequently co-occur in the brain, but they may also interact, and some VCID risk factors (midlife hypertension and diabetes) also increase AD risk. Because CeVD and cardiovascular disease share risk factors and pathophysiology, the cardiovascular clinician is likely to encounter both in the clinic. Moreover, common cardiac disorders, such as atrial fibrillation, heart failure, acute coronary syndrome, and valvular disease, increase VCID risk. There have been recent developments in the diagnostic criteria for VCID, with advances in risk biomarkers, treatment, and prevention of cognitive impairment and dementia. The diagnosis of VCID is a 2-step process, with the initial identification of a cognitive syndrome followed by the establishment of a predominantly vascular etiology, guided by clinical history and examination and substantiated by neuroimaging, preferably magnetic resonance imaging. Clinical presentations include an acute onset, a stepwise decline, a fluctuating course if caused by multiple strokes, or a gradual slow progression if attributable to cerebral small vessel disease. Cognitive deficits can be found in several domains, such as information-processing speed, attention, executive function, and emotional lability, sometimes referred to as the subcortical syndrome, often seen in the early stages of VCID without cortical infarcts. The diagnosis is supported by the identification of large and small infarcts, lacunes, white matter hyperintensities, dilated perivascular spaces and cerebral microbleeds using magnetic resonance imaging. This part 1 of a 2-part JACC review series describes the clinical features, pathophysiology, and biomarkers of VCID for cardiovascular clinicians who have a critical role in its early identification, management, and prevention in their patients.}, }
@article {pmid41496378, year = {2026}, author = {Zhao, Y and Lu, H and Jiang, X}, title = {Advance in neuroprotective effects of proanthocyanidins (PCs): Structure, absorption, bioactivities, mechanism, and perspectives.}, journal = {Pharmacological research}, volume = {223}, number = {}, pages = {108082}, doi = {10.1016/j.phrs.2025.108082}, pmid = {41496378}, issn = {1096-1186}, mesh = {*Proanthocyanidins/chemistry/pharmacology/pharmacokinetics/therapeutic use ; Humans ; *Neuroprotective Agents/chemistry/pharmacokinetics/pharmacology/therapeutic use ; Animals ; *Nervous System Diseases/drug therapy/metabolism ; Gastrointestinal Microbiome/drug effects ; }, abstract = {With the global population growing and aging, along with increasing environmental, metabolic, and lifestyle-related risk factors, the worldwide incidence of stroke, Alzheimer's disease (AD) and other dementias, meningitis, and other neurological disorders-along with associated mortality-has risen significantly. Proanthocyanidins (PCs), which are oligomers and polymers of flavan-3-ols, are widely distributed across the plant kingdom, including in grape seeds, cinnamon, apples, cranberries, lotus seeds, and pine bark. They represent the second most abundant class of polyphenols in nature, after lignin. A substantial body of preclinical evidence indicates that PCs exert significant neuroprotective effects through multiple mechanisms. This review provides a systematic overview of the sources, structural characteristics, and bioavailability of PCs, with a focus on their pharmacological mechanisms in nervous system disease. Specifically, it examines their roles in regulating oxidative stress, neuroinflammation, protein homeostasis, apoptosis, autophagy, and key signaling pathways, including Nrf2/HO-1, CREB/BDNF, PI3K/Akt, MAPK, and NF-κB. Furthermore, this review systematically summarized the distinct structural forms of PCs, including monomers, dimers, trimers, and polymers, and explores their structure-activity relationships (SARs) in modulating the gut-brain axis. Additionally, recent advances in PCS-based nano-delivery systems and clinical studies related to neurological disorders are summarized. Growing evidence indicates that microbial metabolism in the gut serves as a key mechanism underlying their neuroprotective effects. Finally, the potential applications of PCs as promising dietary supplements or therapeutic agents for the prevention and treatment of nervous system diseases are discussed, along with existing challenges and future perspectives.}, }
@article {pmid41496364, year = {2026}, author = {Facchinetti, R and Valenza, M and Ciarla, C and Steardo, L and Serviddio, G and Palombelli, G and Verkhratsky, A and Steardo, L and Canese, R and Cassano, T and Scuderi, C}, title = {Ultramicronized palmitoylethanolamide restores astrocyte-neuron metabolic coupling and Klotho/FGF21 signaling in a triple-transgenic mouse model of Alzheimer's disease.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {195}, number = {}, pages = {118965}, doi = {10.1016/j.biopha.2025.118965}, pmid = {41496364}, issn = {1950-6007}, abstract = {Alzheimer's disease (AD), a multifactorial neurodegenerative disorder, is characterized by metabolic deficiency, neuroinflammation, and synaptic impairment. Astrocyte-neuron metabolic coupling regulates cerebral energy homeostasis through key metabolites such as lactate, glutamate, and taurine. We investigated the therapeutic potential of ultramicronized-palmitoylethanolamide (um-PEA) in restoring the homeostasis of these metabolites in the triple transgenic (3 ×Tg-AD) mouse model of AD. Using in vivo magnetic resonance imaging and spectroscopy (MRI/MRS) combined with Western blot, we evaluated the effects of chronic um-PEA treatment on lactate-glutamate dynamics and taurine metabolism in the frontal cortex and hippocampus of 6- and 12 month-old mice. Our findings demonstrate that 3 ×Tg-AD mice exhibit lactate accumulation, glutamine/glutamate imbalance, and taurine depletion, alongside reduced expression of metabolic processes regulators such as FGF21, Klotho, and insulin receptor. Treatment with um-PEA successfully restored these metabolic changes by: (i) rebalancing lactate-glutamate metabolism, (ii) increasing taurine synthesis and transport, (iii) upregulating FGF21, Klotho, and insulin receptor expression, and (iv) modulating the metalloproteases ADAM10 and ADAM17, which regulate Klotho processing. These results identify um-PEA as a promising metabolic modulator capable of mitigating AD-related neurodegenerative processes. By targeting astrocyte-neuron metabolism and enhancing both FGF21 and Klotho pathways, um-PEA holds significant potential as an adjunctive therapeutic strategy for AD.}, }
@article {pmid41496361, year = {2026}, author = {Huzián, O and Nagy, LI and Hackler, L and Knapp, L and Kocsis, ÁK and Szöts, I and Tamás, G and Puskás, LG and Molnár, G}, title = {Novel drug candidate binds to delta subunit containing GABAA receptors and improves spatial memory.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {195}, number = {}, pages = {118970}, doi = {10.1016/j.biopha.2026.118970}, pmid = {41496361}, issn = {1950-6007}, abstract = {The hydroxyquinoline derivative Q134R is a promising drug candidate for the treatment of Alzheimer's disease with cytoprotective and cognition-enhancing properties. Radioligand binding assays showed that Q134R reduced [[35]S]TBPS binding, consistent with modulation of the picrotoxin site or conformational states that regulate TBPS accessibility. Electrophysiological recordings in mouse brain slices revealed that Q134R significantly increased tonic inhibitory currents in cortical neurogliaform and dentate gyrus granule cells, both known to express delta subunit-containing GABAA receptors. This effect was abolished in mice deficient in the GABAA delta subunit confirming the delta subunit dependency of Q134R's action. Furthermore, in a scopolamine-induced amnesia model, Q134R treatment significantly improved spatial memory performance in wild-type mice, but not in mice lacking in the delta subunit. These results suggest that Q134R enhances tonic inhibition through delta subunit-containing GABAA receptors, which may contribute to the modulation of memory processes and serve as a protective mechanism in early-stage neurodegenerations. These receptor-mediated effects likely contribute to its broader therapeutic efficacy and may complement its previously reported interactions with signaling pathways such as NFAT and HIF-1.}, }
@article {pmid41495612, year = {2025}, author = {Yang, G and Zhu, D and Zhang, K}, title = {Nose-brain axis: A bridge from the nasal cavity to the central nervous system.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-01770}, pmid = {41495612}, issn = {1673-5374}, abstract = {The nose-brain axis is a direct pathway linking the nasal cavity to the central nervous system. Odors, as well as exogenous substances such as pathogens, inflammatory mediators, and drugs, can enter the cranial cavity through pathways including the olfactory nerve, trigeminal nerve, and humoral routes, thereby enabling signal transmission and material exchange from the peripheral nasal cavity to the central nervous system. In recent years, advances in multimodal visualization technologies have made it possible to dynamically monitor the nose-brain axis from the molecular level to the tissue level, providing important means for revealing its functional characteristics and pathological changes. Owing to the existence of the nose-brain axis, nasal inflammation can, through neuro-immune interactions, activate central microglia and astrocytes and induce neuroinflammation, thus promoting the onset and progression of central nervous system diseases. In addition, the nose-brain axis offers a unique route for the treatment of central nervous system disorders. Intranasal drug delivery can bypass the blood-brain barrier, act directly on the central nervous system, increase intracranial drug bioavailability, and produce rapid effects, providing new ideas for treating cross-system diseases. This review systematically summarizes the anatomical pathways of the nose-brain axis, visualization monitoring technologies, and mechanisms by which nasal inflammation affects the central nervous system. It also reviews advances in intranasal drug delivery for emotional disorders, migraine, Parkinson's disease, and Alzheimer's disease, aiming to provide new strategies for studying the mechanisms by which nasal inflammation influences the central nervous system and for cross-system targeted therapy.}, }
@article {pmid41495456, year = {2026}, author = {Chen, Z and Bi, S and Shan, Y and Wang, F and Wang, Y and Qi, Z and Wang, T and Li, X and Li, S and Xiao, H and Wang, S and Cui, B and Qi, Z and Han, Y and Yan, S and Lu, J and , }, title = {MRI-to-PET synthesis via deep learning for amyloid-β quantification in Alzheimer's disease.}, journal = {European radiology}, volume = {}, number = {}, pages = {}, pmid = {41495456}, issn = {1432-1084}, support = {82102010//National Natural Science Foundation of China/ ; 82394434//National Natural Science Foundation of China/ ; }, abstract = {OBJECTIVES: Amyloid-β (Aβ) PET is crucial for diagnosing and monitoring Alzheimer's disease (AD), but its high cost and radiation exposure limit its use. Deep learning techniques make it possible to generate PET from structured MRI data. In this study, we built a deep learning model to generate 3D synthetic Aβ PET images from structural MRI.
MATERIALS AND METHODS: The generative adversarial network with share parameters (ShareGAN) model was trained and tested with 1009 Aβ PET and paired MRI images from the Alzheimer's Disease Neuroimaging Initiative database and three tertiary hospitals in China. The 3D synthetic model operates on the whole volume rather than 2D image slices, realistically reproducing minor discrepancies between neighboring image planes. ShareGAN-based PET images were evaluated using quantitative metrics and visual assessment. Pearson correlation coefficient and Bland-Altman analyses were used to assess the correlation and concordance between synthetic and real PETs.
RESULTS: 3D Synthetic PET images showed high similarity and correlation with real Aβ PET in external testing sets 1 and 2 in terms of structural similarity index measure (0.898, 0.899), peak signal-to-noise ratio (34.690, 34.725), mean absolute error (0.031, 0.031), and standardized uptake value ratio (R = 0.758, 0.828). The diagnostic accuracy of PET positive or negative status in external testing sets 1 and 2 was 88.5% and 89.4%, respectively.
CONCLUSION: MRI-based 3D synthetic Aβ PET images can serve as a safe and cost-effective tool for Aβ status visualization, providing PET-eligible patients with Aβ PET-like imaging analysis to guide subsequent real Aβ PET scans.
KEY POINTS: Question Amyloid-β (Aβ) PET limitations (high cost, radiation, limited access) hinder early Alzheimer's disease (AD) detection. Clinical practice urgently requires a suitable supplementary method for Aβ pathology assessment. Findings AI-synthesized 3D Synthetic Aβ PET from structural MRI demonstrated strong consistency with real PET and effectively triaged high-risk patients for confirmatory scans. Clinical relevance This non-invasive, cost-effective method holds the promise of enabling wider Aβ pathology screening, reduces unnecessary PET scans, and supports early intervention in resource-limited settings, while preserving diagnostic rigor for treatment decisions.}, }
@article {pmid41494605, year = {2026}, author = {Viqueira, L and Navarro, E and Negredo, P and Bernal, JA and Rodríguez-Franco, MI and Tortosa, E and López, MG}, title = {Long-term NRF2-driven microglial repopulation mitigates microgliosis, neuronal loss and cognitive deficits in tauopathy.}, journal = {Brain, behavior, and immunity}, volume = {133}, number = {}, pages = {106253}, doi = {10.1016/j.bbi.2026.106253}, pmid = {41494605}, issn = {1090-2139}, abstract = {Tauopathies, including Alzheimer's disease, feature chronic microglial reactivity that drives neuroinflammation and disease progression. Pharmacological microglial depletion and subsequent repopulation using colony-stimulating factor 1 receptor inhibitors have emerged as a potential therapeutic strategy to reprogram dysfunctional microglia. Despite promising short-term results, the long-term efficacy and pharmacological modulation of repopulated microglia remain poorly understood. Here, we investigated the long-term effects of microglial repopulation alone and in combination with the activation of the cytoprotective nuclear factor erythroid 2 p45-related factor 2 (NRF2) in an in vivo AAV-hTau[P301L] induced model. Integrating different behavioural, immunohistological and transcriptomic analysis, we evaluated cognitive function, tau pathology, neuronal survival and glial reactivity. We found that, whereas microglial repopulation alone did not significantly affect disease progression, NRF2-driven microglial replenishment sustained cognitive function, prevented hippocampal neuronal loss and restored microglial phenotype. Transcriptomic analyses further revealed that the combined treatment modulated tau- associated mitochondrial gene expression changes. These results highlight the importance of shaping the fate of self-renewed microglia and propose NRF2-mediated microglial repopulation as a potential pharmacological strategy for the treatment of tauopathies.}, }
@article {pmid41493713, year = {2026}, author = {Hoveizi, E and Doraghi, K and Rostami, E}, title = {Fabrication and Characterization of Resveratrol-Loaded Solid Lipid Nanoparticles: Evaluation of Neuroprotective, Neurobehavioral, and Molecular Outcomes.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {346}, pmid = {41493713}, issn = {1559-1182}, support = {SCU.SB1403.12464//Shahid Chamran University of Ahvaz/ ; }, mesh = {*Resveratrol/pharmacology/administration & dosage/chemistry ; Animals ; *Nanoparticles/chemistry/ultrastructure ; *Neuroprotective Agents/pharmacology/administration & dosage/chemistry ; Male ; Rats ; Oxidative Stress/drug effects ; *Lipids/chemistry ; Antioxidants/pharmacology ; Neural Stem Cells/drug effects/metabolism ; *Behavior, Animal/drug effects ; Rats, Sprague-Dawley ; Interleukin-1beta/metabolism ; Memory/drug effects ; }, abstract = {Neurodegenerative processes involve oxidative stress, inflammation, and disrupted signaling, which contribute to cognitive decline. Resveratrol offers neuroprotection but suffers from poor solubility and bioavailability. Solid lipid nanoparticles (SLNs) can improve solubility, stability, and neural targeting, thereby enhancing efficacy. This study investigates whether SLN/resveratrol treatment modulates neuroprotective targets (HSP70, IL-1β) and antioxidant enzymes (CAT, GPX, SOD) in vitro and whether it improves inactive avoidance memory in an animal model. SLNs were produced by melting tripalmitin and palmitic acid, adding resveratrol, Tween, and butanol, then combining with water and stirring for 1 day. The resulting formulations were characterized using FTIR, electron microscopy, and DLS. Neural stem cells (NSCs) were treated with SLNs, resveratrol, and SLN/resveratrol, and the expression of oxidative stress enzymes, HSP70, and IL-1β was analyzed. In vivo, a passive avoidance memory model was induced in rats via electrical destruction of the nucleus basalis of Meynert. Molecular analysis showed that resveratrol increased HSP70 expression by 3.1-fold and significantly decreased IL-1β levels. SLN treatment had no notable effect on these genes, but the SLN/resveratrol increased HSP70 expression by fourfold and significantly reduced IL-1β. Resveratrol significantly upregulated the antioxidant enzymes CAT and GPX, whereas SLNs alone had no effect. The SLN/resveratrol also markedly enhanced CAT and GPX levels. Behavioral tests demonstrated that the SLN/resveratrol treatment improved passive avoidance memory in the Alzheimer's model. Collectively, these results indicate that SLN/resveratrol robustly enhances neuroprotection by modulating signaling pathways, reducing oxidative stress, and improving memory, with the SLN delivery system potentially increasing bioavailability and neural exposure.}, }
@article {pmid41493675, year = {2026}, author = {Usman, AS and Manoharan, SD and Che Mohd Nassir, CMN and Abdul Hamid, H and Hein, ZM and Norazit, A and Murthy, J and Zainol, M and Kamaruzzaman, MA and Chiroma, SM and Mustapha, M and Mohd Moklas, MA and Mehat, MZ}, title = {Neuroprotective Effects of Ficus deltoidea in Alzheimer's Disease-Like Rat Model: Insights from Behavior, Histology, and Amyloid Pathology.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {345}, pmid = {41493675}, issn = {1559-1182}, support = {(FRGS/1/2021/SKK0/UPM/02/15)//the Ministry of Higher Education under the Fundamental Research Grant Scheme/ ; }, mesh = {Animals ; *Alzheimer Disease/pathology/drug therapy/metabolism ; *Ficus/chemistry ; *Neuroprotective Agents/pharmacology/therapeutic use ; Male ; Rats, Wistar ; Disease Models, Animal ; *Plant Extracts/pharmacology/therapeutic use ; Plaque, Amyloid/pathology/drug therapy ; Amyloid beta-Peptides/metabolism ; Hippocampus/pathology/drug effects/metabolism ; Amyloid Precursor Protein Secretases/metabolism ; Maze Learning/drug effects ; Rats ; *Behavior, Animal/drug effects ; Spatial Memory/drug effects ; Aspartic Acid Endopeptidases/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by cognitive decline, memory impairment, and accumulation of amyloid-β (Aβ) plaques. While current treatments offer limited efficacy, medicinal plants such as Ficus deltoidea (FD), a traditional remedy, have shown promise due to their neuroprotective and anti-inflammatory properties. An AD-like phenotype was induced in male Wistar rats using D-galactose and aluminum chloride over 70 days. FD extract was administered orally at 50, 100, and 200 mg/kg. Spatial memory was evaluated using the T-maze test. Histological analyses of the hippocampi's Cornu Ammonis 1 and 3 (CA1 and CA3) regions were conducted via hematoxylin and eosin (H&E) staining, and Aβ plaques deposition was assessed with Congo red. Enzyme-linked immunosorbent assay (ELISA) was used to quantify hippocampal levels of Aβ (1-42) and β-secretase-1 (BACE-1). FD treatment significantly enhanced spatial memory, preserved pyramidal neuron integrity in CA1 and CA3, and reduced amyloid plaque formation. Biochemically, FD markedly decreased hippocampal Aβ (1-42) and BACE-1 concentrations in a dose-dependent manner. Thus, FD exhibits multi-target neuroprotective effects in an AD-like model, potentially via modulation of amyloidogenic pathways. Further studies are warranted to explore its mechanisms and therapeutic potential in other brain regions implicated in AD.}, }
@article {pmid41493656, year = {2026}, author = {Cicero, CE and Angelini, L and Abbadessa, G and Bruno, M and Fiume, G and Nucera, B and Ornello, R and Arabia, G and Giuliano, L and Guarnieri, B and Lugaresi, A and Perani, D and Sacco, S and Tassorelli, C and Nicoletti, A and Pellecchia, MT and , }, title = {Sex and gender-related differences in neurological diseases: current challenges and recommendations for clinical practice.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {47}, number = {1}, pages = {108}, pmid = {41493656}, issn = {1590-3478}, mesh = {Humans ; *Nervous System Diseases/therapy/epidemiology ; Female ; *Sex Characteristics ; Male ; Pregnancy ; }, abstract = {Neurological diseases include a large variety of conditions ranging from inflammatory, vascular and neurodegenerative disorders to epilepsy and headache. The impact of sex and gender on various aspects of these conditions (epidemiology, risk factors, pathophysiology, clinical features, treatment, and management of pregnancy and breastfeeding) is still not entirely taken into consideration, despite a rapidly increasing body of evidence. This position paper covers six neurological conditions (Alzheimer's Disease, Cerebrovascular disease, Parkinson's disease, Epilepsy, Headache disorders, Multiple Sclerosis) providing an overview of available evidence on sex and gender differences, identifying knowledge gaps and providing recommendations for clinical practice and future studies. We recommend taking into consideration modifiable sex and gender specific risk factors, the role of hormones across women's lifespan and a personalized treatment approach based on gender. We also recommend that future efforts should be devoted to increase the representation of women in clinical studies, to promote sex and gender-based guideline production and to better characterize the safety profile in pregnancy of newer drugs.}, }
@article {pmid41491579, year = {2026}, author = {Kamali, M and Ansari, M and Nooraee, P and Tajadini, H and Kamali, H and Dehesh, T and Ashrafzadeh, A and Sharififar, F}, title = {Preliminary clinical evaluation of capsules containing standard hydroalcoholic extract of Myrtus communis L. in patients with mild to moderate Alzheimer' disease: a randomized, double-blind parallel-group clinical trial.}, journal = {BMC complementary medicine and therapies}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12906-025-04994-9}, pmid = {41491579}, issn = {2662-7671}, abstract = {BACKGROUND: This study evaluated the effectiveness of Myrtus communis L. extract, known for its antioxidant and anticholinesterase properties, to enhance cognitive function and mitigate disease progression in individuals with mild to moderate Alzheimer's disease (AD).
METHODS: Fifty elderly patients with mild to moderate AD residing in a Kerman nursing home were enrolled in a randomized, placebo-controlled trial conducted between November 2019 to February 2020. Participants were randomly assigned to either an intervention group (n = 25), receiving M. communis L. capsules (500 mg each capsule), or a control group (n = 25), receiving placebo capsules. Cognitive function was assessed at baseline and after four weeks using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) scales. Statistical analyses, performed using SPSS version 22, considered a significance level of p < 0.05.
RESULTS: All fifty patients completed the four-week trial. Baseline characteristics-including sex, mean age, and education level-were well-matched between the intervention and control groups. After four weeks of treatment, the intervention group demonstrated a statistically significant improvement in cognitive function, as evidenced by significantly higher MMSE scores compared to the placebo group (23.4 ± 0.25 vs. 19.6 ± 0.25; p < 0.0001). Concurrently, the intervention group exhibited a significant reduction in dementia severity, indicated by lower CDR scores compared to the control group (0.8 ± 0.04 vs. 1.5 ± 0.04; p < 0.0001).
CONCLUSIONS: These findings suggest that M. communis L. holds promise as a potential complementary therapy for AD, capable of improving cognitive function and potentially slowing disease progression. However, further research is necessary to corroborate these results, elucidate the underlying mechanisms of action, and optimize treatment parameters before definitive conclusions can be drawn.
TRIAL REGISTRATION: irct.ir, ID: 20170702034861N8. Registered on 26/08/2019.}, }
@article {pmid41491073, year = {2026}, author = {Wasim, R and Azmi, S and Ahmad, A and Srivastava, A}, title = {NLRP3 inflammasome and Alzheimer's disease: bridging inflammation and neurodegeneration.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41491073}, issn = {1568-5608}, abstract = {The progressive neurodegenerative disease known as Alzheimer's disease (AD) is characterized by widespread neuronal death, memory loss, and cognitive decline. The NLRP3 inflammasome has emerged as a key modulator of neuroinflammation, which is increasingly implicated in the pathophysiology of AD. In response to endogenous and pathogenic danger signals, the innate immune system's multiprotein complex known as the NLRP3 inflammasome is activated. Pyroptosis and neuroinflammatory cascades are eventually triggered by its activation, which causes caspase-1 to be cleaved and pro-inflammatory cytokines like interleukin-1β and interleukin-18 to be released. NLRP3 activation is strongly stimulated by tau aggregation and β-amyloid plaques in AD, which accelerates neuronal damage and prolongs chronic inflammation. The control and activation of inflammasomes are involved in both canonical and non-canonical pathways as well as mitochondrial dysfunction. Significantly, animal models indicate that NLRP3's therapeutic potential is highlighted by the reduction of amyloid burden and amelioration of cognitive decline that results from its inhibition or genetic deletion. Small-molecule inhibitors and natural substances that can alter NLRP3 activity have been discovered recently, providing intriguing approaches to AD treatment. Despite tremendous advancements, issues with medication selectivity and blood-brain barrier penetration still need to be resolved before these discoveries can be used in clinical settings. Comprehending the complex relationship between NLRP3 activation and Alzheimer's pathology may open the door to new, focused treatments meant to slow or stop the progression of the illness.}, }
@article {pmid41490490, year = {2026}, author = {Wang, W and Huang, R and Lv, L and Ma, X and Li, Z and Zhang, Y and Wu, J and Wu, S and Xu, J and Hu, Y and Turck, CW and Li, H and Hu, X}, title = {Long-term effects of forty-hertz auditory stimulation as a treatment of Alzheimer's disease: Insights from an aged monkey model study.}, journal = {Proceedings of the National Academy of Sciences of the United States of America}, volume = {123}, number = {2}, pages = {e2529565123}, pmid = {41490490}, issn = {1091-6490}, mesh = {Animals ; *Alzheimer Disease/therapy/pathology/cerebrospinal fluid ; Macaca mulatta ; tau Proteins/cerebrospinal fluid ; Disease Models, Animal ; Amyloid beta-Peptides/cerebrospinal fluid ; *Acoustic Stimulation/methods ; Male ; Female ; *Aging ; Humans ; Brain/pathology ; }, abstract = {Based mainly on rodents studies, forty-hertz (40-Hz) physical stimulation has been regarded as a potential noninvasive treatment for Alzheimer's disease (AD). Considering the brain differences between rodents and humans, the effects of 40-Hz physical stimulation need to be further validated using nonhuman primates before its clinical application. Here, we took advantage of a rare opportunity to expose nine aged rhesus monkeys (26 to 31 y old) to 40-Hz auditory stimulation. Given the strong correlation between cerebrospinal fluid (CSF) Aβ and Tau concentrations and corresponding AD pathology in brain parenchyma in clinical practice, we investigated the effects of 40-Hz stimulation on AD pathology by monitoring changes in CSF Aβ and Tau concentrations. Our results revealed that 7 consecutive days of 40-Hz auditory stimulation triggered a rapid and significant increase of Aβ levels by more than 200%, but no effect on Tau levels in the CSF. Additionally, we observed that the elevation of CSF Aβ levels persisted for more than 5 wk after cessation, which had not been reported in any previous studies. After this, a pathological examination of the temporal cortices of 4 of the experimental monkeys was carried out and the data demonstrated that all of them had prevalent extracellular Aβ senile plaque pathology, whereas Tau pathology was negative or very weak. These results provide a good explanation for the differences between the CSF Aβ and Tau protein levels. Together, these first-time results from monkeys suggest that 40-Hz auditory stimulation has strong potential of a noninvasive AD treatment method.}, }
@article {pmid41490210, year = {2026}, author = {Giuffrè, GM and Battisti, F and Tudor, AM and Lenkowicz, J and Avitabile, A and Rosati, AM and Martellacci, N and Patarnello, S and Torelli, F and Cesario, A and Marra, C}, title = {Redefining management of mild cognitive impairment and Alzheimer's disease through the shift from clinical to clinical-biological diagnosis: Insights from a single-center experience.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251411461}, doi = {10.1177/13872877251411461}, pmid = {41490210}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) diagnosis has shifted from a purely clinical framework to a clinical-biological paradigm, driven by biomarker integration. This evolution is motivated by the wider availability of reliable biomarkers and the advent of disease-modifying treatments.ObjectiveTo assess changes over time in clinical characteristics, diagnostic pathways, and healthcare resource utilization in a real-world cohort of individuals with cognitive impairment attending a Memory Clinic.MethodsThis secondary data retrospective observational study analyzed two patient cohorts with newly diagnosed cognitive impairment: one from 2017-2019 and another from 2021-2023. Anonymized medical records and structured hospital data were examined using natural language processing to extract demographic and clinical information, diagnostic pathways, treatment patterns and comorbidities.ResultsThe 2021-2023 cohort was significantly younger, exhibited higher baseline Mini-Mental State Examination scores, and underwent more instrumental assessments than the 2017-2019 cohort. These findings likely reflect a shift in public awareness and attitudes toward cognitive health. AD diagnoses increased in both cohorts over time, while mild cognitive impairment diagnoses declined. The use of diagnostic combinations was more frequent in the recent cohort, in which clinical-biological diagnoses were significantly more prevalent.ConclusionsThis study provides real-world insights into the evolving landscape of cognitive impairment diagnostics and care, underscoring a shift toward earlier, biologically grounded diagnosis, supporting precision medicine in AD care. The expanded use of biomarkers reflects evolving practice standards and prepares the ground for disease-modifying therapies in AD.}, }
@article {pmid41490207, year = {2026}, author = {Liu, Y and Su, H and Guan, T and Li, X and Dong, C and Hu, Z and Zhang, Y}, title = {Risk prediction of progression from normal cognitive function to Alzheimer's disease in elderly aged 65 and above based on deep learning methods.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251410937}, doi = {10.1177/13872877251410937}, pmid = {41490207}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) is a severe neurological disorder for which a complete cure is not currently available. Therefore, predicting the risk of AD in elderly individuals with normal cognitive function is crucial for early prevention, treatment, and family-provided daily care preparation.ObjectiveThis study aimed to establish a risk prediction model for the progression from normal cognitive function to AD in elderly via deep learning (DL) methods to provide a reference for clinical decision-making and the development of screening tools for the early diagnosis of AD.MethodsDeepSurv, DeepHit, and Cox models were constructed, and the consistency index (C-index), integrated Brier score (IBS), and area under the ROC curve (AUC) were used to evaluate the accuracy, calibration and discriminative power of the three prediction models.ResultsThe overall predictive ability of the model was relatively stable, with concordance indices of 0.82 (DeepSurv), 0.83 (DeepHit), and 0.81 (Cox) and IBSs of 0.08, 0.07, and 0.05, respectively. From the perspective of the C-index indicator, the consistency of the deep learning model was better than that of the Cox model.ConclusionsRisk prediction models for the progression from normal cognitive function to AD can be established using easily obtainable early-stage predictors, which are expected to be used for rapid screening of the risk of developing AD in elderly after clinical validation.}, }
@article {pmid41490027, year = {2026}, author = {Yang, JW and Jiang, J}, title = {Association between varicella-zoster virus and Alzheimer's disease: A systematic review and meta-analysis of comprehensive evidence from infection, treatment to prevention.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251411573}, doi = {10.1177/13872877251411573}, pmid = {41490027}, issn = {1875-8908}, abstract = {BackgroundThe association between varicella-zoster virus (VZV) infection and Alzheimer's disease (AD) risk has shown inconsistent results. Given difficulties in early diagnosis and limited therapeutic options for AD, identifying modifiable risk factors is significant for prevention.ObjectiveTo systematically evaluate the impact of VZV infection on AD risk and explore protective effects of antiviral treatment and vaccination.MethodsWe searched PubMed and Web of Science databases up to April 2025. The Newcastle-Ottawa Scale assessed study quality. Random-effects models were used for meta-analysis using risk ratios (RR) as the primary effect measure, with sensitivity and subgroup analyses conducted.ResultsTwenty-one studies were included. Meta-analysis showed: (1) herpes zoster patients had significantly higher AD risk (RR = 1.12, 95% CI: 1.01-1.24, p = 0.04); (2) patients receiving antiviral treatment had lower AD risk (RR = 0.55, 95% CI: 0.37-0.82, p = 0.003); (3) vaccinated individuals had lower AD risk (RR = 0.72, 95% CI: 0.68-0.78, p < 0.0001). The strongest association occurred in the >70 years age group, demonstrating age as an important effect modifier.ConclusionsThis meta-analysis provides systematic evidence supporting that VZV infection increases AD risk while confirming protective effects of antiviral treatment and vaccination. These findings support including herpes zoster vaccination in preventive healthcare for elderly populations.}, }
@article {pmid41488982, year = {2025}, author = {Ressa, R and Ettinger, J and Chowdhury, E and Graham, L and Ndirangu, K and Mancebo, JZ and Bodnar, C}, title = {A value assessment of patient-level outcomes and productivity loss for intravenous and subcutaneous lecanemab for patients with early Alzheimer's disease.}, journal = {Journal of medical economics}, volume = {29}, number = {1}, pages = {118-134}, doi = {10.1080/13696998.2025.2609499}, pmid = {41488982}, issn = {1941-837X}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; Injections, Subcutaneous ; Markov Chains ; Patient Preference ; Administration, Intravenous ; Cost-Benefit Analysis ; Caregivers ; Efficiency ; Decision Support Techniques ; }, abstract = {AIMS: Intravenous (IV) lecanemab is approved for the treatment of patients with early Alzheimer's disease (AD); a subcutaneous (SC) option may offer additional benefits. We assessed the overall value of SC treatments, and direct/indirect outcomes associated with IV and SC lecanemab.
METHODS AND MATERIALS: For the narrative review, PubMed was searched (February 2025) for studies comparing patient preferences for IV/SC treatment administration published between 2015-2025. Study eligibility was determined using patient, intervention, comparator, outcomes, and study criteria. For the decision-analytic model, a Markov model was developed with four lecanemab treatment scenarios. Scenarios one to three included IV initiation (10 mg/kg biweekly) to month 18, followed by either IV initiation continued (10 mg/kg biweekly), SC maintenance (250 mg weekly) or IV maintenance (10 mg/kg every 4 weeks). Scenario four included SC initiation (500 mg weekly) for an 18-month period, followed by SC maintenance (250 mg weekly). Outcomes were administration time/frequency; patient, caregiver, and healthcare professional time; and caregiver productivity loss.
RESULTS: Forty-three publications reported patient treatment preferences. Most (88.4%) reported that patients preferred SC over IV. Key reasons for this were time savings (n = 13/43 studies; 30.2%), convenience (n = 11/43; 25.6%), treatment frequency (n = 12/43; 27.9%). Two studies (n = 2/43; 4.7%) reported an IV preference over SC; for three studies (n = 3/43; 7.0%), treatment preference was driven by administration frequency. Decision-analytic modeling of lecanemab treatment scenarios revealed that IV initiation to IV maintenance had the lowest number of administrations, whereas SC initiation to SC maintenance had the lowest number of treatment hours and caregiver productivity losses.
LIMITATIONS: Caution must be taken when generalizing these results for all AD patients.
CONCLUSIONS: SC treatments show value as a therapeutic option. IV and SC lecanemab availability may offer benefits to patients, caregivers, and society, and improve shared decision making.}, }
@article {pmid41488470, year = {2026}, author = {Cho, Y and Lee, J and Choi, BY and Yun, JH and Han, S and Baek, SH and Park, J and Cho, Y and Kim, HK and Kim, E and Palomera, LF and Lim, J and Jeon, Y and Im, J and Hong, JM and Kim, TK and Kim, SH and Yim, JH and Jo, DG}, title = {Ramalin Ameliorates Alzheimer's Disease Pathology by Targeting BACE1, HDAC6, and MAPK Pathways.}, journal = {MedComm}, volume = {7}, number = {1}, pages = {e70518}, pmid = {41488470}, issn = {2688-2663}, abstract = {Aberrant deposition of β-amyloid (Aβ) and hyperphosphorylated tau, along with neuroinflammation, are key drivers of Alzheimer's disease (AD) pathology. Here, we identify ramalin, a natural antioxidant, as a promising therapeutic agent that alleviates AD pathology by modulating β-site APP cleaving enzyme 1 (BACE1), histone deacetylase 6 (HDAC6), and the mitogen-activated protein kinases (MAPK) pathway. Ramalin reduced BACE1 protein levels, independently of its transcription, translation, or enzymatic activity, an effect mediated by inhibition of HDAC6. Consistently, HDAC6 knockout similarly decreased BACE1 levels, highlighting HDAC6 as a key regulator of BACE1. Ramalin further suppressed neuroinflammatory responses by downregulating inducible nitric oxide synthase (iNOS) and the NLR family pyrin domain containing 3 (NLRP3) inflammasome. In AD mouse models, ramalin treatment significantly attenuated neuroinflammation, Aβ plaque burden, and tau hyperphosphorylation, while improving cognitive performance. Notably, ramalin reversed Aβ oligomer-induced synaptic transmission impairment and restored synaptic vesicle recycling in hippocampal neurons. Transcriptomic analysis identified modulation of the MAPK pathway, with reduced phosphorylation of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK) implicated in tau pathology. These findings establish ramalin as a disease-modifying intervention that provides neuroprotection through concurrent regulation of BACE1, HDAC6, and MAPK signaling pathway. Collectively, our findings highlight ramalin as a compelling disease-modifying candidate with the potential to drive a breakthrough approach targeting AD pathology.}, }
@article {pmid41488323, year = {2025}, author = {Lotlikar, MS and Zellmer, JC and Bhattacharyya, R}, title = {Sigma receptors and mitochondria-associated ER membranes are converging therapeutic targets for Alzheimer's disease.}, journal = {Frontiers in neuroscience}, volume = {19}, number = {}, pages = {1733659}, pmid = {41488323}, issn = {1662-4548}, abstract = {Alzheimer's disease (AD) begins decades before clinical symptoms emerge. The "amyloid hypothesis" suggests that amyloid-β (Aβ) deposition initiates a cascade of tau hyperphosphorylation, neuroinflammation, and neuronal loss leading to cognitive decline. The recent success of anti-Aβ therapies such as Leqembi in prodromal or mild cognitive impaired patients underscores the importance of early intervention and Aβ clearance. However, safety and cost limitations highlight the need for alternative therapeutic strategies. Small-molecule modulators of Sigma-1 and Sigma-2 receptors (σ1R and σ2R) have emerged as promising candidates for AD treatment. σ1R agonists exhibit neuroprotective and anti-amnestic effects under pathological conditions without affecting normal cognition. Beyond AD, σ1R is implicated in several neurodegenerative diseases including ALS (amyotrophic lateral sclerosis), Parkinson's, and Huntington's diseases, stroke, and epilepsy. σ1R plays a key role at mitochondria-associated ER membranes (MAMs)-specialized lipid raft-like domains that form functional membrane contact sites between the endoplasmic reticulum (ER) and mitochondria. β-secretase (BACE1), γ-secretase, and their substrates APP and palmitoylated APP (palAPP) localize in the MAMs, promoting amyloidogenic Aβ production. MAMs serve as dynamic hubs for inter-organelle communication, calcium signaling, and lipid metabolism. The "MAM hypothesis" proposes that MAM dysregulation drives early AD pathology and persists throughout disease progression, contributing to neurofibrillary tangle formation, calcium imbalance, and neuroinflammation. This review aims to summarize the current understanding of σ1R-mediated regulation of MAMs and its neuroprotective mechanisms, highlighting potential therapeutic opportunities for targeting σ1R in AD and other neurodegenerative disorders.}, }
@article {pmid41487944, year = {2026}, author = {Rus Prelog, P and Zupan, M and Gregorič Kramberger, M and Frol, S}, title = {The Concomitant Use of Selective Serotonin Reuptake Inhibitors and Anti-Amyloid Treatment in Alzheimer's Disease: Balancing Benefits and Risks.}, journal = {Dementia and geriatric cognitive disorders extra}, volume = {16}, number = {1}, pages = {1-3}, pmid = {41487944}, issn = {1664-5464}, }
@article {pmid41487496, year = {2025}, author = {Cheng, R and Kim, J}, title = {Intranasal delivery of iron chelators and management of central nervous system disease.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1709259}, pmid = {41487496}, issn = {1663-9812}, abstract = {Brain iron dyshomeostasis plays a critical role in the pathology of multiple central nervous system (CNS) disorders, including neurodegenerative and neuropsychiatric diseases. Iron chelators such as deferoxamine (DFO) and deferiprone (DFP) have demonstrated therapeutic potential in mitigating disease progression in these conditions. However, systemic administration is hindered by poor blood-brain barrier (BBB) permeability, dose-limiting toxicity, and poor patient compliance due to frequent dosing regimens. In recent years, intranasal (IN) drug delivery has emerged as a promising strategy to bypass the BBB, providing a direct nose-to-brain delivery route via olfactory and trigeminal pathways while minimizing systemic exposure. This review provides a comprehensive summary of the current status of iron chelation therapy for CNS disorders with a focus on pharmacokinetics, efficacy, and translational potential of IN administration. While IN DFO has been extensively studied in preclinical models of Alzheimer's disease and stroke, recent developments have expanded the scope to other chelators such as DFP. We compare traditional systemic routes, including oral and intravenous, with intranasal administration, highlighting their respective advantages and limitations for CNS delivery. With ongoing advances in formulation and delivery technologies, IN iron chelators provide a promising alternative for the treatment of CNS disorders characterized by impaired iron homeostasis in the brain.}, }
@article {pmid41487012, year = {2026}, author = {Verma, R and Bahadur, S}, title = {A Comprehensive Review of Naringin Loaded Nano Drug Delivery System in Treatment of CNS Disorders.}, journal = {Current pharmaceutical design}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113816128407188251116030341}, pmid = {41487012}, issn = {1873-4286}, abstract = {Citrus fruits are an abundant source of the polyphenolic phytoconstituent naringenin, which belongs to the class of flavanones. NRG shows a lot of potential as a drug for treating a number of CNS disorders, such as neuroprotective activity, antiamyloidosis, antiparkinson, antialzheimer activity, and more. However, naringenin's hydrophobic nature, which results in limited absorption, limits its therapeutic potential. In this article, we provide an outline of the variety of nanocarriers employed for delivering naringenin as carriers. Some of them include solid lipid nanoparticles, liposomes, micelles, polymeric nanoparticles, nanostructured lipid carriers, nanosuspensions, and nanoemulsions, among others. These formulations of naringenin nanomedicine have been used for the potential treatment of a series of CNS disorders. Based on various research reports, it can be said that with the right nanocarriers, naringenin proves to be a promising therapeutic alternative for the treatment of several CNS ailments, including neurological diseases, Alzheimer's, Parkinson's disease, cerebral ischemia, etc. Therefore, the present manuscript highlights the various aspects of naringenin and its pharmacological activities. Further, naringenin-loaded nanocarriers have been enlisted and discussed in detail.}, }
@article {pmid41486993, year = {2026}, author = {Cai, M and Yan, S and Sun, Y and Huo, Q and Dai, X}, title = {miRNAs: Promising Biomarkers for Alzheimer's Diagnosis and Treatment.}, journal = {Current Alzheimer research}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115672050427877251118111643}, pmid = {41486993}, issn = {1875-5828}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-beta (Aβ) plaque deposition, neurofibrillary tangles of hyperphosphorylated tau protein, and chronic neuroinflammation, leading to synaptic dysfunction and cognitive decline. Current diagnostic methods rely on clinical symptoms and limited biomarkers, while available treatments only provide symptomatic relief without halting disease progression. MicroRNAs (miRNAs), small non-coding RNAs of 19-22 nucleotides, have emerged as crucial regulators of gene expression through post-transcriptional mechanisms and show distinct dysregulation patterns in AD patients' blood, cerebrospinal fluid (CSF), and brain tissues. Key miRNAs such as miR-132, miR-146a, miR-34a, and miR-125b demonstrate consistent alterations in expression levels, correlating with disease progression and offering potential as non-invasive diagnostic tools. This review comprehensively examines the dual role of miRNAs as diagnostic biomarkers and therapeutic targets for AD. We also provide an analysis of specific miRNA signatures in different biofluids (plasma, serum, CSF) and brain regions that correlate with disease stages, highlighting their potential for early and non-invasive diagnosis. Therapeutically, miRNAs modulate multiple AD-related pathways, including neuroinflammation via NF-κB signaling, Aβ production through BACE1 inhibition, and tau phosphorylation via GSK3β regulation. miRNAs also influence synaptic plasticity, mitochondrial function, and autophagy, presenting multifaceted opportunities for intervention. However, challenges, including miRNA heterogeneity, stability, and targeted delivery, remain critical impediments. Advances in nanocarriers, exosomal miRNAs, and viral vectors show promise in overcoming these obstacles, enabling precise miRNA modulation. In addition, we underscore the need for standardized protocols, further validation in clinical cohorts, and the development of cost-effective detection methods to translate miRNA-based approaches into practical diagnostics and therapies. By integrating miRNA biomarkers with existing diagnostic tools and exploring combinatorial therapeutic strategies, researchers can harness the potential of miRNAs to revolutionize AD intervention, paving the way for early detection and effective treatment of this devastating disease.}, }
@article {pmid41486988, year = {2026}, author = {Ranjbari, F and Dadkhah, M and Pirdel, Z and Fathi, F}, title = {Margatoxin Peptide: Preparation and the Potential Use for Biological Applications in Cancer and Neurological Disorders.}, journal = {Protein and peptide letters}, volume = {}, number = {}, pages = {}, doi = {10.2174/0109298665415268251024053300}, pmid = {41486988}, issn = {1875-5305}, abstract = {Scorpion venom compounds are known to contain nucleotides, polypeptides, mucoproteins, lipids, biogenic amines, and other unidentified macromolecules. Several peptides in scorpion fluids have demonstrated a wide range of biological activities with strong specificity for their targeted sites. Margatoxin, isolated from the venom of the scorpion, exhibits desirable properties, including high selectivity, good permeability, and stability in cancer cells, which can be achieved at picomolar doses, thereby blocking voltage-gated K+ channels. This narrative review consolidates results from an extensive literature search conducted in major electronic databases up to September 2024. Important studies were identified using keywords associated with scorpion venom peptides, Kv1.3 channels, cancer treatment, and neurodegenerative disorders. The amino acids that make up Margatoxin have an effective molecular function in blocking voltage-gated K+ channels 1.3. Due to the abnormally high expression of voltage-gated K[7] channel 1.3 in various types of cancers, blockers of this channel can inhibit apoptosis, metabolic changes, tumor angiogenesis, invasion, and migration. On the other hand, these channel blockers have emerged as a promising therapeutic approach for neurological disorders, such as Alzheimer's and Parkinson's diseases. The strong efficacy and targeted action of margatoxin further position it as a promising drug candidate. As the number of individuals affected by cancer and neurological conditions continues to rise, research into scorpion venom peptides like margatoxin may lead to innovative therapeutic options for future treatments.}, }
@article {pmid41486697, year = {2026}, author = {Pan, H and Cheng, X and Zhang, J and Hou, K and Murray, KA and Manglani, K and Zhu, C and Hsu, HK and Mekkittikul, M and Halladay, T and Mirbaha, H and Elezi, G and Abskharon, R and Sawaya, MR and Bombino, A and Williams, CK and DeTure, M and Dickson, DW and Vinters, HV and Whitelegge, JP and Harran, PG and Cole, GM and Frautschy, SA and Eisenberg, DS}, title = {In Vitro and In Vivo Evaluation of Small-Molecule Disassemblers of Pathological Tau Fibrils.}, journal = {ACS chemical neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1021/acschemneuro.5c00940}, pmid = {41486697}, issn = {1948-7193}, abstract = {Aggregation of the microtubule-binding protein tau is the histopathological hallmark of Alzheimer's disease (AD) and other neurodegenerative diseases, which are collectively known as tauopathies. Tau aggregation in AD patients is correlated with neuron loss, brain atrophy, and cognitive decline, and pro-aggregation tau mutations are sufficient to cause neurodegeneration and dementia in humans and tauopathy model mice. Thus, reversing tau aggregation is a potential therapeutic avenue for AD. In a previous study, we discovered CNS-11, a small molecule that disaggregates AD patient brain-extracted tau fibrils in vitro. In this study, we identify two chemical analogs of CNS-11, named CNS-11D and CNS-11G, that disaggregate AD patient brain-extracted tau fibrils and prevent seeding in a tau aggregation cell culture model. We also demonstrate that 8 weeks of treatment with either CNS-11D or CNS-11G reduces levels of insoluble tau in a mouse model of tauopathy. Our work defines the properties of two small molecules that diminish aggregation of tau in vivo and provides further support for structure-based methods to target tau for treatment of AD.}, }
@article {pmid41486173, year = {2026}, author = {Silva-Llanes, I and Smith, LA and Abdelkader-Guillén, A and Jiménez-Villegas, J and Sarrió, D and Moreno-Bueno, G and Lastres-Becker, I}, title = {GASDERMIN D-mediated pyroptosis as a therapeutic target in TAU-dependent frontotemporal dementia mouse model.}, journal = {Journal of biomedical science}, volume = {33}, number = {1}, pages = {6}, pmid = {41486173}, issn = {1423-0127}, support = {PID2022-136854OB-I00//Ministerio de Ciencia, Innovación y Universidades/ ; PID2022-137065OB-I00//Ministerio de Ciencia, Innovación y Universidades/ ; CB16/12/00295//Centro de Investigación Biomédica en Red de Cáncer/ ; CB06/05/0089//Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas/ ; }, mesh = {Animals ; *Pyroptosis/genetics ; Mice ; *tau Proteins/metabolism/genetics ; Disease Models, Animal ; Humans ; *Phosphate-Binding Proteins/metabolism/genetics ; Mice, Transgenic ; *Intracellular Signaling Peptides and Proteins/metabolism/genetics ; *Frontotemporal Dementia/genetics/metabolism/drug therapy/pathology ; Male ; Female ; Alzheimer Disease/genetics ; Mice, Inbred C57BL ; Aged ; Hippocampus/metabolism ; Gasdermins ; }, abstract = {BACKGROUND: Recent research has revealed a strong connection between neuroinflammation and TAU protein-related neurodegeneration. A key discovery shows that the NLRP3 inflammasome, when activated, can significantly impact TAU pathology and subsequent neuronal death. This process involves pyroptosis, a lytic form of programmed cell death driven by inflammasome activation, leading to GASDERMIN D (GSDMD) cleavage and the subsequent release of inflammatory molecules IL-1β and IL-18. In this study, we explore the role of pyroptosis and GSDMD in Alzheimer's disease (AD) and tauopathy models, focusing on the TAU-induced neuroinflammatory process and its correlation with synaptic plasticity loss.
METHODS: Hippocampal tissue from AD patients at Braak stage II-III has been analyzed using qPCR to assess pyroptosis-related gene expression. To determine the role of TAU in pyroptosis and neuroinflammation, we used two different models: one based on intracerebral injection of an adeno-associated virus that specifically overexpresses TAU in the neurons of the hippocampus (AAV-TAU[P301L]), and a transgenic mouse model Tg-TAU[P301S] at 8 and 10 months of age. Gene expression, protein levels, and neuroinflammation markers were evaluated using qPCR and immunofluorescence. Additionally, both genetic (GSDMD-deficient mice) and pharmacological (dimethyl fumarate, DMF) interventions targeting pyroptosis have been explored to assess their impact on neuroinflammation and synaptic plasticity.
RESULTS: AD patients exhibited increased expression of pyroptosis-related genes, supporting the involvement of pyroptosis in neurodegeneration. Furthermore, TAU overexpression induced pyroptosis in both mouse models, and GSDMD protein levels increased alongside reactive microglial morphology. Our data supports that TAU-induced neuroinflammation correlated with synaptic plasticity impairment. GSDMD deficiency significantly reduced pyroptosis-related markers associated to TAU, but unexpectedly worsened synaptic plasticity deficits, suggesting GSDMD may play a dual role in inflammation and synaptic function. Finally, we showed that DMF treatment suppressed pyroptosis gene expression, reduced GSDMD levels, and alleviated neuroinflammation, correlating with improved synaptic marker expression.
CONCLUSION: Our findings demonstrate that TAU-induced pyroptosis contributes to neuroinflammation and synaptic dysfunction. While GSDMD inhibition mitigates inflammation, its absence exacerbates synaptic impairment, highlighting its complex role in tauopathies. Our results indicate that DMF treatment could offer a promising therapeutic avenue to modulate pyroptosis and neuroinflammation, and restore synaptic integrity in tauopathies.}, }
@article {pmid41485615, year = {2026}, author = {Pariya Gholizadeh Dangheralou, SK and Khazaeifard, F and Mehr, SR and Mansouri, SM and Rad, NR and Abbasi-Maleki, S}, title = {Evaluation of neurobiochemical and behavioral responses to carvone nanoemulsion: A neuroprotective approach for Alzheimer's disease-associated dementia in a rat model.}, journal = {Brain research}, volume = {}, number = {}, pages = {150143}, doi = {10.1016/j.brainres.2026.150143}, pmid = {41485615}, issn = {1872-6240}, abstract = {BACKGROUND: Antioxidant supplements have emerged as promising strategies to mitigate the impact of Alzheimer's disease (AD) and associated dementia. We explored the neuroprotective potential of Carvone nanoemulsion (CANO) using a rat model of AD-associated dementia.
METHOD: Our experimental groups comprised non-AD control rats (CON), untreated AD rats (AD), and AD rats treated with CANO at two different dosages: 40 mg/kg (CANO40) and 80 mg/kg (CANO80). We assessed various behavioral parameters, malondialdehyde (MDA) and brain-derived neurotrophic factor (BDNF) levels,ferric-reducing ability of plasma (FRAP).
RESULTS: AD induction caused a significant reduction in step-through latency (P < 0.001), center time (P < 0.001), the number of visits (P < 0.001), and total distance traveled (P < 0.001), time spent in open arms (P < 0.001), and both FRAP (P < 0.001) and BDNF levels (P < 0.001) in comparison to the CON group, while elevating escape latency, time in target zone and platform location latency, and MDA levels (P < 0.001). Treatment with CANO, particularly at the CANO80 dosage, significantly improved these parameters compared to the AD group, resulting in decreased time in the target zone (P < 0.001), escape latency (P < 0.001), and platform location latency (P < 0.001) and higher FRAP (P < 0.05) and BDNF levels (P < 0.05), along with decreased MDA levels (P < 0.05).
CONCLUSION: CANO, especially at the 80 mg/kg dosage, shows promise in alleviating symptoms associated with AD-associated dementia. However, further research is warranted to validate and expand upon these findings.}, }
@article {pmid41485573, year = {2026}, author = {Pi, G and Zhang, L and Lei, H and Zhong, T and Zhang, F and Lu, Y and Qiu, X and Qi, Y and Dong, Y and Zhu, R and Qin, Q and Wang, J and Sarapultsev, A and Luo, S and Cheng, X and Yang, Y and Wang, JZ and Hu, D}, title = {Ursolic acid reduces Aβ-driven aggression via Gab1-mediated autophagy and dorsal hippocampal circuit modulation in Alzheimer's disease.}, journal = {Journal of advanced research}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jare.2025.12.054}, pmid = {41485573}, issn = {2090-1224}, abstract = {INTRODUCTION: Aggression is one of the most debilitating neuropsychiatric symptoms in Alzheimer's disease (AD), posing significant challenges for both patients and caregivers. However, the underlying mechanism remains unclear, and effective therapeutic strategies are lacking.
OBJECTIVES: This study aimed to investigate the neural circuit mechanisms underlying amyloid-beta (Aβ)-driven aggression in AD and explore the therapeutic potential of ursolic acid (UA) in alleviating this behavior.
METHODS: A combination of virus tracing, electrophysiological recording, in vivo Ca2 + recording, and a aggressive behavior test was utilized to investigate the neural circuit vulnerable to Aβ-driven aggression. optogenetic or chemogenetic manipulation was used to identify the regulation of the neural circuit on aggressive behavior. Proteomics and molecular targeting were employed to explore the underlying mechanisms of Aβ-driven aggression and evaluate UA's effects.
RESULTS: We identified that Aβ accumulation drove hyperexcitability of dorsal hippocampal CA3 (dCA3) neurons projecting to the dorsal lateral septum (dLS), thereby triggering aggressive behavior in the 5xFAD mouse model. Optogenetic activation of the dCA3-dLS circuit in wild-type mice induced aggression, whereas either optogenetic or chemogenetic inhibition of this projection alleviated aggression in 5xFAD animals. Proteomic profiling of dCA3 tissue identified Grb2-associated binding protein 1 (Gab1) as a key mediator upregulated in 5xFAD mice and normalized by ursolic acid (UA) treatment. UA reduced Aβ plaque burden, restored autophagic flux (increasing LC3B-II and decreasing p62), and suppressed dCA3-dLS circuit hyperactivity, resulting in durable attenuation of aggressive behavior. Viral knockdown of Gab1 in dCA3 mimicked UA's effects on autophagy, Aβ clearance, circuit excitability, and aggression, whereas Gab1 overexpression blocked UA's benefits.
CONCLUSION: Together, these results define a novel Gab1-dependent autophagy-circuit mechanism for Aβ-induced aggression and establish UA as a promising candidate for alleviating neuropsychiatric symptoms in AD.}, }
@article {pmid41485354, year = {2025}, author = {Lin, X and Tang, L and Hu, Z}, title = {Causal relationship between tractography-based brain white matter structural connectome and risk of psychiatric disorders: A bidirectional Mendelian randomization study.}, journal = {Psychiatry research. Neuroimaging}, volume = {357}, number = {}, pages = {112131}, doi = {10.1016/j.pscychresns.2025.112131}, pmid = {41485354}, issn = {1872-7506}, abstract = {AIM: This study sought to explore the causal link between 206 tractography-derived white matter connectivity metrics in the brain and the risk of nine psychiatric disorders, employing a bidirectional two-sample Mendelian randomization (MR) approach.
METHOD: Summary datasets of 9 psychiatric disorders including anxiety disorder, Alzheimer's disease (AD), major depressive disorder (MDD), autism spectrum disorder (ASD), bipolar disorder (BD), schizophrenia, Tourette syndrome(TS), attention-deficit hyperactivity disorder (ADHD), and cannabis use disorder (CUD) were used. MR analyses were performed using the inverse variance weighted (IVW), weighted median, MR-Egger, MR-PRESSO, and MR-robust adjusted profile score (MR-RAPS) method.
RESULTS: Forward MR analysis showed that the left-hemisphere dorsal attention network to the right-hemisphere limbic network connectome was causally associated with a 32 % higher risk of anxiety disorder [odds ratio(OR) = 1.32; 95 % confidence interval (CI): 1.16, 1.51). Reverse MR analysis indicated that AD was associated with a 7 % higher risk for the left-hemisphere limbic network to the right-hemisphere control network connectome(OR = 1.07; 95 % CI: 1.03, 1.10).
CONCLUSIONS: Our MR analysis reveals causal relationships between brain white matter structural connectivity and psychiatric disorders, advancing our knowledge of the neural mechanisms that contribute to psychiatric disorders and providing evidence for targeted interventions in psychiatric treatment.}, }
@article {pmid41485137, year = {2026}, author = {Zhu, Z and Steward, A and Dehsarvi, A and Roemer-Cassiano, SN and Dewenter, A and Biel, D and Hirsch, F and Frontzkowski, L and Pescoller, J and Klonowski, M and Gnörich, J and Pontecorvo, MJ and Shcherbinin, S and Schöll, M and Buckley, R and Ossenkoppele, R and Xie, F and Guo, T and , and Höglinger, G and Brendel, M and Franzmeier, N}, title = {Defining patient-centered amyloid PET thresholds for the onset of tauopathy in Alzheimer's disease.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71064}, pmid = {41485137}, issn = {1552-5279}, support = {AARG-22-973496/ALZ/Alzheimer's Association/United States ; //Gerhard and Ilse Schick Foundation/ ; BMBF 01KU2203//ERAPerMed/ ; }, mesh = {Humans ; *Positron-Emission Tomography ; Male ; *Alzheimer Disease/diagnostic imaging/metabolism ; Female ; *Tauopathies/diagnostic imaging/metabolism ; Aged ; tau Proteins/metabolism ; Aged, 80 and over ; *Amyloid/metabolism ; Sex Factors ; Age Factors ; Brain/diagnostic imaging/metabolism ; Carbolines ; }, abstract = {INTRODUCTION: Amyloid-induced tauopathy drives clinical decline in Alzheimer's disease (AD). Because age and sex shape tau trajectories, defining patient-centered amyloid thresholds for tauopathy onset could facilitate pre-tauopathy AD identification and aid treatment decisions and prognosis.
METHODS: By including two samples (Alzheimer's Disease Neuroimaging Initiative [ADNI, n = 301]; and 18F-AV-1451-A05 [A05, n = 143]), we explored whether age and sex affect tauopathy transition and determined patient-centered amyloid positron emission tomography (PET) thresholds that mark tauopathy onset.
RESULTS: We found a consistent amyloid PET × age interaction on global tau PET increase in men (ADNI/A05: p = 0.0078/0.018), with younger men showing faster amyloid-associated tau accumulation. We then established patient-centered, amyloid PET-inferred tauopathy transition cut-offs. Women reached this transition at lower amyloid PET levels, and these cutoffs predicted both earlier onset and accelerated cognitive decline (p < 0.001).
DISCUSSION: This study highlights the effect of age and sex on the amyloid-to-tauopathy transition, establishes patient-centered amyloid PET thresholds for tauopathy onset, and links these thresholds to accelerated cognitive decline.
HIGHLIGHTS: Younger age is related to faster amyloid-related tau accumulation in men. We defined a series of amyloid positron emission tomography (PET) thresholds to enable patient-centered inference of amyloid-related tauopathy. Crossing the amyloid PET-defined tauopathy phase is associated with more progressive tau deposition and cognitive decline.}, }
@article {pmid41484932, year = {2026}, author = {Nitzan, K and Bentulila, Z and Bregman-Yemini, N and Ayalon, N and David, D and Break, E and Sarne, Y and Doron, R}, title = {Sex-dependent effects of ultra-low-dose-THC preventive treatment on neuroinflammation and cognitive decline in 5xFAD mice.}, journal = {Biology of sex differences}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13293-025-00815-3}, pmid = {41484932}, issn = {2042-6410}, support = {3-2021-2022b//National Institute for Psychobiology in Israel, Hebrew University of Jerusalem/ ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) remains the most prevalent cause of dementia, yet no existing treatment effectively prevents its onset. Current therapies primarily aim to slow disease progression or manage symptoms, leaving a critical gap in preventive strategies. Recent findings suggest that ultra-low-dose tetrahydrocannabinol (ULD-THC) may exert neuroprotective effects without the adverse consequences associated with chronic THC use. This study investigates whether preventive ULD-THC treatment can mitigate neuroinflammation and early cognitive decline in the 5xFAD mouse model of AD, with a specific focus on sex differences in treatment response.
METHODS: Male and female 5xFAD mice received monthly ULD-THC injections from 3 to 5 months of age, before significant pathology emerged. At 6 months, behavioral assessments were conducted, followed by molecular analyses of hippocampal and prefrontal cortex (PFC) tissue.
RESULTS: Results indicated that ULD-THC attuned AD-related cognitive decline in both males and females, with sex-specific neuroinflammatory responses. Males exhibited reduced hippocampal inflammation, whereas females showed reduced inflammation in the PFC, suggesting distinct neuroprotective mechanisms across sexes.
CONCLUSIONS: These findings highlight ULD-THC's potential as a preventive strategy for AD, emphasizing the importance of sex-dependent therapeutic approaches. By attenuating neuroinflammatory processes before cognitive deficits fully manifest, ULD-THC offers a novel, biologically targeted approach to AD prevention. Future research should explore its long-term efficacy and translational potential in clinical settings.}, }
@article {pmid41484644, year = {2026}, author = {Kim, T and Hong, YJ and Kim, M and Bae, Y and Lee, SB and Kim, SH and Lee, MA and Ko, E and Park, JW and Yang, DW}, title = {Impact of dose and compliance of antidementia medications on long-term outcomes in Alzheimer's disease: a nationwide real-world study.}, journal = {Alzheimer's research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13195-025-01942-0}, pmid = {41484644}, issn = {1758-9193}, abstract = {BACKGROUND: Antidementia medications are widely prescribed for Alzheimer's disease (AD), but their long-term real-world effectiveness remains uncertain. This study investigated whether long-term outcomes differ according to medication dosage and compliance using nationwide data.
METHODS: Data from the Korean National Health Insurance Service (NHIS) covering 47 million individuals were analyzed. Prescription data for acetylcholinesterase inhibitors and memantine were analyzed for dosage and compliance. Among 1,704,547 dementia cases (2010-2016), 466,773 patients with clinically diagnosed AD were included. Medication dosage and compliance during the first three years after diagnosis were categorized to define optimal versus suboptimal treatment. Clinical outcomes included progression to moderate to severe dementia, institutionalization, and mortality. Multivariable logistic regression identified factors associated with outcomes.
RESULTS: Patients who maintained optimal dosage and compliance during the first three years after diagnosis showed a lower rate of progression to moderate to severe dementia than those receiving suboptimal treatments consistently across all classification criteria. Regression analyses revealed that optimal compliance and dosage were strongly associated with reduced progression (OR 0.807 and 0.704, respectively; p < 0.0001) and early mortality within five years. In contrast, mortality and institutionalization rates were not significantly different between groups except that mortality within five years.
CONCLUSIONS: Both medication dosage and persistence were independently associated with better long-term outcomes in AD. Maintaining optimal treatment during the early disease period may delay disease progression and improve survival within five years. This nationwide real-world study provides robust evidence supporting the importance of sustained, adequate antidementia therapy in clinical practice.}, }
@article {pmid41484454, year = {2026}, author = {Ibrahim, M and Khalil, AM and Attia, H and Alseekh, S and Mohamed, AF and El-Yamany, MF}, title = {Gut Microbiome-Sphingolipid Metabolism-Brain Axis Interactions: Neuroprotective Effects of Amitriptyline as Functional Inhibitor of Acid Sphingomyelinase in a Mouse Model of Tauopathy.}, journal = {Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology}, volume = {21}, number = {1}, pages = {3}, pmid = {41484454}, issn = {1557-1904}, mesh = {Animals ; *Sphingomyelin Phosphodiesterase/antagonists & inhibitors/metabolism ; *Gastrointestinal Microbiome/drug effects/physiology ; Mice ; *Amitriptyline/pharmacology/therapeutic use ; Mice, Transgenic ; *Tauopathies/metabolism/drug therapy ; *Brain/drug effects/metabolism ; *Neuroprotective Agents/pharmacology/therapeutic use ; *Sphingolipids/metabolism ; Disease Models, Animal ; Male ; Mice, Inbred C57BL ; }, abstract = {Tauopathies are neurodegenerative diseases characterized by accumulation of hyperphosphorylated tau protein (P-tau). The gut microbiota (GM) is symbiotic with the host and altered in neurodegenerative diseases. Amitriptyline (AMI) is a functional inhibitor of acid sphingomyelinase (ASM) which is abnormally highly expressed in brains of Alzheimer patients. Little data is known about the role of colonic ASM in management of tauopathy. Therefore, the aim of this study was to investigate the role of AMI on reversing gut dysbiosis, ceramide levels, colonic inflammation and intestinal barrier disruption in tauopathy through the bidirectional gut-brain axis. P301S transgenic mice were administered AMI for 35 days. Colonic ASM, ceramides, inflammation and membrane integrity were assessed besides fecal microbiome analysis and serum lipopolysaccharides to assess intestinal membrane disruption. Levels of hippocampal P-tau, protein phosphatase 2 A and neurogenesis were assessed along with cognitive behavior. AMI treatment significantly reduced colonic ASM, ceramide levels, increased abundance of Harryflintia, Dubosiella, and Parasutterella and decreased abundance of Lactobacillus, Lachnoclostridium, Oscillibacter, Oscillospiracea UCG-003, Colidextribacter, Roseburia, Butyricicoccus, and Sphingomondales. In contrast, P301S mice displayed an altered GM profile with enriched Firmicutes and Clostridia, and low proportions of Bacteroidota- a phylum associated with intestinal barrier protection-, and Ruminococcaceae. Also, AMI treatment decreased inflammation and restored colonic membrane integrity with subsequent decrease in serum lipopolysaccharides, P-tau in hippocampus and improvement in cognitive behaviour and neurogenesis. The current results indicate that AMI has neuroprotective effects against tauopathy through modulation of ASM activity, associated ceramide levels, GM composition, colonic inflammation and membrane integrity through bidirectional gut-brain axis.}, }
@article {pmid41484306, year = {2026}, author = {Huang, H and Wu, J and Fang, Z and Wang, Y and Xie, J and Guan, Y}, title = {Recent Advances of the Role of Dl-3-n-Butylphthalide in the Treatment of Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {340}, pmid = {41484306}, issn = {1559-1182}, support = {202510159035//Innovation and Entrepreneurship Training Program for China Medical University Students/ ; }, mesh = {Humans ; *Benzofurans/therapeutic use/pharmacology ; *Alzheimer Disease/drug therapy/metabolism ; Animals ; Oxidative Stress/drug effects ; }, abstract = {Alzheimer's disease (AD) is a prevalent neurodegenerative disorder affecting approximately 55.2 million individuals globally, with complex pathogenesis involving amyloid-β (Aβ) aggregation, tau pathology, neuroinflammation, oxidative stress, and synaptic dysfunction. Current treatments offer only symptomatic relief without halting disease progression. Dl-3-n-butylphthalide (NBP), a small-molecule compound originally derived from celery seeds, has emerged as a promising multi-target therapeutic candidate for AD. Preclinical studies demonstrate that NBP exerts its therapeutic effects in AD by alleviating oxidative stress, enhancing superoxide dismutase (SOD) and glutathione activities, suppressing neuroinflammation by inhibiting NLRP3 inflammasome activation and pro-inflammatory cytokine release (e.g., IL-1β, TNF-α), reducing Aβ deposition and tau hyperphosphorylation, promoting autophagy, and improving synaptic plasticity. A meta-analysis of six trials (n = 851) confirmed that NBP improves Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores with a favorable safety profile, primarily mild gastrointestinal symptoms and transient liver enzyme elevations. This review systematically summarizes recent advances in NBP research, integrating both preclinical mechanisms and clinical evidence, and highlights its potential as a novel multi-target strategy for AD treatment. Further large-scale, long-term trials are warranted to validate its efficacy and explore optimized delivery systems and combination therapies.}, }
@article {pmid41483724, year = {2025}, author = {Strain, JF and Rahmani, M and Phuah, CL and Dierker, D and Luo, J and Owen, C and Vlassenko, AG and Jafri, H and Bourgeat, P and Fripp, J and Jin, L and Moulder, K and Benzinger, T and Xiong, C and Lee, JM and Weiner, M and Masters, CL and Morris, JC and Womack, K and Goyal, MS and , }, title = {Regional growth rates of white matter hyperintensities are associated with beta-amyloid burden.}, journal = {Neurobiology of aging}, volume = {160}, number = {}, pages = {22-32}, doi = {10.1016/j.neurobiolaging.2025.12.006}, pmid = {41483724}, issn = {1558-1497}, abstract = {There is increasing evidence for an association between white matter hyperintensities (WMH) and brain beta-amyloid deposition. How WMH are longitudinally associated with brain beta-amyloid burden requires further investigation, particularly with respect to co-existent vascular risk factors and differences across white matter regions. We measured WMH on MRI and vascular risk factors in a combined neuroimaging data set of cognitively normal and individuals with dementia comprised of the ADNI, AIBL and OASIS3 studies, which includes harmonized centiloid estimates of beta-amyloid burden from PET imaging. WMH were measured using the TrUE-Net algorithm. Vascular risk factors were extracted from provided clinical data and used to calculate individual revised Framingham Stroke Risk Profile (FSRP) scores. Linear mixed effects modelling was used to determine the relationship between the growth rate of WMH and baseline beta-amyloid burden, controlling for age, sex, APOE4 status, and vascular risk factors. 1243 participants [49 % female, mean age 71.7 y (SD 7.6 y)] had at least 3 brain MRIs. Linear mixed models demonstrate robust independent cross-sectional relationships between WMH and baseline beta-amyloid burden (beta coefficient=0.27, p < 0.001), age (beta coefficient=0.04, p < 0.001) and vascular risk factors (beta coefficient=0.25, p < 0.001). Growth rates of WMH increased with baseline beta-amyloid burden (slope=0.021, p < 0.001) and decreased with anti-hypertensive medications (slope=-0.019, p = 0.002), above and beyond age, APOE4 status, and other vascular risk factors. The longitudinal association for beta-amyloid burden persisted in a similar analysis for parietal WM. Our study suggests that in Alzheimer disease research cohorts, WMH progression is associated with age and beta-amyloid burden, particularly in parietal white matter, and slowed by anti-hypertensive treatment.}, }
@article {pmid41482856, year = {2026}, author = {Kalita, R and Sarma, A and Baruah, H and Zaman, A and Goswami, D}, title = {Nose to Brain Delivery of Curcumin Loaded Therapeutic Nanostructures for Neurodegenerative Diseases.}, journal = {Biopharmaceutics & drug disposition}, volume = {}, number = {}, pages = {}, doi = {10.1002/bdd.70021}, pmid = {41482856}, issn = {1099-081X}, abstract = {Neurodegenerative diseases are progressive disorders that damage and eventually kill neurons in the central nervous system (CNS). In recent years, various research has been done on reliable and effective treatment methods for the most common neurodegenerative diseases such as Parkinson's, Alzheimer, and Migraine diseases. Different neurodegenerative disorders such as Huntington's disease, Alzheimer's disease, Parkinson's disease, amyotrophic, Lewy body disease can be treated by curcumin, which is a strong antioxidant polyphenol with neuroprotective and anti-amyloid properties. However, Blood-brain barrier (BBB) and blood cerebrospinal fluid barrier restricts the permeation of curcumin to the brain leads poor distribution of the drug in brain tissue. The intranasal pathway holds promise for enhancing the treatment of CNS disorders since it bypasses the BBB and increases the brain bioavailability of drug. As nanotechnology continues to improve, research on the delivery of drug through intranasal route has grown significantly in last 10 years. Several nanocarriers have been developed such as nano-emulsions, microspheres, dendrimers, liposomes, carbon-based nanoformulation, and nanoparticles to deliver curcumin to the brain via intranasal route for the treatment of neurodegenerative diseases. This study provided a thorough analysis of several curcumin nano-formulations used in intranasal pathway as a novel treatment for neurodegenerative diseases.}, }
@article {pmid41482153, year = {2025}, author = {Yan, Y and Su, J and Xie, M and Kong, Y and Wang, C and Yuan, G and Fang, Y and Hwang, K and Kim, CY and Han, H and Zhang, Z}, title = {Low Intensity Ultrasound-facilitated exosome delivery promotes hippocampal neurogenesis in Alzheimer's disease.}, journal = {Brain stimulation}, volume = {19}, number = {1}, pages = {103015}, doi = {10.1016/j.brs.2025.103015}, pmid = {41482153}, issn = {1876-4754}, abstract = {BACKGROUND: Low-intensity ultrasound (LIUS) and human adipose-tissue mesenchymal stem cell-derived exosomes (hADSC-Exos) have shown neuroprotective potential, but their combined effects in Alzheimer's disease (AD) remain unclear.
OBJECTIVE: To evaluate the safety and efficacy of intranasal hADSC-Exos alone or combined with LIUS in APP/PS1 mice, and explore underlying molecular mechanisms.
METHODS: Female APP/PS1 mice (30 weeks) were randomized into five groups (n = 6). Treatments included intranasal hADSC-Exos, LIUS, or both for 2 months. Behavioral tests, histology, and hippocampal RNA-seq were performed.
RESULTS: LIUS enhanced Exo uptake in HT22 cells by ∼8 % without toxicity. Combined treatment improved learning and memory (escape latency ↓45 s→20 s; P < 0.01), increased neurogenesis markers (GFAP/SOX2, DCX, Ki67), and reduced amyloid and microglial activation. RNA-seq identified 93 specific DEGs in the combination group, with enrichment in synaptic and mitochondrial pathways. Fos and Kcnj13 were top DEGs and both downregulated after therapy (P < 0.05).
CONCLUSIONS: Intranasal hADSC-Exos combined with LIUS is safe, enhances brain delivery, and synergistically improves cognition and neurogenesis in AD mice. The Fos-Kcnj13 axis may mediate these effects, suggesting a promising noninvasive therapeutic strategy.}, }
@article {pmid41482111, year = {2025}, author = {Zheng, R and Liu, X and Liao, Z and Wan, R and Qiu, G and Li, M and Tang, C and Zhou, R and Song, J}, title = {Electroacupuncture ameliorates tau-driven cognitive decline by modulating NF-κB/NLRP3 inflammasome signaling in P301S mice.}, journal = {Experimental neurology}, volume = {398}, number = {}, pages = {115637}, doi = {10.1016/j.expneurol.2025.115637}, pmid = {41482111}, issn = {1090-2430}, abstract = {Alzheimer's disease (AD) progression is driven by a vicious cycle wherein pathological Tau hyperphosphorylation promotes microglial activation and NF-κB/NLRP3 inflammasome signaling, leading to excessive secretion of proinflammatory cytokines that reciprocally exacerbate Tau pathology. While pharmacological NLRP3 inhibitors hold therapeutic potential for AD, critical barriers-including poor blood-brain barrier penetration, suboptimal target selectivity, and safety concerns-persist. This study investigated whether electroacupuncture (EA), a non-pharmacological neuromodulatory approach, could disrupt this Tau-inflammasome cycle. Using P301S Tau transgenic mice, two EA regimens were tested at the GV20 (Baihui) acupoint: 6-month-old mice receiving a 1-month EA intervention, and 6-month-old mice undergoing a prolonged 3-month EA intervention. Cognitive function was evaluated via Y-maze, novel object recognition (NOR), and Morris water maze (MWM) tests, while corticospinal function was assessed using tail-suspension limb-clasping scoring. Hippocampal Tau pathology and inflammatory signaling were analyzed by Western blot and immunohistochemistry, targeting total Tau, phosphorylated Tau, NF-κB, NLRP3, caspase-1, IL-1β, IL-18, TNF-α, and microglial morphology. Short-term (1-month) EA treatment significantly improved spatial working memory and recognition memory. Mechanistically, EA reduced p-Tau levels, suppressed NF-κB activation (decreased p-P65/P65 ratio), downregulated NLRP3 inflammasome components (NLRP3, cleaved caspase-1) and proinflammatory cytokines (IL-1β, IL-18 and TNF-α), and mitigated microglial hyperactivation. Importantly, long-term (3-month) EA treatment persistently suppressed p-Tau accumulation and neuroinflammation, thereby consolidating cognitive benefits even in P301S mice with severe corticospinal dysfunction. These findings establish EA as a multi-targeted immunomodulatory strategy that attenuates Tau-driven neuroinflammation through the TNF-α/NF-κB/NLRP3 signaling axis, highlighting its potential as a safe, non-pharmacological adjunct or alternative therapy for AD and related tauopathies.}, }
@article {pmid41482107, year = {2025}, author = {Chen, X and Yao, H and Ma, S and Zhu, H and Xu, Y and Zhu, Y and Ying, Y and Wang, L and Zhang, Q and Zheng, C and Zhou, Y and Tong, Z and Huang, K and Shentu, Y}, title = {FGF22/FGFR2/YAP modulates ferroptosis to suppress neurodegeneration and cognitive impairment in Alzheimer's disease.}, journal = {Experimental neurology}, volume = {398}, number = {}, pages = {115630}, doi = {10.1016/j.expneurol.2025.115630}, pmid = {41482107}, issn = {1090-2430}, abstract = {Ferroptosis, a programmed cell death triggered by iron accumulation and lipid peroxidation, has been increasingly recognized as a critical mechanism underlying neurodegenerative processes, including Alzheimer's disease (AD). The mechanosensitive regulator YAP is implicated in AD progression and ferroptosis. Here we confirmed that FGF22, a fibroblast growth factor, amelitorated cognitive deficits in β-Amyloid (1-42) (Aβ1-42) treated AD model mice through the FGFR2/YAP pathway, which was further ascertained by various biochemical analyses. Additionally, FGF22 treatment effectively reduced ferroptosis and neuronal apoptosis, thereby attenuating synaptic impairments and neuronal injury in the AD model mice and Aβ1-42-exposed HT22 cells. Collectively, the data presented herein implicate FGF22 as a potential neuroprotective agent in AD models, with its efficacy likely mediated through engaging of the FGFR2/YAP signaling axis.}, }
@article {pmid41481960, year = {2026}, author = {Fazal, F and Dar, NJ and Ahamad, S and Khan, S and Bano, N and Saha, S and Nazir, A and Bhat, SA}, title = {cGAS-STING signaling in Alzheimer's disease: Microglial mechanisms and therapeutic opportunities.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101444}, doi = {10.1016/j.mam.2025.101444}, pmid = {41481960}, issn = {1872-9452}, abstract = {Alzheimer's disease (AD) is increasingly recognized as a neuroinflammatory disorder driven by microglial dysfunction. The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway plays a critical role in neuroinflammation and has been strongly implicated in the pathology of AD. Chronic activation of cGAS-STING contributes to neurodegeneration by driving persistent type I interferon release and excessive pro-inflammatory cytokine production. However, the pathway exhibits context-dependent effects. Transient activation promotes antiviral defense, autophagy, and cellular quality control in the central nervous system. Sustained engagement exacerbates neuroinflammation and synaptic loss. Preclinical studies demonstrate that pharmacological inhibitors (such as NR, TSG, H-151, TDI-6750, TDI-8246) mitigate amyloid beta and tau pathology, attenuate microglial reactivity, and enhance cognitive outcomes. Yet, its essential physiological roles, including antimicrobial immunity and autophagy regulation, pose challenges for therapeutic targeting. This potentially disrupts neuroimmune homeostasis. In this review, we highlight the role of cGAS-STING in AD and explore its potential as a therapeutic target using small-molecule drug candidates. Despite these promising findings, challenges remain, including optimizing blood-brain barrier (BBB) penetration, ensuring immune specificity, and addressing long-term safety concerns. Due to these challenges, no cGAS-STING inhibitors have entered clinical trials for AD. However, the future of AD treatment may involve modulation of neuroinflammatory pathways, with cGAS-STING inhibitors playing a central role in reshaping neuroimmune homeostasis.}, }
@article {pmid41481335, year = {2026}, author = {Noreen, S and Nazir, R and Khan, M and Shah, SA}, title = {Schiff Base Complex rescues mice against scopolamine-induced cognitive dysfunction.}, journal = {Drug and chemical toxicology}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/01480545.2025.2606103}, pmid = {41481335}, issn = {1525-6014}, abstract = {Alzheimer's disease (AD) is a common and debilitating neurodegenerative disease characterized by progressive cognitive impairment, and oxidative stress is a recognized contributor. Despite numerous studies, effective treatments remain scarce. This study synthesized and assessed the neuroprotective effects of a Schiff base complex, Copper(II) 4-(benzylideneamino)-3-hydroxynaphthalene-1-sulfonic acid [Cu(BAHN)2], against scopolamine-induced (SCOP) cognitive and synaptic deficits in adult albino mice. Eight-week-old male BALB/c mice were randomly split into 4 groups: (1) controls (normal saline, 0.9%), (2) SCOP (1 mg/kg), (3) SCOP and Schiff base complex (30 mg/kg) and (4) Schiff base complex alone (30 mg/kg). Cognitive function was assessed using the Morris Water Maze (MWM) and Y-maze test. To assess the biochemical effects of the complex, antioxidant enzyme activities, and western blot analyses were performed. Treatment with the Schiff base complex significantly restored the activity of important antioxidant enzymes-catalase (CAT), peroxidase (POD), superoxide dismutase (SOD) and reduced glutathione (GSH) which were decreased by SCOP exposure. In addition, lipid peroxidation (LPO) rates were decreased. The complex also counteracted SCOP-induced decreases in both pre- and post-synaptic proteins, in line with improved behavioral performance in both cognitive challenges. Mechanistically, the compound activated phosphorylated Akt (p-Akt) and upregulated Nrf2 signaling, as well as downregulating nuclear factor kappa B (NF-kB) and interleukin-1β (IL-1β), show a decrease in neuroinflammation. In summary, these data suggest that the Schiff base complex reduces the oxidative, inflammatory, and synaptic deleterious effects of SCOP, probably, by regulating the p-Akt/Nrf2 pathway. Additional mechanistic studies are needed to understand its potential therapeutic implications in dementia.}, }
@article {pmid41481312, year = {2026}, author = {Banik, A and Amaradhi, R and Sau, M and Rawat, V and Dingledine, R and Ganesh, T}, title = {Antagonism of the EP2 Receptor Reveals Sex-Specific Protection in a Two-Hit Mouse Model of Alzheimer's Disease.}, journal = {ACS chemical neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1021/acschemneuro.5c00780}, pmid = {41481312}, issn = {1948-7193}, abstract = {Neuroinflammation is evident in Alzheimer's disease (AD) brains, exacerbating the pathology and ensuing cognitive deficits in patients. The prostaglandin-E2 receptor EP2 emerged as a neuroinflammatory target in several neurodegenerative diseases, including AD. Antagonism of EP2 mitigates neuroinflammation and cognitive deficits in status epilepticus and stroke models. Here, we investigated the efficacy of a potent and selective EP2 antagonist TG11-77.HCl on the cognitive behavior and neuroinflammation in a two-hit 5xFAD mouse model of AD. We exposed adult 5xFAD mice on B6SJL genetic background and their nontransgenic littermates to a low dose of lipopolysaccharide and administered TG11-77.HCl or the vehicle in the drinking water for 12 weeks. Mice were subjected to Morris water maze and Y-maze testing during their last week of drug treatment. Blood samples were subjected to complete blood count (CBC) analysis and brain tissues were processed to examine the levels of inflammatory transcripts and glial marker expression (mRNA), followed by the quantification of congophilic amyloid deposition and microglial activation (IBA[+]) in the brain by immunohistochemistry. TG11-77.HCl treatment enhanced the spatial memory performance and ameliorated mRNA expression of proinflammatory mediators, chemokines, and cytokines in the neocortex of 5xFAD males only and attenuated astroglia and microglia activation in both male and female 5xFAD mice and the congophilic amyloid load in 5xFAD males only. CBC analysis revealed no changes in peripheral inflammation, irrespective of sex, on treatment with TG11-77.HCl. This study reveals sex-specific protection of selective EP2 antagonism in a two-hit mouse model of AD and supports a prudent therapeutic strategy against neuroinflammation and associated cognitive impairment in AD.}, }
@article {pmid41480618, year = {2025}, author = {Hu, G and Gogzheyan, C and Panja, S and Sil, S and Gendelman, HE}, title = {Extracellular vesicle-based therapies for neurodegenerative diseases.}, journal = {NeuroImmune pharmacology and therapeutics}, volume = {4}, number = {4}, pages = {377-390}, pmid = {41480618}, issn = {2750-6665}, abstract = {Extracellular vesicles (EVs) are mediators of neurodegeneration and emerging therapeutic tools for central nervous system disorders. On the one hand, they help spread beta amyloid, tau, α-synuclein, TDP-43, and mutant SOD1, contributing to the signs and symptoms of Alzheimer's, Parkinson's, Amyotrophic lateral sclerosis, and Huntington's Diseases. By activating glial cells, they promote chronic neuroinflammation through carrying cytokines, inflammasomes, and chemokines. On the other hand, EVs' ability to transport neuroregulatory products and cross the blood-brain barrier makes them ideal vehicles for drug delivery. Their function can be surface-modified to deliver targeted therapies, including anti-inflammatory and neuroprotective regulatory RNAs, proteins, and lipids, as well as factors that help maintain neural homeostasis. Notably, we suggest that colostrum-derived EVs, enriched with growth factors and immune-regulatory microRNAs, offer a natural, scalable, and biocompatible source for neuroprotective treatment. Although EVs can act as "Janus-faced" entities - serving both as disease initiators and versatile therapeutic vehicles - controlling their activity can enable immune-based therapeutics for neurodegenerative diseases.}, }
@article {pmid41480410, year = {2026}, author = {Tang, S and Luo, W and Wu, S and Yuan, M and Wen, J and Zhong, G and Shen, L and Jiang, W and Cheng, C and Wu, X and Xiao, X}, title = {Hippocampus-targeted BDNF gene therapy to rescue cognitive impairments of Alzheimer's disease in multiple mouse models.}, journal = {Genes & diseases}, volume = {13}, number = {2}, pages = {101649}, pmid = {41480410}, issn = {2352-3042}, abstract = {Brain-derived neurotrophic factor (BDNF) can protect neurons from apoptosis and maintain normal synaptic structures, indicating a significant potential for Alzheimer's disease (AD) treatment. However, the method of in vivo BDNF delivery requires further optimization, and the therapeutic efficacy of BDNF in AD animal models needs to be further evaluated. Here, we demonstrated that a newly engineered adeno-associated virus (AAV) serotype termed AAVT42 showed better tropism for neurons than AAV9 in the central nervous system (CNS). We analyzed the therapeutic potentials of AAVT42-delivered BDNF in three AD mouse models: amyloid precursor protein/presenilin-1 (APP/PS1), rTg4510, and 3 × Tg. Long-term BDNF expression in the hippocampus mitigated neuronal degeneration or loss in these AD mice, and alleviated their cognitive impairment, with no discernible effect on amyloid-β deposition or tau phosphorylation. Furthermore, transcriptomic analysis in 3 × Tg mice revealed that BDNF orchestrated the up-regulation of genes associated with neuronal structural organization and synaptic transmissions, such as Neuropeptide Y (Npy), Corticotropin-releasing hormone (Crh), Tachykinin precursor 1 (Tac1), and the down-regulation of Bone morphogenetic proteins (Bmps). Our study highlighted the efficacy of AAVT42 in gene delivery to CNS and validated the therapeutic benefits of BDNF in treating AD, which will be useful for future translational research on AD treatment using an AAV delivery system.}, }
@article {pmid41479956, year = {2025}, author = {Massara, M and Vedovelli, L and Masina, F and M J Edelstyn, N and Silvia Bisiacchi, P and Di Rosa, E}, title = {From cigarettes to compulsions: a longitudinal study in de novo Parkinson's disease.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1708535}, pmid = {41479956}, issn = {1664-1078}, abstract = {INTRODUCTION: Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease. Among the environmental and lifestyle factors associated with disease onset, cigarette smoking represents one of the most paradoxical. While substantial evidence has demonstrated a protective effect of smoking against the development of PD, smoking appears to worsen symptomatology, particularly by exacerbating impulsive-compulsive behaviors (ICBs) in people with PD (PwPD). However, longitudinal studies examining the effects of cigarette smoking on the progression of PD remain limited. Moreover, recent studies often involve mixed samples of treated and untreated PwPD, potentially confounding the impact of dopamine replacement therapy with that of smoking on ICBs.
METHODS: In the present study, we investigated a cohort of de novo PwPD, tracking their motor, cognitive, affective, and behavioral outcomes over 5 years, to better clarify the role of smoking in disease progression. Data were obtained from the Parkinson's Progression Markers Initiative and included 166 PwPD (119 non-smokers and 47 former smokers) and 79 healthy controls (48 non-smokers and 31 former smokers).
RESULTS: Our results revealed that a significantly higher percentage of former-smoker PwPD (28%) exhibited at least one ICB compared to non-smoker PwPD (13%; Pearson's [2](1) = 5.45, p = 0.02). No other significant differences between non-smokers and former smokers emerged in motor or non-motor symptoms, either in PwPD or in healthy individuals.
DISCUSSION: In conclusion, the novelty of our findings lies in showing that smoking-related influences on impulsive-compulsive behaviors in PD are most evident at the de novo stage, before any dopaminergic treatment. This temporal specificity may help resolve previous inconsistencies in the literature and underscores the importance of distinguishing between environmental and pharmacological effects on symptom development.}, }
@article {pmid41478829, year = {2026}, author = {Meade, J and Mesa, H and Alamgir, S and Bieniecka, I and Liu, L and Zhang, Q}, title = {Synaptic toxicity of OGA inhibitors and the failure of ceperognastat.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100456}, doi = {10.1016/j.tjpad.2025.100456}, pmid = {41478829}, issn = {2426-0266}, abstract = {O-GlcNAcase inhibitors (OGAi) have emerged as a promising therapeutic strategy in Alzheimer's disease (AD) by enhancing O-GlcNAcylation, which competes with tau phosphorylation and reduces tau aggregation. However, the Phase II clinical trial failure of ceperognastat, marked by accelerated cognitive decline in the treatment group, has raised significant safety concerns. Here, we examined the acute synaptic effects of three structurally distinct OGAi compounds-ceperognastat, ASN90, and MK8719-in mouse hippocampal slices. Electrophysiological recordings revealed suppression of both short- and long-term synaptic plasticity, including paired-pulse facilitation/depression and long-term potentiation. Immunohistochemical analysis confirmed disrupted synaptic protein levels (increased PSD-95, reduced Synaptophysin 1) and a biphasic shift in tau phosphorylation. These convergent findings suggest a class-wide synaptotoxic mechanism and call for a great caution in the development of disease-modifying therapies in AD. We argue that preclinical drug screening for synaptic functionality is essential in CNS-targeted therapeutic pipelines.}, }
@article {pmid41478820, year = {2026}, author = {Wang, P and Wu, X and Sun, F and Zhang, H and Jiang, Y and Wang, Q and Ding, H and Zhou, Y and Liu, F and Liu, H}, title = {Multi-omics integration reveals shared genetic architecture between metabolic markers and gray matter atrophy in Alzheimer's Disease.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100452}, doi = {10.1016/j.tjpad.2025.100452}, pmid = {41478820}, issn = {2426-0266}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by widespread gray matter volume (GMV) reductions. Emerging evidence links glucose and lipid metabolic dysregulation to AD pathophysiology. However, the extent to which AD-related GMV alterations and metabolic traits share a common genetic basis remains poorly understood.
OBJECTIVES: To explore the shared genetic architecture between GMV alterations in AD and metabolites related to glucose and lipid metabolism, aiming to provide biological insights into the prevention and treatment of AD.
DESIGN: This is a multimodal, cross-disciplinary study combining neuroimaging meta-analysis, transcriptome-neuroimaging association analysis, conjunctional false discovery rate (conjFDR) analysis, and functional enrichment analysis to identify the shared genetic architecture between AD-related brain structural alterations and metabolic traits.
SETTING: Public databases and European populations.
PARTICIPANTS: The meta-analysis included 49 studies (1945 CE patients and 2598 controls). The largest genome-wide association study (GWAS) summary statistics were used for AD (Ncase = 39,918; Ncontrol =358,140), two glycemic traits-glucose (GLU, N = 459,772) and glycated hemoglobin (HbA1c, N = 146,864), and three lipid traits (N = 1320,016)-high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG).
MEASUREMENTS: We conducted a voxel-based morphometric meta-analysis of GMV in AD by systematically reviewing 49 neuroimaging studies, identified through a literature search in PubMed and Web of Science using a predefined search strategy. Building upon these neuroanatomical findings, we performed a transcriptome-neuroimaging association analysis using data from the Allen Human Brain Atlas to identify genes spatially correlated with GMV alterations. To further explore the shared genetic architecture, we integrated GWAS summary statistics for AD and five metabolic markers using conjFDR analysis. Finally, functional enrichment analyses were performed to elucidate the biological relevance of the identified genes through this integrative framework.
RESULTS: Consistent GMV reductions in AD were observed in the bilateral middle temporal gyrus, right superior temporal gyrus, and other key subcortical regions. The conjFDR analysis identified 20, 17, 78, 87, and 82 genes shared between AD-related GMV reductions and GLU, HbA1c, HDL-C, LDL-C, and TG, respectively. Notably, 6 genes were shared across all five metabolic markers. Enrichment analysis implicated these genes in biological processes related to Aβ aggregation and phosphatidylinositol metabolism.
CONCLUSIONS: This study reveals a convergent genetic architecture underlying AD-related GMV atrophy and metabolic dysfunction. These findings may offer novel insights into the molecular interplay between systemic metabolism and neurodegeneration in AD and highlight potential targets for therapeutic strategies.}, }
@article {pmid41478818, year = {2026}, author = {Mummery, CJ and Li-Hsian, CC and Lasagna-Reeves, CA and Ossenkoppele, R and Rowe, CC and Scharre, DW and Wang, H and Kyaga, S and Cummings, JL}, title = {Tau in Alzheimer's disease: Shaping the future patient journey.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100447}, doi = {10.1016/j.tjpad.2025.100447}, pmid = {41478818}, issn = {2426-0266}, abstract = {Alzheimer's disease is a complex and multifactorial disease characterized by two key pathological hallmarks: amyloid-beta plaques and tau neurofibrillary tangles. Recent progress has led to the development and approval of disease-targeted therapies for Alzheimer's disease in the form of anti-amyloid-beta monoclonal antibodies. However, findings suggest that amelioration of multiple pathological drivers may be required to maximize clinical effect. An increasing body of evidence suggests that tau is a critical player in Alzheimer's disease pathophysiology, contributing significantly to neurodegeneration and cognitive decline. There are now several tau-targeting drugs in clinical development. In this review, we build on research and advancements in the field of tau to envision how an increasing focus on tau could shape the future Alzheimer's disease patient journey. We highlight the potential of tau as both a promising therapeutic target and a valuable biomarker, with the potential to inform treatment decisions and provide insight into disease trajectories. We also consider what a greater focus on tau may bring to an already evolving patient care pathway characterized by an increased influx of patients presenting earlier in the disease continuum, changes in workflow and infrastructural requirements, and increased complexity in treatment decision-making, treatment administration, treatment monitoring, and patient tracking. This review underscores the critical changes that may be required and knowledge gaps to be elucidated to ensure healthcare system preparedness for additional classes of disease-targeted therapy to move toward a next-generation, individualized treatment approach to Alzheimer's disease diagnosis and care.}, }
@article {pmid41478817, year = {2026}, author = {Qi, L and Zheng, F and Tu, M and Abdullah, R and Zhao, Y and Su, X and Zhou, D and Peng, G}, title = {Safety profiles of lecanemab: A systematic review and meta-analysis of randomized controlled trials and real-world evidence.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100473}, doi = {10.1016/j.tjpad.2025.100473}, pmid = {41478817}, issn = {2426-0266}, abstract = {BACKGROUND: Safety profiles of lecanemab, an anti-amyloid-β antibody for the treatment of early Alzheimer's disease (AD), remain uncertain and may vary between randomized controlled trials (RCTs) and real-world evidence (RWE) studies.
OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the safety, tolerability, and acceptability of lecanemab based on findings from both RCTs and emerging RWE studies.
METHODS: We systematically searched major databases and clinical trial registries from their inception to June 2025. Random-effects meta-analyses were performed to estimate the pooled incidence of key safety outcomes, including amyloid-related imaging abnormalities (ARIA), infusion-related reactions (IRRs), and treatment discontinuation (due to ARIA, adverse events [AEs], or any cause). The risk of ARIA according to the ApoE4 genotype was assessed via relative risk (RR). This study was registered with PROSPERO (No. CRD420251110679).
RESULTS: A total of two RCTs and five RWE studies encompassing 1576 patients were included. The pooled ARIA incidence was 19% (95% CI: 16%-23%), which was significantly modulated by ApoE4 status (RR 1.45 for heterozygotes, 3.54 for homozygotes vs noncarriers) and the pooled symptomatic ARIA incidence was 3% (95% CI: 2%-4%). IRRs occurred in 26% (95% CI: 19%-34%), with heterogeneity reduced in patients receiving specific pre-infusion prophylaxis. The pooled rate of discontinuation due to AEs was 8% (95% CI: 5%-11%), with discontinuation due to ARIA occurring in 5% (95% CI: 3%-7%) of patients in RWE studies.
CONCLUSIONS: Lecanemab-related ARIA demonstrates a clear ApoE4 gene-dose effect, supporting routine ApoE4 genotyping before treatment. Standardizing pre-infusion prophylaxis may reduce variability in IRRs incidence, while prompt recognition and management of ARIA are critical for improving treatment tolerability. These findings provide important evidence to support the safe clinical use of lecanemab.}, }
@article {pmid41478541, year = {2025}, author = {Zafar, I and Khan, MS and Jamal, A and Shafiq, S and Bahwerth, FS and Khan, NU}, title = {Precision therapeutic strategies for Alzheimer's disease: Amyloid β-targeted foundations and multimodal next-generation approaches.}, journal = {Molecular and cellular neurosciences}, volume = {136}, number = {}, pages = {104070}, doi = {10.1016/j.mcn.2025.104070}, pmid = {41478541}, issn = {1095-9327}, abstract = {Alzheimer's disease (AD) is the leading cause of dementia and a significant unmet medical challenge, pathologically characterized by amyloid β (Aβ) aggregation, tau hyperphosphorylation, synaptic dysfunction, and chronic neuroinflammation. Although Aβ has long been a central therapeutic target, clinical translation has historically been hindered by late-stage intervention, inadequate blood-brain barrier (BBB) penetration, and the molecular heterogeneity of AD. Recent advances with Aβ-targeted monoclonal antibodies, particularly lecanemab and donanemab, have provided the first clinical evidence of disease modification, demonstrating robust amyloid clearance and measurable slowing of cognitive decline in early-stage AD. These results validate the Aβ hypothesis but also highlight persistent barriers, including amyloid-related imaging abnormalities (ARIA), questions about the durability of benefit, challenges in patient stratification, and the high economic burden of biologics. To overcome these limitations, next-generation strategies are emerging that extend beyond single-pathway targeting toward multimodal and precision-based frameworks. Innovative approaches include tau-directed therapies to prevent the propagation of neurofibrillary tangles, immunomodulatory strategies to enhance microglial clearance of aggregated proteins, and neuroprotective interventions to counteract oxidative and inflammatory stress. Concurrently, nanotechnology-based drug delivery systems are being engineered to efficiently traverse the BBB and deliver multifunctional payloads, while artificial intelligence (AI)- driven discovery platforms are accelerating target identification, biomarker integration, and patient stratification. Future perspectives emphasize the importance of preclinical-stage intervention, long-term efficacy trials, and the adoption of personalised treatment paradigms that integrate genomic, biomarker, and digital profiling to optimise outcomes. Collectively, these advances signal a paradigm shift in AD therapeutics, positioning Aβ-targeted therapies as a foundation while paving the way for combination strategies that more effectively address the disease's multifactorial nature.}, }
@article {pmid41478465, year = {2025}, author = {Bandarupalli, T and Noonan, C and Hansen, K and Weaver, R and Baumann, K and Banks, WA and Erickson, MA and Rhea, EM}, title = {Acute peripheral versus central inhibition of insulin receptors differentially alters cytokine and blood-brain barrier responses to an inflammatory stimulus.}, journal = {Brain, behavior, and immunity}, volume = {133}, number = {}, pages = {106251}, doi = {10.1016/j.bbi.2025.106251}, pmid = {41478465}, issn = {1090-2139}, abstract = {The blood-brain barrier (BBB)'s role in protecting the brain from exposure to harmful circulating factors has led to its disruption being implicated in neurodegenerative diseases such as vascular dementia and Alzheimer's disease. Insulin resistance, defined by an impaired response to insulin, is a common feature of metabolic disorders and neurodegenerative diseases. Importantly, individuals can possess peripheral insulin resistance independent of central insulin resistance and vice versa. States of insulin resistance, like diabetes mellitus for peripheral insulin resistance and Alzheimer's disease for central insulin resistance, are associated with inflammation and BBB disruption. However, the contributions of acute impairment of insulin receptor signaling solely in the periphery versus the brain to inflammation and BBB disruption are not clear. As central vs peripheral insulin resistance could have different effects on inflammation, we characterized the effects of acute central versus peripheral insulin receptor inhibition with or without an inflammatory insult, using lipopolysaccharide (LPS) as a prototypic immune stimulus. Male CD-1 mice were treated with an insulin receptor antagonist (S961), peripherally (intraperitoneal) or centrally (intranasal). This treatment was then followed by an intraperitoneal administration of either saline or LPS 30 min later, at a single 3 mg/kg dose known to cause inflammation and BBB disruption. Assays of BBB disruption and brain and serum collection were done 28 h after the injections. Metabolic hormones, cytokines, and the acute phase protein serum amyloid a (SAA) were then measured in serum and brain homogenates. In the absence of LPS, central S961 reduced serum hormones including ghrelin, gastric inhibitory peptide (GIP), and glucagon. Peripheral S961 significantly increased many cytokines in both brain and blood, whereas central S961 decreased serum SAA and increased a few cytokines. BBB integrity was not affected by S961 alone, but central S961 decreased LPS-induced BBB disruption and also lowered serum levels of SAA. These findings highlight the differential effects of peripheral versus central insulin receptor inhibition on cytokine responses and BBB integrity in the presence and absence of acute inflammation, elucidating differences in the molecular mechanisms for insulin receptor signaling depending on the location of signaling dysfunction. The results suggest a potential neuroprotective role of acute central insulin inhibition during acute inflammation.}, }
@article {pmid41478424, year = {2025}, author = {Zhang, Y and Chen, L and Jin, J and Xin, Y and Wang, J and Zhang, A}, title = {Therapeutic application of fecal microbiota transplantation for neurological diseases: Exploring novel mechanisms and perspectives.}, journal = {Experimental neurology}, volume = {398}, number = {}, pages = {115631}, doi = {10.1016/j.expneurol.2025.115631}, pmid = {41478424}, issn = {1090-2430}, abstract = {Recently, fecal microbiota transplantation (FMT) has garnered widespread attention as an emerging therapeutic approach in the field of neurological disorders. In this study, we review the research progress of FMT in treating neurological disorders. First, the development, safety, and efficacy of FMT are introduced. Subsequently, the application and potential mechanisms of FMT in neurodegenerative diseases (such as Parkinson's disease and Alzheimer's disease), neurodevelopmental disorders (such as autism spectrum disorder and attention deficit hyperactivity disorder), and other neurological conditions are elaborated in detail. Particularly, we explore the pivotal role of the microbiota-gut-brain axis in FMT for treating neurological disorders, as well as how FMT influences neurological function by regulating the gut microbiota and its metabolites, immune system and inflammatory responses, and neurotransmitters. However, FMT also faces numerous challenges in the treatment of neurological disorders, such as ethical issues, safety concerns, and standardization problems. Therefore, this review also prospects the future development directions of FMT in the treatment of neurological diseases, including personalized therapy and combination therapies. FMT may be a feasible and promising option for treating various neurological disorders, but a comprehensive understanding of its working principles and continuous improvement of its application in clinical practice are still ongoing.}, }
@article {pmid41477991, year = {2026}, author = {Hu, H and Cheng, Q and Li, D and Li, Y and Li, X and Chen, Y and Guo, Y and Tian, S and Jiang, Y and Chen, Y and Liu, Y and Li, S}, title = {Ponicidin ameliorates Alzheimer's disease through dual inhibition of RIPK1-mediated neuroinflammation and necroptosis.}, journal = {International immunopharmacology}, volume = {171}, number = {}, pages = {116095}, doi = {10.1016/j.intimp.2025.116095}, pmid = {41477991}, issn = {1878-1705}, mesh = {Animals ; *Receptor-Interacting Protein Serine-Threonine Kinases/metabolism/antagonists & inhibitors ; *Alzheimer Disease/drug therapy/metabolism ; Necroptosis/drug effects ; Mice ; Mice, Transgenic ; Disease Models, Animal ; Cell Line ; Microglia/drug effects ; Humans ; *Anti-Inflammatory Agents/pharmacology/therapeutic use ; *Neuroinflammatory Diseases/drug therapy ; Neurons/drug effects ; Male ; Mice, Inbred C57BL ; *Neuroprotective Agents/pharmacology/therapeutic use ; }, abstract = {Ponicidin (Pon), a diterpenoid isolated from Rabdosia rubescens, exhibits a broad range of pharmacological activities, including anti-inflammatory effects. However, its therapeutic potential in Alzheimer's disease (AD), particularly in modulating receptor-interacting protein kinase 1 (RIPK1)-mediated neuroinflammation and necroptosis, remains underexplored. This study aims to investigate the mechanism through which Pon targets RIPK1 to alleviate AD pathogenesis. The interaction between Pon and RIPK1 was confirmed using bio-layer interferometry (BLI) and drug affinity responsive target stability (DARTS) assays. In vitro, the effects of Pon on inflammatory responses and necroptosis were evaluated in BV2 microglial cells (BV2 cells) and HT22 hippocampal neuronal cells (HT22 cells) using Enzyme-linked immunosorbent assay (ELISA), Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), Western blotting (WB), and flow cytometry. In vivo, Pon's therapeutic efficacy was assessed in the 5 × FAD transgenic mouse model of AD through behavioral tests, histological analysis, and biochemical assays. Pon was found to bind RIPK1 with high affinity (KD = 135 nM) and enhance RIPK1's resistance to proteolytic degradation. In microglial cells, Pon effectively inhibited the release of pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) by disrupting the RIPK1-janus kinase 1 (JAK1)-signal transducer and activator of transcription 1 (STAT1) signaling pathway. In neurons, Pon suppressed RIPK1-mediated necroptosis by blocking the RIPK1-RIPK3-mixed lineage kinase domain-like protein (MLKL) cascade. Behavioral analysis of 5 × FAD mice revealed that Pon treatment significantly improved cognitive function, reduced amyloid-beta (Aβ) plaque deposition, and alleviated neuroinflammation and necroptosis in the brain. Pon exerts dual neuroprotective effects by targeting RIPK1, mitigating both neuroinflammation and necroptosis, two critical pathological processes in AD. These findings underscore Pon's potential as a disease-modifying therapy for AD and provide a foundation for the clinical development of natural product-derived RIPK1 inhibitors in neurodegenerative diseases.}, }
@article {pmid41477911, year = {2026}, author = {Yu, W and Zhuang, D and Wang, K and Qu, Y}, title = {JWX-A1223 attenuates cognitive deficits and tau protein hyperphosphorylation via the Akt/GSK3β pathway in APP/PS1 mice.}, journal = {Archives of physiology and biochemistry}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/13813455.2025.2610481}, pmid = {41477911}, issn = {1744-4160}, abstract = {BACKGOUND: Alzheimer's disease (AD) is a neurodegenerative disorder marked by cognitive decline, affecting memory, thinking, and behaviour. Its neuropathology includes amyloid plaques and neurofibrillary tangles in the brain.
MATERIALS: Amyloid plaques consist of misfolded beta-amyloid protein, while tangles are made of hyperphosphorylated tau protein.
METHOD: After treatment with JWX-A1223, the APP/PS1 mice showed significant cognitive improvement in the Morris water maze test. They had shorter escape latency, reduced swimming distance, and longer stay time in the target quadrant, indicating enhanced spatial learning and memory.
RESULTS: The treatment with JWX-A1223 also significantly reduced the phosphorylation levels of tau protein at Ser202, Ser396 and Ser404 sites in the cerebral cortex and hippocampus of mice, while increasing the phosphorylation levels at Ser473 site of Akt and Ser9 site of GSK3β.
CONSLUSION: It indicates that by regulating the activity of the Akt/GSK3β pathway, it alleviates the excessive phosphorylation of tau protein and thereby improves cognitive impairment.}, }
@article {pmid41477735, year = {2026}, author = {Tsai, HR and Lin, YJ and Loh, CH and Lee, YC and Huang, HK}, title = {Risk of Alzheimer Disease and Related Dementia after Retinal Vascular Occlusion: A Nationwide Cohort Analysis.}, journal = {Ophthalmology. Retina}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.oret.2025.10.017}, pmid = {41477735}, issn = {2468-6530}, abstract = {PURPOSE: To evaluate the risk of developing Alzheimer disease (AD) and related dementia in patients with newly diagnosed retinal vascular occlusion.
DESIGN: A nationwide population-based cohort study using claims data from Taiwan's National Health Insurance Research Database (NHIRD).
PARTICIPANTS AND CONTROLS: A total of 39 540 individuals with diagnoses of retinal vascular occlusion between 2011 and 2019 in Taiwan and 395 400 age- and sex-matched nonretinal vascular occlusion individuals without prior diagnoses of any dementia.
METHODS: Patients with newly diagnosed retinal vascular occlusion were identified in the NHIRD, and baseline characteristics were collected. The study endpoints, including AD, vascular dementia (VD), and all-cause dementia, were determined by ≥2 separate outpatient diagnoses or a single discharge diagnosis. Inverse probability of treatment weighting (IPTW) was applied to balance baseline covariates and control potential confounders. Cox proportional hazards models were used to estimate the hazard ratio (HR) for each outcome.
MAIN OUTCOME MEASURES: Development of AD, VD, and all-cause dementia.
RESULTS: After IPTW, 38 522 patients with retinal vascular occlusion and 395 740 nonretinal vascular occlusion individuals were included. Patients with retinal vascular occlusion had increased risks of AD (HR, 1.57; 95% confidence interval [CI], 1.39-1.80), VD (HR, 1.76; 95% CI, 1.58-1.95), and all-cause dementia (HR, 1.58; 95% CI, 1.50-1.65). Both retinal artery occlusion and retinal vein occlusion were associated with increased risks of AD (HR, 1.59; 95% CI, 1.14-2.23; and HR, 1.58; 95% CI, 1.39-1.80, respectively), VD (HR, 1.79; 95% CI, 1.32-2.43; and HR, 1.77; 95% CI, 1.59-1.98, respectively), and all-cause dementia (HR, 1.62; 95% CI, 1.42-1.86; and HR, 1.58; 95% CI, 1.52-1.67, respectively).
CONCLUSIONS: Patients with retinal vascular occlusion had moderately increased risks of AD and related dementias. Therefore, monitoring for dementia symptoms in patients with retinal vascular occlusion may facilitate earlier detection and intervention.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.}, }
@article {pmid41477525, year = {2025}, author = {Zheng, M and Hong, X and Liao, P and Huang, H and Zhang, Y and Xu, W and Li, H}, title = {Plant-Derived Exosome-Like Nanoparticles: A Promising Therapeutic for Neurological Disorders and Drug Delivery.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {15769-15791}, pmid = {41477525}, issn = {1178-2013}, mesh = {Humans ; *Exosomes/chemistry ; *Nanoparticles/chemistry ; Animals ; *Nervous System Diseases/drug therapy ; Blood-Brain Barrier/metabolism ; *Drug Delivery Systems/methods ; *Plants/chemistry ; }, abstract = {Neurological disorders, including ischemic stroke, Alzheimer's disease, and Parkinson's disease, exhibit high incidence rates and pose significant health challenges. Current pharmacological treatments often fail to adequately address clinical needs due to obstacles such as limited penetration of the blood-brain barrier and suboptimal efficacy. Plant-derived exosome-like nanoparticles (PELNs) have emerged as promising therapeutic agents due to their superior biocompatibility, low toxicity, ability to traverse the blood-brain barrier, and abundance of lipids, microRNAs, and other bioactive compounds. This review provides a comprehensive overview of recent advancements in PELNs preparation technologies, elucidates the mechanisms of action of their principal bioactive components, and explores their therapeutic applications across various neurological disorders, thereby offering a theoretical foundation for the development of related treatment strategies. Nonetheless, researches on PELNs continue to encounter significant challenges. At the production level, there is an absence of standardized isolation protocols, and the yields remain inadequate to satisfy clinical requirements. Clinically, the efficacy in humans has yet to be established, and the available safety data are insufficient. Technically, the lack of standardized storage conditions and the susceptibility of biological stability to external factors further complicate the field. This review delineates these challenges to offer insights for advancing both fundamental research and the clinical translation of PELNs.}, }
@article {pmid41477168, year = {2025}, author = {Xiao, Y and Li, H and Han, X and Liu, Y and Sun, J and Sun, C and Wang, Y and Ye, T and Cheng, X}, title = {Qi-Fu-Yin ameliorates physiological frailty in male 5xFAD mice through remodeling the gut microbiota and modulating the cerebral cortex metabolism.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1622286}, pmid = {41477168}, issn = {1663-4365}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a neurodegenerative disease that can only be managed rather than cured, bringing a substantial burden to society. Frailty and cognition are intertwined in a cycle of decline, affecting the prognosis of AD. Qi-Fu-Yin (QFY) is a classic prescription in traditional Chinese medicine for dementia. While most studies have focused on cognitive impairment, research on physiological frailty remains relatively scarce in AD, especially in 5xFAD mice. We aimed to investigate the impacts of QFY on the physiological frailty of male 5xFAD mice.
METHODS: Male 5xFAD mice received QFY, followed by grip strength test, rotarod test, grading score of frailty, lipofuscin staining, SA-β-gal and Aβ co-staining. The metabolite alteration and the intestinal flora composition were analyzed by non-targeted metabolomics and 16S rRNA sequencing. Moreover, Spearman's correlation analysis was used to integrate behavioral results, differentially expressed metabolites, and altered bacterial genera.
RESULTS: We discovered that QFY improved grip strength, riding time, score of frailty, lipofuscin deposition, SA-β-gal, and Aβ in male 5xFAD mice. The results of untargeted metabolomics showed that metabolites such as proline, PS (18:1/18:0), and PFSA-CI were downregulated in the male 5xFAD mice compared with C57BJ/6JXSJL mice, while PE (18:1/18:1) was upregulated. QFY treatment reversed these changes, restoring metabolite levels toward those of C57BJ/6JXSJL mice. Arginine and proline metabolism, alanine, aspartate and glutamate metabolism, and butyrate metabolism were filtered out as the important metabolic pathways between the C57BJ/6JXSJL mice and the male 5xFAD mice, as well as between the 5xFAD mice and the 5xFAD mice with QFY treatment. Moreover, Ruminococcaceae, Subdoligranulum, Bacteroides, Alistipes, Rikenellaceae_RC9_gut_group, and Odoribacter, which were lower in male 5xFAD mice, were improved after QFY intervention.
DISCUSSION: The differential intestinal flora might improve the metabolism of brain tissue as well as muscle strength and coordination through Short-chain fatty acids (SCFAs). The differential metabolites caused by QFY intervention also have an improving effect on physiological frailty. We suggest that QFY exerts protective impacts against the physiological frailty in AD by adjusting the muscle-gut-brain axis.}, }
@article {pmid41477167, year = {2025}, author = {Garcia, ML and Denton, AR and Jackson, NL and Scofield, MD and McMahon, LL}, title = {Pharmacologically increasing O-GlcNAcylation increases complexity of astrocytes in the dentate gyrus of TgF344-AD rats.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1690410}, pmid = {41477167}, issn = {1663-4365}, abstract = {BACKGROUND: Alzheimer's disease (AD) pathology begins two or three decades prior to the onset of cognitive symptoms and is characterized by amyloid-β (Aβ) and hyperphosphorylated tau (pTau) accumulation, reactive glial cells, increased inflammation, and neuronal degeneration in later stages. Preclinical studies report that increasing the post-translational modification, O-GlcNAcylation, involving the addition of a single N-acetylglucosamine (GlcNAc) moiety to serine or threonine residues, can reduce amyloidogenic processing of amyloid precursor protein (APP) and compete with serine phosphorylation on tau, decreasing hyperphosphorylated tau accumulation. Protein O-GlcNAcylation can have anti-inflammatory effects, suggesting the possibility that increasing O-GlcNAcylation may decrease reactive gliosis and other pathological changes in AD.
METHODS: This study aimed to assess the possible beneficial effects of pharmacologically enhancing O-GlcNAcylation by inhibiting O-GlcNAcase (OGA), the enzyme responsible for the removal of O-GlcNAc moieties, on progressive AD pathology using female TgF344-AD rats. The selective OGA inhibitor thiamet-G [TMG; 10 mg/kg, subcutaneously (s.c.)] was administered three times per week for 3 months starting at 6 months of age, a time point when Aβ pathology is evident in the hippocampus. Western blot analysis was used to measure protein levels of GFAP, Iba-1, and Aβ. Immunohistochemistry and confocal imaging were used to assess Aβ plaques, astrocyte and microglia complexity, and degeneration of tyrosine hydroxylase-positive (TH+) axons.
RESULTS: In TgF344-AD rats, we found significantly increased astrocyte complexity, defined as increased process length and branches, increased numbers of microglia, loss of noradrenergic axons (NA), and significant Aβ plaques compared to WT, confirming previous work by us and others. Notably, pharmacologically increasing O-GlcNAcylation further increased astrocyte complexity in TgF344-AD rats, specifically those located in close proximity to Aβ plaques, while microglia morphology and Aβ staining were unaffected. O-GlcNAcylation was not able to lessen the loss of TH + axons in TgF344-AD rats, although fewer dystrophic axons were observed, suggesting a possible beneficial effect.
DISCUSSION: Our findings demonstrate that increasing O-GlcNAcylation in TgF344-AD rats using a cyclical treatment protocol at a time when Aβ pathology is already significant does not provide broad beneficial effects on Aβ accumulation, microglial reactivity, or noradrenergic axon loss, although there appears to be fewer dystrophic axons. Importantly, increasing O-GlcNAcylation in TgF344-AD rats has dual beneficial effects on astrocyte reactivity. Astrocytes in close proximity to Aβ plaques are more complex with longer processes and more branches compared to those in saline-treated TgF344-AD rats at the same distance, enabling them to surround plaques and protect nearby neurons. Astrocytes located at more distal locations from plaques are less reactive than those at the same distance in saline-treated TgF344-AD rats, permitting a less pathological local environment for nearby neurons. Our findings offer new insights into the possible mechanisms that might contribute to the beneficial therapeutic effects of increasing O-GlcNAcylation during progressive AD pathology.}, }
@article {pmid41476782, year = {2025}, author = {Zhu, Y and Liu, H and He, M and Xu, Z and Sun, L and Wu, Z and Niu, X and Huang, S and Wang, J and Ran, X}, title = {Epidemiology and Risk Factors Characteristics of Alzheimer's Disease in Southwestern China: A Cross-Sectional Study.}, journal = {Clinical interventions in aging}, volume = {20}, number = {}, pages = {2685-2704}, pmid = {41476782}, issn = {1178-1998}, mesh = {Humans ; *Alzheimer Disease/epidemiology ; China/epidemiology ; Female ; Male ; Risk Factors ; Aged ; *Cognitive Dysfunction/epidemiology ; Cross-Sectional Studies ; Aged, 80 and over ; Middle Aged ; Prevalence ; Rural Population ; Sex Factors ; Age Factors ; Educational Status ; Comorbidity ; Logistic Models ; }, abstract = {BACKGROUND: To address the regional heterogeneity of Alzheimer's disease, a large-scale epidemiological study of 12,421 elderly individuals was conducted in southwestern China to depict its unique risk characteristics.
METHODS: A total of 12,421 subjects were selected via cluster sampling from southwestern China after low quality data were filtered out. On the basis of investigations and medical imaging examinations, three groups were distinguished: the AD, mild cognitive impairment (MCI), and normal control groups. The risk factors for AD and MCI were analysed via a multivariate logistic regression model.
RESULTS: This study identifies a high burden of cognitive impairment in southwestern China, with 22.07% of adults aged ≥60 years exhibiting cognitive decline and 5.81% diagnosed with Alzheimer's disease rates surpassing national and global averages. Key risk factors included age >80 years, female sex, low education, rural residence, surgical history, and urological comorbidities. These findings underscore the need for region-specific prevention strategies, prioritizing older, less-educated rural women through combined cognitive and vascular interventions, while integrating cognitive screening into primary care in underserved areas for early detection and intervention.
CONCLUSION: Elderly individuals in southwestern China exhibit a high prevalence of cognitive impairment, with AD associated with complex risk factors including established contributors like advanced age, dementia family history, alcohol abuse, and multisystem comorbidities-while notably identifying surgical history and urolithiasis as region specific risk signals. These findings underscore regional, environmental, and ethnic influences on AD pathogenesis, requiring tailored prevention/treatment. Future priorities include integrating brief cognitive screening into primary care, targeting high-risk groups (eg, undereducated rural elderly women), and establishing prospective cohorts to clarify causal links between urolithiasis, surgical history, and cognitive decline for refined region-adapted AD prevention.}, }
@article {pmid41476179, year = {2025}, author = {Taheri, E and Raeeszadeh-Sarmazdeh, M}, title = {Evaluating the effect of minimal TIMP variants on protecting and transport across the rat brain microvascular cells (RBMEC).}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {1020}, pmid = {41476179}, issn = {2045-2322}, support = {P30 GM145646/GM/NIGMS NIH HHS/United States ; }, mesh = {Animals ; Rats ; *Blood-Brain Barrier/metabolism/drug effects ; *Endothelial Cells/metabolism/drug effects ; Matrix Metalloproteinase 9/metabolism ; *Brain/blood supply/metabolism ; *Microvessels/cytology/metabolism ; *Tissue Inhibitor of Metalloproteinase-3/metabolism/genetics/pharmacology ; *Tissue Inhibitor of Metalloproteinase-1/metabolism/genetics/pharmacology ; Tight Junctions/metabolism ; *Tissue Inhibitor of Metalloproteinases/metabolism/genetics/pharmacology ; Zonula Occludens-1 Protein/metabolism ; Cells, Cultured ; Biological Transport ; Capillary Permeability ; }, abstract = {Tissue inhibitors of metalloproteinases (TIMPs), endogenous inhibitors of matrix metalloproteinases (MMPs), can be tailored to regulate MMP activity and mitigate the disruptive effects of specific MMPs when dysregulated in diseases. MMPs, especially MMP-9, are major contributors to the degradation of extracellular matrix components, leading to BBB disruption in neurological disorders. The upregulation of MMPs undermines blood-brain barrier (BBB) integrity and drives neuroinflammation. Engineering minimal protein variants offers enhanced modularity, tissue penetration, and BBB permeability. Minimal TIMP variants were engineered, aiming to improve their therapeutic reach across both sides of the BBB, particularly when delivery to the brain is essential. In this study, we assessed the protective effects of mTC1 and mTC3 on BBB integrity using an in vitro model of rat brain microvascular endothelial cells (RBMECs). Barrier function was evaluated following treatment with recombinant MMP-9, either alone or co-treated with native TIMP-1, TIMP-3, or the engineered minimal variants. MMP-9 induced a dose-dependent increase in BBB permeability, reflected by a decrease in trans-endothelial electrical resistance (TEER) and increased paracellular transport of fluorescent tracers. Co-treatment with TIMP-1, TIMP-3, mTC1, or mTC3 significantly attenuated MMP-9-mediated disruption of tight junctions of RBMECs, preserving TEER values and reducing permeability. Immunofluorescence staining for tight junction proteins, ZO-1 and occludin, further validated the preservation of endothelial integrity in the presence of wild-type human TIMPs and engineered TIMP variants. These findings underscore the potential of engineered minimal TIMPs as molecular tools to stabilize the BBB and support their future application in mechanistic studies focused on BBB protection.}, }
@article {pmid41476028, year = {2026}, author = {Zhang, W and Liu, H and Zhang, C and Li, Y and Fang, K and Zhou, Y and Weng, L and Fang, L and Luo, Y and Xiao, H and Zhou, L and Jiao, B and Shen, L}, title = {Six-month follow-up of ARIA-H and iron deposition in real-world lecanemab therapy for Alzheimer's disease: Evidence from a Chinese 7T MRI cohort.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {22}, number = {1}, pages = {e71044}, pmid = {41476028}, issn = {1552-5279}, support = {U22A20300 82371434//National Natural Science Foundation of China/ ; 2021ZD0201803//STI2030-Major Projects/ ; 2023YFC3603700//the National Key R&D Program of China/ ; 2024JJ2097//the Outstanding Youth Fund of Hunan Provincial Natural Science Foundation/ ; 2024PT5108//the Scientific Research Program of FuRong Laboratory/ ; SMIDF-150-2025A19//the Brain Health Youth Fund of Shanghai Medical Innovation & Development Foundation/ ; }, mesh = {Humans ; *Alzheimer Disease/drug therapy/diagnostic imaging/metabolism ; *Magnetic Resonance Imaging/methods ; Male ; Female ; *Iron/metabolism ; Aged ; Amyloid beta-Peptides/blood ; Follow-Up Studies ; Biomarkers/blood ; *Brain/diagnostic imaging/metabolism/drug effects ; tau Proteins/blood ; Cohort Studies ; China ; Middle Aged ; Peptide Fragments/blood ; East Asian People ; }, abstract = {INTRODUCTION: With the approval of lecanemab for treating Alzheimer's disease (AD), there is an urgent need to evaluate its safety and treatment effects on biomarkers in real-world practice.
METHODS: Patients receiving lecanemab (n = 72) underwent routine 3T and 7T magnetic resonance imaging (MRI) for amyloid-related imaging abnormality (ARIA) monitoring. Longitudinal changes of iron deposition assessed by quantitative susceptibility mapping (QSM) and its association with plasma biomarkers were further evaluated.
RESULTS: With use of 7T MRI, we identified characteristic perivascular features and detected ARIA with hemorrhages/hemosiderin deposition (ARIA-H) ≈4 months earlier than with 3T. QSM detected post-treatment regional susceptibility reductions. Decreased susceptibility in the temporal, frontal lobes, and the thalamus was associated with plasma amyloid beta 42 (Aβ42) and tau phosphorylated at threonine 217 (p-tau217) changes.
DISCUSSION: 7T MRI provides superior ARIA-H detection and iron dynamics monitoring, supporting its role in risk stratification and therapy assessment for lecanemab-treated patients. Iron deposition measured by QSM may serve as a promising neuroimaging marker for amyloid-targeting treatments.
HIGHLIGHTS: Using 7T magnetic resonance imaging (MRI), this study for the first time visualized amyloid-related imaging abnormality with hemorrhages/hemosiderin deposition (ARIA-H) at a submillimeter resolution, characterized by aggregated, clustered cerebral microbleeds in a perivascular distribution, suggesting overlapping pathology with cerebral amyloid angiopathy. The susceptibility-weighted imaging sequence on 7T MRI enabled detection of ARIA-H up to 4 months earlier. Plasma amyloid beta 42 (Aβ42) and tau phosphorylated at threonine 217 (p-tau 217) levels are sensitive biomarkers for amyloid targeted therapy. Quantitative susceptibility mapping (QSM) analysis demonstrated reduced cortical iron burden post-treatment, which has significant associations with plasma Aβ42 and p-tau 217 levels, highlighting QSM-derived iron quantification as a promising neuroimaging indicator for amyloid-targeted therapeutics.}, }
@article {pmid41475761, year = {2026}, author = {Mei, J and Shi, X and Chen, M and Li, Z and Cui, Y and Fang, C and Wu, X and Chen, X and Zeng, K and Yang, L}, title = {Chitosan/selenium nanoparticles Pickering emulsion prolong quercetin retention time to ameliorates cognitive disorder: Focus on restoring the metabolic disorder and gut microbiota.}, journal = {Carbohydrate polymers}, volume = {375}, number = {}, pages = {124804}, doi = {10.1016/j.carbpol.2025.124804}, pmid = {41475761}, issn = {1879-1344}, mesh = {*Quercetin/chemistry/pharmacology/administration & dosage/pharmacokinetics ; Animals ; *Gastrointestinal Microbiome/drug effects ; *Chitosan/chemistry ; Emulsions/chemistry ; *Nanoparticles/chemistry ; *Selenium/chemistry ; Mice ; Male ; Mice, Inbred C57BL ; *Cognitive Dysfunction/drug therapy ; Brain/metabolism/drug effects ; }, abstract = {Gut microbiota influence brain inflammation and cognitive impairment by regulating lipid metabolism. The therapeutic efficacy of quercetin (Que) in Alzheimer's disease (AD) treatment is significantly limited by its poor water solubility and short residence time in vivo. Herein, Chitosan (CS) modified selenium nanoparticles was used to prepare a high-loading Pickering emulsion (Que-CS/Se-PE), improving bioaccessibility of Que. Simulated gastrointestinal fluid experiments demonstrate that Que-CS/Se-PE exhibits strong stability under acidic conditions. In vitro digestion studies indicate that Que-CS/Se-PE enables QUE to target intestinal fluids and release slowly. In vivo imaging revealed that the gastrointestinal retention time of Que-CS/Se-PE was up to 48 h. In HFD + D-gal-induced mice, Que-CS/Se-PE treatment reduced serum TC and brain TNF-α levels by 40.8 % and 31.5 %, respectively, indicating substantial improvement in lipid metabolism and neuroinflammation. Behavioral tests showed that Que-CS/Se-PE improved cognitive performance, with preference index elevated by 2.1-fold. Moreover, the relative abundances of Akkermansia, Lactobacillus, and Bacteroidota increased by 2.7-, 17.8-, and 4.7-fold, respectively. In conclusion, Que-CS/Se-PE exhibits interfacial stability, excellent adhesion, and sustained-release properties, significantly prolonging the retention time of quercetin in vivo and enhancing its bioavailability. Furthermore, it modulates lipid metabolism and gut microbiota, and finally ameliorates cognitive impairment in obesity and age-related AD.}, }
@article {pmid41474058, year = {2026}, author = {Naftchi-Ardebili, K and Singh, K and Popelka, GR and Pauly, KB}, title = {A deep-learning model for one-shot transcranial ultrasound simulation and phase aberration correction.}, journal = {Medical physics}, volume = {53}, number = {1}, pages = {e70259}, pmid = {41474058}, issn = {2473-4209}, support = {R01 Grant EB032743//National Science Foundation/ ; }, mesh = {*Deep Learning ; Humans ; *Image Processing, Computer-Assisted/methods ; Skull/diagnostic imaging ; Ultrasonography ; Tomography, X-Ray Computed ; }, abstract = {BACKGROUND: Transcranial ultrasound is a promising non-invasive neuromodulation technique with applications, including neuronal activity modulation, blood-brain barrier opening, targeted drug delivery, and thermal ablation. Its ability to deliver focused ultrasound waves to precise brain regions has led to over 50 clinical trials targeting conditions such as opioid addiction, Alzheimer's disease, dementia, epilepsy, and glioblastoma. However, skull heterogeneity complicates accurate focal spot prediction and energy delivery, requiring rapid yet precise phase aberration correction in clinical workflows.
PURPOSE: To address the trade-off between computational efficiency and accuracy in current focus prediction methods, we introduce TUSNet, a deep learning framework for rapid and accurate transcranial ultrasound pressure field and phase aberration correction computation.
METHODS: TUSNet, an end-to-end neural network, was trained to predict both 2D transcranial ultrasound pressure fields and phase corrections. TUSNet was trained on 180432 synthetic skull Computed Tomography (CT) segments, and tested on 1232 real skull CT segments. Its performance was benchmarked against k-Wave, a MATLAB-based acoustic simulation package, evaluating computation speed, focal spot accuracy, phase correction accuracy, and pressure magnitude estimation.
RESULTS: TUSNet computed pressure fields and phase corrections in 21 ms, which is over 1200 × $\times$ faster than k-Wave, while achieving 98.3% accuracy in peak pressure magnitude estimation and a mean focal positioning error of only 0.18 mm relative to k-Wave ground truth. End-to-end training took approximately 8 h on 4x NVIDIA A100 80 GB GPUs.
CONCLUSIONS: TUSNet demonstrates that deep learning can provide accurate and rapid estimates of phase aberrations and transcranial pressure fields, offering a promising direction for accelerating ultrasound treatment planning. While the present validation is based on simulated, noise-free ultrasound fields, the results establish a foundation that future experimental studies can build on to assess performance under real-world clinical conditions.}, }
@article {pmid41473419, year = {2026}, author = {Tonegawa-Kuji, R and Karavani, E and Danziger, M and Zhang, P and Hou, Y and Zhou, Y and Bykova, M and Pieper, AA and Rosen-Zvi, M and Cummings, J and Cheng, F}, title = {Critical evaluation of real-world evidence of repurposable medicines in the Alzheimer's disease drug development pipeline using a target trial emulation.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {12}, number = {1}, pages = {e70193}, pmid = {41473419}, issn = {2352-8737}, abstract = {INTRODUCTION: Repurposing Food and Drug Administration (FDA)-approved drugs could accelerate treatment development for Alzheimer's disease (AD).
METHODS: Using the MarketScan claims database (2011 to 2020), we applied a trial emulation approach in two base cohorts: (1) individuals with mild cognitive impairment (MCI cohort) and (2) individuals aged ≥70 years (over-70 cohort). We evaluated drugs represented in clinical trials for AD, comparing them with same-class or active comparators. Covariate-adjusted hazard ratios (HRs) were estimated using inverse-probability-weighted Cox models.
RESULTS: A total of 6 out of 38 (16%) drugs in the MCI cohort and 10 out of 53 (19%) drugs in the over-70 cohort were associated with a lower AD incidence versus same-class comparators. Active comparator analyses indicated that bupropion (vs escitalopram; HR 0.57, 95% confidence interval [CI] [0.49, 0.66]), trazodone (vs sertraline; HR 0.82, 95% CI [0.74, 0.91]), venlafaxine (vs escitalopram; 0.72, 95% CI [0.62, 0.84]), and zolpidem (vs lorazepam; HR 0.69, 95% CI [0.56, 0.85]) were associated with a lower AD incidence in the MCI cohort; these four plus liraglutide were associated with a lower incidence of AD dementia in the over-70 cohort (vs metformin; HR 0.74, 95% CI [0.59, 0.93]).
DISCUSSION: This is the first comprehensive set of trial emulations for FDA-approved drugs that are represented in AD trials. Findings may inform future trial designs.
HIGHLIGHTS: Repurposing FDA-approved drugs originally developed for other diseases could accelerate treatment development for AD.We identified repurposable drugs that are in current or complete clinical trials of AD and emulated trials for these agents using a large-scale insurance claims-based database.Among 54 drugs evaluated, 6/38 (16%) drugs in the MCI cohort and 10/53 (19%) in the over-70 cohort were associated with reduced AD incidence versus same-class comparators. Active comparator analyses indicated that bupropion, trazodone, venlafaxine, and zolpidem were associated with reduced AD incidence in the MCI cohort; these four plus liraglutide were associated with a lower incidence of AD dementia in the over-70 cohort.A minority of repurposed table drugs that are in current or completed clinical trials for AD and meet criteria for inclusion in this study showed no effect in our trial emulation studies.This is the first comprehensive set of trial emulations for FDA-approved drugs that are represented in AD trials. Building on our findings, integrating real-world evidence can inform future trials and accelerate drug development for AD.}, }
@article {pmid41473323, year = {2025}, author = {Salian, VS and Veerareddy, V and Tang, X and Xiao, Y and Kalari, KR and Kashyap, PC and Kandimalla, KK}, title = {Molecular Mechanisms Underlying the Regulation of VCAM-1 Expression by the Short-Chain Fatty Acid Butyrate.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.15.694447}, pmid = {41473323}, issn = {2692-8205}, abstract = {Over the past decade, cerebrovascular inflammation has been increasingly recognized as a contributor to the progression of neurodegenerative diseases, particularly Alzheimer's disease (AD). One of the molecular hallmarks of cerebrovascular inflammation is the increased expression of vascular cell adhesion molecule (VCAM)-1 on blood-brain barrier (BBB) endothelial cells. Exposure to amyloid beta (Aβ) peptides, one of the primary hallmarks of AD, and pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) induces VCAM-1 expression on the BBB endothelium, which facilitates extravasation of leukocytes into the brain thereby promoting an inflammatory response. Therefore, it is crucial to explore therapeutic agents that can inhibit VCAM-1 expression induced by Aβ and TNF-α. Short-chain fatty acids, such as butyrate, produced by the gut microbiota as byproducts of dietary fiber metabolism, are recognized for their anti-inflammatory properties. In this study, we successfully tested the hypothesis that butyrate mitigates Aβ and TNF-α-induced VCAM-1 expression in polarized human cerebral microvascular endothelial cell monolayers, a widely used BBB in vitro model. Our findings indicated that pre-treatment with butyrate significantly reduced Aβ42 and TNF-α mediated upregulation of VCAM-1. Furthermore, we have shown STAT3/GATA6 axis as a key mediator of anti-inflammatory effects of butyrate. These findings provide mechanistic insight into butyrate's protective role and highlight its potential to mitigate Aβ and TNF-α-induced cerebrovascular inflammation in AD.}, }
@article {pmid41473097, year = {2025}, author = {Kang, MH and Kang, MA and Jeon, HJ and Shin, HC and Moon, H and Lee, DG and Park, HM}, title = {Evaluation of the safety and efficacy of a donepezil depot injection in dogs with canine cognitive dysfunction.}, journal = {Frontiers in veterinary science}, volume = {12}, number = {}, pages = {1724060}, pmid = {41473097}, issn = {2297-1769}, abstract = {Canine cognitive dysfunction (CCD) is an age-related neurodegenerative disorder for which effective treatments remain limited, and objective diagnostic and therapeutic assessment tools using biomarkers or neuroimaging are still lacking compared with human Alzheimer's disease. This study evaluated the safety and efficacy of a long-acting donepezil depot injection in dogs with CCD, using behavioral scores and serum neurofilament light chain (NfL) as primary outcomes, with baseline MRI for diagnostic support. Thirty-two dogs with clinically diagnosed CCD were randomly assigned to a high-dose group (n = 11), a low-dose group (n = 11), or a control group (n = 10). Diagnosis was established based on the Canine Cognitive Dysfunction Rating Scale (CCDR), the CAnine DEmentia Scale (CADES), and DISHAA scoring, and baseline MRI was performed in selected dogs with owner consent. A single intramuscular injection of donepezil depot was administered on day 0, and evaluations were conducted on days 14 and 28. The high-dose group showed significant improvements in CCDR, CADES, and DISHAA at both 14 and 28 days, whereas the low-dose group improved primarily at day 28, with earlier effects limited to CADES (p < 0.05). At day 28, both treatment groups had significantly lower serum NfL levels than controls (p < 0.05), while within-group values remained stable. Quality-of-life scores improved in activity, sociability, overall condition, and global QoL. Adverse events were mild and transient. These findings suggest that a single intramuscular injection of long-acting donepezil depot demonstrates favorable safety and potential efficacy in dogs with CCD, with improvements in behavioral scores and NfL supporting its therapeutic potential and highlighting the value of integrating clinical and biomarker-based assessments in future CCD management.}, }
@article {pmid41471864, year = {2025}, author = {Cao, S and Shi, X and Chen, Y and Liu, T and Hu, J and Dong, X and Chen, H and Dai, J and Yin, H}, title = {Gut Microbiota-Targeted Photobiomodulation Ameliorates Alzheimer's Pathology via the Gut-Brain Axis: Comparable Efficacy to Transcranial Irradiation.}, journal = {Microorganisms}, volume = {13}, number = {12}, pages = {}, pmid = {41471864}, issn = {2076-2607}, support = {62175261//National Natural Science Foundation of China/ ; 2023YFB3609103//National Key R&D Program of China/ ; 2021-I2M-1-058//Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences/ ; 24JCZDJC00240//Natural Science Foundation of Tianjin/ ; }, abstract = {Alzheimer's disease (AD) is a major neurodegenerative disorder with limited effective and affordable therapies. Photobiomodulation (PBM) offers a safe, non-invasive treatment strategy, yet conventional transcranial PBM (tc-PBM) is restricted by low skull penetration. To overcome this limitation, gut microbiota-targeted PBM (gm-PBM) has been proposed to modulate the gut-brain axis, though its efficacy and mechanisms remain unclear. Here, six-month-old APPswe/PS1dE9 mice received gm-PBM or tc-PBM (810 nm, 25 mW/cm[2], 20 min/day for 4 weeks). Behavioral testing revealed that both treatments improved spatial learning and memory, while histological analyses showed reduced amyloid-β deposition and microglial shift toward an anti-inflammatory phenotype. Notably, gm-PBM specifically enriched short-chain fatty acid-producing bacteria, elevated propionate, butyrate, and secondary bile acids, and restored intestinal barrier integrity, whereas tc-PBM induced minimal microbiota changes. These findings suggest that gm-PBM confers neuroprotective effects comparable to or exceeding tc-PBM through modulation of the gut microbiota-metabolism-immune axis, highlighting its potential as a non-invasive and cost-effective therapeutic approach for AD.}, }
@article {pmid41471351, year = {2025}, author = {Makhaeva, GF and Utepova, IA and Rudakova, EV and Kovaleva, NV and Boltneva, NP and Zyryanova, EY and Musikhina, AA and Lazarev, VF and Vladimirova, SA and Guzhova, IV and Ganebnykh, IN and Astakhova, TY and Timokhina, EN and Chupakhin, ON and Charushin, VN and Richardson, RJ}, title = {1-Azinyl-1'-Alkenylferrocenes with Anticholinesterase, Antioxidant, and Antiaggregating Activities as Multifunctional Agents for Potential Treatment of Alzheimer's Disease.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {12}, pages = {}, pmid = {41471351}, issn = {1424-8247}, support = {24-63-00016//Russian Science Foundation/ ; }, abstract = {Background/Objectives: This study focused on synthesizing novel alkenyl derivatives of azinylferrocenes and evaluating their potential as Alzheimer's disease (AD) therapeutics. Methods: 1-Azinyl-1'-acetylferrocenes were obtained by regioselective acetylation of azinylferrocenes, followed by the Wittig reaction or reduction of 1-azinyl-1'-acetylferrocenes and subsequent dehydration of the resulting alcohols. The synthesized compounds underwent the following biological activity testing relevant to AD: inhibition of acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and off-target carboxylesterase (CES); antioxidant capacity (ABTS and FRAP assays); inhibition of Aβ42 self-aggregation (thioflavin method); blocking AChE-induced β-amyloid aggregation (propidium displacement); and cytotoxicity in SH-SY5Y and MSC-Neu cells (MTT assay). Results: Quinoline and bipyridine derivatives demonstrated effective cholinesterase inhibition, especially quinoline 7b (AChE IC50 3.32 μM; BChE IC50 3.68 μM), while acridine derivatives were poor inhibitors. Quantum chemical (QC) calculations predicted that acridine derivatives were especially prone to form stable dimers. Molecular docking into protein targets generated by an AlphaFold3 reproduction code showed that these dimers were too bulky to access enzyme active sites, yet they could bind to protein surfaces to inhibit Aβ42 self-aggregation and displace propidium from the AChE peripheral anionic site. All compounds showed high antioxidant activity in ABTS and FRAP assays, with quinoline derivatives being 2-4 times more potent than Trolox. QC calculations supported these findings. Quinoline and bipyridine derivatives also exhibited low cytotoxicity and scant CES inhibition. Conclusions: Overall, the synthesized ferrocenes, particularly the quinoline and bipyridine derivatives, appear promising for further research as multifunctional therapeutic agents targeting AD due to their anticholinesterase, antiaggregating, and antioxidant activities combined with low toxicity.}, }
@article {pmid41471079, year = {2025}, author = {Trasca, DM and Dorin, PI and Carmen, S and Varut, RM and Singer, CE and Radivojevic, K and Stoica, GA}, title = {Artificial Intelligence in Biomedicine: A Systematic Review from Nanomedicine to Neurology and Hepatology.}, journal = {Pharmaceutics}, volume = {17}, number = {12}, pages = {}, pmid = {41471079}, issn = {1999-4923}, abstract = {Background/Objectives: This review evaluates the expanding contributions of artificial intelligence (AI) across biomedicine, focusing on cancer therapy and nanomedicine, cardiology and medical imaging, neurodegenerative disorders, and liver disease. Core AI concepts (machine learning, deep learning, artificial neural networks, model training/validation, and explainability) are introduced to frame application domains. Methods: A systematic search of major biomedical databases (2010-2025) identified English-language original studies on AI in these four areas; 203 articles meeting PRISMA 2020 criteria were included in a qualitative synthesis. Results: In oncology and nanomedicine, AI-driven methods expedite nanocarrier design, predict biodistribution and treatment response, and enable nanoparticle-enhanced monitoring. In cardiology, algorithms enhance ECG interpretation, coronary calcium scoring, automated image segmentation, and noninvasive FFR estimation. For neurological disease, multimodal AI models integrate imaging and biomarker data to improve early detection and patient stratification. In hepatology, AI supports digital histopathology, augments intraoperative robotics, and refines transplant wait-list prioritization. Common obstacles are highlighted, including data heterogeneity, lack of standardized acquisition protocols, model transparency, and the scarcity of prospective multicenter validation. Conclusions: AI is emerging as a practical enabler across these biomedical fields, but its safe and equitable use requires harmonized data, rigorous multicentre validation, and more transparent models to ensure clinical benefit while minimizing bias.}, }
@article {pmid41471033, year = {2025}, author = {Park, YC and Seol, E and Lee, J and Hong, JH and Jung, JG and Sunwoo, J}, title = {Pharmacokinetic Evaluation of GB-5001, a Long-Acting Injectable Formulation of Donepezil, in Healthy Korean Participants: Population Pharmacokinetics with Phase 1 Study.}, journal = {Pharmaceutics}, volume = {17}, number = {12}, pages = {}, pmid = {41471033}, issn = {1999-4923}, support = {Not applicable//G2GBIO Inc./ ; }, abstract = {Background/Objectives: Oral donepezil, an acetylcholinesterase (AChE) inhibitor for Alzheimer's disease, faces adherence challenges. Long-acting injectable (LAI) formulations like GB-5001 aim to enhance adherence by reducing dosing frequency. This Phase 1, open-label, active-controlled, dose-escalation study evaluated the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of GB-5001 in healthy male adults. Methods: Participants were assigned to cohorts receiving GB-5001A or GB-5001D (LAI formulations) via intramuscular (IM) or subcutaneous (SC) injection, or oral Aricept[®]. Safety, PK, and PD (AChE inhibition) were assessed. The influence of CYP2D6 phenotype was explored, and modeling/simulation was performed. Results: Fifty healthy male participants completed the study. After IM administration, GB-5001A (70 mg, 140 mg, 280 mg) showed dose-dependent increases in exposure (AUCinf and Cmax), resulting in significantly extended exposure compared to oral Aricept[®] 10 mg. No serious adverse events were reported; the most common AEs were mild injection site reactions, which occurred in all treatment groups except the GB-5001A IM 70 mg group and the Aricept group. GB-5001A also demonstrated sustained AChE inhibition. Conclusions: GB-5001A, an LAI donepezil, showed favorable safety, dose-proportional PK, and sustained plasma exposure. It achieved a 3-4-fold longer half-life than oral donepezil. These findings, supported by modeling, highlight GB-5001A's potential as a once-monthly IM alternative for Alzheimer's disease treatment.}, }
@article {pmid41469705, year = {2025}, author = {Li, T and Zhang, J and Song, H and Zhang, R and Fan, F and Huang, Z and Zeng, ML and Peng, BW and Zhang, J}, title = {Border-associated macrophages: an emerging perspective from physiological basis and multi-disease roles to the mechanism of vascular cognitive impairment and dementia.}, journal = {Journal of neuroinflammation}, volume = {22}, number = {1}, pages = {302}, pmid = {41469705}, issn = {1742-2094}, support = {82501747//the Natural Science Foundation of China/ ; 82571371//the Natural Science Foundation of China/ ; 2025AFC006//the Natural Science Foundation of Hubei Province/ ; PTXM2025032//Medical Sci-Tech Innovation Platform of Zhongnan Hospital, Wuhan University/ ; ZY2023Z018//Key projects of Traditional Chinese Medicine Scientific research in 2023-2024 by Hubei Provincial Administration of Traditional Chinese Medicine/ ; }, mesh = {Humans ; *Cognitive Dysfunction/pathology/immunology/metabolism ; *Dementia, Vascular/pathology/immunology/metabolism/physiopathology ; Animals ; *Macrophages/pathology/metabolism/immunology ; *Brain/pathology/immunology/metabolism ; }, abstract = {Brain border-associated macrophages (BAMs) are resident immune cells at the border of the central nervous system (CNS), and their physiological functions and roles in neurological diseases have been widely reported. However, the specific mechanisms by which BAMs contribute to vascular cognitive impairment and dementia (VCID) remain unclear. This article systematically reviews the subsets, origin and differentiation, molecular markers of BAMs, and their research progress in various brain diseases such as hypertension, Alzheimer's disease (AD), and stroke. On this basis, this article deeply analyzes the potential hypotheses of BAMs' involvement in the pathogenesis of VCID, including their regulation of neurovascular unit (NVU) homeostasis, their core role in neuroimmune inflammation, their impact on the lipid metabolism pathways in the CNS, and their involvement in the pathogenesis of vascular risk factor-related cognitive impairment (VRFCI). The mechanistic hypotheses proposed in this article aim to provide new perspectives for understanding the pathophysiology of VCID and may open up new directions for the development of early intervention and targeted treatment strategies.}, }
@article {pmid41469664, year = {2025}, author = {Yu, X and Xiao, H and Bao, S and Dong, Y and Dong, Z and Zhao, J and Wang, G and Meng, X and Wang, F}, title = {Cigarette smoke-induced lung-brain barrier dysfunction drives neurocognitive impairment via inflammatory spill-over.}, journal = {Journal of neuroinflammation}, volume = {23}, number = {1}, pages = {10}, pmid = {41469664}, issn = {1742-2094}, support = {2024CX129//the Graduate Innovation Fund of Jilin University/ ; Not applicable//the Medical Basic Research Innovation Center of Airway Disease in North China/ ; Not applicable//Key Laboratory of Pathobiology/ ; 20200601011JC//Key Laboratory of Precision Infectious Diseases, Jilin Province/ ; 2022C036//Engineering Laboratory for Precision Prevention and Treatment of Common Diseases, Jilin Province/ ; 20230204055YY//Department of Science and Technology of Jilin Province: Key Scientific and Technological Research and Development Projects/ ; }, abstract = {BACKGROUND: Although the association between cigarette smoke (CS)-induced chronic obstructive pulmonary disease (COPD) and neurocognitive disorders is recognized, the underlying mechanisms remain unclear. To date, no studies have linked alterations in lung and brain barrier permeability to the “spill-over” of inflammatory factors in CS induced COPD-related neurocognitive disorders (COPD-NCDs).
METHODS: Using GWAS data, a two-sample Mendelian randomization (MR) analysis was conducted to explore the genetic associations between COPD and neurocognitive disorders (dementia, Alzheimer’s disease, etc.). A BALB/c female mouse model with CS exposure (9 cigarettes/day × 24 weeks) was established. Cognitive functions were evaluated using open field tests, novel object recognition tests, and Morris water maze tests. Histopathological changes were observed by HE and Masson staining. Cellular and molecular profiles in brain tissues were analyzed by single-cell RNA sequencing. Levels of inflammatory factors were detected by ELISA. Barrier permeability changes in the lungs and brain were assessed by using Evans Blue staining. Tight junction proteins in lung and brain tissues were measured by immunofluorescence and Western blotting.
RESULTS: MR analysis revealed causal associations between COPD and Alzheimer’s disease, dementia, depression, anxiety, and Parkinson’s disease. CS-exposed mice exhibited COPD phenotypes (emphysema, reduced lung function) and cognitive impairments (memory deficits, anxiety-like behaviors). Activation of microglia/astrocytes and decreased neuronal/synaptic marker expression were observed in the hippocampus. Increased leakage of Evans blue staining in the lungs and brain, along with downregulated expression of tight junction proteins (Occludin, Claudin1, ZO-1), indicated increased blood-brain barrier (BBB) permeability. Elevated levels of inflammatory factors (IL-1β, IL-6, TNF-α) were detected in lung tissues, brain tissues and serum.
CONCLUSIONS: CS exposure disrupts lung barrier function, leading to the “spill-over” of inflammatory factors to the brain via the lung-brain axis. This increases BBB permeability, triggering neuroinflammation, impairing hippocampal neuronal and synaptic function, and ultimately causing neurocognitive disorders. This study elucidates a novel mechanism of COPD-NCDs, which may provide new targets for the treatment of COPD-NCDs.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12974-025-03629-7.}, }
@article {pmid41468784, year = {2025}, author = {Palanivel, V and Salkar, A and Shenoy, A and Eva, TA and Perera, R and Chitranshi, N and Gupta, V and You, Y and Mirzaei, M and Graham, SL and Gupta, V and Basavarajappa, D}, title = {Neuropeptide Y at the crossroads of neurodegeneration: Mechanistic insights and emerging therapeutic strategies.}, journal = {Neuropeptides}, volume = {115}, number = {}, pages = {102583}, doi = {10.1016/j.npep.2025.102583}, pmid = {41468784}, issn = {1532-2785}, abstract = {Neuropeptide Y (NPY), a widely distributed and highly conserved neuropeptide, plays a central role in the regulation of diverse physiological processes, including stress responses, energy homeostasis, vascular tone, and immune modulation, via activation of its receptor subtypes. Beyond its physiological roles, the dysregulation of NPY expression has been documented in several neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Machado-Joseph disease, and retinal disorders such as diabetic retinopathy and glaucoma. These alterations in NPY levels and receptor activity highlight its potential not only as a biomarker for disease progression but also as a promising therapeutic target. Previous evidence revealed that NPY exerts neuroprotection by alleviating excitotoxicity, oxidative stress, mitochondrial dysfunction, and neuroinflammation while concurrently facilitating neurogenesis, synaptic plasticity, and cellular resilience. NPY activates receptor-mediated intracellular signaling cascades like PI3K/Akt, MAPK/ERK, and p38K, that control cellular survival, proteostasis, and inflammation and thereby influence disease trajectories. Understanding NPY operation with these mechanisms can unveil new avenues for targeted therapy. Current insights into the complex roles of NPY in neurodegeneration are discussed in this review, and their implications in diagnostic and treatment strategies are addressed.}, }
@article {pmid41467972, year = {2025}, author = {Chang, ST and Wu, HY and Chiu, YL and Chuang, YF}, title = {Anti-herpetic treatment reduces dementia risk: A systematic review and meta-analysis.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251409323}, doi = {10.1177/13872877251409323}, pmid = {41467972}, issn = {1875-8908}, abstract = {BackgroundHuman herpesvirus (HHV) infections, particularly for herpes simplex virus (HSV) and varicella-zoster virus (VZV), may increase dementia risk, yet the protective effects of anti-herpetic medications remained unclear.ObjectiveThis systematic review and meta-analysis of observational studies aimed to examine the association between anti-herpetic medications and dementia, focusing on HSV or VZV-related infections.MethodsThis study followed PRISMA guidelines (CRD42022368318). Cohort or nested case-control studies published from databases' inception to December 2024 were systematically searched in PubMed, MEDLINE, Embase, Cochrane Library, PsycINFO, and Web of Science. Eligible studies evaluated anti-herpetic medications (e.g., acyclovir, famciclovir, ganciclovir, valacyclovir, valganciclovir) and dementia risk in non-demented adults aged ≥50. Pooled adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) were analyzed using random-effects models. Subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity and effect modifiers.ResultsFourteen cohort studies involving more than 10 million older adults were included. To demonstrate the effects of anti-herpetic medications in various clinical scenarios, the meta-analysis compared: diagnosed and treated versus diagnosed but untreated (aHR=0.77, 95% CI: 0.67-0.89); treated versus untreated regardless of diagnosis (aHR=0.90, 95% CI: 0.87-0.94); and diagnosed and treated versus neither diagnosed nor treated (aHR=0.87, 95% CI: 0.78-0.97). Subgroup analysis and meta-regression identified infection severity as a significant modifier (p < 0.0001), explaining 89.01% of heterogeneity.ConclusionsThis systematic review and meta-analysis reveals notable protective effect of anti-herpetic medication usage on dementia, and the effect is especially pronounced in patients with severe alpha herpesvirus infections.}, }
@article {pmid41467438, year = {2025}, author = {Zhao, J and Wang, J and Guo, X}, title = {Organoids: Key advances, optimization, and technological iterations in their application to neurodegenerative diseases.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00924}, pmid = {41467438}, issn = {1673-5374}, abstract = {Organoid technology, as an innovative approach, has shown great potential in disease modeling, target screening, and the development of treatment strategies. However, traditional organoids still have three major limitations in research: the absence of specific cell types, the lack of blood-brain barrier structure, and insufficient reproducibility of experimental results. In recent years, researchers have gradually overcome these limitations by introducing innovative techniques such as advanced culture methods, microfluidic systems, bioprinting, organoid transplantation, and assembloid construction. This progress has facilitated the widespread application of organoids in the study of neurodegenerative diseases. This paper aims to systematically review the technological innovations of organoids in the study of neurodegenerative diseases. By summarizing classical organoid construction strategies and their limitations, it emphasizes the value of organoids in comprehensive applications within neurodegenerative disease research. In this review, we focus on five specific neurodegenerative diseases: Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and frontotemporal dementia. Research in these diseases demonstrates that organoids improve experimental accessibility and reduce development cycles in disease modeling, target discovery, and therapeutic strategy formation. Using customized equipment and gene editing techniques, these organoids can be tailored to specific needs, providing pathophysiologically relevant disease models and enhancing our understanding of neurodegenerative diseases. Although organoid technology has demonstrated significant advantages in disease research, its potential for treating neurodegenerative diseases has not yet been fully explored, which may become an important direction for future research.}, }
@article {pmid41467376, year = {2025}, author = {Alexandrova, EG and Abakumova, TR and Ziganshina, LE}, title = {Use of nootropics in Alzheimer's disease: An analysis of regulatory positions and drug policies in the countries of the Commonwealth of Independent States.}, journal = {The International journal of risk & safety in medicine}, volume = {}, number = {}, pages = {9246479251410817}, doi = {10.1177/09246479251410817}, pmid = {41467376}, issn = {1878-6847}, abstract = {ObjectiveTo analyse regulatory positions and drug policies of the Commonwealth of Independent States (CIS), compared to those of the EU, UK, USA i of the nootropics, used in Russia for Alzheimer's disease.MethodsWe searched E-library to reveal the list of nootropics used and studied in Russia for Alzheimer's disease. We assessed official pharmaceutical registries of nine countries for registration status of identified nootropics, 7 National Essential Medicines Lists (EML), and four clinical practice guidelines (CPG) on Alzheimer's disease. We compared the results of Russia with other countries regulatory and policy positions.ResultsE-Library searches identified 11 nootropicspiracetam, citicoline, idebenone, vinpocetine, choline alfoscerate, Cerebrolysin®, Kortexin®, ethylmethylhydroxypyridine succinate, glycine, nicergoline, nimodipine. Eight nootropic have registration for use in all CIS countries (excluding idebenone, nimodipine), four (piracetam, nimodipine, nicergoline, idebenone) - in UK, nimodipine - in the USA, and idebenone - in EU. National EMLs included: nine nootropics (Russia), 8 - Belarus and Kazakhstan, 4 - Uzbekistan, 2 - Armenia. The studied nootropic agents are not included on the WHO Model EML and on the National EML of the Kyrgyz Republic. They are not listed in the CPG for Treatment of dementia and Alzheimer's disease in the USA, the EU, and the UK. Russian CPGs for Alzheimer's disease recommend Cerebrolysin® and choline alfoscerate.ConclusionsThe studied nootropics are registered for use and listed on National EMLs of Russia, Armenia, Belarus, Kazakhstan, Uzbekistan. None is included on the WHO Model EML and the National EML of Kyrgyzstan, Only CPG of the RF recommend using two nootropics as adjuvant therapy of Alzheimer's disease, Cerebrolysin® and choline alfoscerate. CPG of the European Union, the United Kingdom, and the USA do not mention nootropics as potential treatment options for Alzheimer's disease.}, }
@article {pmid41466363, year = {2026}, author = {de Magalhães, CG and Moldakozhayev, A and Lopez, MV and Bowman, GL and Chhatwal, JP and Kellis, M and Mohs, R and Nisenbaum, L and Quiroz, YT and Raju, RM and Sperling, RA and Moqri, M and Gladyshev, VN}, title = {The Right Person, the Right Treatment, at the Right Time in Alzheimer's Disease: Insights From the 2025 Brain Aging Symposium.}, journal = {Aging cell}, volume = {25}, number = {1}, pages = {e70351}, pmid = {41466363}, issn = {1474-9726}, mesh = {Humans ; *Alzheimer Disease/therapy/pathology/metabolism ; *Brain/pathology/metabolism ; *Aging/pathology ; Biomarkers/metabolism ; }, abstract = {On October 22nd, 2025, Brain Aging Symposium took place at Harvard Medical School bringing together leading researchers from academia and partner organizations to discuss recent advances in measuring and monitoring human brain aging trajectories, with a particular focus on Alzheimer's disease (AD). A central theme emerged: achieving "the right treatment for the right person and the right time" through precision medicine approaches. Key advances included the unprecedented validation of plasma-based biomarkers, particularly brain-derived p-Tau217 that can identify seeding AD pathology with remarkable specificity, making large-scale screening newly feasible. Integrating multi-level "omic" modalities, spanning genetic information, molecular biomarkers of nutrition, lipid and protein signatures, neuroimaging measures, cognitive assessments, and lifestyle factors, enhances disease risk modeling and trajectory prediction beyond the capacity of any single marker. Early findings highlight critical roles for nutritional and lipid metabolism, and myelin integrity in brain aging, with cell and sex-specific vulnerabilities identified in response to nutrition, social isolation, and metabolic stress. Computational approaches that combine single-cell genomics, epigenomics, and artificial intelligence have been shown to accelerate causal discovery and therapeutic development. However, significant challenges remain: current biomarkers explain only half the variance in cognitive decline, racial and ethnic differences in biomarker levels lack mechanistic understanding, and scalable tools for comprehensive brain aging assessment are needed. The symposium underscored that preventing AD will require intervening during the preclinical asymptomatic phase. These multimodal screening platforms, coupled with mechanistically driven therapeutics, reduction in modifiable risk factors, including nutrition, vascular health, and social determinants of health, could profoundly impact the field.}, }
@article {pmid41465832, year = {2025}, author = {Pilśniak, J and Węgrzynek-Gallina, J and Bednarczyk, B and Buczek, A and Pilśniak, A and Chmiela, T and Jarosińska, A and Siuda, J and Holecki, M}, title = {The Role of Glucagon-like Peptide-1 Receptor Agonists in Alzheimer's and Parkinson's Disease: A Literature Review of Clinical Trials.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {12}, pages = {}, pmid = {41465832}, issn = {2075-1729}, abstract = {Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes and obesity due to their metabolic effects. Emerging evidence suggests they may also have neuroprotective effects, indicating their potential as disease-modifying therapies in neurodegenerative disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD). Preclinical studies in animal models have demonstrated that GLP-1RAs can reduce neuroinflammation, oxidative stress, neuronal apoptosis, and pathological protein aggregation, while enhancing glucose metabolism and mitochondrial function. This narrative review analyzed results from human clinical trials evaluating GLP-1RAs in AD and PD, based on a search of four databases (Web of Science, Medline, Embase, and Clinical Trials). The analysis included eleven studies. In AD, clinical trials suggest that GLP-1RAs such as liraglutide and semaglutide may enhance brain glucose metabolism, facilitate glucose transport across the blood-brain barrier, and benefit neuronal networks. However, most studies did not demonstrate improvements in cognitive functions or radiological markers. Short-term clinical trials of GLP-1RAs, including exenatide and lixisenatide, demonstrated promising effects on motor and selected non-motor symptoms in patients with PD, but their disease-modifying effects remain unproven. GLP-1RAs showed a favorable safety profile. Despite promising findings, small study populations, heterogeneous protocols, and short observation periods limit definitive conclusions. Further larger, long-term studies are needed, particularly to clarify the risk-benefit balance, weight control, and long-term outcomes.}, }
@article {pmid41465466, year = {2025}, author = {Xu, C and Owen, JE and Gislason, T and Benediktsdottir, B and Ye, J and Robinson, SR}, title = {Limited Microvascular Remodelling Occurs in the Aged Human Hippocampus in Obstructive Sleep Apnoea.}, journal = {International journal of molecular sciences}, volume = {26}, number = {24}, pages = {}, pmid = {41465466}, issn = {1422-0067}, support = {Not applicable//RMIT University/ ; }, mesh = {Humans ; *Sleep Apnea, Obstructive/pathology/physiopathology/therapy ; Male ; Middle Aged ; Female ; Aged ; *Hippocampus/blood supply/pathology ; *Microvessels/pathology/physiopathology ; Adult ; *Aging/pathology ; *Vascular Remodeling ; Continuous Positive Airway Pressure ; }, abstract = {In mice, intermittent hypoxia is associated with an increase in microvessels in the hippocampus, whereas in humans with obstructive sleep apnoea (OSA), microvessels are lost from the heart and retina. The present study investigated microvascular changes in the hippocampus of patients with OSA, and whether patient age or use of continuous positive airway pressure (CPAP) influence microvascularisation. Using autopsy samples from 31 people with confirmed OSA, microvessels were immunolabelled and quantitatively analysed. Compared to the Low OSA group, the High OSA group had larger mean microvessel diameters in the fimbria and CA4, and greater mean microvessel length in the fimbria, which are indicative of microvascular remodelling. An absence of angiogenesis was indicated by similar mean vessel counts in both OSA severity groups. Increased age was associated with microvascular remodelling in the fimbria only. Treatment with CPAP was not associated with changed patterns of microvascularisation. We conclude that: (i) no evidence was found for angiogenesis in the human hippocampus in OSA or ageing; (ii) increased OSA severity is associated with microvascular remodelling in the fimbria and CA4; (iii) microvascular remodelling does not appear to be influenced by CPAP use; (iv) limited adaptability of the microvasculature may underpin the vulnerability of the hippocampus to hypoxic injury, particularly in severe OSA.}, }
@article {pmid41465142, year = {2025}, author = {Machowska, M and Leszek, J and Mikołajczyk-Tarnawa, A and Głowacka, K and Trypka, E and Rąpała, M and Piechota, J and Wiela-Hojeńska, A}, title = {The Diagnostic Reliability of BIN1 and TOMM40 Genotyping in Assessing Dementia Risk.}, journal = {Genes}, volume = {16}, number = {12}, pages = {}, pmid = {41465142}, issn = {2073-4425}, support = {RPDS.01.02.01-02-0002/20//Regional Operational Programme of the Lower Silesian Voivodeship 2014-2020, co-financed by the European Union, European Regional Development Fund/ ; }, mesh = {Humans ; *Mitochondrial Precursor Protein Import Complex Proteins/genetics ; Male ; Female ; Aged ; *Cognitive Dysfunction/genetics/diagnosis ; *Tumor Suppressor Proteins/genetics ; Polymorphism, Single Nucleotide ; *Adaptor Proteins, Signal Transducing/genetics ; *Alzheimer Disease/genetics/diagnosis ; *Nuclear Proteins/genetics ; Genotype ; *Dementia/genetics/diagnosis ; *Membrane Transport Proteins/genetics ; Genetic Predisposition to Disease ; Case-Control Studies ; Aged, 80 and over ; Middle Aged ; }, abstract = {OBJECTIVES: Alzheimer's disease (AD) and other dementias represent a growing public health concern, highlighting the need for reliable biomarkers for early diagnosis and treatment monitoring. This study evaluated the potential utility of BIN1 and TOMM40 genotyping in diagnosing mild cognitive impairment (MCI) and early-stage dementia.
METHODS: The BIN1 rs744373 and TOMM40 rs2075650 polymorphisms were genotyped in a cohort of 105 individuals diagnosed with MCI or dementia and in 164 cognitively healthy controls. Genotype distributions were compared between the groups, and the potential role of these variants in diagnostic assessment was explored.
RESULTS: A significantly higher frequency of the TOMM40 rs2075650 GG genotype was observed in patients with AD compared with cognitively healthy controls. In contrast, no statistically significant differences in genotype distribution were found among individuals with mild MCI, vascular dementia, or mixed dementia. Furthermore, the distribution of BIN1 rs744373 alleles did not differ significantly across the analyzed groups.
CONCLUSIONS: Data on the effects of BIN1 rs744373 and TOMM40 rs2075650 polymorphisms in MCI and dementia remain limited and inconsistent. In our study, significant differences were observed only for the TOMM40 rs2075650 GG genotype and G allele, which were more frequent in Alzheimer's disease patients than in controls. No significant associations were found for MCI, vascular dementia, or mixed dementia, nor for the BIN1 rs744373 polymorphism. These results suggest that TOMM40 rs2075650 genotyping may serve as an additional marker for assessing AD risk.}, }
@article {pmid41463129, year = {2025}, author = {Eroglu, B and Velez, D and Jones, K and Deak, F and Eroglu, A}, title = {Amelioration of Alzheimer's Disease Pathology in Zebrafish by Photobiomodulation.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41463129}, issn = {2227-9059}, abstract = {Background/Objectives: The zebrafish is a widely used research model due to its characteristics, such as being transparent during development, sharing 70% of its genes with humans, and having conserved features of vertebrate aging, including deterioration of mitochondrial and cognitive functions. While affecting approximately 15% of the world population, neurodegenerative diseases, such as Alzheimer's disease (AD), are currently incurable, requiring testing of alternative treatment strategies. Hence, this study was conducted to test the hypothesis that an optimized photobiomodulation (PBM) therapy improves AD pathology through its multifaceted beneficial effects, including enhancing mitochondrial function and reducing oxidative stress and neuroinflammation. Methods: A pharmacological zebrafish model of AD was developed by adding small amounts (100 nM) of okadaic acid (OKA) directly to fish tanks for nine days. Next, some of OKA-treated and control zebrafish were subjected to an optimized near-infrared PBM therapy while others remain untreated. Results: When examined after OKA treatment, zebrafish brains displayed histological hallmarks of AD including, neurofibrillary tangles, vacuoles, and neuroinflammation. Behavioral tests using a T-maze revealed that OKA-treated zebrafish spent significantly less time in the reward arm than untreated controls (15.2% vs. 50%). In contrast, a sequential PBM therapy significantly reduced formation of neurofibrillary tangles, vacuoles, neuroinflammation, and improved mitochondrial biogenesis in brains of OKA-treated zebrafish while also improving their cognitive function as evidenced by being able to recall the reward arm and spending more time there similar to controls (55 and 57%, respectively). Conclusions: These findings suggest that (1) a fast, cost-effective zebrafish AD model can be developed using OKA treatment and (2) PBM therapy holds promise to ameliorate AD pathology.}, }
@article {pmid41463053, year = {2025}, author = {N F Guimarães, G and Dos Santos Cardoso, F and Gamboa, L and W Barrett, D and Gonzalez-Lima, F}, title = {Abdominal Photobiomodulation and the Gut-Brain Axis: A Systematic Review of Mechanistic and Translational Evidence.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41463053}, issn = {2227-9059}, abstract = {Background/Objectives: Bidirectional communication between the gut and brain is central to neurological and psychiatric health, and abdominal photobiomodulation (PBM) has emerged as a promising non-invasive way to modulate this axis by targeting intestinal mitochondria, epithelial integrity, and the microbiota. We systematically reviewed preclinical and clinical evidence on abdominal PBM, alone or in combined protocols, reporting microbiome, metabolic, or neurobehavioral outcomes. Methods: Following PRISMA 2020 recommendations, we searched MEDLINE, Scopus, Web of Science, and ScienceDirect through May 2025 for animal and human studies applying PBM to the abdomen and reporting gut-related, metabolic, or brain-related outcomes. Results: Nine studies met the eligibility criteria (five human, four animal). Human trials, mainly in Parkinson's and Alzheimer's disease, used 630-904 nm light and reported gains in mobility, balance, cognition, and olfaction; one trial also showed microbiota modulation with a decreased Firmicutes:Bacteroidetes ratio. Animal models revealed cognitive improvement, reduced neuroinflammation, dopaminergic neuroprotection, and microbial rebalancing. Mechanistic findings converged on enhanced mitochondrial bioenergetics, redox and anti-inflammatory signaling, vagal activation, and short-chain fatty acid-mediated effects. Conclusions: Current evidence, though limited by small samples, heterogeneous dosimetry, combined treatment sites, and few sham-controlled human trials, suggests that abdominal PBM can influence the gut-brain axis through converging mitochondrial, immune, and microbial mechanisms. Adequately powered randomized trials with standardized dosimetry, validated mechanistic biomarkers, and integrative multi-omics analyses are needed to clarify causal pathways and optimize translational applications.}, }
@article {pmid41462869, year = {2025}, author = {Sarbu, M and Ica, R and Biricioiu, MR and Dehelean, L and Zamfir, AD}, title = {Glycosphingolipids in Dementia: Insights from Mass Spectrometry and Systems Biology Approaches.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41462869}, issn = {2227-9059}, support = {PN-IV-P2-2.1-TE-2023-0175//UEFISCDI/ ; UAV-IRG-1-2025-8//Aurel Vlaicu University of Arad, Romania/ ; }, abstract = {This narrative literature review synthesizes recent evidence on glycosphingolipid (GSL) dysregulation in dementia, emphasizing discoveries enabled by mass spectrometry (MS) and systems biology. Focusing on the research published within the last decade, we selected studies that are relevant to GSL alterations in dementia and notable for their methodological advances. The findings were conceptually integrated to emphasize key molecular, analytical, and systems-level aspects across the major dementia types. The results from MS-based glycolipidomics in Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson's disease dementia, and Huntington's disease consistently indicate altered GSL metabolism and shared molecular vulnerabilities in neuronal lipid regulation. At the same time, distinct GSL signatures differentiate individual dementias, reflecting the disease-specific mechanisms of neurodegeneration. The literature also reveals that recent advances in high-resolution MS and integrative analytical workflows have shifted GSL research from descriptive to mechanistic, facilitating the detailed mapping of species linked to neuroinflammation, protein aggregation, and synaptic dysfunction. Systems-level analyses combining MS data with other omics approaches increasingly depict GSLs as active regulators of neuronal function rather than inert membrane components. At the same time, emerging trends position GSLs as promising early biomarkers and potential therapeutic targets, while the growing use of artificial intelligence in MS data analysis is accelerating the detection of their subtle patterns, improving cross-disease comparisons. Together, these results reinforce the major role of MS-based platforms in discovering dementia-associated GSLs, identifying therapeutic targets, and influencing future strategies for diagnosis and treatment.}, }
@article {pmid41462867, year = {2025}, author = {Fonseca, N and Nunes, M and Silva, PMA and Bousbaa, H and Ricardo, S}, title = {Galanthamine Fails to Reverse P-gp-Mediated Paclitaxel Resistance in Ovarian Cancer Cell Lines.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41462867}, issn = {2227-9059}, abstract = {Background: Ovarian cancer has the poorest prognosis of all gynecological malignancies, largely due to its chemoresistance, which poses significant treatment challenges. In this context, drug repurposing emerges as an innovative strategy that employs non-cancer treatments to interact with various signaling pathways, enhancing chemotherapy efficacy while minimizing toxicity. This study investigated the cytotoxic effects of galanthamine, currently used as an Alzheimer's disease, as a potential treatment for high-grade serous carcinoma, both individually and in combination with paclitaxel. Methods: The Presto Blue assay, viability marker assessments, immunocytochemical analysis of apoptosis, and a cumulative assay were employed to evaluate the functionality of P-glycoprotein. Results: The results indicated that galanthamine did not demonstrate cytotoxic or synergistic effects in either high-grade serous carcinoma cell line tested, suggesting that it is not a viable strategy for overcoming paclitaxel resistance in this context. The immunocytochemistry analysis indicated that galanthamine does not affect the expression of proteins related to cell viability and proliferation and is not associated with chemoresistance. Additionally, functional assays showed that galanthamine treatment did not affect its drug efflux function at the cellular level. Conclusions: Overall, the results indicate that galanthamine is unsuitable for reversing paclitaxel resistance despite some literature suggesting its potential interaction with P-glycoprotein.}, }
@article {pmid41461739, year = {2025}, author = {Palachai, N and Buranrat, B and Pariwatthanakun, C and Noisa, P and Mairuae, N}, title = {Neuroprotective effects of Cratoxylum formosum (L.) leaf extract on β-amyloid-induced injury in human neuroblastoma SH-SY5Y cells.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {44730}, pmid = {41461739}, issn = {2045-2322}, support = {//the Faculty of Medicine, Mahasarakham University/ ; //Thai Traditional Medical Knowledge Fund/ ; }, mesh = {*Clusiaceae ; *Plant Extracts/chemistry/pharmacology/therapeutic use ; Drug Evaluation, Preclinical ; Humans ; Cell Line, Tumor ; *Alzheimer Disease/drug therapy ; Oxidative Stress/drug effects ; *Amyloid beta-Peptides ; *Neuroprotective Agents/analysis/pharmacology/therapeutic use ; MAP Kinase Signaling System/drug effects ; Flavonoids/analysis ; Peptide Fragments ; }, abstract = {In Alzheimer's disease (AD), Amyloid beta peptide (Aβ), the primary constituent of senile plaques, has been documented as triggering oxidative stress and leading to the death of neuronal cells. Therefore, this research aims to investigate how the Cratoxylum formosum (L.) leaf extract mitigates oxidative stress and cellular damage induced by Aβ in SH-SY5Y cells. The SH-SY5Y cells were treated with Cratoxylum formosum (L.) extract both with and without Aβ25-35. Neuroprotection was evaluated through viability and lactate dehydrogenase (LDH) assays, accompanied by an analysis of various mechanisms including caspase-3/7 activity, levels of reactive oxygen species (ROS), phosphorylation of protein kinase B (Akt), extracellular signal-regulated kinase 1/2 (ERK1/2), and cAMP-responsive element binding protein (CREB), expression of B-cell lymphoma 2 (Bcl-2) proteins, as well as catalase (CAT) and superoxide dismutase (SOD) activities. Results indicated an escalation in oxidative stress in cells exposed to Aβ, evidenced by increased ROS levels. Aβ further exacerbated caspase-3/7 activity, LDH release, and a decline in cell viability. Conversely, treatment with Cratoxylum formosum (L.) extract exhibited a concentration-dependent reduction in Aβ-induced neurotoxicity, manifesting in enhanced cell survival, reduced LDH release and ROS production, and suppression of caspase-3/7 activity. Moreover, it led to increased phosphorylation of Akt, ERK1/2, CREB, upregulated expression of Bcl-2 proteins, and enhanced activity of SOD and CAT. High-performance liquid chromatography (HPLC) analysis identified chlorogenic acid, 1,5-dicaffeoylquinic acid, and ferulic acid as the major phenolic constituents of Cratoxylum formosum (L.) extract. These results imply that the extract may provide protective effects against Aβ-induced neurotoxicity, although further studies are required to clarify its role in AD.}, }
@article {pmid41461684, year = {2025}, author = {Saremi, M and Safari, S and Alikhani, MY and Komaki, A and Siadat, SD and Asghari, B}, title = {Evidence for neuroprotection by Bacillus coagulans ATCC 7050 via synaptic plasticity and oxidative balance in Alzheimer's disease.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {44690}, pmid = {41461684}, issn = {2045-2322}, support = {Grant Number: 140303292888//Vice Chancellor for Research and Technology, Hamadan University of Medical Sciences/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/physiopathology ; *Oxidative Stress/drug effects ; Male ; *Neuronal Plasticity/drug effects ; Rats ; Rats, Wistar ; *Bacillus coagulans/physiology ; Disease Models, Animal ; Hippocampus/metabolism ; Amyloid beta-Peptides ; *Probiotics/pharmacology/administration & dosage ; Long-Term Potentiation ; *Neuroprotection ; Superoxide Dismutase/metabolism ; Memory, Short-Term ; Glutathione Peroxidase/metabolism ; Malondialdehyde/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, synaptic impairment, and oxidative stress. Probiotics with antioxidant and anti-inflammatory properties have been proposed as potential adjunctive strategies. This study examined whether oral administration of Bacillus coagulans ATCC 7050 could attenuate hippocampal oxidative stress, modulate synaptic plasticity, and influence spatial working memory in an Aβ1-42-induced rat model of AD. Adult male Wistar rats were assigned to Sham, AD, BC (probiotic only), and AD + BC groups. Working memory was assessed by Y-maze, synaptic function by perforant path-dentate gyrus long-term potentiation (LTP) recordings, and oxidative status by hippocampal malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) assays. AD rats exhibited reduced alternation percentage, impaired LTP (fEPSP slope and PS amplitude), elevated MDA, and decreased SOD and GPx activities versus Sham. B. coagulans treatment improved alternation percentage without affecting total entries, preserved PS amplitude from 30 min post-HFS, reduced MDA, and restored SOD activity, with partial GPx recovery. fEPSP slope remained reduced. These findings suggest B. coagulans ATCC 7050 mitigates oxidative stress, preserves neuronal excitability, and improves working memory in an Aβ-based AD model, supporting further investigation of its potential as a safe adjunct in early-stage disease.}, }
@article {pmid41461311, year = {2025}, author = {Li, R and Wu, X and Yao, J and Chen, J and Shui, X and Zheng, X and Tian, W and Wang, L and Zhou, Y and Zhang, T and Chen, D and Liu, Y and Lee, TH}, title = {Selective degradation of DAPK1 via a novel hydrophobic tagging attenuates tau pathology in Alzheimer's disease.}, journal = {Journal of advanced research}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jare.2025.12.037}, pmid = {41461311}, issn = {2090-1224}, abstract = {INTRODUCTION: The upregulation of death-associated protein kinase 1 (DAPK1) is involved in tau hyperphosphorylation, neuronal apoptosis and cognitive dysfunction, which are key pathological features of Alzheimer's disease (AD). This result suggests that DAPK1 is novel therapeutic target for AD.
OBJECTIVES: This study aimed to evaluate the efficacy and mechanism of action of CJ1, a novel hydrophobic tagging (HyT)-based degrader, in targeting DAPK1 and alleviating in AD.
METHODS: A library of HyT-based bifunctional molecules was synthesized and systematically screened for their ability to degrade DAPK1 in vitro. CJ1 emerged as the most potent candidate degrader of DAPK1, and its capacity to induce DAPK1 degradation via the proteasome system was further evaluated. Its effects on tau phosphorylation and neuronal viability were evaluated in multiple cellular models. The in vivo efficacy of systemic CJ1 administration was assessed in two tau-related pathology (tauopathy) mouse models, AAV-hTau-P301L and hTau transgenic mice. Behavioral, biochemical, and histological analyses were performed to evaluate cognitive function, tau pathology, neuroinflammation, neurodegeneration, and safety.
RESULTS: CJ1 selectively promoted the posttranslational degradation of DAPK1 by the proteasome system without affecting DAPK1 mRNA expression. In vitro studies demonstrated that CJ1 significantly reduced tau phosphorylation at multiple AD-related sites. In vivo, CJ1 effectively penetrated the blood-brain barrier, decreased the levels of both the soluble and insoluble forms of hyperphosphorylated tau, and suppressed the formation of neurofibrillary tangles. Additionally, CJ1 treatment restored synaptic and dendritic structures, enhanced spatial learning and memory, attenuated neuroinflammatory responses, preserved neuronal populations, and produced no evidence of systemic toxicity.
CONCLUSION: CJ1 functions as a potent and selective degrader of DAPK1, exerting neuroprotective effects by reducing tau hyperphosphorylation and preserving neuronal structural integrity. These findings support DAPK1 as a promising therapeutic target and suggest that further preclinical studies are warranted to evaluate CJ1 as a potential treatment for tauopathies associated with AD.}, }
@article {pmid41460672, year = {2025}, author = {Sun, L and Wei, G and Ji, F and Ding, Y and Fan, J and Xu, Y and He, C and Zhou, Y and Liu, Z and Sun, Z and Zhou, D}, title = {Proteome-wide association study identifies novel Alzheimer's disease-associated proteins.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251409352}, doi = {10.1177/13872877251409352}, pmid = {41460672}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) is a progressive neurodegenerative disease with limited prevention and treatment options.ObjectiveWe aimed to identify proteins with genetically regulated plasma levels associated with AD and its related phenotypes.MethodsWe conducted a proteome-wide association study (PWAS) using Olink-based plasma proteomes (N = 45,540) from the UK Biobank Pharma Proteomics Project (UKB-PPP) and a large-scale genome-wide association study for AD (N case = 85,934, N control = 401,577). To validate and expand these findings, we conducted longitudinal analyses of AD and mild cognitive disorder (MCD) over a 13.7-year follow-up, along with genetic-based PWAS analyses and cross-sectional studies on hippocampal volume. Protein-protein interaction networks were constructed to explore mechanistic association.ResultsWe identified 30 AD-associated plasma proteins by PWAS, including 17 previously reported and 13 novel candidates (including FES, LRP11, and HDGF). Longitudinal cohort studies supported the role of PILRB and FES in AD and/or MCD. Additionally, the genetically determined higher levels of LRP11 were found to be associated with an increased hippocampal volume, including its subdivisions, along with a reduced risk of AD. In contrast, higher plasma levels of HDGF were linked to a decreased hippocampal volume, accompanied by an increased risk of AD. Protein-protein interaction analysis linked PILRA, PILRB, FES, and LRP11 to several pathological proteins associated with AD, including BIN1, ABCA7, and SORL1.ConclusionsThis study identified 13 novel candidates, with potential roles in hippocampal volume and AD risk, providing insights into disease mechanisms.}, }
@article {pmid41460605, year = {2025}, author = {Fassbender, RV and Kehm, C and Otta, AL and Fink, GR and Onur, OA}, title = {Repetitive transcranial magnetic stimulation enhances alpha power in Alzheimer's disease patients.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251406972}, doi = {10.1177/13872877251406972}, pmid = {41460605}, issn = {1875-8908}, abstract = {BackgroundWith Alzheimer's disease (AD) presenting an ongoing challenge, innovative treatment methods are essential. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising noninvasive intervention, particularly targeting alpha band oscillations associated with AD-related cognitive decline.ObjectiveThis study aimed to investigate the effects of low-intensity rTMS over posterior cortical areas on alpha band oscillations and memory performance in AD patients compared to age-matched healthy controls.MethodsIn a single-blinded, sham-controlled rTMS-EEG study, we examined 14 amyloid-positive AD patients and 14 age-matched healthy controls. Continuous EEG was recorded at rest (eyes closed) before, during, and after stimulation. During stimulation, participants completed an episodic memory task.ResultsWe were able to demonstrate that during rTMS alpha power increased compared to sham, with a notable 25% increase observed in AD patients. However, comparison of memory performance under the sham and stimulation conditions revealed no significant stimulation effect.ConclusionsThese findings support and extend current knowledge of noninvasive brain stimulation mechanisms. Our results suggest that alpha frequency-tuned rTMS over posterior cortical areas can modulate pathological brain activity in AD patients even at low intensities. Given the limited sample size and moderate effect sizes, results should be interpreted with caution. Nevertheless, our results warrant further studies with long-term EEG-rTMS protocols to evaluate the potential therapeutic benefit.}, }
@article {pmid41460506, year = {2025}, author = {Bernard, PJ and Więckowska, A and Grosjean, S and Godyń, J and Sałat, K and Detka, J and Palacz, N and Tyrybon, W and Jończyk, J and Szałaj, N and Zaręba, P and Martin, H and Maj, M and Jozwiak, K and Marco-Contelles, J and Ismaili, L}, title = {First Sustainable One-Pot Tandem Hantzsch Multicomponent Reaction/Click Reaction Approach for Novel Multitarget-Directed Ligands in Alzheimer's Disease.}, journal = {ACS chemical neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1021/acschemneuro.5c00806}, pmid = {41460506}, issn = {1948-7193}, abstract = {This study explores novel multitarget-directed ligands (MTDLs) showing anticholinesterase, antioxidant, neuroprotective, and calcium channel inhibitory activities, as promising compounds for Alzheimer's disease (AD) treatment. The rational design combined dihydropyridines (DHPs), known for calcium channel blocking and neuroprotective properties, with tacrine, a cholinesterase inhibitor. The key innovation of this work lies in the one-pot tandem Hantzsch multicomponent/click reaction used to synthesize new 18 DHPs IIIa-r. This sustainable and original approach aligns with green chemistry principles by reducing waste, energy consumption, and derivatives formation. Notably, DHP IIIj and IIIk demonstrated a multitarget profile and effectively reversed scopolamine-induced amnesia in a mouse model, showcasing its antiamnesic properties. These results suggested that DHP IIIj and IIIk hold promise as innovative therapeutic candidates for AD, validating the potential of MTDL strategy and highlighting the one-pot tandem synthesis as a significant advancement in medicinal chemistry.}, }
@article {pmid41460033, year = {2026}, author = {Hu, XH and Jin, Q and Xie, JL and Wu, CL and Pan, JP}, title = {Docosahexaenoic acid modulates microglial autophagy via miR-589-5p/toll-like receptor 4 axis in Alzheimer's disease.}, journal = {Neuroreport}, volume = {37}, number = {2}, pages = {77-85}, doi = {10.1097/WNR.0000000000002236}, pmid = {41460033}, issn = {1473-558X}, mesh = {*Alzheimer Disease/metabolism ; *Autophagy/drug effects ; *MicroRNAs/metabolism ; *Docosahexaenoic Acids/pharmacology ; *Toll-Like Receptor 4/metabolism/drug effects ; Humans ; *Microglia/drug effects/metabolism ; Animals ; Male ; Mice ; Female ; Aged ; Amyloid beta-Peptides ; Cell Line ; }, abstract = {OBJECTIVE: To investigate the neuroprotective mechanism by which docosahexaenoic acid (DHA) promotes microglial autophagy via the miR-589-5p/toll-like receptor 4 (TLR4) axis in Alzheimer's disease.
METHODS: In vitro, BV2 microglial cells were treated with Aβ25-35 to establish an Alzheimer's disease model and subjected to DHA treatment with or without miR-589-5p inhibition and TLR4 overexpression. Cytotoxic effects were assessed by methylthiazolyldiphenyl-tetrazolium bromide assays. Autophagy markers (LC3-II/I ratio, Beclin1, and p62) were evaluated by Western blot and immunofluorescence. The miR-589-5p/TLR4 interaction was assessed using dual luciferase assays. For clinical validation, peripheral blood samples from healthy controls, patients with mild Alzheimer's disease, and patients with severe Alzheimer's disease (n = 30 each) were analyzed for miR-589-5p and TLR4 mRNA expression via quantitative reverse transcription PCR (qRT-PCR).
RESULTS: In cellular assays, DHA significantly enhanced autophagy by increasing the LC3-II/I ratio and Beclin1 expression while decreasing p62 levels (P < 0.05). Mechanistic validation showed that miR-589-5p inhibition abolished DHA's autophagy-promoting effects, while TLR4 overexpression reversed these benefits. Conversely, miR-589-5p mimic treatment rescued autophagy even under TLR4 overexpression conditions. Dual-luciferase assays confirmed that miR-589-5p directly targets TLR4. Clinically, qRT-PCR analysis revealed that miR-589-5p expression was downregulated and TLR4 expression was upregulated in Alzheimer's disease patients compared to healthy controls, and these alterations were correlated with disease severity (P < 0.05).
CONCLUSION: DHA enhances microglial autophagy via a novel miR-589-5p/TLR4 regulatory axis, a potential Alzheimer's disease therapy and biomarker for Alzheimer's disease progression.}, }
@article {pmid41460031, year = {2026}, author = {Fu, C and Kan, Y and Guo, K and Jiang, L and Zhang, Y and Dong, H and Xie, J}, title = {Tenuigenin ameliorates Alzheimer's disease by targeting MAP2K1: integrated evidence from network pharmacology and experimental validation.}, journal = {Neuroreport}, volume = {37}, number = {2}, pages = {53-66}, doi = {10.1097/WNR.0000000000002239}, pmid = {41460031}, issn = {1473-558X}, support = {gzwkj2025-129//Science and Technology Fund Project of the Guizhou Provincial Health Commission/ ; gzwkj2025-130//Science and Technology Fund Project of the Guizhou Provincial Health Commission/ ; 20222121020675//Project of the Heilongjiang Provincial Health and Family Planning Commission/ ; }, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Humans ; Network Pharmacology/methods ; *Neuroprotective Agents/pharmacology ; *Drugs, Chinese Herbal/pharmacology ; Molecular Docking Simulation ; Amyloid beta-Peptides/metabolism ; Cell Line, Tumor ; }, abstract = {OBJECTIVE: Alzheimer's disease (AD) is a prevalent neurodegenerative disorder primarily characterized by progressive cognitive impairment and synaptic dysfunction. Despite substantial research efforts, effective therapeutic options remain limited. Tenuigenin (TEN), a principal bioactive constituent isolated from the traditional Chinese medicinal herb Polygala tenuifolia, has demonstrated promising neuroprotective effects.
METHODS: This study adopted a comprehensive multitiered approach, combining network pharmacology, machine learning, molecular modeling, and in-vitro experiments, to elucidate the therapeutic targets and mechanisms of TEN in AD. Computational analyses identified mitogen-activated protein kinase kinase 1 (MAP2K1) as a critical target, mediating the effects of TEN. Gene set enrichment analysis indicated that TEN could activate the 26S proteasome pathway, promoting the degradation of neurotoxic proteins, such as amyloid-β (Aβ), thereby reducing their pathological accumulation.
RESULTS: Immune infiltration analysis further revealed that TEN could modulate the distribution of activated natural killer cells and M0 macrophages, playing a role in restoring immune balance in the AD microenvironment. Molecular docking and dynamics simulations demonstrated strong binding affinity and structural compatibility between TEN and MAP2K1. Experimental validation using Aβ-treated SH-SY5Y cells indicated that TEN significantly enhanced cell viability and suppressed MAP2K1 protein expression.
CONCLUSION: In conclusion, this study provided the first integrated evidence that TEN exerts neuroprotective effects in AD by targeting MAP2K1. These findings highlight the multitarget, multipathway therapeutic potential of TEN and support its development as a natural agent for AD prevention and treatment.}, }
@article {pmid41458258, year = {2026}, author = {Jing, C and Li, J and Yu, D and Chao, M and Yan, H and Ge, K and Ma, G and Wang, J and Gao, F and Zhang, G}, title = {Heterotrimetallic Au@Cu2Se nanozymes target inflamed neurons via suppression of oxidative stress and apoptosis to alleviate Alzheimer's disease.}, journal = {Materials today. Bio}, volume = {36}, number = {}, pages = {102646}, pmid = {41458258}, issn = {2590-0064}, abstract = {Neuronal dysfunction mediated by oxidative stress and amyloid-β (Aβ) deposition is widely recognized as a core mechanism in the pathogenesis of Alzheimer's disease (AD). Aβ oligomers specifically interact with key mitochondrial proteins-such as alcohol dehydrogenase, cyclophilin D, and ATP synthase-markedly increasing reactive oxygen species (ROS) production, which leads to mitochondrial membrane potential collapse and disruption of energy metabolism. Although cuprous selenide and gold nanospheres can mimic the catalytic activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD), effectively scavenge excess ROS, restore mitochondrial membrane potential, and promote ATP synthesis through synergistic action, their therapeutic potential is limited by poor targeting specificity in vivo. Moreover, while antioxidant nanoagents show promise in mitigating oxidative stress, their non-specific distribution often necessitates high doses, raising potential off-target toxicity concerns and reducing treatment efficacy. Therefore, developing a delivery system that combines multifunctional neuroprotection with precise targeting to diseased microenvironments remains an urgent need. To address this, we functionalized the surface of Au@Cs nanoparticles with hyaluronic acid (HA) to construct a CD44-targeted Au@Cs-HA-PEG nanosystem. By taking advantage of the high expression of CD44 in microglia and astrocytes under inflammatory conditions, the precise targeting of inflammatory regions in the brains of AD model mice was promoted. In vitro experiments demonstrated that Au@Cs-HA-PEG effectively reduced ROS levels in HT22 cells, reversed mitochondrial membrane potential attenuation, and restored neuronal function. In vivo results showed that these nanoparticles achieved rapid brain enrichment, significantly reduced Aβ plaque deposition and neuroinflammation, and markedly improved learning, memory, and cognitive abilities in AD mice. In conclusion, this study confirms that the Au@Cs-HA-PEG nanosystem ameliorates cognitive dysfunction in AD mice by regulating ROS homeostasis, offering a novel strategy and experimental foundation for targeted therapy of Alzheimer's disease.}, }
@article {pmid41457950, year = {2025}, author = {Algeciras-Schimnich, A and Theobald, JP and Figdore, DJ and Ashrafzadeh Kian, S and Bornhorst, JA}, title = {False positive plasma p-tau217 results associated with heterophilic antibody interference: A potential clinical pitfall.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e71045}, pmid = {41457950}, issn = {1552-5279}, mesh = {Humans ; *tau Proteins/blood/immunology ; *Alzheimer Disease/blood/diagnosis ; *Antibodies, Heterophile/blood ; False Positive Reactions ; Amyloid beta-Peptides/blood ; Biomarkers/blood ; Immunoassay ; Phosphorylation ; Female ; Male ; Aged ; Peptide Fragments ; }, abstract = {INTRODUCTION: Plasma phosphorylated tau at threonine 217 (p-tau217) has emerged as one of the most promising blood-based biomarkers for Alzheimer's disease (AD). While rare, heterophilic antibodies (HAb) are a persistent potential confounding factor in immunoassays.
METHODS: Potential HAb interference in the Lumipulse G pTau217 assay in samples exhibiting concentrations > 10 pg/mL were investigated. Samples were subjected to HAb blocking reagent (HBT), and in some cases, polyethylene glycol (PEG) precipitation and serial dilutions.
RESULTS: In 14 of the 15 suspected HAb cases, HBT treatment greatly reduced measured p-tau217 concentrations. and in one of three specimens selected for further investigation, reduced Aβ42 concentrations PEG precipitation in the three selected samples also reduced p-tau217 concentrations, while serial dilution yielded mixed effects. Control specimens were unaffected by sample treatment or dilutions.
DISCUSSION: HAb may result in falsely elevated p-tau217 and p-tau217/Aβ42 ratio. HAb interference should be considered in cases of unusually high p-tau217 concentrations prior to clinical interpretation.
HIGHLIGHTS: Potential heterophile antibody (HAb) interference in the Lumipulse p-tau217 immunoassay was investigated. Investigation was performed using HAb blocking reagent, and in some cases also using PEG precipitation . Patients with p-tau217 concentrations > 10 pg/mL exhibited positive HAb interference in 14 of 15 cases. HAb interference can lead to falsely positive p-tau217/Aβ42 ratios.}, }
@article {pmid41457949, year = {2025}, author = {Chen, Q and Wen, Q and Zhong, T and Liu, J and Gao, H}, title = {Deep cervical lymphaticovenous anastomosis for Alzheimer's disease: A narrative review.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e71038}, pmid = {41457949}, issn = {1552-5279}, support = {No.B2025292//Medical Scientific Research Foundation of Guangdong Province/ ; GMUCR2025-02028//Plan on enhancing scientific research in GMU,Guangdong, China/ ; }, mesh = {Humans ; *Alzheimer Disease/surgery ; *Lymphatic Vessels/surgery ; *Anastomosis, Surgical/methods ; *Glymphatic System/surgery ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) is a common neurodegenerative disorder with limited treatment options. Recent discoveries of the glymphatic system and meningeal lymphatic vessels (MLVs) have highlighted their critical role in clearing metabolic waste-including amyloid beta and tau proteins-from the brain. Dysfunction of these systems contributes to AD pathogenesis by impairing the clearance of neurotoxic proteins. Deep cervical lymphaticovenous anastomosis (dcLVA) is an innovative microsurgical technique designed to enhance cerebral waste drainage by anastomosing deep cervical lymphatic channels to adjacent veins. This narrative review synthesizes current evidence on the mechanisms, applications, and emerging perspectives of dcLVA for AD. Early studies suggest potential short-term improvements in cognitive scores and neuroimaging biomarkers after surgery, with an acceptable safety profile. However, the evidence is limited to small prospective cohorts and case reports, underscoring the need for larger, randomized controlled trials to validate its efficacy and long-term benefits. dcLVA represents a promising surgical intervention for select patients, particularly those with moderate-to-severe AD who have failed conventional pharmacotherapy, but it requires careful patient selection and further investigation. HIGHLIGHTS: This review proposes deep cervical lymphaticovenous anastomosis (dcLVA) as a mechanism driven surgery that may enhance clearance of amyloid beta (Aβ) and tau through the brain, meningeal, and deep cervical drainage pathways. Early human evidence from a single arm cohort and case reports suggests short term cognitive and imaging signals with acceptable perioperative safety. dcLVA is not recommended as a first line option for early Alzheimer's disease (AD) and may be considered for moderate to severe AD or for patients who are refractory to pharmacotherapy and have objective evidence of drainage impairment. Standardized patient selection and longitudinal imaging and biomarker monitoring are recommended, including Aβ and tau positron emission tomography (PET), diffusion tensor imaging (DTI) analysis along the perivascular space, and cerebrospinal fluid (CSF) or plasma panels. Systemic safety remains an important uncertainty, and future trials should include longitudinal surveillance of hepatic, renal, and hematologic function. Multicenter randomized controlled trials (RCTs) are urgently needed with 12 month Clinical Dementia Rating Sum of Boxes (CDR SB) as a primary endpoint, transparent reporting, and evaluation of combination strategies with anti Aβ therapies.}, }
@article {pmid41457120, year = {2025}, author = {Jiang, T and Ma, W and Dong, W and Zhou, H and Mao, X}, title = {Ferroptosis-associated transcriptional factors in neurological diseases: molecular mechanisms and therapeutic prospects.}, journal = {Experimental & molecular medicine}, volume = {57}, number = {12}, pages = {2763-2781}, pmid = {41457120}, issn = {2092-6413}, mesh = {*Ferroptosis/genetics ; Humans ; *Nervous System Diseases/metabolism/therapy/etiology/pathology ; Animals ; *Transcription Factors/metabolism/genetics ; Iron/metabolism ; Lipid Peroxidation ; }, abstract = {Ferroptosis, a newly discovered type of regulatory cell death with iron-dependent accumulation of lipid peroxides, is widely discussed in a plethora of neurological disorders such as Alzheimer's disease, Parkinson's disease, epilepsy, stroke, traumatic brain injury and spinal cord injury. There are many preclinical and clinical evidences supporting the critical role of ferroptosis in these neurologic conditions, despite the molecular machinery by which ferroptosis modulates brain dysfunction remains uncharacterized. Transcription factors (TFs) are core components of the machinery that manipulates ferroptosis process genetically. Until now, there is no report on the summarization of role of ferroptosis-associated TFs in neurological diseases. Therefore, here we provided the basic knowledge regarding the regulation of TFs on ferroptotic processes including iron metabolism, antioxidant defense and lipid peroxidation. In addition, we also discussed the recent advances in our understanding of ferroptosis-related TFs in the emerging hallmarks of neurological diseases. The fact that Nrf2 activator RTA-408 is approved for clinical evaluation (phase 2 clinical trial) of its efficacy and safety in patients with Alzheimer's disease supports this notion. Future research on proteolysis-targeting chimera (PROTAC) and gene therapy holds promise for optimization of neurological disease treatment.}, }
@article {pmid41456743, year = {2026}, author = {Tait, S and Fratini, F and Boussadia, Z and Gaddini, L and Marra, M and Le Pera, L and Venturini, G and Ferrante, A}, title = {Investigation of dipyridamole-elicited signaling in the brain of Niemann Pick type C mice: A multi-omic study.}, journal = {Brain research bulletin}, volume = {234}, number = {}, pages = {111708}, doi = {10.1016/j.brainresbull.2025.111708}, pmid = {41456743}, issn = {1873-2747}, mesh = {Animals ; *Niemann-Pick Disease, Type C/metabolism/drug therapy/genetics ; *Dipyridamole/pharmacology ; Mice ; Hippocampus/metabolism/drug effects ; *Signal Transduction/drug effects ; Mice, Knockout ; Cerebellum/metabolism/drug effects ; Disease Models, Animal ; Niemann-Pick C1 Protein/genetics ; *Brain/metabolism/drug effects ; Male ; Mice, Inbred C57BL ; Multiomics ; }, abstract = {Niemann Pick type C1 (NPC1) is a rare, fatal disorder characterized by endo-lysosomal (EL) lipid accumulation that leads to damage of both peripheral organs and central nervous system, with cerebellum and hippocampus being particularly affected. Currently very few therapeutic options exist in Europe for NPC. In fact, miglustat is the only approved drug and L-acetylleucine was recently granted for marketing authorization by European Medicine Agency. Thus, the identification of new treatments is mandatory. We have previously demonstrated that dipyridamole (DIP), an approved medicine that is clinically employed as an antiplatelet agent, could rescue recognition memory and increase hippocampal expression of calbindin. On the contrary, the drug was unable to improve cerebellar-dependent motor function. In order to elucidate the mechanism of these region-specific changes induced by DIP, in this work we performed a multi-omic analysis of genes and proteins modulated by the treatment in the hippocampus and cerebellum of a mouse model of NPC1 (Npc1[-/-]). Our results revealed that DIP significantly affected various pathways in the hippocampus at protein level, but it had no significant impact on pathways in the cerebellum (either at gene or protein level). Interestingly, the most affected pathways in the hippocampus of Npc1[-/-] mice administered with DIP were those related to cGMP-PKG activation and to mitochondrial function. Our results paved the way to test DIP in experimental models of other neurodegenerative disorders, such as Alzheimer's disease that is similarly marked by hippocampal and mitochondrial dysfunctions.}, }
@article {pmid41456527, year = {2026}, author = {Li, X and Ji, W and Wu, X and Cai, J and Zheng, M and Zhang, X and Liu, P and Wang, G and Li, X and Wang, S and Huo, Z and Wang, Q and Song, Z and Li, D and Zhou, S and Sun, H and Ma, X and Zou, L and Gao, W}, title = {Cerebralcare Granule® restores intracranial lymphatic drainage system to support proactive brain health in Alzheimer's disease models.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {150}, number = {}, pages = {157617}, doi = {10.1016/j.phymed.2025.157617}, pmid = {41456527}, issn = {1618-095X}, mesh = {Animals ; *Alzheimer Disease/drug therapy/metabolism ; Mice, Transgenic ; Mice ; Disease Models, Animal ; *Drugs, Chinese Herbal/pharmacology ; *Brain/drug effects/metabolism ; Amyloid beta-Peptides/metabolism ; Blood-Brain Barrier/drug effects ; Aquaporin 4/metabolism ; Male ; Lymphangiogenesis/drug effects ; Glymphatic System/drug effects ; Donepezil/pharmacology ; Mice, Inbred C57BL ; }, abstract = {BACKGROUND: Impairment of the intracranial lymphatic drainage system significantly contributes to Alzheimer's disease (AD) by facilitating the accumulation of neurotoxic amyloid-β (Aβ) and tau proteins. Restoring lymphatic function offers a promising preventive strategy against early-stage AD pathology.
PURPOSE: This study aimed to evaluate the effects and mechanisms of Cerebralcare Granule® (CG), a traditional Chinese medicine formula, on cognitive impairment and pathological markers in AD mouse models by modulating intracranial lymphatic clearance pathways.
METHODS: Six-month-old APP/PS1 transgenic mice and wild-type controls received oral administration of CG or donepezil for two months. Behavioral assessments included the Morris water maze, open field, Y-maze, novel object recognition, and passive avoidance tests. Immunohistochemistry, immunofluorescence, and Western blot analyses were used to assess Aβ deposition, glymphatic clearance, astrocytic aquaporin-4 (AQP4) polarization, meningeal lymphangiogenesis, and blood-brain barrier integrity. Tracer-based in vivo imaging confirmed improved CSF influx and efflux dynamics. Brain-penetrant compounds of CG were identified using UPLC-MS/MS, MALDI-TOF-MS imaging, and network pharmacology.
RESULTS: CG treatment significantly improved cognitive performance, reduced Aβ burden, enhanced glymphatic transport, and promoted meningeal lymphatic drainage in APP/PS1 mice. CG restored perivascular AQP4 polarization, improved cerebrospinal fluid-interstitial fluid exchange, facilitated waste removal to cervical lymph nodes, and protected the integrity of the blood-brain barrier. Major brain-penetrant compounds-paeoniflorin, rhynchophylline, and ethyl gallate-were found to target lymphatic signaling pathways (AQP4, VEGFC, VEGFR3, PROX1) effectively.
CONCLUSION: CG exerts protective effects against cognitive impairment and AD pathology by reinforcing the structural and functional integrity of the intracranial lymphatic drainage system, highlighting a novel therapeutic avenue for proactive brain health management in early-stage AD.}, }
@article {pmid41456355, year = {2026}, author = {Haixia, T and Bo, X}, title = {Exercise impact on IRE1α signaling: Novel insights into Alzheimer's disease prevention and treatment.}, journal = {Biochemical and biophysical research communications}, volume = {797}, number = {}, pages = {153156}, doi = {10.1016/j.bbrc.2025.153156}, pmid = {41456355}, issn = {1090-2104}, mesh = {*Alzheimer Disease/prevention & control/therapy/metabolism/pathology ; Humans ; *Signal Transduction ; Endoplasmic Reticulum Stress ; *Endoribonucleases/metabolism ; Animals ; *Protein Serine-Threonine Kinases/metabolism ; *Exercise/physiology ; }, abstract = {Endoplasmic reticulum stress (ERS) and its downstream signaling play a central role in neuroinflammation in Alzheimer's disease (AD). Among them, IRE1α, as a key sensor of ER stress, is a pivotal molecule connecting stress to inflammation. Its aberrant activation drives neuroinflammation, which in turn exacerbates Aβ deposition, Tau pathology, and cognitive decline. Therefore, targeting the IRE1α signaling pathway has become a potential strategy for AD intervention. Recent studies suggest that exercise can alleviate ER stress and directly or indirectly inhibit the excessive activation of IRE1α, thereby reducing its downstream inflammatory signals. This review aims to systematically elucidate the pathogenic mechanism of the IRE1α inflammatory signaling pathway in AD. It also focuses on exploring the evidence of the neuroprotective effect of exercise through regulating this pathway, providing new theoretical basis and direction for exercise-based prevention and treatment of AD.}, }
@article {pmid41455872, year = {2025}, author = {Marei, HE}, title = {Epigenetic Editing in Neurological and Neuropsychiatric Disorders: Pioneering Next-Gen Therapeutics for Precision Gene Control.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {330}, pmid = {41455872}, issn = {1559-1182}, mesh = {Humans ; *Epigenesis, Genetic/genetics ; *Gene Editing/methods ; *Nervous System Diseases/genetics/therapy ; Animals ; *Mental Disorders/genetics/therapy ; *Genetic Therapy/methods ; *Precision Medicine/methods ; Epigenome Editing ; }, abstract = {Epigenetic editing has emerged as a promising approach in the treatment of neurological and neuropsychiatric disorders, enabling the precise and enduring modification of genes associated with these conditions. Interventions that focus on chromatin, such as programmable systems like CRISPR/dCas9, zinc-finger proteins, and TALEs linked to epigenetic effector domains, enable the modification of DNA methylation, histone modifications, and noncoding RNA control at specific loci. This work integrates current progress in understanding the epigenetic landscape of neurological neuropsychiatric disorders, highlighting the functions of DNA methylation (de novo vs maintenance, active versus passive demethylation), histone remodeling, and context-dependent gene regulation. We emphasize that the dysregulation of these processes is essential to diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and major psychiatric disorders. Innovative therapeutic approaches, including KRAB- and TET-based repressors, "hit-and-run" epigenome editing, and targeted noncoding RNA regulation, are analyzed alongside translational methodologies that utilize gene therapy vectors, nanoparticle delivery systems, and inducible expression mechanisms. We also examine proof-of-concept studies that demonstrate how to prevent gene expression and alter the transcriptional networks of diseased cells in living organisms. We identify current challenges, including off-target effects, delivery issues, inadequate understanding of long-term stability, and the need for reliable diagnostics, while highlighting the translational promise of combining epigenetic clearance with biogenesis and repair. This review is aimed at providing a comprehensive and critical examination of the molecular principles, therapeutic strategies, and translational obstacles associated with epigenetic editing in neurological and neuropsychiatric disorders, thereby facilitating the development of next-generation precision therapies.}, }
@article {pmid41455863, year = {2025}, author = {Elbermawy, Y and El-Desouky, S and Arafa, RK and Elfarrash, S and Bassiouny, A}, title = {Synergistic Neuroprotection in Tauopathic Mice via Green-Synthesized Silver Nanoparticles Co-delivering Methylene Blue and Moringa oleifera.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {331}, pmid = {41455863}, issn = {1559-1182}, mesh = {Animals ; *Methylene Blue/pharmacology/administration & dosage/therapeutic use ; *Moringa oleifera/chemistry ; *Metal Nanoparticles/chemistry/administration & dosage ; *Silver/chemistry/pharmacology ; *Neuroprotective Agents/pharmacology/administration & dosage/therapeutic use ; *Neuroprotection/drug effects ; Mice, Transgenic ; Mice ; *Green Chemistry Technology/methods ; *Tauopathies/drug therapy/pathology/metabolism ; Glycogen Synthase Kinase 3 beta/metabolism ; Plant Extracts/administration & dosage/pharmacology ; tau Proteins/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder with limited therapeutic options.Most current treatments target only a single pathogenic pathway. We developed an innovative green-synthesized silver nanoparticle formulation for the co-delivery of methylene blue (MB), a tau aggregation inhibitor, and Moringa oleifera (MO) extract, an antioxidant and anti-inflammatory agent. Silver nanoparticles act as multifunctional carriers, improving drug stability and brain delivery, yielding the combined formulation MOMB-Ag-NPs. MOMB-Ag-NPs were synthesized and characterized using ultraviolet-visible spectroscopy (UV-Vis), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and energy-dispersive X-ray (EDX) analysis. Homozygous P301S tau transgenic mice were assigned to four groups: saline (0.9%, i.p.), MB (4 mg/kg/day, i.p.), MO (260 mg/kg/day, oral), or MOMB-Ag-NPs (4 mg/kg/day MB equivalent, i.p.) for 60 days. In vitro GSK-3β inhibition assays and molecular docking analyses assessed mechanistic interactions. Neuroprotective efficacy was evaluated through survival, behavioral tests, immunohistochemistry, ELISA, and Western blotting. MOMB-Ag-NPs displayed spherical morphology (10-25 nm), high stability, and efficient MB encapsulation (EE 54.7%, DL 93.5%). Both MO and MB inhibited GSK-3β in vitro (IC50 = 9.41 and 65.77 µg/mL), corroborated by molecular docking. In vivo, MOMB-Ag-NPs significantly improved locomotor activity, and cognitive performance. Treated mice showed reduced astrogliosis, decreased pro-inflammatory cytokines (TNF-α, IL-6), enhanced autophagy (LC3β), increased antioxidant defenses (SOD), and differential modulation of the AKT/GSK-3β pathway. This study provides novel evidence that a green-synthesized MB and MO nanoformulation exerts synergistic neuroprotective effects in tauopathy mice, highlighting the translational promise of multitarget strategies for AD treatment.}, }
@article {pmid41455134, year = {2026}, author = {Du, O and Wu, YJ and Li, MY and Du, JR}, title = {The role of HMGB1 in central nervous system (CNS) diseases: mechanisms and therapeutic perspectives.}, journal = {Cytokine}, volume = {198}, number = {}, pages = {157099}, doi = {10.1016/j.cyto.2025.157099}, pmid = {41455134}, issn = {1096-0023}, mesh = {Humans ; *HMGB1 Protein/metabolism ; *Central Nervous System Diseases/metabolism/therapy/pathology ; Animals ; Biomarkers/metabolism ; }, abstract = {Central nervous system (CNS) diseases represent a major global health burden and are among the leading causes of disability and mortality worldwide. The pathological mechanisms underlying CNS disorders are complex and multifactorial, involving processes such as neuroinflammation, oxidative stress, neuronal damage, and synaptic dysfunction. High-mobility group box 1 (HMGB1), a member of the high-mobility group box (HMGB) protein family, is predominantly localized in the nucleus under physiological conditions, where it contributes to DNA repair, transcriptional regulation, and other cellular functions. However, in various CNS pathologies-including stroke, traumatic brain injury (TBI), Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), glioblastoma (GBM), epilepsy, depression, multiple sclerosis (MS), and schizophrenia-HMGB1 is released or secreted into the extracellular space. There, it plays a key role in regulating neuroinflammation, cell death, cell migration, and tissue damage and repair, thereby contributing to disease pathogenesis and progression. HMGB1 not only functions as a critical regulator in the progression of CNS diseases but also serves as a biomarker for predicting poor clinical outcomes. Moreover, a growing body of evidence indicates that therapeutic strategies targeting HMGB1 can significantly alleviate pathological damage in various CNS disorders, highlighting its potential as a promising therapeutic target. This review comprehensively summarizes the structure, post-translational modifications, release mechanisms, and receptor systems of HMGB1, along with its roles and mechanisms in CNS diseases. It also discusses the potential of HMGB1 as a biomarker and examines emerging HMGB1-targeted therapeutic strategies, aiming to provide a theoretical foundation for the treatment and drug development of CNS disorders.}, }
@article {pmid41454738, year = {2025}, author = {Takeda, T and Toritsuka, M and Tamakoshi, H and Iwata, N and Makinodan, M}, title = {Immune involvement in neuropsychiatric disorders: Insights from single-cell transcriptomic studies.}, journal = {Psychiatry and clinical neurosciences}, volume = {}, number = {}, pages = {}, doi = {10.1111/pcn.70018}, pmid = {41454738}, issn = {1440-1819}, support = {JPMJMS239F-1-2//Moonshot Research and Development Program/ ; 21gm6310015h0002//Japan Agency for Medical Research and Development/ ; 21uk1024002h0002//Japan Agency for Medical Research and Development/ ; 21wm04250XXs0101//Japan Agency for Medical Research and Development/ ; 22gm1510009h0001//Japan Agency for Medical Research and Development/ ; 24gm1910004s0402//Japan Agency for Medical Research and Development/ ; 24wm0625510h0001//Japan Agency for Medical Research and Development/ ; 23H04173//Japan Society for the Promotion of Science/ ; 24K02386//Japan Society for the Promotion of Science/ ; }, abstract = {Neuropsychiatric disorders pose profound challenges to both research and treatment, largely due to their clinical heterogeneity and the limited understanding of their underlying biological mechanisms. While bulk RNA sequencing (bulk RNA-seq) has been widely used to study gene expression, it cannot resolve cell-type-specific signals or detect rare cellular subpopulations. In contrast, single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq) have emerged as transformative technologies, enabling transcriptomic profiling at single-cell resolution. These approaches have revealed immunological alterations across a wide range of disorders. This review introduces recent findings from sc/snRNA-seq studies of immune-related mechanisms in psychiatric disorders-including schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder, and attention-deficit/hyperactivity disorder-as well as in neurological conditions such as Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, multiple sclerosis, and anti-NMDA receptor encephalitis. While sc/snRNA-seq overcome averaging effects of bulk RNA-seq by resolving cell types, these methods still face challenges. We outline a roadmap that integrates bulk RNA-seq and sc/snRNA-seq to mitigate the remaining gaps.}, }
@article {pmid41454086, year = {2025}, author = {Mi, X and Shan, K and Ye, X and Cheng, R}, title = {AAD-2004 through clearing H2O2 reduces astrocyte proliferation and promotes neural regeneration after spinal cord injury.}, journal = {Scientific reports}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41598-025-33322-x}, pmid = {41454086}, issn = {2045-2322}, support = {ZKKY2023003//Zhejiang Medical Association/ ; 2024KY658//Scientific Research Program of Zhejiang Medical Technology/ ; }, abstract = {To assess the effect of AAD-2004 on spinal cord injury (SCI) and to explore its mechanism, we employed an in vitro model using OGD/R-challenged astrocytes to investigate the effects of AAD-2004 against cell death (terminal deoxynucleotidyl transferase dUTP nick-end labeling, tunel), oxidative stress (H2O2 level), and the expression of the key neuroprotective factor MAP2.AAD-2004[2-hydroxy-5-[2-(4-trifluoromethylphenyl)-ethylaminobenzoic acid] is a hydrogen peroxide(H2O2) scavenger primarily used for the treatment of amyotrophic lateral sclerosis and Alzheimer disease that has demonstrated certain neuroprotective properties. In parallel, modified allen's method was adopted, further exploring the potential molecular mechanism in vivo. Based on these conditions, histological and behavioral analysis were performed by Nissl staining, basso mouse scale and footprint analysis. The level of molecules associated with glial scar formation, nerve regeneration, axonal regeneration and H2O2 level were analyzed using western blot, immunofluorescence staining and H2O2 kit. AAD-2004 significantly improved the movement function after SCI and inhibited the proliferation of astrocytes, thus preventing the formation of glial scar by inhibiting of H2O2. At the same time, AAD-2004 promoted nerve regeneration, and the effect was due to neuronal regeneration and axonal regeneration pathways. The expression levels of GFAP and vimentin were significantly downregulated in AAD-2004-treated, and the expression level of Ki67 and PH3 were downregulated. The mean fluorescence intensity of neuronal regeneration (Neun[+]and MAP2[+]) and axonal regeneration-related (NF[+] and GAP43[+]) were significantly upregulated after AAD-2004 treatment. Scavenging H2O2 level is a viable therapeutic strategy, and that AAD-2004 is prospective, and that scavenging H2O2 facilitated nerve regeneration and inhibited glial scar formation for SCI.}, }
@article {pmid41453655, year = {2026}, author = {Basri, R and Al-Kuraishy, HM and Fawzy, MN and Alruwaili, M and Batiha, GE}, title = {PACAP: A promising disease-modifying target for Alzheimer's disease.}, journal = {Life sciences}, volume = {386}, number = {}, pages = {124176}, doi = {10.1016/j.lfs.2025.124176}, pmid = {41453655}, issn = {1879-0631}, mesh = {*Pituitary Adenylate Cyclase-Activating Polypeptide/metabolism ; Humans ; *Alzheimer Disease/drug therapy/metabolism ; Animals ; *Neuroprotective Agents/pharmacology/therapeutic use ; Blood-Brain Barrier/metabolism ; }, abstract = {Alzheimer's disease (AD) is a significant public health threat, and current therapeutic approaches provide only minimal symptomatic benefit without slowing its progression. This review covers evidence for the expanding involvement of pituitary adenylate cyclase-activating polypeptide (PACAP), an endogenous neuropeptide with significant and consistent neuroprotective properties in various experimental models of AD. We consolidate evidence that PACAP works via multiple pathways to negate primary pathological events in AD by shifting the metabolism of amyloid precursor protein from the amyloidogenic into non-amyloidogenic, inhibiting tau hyperphosphorylation, controlling neuroinflammation, and promoting synaptic plasticity. The reduced level of PACAP in clinical studies of AD patients supports its therapeutic relevance. Although concerns about PACAP pharmacokinetics and blood-brain barrier (BBB) penetration persist as serious obstacles, recent development of stable analogs and innovative delivery systems holds promise for circumventing these limitations. We also consider how established drugs (metformin, linagliptin, and statins) might provide a degree of neuroprotection in part-seeking through PACAP-related pharmacology. Taken together, the cumulative available evidence places PACAP not only as yet another promising therapeutic candidate but rather as a master regulator of neuroprotection, tackling AD's multifaceted nature. Restoration of PACAP signaling is a very distinct method to intervene in disease development, which offers immeasurable benefit in comparison to symptom relief treatment.}, }
@article {pmid41452714, year = {2025}, author = {Zhang, J and Zhu, D and Hu, M and Pan, M and Chen, C}, title = {A Combination of Low-Dose Δ[9]-THC and Celecoxib as a Therapeutic Strategy for Alzheimer's Disease.}, journal = {Aging and disease}, volume = {}, number = {}, pages = {}, doi = {10.14336/AD.2025.1206}, pmid = {41452714}, issn = {2152-5250}, abstract = {Alzheimer's disease (AD) is the leading cause of dementia in the elderly, and no effective therapies are currently available to prevent, treat, or halt its progression. Δ[9]-Tetrahydrocannabinol (Δ[9]-THC), the primary psychoactive compound in marijuana, has been considered a potential therapeutic agent, but clear evidence for its ability to prevent cognitive decline is lacking. Previous studies have demonstrated that Δ[9]-THC-induced cognitive impairments are associated with the induction of cyclooxygenase-2 (COX-2). In this study, we aimed to evaluate whether Δ[9]-THC alone or in combination with Celecoxib, a selective COX-2 inhibitor, could reduce neuropathology and improve cognitive function in AD model animals. We observed that Δ[9]-THC (3.0 mg/kg), either alone or with Celecoxib (1.0 mg/kg), significantly reduced Aβ and tau pathologies, enhanced synaptic marker expression, and prevented the onset of cognitive decline. Notably, the combination treatment produced greater improvements in spatial learning and effectively mitigated Δ[9]-THC-induced neuroinflammatory responses. Furthermore, Δ[9]-THC reversed or attenuated the dysregulated expression of synaptic and immune/inflammation-related genes and restored the downregulated expression of genes linked to AD observed in both AD patients and AD animal models, with greater efficacy when combined with Celecoxib in AD model mice. These findings suggest that the combination of low-dose Δ[9]-THC and Celecoxib holds promise as an early intervention strategy for preventing AD onset or treating mild cognitive impairment (MCI). Importantly, both Δ[9]-THC (in the form of Dronabinol and Nabilone) and Celecoxib are FDA-approved medications already in clinical use, supporting the strong translational potential of this combination therapy and its feasibility for rapid advancement to clinical trials to assess its efficacy in preventing or delaying AD onset in humans.}, }
@article {pmid41452429, year = {2025}, author = {Heidari, Z and Zakaee, A and Vafadar, A and Alavimanesh, S and Charami, H and Jamali, Z and Jahromi, AH and Rakhsha, A and Savardashtaki, A}, title = {An overview of gene and cell therapy approaches for Alzheimer's disease.}, journal = {Metabolic brain disease}, volume = {41}, number = {1}, pages = {10}, pmid = {41452429}, issn = {1573-7365}, mesh = {*Alzheimer Disease/therapy/genetics ; Humans ; *Genetic Therapy/methods ; *Cell- and Tissue-Based Therapy/methods ; Animals ; }, abstract = {Alzheimer's disease (AD), acknowledged as the leading cause of dementia, is defined by the accumulation of amyloid plaques and neurofibrillary tangles (NFTs) in the brain. This condition presents a significant challenge to global health due to its complex and multifaceted characteristics. Pharmacological treatments for AD mainly focus on relieving symptoms instead of addressing the fundamental progression of the condition. Currently, there are three cholinesterase inhibitors (ChEIs) that can be used for the treatment of AD: donepezil, rivastigmine, and galantamine, along with the N-methyl-D-aspartate (NMDA) receptor antagonist memantine. Although these medications can improve cognitive function and assist patients in their daily activities, it is crucial to understand that they do not halt the progression of the disease itself. Recently, innovative therapeutic strategies have been introduced for the treatment of this disease. Cell and gene therapies hold remarkable potential for the treatment of AD. Gene therapy, in particular, enables the precise modulation of AD-related genes, enhances neuroprotective factors, and mitigates the accumulation of amyloid plaques. Additionally, cell-based therapies utilizing mesenchymal stromal cells (MSCs), neural stem cells (NSCs), and induced pluripotent stem cells (iPSCs) are designed to replace lost neurons, modulate immune responses, and restore functional neural networks. Together, these innovative techniques represent significant advancement in the treatment of AD, instilling hope for enhanced patient outcomes and a higher quality of life. In this review, we emphasize the innovative cell and gene strategies, along with in vitro and preclinical studies, that explore the potential of gene and cell-based therapies as treatments for AD.}, }
@article {pmid41452267, year = {2026}, author = {Cai, X and Huang, Y and Wang, T and Gao, J and Tang, Y and Zhu, C and Rong, S}, title = {Mesoporous PdPt Nanozymes with Target Peptides and Cascade Reactive Oxygen Species Scavenging for Boosting Alzheimer's Disease Treatment.}, journal = {ACS nano}, volume = {20}, number = {1}, pages = {1267-1277}, doi = {10.1021/acsnano.5c17413}, pmid = {41452267}, issn = {1936-086X}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; *Reactive Oxygen Species/metabolism ; *Amyloid beta-Peptides/metabolism/antagonists & inhibitors/chemistry ; Humans ; Porosity ; *Palladium/chemistry ; *Platinum/chemistry ; Animals ; Oxidative Stress/drug effects ; Particle Size ; *Peptides/chemistry/pharmacology ; Surface Properties ; }, abstract = {Alzheimer's disease (AD) is an age-related neurodegenerative disease that has become a major health problem nowadays. Inhibiting the aggregation of amyloid-β (Aβ) peptides has made progress in AD treatments. Here, we synthesized mesoporous PdPt nanozymes to immobilize target peptide KLVFFAED for high-efficiency AD treatment. Thanks to the high surface area of the mesoporous nanospherical structure of PdPt nanozymes, lots of KLVFFAED were grafted with a concentration as high as 439.2 μg mL[-1], amplifying inhibition activity against Aβ aggregations. Importantly, the system has a pre-eminent photothermal property in the near-infrared region and exhibits the ability to photothermally disintegrate Aβ aggregates. Moreover, the integrated superoxide dismutase/catalase mimetic activity of PdPt nanozymes also achieves cascade reactive oxygen species (ROS) scavenging to alleviate oxidative stress and neuroglial damage, thus delaying the progression of AD. Therefore, the designed system can simultaneously block Aβ aggregation, destabilize Aβ fibrils, and clear ROS, which together enhance the therapeutic effects, providing important insights into the applications of nanozymes for AD therapy.}, }
@article {pmid41451887, year = {2025}, author = {Lynch, SY and Jia, J and Miles, N and Boiser, J and Buhl, DL and Graff, O and Zadikoff, C}, title = {ABBV-552 in patients with mild Alzheimer's disease: a randomized phase IIb trial.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70994}, pmid = {41451887}, issn = {1552-5279}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; Male ; Aged ; Female ; Middle Aged ; Aged, 80 and over ; Double-Blind Method ; Treatment Outcome ; Dose-Response Relationship, Drug ; Mental Status and Dementia Tests ; }, abstract = {INTRODUCTION: This proof-of-concept, dose-finding phase IIb trial evaluated treatment with ABBV-552 compared with placebo in participants with clinically diagnosed mild Alzheimer's disease (AD).
METHODS: Participants aged 50 to 90 years with a Mini-Mental State Examination score of 20 to 26 and a global Clinical Dementia Rating score of 0.5 to 1.0 were randomized 1:1:1:1 to placebo or ABBV-552 (1, 5, or 15 mg) daily. The primary endpoint was the change from baseline in the 14-item Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog 14) at week 12.
RESULTS: Two hundred sixty-three participants were randomized. The least-squares mean difference (vs placebo) in change from baseline at week 12 in ADAS-Cog 14 total score (95% confidence interval) for ABBV-552 1 mg was -0.02 (-1.87, 1.83), nominal p = 0.9819; 5 mg, -0.42 (-2.25, 1.42), nominal p = 0.6545; 15 mg, 0.25 (-1.58, 2.08), nominal p = 0.7860. Treatment-emergent adverse events occurred in 48.5% of ABBV-552 recipients versus 42.2% in the placebo group; no safety concerns were identified.
DISCUSSION: ABBV-552 did not demonstrate a meaningful difference versus placebo on the primary endpoint.
HIGHLIGHTS: ABBV-552 is a small molecule that modulates the SV2A receptor in neurons ABBV-552 may enhance synaptic efficiency leading to improved cognition in patients with Alzheimer's disease (AD) Participants with mild AD were treated with either placebo, 1 mg, 5 mg, or 15 mg of ABBV-552 covering an estimated 35% to 80% SV2A receptor occupancy in a phase II randomized clinical trial Results failed to show efficacy over placebo as measured by ADAS-Cog 14 at week 12 ABBV-552 was generally safe and well tolerated.}, }
@article {pmid41451871, year = {2025}, author = {Yang, T and Huhe, H and Williams, SP and Kaur, S and Ay, YA and Davis-Gilbert, ZW and Cary, GA and Paisie, C and Butler, RR and Wiley, J and Betarbet, R and Fu, H and Duong, D and Seyfried, NT and Leal, K and Carter, GW and Edwards, A and Levey, AI and Capener, JL and Drewry, DH and Hossain, MA and Oh, HJ and Axtman, AD and Sukoff Rizzo, SJ and Longo, FM and , }, title = {PAK1 inhibitor NVS-PAK1-1 preserves dendritic spines in amyloid/tau exposed neurons and 5xFAD mice.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e71033}, pmid = {41451871}, issn = {1552-5279}, support = {U54 AG065187/AG/NIA NIH HHS/United States ; //PhRMA Foundation/ ; //Archer Fund/ ; //Jean Perkins Foundation/ ; //NIH grants NIA U54AG065187/ ; //Applebaum Foundation Fund/ ; //The SGC is a registered charity that receives funds from Bayer AG, Boehringer Ingelheim/ ; }, mesh = {Animals ; *Dendritic Spines/drug effects/pathology/metabolism ; *p21-Activated Kinases/antagonists & inhibitors/metabolism ; *tau Proteins/metabolism ; *Amyloid beta-Peptides/metabolism/toxicity ; Mice, Transgenic ; *Alzheimer Disease/pathology/metabolism/drug therapy ; *Neurons/drug effects/metabolism ; Hippocampus/drug effects/pathology ; Disease Models, Animal ; Mice ; Female ; Humans ; Dibenzazepines ; Pyrrolidines ; }, abstract = {INTRODUCTION: Synaptic spine loss in Alzheimer's disease (AD) contributes to cognitive decline. p21-activated kinase 1 (PAK1), a regulator of spine integrity, is aberrantly activated in AD. We investigated whether PAK1 inhibition might preserve dendritic spines in vitro and in vivo.
METHODS: Oligomeric amyloid beta (oAβ) or tau (oTau) were applied to hippocampal neurons ± NVS-PAK1-1, a selective PAK1 inhibitor. NVS-PAK1-1 was orally administered to 5xFAD mice. The effects of NVS-PAK1-1 treatment on PAK1 activity, spine density, and the proteome were assessed using phospho-PAK1 (pPAK1) western blotting, Golgi staining, and mass spectrometry for proteomic analyses.
RESULTS: NVS-PAK1-1 prevented oAβ and oTau-induced spine loss in vitro. In 5xFAD mice, NVS-PAK1-1 demonstrated brain exposure after oral administration and reduced PAK1 activation, prevented spine loss, and partially normalized synaptic proteomic signatures in females in absence of alterations in brain or plasma Aβ.
DISCUSSION: PAK1 inhibition enhances spine resilience in AD models, supporting its therapeutic potential.
HIGHLIGHTS: p21-activated kinase 1 (PAK1) inhibitors prevent oligomeric amyloid beta (oAβ) and oligomeric tau-induced spine loss and dendritic degeneration in cultured mouse hippocampal neurons. NVS-PAK1-1, a selective PAK1 inhibitor, protects against oAβ-induced spine loss in a dose-dependent manner (EC50 = 2 nM). Oral administration of NVS-PAK1-1 achieves brain penetration and bioavailability in normal CD-1 mice, and target engagement in 5xFAD mice. Chronic NVS-PAK1-1 treatment mitigates spine loss in the somatosensory cortex of 6-month-old 5xFAD female mice. Chronic treatment with NVS-PAK1-1 restores proteomic abundance of actin cytoskeleton and dendritic spine-associated proteins, including cofilin 2 and pyruvate dehydrogenase kinases, downstream of PAK1 in young 5xFAD female mice showing spine resilience. Clinical oncology trials with other PAK1 inhibitors support potential repurposing or novel compound development for Alzheimer's disease trials.}, }
@article {pmid41451412, year = {2025}, author = {Li, S and Qian, W and Zhang, Z and Chen, Y and Hou, X and Min, B and Zhou, H and Zhu, X and Ling, J and Yang, W and Cao, S}, title = {Comprehensive safety assessment of donepezil: pharmacovigilance analysis based on the FDA adverse event reporting system.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1655216}, pmid = {41451412}, issn = {1664-2295}, abstract = {BACKGROUND: Alzheimer's disease (AD) has a growing global prevalence, and the need for safe and effective treatments is urgent. Donepezil is commonly used therapeutic agents for AD but has safety controversies. The objective of this study was to thoroughly evaluate donepezil's adverse event profile using actual data.
METHODS: In this study, reports of donepezil-related adverse events were collected from the first quarter of 2004 to the fourth quarter of 2024 through the FAERS database. The association of donepezil-induced adverse events was disproportionality analyzed using Reporting odds Ratios (ROR) and Proportional Reporting Ratio (PRR) and Bayesian Confidence Propagation Neural Network (BCPNN) and Multi-item Gamma Poisson Shrinker (MGPS), among other methods.
RESULTS: A total of 26,120 ADRs with donepezil as the "first suspect" were retrieved during the reporting period. The most common AEs included nausea, vomiting, syncope, and dizziness, which were consistent with the labeling of the medication and clinical trials. Unintended major AEs such as fall, hypotension, tremor, cognitive disorder, mania, and the highest signal of pleurothotonus were also detected. The reports also collected were characterized by a high proportion of female patients (51.3%) and the time of AE induction within 30 days (41%).
CONCLUSION: Donepezil treatment needs to focus on cardiovascular and neurological adverse events, especially for women, elderly patients, or patients with co-morbidities, cardiac monitoring and dose adjustment should be strengthened. Clinics need to balance efficacy and risk, develop individualized dosing regimens, and explore novel therapeutic strategies to improve long-term safety.}, }
@article {pmid41450657, year = {2025}, author = {Zhao, Y and Xi, E and Wang, Z and Gao, N and Sun, H and Zhu, G}, title = {Nanoamplifier Agents Transiently Rise the Metabolism of β‑Amyloid Peptide in Urine for the Early Diagnosis of Alzheimer's Disease.}, journal = {JACS Au}, volume = {5}, number = {12}, pages = {6169-6178}, pmid = {41450657}, issn = {2691-3704}, abstract = {Alzheimer's disease (AD) is the most common form of dementia without effective treatment. Therefore, early diagnosis for timely treatment and delayof the onset of AD are critical. At present, detecting β-amyloid (Aβ) in cerebrospinal fluid is still the most important clinical method. However, the invasive detection method is harmful and difficult to promote. Recent research has shown that Aβ was found not only in blood and cerebrospinal fluid, but also in urine, which could be used for noninvasive testing. Compared with blood/cerebrospinal fluid, the background proteins in urine are very low, but unfortunately the content of Aβ is even lower. Therefore, if the concentration of Aβ is increased with the background proteins maintained at the low level, urine could be an ideal noninvasive early detection target for AD. Gold nanoparticles (AuNP) with ultrasmall size (<6 nm) could be rapidly metabolized by the kidneys and excreted with urine, and easily regulated by the metabolic pathway between kidneys and liver by changing their size. After screening, we found 3 nm AuNP had the highest renal metabolic efficiency, and by modifying with kidney targeting peptides and Aβ antibody 6E10, the complex system (P6-Au) acted as a "Aβ-targeting renal metabolic carrier", which both metabolized rapidly through the kidneys and increased the concentration of Aβ in urine. After tail vein injection of P6-Au, the Aβ content in the urine of 5×FAD transgenic mice increased by more than 20 times within the next 24 h, which resulted in the diagnosis time being advanced from the ninth month to the fifth month and provided a new approach for early detection of AD.}, }
@article {pmid41450541, year = {2025}, author = {Chen, C and Shao, Q and Zhou, S}, title = {Exploring the Mahuang Fuzi Xixin Decoction's mechanism for treating Alzheimer's disease using molecular docking and network pharmacology.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1688316}, pmid = {41450541}, issn = {1663-4365}, abstract = {OBJECTIVE: Explore the potential mechanism of Mahuang Fuzi Xixin Decoction (MFXD) in the treatment of Alzheimer's disease (AD) using network pharmacology, molecular docking approaches, and test its efficacy by in vitro experiments.
METHODS: Active components of MFXD were screened from TCMSP, BATMAN-TCM, and TCMID, with corresponding targets obtained from SwissTargetPrediction and TCMSP. AD-related differential genes were retrieved from GEO. Intersection targets were identified via Venn diagrams, followed by GO/KEGG enrichment analyses, PPI network construction, and molecular docking. In vitro validation experiments were carried out using PC12 cells induced by Aβ25-35 to simulate the pathological state of AD. For the detection of cell viability, the CCK-8 assay was employed to evaluate the protective effect of MFXD and its active components on damaged PC12 cells. Western blot analysis was used to determine the protein expression levels of key molecules involved in AD-related signaling pathways, including phosphorylated p-NF-κB p65, NF-κB p65, p-GSK-3β, GSK-3β, MMP-9, p-Tau, and Tau. Additionally, the ELISA was utilized to measure the secretion level of TNF-α in the supernatant of Aβ25-35-induced PC12 cells, so as to assess the anti-inflammatory effect of MFXD.
RESULTS: Thirty-seven active components and 230 targets of MFXD were identified, along with 4913 AD-related differentially expressed genes from GEO dataset GSE122063, yielding 47 intersection targets. GO annotation enriched these targets in processes like reactive oxygen species metabolism, components like extracellular matrix, and functions like neurotransmitter binding; several pathways were enriched in the KEGG analysis, such as TNF signaling pathway, calcium signaling pathway, and NF-κB signaling pathway. The intersection target PPI network identified MMP9, EGFR, FOS as core targets. Molecular docking results indicated that quercetin binds to the three core targets (MMP9, EGFR, FOS), while luteolin binds preferentially to EGFR and MMP9. In vitro, Aβ25-35-induced PC12 cells treated with quercetin/luteolin had concentration-dependent viability increases (all P < 0.001); 15% MFXD-containing serum restored viability to ≥ 95% (P < 0.001 vs. AD model, comparable to DHCL). Western blot showed AD model had elevated p-NF-κB p65/NF-κB p65, MMP9/β-actin, p-Tau/Tau and reduced p-GSK-3β/GSK-3β (all P < 0.05); MFXD reversed these (all P < 0.05), while DHCL only inhibited p-NF-κB p65/NF-κB p65. ELISA showed MFXD and DHCL both reduced AD model's TNF-α (all P < 0.001).
CONCLUSION: MFXD potentially exerts anti-AD effects through a multi-component, multi-target, multi-pathway approach. Its key active components (quercetin, luteolin) may act by modulating the core target MMP9. Also, MFXD can simultaneously regulate several pathways, such as the TNF signaling pathway, Calcium signaling pathway, and NF-κB signaling pathway, and target Tau protein-related pathology by restoring the phosphorylation level of GSK-3β to suppress abnormal hyperphosphorylation of Tau, and thereby alleviating pathological damage in AD.}, }
@article {pmid41449667, year = {2025}, author = {Günaydin, C and Hackett, NR and Wakim, V and Sondhi, D and Kaminsky, SM and Crystal, RG}, title = {Prime Editing of Alzheimer's Disease High-Risk APOE4 Allele by Brain-Directed Adeno-Associated Virus Vectors.}, journal = {Human gene therapy}, volume = {}, number = {}, pages = {}, doi = {10.1177/10430342251401888}, pmid = {41449667}, issn = {1557-7422}, abstract = {Common variants of the apolipoprotein E (APOE) gene have a major impact on the risk of developing Alzheimer's disease (AD). Relative to homozygotes with the common E3 allele, the APOE4 variant (C112R) increases risk by 3.5-fold in E3/E4 heterozygotes and 15-fold in E4 homozygotes. Since the E3 and E4 alleles differ only by a single nucleotide, gene editing of E4 to E3 is a potential strategy to reduce AD risk in E4 homozygotes. Because the APOE pool in the brain is separate from systemic APOE, editing to treat AD would ideally be directed to the brain. Following in vitro optimization of prime editing guide RNAs, efficient prime editing expression cassettes were inserted into the adeno-associated virus (AAV) split-intein system and packaged into pairs of AAV vectors for in vivo editing. The AAV vectors were administered to human homozygous APOE4-targeted replacement mice (TRE4), and APOE4 to APOE3 editing efficiency was assessed after 4 weeks. The prime editing construct designated APOE3/4-3_10 was the most efficient at APOE4 to APOE3 conversion, both in liver following intravenous delivery and in brain following intrahippocampal delivery. To assess brain-wide editing, two AAV capsids were compared, including AAVrh.10 with administration either directly to the hippocampus or to the cerebrospinal fluid via the cisterna magna and AAV-CAP.B10 administered intravenously. Other than minor differences in APOE4/3-3_10 mediated E4 to E3 editing in the cerebellum, the different capsids and routes yielded similar editing efficacy throughout the brain. This may represent a candidate treatment to reduce the risk of AD.}, }
@article {pmid41448751, year = {2025}, author = {Liu, S and Wang, L and Li, S and Xu, G}, title = {[Effects of 40 Hz light flicker stimulation on hippocampal-prefrontal neural activity characteristics during working memory tasks in Alzheimer's disease model rats].}, journal = {Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi}, volume = {42}, number = {6}, pages = {1107-1114}, pmid = {41448751}, issn = {1001-5515}, mesh = {Animals ; *Alzheimer Disease/physiopathology/therapy ; *Memory, Short-Term/physiology/radiation effects ; *Prefrontal Cortex/physiopathology ; *Hippocampus/physiopathology/physiology ; Rats, Wistar ; Rats ; Disease Models, Animal ; Male ; *Photic Stimulation ; Maze Learning ; }, abstract = {40 Hz light flicker stimulation is deemed to hold considerable promise in the treatment of Alzheimer's disease (AD). However, whether its long-term effect can improve working memory and its related mechanisms remains to be further explored. In this study, 21 adult Wistar rats were randomly divided into the AD light-stimulation group, the AD group and the control group. AD models were established in the first two of these groups, with the light-stimulation group receiving long-term 40 Hz light flicker stimulation. Working memory performance across groups was subsequently evaluated using the T-maze task. To investigate the potential neural mechanisms underlying the effects of 40 Hz light stimulation on working memory, we examined changes in neuronal excitability within the hippocampus (HPC) and medial prefrontal cortex (mPFC), as well as alterations in inter-regional synchronization of neural activity. The findings demonstrated that prolonged 40 Hz light stimulation significantly improved working memory performance in AD model rats. Furthermore, the intervention enhanced the synchronization of neural activity between the hippocampus (HPC) and medial prefrontal cortex (mPFC), as well as the efficiency of information transfer, primarily mediated by theta and low-frequency gamma oscillations. This study provides theoretical support for exploring the mechanisms of 40 Hz light flicker stimulation and its further clinical application in the prevention and treatment of Alzheimer's disease.}, }
@article {pmid41448509, year = {2026}, author = {Kim, N and Jeon, JY and Seo, J and Lee, Y and Kim, HJ and Kim, JS}, title = {A combined model of convolutional neural networks and graph attention networks for improved classification of mild cognitive impairment.}, journal = {NeuroImage}, volume = {325}, number = {}, pages = {121674}, doi = {10.1016/j.neuroimage.2025.121674}, pmid = {41448509}, issn = {1095-9572}, mesh = {Humans ; *Cognitive Dysfunction/classification/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Aged ; Male ; *Neural Networks, Computer ; Female ; Deep Learning ; Aged, 80 and over ; Alzheimer Disease/diagnostic imaging ; Middle Aged ; Brain/diagnostic imaging ; Convolutional Neural Networks ; }, abstract = {Mild cognitive impairment (MCI), a precursor of Alzheimer's disease (AD), underscores the importance of early diagnosis and treatment. With an aging global population, AD prevalence is rising, necessitating more precise diagnostic methods. Deep learning technology shows promise for MCI and AD classification, but existing convolutional neural network (CNN) and graph attention network (GAT) models have limitations in capturing brain structural features and detecting microlesions. To address these issues, we propose a novel approach combining a CNN and modified GAT model to improve MCI classification. Magnetic resonance imaging volume data were analyzed using a CNN, whereas cortical thickness data were modeled using a GAT, leveraging their complementary strengths. Preprocessing involved extracting brain's structural features via the CIVET pipeline, and t-SNE was used to visualize the data's high-dimensional distribution. Final classification was performed using a multilayer perceptron, integrating feature vectors from both models. Performance evaluation metrics included the area under the curve (AUC), F1-score, sensitivity, and specificity. The combined CNN-GAT model outperformed existing single-model approaches, particularly in MCI classification, effectively distinguishing subtle variations between normal aging and MCI. The combined CNN-GAT model improved MCI classification performance by addressing the limitations of existing approaches. By capturing brain structural features and inter-regional relationships, it offers significant potential for advancing early diagnosis and treatment strategies for neurodegenerative diseases. Future efforts will focus on enhancing performance through additional data optimization.}, }
@article {pmid41447429, year = {2026}, author = {Chandrasekaran, A and Malek-Ahmadi, M and Decourt, B and Sabbagh, MN}, title = {Informant-Based Questionnaires in the Diagnostic Pathway for Screening of Cognitive Impairment.}, journal = {Neurology and therapy}, volume = {15}, number = {1}, pages = {29-40}, pmid = {41447429}, issn = {2193-8253}, abstract = {Alzheimer's disease (AD) remains the most common form of dementia in elderly populations. Accurately diagnosing early forms of dementia and AD remains a significant clinical challenge, especially in fast-paced primary care settings. Informant-based questionnaires that rely on close caregivers of the patients, such as the Informant Questionnaire on Cognitive Decline in the Elderly, the Ascertain Dementia 8-Item, the Quick Dementia Rating System, and the Alzheimer's Questionnaire, have recently been shown to be a valuable supplement to current standards of diagnosis, such as performance-based tests. This review aimed to explore the key characteristics of various informant-based questionnaires and evaluate their efficacy in the medical setting. Analysis of each test demonstrated that informant-based assessments show a strong ability to detect cognitive impairment early on in its pathology and can highlight gradual decline over time, compared with the single-timeframe evaluations that performance-based tests provide. Informant-based questionnaires are also able to circumvent challenges associated with the patient's education level, language, and other cultural biases, thus making them useful in diverse populations. When used in conjunction with performance tests, informant-based tests can significantly streamline the diagnostic process for dementia and enhance management and treatment strategies. Further research is advised to effectively integrate these tests into routine clinical practice and establish a new standard of care.}, }
@article {pmid41446880, year = {2025}, author = {van Brummelen, R and van Brummelen, AC}, title = {The role of neuro-supportive substances of natural origin in neurological conditions-A literature-based formulators' perspective.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1647092}, pmid = {41446880}, issn = {1664-2295}, abstract = {Products of natural origin are seldom tested up to a point of full acceptance, mainly due to a lack of financial viability for commercialization. Yet many come with a rich history of use and proof of concept testing. We investigated literature regarding the possible role and function of the best known of these nutraceuticals in relationship to three neurological conditions i.e. stroke, Alzheimer's - (AD) and Parkinson's disease (PD), and their potential as supportive therapies. Current studies suggest that citicoline has a neuroprotective effect in ischemic conditions, playing a role in the restoration of the barrier function of endothelial cells, activating repair mechanisms and possibly decreasing ischemic lesion size in stroke, as well as increasing dopamine availability in PD. Citicoline was also demonstrated to increase the levels of sirtuin 1 (SIRT1), thus reducing inflammation-leading to improved cognitive status and a better quality of life in cognitive impairment. N-Acetylcysteine (NAC) shows pro-cognitive effects, increasing glutathione (GSH) levels that are decreased in AD and PD patients, possibly decreasing neuroinflammation. Mechanistic studies indicate the potential neuroprotective and neurorestorative effects of resveratrol by its anti-inflammatory and anti-apoptotic activity, also increasing SIRT1 levels and promoting the outgrowth of neurite protrusions and synaptogenesis. Curcumin's anti-inflammatory effects via inhibition of interleukin 1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) can potentially delay progression of PD. Some nutraceuticals, e.g., citicoline, show synergism in combination with current therapies. We propose a renewed, risk-benefit approach for inclusion of the investigated nutraceuticals with limited indications in certain neurological treatment regimens.}, }
@article {pmid41446876, year = {2025}, author = {Sun, Y and Chen, D and Ye, Q and You, Z and Zhao, Z and Shi, J and Sun, H and Li, S and Xu, X and Xu, Y and Zhang, P and Tang, Z}, title = {Applications of Endovascular Brain-Computer Interface in Patients with Alzheimer's Disease.}, journal = {Research (Washington, D.C.)}, volume = {8}, number = {}, pages = {1049}, pmid = {41446876}, issn = {2639-5274}, abstract = {Alzheimer's disease (AD) is a prevalent neurodegenerative disorder affecting the elderly, leading to important impairments in cognitive function and the ability to live independently. This results in substantial disability and places an increasing burden on families and society. Currently, the therapeutic approaches adopted in clinical practice predominantly hinge upon cholinesterase inhibitors and the N-methyl-d-aspartate (NMDA) receptor antagonist memantine. Nevertheless, these medications merely alleviate symptoms and fail to tackle the pathological characteristics of AD. In recent years, monoclonal antibodies such as lecanemab and donanemab against β-amyloid (Aβ) have shown good efficacy in clinical practice for early-stage AD patients. However, the early diagnosis of AD remains a challenge. Against this backdrop, endovascular brain-computer interface (EBCI) offers an integrated solution for the early diagnosis and neuroregulatory treatment of AD patients, with minimal invasiveness. This review comprehensively examines the safety and feasibility of EBCI for AD patients, focusing on 3 major application areas: early diagnosis, deep brain stimulation targeting specific brain regions, such as the fornix and the basal nuclei of Meynert, and the use of external neurofeedback devices. Furthermore, we explore future development trends in this field, including miniaturization, integration, and the exploration of deep brain regions.}, }
@article {pmid41446471, year = {2025}, author = {Masna, H and Konda, M and Ganti, L}, title = {Huntington's Disease Research Over Six Decades: Global Insights, Gaps, and Future Directions.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97567}, pmid = {41446471}, issn = {2168-8184}, abstract = {Huntington's disease (HD) is a hereditary neurodegenerative disorder caused by expanded cytosine-adenine-guanine (CAG) repeats in the huntingtin (HTT) gene. It leads to progressive decline in motor function, cognition, and behavior, often following a prolonged pre-symptomatic phase. Although research on HD has progressed, significant gaps remain in understanding its full impact, particularly in areas such as mental health, global collaboration, and early intervention. A bibliometric analysis was conducted using the Web of Science Core Collection to evaluate global research trends in HD and its testing from 1966 to 2025. A total of 1,515 publications were analyzed for authorship patterns, contributing countries, journal sources, and frequently occurring keywords. VOSviewer software v1.6.15 (Centre for Science and Technology Studies, Leiden University, The Netherlands) was used to visualize author networks and keyword co-occurrence. Publication activity peaked in 2014 and 2018, with 101 and 96 articles published, respectively. The United States emerged as the leading contributor to HD research, followed by European countries with fewer publications. Keyword analysis revealed strong associations between HD and other neurodegenerative disorders, such as Alzheimer's and Parkinson's disease, as well as recurring terms related to genetic testing, brain anatomy, and animal models. Limited author collaboration was observed, with only a few dense research clusters present. This analysis highlights the growing body of research on HD, particularly in genetic mechanisms and therapeutic modeling. However, the concentration of research within a few countries and author groups suggests limited global collaboration. Emerging gaps include underrepresentation of mental health impacts, disparities in geographic research output, and narrow journal dissemination. Strengthening international cooperation and diversifying research focus could accelerate progress in diagnosis, treatment, and overall patient care.}, }
@article {pmid41446236, year = {2025}, author = {Fredriksen, K and Joshi, SS and Chang, A and Li, L}, title = {High-density lipoprotein mimetic peptide 4F ameliorates APOE4-associated lipid dysfunction in primary and iPSC-derived astrocytes and cerebral organoids.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.16.694774}, pmid = {41446236}, issn = {2692-8205}, abstract = {APOE is the greatest genetic risk factor for late-onset Alzheimer's disease (AD). In humans, APOE has three isoforms: APOE2 (E2), APOE3 (E3), and APOE4 (E4); E4 increases AD risk, while E3 is neutral and E2 decreases risk. In the brain, APOE is predominantly produced by astrocytes, where it binds lipids to form HDL-like particles, and plays a central role in lipid homeostasis, Aβ clearance, and neuroimmune modulation. Its lipidation state is critical for function, with E4 being poorly lipidated compared to E2 and E3, contributing to the pathogenic effects of E4 while also offering a potential therapeutic target. We have previously demonstrated that the HDL-mimetic peptide 4F increases APOE secretion and lipidation in wild-type mouse astrocytes and counteracts the inhibitory effects of Aβ42. Here, we assessed the ability of 4F to mitigate E4-associated dysfunction using primary astrocytes from humanized E3 and E4 knock-in mice and isogenic human iPSC-derived astrocytes and cerebral organoids. Results showed that 4F enhanced APOE secretion and lipidation in both cellular and organoid models in the absence or presence of aggregated Aβ42. Compared to E3 astrocytes, E4 astrocytes were prone to Aβ42-induced inhibition of APOE secretion and lipidation and increased accumulation of lipid droplets. 4F treatment ameliorated the inhibitory effects of Aβ42 and reduced lipid droplet accumulation. These findings support the therapeutic potential of HDL-mimetic peptides for E4-associated dysfunction in AD.}, }
@article {pmid41446123, year = {2025}, author = {Shao, B and Kula, B and Le, H and Venkhatesh, P and Katti, P and Marshall, AG and Chittaranjan, S and Thapilyal, S and Namdar, HK and Nivedya, C and Roszczyk, A and Mobley, H and Killion, M and St John, E and Martin, P and Rodrigiuez, B and Hamilton, M and Bell, L and Wyckoff, SM and Moran, LA and Philips, M and Hubert, D and Tomeau, B and Afolabi, JM and Kirabo, A and Blanco, I and Reasonover, S and Drake, LE and Lippmann, ES and Evans, C and Santisteban, MM and Cheairs, TG and Mesenga, S and Wanjalla, C and Gaddy, J and McMillan, R and Hernandez Perez, CP and Paing, HH and Schafer, JC and Mobley, B and Berry, J and Crabtree, A and Kovtun, O and Goodwin, S and Garza Lopez, E and Dash, C and Dai, DF and Miller-Fleming, TW and Hinton, A and Smith, NA}, title = {The role of MICOS in modulating mitochondrial dynamics and structural changes in vulnerable regions of Alzheimer's Disease.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41446123}, issn = {2692-8205}, support = {UL1 TR000445/TR/NCATS NIH HHS/United States ; R01 DK133698/DK/NIDDK NIH HHS/United States ; R01 HD090061/HD/NICHD NIH HHS/United States ; R21 DK119879/DK/NIDDK NIH HHS/United States ; U19 HL065962/HL/NHLBI NIH HHS/United States ; P30 DK058404/DK/NIDDK NIH HHS/United States ; S10 RR025141/RR/NCRR NIH HHS/United States ; R01 HL147818/HL/NHLBI NIH HHS/United States ; R25 HL106365/HL/NHLBI NIH HHS/United States ; R01 HD074711/HD/NICHD NIH HHS/United States ; P50 GM115305/GM/NIGMS NIH HHS/United States ; T32 DK007563/DK/NIDDK NIH HHS/United States ; R21 TW012635/TW/FIC NIH HHS/United States ; S10 OD017985/OD/NIH HHS/United States ; P30 EY008126/EY/NEI NIH HHS/United States ; R01 HL144941/HL/NHLBI NIH HHS/United States ; I01 BX005352/BX/BLRD VA/United States ; P30 DK020593/DK/NIDDK NIH HHS/United States ; RC2 GM092618/GM/NIGMS NIH HHS/United States ; P30 CA068485/CA/NCI NIH HHS/United States ; R03 HL155041/HL/NHLBI NIH HHS/United States ; S10 OD025092/OD/NIH HHS/United States ; U01 HG006378/HG/NHGRI NIH HHS/United States ; K01 AG062757/AG/NIA NIH HHS/United States ; R00 AG065445/AG/NIA NIH HHS/United States ; K01 NS110981/NS/NINDS NIH HHS/United States ; UL1 RR024975/RR/NCRR NIH HHS/United States ; R01 NS032830/NS/NINDS NIH HHS/United States ; U01 HG004798/HG/NHGRI NIH HHS/United States ; UL1 TR002243/TR/NCATS NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; R00 DK120876/DK/NIDDK NIH HHS/United States ; D43 TW009744/TW/FIC NIH HHS/United States ; S10 MH130456/MH/NIMH NIH HHS/United States ; }, abstract = {Mitochondrial contact site and cristae organizing system (MICOS) complexes are critical for maintaining the mitochondrial architecture, cristae integrity, and organelle communication in neurons. MICOS disruption has been implicated in neurodegenerative disorders, including Alzheimer's disease (AD), yet the spatiotemporal dynamics of MICOS-associated neuronal alterations during aging remain unclear. Using three-dimensional reconstructions of hypothalamic and cortical neurons, we observed age-dependent fragmentation of mitochondrial cristae, reduced intermitochondrial connectivity, and compartment-specific changes in mitochondrial size and morphology. Notably, these structural deficits were most pronounced in neurons vulnerable to AD-related pathology, suggesting a mechanistic link between MICOS disruption and the early mitochondrial dysfunction observed in patients with AD. Our findings indicate that the loss of MICOS integrity is a progressive feature of neuronal aging, contributing to impaired bioenergetics and reduced resilience to metabolic stress and potentially facilitating neurodegenerative processes. MICOS disruption reduced neuronal firing and synaptic responsiveness, with miclxin treatment decreasing mitochondrial connectivity and inducing cristae disorganization. These changes link MICOS structural deficits directly to impaired neuronal excitability, highlighting vulnerability to AD-related neurodegeneration. These results underscore the importance of MICOS as a critical determinant of neuronal mitochondrial health and as a potential target for interventions aimed at mitigating AD-related mitochondrial dysfunction.}, }
@article {pmid41445693, year = {2025}, author = {Lee, S and Yin, L and Teopiz, KM and Wong, S and Han Le, G and Xiao, N and Stahl, S and Valentino, K and Ho, R and Zhang, MC and Greg Rhee, T and McIntyre, RS}, title = {Effects of glucagon-like peptide-1 receptor agonists on psychiatric disorders: a systematic review.}, journal = {Therapeutic advances in psychopharmacology}, volume = {15}, number = {}, pages = {20451253251396304}, pmid = {41445693}, issn = {2045-1253}, abstract = {Extant literature pertaining to the administration of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for Alzheimer's disease, Parkinson's disease, major depressive disorder, bipolar disorder, substance-, alcohol- and nicotine-use disorders, suggests promising efficacy beyond the current FDA-approved indications (e.g., type 2 diabetes mellitus, obesity). The implicated brain regions of the aforementioned mental disorders contain glucagon-like peptide 1 (GLP-1) receptors associated with improving cognitive and behavioral functioning. Therefore, we aimed to systematically review the treatment effects of GLP-1RAs in various neurocognitive and psychiatric disorders. Online databases including PubMed, OVID, MEDLINE, Embase, PsycINFO and Google Scholar, were searched from inception until October 1, 2024. Additional studies were identified from the reference lists of the included articles. 22 studies were identified, with a total of 186,847 participants included. Results reported that GLP-1RAs meaningfully improved cognitive and affective functioning (e.g., memory), which in some cases was sustained beyond exposure to the agent. Separately, multiple epidemiological studies reported that GLP-1RAs have protective effects, with a suggestion of decrease in the incidence of mental disorders. These results provides the impetus for large, long-term, randomized controlled trials for GLP-1 RAs for the treatment of various mental disorders. This review is not registered in PROSPERO or any other registry.}, }
@article {pmid41445644, year = {2025}, author = {Li, R and Langford, O and Insel, PS and Sperling, RA and Raman, R and Aisen, PS and Donohue, MC}, title = {Divergent latent classes of cognitive decline in the A4 and LEARN studies.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.15.25342305}, pmid = {41445644}, abstract = {IMPORTANCE: Alzheimer disease biomarkers in cognitively unimpaired older adults are associated with later cognitive and clinical decline, yet substantial heterogeneity in the timing and rate of decline remains insufficiently characterized.
OBJECTIVE: To identify subgroups of cognitive decline among biomarker-defined cognitively unimpaired adults and determine baseline predictors of heterogeneity in preclinical Alzheimer disease progression.
Longitudinal data were drawn from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) Study, which enrolled amyloid-positive participants, and the parallel LEARN Study, which enrolled amyloid-negative individuals meeting all other A4 criteria. Participants completed baseline amyloid PET, plasma P-tau217, structural MRI, and serial cognitive assessments. Latent Class Mixed-Effects Models (LCMMs) were used to identify distinct cognitive trajectory classes. Associations between class membership and demographic, clinical, and biomarker characteristics were evaluated.
MAIN OUTCOMES AND MEASURES: The primary outcome was longitudinal change in the Preclinical Alzheimer's Cognitive Composite (PACC).
RESULTS: Three cognitive trajectory classes were identified: stable, slow decliners, and fast decliners. Higher plasma P-tau217, smaller hippocampal volume, and elevated tau PET were associated with greater odds of belonging to declining classes. Among amyloid-positive individuals, approximately 70% were classified as stable over the observed follow-up interval.
CONCLUSIONS AND RELEVANCE: Latent class modeling reveals marked heterogeneity in preclinical cognitive trajectories, even among individuals with biomarker evidence of Alzheimer pathology. The high proportion of stable individuals is consistent with the long presymptomatic interval. Identifying subgroups of decline may improve prognostic modeling and guide enrichment strategies for precision secondary prevention trials.}, }
@article {pmid41444683, year = {2025}, author = {Weissmann, C and Castellanos, LCS and Montes, MM and Uruk, G and Youssef, H and Reichard, RR and Gatto, RG and Josephs, KA}, title = {4R-tau isoform induction via TDP-43 in neurons in response to insulin: converging signaling pathways with implications for neurodegenerative disease.}, journal = {Acta neuropathologica communications}, volume = {13}, number = {1}, pages = {258}, pmid = {41444683}, issn = {2051-5960}, support = {PIP Grant No. 11220210100589CO//Consejo Nacional de Investigaciones Científicas y Técnicas/ ; UBACYT (Grant No. 20020220400291BA)//Universidad de Buenos Aires/ ; R01-AG37491//National Institute for Health Care Management Foundation/ ; R01 AG037491/AG/NIA NIH HHS/United States ; PICT 2020-01211//Agencia Nacional de Promoción de la Investigación, el Desarrollo Tecnológico y la Innovación/ ; }, mesh = {Animals ; *tau Proteins/metabolism ; *DNA-Binding Proteins/metabolism ; *Neurons/metabolism/drug effects ; Humans ; *Signal Transduction/drug effects/physiology ; *Insulin/pharmacology ; Protein Isoforms/metabolism ; HEK293 Cells ; Mice ; *Neurodegenerative Diseases/metabolism ; Phosphorylation/drug effects ; Cells, Cultured ; Cerebral Cortex/cytology/metabolism ; Mice, Inbred C57BL ; }, abstract = {Tau protein isoforms, regulated during development, are influenced by the nuclear factor TDP-43, which plays a crucial role in tau mRNA stability and exon 10 inclusion. Both tau and TDP-43 are prone to pathological phosphorylation and aggregation, with specific phosphorylated forms of TDP-43 linked to cytoplasmic mislocalization and alterations in the 3R/4R tau ratio as detected in different pathologies. In this study, we show that insulin treatment of embryonic mouse primary cortical neurons-cells that normally express only 3R-tau-induces the expression of 4R-tau, suggesting that metabolic signaling can influence tau isoform expression in a developmentally immature neuronal context. In addition, experiments in HEK293 cells revealed isoform-specific stabilization effects and showed that insulin promotes TDP-43 redistribution to the cytoplasm along with a phosphorylation pattern. These results underscore the complex interplay between TDP-43 and tau isoforms and metabolic signaling pathways that play a crucial role in their expression and localization with potential implications for understanding mechanisms of neurodegenerative disease onset and progression.}, }
@article {pmid41444088, year = {2025}, author = {Lynch, S}, title = {Addressing Cognitive Dysfunction: Education, Diagnosis, and Practical Care.}, journal = {The Veterinary clinics of North America. Small animal practice}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cvsm.2025.09.030}, pmid = {41444088}, issn = {1878-1306}, abstract = {Cognitive dysfunction syndrome (CDS) is a common, yet underdiagnosed, neurobehavioral disease of domestic animals. Much like its human counterpart, Alzheimer's disease, CDS is the result of neuronal loss and inflammatory changes in the central nervous system; however, the specific pathophysiology of the disease continues to be researched in efforts to advance diagnostics, prognosis, and treatment. Diagnosis is typically conducted by ruling out possibilities and using assessment tools, including the Canine Dementia Scale and the Canine Cognitive Dysfunction Rating Scale. Treatment is often most successful when a tailored, multimodal approach is initiated early in the disease progression.}, }
@article {pmid41442238, year = {2025}, author = {Periyakoil, VS and Von Gunten, C and Kraemer, H}, title = {Virtual, Nurse-Led Early Primary Palliative Care Intervention (ELICIT) for Community-Dwelling Older Adults With Cognitive Impairment: Protocol for a Randomized Controlled Trial.}, journal = {JMIR research protocols}, volume = {14}, number = {}, pages = {e75082}, pmid = {41442238}, issn = {1929-0748}, support = {R01 AG062239/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Cognitive Dysfunction/nursing/therapy ; *Palliative Care/methods ; Aged ; Independent Living ; Male ; Female ; Aged, 80 and over ; Quality of Life ; Randomized Controlled Trials as Topic ; Primary Health Care ; }, abstract = {BACKGROUND: Although dementia is a serious illness that progresses over many years, little is known about the primary palliative care needs of individuals who have it, especially those living in the community.
OBJECTIVE: This trial aims to test the impact of a virtual, nurse-led early primary palliative care intervention (ELICIT) on older adults living in the community who are chronically ill and have a diagnosis of cognitive impairment or are at risk of it.
METHODS: A total of 200 community-dwelling older adults who were chronically ill and had varying degrees of cognitive impairment were recruited and randomized to either usual care or usual care + a virtual, nurse-led ELICIT. For both arms, we will track the number of participants who (1) report supportive care needs to the blinded evaluators and (2) complete conversations on goals of care and document advance directives and the Physician Orders for Life-Sustaining Treatment form in the electronic health record. We will also track their end-of-life resource use and the percentage of participants who receive goal-concordant care. Changes in Edmonton Symptom Assessment Scale, Patient Activation Measure, and Quality of Life in Alzheimer's Disease scores will be tracked and analyzed.
RESULTS: As of October 2025, we have recruited 200 participants. We are following all study participants on an ongoing basis to determine whether they received goal-concordant care at the end of life and their resource use patterns. We hypothesize that, compared to the usual care arm, more participants in the intervention arm will (1) express supportive care needs to the blinded evaluators, (2) complete goals of care conversations, document advance care planning, and (3) have higher levels of goal-concordant care and lower end-of-life resource use.
CONCLUSIONS: The identification of the primary palliative care needs of community-dwelling older adults who are chronically ill and have various levels of cognitive impairment will help refine the intervention and enable trained nurses to provide virtual early primary palliative care within the scope of nursing.}, }
@article {pmid41441957, year = {2025}, author = {Neve, V and Saqlain, S and Veeranjaneyulu, A and Karwa, P and Kapare, H and Yeralkar, K}, title = {Evaluation of the neuroprotective activity of Momordica dioica against aluminum chloride (AlCl3)-Induced alzheimer's disease in Wistar rats.}, journal = {Discover mental health}, volume = {5}, number = {1}, pages = {198}, pmid = {41441957}, issn = {2731-4383}, abstract = {Alzheimer's disease is a brain condition that slowly erodes a person's memory and cognitive abilities. It is caused by damage to brain cell, particularly in the hippocampus, a region crucial for memory. By 2050 worldwide no. of AD is going increases. Various therapeutic strategies have been explored for AD. The use of herbal products is one of the treatment regimens for AD. In this study, we examined how a herbal extract from Momordica dioica could potentially protect Wistar rats from AD caused by Aluminum chloride. Aluminum chloride (AlCl3) is widely used in preclinical studies to induce Alzheimer-like symptoms, as chronic exposure is known to promote oxidative stress, neuroinflammation, and cholinergic dysfunction-hallmarks of Alzheimer's disease pathology. A total of 86 Wistar rats were randomly assigned to nine experimental groups (n = 6-10 per group), including a normal control group and an Alzheimer's disease (AD) model group. One group treated with Donepezil (2.05 mg/kg), three groups treated with different doses of herbal extract of Momordica dioica (100, 200 and 400 mg/kg), and three groups treated with a combination of Donepezil and herbal extract of Momordica dioica (std + 100, std + 200 and std + 400 mg/kg). The aluminum chloride (17 mg/kg, p.o) was administered once daily for 7 days to induce AD. From the 8th day onward, the herbal extract of Momordica dioica was administered orally for 21 consecutive days at doses of 100, 200, and 400 mg/kg to groups 4, 5, and 6 respectively, as well as in combination with Donepezil (2.05 mg/kg) in groups 7, 8, and 9. This brought the total duration of the study to 28 days." Elevated Plus Maze and Forced Swim test was used for the behavioral assessment. After that, brain samples were collected for biochemical analysis. Herbal Extract significantly improved AlCl3-induced behavioral impairments and cognition deficits in Forced Swim Test, Elevated Plus Maze Test significantly with high dose. Then, herbal extract of Momordica dioica facilitated cholinergic activity via inhibiting acetylcholinesterase (AChE) activity. Besides, herbal extract of Momordica dioica decreased lipid peroxidation level & Nitrite level but enhanced levels of glutathione, Succinate dehydrogenase, Catalase and superoxide dismutase and results are more convincing with high dose. Histopathological analysis further confirmed reduced neuronal degeneration and better preservation of brain architecture, especially at higher doses of the herbal extract." The results suggested that herbal extract of Momordica dioica ameliorated AlCl3-induced cognitive and memory impairments, possibly through regulating AChE activity, suppressing oxidative stress. The herbal extract of Momordica dioica significantly improved behavioral impairments and cognition deficits, particularly at high doses. It facilitates cholinergic activity by inhibiting AChE activity and reduced oxidative stress. Overall, the conclusion states that the herbal extract may ameliorate and memory impairments associated with AD.}, }
@article {pmid41441560, year = {2025}, author = {Clevenger, C and Jackson, WC and Stroud, J and Brubaker, M and Patel, M and Bucior, I and Bratlee-Whitaker, E and Brown, TM and Fehnel, S and Peschin, S and Cummings, J and Grossberg, G}, title = {Development and evaluation of the agitation in Alzheimer's screener for caregivers (AASC): a clinical tool to screen for agitation.}, journal = {Current medical research and opinion}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/03007995.2025.2606562}, pmid = {41441560}, issn = {1473-4877}, abstract = {OBJECTIVE: Although agitation is a common neuropsychiatric symptom in Alzheimer's dementia, it can be challenging to recognize and diagnose. Caregivers of individuals with Alzheimer's dementia are often the first to encounter agitation behaviors but may struggle to recognize and communicate symptoms to healthcare professionals (HCPs). Here, we describe the development and evaluation of the Agitation in Alzheimer's Screener for Caregivers (AASC), a practical screening tool to identify agitation symptoms and facilitate caregiver-HCP communication.
METHODS: The AASC was developed based on the International Psychogeriatric Association (IPA) criteria for agitation in cognitive disorders, input from multidisciplinary experts, and qualitative interviews with caregivers of patients with Alzheimer's dementia. Thereafter, a 2-phase quantitative evaluation study was conducted to refine the AASC and assess the predictive validity of the final tool against IPA criteria. Data were collected from caregiver-HCP dyads, where caregivers completed the AASC and HCPs used IPA criteria to inform their assessment of agitation.
RESULTS: A total of 226 caregiver-HCP dyads were quantitatively evaluated. The mean age of caregivers was 61 years; many were spouses/partners (46%), White (60%), and female (62%), providing an average of 60 h of care weekly (range: 9-168 h). Following initial assessment and refinement, the final AASC, evaluated in a subset of 105 dyads, showed a 73.3% agreement with IPA criteria, with sensitivity of 0.77, specificity of 0.70, and kappa and F1 scores of 0.47 and 0.71, respectively. Most patients were classified as having mild (41%) to moderate (37%) Alzheimer's dementia, while 22% had severe disease.
CONCLUSION: The AASC is a reliable, easy-to-use, 2-item screener for the presence and impact of agitation, in agreement with IPA criteria. The AASC supports caregivers and HCPs by providing an accessible framework for recognizing agitation throughout all stages of Alzheimer's dementia and prompting comprehensive assessment for diagnosis and appropriate treatment planning.}, }
@article {pmid41440958, year = {2025}, author = {Rahmani, AR and Madani, SA and Aminov, E and Gogokhia, L and Bench, T and Kalogeropoulos, A}, title = {Heart Failure and Cognitive Impairment Through the Lens of the Gut Microbiome: A Narrative Review.}, journal = {Journal of personalized medicine}, volume = {15}, number = {12}, pages = {}, pmid = {41440958}, issn = {2075-4426}, abstract = {Heart failure (HF) affects over 55 million individuals globally, with prevalence projected to exceed 11 million in the United States by 2050 and is increasingly recognized as a systemic disorder extending beyond hemodynamic dysfunction to encompass profound alterations in neural and gut physiology. Cognitive impairment affects nearly half of HF patients and represents a major determinant of morbidity, self-care capacity, and mortality. Recent advances suggest that the gut microbiome serves as a pivotal intermediary in the heart-brain crosstalk, influencing neurocognitive outcomes through inflammatory, metabolic, and neurohumoral pathways. Dysbiosis in HF disrupts intestinal barrier integrity, facilitating translocation of endotoxins and microbial metabolites such as trimethylamine-N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, which in turn modulate neuroinflammation, cerebral perfusion, and neuronal signaling. The gut-heart-brain axis provides an integrative framework linking HF and cognitive impairment pathophysiology through dysbiosis-driven systemic inflammation and metabolite dysregulation. Gut-derived biomarkers and microbiome-targeted interventions represent promising strategies for detection of early alterations and precision treatment, highlighting the urge for prospective, multi-omics studies to establish causality and therapeutic efficacy. This review synthesizes current evidence connecting gut microbiome dysbiosis and metabolite alterations to both HF and cognitive impairment pathophysiology and proposes translational strategies for integrating microbiome-targeted therapies in HF patients with cognitive dysfunction.}, }
@article {pmid41438688, year = {2026}, author = {Su, T and Li, Z and Yang, Y and Dai, Y and Li, Y and Zhao, H}, title = {In vitro 3D models of neuron-astrocyte interactions.}, journal = {Biochemistry and biophysics reports}, volume = {45}, number = {}, pages = {102400}, pmid = {41438688}, issn = {2405-5808}, abstract = {The pathological processes of neurodegenerative diseases (e.g., Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis) also include relationships between neuron and glia cells. Conventional two-dimensional (2D) cell cultures have limitations to mimic the microenvironment of cells inside living organisms because of flaws in intercellular relationships investigated using 2D cell cultures. Recent advances have introduced three-dimensional (3D) cell cultures that have the capability to create 3D cellular architecture to mimic advanced platforms for scientific inquiries into neurodegenerative diseases, simulating microenvironments inside living organisms.This review provides a brief overview of the development of in vitro 3D cell culture models of astrocytes and attempts to highlight the role of astrocytes in crucial pathophysiologic events occurring in 3D cultures. Studies have shown the use of in vitro 3D cultures to better represent the dual functions of astrocytes in neurodegenerative disorders. Looking ahead to the future, novel advances in microfluidics and multi-omics analysis promise to further improve 3D cultures and push forward new insights into neurological dysfunction to spark innovative advances for treatment strategies.}, }
@article {pmid41437993, year = {2025}, author = {Fliri, A and Sostek, R and Kajiji, S}, title = {Protein swarm-based cause-effect analysis: effects of microRNAs on cooperation networks linking COVID-19 infections, atherosclerosis, and Alzheimer's disease.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1577844}, pmid = {41437993}, issn = {2297-055X}, abstract = {Well-being depends on the integrated operation of biological processes at all levels of system organization, from individual cells to tissues and organ systems, collectively sustaining homeostasis and optimal bodily functions. The regulation of cooperation among these processes is mediated by information flow within networks possessing diverse structural, functional, and temporal properties. Disruption in these networks is observed in conditions such as infections, inflammatory diseases, and cancer. To advance understanding of immune system roles and to elucidate mechanisms underlying health vulnerability during disease, we utilized proteomics data related to 4,800 diseases along with protein swarm-based cause-effect analyses to identify principles governing plasticity and self-organizing capabilities of immune systems. Our findings demonstrate that the precision of immune system functions is regulated by dynamic alterations in the topologies of cooperation networks that are partially modulated by microRNAs. Additionally, our analysis indicates that investigating the underlying causes of diseases through the study of cooperative network functions and their interactions with microRNAs-rather than concentrating exclusively on individual protein targets or microRNAs-provides significant insights for devising effective treatment strategies for infections, cardiovascular conditions, Alzheimer's disease, cancer, aging, and related health concerns.}, }
@article {pmid41436813, year = {2025}, author = {Birnbaum, EM and Xie, L and Serrano, P and Rockwell, P and Figueiredo-Pereira, ME}, title = {BT-11 targets the LANCL2 pathway to attenuate cognitive deficits and hippocampal pathology in Alzheimer's transgenic rats.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {1848}, pmid = {41436813}, issn = {2045-2322}, support = {TL1-TR0002386//NIH Weill Cornell CTSC/ ; R01AG057555//NIH/NIA/ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism/genetics ; *Hippocampus/pathology/drug effects/metabolism ; Male ; Rats ; Female ; Rats, Transgenic ; *Cognitive Dysfunction/drug therapy/pathology/metabolism ; Disease Models, Animal ; Signal Transduction/drug effects ; *Membrane Proteins/metabolism ; Rats, Inbred F344 ; }, abstract = {Neuroinflammation is a key pathological hallmark of Alzheimer's disease (AD). Investigational and FDA approved drugs targeting inflammation already exist, thus drug repurposing for AD is a suitable approach. BT-11 is an investigational drug that reduces inflammation in the gut and improves cognitive function. BT-11 is orally active and binds to lanthionine synthetase C-like 2 (LANCL2), a glutathione-s-transferase, thus potentially reducing oxidative stress. We investigated the effects of BT-11 long-term treatment on the TgF344-AD rat model of AD. BT-11 (1) reduced spatial memory deficits, and hippocampal Abeta plaque load, and increased neuronal levels in males, and reduced microglia numbers in females, and (2) induced transcriptomic changes in signaling receptor, including G-protein coupled receptor pathways in both males and females, with changes in neurotrophic factors only in males. We detected LANCL2 in hippocampal nuclear and cytoplasmic fractions with potentially different post-translational modifications, suggesting distinct functions based on its subcellular localization. LANCL2 was present in oligodendrocytes, indicating a role in oligodendrocyte function. To our knowledge, these last two findings have not been reported. Overall, our data support that targeting LANCL2 with BT-11 improves cognition and reduces AD-like pathology potentially by modulating G-protein signaling. LANCL2's localization in oligodendrocytes suggest a possible role oligodendrocyte function that warrants further investigation. Our studies contribute to the field of new immunomodulatory AD therapeutics and establish LANCL2 as a promising therapeutic target meriting further mechanistic investigation.}, }
@article {pmid41435831, year = {2025}, author = {Chaubey, K and Vázquez-Rosa, E and Tripathi, SJ and Shin, MK and Yu, Y and Dhar, M and Chakraborty, S and Yamakawa, M and Wang, X and Sridharan, PS and Miller, E and Bud, Z and Corella, SG and Barker, S and Caradonna, SG and Koh, Y and Franke, K and Cintrón-Pérez, CJ and Rose, S and Fang, H and Cintrón-Pérez, AA and Tomco, T and Zhu, X and Fujioka, H and Gefen, T and Flanagan, ME and Williams, NS and Wilson, BM and Chen, L and Dou, L and Cheng, F and Rexach, JE and Woo, JA and Kang, DE and Paul, BD and Pieper, AA}, title = {Pharmacologic reversal of advanced Alzheimer's disease in mice and identification of potential therapeutic nodes in human brain.}, journal = {Cell reports. Medicine}, volume = {}, number = {}, pages = {102535}, doi = {10.1016/j.xcrm.2025.102535}, pmid = {41435831}, issn = {2666-3791}, abstract = {Alzheimer's disease (AD) is traditionally considered irreversible. Here, however, we provide proof of principle for therapeutic reversibility of advanced AD. In advanced disease amyloid-driven 5xFAD mice, treatment with P7C3-A20, which restores nicotinamide adenine dinucleotide (NAD[+]) homeostasis, reverses tau phosphorylation, blood-brain barrier deterioration, oxidative stress, DNA damage, and neuroinflammation and enhances hippocampal neurogenesis and synaptic plasticity, resulting in full cognitive recovery and reduction of plasma levels of the clinical AD biomarker p-tau217. P7C3-A20 also reverses advanced disease in tau-driven PS19 mice and protects human brain microvascular endothelial cells from oxidative stress. In humans and mice, pathology severity correlates with disruption of brain NAD[+] homeostasis, and the brains of nondemented people with Alzheimer's neuropathology exhibit gene expression patterns suggestive of preserved NAD[+] homeostasis. Forty-six proteins aberrantly expressed in advanced 5xFAD mouse brain and normalized by P7C3-A20 show similar alterations in human AD brain, revealing targets with potential for optimizing translation to patient care.}, }
@article {pmid41433150, year = {2025}, author = {Hara, N and Kamada, M and Yamaguchi, H and Uenishi, T and Tanizawa, Y and Ueda, K and Osaga, S and Hatakeyama, N}, title = {Survey on family caregiver experiences before and after dementia diagnosis and support-related issues in Japan.}, journal = {Current medical research and opinion}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/03007995.2025.2603820}, pmid = {41433150}, issn = {1473-4877}, abstract = {OBJECTIVE: This study aimed to elucidate the experiences of family caregivers of people with dementia before and after diagnosis, including regarding medical treatment and support.
METHODS: We conducted a survey of 198 family caregivers of people with dementia in Japan to assess caregiver experiences regarding medical examination and diagnosis, patient functional status, and support resources.
RESULTS: The mean time from suspicion of dementia to the start of medical evaluation was 15.1 months, and the mean time from the start of medical evaluation to a confirmed diagnosis was 4.7 months. Time to the initial medical visit was significantly longer when the family caregiver was a child or daughter- or son-in-law, when dementia onset was younger, or when the first noticed symptom was forgetfulness (all p < 0.001). Family caregivers received dementia-related information from medical institutions and community comprehensive support centers, but satisfaction with these resources varied. Early diagnosis was valued for clarifying concerns about observed changes (62.1% of respondents), whereas uncertainty until diagnosis caused the greatest anxiety (34.3%), underscoring the need for coordinated support.
CONCLUSION: Family caregivers of people with dementia reported barriers to timely diagnosis and post-diagnosis support, highlighting the need for improved care pathways, enhanced collaboration between medical institutions and communities, and better access to support resources.}, }
@article {pmid41433006, year = {2025}, author = {Uppuluri, CT and Prasad, YSKV and Asadi, K and Kumari, TP and Pelluri, R and Chakravarthi, G and Nalluri, BN and Gurram, PC}, title = {PDE5 Inhibitors as Modulators of Alzheimer's-Associated Inflammation and Oxidative Stress: A Meta-Analytical Assessment of Preclinical Studies.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {322}, pmid = {41433006}, issn = {1559-1182}, mesh = {*Alzheimer Disease/drug therapy/metabolism/complications ; *Oxidative Stress/drug effects ; Animals ; *Phosphodiesterase 5 Inhibitors/therapeutic use/pharmacology ; *Inflammation/drug therapy/metabolism ; Humans ; Antioxidants/pharmacology ; Biomarkers/metabolism ; Anti-Inflammatory Agents/pharmacology/therapeutic use ; }, abstract = {Neuroinflammation and oxidative stress contribute significantly to cognitive decline, a hallmark of neurodegenerative diseases such as Alzheimer's disease (AD). Addressing cognitive decline is a critical medical need, and phosphodiesterase-5 inhibitors (PDE5Is) may offer a promising solution. This meta-analysis highlights the anti-inflammatory and antioxidant actions of PDE5Is, which may help counter neuroinflammation and oxidative stress in neurodegenerative diseases including AD. We reviewed over 1,258 studies and considered 34 preclinical rodent studies of inflammation or oxidative stress. Quantitative data on biomarkers such as Tumor necrosis factor alpha (TNF-α), Interleukin 1 beta (IL-1β), IL-6, NF-κB, IL-10, Superoxide dismutase (SOD), Catalase (CAT), Glutathione peroxidase (GPx), Glutathione (GSH), Malondialdehyde (MDA), Myeloperoxidase (MPO), and caspase-3 was extracted and analyzed using a random-effects model. Study quality was evaluated with a modified CAMARADES checklist, and heterogeneity was assessed using the I[2] statistic. PDE5Is treatment significantly lowered pro-inflammatory cytokines and oxidative stress markers, while boosting the levels of critical anti-inflammatory and antioxidant molecules. The pooled standardized mean differences (SMDs) indicated treatment efficacy for nearly all biomarkers. Notably, the studies on Alzheimer's models confirmed similar therapeutic benefits in reducing amyloid burden and enhancing cognitive outcomes. With a strong safety profile and ability to modulate Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and Nuclear erythroid-related factor 2 (Nrf2) pathways, PDE5Is offer promising neuroprotective potential. Thus, repurposing PDE5Is may develop new disease-modifying therapies for Alzheimer's, making clinical investigation crucial.}, }
@article {pmid41432804, year = {2025}, author = {Orso, B and Bollack, A and Sheikh, ZH and Morbelli, S and Pardini, M and Farrar, G}, title = {Heterogeneity of dementia with lewy bodies: Insights from clinical presentations, neuropathology, and biomarkers.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {47}, number = {1}, pages = {31}, pmid = {41432804}, issn = {1590-3478}, mesh = {Humans ; *Lewy Body Disease/pathology/genetics/diagnosis/physiopathology/diagnostic imaging/metabolism ; Biomarkers/metabolism ; *Brain/pathology/diagnostic imaging ; }, abstract = {BACKGROUND: Dementia with Lewy Bodies (DLB) is a neurodegenerative disorder characterised by α-synuclein pathology, causing cognitive decline, motor and non-motor symptoms. This review explores the clinical and neuropathological heterogeneity of DLB, which complicates its early diagnosis, prognosis, and treatment. The staging of Lewy body (LB) pathology varies, with both brain-first and body-first hypotheses suggesting different origins and pathways for disease progression. Co-pathologies, such as amyloid-β plaques, tau tangles, and cerebrovascular changes, further influence the clinical presentation and rate of disease progression in DLB patients, contributing to significant variability. In this review, the role of genetic factors, particularly APOE ε4 and GBA mutations, in shaping DLB's clinical and pathological diversity is also emphasized. Heterogeneous manifestations, including REM sleep behavior disorder (RBD), mild cognitive impairment, and psychiatric-onset DLB, highlight the need for improved biomarkers to guide early diagnosis. Neuroimaging techniques such as [[18]F]FDG PET and [[123]I]FP-CIT SPECT help distinguish DLB from other dementias, like Alzheimer's disease (AD), though challenges remain in identifying co-pathologies with precision.
CONCLUSION: Overall, the paper explores the complexity of DLB's heterogeneous nature, advocating for deeper exploration of its diverse pathological pathways, genetic predispositions, and clinical profiles to improve diagnosis and treatment outcomes. Understanding this heterogeneity is crucial for the development of personalized therapeutic strategies and effective management of the disease.}, }
@article {pmid41432779, year = {2025}, author = {Bergamin, E and Turco, F and Unti, E and Del Chicca, M and Ceravolo, R and Tognoni, G and Del Prete, E}, title = {Functional propriospinal myoclonus in Alzheimer's disease: coincidence or a new challenge?.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {47}, number = {1}, pages = {34}, pmid = {41432779}, issn = {1590-3478}, mesh = {Humans ; Female ; *Alzheimer Disease/complications/physiopathology ; Middle Aged ; *Myoclonus/physiopathology/complications/diagnosis/etiology ; Electroencephalography ; }, abstract = {Propriospinal myoclonus (PSM) is a rare hyperkinetic movement disorder characterized by involuntary and repetitive axial muscle contractions. Although traditionally classified as idiopathic or symptomatic, a functional etiology has often been described for PSM. Functional neurological disorders (FNDs), including functional PSM, are defined by symptoms inconsistent with other organic neurological conditions and often arise from brain circuit dysfunction affecting emotion processing, agency, attention, interoception, and predictive processing. Electrophysiological biomarkers such as Bereitschaftspotential (BP) and event-related desynchronization (ERD) offer diagnostic support, with ERD showing promise for functional PSM diagnosis. We report the first case of functional PSM in a 61-year-old woman with Alzheimer's Disease (AD). She presented with involuntary arrhythmic trunk movements, associated with anxiety and restlessness, resolving with distraction. Electrophysiological evaluation revealed ERD without BP, supporting a functional diagnosis. The coexistence of FMDs and neurodegenerative diseases like AD, though rare, underscores shared pathophysiological mechanisms, including disrupted agency and altered cortical processing. Treatment with Sertraline improved motor symptoms and anxiety, illustrating the importance of personalized management strategies in such cases. This report highlights the necessity for clinicians to recognize FMD in neurodegenerative diseases, promoting accurate diagnosis through biomarkers and integrated treatment approaches to improve patient outcomes. Further research is essential to refine diagnostic tools and therapeutic strategies for functional PSM in AD.}, }
@article {pmid41432310, year = {2026}, author = {Krattli, RP and Markarian, M and Madan, S and Swami, D and McQuade, A and Baulch, JE and Blurton-Jones, M and Acharya, MM}, title = {Comparing Functional Consequences of Human iPSC-Microglia and Neural Stem Cell-Derived Extracellular Vesicles in Mitigating Cognitive Decline in Alzheimer's Disease.}, journal = {Aging cell}, volume = {25}, number = {1}, pages = {e70341}, pmid = {41432310}, issn = {1474-9726}, support = {DISC1-10079//California Institute for Regenerative Medicine/ ; DISC2-12400//California Institute for Regenerative Medicine/ ; //UC Irvine Sue and Bill Gross Stem Cell Research Center/ ; R01CA262213//U.S. National Institutes of Health (NIH)/ ; }, mesh = {*Alzheimer Disease/pathology/complications/therapy ; Humans ; *Extracellular Vesicles/metabolism/transplantation ; Animals ; *Microglia/metabolism ; *Induced Pluripotent Stem Cells/metabolism/cytology ; Mice ; *Neural Stem Cells/metabolism ; *Cognitive Dysfunction/therapy/pathology ; Disease Models, Animal ; }, abstract = {Stem cell-derived extracellular vesicles (EVs) show promise as a therapeutic approach for neurodegenerative diseases, particularly Alzheimer's Disease (AD), where traditional regenerative interventions have achieved limited success. Our previous research demonstrated the neuroprotective benefits of human neural stem cell (hNSC)-derived EVs in 2- and 6-month-old AD mice (5xFAD) that exibited improved cognitive function and reduced AD-related neuropathology. This study aimed to compare the neuroprotective efficacy of EVs derived from two human cell lines: hNSCs from H9 embryonic stem cells and human iPSC-derived microglia (iMGLs). Additionally, we investigated the efficacy of an expanded EV treatment paradigm at subsequently longer time points. Three-month-old 5xFAD mice received weekly retro-orbital vein injections of either hNSC- or iMGL-derived EVs for 4 weeks. Cognitive function testing revealed comparable cognitive improvements in both EV treatment groups compared to vehicle-injected AD mice. Both iMGL- and hNSC-derived EVs significantly reduced amyloid beta plaques, astrogliosis, and microglial activation, while restoring synaptophysin and postsynaptic density protein PSD-95 to control levels in AD brains. Gene expression analysis revealed significantly reduced neuroinflammation and elevated neuroprotective signatures following both EV treatments. MicroRNA analysis of the EV-derived cargo revealed unique and shared miRNA signatures associated with differentially expressed genes in both cell lines. These findings demonstrate the feasibility and neuroprotective benefits of recurrent systemic injections of EVs derived from human NSCs and differentiated human microglia lines in alleviating cognitive dysfunction and neuropathology in Alzheimer's disease.}, }
@article {pmid41431971, year = {2026}, author = {Mohammed, AI and Mohammed, AI and Reynolds, E}, title = {Mind Your Mouth: Impact of Oral Bacteria on Alzheimer's Disease.}, journal = {Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology}, volume = {55}, number = {1}, pages = {1-6}, doi = {10.1111/jop.70111}, pmid = {41431971}, issn = {1600-0714}, mesh = {*Alzheimer Disease/microbiology/etiology ; Humans ; Porphyromonas gingivalis/pathogenicity ; *Periodontitis/microbiology/complications ; *Mouth/microbiology ; Risk Factors ; Cognitive Dysfunction/microbiology ; }, abstract = {BACKGROUND: Emerging evidence suggests a compelling nexus between periodontitis, a chronic inflammatory disease associated with an oral infection, and the development of Alzheimer's disease. Porphyromonas gingivalis , a keystone periodontal pathogen, has been detected in Alzheimer's disease-affected brain tissue and implicated in triggering neuroinflammation and promoting hallmark pathologies, including amyloid-beta accumulation and tau hyperphosphorylation, through virulence factors such as gingipains. With Alzheimer's disease posing a mounting global health challenge and periodontitis affecting a significant portion of the population, recognizing this link is both timely and critical.
METHODS: This editorial explores the biological and epidemiological evidence linking periodontal health to cognitive decline, evaluating studies on pathogen presence, inflammatory mechanisms, and associations between oral infection and neurodegeneration.
RESULTS: Evidence indicates that oral infections, particularly periodontitis, may play a more central role in neurodegeneration than previously acknowledged. Detection of periodontal pathogens in brain tissue, along with mechanistic studies demonstrating promotion of hallmark Alzheimer's pathologies, highlights the potential impact of chronic oral inflammation on cognitive decline.
CONCLUSION: An integrated healthcare approach uniting dentistry, neurology, and public health is needed to prioritize oral health as a modifiable risk factor for dementia. Early diagnosis and treatment of periodontitis may represent a promising and underutilized strategy to reduce systemic inflammation and mitigate the risk of Alzheimer's disease.}, }
@article {pmid41431125, year = {2025}, author = {Pérez-Ruixo, C and Li, L and Galpern, WR and Perez-Ruixo, JJ}, title = {Mechanistic Population Pharmacokinetic-Pharmacodynamic Model of the Tau-Targeted Antibody Posdinemab in Healthy Participants and Participants with Alzheimer's Disease.}, journal = {Clinical pharmacology and therapeutics}, volume = {}, number = {}, pages = {}, doi = {10.1002/cpt.70173}, pmid = {41431125}, issn = {1532-6535}, abstract = {Disrupted homeostasis and transneuronal spread of hyperphosphorylated Tau protein (pTau) are hypothesized to be key pathogenic drivers of Alzheimer's disease (AD). Posdinemab (JNJ-63733657), a humanized IgG1/kappa monoclonal antibody that targets phosphorylated Tau protein at amino acid 217 (p217+tau), is currently in clinical development for the treatment of AD. In a first-in-human Phase 1 study (NCT03375697), posdinemab was well tolerated at doses up to 60 mg/kg, demonstrated linear pharmacokinetics (PK) in serum, and induced dose-dependent reductions in p217+tau levels in cerebrospinal fluid (CSF). The objective of the current analysis was to develop a mechanism-based population pharmacokinetic-pharmacodynamic (popPK-PD) model to guide the Phase 2 (Auτonomy) dose selection of posdinemab in participants with AD using the Phase 1 data from 69 adults. A two-compartment model was selected, which successfully described the available clinical PK-PD data and demonstrated that posdinemab PK in serum is linear, dose-proportional, and time-independent. Suppression of free p217+tau in CSF was used to reflect free antibody available to bind tau seeds in interstitial fluid (ISF). The PK-PD model-based simulations for fixed intravenous doses of 1,000 mg and 3,000 mg every 4 weeks predicted >90% reduction in tau seeds in ISF by Day 391 and Day 154, respectively, following treatment initiation. This model provides a physiologically relevant simulation-framework to investigate the impact of various posdinemab dose levels on PK-PD profiles, thereby supporting the clinical trial design of the Auτonomy study (NCT04619420).}, }
@article {pmid41430548, year = {2025}, author = {Li, L and Kong, J and Fan, R and Yuan, Y and Zhu, L}, title = {Role of tRNA-Derived Fragments and Their Modifications in the Pathogenesis and Treatment of Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {321}, pmid = {41430548}, issn = {1559-1182}, mesh = {*Alzheimer Disease/genetics/therapy/metabolism/pathology ; *RNA, Transfer/metabolism/genetics ; Humans ; Animals ; }, abstract = {Transfer RNAs (tRNAs), an essential class of noncoding RNAs, have recently emerged as a hotspot in the study of neurodegenerative diseases. The biological function of tRNA depends on precise processing and complex chemical modifications. During processing, tRNAs not only produce functional tRNAs used in protein synthesis but also generate tRNA-derived fragments (tRFs) that play roles in gene expression regulation. In addition, a series of chemical modifications, such as methylation, occur on the bases or phosphate backbone of tRNAs. In the progression of Alzheimer's disease (AD), researchers have observed significant changes in both the abundance and modification patterns of tRFs. This review summarizes the roles and regulatory mechanisms of tRFs and their chemical modifications in AD and integrates findings on potential tRF target genes to provide new insights into the pathogenesis of AD. Evidence suggests that distinct tRFs regulate gene expression through complementary interactions with specific targets. For example, AS-tDR-011389 upregulates CaMK2N1 expression by binding to its 3' untranslated region, suggesting that it may modulate calcium homeostasis in AD because CaMK2N1 is known to be involved in calcium signaling. Furthermore, tRF5-ProAGG was shown to target SV2B through predicted tRF5-mRNA pairing and qRT-PCR validation. Dysregulation of SV2B expression indicates that tRF5-ProAGG may influence synaptic vesicle trafficking and synaptic plasticity, thereby affecting neurotransmitter release and synaptic transmission in AD. Additionally, widespread reductions in cytoplasmic and mitochondrial tRNA methylation, accompanied by decreased expression of modification enzymes, have been observed in 5XFAD mice. These aberrant modifications may impair tRNA function, disrupt gene expression and protein translation, and ultimately contribute to AD progression.}, }
@article {pmid41429557, year = {2025}, author = {Liu, HY and Lin, YL}, title = {[Advances in measurements and standardization of plasma phosphorylated tau217 as a biomarker for Alzheimer's disease].}, journal = {Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]}, volume = {59}, number = {12}, pages = {2209-2215}, doi = {10.3760/cma.j.cn112150-20250331-00265}, pmid = {41429557}, issn = {0253-9624}, support = {320.6750.2024-03-38//Wu Jieping Medical Foundation "Reference Interval and Clinical Application of Plasma biomarkers p-Tau217 and NfL in Alzheimer's Disease"/ ; 2023A04J0439//School-enterprise Joint Project of Guangzhou Science and Technology Commission Institute "Molecular Markers of Genetic Susceptibility to Patients with Alzheimer's Disease"/ ; 2026C-TS046//Clinical Characteristic Project in Guangzhou "Combined Detection of Alzheimer's Disease Risk Genes and Pharmacogenomics Based on MALDI-TOF Mass Spectrometry"/ ; }, mesh = {*Alzheimer Disease/blood/diagnosis ; Humans ; *tau Proteins/blood ; Biomarkers/blood ; Phosphorylation ; }, abstract = {With the approval of targeted drugs for modification therapy of Alzheimer's disease, the role of blood markers in the diagnosis and treatment of Alzheimer's disease is becoming more and more important. The economical and easily accessible plasma phosphorylated tau217 (p-tau217) is one of the most promising biomarkers for clinical application. Since it was first found in 2020, it has attracted wide attention in just a few years, rapidly becoming a research hotspot in this field, and is adopted as one of the core diagnostic biomarkers. This article reviewed the clinical measurements of plasma p-tau217 and the standardization of sample processing.}, }
@article {pmid41429381, year = {2025}, author = {AmeliMojarad, M and AmeliMojarad, M}, title = {Antibody drug conjugates in Alzheimer's disease: emerging strategies and future directions.}, journal = {Neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.neuroscience.2025.12.053}, pmid = {41429381}, issn = {1873-7544}, abstract = {Antibody-drug conjugates (ADCs) are emerging as a targeted therapeutic strategy for Alzheimer's disease (AD), offering precise delivery of disease modifying agents with reduced systemic toxicity. By linking monoclonal antibodies to small-molecule payloads, ADCs hold promise in overcoming key challenges in AD treatment, including poor blood-brain barrier (BBB) penetration and off-target effects. This review provides a critical synthesis of ADC strategies in neurodegeneration, with emphasis on molecular design, payload selection, and delivery mechanisms. Distinctively, we integrate lessons from oncology-based ADC development into the neurodegenerative context, highlighting how these cross disciplinary insights open new avenues for tackling multifactorial AD pathology, including amyloid-beta (Aβ) and tau-related mechanisms. By outlining translational progress, ongoing clinical efforts, and future directions, this review positions ADCs not only as a promising precision medicine approach but also as a novel framework for advancing therapeutic innovation in complex neurodegenerative disorders.}, }
@article {pmid41429258, year = {2026}, author = {Zoroddu, S and Sedda, S and Mangoni, AA and Carru, C and Zinellu, A}, title = {Malondialdehyde in cognitive impairment: A systematic review and meta-analysis.}, journal = {Neuroscience and biobehavioral reviews}, volume = {181}, number = {}, pages = {106531}, doi = {10.1016/j.neubiorev.2025.106531}, pmid = {41429258}, issn = {1873-7528}, mesh = {Humans ; *Cognitive Dysfunction/blood ; *Malondialdehyde/blood ; *Alzheimer Disease/blood ; Biomarkers/blood ; Oxidative Stress/physiology ; }, abstract = {Malondialdehyde (MDA) is a marker of lipid peroxidation and oxidative stress, processes involved in neurodegeneration and cognitive decline. This systematic review and meta-analysis evaluated circulating MDA concentrations in individuals with Alzheimer's disease (AD) or mild cognitive impairment (MCI) compared to cognitively healthy controls. A systematic search of PubMed, Scopus, and Web of Science up to 18 July 2025 identified 36 studies (48 group comparators) including 2132 patients and 2169 controls. Pooled analysis revealed significantly higher MDA concentrations in cognitively impaired individuals (SMD = 1.46, 95 % CI 1.10-1.83; p < 0.001), with consistent increases in both AD (SMD = 0.82) and MCI (SMD = 1.24). Subgroup analyses showed comparable results across serum and plasma samples and across different geographical regions, while the analytical method influenced the effect size. Trim-and-fill analysis confirmed the robustness of findings despite publication bias. Circulating MDA is elevated in cognitive impairment, supporting its potential as a biomarker of early neurodegeneration and oxidative stress. Future studies should standardize measurement approaches and assess the utility of MDA for prognosis and treatment response.}, }
@article {pmid41428961, year = {2025}, author = {Hasegawa, M and Kawaguchi, T and Kiyohara, H and Teratani, T and Nakamoto, N and Mikami, Y and Kanai, T}, title = {Neural regulation of gut inflammation via autonomic nerves: therapeutic implications for inflammatory bowel disease.}, journal = {Immunological medicine}, volume = {}, number = {}, pages = {1-24}, doi = {10.1080/25785826.2025.2604347}, pmid = {41428961}, issn = {2578-5826}, abstract = {Inflammatory bowel disease (IBD) is a debilitating and treatment-refractory condition with a complex and incompletely understood etiology. Recent advances in neuroimmunology have revealed that intestinal homeostasis is regulated by bidirectional communication between the autonomic nervous system and the immune system. In particular, vagus nerve-mediated cholinergic anti-inflammatory signaling plays a central role in modulating intestinal immune responses and represents a key mechanism linking neural regulation to IBD pathogenesis and therapy. In parallel, the gut-brain axis has emerged as a critical regulator of intestinal inflammation and systemic disease. Psychological stress alters gut immune function through mechanisms involving enteric glial activation and microbiota-derived metabolites, contributing to treatment-resistant depression via immune activation and changes in short-chain fatty acid profiles. Moreover, gut microbiota dysbiosis has been implicated in neurodegenerative disorders such as Alzheimer's and Parkinson's diseases, potentially preceding central pathology through vagal signaling and systemic inflammation. Together, these findings position the gut microbiota as an immunological and neurological hub connecting intestinal, systemic, and brain health. This review summarizes recent advances in gut-brain axis-mediated immune regulation in IBD and highlights emerging bioelectronic neuromodulation strategies targeting autonomic circuits as promising non-pharmacological approaches to restore gut immune balance.}, }
@article {pmid41428676, year = {2025}, author = {Tang, P and Chen, X and Li, P and Zhang, L and Tang, B and Wen, J and Liu, Y and Kalsoom, I and Cheng, C}, title = {Discovery of F-18 labeled repurposed CNS drugs by computational strategy for effective tau imaging and alzheimer's diagnosis.}, journal = {PloS one}, volume = {20}, number = {12}, pages = {e0338901}, pmid = {41428676}, issn = {1932-6203}, mesh = {*Alzheimer Disease/diagnostic imaging/diagnosis/metabolism/drug therapy ; *tau Proteins/metabolism ; Humans ; *Drug Repositioning/methods ; *Fluorine Radioisotopes/chemistry ; *Central Nervous System Agents/chemistry/pharmacology ; Positron-Emission Tomography/methods ; Blood-Brain Barrier/metabolism ; Algorithms ; Drug Discovery ; }, abstract = {Alzheimer's disease (AD) remains a significant challenge in diagnosis and treatment, with current methods insufficient for early detection. A major obstacle is the lack of effective imaging agents targeting the Tau protein, which plays a key role in AD pathology. To address this, we developed a computational methodology for selecting F-18 labeled drug candidates from a library of CNS-penetrant compounds curated from literature and databases. The library, consisting of 977 compounds, was evaluated based on clinical data, target proteins, pathways, toxicity, and other relevant factors. We implemented Python-based algorithms to select the top 39 compounds from virtual screening results, prioritizing those with optimal Tau binding affinity and BBB permeability. Additionally, we developed an algorithm to identify F-18 labeling candidates that maintain their biological activity post-labeling. We then performed virtual screening of an F-18 labeled drug library and selected the top 3 compounds based on stability and imaging potential. The selected compounds exhibited molecular weights of 350-520 Da, favorable logP values (2.05-2.72), and high BBB permeability. Our findings indicate that Drug 388 (BI-D1870), binds to Tau with a binding free energy of ΔG = -8.79 kcal/mol. Drug 416 (reported BRAF inhibitor, RG6344) shows a binding free energy of ΔG = -7.91 kcal/mol, while Drug 610 (Iloperidone/HP 873), a D2/5-HT2 receptor antagonist, exhibits a predicted binding free energy of ΔG = -6.88 kcal/mol with the target Tau protein respectively. Molecular dynamics simulations confirmed stable Tau-drugs interactions, with minimal RMSD fluctuations, indicating strong binding. The F-18 label enabled real-time PET imaging, allowing non-invasive tracking of the drug's binding to Tau in the brain. Our approach provides a comprehensive solution to the current limitations in Alzheimer's diagnosis by offering F-18 labeled drugs that effectively target Tau protein without compromising their biological activity, advancing both diagnostic and therapeutic strategies for AD.}, }
@article {pmid41428481, year = {2025}, author = {Feng, T and Chen, W and Bian, Z and Sun, H and Shen, L}, title = {Protective effects of Dendrobium nobile Lindl. alkaloids in a novel mouse model of Alzheimer's disease with chronic cerebral hypoperfusion.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251406645}, doi = {10.1177/13872877251406645}, pmid = {41428481}, issn = {1875-8908}, abstract = {BackgroundIncreasing numbers of studies indicate that the pathophysiological progression of Alzheimer's disease (AD) could be accelerated by chronic cerebral hypoperfusion (CCH). These findings suggest that cerebrovascular dysfunction may induce cognitive impairment in AD by expediting neurodegeneration. Dendrobium nobile Lindl. alkaloids (DNLA), the primary active components of Dendrobium nobile Lindl., have been shown to enhance cognitive function and exhibit neuroprotective effects in AD animal models.ObjectiveHowever, the impact of DNLA on AD with CCH is still elusive.MethodsIn this study, we explored the therapeutic potential and underlying mechanisms of DNLA using a novel AD plus CCH mouse model.ResultsOur results demonstrate that DNLA significantly improved cerebral blood flow, attenuated motor and cognitive decline, reduced amyloid-β deposition, mitigated neuroinflammation, and alleviated neural oxidative stress in 12-month-old AD mice with CCH.ConclusionsOur study suggests that DNLA exerts multiple neuroprotective effects, effectively preserving motor and cognitive function in AD with CCH mice of 12 months. Thus, DNLA represents a promising therapeutic candidate for the prevention and treatment of AD plus CCH.}, }
@article {pmid41428479, year = {2025}, author = {Ji, Y and Cui, X and Ding, Z and Wang, X and Wang, Y and Zhang, Y and Yuan, Z and Chang, Z and Liu, K and Liu, Y}, title = {Reveal the mechanism of action of donepezil combined with nimodipine in the treatment of Alzheimer's disease via metabolomics and lipidomics analyses in rats.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251407109}, doi = {10.1177/13872877251407109}, pmid = {41428479}, issn = {1875-8908}, abstract = {BackgroundWith the aging population, the number of Alzheimer's disease (AD) patients has been increasing annually, creating an urgent need for AD therapeutic drugs. Donepezil combined with nimodipine (DN) has demonstrated therapeutic potential in the treatment of AD, but its mechanism of action remains unclear.ObjectiveTo reveal the mechanism of DN in the treatment of AD rats.MethodsThe AD rat model was established and evaluated by behavioral experiments and pathology. The therapeutic mechanism of DN in AD treatment was investigated through lipidomics and hippocampal metabolomics analyses based on ultra-high-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry (UPLC-Q-TOF/MS).ResultsThe learning and memory ability of AD rats can be improved after DN treatment. Significant changes were observed in 40 serum lipid metabolites and 19 hippocampal metabolites. These metabolites are mainly involved in glycerophospholipid metabolism, sphingolipid metabolism, amino acid metabolism, unsaturated fatty acid metabolism and other processes in AD rats.ConclusionsDN could improve cognitive function and nerve damage in AD rats. It may plays a therapeutic role in AD rats by regulating cholinergic damage, Ca[2+] overload, oxidative stress, neuroinflammation, and energy deficiency caused by metabolic disorders, which has practical significance for further research and clinical application of DN.}, }
@article {pmid41428477, year = {2025}, author = {Solfrizzi, V and Imbimbo, BP}, title = {Comparing clinical effect sizes of Souvenaid[TM], lecanemab, and donanemab in early Alzheimer's disease.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251406221}, doi = {10.1177/13872877251406221}, pmid = {41428477}, issn = {1875-8908}, abstract = {BackgroundLecanemab and donanemab are anti-amyloid-β monoclonal antibodies recently approved in the United States and Europe for the treatment of early Alzheimer's disease (AD). Their modest clinical benefit, safety profile, and cost raise debate about real-world applicability. Fortasyn Connect (Souvenaid[TM]), a multi-nutrient intervention, has shown potential clinical benefits in prodromal AD.ObjectiveTo compare the clinical effect sizes (Cohen's d) and estimated months of preserved independence in instrumental activities of daily living (IADLs) for lecanemab, donanemab, and Souvenaid™, based on published pivotal clinical trial data.MethodsCohen's d on the Clinical Dementia Rating-Sum of Boxes (CDR-SB) was computed using standardized mean differences and 95% confidence intervals (CIs) derived from published trials. Times of functional independence were estimated using the Hartz approach.ResultsPoint estimates of Cohen's d effect sizes on CDR-SB were -0.34, -0.33, and -0.52 for lecanemab, donanemab, and Souvenaid™, respectively, with no statistically significant differences between drugs. Estimated gains in IADL independence were 10 months for lecanemab, 8 months for donanemab, and 27 months for Souvenaid™.ConclusionsDespite differences in study designs, Souvenaid[TM] demonstrated comparable clinical efficacy with superior safety, accessibility, and cost profile. These findings support further evaluation of Souvenaid[TM] as a non-invasive, scalable option in early AD management.}, }
@article {pmid41428410, year = {2025}, author = {Gravelsins, L and Gervais, NJ and Brown, A and Ramana, S and Zhao, S and Nicoll, G and Bernardini, MQ and Jacobson, M and Einstein, G}, title = {Younger midlife females with bilateral salpingo-oophorectomy: respiratory disturbances during sleep.}, journal = {Climacteric : the journal of the International Menopause Society}, volume = {}, number = {}, pages = {1-9}, doi = {10.1080/13697137.2025.2595987}, pmid = {41428410}, issn = {1473-0804}, abstract = {OBJECTIVE: There are many menopauses; bilateral oophorectomy is associated with the worst cognitive outcomes. Compared to females with intact ovaries, females with bilateral oophorectomy experience early, abrupt ovarian hormone loss and are at increased risk for later-life Alzheimer's disease. They also have double the odds of developing later-life sleep disordered breathing (SDB) - a modifiable Alzheimer's risk factor. With respect to bilateral oophorectomy, it is unknown when respiratory disturbances occur or whether estradiol therapy (ET) ameliorates them. Also unknown is whether SDB influences cognition in this group.
METHOD: Females with risk-reducing bilateral salpingo-oophorectomy (BSO) taking ET (BSO+ET, n = 19) or not (BSO, n = 16) and premenopausal age-matched controls (AMC, n = 17) were assessed for SDB markers using take-home polysomnography and for working memory performance.
RESULTS: The BSO group showed signs of respiratory disturbance compared to the AMC group. Memory performance was uncorrelated with respiratory metrics. While the BSO+ET group showed an intermediate sleep phenotype, estrone glucuronide levels correlated with improved respiratory metrics.
CONCLUSION: The results suggest that respiratory disturbances manifest as early as 5 years post-BSO in younger females; ET offers some amelioration. The close relationship between sleep disruption and Alzheimer's risk emphasizes the importance of SDB screening post-BSO for early intervention.}, }
@article {pmid41428270, year = {2025}, author = {Verma, S and Kumari, K and Kesharwani, P and Verma, K and Dwivedi, J and Paliwal, S and Sharma, S}, title = {Is the Era of One-Size-Fits-All Alzheimer's Treatment Officially Over?.}, journal = {Journal of molecular neuroscience : MN}, volume = {76}, number = {1}, pages = {3}, pmid = {41428270}, issn = {1559-1166}, mesh = {*Alzheimer Disease/drug therapy/therapy/metabolism ; Humans ; Animals ; Precision Medicine ; Biomarkers ; }, abstract = {Alzheimer's disease (AD) is prevalent in more than 55 million worldwide, a figure estimated to almost triple by 2050, highlighting the need for highly effective treatments. However, despite the large expenditure of research over several decades, over 90% of clinical trials-countless amyloid-β-targeted drugs among them-have failed, stressing the shortcomings of reductionist, one-target approaches. More and more, AD is viewed as a complex systems disorder, resulting from interlinked disruptions in proteostasis, neuroinflammation, vascular integrity, synaptic plasticity, and metabolic regulation. Such an understanding has transformed the therapeutic paradigm toward precision, multimodal treatment, integrating disease-modifying agents with biomarker-based diagnosis and patient stratification. Improved blood- and imaging-based biomarkers, new molecular targets, and drug-delivery technologies offer the hope for earlier intervention and more personalized treatment. Looking to the future, the way forward will rely on the integration of systems biology, computational modeling, and translational neuroscience into adaptive trial design able to tackle the heterogeneity of the disease. These developments combined constitute the progressive shift away from "one-size-fits-all" treatments towards a future of personalized, mechanism-based therapies in Alzheimer's disease.}, }
@article {pmid41428168, year = {2025}, author = {Babu, PR and Turner, C and Ryznar, R}, title = {Cross-seeding of IAPP and Aβ42: A review of the molecular link between type 2 diabetes and Alzheimer's disease.}, journal = {Metabolic brain disease}, volume = {41}, number = {1}, pages = {8}, pmid = {41428168}, issn = {1573-7365}, abstract = {UNLABELLED: Alzheimer’s Disease (AD) and Type 2 Diabetes Mellitus (T2DM) are interconnected conditions, both marked by the aggregation of amyloidogenic proteins: amyloid-β 42 (Aβ42) in AD and islet amyloid polypeptide (IAPP) in T2DM. Emerging evidence suggests that IAPP can cross the blood–brain barrier and interact with Aβ42, forming heterocomplexes that promote aggregation. This narrative review aims to describe the molecular mechanisms underlying IAPP and Aβ42 cross-seeding and evaluate its contribution to AD pathogenesis in the context of T2DM. A systematic search of PubMed was conducted using relevant MeSH terms. IAPP-Aβ42 cross-seeding enhances amyloid aggregation and cytotoxicity, but its impact on AD progression is best understood as part of a multifactorial process rather than a single driving cause. While preclinical models suggest amyloid-targeting approaches can reduce amyloid burden, clinical trials have largely failed to show cognitive benefits, likely due to late-stage intervention and the complex pathology of AD. Future research should focus on identifying early biomarkers for AD, clarifying IAPP-Aβ42 cross-seeding mechanisms, and exploring combination therapies targeting multiple pathological pathways. Early intervention may improve treatment efficacy, particularly in patients with comorbid T2DM.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11011-025-01767-8.}, }
@article {pmid41427392, year = {2025}, author = {LaGrow, TJ and Itkyal, V and Watters, H and Jensen, KM and Ballem, R and Pan, WJ and Iraji, A and Calhoun, VD and Keilholz, S}, title = {Spatiotemporal Network Dynamics Reveal Alzheimer's Disease Progression.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41427392}, issn = {2692-8205}, support = {R01 AG062581/AG/NIA NIH HHS/United States ; }, abstract = {Alzheimer's disease (AD) is characterized by progressive disruptions in large-scale brain networks that precede cognitive decline, yet conventional functional connectivity analyses often fail to detect disruptions in coordination among large-scale brain networks that may be critical for early detection. This study leverages quasi periodic patterns (QPPs) and complex principal component analysis (cPCA) to characterize spatiotemporal network alterations across longitudinally stable (normal cognitive, mild cognitive impairment, dementia of Alzheimer's type) and transitioning (normal cognitive to mild cognitive impairment, mild cognitive impairment to dementia of Alzheimer's type) cohorts from the Alzheimer's Disease Neuroimaging Initiative using resting state fMRI. QPPs were used to derive recurrent spatiotemporal templates and network integrity measures at the intrinsic connectivity network level, while cPCA decomposed Hilbert transformed time series into complex valued patterns that capture amplitude and phase relationships. Nonparametric group comparisons revealed a structured trajectory in which limbic, subcortical, and higher cognition networks, including triple network components, are affected early, followed by progressive disruption in visual, cerebellar, sensorimotor, and additional triple network systems. Transitioning cohorts showed many of these alterations before formal diagnostic conversion, indicating that spatiotemporal signatures carry preclinical information. QPP based metrics were particularly sensitive to limbic and subcortical degradation, whereas cPCA emphasized changes in higher order, visual, and cerebellar patterns, revealing complementary aspects of the same underlying pathology. These findings extend prior QPP only work and highlight the utility of combining QPP and cPCA based measures as a dynamic, network-level biomarker framework for AD progression. with potential applications in early detection, characterizing disease trajectories, and treatment monitoring.}, }
@article {pmid41427244, year = {2025}, author = {Balagurusamy, B and Ganesan, V and Gopi, V and Ilayaperumal, P}, title = {Liposomal and Nanomaterial-Based Strategies for Targeted Alzheimer's Disease Therapy.}, journal = {ACS omega}, volume = {10}, number = {49}, pages = {60004-60019}, pmid = {41427244}, issn = {2470-1343}, abstract = {Alzheimer's disease (AD) remains a major neurodegenerative disorder with limited therapeutic options. Liposomal drug delivery has emerged as a promising strategy to enhance drug bioavailability and targeted delivery across the blood-brain barrier. This review explores the role of liposomes and nanomaterials in AD therapy, focusing on their versatility for drug delivery, including intranasal formulations, gene therapy, and reactive oxygen species (ROS)-responsive systems. Various liposomal formulations, such as mannose-modified, antibody-targeted, exosome-like, and biomaterial-based carriers, have shown significant potential in improving therapeutic efficacy. Natural compound-loaded liposomes, including polyphenols, tannic acid, and plant extracts, offer neuroprotective benefits. Furthermore, the inhibition of amyloid-β (Aβ) aggregation, a key pathological feature of AD, is addressed through innovative liposomal approaches, including peptide-conjugated, chiral-modified, and transferrin-targeted liposomes. This review highlights the synergistic role of glymphatic clearance and microglial phagocytosis in reducing the amyloid burden. Liposomal-based strategies are promising for advancing AD treatment by improving drug stability, specificity, and brain-targeting efficiency.}, }
@article {pmid41427231, year = {2025}, author = {Borrego-Sánchez, A and García-Frutos, EM and Darder, M and Sainz-Díaz, CI}, title = {Molecular Insights of 7‑Azaindole Drugs and Their Intercalation in the Confined Space of Montmorillonite.}, journal = {ACS omega}, volume = {10}, number = {49}, pages = {60287-60297}, pmid = {41427231}, issn = {2470-1343}, abstract = {Two derivatives of the group of 7-azaindoles, 1-benzyl-3-(piperidin-1-ylmethyl)-1H-pyrrolo [2,3-b] pyridine, and 1-benzyl-5-methoxy-3-(piperidin-1-ylmethyl)-1H-pyrrolo [2,3-b] pyridine as mono-oxalate salts are studied in this work as potential neuroprotective drugs for the treatment of Alzheimer's disease. Previously, we studied the use of a natural montmorillonite clay mineral as a candidate for a drug delivery system, finding that these drugs can be intercalated into the confined interlayer space of montmorillonite and subsequently released in a human medium for therapeutic use. However, some aspects of this study could not be explained. This work has studied this process at the atomic and molecular levels by using the Interface force field (FF). Initially, this methodology was validated in this work, reproducing the experimental crystal structure of these 7-azaindole drugs. Then, this FF was applied to calculate the intercalation of these drugs by cation exchange into montmorillonite according to the experimental results. Our calculations have reproduced this intercalation at the cation exchange capacity at the molecular level, finding that the experimental structure can only be justified with the intercalation of five drug molecules per 4 × 2 × 1 supercell of clay mineral inside the confined interlayer space. In addition, this intercalation does not produce a monolayer disposition postulated initially from experiments. On the contrary, our molecular dynamics simulations show that the intercalated molecules adopt a disordered disposition with a certain tendency to form a bilayer configuration in the confined interlayer space of montmorillonite. Besides, the spectroscopic infrared properties are useful for monitoring the preparation and encapsulation processes of pharmaceutical drugs. Then, these properties were studied experimentally and calculated theoretically. The calculated frequencies of the crystal structure of these 7-azaindole drugs allowed assignments of the experimental FT-IR spectra. This collaborative work with experimental and theoretical research enhances the knowledge for a promising drug delivery system for anti-Alzheimer therapy.}, }
@article {pmid41426989, year = {2025}, author = {Sagaro, GG and Amenta, F}, title = {Comparison of the effects of choline alphoscerate and citicoline in patients with dementia disorders: a systematic review and meta-analysis.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1649661}, pmid = {41426989}, issn = {1664-2295}, abstract = {BACKGROUND: Over 44 million people worldwide live with dementia, affecting their quality of life and well-being. Choline alphoscerate and citicoline supplements are commonly used to improve cognitive function in dementia patients. However, their efficacy remains inconsistent.
OBJECTIVE: This systematic review aimed to investigate and compare the effects of choline alphoscerate and citicoline on cognitive impairments, behavioural symptoms, and other clinical conditions in patients with dementia disorders.
METHODS: PubMed and Scopus were searched to identify relevant studies. We calculated weighted mean differences (WMD) or standardized mean differences (SMD) and 95% confidence intervals (CI) for continuous outcomes and odds ratios (OR) and 95% CI for binary outcomes.
RESULTS: This review included data from 358 participants across three randomized controlled trials (RCTs). As measured by the Sandoz Clinical Assessment for Geriatric Patients (SCAG), choline alphoscerate significantly improved clinical conditions in patients with dementia disorders compared with citicoline at the end of treatment [WMD: -3.92 (95% CI: -7.41 to -0.42)]. Specifically, our pooled analysis revealed that choline alphoscerate showed significant improvements in cognitive function, interpersonal relationships, affective disorders, apathy, and somatic functioning compared to citicoline at the end of treatment, as measured by the SCAG. However, there was no significant difference between the choline alphoscerate and citicoline treatment groups on memory or word fluency tests (WFT). Dropout rates for choline alphoscerate and citicoline were 9.4 and 6.7%, respectively [OR: 1.44 (95% CI: 0.66 to 3.13)], indicating no significant differences in acceptability.
CONCLUSION: Our findings indicate that choline alphoscerate is more effective than citicoline in improving the clinical conditions of dementia patients.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024626782, Identifier: CRD42024626782.}, }
@article {pmid41426276, year = {2025}, author = {Sun, W and Bi, H and Qi, Z and Hu, M and Wang, W}, title = {Status and trends of transcranial magnetic stimulation research in Alzheimer's disease: A bibliometric and visual analysis.}, journal = {Journal of Alzheimer's disease reports}, volume = {9}, number = {}, pages = {25424823251407542}, pmid = {41426276}, issn = {2542-4823}, abstract = {Alzheimer's disease (AD) is a common neurodegenerative disease characterized by progressive memory loss and cognitive dysfunction and is the most common cause of dementia. In recent years, transcranial magnetic stimulation (TMS) has been widely used in the treatment of AD and has achieved better therapeutic results. In this study, from the perspective of bibliometrics, we used VOSviewer and CiteSpace software to visualize and analyze the research progress of TMS in AD in terms of scientific knowledge mapping, and to systematically review the current status and trend of the global research on TMS in the treatment of AD, in order to provide references and guides for future research in this field. Our bibliometric analysis of 605 publications (1999-2024) reveals three pivotal findings: The Italy dominate TMS-AD research output; repetitive transcranial magnetic stimulation (rTMS) targeting the precuneus and dorsolateral prefrontal cortex (DLPFC) shows consistent cognitive benefits; Emerging technologies are reshaping therapeutic precision. Intermittent theta burst stimulation as an emerging TMS stimulation mode is gradually becoming a future research direction. In the future, more attention will be paid to individualized therapeutic solutions and more precise stimulation with the help of neuronavigation to improve the therapeutic effect of TMS.}, }
@article {pmid41425927, year = {2025}, author = {Qin, R and Li, C and Yuan, X and Chen, Y}, title = {Microbiome-targeted Alzheimer's interventions via gut-brain axis.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1729708}, pmid = {41425927}, issn = {1664-302X}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder with limited treatment options, underscoring the need for novel therapeutic targets. The gut-brain axis has emerged as a critical bidirectional communication system, with growing evidence establishing gut dysbiosis as a causal factor in AD pathogenesis. This dysbiosis, characterized by a reduction in beneficial microbes and an increase in pro-inflammatory taxa, compromises intestinal and blood-brain barrier integrity, promoting systemic inflammation and the translocation of neurotoxic agents like lipopolysaccharide (LPS). Consequently, the balance of key microbial metabolites is disrupted, reducing neuroprotective short-chain fatty acids (SCFAs) and indoles while elevating inflammatory mediators, which collectively exacerbate neuroinflammation, amyloid-β (Aβ) deposition, and tau pathology. This review evaluates promising interventions, including probiotics, anti-inflammatory diets, exercise, and phytochemicals that can restore microbial balance, enhance barrier function, and improve cognitive outcomes in preclinical and early clinical studies. However, clinical translation is hindered by an overreliance on animal models, short-term studies, and insufficient mechanistic insight. Future research must prioritize large-scale human trials, multi-omics integration to elucidate signaling pathways, and personalized approaches that account for host genetics and baseline microbiome composition to fully harness the therapeutic potential of the gut-brain axis for AD.}, }
@article {pmid41425084, year = {2025}, author = {Pérez-Martínez, DA and Jarry, AC and Martino, G and Pesce, G and Pieniazek, I and Presto, J and Miernik, P and Casciano, R and Frederiksen, KS}, title = {Uncovering barriers to early diagnosis of Alzheimer's disease: a European perspective.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70178}, pmid = {41425084}, issn = {2352-8737}, abstract = {INTRODUCTION: Timely and accurate diagnosis of early Alzheimer's disease (AD) is critical to maximizing the potential benefits of disease-modifying therapies; however, it remains a challenge in clinical practice.
METHODS: A double-blind survey was conducted among general practitioners (GPs; n = 52) and AD specialists (neurologists, psychiatrists, geriatricians, and others; n = 75) across five European countries to evaluate healthcare practitioners' (HCPs) perceptions of diagnosing AD. Data from all countries were pooled and presented overall.
RESULTS: GPs are usually the first point of contact for patients with mild cognitive impairment (MCI)/AD. Only 30% of patients received a formal diagnosis of AD during the MCI stage, and it took patients 15.2 months from symptom onset to their first primary care visit. The most common challenges identified by HCPs were referral times, lack of effective treatment, and resource and time constraints.
DISCUSSION: Systemic reforms are required to remove barriers in early AD diagnosis, including tailored training and coordinated care between GPs and AD specialists.
HIGHLIGHTS: Timely diagnosis of eAD remains a major challenge in clinical practice.Only one-third of patients received a formal diagnosis of AD during the MCI stage.It took patients 15.2 months from symptom onset to first primary care visit.Key diagnostic barriers include referral delays and lack of effective treatments.Addressing these issues may improve eAD diagnosis and timely intervention.}, }
@article {pmid41424971, year = {2025}, author = {Zhao, J and Wang, X and Li, B}, title = {The Bidirectional Mechanism of Uric Acid Levels on Alzheimer's Disease: A Narrative Review.}, journal = {International journal of general medicine}, volume = {18}, number = {}, pages = {7639-7651}, pmid = {41424971}, issn = {1178-7074}, abstract = {Alzheimer's disease (AD) is a central nervous system disorder marked by the extracellular accumulation of β-amyloid (Aβ) plaques in the cerebral cortex and the intracellular aggregation of hyperphosphorylated tau protein, manifesting as progressive cognitive decline and neurodegeneration. The pathological mechanisms of AD are intricate, in clinical treatment, cholinesterase inhibitors have been widely used for many years as symptomatic therapy, alleviating symptoms by improving neurotransmitter levels, but they cannot halt disease progression. Anti-Aβ monoclonal antibodies belong to disease-modifying therapies, although they have achieved breakthrough advances in recent years, strict monitoring requirements must be followed. In recent years, numerous studies have revealed a "U-shaped" association between uric acid (UA) levels and AD risk, along with population heterogeneity. Furthermore, fluctuations in UA levels exert a "bidirectional effect" on AD. At physiological concentrations, UA may confer neuroprotective benefits through antioxidant activity, inhibition of neuroinflammation, preservation of the blood-brain barrier (BBB), regulation of autophagy, and promotion of the clearance of Aβ and tau proteins. Conversely, abnormal UA levels may accelerate AD progression by inducing oxidative stress, activating inflammatory responses, and compromising the BBB. We conducted a comprehensive literature review across multiple medical databases, including PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The selected articles underwent critical evaluation, summarization, and incorporation into this review to highlight research achievements in this domain. This narrative review summarizes current pharmacological treatments for AD and UA, encompassing traditional Chinese medicine (TCM) monomers, compounds, and Western medications. It also thoroughly explores and elucidates the complex mechanism underlying the "bidirectional effect" of UA levels and metabolic pathways on AD, offering insights and theoretical support for future AD drug development.}, }
@article {pmid41424842, year = {2026}, author = {Lee, S and Kum, J and Kim, K and Park, TY and Ko, H and Na, DL and Kang, SY and Kim, H and Kim, Y and Kim, J}, title = {Clearance of amyloid plaque via focused ultrasonication in a mouse model of Alzheimer's disease.}, journal = {Theranostics}, volume = {16}, number = {5}, pages = {2310-2323}, pmid = {41424842}, issn = {1838-7640}, mesh = {Animals ; *Alzheimer Disease/therapy/pathology/metabolism ; *Plaque, Amyloid/therapy/pathology/metabolism ; Disease Models, Animal ; Mice ; Amyloid beta-Peptides/metabolism ; Humans ; Cell Line, Tumor ; Mice, Transgenic ; *Ultrasonic Therapy/methods ; Brain/pathology/metabolism ; Peptide Fragments/metabolism ; }, abstract = {Background: The success of anti-amyloid-β (Aβ) monoclonal antibodies in recent clinical trials validates the promising approach of clearing amyloid-β in Alzheimer's therapy. Building on these successes, focused ultrasound (FUS), a non-invasive therapeutic modality that delivers acoustic energy to targeted brain regions with high precision, has emerged as a potential technique to modulate Aβ pathology, either in combination with drugs or as a standalone treatment. This study focused on the standalone potential of FUS to reduce Aβ plaques without accompanying drugs. Methods: Synthetic Aβ42 aggregates were prepared and exposed to FUS. The changes in fibril and oligomer levels were analyzed using Thioflavin T (ThT) fluorescence, gel electrophoresis combined with photo-induced cross-linking of unmodified protein (PICUP) chemistry, transmission electron microscopy (TEM), and immunoblotting. The effect of FUS on Aβ42-induced cytotoxicity was evaluated in SH-SY5Y human neuroblastoma cells. FUS-mediated dissociation of Aβ plaques was performed by ex vivo and in vivo methods on the 5XFAD mouse model. In the ex vivo experiment, FUS was applied to brain slices, specifically targeting the hippocampal region. In the in vivo experiment, the left hippocampus of awake animals was sonicated in a transcranial manner ten times over two weeks using a miniature ultrasound transducer affixed to the skull. For both ex vivo and in vivo experiments, immunohistochemistry was performed on brain sections for measuring Aβ plaques after sonication. Blood was collected from animals before and after in vivo stimulation for plasma analysis. Results: In vitro, FUS treatment reduced the β-sheet structure of synthetic Aβ42 aggregates by up to 55.28% in the ThT assay, and fibrillar Aβ42 levels by up to 62.27% in the gel electrophoresis, as further confirmed by TEM imaging, which showed disrupted fibrillar structures. The level of oligomeric Aβ42 was also reduced by up to 65.02% following FUS exposure. SH-SY5Y cells treated with FUS-treated Aβ42 aggregates exhibited improved viability from 81.56% to 90.48%, showing a tendency of attenuated Aβ42-induced cytotoxicity by FUS. Ex vivo FUS stimulation significantly reduced the number of Aβ plaques in the hippocampal region compared to untreated brain slices. In vivo transcranial FUS reduced both the number and size of plaques in the FUS-treated hippocampal and thalamic region compared to the contralateral side. Plasma analysis with Aβ42 enzyme-linked immunosorbent assay revealed a 65.91% increase in Aβ levels following FUS treatment compared to pre-treatment levels, suggesting that Aβ plaques dissociated by FUS were released into the bloodstream. Conclusions: FUS exposure effectively reduced amyloid plaques in both ex vivo and in vivo models by disrupting fibrillar and oligomeric Aβ, demonstrating its potential as a non-invasive strategy for Aβ clearance.}, }
@article {pmid41424797, year = {2025}, author = {Yang, H and Wang, Y and Xu, Y and Wang, C}, title = {CX3CR1: a potential microglia-specific PET imaging target in Alzheimer's and Parkinson's diseases.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1678159}, pmid = {41424797}, issn = {1663-9812}, abstract = {Microglia are the resident immune cells of the central nervous system (CNS), playing a crucial role in maintaining brain homeostasis and mediating neuroimmune responses. The chemokine receptor CX3CR1, predominantly expressed on microglia, regulates microglial function via interactions with its neuronal ligand CX3CL1. The CX3CR1-CX3CL1 signaling exhibits complex, context-dependent roles in neurodegenerative diseases. In Alzheimer's disease (AD) and Parkinson's disease (PD) animal models, CX3CR1 deficiency shows paradoxical outcomes, attenuating or exacerbating amyloid-β (Aβ) and tau pathologies in AD, while consistently worsening α-synuclein-induced neurodegeneration in PD. Although CX3CR1 emerges as a promising therapeutic and diagnostic target, its complex role in microglial dynamics remains incompletely understood. Positron emission tomography (PET) imaging provides a powerful, noninvasive method for investigating biological processes in vivo. There is an urgent need to develop and validate new PET tracers targeting microglial CX3CR1 in the CNS, further offering new opportunities for the diagnosis and treatment of neuroinflammation-associated neurodegenerative diseases.}, }
@article {pmid41424796, year = {2025}, author = {Pirozhkov, SV and Vukolova, MN and Bulgakova, VV and Lutokhina, YA and Bolevich, SB and Sobolevsky, AI and Yelshanskaya, MV}, title = {Endothelium glutamate receptors in brain pathology.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1709274}, pmid = {41424796}, issn = {1663-9812}, abstract = {The endothelium in brain microcirculation functions not only as a barrier but also as a signal transduction component within a system that regulates multiple vascular processes, including muscle tone, permeability, and structural integrity. The control of local blood flow is vital to ensure adequate oxygen and nutrient supply, efficient removal of catabolic waste, and the maintenance of proper brain cell function. The role of endothelial glutamate receptors in brain pathology is an emerging area of research, particularly important for understanding how these receptors contribute to neurological diseases and disorders. Endothelial cells (ECs), which are considered active players in maintaining brain homeostasis, express glutamate receptors on their surface. Activation of these receptors can trigger a cascade of signaling events, including synthesis of nitric oxide (NO) and proinflammatory molecules. N-Methyl-D-Aspartate receptors (NMDARs) play a significant role in functional hyperemia, also known as neurovascular coupling (NVC), which is essential for maintaining the energy balance in brain cells. Growing evidence suggests that disturbance of this balance is implicated in several neurological diseases, such as Alzheimer's disease, stroke, and traumatic brain injury (TBI), where endothelial dysfunction may impair blood flow regulation, contributing to further neuronal damage and cognitive decline. This review focuses on the glutamate receptor-mediated alterations in endothelial permeability and the prevention of the brain pathology through direct modulation of these receptors. Notably, the metabotropic glutamate receptor mGluR1, along with NMDARs, may cause deleterious effects in brain ischemia, as their activation increases the permeability of the vessel wall. Stimulation of NMDARs may also lead to ferroptosis in ECs. EC dysfunction results in significant blood-brain barrier (BBB) disruption, allowing infiltration by inflammatory cells and the accumulation in brain of pathological proteins, such as amyloid-beta (Aβ) or autoantibodies. This contributes to neuronal dystrophy and apoptosis, as seen in Alzheimer's disease and autoimmune encephalopathy. Activated ECs generate proinflammatory mediators that attract leukocytes and sustain the neuroinflammatory response. Infiltrating peripheral white blood cells are key contributors to inflammatory damage following TBI. Regulation of ECs through glutamate receptors therefore represents a promising therapeutic strategy for treatment of neurodegenerative diseases, as well as ischemic and traumatic brain injuries.}, }
@article {pmid41424575, year = {2026}, author = {Sharma, A and Sathiyanarayanan, L and Arulmozhi, S}, title = {Investigating the therapeutic potential of pinocembrin in Alzheimer's disease: insights from network pharmacology and molecular docking.}, journal = {In silico pharmacology}, volume = {14}, number = {1}, pages = {7}, pmid = {41424575}, issn = {2193-9616}, abstract = {The complicated neurodegenerative disease known as Alzheimer's disease (AD) is typified by neural malfunction, cognitive impairment, and gradual memory loss. Multi-target treatment approaches are desperately needed since AD etiology is complicated. Using network pharmacology, molecular docking, and in vitro experimental validation, this study explores the therapeutic potential of pinocembrin, a flavonoid recognized for its neuroprotective, antioxidant, and anti-inflammatory qualities. Network pharmacology study revealed nine important AD-associated targets of Pinocembrin, which are involved in neurotransmitter modulation, oxidative stress response, and neuronal protection. These targets include CA2, CYP1B1, CYP19A1, DPP4, ESR1, ESR2, HSP90AB1, MAOB, and SHBG. The relationship of these targets with important networks linked to AD, including PI3K-Akt signaling, estrogen signaling pathways, and neuroactive ligand-receptor interaction, was further validated by Gene Ontology (GO) and KEGG pathway enrichment analysis. According to ADMET study, Pinocembrin has good pharmacokinetic characteristics, such as low anticipated toxicity, intermediate blood-brain barrier permeability, and high gastrointestinal absorption. Strong and consistent binding affinities were shown by molecular docking studies, especially with CYP1B1 (-8.1 kcal/mol), DPP4 (-7.3 kcal/mol), and CA2 (-7.6 kcal/mol), indicating possible inhibitory effects on these targets. The compound's medicinal property was further supported by in vitro validation. Pinocembrin's safety profile was validated by the MTT assay, which demonstrated high cell survival (>90%) in PC12 neuronal cells at all tested dosages. In comparison to donepezil as a reference, pinocembrin also demonstrated moderate acetylcholinesterase (AChE) inhibitory action, with an IC50 of 50 µM. Furthermore, DPPH, ABTS, and H2O2 scavenging assays were used to indicate antioxidant activity. The IC50 values for these assays were 150 µg/mL, 78.6 µg/mL, respectively, and total reducing power was 46.5 mg EAA/g. All of these results point to the possibility of pinocembrin as a multi-target therapy drug for Alzheimer's disease. To verify its effectiveness and refine its pharmacological profile for therapeutic use, more in vivo research and molecular dynamics simulations are necessary.}, }
@article {pmid41424454, year = {2025}, author = {Egba, SI and Edeh, MO and Uchenna, NO and Igwe, MC and Ogbodo, JO}, title = {Nasal Delivery of Phytochemicals Using Nanocarriers: Therapeutic Opportunities and Translational Challenges.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {15017-15041}, pmid = {41424454}, issn = {1178-2013}, mesh = {Humans ; *Phytochemicals/administration & dosage/pharmacokinetics/chemistry/therapeutic use ; Administration, Intranasal ; Animals ; *Nanoparticles/chemistry ; Nasal Mucosa/metabolism ; *Drug Carriers/chemistry ; Curcumin/administration & dosage/pharmacokinetics ; *Nanoparticle Drug Delivery System/chemistry ; *Drug Delivery Systems/methods ; Biological Availability ; Nanotechnology ; }, abstract = {The integration of phytochemicals with nanotechnology represents a promising approach to enhance nasal drug delivery, improving therapeutic efficacy and targeted brain delivery. This review explores recent advances in phytochemical-nanotechnology formulations and their applications in managing neurodegenerative diseases, respiratory disorders, and cancers. Phytochemicals such as curcumin, resveratrol, and quercetin exhibit potent pharmacological properties but suffer from poor solubility and limited bioavailability. Nanotechnology-based systems-including nanoparticles, liposomes, and nanoemulsions-overcome these drawbacks by improving stability, absorption, and controlled release. However, challenges such as nasal mucosa irritation, formulation complexity, regulatory barriers, and scalability still impede clinical translation. Notably, encapsulation of curcumin in polymeric nanoparticles has been shown to enhance its solubility and bioavailability, producing improved therapeutic outcomes in preclinical Alzheimer's models. Overall, this review underscores the synergistic potential of phytochemicals and nanotechnology in developing innovative nasal delivery platforms capable of providing targeted, effective, and patient-friendly treatment options for a range of medical conditions.}, }
@article {pmid41423583, year = {2025}, author = {Katuwawala, K and Bharadwaj, P and Martins, I and De Silva, BGDNK and Ho, V and Dissanayake, A and Martins, RN and Fernando, WMADB}, title = {Unraveling the Significance of Fecal MicroRNA Profile in Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {319}, pmid = {41423583}, issn = {1559-1182}, mesh = {*Alzheimer Disease/genetics/diagnosis/metabolism/microbiology ; *MicroRNAs/genetics/metabolism ; Humans ; *Feces/chemistry ; Gastrointestinal Microbiome ; Animals ; }, abstract = {Alzheimer's disease (AD), a complex neurodegenerative disorder characterised by progressive cognitive decline, affects millions globally. With no current cure, treatment focuses on symptom management and slowing disease progression. Early identification is therefore crucial. Fecal microRNA (miRNA) analysis is emerging as a promising non-invasive diagnostic tool. Evidence suggests that miRNAs present in fecal samples may regulate gene expression linked to AD pathology, impacting cellular functions and disease progression. Dietary factors critically influence gut microbiota composition and diversity, affecting brain health via the gut brain axis. Macronutrients such as carbohydrates, proteins, and fats modulate miRNA expression and gut microbiota, influencing AD risk. High-fat diets can increase inflammation and contribute to AD. This review aims to provide a comprehensive overview of how diet-modulated fecal miRNAs and gut microbiota interplay may serve as novel, non-invasive indicators for early detection and intervention strategies in AD.}, }
@article {pmid41423566, year = {2025}, author = {Kong, D and Zhang, T and Hou, G and Liu, G and Qi, X and Xing, H}, title = {A novel method for acoustic modeling of cranial bone based on the porosity index.}, journal = {Scientific reports}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41598-025-33411-x}, pmid = {41423566}, issn = {2045-2322}, support = {2022YFS0048//Sichuan Science and Technology Program/ ; 82027808//National Natural Science Foundation of China/ ; 2020SCUNL210//Science Specialty Program of Sichuan University/ ; }, abstract = {Transcranial ultrasound stimulation (TUS) has emerged as a clinically validated neuromodulation technique. Particularly, phased array ultrasound can be applied in TUS to focus on the cortex or deep brain non-invasively, such as the ventral intermediate thalamic nucleus (VIM) and Precuneus (PCu) region for the treatment of essential tremor (ET) and Alzheimer Disease (AD). Current TUS treatment planning relies on computed tomography (CT)-derived skull porosity measurements, which involve patient radiation exposure and potential registration errors. This study proposes a Porosity Index (PI)-based method, derived from Ultrashort Echo Time (UTE) Magnetic Resonance (MR) images, for establishing skull acoustic models as a viable alternative, aiming to eliminate these limitations. Acoustic simulations using the K-Wave open-source platform were performed to validate the PI method's accuracy in predicting skull porosity and simulating focal distributions compared to CT. Focal spot characteristics were quantified using five metrics: peak intensity, target intensity, focal positioning error, Dice similarity coefficient, and Pearson correlation coefficient between CT- and PI-based simulation results. Statistical differences between these metrics were assessed using Tukey's multiple comparisons test. Quantitative comparisons against the gold-standard CT approach demonstrated comparable performance in peak focal intensity (deviation < 5%) and spatial pressure distribution patterns (Dice coefficient > 0.82). No significant differences (p > 0.05) were observed for any of the evaluated metrics. Our findings demonstrate that both the sound pressure distribution and prediction of the porosity are comparable with those from the reference CT. Using the PI to replace the traditional CT porosity has high feasibility and can achieve the purpose of reducing unnecessary radiation exposure and registration error for patients.}, }
@article {pmid41423172, year = {2026}, author = {Luo, J and Tan, Z and Shang, P and Huang, S and Liu, Y and Wang, Y and Xie, H and Chen, Q}, title = {Accelerated intermittent theta burst stimulation combined with cognitive training modulates cortical plasticity and brain activation in patients with amnestic mild cognitive impairment.}, journal = {Experimental gerontology}, volume = {213}, number = {}, pages = {113009}, doi = {10.1016/j.exger.2025.113009}, pmid = {41423172}, issn = {1873-6815}, mesh = {Humans ; *Cognitive Dysfunction/therapy/physiopathology/psychology ; Male ; *Neuronal Plasticity ; Female ; Aged ; *Transcranial Magnetic Stimulation/methods ; Cognition ; Middle Aged ; Spectroscopy, Near-Infrared ; Theta Rhythm ; Dorsolateral Prefrontal Cortex/physiopathology ; *Amnesia/physiopathology/therapy ; Aged, 80 and over ; Cognitive Training ; }, abstract = {Amnestic mild cognitive impairment (aMCI) is the prodromal period of Alzheimer's disease without effective treatment. This research aimed to investigate the effects of accelerated intermittent theta burst stimulation (iTBS) combined with adaptive cognitive training (COG) on cognitive function in aMCI patients and explore the underlying neural mechanisms. Twenty-four aMCI patients participated in either the real (n = 12) or sham (n = 12) stimulation group. Both groups received adaptive COG, which comprised three sessions of real or sham iTBS delivered on the left dorsolateral prefrontal cortex (DLPFC) once a day for 14 days. The primary outcomes were the Montreal Cognitive Assessment (MoCA) and Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores. Secondary outcomes were changes in cortical plasticity measured by transcranial magnetic stimulation and brain activation monitored by functional near-infrared spectroscopy (fNIRS). Patients were evaluated before and after the intervention. Patients with aMCI who received iTBS combined with COG had a significant improvement in cognitive performance, as assessed by the ADAS-Cog and N-back. In the iTBS+COG group, cortical plasticity measured 30 min post-intervention correlated with ADAS-Cog changes (r = -0.59, p = 0.043). Furthermore, this plasticity was associated with 1-back activation (r = -0.58, p = 0.050), and 2-back activation correlated with ADAS-Cog changes (r = -0.59, p = 0.042). Accelerated iTBS targeted to the left DLPFC combined with adaptive COG promoted cognitive improvement in aMCI patients more effectively by modulating cortical plasticity and brain activation. Cortical plasticity and brain activation might be valuable measurements for understanding cognitive function (Chinese Clinical Trial Registry: ChiCTR2400087943).}, }
@article {pmid41423157, year = {2026}, author = {Liu, J and Yang, J and Liu, S and Sun, W and Xu, B and Liu, J and Wei, F}, title = {Renshen Shouwu formula alleviates Alzheimer's disease pathology by modulating tryptophan metabolism and activating the SIRT1 signaling pathway.}, journal = {Journal of ethnopharmacology}, volume = {359}, number = {}, pages = {121073}, doi = {10.1016/j.jep.2025.121073}, pmid = {41423157}, issn = {1872-7573}, mesh = {Animals ; *Tryptophan/metabolism ; *Alzheimer Disease/drug therapy/pathology/metabolism ; *Sirtuin 1/metabolism ; Mice ; *Drugs, Chinese Herbal/pharmacology/therapeutic use ; Signal Transduction/drug effects ; Gastrointestinal Microbiome/drug effects ; Disease Models, Animal ; Male ; *Neuroprotective Agents/pharmacology ; Cerebral Cortex/drug effects/pathology/metabolism ; }, abstract = {The Renshen Shouwu is a traditional Chinese medicine formula, whose active components have neuroprotective and multiple pharmacological effects. However, Alzheimer's disease (AD) is a complex neurodegenerative disorder, and the exact mechanism of its treating AD remains to be elucidated, and more in - depth research is needed.
AIM OF THE STUDY: The aim of this study is to elucidate the protective effect and potential molecular mechanisms of Renshen Shouwu Formula (RSSW) on AD.
MATERIALS AND METHODS: Using senescence-accelerated mouse prone 8 (SAMP8) mice as an AD model, the cerebral cortex morphology was assessed by H&E staining. Non-targeted and targeted metabolomics, together with 16S rRNA sequencing, were performed to analyze the effects of RSSW on metabolic changes and gut microbiota in SAMP8 mice. Furthermore, potential therapeutic targets of RSSW were predicted by network pharmacology and validated via Western blot.
RESULTS: RSSW treatment significantly mitigated pathological damage in the cerebral cortex, and reduced pro-inflammatory cytokine levels in SAMP8 mice. Results of both non-targeted and targeted metabolomics analyses indicated that RSSW intervention could improve tryptophan metabolism in SAMP8 mice by elevating tryptophan levels, suppressing kynurenine pathway overactivation, and enhancing serotonin and indole derivative biosynthesis. Additionally, RSSW administration markedly increased the relative abundance of Lactobacillus in gut microbiota, which showed positive correlations with the levels of tryptophan, serotonin pathway metabolites, and neurotransmitters, and negatively with kynurenine pathway metabolites. Furthermore, network pharmacology identified that SIRT1 could serve as a potential target for RSSW in AD. Notably, RSSW upregulated SIRT1 protein levels and reduced levels of Ac-p53 and acetylated NF-κB proteins in the hippocampus of SAMP8 mice.
CONCLUSIONS: RSSW suppresses the progression of AD by regulating tryptophan metabolism, reshaping the gut microbiota, and activating SIRT1-mediated signaling pathways. These findings suggest that RSSW may be a promising therapeutic strategy for AD through multi-path action mechanisms.}, }
@article {pmid41421725, year = {2026}, author = {Das, SK and Bashir, B and Kolekar, KA and Harish, V and Patle, D and Vishwas, S and Mittal, N and Jha, SK and Kumar, P and Gupta, G and Dureja, H and Dua, K and Chang, D and Kuppusamy, G and Singh, SK}, title = {Protein and peptide based nanotherapeutics for the management of Alzheimer's disease: Current insights and future directions.}, journal = {Ageing research reviews}, volume = {114}, number = {}, pages = {103000}, doi = {10.1016/j.arr.2025.103000}, pmid = {41421725}, issn = {1872-9649}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Humans ; Animals ; *Peptides/administration & dosage/therapeutic use ; *Proteins/administration & dosage/therapeutic use ; Nanoparticles ; *Nanomedicine/methods/trends ; Drug Delivery Systems ; }, abstract = {Alzheimer's disease (AD) is the most chronic neurodegenerative disease. The pathological hallmark of AD includes the accumulation of amyloid-beta plaques (Aβ), oxidative stress as well as chronic inflammatory reactions. Current treatments, such as acetylcholinesterase inhibitors, N-methyl-D-aspartate (NMDA) receptor antagonists, and recently approved monoclonal antibodies, offer symptomatic relief or slightly slow down progression. However, they too are constrained by high cost, side effects and limited activity. Proteins and peptides are emerging focus of attention as promising therapeutics, due to their higher selectivity, participation in many pathological pathways, and are lesser toxicity than other therapies in recent years. These biomolecules mediate their effect by decreasing amyloid aggregation, preventing tau hyperphosphorylation, regulating oxidative damage and repairing synapses. Various proteins and peptides such as SS31, LPfFFD-PEG, SEN1576, α sheet peptides, D-(PGKLVYA), RI-OR2-TAT, TFP5, SEN304, PP-Leu, Ac-Leu-Pro-Phe-Phe-Asp-NH2 (iAb5p), and Cyclo (17, 21)- (Lys17, Asp21) Aβ (1-28) have been used in the treatment of AD. Nonetheless, these peptides have a limited clinical translatability due to their vulnerability to enzymatic degradation, systemic circulation instability, low bioavailability, and limited penetration across the blood-brain barrier (BBB). To overcome these challenges, nanotechnology-based treatments have become a revolutionary solution. Both functionalized and non-functionalized protein and peptide-loaded nanoparticles provide protection against degradation, cross the BBB, and allow sustained and targeted delivery of neuronal tissues. The ligand-functionalized nanoparticle systems increase the accumulation of therapeutics in the brain as they cross the blood-brain barrier more efficiently. These are also able to protect the circulatory proteins and peptides, and eventually lead to improved therapeutic results in preclinical models. The present review highlights the therapeutic and delivery potential of protein- and peptide-based nanocarriers as dual therapeutic and delivery vectors with disease-modifying capability and precision targeting. Together, these advances have placed nanotechnology-based protein and peptide therapeutics for better management of AD.}, }
@article {pmid41421687, year = {2025}, author = {Lin, HW and Li, SP and Wen, JX and Zhang, JX and Zhang, BM and Wang, YJ and Cui, XJ and Yao, M}, title = {Multi-target neuroprotective effects of notoginsenoside R1 in neurodegenerative diseases: From pharmacokinetics to translational prospects.}, journal = {Pharmacological research}, volume = {224}, number = {}, pages = {108074}, doi = {10.1016/j.phrs.2025.108074}, pmid = {41421687}, issn = {1096-1186}, abstract = {Neurodegenerative diseases impose a heavy social and economic burden, and effective therapeutic strategies are essential for slowing disease progression and improving patient quality of life. Notoginsenoside R1 (NGR1), a key saponin derived from Panax notoginseng (Burk. F.H. Chen), has been widely studied in experimental models of neurodegenerative diseases, such as stroke and Alzheimer's disease (AD). Based on a rigorous literature screening and a meta-analysis of animal studies, we confirmed that NGR1 significantly reduces infarct volumes in cerebral ischemia-reperfusion models and improves escape latency in AD mice. Mechanistically, NGR1 confers neuroprotection by attenuating oxidative stress, suppressing neuroinflammation, inhibiting apoptosis, and preserving the neurovascular unit. Furthermore, using network pharmacology, reverse virtual screening, and molecular docking, we preliminarily identified potential targets and signaling pathways, providing a theoretical basis for future studies. However, clinical translation of NGR1 remains limited due to poor oral bioavailability and restricted permeability across the blood-brain and blood-spinal cord barriers. To address these challenges, we summarized delivery strategies, including nanoparticle-based carriers, intranasal administration, and permeability enhancers, to facilitate NGR1 entry into the central nervous system. We also discussed additional potential approaches, such as structural modification and targeted delivery, analyzing their respective advantages and limitations. Collectively, these findings highlight NGR1 as a promising candidate for the prevention and treatment of neurodegenerative diseases.}, }
@article {pmid41421353, year = {2025}, author = {Sillau, SH and Coughlan, C and Ahmed, MM and Nair, K and Araya, P and Galbraith, MD and Ritchie, A and Ching-Jung Wang, A and Elos, MT and Bettcher, BM and Espinosa, JM and Chial, HJ and Epperson, N and Boyd, TD and Potter, H}, title = {Blood measure of neuronal death is exponentially higher with age, especially in females, and halted in Alzheimer's disease by GM-CSF treatment.}, journal = {Cell reports. Medicine}, volume = {}, number = {}, pages = {102525}, doi = {10.1016/j.xcrm.2025.102525}, pmid = {41421353}, issn = {2666-3791}, abstract = {Aging increases the risk of neurodegeneration, cognitive decline, and Alzheimer's disease (AD). We report that plasma concentrations of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and neurofilament light (NfL) become exponentially higher from ages 2 to 85 in cross-sectional samples, serving as neuronal death/damage biomarkers across the lifespan. UCH-L1 concentrations rise faster in females, who exhibit increased AD risk. Glial fibrillary acidic protein (GFAP) concentrations increase exponentially after age 40, especially in females. Age-adjusted UCH-L1, NfL, and GFAP plasma concentrations are greatly elevated in mildly cognitively impaired participants. Treatment of human AD trial participants with granulocyte-macrophage colony-stimulating factor (GM-CSF/sargramostim) apparently halts neuronal cell death: UCH-L1 biomarker concentrations are reduced to those of 5-year-old healthy controls. GM-CSF treatment also reduces neuronal apoptosis and astrogliosis in a rat model of AD. An exponential increase in neurodegeneration with age, accelerated by astrogliosis/inflammation, may underlie the contribution of aging to cognitive decline and AD and can be halted by GM-CSF/sargramostim treatment.}, }
@article {pmid41421243, year = {2026}, author = {Keleş, T and Biyiklioglu, Z and Seyhan, G and Öz, E and Reis, R and Barut, B}, title = {Potential water-soluble metal phthalocyanine candidates for the treatment of Alzheimer's disease: Synthesis, cholinesterase enzyme inhibition, kinetic analysis and cytotoxicity against human neuroblastoma (SH-SY5Y).}, journal = {Journal of inorganic biochemistry}, volume = {276}, number = {}, pages = {113197}, doi = {10.1016/j.jinorgbio.2025.113197}, pmid = {41421243}, issn = {1873-3344}, mesh = {Humans ; *Indoles/chemistry/pharmacology/chemical synthesis ; *Cholinesterase Inhibitors/pharmacology/chemical synthesis/chemistry ; Isoindoles ; *Neuroblastoma/drug therapy/pathology ; Cell Line, Tumor ; Acetylcholinesterase/metabolism/chemistry ; *Alzheimer Disease/drug therapy/enzymology ; Kinetics ; Butyrylcholinesterase/metabolism/chemistry ; Water/chemistry ; Solubility ; Cell Survival/drug effects ; }, abstract = {In this study, manganese (III), cobalt (II), copper (II) and zinc (II) phthalocyanines and their quaternized cationic derivatives bearing morpholine groups in the non-peripheral position were producedand characterized by various spectroscopic techniques such as UV-Vis, FT-IR, [1]H and [13]C NMR (only for Zn(II)), MALDI-TOF mass spectra. The inhibitory potential of new compounds on AChE and BuChE enzymes was investigated and IC50 values were determined. It was found that water-soluble derivatives showed stronger inhibitory properties. The most effective compounds in AChE inhibition were water-soluble zinc (II) phthalocyanine (ZT6Q) (IC50 = 0.85 ± 0.18 μM) and water-soluble manganese (III) phthalocyanine ZT3Q (IC50 = 2.26 ± 0.38 μM), while ZT6Q showed the strongest effect in BuChE inhibition (IC50 = 5.15 ± 0.48 μM). Lineweaver-Burk analyses revealed that these compounds inhibited both enzymes in a mixed manner. Ki and Kii values were also calculated. In cell viability tests against human neuroblastoma (SH-SY5Y), ZT6Q did not show cytotoxic effects up to 10 μM, on the contrary, they increased cell viability. However, ZT3Q exhibited higher cytotoxicity at 48 h exposure. The findings indicate that these compounds can be evaluated as potential therapeutic agents.}, }
@article {pmid41420771, year = {2025}, author = {Hossain, A and Mia, E and Hasan, SA and Alshahrani, MY and Bristy, AH and Alam, S and Poly, IJ and Rakib, IH and Hossan, R and Hosen, SA and Akter, K and Khalipha, ABR}, title = {Piceatannol as a multi-target neuroprotective agent: mechanistic insights and therapeutic prospects in neurological disorders.}, journal = {Metabolic brain disease}, volume = {41}, number = {1}, pages = {6}, pmid = {41420771}, issn = {1573-7365}, mesh = {*Neuroprotective Agents/therapeutic use/pharmacology ; Humans ; Animals ; *Nervous System Diseases/drug therapy/metabolism ; Oxidative Stress/drug effects ; Antioxidants/pharmacology/therapeutic use ; Stilbenes ; }, abstract = {Neurological disorders like Alzheimer's, Parkinson's, and stroke involve oxidative stress and inflammation. Current treatments mainly ease symptoms but have side effects. Piceatannol, a natural polyphenol, shows promise as a safer, multi-target neuroprotective agent. This review aims to compile and analyze preclinical evidence on PCN, elucidate its underlying mechanisms, and explore its therapeutic prospects in the management of neurological disorders. A comprehensive literature search was conducted using PubMed/MEDLINE and Google Scholar, incorporating in vitro and in vivo studies that evaluated PCN in relevant models. Findings indicate that PCN exerts neuroprotection through potent antioxidant effects, enhancing superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities, and activating Nrf2 signaling while suppressing proinflammatory mediators via nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and mitogen-activated protein kinase (MAPK) pathway inhibition. It also stabilizes mitochondrial function, prevents neuronal apoptosis by modulating Bcl-2/Bax balance and caspase activity, and mitigates ferroptosis. Furthermore, PCN reduces disease-specific pathological markers such as amyloid-β (Aβ) and acetylcholinesterase (AChE), improving memory, motor performance, and neurobehavioral outcomes. These effects are observed in diverse models, including cerebral ischemia-reperfusion injury (CIRI), subarachnoid hemorrhage (SAH), Alzheimer's disease, chronic unpredictable stress (CUS), and prion-related neurodegeneration. In conclusion, PCN's multi-target actions and safe clinical trial position make it a strong candidate for neurodegenerative disease therapy. While preclinical data are compelling, rigorous clinical trials are essential to validate efficacy, optimize dosage, and explore its potential as a standalone or adjunctive treatment for neurological disorders.}, }
@article {pmid41420750, year = {2025}, author = {Motevalli, H and Mehrani, A and Zolfaghari, K and Khodaee, P and Yazdanpanah, N and Saleki, K and Rezaei, N}, title = {TLRs and NLRs modulate oral microbiome involvement in Alzheimer's disease.}, journal = {Metabolic brain disease}, volume = {41}, number = {1}, pages = {7}, pmid = {41420750}, issn = {1573-7365}, mesh = {Humans ; *Alzheimer Disease/metabolism/microbiology ; *Microbiota/physiology ; *Toll-Like Receptors/metabolism ; Animals ; *Mouth/microbiology ; Dysbiosis/metabolism ; }, abstract = {Alzheimer's disease (AD) is the most common and irreversible type of dementia, accounting for more than half of all dementia cases. Early diagnosis of AD plays a role in slowing the progression of the disease and also preserving the quality of life of patients. However, there is often a time lag of several decades between the biological onset of the disease and the time of clinical diagnosis. At the time of diagnosis, the patient often has noticeable cognitive decline, which reduces the effectiveness of available treatments. This diagnostic time lag from onset to the onset of symptoms highlights the need to identify accessible and cost-effective screening tools, such as biomarker-based diagnostic and screening methods. Studies have implicated disorders of the oral-brain axis in the pathogenesis of neurodegenerative diseases such as AD. Oral dysbiosis has been epidemiologically associated with an increased risk of cognitive decline and AD, making the oral microbiome a potential biomarker for screening and early diagnosis of AD. Oral dysbiosis also plays a role in the pathogenesis of AD by increasing systemic inflammation and neuroinflammation. TLR/NLR signaling has been identified as a key intrinsic pathway in the pathogenesis of these neuroinflammations and systemic inflammation, which may suggest the use of inhibitors such as TAK-242/MCC950 as a potential therapeutic approach in the treatment of AD, although preclinical and clinical evidence for the use of these inhibitors in the course of AD is still very limited. In this review, we discuss oral dysbiosis in AD and review studies investigating the mouth-brain axis as an effective pathway in AD from diagnosis to treatment.}, }
@article {pmid41420698, year = {2025}, author = {Yan, Z and Yotsuya, Y and Hasegawa, Y}, title = {Neuroprotective Effect of Marine-Derived Nacre Extract against Aβ-Induced Toxicity via Preservation of Mitochondrial Function and Biogenesis.}, journal = {Neurochemical research}, volume = {51}, number = {1}, pages = {19}, pmid = {41420698}, issn = {1573-6903}, mesh = {Animals ; PC12 Cells ; *Amyloid beta-Peptides/toxicity ; *Neuroprotective Agents/pharmacology/therapeutic use/isolation & purification ; Rats ; *Mitochondria/drug effects/metabolism ; Mice ; Male ; Membrane Potential, Mitochondrial/drug effects ; *Organelle Biogenesis ; Alzheimer Disease/drug therapy/metabolism ; Mice, Inbred C57BL ; }, abstract = {Pearls, formed from the nacreous layers of marine mollusks, have long been used in traditional medicine, yet the molecular basis of their bioactivity remains insufficiently characterized. Mitochondrial dysfunction is a central feature of Alzheimer's disease (AD) pathology and represents a critical therapeutic target. Although nacre extract has been reported to improve cognitive impairment, its effects on mitochondrial function and biogenesis under amyloid-β (Aβ)-induced toxicity remain unclear. In this study, we examined the impact of nacre extract on mitochondrial activity in PC12 cells and in an Aβ-injected mouse model. Treatment with nacre extract significantly alleviated Aβ-induced mitochondrial dysfunction in PC12 cells, restoring membrane potential, ATP production, and the expression of mitochondrial biogenesis-related genes, including PPARγ and Nrf1. MitoBright LT staining demonstrated recovery of mitochondrial mass following extract administration. In vivo, we first isolated and identified a sulfated polysaccharide fraction from nacre extract, which significantly improved Aβ-induced memory impairment. In parallel, this fraction preserved mitochondrial function in the brains of Aβ-injected mice, as evidenced by maintained membrane potential, ATP levels, and hippocampal succinate dehydrogenase expression. Together, these findings demonstrate that nacre extract exerts neuroprotective effects through its sulfated polysaccharide fraction, highlighting its potential as a marine-derived therapeutic resource against AD-related neurodegeneration.}, }
@article {pmid41419667, year = {2025}, author = {Sabbagh, MN and Cummings, JL and Ballard, C and van der Flier, WM and Heneka, MT and Holst, JJ and Knudsen, LB and Salloway, S and Tansey, MG and Drucker, DJ}, title = {Repurposing glucagon-like peptide-1 receptor agonists for the treatment of neurodegenerative disorders.}, journal = {Nature aging}, volume = {}, number = {}, pages = {}, pmid = {41419667}, issn = {2662-8465}, abstract = {With therapeutic progress in Alzheimer's disease (AD), more molecular and mechanistic targets are coming into focus. Beyond amyloid, emerging targets include tau, neuroinflammation and neurotransmitters. Targeting neuroinflammation in neurodegenerative diseases has been explored using cyclooxygenase inhibitors, but it has mostly been unsuccessful. Among the drug classes under investigation for AD are the glucagon-like peptide-1 receptor agonists (GLP-1RAs), which are approved for the treatment of type 2 diabetes (T2D), obesity and cardiovascular disease. GLP-1RAs are candidate treatments for AD based on several concepts. First, epidemiological data reveal that patients with T2D and cardiovascular disease receiving GLP-1RAs have substantial reductions in the risk of developing all-cause dementia. Second, GLP-1RAs reduce neuroinflammatory changes in preclinical models. Clinical trials have not yet shown that GLP-1RAs can slow the rate of cognitive decline in mild cognitive impairment and mild dementia due to AD. Here, we summarize data supporting the use of GLP-1RAs for the treatment of neurodegenerative diseases, with a focus on AD.}, }
@article {pmid41419665, year = {2025}, author = {He, A and Wang, Y and Shen, Y and Dong, Z and Luo, L and Ge, X and Liu, X and Mao, Y and Zhang, T and Li, X and Li, H and Jing, W and Zhu, LQ and Zhang, Q and Lu, Y}, title = {Allosteric activation of a cell-type-specific GPR120 inhibits amyloid pathology of Alzheimer's disease.}, journal = {Nature aging}, volume = {}, number = {}, pages = {}, pmid = {41419665}, issn = {2662-8465}, support = {82430044//National Natural Science Foundation of China (National Science Foundation of China)/ ; 32421003//National Natural Science Foundation of China (National Science Foundation of China)/ ; 82271486//National Natural Science Foundation of China (National Science Foundation of China)/ ; 82325017//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, abstract = {Black rice diets are enriched with unsaturated fatty acids that are thought to be beneficial for neurodegenerative disorders in aging. Here we find that α-linolenic acid (ALA) and 11,14-eicosadienoic acid (EDA), which are naturally enriched in black rice, inhibit amyloid pathology, rescue cognition and extend lifespan in mouse preclinical models of Alzheimer's disease via allosteric activation of G protein-coupled receptor 120 (GPR120) in plaque-associated macrophages and activated microglia. We generate the structures of GPR120 bound to ALA and EDA. We demonstrate that ALA and EDA allosterically modulate and synergistically activate GPR120 for macrophagic phagocytosis and clearance of β-amyloid aggregates in Alzheimer's disease mice. A cell-type-specific deletion of GPR120, or Gαi1, completely abrogates the therapeutic effects of ALA and EDA. This deletion can be rescued by a constitutive active Gαi1-Q204L. These findings show a cell-type-specific function of GPR120 in the brain and provide an enriched allosteric mechanism of GPR120 activation for the treatment of Alzheimer's disease.}, }
@article {pmid41419043, year = {2026}, author = {Zheng, SG and Ye, RL and Huang, XN and Ye, WJ and Li, H and Zeng, NX}, title = {From medicinal herb to neuroprotective candidate: A review of curculigoside's potential in central nervous system disorders.}, journal = {Journal of ethnopharmacology}, volume = {359}, number = {}, pages = {121048}, doi = {10.1016/j.jep.2025.121048}, pmid = {41419043}, issn = {1872-7573}, mesh = {Humans ; *Neuroprotective Agents/pharmacology/therapeutic use ; Animals ; *Glucosides/pharmacology/therapeutic use ; *Central Nervous System Diseases/drug therapy ; *Benzoates/pharmacology/therapeutic use ; Plants, Medicinal/chemistry ; Medicine, Chinese Traditional ; }, abstract = {UNLABELLED: Central nervous system disorders represent a major global cause of mortality and disability, with limited effective treatments available. Traditional Chinese Medicine theory posits a close link between kidney and brain function. Curculigoside, the primary bioactive phenolic glycoside and chemical marker of the kidney-tonifying herb Curculigo orchioides Gaertn, can cross the blood-brain barrier and demonstrates neuroprotective potential. However, to date, no comprehensive review has summarized its effects on central nervous system disorders. To our knowledge, this is the first comprehensive review to summarize and critically evaluate the therapeutic potential and mechanisms of curculigoside across a wide spectrum of central nervous system disorders.
AIM OF THE REVIEW: This study aimed to summarize the therapeutic effects and underlying mechanisms of curculigoside against various central nervous system disorders, evaluate its clinical translational potential, and provide new insights and strategies for clinical treatment.
METHOD: This study comprehensively searched PubMed, Web of Science, Google Scholar, China National Knowledge Infrastructure, and Wanfang Database for studies published before 31 May 2025.
RESULTS: Studies demonstrate curculigoside's efficacy in models of Alzheimer's disease, post-traumatic stress disorder, major depressive disorder, cerebral ischemic stroke, post-stroke depression, perioperative neurocognitive disorders, vascular dementia, and spinal cord injury. Its multifaceted mechanisms include enhancing neurotransmitter systems, reducing neurotoxic proteins, improving synaptic plasticity, and exerting anti-apoptotic, anti-inflammatory, antioxidant, and anti-ferroptotic effects, alongside promoting mitophagy, angiogenesis, oxidative phosphorylation, and neurogenesis/neural regeneration. Collectively, this evidence positions curculigoside as a multi-target neuroprotective agent with promising development prospects; however, its translational potential depends on future breakthroughs in addressing key challenges, including the conduct of large-scale clinical studies to verify its efficacy and safety, a deeper elucidation of its pharmacological mechanisms and toxicological profile, and the development of innovative strategies to improve its bioavailability, blood-brain barrier penetration, and retention in the brain.}, }
@article {pmid41418600, year = {2025}, author = {Samir, M and Abo-Dya, NE and Elsherbiny, NM and Metwally, K and Abouleisa, RRE and Mohamed, TMA and Farraj, KA and Mohamed, ME and Elbadawi, MM and Elbastawesy, MAI and Badawi, WA}, title = {Design, synthesis, and biological evaluation of Benzimidazole-Aminopyrimidine hybrids as selective P38α MAPK inhibitors targeting Neuroinflammation in an AlCl3-induced rat model of Alzheimer's disease.}, journal = {Bioorganic chemistry}, volume = {169}, number = {}, pages = {109391}, doi = {10.1016/j.bioorg.2025.109391}, pmid = {41418600}, issn = {1090-2120}, abstract = {p38α MAP kinase is a key driver of neuroinflammation in Alzheimer's disease (AD). It plays a crucial role in initiating the release of proinflammatory cytokines such as TNF-α and IL-1β. A novel series of benzimidazole-aminopyrimidine-hybrids (4a-m) was designed and synthesized as selective p38α inhibitors by combining two purine isosteric scaffolds with a flexible methyl thioether linker. Targets 4a-m were synthesized in good to excellent yields, characterized using NMR spectroscopy and mass spectrometry, and their purity was confirmed using elemental analysis. Docking and molecular dynamics studies suggested that several compounds bind strongly to p38α. Enzyme assays confirmed that four derivatives (4c, 4d, 4i, and 4j) inhibit p38α in the low-nanomolar range (IC50 ≈ 26-46 nM) with much weaker activity on p38β, p38γ, and p38δ, indicating an α-selective profile. Among them, 4i showed the lowest IC50 value (≈26 nM). Predicted blood-brain barrier (BBB) permeability parameters highlighted 4c and 4d as the best candidates for in vivo testing. Their neuroprotective effects were examined in an AlCl3-induced Alzheimer's-like rat model. Both compounds showed good in silico BBB permeability and were tested in an AlCl3-induced rat model of Alzheimer's disease. Treatment with 4c and 4d significantly decreased brain concentrations of NF-κB p65 by 35 % and 25 %, respectively, TNF-α (33 % and 20 %, respectively), and IL-1β (39 % and 20 %, respectively), along with notable histopathological improvement in cortical and hippocampal tissues. These findings collectively designate 4c as a robust, brain-penetrable p38α-targeting inhibitor that mitigates AD-associated neuroinflammation, signifying it as a promising candidate for subsequent development.}, }
@article {pmid41418563, year = {2026}, author = {Valentino, K and Shen, B and Waisman, B and Le, GH and Ballum, H and Cheung, W and McIntyre, RS}, title = {Efficacy of xanomeline and xanomeline trospium in the treatment of cognitive impairment: A systematic review of preclinical and clinical trials.}, journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, volume = {103}, number = {}, pages = {112735}, doi = {10.1016/j.euroneuro.2025.11.012}, pmid = {41418563}, issn = {1873-7862}, mesh = {*Cognitive Dysfunction/drug therapy ; Humans ; Animals ; *Nortropanes/pharmacology/therapeutic use ; Drug Evaluation, Preclinical ; Clinical Trials as Topic ; *Benzilates/pharmacology/therapeutic use ; *Muscarinic Agonists/pharmacology/therapeutic use ; Treatment Outcome ; Pyridines ; Thiadiazoles ; }, abstract = {The high prevalence, persistence and clinical burden of cognitive impairment on health outcomes in persons with schizophrenia and bipolar disorder invites the need for innovative, mechanistically informed pharmacotherapeutic interventions. Evidence implicates dysregulation of muscarinic signalling as a mediator of cognitive dysfunction, identifying it as a potential therapeutic target. In accordance with the PRISMA guidelines, a systematic search was performed using the following electronic databases: PubMed, Medline, Cochrane Library, PsycInfo, Embase, Scopus, and Web of Science. Databases were searched from inception to May 1, 2025. Study screening and selection was performed by three reviewers (K.V., B.S., and B.W.). Included studies reported on the effects of xanomeline and/or xanomeline trospium on cognitive function. A total of 24 studies were included in this review. Preclinical and clinical studies consistently demonstrate that xanomeline trospium is well tolerated in both short and long-term evaluations. Furthermore, xanomeline trospium has been associated with cognitive improvements in both animal models and clinical populations (e.g., Alzheimer's disease (AD), schizophrenia), including improvements in verbal learning, delayed memory, and reaction time. Xanomeline trospium, an FDA approved muscarinic M1/M4 partial agonist with demonstrated safety, tolerability, and efficacy, represents a novel pharmacological intervention for the treatment of schizophrenia. The convergence of preclinical and clinical findings supports the hypothesis that xanomeline trospium exerts direct pro cognitive effects in persons with schizophrenia, bipolar disorder, and potentially other neuropsychiatric conditions (e.g., AD). Limitations of the current study include limited indications investigated and the absence of a comprehensive analysis of xanomeline's overall neurobiologic effects.}, }
@article {pmid41418456, year = {2026}, author = {Gong, XN and Zhou, YX and Wang, CY and Wang, TT and Gao, ZY and Long, WC and Li, R and Cai, L}, title = {CPD47, a novel GSK-3β inhibitor, demonstrates antidepressant-like effects via the GSK-3β/β-catenin signaling pathway: Involvement of neurogenesis promotion and neuroinflammation inhibition.}, journal = {International immunopharmacology}, volume = {169}, number = {}, pages = {116065}, doi = {10.1016/j.intimp.2025.116065}, pmid = {41418456}, issn = {1878-1705}, mesh = {Animals ; Rats ; Neurogenesis/drug effects ; *Glycogen Synthase Kinase 3 beta/antagonists & inhibitors/metabolism ; *Antidepressive Agents/pharmacology/therapeutic use ; PC12 Cells ; beta Catenin/metabolism ; Male ; *Depression/drug therapy ; Hippocampus/drug effects/pathology ; Rats, Sprague-Dawley ; Signal Transduction/drug effects ; Behavior, Animal/drug effects ; Stress, Psychological/drug therapy ; Disease Models, Animal ; *Neuroinflammatory Diseases/drug therapy ; Corticosterone ; }, abstract = {The GSK-3β/β-catenin signaling axis is critically involved in the pathogenesis of depression. Targeted inhibition of GSK-3β to activate β-catenin signaling may provide a promising depression therapy. The novel GSK-3β inhibitor compound 47 (CPD47) has exhibited therapeutic promise in neurodegenerative disorders such as Alzheimer's disease, but its potential antidepressant effects and underlying mechanisms remain to be elucidated. This study assessed CPD47's protective effects against PC12 cell injury induced by corticosterone (CORT) and its antidepressant-like activity in rats exposed to chronic unpredictable mild stress (CUMS), with a special focus on the mechanisms involving the regulation of the GSK-3β/β-catenin signaling pathway. In this research, CPD47 treatment attenuated CORT-induced neurotoxicity in PC12 cells, as indicated by increased viability, decreased apoptosis, reduced oxidative stress, and suppressed inflammatory responses. In vivo, administration of CPD47 substantially alleviated depressive-like behaviors in CUMS rats, as indicated by behavioral improvements in sucrose preference, forced swim, sucrose splash, and open field tests. Additionally, CPD47 ameliorated hippocampal pathological damage and promoted hippocampal neurogenesis in CUMS rats. Notably, CPD47 markedly mitigated neuroinflammation in the hippocampus of CUMS rats. Mechanistically, CPD47 significantly inhibited GSK-3β activity and activated β-catenin signaling both in vitro and in vivo, with upregulated p-GSK-3β (Ser9) and β-catenin expression and decreased p-β-catenin. Importantly, GSK-3β overexpression abolished CPD47's benefits in CORT-stimulated PC12 cells, providing further evidence that GSK-3β is its crucial molecular target. Collectively, our findings indicate that CPD47 produces potent antidepressant-like effects through modulation of the GSK-3β/β-catenin axis, highlighting its promise as a candidate for depression therapy.}, }
@article {pmid41417293, year = {2025}, author = {Sun, Y and Shao, M and Du, L and Gan, Y and Guan, Y and Cheng, G and Li, S and Jin, H and Li, B and Zhang, G and Yan, S and Xiao, X}, title = {Exploring neuroprotective effects of Chuanzhitongluo capsule on an alzheimer's disease rat model.}, journal = {Metabolic brain disease}, volume = {41}, number = {1}, pages = {5}, pmid = {41417293}, issn = {1573-7365}, support = {2021CXGCO10508//Major Scientific and Technological Innovation Project of Shandong Province/ ; 2019YFC1711205//National Key Research and Development Program of China/ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/metabolism/chemically induced ; *Neuroprotective Agents/pharmacology/therapeutic use ; *Drugs, Chinese Herbal/therapeutic use/pharmacology ; Rats ; Male ; Disease Models, Animal ; Rats, Sprague-Dawley ; Oxidative Stress/drug effects ; Capsules ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) poses significant challenges to public health and well-being, with current treatments often providing limited efficacy. Chuanzhitongluo capsule (CZTL) has neuroprotective effects, and is expected to be used for the treatment of AD. In this study, the chemical composition, pharmacological effects and underlying mechanisms of CZTL against AD were systematically investigated. We identified the major components of CZTL through ultra-high-performance liquid chromatography coupled with a quadrupole time-of-flight mass spectrometer. AD rat model was established via scopolamine injection, followed by the administration of CZTL at various dosages, and pharmacological effects were then systematically evaluated. Furthermore, the potential mechanisms were explored using metabolomics and immunohistochemistry. Seventeen chemical constituents were identified from CZTL. Pretreatment with CZTL led to significant improvements in cognitive function and reductions in neuronal loss among AD rats. CZTL administration decreased abnormal protein aggregates (Aβ and Tau), along with markers of oxidative stress and inflammation. Metabolomic and immunohistochemical analyses indicated that CZTL modulated nicotinamide metabolism and impacted levels of NAD+, UMP, nitric oxide, and SIRT1 activity. These results suggest that CZTL effectively mitigates cognitive deficits and neuronal loss in AD by regulating nicotinamide and SIRT1, while inhibiting oxidative stress and inflammation. This study lies in their contribution to the development of novel anti-AD therapies derived from traditional Chinese medicine, paving the way for new approaches in managing neurodegenerative diseases.}, }
@article {pmid41417196, year = {2025}, author = {Ding, Z and Hou, Q and Shao, N and Gao, W and Cai, B and Hu, S}, title = {Polydatin Attenuates Cognitive Deficits and Neuroinflammation by Inhibiting the P2X7/NLRP1 Inflammasome Pathway in APP/PS1 Mice and Aβ-Treated HT22 Cells.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {311}, pmid = {41417196}, issn = {1559-1182}, support = {2023AH050830//Scientific Research Foundation of Education Department of Anhui Province/ ; 2022rcyb017//the Talent Project of Anhui University of Chinese Medicine/ ; }, mesh = {Animals ; *Glucosides/pharmacology/therapeutic use ; *Amyloid beta-Peptides/toxicity ; *Inflammasomes/metabolism ; *Neuroinflammatory Diseases/drug therapy/metabolism/pathology/complications ; Mice, Transgenic ; *Presenilin-1/metabolism ; *Stilbenes/pharmacology/therapeutic use ; *Receptors, Purinergic P2X7/metabolism ; *Signal Transduction/drug effects ; Hippocampus/pathology/drug effects/metabolism ; Mice ; *Adaptor Proteins, Signal Transducing/metabolism ; Cell Line ; *Apoptosis Regulatory Proteins/metabolism ; *Amyloid beta-Protein Precursor/metabolism ; *Cognition Disorders/drug therapy/metabolism/pathology/complications ; Pyroptosis/drug effects ; Alzheimer Disease/drug therapy ; Peptide Fragments/toxicity ; Cognitive Dysfunction/drug therapy ; Male ; Oxidative Stress/drug effects ; }, abstract = {Aβ deposition is a central pathological hallmarks of Alzheimer's disease (AD), contributing to oxidative stress, neuroinflammation, and neuronal pyroptosis. Polydatin (PD) is a natural polyphenolic compound with known anti-inflammatory and antioxidant properties, has been rarely studied in the context of AD. This study aims to investigate the neuroprotective effects and underlying mechanisms of PD in APP/PS1 transgenic mice and Aβ25-35-treated HT22 cells. Spatial exploration experiments indicate that PD administration (200 mg/kg/day) attenuated cognitive deficits. Histopathological analyses, including hematoxylin-eosin staining and transmission electron microscopy, revealed that PD mitigated hippocampal structural damage in APP/PS1 mice. Western blot and RT-qPCR results showed that PD markedly reduced the expression of pyroptosis-related proteins, including P2X7, NLRP1, ASC, caspase-1, and GSDMD, as well as oxidative stress markers in the hippocampus. In vitro, Aβ25-35 exposure led to an increased expression of P2X7 and components of the NLRP1 inflammasome in HT22 cells, which was reversed by PD treatment. What's more, siRNA knockdown experiments revealed that silencing P2X7 significantly downregulated NLRP1, whereas siNLRP1 had no significant effect on P2X7 expression, suggesting that P2X7 functions upstream of NLRP1. These findings indicate that PD alleviates AD-like pathology by suppressing P2X7/NLRP1 inflammasome-mediated pyroptosis, highlighting its potential as a multi-target therapeutic candidate for AD intervention.}, }
@article {pmid41417181, year = {2025}, author = {Zhang, R and Mu, S and Zhang, S and Qin, X and Du, G and Zhou, Y}, title = {Arctium lappa L. Leaves Alleviate Alzheimer's Disease-Like Pathologies by Modulating the Tricarboxylic Acid Cycle and Inhibiting STAT3/NF-кB Signaling.}, journal = {Plant foods for human nutrition (Dordrecht, Netherlands)}, volume = {81}, number = {1}, pages = {2}, pmid = {41417181}, issn = {1573-9104}, support = {No. 202403021212284//Fundamental Research Program of Shanxi Province/ ; No. 202403021211150//Fundamental Research Program of Shanxi Province/ ; No. 2024ZYY2A029//Shanxi Provincial Administration of Traditional Chinese Medicine research project/ ; No. 2024-021//Research Project Supported by Shanxi Scholarship Council of China/ ; }, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Animals ; NF-kappa B/metabolism ; Plant Leaves/chemistry ; STAT3 Transcription Factor/metabolism ; Rats ; Signal Transduction/drug effects ; *Arctium/chemistry ; Male ; Hippocampus/drug effects/pathology ; Rats, Sprague-Dawley ; *Citric Acid Cycle/drug effects ; Disease Models, Animal ; *Plant Extracts/pharmacology ; Neuroprotective Agents/pharmacology ; Amyloid beta-Peptides/metabolism ; tau Proteins/metabolism ; }, abstract = {Current drugs for Alzheimer's disease (AD) have limited efficacy and often cause adverse side effects. Burdock leaves, known for their heat-clearing and anti-inflammatory properties, can be consumed as a vegetable or brewed into tea. According to traditional Chinese medicine, heat-clearing and anti-inflammatory strategies are considered beneficial for the treatment of AD. Nevertheless, it remains unclear whether burdock leaves have neuroprotective effects or can alleviate neuroinflammation to delay AD progression. Herein, we found that the decline in learning and memory, as well as cognitive impairments in AD model rats, were significantly improved following burdock leaf intervention. Notably, the medium- and high-dose groups showed superior therapeutic outcomes compared to the low-dose group. Histopathological analysis of rat hippocampal tissue revealed that burdock leaves mitigated hippocampal lesions, neuronal loss, pathological amyloid β-protein accumulation, and abnormal phosphorylation of the microtubule-associated Tau protein. Metabolomics studies identified the tricarboxylic acid (TCA) cycle as a key metabolic pathway modulated by burdock leaves in AD regulation. Western blot analysis revealed that the therapeutic effects of burdock leaves may be mediated through the suppression of the STAT3/NF-κB signaling pathway and downregulation of inflammatory protein expression. Of note, the present study uncovered that burdock leaves could delay AD progression by ameliorating metabolic dysregulation and inhibiting STAT3/NF-κB-mediated inflammatory pathways, positioning them as a promising candidate for further exploration in AD therapeutics.}, }
@article {pmid41416491, year = {2025}, author = {Janve, VA and Seto, M and Sperling, RA and Aisen, PS and Rissman, RA and Koran, MEI and Dumitrescu, L and Buckley, RF and Hohman, TJ and , }, title = {Blood gene expression network expression strongly relates to brain amyloid burden.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70982}, pmid = {41416491}, issn = {1552-5279}, support = {//Eli Lilly and Co./ ; /ALZ/Alzheimer's Association/United States ; //GHR Foundation/ ; //National Institutes of Health-National Institute on Aging/ ; //Accelerating Medicines Partnership/ ; }, mesh = {Humans ; Male ; Female ; *Brain/metabolism/diagnostic imaging/pathology ; *Alzheimer Disease/genetics/diagnostic imaging/blood ; Aged ; Positron-Emission Tomography ; *Gene Regulatory Networks ; Histones/genetics ; *Amyloid/metabolism ; *Amyloidosis/genetics ; Aged, 80 and over ; }, abstract = {INTRODUCTION: Amyloid deposition occurs decades before symptoms emerge in Alzheimer's disease (AD). We leveraged blood transcriptomics and positron emission tomography (PET) measures of amyloidosis to identify gene networks in the blood that relate to amyloid burden in the brain.
METHODS: Whole-blood RNA sequencing and amyloid PET were leveraged from 1739 cognitively unimpaired participants in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study. Linear regression related gene module expression to amyloid covarying for age, sex, education, and apolipoprotein E (APOE) ε2 and ε4 genotypes.
RESULTS: Of the 18 gene modules, one histone gene cluster module was associated with amyloid (β = -0.55, false discovery rate-adjusted p value = 0.029). We also observed nominal associations for the predicted proportion of activated natural killer (NK) cells (β = -0.454, p = 0.02) and CD4+ activated memory T cells (β = -0.169, p = 0.03) with amyloid deposition.
DISCUSSION: Our results implicate the histone gene cluster on chromosome 6 and immune cell proportions as blood correlates of brain amyloid deposition in preclinical AD.
HIGHLIGHTS: Higher expression of network module with histone gene cluster on chromosome 6 associated with lower amyloid levels. Four histone genes, H1-5, H3C3, H2BC3, H2AC14, and RRM2, emerged as key genes driving this association, where H1-5 emerged as a hub gene for this module. Pathways, including nucleosome assembly and DNA damage, were enriched in the histone module. A higher fraction of activated NK and activated CD4+ T cells was related to lower amyloid burden.}, }
@article {pmid41415890, year = {2025}, author = {Jia, S and Li, Q and Rui, X and Qin, W and Zhang, W and Dou, J and Zhang, X}, title = {The ubiquitin-proteasome system in Alzheimer's disease: mechanism of action and current status of treatment.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1730206}, pmid = {41415890}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD) is one of the most common neurodegenerative disorders; current therapies can neither cure AD nor prevent its progression. The pathological hallmark of AD is the excessive deposition of abnormal proteins in the brain, primarily including β-amyloid (Aβ) and phosphorylated Tau proteins. The ubiquitin-proteasome system (UPS), a central intracellular protein degradation mechanism that removes misfolded proteins and maintains cellular homeostasis by inhibiting aberrant protein aggregation, plays an important role in the regulation of various physiological functions, as well as in the development of disease. Any abnormality in this process leads to protein misfolding and aggregation, and the accumulation and aggregation of ubiquitinated proteins is a common feature of many neurodegenerative diseases, including AD. A growing number of studies have confirmed the significance of UPS in the AD process, which may act in conjunction with other mechanisms leading to the development of AD, and may even be the direct cause of AD. UPS offers a whole new possibility for the development of drugs for AD prevention and treatment, as well as new strategies and approaches for the treatment of neurodegenerative diseases. Therefore, this review is based on UPS, describes the possible mechanisms of action of UPS in AD, and summarizes the preclinical studies of modulating UPS for the treatment of AD.}, }
@article {pmid41415446, year = {2025}, author = {Linden, AK and Affaneh, A and Aylward, A and Wong, Y and Kessler, JA and Peng, CY}, title = {Differential Regulation of APOE4-Mediated Astrocytic Lipid Metabolism by BMP Signaling Exacerbates Alzheimer's Disease Pathologies in Neurons.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.12.14.694212}, pmid = {41415446}, issn = {2692-8205}, abstract = {The two greatest risk factors for Alzheimer's Disease (AD) are aging and Apolipoprotein E4 (APOE4) polymorphism, yet how these factors interact remain unclear. In this study, we investigate how bone morphogenetic protein (BMP) signaling, which increases with age, contributes to APOE4-induced lipid metabolic dysfunctions using induced-pluripotent stem cell (iPSC)-derived astrocytes and cocultured neurons. Surprisingly, BMP signaling differentially altered lipid droplet formation, cholesterol synthesis and breakdown, and fatty acid-oxidation in APOE4 compared to APOE3 astrocytes, and increased secretion of oxidized LDL (oxLDL). Furthermore, neurons cocultured with BMP4-treated APOE4 astrocytes showed altered transcriptomic profiles based on scRNA-seq as well as increased tau phosphorylation (p-tau). oxLDL treatment similarly increased p-tau and reduced neuronal survival. Conversely, lipid uptake inhibition in neurons rescued the BMP4/APOE4 astrocyte-induced neuronal phenotype. These data demonstrate key interactions between APOE4 and aging-associated molecular signaling in AD pathogenesis and establish a causal linkage between astrocytic lipid metabolism and neuronal tau hyperphosphorylation.}, }
@article {pmid41413577, year = {2025}, author = {Chu, C and Wang, Y and Ma, L and Ouyang, Y and Zisis, G and Masters, CL and Goudey, B and Jin, L and Pan, Y and , }, title = {Development and validation of an interpretable clinical scoring model to monitor the progression of preclinical Alzheimer's disease.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {268}, pmid = {41413577}, issn = {1758-9193}, support = {GNT2007912//National Health and Medical Research Council/ ; 23AARF-1020292/ALZ/Alzheimer's Association/United States ; }, abstract = {BACKGROUND: Monitoring the progression of preclinical Alzheimer's disease (AD) is challenging due to the absence of obvious cognitive impairment, yet it's crucial for determining the optimal timing for disease-modifying treatments.
METHODS: This prognostic study used data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) study. The development cohort included 412 participants from the placebo arm, and external validation was performed using 342 participants from the treatment arm. All participants had baseline brain amyloid-beta (Aβ) positron emission tomography (PET) standardized uptake value ratios (SUVR) below 1.4. Using the AutoScore machine learning framework, we developed two interpretable models: the AutoScore Amyloid-Beta (ASAB) model to predict Aβ accumulation (> 1.4 SUVR) and the AutoScore Phosphorylated Tau (ASPT) model to predict plasma phosphorylated tau-217 (pTau-217) elevation (> 0.3 pg/mL) over 4.5 years. Model performance was assessed using the area under the receiver operating characteristic curve (AUC-ROC) with 95% confidence intervals (CIs).
RESULTS: The ASAB model achieved an AUC-ROC of 0.87 (95% CI, 0.79–0.95), and the ASPT model achieved 0.86 (95% CI, 0.78–0.94). Modified models excluding baseline Aβ SUVR or pTau-217 values maintained a strong performance (AUC-ROC 0.76–0.82). External validation demonstrated a robust performance, with an AUC-ROC of 0.83 (95% CI, 0.78–0.87) for ASAB and 0.84 (95% CI, 0.80–0.89) for ASPT. Key predictors included baseline biomarker levels, cholesterol, platelet count, alanine transaminase, and creatine kinase.
CONCLUSIONS: The AutoScore-based models accurately predict longitudinal Aβ and pTau-217 levels using readily available clinical and laboratory data. These interpretable tools could help clinicians and researchers monitor preclinical AD progression and identify optimal windows for intervention.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13195-025-01931-3.}, }
@article {pmid41411709, year = {2026}, author = {Fisk, D and William, T and Spiwak, R and Modirrousta, M and Ko, JH and Sareen, J}, title = {Combining repetitive transcranial magnetic stimulation with transcranial direct current stimulation in treating psychiatric conditions: A systematic review.}, journal = {Psychiatry research}, volume = {356}, number = {}, pages = {116902}, doi = {10.1016/j.psychres.2025.116902}, pmid = {41411709}, issn = {1872-7123}, mesh = {Humans ; *Transcranial Direct Current Stimulation/methods ; *Transcranial Magnetic Stimulation/methods ; *Mental Disorders/therapy ; Combined Modality Therapy ; }, abstract = {BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have been thoroughly explored in the treatment of various psychiatric disorders and neuropsychiatric symptoms. However, whether combining rTMS and tDCS can safely and effectively treat psychiatric conditions remains unknown. In this systematic review, we seek to summarize all existing studies that have combined rTMS and tDCS to remedy psychiatric disorders and symptoms.
METHODS: We searched four databases in addition to grey literature to identify relevant studies. All abstracts and manuscripts were independently reviewed by two reviewers. For inclusion, studies necessarily consisted of those who received both rTMS and tDCS for a psychiatric condition or symptom.
RESULTS: Fourteen studies were reviewed, which had relevance to unipolar depression (five), bipolar disorder (two), obsessive-compulsive disorder (two), Alzheimer's Disease (one), chronic insomnia (two), depressive and anxiety symptoms (one) and stress (one). In three RCTs on unipolar depression, the group receiving both rTMS and tDCS experienced significant reductions in mean Hamilton Depression Rating Scale (HDRS) scores (by 18.22, 16.59 and 20.04) as well as response rates (83.33 % and 91.7 %) and remission rates (83.3 %) - all of which were generally superior compared to treatment with rTMS or tDCS alone. For chronic insomnia, one RCT noted greater improvements in sleep quality/efficiency and depressive symptoms compared to monotherapy. The type and frequency of side effects were comparable to monotherapy, and no significant adverse events were reported.
CONCLUSION: The existing evidence suggests that combining rTMS and tDCS alone yields greater symptomatic benefit for unipolar depression compared to either treatment alone. Further studies involving additional protocols and disorders could elucidate the utility of combined treatment.}, }
@article {pmid41410987, year = {2025}, author = {Nakayama, Y and Chambers, JK and Uchida, K}, title = {Phosphorylated tau aggregation in the brains of aged Artiodactyla animals.}, journal = {Journal of neuropathology and experimental neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/jnen/nlaf139}, pmid = {41410987}, issn = {1554-6578}, support = {22KA3003//Japanese Ministry of Health and Welfare Sciences Research/ ; JPMJSP2108//JST SPRING/ ; }, abstract = {The aggregation of amyloid-β (Aβ) and phosphorylated tau (p-tau) in the human brain is associated with Alzheimer disease (AD). Although Aβ aggregation has been reported in various mammals, significant p-tau aggregation has been reported in only a few species. We examined Aβ and p-tau aggregation in the brains of 30 animals belonging to 12 artiodactyl species. Amyloid-β aggregates were observed in 2 animals (21 and 22 years old); p-tau aggregates were observed in all animals >9 years of age (n = 12). Regarding tau pathology, mildly affected animals exhibited neuropil threads (NTs), whereas severely affected animals exhibited NTs and neurofibrillary tangles. The most severe p-tau aggregation was observed in the parahippocampal gyrus, basal ganglia, hippocampus, and cerebral cortex. Proteinase K treatment resulted in high proteinase resistance for 4-repeat tau and low resistance for 3-repeat tau. These results suggest that p-tau aggregation occurs prior to Aβ aggregation in artiodactyls, which differs from other mammalian species and human AD. Regarding the distribution, p-tau aggregated in neurites and then in the neuronal cell soma of the parahippocampal gyrus and spread to associated regions of the brain. Moreover, 4-repeat tau was the main component of proteinase-resistant p-tau aggregates in the artiodactyl brains studied.}, }
@article {pmid41410687, year = {2025}, author = {Steward, A and Dewenter, A and Hirsch, F and Roemer-Cassiano, SN and Zhu, Z and Dehsarvi, A and Biel, D and Klonowski, M and Frontzkowski, L and Palleis, C and Gnörich, J and Dichgans, M and Höglinger, G and Brendel, M and Franzmeier, N}, title = {ApoE4 lowers the ptau217 threshold for tau aggregation and spread in an allele dose-dependent manner.}, journal = {Brain : a journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/brain/awaf463}, pmid = {41410687}, issn = {1460-2156}, abstract = {In Alzheimer's disease, carriage of the ApoE4 risk allele is linked to faster tau accumulation at lower amyloid-PET levels, thereby accelerating disease progression. However, it remains unclear whether this ApoE4-facilitated transition from amyloidosis to tauopathy is mechanistically promoted by increased secretion of phosphorylated (p)tau, a key intermediate that drives the amyloid-to-tauopathy transition, or alternatively by increased ptau-driven tau aggregation. Therefore, we investigated where along the amyloid-to-tau axis ApoE4 accelerates tau aggregation and assessed i) whether ApoE4 increases ptau secretion or ii) whether ApoE4 increases ptau-associated tau aggregation. To this end, we analysed two large-scale APOE-genotyped cohorts covering the full Alzheimer's disease spectrum (ADNI: n=201) as well as a preclinical cohort (A4-LEARN: n=200), integrating baseline amyloid-PET, plasma ptau217 and CSF ptau181 with longitudinal tau-PET. Using linear regression, we tested whether ApoE4-carriage moderates i) amyloid-PET-associated plasma ptau217 increases or ii) ptau217-associated tau spreading from local epicentres across patient-tailored tau spreading stages. All analyses were independently validated across both cohorts, including an additional replication in an ADNI subset (n=115) with available CSF ptau181 measures as an alternative marker of ptau secretion. Finally, we used logistic regression to determine ApoE4 allele count-stratified plasma ptau217 thresholds marking early pathological tau-PET increases. We found that ApoE4 did not facilitate amyloid-PET-associated ptau increases, suggesting that amyloid-related ptau secretion is not altered by ApoE4-carriage. Contrastingly, we found that plasma ptau217 elevations were linked to faster tau-PET spread from local epicentres across connected brain regions in an ApoE4-allele dose-dependent manner, independent of amyloid (ADNI/A4-LEARN: mean β=0.44/0.56, p<0.001/<0.001). Lastly, we found that a higher ApoE4 allele count was linked to lower ptau217 thresholds marking transition to tauopathy, i.e. early abnormal tau-PET increases, consistently across both samples (ADNI: 0/1/2 ApoE4 alleles=0.62/0.34/0.15pg/ml, representing ∼45% and ∼76% reductions from non-carriers; Fujirebio ptau217 assay; A4/LEARN: 0/1/2 ApoE4 alleles=0.31/0.23/0.18pg/ml, representing ∼26% and ∼42% reductions; Eli Lilly ptau217 assay). These findings suggest that ApoE4, i.e. the key genetic risk factor for sporadic Alzheimer's disease, facilitates amyloid-dependent tau aggregation in an allele dose-dependent manner by enhancing the ptau-driven spread of fibrillar tau, leading to an earlier transition from amyloidosis to tauopathy at lower ptau217 levels. This has implications for plasma ptau-based screening approaches and therapeutic timing of anti-amyloid drugs in ApoE4 carriers: Specifically, ApoE4 carriers may require genotype-adjusted ptau thresholds to detect Alzheimer's disease pathophysiology, as well as anti-amyloid treatment at lower ptau levels to prevent the transition to tauopathy, which ultimately drives neurodegeneration and cognitive decline.}, }
@article {pmid41410237, year = {2025}, author = {Kranz, DL and de Leon Velez, O and Ulupinar, E and Ozdinler, PH and Silverman, RB and Klein, WL}, title = {Identification of a glia-associated amyloid β oligomer subtype and the rescue from reactive astrogliosis by inhibitor NU-9.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70968}, pmid = {41410237}, issn = {1552-5279}, support = {//NIH/ ; AG061708//Foundation for the National Institutes of Health/ ; }, mesh = {Animals ; *Amyloid beta-Peptides/metabolism ; *Gliosis/pathology/metabolism/drug therapy ; Mice ; *Alzheimer Disease/pathology/metabolism/drug therapy ; Mice, Transgenic ; Astrocytes/metabolism/drug effects/pathology ; *Neuroglia/metabolism/drug effects ; Disease Models, Animal ; Microglia/metabolism/drug effects ; Brain/pathology/metabolism/drug effects ; Humans ; Neurons/metabolism/pathology ; }, abstract = {INTRODUCTION: Neuronal degeneration and immune cell activation occur early in Alzheimer's disease (AD), but the responsible molecules remain undetermined. While exogenous amyloid beta oligomers (AβOs) induce neuronal death and gliosis, the role of endogenous AβOs is less defined.
METHODS: Brain sections from 1- to 12-month-old 5xFAD mice were immunolabeled for AβOs, activated glia, phosphorylated transactive response DNA-binding protein 43 kDa (pTDP-43), and other AD markers. Neuropathology was analyzed following 60-day oral treatment with NU-9, a small-molecule AβO inhibitor.
RESULTS: By 8 weeks, AβOs accumulated in the subiculum alongside early reactive astrocytes and activated microglia. Clinical-stage antibody ACU193 detected AβOs in early-stage degenerating neurons, while NU4-labeled denser deposits in late-stage degenerating neurons. ACU193[+] AβOs accumulated on reactive astrocyte surfaces, which also contained pTDP-43, and later emerged inside activated microglia. NU-9 reduced astrocyte-associated ACU193[+ ]AβOs, pTDP-43, and markedly diminished glial fibrillary acidic protein.
DISCUSSION: These findings demonstrate in vivo efficacy of NU-9 and support targeting ACU193[+ ]AβOs to mitigate AD progression.
HIGHLIGHTS: ACU193[+] AβOs accumulated as puncta in neurons at an early stage of degeneration, while NU4[+] AβOs appeared as dense deposits only in late-stage degenerating neurons. The onset and progression of ACU193[+] AβOs paralleled activated microglia and reactive astrocytes. ACU193[+] AβOs significantly increased on reactive astrocyte surfaces, as NU4[+] AβOs accumulated in halos around Thio-S[+] plaque cores. In older mice, the ACU193 signal decreased on astrocytes and was found inside activated microglia. Sixty-day oral NU-9 treatment significantly reduced astrocyte ACU193[+] AβOs and markedly decreased reactive astrogliosis.}, }
@article {pmid41409874, year = {2025}, author = {Miyahara, R and Akiyama, O and Yoshida, N and Suzuki, M and Ashizawa, K and Kodama, T and Shimizu, Y and Kondo, A}, title = {A case of cerebral sparganosis diagnosed by surgical resection and molecular analysis.}, journal = {Surgical neurology international}, volume = {16}, number = {}, pages = {512}, pmid = {41409874}, issn = {2229-5097}, abstract = {BACKGROUND: Sparganosis is a rare parasitic infection caused by the plerocercoid larvae (spargana) of Spirometra species. Central nervous system (CNS) involvement is uncommon; cerebral sparganosis can be particularly challenging to diagnose because its clinical presentation and imaging features often mimic those of more common parasitic infections (e.g., neurocysticercosis) or neoplastic lesions.
CASE DESCRIPTION: A 74-year-old woman with slowly progressive Alzheimer's disease, who had undergone regular brain magnetic resonance imaging (MRI) examinations over the past three years, was incidentally found to have a slowly enlarging lesion with surrounding edema in the left frontal lobe on MRI of the brain. The lesion demonstrated calcification and radiological features atypical for a neoplastic process, thus prompting a left frontal craniotomy for diagnostic purposes. Intraoperatively, a whitish, linear structure was removed. Frozen section revealed granulomatous inflammation with parasitic structures. Molecular biological analysis identified the specimen as a Spirometra larva (Type I), confirming the diagnosis of cerebral sparganosis. Postoperatively, her baseline cognitive impairment persisted; however, follow-up MRI at 1 month demonstrated resolution of the enhancing lesion, and no new neurological deficits occurred.
CONCLUSION: Cerebral sparganosis should be considered in the differential diagnosis of intracranial mass lesions with a tumor-like appearance. Although the diagnosis remains challenging, molecular techniques permit definitive confirmation. Surgical resection serves a dual role, facilitating both accurate diagnosis and treatment.}, }
@article {pmid41409674, year = {2025}, author = {Sai, I and Grill, JD and Younes, K and Winer, JR and Cody, KA and Sperling, R and Mormino, EC and Young, CB}, title = {Cognitive screening biases in a secondary prevention Alzheimer's disease clinical trial.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, doi = {10.64898/2025.11.28.25341235}, pmid = {41409674}, abstract = {INTRODUCTION: Alzheimer's disease (AD) prevention trials have multiple screening steps to identify cognitively unimpaired individuals with AD biomarker evidence. Cognitive/functional screening tests may be biased in underrepresented groups, thereby impacting trial eligibility.
METHODS: 6669 participants screened for the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study were grouped by ethnoracial background and testing language. Ethnoracial/language differences in ineligibility reason, cognitive/functional test performance, and amyloid positivity rates were examined.
RESULTS: Ethnoracial minorities were least likely to meet eligibility criteria. Patterns of incorrect Mini-Mental State Examination items and impaired Clinical Dementia Rating functional domains differed between groups excluded for impaired cognition/function, suggesting test biases. The Free and Cued Selective Reminding Test yielded more similar exclusion rates across groups than Logical Memory. Cognitive/functional screening biases may impact subsequent biomarker screening as amyloid positivity rates were lowest in ethnoracial minorities.
DISCUSSION: Biases in cognitive/functional screening tests may disproportionately exclude ethnoracial minorities in AD prevention trials.}, }
@article {pmid41408986, year = {2025}, author = {Liu, C and Ene, J and Lu, W and Syed, F and Sun, L and Raulin, AC and Ren, Y and Wang, X and Kanekiyo, T and Li, Y}, title = {Immuno-Regulation of Brain Region-Specific Organoids Containing Isogenic Microglia-Like Cells.}, journal = {Advanced healthcare materials}, volume = {}, number = {}, pages = {e03579}, doi = {10.1002/adhm.202503579}, pmid = {41408986}, issn = {2192-2659}, support = {2017869//NSF/ ; R01NS125016//Foundation for the National Institutes of Health/ ; R21EB033495//Foundation for the National Institutes of Health/ ; }, abstract = {Most brain organoids derived from human induced pluripotent stem cells (iPSCs) lack microglia and thus immune function. Microglia-like cells (MGCs) can be differentiated from iPSCs, while the characteristics of isogenic MGC-containing brain organoids in modeling neurodegeneration and cell-cell communications have not been well investigated. In this study, iPSC-derived MGCs are co-cultured with isogenic forebrain cortical organoids (iFCo), which are stimulated with extracellular vesicles (EVs) of brain organoids differentiated from Alzheimer's disease (AD) patient-derived iPSCs (APOE ε4/ε4 and presenilin 1). The AD EV-stimulated co-culture organoids are treated with EVs from healthy MGCs or co-culture. Differential responses of the co-cultured organoids and the MGCs to AD EVs are demonstrated. The co-cultured organoids mitigated pro-inflammatory gene expressions. EVs from healthy MGCs or co-culture reduced the expression of IL-12β, iNOS, TREM2, and CASS4, which are associated with neural inflammation and degeneration, as well as showed regulation on genes involved in microglial activation and carbon metabolism. AD EV cargo analysis by proteomics and microRNA-sequencing revealed APOE and APP proteins and microRNAs regulated pathways such as mitophagy. This study paves the way for understanding the role of microglia and brain organoids in modeling neural degeneration and the development of EV-based cell-free therapeutics for AD treatment.}, }
@article {pmid41408378, year = {2025}, author = {Neuharth, JI and Hernandez, KS and Bernholtz, J and Edwards, H and Stewart, A}, title = {Consideration of sex as a biological variable over the history of the 5xFAD Alzheimer's Disease mouse model.}, journal = {Biology of sex differences}, volume = {16}, number = {1}, pages = {105}, pmid = {41408378}, issn = {2042-6410}, support = {NIH T32NS007421/NH/NIH HHS/United States ; Lulu Merle Johnson Recruitment Fellowship//University of Iowa/ ; }, mesh = {Animals ; *Alzheimer Disease ; Disease Models, Animal ; Male ; Female ; Mice ; Mice, Transgenic ; *Sex Characteristics ; }, abstract = {BACKGROUND: Women are nearly twice as likely to be diagnosed with Alzheimer's Disease (AD) over their lifetime. However, historically, preclinical studies utilizing AD rodent models to define new therapeutic targets in AD treatment have neglected to consider the confounding influence of subject sex leading to a lack of mechanistic insight into the biological underpinnings of sex bias in AD.
METHODS: Here, we tracked choice of subject sex over the twenty-year history of the 5xFAD mouse, one of the most frequently cited pre-clinical AD models. We analyzed 1,330 primary research articles indexed on PubMed and recorded information provided regarding subject sex and/or as a rationale for not including datasets separated by sex, if noted. Trends were then plotted as a function of time ending in December 2024.
RESULTS: In the last 15 years, the number of published manuscripts on the 5xFAD model omitting information on subject sex has progressively declined. However, the proportion of studies utilizing either males only (29%) or combining data from both sexes (24%) far surpasses studies acknowledging sex as a biological variable (SABV) (< 12%) with no significant changes noted over time. On average, the ratio of male only: female only studies of 5xFAD mice hovered around 2:1. The most frequently cited reason for omitting sex-based analyses was either a lack of sex differences found (29%), accelerated development of plaque burden in 5xFAD females (17%), or the possibility of within- or between-sex variability (15%). Mention of SABV has steadily increased in studies utilizing 5xFAD mice peaking at ~ 30% of manuscripts published in 2024. However, two key confounds in the 5xFAD model, including the potential impact of an estrogen response element (ERE) and parental imprinting in the Thy1 promoter driving transgene expression, have been largely ignored.
CONCLUSIONS: The 5xFAD model represents a compelling example of how neglecting to recognize the impact of biological sex on neural function can compromise study design and data interpretation. Given sex-dependent Thy1 promoter regulation may skew phenotypic outcomes, investigators should judiciously interpret sex differences observed in any AD mouse utilizing the Thy1 promoter to drive transgene expression.}, }
@article {pmid41408021, year = {2025}, author = {Kaur, K and Kulkarni, YA and Wairkar, S}, title = {Improved Oral Bioavailability and Brain Distribution of Hesperidin via Cochleate Formulation: Statistical Optimization and Pharmacokinetic Study.}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {59}, pmid = {41408021}, issn = {1530-9932}, mesh = {*Hesperidin/pharmacokinetics/administration & dosage/chemistry ; Animals ; Biological Availability ; Rats, Wistar ; Administration, Oral ; Liposomes/chemistry ; Rats ; *Brain/metabolism ; Male ; Particle Size ; Chemistry, Pharmaceutical/methods ; Solubility ; Tissue Distribution ; Drug Liberation ; }, abstract = {Hesperidin, a flavanone, exhibits antioxidant, anti-inflammatory, and anti-amyloidogenic properties, making it a promising candidate for the treatment of Alzheimer's disease. The hesperidin possesses poor solubility, and its oral bioavailability is < 20%. Therefore, hesperidin cochleates (HC) were prepared using the trapping method of calcium ions into preformed liposomes to improve oral bioavailability. The HC formulation was statistically optimized by applying a 3-level factorial design. Optimum cochleates were observed, with an average particle size of 398.9 nm, a zeta potential of -39.1 mV, and an entrapment efficiency of 92.2%, respectively. The in vitro release of hesperidin from cochleates (Batch 15) was 97% in phosphate buffer at pH 7.4 after 24 h. The HC formulation exhibited a 1% release at a gastric pH of 1.2, indicating its stability in the stomach, allowing the formulation to reach the absorption site. In Wistar rats, a comparative pharmacokinetic study was conducted between hesperidin liposomes and HC. Hesperidin concentration was 2.21-fold higher in plasma and 1.2-fold higher in the brain after cochleates administration than in the liposomal formulation and more than 25-fold greater than plain API. Thus, cochleates may be superior oral carriers for hesperidin, improving its oral bioavailability for the treatment of Alzheimer's disease.}, }
@article {pmid41407043, year = {2026}, author = {Fan, B and Liang, Y and Zhi, T and Wu, L and Wu, Y and Yang, Y and Xie, Z and Wu, X}, title = {GPR55 deficiency exacerbates cognitive impairments and Alzheimer's disease-like pathology in mice.}, journal = {Neurochemistry international}, volume = {192}, number = {}, pages = {106105}, doi = {10.1016/j.neuint.2025.106105}, pmid = {41407043}, issn = {1872-9754}, mesh = {Animals ; *Alzheimer Disease/pathology/metabolism/genetics ; Mice ; *Cognitive Dysfunction/metabolism/pathology/genetics ; Hippocampus/metabolism/pathology ; Mice, Knockout ; Mice, Transgenic ; *Receptors, Cannabinoid/deficiency/genetics ; Mice, Inbred C57BL ; Male ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is the most common type of dementia, characterized by progressive cognitive decline and neuronal damage. Although studies have indicated a link between G-protein coupled receptor 55 (GPR55) and AD-related cognitive impairment, the underlying mechanisms remain unclear. Here, we aim to further investigate the role of GPR55 in the pathogenesis of AD.
METHODS: We used viral vectors to knock down GPR55 expression in the hippocampus of normal mice. We also generated GPR55 knockout in AD mice by crossing GPR55[-/-] mice with APP/PS1 transgenic mice (APP/PS1; GPR55[-/-]). Behavioral tests were conducted to assess spatial memory deficits in 9-month-old APP/PS1; GPR55[-/-] mice. We also assessed the amyloid β (Aβ) deposition, glial cell activation, and synaptic protein expression in the hippocampus. In addition, we used AAV9 viruses to overexpress GPR55 in the hippocampus of APP/PS1; GPR55[-/-] mice to further observe its effect on cognitive function.
RESULTS: Knockdown of GPR55 in the hippocampus induces AD-like pathology, cognitive dysfunction, neuroinflammation, and synaptic plasticity damage in normal mice. This was evidenced by increased hippocampal levels of Aβ and p-Tau, enhanced glial cell activation accompanied by upregulation of proinflammatory cytokines, and aggravated synaptic plasticity damage in the normal mice. Furthermore, knockdown of GPR55 induced the reduction of P-AKT1/2/3/AKT1/2/3 and P-GSK3β/GSK3β, while increasing the expression of P-ERK1/2/ERK1/2 in the hippocampus of normal mice. In addition, GPR55 deficiency exacerbated AD-like pathology and spatial learning and memory deficits in APP/PS1 mice. Conversely, AAV9-mediated overexpression of GPR55 rescued spatial memory impairments in APP/PS1; GPR55[-/-] mice.
CONCLUSIONS: These findings underscore the critical role of GPR55 in AD progression and highlight its potential as a therapeutic target for AD treatment.}, }
@article {pmid41406951, year = {2025}, author = {Fang, S and Cui, F and Drucker, DJ}, title = {Glucagon-like peptide-1 medicines in neurological and psychiatric disorders.}, journal = {Cell reports. Medicine}, volume = {6}, number = {12}, pages = {102511}, pmid = {41406951}, issn = {2666-3791}, mesh = {Humans ; *Glucagon-Like Peptide 1/therapeutic use/metabolism ; *Mental Disorders/drug therapy ; *Nervous System Diseases/drug therapy ; Diabetes Mellitus, Type 2/drug therapy ; }, abstract = {Glucagon-like peptide-1 (GLP-1) medicines are used for the treatment of type 2 diabetes (T2D) and obesity and reduce rates of cardiovascular disease, including stroke, in people with T2D. Substantial evidence from real-world data and clinical trials highlights the therapeutic potential of GLP-1 medicines for the treatment of neurodegenerative disorders such as Parkinson's and Alzheimer's diseases. Similarly, there is growing evidence for the potential utility of using GLP-1 medicines to reduce rates of smoking, or use of alcohol, tobacco, cannabis, or cocaine in individuals with substance use disorders. More limited clinical data suggest utility for GLP-1 medicines in patients with migraine or intracranial hypertension. The available data suggest that the use of GLP-1 medicines exhibits an acceptable safety profile in most individuals with neuropsychiatric disorders. Here, we review recent clinical evidence and ongoing trials exploring the efficacy and safety of GLP-1 medicines across a broad range of neurological conditions.}, }
@article {pmid41406583, year = {2025}, author = {Yıldızbaş, A and Taslimi, P and Tüzün, B and Sadeghian, N and Kurt, R and İstek, A}, title = {Chemical composition and bioactivity of Sideritis taurica Stephan ex Wild. (Lamiaceae) leaves: GC/MS analysis, antioxidant and enzyme inhibition activities, and in silico studies.}, journal = {Journal of chromatography. B, Analytical technologies in the biomedical and life sciences}, volume = {1270}, number = {}, pages = {124894}, doi = {10.1016/j.jchromb.2025.124894}, pmid = {41406583}, issn = {1873-376X}, abstract = {Since ancient times, Sideritis taurica and other Sideritis species have been used in traditional medicine in Türkiye and beyond for treating a variety of ailments, including coughs, sore throats, gastrointestinal, respiratory, and urogenital disorders, as well as wounds, colds, and flu, and are believed to possess numerous therapeutic properties such as antispasmodic, analgesic, antibacterial, anti-inflammatory, and antioxidant effects. This study aimed to evaluate the enzyme inhibition and antioxidant activities of various extracts from S. taurica leaves collected from Kurucaşile, Bartın, Türkiye. The extracts were prepared using ethanol, methanol, and hot/cold water extraction methods from leaves that were dried at room temperature and stored in a freezer. Enzyme inhibition activities were assessed against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), α-glucosidase, and α-amylase, with IC50 values calculated. Antioxidant activities were measured using DPPH, ABTS, and CUPRAC assays. Furthermore, ADME/T (Absorption, Distribution, Metabolism, Excretion, and Toxicity) and molecular docking calculations were performed on the phytochemical components of S. taurica to investigate their effects and interactions with human metabolism. These calculations were performed on a number of proteins, including alpha-amylase protein (PDB ID: 1HNY), AChE protein (PDB ID: 4M0E), and BChE protein (PDB ID: 5NN0). The purpose of these calculations was to investigate the interaction between these substances and human metabolism. The results indicated that the ethanol and methanol extracts exhibited the highest inhibition on AChE and BChE (IC50 values of 73.99 μg/mL and 5.04 μg/mL, respectively). The methanol extracts also demonstrated potent inhibition against α-glucosidase (IC50 value of 25.81 μg/mL) and α-amylase (IC50 value of 70.42 μg/mL). Regarding antioxidant activity, the methanol extracts showed the highest radical scavenging activity in the DPPH (87.88 %) and ABTS (99.97 %) tests. Additionally, the methanol extracts stored in the freezer exhibited the best-reducing power in the CUPRAC assay (2.436 ± 0.1669). These findings underscore the potential of S. taurica as a source of natural antioxidants and enzyme inhibitors, suggesting its applicability in the treatment of neurodegenerative diseases such as Alzheimer's disease. In conclusion, extracts obtained from S. taurica leaves, particularly those derived from room temperature-dried leaves, demonstrate significant enzyme inhibition and antioxidant properties. Also, the findings support the consideration of S. taurica as a natural therapeutic source for neurodegenerative diseases and emphasize for further investigation into its active components and health benefits.}, }
@article {pmid41405876, year = {2025}, author = {}, title = {Valacyclovir Treatment of Early Symptomatic Alzheimer Disease: Research Summary.}, journal = {JAMA}, volume = {}, number = {}, pages = {e2522830}, doi = {10.1001/jama.2025.22830}, pmid = {41405876}, issn = {1538-3598}, }
@article {pmid41405855, year = {2025}, author = {Devanand, DP and Wisniewski, T and Razlighi, Q and Qian, M and Wei, R and Andrews, HF and Acosta, EP and Bell, KL and Pelton, GH and Deliyannides, D and Perrin, AC and Caccappolo, E and Gershon, AA and Prasad, KM and Kreisl, WC and Mintz, A and Huey, ED}, title = {Valacyclovir Treatment of Early Symptomatic Alzheimer Disease: The VALAD Randomized Clinical Trial.}, journal = {JAMA}, volume = {}, number = {}, pages = {}, pmid = {41405855}, issn = {1538-3598}, abstract = {IMPORTANCE: Neuroscientific, epidemiological, and electronic health record studies implicate herpes simplex virus (HSV) as potentially etiological for Alzheimer disease (AD).
OBJECTIVE: To compare the efficacy and adverse effects of valacyclovir vs placebo in participants with early symptomatic AD and HSV seropositivity (HSV-1 or HSV-2).
This randomized clinical trial included adults with a clinical diagnosis of probable AD or a clinical diagnosis of mild cognitive impairment with positive biomarkers for AD, a positive serum antibody test (IgG or IgM) for HSV-1 or HSV-2, and a Mini-Mental State Examination score of 18 to 28. The trial was conducted at 3 US outpatient clinics specializing in memory disorders. Recruitment occurred from January 2018 to May 2022; the last follow-up occurred in September 2024.
INTERVENTION: Either 4 g/d of valacyclovir (n = 60) or matching placebo (n = 60).
MAIN OUTCOMES AND MEASURES: The primary outcome was least-squares mean (LSM) change at 78 weeks in the 11-item Alzheimer's Disease Assessment Scale Cognitive (ADAS-Cognitive) Subscale score (range, 0-70; higher scores indicate greater impairment). The secondary outcomes were LSM change in the Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) Scale score; LSM change in the 18F-florbetapir amyloid positron emission tomography (PET) standardized uptake value ratio (SUVR; higher scores indicate higher amyloid levels) for 6 brain regions (medial orbitofrontal, anterior cingulate, parietal lobe, posterior cingulate, temporal lobe, and precuneus); and LSM change in 18F-MK-6240 tau PET medial temporal SUVR (higher scores indicate higher tau levels) for 4 brain regions (amygdala, hippocampus, entorhinal, and parahippocampus). The frequency of adverse events was the safety outcome.
RESULTS: Of the 120 participants (mean age, 71.4 [SD, 8.6] years; 55% were female), 93 (77.5%) completed the trial. At 78 weeks, the LSM change in the 11-item ADAS-Cognitive Subscale score was 10.86 (95% CI, 8.80 to 12.91) in the valacyclovir group vs 6.92 (95% CI, 4.88 to 8.97) in the placebo group, indicating greater cognitive worsening with valacyclovir than placebo (between-group difference, 3.93 [95% CI, 1.03 to 6.83]; P = .01). The LSM change in the ADCS-ADL Scale score at 78 weeks was -13.78 (95% CI, -17.00 to -10.56) in the valacyclovir group vs -10.16 (95% CI, -13.37 to -6.96) in the placebo group (between-group difference, -3.62 [95% CI, -8.16 to 0.93]). At 78 weeks, the LSM change in the 18F-florbetapir amyloid PET SUVR was 0.03 (95% CI, -0.04 to 0.10) in the valacyclovir group vs 0.01 (95% CI, -0.06 to 0.08) in the placebo group (between-group difference, 0.02 [95% CI, -0.08 to 0.12]). The LSM change in the 18F-MK-6240 tau PET medial temporal SUVR at 78 weeks was 0.07 (95% CI, -0.06 to 0.19) in the valacyclovir group vs -0.04 (95% CI, -0.15 to 0.07) in the placebo group (between-group difference, 0.11 [95% CI, -0.06 to 0.28]). The most common adverse events were elevated serum creatinine level (5 participants [8.3%] in the valacyclovir group vs 2 participants [3.3%] in the placebo group) and COVID-19 infection (3 [5%] vs 2 [3.3%], respectively).
CONCLUSIONS AND RELEVANCE: Valacyclovir was not efficacious with cognitive worsening for the primary outcome and it is not recommended to treat individuals with early symptomatic AD and HSV seropositivity.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03282916.}, }
@article {pmid41405805, year = {2025}, author = {Blair, HA}, title = {Sublingual Cyclobenzaprine: First Approval.}, journal = {Clinical drug investigation}, volume = {}, number = {}, pages = {}, pmid = {41405805}, issn = {1179-1918}, abstract = {TONMYA[™] is a sublingual eutectic formulation of cyclobenzaprine being developed by Tonix Pharmaceuticals for the treatment of various conditions, including fibromyalgia, post-traumatic stress disorder (PTSD), acute stress disorder, major depressive disorder, post-acute COVID-19 syndrome, alcohol use disorder, and agitation in Alzheimer's disease. The sublingual formulation was designed for rapid transmucosal absorption to produce diurnal variation in peak-to-trough drug concentrations, making it suitable for long-term bedtime use. On 15 August 2025, sublingual cyclobenzaprine was approved for the treatment of fibromyalgia in adults in the USA. This article summarizes the milestones in the development of sublingual cyclobenzaprine leading to this first approval for fibromyalgia.}, }
@article {pmid41404527, year = {2025}, author = {Nestor, PJ and Pelekanos, M and Leinenga, G and Song, J and Lee, W and Richter-Stretton, G and McElligott, C and Fazlollahi, A and Mattingley, JB and Harris, A and Beale, H and Roberts, J and de Las Heras, R and Götz, J}, title = {A pilot safety and tolerability study of scanning ultrasound as a neuromodulation therapy in Alzheimer's disease.}, journal = {Brain communications}, volume = {7}, number = {6}, pages = {fcaf445}, pmid = {41404527}, issn = {2632-1297}, abstract = {Clearing amyloid-β pathology in Alzheimer's disease (AD) has been considered a prerequisite for restoring cognitive functions. Intriguingly, by application of a modality of scanning ultrasound (SUS) to mice that does not remove amyloid-β, we previously achieved significant cognitive improvements. This prompted us to explore SUS as a non-invasive brain stimulation strategy in an open-label safety trial in AD. We conducted a human pilot study in 12 participants with AD with the primary objective of determining feasibility, safety and tolerability. Exploratory secondary end-points were cognitive and behavioural measures, resting-state EEG and functional MRI. A portable device termed UltraThera[Pilot] was built under medical device standard guidelines, integrating a Brainsight image-guided neuronavigation system. A single-element 286-kHz transducer was programmed to deliver non-derated ultrasound doses of 2.6, 1.95 or 1.3 MPa. With four treatment sessions spaced fortnightly, four participants received 30 sonications per session (precuneus, ∼30 cm[3] brain tissue) and the remaining 8 received 100 sonications per session (bilateral precuneus and temporo-parietal association cortex, ∼100 cm[3]). Safety monitoring, EEG, MRI, cognitive and neuropsychiatric evaluations were performed. The treatment was fast, safe and well-tolerated at the 1.95 MPa dose. MRI showed no changes, whereas changes were observed in aperiodic EEG content. Cognitive performance did not change but statistically significant improvements in behavioural and psychological symptoms were found using the Neuropsychiatric Inventory test. In conclusion, this SUS safety trial met its primary and secondary end-points in biomarker-confirmed mild-to-moderate AD. It informs our future work in an upcoming efficacy trial in an AD population.}, }
@article {pmid41404461, year = {2025}, author = {Li, W and Liu, X and Gao, C and Li, W and Liao, X}, title = {Network meta-analysis of the efficacy of pharmacological treatments for post-stroke cognitive impairment and vascular cognitive impairment.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1683496}, pmid = {41404461}, issn = {1664-2295}, abstract = {BACKGROUND: Based on recent reviews, vascular cognitive impairment (VCI) encompasses a spectrum of cognitive deficits caused by cerebrovascular disease and its risk factors, ranging from mild cognitive impairment to dementia, and often coexists with neurodegenerative conditions like Alzheimer's disease. VCI is categorized into four clinical-imaging subtypes, including post-stroke cognitive impairment (PSCI)-a common stroke complication and major VCI subtype. Current guidelines recommend cholinesterase inhibitors and NMDA receptor antagonists as first-line treatments for VCI, with expert consensus supporting donepezil and rivastigmine for PSCI. However, existing evidence primarily derives from placebo-controlled or head-to-head drug comparisons, lacking comprehensive evaluations of multiple cognitive enhancers. This study aims to systematically assess the efficacy and safety of cognitive-enhancing drugs in VCI, with a focused analysis on PSCI, to better inform clinical decision-making and improve patient outcomes.
METHODS: We systematically searched four databases using predefined search strategies. Eligible studies were selected based on predetermined criteria. The included studies were analyzed with StataSE 16.0, RevMan 5.3, and Grade software to compare the efficacy and safety of cognitive-enhancing drugs to identify the optimal treatment for VCI and PSCI.
RESULTS: Sixteen studies (5,599 participants) were included. In terms of cognitive outcomes, sailuotong was superior to placebo on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) (MD = -3.00, 95% CI: -4.50, -1.50) and ranked best (SUCRA 88.5%). Memantine was most effective on the Mini-Mental State Examination (MMSE) (MD = 1.23, 95% CI: 0.23-2.23; SUCRA 80.8%). For the secondary outcome, the MoCA assessment showed that Ginkgo biloba extract significantly improved Montreal Cognitive Assessment (MoCA) scores compared to placebo (MD = 1.29, 95% CI: 1.24, 1.35). Regarding safety, donepezil significantly increased the risk of overall adverse events compared to placebo (OR: 1.57; 95% CI: 1.19-2.06).
CONCLUSION: Our network meta-analysis suggests that memantine might have the best effect for PSCI, with sailuotong potentially serving as a secondary option. However, these estimates are based on a small randomized controlled trial and a sparse network. Therefore, the current evidence is limited, highlighting the need for more high-quality studies to robustly validate the therapeutic potential of these interventions for VCI and PSCI.
https://www.crd.york.ac.uk/PROSPERO/, identifier in PROSPERO (CRD420250627957).}, }
@article {pmid41404160, year = {2025}, author = {Roche, S and Naran, N and Scholtz, J and Liu, KY and Reeves, S and Howard, R}, title = {Systematic review and meta-analysis of antipsychotic discontinuation in dementia.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70188}, pmid = {41404160}, issn = {2352-8737}, abstract = {INTRODUCTION: Antipsychotics are used to treat behavioral and psychological symptoms of dementia (BPSD). However, treatment is associated with adverse outcomes. A 2018 Cochrane review found low-quality evidence that discontinuation may have little effect on BPSD by primarily comparing the difference in number of study non-completers between treatment groups and did not report a pooled effect size for relapse risk. We performed a meta-analysis of the pooled risk ratio (RR) of relapse of symptoms following antipsychotic medication discontinuation in people with dementia. We hypothesized that trial design (enriched responder samples vs long-term user withdrawal), treatment duration, length of follow-up, withdrawal speed, and sex of participants would affect relapse risk.
METHODS: We systematically searched PsycINFO, EMBASE, PubMed, and ClinicalTrials.gov databases for studies published between January 2018 and June 2024. The eight papers identified in the 2018 Cochrane review were also included in the meta-analysis. The study was registered with PROSPERO (CRD42024570329).
RESULTS: A total of nine studies were included, providing 682 observations with 135 events. Relapse definitions included participant removal due to worsening behavior or starting regular prescription of antipsychotic/rescue medication. A random-effects model found a pooled RR of relapse of 1.52 (95% CI: 1.18 to 1.95, p = 0.005) with stopping antipsychotics. Meta-regressions showed no effect of trial type, withdrawal speed, length of follow-up, or participant sex on RR.
DISCUSSION: While it is important to prescribe cautiously and to reduce and withdraw prescriptions in those who are considered to no longer need antipsychotics, there is a subgroup of patients for whom continuing medication is important. It was particularly surprising that the relative risk of relapse was unaffected by trial design, with similar effect sizes in both trials aiming to reduce prescription and prove efficacy. Further research is needed to identify factors associated with successful antipsychotic withdrawal.
HIGHLIGHTS: An updated meta-analysis of trials of withdrawal of antipsychotics in dementia.Relative risk of symptom relapse increased when stopping antipsychotics.Relapse risk was not affected by trial design or prior length of treatment.Relapse risk was not affected by length of follow-up, withdrawal speed, or sex.}, }
@article {pmid41403906, year = {2025}, author = {Duan, Y and Han, C and Zheng, H and Yu, J and Luo, M}, title = {Global, regional, and national burden of Alzheimer's disease and other dementias from 1990 to 2021: findings from the Global Burden of Disease Study 2021.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1678212}, pmid = {41403906}, issn = {1663-4365}, abstract = {BACKGROUND: As the global population continues to age, the growing number of elderly individuals has contributed to an increase in age-related conditions and illnesses, such as dementia, which places considerable financial and emotional pressure on both families and society. Alzheimer's disease (AD), the most prevalent form of dementia among the elderly, significantly impacts their quality of life and ability to perform daily activities independently. Over the past three decades, the age-standardized mortality rate has declined and life expectancy has steadily increased worldwide. However, this long-term progress was disrupted by the COVID-19 pandemic, which reversed some of the gains made in life expectancy and contributed to a global decline. The pandemic has notably affected global health, exacerbating the prevalence of Alzheimer's disease and other dementias (ADOD).
METHODS: In line with the analytical approach used in the Global Burden of Disease Study (GBD) 2021, we examined the counts and age-standardized rates (ASR) for the prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) associated with ADOD, categorized by region, country, sex, and age from 1990 to 2021. To assess temporal patterns over the study period, we calculated the estimated annual percentage changes (EAPCs).
RESULTS: From 1990 to 2021, both the number and age-standardized rates (ASR) of prevalence, incidence, mortality, and DALYs associated with ADOD showed a significant increase globally. Regionally, high-middle SDI regions had the highest ASPR at 766.2 per 100,000 (95% UI: 659.8, 879.6), with the most considerable rise, reflected in an EAPC of 0.21 (95% CI: 0.17, 0.25). In East Asia, the highest age-standardized incidence rate (ASIR) was reported, at 149.6 (95% UI: 129.6, 171.1) per 100,000 people, along with the greatest increase in ASIR, at 0.4 (95% UI: 0.33, 0.47) among the 21 GBD regions. On a national level, China experienced the greatest burden of ADOD, with the highest ASPR of 900.8 (95% UI: 770.9, 1043.2) and the highest ASIR of 151.5 (95% UI: 131.2, 173.3) per 100,000 people. The 80-84 age group exhibited the highest rates of prevalence, incidence, and DALYs, whereas the number of deaths in the 85-89 age group surpassed those in other age categories. Throughout all age groups, females experienced a higher burden of ADOD than males, regardless of the time or geographical location. The burden of ADOD reached its lowest point in 2019 but has increased steadily since then.
CONCLUSION: In summary, this study highlights the global epidemiological trends of ADOD from 1990 to 2021, including the impact of the COVID-19 pandemic on it. As the population ages, ADOD has emerged as a significant public health concern worldwide. Although some regions have made progress in managing the burden of ADOD, most regions and countries still face a heavy disease burden. More effective prevention and treatment strategies are needed to alleviate the impact of ADOD. In particular, greater focus should be placed on women and the elderly.}, }
@article {pmid41403678, year = {2025}, author = {Sinan Tokalı, F and Şenol, H and Demir, Y and Uluçay, O and Ameen, M and Shafiq, Z}, title = {New Mannich-type arylidenerhodanines as potent inhibitors of AChE and BChE: synthesis, biological evaluation, cytotoxicity and molecular modeling.}, journal = {RSC advances}, volume = {15}, number = {58}, pages = {50186-50205}, pmid = {41403678}, issn = {2046-2069}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder with a gradual increase in severity. The underlying cause of the disease is the dysfunction of cholinergic neurotransmission affecting mainly the activity of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Within the context of the present research, a new group of 3,5-disubstituted rhodanine derivatives containing tertiary amine groups has been prepared and their potency in the inhibition of AChE and BChE was assessed. Enzymatic assays demonstrated that compounds 6 and 11 exhibited exceptional inhibitory potency, with K i values of 13.61 nM and 12.70 nM against AChE, and 10.44 nM and 25.11 nM against BChE, respectively, surpassing the reference inhibitors tacrine (145.21 nM for AChE and 169.54 nM for BChE) and donepezil (67.41 nM for AChE and 62.44 nM for BChE). Cytotoxicity studies confirmed minimal toxicity in human umbilical vein endothelial cells (HUVEC) at concentrations several times higher than the effective inhibitory doses (IC50 = 79.13 µM for 6 and 69.14 µM for 11). The results from molecular docking and MM-GBSA calculations supported this presumption by foretelling strong binding affinities, where compound 11 was the one to show a free energy of -103.26 kcal mol[-1] for AChE and compound 6 -86.75 kcal mol[-1] for BChE. Moreover, the 250 ns molecular dynamics simulations gave a confirmation of the structural stability and the prolonged existence of the key interactions in the enzyme active sites during the entire time. The findings of this research emphasize compounds 6 and 11 as potential candidates for the creation of strong cholinesterase inhibitors for the treatment of Alzheimer's disease, thus encouraging additional studies.}, }
@article {pmid41403033, year = {2026}, author = {Berthier, ML and Sosa-Welford, A and Orozco-Arroyave, JR and López-Barroso, D and Torres-Prioris, MJ and Dávila, G and García, AM}, title = {Speech and language outcome measures in clinical trials of Alzheimer's and Parkinson's diseases.}, journal = {Expert review of neurotherapeutics}, volume = {26}, number = {1}, pages = {15-34}, doi = {10.1080/14737175.2025.2600616}, pmid = {41403033}, issn = {1744-8360}, mesh = {Humans ; *Alzheimer Disease/complications/diagnosis/therapy ; *Parkinson Disease/complications/diagnosis/therapy ; Clinical Trials as Topic ; *Outcome Assessment, Health Care ; *Language Disorders/diagnosis/etiology ; }, abstract = {INTRODUCTION: Alongside core diagnostic symptoms, Alzheimer's disease (AD) and Parkinson's disease (PD) involve early and pervasive speech-language impairments (SLI), often appearing in preclinical stages and capturing disease severity. However, speech language outcome measures are under-represented in clinical trials, missing out on critical clinical outcome assessments (COAs).
AREAS COVERED: The purpose of this review is to survey the findings from classical (analogical) and novel (digital) speech-language measures as pathways toward more precise diagnosis and response to treatment indices in interventional clinical trials. This narrative review covers two main areas; first, it examines the strengths and limitations of SL measures in traditional cognitive testing scales to identify adequate COAs for AD and PD. Second, it overviews findings on classical and digital COAs that hold great promise despite their widespread absence in clinical trials.
EXPERT OPINION: Incorporating strategic SL COAs in clinical trials may identify early, severity-sensitive deficits and enhance the clinical insights thus obtained. The modification of clinical trial designs will nevertheless be required to increase sensitivity to identify meaningful clinical outcomes.}, }
@article {pmid41402453, year = {2025}, author = {Rasà, DM and Stanga, S and Santonicola, P and Mazzarella, N and Camera, A and Matino, I and Zampi, G and Boido, M and Di Schiavi, E and Vercelli, A}, title = {10H-phenothiazine exerts beneficial effects in spinal muscular atrophy in vitro and in vivo models.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {45757}, pmid = {41402453}, issn = {2045-2322}, support = {Department of Excellence//Ministry of University and Research (MUR)/ ; 24401//AFM-Telethon/ ; P40 OD010440/OD/NIH HHS/United States ; Mission M4C2I1.3, PRR.AP015.118//National Recovery and Resilience Plan (NRRP)/ ; GGP16203//Italian Telethon Foundation/ ; }, mesh = {Animals ; *Muscular Atrophy, Spinal/drug therapy/pathology/metabolism/genetics ; Mice ; Disease Models, Animal ; *Phenothiazines/pharmacology/therapeutic use ; Motor Neurons/drug effects/metabolism/pathology ; Survival of Motor Neuron 1 Protein/genetics/metabolism ; Cells, Cultured ; *Neuroprotective Agents/pharmacology ; Cell Survival/drug effects ; Drug Repositioning ; }, abstract = {Spinal Muscular Atrophy (SMA) is a neurodegenerative disorder affecting lower motor neurons (MNs) and leading to muscle atrophy, due to mutation of the SMN1 gene, which encodes SMN protein. Experimental studies also demonstrated the upper MN impairment. The available approved drugs for SMA increase the SMN protein production. Although effective, outcomes are dependent upon treatment timing and disease severity. Drug repositioning may represent a valid strategy to identify new treatments by repurposing FDA/EMA-approved drugs that, combined with the available ones, could delay neurodegeneration. To this aim, for the first time we used primary cortical neurons derived from the SMNΔ7 mice as defective in vitro disease model, to preliminary assess drug efficacy on neuronal survival and morphology. Under basal conditions, SMA cortical neurons showed significantly reduced vitality and altered morphology compared to WT neurons. All the parameters were rescued after treatment with known compounds (Valproic Acid, 4-aminopyridine and N-acetylcysteine), already tested in either preclinical or clinical context for SMA. We then investigated for the first time in SMA pathology the efficacy of 10H-phenothiazine (10H-PTZ), known to exert neuroprotection and to target altered mechanisms in Parkinson's and Alzheimer's disease. Its administration to SMA cortical neurons induced significant protective effects on both neuronal survival and morphology that were further confirmed in vivo, in a C. elegans SMA model. Overall, our results provide valuable insights, both in vitro and in vivo, into the potential of 10 H-PTZ repurposing for SMA, although additional functional studies will be required.}, }
@article {pmid41401902, year = {2025}, author = {Li, HR and Shi, JZ and Zhang, MJ and Yun, LY and Zhou, YF and He, YY and Li, X and Du, GH and Pang, XB and Wang, MW and Xie, XM and Kou, JJ}, title = {Cftr nominates a novel therapeutic target for Alzheimer's disease: Evidence from integrative omics and in vitro validation.}, journal = {Neuropharmacology}, volume = {286}, number = {}, pages = {110808}, doi = {10.1016/j.neuropharm.2025.110808}, pmid = {41401902}, issn = {1873-7064}, abstract = {Alzheimer's disease (AD), among the most prevalent neurodegenerative disorders, poses substantial challenges for therapeutic development due to its complex pathophysiology, necessitating novel treatment strategies. This study applied an integrated transcriptomics and untargeted metabolomics approach to hippocampal tissues from wild-type and 3 × Tg-AD mice to identify AD-associated molecular alterations and key pathways. KEGG pathway enrichment analysis of significantly differentially expressed genes and metabolites identified several core candidate genes, including C5ar1, Gabrg1, Ptger1, Tac1, Lpar2, Pnp2, Cftr, and Sstr3. PCR-based validation in both in vivo and in vitro models confirmed Cftr as the most promising candidate for further investigation. In Aβ25-35-induced cellular AD models, Cftr knockdown or pharmacological inhibition activated the NLRP3 inflammasome pathway, exacerbating neuroinflammation and oxidative stress, whereas enhancing Cftr activity attenuated these pathological processes. These results establish Cftr as a potential therapeutic target for AD and reveal that its modulation of NLRP3 inflammasome signaling represents a strategic avenue for mitigating neuroinflammation and oxidative stress, suggesting a promising direction for intervening in AD progression.}, }
@article {pmid41401892, year = {2026}, author = {Jogeshwar, BK and Lu, S and Nephew, BC}, title = {Neuroanatomical-based machine learning prediction of Alzheimer's Disease across sex and age.}, journal = {Neuroscience}, volume = {594}, number = {}, pages = {95-112}, doi = {10.1016/j.neuroscience.2025.12.030}, pmid = {41401892}, issn = {1873-7544}, mesh = {Humans ; *Alzheimer Disease/diagnostic imaging/pathology ; Aged ; Male ; Female ; Aged, 80 and over ; *Machine Learning ; Magnetic Resonance Imaging/methods ; Cognitive Dysfunction/diagnostic imaging/pathology ; *Brain/pathology/diagnostic imaging ; Sex Characteristics ; Age Factors ; Hippocampus/pathology/diagnostic imaging ; }, abstract = {Alzheimer's Disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. In 2024 it affected approximately 1 in 9 people aged 65 and older in the U.S., 6.9 million individuals. Early detection and accurate AD diagnosis are crucial for improving patient outcomes. Magnetic resonance imaging (MRI) has emerged as a valuable tool for examining brain structure and identifying potential AD biomarkers. This study performs predictive analyses by employing machine learning techniques to identify key brain regions associated with AD using numerical data derived from anatomical MRI scans, going beyond standard statistical methods. Using the Random Forest Algorithm, we achieved 92.87 % accuracy in detecting AD from Mild Cognitive Impairment and Cognitive Normals. Subgroup analyses across nine sex- and age-based cohorts (69-76 years, 77-84 years, and unified 69-84 years) revealed the hippocampus, amygdala, and entorhinal cortex as con- sistent top-rank predictors. These regions showed distinct volume reductions across age and sex groups, reflecting distinct age- and sex-related neuroanatomical patterns. Younger males and females (aged 69-76) exhibited volume decreases in the right hippocampus, suggesting its importance in the early stages of AD. Older males (77-84) showed substantial volume decreases in the left inferior temporal cortex. The left middle temporal cortex showed decreased volume in females, suggesting a potential female-specific influence, while the right entorhinal cortex may have a male-specific impact. These age-specific sex differences could inform clinical research and treatment strategies, aiding in identifying neuroanatomical markers and therapeutic targets for future clinical interventions.}, }
@article {pmid41401852, year = {2026}, author = {Huang, YW and Chan, HC and Khoo, JY and Chan, ML and Bender, D and Ponnusamy, VK and Belaidi, AA and Ke, LY}, title = {Assessing the critical role of ceramide in the pathogenesis of Alzheimer's disease and its clinical significance.}, journal = {Neurochemistry international}, volume = {192}, number = {}, pages = {106104}, doi = {10.1016/j.neuint.2025.106104}, pmid = {41401852}, issn = {1872-9754}, mesh = {*Alzheimer Disease/metabolism/pathology/drug therapy ; Humans ; *Ceramides/metabolism ; Animals ; Amyloid beta-Peptides/metabolism ; Brain/metabolism/pathology ; Clinical Relevance ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-β (Aβ) deposition, tau hyperphosphorylation, and synaptic loss. Emerging evidence indicates that apolipoprotein E (APOE) polymorphism and dysregulated ceramide metabolism are critical links among these pathogenic processes. Ceramide accumulation in the brain contributes to Aβ generation, tau phosphorylation, and neuronal apoptosis. Elevated ceramide levels have been observed in plasma, cerebrospinal fluid, and peripheral organs such as the liver, reflecting systemic lipid dysregulation. Lipoproteins-particularly low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL)-transport ceramide across the blood-brain barrier, while apoE4 isoforms exacerbate this process by disrupting vascular integrity and lipid homeostasis. In addition, hepatic and gut-derived ceramides may influence neurodegeneration through the liver-gut-brain axis. Therapeutic interventions targeting ceramide synthesis (serine palmitoyltransferase inhibitors), production (neutral sphingomyelinase inhibitors), and the ceramide/sphingosine-1-phosphate (S1P) balance show potential in preclinical models for reducing Aβ pathology, tau aggregation, and neuroinflammation. These findings position ceramide metabolism as a critical mediator of AD pathogenesis and a promising target for diagnosis and treatment. Modulating ceramide and S1P signaling could complement current amyloid- and tau-directed therapies, offering new opportunities for disease modification and early intervention.}, }
@article {pmid41400820, year = {2025}, author = {Al-Mayahi, S and Andersson, ML and Mo, M and Garcia-Ptacek, S and Xu, H and Wikström, E and Eriksdotter, M}, title = {Increased mortality in dementia patients using inhaled anticholinergics: A nationwide register study from the Swedish registry on dementia/cognitive disorders, SveDem.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251406309}, doi = {10.1177/13872877251406309}, pmid = {41400820}, issn = {1875-8908}, abstract = {BackgroundPatients with chronic obstructive pulmonary disease (COPD) face increased risks of cognitive impairment and mortality compared with the general population. Inhaled anticholinergics (LAMA/SAMA) are central in COPD treatment. The link between COPD and dementia is well studied, while effects of COPD medications on survival in dementia patients, have received limited attention.ObjectiveDescribe dementia patients using LAMA/SAMA in the Swedish Dementia Registry (SveDem) and compare survival between users (exposed) and non-users (unexposed).MethodsThis register-based study used data from SveDem and the Swedish Prescribed Drug Register to identify dementia patients using inhaled anticholinergics. All patients diagnosed with dementia between 2008-01-01 and 2017-12-31 were included. Exposed patients had at least one LAMA/SAMA dispensation per year in the two years prior the index date or more than one in the year before. Standardized-mortality-rates (SMR) were calculated, and survival analysed using Kaplan-Meier and Cox regression.ResultsA total of 74,018 dementia patients were included, of whom 3.5% had used inhaled anticholinergics. Alzheimer's disease was the most common dementia type. SMR was higher in exposed patients across all age groups: 8.21 versus 4.08 (ages 61-75) and 2.94 versus 1.84 (ages 75-90). Exposed had a higher risk of death (crude HR 1.73, 95% CI: 1.62-1.86) compared to unexposed.ConclusionsIn this register-based study we observed an association between inhaled anticholinergic use and reduced survival in dementia patients. This association is thought to be mainly driven by the underlying disease, COPD. Further studies are needed to clarify effects of inhaled anticholinergics on survival.}, }
@article {pmid41400119, year = {2026}, author = {Basak, S and Colafrancesco, AM and Hernandez, RD and Wei, X and McMeekin, LJ and Dang, D and Simmons, M and Browning, JL and Noel, K and Zhou, F and Lund, FE and Saad, JS and Watsen, SG and Pickrell, AM and Cowell, RM and Olsen, ML}, title = {Novel Roles for the Ectoenzyme CD38 in the Maintenance of Transcriptional and Metabolic Homeostasis in Astrocytes.}, journal = {Glia}, volume = {74}, number = {2}, pages = {e70112}, pmid = {41400119}, issn = {1098-1136}, support = {R01NS124037/NH/NIH HHS/United States ; T32NS09.5775/NH/NIH HHS/United States ; 1S10RR026478/NH/NIH HHS/United States ; P30 CA013148/CA/NCI NIH HHS/United States ; }, mesh = {Animals ; *Astrocytes/metabolism ; *ADP-ribosyl Cyclase 1/metabolism/genetics/deficiency ; *Homeostasis/physiology ; Mice ; Mice, Knockout ; Mice, Inbred C57BL ; NAD/metabolism ; Male ; *Membrane Glycoproteins/metabolism/genetics ; Brain/metabolism ; Mesencephalon/metabolism ; }, abstract = {CD38 is an ectoenzyme that converts NAD+ to NAM to help maintain bioenergetic homeostasis. CD38 dysregulation and gene variation is reported in neurodegenerative conditions such as Parkinson's disease (PD) and Alzheimer's disease (AD), highlighting the need to better understand CD38 biology within the brain. Here, we demonstrate enrichment of Cd38 in midbrain astrocytes and describe how CD38 deficiency influences brain metabolism, astrocytic gene expression, and bioenergetics. We demonstrate increased NAD content, decreased NAM content, and increased NAD/NAM in the midbrain and striatum of CD38-deficient (Cd38[-/-]) mice, indicating the dependence on CD38 for NAD to NAM conversion in the brain. RNA-sequencing of isolated astrocytes revealed numerous differentially expressed genes in Cd38[+/-] and Cd38[-/-] mice, with alterations in mitochondrial, metabolic, senescence-related, astrocyte reactivity, and other genes involved in PD and AD etiology. Furthermore, functional metabolic analysis of midbrain revealed changes in pyruvate oxidation, age-dependent increase of citrate synthase (CS) activity, and reduction of cytochrome c oxidase-to-CS ratio in Cd38 deficiency. These findings identify a novel role for astrocytes in the regulation of CD38-dependent NAD/NAM homeostasis in the brain and provide a framework for future studies evaluating the relationship between CD38 dysfunction, aging, and vulnerability of neuronal populations in neurodegenerative disease. Importantly, these studies underscore the necessity to better resolve the impact of CD38 deficiency on brain metabolism, considering ongoing clinical trials and discussions related to the use of CD38 modulators for the treatment of cancers, age-related decline, and neurodegenerative disease.}, }
@article {pmid41399980, year = {2025}, author = {Chu, F and Zhou, X and Ma, R and Liu, R and Liu, X and Zhu, K and Wang, Y and Wang, X and Li, Y and Zhang, S and Yin, T and Liu, Z}, title = {Piezo1-Targeted Magnetoacoustic Nanobubbles Rescue Alzheimer's Pathology by Electromechanical Neuromodulation and Amyloid-β Clearance.}, journal = {ACS nano}, volume = {}, number = {}, pages = {}, doi = {10.1021/acsnano.5c13702}, pmid = {41399980}, issn = {1936-086X}, abstract = {Amyloid-β (Aβ) is considered a core pathological feature of Alzheimer's disease (AD), and its clearance efficiency is highly dependent on the function of the Piezo1 channel in microglia. However, the activity of Piezo1 is impaired under the pathological conditions of AD, and existing pharmacological strategies struggle to achieve precise targeted intervention in deep brain regions. To address these concerns, our research proposes a synergistic therapeutic paradigm leveraging transcranial magneto-acoustic stimulation (TMAS) to actuate microglial-Piezo1-targeted magnetic nanobubbles (PT-MNBs) for AD treatment. TMAS noninvasively focuses physical energy into deep brain lesion areas through a magnetoacoustic coupling field and drives PT-MNBs to generate responsive mechanical and electrical stimulation signals. PT-MNBs achieve microglia-specific anchoring through surface-modified phosphatidylserine, while conjugated anti-Piezo1 antibodies precisely deliver mechano-electrical stimulation signals to antibody-functionalized Piezo1 ion channels in microglial populations. This synchronously activates the mechanical- and voltage- sensitive domains of Piezo1 to recruit microglia to areas of inflammation and increase Aβ clearance, ameliorating synaptic plasticity impairment and ultimately reversing the pathological progression of AD. This dual-action mechanism achieves spatially precise manipulation of cellular mechanical and electrical activity in deep brain regions of AD mice and enhances Piezo1 function through precise energy delivery, enhancing their ability to clear Aβ plaques, opening an avenue for a noninvasive, deep-targeted physical stimulation-mediated nanoparticle synergistic therapy for AD.}, }
@article {pmid41399798, year = {2025}, author = {Ghosh, S and Debnath, I and Bhunia, S and Nandi, S and Ashique, S and Nayak, A and Mallick, S and Basak, S}, title = {Decoding natural products for neuroprotection: Pathway networks and structural insights for drug development.}, journal = {Chinese herbal medicines}, volume = {17}, number = {4}, pages = {643-672}, pmid = {41399798}, issn = {2589-3610}, abstract = {Neurodegenerative diseases (NDs), including Alzheimer's, Parkinson's, Huntington's, and amyotrophic lateral sclerosis, are progressive disorders marked by neuronal dysfunction and death, driven by pathological mechanisms such as oxidative stress, mitochondrial dysfunction, neuroinflammation, apoptosis, and protein misfolding. Despite scientific advances, current treatments remain largely palliative, underscoring the need for multitargeted therapeutic strategies. This narrative review synthesizes preclinical and clinical evidence to explore the neuroprotective potential of natural products, with a focus on their ability to modulate key molecular pathways implicated in NDs. A comprehensive literature search across Scopus, ScienceDirect, PubMed, MDPI, and Web of Science identified relevant studies. Bioactive compounds such as curcumin, resveratrol, ginsenosides, quercetin, and marine-derived molecules like fucoxanthin and phlorotannin demonstrated antioxidant, anti-inflammatory, anti-amyloidogenic, and mitochondrial-protective effects by modulating pathways including PI3K/Akt, NF-κB, and Nrf2/ARE, thereby mitigating neuronal damage and promoting cell survival. Natural products from diverse sources, including honey, ginseng, marine macroalgae, and cyanobacteria, exhibited broad-spectrum neuroprotective properties, with advances in nano-formulations improving bioavailability and brain penetration. Furthermore, emerging approaches such as gene-drug interaction studies and scaffold-based drug design offer promising avenues for enhancing clinical translation. While natural products provide a holistic, multitargeted approach to combat NDs, challenges related to bioavailability and therapeutic translation persist, necessitating future research that integrates advanced drug delivery systems, precision medicine, and synthetic modifications to develop innovative and effective treatment paradigms.}, }
@article {pmid41399730, year = {2025}, author = {Zhang, Y and Chen, S and Yan, G and Zhang, Z and Amina, and Wang, T and Wang, S and Zhang, C and Sun, Y}, title = {MAPT mutation-induced behavioral variant frontotemporal dementia in an Asian patient: a multimodal biomarker case report resolving diagnostic challenges with Alzheimer's disease.}, journal = {Frontiers in genetics}, volume = {16}, number = {}, pages = {1645068}, pmid = {41399730}, issn = {1664-8021}, abstract = {BACKGROUND: The clinical phenotypic overlap between frontotemporal dementia (FTD) and Alzheimer's disease (AD) frequently leads to misdiagnosis, while biomarkers (e.g., Aβ-PET) and genetic testing provide critical differential diagnostic evidence. Although MAPT gene mutations represent common genetic etiologies of FTD, their occurrence in Asian populations remains underreported. Specifically, FTD caused by the MAPT IVS10 + 16C>T mutation shows limited documentation in Asian populations, with its phenotypic heterogeneity and treatment responses remaining poorly characterized.
METHODS: We present a case of FTD manifesting progressive memory decline, compulsive behaviors, and apathy. MRI revealed bilateral frontoparietotemporal atrophy with prominent medial temporal lobe and hippocampal involvement, initially misdiagnosed as AD. Subsequent Aβ-PET negativity emerged as a pivotal diagnostic turning point, and identification of a heterozygous MAPT mutation (IVS10 + 16C>T) confirmed behavioral variant FTD (bvFTD) diagnosis. Partial improvement in compulsive behaviors and verbal fluency was observed following memantine treatment. A literature review summarizes clinical characteristics of FTD associated with IVS10 + 16C>T mutations.
RESULTS: Comprehensive neuropsychological assessment, cranial MRI, and negative Aβ-PET excluded AD pathology. Genetic confirmation of MAPT IVS10 + 16C>T mutation established bvFTD diagnosis. Three-month memantine treatment reduced compulsive behaviors without cognitive improvement. Literature analysis indicates this mutation's rarity in Asian populations, typically presenting with behavioral abnormalities frequently misdiagnosed as AD.
CONCLUSION: This study rectified misdiagnosis of MAPT IVS10 + 16C>T-associated bvFTD through multimodal diagnostics, emphasizing the synergistic value of genetic testing and neuroimaging. Memantine's partial behavioral symptom alleviation suggests potential mutation-specific therapeutic efficacy requiring further validation. Future directions should optimize diagnostic protocols (e.g., cost-effective genetic screening) and address barriers to early diagnosis in Asian populations.}, }
@article {pmid41399578, year = {2025}, author = {Gassull, A}, title = {Ethical Challenges in Managing a Displaced Neer III Humeral Head Fracture in an Undocumented Immigrant With Early Alzheimer's Disease: A Case Report.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e96805}, pmid = {41399578}, issn = {2168-8184}, abstract = {This report describes an 82-year-old undocumented Peruvian female immigrant presenting to the ED with right elbow pain and limited shoulder mobility, diagnosed with a displaced Neer III right humeral head fracture sustained two days prior. She had not clearly communicated shoulder pain to her family for two days post-injury, possibly due to early Alzheimer's disease, which may have impaired her ability to recognize or articulate the severity of her injury, illustrating the clinical-ethical intersection. Radiographic imaging confirmed the fracture with medial displacement, necessitating surgical intervention. Due to her undocumented status and lack of health insurance, she was required to pay the full cost of a reverse shoulder prosthesis (€24,000), which she could not afford. Her Alzheimer's-related dependency and absence of family support in Peru prevented seeking treatment abroad, resulting in discharge with a sling. Comprehensive blood tests ruled out metabolic contributors to her fall. This case highlights ethical challenges in healthcare access for undocumented immigrants, compounded by Alzheimer's-related communication and dependency issues, underscoring disparities and the need for equitable care. This case exemplifies how clinical vulnerability and legal status can intersect to create barriers in emergency and trauma care.}, }
@article {pmid41399419, year = {2025}, author = {Chen, HW}, title = {Axial Spinal Traction as a Potential Modulator of Cerebrospinal and Glymphatic Circulation in Neurodegenerative Diseases: A Technical Report and Biomechanical Hypothesis.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e99153}, pmid = {41399419}, issn = {2168-8184}, abstract = {Impairment of glymphatic function contributes to the accumulation of metabolic and proteinaceous waste products implicated in neurodegenerative diseases such as Alzheimer's disease, frontotemporal dementia, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, and certain spinocerebellar ataxias. Pelvis-stabilized axial spinal traction (PSAST) is a biomechanical technique designed to produce brief, controlled cranio-caudal elongation of the vertebral column and spinal dural sac, potentially generating transient pressure gradients capable of influencing cerebrospinal fluid (CSF) dynamics and glymphatic circulation. The technique has been applied in the author's musculoskeletal practice for more than eight years without observed persistent or treatment-related adverse effects, although such practice-based experience does not constitute a formal safety evaluation. Improved sleep quality has been the most consistently reported patient-perceived response to PSAST, a clinically notable observation given the dependence of glymphatic function on consolidated slow-wave sleep. These practice-based observations provide preliminary, hypothesis-generating support for exploring whether controlled axial elongation may modulate cerebrospinal and glymphatic physiology. To the best of the author's knowledge, this report presents the first peer-reviewed technical description of a reproducible, whole-axis axial spinal traction procedure with defined force parameters intended to examine potential modulation of CSF and glymphatic circulation. The report outlines the PSAST protocol and its biomechanical rationale and safety considerations and proposes its potential relevance as a noninvasive, investigational approach for conditions associated with impaired glymphatic function.}, }
@article {pmid41399037, year = {2025}, author = {Di Donna, MG and Motta, C and Bonomi, CG and Bernocchi, F and Ricci, F and Poli, M and Koch, G and Martorana, A}, title = {Reframing TDP-43 in Alzheimer's disease: From co-pathology to neurovascular culprit.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70988}, pmid = {41399037}, issn = {1552-5279}, mesh = {Humans ; *Alzheimer Disease/pathology/metabolism ; Astrocytes/metabolism/pathology ; *Blood-Brain Barrier/metabolism/pathology ; *Brain/pathology/metabolism ; *DNA-Binding Proteins/metabolism ; Endothelial Cells/metabolism/pathology ; }, abstract = {Alzheimer's disease (AD) is widely recognized as a multifactorial disorder involving neurovascular and glial dysfunction beyond amyloid-β and tau pathology. In this Perspective, we synthesize recent evidence to propose a conceptual framework linking transactive response (TAR) DNA-binding protein 43 kDa (TDP-43) to neurovascular unit (NVU) disruption in AD. Traditionally considered a neuronal co-pathology, TDP-43 also aggregates in astrocytes and endothelial cells, impairing blood-brain barrier (BBB) integrity, glymphatic clearance, and metabolic homeostasis. Endothelial TDP-43 loss disrupts β-catenin signaling and fibronectin, triggering vascular breakdown and neuroinflammation. Astrocytic perivascular aggregates correlate with reduced aquaporin-4 (AQP4) and CD146, further compromising clearance pathways. These vascular-glial mechanisms may accelerate AD progression and help explain clinical heterogeneity and limited therapeutic response in TDP-43-positive patients. We argue for the reclassification of TDP-43 as a potential upstream driver of disease progression. Such a shift would support the development of integrative biomarkers and precision treatment strategies targeting NVU dysfunction. HIGHLIGHTS: Transactive response (TAR) DNA-binding protein 43 kDa (TDP-43) may act as a driver of neurovascular dysfunction in Alzheimer's disease (AD). We propose reclassifying TDP-43 from co-pathology to upstream contributor. TDP-43 affects endothelial cells and astrocytes, disrupting blood-brain barrier (BBB) and clearance. Neurovascular unit (NVU) dysfunction links TDP-43 to inflammation, hypoperfusion, and cognitive decline. A vascular-glial model of AD opens new therapeutic and biomarker opportunities.}, }
@article {pmid41398677, year = {2025}, author = {Wang, B and Wang, Y and Yang, F and Han, F and Li, K and Sun, K and Liang, P}, title = {The effect of repetitive transcranial magnetic stimulation on immediate and long-term cognitive functions in Alzheimer's dementia and mild cognitive impairment: a meta-analysis.}, journal = {Journal of neuroengineering and rehabilitation}, volume = {22}, number = {1}, pages = {262}, pmid = {41398677}, issn = {1743-0003}, support = {LGKCYLWS2022034//Key Project of Medical and health technology of Longgang District, Shenzhen/ ; }, mesh = {Humans ; *Alzheimer Disease/therapy/psychology ; *Cognitive Dysfunction/therapy/psychology ; *Transcranial Magnetic Stimulation/methods ; *Cognition/physiology ; Randomized Controlled Trials as Topic ; Neuropsychological Tests ; Treatment Outcome ; Aged ; }, abstract = {BACKGROUND: Alzheimer's dementia (AD) and mild cognitive impairment (MCI) are characterized by progressive cognitive decline. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technology, has been widely used to improve cognition in AD and MCI. However, the impact of rTMS on immediate and long-term cognitive functions in AD and MCI, as well as the optimal stimulating parameters, need further clarification.
METHOD: Thirty-one randomized controlled trials were included to examine the effects of rTMS on immediate cognition (post-treatment cognition), while nine trials were specifically used to assess its impact on long-term cognition (follow-up cognition). All participants were tested on at least one of the neuropsychological scales of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Alzheimer's disease Assessment Scale-Cognitive Section (ADAS-Cog) to evaluate global cognitive outcomes of rTMS. The study followed the guidelines for meta-analysis of intervention studies and assessed the risk of bias of the included studies. Moderator analysis was used to examine factors that might affect treatment effect. Sensitivity analysis was used to evaluate stability of results. Meta-regression analysis was used to assess the interpretability of heterogeneity. Begg's and Egger's test and funnel plot were applied to assess publication bias.
RESULTS: The results demonstrated that rTMS significantly improved immediate cognition (SMD = 0.93, 95% CI = 0.64 to 1.22, p < 0.001) and long-term cognition (SMD = 0.42, 95% CI = 0.13 to 0.70, p = 0.004) across all patients (including AD and MCI). Moderator analysis revealed that targeting dorsolateral prefrontal cortex (DLPFC), using intensities of 80% or less of the motor threshold, total time of 800 min or more and stimulation sessions greater than 20 significantly enhanced immediate cognitive performance than their counterparts. In contrast, stimulation frequency, duration/session and patient type showed no significant impact on immediate cognition. For long-term cognition, differences in stimulation protocols had no influence on treatment effect for all patients.
CONCLUSION: rTMS had a positive effect on immediate and long-term cognition in AD and MCI, stimulation region, intensity, total time and number of sessions significantly improve immediate cognition. These findings suggest that rTMS has potential as a promising adjunctive treatment for AD and MCI.}, }
@article {pmid41398371, year = {2025}, author = {Yoon, J and Ha, H and Lee, HW and Kim, S and Yu, YM and Chun, H}, title = {Potential beneficial effects of PD-1/PD-L1 blockade in Alzheimer's disease: a systematic review and meta-analysis of preclinical and clinical studies.}, journal = {Molecular psychiatry}, volume = {}, number = {}, pages = {}, pmid = {41398371}, issn = {1476-5578}, abstract = {BACKGROUND: Programmed cell death protein 1 (PD-1) and its ligand (PD-L1) are crucial in cancer immune evasion and in modulating neuroinflammation. Although PD-1/PD-L1 signaling is believed to modulate immune and neuronal responses, its role in AD pathophysiology remains unclear, with existing studies reporting inconsistent findings.
METHOD: This systematic review and meta-analysis investigated the effects of PD-1/PD-L1 blockade on AD-related pathology and cognitive behavior in preclinical studies. Additionally, we evaluated the impact of PD-1/PD-L1 inhibitors on cognitive outcomes in clinical studies involving cancer patients. Relevant research was systematically identified using the MEDLINE, Embase, CENTRAL, and Web of Science databases from their inception until July 31, 2025. Overall, 40 studies were included in this meta-analysis, conducted using R software.
RESULTS: Preclinical studies revealed that blockade of PD-1 signaling reduces amyloid-beta plaque burden, tau phosphorylation, and astrocyte reactivity in AD mouse models. These pathological improvements were accompanied by enhanced cognitive performance, whereas wild-type mice showed no significant cognitive changes under the same treatment, whereas wild-type mice showed no significant cognitive changes under the same treatment. Furthermore, clinical studies demonstrated the beneficial effect of PD-1 signaling inhibitors on cognitive function in patients with cancer.
CONCLUSIONS: PD-1/PD-L1 inhibition impacts AD pathology and cognitive function, suggesting its potential as a therapeutic development strategy for AD. Further studies are warranted to clarify the exact mechanisms, opening avenues for future therapies that modulate the PD-1/PD-L1 pathway for AD.}, }
@article {pmid41398125, year = {2025}, author = {Huang, FW and Bello, ST}, title = {Role of Neuronal Cholecystokinin Receptor: An Emerging Therapeutic Target for Ameliorating Neurological Diseases.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {296}, pmid = {41398125}, issn = {1559-1182}, support = {11103220, 11101521, 11102422//Hong Kong Research Grants Council/ ; }, mesh = {Animals ; Humans ; *Receptors, Cholecystokinin/metabolism/antagonists & inhibitors ; *Nervous System Diseases/metabolism/drug therapy ; *Neurons/metabolism ; Cholecystokinin/metabolism ; }, abstract = {Neuronal cholecystokinin (CCK) is the most abundant neuropeptide in the mammalian brain and serves as a critical neuromodulator regulating the physiological states of animals. Previous research on CCK primarily focused on its roles in digestive function, satiety regulation, and emotional modulation, while its involvement in the development of brain diseases remains largely unexplored. Interestingly, recent studies have revealed that CCK-2 receptor antagonists have significant effects on neural modulation, suggesting a potential strategy for the treatment of brain disorders such as Alzheimer's disease, depression, and motor neuron disease, among others. To elucidate the neural effects of CCK on the progression of neurological disorders, we review the available evidence on the neuropeptide CCK in brain diseases at multiple levels and propose novel and complementary approaches to the treatment of brain diseases based on recent developments.}, }
@article {pmid41398046, year = {2025}, author = {Heron, R and Amato, C and Monteiro-Black, B and Williams, RJ and Wood, W}, title = {Amyloid-beta induces distinct forms of cell death in different neuronal populations.}, journal = {Cell death and differentiation}, volume = {}, number = {}, pages = {}, pmid = {41398046}, issn = {1476-5403}, support = {22460/Z/21/Z//Wellcome Trust (Wellcome)/ ; 218627/Z/19/Z//Wellcome Trust (Wellcome)/ ; 218627/Z/19/Z//Wellcome Trust (Wellcome)/ ; MR/W019264/1//RCUK | Medical Research Council (MRC)/ ; 894935//EC | EU Framework Programme for Research and Innovation H2020 | H2020 Priority Excellent Science | H2020 Marie Skłodowska-Curie Actions (H2020 Excellent Science - Marie Skłodowska-Curie Actions)/ ; }, abstract = {Recent FDA approval for treating Alzheimer's disease (AD) with amyloid-beta (Aβ) immunotherapy is a historic breakthrough, which has rekindled widespread interest in understanding the molecular basis of Aβ toxicity. In this study, we developed a novel Drosophila model to investigate Aβ42-induced pathologies in vivo and in real time. Strikingly, we unveiled compelling evidence that secreted Aβ42 affects different neurons in distinct ways-both in susceptibility to Aβ42 deposition and in the mode of cell death triggered. Additionally, we observed altered larval crawling behaviour which-remarkably-could be recovered by inhibiting ferroptotic cell death with small molecule inhibitors. Collectively these findings showcase this as a powerful new model for investigating Aβ toxicity in AD and identifying novel treatment strategies.}, }
@article {pmid41397735, year = {2025}, author = {Zong, G and Li, R and Jiang, Y and Chen, Z and Yan, S and Yi, Z and Ren, X and Jia, B}, title = {[Two cases of urinary retention in patients with Alzheimer's disease with agitation treated by acupuncture].}, journal = {Zhongguo zhen jiu = Chinese acupuncture & moxibustion}, volume = {45}, number = {12}, pages = {1822-1824}, doi = {10.13703/j.0255-2930.20250804-k0002}, pmid = {41397735}, issn = {0255-2930}, mesh = {Aged ; Humans ; Acupuncture Points ; *Acupuncture Therapy ; *Alzheimer Disease/complications/therapy/psychology ; *Psychomotor Agitation/therapy/complications ; *Urinary Retention/therapy/etiology ; }, abstract = {This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.}, }
@article {pmid41397578, year = {2026}, author = {Wang, X and Wang, X and Zhao, C and Zhao, H and Wang, P and Song, T}, title = {Enhancement of cognitive behavior and hippocampal neural oscillations by rhythmic unipolar pulsed magnetic stimulation in 5xFAD Alzheimer's disease mice.}, journal = {Behavioural brain research}, volume = {500}, number = {}, pages = {115995}, doi = {10.1016/j.bbr.2025.115995}, pmid = {41397578}, issn = {1872-7549}, mesh = {Animals ; *Alzheimer Disease/therapy/physiopathology ; Mice ; Mice, Transgenic ; Disease Models, Animal ; *Gamma Rhythm/physiology ; *Magnetic Field Therapy/methods ; Theta Rhythm/physiology ; Male ; *CA1 Region, Hippocampal/physiopathology ; *Behavior, Animal/physiology ; *Hippocampus/physiopathology ; Cognitive Dysfunction/therapy/physiopathology ; *Cognition/physiology ; }, abstract = {Alzheimer's disease (AD) imposes a heavy burden on families and society. Rhythmic magnetic stimulation has emerged as a promising non-invasive therapy to mitigate AD-related cognitive decline. In this study, we applied a rhythmic unipolar compound pulsed magnetic field (cPMF; carrier frequency: 40 Hz, repetition rate: 5 Hz, magnetic flux density: 0-20 mT) incorporating both theta and gamma rhythms to evaluate its effects on behavior and neural oscillations in AD mice and to explore the underlying mechanisms. 5xFAD mice received unipolar cPMF stimulation for 1 h/d over 8 consecutive weeks. Learning and memory were assessed using the novel object recognition (NOR) and the Morris water maze (MWM) tests. In NOR test, unipolar cPMF-treated mice showed a higher cognitive index in test phase 2, and in MWM test, exhibited shorter escape latencies in the training trial and spent less time to first cross the precise former platform location with a higher crossing frequency over this target area in the probe trial. Local field potentials (LFPs) in the hippocampal CA1 area were recorded via in vivo electrophysiology. LFP analysis showed that unipolar cPMF treatment enhanced power of cognitive-related neural oscillations and strengthened theta-gamma phase-amplitude coupling. RNA sequencing analysis further indicated that unipolar cPMF-treated mice exhibited differential gene expression in molecular function and multiple neurotransmitter synaptic signaling pathways. In conclusion, unipolar cPMF might improve cognitive function in 5xFAD mice by modulating cognitive-related neural oscillations. These findings could provide experimental support for the low-intensity pulsed magnetic stimulation as a potential therapeutic strategy for AD.}, }
@article {pmid41397211, year = {2026}, author = {Satyadev, N and Piura, YD and Tipton, PW and Dunham, SR and Morris, JC and Geschwind, MD and Brier, M and Graff-Radford, NR and Day, GS}, title = {Standardizing "Rapid": Applying the Clinical Dementia Rating to Define Rapidly Progressive Dementia.}, journal = {Neurology}, volume = {106}, number = {1}, pages = {e214439}, doi = {10.1212/WNL.0000000000214439}, pmid = {41397211}, issn = {1526-632X}, mesh = {Humans ; Female ; Male ; Disease Progression ; Aged ; *Dementia/diagnosis ; Aged, 80 and over ; Retrospective Studies ; Middle Aged ; *Mental Status and Dementia Tests/standards ; }, abstract = {BACKGROUND AND OBJECTIVES: Rapidly progressive dementia (RPD) accounts for 3%-4% of dementia cases yet presents a disproportionate clinical challenge given the wide differential diagnosis and the need to quickly identify potentially treatment-responsive causes. The lack of a standardized definition of RPD challenges generalization of published findings and precludes multisite studies. We sought to determine whether a standardized definition, based on the Clinical Dementia Rating (CDR), could reliably distinguish individuals with a broad spectrum of causes of RPD early in the symptomatic course.
METHODS: RPD was defined as dementia (global CDR ≥1) developing within 1 year or incapacitation (global CDR ≥2) within 2 years of symptom onset. Patients with suspected RPD were referred from inpatient and outpatient settings at Mayo Clinic in Florida (Jacksonville, FL) and Washington University in St. Louis (Saint Louis, MO) and prospectively evaluated (RaPID cohort). Retrospective data from participants assessed across 46 research centers were also analyzed (National Alzheimer's Coordinating Center [NACC] data set). Characteristics and rates of progression (main outcome) were compared between typically progressive and RPD. Univariable and multivariable analyses were performed using Mann-Whitney U/Kruskal-Wallis (continuous) and Fisher exact/χ[2] tests (binary), respectively. Our definition of RPD was compared against definitions identified through a scoping review conducted using a validated 6-stage approach.
RESULTS: In the RaPID cohort, 185 of 248 (74.6%) patients met our CDR-based RPD definition (median [range] age-at-symptom onset: 68.8 years [22.0-90.7]; 45.4% female). Autoimmune (55/185, 29.7%), neurodegenerative (51/185, 27.6%), and prion diseases (35/185, 18.9%) predominated. Among 20,418 NACC participants with cognitive impairment, 836 (4.1%) met our RPD definition (median [range] age-at-symptom onset: 74 years [24-103]; 57.1% female). Neurodegenerative diseases predominated, especially Alzheimer disease (485/836, 58.0%). Individuals with RPD declined substantially faster (ΔCDR sum-of-boxes/year: RaPID, 14.4 ± 5.3 vs 4.3 ± 4.3, p < 0.001; NACC, 6.7 ± 3.1 vs 1.7 ± 1.4, p < 0.001). Our scoping review identified 22 studies that applied 10 distinct definitions of RPD. Uniquely, our CDR-based definition clearly distinguished individuals with a broad spectrum of causes of RPD, assessed across multiple sites/settings, supporting early diagnosis with minimal resource requirements.
DISCUSSION: The CDR-based definition of RPD effectively identified individuals with a broad spectrum of causes of RPD early in the symptomatic course. The need for training and time to reliably administer the CDR may limit application of the proposed definition of RPD. Validation in additional cohorts is required to support generalizability.}, }
@article {pmid41396874, year = {2025}, author = {Zu, J and Li, C and Cui, M and Liu, X and Pan, Z and Li, X and Zhang, F and Gentz, J and Mitteregger-Kretzschmar, G and Herms, J and Shi, Y}, title = {Pioglitazone attenuates complement-mediated microglial synaptic engulfment in an Alzheimer's disease model.}, journal = {Brain : a journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/brain/awaf462}, pmid = {41396874}, issn = {1460-2156}, abstract = {Synaptic loss is an early hallmark of Alzheimer's disease (AD), predominantly driven by aberrant microglial reactivity. Pioglitazone, a peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist with anti-diabetic properties, has been shown to suppress microglial activity and improve cognitive performance in both AD models and clinical studies. However, whether its neuroprotective effects involve direct modulation of synaptic architecture remains unclear. Here, using longitudinal in vivo two-photon imaging, multi-channel immunohistochemistry, super-resolution confocal microscopy, and 3D reconstruction techniques in an AD mouse model, we analysed synaptic and microglial interactions. We show that a 4-week pioglitazone treatment preserves dendritic spine density and enhances spine stability over time. Mechanistically, pioglitazone reduces synaptic C1q deposition, thereby limiting complement-mediated microglial synaptic engulfment and attenuating synapse loss. These findings identify pioglitazone as a modulator of complement-dependent microglial synaptic pruning and support its therapeutic potential in preserving synaptic integrity during early AD pathogenesis.}, }
@article {pmid41396614, year = {2025}, author = {Brown, CA and Mundada, NS and Cousins, KAQ and Sadeghpour, N and Lyu, X and McGrew, E and Korecka, M and Chen-Plotkin, A and Xie, L and Wisse, LEM and Detre, JA and McMillan, CT and Lee, EB and Nasrallah, IM and Das, SR and Mechanic-Hamilton, D and Yushkevich, PA and Shaw, LM and Wolk, DA and , }, title = {Evaluation of Copathology and Clinical Trajectories in Individuals With Tau-Clinical Mismatch.}, journal = {JAMA neurology}, volume = {}, number = {}, pages = {}, pmid = {41396614}, issn = {2168-6157}, abstract = {IMPORTANCE: Even within individuals who are amyloid positive, clinical symptoms can be impacted by Alzheimer pathology, other pathologic proteins, and cognitive reserve or resilience. Understanding how each of these factors contributes to a patient's clinical presentation is crucial for prognosis and treatment decisions in the era of disease-modifying therapies.
OBJECTIVE: To evaluate tau-clinical mismatch as a means to identify those more likely to harbor copathology and/or exhibit resilience to Alzheimer pathology.
This was a longitudinal, observational cohort study conducted from 2004 to 2024. The setting included multiple academic medical centers in the US participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI) or Penn Alzheimer's Disease Research Center (Penn-ADRC). Included in the analysis were individuals with clinical assessment and measures of either tau positron emission tomography (tau-PET) or phosphorylated tau 217 (p-tau217) who were selected from individuals positive for amyloid β (Aβ+) in the ADNI cohort (aged 55-95 years) and the Penn-ADRC cohort (aged 54-92 years).
EXPOSURES: Clinical assessment (Clinical Dementia Rating Sum of Boxes [CDR-SB]) and tau burden (tau-PET or p-tau217) for mismatch group classification.
MAIN OUTCOMES AND MEASURES: Cross-sectional measures of neurodegeneration (medial temporal lobe volume and thickness, cortical thickness, TAR DNA-binding protein 43 [TDP-43] imaging signature), α-synuclein cerebrospinal fluid seed-amplification assay, and longitudinal CDR-SB.
RESULTS: A total of 365 participants (mean [SD] age, 75.4 [7.9] years; 192 female [52.6%]) in the ADNI tau-PET group and 524 participants (mean [SD] age, 77.1 [7.9] years; 268 male [51.1%]) in the ADNI p-tau217 group were selected from the 998 individuals who were Aβ+ in the ADNI cohort and used to generate tau-clinical mismatch models with 55.6% to 57.1% classified as canonical (CDR-SB commensurate to tau), 23.7% to 24.7% as resilient (CDR-SB < tau), and 19.3% to 19.7% as vulnerable (CDR-SB > tau). Vulnerable groups had evidence of greater likelihood of copathology, with TDP-43 neurodegeneration patterns and α-synuclein positivity. Mismatch groups showed diverging clinical trajectories with earlier cognitive impairment in vulnerable groups and later impairment in resilient individuals. Similar findings were seen when applied to an independent dataset of 244 individuals (mean [SD] age, 73.7 [6.8] years; 139 female [57.0%]) of the 248 who were Aβ+ in Penn-ADRC cohort. Finally, these models were applied to a cohort receiving antiamyloid therapy to show the utility of this method for predicting individual cognitive trajectories during therapy.
CONCLUSION AND RELEVANCE: Results of this cohort study suggest that tau-clinical mismatch identified individuals more likely to have an accelerated disease course due to the presence of copathology and those exhibiting greater cognitive resilience to disease pathology. These models provide an important tool that can be implemented in clinical practice to provide improved individualized prognosis and, potentially, monitoring of response to disease-modifying therapy.}, }
@article {pmid41396413, year = {2025}, author = {Zuliani, G and Brombo, G and Romagnoli, T and Polastri, M and Dario, FDP and Zuin, M}, title = {Effectiveness of acetylcholinesterase inhibitors and memantine in patients affected by severe dementia.}, journal = {GeroScience}, volume = {}, number = {}, pages = {}, pmid = {41396413}, issn = {2509-2723}, abstract = {The efficacy of acetylcholinesterase inhibitors (AChEI) and memantine (ME) in severe dementia remains uncertain, and real world data are limited. We evaluated the progression of cognitive decline and mortality rates in a cohort of outpatients with severe dementia treated with AChEI and/or ME or not treated, from the National Alzheimer's Coordinating Center Uniform Data Set (NACC-UDS). Overall, 703 patients (mean age:78.3 ± 7.2 years; females:56.1%) with severe dementia (Mini-Mental State Examination-MMSE ≤ 10/30) were included [407 late-onset Alzheimer's disease (LOAD), 126 Lewy body dementia (LBD), 170 vascular dementia (VD)]. Patients were grouped by treatment status: untreated (AChEI - /ME - ; n.70), AChEI only (AChEI + ; n.294), ME only (ME + ; n.215), combined therapy (AChEI + /ME + ; n.124). During follow-up (mean:1.7 ± 0.3 years; range:0.2-2.9 years) the mean MMSE scores declined by - 1.7 points (Standard Deviation: -1.55 to -1.9) in AChEI - /ME - (p for trend:0.001), - 1.5 points (-1.55 to -1.9) in AChEI + (p:0.001), - 0.7 points (-0.5 to -0.9) in ME + (p:0.09), while it increased by + 0.7 points (+ 0.4 to + 1.0) in AChEI + /ME + (p:0.001). Survival rates were 8% in AChEI - /ME - , 10% in AChEI + , 28% in ME + , and 49% in AChEI + /ME + . In Cox proportional hazards analysis (age and sex adjusted), AChEI + /ME + exhibited a 39% reduction in total mortality compared with no treatment (HR:0.61; 95%CI:0.49-0.77; p < 0.001), ME + displayed a 22% reduction (HR:0.78; 95%CI:0.65-0.94; p:0.007), while AChEI + showed no association (HR:0.97; 95%CI:0.80-1.18; p:0.75). When the Cox proportional hazards models were stratified by dementia subtype, consistent significant patterns were observed in LOAD and LBD. In this real-world cohort of older adults with severe dementia, the combination therapy (ME + AchEI) seems to be associated with the best outcomes, including a stabilization of cognitive function and reduced total mortality.}, }
@article {pmid41396167, year = {2026}, author = {Robinson, L and Bray, J and Melis, V and Harrington, CR and Wischik, CM and Riedel, G}, title = {Effects of hydromethylthionine mesylate and rivastigmine in a pharmacological mouse model of Alzheimer's disease.}, journal = {Behavioural pharmacology}, volume = {37}, number = {1}, pages = {64-69}, pmid = {41396167}, issn = {1473-5849}, support = {PAR 1577//WisTa Laboratories Ltd/ ; }, mesh = {Animals ; *Rivastigmine/pharmacology ; *Alzheimer Disease/drug therapy/physiopathology ; Mice ; Scopolamine/pharmacology ; Disease Models, Animal ; Female ; Maze Learning/drug effects ; Cholinesterase Inhibitors/pharmacology/administration & dosage ; *Tacrine/analogs & derivatives/pharmacology ; Memory/drug effects ; }, abstract = {The results from clinical trials have indicated that the tau aggregation inhibitor hydromethylthionine mesylate (HMTM) produces disease-modifying effects in Alzheimer's disease (AD) patients when administered alone, but less of an effect when administered in conjunction with cholinesterase inhibitors (ChEIs). The use of ChEIs for AD has been supported by their ability to reverse scopolamine-induced cognitive impairments in rodents reminiscent of those seen in AD patients. We have previously shown that another tau aggregation inhibitor, methylthionine chloride (MTC), is able to reverse scopolamine-induced deficits in spatial learning and memory. The objective here was to determine the symptomatic efficacy of HMTM and rivastigmine, alone or in combination, in a scopolamine model of AD. Female NMRI mice were treated systemically with scopolamine (0.5 mg/kg) or vehicle in combination with ChEI rivastigmine (0.5 mg/kg) or HMTM (5 or 15 mg/kg) daily before assessment of spatial learning and memory performance in a reference memory task in the water maze. Systemic administration of scopolamine induced significant impairments in the spatial learning of the mice compared to vehicle treatment. These deficits were reversed by treatment with HMTM at both doses and with rivastigmine when given alone. Furthermore, coadministration of rivastigmine with HMTM ameliorated the impairments induced by scopolamine. These findings extend our previous observations with MTC and confirm that HMTM also has a dual mode of action, disease modification through tau aggregation inhibition, but also having symptomatic effects through its normalisation of cholinergic activity.}, }
@article {pmid41396015, year = {2025}, author = {Leng, L and Liao, Z and Lu, P and Sun, Y and Weng, Q and Fan, W and Zhu, H and Wu, W and Liu, P and Liu, X and Zhang, K and Wang, W and Luo, B and Wang, Z and Peng, G}, title = {Real-world experience with baseline characteristics and safety of lecanemab for Alzheimer's disease in Eastern China.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251406619}, doi = {10.1177/13872877251406619}, pmid = {41396015}, issn = {1875-8908}, abstract = {BackgroundLecanemab reduces amyloid levels and modestly slows cognitive decline in a large cohort of early Alzheimer's disease (AD) but lacks real-world safety data in Chinese population.ObjectiveThe real-world study aims to analyze baseline characteristics and preliminary safety of lecanemab for AD in Zhejiang Province, and to evaluate the efficacy of plasma biomarkers for patient screening.MethodsThis multi-center study included 190 patients with AD in Zhejiang Province, who completed baseline assessments and received lecanemab treatment with follow-up.ResultsThe study included 176 participants with early AD and 14 moderate. In the early AD (mean age 68.04 years, Mini-Mental State Examination 20.03 and Montreal Cognitive Assessment 14.93), 124 (70.5%) participants were female, and 127 (72.1%) were junior high school education level or less. APOE4 heterozygote was predominant (48.9%). Logistic regression for distinguishing early AD from the Aβ negative cognitively unimpaired populations showed that p-Tau 217 independently provided better classification efficacy (area under the curve = 0.9983, p < 0.0001). In the early AD, 29 (16.5%) participants experienced infusion-related reactions (IRR) after the first-dose lecanemab, and amyloid-related imaging abnormalities (ARIA) were identified in 17 patients (9.7%), while 3 (21.4%) with IRR and none ARIA observed in the moderate AD.ConclusionsThe real-world lecanemab cohort had more females, lower educational level, and higher disease burden compared with the clinical trial cohort. Overall lecanemab exhibited a manageable short-term safety profile with no measurable cognitive efficacy. Extensive monitoring and management are required for ARIA of clinically importance. The plasma p-Tau 217 showed high accuracy for early AD screening.}, }
@article {pmid41394556, year = {2025}, author = {Seto, M and Klinger, HM and Clifton, M and Janve, VA and Brown, JA and Birkenbihl, C and Coughlan, G and Townsend, DL and Wang, TC and Properzi, M and Hanseeuw, B and Chhatwal, J and Yang, HS and Rissman, RA and Aisen, P and Cuppels, M and Donohue, MC and Raman, R and Johnson, KA and Sperling, RA and Dumitrescu, L and Hohman, TJ and Buckley, RF}, title = {Blood-based Transcriptomics Reveal Sex- and Amyloid-Modulated Biology of Plasma pTau217 in Preclinical Alzheimer's Disease.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41394556}, issn = {2692-8205}, support = {DP2 AG082342/AG/NIA NIH HHS/United States ; R01 AG063689/AG/NIA NIH HHS/United States ; U19 AG010483/AG/NIA NIH HHS/United States ; }, abstract = {Plasma pTau217, an emerging Alzheimer's disease (AD) biomarker, may reflect a synaptic response to β-amyloid (Aβ) plaques before cortical tangle formation, but the broader biological processes at play remain unclear. Using whole blood RNAseq, we sought to identify gene expression associated with plasma pTau217 and to determine whether APOEε4, sex, and neocortical Aβ-PET burden further amplify these associations in 724 participants from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) Studies. 1,540 genes were moderated by Aβ-PET, and 772 genes were moderated by both Aβ-PET and sex. Our findings include genes previously associated with AD (e.g., TREML2) and implicate biological functions such as chromatin remodeling, lipid signaling, and RNA processing that interact with Aβ-PET and sex to impact plasma pTau217. Our results underscore the complexity of molecular mechanisms that can be linked to plasma pTau217, particularly in the context of elevated Aβ-PET.}, }
@article {pmid41394158, year = {2025}, author = {Li, Y and Zhang, Y and Liu, M and Dawuti, T and Chen, X and Xiao, H}, title = {Polyphenol-rich Morus nigra L. extract mitigates neuroinflammation and cognitive impairment through gut-brain axis modulation in an Alzheimer's disease rat model.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1695768}, pmid = {41394158}, issn = {1663-9812}, abstract = {BACKGROUND: The gut-brain axis (GBA) has emerged as a critical pathway in the pathogenesis of Alzheimer's disease (AD), offering a potential target for dietary interventions. This study aimed to explore the neuroprotective effects of a polyphenol-enriched extract from Morus nigra L. fruits (MMF) in an AD rat model, focusing on gut-brain communication.
METHODS: AD-like pathology was induced in rats using a combination of D-galactose and aluminum chloride, followed by a 10-week MMF treatment. Cognitive performance was evaluated using the Morris water maze, and brain Aβ1-42 accumulation and neuroinflammation (Iba1, GFAP) were assessed. Multi-omics approaches, including 16S rDNA sequencing and untargeted colonic metabolomics, were applied.
RESULTS: MMF treatment significantly enhanced spatial memory, reduced hippocampal Aβ burden, and attenuated glial activation. Furthermore, MMF restored gut microbial diversity and increased the abundance of short-chain fatty acid-producing Firmicutes taxa, which were inversely correlated with inflammation. Metabolomics analysis revealed that MMF modulated bile acid and lipid metabolic pathways, with β-muricholic acid, DHA, and ergosterol identified as key effectors.
CONCLUSION: MMF alleviates AD pathology through modulation of the gut microbiota and metabolic reprogramming, suggesting a promising microbiota-targeted strategy for AD prevention.}, }
@article {pmid41394066, year = {2025}, author = {Rubiño-Díaz, JÁ and Zapata-Moreno, M}, title = {Highly sensitive early-onset Alzheimer's disease: a case report.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1688924}, pmid = {41394066}, issn = {1664-1078}, abstract = {BACKGROUND: Early-onset Alzheimer's disease (EOAD) is an atypical syndrome that can be confused with other neurodegenerative diseases. This disease presents before the age of 65, with symptoms that generally affect executive functions, praxis, and visuoperceptual abilities, as opposed to episodic memory. Highly sensitive individuals present the temperament trait of sensory processing sensitivity, which is characterized by a differential susceptibility compared to other individuals. Neuropsychological evaluation should involve a holistic and integrative person-centered care approach for optimal treatment and disease progression.
CASE SUMMARY: A highly sensitive 54-year-old individual was diagnosed with EOAD at age 47 in 2017. Neuropsychological follow-up was conducted for 6 years. Initial neuropsychological testing revealed a cognitive pattern with impairments in executive functions, attention, and visual perception, the advancement of which led to a progressive deterioration in daily, occupational, and social functioning. During this period, he received psychotherapy from a psychologist specializing in neuropsychology and high sensitivity, using a holistic and integrative approach. Initially, sessions were held twice a week throughout the first year of consultation and, subsequently, continued at the patient's home and in his usual context, using a completely ecological perspective and consisting of person-centered care. In 2022, the patient, aged 59, was admitted to a nursing home. This situation, outside his usual environment, without autobiographical references and his own life story, led to accelerated deterioration, with the patient ultimately dying at age 60, in 2023.
CONCLUSION: The patient with highly sensitive EOAD was followed for 6 years by a psychologist specializing in neuropsychology and high sensitivity. Neuropsychological intervention was maintained with a holistic and integrative person-centered approach using the unmet needs model to address cognitive, psychological, and functional levels. Follow-up with this approach could be key to slowing the disease and ensuring patient satisfaction throughout the entire progression of the illness. Greater visibility into unusual cases like this will enable psychology professionals to be vigilant for timely differential and diagnostic testing, which will significantly impact the treatment and progression of the illness, ultimately influencing quality of life and well-being through an optimal neuropsychological approach.}, }
@article {pmid41393110, year = {2025}, author = {Kim, EH and Lee, YJ and Moon, YS and Kwon, OD and Kwon, DR}, title = {Evaluation of microcurrent as an adjunct to donepezil therapy in an Alzheimer's disease mouse model: a pilot study.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1689593}, pmid = {41393110}, issn = {1663-4365}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder due to Aβ plaque accumulation, followed by loss of synapses and decline in cognitive abilities. Donepezil is currently one of the standard pharmacological treatments for Alzheimer's disease. Recently, microcurrent (MC) therapy has emerged as a non-pharmacological adjunct for AD management. Recently, microcurrent therapy emerged as a non-pharmacological alternative to treat AD.
OBJECTIVE: The study investigates the therapeutic outcomes of the MC as an adjuvant to donepezil in mitigating cognitive dysfunction in the transgenic mouse model (5XFAD).
METHODS: Transgenic 5xFAD mice were assigned to the control, donepezil, MC, or MC + donepezil (combination) groups. Behavioral performance was assessed using the novel object recognition (NOR) and radial arm maze (RAM) tests. Amyloid burden, glial activation, cytokine expression, apoptotic signaling, and intracellular pathways (PI3K-AKT, AMPK, and JAK2/3) were analyzed by immunohistochemistry and Western blotting.
RESULTS: Combined treatment with donepezil and microcurrent showed a trend toward improved cognitive performance and reduced pathology compared to donepezil alone, although these differences were not statistically significant. Aβ plaque burden in the cortex and the hippocampus was reduced by approximately 68%, thereby exceeding reductions observed with either treatment alone. Microglial and astroglial activation (Iba1, GFAP, and CD68) and pro-inflammatory cytokines (TNF-α and IL-1β) were reduced in both the donepezil and combination groups compared with untreated 5xFAD mice, with no significant difference between 5xD and 5xD + MC. Apoptotic markers (cleaved caspase-3 and cleaved PARP) were significantly reduced in both treatment groups compared with untreated controls but not significantly different between donepezil and combination therapy. At the molecular level, both donepezil and combination therapy activated PI3K-AKT and AMPK signaling and increased inhibitory phosphorylation of GSK-3β compared with untreated 5xFAD mice; no significant difference was observed between the two treatment groups.
CONCLUSION: Donepezil combined with microcurrent therapy showed comparable efficacy to donepezil alone, with numerical trends toward further improvement in cognitive function and pathology, but without statistically significant differences. Both treatments reduced Aβ burden, attenuated glial activation, and modulated survival-related pathways to a similar extent. These findings support a multi-target therapeutic strategy and highlight the translational potential of integrating microcurrent therapy with standard pharmacological treatment for AD.}, }
@article {pmid41392105, year = {2025}, author = {Barani, M and Zargari, F and Mirinejad, S and Madani, F and Hajinezhad, MR and Sargazi, S}, title = {Ginsenoside Rg3-encapsulated pegylated niosomes exhibit multimodal therapeutic potential in Alzheimer's disease.}, journal = {Scientific reports}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41598-025-32528-3}, pmid = {41392105}, issn = {2045-2322}, support = {4021411//National Institute for Medical Research Development/ ; }, abstract = {Ginsenoside Rg3 (GRg3), a bioactive compound extracted from ginseng, has demonstrated the ability to inhibit Aβ production and deposition. In this study, PEGylated GRg3-loaded niosomes were developed and characterized for potential AD treatment. Their efficacy was assessed using in vitro and in vivo models, as well as molecular dynamics simulations of self-assembly. Our formulation achieved a relatively high encapsulation efficiency of 83.02% and a controlled release profile, with 75.73% of the drug released over 48 h. In vitro, co-administration of Aβ with free or PEGylated GRg3-loaded niosomes markedly reduced the levels of Total Antioxidant Capacity, Malondialdehyde (MDA), and caspase-3 gene expression compared to the Aβ-only group. In vivo evaluations revealed that treatment with the niosomal formulation did not significantly alter behavioral parameters, MDA levels, or Superoxide Dismutase activity. However, catalase activity was significantly higher than in the control group. Histopathological and immunohistochemical analyses showed reduced neurovascular damage and preservation of blood-brain barrier (BBB) and hippocampal integrity in the treated group. MD simulations confirmed the spontaneous self-assembly of surfactant molecules into a bilayer structure with successful incorporation of GRg3. Our findings underscore the potential of PEGylated niosomes as efficient nanocarriers for GRg3 delivery in the AD treatment.}, }
@article {pmid41391900, year = {2026}, author = {Ehret, F and Rogers, CL and Fontanesi, J and Wilson, GD and Chitti, BS and Starner, J and Sidiqi, B and Goenka, A and Schulder, M and Bruynzeel, AME and Verhoeff, JJC and MacDonagh, AC and Park, HI and Shih, HA and Kleinberg, L}, title = {Radiation Therapy for Non-Malignant Central Nervous System Tumors, Disorders, and Illnesses - Current Applications and Future Directions.}, journal = {Seminars in radiation oncology}, volume = {36}, number = {}, pages = {77-94}, doi = {10.1016/j.semradonc.2025.08.005}, pmid = {41391900}, issn = {1532-9461}, mesh = {Humans ; *Central Nervous System Neoplasms/radiotherapy ; *Mental Disorders ; }, abstract = {Radiation therapy has a central role in the treatment of various malignant central nervous system tumors, including gliomas, high-grade meningiomas, and brain metastases. This also applies to a plethora of non-malignant central nervous system lesions, such as vestibular schwannomas and arteriovenous malformations, and, in specific situations, for selected functional and psychiatric disorders. In patients with these conditions, the goal of radiation therapy is generally to preserve and stabilize function. In addition, as these illnesses, with some exceptions such as arteriovenous malformations, are rarely life-threatening, the risks of radiation therapy must be interpreted in a different context than for patients with malignancy. Given the continuous and growing interest in the use of radiation therapy for non-malignant tumors and functional conditions, this review summarizes the current and future directions in central nervous system applications, addressing its use for the management of vestibular schwannomas, arteriovenous malformations, trigeminal neuralgia, tremor, Alzheimer's disease, and other psychiatric conditions, such as obsessive-compulsive disorder, addiction, and eating disorders.}, }
@article {pmid41391736, year = {2025}, author = {Chen, H and Zhang, Z and Yi, W and Wang, N and Dong, X and Xing, Y and Liu, Q and Wu, Y and Ma, X}, title = {Bone-brain crosstalk: emerging roles of osteocalcin in central nervous system disorders.}, journal = {Neuroscience}, volume = {595}, number = {}, pages = {1-8}, doi = {10.1016/j.neuroscience.2025.12.028}, pmid = {41391736}, issn = {1873-7544}, abstract = {Despite significant advancements in understanding the pathogenesis of various central nervous system (CNS) disorders, challenges remain in the early intervention and targeted therapies for common neurodegenerative and psychiatric conditions such as Parkinson's disease (PD), Alzheimer's disease (AD), anxiety, depression, and strokes. Recent studies have increasingly focused on the interaction between the peripheral and central nervous systems, emphasizing the regulatory influence of peripheral mechanisms on CNS disorders. This evolving perspective paves the way for innovative treatment strategies for CNS diseases, with the bone-brain axis emerging as a key regulatory pathway. This axis was first systematically proposed to highlight the role of bone-derived hormones in brain function. Importantly, bone tissue extends its functions beyond mere structural support and movement; it secretes molecules like osteocalcin (OCN) that influence neuronal and glial cell activities. This interaction is vital for regulating multiple CNS processes, including mood, cognition, inflammation, and the formation and differentiation of myelin. Upon release from bone tissue, OCN enters the bloodstream and affects peripheral organs via the Gprc6a receptor, while also crossing the blood-brain barrier to interact with receptors such as Gpr158 and Gpr37 in specific brain areas. This intra-brain interaction significantly impacts the progression and prognosis of various CNS disorders. This article undertakes a comprehensive analysis of OCN modulation in CNS disorders and its underlying mechanisms, laying the groundwork for further exploration of its clinical applications and suggesting new research avenues and therapeutic strategies for CNS diseases.}, }
@article {pmid41391511, year = {2026}, author = {Gawai, M and Nistane, N and Tatode, AA and Qutub, M and Umekar, MJ and Premchandani, T and Taksande, JB}, title = {Transforming anti-Alzheimer's therapy by targeting endogenous receptorrial system through ligand-conjugated nanoformulations.}, journal = {Ageing research reviews}, volume = {114}, number = {}, pages = {102994}, doi = {10.1016/j.arr.2025.102994}, pmid = {41391511}, issn = {1872-9649}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Humans ; Ligands ; Animals ; Blood-Brain Barrier/metabolism/drug effects ; *Drug Delivery Systems/methods ; *Nanoparticles/administration & dosage ; Brain/metabolism/drug effects ; }, abstract = {Alzheimer's Disease (AD) is the most prevalent neurodegenerative disorder, contributing to the majority of dementia cases in the elderly globally. Characterized by progressive cognitive decline, AD is associated with complex neuropathological changes, including the accumulation of amyloid-beta (Aβ) plaques and tau tangles, synaptic loss, and neuroinflammation. One of the significant challenges in treating AD is the blood-brain barrier (BBB), which prevents many therapeutic agents from reaching the brain. Despite advancements in understanding AD's pathology, limited treatment options are available, largely due to the inability of conventional drugs to effectively target the brain. Ligand-conjugated nanoparticles (NPs) are promising for targeted drug delivery to the brain. These NPs, engineered with ligands that can bind to specific receptors or transporters on the BBB, facilitate the crossing of the barrier via receptor-mediated endocytosis or adsorptive-mediated transcytosis. This strategy enhances therapeutic agents' bioavailability and cellular uptake, offering a potential solution to overcome current limitations in AD treatment. Using nanotechnology to design ligand-conjugated NPs for targeted and sustained drug delivery could significantly improve therapeutic outcomes for AD patients by addressing key pathological processes in the brain.}, }
@article {pmid41391505, year = {2025}, author = {Liu, Y and Zhang, J and Li, W and Qu, Q and Shan, Z and Liu, C and Jiao, K and Hou, X}, title = {Osthole ameliorates cognitive impairment in ovariectomized rats via estrogen-mediated enhancement of cholinergic function and regulation of neurotransmitter homeostasis.}, journal = {Neuropharmacology}, volume = {286}, number = {}, pages = {110806}, doi = {10.1016/j.neuropharm.2025.110806}, pmid = {41391505}, issn = {1873-7064}, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive dysfunction that is closely associated with cholinergic system damage. Estrogen deficiency is a well-established risk factor for AD in women. Osthole (OST), a phytoestrogen with mild, bidirectional regulatory properties, has been proposed as a potential estrogen replacement. This study aimed to investigate the mechanisms by which OST ameliorates cognitive impairment. Cognitive deficits were induced in female Sprague-Dawley rats by bilateral ovariectomy (OVX), and OST was subsequently administered by oral gavage. Behavioral tests revealed that OST significantly improved learning and memory and reduced anxiety-like and depression-like behaviors in OVX rats. H&E staining and Nissl staining demonstrated that OST reversed neuronal damage in the hippocampus and cortex. Western blotting, ELISA, and immunofluorescence staining indicated that OST treatment restored the estrogen-cholinergic-NGF axis: E2, ERα, and ERβ expression were upregulated; Ach, ChAT, NGF, and TrkA levels were increased, whereas AChE activity was decreased. Moreover, OST inhibited neuronal apoptosis by elevating Bcl-2 and reducing Bax expression, enhanced the expression of markers of synaptic plasticity (PSD95, SYN, and BDNF), and modulated neurotransmitter release (GABA and E). Collectively, these multi-target effects identify OST as a promising candidate for treating AD in women.}, }
@article {pmid41390238, year = {2025}, author = {Mummery, CJ and Rasmussen, J and Blackburn, D and Coulthard, E and Davies, RR and Dorsey, R and Fox, NC and Hosseini, AA and Ivenso, C and Jones, M and Kennelly, SP and Kipps, C and Lashley, D and Mackay, G and Negi, R and Nilforooshan, R and Passmore, PA and Perry, R and Raymont, V and Rowe, JB and Russ, TC and Taylor, JP and Burns, A}, title = {Lecanemab appropriate use recommendations for clinical practice in the UK.}, journal = {Journal of neurology, neurosurgery, and psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1136/jnnp-2025-336597}, pmid = {41390238}, issn = {1468-330X}, abstract = {Lecanemab is an anti-amyloid monoclonal antibody, recently approved in the UK as a treatment for mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD) in adults who are apolipoprotein E ε4 gene (APOE4) heterozygotes or non-carriers.A group of UK neurologists, old age psychiatrists and geriatricians with expertise in AD convened to agree appropriate use recommendations for lecanemab in UK clinical practice. The primary focus of these recommendations is safety.Eligibility criteria for lecanemab in the UK include (a) a clinical diagnosis of MCI or mild dementia due to AD, (b) the presence of amyloid-β pathology, confirmed using approved methods (ie, an amyloid positron emission tomography scan or cerebrospinal fluid assay) and (c) APOE4 heterozygous or non-carrier status. Eligibility screening should be conducted in secondary care and those identified as being potentially eligible for lecanemab should be referred to a specialist centre for confirmation of the likely pathological diagnosis, APOE4 counselling and testing and a multidisciplinary consensus decision regarding treatment eligibility. Lecanemab is administered as an intravenous infusion every 2 weeks, and those eligible for treatment should have brain magnetic resonance imaging (MRI) scans prior to the 1st, 5th, 7th and 14th infusions. Specific guidance is provided for safety monitoring and management of potential adverse reactions, including amyloid-related imaging abnormalities and infusion-related reactions.The introduction of lecanemab into UK clinical practice provides an important opportunity to improve services for all people living with dementia, not just those eligible for lecanemab treatment.}, }
@article {pmid41390089, year = {2026}, author = {Sheng, J and Wang, L and Zhang, Q and Chien Chou, JT and Zhang, R and Li, T and Lu, Y}, title = {Integrating multimodal data to identify single nucleotide polymorphism-related biomarkers and regulatory mechanisms in Alzheimer's disease.}, journal = {Neuroscience}, volume = {593}, number = {}, pages = {141-159}, doi = {10.1016/j.neuroscience.2025.12.022}, pmid = {41390089}, issn = {1873-7544}, mesh = {Humans ; *Alzheimer Disease/genetics/metabolism ; *Polymorphism, Single Nucleotide/genetics ; Biomarkers/metabolism ; Transcriptome ; Gene Expression Profiling ; Aged ; Female ; Male ; }, abstract = {Alzheimer's disease (AD) is the most common neurodegenerative disease with unclear regulatory mechanisms at the cell-type level. A multi-omics model called single nucleotide polymorphisms (SNPs)-transcriptomic-single-nucleus ribonucleic acid sequencing (snRNA-seq) integration (STSNI) is proposed to identify SNPs-related biomarkers and regulatory mechanisms in AD. Differential expression analysis identified differentially expressed genes (DEGs) between AD patients and healthy controls (HCs) in the GSE118553 dataset. Cell-type annotation in the GSE138852 dataset revealed several cell subclusters, and DEGs were identified within these subclusters. Intersection analysis among DEGs from the GSE118553 dataset, cell-subcluster-specific DEGs from the GSE138852 dataset, and SNP-associated genes from the ADNI2 dataset yielded 14 overlapping genes. Using the least absolute shrinkage and selection operator (LASSO) and support vector machine-recursive feature elimination (SVM-RFE) algorithms, six biomarkers were identified. Functional enrichment and gene set enrichment analysis (GSEA) linked these biomarkers to pathways such as carboxylic acid catabolic process, exocytic vesicle membrane, and carbon metabolism. Meanwhile, six cell types were identified, including astrocytes, endothelial cells, oligodendrocytes, oligodendrocyte progenitor cells (OPCs), microglia, and neurons. The biomarker-transcription factor (TF) network indicated that Cispb M4676 regulates IQGAP2, NRXN1, GRIA3 and FGF14. Overall, our study identified six SNP-related biomarkers (IQGAP2, HHAT, FGF14, CTNNA3, GRIA3, and NRXN1) associated with AD. The STSNI framework provided novel insights into the cellular and molecular mechanisms underlying AD. Significance Statement: As the global population continues to age, Alzheimer's disease (AD) has emerged as a major public health concern. The pathological changes associated with AD include the formation of extracellular amyloid plaques, intracellular neurofibrillary tangles, and neuronal loss with gliosis proliferation. Bioinformatics methods are used to explore the immune infiltration characteristics, biological pathways and regulatory mechanisms of single nucleotide polymorphisms (SNPs) related key genes in AD. The pathogenesis of AD from the overall level and single-cell level is explored based on SNPs-related genes, combined with snRNA-seq data and transcriptome data. This study provides an opportunity for the discovery of novel diagnostic molecular markers and potential treatment targets to serve as the foundation for the development of more effective management techniques for AD.}, }
@article {pmid41389844, year = {2026}, author = {Shi, H and Zhao, Y}, title = {Astaxanthin inhibits the aggregation and cytotoxicity of tau4RDΔK280 via possible interaction with the aggregation-prone segments.}, journal = {Neurochemistry international}, volume = {192}, number = {}, pages = {106103}, doi = {10.1016/j.neuint.2025.106103}, pmid = {41389844}, issn = {1872-9754}, mesh = {*tau Proteins/metabolism/genetics/antagonists & inhibitors ; Xanthophylls/pharmacology ; Animals ; Mice ; Tauopathies/metabolism/drug therapy/genetics ; *Protein Aggregates/drug effects/physiology ; Humans ; *Protein Aggregation, Pathological/metabolism/drug therapy ; Cell Survival/drug effects/physiology ; Neuroprotective Agents/pharmacology ; Molecular Docking Simulation/methods ; }, abstract = {Tauopathies are a group of neurodegenerative disorders characterized by the presence of abnormal aggregates of microtubule associated protein tau in the brain. In the most common tauopathy, Alzheimer's disease (AD), the aggregation of tau is closely linked with synaptic dysfunction and neuronal death, while targeting the aggregation of tau has been demonstrated to have therapeutic potential. Astaxanthin is a carotenoid with neuroprotective function, which has been shown to inhibit Aβ-induced pathology in AD animal and cell models. However, the effects of astaxanthin on tau aggregation and toxicity are much less explored. In this study, we generated a cell model of tauopathy overexpressing the amyloidogenic pro-aggregant tau repeat domains carrying the FTDP-17 mutation ΔK280 in N2a cells (N2a-tau4RDΔK280). It was found that astaxanthin treatment alleviated the cytotoxicity of N2a-tau4RDΔK280 cells while reducing the amount of tau4RDΔK280 aggregates in the cells. Results from the thioflavin T aggregation assay demonstrated that astaxanthin inhibited the aggregation of tau4RDΔK280 in vitro. Further analyses with transmission electron microscopy confirmed that astaxanthin reduced the formation of amyloid fibril structures of tau4RDΔK280 in vitro. Thus, astaxanthin might inhibit the cytotoxicity of N2a-tau4RDΔK280 cells by preventing the formation of tau4RDΔK280 aggregates. Molecular docking simulation analyses revealed that astaxanthin was able to directly interact with tau4RDΔK280 as well as several key aggregation-prone segments of tau protein. In conclusion, our results demonstrated that astaxanthin might exert neuroprotection by inhibiting the formation of tau aggregates via direct interaction with the key aggregation-prone segments.}, }
@article {pmid41389629, year = {2026}, author = {Ruiz de Martín Esteban, S and Grande, MT and Martínez-Relimpio, AM and Herráez-Aguilar, D and Mostany, R and Hillard, CJ and Hind, WH and Romero, J}, title = {Treatment with a botanical mixture of cannabidiol:Δ[9]-tetrahydrocannabinol enhances microglial phagocytosis and shapes amyloid plaques in a mouse model of Alzheimer's disease.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {194}, number = {}, pages = {118902}, doi = {10.1016/j.biopha.2025.118902}, pmid = {41389629}, issn = {1950-6007}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism ; *Dronabinol/pharmacology/therapeutic use ; *Cannabidiol/pharmacology/therapeutic use ; *Microglia/drug effects/pathology/metabolism ; Male ; *Phagocytosis/drug effects ; Disease Models, Animal ; Mice ; *Plaque, Amyloid/pathology/drug therapy/metabolism ; Mice, Transgenic ; Behavior, Animal/drug effects ; Anxiety ; Motor Activity/drug effects ; }, abstract = {The potential use of phytocannabinoids in neurodegenerative disorders is currently under intense investigation based on their potential anti-inflammatory, antioxidant, and neuroprotective effects. Here, we tested the effects of chronic (28 days) treatment with a complex botanical mixture of purified cannabidiol:Δ[9]-tetrahydrocannabinol (CBD:THC, 99:1) in male 5xFAD mice, a murine model of Alzheimer's disease that recapitulates amyloid pathology. Effects of exposure to this cannabinoid mixture were evaluated using behavioral tests (elevated plus maze for anxiety, tail suspension for depression-like behavior, rotarod for motor coordination, open field for locomotor activity, and novel object recognition for memory), quantification of protein expression (IL-1β, CD40, TREM2, COX2), assessment of functional parameters (microglial phagocytic activity by flow cytometry), and in vivo multiphoton microscopy (time-course of changes of neuritic plaque structural features). Twice daily dosing with 50 mg/kg subcutaneously (s.c.) significantly reduced locomotion, increased anxiety- and depression-like behaviors and had no effect on memory and motor coordination. In vivo imaging experiments suggest that the CBD:THC treatment enhanced microglial phagocytic activity on amyloid plaques; this effect was observed both in plaque features (multiphoton microscopy measurements) as well as in microglia (flow cytometry data). Exposure to CBD:THC induced significant changes in in vivo microglia-amyloid interactions, increasing phagocytic activity and reducing the amyloid peptide accumulation in the neuritic plaques. Thus, CBD:THC (99:1) may be a promising treatment to reduce amyloid pathology, though caution should be noted due to the behavioral alterations observed, i.e., increased anxiety- and depression-like behaviors as well as decreased locomotion.}, }
@article {pmid41389410, year = {2026}, author = {Li, X and Yan, S and Li, M and Liu, R and Lu, Q and Lu, M and Bai, F and Shen, QD}, title = {Piezoelectric nanoparticle-driven rhythmic ultrasound neuromodulation for treatment of early-stage Alzheimer's disease.}, journal = {Biomaterials}, volume = {328}, number = {}, pages = {123905}, doi = {10.1016/j.biomaterials.2025.123905}, pmid = {41389410}, issn = {1878-5905}, mesh = {Animals ; *Alzheimer Disease/therapy/pathology/physiopathology ; *Nanoparticles/chemistry ; Mice ; Male ; Ultrasonic Waves ; Hippocampus ; Disease Models, Animal ; Neuronal Plasticity ; Mice, Inbred C57BL ; Humans ; Mice, Transgenic ; }, abstract = {Synaptic dysfunction and loss are central drivers of cognitive decline in Alzheimer's disease (AD), yet current therapeutic approaches targeting amyloid-β or tau pathology have largely failed to rescue synaptic function. Neural oscillations and synaptic plasticity are tightly coupled and underpin functional brain networks, suggesting that modulating oscillatory dynamics may offer new therapeutic avenues. Here, we developed a strategy for precise, non-genetic neuromodulation using focused ultrasound and piezoelectric Ba0.85Ca0.15Zr0.1Ti0.9O3 (BCZT) nanoparticles to generate targeted, gamma-frequency electromagnetic fields in the hippocampal CA3 subregion of early-stage AD mouse models. This rhythmic stimulation effectively restored impaired gamma oscillations, enhanced synaptic plasticity, and remodeled memory-related network connectivity, as validated by local field potential recordings, patch-clamp electrophysiology, and functional MRI. Mechanistically, we demonstrate that NF-κB transcription factor activation during rhythmic stimulation regulates AMPAR trafficking by balancing synaptic internalization and delivery, with concurrent upregulation of P300-mediated histone acetylation. Our findings establish a novel paradigm for spatially precise, periodic neuromodulation that restores hippocampal information processing and network function in early AD, highlighting the therapeutic potential of piezoelectric nanomaterials for neural circuit repair in AD and other neurodegenerative diseases characterized by impaired neural rhythms.}, }
@article {pmid41389269, year = {2025}, author = {Isaković, J and Athanassiadis, A and Khubeis, M}, title = {Stem cells strike back: advancements in Alzheimer's and Parkinson's disease treatment and modeling efforts from 2019 to 2024.}, journal = {Journal of molecular medicine (Berlin, Germany)}, volume = {104}, number = {1}, pages = {2}, pmid = {41389269}, issn = {1432-1440}, mesh = {Humans ; *Alzheimer Disease/therapy ; *Parkinson Disease/therapy ; *Stem Cell Transplantation/methods ; Animals ; Clinical Trials as Topic ; *Stem Cells/cytology/metabolism ; Cell Differentiation ; }, abstract = {This review critically evaluates the current state of stem cell therapy (SCT) for treating and modeling of Alzheimer's (AD) and Parkinson's disease (PD). It includes an in-depth analysis of both preclinical and clinical studies, with a particular focus on clinical trials conducted between 2019 and 2024, reflecting recent advancements in the field. Preclinical studies were examined to elucidate the molecular mechanisms underlying SCT and identify developments that could be translated into clinical practice. Within these studies, stem cells, including embryonic stem cells (ESCs), mesenchymal stem cells (MSCs), neural stem cells (NSCs), and induced pluripotent stem cells (iPSCs), have shown high differentiation and proliferation abilities. These properties, along with their capacity to inhibit inflammation, prevent apoptosis, and stimulate angiogenesis, make them promising candidates for treating AD and PD. Over the past 15 years, 76 SCT-based trials have been conducted-27 for AD and 48 for PD-with more than half occurring in the past 5 years. Despite the promise of SCT, the field faces challenges such as ethical concerns regarding the use of ESCs, heterogeneity of isolated cultures, and inconsistent results across preclinical trials. Novel materials and electromagnetic fields (EMFs) offer potential solutions to these issues. While bioengineering approaches can enhance the successful engraftment of transplanted stem cells, EMFs can direct the cells' migration and differentiation. In conclusion, although significant progress has been made in SCT, ongoing efforts are needed to address existing challenges. Nevertheless, SCT holds considerable promise for the future, offering potential breakthroughs in the treatment of neurodegenerative diseases.}, }
@article {pmid41388533, year = {2025}, author = {Khan, AR and Makhoul, GW and Raji, MA}, title = {Mirtazapine for gastrointestinal side effects of glucagon-like peptide-1 receptor agonist therapy in older adults.}, journal = {Endocrine regulations}, volume = {59}, number = {1}, pages = {260-264}, doi = {10.2478/enr-2025-0030}, pmid = {41388533}, issn = {1336-0329}, mesh = {Humans ; Aged ; Female ; *Glucagon-Like Peptide-1 Receptor Agonists ; *Diabetes Mellitus, Type 2/drug therapy ; *Mirtazapine/therapeutic use ; *Hypoglycemic Agents/adverse effects ; Glucagon-Like Peptides/adverse effects ; *Gastrointestinal Diseases/chemically induced/drug therapy ; Nausea/chemically induced/drug therapy ; Vomiting/chemically induced/drug therapy ; Glucagon-Like Peptide 1 ; }, abstract = {Objective. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) play a role in management of type 2 diabetes (T2D) and obesity by promoting glycemic control and weight reduction. Beyond these benefits, GLP-1 RAs have demonstrated positive effects on cardiovascular, renal, and neurological health, with emerging evidence supporting their therapeutic potential in conditions such as chronic kidney disease, asthma, obstructive sleep apnea, Parkinson's disease, and Alzheimer's disease. However, their widespread clinical use is often hindered by gastrointestinal side effects including nausea, anorexia, vomiting, and diarrhea that limit adherence and dose titration. Effective management of these adverse effects is essential to optimize treatment outcomes and maintain long-term therapy. Case report. A 72-year-old woman with a history of cognitive impairment, T2D, atrial fibrillation, obesity, and mood disorders presented with persistent gastrointestinal symptoms while receiving semaglutide. Dose escalation was restricted due to severe nausea, vomiting, and diarrhea, which markedly affected her quality of life. To manage these symptoms, mirtazapine was initiated. Following its introduction, the patient reported significant improvement in gastrointestinal tolerance enabling continued semaglutide therapy and successful dose advancement. Additional benefits included enhanced mood, better sleep, and overall well-being. No adverse effects related to mirtazapine were observed throughout the treatment. Conclusion. This case suggests that mirtazapine may be beneficial in mitigating GLP-1 RA-induced gastrointestinal side effects, thereby improving adherence and therapeutic efficacy. Further research is needed to evaluate the safety, mechanism, and generalizability of this approach in broader clinical practice.}, }
@article {pmid41388352, year = {2026}, author = {Akinluyi, ET and Takahashi-Yamashiro, K and Connolly, MG and Poon, WW and Macauley, MS}, title = {Interplay between CD33 and TREM2 in Alzheimer's Disease: Potential Mechanistic Insights into Microglial Function in Amyloid Pathology.}, journal = {ACS chemical neuroscience}, volume = {17}, number = {1}, pages = {62-76}, doi = {10.1021/acschemneuro.5c00805}, pmid = {41388352}, issn = {1948-7193}, mesh = {*Alzheimer Disease/metabolism/pathology/genetics ; Humans ; *Microglia/metabolism ; *Sialic Acid Binding Ig-like Lectin 3/metabolism ; *Receptors, Immunologic/metabolism ; *Membrane Glycoproteins/metabolism ; Animals ; *Amyloid beta-Peptides/metabolism ; Plaque, Amyloid/metabolism/pathology ; Brain/metabolism/pathology ; }, abstract = {Alzheimer's disease (AD) is a prevalent neurodegenerative disorder characterized by the accumulation of amyloid-β (Aβ) plaques, tau neurofibrillary tangles, and progressive neuronal loss leading to cognitive decline. With millions affected worldwide, there remains an urgent need for innovative treatment strategies to combat this disease. Genome-wide association studies (GWAS) have identified genes expressed in microglia, the resident immune cells of the brain, as key mediators of AD susceptibility. Among microglial risk genes, CD33 and TREM2 stand out for their contrasting roles in AD risk. Accumulating evidence indicates that these receptors converge on overlapping signaling pathways to regulate microglial activation and Aβ clearance. Here, we review the current understanding of CD33 and TREM2 biology in AD, with a focus on their potential crosstalk and functional antagonism. We propose potential mechanistic models by which human CD33 isoforms regulate TREM2 activity in either the absence or presence of Aβ pathology and discuss therapeutic strategies targeting this axis. Together, these insights suggest new avenues for microglia-targeted interventions in AD.}, }
@article {pmid41387197, year = {2026}, author = {Fredriksen-Goldsen, KI and Teri, L and Kim, HJ and Jones-Cobb, B and LaFazia, D and McKenzie, G and Petros, R and Jung, H and Oswald, AG and Hoy-Ellis, C and Emlet, C}, title = {Innovations in Dementia Empowerment and Action: RCT for Underserved Communities.}, journal = {Journal of the American Geriatrics Society}, volume = {74}, number = {1}, pages = {119-131}, doi = {10.1111/jgs.70189}, pmid = {41387197}, issn = {1532-5415}, support = {R01AG055488//National Institute on Aging of the National Institutes of Health/ ; }, mesh = {Humans ; Male ; Female ; Aged ; Single-Blind Method ; Quality of Life ; *Dementia/therapy/psychology ; *Empowerment ; *Cognitive Behavioral Therapy/methods ; Medically Underserved Area ; Aged, 80 and over ; Caregivers/psychology ; Social Stigma ; Exercise ; *Vulnerable Populations/psychology ; Middle Aged ; }, abstract = {BACKGROUND: Research has revealed dementia disparities among underserved older adults. Built upon standard-Reducing Disability in Alzheimer's Disease (s-RDAD), Innovations in Dementia Empowerment and Action (IDEA) is designed and culturally tailored for underserved communities through an empowerment stigma-reduction cognitive-behavioral intervention and tested with sexual and gender minority (SGM) adults and care partners.
METHODS: The study is a 2-arm (IDEA and s-RDAD), single-blind, randomized controlled trial (RCT) with a staggered multiple baseline design. With 161 dyads (person living with dementia/care partner), the aim of the study is to compare the two arms via between and within group differences on primary (physical activity) and secondary outcomes (e.g., quality of life, physical functioning, and resource literacy) at post-treatment, and 30 and 56 week follow-up.
RESULTS: When comparing the two arm between-group differences, the IDEA care partners' community resource literacy was significantly higher at 30-week follow-up than for s-RDAD (contrast = 0.10, p = 0.005). While both intervention arms demonstrated efficacy with significant improvement in physical activity (contrastIDEA = 0.10, p = 0.010; contrasts-RDAD = 0.14, p < 0.001) and quality of life (contrastIDEA = 0.06, p < 0.001; contrasts-RDAD = 0.03, p = 0.035) for the person with dementia at post-treatment, positive treatment effects on physical activity (contrastIDEA = 0.09, p = 0.032) and quality of life (contrastIDEA = 0.03, p = 0.040) persisted at 30 weeks for IDEA but not for s-RDAD.
CONCLUSION: While both intervention arms were efficacious, IDEA demonstrated sustained efficacy. The cultural tailoring of interventions is promising to address disparities in dementia care and interventions in underserved communities. Future research is needed for the translation of this efficacious intervention to the larger community.
CLINICALTRIALS: gov identifier: NCT03550131.}, }
@article {pmid41385058, year = {2025}, author = {Jiang, H and Escamilla, S and Beestrum, M and Salas-Lucia, F}, title = {Cost-effectiveness of testing biofluid biomarkers to diagnose Alzheimer's disease: a systematic review.}, journal = {The European journal of health economics : HEPAC : health economics in prevention and care}, volume = {}, number = {}, pages = {}, pmid = {41385058}, issn = {1618-7601}, abstract = {BACKGROUND: Alzheimer's disease (AD) affects tens of millions of individuals and their families in the world. As AD progresses, the effectiveness of treatment declines, making a timely diagnosis crucial. One promising approach for timely diagnosis is testing biofluid biomarkers in patients' blood and cerebrospinal fluid (CSF). However, a comprehensive evaluation of whether these tests are cost-effective is missing. Here, we conducted a systematic review to assess the cost-effectiveness of testing biofluid biomarkers to diagnose AD.
METHOD: We searched PubMed, Embase, Cochrane Library, and Web of Science for studies published until October 2024. Studies were included if published in English, conducted an economic evaluation of CSF or blood biomarker testing to diagnose AD, and provided economic outcomes. We assessed the quality of studies using the CHEERS 2022 criteria.
RESULTS: Nine studies were included: six evaluated CSF biomarker tests and three on blood biomarker tests. All studies used model-based simulations (decision trees or Markov models) rather than trial-based evaluations. CSF biomarker tests were mostly cost-effective compared to neurocognitive assessments or neuroimaging, while blood biomarker tests showed mixed results. Key cost-effectiveness contributors included AD prevalence, diagnostic accuracy, and treatment effectiveness. Studies met ~ 80% of the CHEERS criteria, with missing information on patient engagement.
CONCLUSION: Our review supports that biofluid biomarker testing could be cost-effective to diagnose AD. Given the lack of trial-based economic evaluations, model-based studies are a valuable starting point. Future evaluations should incorporate patient-centered outcomes and consider the emotional value and other socio-economic factors that affect patients and families suffering from AD.}, }
@article {pmid41384832, year = {2025}, author = {Villarejo Galende, A and González-Sánchez, M and Hilario, A and Llamas-Velasco, S and Morenas-Rodríguez, E and Muñoz-García, MI and Ramos-González, A and Pérez-Martínez, DA and Blanco-Palmero, VA}, title = {Severe symptomatic amyloid-related imaging abnormalities in Alzheimer's disease: Two case reports and systematic review of reported cases.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251404505}, doi = {10.1177/13872877251404505}, pmid = {41384832}, issn = {1875-8908}, abstract = {BackgroundAmyloid-related imaging abnormalities (ARIA) are a recognized complication of anti-amyloid monoclonal antibodies for Alzheimer's disease (AD). While typically asymptomatic, a subset of patients develops severe clinical symptoms and radiological findings requiring intensive management. Data on their presentation, treatment, and outcomes remain limited.ObjectiveWe report two cases and analyze the clinical features of all published cases of severe symptomatic ARIA, with a focus on associated risk factors, therapeutic approaches, and patient outcomes.MethodsWe report two cases of severe symptomatic ARIA in patients treated with gantenerumab. A systematic review was conducted following PRISMA guidelines using MEDLINE, Web of Science, and manual reference screening. We included case reports and series providing individual-level data on symptomatic ARIA episodes classified as severe by clinical criteria. Demographic, genetic, clinical, radiological, therapeutic, and outcome data were extracted.ResultsThirty-six cases were included (2 new and 34 from 21 publications). Fifteen cases were associated with lecanemab, 10 with gantenerumab, 6 with donanemab, and 5 with other antibodies. APOE ε4 was present in 62.5%, including 10 ε4/ε4 homozygotes. Baseline MRI showed hemorrhagic markers in 10 cases, including superficial siderosis in 2 of the 5 patients with isolated macrohemorrhages. Most episodes occurred within 6 months of treatment. Symptoms included altered consciousness (75%), focal deficits (66.7%), seizures (38.9%), and headache (36.1%). ARIA-E resolved in all non-fatal cases. Corticosteroids were used in 72%. Among the patients whose outcome data were available, 15 patients recovered completely, 10 had persistent deficits, and 10 died.ConclusionsSevere symptomatic ARIA is a rare but serious adverse effect of anti-amyloid therapy. Standardized diagnostic and therapeutic guidelines are needed to minimize ARIA-related morbidity and mortality.PROSPERO registration no. CRD420251055067.}, }
@article {pmid41383948, year = {2025}, author = {Mu, L and Wang, Y}, title = {The role of gut microbiota-derived metabolites in neuroinflammation.}, journal = {Neuroprotection (Chichester, England)}, volume = {3}, number = {2}, pages = {131-144}, pmid = {41383948}, issn = {2770-730X}, abstract = {Neuroinflammation, a key defense mechanism of the nervous system, is associated with changes in inflammatory markers and stimulation of neuroimmune cells such as microglia and astrocytes. Growing evidence indicates that the gut microbiota and its metabolites directly or indirectly regulate host health. According to recent studies, bacterial dysbiosis in the gut is closely linked to several central nervous system disorders that cause neuroinflammation, including multiple sclerosis, Alzheimer's disease, Parkinson's disease, sepsis-associated encephalopathy, and ischemic stroke. Recent findings indicate a bidirectional communication network between the gut microbiota and central nervous system that influences neuroinflammation and cognitive function. Dysregulation of this system can affect the generation of cytotoxic metabolites, promote neuroinflammation, and impair cognition. This review explores the lesser-studied microbiota-derived metabolites involved in neuroinflammation-bile acids, trimethylamine-N-oxide, and indole derivatives-as targets for creating new treatment tools for neuroinflammatory illnesses, as well as possible biomarkers for early diagnosis and prognosis.}, }
@article {pmid41383947, year = {2025}, author = {Schwartz, SS and Rhea, EM and Banks, WA and Herman, ME}, title = {Beta cells to brain cells: The pivotal role of insulin and glucose metabolism in Alzheimer's disease.}, journal = {Neuroprotection (Chichester, England)}, volume = {3}, number = {2}, pages = {145-164}, pmid = {41383947}, issn = {2770-730X}, abstract = {The risk factors and neuropathologies of cognitive decline and the onset and progression of dementia-related disorders were, until recently, obtuse. A critical predisposing factor to Alzheimer's disease (AD) that has emerged is glucose dysmetabolism. It is now understood that energy imbalances or excess nutrient intake sit in the crosshairs of neurodegeneration. Within the brain, the regulation of glucose operates semiautonomously from the periphery to ensure a defended, uninterrupted supply of glucose for neuronal processes. In this localized brain energetic milieu, hyperglycemia, hyperinsulinemia, and insulin resistance constitute independent risk factors for AD. Disturbances in the blood‒brain barrier (BBB) and brain insulin resistance are two newly understood insults connecting glucose metabolism with AD. This dysglycemia waylays insulin signaling, an otherwise potentially protective mechanism against AD plaques. In parallel, studies in the clinical setting demonstrate that glucose-lowering in patients with type 2 diabetes (T2D) reduces the risk of AD. The American Diabetes Association (ADA) elevated its guidelines to include cognitive issues (or risk) as a comorbidity in T2D patient treatment plans. Choice of antidiabetes therapy is imperative: evidence supports the use of metformin, dipeptidyl peptidase 4 inhibitors, glucagon-like peptide-1 receptor analogs, and sodium glucose cotransporter 2 inhibitors to help prevent and mitigate cognitive outcomes and AD. Sulfonylureas, on the other hand, may actually worsen cognitive deficits and integrity. We are at a fascinating juncture: preclinical research is at a stage to inform the development of rational previously unexplored targets. Simultaneously, current clinical evidence is translatable now into real-world strategies to reduce the incidence and severity of comorbid AD in our aging population.}, }
@article {pmid41383815, year = {2025}, author = {Zhang, R and Liu, YY and Xia, X and Li, X}, title = {Unvalidated efficacy and significant risks hinder clinical use of deep cervical lymphatic-venous anastomosis for Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1671741}, pmid = {41383815}, issn = {1663-4365}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cognitive decline and the pathological accumulation of amyloid-beta (Aβ) plaques and tau tangles. Recent studies suggest that dysfunction of the cerebral lymphatic clearance system may contribute to the progression of AD. This review critically examines the potential of deep cervical lymphatic-venous anastomosis (LVA) as a treatment for enhancing brain protein clearance and reducing cognitive decline in AD patients. Although animal models indicate that improving lymphatic drainage could facilitate Aβ clearance, clinical evidence is still insufficient. Current studies often have small sample sizes, short follow-up periods, and methodological weaknesses. Despite preliminary reports of cognitive improvements in small-scale clinical trials, the efficacy of LVA remains unproven, making widespread clinical adoption premature. Ethical concerns and technical challenges also pose significant barriers to clinical implementation. Rigorous randomized controlled trials (RCTs) are necessary to assess the long-term safety and efficacy of LVA for treating AD. Furthermore, the establishment of clear ethical and regulatory frameworks is essential before clinical use.}, }
@article {pmid41383524, year = {2025}, author = {Zhang, X and Zhong, M and Li, Y and Wang, H and Xi, G and Wang, F and Cheng, C and Shi, Y}, title = {Oral microbiota and central nervous system diseases: A review.}, journal = {Neuroprotection (Chichester, England)}, volume = {3}, number = {1}, pages = {79-94}, pmid = {41383524}, issn = {2770-730X}, abstract = {Oral microbiota is the second largest microbial colony in the body and forms a complex ecological community that influences oral and brain health. Impaired homeostasis of the oral microbiota can lead to pathological changes, resulting in central nervous system (CNS) diseases. However, the mechanisms and clinical value of how the oral microbiome influences the brain remain unclear. This review summarizes recent clinical findings on the role of the oral microbiota in CNS diseases and proposes potential approaches to understand the way the oral microbiota and brain communicate. We propose three underlying patterns involving neuroinflammation, neuroendocrine regulation, and CNS signaling between oral microbiota and CNS diseases. We also summarize the clinical characteristics and potential utilization of the oral microbiota in ischemic stroke, Alzheimer's and Parkinson's disease, intracranial aneurysms, and mental disorders. Although the current findings are preliminary and clinical evidence is incomplete, oral microbiota is a potential biomarker for the clinical diagnosis and treatment of CNS diseases.}, }
@article {pmid41383520, year = {2025}, author = {Saxena, SK and Sharma, D and Kumar, S and Maurya, VK and Ansari, S and Malhotra, HS and Singh, A}, title = {Decoding the role of large heat shock proteins in the progression of neuroinflammation-mediated neurodegenerative disorders.}, journal = {Neuroprotection (Chichester, England)}, volume = {3}, number = {1}, pages = {48-62}, pmid = {41383520}, issn = {2770-730X}, abstract = {Chronic neuroinflammation and protein aggregation are the fundamental events mainly responsible for the progression of neurodegenerative diseases (NDs). Potential neurotoxic changes in the intra- and extracellular environment are typical hallmarks of many NDs. Treatment of ND is challenging, as the symptoms in these patients arises when a significant numbers of neurons have already been destroyed. Heat shock proteins (HSPs) can bind to recipient cells that are susceptible to stress, such as neurons, in the extracellular environment, therefore enhancing stress resistance. Among all, HSP60, HSP70, and HSP90 are highly conserved molecular chaperones involved in protein folding and assembly, maintaining cellular homeostasis in the central nervous system. Notably, α-synuclein accumulation is a major pathophysiology in Parkinson's disease, where HSP90 modulates the assembly of α-synuclein in vesicles to prevent its accumulation. Moreover, HSP90 regulates the activity of the glycogen synthase kinase-3β protein, which is crucial in diabetes mellitus-associated neurocognitive disorder. Therefore, understanding the molecular mechanism by which HSPs facilitate protein aggregation and respond to inflammatory stimuli, including metabolic disease such as diabetes, is essential for understanding the significance of HSPs in NDs. This review emphasizes the role of various HSPs in the progression of NDs such as Alzheimer's, Parkinson's, multiple sclerosis, and Huntington's disease, including diabetes, which is one of the major risk factors for neurodegeneration.}, }
@article {pmid41383377, year = {2024}, author = {Hanumanthappa, R and Parthasarathy, A and Heggannavar, GB and Pc, K and Nanjaiah, H and Kumbhar, R and Devaraju, KS}, title = {Recent advances in therapeutic strategies for Alzheimer's and Parkinson's disease using protein/peptide co-modified polymer nanoparticles.}, journal = {Neuroprotection (Chichester, England)}, volume = {2}, number = {4}, pages = {255-275}, pmid = {41383377}, issn = {2770-730X}, abstract = {The blood-brain barrier (BBB), which protects the brain from foreign molecules, makes delivery of drugs to the central nervous system is challenging. Nanoparticles (NPs) have been used over the past decade as drug delivery systems for the treatment of many disorders with great results. However, the effectiveness of NPs in delivering drugs to the brain for the treatment of Alzheimer's disease (AD) and Parkinson's disease (PD) is limited by the BBB. A recent breakthrough in nanotechnology delivery systems involves the use of surface-modified polymer NPs that enhance drug absorption and transport across the BBB; however, the technology still has some limitations. Studies conducted over the past few years have demonstrated that NPs modified with peptides or proteins can effectively cross the BBB via specific receptors, thus enhancing their delivery efficiency. In this review, we explore the use of polymer NPs combined with peptides and proteins for the treatment of AD and PD. This discussion focuses on the pathophysiology of these diseases, the BBB, and the potential of therapeutics based on co-modifying NPs with peptides and proteins. Additionally, we outline future directions for the use of polymer NPs conjugated with these biomolecules.}, }
@article {pmid41382294, year = {2025}, author = {Su, X and Takayanagi, R and Maeda, H and Saido, TC and Ohshima, T}, title = {Sex-related upregulation of bone morphogenetic protein signaling inhibits adult neurogenesis in APP[NL-G-F] alzheimer's disease model mice.}, journal = {Biology of sex differences}, volume = {16}, number = {1}, pages = {103}, pmid = {41382294}, issn = {2042-6410}, support = {JP22K06464//Japan Society for the Promotion of Science/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/physiopathology ; *Neurogenesis/physiology ; Female ; Male ; Up-Regulation ; Mice, Transgenic ; Disease Models, Animal ; Signal Transduction ; Mice, Inbred C57BL ; *Bone Morphogenetic Proteins/metabolism ; *Sex Characteristics ; Hippocampus/metabolism ; Mice ; Neural Stem Cells ; Estrogens/pharmacology ; }, abstract = {BACKGROUND: Bone morphogenetic proteins (BMPs) have been reported in many studies to be related to adult neurogenesis. Neurogenic impairment is a hallmark of Alzheimer's disease (AD), while the involvement of BMPs remains unclear.
METHODS: AD models were established using APP[NL-G-F] transgenic mice and C57BL/6 mice subjected to intracerebral injection of Aβ(25-35) peptide. Female APP[NL-G-F] mice received pharmacological inhibitor treatment, whereas Neuro2a cells were exposed to estrogen stimulation in vitro. Immunofluorescence staining was conducted to evaluate hippocampal neural stem cell proliferation. The hippocampus and cellular pellets were isolated, and quantitative PCR (qPCR) was employed to determine mRNA expression levels.
RESULTS: Our study revealed that APP[NL-G-F] mice and Aβ-injected mice exhibited impaired neurogenesis in the brain, with a clear sex-dependent difference only in APP mice. Several BMPs were markedly upregulated in the hippocampus of AD model mice, with significantly higher expression in females than in males. BMP inhibitor attenuated neural stem cell proliferation deficits in female APP[NL-G-F] mice. Estrogen stimulation robustly enhanced BMP6 expression in Neuro2a cells.
CONCLUSIONS: Our findings reveal a sex-dependent impairment of neurogenesis in APP[NL-G-F] mice driven by BMP signaling. Blocking BMP signaling enhances adult neural stem cell proliferation in female APP[NL-G-F] mice, providing a potential therapeutic target for AD.}, }
@article {pmid41382170, year = {2025}, author = {Jannati, A and Thompson, K and Toro-Serey, C and Gomes-Osman, J and Banks, RE and Higgins, C and Showalter, J and Bates, D and Tobyne, S and Pascual-Leone, A}, title = {Concurrent detection of cognitive impairment and amyloid positivity with a multimodal machine learning-enabled digital cognitive assessment.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {261}, pmid = {41382170}, issn = {1758-9193}, mesh = {Humans ; *Machine Learning ; *Cognitive Dysfunction/diagnosis/metabolism ; *Amyloid beta-Peptides/metabolism ; Male ; Female ; Aged ; Neuropsychological Tests ; *Alzheimer Disease/diagnosis ; Biomarkers/blood ; Aged, 80 and over ; tau Proteins/metabolism ; Brain/metabolism/diagnostic imaging ; Middle Aged ; }, abstract = {BACKGROUND: Early identification of cognitive impairment and brain pathology associated with Alzheimer's disease (AD) is essential to maximize benefits from lifestyle interventions and emerging pharmacologic disease-modifying treatments (DMT). Digital cognitive assessments (DCAs) can quickly capture an array of metrics that can be used to train machine-learning (ML) models to concurrently evaluate different outcomes. DCAs have the potential to optimize clinical workflows and enable efficient assessment of cognitive function and the likelihood of a given underlying pathology.
METHODS: We assessed the ability of a multimodal ML-enabled DCA, the Digital Clock and Recall (DCR), to concurrently estimate brain amyloid-beta (Aβ) status and detect cognitive impairment, as compared with traditional cognitive assessments, including the MMSE, RAVLT, a DCA, Cognivue[®], and blood-based biomarkers in 930 participants from the Bio-Hermes-001 clinical study.
RESULTS: Aβ42/40, p-tau181, APS, and p-tau217 poorly classified cognitive impairment (AUCs: 0.61; 0.63; 0.63; 0.70, respectively), but accurately classified Aβ status (AUCs: 0.81; 0.78; 0.85, 0.89, respectively). MMSE, RAVLT, and Cognivue poorly classified Aβ status (AUCs: 0.70, 0.73, 0.70, respectively). However, separate multimodal, DCR-based ML classification models, run in parallel, accurately classified both cognitive impairment (AUC = 0.83) and Aβ-PET status (AUC = 0.81).
CONCLUSIONS: DCAs that leverage digital technologies to generate advanced metrics, such as the DCR, enable accurate and efficient detection of cognitive impairment associated with AD pathology. They have the potential to empower health systems and primary care providers to help their patients make timely treatment decisions.}, }
@article {pmid41381656, year = {2025}, author = {Riley, S and Nguyen, V and Bhattacharjee, R and Ng, PQ and Ritchie, T and Kamath, KS and Fisk, I and Gecz, J and Kumar, R and Searle, IR}, title = {TMT-based quantitative proteomic assessment of Vicia sativa induced neurotoxicity by β-cyano-L-alanine and γ-glutamyl-β-cyano-L-alanine in SH-SY5Y cells.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {510}, pmid = {41381656}, issn = {2045-2322}, support = {LP200200957//Australian Research Council/ ; UA720//South Australian Grains and Industry Trust/ ; BB/V018108/1/BB_/Biotechnology and Biological Sciences Research Council/United Kingdom ; }, mesh = {Humans ; *Proteomics/methods ; Cell Line, Tumor ; Tandem Mass Spectrometry ; *Proteome ; *Dipeptides/toxicity ; Apoptosis/drug effects ; Oxidative Stress/drug effects ; *Alanine/analogs & derivatives/toxicity ; }, abstract = {β-cyano-L-alanine (BCA) and γ-glutamyl-β-cyano-L-alanine (GBCA) are the primary antinutritional compounds in Vicia sativa, a high-protein, drought-tolerant legume. While their neurotoxicity in monogastric animals has been reported, the molecular basis remains largely unknown. In this study, we optimised a rapid in vitro assay using retinoic acid-differentiated SH-SY5Y human neuroblastoma cells to assess BCA and GBCA toxicity, and then applied Tandem mass tags (TMT)-mass spectrometry (MS)-based quantitative proteomics to identify dysregulated proteins. BCA treatment dysregulated the proteins involved in DNA damage, translation, and oxidative stress, many of which are associated with neurodegenerative diseases such as amyotrophic lateral sclerosis and Alzheimer's disease, as well as various cancers. In contrast, GBCA impacted the proteins linked to mitosis, cell cycle regulation, and apoptosis pathways. Interestingly, the absence of overlapping dysregulated proteins between BCA- and GBCA-treated cells suggested that the two toxins likely induce neurotoxicity via distinct mechanisms. These findings offer new insights into the molecular and cellular alterations caused by V. sativa toxins and their implications for animal feed safety.}, }
@article {pmid41381439, year = {2025}, author = {Ang, S and Zhang, X and Hong, J and Xue, K and Li, J and Du, X and Gao, Y and Wang, X and Li, X and Chen, B and Li, Y and Zhang, J and Liu, S}, title = {The safety and efficacy of gamma frequency auditory and visual stimulation in the treatment of alzheimer's disease: a systematic review and meta-analysis.}, journal = {Translational psychiatry}, volume = {15}, number = {1}, pages = {523}, pmid = {41381439}, issn = {2158-3188}, support = {82271546//National Natural Science Foundation of China (National Science Foundation of China)/ ; 2025-ZZ-004//National Clinical Key Specialty Construction Program - Independent Research Project/ ; }, mesh = {Humans ; *Alzheimer Disease/therapy ; *Cognitive Dysfunction/therapy ; *Acoustic Stimulation/methods/adverse effects ; *Photic Stimulation/methods/adverse effects ; *Gamma Rhythm ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder associated with cognitive decline and significant global health burden. Current treatments offer limited benefits, highlighting the need for novel therapies. Gamma-frequency auditory and visual stimulation (GFAVS), utilizing 40 Hz neuromodulation, has gained attention as a non-invasive treatment for cognitive deficits and underlying pathophysiology in AD.
OBJECTIVE: This systematic review and meta-analysis aimed to assess the safety and efficacy of GFAVS in treating Alzheimer's disease (AD) and mild cognitive impairment (MCI).
METHODS: A comprehensive literature search across multiple databases (PubMed, Cochrane Library, MEDLINE, Web of Science, and Embase) was performed up to November 2025. Controlled trials involving adults (≥50 years) with AD or MCI, using GFAVS, were included. Meta-analyses assessed adverse events, cognitive function, and brain changes.
RESULTS: Eleven studies (341 participants) were included. GFAVS was safe, with no significant increase in overall adverse events (RR = 0.99, P = 0.93; RD = -0.01, P = 0.93). However, GFAVS significantly increased the risk of tinnitus (RR = 6.46, P = 0.08; RD = 0.16, P = 0.01). GFAVS significantly improved structural brain changes (SMD = 1.74, P = 0.02), especially in mixed AD and MCI populations (SMD = 3.05, P < 0.00001). Nevertheless, no significant improvements were observed in cognitive function (SMD = 0.16, 95% CI [-0.36 to 0.68], P = 0.55) or activities of daily living (SMD = 0.53, 95% CI [-1.26 to 2.33], P = 0.56), despite the observed structural brain changes. High heterogeneity was observed.
CONCLUSION: GFAVS appears to be well tolerated and may induce structural brain alterations in individuals with Alzheimer's disease or mild cognitive impairment; however, its impact on cognition or daily functioning remains to be established. Large-scale, rigorously designed trials are required to clarify optimal protocols and address the observed heterogeneity.}, }
@article {pmid41379906, year = {2025}, author = {Zhang, L and Li, L and Cao, P and Yang, J and Zaiane, OR and Wang, F}, title = {An Efficient Transfer Learning With Prompt Learning for Brain Disorders Diagnosis.}, journal = {IEEE journal of biomedical and health informatics}, volume = {PP}, number = {}, pages = {}, doi = {10.1109/JBHI.2025.3625375}, pmid = {41379906}, issn = {2168-2208}, abstract = {The limited availability of training data significantly restricts the performance of deep supervised models for brain disease diagnosis. It is crucial to develop a learning framework through cross-disease transfer learning that can extract more information from the limited data. To address this challenge, we concentrate on prompt learning and endeavor to extend its application to the brain networks. Specifically, we propose a novel prompt learning framework called BPformer, which integrates knowledge transferred across diseases via specific prompts while keeping the original architecture of BPformer unchanged. The specific prompts incorporate 1) a mask prompt to determine whether the edges are noisy or discriminating, 2) disorder prompts for modeling consistent and disorder-specific knowledge, and 3) adaptive instance-level prompts to account for inter-individual variations. We evaluate BPformer on the private center Nanjing Medical University dataset, the public Autism Brain Imaging Data Exchange dataset, and the public Alzheimer's Disease Neuroimaging Initiative dataset. We demonstrate the effectiveness of the proposed model across various disease classification tasks, including major depressive disorder, bipolar disorder, alzheimer's disease, and autism spectrum disorder diagnoses. In addition, the proposed method enables disease interpretability and subtype analysis, empowering physicians to provide patients with more accurate and fine-grained treatment plans.}, }
@article {pmid41379352, year = {2025}, author = {Mohanty, R and Wheatley, S and Chiotis, K and Marseglia, A and Westman, E and , }, title = {Distinct cerebrovascular pathways underlying Alzheimer's disease-related neurodegeneration.}, journal = {Acta neuropathologica}, volume = {150}, number = {1}, pages = {64}, pmid = {41379352}, issn = {1432-0533}, support = {U01 AG024904/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Alzheimer Disease/pathology/diagnostic imaging/complications ; Female ; Male ; Aged, 80 and over ; Aged ; *Brain/pathology/diagnostic imaging ; *Cerebrovascular Disorders/pathology/diagnostic imaging ; White Matter/pathology ; Cerebrovascular Circulation/physiology ; Neuroimaging ; Cerebral Amyloid Angiopathy/pathology ; Arteriolosclerosis/pathology ; }, abstract = {The etiology of cerebrovascular pathology is heterogeneous. Independent or synergistic role of this pathology relative to Alzheimer's disease (AD) pathology is necessary to clarify distinct neurodegenerative pathways. We evaluated the interplay of various cerebrovascular markers postmortem and their in vivo neuroimaging, clinical and neuropathologic correlates using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). In 109 individuals, postmortem cerebrovascular pathology (atherosclerosis of the circle of Willis, cerebral amyloid angiopathy [CAA], arteriolosclerosis, white matter rarefaction, old infarcts, microinfarcts, hemorrhages, other ischemic/vascular changes) was characterized. Additionally, we assessed in vivo neuroimaging (cortical thickness, subcortical volume, white matter lesion burden, glucose standardized uptake value ratio, fractional anisotropy of white matter tracts, cerebral blood flow), cognitive, and neuropathologic measures (atrophy, AD pathology and copathologies including Lewy body, TDP-43, hippocampal sclerosis). The study sample had mean (standard deviation) age of 82.9 (7.2) years and included 29 women (27%) and 84 (77%) with intermediate/high AD neuropathologic change. Arteriolosclerosis and CAA emerged as dominant cerebrovascular markers using multiple correspondence analysis. More severe arteriolosclerosis was explained by higher white matter lesion burden and greater postmortem hippocampal atrophy (β = 143.2, 95% CI 63.9 to 230.1, p = 0.0003), but not AD pathology. More severe CAA was explained by fractional anisotropy (β = - 20, 95% CI - 41.5 to -3.1, p = 0.02) adjusted for AD pathology and reduced integrity of superior cerebellar peduncle, posterior thalamic radiation, and sagittal stratum tracts (rho < - 0.6, false discovery rate corrected p < 0.05). More severe CAA was also explained by cortical atrophy and AD pathology (β = 0.6, 95% CI 0.2 to 1.2, p = 0.007), and associated with poorer memory (β = - 0.2, 95% CI - 0.3 to -0.09, p = 0.0009). Results demonstrate two dominant cerebrovascular pathways. An arteriolosclerosis-driven pathway is unspecific to AD pathology, whereas a CAA-driven pathway is specific to AD pathology. Cerebrovascular pathology is associated with AD pathology in an etiology-dependent manner which may influence eligibility for treatment or treatment-emergent adverse events in disease-modifying therapies for AD.}, }
@article {pmid41379219, year = {2025}, author = {Taylor, LW and Simzer, EM and Young, LFP and Holt, K and Spires-Jones, TL and Durrant, CS}, title = {Confirmation of p-tau Ser356's association with Alzheimer's disease pathology and lowering in response to WZ4003 treatment in brain slice cultures. Reply to: "Phospho-tau Ser356 is mostly confined to pre-NFT neurons in Alzheimer's pathology".}, journal = {Acta neuropathologica}, volume = {150}, number = {1}, pages = {63}, pmid = {41379219}, issn = {1432-0533}, support = {UKDRI-Edin005//UK Dementia Research Institute/ ; RADF-2019a-001//Race Against Dementia/ ; AS-PG-21-006/ALZS_/Alzheimer's Society/United Kingdom ; }, }
@article {pmid41378779, year = {2025}, author = {Begines, P and Fernández-Bolaños, JG and López, Ó}, title = {An updated patent review of acetylcholinesterase inhibitors for the treatment of Alzheimer's disease (2021-present).}, journal = {Expert opinion on therapeutic patents}, volume = {}, number = {}, pages = {1-32}, doi = {10.1080/13543776.2025.2602702}, pmid = {41378779}, issn = {1744-7674}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder with a complex and not fully elucidated etiology. An exponential rise in its incidence underscores the urgent need for effective therapeutic strategies. AD imposes a significant economic burden on public healthcare systems and on patient's families.
AREAS COVERED: This manuscript focuses on the review of potent acetylcholinesterase (AChE) inhibitors, either through chemical synthesis or isolation from natural sources, aimed at restoring acetylcholine levels. Most of the compounds discussed act as multitarget agents and are categorized into four groups: drug derivatives (9 patents), heterocyclic scaffolds (16 patents), natural products from plant extracts (12 patents), and synthetic compounds inspired by natural templates (18 patents).
EXPERT OPINION: AChE inhibition remains a compelling target in AD drug design, as it enhances acetylcholine levels and can alleviate cognitive decline. Furthermore, inhibitors that interact with the peripheral anionic site (PAS) of AChE may reduce β-amyloid self-aggregation, thereby preventing the deposition of neurotoxic peptides in the brain. However, targeting AChE alone is insufficient for the development of effective therapeutics. A multitarget approach, combining AChE inhibition with pharmacophores addressing β-amyloid aggregation, neuroinflammation, oxidative stress, and other pathological hallmarks, holds greater promise for the development of more efficient anti-Alzheimer's agents.}, }
@article {pmid41378217, year = {2025}, author = {Li, W and Huang, W and Zhou, P and Yao, Y and Cai, B and Ye, S}, title = {Sporoderm-removed ganoderma lucidum spore powder (S-GLSP) alleviates neuroinflammation injury by regulating microglial polarization through inhibition of NLRP3 inflammasome activation.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1690192}, pmid = {41378217}, issn = {1663-9812}, abstract = {INTRODUCTION: Sporoderm-Removed Ganoderma lucidum Spore Powder (S-GLSP), derived from the spores of the medically valued fungus Ganoderma lucidum, exhibits diverse pharmacological activities and shows considerable potential in the treatment of Alzheimer's disease (AD). However, its underlying mechanisms of action remain incompletely elucidated. This study aims to investigate the protective effects of S-GLSP against AD and to explore the molecular mechanisms involved.
MATERIALS AND METHODS: The chemical profile of S-GLSP extract was characterized using LC-MS/MS. Alzheimer's disease models were established both in vivo and in vitro: a rat model was induced by D-galactose combined with intracerebroventricular injection of Aβ, while a cellular model was stimulated with LPS. The neuroprotective effects of S-GLSP were assessed through behavioral tests and hematoxylin-eosin (HE) staining. Immunofluorescence staining, Western blot (WB), RT-qPCR, and ELISA were employed to evaluate microglial polarization and NLRP3 inflammasome activation. Cell viability was measured using MTT and EdU assays. Finally, NLRP3 knockdown was performed to verify whether S-GLSP modulates microglial polarization via regulation of the NLRP3 inflammasome.
RESULTS: A total of 42 chemical compounds were identified in S-GLSP, including flavonoids, alkaloids, terpenoids, saccharides, phenolics, fatty acids, nucleosides, amino acids, and other. S-GLSP treatment alleviated neuronal damage, improved learning and memory deficits, and reduced the expression of phosphorylated tau (p-tau) in AD model rats. Further experiments in vitro and in vivo showed that S-GLSP downregulated M1 phenotypic markers (CD86, iNOS, TNF-α) and upregulated M2 markers (CD206, Arg-1, IL-10). Moreover, S-GLSP inhibited NLRP3 inflammasome activation and regulated the secretion of IL-1β and IL-18, effects that were consistent with those observed following NLRP3 knockdown.
CONCLUSION: Our findings demonstrate that S-GLSP alleviates Alzheimer's disease pathology by inhibiting NLRP3 inflammasome activation, promoting a shift in microglial polarization from the M1 to the M2 phenotype, and modulating the release of inflammatory cytokines. This study provides novel mechanistic insights into the therapeutic potential of S-GLSP for AD.}, }
@article {pmid41377997, year = {2025}, author = {Monteiro, R and Dunn, JT and Rodriguez, G and Fisher, DW and Dong, H}, title = {Targeting central immune signaling enhances the effects of methylphenidate in alleviating apathy-like behavior in 5xFAD mice.}, journal = {Research square}, volume = {}, number = {}, pages = {}, pmid = {41377997}, issn = {2693-5015}, support = {R01 AG062249/AG/NIA NIH HHS/United States ; R01 AG079989/AG/NIA NIH HHS/United States ; }, abstract = {Alzheimer's disease (AD) is frequently accompanied by neuropsychiatric symptoms (NPS), among which apathy, one of the most prevalent and burdensome, accelerates cognitive decline and disease progression, yet its molecular underpinnings remain unclear. Our previous RNA-sequencing of AD subjects revealed abnormal immune gene expression uniquely associated with apathy. In this study, we investigated whether these changes are also linked to apathy-like behavior in 5xFAD mice, and whether administration of C3a receptor antagonist SB290157, alone or with methylphenidate, modifies these behaviors. We first validated the expression of apathy-related immune hub genes identified in human AD in the prefrontal cortex (PFC) of 16-month-old 5xFAD mice using RT-qPCR. Separate cohorts of similarly aged 5xFAD and WT mice then received SB290157 and/or methylphenidate for two weeks. Results indicate that increased immune-related genes, including Tyrobp, C3, C3ar, C1qa, C1qb, and C1qc expression, were strongly correlated with apathy-like behavior in 5xFAD mice. Combined SB290157 and methylphenidate treatment significantly improved nest-building behavior, reduced C3 and C3ar protein expression, as well as restored dendritic spine density in the PFC. Our results confirm complement-mediated immune dysregulation is linked to apathy and suggest that co-targeting complement and catecholaminergic pathways may offer a novel therapeutic strategy for alleviating apathy in AD.}, }
@article {pmid41377219, year = {2025}, author = {Pandey, P and Rajput, S and Gaur, T and Khandia, R and Gurjar, P}, title = {Animal models in human surgery and implant innovation: ethical considerations and scientific advancements.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {12}, pages = {8291-8303}, pmid = {41377219}, issn = {2049-0801}, abstract = {The main aim of biological research is to bridge the gap between preclinical findings and clinical applications so that human health can be improved. Animal models are beneficial in replicating disease mechanisms, facilitating diagnosis, and assessing treatment efficacy for any disease. They play a vital role in drug discovery, toxicological assessments, dosage determination, and the evaluation of side effects, all while adhering to the ethical guidelines. These models are effectively used to treat a wide range of human diseases, including autoimmune disorders, rheumatoid arthritis, epilepsy, Alzheimer's disease, cardiovascular conditions, atherosclerosis, severe acute respiratory syndrome/Coronavirus disease 2019 (SARS/COVID-19), and diabetes. In disease modeling, they significantly contribute to drug development, medical device testing, tissue engineering, wound healing, and bone and cartilage regeneration. One cannot deny the fact that there are major significances of small and large animal models in scientific studies, apart from various advantages and challenges. Animal Models play an essential role in pharmaceutical research, biomedical research, genome editing, transgenic studies, and surgical applications. These models enable scientists and researchers to perform experiments that would be ethically or practically impossible in humans. In recent years, various animal species have been widely used to study health problems, including the 2019 Coronavirus pandemic, diabetes, and obesity. Mice, pigs, rabbits, rats, murine, primate, porcine, and aquatic models have played a crucial role in understanding the neurological, behavioral, cardiovascular, and oncological disorders while contributing to the development of innovative therapeutic approaches for their treatment. The studies in which pain is inflicted on animals must follow strict ethical standards. Whereas research involving painless animal death is often more accepted because of the fact that animals have limited awareness of their future. This review highlights the use of animal models in indispensable contributions to modern medicine and underscores their relevance in disease research, treatment development, and ethical considerations in experimental studies and their scientific advancements.}, }
@article {pmid41376208, year = {2025}, author = {Li, X and Gao, W and Ye, Q and Li, H}, title = {The Role and Therapeutic Potential of the cGAS-STING Signaling Pathway in Alzheimer's Disease.}, journal = {Brain and behavior}, volume = {15}, number = {12}, pages = {e71130}, pmid = {41376208}, issn = {2162-3279}, support = {LH2023H064// Natural Science Foundation of Heilongjiang Province of China/ ; 82105035//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Alzheimer Disease/metabolism/drug therapy ; *Nucleotidyltransferases/metabolism ; *Signal Transduction/physiology ; *Membrane Proteins/metabolism ; Animals ; Autophagy/physiology ; }, abstract = {PURPOSE: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, posing a significant challenge to global public health. As a core signaling pathway in the mammalian innate immune system, the cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway plays a pivotal role in maintaining intracellular homeostasis. This review aims to systematically elucidate the role and therapeutic potential of the cGAS-STING signaling pathway in AD, focusing on its involvement in key pathological processes and its relevance to AD risk factors.
METHOD: Through literature search, we summarized the molecular mechanisms of the cGAS-STING pathway and its dysregulation in AD, emphasizing the integrated evidence linking cGAS-STING to neuroinflammation, autophagy impairment, and neuronal death, as well as its interactions with aging, obesity, cardiovascular disease, and diabetes.
FINDINGS: The cGAS-STING pathway is critically involved in AD pathogenesis, contributing to neuroinflammation, defective autophagy, and neuronal loss. Its activation is associated with multiple AD risk factors, suggesting a broad influence on disease progression. Pharmacological inhibition of cGAS-STING shows promise in attenuating these pathological features in preclinical models.
CONCLUSION: The cGAS-STING signaling pathway plays a central regulatory role in the central nervous system, and its dysregulation promotes neuroinflammation and is closely associated with AD. This pathway forms a vicious cycle by integrating multiple pathological signals, including mitochondrial dysfunction and endoplasmic reticulum stress. Small-molecule inhibitors and natural products targeting this pathway have demonstrated significant efficacy in preclinical studies, providing a basis for developing disease-modifying therapies for AD. Future efforts should focus on multi-target combination strategies (e.g., STING inhibitors co-administered with Aβ/tau drugs) and dynamically deciphering pathway alterations across AD stages to advance personalized treatment approaches.}, }
@article {pmid41375579, year = {2025}, author = {O'Donnell, AJ and Zhao, X and Parr, A and Aspinall, S and Anderson, TS}, title = {Early Outcomes of Lecanemab for Alzheimer's Disease in the Veterans Health Administration.}, journal = {Journal of clinical medicine}, volume = {14}, number = {23}, pages = {}, pmid = {41375579}, issn = {2077-0383}, support = {N/A//Technology Enhancing Cognition and Health - Geriatric Research Education and Clinical Center (TECH-GRECC), VA Pittsburgh Healthcare System/ ; }, abstract = {Background/Objectives: While lecanemab (Leqembi) and several amyloid targeting therapies were approved for Alzheimer's disease, questions remain on real-world implementation, safety, and effectiveness. The objective of this study was to describe the uptake and early outcomes of Veterans initiating lecanemab. Methods: This retrospective cohort study included Veterans who initiated lecanemab in the Veteran's Health Administration (VHA) between October 2023 and July 2024. Treatment persistence and monitoring, change in Montreal Cognitive Assessment (MoCA) score, incidence of adverse events, including amyloid-related imaging abnormalities (ARIA), and healthcare utilization were analyzed at 7 months. Results: Overall, 32 Veterans (mean [SD] age 75.3 [6.0] years, 100% male, 97% white, 84% urban dwelling) initiated lecanemab. Seventeen patients (53%) had mild cognitive impairment, 15 (47%) had mild dementia; mean baseline MoCA score was 21.3 (SD 3.4). At 7 months following treatment initiation, we assessed process, safety, and effectiveness outcomes. Process outcomes: In all, 25 patients (78%) were persistent with treatment. Safety outcomes: Three patients (9%) experienced a stroke, and 7 (22%) experienced ARIA. Effectiveness outcomes: Only 12 (38%) patients had a MoCA completed by 7 months, and the mean change in MoCA was 0.0 (SD 3.7, p = 1.0). A follow-up amyloid positron emission tomography (PET) scan was completed by 9 (28%) patients, and 5 had reductions in amyloid. Conclusions: Initial observations in a small VHA cohort suggest that uptake of lecanemab was limited, and the finding that nearly 30% of patients experienced ARIA or stroke within 7 months of initiation underscores the importance of monitoring the lecanemab safety and effectiveness long-term. These early findings should be interpreted cautiously given the limited sample size and very limited follow-up MoCA data.}, }
@article {pmid41375185, year = {2025}, author = {Vieira, RC and Nascimento, LA and Nascimento, AA and Alves, NRM and Nascimento, ÉCM and Martins, JBL}, title = {NCIVISION: A Siamese Neural Network for Molecular Similarity Prediction MEP and RDG Images.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {23}, pages = {}, pmid = {41375185}, issn = {1420-3049}, support = {306682/2021-4 and 308419/2025-1//National Council for Scientific and Technological Development/ ; 00193-00000869/2021-31//Foundation for Research Support of the Federal District/ ; }, mesh = {*Neural Networks, Computer ; Static Electricity ; *Drug Discovery/methods ; Humans ; Cholinesterase Inhibitors/chemistry/pharmacology ; Protein Kinase Inhibitors/chemistry/pharmacology ; }, abstract = {Artificial neural networks in drug discovery have shown remarkable potential in various areas, including molecular similarity assessment and virtual screening. This study presents a novel multimodal Siamese neural network architecture. The aim was to join molecular electrostatic potential (MEP) images with the texture features derived from reduced density gradient (RDG) diagrams for enhanced molecular similarity prediction. On one side, the proposed model is combined with a convolutional neural network (CNN) for processing MEP visual information. This data is added to the multilayer perceptron (MLP) that extracts texture features from gray-level co-occurrence matrices (GLCM) computed from RDG diagrams. Both representations converge through a multimodal projector into a shared embedding space, which was trained using triplet loss to learn similarity and dissimilarity patterns. Limitations associated with the use of purely structural descriptors were overcome by incorporating non-covalent interaction information through RDG profiles, which enables the identification of bioisosteric relationships needed for rational drug design. Three datasets were used to evaluate the performance of the developed model: tyrosine kinase inhibitors (TKIs) targeting the mutant T315I BCR-ABL receptor for the treatment of chronic myeloid leukemia, acetylcholinesterase inhibitors (AChEIs) for Alzheimer's disease therapy, and heterodimeric AChEI candidates for cross-validation. The visual and texture features of the Siamese architecture help in the capture of molecular similarities based on electrostatic and non-covalent interaction profiles. Therefore, the developed protocol offers a suitable approach in computational drug discovery, being a promising framework for virtual screening, drug repositioning, and the identification of novel therapeutic candidates.}, }
@article {pmid41375178, year = {2025}, author = {Tsopka, IC and Pontiki, E and Sigala, I and Nikolakaki, E and Prousis, KC and Hadjipavlou-Litina, D}, title = {Design, Synthesis, Biological Evaluation, and In Silico Studies of Novel Multitarget Cinnamic Acid Hybrids.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {23}, pages = {}, pmid = {41375178}, issn = {1420-3049}, mesh = {*Cinnamates/chemistry/pharmacology/chemical synthesis ; Humans ; *Drug Design ; Antioxidants/pharmacology/chemistry/chemical synthesis ; Anti-Inflammatory Agents/pharmacology/chemical synthesis/chemistry ; Lipoxygenase Inhibitors/pharmacology/chemical synthesis/chemistry ; Lipid Peroxidation/drug effects ; Molecular Docking Simulation ; Cyclooxygenase Inhibitors/pharmacology/chemical synthesis/chemistry ; Computer Simulation ; Structure-Activity Relationship ; Nitric Oxide Donors/chemistry/pharmacology/chemical synthesis ; Nitric Oxide ; Lipoxygenase/metabolism ; Molecular Structure ; Cell Line, Tumor ; Cyclooxygenase 2/metabolism/chemistry ; }, abstract = {Chronic inflammation is implicated in the development of various multifactorial diseases, including cancer, diabetes, arthritis, cardiovascular disorders, Alzheimer's disease, and autoimmune diseases. The enzymes that play a key role in the onset of the inflammation are cyclooxygenases (COXs) and lipoxygenases (LOXs). In recent years, cinnamic acid hybrid molecules, particularly those incorporating a nitric oxide (NO) donor moiety, have attracted considerable attention as potential pharmacological agents for the treatment of multifactorial diseases. In the present study, novel cinnamic acid-nitric oxide (NO) donor hybrids were synthesized as multitarget agents and evaluated for their antioxidant, anti-inflammatory, and cytotoxic properties. In particular, hybrids 5a-i, 6a-i, 9a-i, and 11 were synthesized and evaluated as lipid peroxidation and LOX inhibitors, while selected molecules were further tested as COX-1 and COX-2 inhibitors. Hybrids 6a-i, 9a-i, and 11 that contain a NO donor moiety, were additionally tested as albumin denaturation inhibitors and for their ability to release NO. The results indicated that compound 9a is a promising multitarget agent, exhibiting the lowest IC50 for LOX inhibition, significant antioxidant activity, and the highest NO donor potency. Furthermore, compound 9e demonstrated significant inhibitory activity against both COX-2 and LOX, suggesting its potential as a dual COX-LOX inhibitor. Additionally, compound 6i exhibited the strongest cytotoxic activity among the tested compounds, with EC50 values ranging from 36 to 45 μM across multiple cancer cell lines. All synthesized compounds were also evaluated through in silico studies.}, }
@article {pmid41374080, year = {2025}, author = {Kimble, R and Shannon, OM}, title = {Can Beetroot (Beta vulgaris) Support Brain Health? A Perspective Review on Alzheimer's Disease.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, pmid = {41374080}, issn = {2072-6643}, mesh = {Humans ; *Alzheimer Disease/prevention & control ; *Beta vulgaris/chemistry ; *Brain/drug effects ; Antioxidants/pharmacology ; Nitrates/pharmacology ; Oxidative Stress/drug effects ; Neuroprotective Agents/pharmacology ; Animals ; Polyphenols/pharmacology ; Betalains/pharmacology ; }, abstract = {Alzheimer's disease (AD), the leading cause of dementia, has limited treatment options despite extensive pharmacological research. This has increased interest in dietary strategies that act across multiple pathological mechanisms. Beetroot (Beta vulgaris), known for its cardiovascular and metabolic benefits, contains a distinctive combination of bioactive compounds including inorganic nitrate, betalains, and polyphenols. Together these constituents influence vascular function, oxidative stress, mitochondrial efficiency, inflammation, and the microbiota. Previous reviews have typically focused on dietary nitrate in dementia prevention or have examined nitrate and betalains separately. In contrast, this review synthesises evidence on beetroot as a combined neuroprotective food. Preclinical data indicate that beetroot and its key constituents enhance antioxidant defences, support neuronal bioenergetics, and modulate cholinergic and inflammatory pathways. Human studies further suggest that nitrate-rich beetroot can improve cerebral blood flow and vascular responsiveness, and that higher intakes of plant-derived nitrate are associated with reduced cognitive decline. However, findings are inconsistent, most trials are small and short in duration, and research directly involving people with AD is scarce. By integrating vascular, antioxidant, and microbiome perspectives, this review identifies beetroot as a promising yet underexplored dietary candidate for AD management. Further mechanistic studies and multidomain approaches combining metagenomics, biomarkers, neuroimaging, and cognitive outcomes are needed.}, }
@article {pmid41374061, year = {2025}, author = {Calzoni, E and Cusumano, G and Bertoldi, A and Alabed, HBR and Pellegrino, RM and Buratta, S and Urbanelli, L and Zengin, G and Emiliani, C}, title = {Rhubarb-Derived Extracellular Vesicles Mitigate Oxidative Stress and Metabolic Dysfunction in an Alzheimer's Cellular Model.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, pmid = {41374061}, issn = {2072-6643}, support = {CUP J97G22000170005//National Innovation Ecosystem grant ECS00000041/ ; }, mesh = {*Oxidative Stress/drug effects ; *Rheum/chemistry ; *Alzheimer Disease/metabolism ; Humans ; *Extracellular Vesicles/metabolism ; *Antioxidants/pharmacology ; Energy Metabolism/drug effects ; Reactive Oxygen Species/metabolism ; }, abstract = {Background/Objectives: Extracellular vesicles derived from edible plants have emerged as bioactive nanostructures with potential therapeutic and nutraceutical properties and are currently being investigated as natural carriers for the treatment of oxidative stress-induced damage and oxidative stress-related diseases, including neurodegenerative disorders such as Alzheimer's disease (AD). Recent studies suggest that PDEVs exhibit high stability within the gastrointestinal tract and selective tissue-targeting abilities, facilitating the efficient delivery of bioactive molecules. Methods: This study investigates the antioxidant effects of Rheum rhabarbarum-derived EVs by assessing the antioxidant activity through different in vitro assays and their effects on oxidative stress and energy metabolism in the cellular model of Alzheimer's disease. Results: Rhubarb-derived EVs showed measurable antioxidant capacity in chemical assays and were non-toxic under the tested conditions. Treatment reduced intracellular ROS levels and modulated oxidative stress-related proteins, suggesting a potential protective effect against oxidative damage. Moreover, metabolic analysis revealed a decrease in glycolytic activity, indicating a potential restoration of cellular bioenergetic homeostasis. Conclusions: These results provide preliminary evidence supporting the nutraceutical interest of rhubarb-derived EVs in counteracting oxidative stress, while further studies will be needed to confirm their biological relevance and therapeutic potential.}, }
@article {pmid41373689, year = {2025}, author = {Brehar, FM and Costea, D and Tataru, CP and Rădoi, MP and Ciurea, AV and Munteanu, O and Tulin, A}, title = {The Fluidic Connectome in Brain Disease: Integrating Aquaporin-4 Polarity with Multisystem Pathways in Neurodegeneration.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373689}, issn = {1422-0067}, mesh = {*Aquaporin 4/metabolism ; Humans ; Animals ; Blood-Brain Barrier/metabolism ; *Brain Diseases/metabolism/pathology ; *Connectome/methods ; Astrocytes/metabolism ; *Neurodegenerative Diseases/metabolism/pathology ; Glymphatic System/metabolism ; }, abstract = {The way in which Aquaporin-4 (AQP4) is localized on the astrocytes' surface-i.e., with AQP4 channels predominantly located on the endfeet of astrocytes near the blood vessels-represents an important structural element for maintaining brain fluid homeostasis. In addition to this structural function, AQP4 polarity also facilitates glymphatic transport, the maintenance of the blood-brain barrier (BBB) functions, ion buffering, and neurotransmitter removal, and helps regulate neurovascular communications. The growing body of literature suggests that the loss of AQP4 polarity-a loss in the organization of AQP4 channels to the perivascular membrane-is associated with increased vascular, inflammatory, and metabolic disturbances in the context of many neurological diseases. As a result, this review attempts to synthesize both experimental and clinical studies to highlight that AQP4 depolarization often occurs in conjunction with early signs of neurodegeneration and neuroinflammation; however, we are aware that the loss of AQP4 polarity is only one factor in a complex pathophysiological environment. This review examines the molecular structure responsible for maintaining the polarity of AQP4-such as dystrophin-syntrophin complexes, orthogonal particle arrays, lipid microdomains, trafficking pathways, and transcriptional regulators-and describes how the vulnerability of these systems to various types of vascular stress, inflammatory signals, energy deficits, and mechanical injury can lead to a loss of AQP4 polarity. Furthermore, we will explore how a loss of AQP4 polarity can lead to the disruption of perivascular fluid movement, changes in blood-brain barrier morphology, enhanced neuroimmune activity, changes in ionic and metabolic balance, and disruptions in the global neural network synchronization. Importantly, we recognize that each of these disruptions will likely occur in concert with other disease-specific mechanisms. Alterations in AQP4 polarity have been observed in a variety of neurological disorders including Alzheimer's disease, Parkinson's disease, multiple sclerosis, traumatic brain injury, and glioma; however, we also observe that the same alterations in fluid regulation occur across all of these different diseases, but that no single upstream event accounts for the alteration in polarity. Ultimately, we will outline emerging therapeutic avenues to restore perivascular fluid transport, and will include molecular-based therapeutic agents designed to modify the anchoring of AQP4, methods designed to modulate the state of astrocytes, biomaterials-based drug delivery systems, and therapeutic methods that leverage dynamic modulation of the neurovascular interface. Future advances in multi-omic profiling, spatial proteomics, glymphatic imaging, and artificial intelligence will allow for earlier identification of AQP4 polarity disturbances and potentially allow for the development of more personalized treatment plans. Ultimately, by linking these concepts together, this review aims to frame AQP4 polarity as a modifiable aspect of the "fluidic connectome", and highlight its importance in maintaining overall brain health across disease states.}, }
@article {pmid41373648, year = {2025}, author = {Ishikawa, K and Fujikawa, R and Okita, K and Kimura, F and Watanabe, T and Katsurabayashi, S and Iwasaki, K}, title = {Microglia in Brain Aging and Age-Related Diseases: Friends or Foes?.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373648}, issn = {1422-0067}, support = {24K18288 (R.F.), 23K27496 (S.K.) and 24H02336 (S.K.)//JSPS KAKENHI/ ; }, mesh = {Humans ; *Microglia/metabolism/pathology ; *Aging/pathology ; *Brain/pathology/metabolism ; Animals ; *Neurodegenerative Diseases/pathology/metabolism ; }, abstract = {With the global rise in population aging, establishing effective strategies for the prevention and treatment of age-related neurodegenerative diseases, as well as their prodromal stage of cognitive frailty, has become an urgent challenge. Recent studies have revealed that the neural basis of both frailty and age-related disorders is closely associated with chronic neuroinflammation and impaired clearance of cellular debris, processes that are primarily regulated by microglia, the resident immune cells of the brain. As aging progresses, microglia exhibit reduced surveillance and motility, diminished phagocytic efficiency, and transition into a proinflammatory, hyperresponsive state. Such maladaptive microglia contribute to synaptic loss, white matter deterioration, and the spread of neurodegenerative pathology. Conversely, single-cell transcriptomic studies have identified distinct microglial subsets, including CD11c[+] microglia, which show upregulation of lysosomal and lipid metabolism pathways, enhanced debris clearance, and elevated neurotrophic factor expression. These features suggest that certain microglial populations adopt protective or adaptive phenotypes that preserve neural integrity. However, under chronic inflammation or pathological conditions, even protective microglia may become inflammation-promoting. This review summarizes current evidence on microglial changes in aging, frailty, and neurodegeneration, emphasizing their dual roles and discussing strategies that modulate microglial function to maintain brain health and prevent or treat frailty and age-related diseases.}, }
@article {pmid41373506, year = {2025}, author = {Muzaffar, S and Tyagi, A and Pugazhenthi, S}, title = {Therapeutic Potential of Irisin in Neurodegenerative Diseases.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373506}, issn = {1422-0067}, support = {NEUD-004-07F//United States Department of Veterans Affairs/ ; }, mesh = {Humans ; *Fibronectins/metabolism/therapeutic use/genetics ; Animals ; *Neurodegenerative Diseases/metabolism/drug therapy ; Exercise ; }, abstract = {Irisin is a myokine secreted by muscle in response to exercise. It is derived from a transmembrane protein called fibronectin type III domain-containing protein 5 (FNDC5). The Fndc5 gene is expressed in several tissues, including skeletal muscle, brain, adipose tissue, heart, kidney, and lung. Irisin is cleaved from FNDC5 protein by the enzyme furin and released into circulation. In addition to exercise, several drugs have been shown to increase the production of irisin. Administration of exogenous irisin mimics the beneficial actions of exercise. Irisin can cross the blood-brain barrier and exert neuroprotective actions in the brain. It has been shown to reverse Alzheimer's pathologies in clinical and animal studies. Irisin also exerts protective effects against obesity, diabetes, and cardiovascular disease, diseases that often coexist with aging AD patients. Multiple approaches have been taken to suggest that exercise may act through irisin. Studies have provided direct evidence linking the two using Fndc5 gene deletion and irisin antibodies. Irisin binds to αVβ1/β5 integrins to mediate the activation of integrin-FAK pathways. While exercise as a lifestyle modification for healthy aging is well recognized, it may present limitations in some aging populations, especially those with disease conditions, including Parkinson's disease. Administration of exogenous irisin or small molecules that increase the expression of endogenous irisin or facilitate its actions are some alternate approaches that can mimic the beneficial actions of exercise. This review discusses the therapeutic potential of irisin in the treatment of neurodegenerative and other aging-associated diseases.}, }
@article {pmid41373466, year = {2025}, author = {Adamski, P and Szeleszczuk, Ł and Gackowski, M and Grodner, B}, title = {Creatine and Taurine as Novel Competitive Inhibitors of Acetylcholinesterase: A Biochemical Basis for Nutritional Modulation of Brain Function.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373466}, issn = {1422-0067}, mesh = {*Taurine/pharmacology/chemistry ; *Cholinesterase Inhibitors/pharmacology/chemistry ; *Acetylcholinesterase/metabolism/chemistry ; Molecular Docking Simulation ; Humans ; *Creatine/pharmacology/chemistry ; *Brain/drug effects/physiology/metabolism ; Kinetics ; }, abstract = {Acetylcholinesterase (AChE) is a key enzyme responsible for terminating cholinergic neurotransmission by hydrolyzing acetylcholine. While clinically approved AChE inhibitors such as donepezil, rivastigmine, and galantamine are used in the symptomatic treatment of Alzheimer's disease and related dementias, little is known about the modulatory effects of common dietary compounds on AChE activity. In this study, we investigated the influence of creatine (CR) and taurine (TA)-two widely consumed nutritional supplements with reported neuroprotective and cognitive-enhancing properties-on AChE. Enzyme kinetics were evaluated using a modified Ellman's method, and Lineweaver-Burk analyses revealed that both CR and TA act as competitive inhibitors. Calculated parameters (Km, Vmax), inhibition constants (Ki), and half maximal inhibitory concentrations (IC50) consistently indicated stronger potency for CR (IC50 = 0.0056 ± 0.00018 mM) compared to TA (IC50 = 0.0097 ± 0.00035 mM). To complement the experimental data, molecular docking was performed using two crystal structures of human AChE. Docking confirmed that both ligands preferentially occupy the active-site region in a manner consistent with competitive inhibition, with CR showing more favorable binding scores than TA. Although markedly weaker than clinical drugs, these findings provide the first biochemical and in silico evidence that CR and TA directly interact with AChE, suggesting subtle cholinergic modulation relevant to cognitive function and neuroprotection.}, }
@article {pmid41372777, year = {2025}, author = {Mi, F and Li, H and Pan, D and Yu, C}, title = {Effect of organismal rhythmic activity on Aβ clearance by the glymphatic system.}, journal = {European journal of medical research}, volume = {31}, number = {1}, pages = {70}, pmid = {41372777}, issn = {2047-783X}, mesh = {Humans ; *Glymphatic System/metabolism ; *Amyloid beta-Peptides/metabolism ; *Alzheimer Disease/metabolism/physiopathology ; *Circadian Rhythm/physiology ; Animals ; Exercise/physiology ; }, abstract = {Abnormal deposition of β-amyloid (Aβ) is a significant pathological feature of neurodegenerative diseases, particularly Alzheimer's disease (AD). The glymphatic system (GS) plays a crucial role in Aβ clearance. Various rhythmic activities of the organism dynamically influence Aβ clearance by modulating GS function. In this paper, we systematically review the mechanisms linking cardiovascular rhythms, respiratory rhythms, neural rhythms, circadian rhythms, and exercise patterns to Aβ clearance via the GS. Cardiovascular rhythms affect cerebral perfusion pressure and vascular pulsation to regulate GS transport efficiency; respiratory rhythms modulate intracranial pressure and cerebrospinal fluid (CSF) circulation through thoracic pressure variations; neural rhythms (including delta waves during non-rapid eye movement (NREM) sleep and neurovascular coupling) synchronize neuro-glial-vascular interactions to enhance GS clearance. Circadian rhythms coordinate these primary rhythms by regulating melatonin levels and cerebral blood flow, while exercise patterns adjust GS function via aquaporin-4 (AQP4) polarization. Additionally, we elaborate on the cascade effect of AD resulting from rhythmic dysregulation. A thorough understanding of how rhythmic activities impact Aβ clearance by the GS may offer new perspectives and potential intervention strategies for the prevention and treatment of AD through the concept of "synchronized multiple rhythms"-a novel framework that integrates multi-rhythm synergy. Clinically, this work provides a theoretical basis for developing targeted interventions, such as personalized exercise timing regimens, respiratory rhythm training, and closed-loop neurovascular feedback devices, to restore GS function in AD patients.}, }
@article {pmid41372196, year = {2025}, author = {Du, M and Li, N and Li, T and Zhao, Z and Liu, H and Li, X and Gong, N and Duan, B and Wang, W and Jian, Y and Ma, W and Zhang, X and Wang, Y and Zhang, Z and Bai, Y and Wang, X and Wang, C and Liu, J and Guan, X and Zhou, F and Wang, W and Li, L and Zhu, X and Lei, Y and Duan, Y and Han, G and Wei, P and Gao, S and Wang, S and Chen, A and Huang, Y and Yang, H and Xue, X and Zhang, H}, title = {Chimeras co-targeting antigens and FcγRIIb trigger degradation of extracellular soluble proteins and pathological aggregates.}, journal = {Nature communications}, volume = {17}, number = {1}, pages = {514}, pmid = {41372196}, issn = {2041-1723}, support = {82261138553//National Natural Science Foundation of China (National Science Foundation of China)/ ; 82373898//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, mesh = {Humans ; Animals ; *Receptors, IgG/metabolism/immunology/genetics ; Amyloid beta-Peptides/metabolism/immunology ; Receptors, Fc/metabolism/genetics/immunology ; Blood-Brain Barrier/metabolism ; Alzheimer Disease/therapy/immunology ; Mice ; Dependovirus/genetics ; *Antigens/immunology/metabolism ; Histocompatibility Antigens Class I/metabolism/immunology/genetics ; Proprotein Convertase 9/metabolism/immunology ; Proteolysis ; Lysosomes/metabolism ; Recombinant Fusion Proteins/genetics ; HEK293 Cells ; *Protein Aggregation, Pathological/metabolism ; }, abstract = {While the clinical utility of conventional antibody therapies is undeniable, their therapeutic potential is often constrained high antigen loads and the recycling of antibody-antigen complexes via neonatal Fc receptor (FcRn). Here, we present a platform, based on a design similar to bispecific antibodies, FcγRIIb-Targeting Chimeras (FcRTAC). These constructs recognise antigens with one arm and bind FcγRIIb with the other arm to harness the unique endocytic properties of FcγRIIb to direct the recognized pathogenic antigens to lysosomes for irreversible degradation. The FcRTAC platform demonstrates broad therapeutic potential across multiple disease-relevant targets, including IgE, proprotein convertase subtilisin/kexin type 9 (PCSK9) and amyloid-β (Aβ). Notably, a single intravenous administration of blood brain barrier (BBB)-penetrating adeno-associated viral vector (AAV) encoding an Aβ-targeting FcRTAC construct achieves sustained therapeutic effects, establishing proof-of-concept for AAV-mediated delivery of an Aβ degrader as a strategy for Alzheimer's disease treatment. Our comprehensive investigation of binding properties of FcRTACs reveals critical molecular determinants of function and enables development of optimized engineering approaches. In summary, our approach represents a versatile therapeutic platform for treating diverse diseases ranging from autoimmune disorders to neurodegenerative conditions, while simultaneously serving as a user-friendly, plug-and-play research tool for extracellular protein knockout in basic biological research.}, }
@article {pmid41371839, year = {2026}, author = {Kubohira, Y and Okano, N and Taharabaru, T and Ishimatsu, A and Era, T and Yanagihara, K and Ishikura, K and Nakagawa, Y and Higashi, T and Motoyama, K}, title = {A water-soluble β-cyclodextrin polymer reduces cholesterol accumulation and autophagy dysfunction in vitro and in Niemann-Pick type C disease model mice.}, journal = {Carbohydrate polymers}, volume = {374}, number = {}, pages = {124676}, doi = {10.1016/j.carbpol.2025.124676}, pmid = {41371839}, issn = {1879-1344}, mesh = {Animals ; *Cholesterol/metabolism ; *Niemann-Pick Disease, Type C/drug therapy/metabolism/pathology ; *Autophagy/drug effects ; Mice ; Humans ; *beta-Cyclodextrins/chemistry/pharmacology ; Disease Models, Animal ; *Cyclodextrins/chemistry/pharmacology ; Water/chemistry ; Cell Line, Tumor ; Solubility ; Cellulose ; }, abstract = {Niemann-Pick disease type C (NPC) and Alzheimer's disease (AD) are characterised by cognitive dysfunction and neurological impairment. In both diseases, the abnormal accumulation and disruption of cholesterol homeostasis in the brain may contribute to the pathogenesis and exacerbation of symptoms. Cyclodextrins (CDs) are attracting attention as therapeutic agents that can reduce free cholesterol in the brain. A water-soluble β-CD polymer (β-CDP) consisting of multiple β-CDs cross-linked by epichlorohydrin was recently developed and reportedly has improved safety and higher circulation time in the bloodstream. In this study, we evaluated the potential of β-CDP as a promising therapeutic agent for NPC and AD. β-CDP lowered free cholesterol levels and reversed autophagy dysfunction in cholesterol-accumulated human neuroblastoma cells. Longer circulation time in the bloodstream and reduced cholesterol accumulation in NPC mice were also observed after its subcutaneous administration. These results suggest that β-CDP may be a safe therapeutic agent in the treatment of NPC and AD.}, }
@article {pmid41371570, year = {2026}, author = {Supasai, S and Suntaratti, P and Odton, M and Longji, T and Karananan, T and Yasom, S and Ampawong, S and Limpanont, Y and Mutirangura, A}, title = {HMGB1 Box A gene therapy reverses cognitive and neuropathological features in AlCl3/D-galactose rat model of Alzheimer's disease.}, journal = {Experimental neurology}, volume = {397}, number = {}, pages = {115583}, doi = {10.1016/j.expneurol.2025.115583}, pmid = {41371570}, issn = {1090-2430}, mesh = {Animals ; *Alzheimer Disease/therapy/chemically induced/pathology/genetics ; Rats ; *HMGB1 Protein/genetics/therapeutic use ; Aluminum Chloride/toxicity ; *Genetic Therapy/methods ; Male ; Disease Models, Animal ; Galactose/toxicity ; Rats, Sprague-Dawley ; Hippocampus/pathology/metabolism ; Maze Learning/physiology/drug effects ; }, abstract = {Alzheimer's disease (AD), the leading cause of dementia, is pathologically defined by the accumulation of amyloid-β and tau pathology, resulting in progressive cognitive decline. Our previous work demonstrated that high mobility group box 1 (HMGB1) Box A plasmids alleviated cellular senescence and restored cognitive performance in aged rat models, supporting their therapeutic potential for neurodegenerative disorders such as AD. In this study, we investigated the efficacy of HMGB1 Box A gene therapy in an AD-like rat model chronically induced by AlCl3 and D-galactose. Following the onset of AD pathology, Box A plasmids were administered weekly at varying doses over eight weeks. Box A treatment significantly improved behavioral outcomes, including responsiveness, locomotor activity, and learning and memory performance. At the neuropathological level, Box A reduced hippocampal Aβ accumulation and tau pathology, restored neuronal density, and attenuated synaptic degeneration. Moreover, it suppressed hippocampal microgliosis, astrogliosis, and the expression of proinflammatory mediators. Box A also diminished markers of cellular senescence in the hippocampus. These findings demonstrate that HMGB1 Box A gene therapy confers multi-level neuroprotective effects in AD, from molecular and cellular restoration to behavioral recovery. This strategy holds strong promise as a disease-modifying treatment for AD, contributing to improved well-being by advancing therapeutic innovation to promote healthy aging and combat age-related neurodegenerative diseases.}, }
@article {pmid41370943, year = {2026}, author = {Xu, J and He, Z and Pan, Y and Cao, B and Chen, G}, title = {Nanotherapeutic potential of Baicalein-encapsulated hUC-MSC exosomes in Alzheimer's disease: Modulating oxidative stress and neuroinflammation.}, journal = {Biomaterials advances}, volume = {181}, number = {}, pages = {214619}, doi = {10.1016/j.bioadv.2025.214619}, pmid = {41370943}, issn = {2772-9508}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism ; *Oxidative Stress/drug effects ; *Flavanones/pharmacology/therapeutic use/administration & dosage/chemistry ; *Exosomes/chemistry/metabolism ; Humans ; Rats ; Male ; *Mesenchymal Stem Cells/cytology/metabolism ; Amyloid beta-Peptides/metabolism ; Rats, Sprague-Dawley ; *Neuroprotective Agents/pharmacology/therapeutic use/administration & dosage ; Antioxidants/pharmacology ; *Neuroinflammatory Diseases/drug therapy ; Disease Models, Animal ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by excessive amyloid-β (Aβ) accumulation, neuroinflammation, and oxidative stress. Exosomes derived from human umbilical cord mesenchymal stem cells (hUC-MSC@Exo) represent promising nanoscale carriers for targeted drug delivery. In this study, Baicalein (Bac), a potent antioxidant and anti-inflammatory flavonoid, was encapsulated into hUC-MSC-derived exosomes (Exo@Bac) to enhance its therapeutic efficacy. The neuroprotective potential of Exo@Bac was evaluated in a rat model of Aβ1-42-induced AD. Rats received intraperitoneal injections of Bac, hUC-MSC@Exo, or Exo@Bac, and cognitive performance was assessed using the passive avoidance test and Morris water maze. Exo@Bac treatment significantly improved memory deficits and elevated brain-derived neurotrophic factor (BDNF) expression compared to controls. Histopathological analyses revealed reduced neuronal damage and apoptosis, alongside decreased Aβ1-42 deposition in Exo@Bac-treated rats. Furthermore, Exo@Bac enhanced antioxidant defense (increased SOD), attenuated pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), and lowered lipid peroxidation (MDA). Mechanistically, Exo@Bac promoted AMPK phosphorylation while suppressing NF-κB p65 signaling, indicating modulation of both oxidative stress and neuroinflammatory pathways. These findings demonstrate that Exo@Bac acts as a nanotherapeutic agent capable of mitigating AD pathology, highlighting its potential as a novel strategy for Alzheimer's disease therapy.}, }
@article {pmid41369702, year = {2025}, author = {Hooshmandi, E and Rafiei, E and Owjfard, M and Mohammadi, Y and Koohpeyma, F and Simani, L and Safari, MS and Rai, SN and Ashjazadeh, N and Pandamooz, S and Bayat, M and Salehi, MS}, title = {Neuroprotective and Immunomodulatory effects of human hair follicle stem cells on streptozotocin-induced memory impairment in rats: insights into inflammation and neurotrophic mechanisms.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {178}, pmid = {41369702}, issn = {1573-4978}, support = {29005//Vice-Chancellor for Research, Shiraz University of Medical Sciences/ ; }, mesh = {Animals ; Male ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Humans ; *Memory Disorders/chemically induced/therapy/metabolism ; *Hair Follicle/cytology ; Hippocampus/metabolism ; Inflammation ; Stem Cell Transplantation/methods ; Alzheimer Disease/therapy ; Disease Models, Animal ; *Stem Cells/cytology/metabolism ; Brain-Derived Neurotrophic Factor/metabolism ; Neuroinflammatory Diseases ; Neuroprotective Agents/pharmacology ; }, abstract = {BACKGROUND/OBJECTIVE: Alzheimer's disease (AD), a primary cause of dementia, involves cognitive decline and neuroinflammation. Human hair follicle stem cells (hHFSCs) have shown neuroprotective potential, but their effects on immune modulation, especially in xenogeneic transplantation, remain unclear. This study aimed to investigate the therapeutic potential of hHFSCs against memory impairment and neuroinflammation induced by streptozotocin (STZ) in male rats.
METHODS: Adult male Sprague-Dawley rats were intracerebroventricularly injected with STZ (3 mg/kg) to induce AD-like cognitive deficits. hHFSC transplantation (1 × 10[6]) was done on days 4, 14, and 21 post-surgery. Y-maze and Passive avoidance were used to assess memory. Hippocampal tissue was analyzed for mRNA expression of pro/anti-inflammatory factors and neurotrophic markers using quantitative RT-PCR. Histological evaluation quantified hippocampal pyramidal neurons and volume.
RESULTS: STZ significantly impaired memory in passive avoidance test, but not Y-maze. hHFSC significantly improved memory performance. mRNA analysis revealed elevated BDNF, TGFβ, and GFAP levels in the STZ group. The increased TGFβ and GFAP levels continued following hHFSC treatment, indicating a compensatory response. Moreover, pro-inflammatory factors (IL-1β, IL-6, and TNFα) were upregulated following hHFSC therapy, suggesting persistent neuroinflammation. hHFSC led to anti-inflammatory effects through the elevation of IL-10. In addition, hHFSCs significantly reduced hippocampal atrophy and neuronal loss induced by STZ.
CONCLUSION: hHFSCs exhibit partial neuroprotective effects against STZ-induced memory impairment. The simultaneous upregulation of pro- and anti-inflammatory markers underscores the complexity of the inflammatory response in this xenogeneic model. Future investigations should consider immunocompromised models or immunosuppressive protocols better to isolate the therapeutic effects of hHFSCs from immune responses.}, }
@article {pmid41369361, year = {2025}, author = {Yu, SP and Gu, X and Jiang, MQ and Sastry, A and Wu, L and Li, Y and Wei, L}, title = {Combined Preventive and Preconditioning Treatments for the Comorbidity of Alzheimer's Disease and Ischemic Stroke in a GluN3A Knockout Mouse and a 5xFAD Mouse.}, journal = {Cells}, volume = {14}, number = {23}, pages = {}, pmid = {41369361}, issn = {2073-4409}, support = {AG067473, NS114221; RX001473 (VA); RX003865 (VA)//National Instutute of Health, USA, VA Research Administration, USA/ ; }, mesh = {Animals ; *Alzheimer Disease/prevention & control/complications ; *Ischemic Stroke/prevention & control/complications ; Mice ; *Receptors, N-Methyl-D-Aspartate/metabolism/genetics/deficiency ; Mice, Knockout ; Disease Models, Animal ; Memantine/pharmacology/therapeutic use ; Male ; Comorbidity ; Mice, Inbred C57BL ; }, abstract = {Alzheimer's disease (AD) and stroke have been identified as risk factors for each other. More than half of AD patients suffer stroke attacks and worse ischemic injuries. There has been a lack of research focus and clinical treatment for the comorbidity of these neurological disorders. AD and ischemic stroke share characteristic pathophysiology, including hyperactivities of excitatory neurons and NMDA receptors (NMDARs), excitotoxicity, and synapse/neurovascular destruction. Our recent investigations identified the deficiency of the NMDAR regulatory GluN3A (NR3A) subunit as a novel pathogenesis of sporadic AD. The present investigation tested a preemptive treatment to prevent AD development in two AD models and, in the meantime, to prime the susceptible brain against upcoming ischemic attacks. In the preclinical stage of 3-month-old GluN3A KO mice, an NMDAR-mediated sporadic AD model, and 5xFAD mice, an amyloid-based familial AD model, treatments with memantine (MEM), an NMDAR antagonist (10 mg/kg/day in drinking water) and a drug-free control were started when cognition of these mice was generally normal. Three months later, the mice were subjected to focal cerebral ischemic surgery, followed by continued 1.5-2.0 months of MEM or vehicle control. Morphological, pathological, and functional assessments were performed and compared at different time points. In both AD models, the early MEM treatment confined AD progression before and after stroke, reduced ischemia-induced brain injury, suppressed neuroinflammation, and improved locomotion, sensorimotor, psychological, and cognitive functions. This is the first report endorsing a shared mechanism of NMDAR hyperactivity in AD and stroke in AD models with distinctive risk factors. The dual therapeutic effects of the preemptive MEM treatment provide a disease-modifying possibility for individuals who are susceptible to sporadic or familial AD as well as ischemic stroke.}, }
@article {pmid41368712, year = {2025}, author = {He, Q and Xia, Y and Shen, Q and Huang, C and Nie, X and Hu, X and Tang, X}, title = {Relationships between sarcopenia and Alzheimer's disease: screening for mitochondria-related biomarkers.}, journal = {Computer methods in biomechanics and biomedical engineering}, volume = {}, number = {}, pages = {1-22}, doi = {10.1080/10255842.2025.2598656}, pmid = {41368712}, issn = {1476-8259}, abstract = {This study aims to identify mitochondrial-related biomarkers for sarcopenia and Alzheimer's disease (AD). Through the GEO database and machine learning algorithms, three diagnostic biomarkers (FKBP5, PRKAG1, and FBP2) were identified, and the constructed models showed good diagnostic accuracy in both internal and external datasets. Furthermore, multiple analyses such as GSEA, immune infiltration, and drug prediction were conducted. These findings provide new insights into shared pathological mechanisms and clinical diagnosis and treatment of sarcopenia and AD. Further clinical and experimental studies are needed to validate these results.}, }
@article {pmid41368444, year = {2025}, author = {Pang, R and Jia, Q and Ma, C and Li, T and Bi, W and Wang, H and Liu, R and Chen, P and Lee, ES and Jiang, HB}, title = {Alzheimer's Disease: The Current and Emerging Treatment Approaches.}, journal = {Behavioural neurology}, volume = {2025}, number = {}, pages = {9627699}, pmid = {41368444}, issn = {1875-8584}, mesh = {*Alzheimer Disease/therapy/drug therapy ; Humans ; Genetic Therapy/methods ; Amyloid beta-Peptides/metabolism ; Animals ; Plaque, Amyloid ; Neurofibrillary Tangles/pathology ; Plant Extracts/therapeutic use ; }, abstract = {Alzheimer's disease (AD) is a chronic progressive neurodegenerative disease characterized by amyloid β (Aβ) plaques and neurofibrillary tangles (NFTs) as its main pathological features. It mainly manifests as cognitive dysfunction, and its pathological process may occur before symptom onset. However, the current drugs and methods for treating AD have unsatisfactory therapeutic outcomes. Therefore, finding a treatment that can inhibit the progression of AD by targeting its pathological features is an urgent need. This review summarizes the current traditional drugs that can delay the progression of AD and new drugs that act on the pathological characteristics of AD and highlights the potential value of related plant extracts. In addition, this review explores the application of different vectors, such as viral vectors and nanoparticles, in gene therapy and drug delivery. These data will provide novel ideas for new drug development and the search for new therapeutic mechanisms.}, }
@article {pmid41368288, year = {2025}, author = {Wang, X and Yang, F and Chen, P and Yang, M and Deng, Y and Zhan, Z}, title = {Mesenchymal Stem Cell-Derived Extracellular Vesicles in Alzheimer's Disease: A Novel Cell-Free Therapeutic Strategy and Diagnostic Biomarker.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {14375-14391}, pmid = {41368288}, issn = {1178-2013}, mesh = {*Alzheimer Disease/therapy/diagnosis ; *Extracellular Vesicles/metabolism/transplantation ; Humans ; *Mesenchymal Stem Cells/cytology/metabolism ; Biomarkers/metabolism/analysis ; Animals ; }, abstract = {With the ongoing trend of population aging worldwide, the incidence of Alzheimer's disease (AD) is steadily increasing. In the absence of effective therapeutic options for atypical forms of AD, reducing its prevalence and improving treatment outcomes have become pressing priorities. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) have attracted growing attention as a new cell-free therapeutic approach for AD due to their high stability, low immunogenicity, and minimal tumorigenic risk. This review provides a comprehensive overview of the pathological mechanisms underlying AD, highlights the diagnostic potential of MSC-EVs, and elaborates on their therapeutic advantages and mechanisms of action. Furthermore, it addresses the key challenges and considerations associated with the clinical translation of MSC-EVs.}, }
@article {pmid41367378, year = {2025}, author = {Toyli, A and Shaik, A and Zhao, C and Chen, QH and Sha, Q and Zhou, W}, title = {The heart-brain axis: unraveling the interconnections between cardiovascular and Alzheimer's diseases.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1685461}, pmid = {41367378}, issn = {2297-055X}, abstract = {Cardiovascular disease (CVD) and Alzheimer's disease (AD) are leading causes of death and disability worldwide, and recent research has increasingly illuminated a complex, bidirectional relationship between the two. This review synthesizes epidemiological, mechanistic, imaging, and genetic evidence linking CVD and AD through the heart-brain axis-a network of interrelated physiological and demographic pathways. We detail how cerebral hypoperfusion, inflammation, blood-brain barrier dysfunction, imbalance of the autonomic nervous system, and systemic amyloidosis contribute to shared neurodegenerative and cardiovascular outcomes. Multi-organ imaging studies, including MRI and PET, reveal that dysfunction of the cardiovascular system correlates with brain atrophy, white matter lesions, glymphatic impairment, and accumulation of AD-related proteinopathies. Genetic analyses further support overlapping risk architectures, particularly involving APOE and loci associated with lipid metabolism, vascular integrity, and inflammation. Age and sex are critical modifiers, with midlife CVD exerting the strongest influence on later cognitive decline, and sex-specific physiological responses shaping disease susceptibility. Finally, we explore how modifiable lifestyle factors, pharmacologic interventions, and precision medicine approaches targeting inflammatory and vascular pathways can jointly reduce the burden of both CVD and AD. Multidisciplinary collaboration to understand the interconnected biology of the heart and brain is essential for advancing integrated prevention and treatment strategies in aging populations.}, }
@article {pmid41367129, year = {2025}, author = {Yang, C and Li, B and Yang, S and Wang, X and Zhu, G and Wang, J}, title = {Electroacupuncture Prevents Against AD-Like Phenotypes in APP/PS1 Mice: Investigation of the Mechanisms From Cerebral Microangiopathy.}, journal = {CNS neuroscience & therapeutics}, volume = {31}, number = {12}, pages = {e70696}, pmid = {41367129}, issn = {1755-5949}, support = {2023CXMMTCM013//Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM/ ; 2023CXMMTCM021//Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM/ ; 82474633//National Natural Science Foundation of China/ ; 202304295107020105//Anhui Provincial Key R&D Programme/ ; 2208085MH282//Anhui Natural Science Foundation/ ; 2508085MH226//Anhui Natural Science Foundation/ ; 2024AH051045//The Key project of Anhui Natural Science Research/ ; ZYJCLLYB-11//Open Fund for Key Disciplines of Basic Theory of Traditional Chinese Medicine/ ; }, mesh = {Animals ; *Electroacupuncture/methods ; Mice ; *Alzheimer Disease/prevention & control/genetics/pathology/therapy ; Mice, Transgenic ; Amyloid beta-Protein Precursor/genetics ; Presenilin-1/genetics ; Male ; Phenotype ; Cerebrovascular Circulation/physiology ; Disease Models, Animal ; Hippocampus ; Mice, Inbred C57BL ; }, abstract = {BACKGROUND: Electroacupuncture (EA) has been widely used in Alzheimer's disease (AD) treatment. However, its underlying mechanisms remain poorly elucidated.
PURPOSE: This study aimed to investigate the effects of EA on AD-like phenotypes and explore the mechanisms.
METHODS: We first evaluated AD-like behaviors and cerebral blood flow (CBF) changes in APPswe/PS1dE9 (APP/PS1) mice at different ages. Subsequently, the therapeutic effects of EA at acupoints Baihui (GV20), Guanyuan (CV4), and Zusanli (ST36), as well as sunitinib, a PDGFRβ-specific inhibitor, on AD-like phenotypes in APP/PS1 mice were investigated. CBF was monitored by laser speckle imaging, and hippocampal synaptic ultrastructure and microvascular morphology were examined by transmission electron microscopy (TEM). Western blot was performed to measure related protein expression. Finally, functional ultrasound (fUS) imaging was used to assess changes in brain-wide functional connectivity.
RESULTS: Compared with age-matched wild-type (WT) mice, 6- and 9-month-old APP/PS1 mice exhibited significant cognitive decline, while all age groups (3-, 6-, and 9-month-old) of APP/PS1 mice showed significantly reduced CBF. APP/PS1 mice showed elevated expression of microvascular markers in both the hippocampus and cortex. EA significantly ameliorated AD-like behaviors and prevented CBF reduction as well as microvascular deformation in 6-month-old APP/PS1 mice compared with non-treatment group. TEM and western blot analysis revealed damaged synaptic structure and reduced synaptic proteins in APP/PS1 mice, all of which were markedly alleviated by EA treatment. In addition, EA treatment downregulated the aberrantly elevated expression of PDGFRβ and CD31, enhanced the levels of tight junction proteins (Occludin, Claudin-5, and ZO-1) and glucose transporter 1 (GLUT1), and suppressed the expression of inflammatory proteins. Of note, intervention with sunitinib also improved AD-like behaviors in APP/PS1 mice. Remarkably, fUS imaging results showed that EA enhanced the functional connection between hippocampal regions of APP/PS1 mice.
CONCLUSION: Our data demonstrates that EA ameliorates AD-like phenotypes, potentially through preventing microangiopathy.}, }
@article {pmid41366853, year = {2025}, author = {Lin, Z and Hong, Y and Hu, Y and Xiao, Q and Peng, SL and Wu, D and Guo, T and Jiang, D}, title = {White matter hyperintensity modulates the amyloid-tau-cognition association and anti-amyloid treatment efficacy in asymptomatic older adults.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70990}, pmid = {41366853}, issn = {1552-5279}, support = {//National Institutes of Health-National Institute on Aging/ ; //Eli Lilly and Company/ ; /ALZ/Alzheimer's Association/United States ; //Accelerating Medicines Partnership/ ; //GHR Foundation/ ; 82302144//National Natural Science Foundation of China/ ; 62401363//National Natural Science Foundation of China/ ; 24PJA047//Shanghai Pujiang Program/ ; //Xiaomi Young Scholar Program/ ; }, mesh = {Humans ; *White Matter/pathology/diagnostic imaging ; Male ; Female ; Aged ; *tau Proteins/metabolism ; *Cognitive Dysfunction/pathology/diagnostic imaging/drug therapy/metabolism ; *Amyloid beta-Peptides/metabolism ; *Alzheimer Disease/drug therapy/pathology/diagnostic imaging/metabolism ; Magnetic Resonance Imaging ; Aged, 80 and over ; *Cognition ; Treatment Outcome ; }, abstract = {INTRODUCTION: White matter hyperintensities (WMH), a key imaging biomarker of small vessel injury, may play a complex role in Alzheimer's disease (AD). We hypothesize that WMH not only directly contributes to cognitive decline but also moderates the relationship among AD pathology, treatment, and cognitive decline.
METHODS: A total of 1169 participants with 240-week follow-up in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study were analyzed. Linear regression models examined WMH's contribution to cognitive decline, its interaction with Aβ on p-Tau217 level, and its interaction with anti-amyloid treatment on cognitive decline.
RESULTS: Increase in WMH volume independently contributed to cognitive decline (p = 0.0028). Baseline WMH significantly moderated the relationship between Aβ change and p-Tau217 change (p = 0.0035). Specifically, Aβ accumulation correlated with p-Tau217 increase only in participants with low baseline WMH. WMH growth was associated with cognitive decline only in the treatment group (p < 0.0001).
DISCUSSION: WMH modulates the interplay of pathologies, emphasizing the need for comprehensive treatment approaches targeting multiple pathways.
HIGHLIGHTS: White matter hyperintensity (WMH) independently contributed to cognitive decline. WMH modulated the longitudinal relationship between Aβ and p-Tau217. WMH interacted with anti-amyloid treatment on longitudinal cognitive decline.}, }
@article {pmid41366831, year = {2025}, author = {Moretti, DV and Kuhn, E and Dubbelmann, MA and Sikkes, SAM and Castilhos, RM and Chapman, S and Gifford, KA and Butterbrod, E and Nosheny, RL and , }, title = {Clinical definition, biological characterization, and detection guidelines of subjective cognitive decline due to Alzheimer's disease and related dementia: A position paper from ISTAART SCD PIA.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70847}, pmid = {41366831}, issn = {1552-5279}, mesh = {Humans ; *Alzheimer Disease/diagnosis/complications/psychology ; Biomarkers ; *Cognitive Dysfunction/diagnosis/etiology/psychology ; Neuropsychological Tests ; }, abstract = {Subjective cognitive decline (SCD)-self-perceived cognitive worsening without objective deficits-has emerged as a clinically meaningful, potential early manifestation of Alzheimer's disease (AD). Positioned at the intersection of normal aging, neuropsychiatric symptoms, and preclinical neurodegeneration, SCD offers a unique window for early detection and intervention. However, detection heterogeneity, variable prognostic trajectories, and limited equity in assessment hinder its full clinical utility. This position paper synthesizes current evidence on SCD's diagnostic complexity, neurobiological underpinnings, and modifiable influences. We highlight the need for harmonized assessment frameworks, scalable digital tools, inclusive research, and ethically grounded biomarker disclosure practices. Importantly, we advocate for personalized, (non-)pharmacological interventions targeting this early phase. By refining the conceptualization and operationalization of SCD, we can better identify individuals at heightened AD risk and deliver timely, equitable, and meaningful prevention strategies. SCD represents a pivotal inflection point in the dementia continuum-and a call to shift toward proactive brain health. HIGHLIGHTS: Subjective cognitive decline (SCD) may signal early-stage Alzheimer's despite normal test performance. Diagnostic heterogeneity limits current clinical and research utility. Biomarkers and digital tools could enhance risk stratification in SCD. Mental health and social context shape symptom reporting and outcomes. SCD offers a window for tailored (non-drug) preventive interventions.}, }
@article {pmid41366707, year = {2025}, author = {Feng, Y and Wang, S and Xia, H and Jiang, X and Wu, M and Pan, S and Song, W}, title = {Meningeal lymphatics as a therapeutic target for neurodegenerative disorders.}, journal = {Translational neurodegeneration}, volume = {14}, number = {1}, pages = {65}, pmid = {41366707}, issn = {2047-9158}, support = {82230043//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Meninges/immunology/pathology ; *Neurodegenerative Diseases/immunology/therapy/drug therapy/pathology ; *Lymphatic Vessels/immunology/pathology ; Animals ; Brain ; Glymphatic System ; }, abstract = {Advancements in visualization methods have brought the meningeal lymphatic system (MLS) into the spotlight. The meningeal lymphatic vessels (mLVs) play a vital role in draining cerebrospinal fluid and immune cells, acting as a central hub for immune surveillance in the brain. Age-related morphological and functional declines of mLVs suggest their involvement in the pathogenesis of neurodegenerative disorders (NDDs). In this article, we summarize key discoveries about the MLS over the past decade, highlight the neuro-immune crosstalk in the meninges, and discuss the role of mLVs in both brain homeostasis and neurodegeneration. As a critical regulator of brain function and a potential therapeutic target, the MLS offers a promising avenue for the diagnosis and treatment of NDDs, particularly Alzheimer's Disease.}, }
@article {pmid41366593, year = {2025}, author = {Lee, WJ and Cho, K and Lee, D and Lee, S and Kim, GW}, title = {Therapeutic Efficacy of Autologous Blood-Derived Stem Cells with Growth Factors in Moderate to Severe Alzheimer's Disease: A Clinical Trial.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {277}, pmid = {41366593}, issn = {1559-1182}, mesh = {Humans ; *Alzheimer Disease/therapy/diagnostic imaging ; Male ; Female ; Aged ; Treatment Outcome ; *Intercellular Signaling Peptides and Proteins/therapeutic use ; Transplantation, Autologous ; Brain/diagnostic imaging/metabolism/pathology ; *Stem Cell Transplantation/methods ; *Severity of Illness Index ; *Stem Cells/cytology ; Cognition ; Aged, 80 and over ; }, abstract = {Alzheimer's disease (AD) is characterized by cognitive decline, memory loss, and a gradual loss of daily functioning. Unfortunately, despite extensive research, effective treatments for AD remain limited. Of these, stem cell-based therapies show promise for their regenerative potential and ability to modulate pathological processes. Autologous blood-derived stem cells (ABSCs), which are isolated from a patient's own blood, have demonstrated therapeutic efficacy in AD. This clinical study evaluated the safety and efficacy of ABSCs on patients with AD and investigated the changing levels of growth factors derived from ABSCs treatment. The efficacy of the treatment on cognitive function was assessed using the Mini-Mental State Examination, Clinical Dementia Rating, and AD Assessment Scale-Cognitive Subscale, all widely used tools to assess cognitive function in patients with AD. The neuroimaging and molecular mechanisms were the secondary outcomes. The neuroimaging examinations performed included PET-CT with amyloid imaging, for assessing amyloid plaque deposition in the brain at baseline and at 3 and 6 months after treatment; FDG-PET, for measuring brain glucose metabolism and acquiring insights into neuronal activity and overall brain function; and MRI, performed at baseline and follow-up, for assessing structural brain changes. ABSCs treatment resulted in notable improvements in cognitive function, reductions in amyloid plaque burden, and improved neuroimaging outcomes. Autologous stem cell therapy also reduced the risk of immune rejection, offering a safety advantage over allogeneic stem cell therapies. Furthermore, the use of growth factors to enhance stem cell efficacy aligns with existing research demonstrating improvements in stem cell limitations. This study provides compelling evidence that ABSCs combined with growth factors exhibit significant therapeutic potential for patients with moderate to severe AD. Our findings indicate that our current combination treatment may offer a multi-target approach to addressing the complex pathogenesis of neurodegenerative diseases and is thereby a potentially sustainable therapeutic strategy for AD. Furthermore, the combination of ABSCs with growth factors can potentially provide a much-needed therapeutic alternative for AD.}, }
@article {pmid41365480, year = {2026}, author = {Majumder, M and Dutta, D and Paidi, RK and Pahan, K}, title = {Activation of PPARα by gemfibrozil lowers tau-associated neuropathology in the MAPT mouse model of Alzheimer's disease.}, journal = {Brain research}, volume = {1873}, number = {}, pages = {150089}, doi = {10.1016/j.brainres.2025.150089}, pmid = {41365480}, issn = {1872-6240}, mesh = {Animals ; *Gemfibrozil/pharmacology ; *Alzheimer Disease/metabolism/pathology/drug therapy ; *tau Proteins/metabolism/genetics ; *PPAR alpha/metabolism/genetics/agonists ; Disease Models, Animal ; Mice, Transgenic ; Mice ; Hippocampus/metabolism/drug effects/pathology ; Neurons/metabolism/drug effects/pathology ; Tauopathies/metabolism/drug therapy/pathology ; Gliosis ; Male ; Humans ; Phosphorylation/drug effects ; }, abstract = {The current dogma states that inhibiting tau accumulation and its associated neuropathologies might be a relevant strategy to prevent neuronal loss and cognitive dysfunction in Alzheimer's disease (AD). The present study demonstrates the therapeutic potential of an FDA-approved lipid lowering drug and an agonist of peroxisome proliferator and activated receptor α (PPARα), called gemfibrozil, in reducing tau accumulation and associated neuropathologies in the MAPT (PS19) mouse model of AD, expressing P301S mutated form of human tau protein in neurons. Daily oral treatment of gemfibrozil in MAPT mice reduced total tau and phosphorylated form of tau in the hippocampal subregions including CA1 and DG. Concurrently, gemfibrozil treatment upregulated PPARα level in the hippocampus and that was accompanied with inhibition of microgliosis and astrogliosis. Gemfibrozil also attenuated the loss of synaptic plasticity as determined by the expression of post-synaptic protein, PSD95, and calcium influx in the hippocampal tissue. The instrumental role of PPARα in gemfibrozil-mediated reduction of tauopathy was confirmed as PPARα deficiency in MAPT mice significantly augmented tau and phospho-tau accumulation in the hippocampus and gemfibrozil treatment failed to reverse tau pathology and gliosis in the brain of PPARα deficient MAPT mice. Lastly, gemfibrozil improved the cognitive function of MAPT mice during the symptomatic phase of disease progression, but it failed to reverse cognitive impairment in the PPARα deficient MAPT mice. These data suggest that neuroprotective effects of gemfibrozil in MAPT mice is mediated by PPARα. Moreover, targeting PPARα by small molecules like gemfibrozil may hold translational potential against tauopathy.}, }
@article {pmid41365196, year = {2026}, author = {Zhang, X and Yang, J and Xiao, M and Zhang, J and Cai, C and Wei, W and Fang, S and Ren, X and Guo, K and Yang, P and Wang, W and Hu, Y and Fang, J}, title = {Yangxue Qingnao Wan ameliorates cognitive impairment in scopolamine-induced AD mice via modulating neuropeptide signaling pathways and suppressing neuroinflammation.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {150}, number = {}, pages = {157602}, doi = {10.1016/j.phymed.2025.157602}, pmid = {41365196}, issn = {1618-095X}, mesh = {Animals ; Scopolamine ; *Drugs, Chinese Herbal/pharmacology ; Mice ; *Cognitive Dysfunction/drug therapy ; Signal Transduction/drug effects ; *Alzheimer Disease/drug therapy/chemically induced ; Male ; *Neuroprotective Agents/pharmacology ; Neuroinflammatory Diseases/drug therapy ; Oxidative Stress/drug effects ; Disease Models, Animal ; Mice, Inbred C57BL ; }, abstract = {BACKGROUND: Alzheimer's disease (AD), a fatal neurodegenerative disorder with increasing incidence worldwide, remains a significant therapeutic challenge. Yangxue Qingnao Wan (YXQNW), a traditional Chinese medicine, has shown promise in AD treatment. However, its intricate mechanism of action necessitates further investigation. Clarifying YXQNW's active components and molecular targets could advance novel therapeutic strategies for AD.
PURPOSE: This research aimed to identify anti-AD bioactive compounds in YXQNW and investigate their mechanisms using transcriptomic profiling and network proximity analysis.
METHODS: The neuroprotective effects of YXQNW were evaluated in scopolamine (SCOP)-induced AD mice through behavioral tests, histopathological assessments, and biochemical analyses (acetylcholinesterase activity, oxidative stress markers and pro-inflammatory cytokines). Transcriptomic analysis was employed to explore YXQNW's regulatory targets and pathways. Key targets were validated by RT-qPCR, immunofluorescence (IF) and Western blot. Network proximity was used to predict anti-AD components, followed by in vitro mechanism validation in SCOP-induced HT22 cells using Gpr139 agonist and antagonist.
RESULTS: YXQNW ameliorated spatial memory deficits, cholinergic dysfunction, oxidative stress, and neuroinflammation in vivo. Transcriptomics analysis uncovered significantly modulation of neuropeptide signaling pathways, including upregulation of Gpr139 and downregulation of Gal/Galr1, mitigating cognitive impairment. Network proximity identified 8 anti-AD components, with Palmatine, Ligustilide, and Obtusifolin demonstrating efficacy in reducing oxidative stress, inflammation, and neuronal damage in vitro, and could also regulate the expression of neuropeptides. Moreover, Palmatine inhibits neuroinflammation via regulating Gpr139 protein expression.
CONCLUSIONS: YXQNW alleviates AD-like pathology by restoring cholinergic homeostasis, suppressing oxidative stress and neuroinflammation, and regulating neuropeptide signaling. And its active ingredient (Palmatine) can inhibit inflammatory response by regulating the expression of Gpr139 protein. This study supports YXQNW's clinical application and provides novel insights for AD drug discovery.}, }
@article {pmid41365116, year = {2025}, author = {Taj, T and Kaushik, M and Islam, A and Das, J and Kumar, B and Hussain, MS and Ramzan, M and Ashique, S and Tariq, M and Sridhar, SB and Yasmin, S and Panigrahy, UP and Malik, T and Ansari, MY}, title = {Microbiota-brain interaction: The role of gut-derived proteins in addressing various neurological disorders including Parkinson's (PD) and Alzheimer's diseases (AD).}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {193}, number = {}, pages = {118861}, doi = {10.1016/j.biopha.2025.118861}, pmid = {41365116}, issn = {1950-6007}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Brain/metabolism/physiopathology ; Animals ; *Parkinson Disease/microbiology/metabolism/physiopathology ; *Alzheimer Disease/microbiology/metabolism/physiopathology ; Probiotics ; Dysbiosis ; *Nervous System Diseases/microbiology ; }, abstract = {The microbiota-brain interaction is a complex network connecting gut microbiota to the enteric nervous system (ENS) and the central nervous system (CNS) that are crucial for neurotransmission and neurological health. Metabolites such as short-chain fatty acids (SCFA), neurotransmitters, and neuromodulators from the gut microbiota influence behavior and brain function. This review focuses on the study related with gut bacteria, including Bifidobacterium infantis and Lactobacillus species, producing various metabolites in gut including bile acids, SCFA, histamine, and others to communicate with the brain or CNS. Dysbiosis can lead to neurological conditions such as anxiety, depression, PD, and AD. SCFAs from gut bacteria bind to the free fatty acid receptors of intestinal epithelial cells (IECs), affecting neurones and influencing neuroactivity. Gut bacteria also produce neurotransmitters that regulate growth hormone release through interactions with the CNS and endocrine systems. Brain signals interact directly with the pituitary and adrenal glands through the hypothalamic-pituitary-adrenal (HPA) axis, which in turn communicates with enteroendocrine cells (EECs). Investigating probiotics, prebiotics, and dietary changes could open new avenues for treatment for mental and neurological problems.}, }
@article {pmid41365088, year = {2026}, author = {Shi, Y and Zhang, H and Cong, S and Zhu, X and Liu, Y and Li, J and Tang, K and Xue, R and Liu, X and Tan, Z and Chen, J and Deng, Y}, title = {Benzylpiperidine-pyridazin-3(2H)-one derivatives as potential multifunctional agents against Alzheimer's disease.}, journal = {European journal of medicinal chemistry}, volume = {303}, number = {}, pages = {118437}, doi = {10.1016/j.ejmech.2025.118437}, pmid = {41365088}, issn = {1768-3254}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Amyloid beta-Peptides/antagonists & inhibitors/metabolism ; Animals ; *Cholinesterase Inhibitors/pharmacology/chemistry/chemical synthesis ; Structure-Activity Relationship ; Humans ; *Neuroprotective Agents/pharmacology/chemistry/chemical synthesis ; Mice ; *Piperidines/chemistry/pharmacology/chemical synthesis ; *Pyridazines/chemistry/pharmacology/chemical synthesis ; *Antioxidants/pharmacology/chemistry/chemical synthesis ; Molecular Structure ; Acetylcholinesterase/metabolism ; Dose-Response Relationship, Drug ; Peptide Fragments/antagonists & inhibitors/metabolism ; Male ; Protein Aggregates/drug effects ; }, abstract = {Based on multitarget-directed-ligands (MTDLs) strategy, a series of benzylpiperidine-pyridazin-3(2H)-ones were designed, synthesized and evaluated as innovative multifunctional agents for Alzheimer's disease (AD). Biological evaluation revealed that most compounds exhibited excellent acetylcholinesterase (AChE) inhibition, potent antioxidant activity and moderate β-amyloid (Aβ1-42) aggregation inhibition. Among them, compound 7a emerged as a synergistic multifunctional agent with significant inhibition of AChE (EeAChE: IC50 = 0.21 μM; HsAChE: IC50 = 13 nM) and anti-Aβ activity (IC50 = 2.92 μM for self-induced Aβ1-42 aggregation; IC50 = 1.28 μM for disaggregation of Aβ1-42 fibrils; IC50 = 3.72 μM for Cu[2+]-induced Aβ1-42 aggregation; IC50 = 2.16 μM for disaggregation of Cu[2+]-induced Aβ1-42 fibrils). In addition, 7a was endowed with the potential to serve as antioxidant (2.88 Trolox equivalents), metals chelator and anti-neuroinflammatory agent for synergistic treatment. Moreover, 7a exhibited pronounced neuroprotective effects across multiple cellular models. Pharmacokinetically, 7a displayed favorable brain penetration (AUCbrain/plasma = 0.77) and sustained exposure. In vivo evaluation demonstrated that 7a effectively ameliorated scopolamine-induced cognitive impairment in the Morris water maze, which was associated with restored cholinergic function and mitigated oxidative stress in mice. The synergistic multi-target efficacy combined with favorable pharmacokinetic properties underscores its potential as a disease-modifying therapeutic agent for AD.}, }
@article {pmid41364547, year = {2026}, author = {Kim, SR and Kim, SK and Kobayashi, H and Nishikawa, H}, title = {Efficacy of MR Imaging Findings in Clinical Management of Hepatic Encephalopathy and Alzheimer's Disease.}, journal = {Hepatology research : the official journal of the Japan Society of Hepatology}, volume = {56}, number = {1}, pages = {11-20}, doi = {10.1111/hepr.70091}, pmid = {41364547}, issn = {1386-6346}, abstract = {In the aging society, distinguishing hepatic encephalopathy (HE) from Alzheimer's disease (AD) poses significant clinical challenges attributed to overlapping neuropsychiatric symptoms including memory loss, disorientation, and impaired daily functioning. Traditional diagnostic approaches relying on clinical assessment and biochemical markers often prove insufficient, necessitating advanced neuroimaging techniques for differential diagnosis. This review examines magnetic resonance imaging (MRI) techniques for differential diagnosis of HE and AD, focusing on T1-weighted imaging findings characteristic of HE, and voxel-based specific regional analysis system (VSRAD) applications in AD diagnosis. Analysis of the literature encompassed peer-reviewed articles examining neuroimaging patterns, diagnostic accuracy, and clinical correlations in both HE and AD. T1-weighted MRI displays bilateral symmetric hyperintensity at the globus pallidus in 70%-90% of HE patients attributed to manganese deposition secondary to impaired hepatic clearance, and provides evidence of HE-related brain changes independent of ammonia levels. VSRAD analysis reveals characteristic medial temporal lobe atrophy patterns in AD, with diagnostic accuracy rates of 91.6% for very mild, 95.8% for mild, and 98.2% for moderate-to-severe AD. Clinical studies demonstrate that brain atrophy detected by VSRAD correlates significantly with functional impairment in activities of daily living, independent of conventional liver function parameters. The integration of T1-weighted MRI and VSRAD analysis provides enhanced diagnostic accuracy for differentiating HE-associated cognitive impairment from primary neurodegenerative conditions, offering valuable prognostic information regarding functional capacity and cognitive trajectory. This systematic neuroimaging approach enables more precise therapeutic decision-making, signals treatment expectations, and directs rehabilitation planning and long-term care strategies in an aging population with increasing prevalence of both hepatic and neurodegenerative disorders.}, }
@article {pmid41364455, year = {2025}, author = {Nakamura, Y and Kurokawa, T and Terashima, S and Nishimura, A}, title = {Efficacy and safety of a novel, extended-release rivastigmine transdermal patch (TW-4752N) in patients with Alzheimer's disease: A 24-week randomized, double-blind trial with a 28-week open-label extension.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251401601}, doi = {10.1177/13872877251401601}, pmid = {41364455}, issn = {1875-8908}, abstract = {BackgroundRivastigmine may offer greater efficacy and convenience of use with a novel formulation than previously reported.ObjectiveTo evaluate the efficacy and safety of a novel, twice-weekly rivastigmine patch (TW-4752N) (TW) in Alzheimer's disease (AD) patients with mild to moderate dementia.MethodsThis was a multicenter, phase III, double-blind study comparing TW and an existing rivastigmine transdermal patch (RT) with an open-label extension. The primary endpoint was the change in ADAS-Jcog total score at week 24 from baseline. Secondary endpoints included the ADAS-Jcog total score at weeks 8, 16, and 24.ResultsA total of 354 and 362 patients were available for efficacy and safety analysis, respectively. Changes in ADAS-Jcog total score at week 24 from baseline were similar between the two groups in the full analysis set with an intergroup difference of -0.84 ± 0.44 (95% CI, -1.695 to 0.016) and with the upper limit of the 95% CI being below the non-inferiority margin of 1.1, demonstrating the non-inferiority of TW. However, analysis of the per-protocol set demonstrated a significant intergroup difference in favor of TW likely suggesting a greater treatment effect with TW than with RT (p = 0.032). Adverse events (AEs) reported in ≥3% of patients were similar between the groups, with the only AE with an intergroup difference of ≥10% in incidence being application site pruritus (TW/RT, 27.6%/17.1%).ConclusionsTW represents a viable alternative option of interest to patients with AD, providing comparable or potentially greater efficacy than RT and comparable safety, as well as greater convenience of use.}, }
@article {pmid41362973, year = {2025}, author = {Burd, SG and Bogolepova, AN and Lebedeva, AV and Rubleva, YV and Kovalenko, EA and Makhnovich, EV and Osinovskaya, NA and Gileva, EA and Pantina, NV and Kovaleva, II and Efimenko, AP and Bokitko, TA and Alekseeva, GA}, title = {[Epileptic seizures in patients with Alzheimer's disease].}, journal = {Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova}, volume = {125}, number = {11}, pages = {36-43}, doi = {10.17116/jnevro202512511136}, pmid = {41362973}, issn = {1997-7298}, mesh = {Humans ; *Alzheimer Disease/complications/epidemiology ; *Epilepsy/epidemiology/etiology/diagnosis/drug therapy ; Risk Factors ; Prevalence ; }, abstract = {Neurodegenerative diseases are one of the leading causes of epileptic seizures with onset in later life. Particular attention is paid to Alzheimer's disease (AD), as a disease that accounts for up to 70% of cases of all types of dementia, and, according to the literature, shares genetic and pathophysiological mechanisms with epilepsy. This paper reviews the literature on the prevalence of epilepsy in AD patients. The reasons for the widely varying data (ranging from 0.5 to 64%) depending on the selected population, the reliability of the established diagnosis, the form and genetic characteristics of the disease, as well as the examination methods used, are considered. The main risk factors for the development of AD and epilepsy, semiotics and features of seizures in patients with AD, as well as approaches to the treatment of such patients, are also covered.}, }
@article {pmid41362151, year = {2025}, author = {Jafari, EA and Alshahawey, M and Zaman, MA and Smith, SM and Gong, Y and Smith, GE and McDonough, CW}, title = {Characterizing Alzheimer's Disease and Related Dementia in a Hypertension Population Within the State of Florida Using Electronic Health Record-Based Data.}, journal = {Clinical pharmacology and therapeutics}, volume = {}, number = {}, pages = {}, doi = {10.1002/cpt.70150}, pmid = {41362151}, issn = {1532-6535}, support = {NIH P30 AG066506//1Florida Alzheimer's Disease Research Center/ ; K01 HL141690/GF/NIH HHS/United States ; R03 HL172123/GF/NIH HHS/United States ; R03 HL172987/GF/NIH HHS/United States ; AG066506/GF/NIH HHS/United States ; CDRN-1501-26692/PCORI/Patient-Centered Outcomes Research Institute/United States ; RI-CRN-2020-005/PCORI/Patient-Centered Outcomes Research Institute/United States ; RI-FLORIDA-01-PS1/PCORI/Patient-Centered Outcomes Research Institute/United States ; UL1TR001427//NIH National Center for Advancing Translational Sciences/ ; UL1TR000064//NIH National Center for Advancing Translational Sciences/ ; }, abstract = {Hypertension is a known modifiable risk factor for Alzheimer's disease and related dementia (ADRD). However, it is unknown how variance in hypertension control, antihypertensive medications, and social determinants of health, such as social deprivation index (SDI), influence the risk of developing ADRD. Validated hypertension computable phenotype algorithms were applied to electronic health record data from the OneFlorida Data Trust (1/1/2013-12/31/2016), to identify apparent treatment-resistant hypertension (aTRH), and hypertension-control levels (well-controlled hypertension, intermediate-controlled hypertension, uncontrolled hypertension). The primary outcome was a new ADRD diagnosis using validated ICD-9/10 codes. Multiple adjusted stepwise logistic regression models were used to identify factors associated with ADRD development. ADRD cumulative hazard incidence per hypertension control levels was assessed using the Nelson-Aalen estimator and log-rank test. A total of 57,273 hypertension patients with 6401 (11%) incident ADRD cases were included in the analysis. The average age was 67 years, with 57% females and 32% identifying as Black or African American. aTRH was a significant ADRD predictor (OR: 1.327, 95% CI: 1.234-1.427), compared to other hypertension phenotypes. aTRH was also significantly associated with a higher incidence of ADRD over time (P < 0.0001). Patients prescribed thiazide diuretics (OR: 0.894, 95% CI: 0.837-0.956) and fixed-dose combination medications (OR: 0.804, 95% CI: 0.732-0.882) had a lower risk of ADRD. A linear relationship between SDI quartiles and ADRD risk was found. aTRH was significantly associated with the development of ADRD. Our study also highlights the importance of comprehensive hypertension control and socioeconomic interventions in preventing or reducing ADRD risk in hypertension patients.}, }
@article {pmid41360503, year = {2025}, author = {Li, G and Li, P and Huang, L and Zhu, J and Qin, X and Lu, Y}, title = {[Protective effects of quercetin, the key component of Zuo Gui Wan, against Alzheimer's disease via the PI3K/AKT pathway: insights from network pharmacology, molecular docking, and cell experiments].}, journal = {Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences}, volume = {}, number = {}, pages = {1-12}, doi = {10.3724/zdxbyxb-2025-0661}, pmid = {41360503}, issn = {1008-9292}, abstract = {OBJECTIVES: To investigate the protective mechanism of quercetin, the core component of Zuo Gui Wan, against Alzheimer's disease through the PI3K/AKT signaling pathway, based on network pharmacology, molecular docking, and cell experi-ments.
METHODS: The active components of Zuo Gui Wan were identified by searching TCMSP, PubChem, Swiss Target Prediction, and BATMAN-TCM databases, and their potential targets were predicted. The target information was standardized using Uniprot, and Alzheimer's disease-related target genes were obtained from Drugbank, GeneCards, and OMIM. The intersection of these datasets was used to identify the potential targets of Zuo Gui Wan for treating Alzheimer's disease. Gene Ontology (GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. The protein-protein interaction (PPI) network of potential targets was visualized using Cytoscape 3.10.1 software and the STRING database. The key active compounds and core potential targets for treating Alzheimer's disease with Zuo Gui Wan were identified through calculation. Based on the enrichment analysis results and literature, quercetin and the PI3K/AKT pathway were selected for verification. Molecular docking and binding ability prediction between quercetin and the core target AKT were performed using CB-Dock2, and visualization was conducted with AutoDock and PyMOL software. Finally, Aβ1-42-induced HT-22 mouse hippocampal neuronal cells were used to construct an Alzheimer's disease cell model. Quercetin, the PI3K inhibitor LY294002, and the activator EGF were used as interventions. The groups were divided as follows: Control, Aβ1-42, Aβ1-42+Quercetin 2.5 μM, Aβ1-42+Quercetin 5 μM, Aβ1-42+Quercetin 10 μM, Aβ1-42+EGF, and the PI3K/AKT modulation group: Control, LY294002, LY294002+Quercetin 10 μM, LY294002+EGF. CCK-8 assays were performed to detect cell viability, while JC-1, Calcein AM-PI, and Hoechst staining were used to assess cell apoptosis. Western blotting was employed to detect the expression of relevant target proteins.
RESULTS: Network pharmacology and cell experiments collectively demonstrate that the key active ingredient of Zuo Gui Wan, quercetin, targets core proteins such as AKT1 and GSK3β through a network-based approach, significantly enriching the PI3K/AKT pathway. Molecular docking results indicate that quercetin has a strong binding affinity with AKT. Experimental validation in the Aβ1-42 oligomer-induced HT-22 model reveals that quercetin significantly activates the PI3K/AKT signaling pathway, which is inhibited by Aβ1-42 oligomers, as well as Bcl-2 protein expression. It also suppresses the expression of Cleaved Caspase 3/Caspase 3, BAX, and Cytochrome C proteins. JC-1, Hoechst 33342, and Calcein AM-PI staining results further show that quercetin can significantly alleviate apoptosis induced by Aβ1-42 oligomers in HT-22 cells. Treatment with the PI3K inhibitor LY294002 in HT-22 cells leads to reduced cell viability and decreased expression of p-AKT/AKT and Bcl-2 proteins, while increasing the expression of Cleaved Caspase 3/Caspase 3, BAX, and Cytochrome C proteins. Additionally, apoptosis levels increase as observed in JC-1, Hoechst 33342, and Calcein AM-PI staining, all of which can be reversed by quercetin and the PI3K agonist EGF.
CONCLUSIONS: Quercetin, the key active ingredient of Zuo Gui Wan, exerts its protective effects against Alzheimer's disease by regulating the PI3K/AKT signaling pathway, inhibiting neuronal cell damage and apoptosis.}, }
@article {pmid41360445, year = {2025}, author = {Menczel Schrire, Z and Mitchell, HF and Low, LF and Espinosa, N and Eames, P and Toltz, J and Walsh, P and Mowszowski, L and Espinoza, D and Lin, CS and Peres Da Costa, N and Naismith, SL}, title = {NeuroMusic: protocol for a randomised-controlled trial of keyboard and singing music training programmes for older adults with mild cognitive impairment.}, journal = {BMJ open}, volume = {15}, number = {12}, pages = {e104158}, pmid = {41360445}, issn = {2044-6055}, mesh = {Humans ; *Cognitive Dysfunction/therapy ; *Music Therapy/methods ; Aged ; Single-Blind Method ; *Singing ; Randomized Controlled Trials as Topic ; *Music ; Cognition ; Neuronal Plasticity ; Australia ; Female ; Male ; }, abstract = {INTRODUCTION: Music-based training programmes, such as learning how to play an instrument or sing in a choir, have been suggested as potential interventions for promoting healthy brain ageing in older adults at risk of cognitive decline because of their ability to enhance cognitive functions and potentially promote neuroplasticity. However, there is limited empirical evidence in older adults at risk of dementia, especially that evaluates both piano and singing interventions and their effects on cognition and neuroplasticity. In this protocol, we outline a study to assess the efficacy of keyboard and singing music training programmes on reducing cognitive decline and other outcomes in older adults with Mild Cognitive Impairment (MCI).
METHODS AND ANALYSIS: This randomised, single-blind, controlled, parallel-group trial aims to enrol 432 individuals with MCI from the community in Sydney, Australia. Participants are randomly allocated to participate in either keyboard lessons, singing lessons or a film discussion control group once a week for 3 months. The primary objective is to assess the effectiveness of two music training programmes (keyboard and choral singing) for enhancing verbal memory after 3 months compared with control. Additionally, we will examine how these music-based interventions affect other aspects of cognition, mood, sleep, overall well-being, markers of brain plasticity and blood biomarkers of Alzheimer's disease and neurodegeneration. Tertiary objectives are to identify factors that impact the success of the interventions, such as participation rates, engagement levels and key demographic and clinical features. Outcomes are collected at baseline and at 3 and 9 months. The primary endpoint analysis will include all randomised participants to estimate the treatment effect using intention-to-treat principles. Primary and secondary outcomes will be analysed using linear mixed models and effect size measures will be calculated.This study will be the first robust, randomised controlled trial to assess the potential and relative value of music engagement for cognitive decline in high-risk MCI individuals, as well as broader effects on other markers of mental health, well-being and neurodegeneration. Co-designed with implementation in mind, the music interventions can potentially be delivered within memory clinic or community settings.
ETHICS AND DISSEMINATION: The Sydney University Human Research Ethics Committee (2023-026) has approved this protocol. The trial findings will be shared through conferences, publications and media.
TRIAL REGISTRATION NUMBER: Australian and New Zealand Clinical Trials Registry (ACTRN12623000407695), Registered 21/04/2023 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385552 PROTOCOL VERSION: 2.02 29/11/2024.}, }
@article {pmid41359976, year = {2025}, author = {Pan, L and Song, X and Su, G and Gandy, LA and Fang, B and Buttaci, M and Gibson, J and Xia, K and Zhang, F and Liu, J and Wang, L and Temple, S and Wang, C}, title = {N-Sulfated Heparan Sulfate Promotes Reelin Signaling as a Co-receptor.}, journal = {Journal of the American Chemical Society}, volume = {147}, number = {51}, pages = {46773-46779}, pmid = {41359976}, issn = {1520-5126}, mesh = {Reelin Protein ; *Heparitin Sulfate/metabolism/chemistry ; *Cell Adhesion Molecules, Neuronal/metabolism/chemistry ; *Serine Endopeptidases/metabolism/chemistry ; *Extracellular Matrix Proteins/metabolism/chemistry ; *Nerve Tissue Proteins/metabolism/chemistry ; Humans ; *Signal Transduction ; HEK293 Cells ; Animals ; }, abstract = {Heparan sulfate (HS) plays a central role in signal transduction, while Reelin is an essential signaling protein in both the developing and adult brain. A Reelin COLBOS variant was recently discovered with enhanced HS binding and resilience against autosomal dominant Alzheimer's disease (ADAD), underscoring the importance of Reelin-HS interactions. However, the glycan determinants of Reelin-HS interactions have not been well-characterized, which we systematically investigated here. Surface plasmon resonance (SPR) showed that full length Reelin binds HS with high affinity (KD = 17 ± 5 nM), which is enhanced by the COLBOS variant (KD = 10 ± 2 nM). Competition SPR and glycan array studies further revealed that HS N-sulfation is critical for Reelin-HS binding, consistent with Haddock modeling. In cell surface binding assays, heparinase treatment, which degrades HS, or the knockout of a key HS N-sulfation enzyme (NDST1) significantly reduced Reelin attachment. Functionally, a cellular split-luciferase assay showed that heparinase treatment or adding heparin in culture medium reduces Reelin-induced ApoER2 dimerization, demonstrating that HS is a coreceptor for Reelin receptor activation. In contrast, N-desulfated heparin does not inhibit Reelin receptor dimerization. Our work establishes HS as a coreceptor for Reelin signaling and N-sulfation as a key glycan determinant of Reelin-HS recognition. Our work provides mechanistic insights into diverse neurodevelopmental and neurodegenerative diseases associated with Reelin signaling and suggests novel therapeutic strategies targeting HS sulfation.}, }
@article {pmid41359335, year = {2025}, author = {Cantoni, V and Casula, EP and Tarantino, B and Cupidi, C and Huber, N and Altomare, D and Premi, E and Zummo, E and Esposito, R and Leonardi, C and Herukka, SK and Solje, E and Ferrari, A and Cotelli, MS and Gasparotti, R and Martorana, A and Fracassi, C and Santarnecchi, E and Koch, G and Haapasalo, A and Grassi, M and Benussi, A and Borroni, B}, title = {Home-Based Gamma Transcranial Alternating Current Stimulation in Patients With Alzheimer Disease: A Randomized Clinical Trial.}, journal = {JAMA network open}, volume = {8}, number = {12}, pages = {e2546556}, pmid = {41359335}, issn = {2574-3805}, mesh = {Humans ; *Alzheimer Disease/therapy/physiopathology ; Male ; Female ; *Transcranial Direct Current Stimulation/methods ; Aged ; Double-Blind Method ; Middle Aged ; Feasibility Studies ; Treatment Outcome ; Italy ; Electroencephalography ; Aged, 80 and over ; }, abstract = {IMPORTANCE: Alzheimer disease (AD) is characterized by dysregulated gamma brain oscillations. Transcranial alternating current stimulation (tACS) is a novel, noninvasive brain stimulation technique capable of entraining cerebral oscillations at targeted frequencies.
OBJECTIVE: To assess the safety, feasibility, and efficacy of home-based gamma tACS applied over the precuneus in patients with prodromal and mild AD.
This double-blind, randomized, sham-controlled clinical trial with an open-label extension phase was conducted at a tertiary AD research clinic in Italy from December 10, 2022, to October 15, 2024. Patients with a diagnosis of AD were eligible to participate.
INTERVENTION: Participants were randomized to receive either home-based gamma tACS (5 sessions/wk, 60 minutes each) or sham stimulation for 8 weeks (double-blind phase). All participants subsequently received gamma tACS for an additional 8 weeks (open-label phase) and an 8-week follow-up.
MAIN OUTCOMES AND MEASURES: The primary end points were safety, feasibility, and clinical efficacy. Secondary end points included measures of biological efficacy, including gamma band power via electroencephalography, cholinergic neurotransmission, AD plasma biomarker levels, and brain connectivity as assessed via magnetic resonance imaging.
RESULTS: Sixty consecutive patients with prodromal or mild AD were screened; 50 were randomized to gamma or sham tACS (mean [SD] age, 67.3 [7.8] years; 25 [50.0%] female and 25 [50.0%] male). Home-based gamma tACS was safe and well-tolerated. A significant enhancement in global cognitive functions, activities of daily living, and associative memory performances was observed. Marginal mean differences between the sham vs gamma tACS groups were significant for the Clinical Dementia Rating sum of boxes (0.35; 95% CI, 0.10-0.61; P = .007), Alzheimer Disease Assessment Scale-cognitive subscale (0.93; 95% CI, 0.50-1.36; P = .001), Alzheimer Disease Cooperative Study-Activities of Daily Living (-0.55; 95% CI, -0.89 to -0.21; P = .02), and Face-Name Association Test (-1.14; 95% CI, -1.66 to -0.61; P ≤ .001). During the open-label phase, a significant marginal mean difference was observed for Alzheimer Disease Assessment Scale-cognitive subscale (-0.59; 95% CI, -1.02 to -0.16; P = .007), Alzheimer Disease Cooperative Study-Activities of Daily Living (0.41; 95% CI, 0.04-0.08; P = .02), and Face-Name Association Test (1.04; 95% CI, 0.50-1.57; P = .003). Neurophysiological measures showed an increase in cholinergic transmission, coinciding with an increase in gamma power following gamma tACS, effects not seen with sham stimulation. No changes of plasma biomarkers were observed. No add-on effect was observed after 2 repeated treatments with gamma tACS, suggesting that 8 rather than 16 weeks of treatment represents the ideal duration.
CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, home-based gamma tACS was feasible and improved clinical outcomes in AD, with neurophysiological evidence of brain engagement. These findings support further investigation of gamma tACS as a potential therapeutic intervention for AD.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05643326.}, }
@article {pmid41359327, year = {2025}, author = {Gotlieb, E and Joseph, B and Blank, L and Jetté, N}, title = {Barriers and Consequences of Prior Authorization for Neurologic Medications: A Scoping Review.}, journal = {JAMA neurology}, volume = {}, number = {}, pages = {}, doi = {10.1001/jamaneurol.2025.4560}, pmid = {41359327}, issn = {2168-6157}, abstract = {IMPORTANCE: Prior authorization (PA) is widely used by insurers to control health care costs and promote high-value care, but it can create significant barriers to accessing medications. This is particularly concerning in neurology, where timely treatment is critical to avoid disease progression and optimize patient outcomes.
OBJECTIVE: To assess the consequences, barriers, and facilitators of PA policies affecting access to pharmacologic treatment in 6 common neurologic conditions-Alzheimer disease, Parkinson disease, multiple sclerosis, migraine, cerebrovascular disease, and epilepsy-with focus on impacts on patients, clinicians, and administrators.
EVIDENCE REVIEW: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines for scoping reviews were followed, and the study protocol was registered on Open Science Framework. MEDLINE and Embase were searched up to November 1, 2024, using Ovid for studies that assessed the role of PA as a primary or secondary outcome for the 6 included neurologic conditions, or for neurology broadly if strongly applicable to the study aim, after the signage of the Affordable Care Act in March 2010. Abstract screening and full-text review were done in duplicate. Key information was charted in extraction, including study characteristics, demographics, methods, results, and implications for relevant stakeholders. The results were aggregated and thematically analyzed.
FINDINGS: A total of 364 studies were identified using our search strategy on Ovid, 278 records were screened, and 20 studies were included in this review. The most frequently identified consequences for patients were delays in care (60%) and increase in disease activity (25%). The most frequently identified consequence for clinicians (35%) and administrators (15%) was time burden. The most common facilitators were the use of clinical pharmacists or technicians (20%) and health system specialty pharmacies (15%).
CONCLUSIONS AND RELEVANCE: According to the results of this scoping review, PA can contribute to significant access barriers for people with neurological conditions and is associated with burden for all stakeholders involved. Reforms to PA can work towards more equitable access to medications for patients.}, }
@article {pmid41358721, year = {2026}, author = {Ke, S and Chen, Z and Qi, Y and Zhang, J and Chen, Q and Chen, J and Bo, H}, title = {Heyndrickxia coagulans as a next-generation probiotic: current evidence and future perspectives.}, journal = {Food & function}, volume = {17}, number = {1}, pages = {15-40}, doi = {10.1039/d5fo03559g}, pmid = {41358721}, issn = {2042-650X}, mesh = {*Probiotics/therapeutic use ; Humans ; Animals ; *Lactobacillaceae/physiology ; }, abstract = {Heyndrickxia coagulans, a spore-forming probiotic, has garnered significant attention due to its exceptional tolerance to gastric acid and heat, alongside its multifaceted therapeutic potential. This review systematically delineates the unique biological characteristics of this bacterium, which include high survivability mediated by its spore form (retaining 73% viability after microwave treatment at 260 °C), dual lactate fermentation pathways, and plasticity in ATP synthesis that depends on pH and growth rate. Clinical evidence supports its efficacy in managing metabolic disorders (e.g., type 2 diabetes and non-alcoholic fatty liver disease), gastrointestinal conditions (e.g., constipation and irritable bowel syndrome), and neuropsychiatric disorders (e.g., depression and Alzheimer's disease). The underlying mechanisms involve the production of short-chain fatty acids (SCFAs), modulation of the TLR4/MyD88/NF-κB signaling pathway, and suppression of oxidative stress. Notably, therapeutic effects are strain-specific: H. coagulans MTCC 5856 (2 × 10[10] CFU day[-1]) significantly reduces abdominal distension (P < 0.01), while the strain Unique IS-2 alleviates anxiety-like behaviors by upregulating hippocampal BDNF. Although toxicological assessments establish a no observed adverse effect level (NOAEL) of >1000 mg kg[-1] in rodent models, its limited capacity for intestinal colonization presents a clinical challenge. Future research should prioritize large-scale clinical trials, multi-omics mechanistic investigations, and the development of synbiotic formulations to fully realize its potential as a next-generation therapeutic agent.}, }
@article {pmid41358632, year = {2025}, author = {Zhang, S and Wang, T and Xue, G and Zheng, R and Ding, N and Yang, J and Zhang, M}, title = {Dysregulated mTOR signaling in Alzheimer's disease: Linking pathogenic mechanisms to emerging therapeutic strategies.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251400667}, doi = {10.1177/13872877251400667}, pmid = {41358632}, issn = {1875-8908}, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline and multifaceted pathogenic mechanisms (including amyloid-β [Aβ] plaques, tau neurofibrillary tangles, synaptic dysfunction, and neuroinflammation). Importantly, no effective disease-modifying treatment is currently available for AD. Emerging evidence implicates dysregulated mammalian target of rapamycin (mTOR) signaling as a key contributor to AD pathogenesis. This review analyzes how aberrant mTOR signaling influences major aspects of AD pathology, including Aβ production and clearance, tau protein hyperphosphorylation, autophagy dysfunction, synaptic plasticity impairments, neuroinflammation, and oxidative stress. Notably, hyperactivated mTOR accelerates AD progression through multiple mechanisms. It promotes Aβ accumulation and tau pathology, suppresses autophagic clearance of toxic aggregates, and disrupts neuronal homeostasis, thereby exacerbating cognitive decline. Consequently, mTOR has gained attention as a therapeutic target. This review evaluates the therapeutic potential of various mTOR-targeted interventions, such as the mTORC1 inhibitor rapamycin and its analogues (rapalogs), second-generation ATP-competitive mTOR inhibitors, and certain natural compounds and traditional Chinese medicine approaches. These strategies have demonstrated promise in mitigating AD-related pathology by enhancing autophagy, reducing Aβ/tau burden, and preserving synaptic and cognitive function in preclinical studies. However, the clinical translation of mTOR-targeted therapies faces key challenges, including poor blood-brain barrier penetration of many mTOR inhibitors, potential systemic side effects, and limited clinical validation to date. Further research is needed to optimize brain delivery, dosing regimens, and target specificity to fully realize the therapeutic potential of mTOR modulation in AD.}, }
@article {pmid41358629, year = {2025}, author = {Kandeel, M and Mahmoud, M}, title = {Comparative efficacy and safety of different brexpiprazole doses for agitation in Alzheimer's disease: A systematic review and network meta-analysis.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251404500}, doi = {10.1177/13872877251404500}, pmid = {41358629}, issn = {1875-8908}, abstract = {BackgroundAgitation in Alzheimer's disease significantly impacts patient outcomes and caregiver burden. Brexpiprazole has emerged as a promising treatment option, but optimal dosing remains unclear.ObjectiveTo evaluate the comparative efficacy and safety of different brexpiprazole doses in treating agitation associated with Alzheimer's disease through a systematic review and network meta-analysis (NMA).MethodsFollowing PRISMA guidelines, we searched PubMed, Embase, Web of Science, and Scopus through January 2025. Four randomized controlled trials (N = 1451) comparing various brexpiprazole doses (0.5-3 mg/day) with placebo were included. Primary outcomes included changes in the Cohen-Mansfield Agitation Inventory (CMAI), the Clinical Global Impression-Severity Scale (CGI-S), and the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH) scores, alongside safety measures.ResultsBrexpiprazole 2 mg demonstrated significant improvement in CMAI scores versus placebo (mean difference [MD]: -5.88; 95% CI: -8.13 to -3.63) and CGI-S scores (MD: -0.48; 95% CI: -0.95 to -0.01). Multiple doses showed significant NPI-NH improvements, with 2-3 mg showing the strongest effect (MD: -4.60; 95% CI: -7.54 to -1.66). Higher doses (2-3 mg) increased treatment-emergent adverse events (risk ratio [RR]: 1.20-1.33) but showed no significant difference in serious adverse events compared to placebo.ConclusionsBrexpiprazole 2 mg provides optimal therapeutic benefit while maintaining a favorable safety profile. The findings support initiating treatment at lower doses with careful titration to 2 mg based on individual response and tolerability. Future research should focus on long-term outcomes and real-world effectiveness.}, }
@article {pmid41358624, year = {2025}, author = {Seixas-Lima, B and Rosa-Neto, P and Phillips, NA and Borrie, M and Roncero, CT and Lahiri, D and Dori, D and Eintracht, S and Chertkow, H}, title = {Peripheral inflammation in a Canadian cohort of neurodegenerative conditions: Occurrence, determinants, and impact.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251401611}, doi = {10.1177/13872877251401611}, pmid = {41358624}, issn = {1875-8908}, abstract = {Background"Inflammaging" describes chronic low-grade inflammation observed in aging individuals. It may play a major role in neurodegeneration.ObjectiveTo assess blood inflammatory markers in older adults. We hypothesized that elevated inflammation would be found in some cognitively normal older adults but would be more prevalent in individuals with cognitive impairment.MethodsInterleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in 514 Canadian individuals in COMPASS-ND, a detailed study of cognitive impairment in the elderly. Cumulative link model (CLM) was used to investigate the relationship between inflammation status (low, medium, or high tertiles) and demographic and lifestyle factors along with cognitive function and cognitive diagnoses.ResultsWe found that 12% of cognitively normal older adults had IL-6 levels in the highest tertile, but this increased in cognitively impaired cohorts-36% in Alzheimer's disease, 55% mixed dementia, 30% mild cognitive impairment, and 39% vascular mild cognitive impairment. We found that 36% of cognitively unimpaired older individuals display "elevated" IL-6 (middle and high tertile values), while approximately 70% of those with cognitive impairment also do so. Inflammation markers increased most robustly in association with age, higher body mass index, and higher Fazekas (MRI white matter hyperintensity) score. There were also weaker associations with female sex, nutrition, number of comorbidities, and poor sleep.ConclusionsPeripheral low-grade inflammation was common, particularly in individuals with cognitive impairment; and obesity and age were the main drivers. It remains unclear whether treatment targeting such inflammation might have a therapeutic role in dementia prevention.}, }
@article {pmid41357417, year = {2025}, author = {Roy, A and Kumar, D and Bhattacharya, P and Borah, A}, title = {In silico decoding strategic pathways inhibition by coptisine for halting Alzheimer's pathology: a mechanistic insight.}, journal = {In silico pharmacology}, volume = {13}, number = {3}, pages = {202}, pmid = {41357417}, issn = {2193-9616}, abstract = {Alzheimer's Disease (AD) is a brain disorder with various neuropathological hallmarks and has become a major concern globally due to limited therapeutic options. Cholinergic dysfunction due to the depletion of acetylcholine (ACh) levels in the synapse caused by increased acetylcholinesterase (AChE) activity is one of the major factors that drives AD progression. AChE also accelerates amyloid beta (Aβ) formation and leads to amyloid plaque deposition in the brain. Production of Aβ from amyloid precursor protein (APP) with sequential cleavage by β-secretase (BACE1) and γ-secretase causes severe brain damage due to plaque toxicity. Neurofibrillary tangles (NFTs), a neuronal catastrophe resulting from hyperphosphorylation of tau protein due to upregulation of glycogen synthase kinase 3 beta (GSK3β) and downregulation of Wnt signaling because of Dickkopf-1 and low density lipoprotein receptor-related protein 6 (DKK1-LRP6) interaction, are a major pathogenic event in AD. Recent research has increasingly focused on targeting amyloidopathy, tauopathy, and cholinergic pathways as therapeutic strategies for mitigating AD pathology. Coptisine, a bioactive alkaloid having enormous pharmacological properties, including neuroprotective action, is considered in our in-silico investigation. Collective inhibition of key targets in AD pathogenesis, like AChE, β-secretase (BACE1), γ-secretase, GSK3β, and DKK1-LRP6 interaction, could be a positive approach in the arsenal of Alzheimer's treatment. In this article, we report that coptisine can inhibit these five major targets as evident from our molecular docking study, and propose it as a potential multi-target drug to play a key role in halting AD pathology. Further, comparative analysis based on predicted values of cheminformatics and pharmacokinetic profiling of coptisine and known inhibitors increases its possibility to ameliorate AD. However, robust research, including a preclinical and clinical study on coptisine for its safety and efficacy assessment against AD pathology, is warranted for its validation as an anti-AD drug.}, }
@article {pmid41357230, year = {2025}, author = {Xu Lou, I and Zhou, H and Wan, H}, title = {The critical role of Th17 cells and IL-17A in autoimmune and inflammation-associated neurological diseases: mechanisms and therapeutic perspectives.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1656422}, pmid = {41357230}, issn = {1664-3224}, mesh = {Humans ; *Th17 Cells/immunology/metabolism ; *Interleukin-17/immunology/metabolism ; Animals ; Inflammation/immunology ; *Autoimmune Diseases/immunology/therapy ; *Nervous System Diseases/immunology/therapy/etiology/metabolism ; *Neuroinflammatory Diseases/immunology/therapy ; }, abstract = {Helper T cells 17 (Th17) and their effector cytokine, interleukin-17A (IL-17A), play a dual role in immune homeostasis. On one hand, they are essential in defense against extracellular pathogens, such as bacteria and fungi, by inducing chemokine production and recruiting neutrophils. On the other hand, their dysregulated activity is strongly linked to autoimmune and inflammatory disorders, including multiple sclerosis, Alzheimer's disease, Parkinson's disease, and others. This article reviews the molecular mechanisms regulating Th17 differentiation and function, emphasizing the role of transcription factors like RORγt and RORα, as well as the influence of cytokines such as IL-6, IL-23, and TGF-β. Additionally, it explores the imbalance between pro-inflammatory Th17 cells and regulatory T cells (Tregs), a critical axis in the pathogenesis of autoimmune and neuroinflammatory diseases. In the context of neurological disorders, Th17 cells can infiltrate the central nervous system (CNS), where they contribute to neuroinflammation by activating microglia and astrocytes, exacerbating damage in conditions such as multiple sclerosis, traumatic brain injury, and neurodegenerative diseases. Emerging therapies, including anti-IL-17 monoclonal antibodies and natural modulators, are discussed as potential strategies to restore the Th17/Treg balance without compromising protective immunity. Finally, the need for further research is highlighted to elucidate the specific mechanisms of Th17 infiltration into the CNS, their interaction with the gut microbiota, and the development of personalized therapies. The integration of immunological, metabolic, and environmental approaches offers promising perspectives for the treatment of Th17/IL-17-mediated diseases.}, }
@article {pmid41357129, year = {2025}, author = {Rananaware, P and Singh, S and Brahmkhatri, VP}, title = {Scavenging of reactive oxygen and nitrogen species using nanoparticles and their applications in disease management.}, journal = {RSC advances}, volume = {15}, number = {56}, pages = {47955-47980}, pmid = {41357129}, issn = {2046-2069}, abstract = {Nanomaterials constitute a new trend of disease management that is associated with advanced nanotechnology and bioengineered materials, presenting new solutions for various diseases that were previously problematic to handle with traditional chemical drugs or natural materials. Due to their high surface area, charge, variable size, and other properties, nanomaterials have been broadly used to manage several diseases. Specifically, nanomaterials have appeared with a significant ability to act as RONS scavengers for treatment and disease management. This is a result of their versatility in various applications, controlled release, enhanced reactivity, and unique biochemical properties. Recently, specific nanomaterials for treatment and disease management have been effectively developed into clinical tests. This review article focuses on the different types of nanomaterials that are effective for RONS scavenging and are used for different biomedical applications associated with excessive RONS generation. Nanoparticle-based systems have gained significant attention in recent years for their potential applications in scavenging reactive oxygen and nitrogen species (RONS) as part of disease management strategies. These nanoparticles can be designed to enhance the delivery, stability, and efficacy of antioxidants or other scavenging agents. The current review article provides a complete overview of the anti-inflammatory nature and use of nanoparticle systems by examining the molecular and pathological mechanisms of oxidative stress and the function of this stress in both cell and tissue damage. However, it is important to consider the biocompatibility, stability, and potential toxicity of these nanoparticle systems for therapeutic applications. Additionally, targeted delivery and controlled release mechanisms can enhance their efficacy in scavenging RONS at specific disease sites. RONS play a dual role in biological systems-they are essential for various physiological processes, such as cell signalling and host defence, but their overproduction can lead to oxidative and nitrosative stress, contributing to the development and progression of several diseases. Managing RONS is a key aspect of disease prevention and treatment. This article focuses on the use of nanomaterials for the treatment of various cancers, and in other areas such as tissue engineering, wound healing, osteoclast genesis, inflammation, and neurodegenerative disorders, such as Parkinson's and Alzheimer's disease, through RONS scavenging.}, }
@article {pmid41356945, year = {2025}, author = {Kumar, P and Bhat, A and Goel, D and Mittal, M}, title = {Clinico-Etiological Profile of Young-Onset Dementia From a Tertiary Care Center in Northern India.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e96203}, pmid = {41356945}, issn = {2168-8184}, abstract = {BACKGROUND: This study examines young-onset dementia (YOD). Young-onset dementia refers to cases of dementia that manifest earlier in life and often pose unique clinical and management challenges. Despite its significant impact, data on YOD in northern India remain limited.
OBJECTIVE: To evaluate the clinico-etiological profile and cognitive characteristics of young-onset dementia patients presenting to a tertiary care center in Uttarakhand, India.
METHODS: This is a longitudinal follow-up study that was conducted over 1.5 years in the Department of Neurology. A total of 37 patients under 65 years of age out of 40 selected, diagnosed with major neurocognitive disorder (DSM-5), were included. Comprehensive clinical assessments, brain imaging, and cognitive evaluations were conducted. Data were analyzed using IBM Corp. Released 2018. IBM SPSS Statistics for Windows, Version 24. Armonk, NY: IBM Corp., with chi-square tests, analysis of variance (ANOVA), and Bonferroni corrections, with significance set at p<0.05.
RESULTS: The majority of patients were males (65%) and aged 56 to 65 years (50%). Vascular dementia was the most common cause (37.8%), followed by Alzheimer's disease (18.9%) and frontotemporal dementia (13.5%). Based on the verbal-language/orientation-memory (VLOM) ratio, 27.5% had frontotemporal-type dementia and 7.5% had Alzheimer-type dementia. Significant cognitive decline (p < 0.05) in MMSE and ACE-III scores was observed in Alzheimer's disease and frontotemporal dementia. Vitamin B12 deficiency showed 13.5% improvement with treatment. VLOM ratios effectively differentiated frontotemporal dementia (FTD) from AD.
CONCLUSION: This study concluded that vascular dementia is the leading cause of YOD in this region, reflecting a high burden of modifiable vascular risk factors. The VLOM ratio offers diagnostic value in distinguishing dementia subtypes. Early identification and intervention are essential to address the functional burden of YOD.}, }
@article {pmid41356558, year = {2025}, author = {Wang, H and Yang, F and Gao, Z and Cheng, Z and Liang, X}, title = {The gut-brain axis in Alzheimer's disease: how gut microbiota modulate microglial function.}, journal = {Frontiers in aging}, volume = {6}, number = {}, pages = {1704047}, pmid = {41356558}, issn = {2673-6217}, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disorder that can be caused by multiple factors, such as abnormal amyloid-beta (Aβ) deposition, pathological changes in Tau protein, lipid metabolism disorders, and oxidative stress. Recent studies have revealed the potential link between gut microbiota and AD, particularly the impact of gut microbiota and its derivatives on microglia. As immune cells in the central nervous system (CNS), microglia are involved in neuroinflammation and the regulation of cognitive function. Research indicates that the dysregulation of gut microbiota may affect the phenotype and function of microglia through various mechanisms, including direct metabolite action and indirect immune and neurotransmitter regulation. This article reviews the direct and indirect effects of gut microbiota and its derivatives on microglia, explores their role in the pathogenesis of AD, and discusses therapeutic strategies based on gut microbiota, such as dietary regulation, probiotics, fecal microbiota transplantation, and traditional Chinese medicine. Although existing studies have shown the potential of these interventions, further research is needed to completely understand their application in the treatment of AD.}, }
@article {pmid41355970, year = {2026}, author = {Park, A and Hong, SM and Lee, Y and Lee, J and Jeon, S and Seo, SY and Lee, J and Kim, SH and Ko, EJ and Lee, HR and Jung, SH and Bae, M and Kang, MC and Park, MG and Nam, S and Kim, SY}, title = {Deep learning identifies TP-41 for methylglyoxal scavenging in Alzheimer's treatment.}, journal = {Theranostics}, volume = {16}, number = {3}, pages = {1103-1122}, pmid = {41355970}, issn = {1838-7640}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; *Pyruvaldehyde/metabolism ; Animals ; *Deep Learning ; Mice ; Disease Models, Animal ; Glycation End Products, Advanced/metabolism ; Humans ; Male ; Memory Disorders/drug therapy ; Mice, Inbred C57BL ; }, abstract = {Rationale: Increased levels of advanced glycation end products (AGEs) have been observed in the brain tissues of patients with Alzheimer's disease (AD). Methylglyoxal (MGO) is a potent precursor of AGEs. To date, there have been no reports of utilizing deep learning (DL) technologies to target MGO scavengers for the development of AD therapeutics. Therefore, DL-driven approaches may play a crucial role in identifying potential MGO scavengers and candidates for Alzheimer's treatment. Methods: We developed "DeepMGO," a novel DL-based MGO scavenging activity prediction model, trained on 2,262 MGO scavenging activity assays from 660 compounds. Using this approach, we identified and validated TP-41 as a potential MGO scavenger in a mouse model of memory impairment. Results: DeepMGO demonstrated robust predictive performance and identified novel compounds with high MGO scavenging activity. TP-41 ameliorated depression symptoms and memory deficits in mouse models. Conclusions: Using DeepMGO, we identified TP-41 as a potential therapeutic agent for AD.}, }
@article {pmid41355958, year = {2026}, author = {Wu, Y and Fan, Y and Bao, S and Song, Y and Wang, R and Wu, J and Liu, X and Jin, J and Kong, L and Hou, B and Liang, P and Chen, T and Liu, W and Peng, B and He, F and Zhou, Y and Xu, J and Chen, Y and Han, S and Yin, J and He, X}, title = {Mertk promotes early microglial-mediated synaptic engulfment in Alzheimer's disease.}, journal = {Theranostics}, volume = {16}, number = {3}, pages = {1238-1261}, pmid = {41355958}, issn = {1838-7640}, mesh = {*Microglia/metabolism ; *Alzheimer Disease/metabolism/pathology/genetics ; *c-Mer Tyrosine Kinase/metabolism/genetics ; Animals ; Mice ; *Synapses/metabolism/pathology ; Disease Models, Animal ; Phagocytosis ; Hippocampus/metabolism/pathology ; Amyloid beta-Peptides/metabolism ; PPAR gamma/metabolism ; Mice, Knockout ; Mice, Inbred C57BL ; Humans ; Mice, Transgenic ; Male ; }, abstract = {Rationale: Synaptic deficits occur prior to the emergence of Aβ plaques and tau pathology in Alzheimer's disease (AD). Dysregulated microglia excessively prune synapses, leading to synaptic loss. While microglia phagocytic receptor Mertk participates in synaptic pruning, the role of Mertk in driving early synaptic loss in AD remains elusive. Methods: Single-cell RNA sequencing (scRNA-seq) was used to analyze transcriptional changes of microglia in early stage of AD mice. Mertk-mediated synaptic engulfment was investigated both in vivo and in vitro. Results: Phagocytic-associated microglia with upregulated Mertk were identified in the early stage of AD mice. Dysregulated synaptic pruning by microglia caused hippocampal synaptic loss and memory deficits in two AD mouse models. Notably, Mertk knockout or antagonist treatment reversed excessive synapse elimination by microglia. Mechanistically, Aβo-induced PPARγ promoted Mertk transcription, mediating microglial phagocytosis of synapses. Conclusions: Collectively, our findings suggest that PPARγ-regulated, Mertk-mediated microglial synaptic engulfment contributes to early synaptic loss in AD, highlighting microglial Mertk as a potential therapeutic target for AD.}, }
@article {pmid41355756, year = {2025}, author = {Liu, F and Tang, YL and Zhang, ZB and Tan, YH and Lin, SH and Wang, NY and Li, JN and Pan, ZJ and Li, JF and Huang, JF and Ding, YQ and Guo, CM and Xu, L and Peng, C and Zhou, QX}, title = {Modifying Glucose Metabolism Reverses Memory Defects of Alzheimer's Disease Model at Late Stages.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {}, number = {}, pages = {e06695}, doi = {10.1002/advs.202506695}, pmid = {41355756}, issn = {2198-3844}, support = {2022ZD0204900//National Program of Brain Science and Brain-Inspired Intelligence Technology 2030/ ; 32271080//National Natural Science Foundation of China/ ; 32071029//National Natural Science Foundation of China/ ; 82473909//National Natural Science Foundation of China/ ; 32170662//National Natural Science Foundation of China/ ; 32070818//National Natural Science Foundation of China/ ; 202401AS070131//Yunnan Fundamental Research Project/ ; 202402AA310014//Yunnan Provincial Science and Technology Department/ ; LG-QS-202205-05//The Lingang Laboratory/ ; 202001BB050005//Natural Science Foundation of Yunnan Province/ ; //Xingdian talent program of Yunnan Province/ ; }, abstract = {Significant efforts have harvested a sophisticated understanding of Alzheimer's disease (AD) including amyloid beta (Aβ) cascade mechanisms, although effective treatment for reversing or stopping AD progression is not available. This study reports that ferul enanthate (SL), a novel derivative of active agents targeting brain microvessels, oxidative phosphorylation, and ATP generation can reverse the hippocampus-dependent spatial memory defects and reduce Aβ plaques in AD model mice (APP/PS1) at advanced stages. Spatial transcriptomics discovers that SL endows a cluster of genes expressing in Aging-AD-Rescue (AAR) pattern, which is prominent in hippocampal dendritic region where Aβ plaques are densely deposited. Furthermore, this AAR rule covers hippocampal Glut1 (glucose transporter 1) expression and ATP generation, which are further confirmed by immunoblotting or immunofluorescence studies. Our data demonstrate that SL can still reverse memory defects at advanced stages of AD mice by modifying aging-dependent multiple pathologies of AD, particularly promoting Glut1 expression and ATP generation.}, }
@article {pmid41355547, year = {2025}, author = {Lu, Q and Di, X and Guo, X}, title = {Comprehensive Review on the Protective Effects of Lycium barbarum Polysaccharide on Neurodegenerative Diseases.}, journal = {Endocrine, metabolic & immune disorders drug targets}, volume = {}, number = {}, pages = {}, doi = {10.2174/0118715303393082251027072838}, pmid = {41355547}, issn = {2212-3873}, abstract = {Neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Huntington's disease, ischemic stroke, and other related conditions, significantly impact the quality of life, particularly in low-income nations. The pathogenesis of these diseases is driven by neuroinflammation, oxidative stress, apoptosis, mitochondrial dysfunction, and regulation of autophagy. To date, no therapies or medications can fully reverse the progression of these diseases. Natural polysaccharides have demonstrated significant therapeutic potential in the treatment of neurodegenerative diseases. Lycium barbarum polysaccharide, derived from the traditional Chinese medicine Lycium barbarum L., has attracted considerable attentionfor its diverse biological activities, biodegradability, ease of modification, and low toxicity. This review aims to systematically evaluate the neuroprotective effects of Lycium barbarumpolysaccharides and their mechanisms in various neurodegenerative disease models. For this study, we used multiple scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar. We verified the correct plant name through the website plantlist.org. The search results were interpreted and documented based on the retrieved bibliographic information. Lycium barbarum polysaccharide has shown significant therapeutic potential for the treatment of neurodegenerative diseases. Experimental evidence reveals its neuroprotective effects through various mechanisms, including reducing neuroinflammation, alleviating oxidative stress, inhibiting apoptosis, improving mitochondrial function, and regulating autophagy. The current review established that Lycium barbarum polysaccharide holds promise as a therapeutic agent for neurodegenerative diseases. However, further research is required to address the limitations identified in previous studies and to guide future experimental investigations and clinical applications.}, }
@article {pmid41355080, year = {2025}, author = {van Dyck, CH and Sperling, R and Johnson, K and Dhadda, S and Kanekiyo, M and Li, D and Gee, M and Hersch, S and Irizarry, M and Kramer, L}, title = {Long-term safety and efficacy of lecanemab in early Alzheimer's disease: Results from the clarity AD open-label extension study.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70905}, pmid = {41355080}, issn = {1552-5279}, support = {//Eisai Inc. and Biogen/ ; }, mesh = {Humans ; *Alzheimer Disease/drug therapy/pathology ; Female ; Male ; Aged ; Quality of Life ; Treatment Outcome ; Disease Progression ; Amyloid beta-Peptides ; Aged, 80 and over ; }, abstract = {INTRODUCTION: In Clarity AD, lecanemab reduced markers of amyloid in early symptomatic Alzheimer's disease and slowed cognitive and functional decline at 18 months. Herein, we report 36-month data from the ongoing open-label extension (OLE).
METHODS: Clarity AD is an 18-month, randomized study (Core), with an OLE where participants received open-label lecanemab. Clinical and health-related quality-of-life (HRQoL) outcomes were evaluated overall and by examining "delayed-start" and "early-start" cohorts. Low pathology (i.e., low baseline amyloid or tau) subgroups were analyzed.
RESULTS: ARIA rates were low after 6 months and not associated with long-term progression. Across clinical and HRQoL endpoints, lecanemab-treated participants continued to benefit through 36 months. Separation between early and delayed start was maintained between 18 and 36 months. The low pathology subgroup showed stability or improvement over 18-36 months.
DISCUSSION: Benefit continued to accrue with ongoing lecanemab treatment through 36 months. Results in the low pathology subgroup support early initiation of lecanemab treatment.
HIGHLIGHTS: This research evaluated the long-term efficacy, safety, and HRQoL results from an ongoing extension of the phase 3 Clarity AD, which included open-label lecanemab treatment for up to 36 months. Overall, the results show participants continue to accrue a lecanemab treatment benefit up to 36 months and highlight the importance of continued long-term lecanemab treatment. Results presented in our paper demonstrate that lecanemab continued suppression of amyloid plaque levels and significantly slowed clinical decline on multiple measures of cognition, function, and quality of life in early AD at 18 months and continued for 36 months to date. No new safety signals were observed with continued lecanemab treatment. After the first 6 months, ARIA rates were low and similar to ARIA rates on placebo, with no association between ARIA occurrence and accelerated long-term clinical progression. Taken together with existing data, these results provide a clear rationale and a demonstration of the disease modification effects of long-term lecanemab therapy.}, }
@article {pmid41354641, year = {2025}, author = {Feyzbakhsh, H}, title = {Nanoparticle-based strategies for overcoming the blood-brain barrier in CNS disorders and brain cancer: precision diagnostics and therapeutics for Alzheimer's, Parkinson's, multiple sclerosis, and glioblastoma.}, journal = {Tissue barriers}, volume = {}, number = {}, pages = {2599564}, doi = {10.1080/21688370.2025.2599564}, pmid = {41354641}, issn = {2168-8370}, abstract = {Nanoparticle (NP)-based technologies are transforming the management of central nervous system (CNS) disorders such as Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), and brain cancer (BC), glioblastoma, by surpassing the blood-brain barrier (BBB) and blood-brain tumor barrier (BBTB). This review integrates NP approaches, comprising organic (e.g. liposomes, polymeric NPs), inorganic (e.g. gold, iron oxide), carbon-based, and hybrid systems, to overcome disease-specific barriers. In AD, superparamagnetic iron oxide NPs (SPIONs) and gold NPs (AuNPs) improve amyloid-beta plaque and tau protein detection, while liposomes precisely deliver anti-amyloid drugs. For PD, dopamine-loaded liposomes and cerium oxide NPs reinstate dopaminergic function and decrease oxidative stress, with improved motor outcomes. In MS, PEGylated liposomes and PLGA NPs regulate autoimmune responses, inducing remyelination and attenuating neuroinflammation. For BC, dendrimers and magnetic NPs facilitate targeted chemotherapy delivery across the BBB/BBTB, improving glioblastoma treatment outcomes. We compare NP types critically based on physicochemical characteristics, efficacy, toxicity, and clinical translation potential, highlighting gaps in long-term safety and scalability. Challenges like NP toxicity and regulatory complexities are discussed, suggesting biocompatible designs and standardized FDA/EMA pathways. By consolidating diagnostic and therapeutic innovations, this review outlines a roadmap for NP-based precision medicine, paving the way for clinical translation and better patient outcomes in CNS disorders and brain cancer.}, }
@article {pmid41354326, year = {2025}, author = {Wiredu, K and Gowda, P and Rhee, J and Mueller, A and Simon, C and Kelly Graves, O and Qu, JZ and Spite, M and McKay, TB and Akeju, O}, title = {Long-chain polyunsaturated fatty acid lipid and oxylipin alterations in postoperative delirium after cardiac surgery.}, journal = {Journal of lipid research}, volume = {67}, number = {1}, pages = {100959}, pmid = {41354326}, issn = {1539-7262}, abstract = {Lipids play a crucial role in signaling, membrane dynamics, and inflammatory regulation, yet their involvement in postoperative delirium pathogenesis remains unclear. This study examined serum lipidomic alterations in postoperative delirium and assessed the effects of dexmedetomidine treatment on these changes. Lipidomic profiling was conducted at baseline and postoperative day 1 in two independent cohorts of cardiac surgery patients. Mass spectrometry-based shotgun lipidomics and targeted lipid analyses were used to assess lipidomes and oxylipins, respectively. Cardiac surgery was associated with decreased serum lysophospholipids. Postoperative delirium was associated with increased long-chain polyunsaturated fatty acid phospholipids, particularly phosphatidylethanolamines, and elevated oxylipins. Dexmedetomidine, a potential delirium-mitigating medication, reduced long-chain polyunsaturated fatty acid phospholipids. These findings highlight lipid modulation as a potential target for postoperative delirium prevention.}, }
@article {pmid41353845, year = {2026}, author = {Azadmaleki, H and Zolnour, A and Rashidi, S and Noble, JM and Hirschberg, J and Esmaeili, E and Morovati, T and Zolnoori, M}, title = {TransformerCARE: A novel speech analysis pipeline using transformer-based models and audio augmentation techniques for cognitive impairment detection.}, journal = {International journal of medical informatics}, volume = {207}, number = {}, pages = {106208}, doi = {10.1016/j.ijmedinf.2025.106208}, pmid = {41353845}, issn = {1872-8243}, mesh = {Humans ; *Cognitive Dysfunction/diagnosis ; Female ; Male ; Aged ; *Speech ; Algorithms ; }, abstract = {OBJECTIVE: Early diagnosis of cognitive impairment, including Alzheimer's and other dementias, is critical for effective treatment and slowing disease progression. However, over 50% of cases remain undiagnosed until advanced stages due to limitations in current methods. Recognizing speech impairments as early markers of cognitive decline, this study evaluated the utility of speech analysis as a technique for early detection. We introduce TransformerCARE, a speech processing pipeline utilizing advanced speech transformer models.
METHODS: TransformerCARE incorporated a series of key steps, including preprocessing, speech segmentation, transformer fine-tuning, segment aggregation, performance evaluation, and data augmentation. In the fine-tuning step, we evaluated the performance of four state-of-the-art speech transformer models: Wav2vec 2.0, HuBERT, WavLM, and DistilHuBERT. For data augmentation, we adopted multiple techniques, with particular emphasis on frequency masking due to its ability to preserve subtle acoustic cues associated with cognitive impairment. We measured the performance of TransformerCARE on the ADReSSo Challenge dataset from DementiaBank, comprising 237 subjects (122 cognitively impaired and 115 cognitively normal).
RESULTS: TransformerCARE demonstrated its highest performance with HuBERT, achieving an AUC of 81.80 (F1-score = 79.31) using an aggregation technique that averaged embeddings of 14-second speech segments. Augmenting the training data with frequency masking improved performance by 5 %, resulting in an AUC of 86.11 (F1-score = 84.63). We also demonstrated that incorporating clinicians' speech during patient interactions can improve the performance of the pipeline. Our error analysis revealed significant differences between the acoustic patterns of correctly identified negative cases (true negatives) and those incorrectly identified as positive (false positives), as well as between correctly identified positive cases (true positives) and those incorrectly identified as negative (false negatives). This indicates specific deviations in speech characteristics among inaccurately diagnosed subjects.
CONCLUSION: In summary, TransformerCARE demonstrates strong potential for integration into clinical workflows as a screening tool for cognitive impairment, aiding in the timely and appropriate care of affected patients.}, }
@article {pmid41353509, year = {2025}, author = {Kolouei, A and Barati, M and Abbas-Mohammadi, M}, title = {Investigating the binding potential of the Melissa officinalis oil against Alzheimer's targets by molecular docking and in vitro evaluations.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {736}, pmid = {41353509}, issn = {2045-2322}, mesh = {*Molecular Docking Simulation ; *Alzheimer Disease/drug therapy/metabolism ; *Melissa/chemistry ; PC12 Cells ; Animals ; Rats ; Antioxidants/pharmacology/chemistry ; Amyloid Precursor Protein Secretases/metabolism/chemistry ; *Oils, Volatile/pharmacology/chemistry ; Amyloid beta-Peptides/metabolism/chemistry ; Acetylcholinesterase/metabolism/chemistry ; *Plant Oils/pharmacology/chemistry ; Cell Survival/drug effects ; Humans ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder with limited treatment options. Melissa officinalis (M. officinalis), traditionally used for its medicinal properties, contains compounds that may offer therapeutic benefits for AD. We extracted essential oils from M. officinalis using supercritical CO2 and identified 31 compounds via GC-MS, supplemented by 20 non-volatile compounds from the Dictionary of Natural Products. Molecular docking was performed against five AD-related targets: β-Secretase, γ-Secretase, amyloid-β) A(, neprilysin, and acetylcholinesterase. The oil's antioxidant capacity and cytotoxicity on PC12 cells were evaluated using DPPH and MTT assays, respectively. Docking analysis revealed that sajerinic acid had the highest affinity for acetylcholinesterase, neprilysin, and γ-Secretase. Aβ and β-Secretase were most affected by 3',4',5,7-tetrahydroxyflavone, 3'-O-β-D-glucuronopyranoside, γ-O-β-D-glucopyranoside and 2,3,19,23-tetrahydroxy-12-ursen-28-oic acid-23-sulfate, 28-O-β-D-glucopyranosyl ester, respectively. Among oil compounds, triethyl citrate showed the highest affinity for β-Secretase, neprilysin, and γ-Secretase, while 2,2-dimethoxybutane exhibited the highest potential for interaction with Aβ and acetylcholinesterase. The oil reduced PC12 cell survival in a dose-dependent manner. The extract also displayed significant antioxidant activity, suggesting a potential to reduce oxidative stress. These findings suggest that M. officinalis contains compounds with potential anti-Alzheimer's properties, warranting further investigation. The identified compounds could serve as leads for developing novel therapeutics, and the antioxidant activity of the extract supports its traditional use in managing neurodegenerative conditions. Further studies are needed to validate these findings in vivo and explore the therapeutic potential of M. officinalis in AD.}, }
@article {pmid41353403, year = {2025}, author = {Bhargavan, B and Annadurai, N and Kanmogne, GD}, title = {Glycogen synthase kinase-3 activation and dysregulation of amyloid transport receptors expression and shedding in HIV-induced Alzheimer's disease-like pathology: modulatory effects of CCR5 antagonists.}, journal = {Acta neuropathologica communications}, volume = {14}, number = {1}, pages = {16}, pmid = {41353403}, issn = {2051-5960}, support = {R01 MH132517/MH/NIMH NIH HHS/United States ; R21 MH123303/MH/NIMH NIH HHS/United States ; 1R21 MH123303 and 1R01 MH132517/MH/NIMH NIH HHS/United States ; }, abstract = {UNLABELLED: Neurocognitive impairments occur in about 50% of HIV-infected humans and are associated with Alzheimer’s disease (AD)-like brain pathologies, including increased amyloid-beta1-42(Aβ42) and phospho-Tau. We previously demonstrated that HIV-infected humanized mice develop these AD-like pathologies associated with neurodegeneration. The underlying mechanisms are unknown. Here, we investigate whether HIV-induced Aβ and phospho-Tau involve dysregulation of transporters and kinases that regulate Tau phosphorylation and Aβ clearance, and the effects of CCR5 antagonists on these effectors. We analyzed human and animal (humanized mice) brain tissues, microvessels, plasma/serum, and human brain microvascular endothelial cells (HBMEC) for effects of HIV-1 infection, maraviroc treatment, and CCR5 knockdown/overexpression on Aβ, phospho-Tau, low-density lipoprotein receptor–related protein-1(LRP1), receptor for advanced glycation end-products (RAGE), and GSK-3α/β transcription, expression, and activation, LRP1 and RAGE cleavage/shedding, Aβ endothelial uptake and transport/clearance. HIV infection significantly increased phospho-Tau (serine396, serine199, threonine181), Aβ42 and GSK-3α/β activation in humans and animals’ brain cortex. HIV significantly decreased LRP1 and increased RAGE transcription and expression in brain tissues and microvessels, with accentuated LRP1 and RAGE dysregulation in humans with neurocognitive impairments. HIV significantly increased soluble (s)LRP1 and decreased sRAGE. Maraviroc abrogated HIV-induced CNS GSK-3α/β activation and Tau hyperphosphorylation, prevented LRP1 downregulation and RAGE upregulation, significantly decreased sLRP1 and increased sRAGE, increased Aβ42 efflux eightfold and decreased brain Aβ42 levels 11.7-fold. Maraviroc abrogated Aβ42-induced decrease in HBMEC tightness, significantly decreased endothelial RAGE, increased LRP1, and Aβ42 endothelial transport via LRP1 crosstalk. CCR5 knockdown blocked maraviroc-induced increased endothelial Aβ transport. These data suggest that therapeutically targeting CCR5 can abrogate HIV-induced GSK-3α/β activation and phospho-Tau, prevent LRP1 downregulation and shedding and increase brain Aβ efflux/clearance, prevent RAGE upregulation, Aβ brain influx, and AD-like neuropathology.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40478-025-02197-4.}, }
@article {pmid41352683, year = {2026}, author = {Shim, GH and Lau, ECY and Huynh, ALH and Lu, CY and Tan, ECK}, title = {Influence of patient characteristics on efficacy and safety of anti-amyloid monoclonal antibodies in Alzheimer's disease: A systematic review and meta-analysis.}, journal = {Ageing research reviews}, volume = {114}, number = {}, pages = {102981}, doi = {10.1016/j.arr.2025.102981}, pmid = {41352683}, issn = {1872-9649}, mesh = {Humans ; *Alzheimer Disease/drug therapy/genetics ; *Antibodies, Monoclonal/therapeutic use/adverse effects ; Treatment Outcome ; *Amyloid beta-Peptides/antagonists & inhibitors/immunology ; }, abstract = {BACKGROUND: Lecanemab and donanemab are the first anti-amyloid monoclonal antibodies (mAbs) clinically available as disease-modifying therapies for Alzheimer's disease (AD). However, it remains unclear whether their treatment effects differ across demographic, clinical, or genetic subgroups.
OBJECTIVE: This systematic review aimed to explore how patient characteristics modify the efficacy, safety and humanistic outcomes of anti-amyloid mAbs lecanemab and donanemab in patients with early AD.
METHODS: A systematic search of MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library was conducted from database inception to July 30th, 2025, using a combination of keywords and Medical Subject Heading terms relating to lecanemab and donanemab. Meta-analyses were conducted for safety outcomes where sufficient data was available.
RESULTS: Sixteen studies representing six randomised clinical trials (total N = 5633) were included. Both lecanemab and donanemab showed the greatest slowing of cognitive decline in White/Caucasian patients and apolipoprotein E4 (ApoE4) non-carriers. Amyloid-related imaging abnormalities with edema/effusion (ARIA-E) and microhemorrhages (ARIA-H) were more prevalent in ApoE4 carriers. The risk of ARIA-E was 2.19 times higher (95 %CI:1.91-2.50) and ARIA-H was 3.45 times higher (95 %CI:1.35-8.72) in ApoE4 carriers versus non-carriers. Statistically significant improvements in health-related quality of life were observed with lecanemab in ApoE4 heterozygous participants and in those aged 65-74 years.
CONCLUSIONS: The efficacy and safety of anti-amyloid mAbs in AD may differ based on patients' demographic and genetic factors. These findings highlight the potential for personalised treatment strategies and inform national drug policies. Further research is needed to evaluate long-term outcomes and address under-studied patient populations.
SUMMARY: The efficacy and safety of lecanemab and donanemab varied across patient subgroups, including age, sex, race/ethnicity and genetic factors such as ApoE4 genotype status. The risk of ARIA was higher in ApoE4 carriers, particularly the homozygous.}, }
@article {pmid41352634, year = {2026}, author = {Geleta, LA and Doyle, C and Garton, FC and Fowler, M and Carr, JM and Akkari, PA and McRae, AF and Rogers, ML and Madakkatel, I and Benyamin, B}, title = {The roles of human endogenous retrovirus in neurodegenerative diseases: A systematic review.}, journal = {Brain, behavior, and immunity}, volume = {132}, number = {}, pages = {106201}, doi = {10.1016/j.bbi.2025.106201}, pmid = {41352634}, issn = {1090-2139}, mesh = {Humans ; *Endogenous Retroviruses/genetics/physiology ; *Neurodegenerative Diseases/virology/genetics ; Alzheimer Disease/virology ; Amyotrophic Lateral Sclerosis/virology ; Parkinson Disease/virology ; Frontotemporal Dementia/virology ; }, abstract = {BACKGROUND: Human endogenous retroviruses (HERVs) constitute ∼8 % of the human genome, far exceeding the 2 % occupied by protein-coding genes. Although most HERV sequences are inactive, some HERV elements can be reactivated under certain conditions and may contribute to neurodegenerative diseases (NDDs). However, the findings vary across different HERV families, disease models, and detection methods. Here, we systematically review and synthesize the available evidence on the role of HERVs in human NDDs and reconcile inconsistencies in the literature.
METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Library, PsycINFO, Scopus, Web of Science, CINAHL, and Emcare to identify relevant studies. Two independent reviewers screened studies, assessed quality, and extracted data. Qualitative synthesis was conducted for all included NDDs, specifically Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and Parkinson's disease (PD), and due to data availability, meta-analysis was used to assess the impact of HERVs antibodies on ALS only.
RESULTS: Twenty-six studies (N ranges: 6-485) met the inclusion criteria, with majority focusing on HERV-K and ALS. Across studies, the association between HERV expression and NDDs was inconsistent, particularly for ALS, PD, and FTD, whereas investigations in AD showed a more consistent upregulation of specific HERVs. Studies relying on polymerase chain reaction (PCR) (typically smaller) showed inconsistent associations (21 studies), while RNA sequencing studies reported consistent associations (9 studies). A preliminary meta-analysis revealed a fivefold increase [OR: 5.83; 95 % CI: 4.14, 8.18] in ALS risk among participants with positive HERV antibodies.
CONCLUSIONS: The inconsistencies in HERV involvement across NDDs highlight the need for further studies employing standardized methodologies. RNAseq findings on the association of HERVs expression and NDDs support the need for large-scale RNA sequencing studies (rather than small, PCR studies) and careful tissue selection to clarify HERVs' role in NDDs. The association of HERV-K antibodies with ALS risk and prognosis suggests a significant role in disease, which could help detect biomarkers and used as a target for treatment.}, }
@article {pmid41351718, year = {2025}, author = {Krishnan, M and Kumaresan, M and Ravi, S and Martin, LC and Manikandan, B and Raman, T and Ramar, M}, title = {Bornyl Acetate and Menthol Provide Neuroprotection Against Lipopolysaccharide-Induced Alzheimer's Disease-Like Condition in C57BL/6 Mice by Downregulating NARC-1 Lipid Antagonist.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {262}, pmid = {41351718}, issn = {1559-1182}, mesh = {Animals ; *Alzheimer Disease/drug therapy/chemically induced/metabolism/pathology/prevention & control ; Mice, Inbred C57BL ; Lipopolysaccharides ; *Menthol/pharmacology/therapeutic use ; *Down-Regulation/drug effects ; Male ; *Neuroprotective Agents/pharmacology/therapeutic use ; Mice ; *Neuroprotection/drug effects ; Oxidative Stress/drug effects ; }, abstract = {Alzheimer's disease (AD) is a progressive neurological illness that causes Aβ deposition and cognitive impairments. Anti-cholinesterase and anti-depressant drugs are used as medications; however, their side effects spotlight the need for alternate treatments. Bornyl acetate and menthol are monoterpenes with bioactive potential investigated against inflammation induced by lipopolysaccharide (LPS) in C57BL/6 mice. In our study, we analysed various behavioural changes along with memory activities as well as assessed neuronal damage, acetylcholinesterase activity, amyloid deposition, mitochondrial membrane integrity, calcium deposition and oxidation derivatives. In addition, we also examined gene and protein expression associated with lipid dysfunction in neuroinflammation. Our findings revealed that monoterpenes such as bornyl acetate and menthol potentially improved LPS-induced behaviour changes and cognitive activities. In addition, these compounds have the potential effects against amyloid plaque formation, calcium build-up, mitochondrial membrane damage and oxidative markers (malondialdehyde, protein carbonyls and advanced glycation end products) in the LPS-injected C57BL/6 mice. Treatment with bornyl acetate and menthol also inhibited neural apoptosis-regulated convertase (NARC-1)/proprotein convertase subtilisin/kexin type 9 (PCSK-9) by upregulating low-density lipoprotein receptor-related protein (LRP)-1 protein expression. Cholesterol oxidation genes, including 11β-hydroxysteroid dehydrogenase 1 & 2, as well as proinflammatory microglial, apoptotic and amyloidogenic protein and gene expression, were decreased respectively when treated with monoterpenes while promoting the upregulation of anti-inflammatory. Based on the results, we concluded that these compounds can potentially target and prevent neuroinflammation, including Alzheimer's disease.}, }
@article {pmid41351658, year = {2025}, author = {Singh, I and Singh, AK}, title = {Senolytics as Modulators of Critical Signaling Pathways: a Promising Strategy to Combat Brain Aging and Neurodegenerative Disorders.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {261}, pmid = {41351658}, issn = {1559-1182}, support = {CRG/2022/006612//Anusandhan National Research Foundation/ ; }, mesh = {Humans ; *Aging/drug effects/metabolism/pathology ; *Signal Transduction/drug effects ; *Neurodegenerative Diseases/drug therapy/metabolism/pathology ; *Brain/drug effects/metabolism/pathology ; Animals ; *Senotherapeutics/pharmacology/therapeutic use ; Oxidative Stress/drug effects ; }, abstract = {Aging of the brain, an intricate process, is a significant risk factor for neurodegenerative disorders (NDDs), such as Alzheimer's disease and Parkinson's disease. Senescent cell accumulation is an important hallmark of brain aging. These cells resist apoptotic cell death, produce proinflammatory cytokines, increase oxidative stress, and store toxic proteins that exacerbate neurodegeneration. These senescent cells cause neuroinflammation and dysfunction of the neuronal microenvironment by transmitting senescent phenotypes to neighboring healthy cells. Senolytics have become a viable treatment option to reduce the effects of brain aging since they specifically target and destroy senescent cells. Numerous senolytic compounds, such as dasatinib, fisetin, and quercetin, effectively eliminate senescent cells and reduce the accumulation of harmful substances, including misfolded toxic protein aggregates and reactive oxygen species, thereby helping to maintain tissue homeostasis. These medications aid in reducing oxidative stress and inflammation, two significant factors in brain aging and NDDs, by encouraging the removal of senescent cells. The key molecules involved in this process are mTOR, Nrf2-Keap1, AMPK, and Sirtuin 1 (SIRT1). The modulation of the mTOR and AMPK pathways affects autophagy and cellular metabolism, facilitating the elimination of harmful accumulations and damaged cell organelles. In addition, cellular repair and improved antioxidant defense are encouraged by the activation of the SIRT1 and Nrf2 pathways. The combination of senolytic therapy with these signaling pathways provides a novel approach to attack the cellular and molecular foundations of brain aging and neurodegenerative disorders.}, }
@article {pmid41350983, year = {2025}, author = {Deng, H and Lee, TA and Gaber, CE and Kim, K and Crawford, SY and Bayliss, EA and Singh, S and Young, JG and Toh, S and Li, X}, title = {Treatment patterns of symptomatic treatments for Alzheimer's disease and related dementias.}, journal = {BMC geriatrics}, volume = {26}, number = {1}, pages = {39}, pmid = {41350983}, issn = {1471-2318}, abstract = {BACKGROUND: Limited real-world evidence exists on the patterns of symptomatic treatment use for Alzheimer’s disease and related dementias (ADRD).
METHODS: Using data from the Merative[®] MarketScan Research Databases, we analyzed treatment patterns in ADRD patients aged ≥ 65 from 2011 to 2021. Initial treatment choices, subsequent changes, and factors influencing these changes were evaluated over an 18-month period.
RESULTS: Among 74,212 acetylcholinesterase inhibitor (AChEI) and 15,917 memantine initiators, 56% switched or discontinued their initial treatment within 6 months. By 18 months, 15% of monotherapy initiators remained on initial treatment and 19% escalated to dual therapy, with 13% of AChEI initiators switching to memantine. After discontinuation, 73% reinitiated treatment within 18 months. Patients with milder dementia severity, fewer comorbidities, and lower frailty levels were more likely to switch to alternative treatments.
CONCLUSIONS: Patients with ADRD demonstrated low persistence with their initial symptomatic therapy, coupled with high rates of re-initiation following discontinuation.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-025-06745-4.}, }
@article {pmid41350761, year = {2025}, author = {He, H and Razlighi, QR and Gazes, Y and Habeck, C and Stern, Y and , }, title = {Integrating individualized connectome with amyloid pathology improves predictive modeling of future cognitive decline.}, journal = {Communications medicine}, volume = {5}, number = {1}, pages = {515}, pmid = {41350761}, issn = {2730-664X}, support = {R01 AG026158/AG/NIA NIH HHS/United States ; R01 AG038465/AG/NIA NIH HHS/United States ; U01 AG024904/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND: The deposition of amyloid-β (Aβ) in the human brain is a hallmark of Alzheimer's disease and is associated with cognitive decline. Aβ pathology is traditionally assessed at the whole-brain level across neocortical regions using positron emission tomography (PET). However, these measures often show weak associations with future cognitive impairment. A more sensitive pathology metric is needed to quantify early Aβ burden and better predict cognitive decline. Here, we aim to develop a network-based metric of Aβ burden to improve early prediction of cognitive decline in aging populations.
METHODS: We integrated subject-specific brain connectome information with Aβ-PET measures to construct a network-based metric of Aβ burden. Cross-validated predictive modeling was used to evaluate the performance of this metric in predicting longitudinal cognitive decline. Furthermore, we identified a neuropathological signature pattern linked to future cognitive decline, and we validated this pattern in an independent cohort.
RESULTS: Our results demonstrate that incorporating individualized structural connectome, but not functional connectome, information into Aβ measures enhances predictive performance for prospective cognitive decline. The identified neuropathological signature pattern is reproducible across cohorts.
CONCLUSION: These findings advance our understanding of the spatial patterns of Aβ pathology and its relationship to brain networks, highlighting the potential of connectome-informed network-based metrics for Aβ-PET imaging in identifying individuals at higher risk of cognitive decline.}, }
@article {pmid41350438, year = {2025}, author = {Liu, D and Li, X and Shi, P and Hong, W and Huang, J and Hou, M and Ma, L and Liao, Q and Yang, H and Fu, X and Zhou, H and Lu, J and Liu, Y and Feng, X and Wang, D and Zhou, R}, title = {7,8-Dihydroxyflavone ameliorates bone loss by regulating TRKB/AKT/FOXO3a pathway in a mouse model of alzheimer's disease.}, journal = {Psychopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41350438}, issn = {1432-2072}, support = {81972112//National Natural Science Foundation of China/ ; }, abstract = {BACKGROUND: The incidence of osteoporosis is increased in Alzheimer's disease (AD). The pathogenesis of AD with osteoporosis is still unknown, there is no ideal treatment as yet for it. 7,8-Dihydroxyflavone (7,8-DHF), a functional brain-derived neurotrophic factor (BDNF) mimetic, shows therapeutic potential for neurological and orthopedic disorders.
OBJECTIVES: This research investigated the molecular mechanisms by which 7,8-DHF mitigates bone loss and cognitive dysfunction in osteoporotic AD mice.
METHODS: Micro-CT analysis quantified bone loss in AD mice. The Morris water maze (MWM) assessed mouse cognitive function, and immunohistochemical analysis measured Aβ plaque deposition. qPCR and Western blotting measured expression levels of APP, Aβ42, TRKB, and FOXO3a in osteoblasts isolated from femoral bone marrow mesenchymal stem cells (BMSCs) and brain tissue. ELISA determined the levels of IL-1β, IL-6, osteocalcin (OCN), fibroblast growth factor 23 (FGF23) and sclerostin. For in vitro experiments, osteoblast differentiation was monitored in MC3T3-E1 cells co-cultured with Aβ42, with concurrent measurement of TRKB, AKT, and FOXO3a expression. The efficacy of 7,8-DHF against bone loss and osteoblast differentiation was systematically evaluated.
RESULTS: Cognitive impairment and bone loss manifested in APP/PS1 mice. 7,8-DHF treatment ameliorated bone mass reduction, decreased Aβ42 expression in bone tissue, and enhanced TRKB expression. Concurrently, 7,8-DHF improved cognitive function and accelerated clearance of [¹²⁵I]-Aβ42 from the brain. In in-vitro, Aβ42 increased inflammatory cytokine levels, suppressed TRKB expression, and impaired osteoblast differentiation. 7,8-DHF reduced the levels of AKT and pFOXO3a by TRKB.
CONCLUSION: 7,8-DHF could alleviate bone mass loss in AD mice by regulating the TRKB/AKT/FOXO3a pathway. This finding provides new ideas for the treatment strategy of AD with osteoporosis and is beneficial to the health of the elderly.}, }
@article {pmid41350162, year = {2026}, author = {Rosenberg, PB and Amjad, H and Burhanullah, H and Nowrangi, M and Vandrey, R and Pierre, MJ and Outen, JD and Schultz, M and Marano, C and Agronin, M and Wilkins, JM and Harper, D and Laffaye, T and Reardon, E and Turner, K and Ozonsi, R and Drury, M and Nguyen, A and Hasoğlu, T and Cromwell, J and Leoutsakos, JM and Forester, BP}, title = {A Randomized Controlled Trial of the Safety and Efficacy of Dronabinol for Agitation in Alzheimer's Disease.}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {34}, number = {2}, pages = {167-179}, pmid = {41350162}, issn = {1545-7214}, support = {K23 AG064036/AG/NIA NIH HHS/United States ; R01 AG050515/AG/NIA NIH HHS/United States ; R03 AG063237/AG/NIA NIH HHS/United States ; }, mesh = {Aged ; Aged, 80 and over ; Female ; Humans ; Male ; *Alzheimer Disease/complications/drug therapy ; Double-Blind Method ; *Dronabinol/adverse effects/therapeutic use/administration & dosage/pharmacology ; *Psychomotor Agitation/drug therapy/etiology ; Treatment Outcome ; }, abstract = {IMPORTANCE: Agitation in Alzheimer's disease (AD) is a great source of distress for patients and caregivers and a major public health burden. Current treatments are only modestly effective and many have safety issues including mortality risk. Novel therapeutic options are needed. There is preliminary evidence for the safety and efficacy of dronabinol (tetrahydrocannabinol, THC) for agitation in AD.
OBJECTIVE: Assess the safety and efficacy of dronabinol (THC) to decrease agitation in AD.
DESIGN: THC-AD was a 3-week randomized parallel double-blind placebo-controlled clinical trial, conducted between 2017 and 2024.
SETTING: 5 inpatient and outpatient academic clinical research centers in the Eastern U.S.
PARTICIPANTS: Volunteer sample of 75 participants meeting inclusion criteria for agitation of AD (International Psychogeriatric Association Provision Criteria) with Neuropsychiatric Inventory Clinician Version Agitation or Aggression (NPI-C A/A) domains total score of 4 or greater. Major exclusion criteria included seizure disorder, delirium, and non-AD dementia.
INTERVENTIONS: 3 weeks dronabinol vs. placebo titrated up to target dose of 10 mg daily in divided twice-daily.
MAIN OUTCOMES AND MEASURES: Prespecified co-primary agitation outcomes were the Pittsburgh Agitation Scale (PAS) and NPI-C A/A total score.
RESULTS: The majority of participants were female and were taking concomitant psychotropic medications (antidepressants and antipsychotics) at baseline. Study participants were moderately agitated at baseline, were diverse in ethnic background (9% Black, 11% Hispanic/Latina/Latino), and had severe cognitive impairment evidenced by MMSE or SIB-8. 84% completed the 3-week trial. Dronabinol decreased agitation on both primary outcomes greater than placebo to a clinically relevant extent. The fitted between-arm difference in PAS decline/week was -0.74 (SE 0.3, p = 0.015, effect size = 0.53) and for NPI-C A/A the decline was not significant at -1.26 (SE 0.67, p = 0.094, effect size = 0.36). No secondary outcomes differed between treatment arms including sleep, activities of daily living, Cohen-Mansfield Agitation Inventory (CMAI), cognition, intoxication, or use of 'as-needed' lorazepam or trazodone. Dronabinol treatment was not associated with greater intoxication nor with other adverse events (AEs) except for somnolence.
CONCLUSIONS AND RELEVANCE: Adjunctive dronabinol treatment was safe and effective for treating agitation in AD.
CLINICAL TRIALS REGISTRATION: NCT02792257.}, }
@article {pmid41349452, year = {2026}, author = {Rossiter, K}, title = {Despite all our rage: An autoethnographic analysis on the role of shared affect in dementia caregiving relationships.}, journal = {Social science & medicine (1982)}, volume = {389}, number = {}, pages = {118802}, doi = {10.1016/j.socscimed.2025.118802}, pmid = {41349452}, issn = {1873-5347}, mesh = {Humans ; *Caregivers/psychology ; *Dementia/psychology ; Female ; Anthropology, Cultural ; Male ; *Rage ; Aged ; Middle Aged ; Interpersonal Relations ; *Alzheimer Disease/psychology ; }, abstract = {Using an autoethnographic approach, this paper explores the phenomenon of shared rage between Alzheimer's patients and their informal family caregivers. Unlike previous analyses regarding dementia care, this work understands that rage within caregiving relationships is both dynamic and productive. Drawing broadly from social scientific studies regarding emotional labour and "feeling work," this work argues that Alzheimer's sufferers and their informal caregivers form two halves of a dyad, each of whom may use rage as a form of protection against loss of relational identity and pursuant grief, and to demand humane and dignified treatment from broken formal care systems. This individual rage simultaneously offers a point of connection between both halves of the caregiving dyad, which is otherwise torn asunder by interpersonal manifestations of the disease. Ultimately this paper argues for a brave, curious and compassionate response to caregiving dyads in which experiences of rage are not stigmatized, minimized or medicalized. Rather, this analysis suggests that experiences of anger are recognized as an often-excruciating form of emotional labour necessitated by an insidious disease and inadequate formal care systems.}, }
@article {pmid41349262, year = {2025}, author = {Qi, L and Lin, L and Zheng, J and Liu, X and Liu, X and Chen, Z and Liu, L}, title = {Liraglutide improves cognitive function by reducing amyloid-beta peptide accumulation and inhibiting inflammation in 5 × FAD mice.}, journal = {The journals of gerontology. Series A, Biological sciences and medical sciences}, volume = {}, number = {}, pages = {}, doi = {10.1093/gerona/glaf265}, pmid = {41349262}, issn = {1758-535X}, abstract = {Alzheimer's disease (AD) is a degenerative disease of the central nervous system characterized by progressive memory decline. The increasing prevalence of AD has attracted considerable attention globally. The glucagon-like peptide-1 analog, liraglutide, a drug widely used in the treatment of type 2 diabetes, has shown promising neuroprotective effects in AD, including enhancing neuronal survival, reducing amyloid beta protein accumulation, improving synaptic plasticity, and reducing tau protein hyperphosphorylation. However, its potential impact on cognitive function remains unclear. We evaluated the effects of liraglutide (25 nmol/day for 8 weeks) on the cognitive ability of 12-month-old 5 × familial Alzheimer's disease (FAD) mice. The Morris water maze test was used to evaluate the spatial learning ability of mice. Histological evaluations were performed by Nissl staining and transmission electron microscopy. Neuroinflammation was detected by double immunofluorescence staining and enzyme-linked immunosorbent assay. Protein expression in the cortex and hippocampal was detected by immunohistochemistry and Western blotting. The spatial cognitive ability improved in 5 × FAD mice after liraglutide administration and was associated with an increased number of pyramidal cells in the cortex and hippocampus. Liraglutide also alleviated ultrastructural changes in the chemical synapses and reduced both local and systemic inflammation in AD mice. Furthermore, liraglutide reduced amyloid β protein expression, which may be associated with the regulation of nuclear factor kappa B/beta-secretase 1 pathways in AD mice. The potential of liraglutide to improve the cognitive function in AD mice offers an effective pharmacological approach for treating neurodegenerative diseases.}, }
@article {pmid41347369, year = {2026}, author = {Yang, J and Deng, Y and Qin, S and Chen, Z and Lu, Y and Ji, S and Hang, T and Song, M}, title = {An aggregation-induced emission-active theranostic agent for selectively detecting and intervening pathological Tau protein.}, journal = {Journal of materials chemistry. B}, volume = {14}, number = {1}, pages = {261-272}, doi = {10.1039/d5tb01783a}, pmid = {41347369}, issn = {2050-7518}, mesh = {*tau Proteins/metabolism/analysis ; Humans ; *Fluorescent Dyes/chemistry/chemical synthesis/pharmacology ; *Theranostic Nanomedicine ; Stilbenes/chemistry ; Optical Imaging ; }, abstract = {The accumulation of Tau aggregates is commonly linked with various neurodegenerative diseases, such as Alzheimer's disease, Pick's disease, and corticobasal degeneration. Notwithstanding substantial investments in the development of clinical strategies for effective intervention, traditional design paradigms are predominantly confined to molecules featuring either a solitary function or single-dimensional mode of intervention, ignoring the necessity of personalized and precise medicine. Herein, we design and synthesize a dual-functional aggregation-induced emission-active agent to serve as both a fluorescent probe for the imaging of pathological Tau and a modulator for intervention. This amphiphilic theranostic agent, named TPE-P9, is prepared via a one-pot Michael reaction between hydrophobic maleimide-modified tetraphenylethylene (TPE-Mal) and a hydrophilic cysteine-modified Tau-targeting peptide (CKVQIINKK). Microscale thermophoresis measurement and in vitro fluorescence analysis demonstrate that TPE-P9 exhibits specific binding affinity (Kd = 4.46 µM) and high selectivity towards Tau fibrils, featuring a pronounced low background interference, which is superior to the classical amyloid protein probe thioflavin T (ThT). At the living cellular level, TPE-P9 is capable of readily imaging endogenic pathological Tau to distinguish normal neurons from the lesional neurons in situ, and the staining consequence is almost consistent with that of ThT. On the other hand, as a modulator, TPE-P9 can potently protect neurons from cytotoxic Tau-induced apoptosis both by inhibiting aberrant post-translational modification-induced Tau self-assembly and by blocking the produced pathological Tau propagation, enhancing cell viability by 35.4%. These findings offer valuable insights for the development of innovative image-guided therapeutic strategies for targeted tauopathies treatment.}, }
@article {pmid41346709, year = {2026}, author = {Liu, S and Semyachkina-Glushkovskaya, O and Yu, T and Ilukov, E and Rafailov, E and Sokolovski, S and Kurths, J and Zhu, D}, title = {Neuro-lymphaphotonics opens new horizons of the future technologies for the therapy of brain diseases.}, journal = {Theranostics}, volume = {16}, number = {2}, pages = {776-793}, pmid = {41346709}, issn = {1838-7640}, mesh = {Humans ; *Brain Diseases/therapy ; Animals ; Brain ; *Low-Level Light Therapy/methods ; *Lymphatic Vessels/radiation effects ; Blood-Brain Barrier ; }, abstract = {Pharmacological treatment of brain diseases is hampered by the blood-brain barrier that prevents the vast majority of drugs from entering the brain. For this reason, the pharmaceutical industry is reluctant to invest in the development of new neurotropic drugs. Even if effective pharmacological strategies for the treatment of brain diseases will be found, it will take 10-15 years between the emergence of an idea and the introduction of a drug to the market. This creates priority for the development of neuro-lymphaphotonics based on the development of promising non-pharmacological strategies for managing functions of the meningeal lymphatic vessels (MLVs). MLVs play a crucial role in the removal of toxins and metabolites from brain as well as in regulation of brain homeostasis and its immunity. Since MLVs are located on the brain surface, light penetrating the skull easily reaches MLVs and affects their functions. Therefore, MLVs are an ideal target for photobiomodulation (PBM). The pioneering studies have shown that PBM of MLVs is a promising strategy for the treatment of a wide range of neuropathology, including Alzheimer's or age-related brain diseases, brain tumor, intracranial hemorrhage, brain damages caused by diabetes. It has recently been discovered that sleep enhances the therapeutic effects of PBM and is a "therapeutic window" in overcoming the limitations of PBM in the elderly. Considering that the PBM technologies are non-invasive and safe with commercially viable possibilities (portability and low cost), neuro-lymphaphotonics open up promising prospects for the development of future technologies for the effective therapy of brain diseases.}, }
@article {pmid41345983, year = {2025}, author = {Abi-Ghanem, C and Opiela, AK and Paul, AS and Comito, ML and Hao, L and Martino, G and Kyaw, NR and Salinero, AE and Mansour, FM and Kelly, RD and Mutahi, AM and Sura, A and Thrasher, CA and Groom, EA and Batchelder, MR and Zuloaga, KL}, title = {Loss of ovarian hormones is detrimental in early disease stages of mouse models of Alzheimer's disease and multi-etiology dementia.}, journal = {Biology of sex differences}, volume = {17}, number = {1}, pages = {4}, pmid = {41345983}, issn = {2042-6410}, support = {R01 NS110749/NS/NINDS NIH HHS/United States ; AARG-21-849204/ALZ/Alzheimer's Association/United States ; U01 AG072464/AG/NIA NIH HHS/United States ; 908878//American Heart Association/ ; 25PRE1374600//American Heart Association/ ; A2022001F//Bright-Focus Foundation/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/physiopathology/pathology ; Female ; Disease Models, Animal ; Ovariectomy ; Mice ; Mice, Transgenic ; *Estradiol ; *Dementia/etiology ; }, abstract = {BACKGROUND: Up to 80% of Alzheimer's disease (AD) patients suffer from brain vascular damage resulting in multi-etiology dementia (MED). Sex is a well-known risk factor for dementia; out of three AD patients two are women. 17β-estradiol, a predominant ovarian hormone in woman before menopause, is known to have beneficial effects on the cerebrovasculature, neuroinflammation and neuroprotection. Here, we investigated the consequences of the loss of ovarian hormones caused by surgical menopause (ovariectomy) on AD and MED.
METHODS: The App[NL-F] knock-in mice were used to model AD. At about 5.5 months of age, a stage corresponding to early disease pathology, female App[NL-F] mice were subjected to ovariectomy (OVX) or sham surgery (Intact) and left to recover for 3 weeks to clear any endogenous gonadal hormones. In half of the mice from each group, MED was modeled using chronic cerebral hypoperfusion (unilateral carotid artery occlusion), a model of vascular contributions to cognitive impairment and dementia (VCID). Control animals (AD only model) received sham surgery. Mice were then subjected to a battery of behavioral tests before being euthanized and brains were collected to assess pathology.
RESULTS: We found that loss of ovarian hormones impairs spatial learning and memory, impairs activities of daily living, and affects underlying pathology including compromising microglial response. Some of these effects were exacerbated by cerebral hypoperfusion (VCID).
CONCLUSIONS: These results shed light on the effects of ovarian hormone loss after surgical menopause in female mouse model of AD and MED in order to better understand sex-specific risk factors.}, }
@article {pmid41345807, year = {2025}, author = {Lawrence, JM and Dampier, W and Mell, JC and De Souza, DR and Schardien, K and Yeakle, K and Barnett, RJ and Sen, B and Ahmed, A and Bouchard, M and Wigdahl, B and Nonnemacher, MR}, title = {Inflammatory microglia signals drive A1-like polarization of astrocytes even in the presence of HIV-1 Tat.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {251}, pmid = {41345807}, issn = {1559-1182}, support = {R01 NS089435/NS/NINDS NIH HHS/United States ; T32 MH079785/MH/NIMH NIH HHS/United States ; MH079785/MH/NIMH NIH HHS/United States ; NS089435/NS/NINDS NIH HHS/United States ; }, mesh = {*Astrocytes/metabolism/pathology/drug effects ; Humans ; *Microglia/metabolism/pathology/drug effects ; *tat Gene Products, Human Immunodeficiency Virus/metabolism/pharmacology ; *Inflammation/pathology/metabolism ; Blood-Brain Barrier/metabolism/pathology/drug effects ; *Signal Transduction/drug effects ; *Cell Polarity/drug effects ; *HIV-1/metabolism ; Endothelial Cells/metabolism/drug effects ; Cells, Cultured ; }, abstract = {In the context of neurodegeneration, activated microglia facilitate inflammation via secretion of TNF-α, IL-1α, and C1q. Astrocytes exposed to this signaling array polarize to a reactive inflammatory phenotype, termed A1 or A1-like. Astrocytes are essential for neuronal survival, synaptic support, and blood-brain barrier (BBB) function, but A1-like astrocytes upregulate inflammatory gene expression, downregulate neurotrophic factors, and secrete neurotoxic signals. The consequences of A1-like polarization on BBB function are unknown but may have etiological implications for some diseases. Frequently identified by upregulation of complement component 3 (C3), A1-like astrocytes have been characterized in neurodegenerative disorders like Alzheimer's disease, with polarization correlated with disease progression and severity. However, the role of A1-like astrocytes in neurodegeneration associated with chronic viral infections, like HIV-1-associated neurocognitive disorder (HAND), remains unclear. An in vitro system using primary human astrocytes, as well as a BBB model featuring primary human brain microvascular endothelial cells (BMECs) co-cultured with astrocytes, was used to elucidate cellular and molecular consequences of chronic astrocyte activation. As measured by whole transcriptome analysis and protein expression assays, repeated treatment with TNF-α, IL-1α, and C1q induced A1-like polarization of astrocytes both in monoculture and in a BBB model, resulting in increased secretion of pro-inflammatory signals. No substantial change to BBB permeability was observed. In contrast, exposure to HIV-1 viral protein Tat did not independently induce A1-like polarization. Ongoing investigations into the effect of astrocyte polarization on BBB integrity and treatment with pathogenic proteins may provide insights into the role of neurotoxic astrocytes in neurovirologic pathologies.}, }
@article {pmid41345718, year = {2025}, author = {Platen, M and Gläser, E and Dahling, V and Gesell, D and Hauptmann, M and Horenkamp-Sonntag, D and Koller, D and Kubat, D and Marschall, U and Riederer, C and Scheibner, H and Schroth, J and Swart, E and Michalowsky, B}, title = {Regional disparities of antidementia drug treatment in Germany: what can we learn for the new generation of Alzheimer's therapies.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {259}, pmid = {41345718}, issn = {1758-9193}, mesh = {Humans ; Germany/epidemiology ; *Alzheimer Disease/drug therapy/epidemiology ; Male ; Female ; Aged ; *Healthcare Disparities/statistics & numerical data ; Aged, 80 and over ; Rural Population ; *Nootropic Agents/therapeutic use ; Socioeconomic Factors ; Middle Aged ; }, abstract = {BACKGROUND: Current antidementia drugs can temporarily slow cognitive decline in Alzheimer's disease but are underused. Regional and socioeconomic disparities, including limited specialist access in rural or deprived areas, may exacerbate inequities and challenge the rollout of emerging disease-modifying therapies. This study aimed to evaluate associations between regional contextual factors and antidementia drug prescription (AD-Rx) among newly diagnosed people living with Alzheimer's disease (PlwAD) in Germany and to identify spatial clustering of prescribing patterns.
METHODS: This study analyzed anonymized claims data from three statutory health insurers for 53,753 PlwAD who received their first diagnosis between January 2020 and December 2022. Regions, defined by three-digit postal codes (ZIP3, n = 576), were categorized by the German Index of Socioeconomic Deprivation (GISD) quintiles and Degree of Urbanization (urban, suburban, rural). Multilevel logistic regression with random intercepts for ZIP3 was used to assess associations between receiving AD-Rx (dichotomous) and urbanization and deprivation, adjusting for age, sex, the Charlson Comorbidity Index, the long-term care level and the year of diagnosis. Global Moran's I was used to evaluate large-scale spatial clustering, and regional Moran's I was calculated to detect regional hotspots and coldspots.
RESULTS: Overall, 64% of PlwAD received at least one AD-Rx. Rural residency was associated with slightly lower odds of receiving AD-Rx compared to urban areas (OR 0.92; 95%CI 0.87-0.98; p = 0.010), whereas deprivation was not. Interaction models demonstrated that an increased deprivation further reduced AD-Rx odds in rural areas (OR per GISD unit = 0.98; 95% CI 0.96-0.99; p = 0.024). Global Moran's I revealed no significant large-scale clustering (I = 0.011; p = 0.613), but regional analysis identified several regional hotspots (high-high clusters) predominantly in moderately deprived urban areas and coldspots (low-low clusters) in highly deprived or rural areas.
CONCLUSION: Alzheimer's patients in rural and high-deprivation regions face limited access to recommended antidementia medications. Targeted interventions, such as teleconsultations, expanding specialist outreach, and collaborative care models in underserved areas, as well as regional dementia networks and national registries, could promote the equitable delivery of current and future Alzheimer's antibody therapies. However, further qualitative and quantitative research is needed to identify the underlying regional causes of these treatment disparities.
TRIAL REGISTRATION: DRKS00031944.}, }
@article {pmid41345521, year = {2025}, author = {Elnemais Fawzy, M and Wang, S and Palmer, P and Gatchel, J and Marshall, GA and Gagliardi, G and Vannini, P and , }, title = {Association between anosognosia and neuropsychiatric symptoms in Alzheimer's disease dementia patients.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {316}, pmid = {41345521}, issn = {2045-2322}, support = {R01 AG061083/AG/NIA NIH HHS/United States ; U01 AG024904/AG/NIA NIH HHS/United States ; AG061083/NH/NIH HHS/United States ; }, mesh = {Humans ; *Alzheimer Disease/psychology/complications/diagnostic imaging ; Male ; Female ; Aged ; *Agnosia/psychology/complications/epidemiology ; Aged, 80 and over ; Neuropsychological Tests ; Positron-Emission Tomography ; }, abstract = {Anosognosia, the lack of awareness of memory decline, and Neuropsychiatric Symptoms (NPS) are prevalent and debilitating symptoms in Alzheimer's disease (AD) dementia. Understanding the coexistence of these symptoms may help guide clinical interventions and treatment strategies. This study aimed to compare NPS prevalence in patients with and without anosognosia at baseline and to assess the association between anosognosia and NPS over time. We examined patients with AD dementia enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI). To be included in the current study, patients had to have undergone baseline assessments and at least one subsequent follow-up evaluation. Furthermore, all patients had to have amyloid (as assessed using Positron Emission Tomography, PET), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), and Everyday Cognition (ECog) variables available throughout the study. Anosognosia, our exposure of interest, was determined using Ecog scores from patients and study partners. Study partners evaluated the presence or absence of 12 NPS (our outcomes of interest) using the NPI. Cox proportional hazards models, excluding patients who had any symptoms of NPS at baseline, were used to evaluate NPS onset by group (anosognosia/no anosognosia) while adjusting for age, sex, years of education, and MMSE. 112 patients with follow-up data (mean = 1 year) were included in this study. Of these, 47.3% (n = 53) had anosognosia, while 52.7% (n = 59) did not. In those with anosognosia at baseline, we observed a trend toward greater prevalence of agitation and motor symptoms. Exploratory time-to-event analysis demonstrated that the patients with anosognosia had a faster onset of apathy (HR: 2.78, 95% CI: 1.37-5.62, p = 0.01) compared to the patients without anosognosia. In this exploratory study, while there were no significant differences in frequency of NPS at baseline between the groups, patients with anosognosia demonstrated faster onset of apathy as compared to patients without anosognosia. These findings underscore the importance of longitudinal assessments and tailored interventions targeting the management of NPS in AD dementia patients with anosognosia. Further research is warranted to explain the underlying mechanisms driving these associations and to inform the development of targeted therapeutic strategies aimed at improving patient outcomes in this population.}, }
@article {pmid41344886, year = {2025}, author = {Perovnik, M and Simončič, U and Jamšek, J and Gregorič Kramberger, M and Brumberg, J and Meyer, PT and Perani, D and Caminiti, SP and Brendel, M and Stockbauer, AC and Camacho, V and Alcolea, D and Vandenberghe, R and Van Laere, K and Ko, JH and Lee, CS and Pardini, M and Lombardo, L and Padovani, A and Pilotto, A and Ochoa-Figueroa, MA and Davidsson, A and Cháfer-Pericás, C and Álvarez-Sánchez, L and Garibotto, V and Lemstra, AW and Ferreira, D and Morbelli, SD and Tang, CC and Eidelberg, D and Trošt, M and , }, title = {Metabolic brain networks in dementia with Lewy bodies: from prodromal to manifest disease stages.}, journal = {Journal of neurology, neurosurgery, and psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1136/jnnp-2025-336935}, pmid = {41344886}, issn = {1468-330X}, abstract = {BACKGROUND: Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia, yet it remains under-recognised and misdiagnosed, which delays treatment, causes inaccurate prognosis and limits research opportunities. Imaging with 2-[[18]F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) is a supportive DLB biomarker. We evaluated a multivariate, quantifiable metabolic network biomarker, termed DLB-related pattern (DLBRP), for its further clinical translation across centres and disease stages.
METHODS: We analysed demographic, clinical and FDG PET imaging data of 1180 participants from 14 tertiary centres and two multicentre datasets. We included 379 DLB, 28 mild cognitive impairment-LB (MCI-LB), 195 dementia due to Alzheimer's disease (ADD), 172 MCI-AD without α-synuclein co-pathology (MCI-AD-S-), and 73 MCI-AD with α-synuclein co-pathology (S+) patients, along with a comparative group of 333 normal controls (NCs). From the scans, we calculated the expression of DLBRP, AD-related pattern (ADRP) and Parkinson's disease-related pattern (PDRP) and compared them across groups. DLBRP scores were correlated with clinical measurements.
RESULTS: Across independent cohorts, DLBRP robustly distinguished DLB from NCs (sensitivity >89%, specificity >90%), and scores correlated with Unified Parkinson's Disease Rating Scale Part III and independently predicted Mini-Mental State Examination. DLBRP was elevated already in MCI-LB. In a small longitudinal dataset, we observed steady increases in DLBRP expression with scores exceeding the diagnostic threshold prior to dementia onset. DLBRP and PDRP discriminated DLB from ADD (sensitivity, 74%-90%; specificity, 80%). In MCI-AD groups, ADRP was expressed, whereas DLBRP and PDRP were increased only in MCI-AD-S+, although comparatively less than in MCI-LB.
CONCLUSIONS: This study demonstrates the value of DLBRP in diagnosing prodromal and manifest DLB and distinguishing them from their AD counterparts. While overlap between patterns may reflect actual co-pathology, this possibility cannot be accepted without thorough pathological confirmation. The current findings support the use of DLBRP in patient evaluation and in future trial design.}, }
@article {pmid41344825, year = {2025}, author = {Johnson, SL and Gibbons, SR and Nielsen, CJ}, title = {Theranostics Beyond Oncology: Emerging Applications.}, journal = {Journal of nuclear medicine technology}, volume = {53}, number = {Suppl 1}, pages = {141S-143S}, doi = {10.2967/jnmt.125.271192}, pmid = {41344825}, issn = {1535-5675}, mesh = {Humans ; *Theranostic Nanomedicine/methods ; }, abstract = {Theranostics, the combination of targeted diagnostic imaging and treatment, is rapidly expanding its role beyond oncology into various noncancerous diseases. Recent advances in radiopharmaceuticals, molecular imaging, and nanoparticle-based technologies are enabling the detection and treatment of conditions in cardiology, neurology, autoimmune, and bone marrow disorders. These innovations include targeted imaging and therapy for atherosclerosis and cardiac amyloidosis, as well as neurodegenerative disorders such as Alzheimer disease. Additionally, they encompass biomarkers such as fibroblast activation protein inhibitor and radiolabeled glucocorticoids in autoimmune and inflammatory diseases, as well as the selective ablation of diseased tissue in bone marrow conditioning. Despite the promise of these developments, several challenges must be considered, including the integration of theranostic strategies into standard practice and establishing their efficacy through robust clinical trials. This review examines the emerging nononcologic applications of theranostics, highlighting current research and future potential.}, }
@article {pmid41341968, year = {2026}, author = {Hong, J and An, HK and Nam, H and Choi, J and Yu, SW}, title = {Presenilin 2 regulates corticosterone-induced autophagic death of adult hippocampal neural stem cells.}, journal = {Animal cells and systems}, volume = {30}, number = {1}, pages = {35-46}, pmid = {41341968}, issn = {1976-8354}, abstract = {Chronic psychological stress is a well-known risk factor for neurodegenerative diseases including Alzheimer disease (AD), yet the underlying mechanisms remain unclear. We previously showed that chronic stress impairs adult hippocampal neurogenesis by triggering autophagic cell death of adult hippocampal neural stem (HCN) cells. Impairment of adult hippocampal neurogenesis is widely observed in the brains of human AD patients and animal models. However, it remains unknown whether stress-induced death of HCN cells is related to the pathogenesis of AD. In this study, we investigated whether the stress hormone, corticosterone (CORT) induces HCN cell death through presenilin 2 (Psen2), a gene associated with familial AD. Using CRISPR/Cas9-based knockout models and in vitro CORT treatment, we found that Psen2 expression is upregulated by CORT and Psen2 deletion prevents CORT-induced death in HCN cells. However, the Psen2 N141I mutation, despite its pathogenicity in AD, did not exacerbate CORT-induced cell death in vitro and hippocampus-dependent behavioral deficits in vivo. These findings indicate that while Psen2 is essential for stress-induced death of HCN cells, the Psen2 N141I mutation alone may not be sufficient to link chronic stress to AD pathogenesis.}, }
@article {pmid41341510, year = {2025}, author = {Yang, J and Yang, F and Chen, G and Liu, M and Yuan, S and Zhang, TE}, title = {Receptor-mediated mitophagy: a new target of neurodegenerative diseases.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1665315}, pmid = {41341510}, issn = {1664-2295}, abstract = {Neurodegenerative diseases are a category of neurological conditions with high prevalence that pose major treatment challenges. Common pathologies involve protein accumulation and mitochondrial damage. Mitophagy maintains cellular homeostasis by removing defective mitochondria, which are associated with the pathogenesis of neurodegenerative diseases. Although the ubiquitin-dependent mitophagy mediated by the PINK1-Parkin pathway has been extensively studied, growing evidence indicates that receptor-mediated mitophagy plays a crucial compensatory role in neurons, particularly when the PINK1-Parkin pathway is impaired. This review focuses on the emerging field of receptor-mediated mitophagy, systematically elaborating its role as a key homeostatic mechanism operating independently of the canonical PINK1/Parkin pathway. It provides a focused analysis of the specific functions and activation mechanisms of key receptors-including BNIP3, NIX, FUNDC1, and AMBRA1-in models of Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. Furthermore, this review explores the clinical potential of targeting these specific receptors for precise intervention, aiming to provide a new theoretical foundation and direction for developing therapeutic strategies against neurodegenerative diseases.}, }
@article {pmid41341242, year = {2024}, author = {Gutman, B and Shmilovitch, AH and Aran, D and Shelly, S}, title = {Twenty-Five Years of AI in Neurology: The Journey of Predictive Medicine and Biological Breakthroughs.}, journal = {JMIR neurotechnology}, volume = {3}, number = {}, pages = {e59556}, pmid = {41341242}, issn = {2817-092X}, abstract = {Neurological disorders are the leading cause of physical and cognitive disability across the globe, currently affecting up to 15% of the world population, with the burden of chronic neurodegenerative diseases having doubled over the last 2 decades. Two decades ago, neurologists relying solely on clinical signs and basic imaging faced challenges in diagnosis and treatment. Today, the integration of artificial intelligence (AI) and bioinformatic methods is changing this landscape. This paper explores this transformative journey, emphasizing the critical role of AI in neurology, aiming to integrate a multitude of methods and thereby enhance the field of neurology. Over the past 25 years, integrating biomedical data science into medicine, particularly neurology, has fundamentally transformed how we understand, diagnose, and treat neurological diseases. Advances in genomics sequencing, the introduction of new imaging methods, the discovery of novel molecular biomarkers for nervous system function, a comprehensive understanding of immunology and neuroimmunology shaping disease subtypes, and the advent of advanced electrophysiological recording methods, alongside the digitalization of medical records and the rise of AI, all led to an unparalleled surge in data within neurology. In addition, telemedicine and web-based interactive health platforms, accelerated by the COVID-19 pandemic, have become integral to neurology practice. The real-world impact of these advancements is evident, with AI-driven analysis of imaging and genetic data leading to earlier and more accurate diagnoses of conditions such as multiple sclerosis, Parkinson disease, amyotrophic lateral sclerosis, Alzheimer disease, and more. Neuroinformatics is the key component connecting all these advances. By harnessing the power of IT and computational methods to efficiently organize, analyze, and interpret vast datasets, we can extract meaningful insights from complex neurological data, contributing to a deeper understanding of the intricate workings of the brain. In this paper, we describe the large-scale datasets that have emerged in neurology over the last 25 years and showcase the major advancements made by integrating these datasets with advanced neuroinformatic approaches for the diagnosis and treatment of neurological disorders. We further discuss challenges in integrating AI into neurology, including ethical considerations in data use, the need for further personalization of treatment, and embracing new emerging technologies like quantum computing. These developments are shaping a future where neurological care is more precise, accessible, and tailored to individual patient needs. We believe further advancements in AI will bridge traditional medical disciplines and cutting-edge technology, navigating the complexities of neurological data and steering medicine toward a future of more precise, accessible, and patient-centric health care.}, }
@article {pmid41339994, year = {2025}, author = {Sivalingam, AM and Sureshkumar, DD}, title = {The Central Role of m6A as Epigenetic Regulator in Metabolic Disorders of Therapeutic Potential and Clinical Implications.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {247}, pmid = {41339994}, issn = {1559-1182}, mesh = {Humans ; *Epigenesis, Genetic ; *Metabolic Diseases/genetics/therapy/metabolism ; *Adenosine/analogs & derivatives/metabolism/genetics ; Animals ; Aging/genetics ; }, abstract = {N6-methyladenosine (m6A) is the most common reversible mRNA modification, regulating fundamental cellular processes. It plays a vital role in aging and age-related diseases by influencing gene expression, RNA splicing, and stability. Growing evidence suggests that m6A modifications orchestrate key hallmarks of aging, including cellular senescence, stem cell exhaustion, and chronic inflammation factors that contribute to neurodegeneration, cardiovascular disease, and cancer. The intricate crosstalk between m6A and chromatin modifications is now recognized as a fundamental mechanism shaping age-associated epigenetic landscapes and influencing disease susceptibility. Core m6A regulators, such as METTL3, FTO, and ALKBH5, are implicated in age-related metabolic decline, neurodegeneration, and impaired tissue regeneration, making them promising therapeutic targets. Dysregulated m6A patterns are linked to aberrant RNA metabolism, protein aggregation, and synaptic dysfunction in Alzheimer's and Parkinson's diseases, while in cardiovascular and metabolic disorders, m6A modifications contribute to endothelial dysfunction, inflammation, and oxidative stress. Recent breakthroughs in computational modeling and RNA-editing technologies have revolutionized m6A research. High-precision deep-learning models (e.g., m6A-DCR) and CRISPR-based m6A editing tools provide powerful platforms to decode m6A's role in aging and disease progression. These advances pave the way for novel therapeutic strategies, offering opportunities for early diagnostics, precision medicine, and personalized interventions. Despite these promising developments, challenges remain in translating m6A-targeted therapies into clinical applications. Future research must enhance treatment specificity, minimize off-target effects, and elucidate the broader implications of m6A in aging. Advancing our understanding of m6A's functional landscape is essential for developing next-generation RNA-based therapeutics to combat aging and its associated diseases.}, }
@article {pmid41339497, year = {2025}, author = {Babu, T and Mahendran, R and Ajitha, P and Rajendran, S}, title = {Intra-scale interaction and cross-scale fusion network for detecting the progression of neurodegeneration in Alzheimer's disease.}, journal = {Scientific reports}, volume = {16}, number = {1}, pages = {1377}, pmid = {41339497}, issn = {2045-2322}, abstract = {Alzheimer’s disease (AD), one of the most widespread neurodegenerative disorders, can be mitigated through early recognition and treatment. Recent research has shown that multimodal fusion is effective for the early-stage diagnosis of AD. However, most existing methods do not adequately account for the differences in data modality domains, their interconnections, and relative relevance.In this paper, we introduce a robust Intra-scale Interaction and Cross-scale Fusion Network (ISI-CSFN) for AD progression detection. The proposed model employs a linearized convolutional attention module to enable interaction between global information captured by the Cascaded Transformer (CTransformer) and local features extracted by the Depthwise Separable Convolution Network (DSCN). This mechanism enhances the discriminative ability for AD progression detection by allowing each modality-specific branch to incorporate complementary contextual representations from the others while maintaining the integrity of its own features.Furthermore, the model integrates background (BG) information with multimodal temporal data for simultaneous prediction of several cognitive score variables. The proposed method achieves strong results for both regression and multi-class progression tasks. Specifically, the accuracy of our approach is 97.26% for NC vs. AD, 89.25% for NC vs. sMCI, and 84.74% for NC vs. pMCI classifications. In addition, the model attains the highest correlation coefficient and the lowest root mean square error (RMSE) across several clinical score regression tasks.}, }
@article {pmid41338979, year = {2025}, author = {Nakamura, K and Kanou, M and Ito, S and Jimbo, T and Kouzaki, K and Nakazato, K and Nakamjima, R and Yamanouchi, K and Ueda, H and Yamana, K}, title = {Beta-nicotinamide mononucleotide attenuates creatine kinase release in Duchenne muscular dystrophy model rats.}, journal = {The Journal of veterinary medical science}, volume = {}, number = {}, pages = {}, doi = {10.1292/jvms.25-0258}, pmid = {41338979}, issn = {1347-7439}, abstract = {Beta-nicotinamide mononucleotide (beta-NMN) is a direct precursor of nicotinamide adenine dinucleotide (NAD[+]), a coenzyme essential for maintaining homeostasis in living organisms. NMN administration has attracted attention as a potential treatment for aging and age-related conditions, including diabetes, Alzheimer's disease, and chronic kidney disease. Duchenne muscular dystrophy (DMD) is a progressive, degenerative muscle disease caused by X-linked frameshift mutations in the Dmd gene. NAD[+] levels in skeletal muscle decline in DMD pathology. In this study, we explored the therapeutic potential of NMN as an NAD[+] booster for muscular dystrophy by administering NMN to DMD rats, which exhibit severe phenotypes comparable to those of human DMD patients, for 2 months. Although NMN administration did not improve muscle function in DMD rats, it did reduce the release of creatine kinase in their blood. RNA-seq analysis revealed that NMN administration could reverse DMD-related gene expression changes associated with skeletal muscle homeostasis. These results suggest that NMN can protect skeletal muscle against degeneration in DMD and may hold therapeutic potential for DMD patients.}, }
@article {pmid41338440, year = {2026}, author = {Zarei, O and Talebi Moghaddam, M and Moradi Vastegani, S}, title = {Machine learning and deep learning in clinical practice: Advancing neurodegenerative disease diagnosis with multimodal markers.}, journal = {Brain research bulletin}, volume = {234}, number = {}, pages = {111667}, doi = {10.1016/j.brainresbull.2025.111667}, pmid = {41338440}, issn = {1873-2747}, mesh = {Humans ; *Neurodegenerative Diseases/diagnosis ; *Deep Learning ; *Machine Learning/trends ; Biomarkers ; Neuroimaging/methods ; }, abstract = {Neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and multiple sclerosis, present major global health challenges due to their progressive and incurable nature. Early and accurate diagnosis is critical to slow disease progression and optimize therapeutic interventions, yet conventional diagnostic approaches, such as neuroimaging, cerebrospinal fluid biomarker analysis, and clinical evaluation are often inadequate at the prodromal stage. Recent advances in artificial intelligence, particularly machine learning (ML), have provided new opportunities for precision diagnosis and treatment in neurology, using large data and multimodal biomarkers. Applications of ML to data from neuroimaging, electrophysiology, behavioral functions, speech and handwriting analysis, and molecular biomarkers have shown promising improvements in diagnostic accuracy, patient classification, and therapeutic recommendations. However, significant challenges remain, including data heterogeneity, model interpretability, population diversity, and ethical concerns surrounding patients' privacy. The purpose of this review is to examine current applications of ML in the diagnosis and management of neurodegenerative diseases through various data, highlight its strengths and limitations, and discuss future directions for using these approaches in clinical practice. We also outline emerging directions, including multimodal fusion with longitudinal data, federated and privacy-preserving learning, and the potential of explainable AI (XAI) and large language models (LLMs) in clinical decision support.}, }
@article {pmid41338169, year = {2026}, author = {Li, S and Li, X and Li, S and Chen, D and Xia, C}, title = {Discovery of novel hybrids of coumarin and quinoline as potential anti-Alzheimer's disease agent.}, journal = {Bioorganic & medicinal chemistry}, volume = {133}, number = {}, pages = {118499}, doi = {10.1016/j.bmc.2025.118499}, pmid = {41338169}, issn = {1464-3391}, mesh = {*Coumarins/chemistry/pharmacology/therapeutic use ; *Quinolines/chemistry/pharmacology/therapeutic use ; *Alzheimer Disease/drug therapy/metabolism/pathology ; Animals ; Humans ; Mice ; Structure-Activity Relationship ; *Neuroprotective Agents/pharmacology/chemistry/chemical synthesis/therapeutic use ; Mice, Transgenic ; Amyloid beta-Peptides/metabolism/antagonists & inhibitors ; Molecular Structure ; *Drug Discovery ; *Cholinesterase Inhibitors/chemistry/pharmacology/chemical synthesis ; Oxidative Stress/drug effects ; Dose-Response Relationship, Drug ; Amyloid Precursor Protein Secretases/antagonists & inhibitors/metabolism ; Blood-Brain Barrier/metabolism ; Cell Line, Tumor ; }, abstract = {The multifaceted nature of Alzheimer's disease (AD) spurred growing interest in developing multi-target-directed ligands (MTDLs) for its prevention and treatment. Coumarin and quinoline scaffolds, recognized for their broad spectrum of AD-related biological activities including amyloid-β (Aβ) aggregation regulation, cholinesterase (ChE) inhibition, β-secretase 1 (BACE1) inhibition and neuroprotection, were identified as potential building blocks. Here in this study, 24 novel coumarin-quinoline hybrid compounds were rationally designed and synthesized. Inhibition studies targeting Aβ, ChE and BACE1 identified compound B8 as a promising lead compound. B8 exhibited effective binding to Aβ, and significantly attenuated Aβ-induced SH-SY5Y cell death by lowering oxidative stress and decreasing cellular apoptosis. Crucially, B8 demonstrated excellent blood-brain barrier (BBB) permeability, and intragastric administration of B8 to 7-month-old APP/PS1 transgenic mice resulted in improved cognitive function. This improvement was supported by the protection of hippocampal and cortical neurons from necrosis, attenuation of oxidative stress and inflammation in these brain regions, as well as a reduction in Aβ deposition. These findings highlight the potential of coumarin-quinoline hybrids as a novel class of AD therapeutics, with B8 emerging as a promising lead candidate warranting further investigation.}, }
@article {pmid41338025, year = {2026}, author = {Wagdy, M and Ibrahim, AA and Yahia, AM and Maher, RM and Abo-Elwafa, AH and Salah, A and Heikal, YM}, title = {Neurobiotech innovative strategies targeting Alzheimer's disease through therapeutic micro and macroalgae potentials.}, journal = {Journal of neuroimmunology}, volume = {411}, number = {}, pages = {578821}, doi = {10.1016/j.jneuroim.2025.578821}, pmid = {41338025}, issn = {1872-8421}, mesh = {*Alzheimer Disease/therapy/drug therapy ; Humans ; *Seaweed ; Animals ; *Microalgae ; Antioxidants/therapeutic use ; *Neuroprotective Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder identified by cognitive decline, memory loss, and behavioral changes, affecting approximately 50 million people worldwide. Genetic predisposition, environmental variables, and aging all play a role in the development of AD. Current therapeutic approaches primarily focus on alleviating symptoms through drugs such as donepezil and memantine. However, these treatments offer limited efficacy and may be accompanied by adverse effects. In contrast, natural therapies derived from algae present a promising alternative. Microalgae, including Chlorella and Spirulina, and macroalgae such as Fucus vesiculosus, Ecklonia cava, Sargassum, Laminaria japonica, and Fucus species, are rich in bioactive molecules having antioxidant and anti-inflammatory characteristics. These substances demonstrated potential in addressing the pathological features of AD, such as oxidative stress and neuroinflammation. Furthermore, advances in biotechnological tools like CRISPR-Cas9 gene editing are poised to enhance the efficacy of these natural therapies by targeting and modifying disease-associated genes. This review aims to bridge the fields of neurobiotechnology and marine bioresources by examining the synergistic potential of algal compounds and gene-editing strategies in combating Alzheimer's disease. Algal-derived compounds are utilized in pharmaceuticals, nutraceuticals, and dietary supplements, and may offer neuroprotective benefits that could aid in the prevention or treatment of AD.By integrating insights from molecular biology, pharmacology, and genomics, we seek to illuminate a novel, multidisciplinary framework for future therapeutic innovation.}, }
@article {pmid41337426, year = {2025}, author = {Li, J and Gao, Y and Yang, P and Guan, Z and Wang, T and Ma, G and Lei, B}, title = {Multi-Modal Feature Fusion Using Transformer for Early Alzheimer's Disease Diagnosis.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-4}, doi = {10.1109/EMBC58623.2025.11253151}, pmid = {41337426}, issn = {2694-0604}, mesh = {*Alzheimer Disease/diagnosis/diagnostic imaging ; Humans ; Deep Learning ; Algorithms ; Early Diagnosis ; }, abstract = {Alzheimer's disease (AD) is a common neurodegenerative disorder. Early and accurate diagnosis of AD is essential for effective treatment. However, due to the class imbalance problem, there is a significant data gap between different categories. Moreover,the data feature differences of AD are relatively small, which poses challenges for its application in the early diagnosis of AD. To tackle these problems, we propose an intelligent early AD diagnosis model based on Transformer. The deep learning diagnosis model utilizes Transformer to integrate image features and non-image features. Furthermore, it incorporates a class imbalance loss function to optimize the performance of early AD diagnosis, thereby enhancing the model's ability to recognize underrepresented classes. In order to alleviate the problem of class imbalance and test the model performance, we used stratified 5-fold cross validation to verify the model effect.Experimental results demonstrate that our model can significantly improve the accuracy of AD diagnosis, which is markedly better than traditional methods. Additionally, loss function we used more effectively mitigates the problem of class imbalance. We believe this work can effectively reduce the burden on medical staff to diagnose early AD.}, }
@article {pmid41337360, year = {2025}, author = {Lee, HP and Arginteanu, T and Kudela, P and Wyse-Sookoo, K and Anderson, WS and Salimpour, Y}, title = {Phase-Dependent Neuromodulation in a Computational Hippocampal Model.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-4}, doi = {10.1109/EMBC58623.2025.11254724}, pmid = {41337360}, issn = {2694-0604}, mesh = {*Hippocampus/physiology ; Humans ; *Models, Neurological ; Computer Simulation ; Theta Rhythm/physiology ; Neurons/physiology ; Animals ; }, abstract = {The critical role of phase-amplitude coupling (PAC) between oscillations of differing frequencies highlights the promise of phase-dependent neuromodulation as a therapeutic strategy for various neurological conditions. In the hippocampus, theta-gamma PAC is linked to key memory processes and information transfer. Computational models avoid technical challenges in in vivo and in vitro experiments and offer a practical alternative for exploring the mechanisms behind phase-dependent effects. In this study, we built on a published CA3 hippocampal computational model implemented in the NEURON-Python environment. We used a closed-loop autoregressive (AR) forward prediction model that sampled the network's local field potential (LFP) to achieve real-time calculation of stimulus time points locked to a target phase of the theta oscillation. Our approach enabled the delivery of current injections to all neuronal populations at either the peak or the trough of the theta rhythm. Analysis of the resulting network LFP showed distinct phase-dependent changes in the theta band during stimulation. The peak-phase stimulation significantly enhanced theta-gamma coupling. Further study on a large-scale human-based model is needed to better capture these phase-dependent effects. Overall, the results underscored the importance of closed-loop stimulation systems and the potential of phase-targeted neuromodulation to influence PAC. These findings offer new avenues for treating disorders marked by disrupted oscillations, including Alzheimer's disease and other memory disorders.Clinical Relevance- This study provides investigations of the origins of neuronal oscillations and the development of a brain stimulation technique for modulating the level of oscillations, possibly contributing to the development of novel treatment methods for neurological disorders associated with abnormal oscillations..}, }
@article {pmid41337282, year = {2025}, author = {Uhm, J and Kim, HY and Choe, B and Agrawal, H and Yoon, S and Yun, JH}, title = {Smartphone Keystroke-based Cognitive Impairment Diagnostic Methodology.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-7}, doi = {10.1109/EMBC58623.2025.11253467}, pmid = {41337282}, issn = {2694-0604}, mesh = {Humans ; *Smartphone ; *Cognitive Dysfunction/diagnosis ; Male ; Aged ; Female ; }, abstract = {With the global population rapidly aging, dementia has emerged as a major public health concern. Significant efforts are being made to address the health and other problems associated with dementia. Although several advances have been made in the diagnosis and treatment of dementia, many challenges remain unresolved. Existing dementia diagnostic methods are often not performed in a timely manner due to poor accessibility, leading to delays in initiation of treatment. In this study, we propose a smartphone keystroke-based diagnostic method as a solution to overcome the limitations associated with the early diagnosis and treatment of dementia. As compared to other existing methods, the proposed diagnostic method is easier to develop and maintain, promoting commercialization and widespread use. The diagnostic method has been designed to extract language-agnostic keystroke data features from smartphone keyboard input logs. Rather than simply extracting features assessing motor skills from keystroke data or features demonstrating language usage patterns from text, this study focused on features that can assess cognitive abilities without using linguistic characteristics. Clinical trials were conducted in patients with mild cognitive impairment and early Alzheimer's dementia were conducted, and a series of experiments and validation tests were performed using the trial data. The results demonstrated that the proposed smartphone keystroke-based diagnostic method is effective in diagnosing cognitive impairment. The proposed method does not require the use of any special equipment except smartphones, which facilitates low-cost commercialization. This study presents a diagnostic method that addresses the problem of people who avoid tests for the diagnosis of dementia due to economic and psychological burdens.Clinical RelevanceThis study provides an approach for early detection of dementia using ordinary smartphone keystroke logs. The proposed method has the potential to improve the quality of life of patients with dementia. Following large-scale clinical research and the integration of more digital biomarkers, the methodology proposed in this study can potentially facilitate the development of an early diagnostic platform for dementia.}, }
@article {pmid41336985, year = {2025}, author = {Salinas-Medina, A and Gonzalez-Mitjans, A and Toussaint, PJ and Liu, X and Evans, A}, title = {HISRON: AI-Driven GPU-Accelerated Framework for Scalable High-Resolution Neuroimaging Analysis.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-7}, doi = {10.1109/EMBC58623.2025.11253703}, pmid = {41336985}, issn = {2694-0604}, mesh = {Humans ; *Neuroimaging/methods ; *Image Processing, Computer-Assisted/methods ; *Computer Graphics ; Algorithms ; *Artificial Intelligence ; Brain/diagnostic imaging ; }, abstract = {Ultra-high-resolution imaging, particularly cellular neuroimaging, poses challenges from terabyte-scale data and computational complexity. We present HISRON (High-Resolution Scalable Neuroimaging) a GPU-accelerated framework enabling scalable multidimensional analysis, combining unsupervised learning for adaptive feature extraction, benchmarked anisotropic diffusion for noise reduction, and promptable segmentation models with a zero-shot generalization feature. Dynamic overlap-aware tiling maximizes parallelization while preserving spatial context, enabling real-time processing of complex structures. Built on NVIDIA CUDA and CuPy, the framework achieves transformative efficiency: 10x faster noise reduction and detection of 200,000 neuron centroids in 30 seconds (40% pipeline improvement). This advances integration with AI-driven segmentation/classification pipelines, overcoming bottlenecks in high-dimensional computer vision. By emphasizing scalability, our method accelerates analysis of biomedical imaging data, directly supporting translational healthcare innovations in neuroscience. The tool's adaptability underscores its potential for clinical research, enhancing precision in neuroanatomical studies and fostering discoveries in brain function and pathology.Clinical relevance-The proposed framework directly addresses critical challenges in modern clinical neuroimaging, where the analysis of high-resolution data is essential for diagnosing and monitoring neurological disorders such as Alzheimer's, Parkinson's diseases, and epilepsy. By enabling real-time processing of terabyte-scale datasets, this technology reduces delays in image interpretation, facilitating faster decision-making in time-sensitive scenarios, such as intraoperative imaging during neurosurgery or stroke assessment. The zero-shot segmentation model's adaptability ensures robust performance across heterogeneous imaging protocols, which is vital for multicenter clinical studies and personalized treatment planning. Additionally, the framework's efficiency in detecting neuron populations at scale supports large-scale neuroanatomical studies, enhancing our understanding of brain connectivity abnormalities in psychiatric and neurodegenerative conditions. By lowering computational barriers, this tool democratizes access to advanced imaging analytics, empowering clinics with limited resources to adopt precision medicine approaches. These advancements align with the growing demand for AI-driven scalable solutions to improve diagnostic accuracy, accelerate therapeutic discovery, and optimize patient outcomes in neurology and neurorehabilitation.}, }
@article {pmid41336397, year = {2025}, author = {Seo, K and Hwang, J and Kim, K and Argrawal, H and Yun, JH and Yoon Kim, H}, title = {End-to-End Classification of Cognitive Impairment Using Daily-Life Gait Data.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-7}, doi = {10.1109/EMBC58623.2025.11254035}, pmid = {41336397}, issn = {2694-0604}, mesh = {Humans ; *Cognitive Dysfunction/diagnosis/physiopathology/classification ; *Gait ; Aged ; Male ; Female ; Middle Aged ; Smartphone ; Accelerometry ; *Activities of Daily Living ; Alzheimer Disease/diagnosis/physiopathology ; Wearable Electronic Devices ; }, abstract = {We investigated the feasibility of using commercial smart devices to prescreen cognitive impairments for timely intervention. A total of 125 individuals aged 50 and older were recruited from a local clinic and categorized into groups based on cognitive diagnosis: Mild Alzheimer's Disease (AD), Mild Cognitive Impairment (MCI), and Subjective Cognitive Decline (SCD).This study focused on distinguishing individuals requiring treatment (AD and MCI) from those without cognitive impairment (SCD) using gait-related data collected from daily life. This classification task was particularly challenging, as the SCD group shares cognitive symptoms with MCI and the data was collected in non-controlled, real-world conditions.Participants used smartphones and smartwatches for one month to collect accelerometer and gyroscope data during daily activities. We preprocessed walking segments and trained a deep learning classifier to differentiate between the two groups. The model achieved an area under the curve (AUC) of 0.70, demonstrating the potential of wearable-based gait analysis for cognitive impairment detection. A sensor ablation study revealed that wrist-worn gyroscope data alone achieved a comparable AUC of 0.70, suggesting a moderate association between arm motion and cognitive impairment. The results further indicated that integrating smartphone accelerometers and smartwatch gyroscopes enhanced classification performance.This study is part of a broader multimodal research initiative that integrates gait analysis with voice recordings, phone usage patterns, and other behavioral data to improve cognitive impairment classification. Future work will explore multi-modal fusion techniques to enhance accuracy and reliability, with the long-term goal of developing accessible, real-world screening tools for early detection.}, }
@article {pmid41336106, year = {2025}, author = {Shanmugasundaram, S and K, GG and Sinha, N}, title = {EEG Complexity Measures for Alzheimer's and Frontotemporal Dementia Classification Using Explainable Machine Learning.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2025}, number = {}, pages = {1-7}, doi = {10.1109/EMBC58623.2025.11253046}, pmid = {41336106}, issn = {2694-0604}, mesh = {Humans ; *Alzheimer Disease/diagnosis/physiopathology/classification ; *Electroencephalography/methods ; *Frontotemporal Dementia/diagnosis/physiopathology/classification ; *Machine Learning ; Male ; Female ; Aged ; Signal Processing, Computer-Assisted ; Middle Aged ; }, abstract = {This study aimed to classify patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD) from healthy controls (CN) using non-linear EEG features. We explored various classification tasks, including binary classifications (CN vs. AD, CN vs. FTD, FTD vs. AD) and multi-class classifications, employing machine learning models such as XGBoost, multi-layer perceptron, k-nearest neighbors, and support vector machines. To understand the model's decision-making process, we employed explainable AI (XAI) using SHAP (SHapley Additive exPlanations) analysis. An EEG dataset of 88 subjects: 36 with AD, 29 controls, and 23 with FTD, was used. The occipital electrode O2 played a crucial role in differentiating AD from controls. In both FTD vs. AD and CN vs. FTD classifications, features from the frontal and temporal electrodes exhibited the highest importance. The results showed that XGB and MLP perform best across all classification tasks, with 100% accuracy achieved in CN vs. AD classification and area under the curve values of 0.99 for most classifiers. Distinguishing unhealthy patients (AD and FTD) from healthy controls yielded lower performance, potentially due to the differential EEG signal alterations in these conditions. The multi-class classification of AD, FTD, and controls achieved accuracy of 82%, lower than the binary classification tasks. The study proposed a novel methodology combining non-linear EEG features and machine learning models, offering the potential for improved disease detection.Clinical relevance- This study offers the potential to provide a non-invasive, efficient method for early detection and differentiation of AD and FTD from healthy controls. The ability to classify these neurodegenerative diseases using EEG, a widely accessible and cost-effective tool, could significantly aid in the timely diagnosis and monitoring of disease progression. This could lead to more personalized treatment plans and improved patient care.}, }
@article {pmid41335145, year = {2025}, author = {Banu, Z and Das, NR}, title = {Protective effects of alkaloidal fraction of Elaeocarpus angustifolius Blume against AlCl3-evoked neurotoxicity: insights from an in vivo model of Alzheimer's disease.}, journal = {Metabolic brain disease}, volume = {40}, number = {8}, pages = {330}, pmid = {41335145}, issn = {1573-7365}, mesh = {Animals ; *Alzheimer Disease/drug therapy/chemically induced/metabolism/pathology ; Aluminum Chloride/toxicity ; *Neuroprotective Agents/pharmacology/therapeutic use ; Rats ; Male ; *Plant Extracts/pharmacology/therapeutic use ; Disease Models, Animal ; *Alkaloids/pharmacology/therapeutic use ; Hippocampus/drug effects/metabolism/pathology ; Oxidative Stress/drug effects ; Maze Learning/drug effects ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and neuronal degeneration. Current treatments offer limited efficacy. Elaeocarpus angustifolius Blume (Rudraksha), used traditionally in Ayurveda for neurological disorders, has shown potential for cognitive health, warranting investigation in AD models. This study aimed to evaluate the neuroprotective efficacy of an alkaloid-rich fraction of E. angustifolius (EAF) in an AlCl3-induced rat model of AD. AD-like symptoms were induced by oral administration of AlCl3 (100 mg/kg) for 60 days, followed by a 30-day oral treatment with EAF (200 and 400 mg/kg). Cognitive performance was assessed using the Morris water maze, elevated plus maze, novel object recognition, and locomotor activity tests. Biochemical and molecular markers were analysed, and hippocampal histopathology was conducted. AlCl3 exposure caused significant cognitive and motor deficits, elevated Aβ1-42 and phosphorylated tau, decreased acetylcholine and dopamine, increased glutamate and NF-κB, and reduced NRF-2 expression, indicating oxidative stress and neuroinflammation. EAF treatment significantly improved behavioral outcomes, reduced Aβ1-42 and tau levels, restored neurotransmitter balance, enhanced antioxidant markers (GSH, SOD, CAT), and reduced MDA. It suppressed NF-κB and upregulated NRF-2, suggesting antioxidant and anti-inflammatory effects. Histopathological analysis confirmed hippocampal neuroprotection. EAF exhibited significant neuroprotective effects by mitigating oxidative stress, neuroinflammation, and AD-related pathologies, including amyloid accumulation and cholinergic dysfunction. These findings support the potential of EAF as a therapeutic candidate for AD prevention and management.}, }
@article {pmid41333818, year = {2025}, author = {An, L and Zhang, J and Wang, X and Ge, Y and Sun, K and Dong, J and Wang, P and Li, W and Li, M and Hu, X and Wang, B and Yu, XA}, title = {Nanocarriers based therapy and diagnosis of brain diseases: cross the blood-brain barrier.}, journal = {Science and technology of advanced materials}, volume = {26}, number = {1}, pages = {2554048}, pmid = {41333818}, issn = {1468-6996}, abstract = {The blood-brain barrier (BBB) is the protective interface that isolates the central nervous system from circulating blood, which restricts approximately 98% of small molecule drugs and nearly all large molecules from entering the brain. Current methods to bypass the BBB, such as laser-guided interstitial thermal therapy and magnetic resonance guided focused ultrasound, are fraught with risks like impairing BBB integrity and brain damage, and are not suitable for long-term treatment. Nanocarriers have emerged as promising tools due to their ability to enhance drug delivery across the BBB while minimizing systemic toxicity. These nanocarriers leverage mechanisms including receptor-mediated, carrier-mediated, cell mediated and extra-stimuli mediated transport to improve BBB traverse and brain targeting. The review evaluates these strategies separately, discussing their potential and limitations for clinical application, and highlights recent advancements in integrating and optimizing nanocarriers utilizing synergistic strategies for the treatment and diagnosis of neurological disorders, including tumors, Alzheimer's disease, Parkinson's disease, and brain infections.}, }
@article {pmid41332987, year = {2025}, author = {Huai, JX and Chang, EE and Zhu, YR and Ma, WL and Lv, TS and Sun, J and Zhou, XQ}, title = {Diabetic encephalopathy: metabolic reprogramming as a potential driver of accelerated brain aging and cognitive decline.}, journal = {Frontiers in cell and developmental biology}, volume = {13}, number = {}, pages = {1701406}, pmid = {41332987}, issn = {2296-634X}, abstract = {Diabetic encephalopathy (DE) is a serious neurological complication of diabetes and is expressed as progressive decline in cognitive function, emotional disorders, and changes in brain structure. This review brings together the relevant evidence and demonstrates that metabolic reprogramming, the adaptive reconfiguration of the core metabolic pathway in response to hyperglycemia, is a potential driver of accelerated brain aging in DE. The main pathological characteristics are: abnormal brain insulin signaling, resulting in a decrease in neuronal glucose intake and a decrease in mitochondrial oxidative phosphorylation, oxidative stress and neuroinflammation caused by high blood sugar, in which excess reactive oxygen species (ROS), impairs mitochondrial integrity and leads to activation of microglia cells. The impaired mitophagy and the macrophages remove defects and cause the accumulation and energy collapse of the dysfunctional organelles. In addition, it promotes excessive glycolytic flux, lipolysis disorder, lactic acid accumulation, and ceramide-dependent synaptic damage. We further examine shared metabolic mechanisms between DE and neurodegenerative diseases such as alzheimer's disease (AD) and treatment strategies for pathological metabolic reprogramming including GLP-1 receptor agonists, NAD[+] boosters, and AMPK activators. This analysis laid the foundation for new intervention measures against the development of DE.}, }
@article {pmid41332414, year = {2025}, author = {Zhao, X and Xu, Z and Wang, D and Li, T and Xu, L and Li, Z and Bai, X and Zhu, H and Liu, Y and Wang, Y}, title = {Nanotechnology-based targeted regulation of NLRP3 Inflammasome: therapeutic strategies and clinical application prospects in inflammatory diseases.}, journal = {Drug delivery}, volume = {32}, number = {1}, pages = {2580730}, pmid = {41332414}, issn = {1521-0464}, mesh = {*NLR Family, Pyrin Domain-Containing 3 Protein/metabolism/antagonists & inhibitors ; Humans ; *Inflammasomes/metabolism ; Animals ; *Inflammation/drug therapy/metabolism ; Drug Delivery Systems/methods ; Nanotechnology/methods ; *Anti-Inflammatory Agents/administration & dosage/pharmacology ; Reactive Oxygen Species/metabolism ; Nanoparticles ; Nanomedicine/methods ; }, abstract = {The NLRP3 inflammasome plays a critical role in the onset and progression of various inflammatory diseases, making targeting its activation an important research direction for treating these conditions. Nanotechnology can effectively inhibit the activation of the NLRP3 inflammasome through several mechanisms, such as scavenging reactive oxygen species (ROS), regulating calcium ion flux, and stabilizing mitochondrial function, thereby alleviating inflammation and promoting tissue repair. Studies have demonstrated that nanomaterials exhibit promising anti-inflammatory effects in animal models, showing broad application potential, particularly in the treatment of conditions such as atherosclerosis, diabetes, and Alzheimer's disease. However, the clinical translation of nanotherapy still faces numerous challenges, including issues related to material biocompatibility, long-term safety, targeting efficiency, and controlled drug delivery. Future research should integrate targeting ligands, responsive materials, and multifunctional nanoplatforms to enhance the specificity and efficacy of treatments while minimizing side effects. Additionally, the prospects of nanotechnology in personalized treatment and clinical applications are substantial, necessitating further integration of basic research with clinical validation to expedite the clinical translation of NLRP3-targeted nanomedicines.}, }
@article {pmid41331838, year = {2025}, author = {Kumar, N and Jangid, K and Kumar, V and Devi, B and Arora, T and Mishra, J and Kumar, V and Dwivedi, AR and Parkash, J and Bhatti, JS and Kumar, V}, title = {Investigations of 3-Hydroxy Chromone Derivatives as Multipotent Therapeutics for the Treatment of Alzheimer's Disease: In Silico and In Vitro Interventions and Fluorescence Studies.}, journal = {ACS chemical neuroscience}, volume = {16}, number = {24}, pages = {4751-4768}, doi = {10.1021/acschemneuro.5c00847}, pmid = {41331838}, issn = {1948-7193}, mesh = {Humans ; *Alzheimer Disease/drug therapy/metabolism ; *Cholinesterase Inhibitors/pharmacology/chemistry ; Monoamine Oxidase/metabolism ; Monoamine Oxidase Inhibitors/pharmacology/chemistry ; *Chromones/pharmacology/chemistry ; Amyloid beta-Peptides/metabolism ; Acetylcholinesterase/metabolism ; *Neuroprotective Agents/pharmacology/chemistry ; Cell Line, Tumor ; Antioxidants/pharmacology ; Reactive Oxygen Species/metabolism ; Molecular Docking Simulation ; }, abstract = {Chromone-based small organic molecules are designed and synthesized as putative multipotent ligands to intervene in several interlinked pathological pathways of Alzheimer's disease. The synthesized compounds were evaluated as acetylcholinesterase, monoamine oxidase, and amyloid β aggregation inhibitors using biochemical assays. Most of the compounds were found to inhibit the enzymes in a lower micromolar concentration range. In the series, two compounds, i.e., NSS-16 and NSS-18, displayed a balanced activity profile with the IC50 values of 1.77 and 1.53 μM against AChE and 2.06 and 1.51 μM against MAO-B. NSS-16 and NSS-18 showed moderate inhibitory activity against the self-induced Aβ aggregation with inhibition percentages of 17.8 and 24.0%, respectively. These compounds also showed potent antioxidant activity and formed metal chelates. In addition, the compounds were tested against SH-SY5Y neuronal cells and found to be neuroprotective and noncytotoxic. Moreover, the compounds inhibited reactive oxygen species (ROS) production up to 70% and exhibited a mixed type of inhibition in enzyme kinetic studies of AChE. These chromone derivatives showed a strong fluorescence intensity with a quantum yield of 30-50% and can be utilized in various biological studies including in vitro and in vivo assessments. Computational studies showed that the lead compounds fit well in the active cavity of enzymes and displayed thermodynamic stability for a time interval of 100 ns. Thus, these compounds displayed a multipotent activity profile and have the potential to be developed as potential therapeutics for AD.}, }
@article {pmid41330788, year = {2025}, author = {Zimmer, JA and Sims, JR and Evans, CD and Nery, ESM and Wang, H and Wessels, AM and Tronchin, G and Sato, S and Raket, LL and Andersen, SW and Sapin, C and Paget, MA and Gueorguieva, I and Ardayfio, P and Khanna, R and Brooks, DA and Matthews, BR and Mintun, MA and , }, title = {Donanemab in early symptomatic Alzheimer's disease: results from the TRAILBLAZER-ALZ 2 long-term extension.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100446}, doi = {10.1016/j.tjpad.2025.100446}, pmid = {41330788}, issn = {2426-0266}, abstract = {BACKGROUND: Donanemab significantly slowed clinical progression in participants with early symptomatic Alzheimer's disease (AD) during the 76-week placebo-controlled period of TRAILBLAZER-ALZ 2.
METHODS: Participants who completed the placebo-controlled period were eligible for the 78-week, double-blind, long-term extension (LTE). Early-start participants were randomized to donanemab in the placebo-controlled period. Delayed-start participants (randomized to placebo) started donanemab in the LTE. Participants who met amyloid treatment course completion criteria were switched to placebo. An external control cohort comprised participants from the AD Neuroimaging Initiative (ADNI).
RESULTS: At 3 years, donanemab slowed disease progression on the Clinical Dementia Rating Scale (CDR)-Sum of Boxes (CDR-SB) in early-start participants versus a weighted ADNI control (-1.2 points; 95 % confidence interval [CI], -1.7, -0.7). Seventy-six weeks after initiating donanemab, delayed-start participants also demonstrated slower CDR-SB progression versus a weighted ADNI control (-0.8 points; 95 % CI, -1.3, -0.3). Participants who completed treatment by 52 weeks demonstrated similar slowing of CDR-SB progression at 3 years. Compared with delayed-start participants, early-start participants demonstrated a significantly lower risk of disease progression on the CDR-Global over 3 years (hazard ratio=0.73; p < 0.001). In both groups, >75 % of participants assessed by positron emission tomography 76 weeks after starting donanemab achieved amyloid clearance (<24.1 Centiloids). The addition of LTE data to prior modeling predicted a median reaccumulation rate of 2.4 Centiloids/year. No new safety signals were observed compared to the established donanemab safety profile.
CONCLUSIONS: Over 3 years, donanemab-treated participants with early symptomatic AD demonstrated increasing clinical benefits and a consistent safety profile, with limited-duration dosing.
TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04437511.}, }
@article {pmid41330635, year = {2025}, author = {Crowe, A and Yao, Y and Newman, M and Hoxha, K and Baffic, T and Brunden, KR}, title = {HDAC6 Inhibition Reduces Seeded Tau and α-Synuclein Pathologies in Primary Neuron Cultures and Wild-type Mice.}, journal = {The Journal of neuroscience : the official journal of the Society for Neuroscience}, volume = {}, number = {}, pages = {}, doi = {10.1523/JNEUROSCI.1092-25.2025}, pmid = {41330635}, issn = {1529-2401}, abstract = {A previous compound screen identified two molecules with histone deacetylase 6 (HDAC6) inhibitory activity that reduced Alzheimer's disease (AD)-like tau inclusions in a primary rat cortical neuron model seeded with AD-brain derived tau fibrils. Testing here of additional HDAC6-selective inhibitors confirmed that compounds of this type decreased neuronal tau inclusions. Moreover, HDAC6 inhibitors also reduced Parkinson's disease (PD)-like α-synuclein aggregates in primary neurons seeded with recombinant α-synuclein fibrils. Knockdown of HDAC6 expression through treatment of seeded neuron cultures with AAV harboring HDAC6-specific shRNA also resulted in a reduction of tau and α-synuclein inclusions. Multiple compounds were evaluated for their ability to inhibit brain HDAC6 in mice, and ACY-738 was found to effectively inhibit brain HDAC6 activity upon oral dosing. ACY-738 was utilized in an efficacy study in which tau and α-synuclein pathologies were induced in wild-type mice through intracerebral injections of AD-brain derived tau and α-synuclein fibrils. Groups of male and female mice first received ACY-738 in drinking water one day prior to (pre-seeding) or one week after (post-seeding) brain injections of fibrils, followed by continued dosing for an additional 3 months. A control group of fibril-injected mice received water without ACY-738. Immunohistochemical evaluations revealed that ACY-738 administration resulted in significant reductions of tau pathology in both dosing schemes. Moreover, α-synuclein pathology was significantly reduced in mice with pre-seeding ACY-738 administration, with a strong trend toward reduction after post-seeding dosing. These results suggest that HDAC6 inhibitors have potential for the treatment of AD, PD and related diseases.Significance Statement The spread and abundance of brain tau pathology correlate with AD patient cognitive status, and there are presently no approved drugs that target tau. We demonstrate that HDAC6 inhibition or knockdown reduce both tau and α-synuclein inclusions that develop in wild-type rodent neuron models. A preferred HDAC6 inhibitor, ACY-738, was identified that inhibits brain HDAC6 when administered orally to mice. This compound was examined in a wild-type mouse model that develops concurrent seeded tau and α-synuclein brain inclusions. Significant reductions of both tau and α-synuclein inclusions were observed in mice dosed with ACY-738, suggesting that HDAC6 inhibition may be a therapeutic strategy for AD, PD and related diseases.}, }
@article {pmid41330156, year = {2026}, author = {Costa, A and Provensi, G and Titi, C and Leri, M and Bucciantini, M and Ferraroni, M and Keeton, AB and Moore, AM and Piazza, GA and Abadi, AH and Angeli, A and Supuran, CT}, title = {Exploring dual inhibitors Carbonic Anhydrases and Phosphodiesterase 5 as potential agents for treatment Alzheimer's disease.}, journal = {European journal of medicinal chemistry}, volume = {303}, number = {}, pages = {118404}, doi = {10.1016/j.ejmech.2025.118404}, pmid = {41330156}, issn = {1768-3254}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Humans ; *Carbonic Anhydrase Inhibitors/pharmacology/chemistry/chemical synthesis/therapeutic use ; Animals ; Mice ; *Phosphodiesterase 5 Inhibitors/pharmacology/chemistry/chemical synthesis/therapeutic use ; Structure-Activity Relationship ; Molecular Structure ; *Cyclic Nucleotide Phosphodiesterases, Type 5/metabolism ; Dose-Response Relationship, Drug ; *Carbonic Anhydrases/metabolism ; Cell Survival/drug effects ; Amyloid beta-Peptides/antagonists & inhibitors ; Cell Line, Tumor ; Male ; Crystallography, X-Ray ; }, abstract = {In this study, we report for the first time the design and evaluation of a series of compounds with potential therapeutic relevance for Alzheimer's disease (AD), able to inhibit both human Carbonic Anhydrase (hCA) isoforms most involved in this disease as well as Phosphodiesterase 5 (PDE5), using sildenafil as the structural scaffold. A total of 19 new dual-target molecules were synthesized and biologically assessed, leading to the identification of compound 8a as the most promising candidate, exhibiting potent inhibition toward both enzymatic targets. The binding interactions of three selected derivatives (6, 8a, and 10d) with hCA II were elucidated by X-ray crystallography experiments. Moreover, compound 8a demonstrated a favourable safety profile, as it did not markedly impair cell viability on differentiated SH-SY5Y at concentrations up to 100 μM and conferred protection against Aβ-induced cytotoxicity showing superior efficacy compared to the single-target reference agents acetazolamide (AAZ) and sildenafil in mitigating oxidative stress. In vivo, chronic administration of compound 8a prevented deficits in both recognition and working memory in Aβ1-42-infused mice, outperforming vehicle-treated controls. Collectively, these findings highlight the potential of dual CA/PDE5 inhibition as a novel therapeutic strategy for Alzheimer's disease.}, }
@article {pmid41329964, year = {2025}, author = {Chen, M and Tang, G and Zhang, Y and Qian, ZJ}, title = {Exploring the Protective Effects of Two Alkaloids 1 and 2 from Aspergillus terreus C23-3 on Neuronal Cells by Combining Bioinformatics Prediction and Experimental Verification.}, journal = {ACS chemical neuroscience}, volume = {16}, number = {24}, pages = {4700-4710}, doi = {10.1021/acschemneuro.5c00739}, pmid = {41329964}, issn = {1948-7193}, mesh = {*Aspergillus/chemistry ; *Alkaloids/pharmacology ; *Neurons/drug effects/metabolism ; Animals ; *Neuroprotective Agents/pharmacology ; Molecular Docking Simulation ; Apoptosis/drug effects ; Mice ; Glycogen Synthase Kinase 3 beta/metabolism ; Computational Biology/methods ; Phosphorylation/drug effects ; Cell Line ; Cell Survival/drug effects ; }, abstract = {Alzheimer's disease (AD) is an irreversible neurodegenerative disease that can lead to brain cell death and brain atrophy, manifested as memory loss, cognitive decline, and behavioral abnormalities. Its mechanism is complex, and there is currently no effective treatment method. The search for new therapies and natural drug candidates has become the focus of research. In recent years, marine-derived strains of Aspergillus terreus have become an important research direction for treating AD due to the unique structure and biological activity of their secondary metabolites. In this study, we investigated the potential of two alkaloids from Aspergillus terreus C23-3 in the treatment of AD through bioinformatics analysis and experimental validation. Bioinformatics analyses showed that the two alkaloids may act by modulating key targets associated with AD, especially alkaloid 2, which may exert significant therapeutic effects on AD by inhibiting glycogen synthase kinase-3β (GSK-3β) activity and reducing the level of hyperphosphorylation of Tau proteins. Molecular docking experiments showed that alkaloids 1 and 2 formed stable complexes with GSK-3β with a high affinity. Cellular experiments showed that alkaloids 1 and 2 could effectively inhibit apoptosis and injury in HT-22 cells. Further studies showed that alkaloid 2 reduced the phosphorylation level of Tau protein and attenuated oxidative-stress-induced neurological injury by inhibiting GSK-3β and its related pathways. These results suggest that alkaloid 2 has significant potential for AD therapy.}, }
@article {pmid41328628, year = {2026}, author = {Ren, S and Singh, J and Gsteiger, S and Cogley, C and Reed, B and Abrams, KR and Dawoud, D and Owen, RK and Tappenden, P and Quinn, TJ and Bujkiewicz, S}, title = {Evaluating amyloid-beta as a surrogate endpoint in trials of anti-amyloid-beta drugs in Alzheimer's disease: a Bayesian meta-analysis.}, journal = {Journal of comparative effectiveness research}, volume = {15}, number = {1}, pages = {e250095}, pmid = {41328628}, issn = {2042-6313}, mesh = {*Alzheimer Disease/drug therapy ; Humans ; Bayes Theorem ; *Amyloid beta-Peptides/metabolism/antagonists & inhibitors ; Biomarkers/metabolism ; Randomized Controlled Trials as Topic ; Antibodies, Monoclonal, Humanized/therapeutic use ; *Antibodies, Monoclonal/therapeutic use ; }, abstract = {Aim: The use of amyloid-beta (Aβ) clearance to support regulatory approvals of drugs in Alzheimer's disease (AD) remains controversial. We evaluate Aβ as a potential trial-level surrogate endpoint for clinical function in AD. Materials & methods: Data on the effectiveness of anti-Aβ monoclonal antibodies (MABs) on Aβ and multiple clinical outcomes were identified from randomized controlled trials through a literature review. A Bayesian bivariate meta-analysis was used to evaluate Aβ as a surrogate endpoint for clinical function across all MABs and for each individual anti-Aβ MAB. The analysis for individual therapies was conducted in subgroups of treatments and by applying Bayesian hierarchical models to borrow information across treatments. Results: We identified 23 randomized controlled trials with 39 treatment contrasts for seven MABs. The surrogate relationship between treatment effects on Aβ and Clinical Dementia Rating-Sum of Boxes (CDR-SOB) across all MABs was strong: with a meaningful slope of 1.41 (0.60, 2.21) and small variance of 0.02 (0.00, 0.05). For individual treatments, the surrogate relationships were suboptimal, displaying large uncertainty. Sharing information across treatments considerably reduced the uncertainty, resulting in moderate surrogate relationships for aducanumab and lecanemab. No meaningful association was detected for other clinical outcomes, including Mini Mental State Examination and Alzheimer's Disease Assessment Scale-Cognitive Subscale. Conclusion: Although our results from the analysis of data across all MABs suggested that Aβ was a potential surrogate endpoint for CDR-SOB, individually the surrogacy patterns varied across treatments and showed no evidence of association. Bayesian information-sharing revealed moderate surrogate relationship only for aducanumab and lecanemab.}, }
@article {pmid41328259, year = {2025}, author = {Shan, G and Cummings, J}, title = {Assessing safety and efficacy in subpopulations in Alzheimer's disease clinical trials: contextualizing representativeness.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70186}, pmid = {41328259}, issn = {2352-8737}, abstract = {UNLABELLED: Efficacy outcomes in clinical trials are based on well-powered analyes of the entire participating population. Trial populations will comprise many types of demographic and biological subgroups, including individuals of different sexes, groups of older and younger individuals, participants with or without the apolipoprotein E ε4 (APOE) genotype, ethnoracial groups, participants from urban versus rural communities, participants with lower and higher educational levels, or individuals who have or have not undergone previous therapies such as anti-amyloid monoclonal antibodies (MABs). Each subgroups is underpowered to draw definitive outcomes, and analyses can lead to inaccurate conclusions. Disciplined subgroup analysis can be hypothesis generating and can help guide drug development decision-making. The risks associated with subgroup analysis can be mitigated by using standard terminology, prespecifying outcomes of interest, stratifying randomization, conducting interaction analyses to identify confounds, and limiting the number of subgroup comparisons. Alternative efficacy and safety analyses such as the interaction test and non-inferiority analyses may yield important insights. Together, these design and analytic straegies may allow trialists to avoid spurious interpretations and derive more informative conclusions regarding the impact of therapy on subgroups in Alzheimer's disease (AD) clinical trials. Greater understanding of safety and efficacy in the subgroups participating in trials is crtically important for indicating what conclusions can be generalized if the candidate therapy is approved.
HIGHLIGHTS: Clinical trials are sized to allow well-powered conclusions based on analysis of the entire participating population.Trial populations geared to be representative of the subgroups of the older population with AD are underpowered to allow drawing confident conclusions about efficacy or safety in subgroups.Strategies such as non-inferiority analysis combined with transparent reporting of the analytic framework may facilitate understanding treatment efficacy and safety in subgroups.}, }
@article {pmid41327837, year = {2025}, author = {Padture, A and Gupta, S and Sivaram, A and Swamy, KV}, title = {Repurposing of Potential Curcumin Derivatives Against Cyclooxygenase-2 Using In Silico Methods and Its Implications in Neurological Disorders.}, journal = {Biotechnology and applied biochemistry}, volume = {}, number = {}, pages = {}, doi = {10.1002/bab.70106}, pmid = {41327837}, issn = {1470-8744}, abstract = {Cyclooxygenase-2 (COX-2) plays a crucial role in inflammatory responses and has been implicated in neuroinflammatory processes associated with neurological disorders such as Alzheimer's disease. While selective COX-2 inhibitors (coxib class of drugs) have been developed, their use is limited by adverse effects, necessitating the exploration of alternative therapeutic approaches. This study investigates the potential of curcumin derivatives as COX-2 inhibitors and their possible therapeutic applications in neurological disorders. Previous in silico studies show various amino acids interacting with naturally occurring curcumin derivatives. We explored the potential of 2561 curcumin derivatives as COX-2 enzyme inhibitors by examining their binding affinity to the protein. Using molecular docking, we assessed their interactions with two regions of COX-2, identifying five standout compounds with powerful binding affinities. The binding energies of these compounds lie around -10.7 and -10.6 kcal/mol. To better understand how these top candidates behave in a dynamic biological environment, we ran molecular dynamics simulations focusing on their interactions with one part of the enzyme. These simulations revealed that the compounds formed stable complexes with COX-2, maintaining consistent hydrogen bonds and hydrophobic contacts throughout. RMSD and RMSF graphs exhibit greater stability of these compounds as compared to the control molecule. Finally, energy calculations confirmed that these interactions were not only stable but also energetically favorable, suggesting that several curcumin derivatives could be promising COX-2 inhibitors. This study provides valuable insights into the potential of curcumin derivatives as COX-2 inhibitors and their possible therapeutic applications in neurological disorders. The identified compounds warrant further investigation through in vitro and in vivo studies to validate their efficacy and safety as potential alternatives to current selective COX-2 inhibitors in the treatment of neuroinflammatory conditions.}, }
@article {pmid41327376, year = {2025}, author = {Liu, LR and Li, L and Lu, LL and Fan, SJ and Liu, LZ and He, RB and Li, H and Xian, XH and Li, WB}, title = {Ceftriaxone alleviates mitochondrial damage through the inhibition of extrasynaptic NMDA receptor-mediated changes in intracellular calcium levels to improve cognitive deficits in APP/PS1 mice.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {253}, pmid = {41327376}, issn = {1758-9193}, support = {H2024206387//Natural Science Foundation of Hebei Province/ ; 81971007//National Natural Science Foundation of China/ ; }, mesh = {Animals ; *Ceftriaxone/pharmacology/therapeutic use ; *Mitochondria/drug effects/metabolism ; Mice ; *Calcium/metabolism ; *Receptors, N-Methyl-D-Aspartate/metabolism/antagonists & inhibitors ; *Cognitive Dysfunction/drug therapy/metabolism ; Mice, Transgenic ; Mice, Inbred C57BL ; Presenilin-1/genetics ; Male ; Amyloid beta-Protein Precursor/genetics ; Disease Models, Animal ; Alzheimer Disease/metabolism ; Hippocampus/drug effects/metabolism ; Excitatory Amino Acid Transporter 2/metabolism/genetics ; }, abstract = {BACKGROUND: Mitochondrial dysfunction and dysregulated calcium homeostasis contribute to Alzheimer's disease (AD) pathogenesis. The extrasynaptic N-methyl-D-aspartic acid (NMDA) receptor (eNMDAR) plays a crucial role in calcium influx and subsequent signaling cascades. In individuals with AD, the reduced expression and function of glutamate transporter-1 (GLT-1) result in glutamate spillover from the synaptic clefts to the extrasynaptic region, thereby activating eNMDAR and inducing mitochondrial damage. Ceftriaxone (Cef) has been reported to ameliorate cognitive deficits in APPswe/PS1dE9 (APP/PS1) mice by upregulating GLT-1. This study aimed to explore whether Cef alleviates mitochondrial dysfunction to improve cognitive impairment and the roles of GLT-1 and eNMDAR, particularly the participation of eNMDAR-induced intracellular calcium signaling in this process.
METHODS: C57BL/6J, APP/PS1, and GLT-1-knockdown APP/PS1 mice were used. NMDA (1 mM, 2 µL per ventricle) was injected cerebroventricularly into APP/PS1 mice once to activate eNMDAR. Cef (200 mg/kg) was intraperitoneally administered for 14 days. Cognitive function was evaluated by novel object recognition, novel location recognition and Morris water maze tests. Hippocampal mitochondrial ultrastructure was observed using transmission electron microscopy. Hippocampal mitochondrial membrane potential (MMP) was detected using JC-1 staining. The expression of eNMDAR and proteins related to mitochondrial biogenesis and dynamics was evaluated by western blot. A neuron‒astrocyte coculture derived from the cerebral cortex of embryonic mice was used to evaluate the effects of Cef on eNMDAR-induced neuronal calcium influx, mitochondrial calcium accumulation and MMP loss using live-cell imaging.
RESULTS: Cef treatment attenuated hippocampal mitochondrial dysfunction, including ultrastructural damage, reduced aspect ratio, dysregulation of MMP, impaired biogenesis and dynamics, and cognitive deficits, and prevented the upregulation of eNMDAR expression in APP/PS1 mice in a GLT-1-dependent manner. These protective effects on hippocampal mitochondrial dysfunction and cognitive deficits were counteracted by eNMDAR activation. Furthermore, Cef incubation inhibited eNMDAR-mediated calcium influx in a GLT-1-dependent way and reduced MMP in primary cortical neurons. Notably, Cef incubation significantly suppressed mitochondrial calcium overload, which was mechanistically linked to the observed decline in MMP.
CONCLUSIONS: Cef treatment prevented the upregulation of eNMDAR expression and the subsequent extracellular calcium influx in a GLT-1-dependent manner, thereby reducing mitochondrial calcium loading and ultimately mitigating mitochondrial damage and cognitive deficits in APP/PS1 mice.}, }
@article {pmid41327179, year = {2025}, author = {Eshak, D and Arumugam, M}, title = {Nanomaterials: an overview of current trends and future prospects in neurological disorder treatment.}, journal = {Journal of translational medicine}, volume = {23}, number = {1}, pages = {1366}, pmid = {41327179}, issn = {1479-5876}, mesh = {Humans ; *Nervous System Diseases/therapy/drug therapy ; *Nanostructures/therapeutic use/chemistry ; Animals ; Blood-Brain Barrier ; }, abstract = {The World Health Organization (WHO) has identified neurological disorders (NDs) as one of the major health concerns worldwide, resulting in high mortality rates. NDs are conditions affecting the central and peripheral nervous systems, including the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, neuromuscular junctions, and muscles. These neurological diseases include Alzheimer's disease, Parkinson's disease, glioma/brain cancer, Huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, neuroinfections, ischemic stroke, trauma, hypoxia/anoxia, and depression. Unfortunately, these disorders remain difficult to treat due to the limited ability of conventional drugs to cross the blood-brain barrier (BBB) and achieve significant pharmacological effects in the brain. There is an urgent need to develop methods that can enhance drug efficacy and bypass the BBB. The application of various nanomaterials represents a promising approach to address these neurological disorders. Drugs incorporated with nanomaterials help improve therapeutic outcomes, reduce toxicity, provide better stability, enable targeted delivery, and enhance drug loading capacity. Numerous types and morphologies of inorganic and organic nanomaterials are increasingly employed for treating NDs, including quantum dots, dendrimers, metal nanoparticles, polymeric nanoparticles, liposomes, carbon nanotubes, metal oxide nanoparticles, and micelles. Their exceptional properties such as sensitivity, selectivity, and potential to bypass the BBB make them suitable for both diagnosis and treatment of NDs. In this review article, we briefly summarize the etiology and pathophysiology of various NDs along with current literature highlighting the use of nanomaterials for treating neurological disorders.}, }
@article {pmid41326296, year = {2025}, author = {Welchman, AE and Kourtzi, Z}, title = {Solving the 'Goldilocks problem' in dementia clinical trials with multimodal AI.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100397}, doi = {10.1016/j.tjpad.2025.100397}, pmid = {41326296}, issn = {2426-0266}, abstract = {The development of effective therapeutics for Alzheimer's Disease and related dementias (ADRD) has been hindered by patient heterogeneity and the limitations of current diagnostic tools. New treatments have no chance of working if given to patients who cannot benefit from them. This perspective explores how advances in Artificial Intelligence (AI), particularly multimodal machine learning, can solve the 'Goldilocks problem' of identifying patients for inclusion in clinical trials and support precision treatment in real-world healthcare settings. We examine the challenges of patient stratification, grounded by a conceptual framework of identifying each person's stage and subtype of dementia. We review data from several clinical trials of Alzheimer's disease therapeutics, to explore how AI-guided patient stratification can improve trial outcomes, reduce costs and improve recruitment. Further, we discuss the integration of AI into clinical workflows, the importance of model interpretability and generalizability, and ethical imperative to address algorithmic bias. By combining AI with scientific insight, clinical expertise, and patient experience, we argue that intelligent analytics can accelerate the discovery and delivery of new diagnostics and therapeutics, ultimately transforming dementia care and improving outcomes for patients around the globe.}, }
@article {pmid41326295, year = {2025}, author = {Au, R and Popp, Z and Low, S and Ashton, NJ and Zetterberg, H}, title = {Reinventing "N" in the A/T/N framework: The case for digital.}, journal = {The journal of prevention of Alzheimer's disease}, volume = {}, number = {}, pages = {100395}, doi = {10.1016/j.tjpad.2025.100395}, pmid = {41326295}, issn = {2426-0266}, abstract = {Breakthroughs in biomarkers for amyloid (A), tau (T), and neurodegeneration (N) have advanced the prospects of accurate Alzheimer's disease (AD) diagnosis. However, presence of pathology does not always translate into clinical expression and there are still clear knowledge gaps as to whether someone with AD biological indicators will lead to clinically apparent disease necessary to warrant drug treatments that carry toxicity risk. Reliance on decades-old assessment tools inhibits detection and monitoring at preclinical and early disease stages when new treatments could prove most effective. Evidence has accumulated that digital measures provide accurate detection of disease at early stages. We call for a re-evaluation of the A/T/N diagnostic framework, with digital evaluation measures complementing non-AD specific neurodegeneration markers, and even potentially replacing those non-specific to AD, to provide a clinically relevant feature critical to clinical trial advances and treatment decisions. Achieving this will only be possible if further research into novel digital evaluation tools is pursued with the same support and consideration as amyloid and tau.}, }
@article {pmid41325816, year = {2026}, author = {Farhana, F and Sultana, MA and Hia, RA and Hegde, V}, title = {Postmenopausal sarcopenia and Alzheimer's disease: The interplay of mitochondria, insulin resistance, and myokines.}, journal = {Neuroscience and biobehavioral reviews}, volume = {180}, number = {}, pages = {106501}, doi = {10.1016/j.neubiorev.2025.106501}, pmid = {41325816}, issn = {1873-7528}, mesh = {Humans ; *Alzheimer Disease/metabolism/physiopathology ; *Sarcopenia/metabolism/physiopathology ; *Insulin Resistance/physiology ; *Postmenopause/metabolism ; Female ; *Mitochondria/metabolism ; Animals ; Muscle, Skeletal/metabolism ; Myokines ; }, abstract = {As life expectancy increases, cognitive impairments such as Alzheimer's disease (AD) create serious problems for older adults. Women regardless of ethnicity and age group, are disproportionately affected, accounting for two-thirds of AD cases, with post-menopausal women representing over 60 % of those affected. Sarcopenia, defined by gradual reduction of skeletal muscle mass, strength, and activities, is increasingly correlated with an elevated risk of cognitive decline in post-menopausal women. Menopause-related hormonal decline (particularly estrogen loss) and aging contribute to sarcopenia, characterized by muscle mitochondrial dysfunction, oxidative stress, and insulin resistance. This sarcopenia-driven reduction in muscle mass and functional capacity further reduces the production of myokines (e.g., BDNF, irisin), impairing neuronal proliferation, adult neurogenesis, and spatial learning/memory. These pathophysiological changes show a contributing link between sarcopenia and AD progression in post-menopausal women. This review is unique in that it discusses the triangular interplay between menopause, sarcopenia, and AD, offering an integrated mechanistic framework that links hormonal decline, muscle loss, and neurodegeneration. We aim to clarify the pathophysiological causes behind the muscle-brain axis and suggest viable treatment approaches to slow down sarcopenia and cognitive deterioration in postmenopausal women based on current evidence. The formulation of targeted strategies for enhancing the quality of life and lessening healthcare expenditures in this expanding population depends on the advancement of understanding this complex interconnection between menopause, sarcopenia and cognition.}, }
@article {pmid41325201, year = {2025}, author = {Zhao, N and Wang, Y and Yang, S and Guo, W and Li, Z and Cao, H and Zhang, Z and Li, Y and Chen, D and Xia, S and Xie, Z and Qu, Y and Wu, Y and Li, J and Yi, L and Wang, G and Guo, M}, title = {Surgical Protocols for Deep Cervical Lymphovenous Anastomosis in a Rat Model: Lymph Node and Lymphatic Vessel Anastomoses.}, journal = {Journal of visualized experiments : JoVE}, volume = {}, number = {225}, pages = {}, doi = {10.3791/69201}, pmid = {41325201}, issn = {1940-087X}, mesh = {Animals ; *Lymphatic Vessels/surgery ; *Anastomosis, Surgical/methods ; Rats ; *Lymph Nodes/surgery ; Neck/surgery ; *Veins/surgery ; Female ; }, abstract = {Deep cervical lymphovenous anastomosis (dcLVA) has become a promising treatment strategy for Alzheimer's disease (AD), offering significant improvements compared to the current limited treatment options. However, the underlying mechanism of dcLVA remains unclear. Although clinical trials are ongoing, animal models simulating dcLVA provide a valuable tool for exploring its mechanism. This study aims to develop a standardized protocol for creating dcLVA models in animals to facilitate basic research and address clinical challenges. We describe the surgical procedures and key steps for anastomosing the deep cervical lymph node (dcLN) and its afferent lymphatic vessel (ALV) with the posterior facial vein (PFV), detailing these two distinct surgical methods: deep cervical lymph node-vein anastomosis (dcLnVA) and deep cervical lymphatic vessel-vein anastomosis (dcLaVA). Beyond promoting lymphatic drainage, the comparison of these two surgical methods also helps us to understand and explore the role of the deep cervical lymph node and deep cervical lymphatic system in the pathogenesis of AD. Overall, the complete and clear presentation of the surgical procedure and key anatomical landmarks in the rat helps to standardize the surgical protocol, which can minimize confounding factors and reduce inter-experimental variability, thus laying a solid methodological foundation for a deeper understanding of the mechanisms involved.}, }
@article {pmid41324859, year = {2025}, author = {Shi, C and Dong, J and Hui, X and Xu, Z and Zhao, Z and Dong, L}, title = {Production, Mechanisms, and Therapeutic Strategies of Tryptophan Metabolites in CNS Diseases.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {226}, pmid = {41324859}, issn = {1559-1182}, support = {22XYJ0002//Xi'an Innovation Capability Strong Foundation Plan/ ; }, mesh = {Humans ; *Tryptophan/metabolism ; Animals ; *Central Nervous System Diseases/metabolism/therapy/drug therapy ; Gastrointestinal Microbiome/physiology ; }, abstract = {Tryptophan (TRP) metabolites, which are produced from TRP via three pathways-kynurenine, 5-hydroxytryptamine, and indole-are key signaling molecules of the gut-brain axis and are involved in a variety of central nervous system (CNS) disease processes, such as Alzheimer's disease, depression, and schizophrenia by orchestrating inflammatory responses, redox imbalances, neurotransmitter dynamics, mitochondrial dysfunction, and apoptotic/autophagic pathways. However, TRP metabolites exhibit bidirectional modulatory effects, combining different neuroprotective and neurotoxic substances, depending on their metabolic environment and concentration thresholds, posing significant challenges for therapeutic strategies. Therefore, it is important to modulate TRP metabolite production factors, including the regulation of key enzymes in metabolic pathways, the gut microbiota, hormones, and the disease pathology microenvironment, to promote the production of neuroprotective metabolites and inhibit neurotoxic metabolite production. In this review, we detail the influencing factors affecting TRP metabolite production, the regulatory role of TRP metabolites in CNS disorders, and therapeutic strategies related to TRP metabolites for CNS disorders. Targeting TRP metabolizing enzymes or remodeling the ecology of the gut microbiota could be a new strategy for the treatment of CNS diseases, providing a theoretical basis for future precision intervention in CNS diseases.}, }
@article {pmid41323809, year = {2025}, author = {Horgan, NG and Djurovic-Topalovic, A and Ademoye, TA and Reyes-Charles, HI and Kobayashi, N and Plascencia-Villa, G and Perry, G and Murakami, T and Fortin, JS}, title = {Epigallocatechin-3-Gallate: A potential amyloid Fibril Disaggregator of Serum amyloid A1.}, journal = {Biochemistry and biophysics reports}, volume = {44}, number = {}, pages = {102365}, pmid = {41323809}, issn = {2405-5808}, abstract = {Serum amyloid A1 (SAA1) is a 122-amino acid protein that, after cleavage, matures into a 104-amino acid form. Its N-terminus is responsible for binding high-density lipoprotein (HDL), while the C-terminus maintains its structural integrity. As an acute-phase protein, SAA1 is produced by the liver in response to acute inflammation. SAA1 is also a precursor to amyloid A (AA), and its accumulation can lead to AA amyloidosis-a condition secondary to chronic inflammation that causes tissue damage and organ dysfunction. Our study explores methods to disaggregate SAA1 fibrils isolated from the cat spleen, chicken liver, and cow liver. Specifically, we investigate the use of epigallocatechin-3-gallate (EGCG), a polyphenolic flavonoid extracted from green tea known for its anti-inflammatory and antioxidant properties, to disaggregate these fibrils. Dynamic light scattering (DLS) and transmission electron microscopy (TEM) were used to analyze these fibrils after treatment with 1 % DMSO and 400 μM of EGCG in 10 mM PBS (pH 7.4). The results demonstrated that EGCG effectively reduced fibril size, as confirmed by DLS characterization, with the disappearance or diminished prominence of the 10[3-4] nm peak. Additional TEM results confirmed that EGCG disaggregated amyloid-beta fibrils isolated from Alzheimer's disease brains. These findings suggest that compounds like EGCG could be valuable in treating inflammatory and neurodegenerative conditions by disaggregating amyloid fibrils.}, }
@article {pmid41323723, year = {2025}, author = {Dewangan, B and Swain, P and Patra, S and Bodhe, PR and Kulkarni, N and Sahu, B}, title = {Synthesis and evaluation of HFIP bearing triazolo-amides as amyloid-β aggregation inhibitors and suppressors of aggregation induced neuroinflammation.}, journal = {RSC medicinal chemistry}, volume = {}, number = {}, pages = {}, pmid = {41323723}, issn = {2632-8682}, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disease with biological signatures of amyloid beta (Aβ) aggregated plaques and increased levels of bio-metals like copper (Cu), zinc (Zn), and iron (Fe). Aβ-induced lysosomal membrane permeabilization is a key event in neuronal injury in AD. Aβ aggregation also modulates mitochondria membrane potential (MMP), activates interleukin 1β and NLRP3 inflammasome eventually leading to increased reactive oxygen species (ROS) production, neuronal apoptosis and mitochondrial dysfunction. Here, we report a multi-functional compound (2f) identified through structure-activity relationship study from a series of polyfluorinated triazole compounds. Compound 2f suppressed metal induced aggregation, downregulated NLRP3 inflammasome and IL-1β expression. It has maintained the lysosomal acidic pH and restored mitochondrial membrane potential. HFIP bearing triazolo amide (2f) was found to chelate with Cu(ii) and Zn(ii) selectively in the presence of a range of other physiologically relevant metals. Further, a molecular dynamics (MD) simulation study revealed 2f disrupted the aggregation via interacting with chain A of pentameric Aβ. Therefore the HFIP bearing triazole amides may serve as potential scaffolds for drug development towards the treatment of AD.}, }
@article {pmid41322563, year = {2025}, author = {Dias, AJ and Sena Oliveira, A and Silva, AC and Braga, AL}, title = {Rational Design and Greener Synthesis of Selenylated Indolamides as Potential Anti-Alzheimer's Agents.}, journal = {ACS omega}, volume = {10}, number = {46}, pages = {56334-56348}, pmid = {41322563}, issn = {2470-1343}, abstract = {This study presents the rational design and sustainable synthesis of selenylated indolamides as potential therapeutic agents for Alzheimer's disease. Through computational approaches, including molecular docking and pharmacokinetic analyses, we identified key structural modifications that improve acetylcholinesterase inhibition, a critical target for AD treatment. We employed an environmentally benign I2/DMSO oxidation system to optimize the synthetic protocol, enabling the efficient selenylation of 27 indolamide derivatives (5a-6a) via a straightforward and practical transformation, delivering high yields of up to 99%. Importantly, the methodology proved scalable, delivering an 88% yield on a gram-scale reaction. In silico ADMET predictions using the pkCSM platform indicated that C2-selenylated indolamides possess an improved safety profile and promising pharmacokinetic properties, suggesting their potential for further drug development. In particular, compounds 5a and 5y demonstrated the best balance between reaction yield and docking score (94% and 86.17; 98% and 93.71, respectively). These findings highlight the significance of incorporating green chemistry principles alongside advanced in silico methodologies to drive innovation in drug discovery.}, }
@article {pmid41322352, year = {2025}, author = {Liu, S and Zhao, M and Liu, Y and Yang, X and Yan, H and Xu, H and Wu, Y and Xu, Y}, title = {Comparative efficacy and safety of symptomatic therapy and disease-modifying therapy for Alzheimer's disease: a systematic review and network meta-analysis.}, journal = {Frontiers in neuroscience}, volume = {19}, number = {}, pages = {1656906}, pmid = {41322352}, issn = {1662-4548}, abstract = {BACKGROUND: The management of Alzheimer's disease has shifted toward disease-modifying therapies aimed at delaying disease progression rather than focusing solely on symptomatic treatment. This study summarizes the latest evidence regarding the benefits and harms of anti-Alzheimer's disease drugs.
METHODS: We conducted a comprehensive review of randomized controlled trials from PubMed, Embase, Cochrane Library, Web of Science databases, and other sources up to April 2025. Two researchers independently reviewed the literature and analyzed the data. A network meta-analysis was performed using Review Manager version 5.3 and Stata version 18.0 to calculate mean differences (MDs) and 95% confidence intervals (CIs) for direct and indirect comparisons. Treatment efficacy was evaluated using the Surface Under the Cumulative Ranking Curve (SUCRA). Bias was assessed using the Revised Cochrane Risk of Bias Tool version 2.0, and publication bias was analyzed with funnel plots.
RESULTS: The network meta-analysis included 23 randomized controlled trials with 16,010 participants, evaluating nine pharmacological interventions ranging from traditional symptomatic therapies to four United States Food and Drug Administration- and National Medical Products Administration-approved disease-modifying therapies, notably anti-amyloid beta monoclonal antibodies. Aducanumab significantly improved ADAS-cog scores compared with placebo (MD -5.97, 95%CI -10.33, -1.61; SUCRA: 93.0%) and demonstrated notable improvements in ADCS-ADL scores (MD 4.99, 95%CI 2.27, 7.72; SUCRA: 98.6%). Memantine ranked highest for neuropsychiatric symptoms (SUCRA: 80.8%). Aducanumab also had the highest SUCRA for CDR-SB (91.5%) and showed moderate superiority in MMSE scores (MD 3.55, 95%CI 1.35, 5.75; SUCRA: 98.2%).
CONCLUSION: Symptomatic treatments, especially memantine for neuropsychiatric symptoms, remain effective. However, the network meta-analysis indicates that, for patients with mild cognitive impairment or mild Alzheimer's disease, aducanumab demonstrates the greatest potential for cognitive and clinical improvement (MMSE, ADAS-cog, ADCS-ADL), despite associated risks such as adverse events and amyloid-related imaging abnormalities linked to disease-modifying therapies. Lecanemab provides moderate benefits, while donanemab appears less effective. Thus, clinicians should apply disease-modifying therapies cautiously and individually, carefully balancing potential risks and benefits for each patient.
PROSPERO [CRD42025637730], https://www.crd.york.ac.uk/PROSPERO/.}, }
@article {pmid41322300, year = {2025}, author = {Domínguez-Fernández, C and Kumar, A and Kumar, R and Darreh-Shori, T}, title = {From heart to brain: cognitive potential of propranolol and diltiazem through cholinergic enhancement via butyrylcholinesterase inhibition.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1694610}, pmid = {41322300}, issn = {1663-9812}, abstract = {BACKGROUND: Butyrylcholinesterase (BChE) has emerged as a promising therapeutic target in the treatment of Alzheimer's disease (AD), particularly in its later stages when acetylcholinesterase (AChE) activity declines. Drug repurposing offers a strategic approach to identify novel BChE inhibitors among existing FDA-approved compounds.
OBJECTIVE: This study aimed to evaluate the cholinesterase inhibitory potential of propranolol and diltiazem-two widely used cardiovascular drugs-through in silico modelling and in vitro and ex vivo enzyme-inhibition kinetic.
METHODS: Molecular docking was performed using AutoDock Vina to assess the binding affinity of propranolol and diltiazem to AChE and BChE. In vitro screening and inhibition were measured using a modified Ellman's assay with human recombinant AChE and plasma-derived BChE. Ex-vivo IC50 and Ki values were determined through kinetic analyses in pooled plasma samples, and inhibition modes were characterized using nonlinear regression models.
RESULTS: Both propranolol and diltiazem selectively inhibited BChE, with minimal activity against AChE. At 100 μM, BChE inhibition exceeded 80% for both compounds, while AChE inhibition was limited to 18% (propranolol) and 2% (diltiazem). Propranolol exhibited a Ki of 0.19 µM, comparable to the selective BChE inhibitor ethopropazine (Ki = 0.15 µM), and acted as a competitive inhibitor. Diltiazem exhibited a higher Ki of 2.3 µM. These effects were observed at concentrations within or near reported brain levels for propranolol, suggesting potential in vivo relevance.
CONCLUSION: Propranolol and diltiazem demonstrate selective BChE inhibition, with propranolol showing potency comparable to established potent BChE inhibitors. Given their established safety profiles and CNS activity, these compounds represent promising candidates for repurposing in the treatment of AD and other cognitive disorders. Further in vivo studies are warranted to explore their therapeutic potential.}, }
@article {pmid41321177, year = {2025}, author = {Sahakian, BJ}, title = {The role of psychopharmacology and cognitive neuroscience in understanding the brain in the treatment of psychiatric disorders and neurological diseases for the benefit of society.}, journal = {Journal of psychopharmacology (Oxford, England)}, volume = {}, number = {}, pages = {2698811251397329}, doi = {10.1177/02698811251397329}, pmid = {41321177}, issn = {1461-7285}, abstract = {This perspectives piece reflects on some of the major scientific contributions in psychopharmacology, cognitive neuroscience, and public policy of Professor Barbara J. Sahakian, Commander of the Most Excellent Order of the British Empire (CBE). Her pioneering research has advanced the understanding of brain mechanisms, including neurotransmitter modulation, and psychological processes involved in cognition, emotion, and motivation, leading to novel treatments for disorders such as Alzheimer's disease, attention deficit hyperactivity disorder, obsessive-compulsive disorder, and depression. She has also contributed to a better understanding of brain mechanisms underlying and psychological processes involved in these disorders. She has championed early detection of Alzheimer's disease through neuropsychological tools, such as the Cambridge Neuropsychological Test Automated Battery (CANTAB) paired associates learning (PAL) test and contributed to identifying cognitive and neural changes in Huntington's disease gene carriers. Beyond clinical research, Sahakian has influenced public health policy through initiatives such as the UK Government Foresight Project on Mental Capital and Wellbeing and the National Institute for Health and Care Excellence guidelines on gambling-related harms. She has also led efforts in neuroethics and public engagement, co-authoring accessible science books and participating in global forums. Recent research emphasises preventative psychiatry, including lifestyle interventions, such as diet, sleep, social connection, and lifelong learning as preventive strategies for cognitive decline and mental health problems. Through interdisciplinary collaborations and mentorship, Sahakian continues to inspire the next generation of scientists to pursue innovative research for societal benefit in neuropsychopharmacology and cognitive neuroscience.}, }
@article {pmid41320930, year = {2026}, author = {Suthar, T and Maurya, R and Sonwani, A and Upadhayay, P and Datusalia, AK and Naqvi, S and Jain, K}, title = {Nose-to-Brain Delivery of Donepezil Hydrochloride via Oleic Acid-Conjugated PAMAM G4 Dendrimers for the Treatment of Alzheimer's-Like Dementia.}, journal = {Molecular pharmaceutics}, volume = {23}, number = {1}, pages = {177-195}, doi = {10.1021/acs.molpharmaceut.5c00761}, pmid = {41320930}, issn = {1543-8392}, mesh = {*Dendrimers/chemistry ; *Donepezil/administration & dosage/pharmacokinetics/chemistry ; *Alzheimer Disease/drug therapy ; Animals ; *Brain/metabolism/drug effects ; *Oleic Acid/chemistry ; Administration, Intranasal ; Cholinesterase Inhibitors/administration & dosage/pharmacokinetics ; Humans ; Rats ; Drug Liberation ; Drug Delivery Systems/methods ; Male ; Drug Carriers/chemistry ; Cell Line, Tumor ; }, abstract = {Alzheimer's disease (AD) is a complex, progressive neurodegenerative disorder characterized by dementia and cognitive impairments. Acetylcholinesterase (AChE) inhibitors are generally prescribed for clinical management of AD symptoms. Donepezil hydrochloride (DPZ) is a reversible, selective, and noncompetitive inhibitor of AChE recommended for the treatment of mild-to-moderate AD. However, a higher dose of this drug must be administered to achieve adequate therapeutic concentrations in the brain, leading to peripheral side effects. In the present research work, oleic acid (OA) conjugated PAMAM G4 dendrimers (OA-G4) are explored for delivering DPZ to the brain. OA was conjugated to PAMAM G4 dendrimers using EDC conjugation chemistry, and the conjugation was confirmed by nuclear magnetic resonance (NMR) and Fourier-transform infrared (FTIR) spectroscopy. DPZ was successfully loaded on the OA-G4 conjugate, and the loading and entrapment efficiency were found to be 78.59% ± 5.52% and 62.12% ± 0.67%, respectively. The drug release studies showed a faster release of DPZ from the DPZ-OA-G4 conjugate for the initial 6 h, followed by a sustained release, with 68.44% ± 1.88% of the drug released in 24 h. Cytotoxicity studies in SH-SY5Y cells demonstrated the safety and cytocompatibility of the conjugate at a wide range of concentrations. Cell internalization study revealed deep localization of the dendrimeric nanoconjugate in SH-SY5Y cells. Biodistribution studies of the OA-G4 conjugate through the intranasal route, using an IVIS whole-body live imaging system, demonstrated abundant fluorescence in the brain, indicating efficient brain targeting via nose-to-brain delivery. Neurobehavior studies in male SD rats suggested significant attenuation of AlCl3-induced cognitive decline in DPZ-OA-G4 treated animals, which was further confirmed with biochemical and histological evaluations. In conclusion, this study provides proof of concept that DPZ can be successfully targeted to the brain using ligand-conjugated dendrimeric systems via intranasal administration, a noninvasive route that enables direct nose-to-brain delivery, bypasses the blood-brain barrier, and minimizes systemic side effects.}, }
@article {pmid41319675, year = {2025}, author = {Langbaum, JB and Bradbury, AR and Egleston, BL and McCarty Wood, E and Langlois, CM and Largent, EA and Harkins, K and Erickson, CM and Stites, SD and Oyen, E and Riviere, ME and Liu, F and Graf, A and Kim, SYH and Grill, JD and Reiman, EM and Tariot, PN and Roberts, JS and Karlawish, J}, title = {Impact of learning APOE genotype on cognitively unimpaired adults: a pre-screening cohort study of the Alzheimer's Prevention Initiative Generation Study 1.}, journal = {The lancet. Healthy longevity}, volume = {6}, number = {11}, pages = {100778}, pmid = {41319675}, issn = {2666-7568}, support = {P30 AG072980/AG/NIA NIH HHS/United States ; UF1 AG046150/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; Female ; Male ; Middle Aged ; *Alzheimer Disease/genetics/prevention & control/psychology ; Aged ; *Apolipoproteins E/genetics ; Genotype ; Depression ; Anxiety ; Apolipoprotein E4/genetics ; Cohort Studies ; Cognition ; Genetic Predisposition to Disease ; }, abstract = {BACKGROUND: The apolipoprotein E (APOE) gene is the best established genetic risk factor for Alzheimer's disease in later life, with the ε4 allele conferring higher risk. APOE disclosure is becoming increasingly common in the clinical care of people with Alzheimer's disease and in cognitively unimpaired adults. In this study, we aimed to describe changes in measures of genetic disease knowledge and psychiatric symptoms following APOE disclosure to cognitively unimpaired adults.
METHODS: Data were collected as part of the screening phase of the global, multicentre, Alzheimer's Prevention Initiative Generation Study 1 (NCT02565511). Eligible individuals were cognitively unimpaired (Mini-Mental State Exam total score ≥24), aged 60-75 years, and psychologically pre-screened for readiness (by measures of depressive symptoms and anxiety) to receive their APOE genotype from a health-care provider. Participants were assessed before disclosure, and 2-7 days, 6 weeks, 6 months, and 12 months after disclosure. Multivariable linear and ordinal logistic regressions were used to compare changes in genetic disease knowledge, anxiety, depression, and distress by APOE4 genotype status, adjusting for key covariates, with a focus on 2-7 days after disclosure. Multiple imputation by chained equations methods was used to account for missing outcome data.
FINDINGS: The trial took place between Nov 30, 2015, and Sept 23, 2019. In total, 9496 participants (including 790 APOE4 homozygotes, 4869 heterozygotes, and 3837 non-carriers) learned their APOE genotype from a health-care provider as part of Generation Study 1 screening. 4038 (42·5%) participants were in the 65-69-year age group, 5790 (61·0%) were female, 3706 (39·0%) were male, and 8862 (93·3%) self-identified as White. Increase in genetic disease knowledge 2-7 days after disclosure was greater in APOE4 homozygotes (mean 1·19 [SD 3·95]) than in heterozygotes (0·78 [3·95], p=0·042) and non-carriers (0·29 [3·96], p=0·0002). Disease-specific distress 2-7 days after disclosure increased more in homozygotes (2·25 [6·42]) than in heterozygotes (0·53 [5·08], p<0·0001) and non-carriers (0·79 [4·95], p<0·0001). Levels of anxiety 2-7 days after disclosure increased in homozygotes (0·17 [2·95]) but decreased in heterozygotes (-0·67 [2·68], p<0·0001) and non-carriers (-0·66 [2·67], p<0·0001). There were no significant changes in depressive symptoms following disclosure for any APOE4 group. Notably, for all APOE4 groups, increases in distress and anxiety were small and did not reach predefined levels of clinical concern.
INTERPRETATION: In cognitively unimpaired, psychologically pre-screened adults, APOE disclosure by a trained health-care provider was generally safe and well tolerated, consistent with results from previous studies. To our knowledge, this is the largest study experience of APOE disclosure to date, especially for homozygotes, and is notable for the older age of participants compared with previous research. These results are timely and important given anticipated increases in APOE disclosure to guide clinical decision making once an Alzheimer's disease prevention treatment is approved for cognitively unimpaired adults or if patients' family members are interested in genetic testing. Scalable approaches for returning Alzheimer's disease risk information are critical to meeting anticipated demand. Results from this study may be useful to bolster clinical translatability of disclosure programmes.
FUNDING: The National Institute on Aging, Alzheimer's Association, Banner Alzheimer's Foundation, GHR Foundation, F-Prime Biomedical Research Initiative (FBRI), and Novartis Pharma.}, }
@article {pmid41319153, year = {2025}, author = {Wu, CY and Chen, L and Fatima, H and Gatchel, J and Das, S and Kivisäkk, P and Arnold, SE and Dodge, HH}, title = {Combined use of plasma p-tau217, NfL, and GFAP predicts domain-specific cognitive decline in cognitively unimpaired and MCI individuals.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {12}, pages = {e70934}, pmid = {41319153}, issn = {1552-5279}, support = {P30AG062421/GF/NIH HHS/United States ; R01AG051628/GF/NIH HHS/United States ; R01AG056102/GF/NIH HHS/United States ; K01AG088184/GF/NIH HHS/United States ; }, mesh = {Humans ; *tau Proteins/blood ; Male ; Female ; *Cognitive Dysfunction/blood/diagnosis ; *Glial Fibrillary Acidic Protein/blood ; *Neurofilament Proteins/blood ; Biomarkers/blood ; Aged ; Phosphorylation ; Neuropsychological Tests ; Aged, 80 and over ; }, abstract = {INTRODUCTION: Accurate identification of individuals at risk for cognitive decline is critical for treatment planning and trial enrichment strategies. We evaluated the combined utility of plasma phosphorylated tau at threonine 217 (p-tau217), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) in predicting domain-specific cognitive decline.
METHODS: Participants (n = 523; 40.9% cognitively unimpaired [CU]; 59.1% mild cognitive impairment [MCI]) were from the Massachusetts Alzheimer's Disease Research Center. Cognition was assessed using the National Alzheimer's Coordinating Center Uniform Data Set. Participants were classified as high(+)/low(-) for each biomarker using Gaussian mixture models.
RESULTS: Among all participants, high p-tau217 alone [p-tau217(+)NfL(-)GFAP(-)] was associated with a steeper decline in episodic/semantic memory and processing speed compared to the all-low group (p ≤ 0.02). With the addition of high GFAP [p-tau217(+)NfL(-)GFAP(+)], steeper decline extended to most cognitive domains, including global cognition and executive function, compared to the all-low group. In CU, faster decline in global cognition and executive function was seen when all biomarkers were elevated ([p-tau217(+)NfL(+)GFAP(+)]; p ≤ 0.04).
DISCUSSION: Combined plasma biomarkers predict decline in cognitive domains vulnerable to early disease.
HIGHLIGHTS: High phosphorylated tau at threonine 217 (p-tau217) alone was associated with declines in semantic/episodic memory, whereas its combination with elevated glial fibrillary acidic protein (GFAP) predicted declines in a wider range of cognitive domains. Elevated neurofilament light chain (NfL) amplifies the cognitive decline already driven by p-tau217 and GFAP. In cognitively unimpaired individuals, subtle domain-specific cognitive declines can be detected when both core and non-core Alzheimer's disease biomarkers are used. Our finding highlights the importance of focusing on vulnerable cognitive domains during early disease where global cognition may appear stable but specific impairments can be masked within composite scores.}, }
@article {pmid41318982, year = {2025}, author = {Huang, Y and Guo, Y and Zhang, H and Deng, J and Huang, Z and Chen, A and Wu, X and Lin, D and Ye, P and Chen, X and Zheng, X}, title = {Repeated Exposure to Lidocaine Induces Alzheimer's‐Like Cognitive Impairment and Neuropathology in Aged Mice Through BDNF‐Regulated Autophagy.}, journal = {Journal of cellular and molecular medicine}, volume = {29}, number = {23}, pages = {e70970}, pmid = {41318982}, issn = {1582-4934}, support = {82171186//National Natural Science Foundation of China/ ; 82471278//National Natural Science Foundation of China/ ; 2023Y9282//The Joint Funds for the Innovation of Science and Technology of Fujian Province/ ; 2023Y9315//The Joint Funds for the Innovation of Science and Technology of Fujian Province/ ; 2021QH1307//Startup Fund for scientific research, Fujian Medical University/ ; }, mesh = {Animals ; *Brain-Derived Neurotrophic Factor/metabolism ; *Autophagy/drug effects ; Mice ; *Lidocaine/adverse effects ; *Cognitive Dysfunction/pathology/metabolism/chemically induced ; *Alzheimer Disease/pathology/metabolism/chemically induced ; Hippocampus/pathology/metabolism/drug effects ; Male ; Signal Transduction/drug effects ; Receptor, trkB/metabolism ; Astrocytes/metabolism/drug effects/pathology ; Disease Models, Animal ; TOR Serine-Threonine Kinases/metabolism ; *Aging/pathology ; Amyloid beta-Peptides/metabolism ; Mice, Inbred C57BL ; }, abstract = {Lidocaine is widely used for perioperative pain management, but repeated exposure may cause neurotoxicity, including neurological deficits. This study investigates mechanisms underlying cognitive decline induced by repeated lidocaine exposure. Eighteen-month-old mice received repeated clinically relevant lidocaine infusions over 3 days. Cognitive function was assessed by Morris water maze, Y-maze and open field tests. Hippocampal pathology was examined via TEM, Nissl staining, immunofluorescence for astrocyte polarisation and Aβ deposition, and western blot for tau, BDNF, TrkB, mTOR and autophagy proteins. The TrkB agonist 7,8-DHF was used to modulate BDNF/TrkB/mTOR signalling. Repeated lidocaine exposure impaired cognition and induced Alzheimer's-like hippocampal pathology, as evidenced by increased accumulation of Aβ and tau toxic proteins, along with neuronal death. It reduced BDNF expression, inhibited TrkB phosphorylation, and activated mTOR signalling, leading to autophagy inhibition and pathological protein accumulation. Lidocaine shifted astrocytes towards the neurotoxic A1 phenotype, decreasing neuroprotective A2 astrocytes and BDNF synthesis. TrkB agonist treatment restored signalling, enhanced autophagy and improved cognitive deficits and pathology. Repeated lidocaine exposure promotes A1 astrocyte increase and A2 decrease, inhibiting autophagy via the BDNF/TrkB/mTOR pathway, resulting in toxic protein deposition and Alzheimer's-like cognitive impairment.}, }
@article {pmid41318018, year = {2025}, author = {de Souza, PC and Bezerra, TPW and de Melo Rêgo, MJB and da Rosa, MM}, title = {Advances in neurological therapies: A review of clinical trials in Alzheimer's, Parkinson's, and multiple sclerosis.}, journal = {The American journal of medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.amjmed.2025.11.025}, pmid = {41318018}, issn = {1555-7162}, abstract = {The period from 2020 to 2025 marked a pivotal juncture in the treatment of major neurological diseases, with Phase II-IV trials delivering the first compelling evidence for disease-modifying interventions in Alzheimer's disease, Parkinson's disease, and multiple sclerosis. This narrative review provides a critical analysis of this evolving therapeutic landscape, focusing on efficacy, safety, and practical implications. Our analysis reveals unprecedented yet heterogeneous progress. In Alzheimer's disease, anti-amyloid monoclonal antibodies (donanemab, lecanemab) achieved regulatory approval, establishing a new treatment paradigm despite modest efficacy and risks of amyloid-related imaging abnormalities (ARIA). In Parkinson's disease, GLP-1 receptor agonists (lixisenatide) demonstrated the first convincing disease modification signals in Phase II trials. For multiple sclerosis, the failure of Bruton's tyrosine kinase (BTK) inhibitors contrasted with the consolidation of anti-CD20 therapies as the therapeutic standard, refined by innovations in dosing and delivery. Collectively, these findings herald a new era of disease-modifying therapy in neurology, though current gains remain limited and dependent on biomarker stratification and safety monitoring. The challenge ahead is translating these successes into accessible, sustainable clinical benefits.}, }
@article {pmid41317176, year = {2025}, author = {Pour, FT and Saadatpour, F and Salari, A}, title = {Comprehensive and In-Depth Molecular and Pathway Studies of the Hippocampus in Alzheimer's Disease.}, journal = {Cellular and molecular neurobiology}, volume = {45}, number = {1}, pages = {110}, pmid = {41317176}, issn = {1573-6830}, support = {CSBI14011102//Cognitive Science and Biology Institute (CSBI)/ ; SBNGC14011101//Systems Biology and Next Generation Company (SBNGC)/ ; }, mesh = {*Alzheimer Disease/genetics/metabolism/pathology ; Humans ; *Hippocampus/metabolism/pathology ; Protein Interaction Maps/genetics ; *Signal Transduction/genetics ; Gene Regulatory Networks ; Gene Expression Profiling ; Male ; Gene Expression Regulation ; Female ; }, abstract = {Alzheimer's disease (AD) still lacks a conclusive treatment, largely due to an incomplete understanding of the molecular mechanisms involved. To enhance our knowledge of AD pathogenesis and identify potential therapeutic targets, this study integrates differential gene expression analysis, pathway enrichment, hub gene discovery, protein-protein interaction (PPI) clustering, and transcription factor/protein kinase regulation into a single, cohesive pipeline. This comprehensive systems-level approach moves beyond single-gene analyses to offer a broader, mechanistically focused insight into AD biology. Using RNA-seq data from the CA1 region of the hippocampus-a subregion selectively affected in early AD-we identified 1,104 differentially expressed genes (DEGs). Among the enriched pathways, "7-alpha-hydroxycholesterol" was upregulated, while "vacuolar organization" was downregulated in AD samples. Furthermore, five novel hub genes (MRPS7, RPL5, GFM1, RAD51, and ASPM) were identified within the PPI network. The first three-MRPS7, RPL5, and GFM1-along with ACO2 and MT-ATP6, are potentially linked to hereditary forms of AD due to their roles in mitochondrial function. We also discovered four collaborative clusters within the network that notably associated with the "inflammatory response", "7-alpha-hydroxycholesterol", "Mitochondrial dysfunction" and "Oxidative phosphorylation" pathways, making them promising candidates for therapeutic and diagnostic investigation due their behavioral information members. Additionally, we identified ten transcription factors (GATA2, CHD1, THRA, IRF7, ZBTB48, POLE4, ZNF219, SLC2A4RG, NR1D1, and RXRA) and one protein kinase (PRKCZ) as potential regulatory elements in AD. This study broadens our understanding of Alzheimer's disease by identifying five candidate hub genes, two functional PPI clusters, two signaling pathways, and eleven regulatory proteins, thereby laying the groundwork for future therapeutic and diagnostic developments in molecular AD research.}, }
@article {pmid41316284, year = {2025}, author = {Chen, C and Mo, M and Åkerman, M and Garcia-Ptacek, S and Xu, H and Eriksdotter, M}, title = {Dynamic associations of cholinesterase inhibitors and memantine with cognitive trajectories in individuals with Alzheimer's or mixed dementia: a real-world analysis using the quality registry SveDem.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {256}, pmid = {41316284}, issn = {1758-9193}, abstract = {BACKGROUND: Alzheimer’s disease (AD) and mixed dementia (MxD) represent major public health concerns, yet there is limited real-world evidence on the long-term associations of commonly prescribed pharmacological treatments, particularly cholinesterase inhibitors (ChEIs) and their combination with memantine. This study aims to evaluate the long-term, time-varying associations of ChEIs and memantine on cognitive decline in a large, nationwide cohort of individuals diagnosed with AD or MxD.
METHODS: This observational study utilized data from the Swedish registry for cognitive/dementia disorders (SveDem), analyzing 32,282 individuals diagnosed with AD or MxD between 2007 and 2022. Patients were followed for up to 11 years to track treatment patterns and cognitive trajectories. Initiation of ChEIs (donepezil, galantamine, or rivastigmine) or memantine within six months after an AD or MxD diagnosis and then the time-varying medications (ChEIs alone, memantine alone or memantine added on to ChEIs) within six months after each follow-up were analyzed. Linear mixed-effects model was used to assess cognitive decline measured by Mini-Mental State Examination (MMSE) score trajectories.
RESULTS: Of the 32,282 participants (mean age 78.4 years; 61% women), 78.4% initiated treatment with ChEIs alone, and 21.6% with memantine alone. Over time, prescription patterns shifted from monotherapy to combination therapy, with donepezil and galantamine more likely to achieve 1 Defined Daily Dosages (DDD) than rivastigmine users. Memantine alone users experienced a yearly cognitive decline of 1.79 MMSE points (95% CI: −1.85, −1.73). Compared with memantine users, patients on ChEIs alone declined 0.65 points less per year (95% CI: −0.59, −0.72), while those on combination therapy declined 0.19 points less per year (95% CI: −0.10, −0.28). Among ChEIs, donepezil users experienced an annual decline of 1.02 points (95% CI: −1.06, −0.98). In comparison, galantamine users declined an additional 0.05 points per year (95% CI: −0.11, 0.01), and rivastigmine users declined an additional 0.17 points per year (95% CI: −0.24, −0.11), relative to donepezil.
CONCLUSIONS: In this large cohort of patients with AD or MxD, ChEIs users alone, particularly donepezil and galantamine, showed slower cognitive decline compared to users of memantine or combination therapy users. While differences were modest, the results contribute to a better understanding of treatment trajectories in routine clinical practice.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13195-025-01918-0.}, }
@article {pmid41315790, year = {2025}, author = {Dong, D and Ahmed, W and Sagar, R and Boyd, RJ and Mahairaki, V}, title = {Mapping key mitochondrial genes in Alzheimer's disease through human tissue and iPSC derived neurons.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {42766}, pmid = {41315790}, issn = {2045-2322}, support = {RF190106435;DFD-18159;T32AG0585279;//NIA;The Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease at Johns Hopkins;National Institutes of Health/ ; RF190106435;DFD-18159;T32AG0585279;//NIA;The Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease at Johns Hopkins;National Institutes of Health/ ; RF190106435;DFD-18159;T32AG0585279;//NIA;The Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease at Johns Hopkins;National Institutes of Health/ ; RF190106435;DFD-18159;T32AG0585279;//NIA;The Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease at Johns Hopkins;National Institutes of Health/ ; RF190106435;DFD-18159;T32AG0585279;//NIA;The Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease at Johns Hopkins;National Institutes of Health/ ; }, mesh = {Humans ; *Alzheimer Disease/genetics/pathology/metabolism ; *Induced Pluripotent Stem Cells/metabolism/cytology ; *Neurons/metabolism/pathology ; *Mitochondria/genetics/metabolism ; *Genes, Mitochondrial ; Oxidative Stress/genetics ; Gene Expression Profiling ; Gene Ontology ; Brain/metabolism/pathology ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative condition that has become a global health challenge due to an aging world population and no available effective treatment. Mitochondrial dysfunction plays a crucial role in the development of AD due to its critical role in neuronal survival and function. However, the specific mitochondrial genes and pathways involved in AD pathogenesis remain poorly defined. In this study, we incorporated seven AD human postmortem and three AD iPSC-derived neurons (iNs) gene expression datasets to identify mitochondria-related Differentially Expressed Genes (mitoDEGs) between AD and control. The Gene Ontology (GO) analysis is conducted to investigate the AD biological mechanisms, and a random forest model is developed to assess how well the key mitoDEGs differentiate AD and control groups. Through our analysis, we identified fourteen key mitochondria related genes that show significant dysregulation in both postmortem brain tissues and iNs derived from AD patients. These genes have strong connections to oxidative stress, indicating mitochondrial dysfunction plays a crucial role in Alzheimer's disease pathology. Our study identified the key genes and pathways as promising targets for future research and therapeutic interventions, highlighting the importance of mitigating oxidative stress and restoring mitochondrial function in AD.}, }
@article {pmid41314754, year = {2025}, author = {Jana, MK and Swarup, V and Tripathy, S and Gupta, NM and Chatla, SS and Joshi, D and Mandal, S and Giri, A and Jana, S and Narayan, M and Maiti, SB and Das, S}, title = {Future horizons: Innovation, aging, and equity.}, journal = {Progress in brain research}, volume = {297}, number = {}, pages = {427-468}, doi = {10.1016/bs.pbr.2025.08.010}, pmid = {41314754}, issn = {1875-7855}, mesh = {Humans ; *Aging ; *Precision Medicine/trends/methods ; *Neurodegenerative Diseases/therapy/diagnosis ; Artificial Intelligence ; }, abstract = {Precision medicine is on the verge of transforming the treatment of neurodegenerative diseases (NDDs) like Alzheimer's disease (AD) and Parkinson's disease (PD), in response to the intricate interactions of genetic, epigenetic, environmental, and lifestyle factors underlying disease heterogeneity. As the world's aging populations grow, with dementia cases expected to double by 2040 and the costs amounting to over €130 billion a year in Europe alone, there is an urgent need for novel strategies to stem the socioeconomic costs of NDDs. Conventional "one-drug-fits-all" strategies that depend on late-stage symptom treatment are progressively insufficient for disorders that are marked by heterogeneous molecular pathways and unpredictable clinical courses. Recent improvements in artificial intelligence (AI), multi-omics integration, and biomarker research now allow patients to be stratified into subpopulations following their genetic risk profiles, neuroimaging signatures, and fluid biomarkers (e.g., amyloid-beta, tau, α-synuclein), enabling early diagnosis and focused treatments. For example, artificial intelligence platforms such as the IHI-PROMINENT project are creating forecasting algorithms to chart disease progression and tailor treatment outcomes, and gene therapy and antisense oligonucleotides (ASOs) address precise mutations in familial AD and PD. These advances are supported by pharmacogenomics, which individualizes drug regimens according to metabolic profiles to reduce side effects and maximize efficacy. Still, translating these advances into practice has major barriers to overcome, such as large-scale biomarker validation, multi-omics standardization, and incorporating real-world evidence from digital health technologies. Aging populations only add complexity to this environment, as comorbidities like diabetes and cardiovascular diseases interact with neurodegenerative pathways, requiring system-based, holistic approaches to care. Equity is still a key challenge: differences in access to sophisticated diagnostics (e.g., PET scans, CSF examination) and expensive therapies (e.g., monoclonal antibodies, CAR-T cell therapy) threaten to worsen global health disparities. In retaliation, initiatives such as the JPND research paradigm advance remote clinical trials and telemedicine platforms for the diverse community in decentralized settings, and policies target reducing financial disincentives through risk-sharing strategies and public-private partnerships. Precision medicine in the treatment of NDDs depends on an integrated network among academia, clinics, and industry, by taking advantage of communal biobanks and AI-enabled big data analysis, for refining the drug development process and validating new targets, e.g., neuroinflammatory signaling and gut-brain axis dysfunction. Innovations, like CRISPR-mediated editing and ambient neuroimaging, have innate or potential power to personalize treatment by identifying early-stage and even pre-symptomatic patients and modulating one's lifestyle in light of genetic risk. However ethical considerations around data privacy, algorithmic bias, and informed consent for Sustained therapeutic interventions over a lifetime should guide, not lag, the transformation. With the drive toward preventive rather than delayed care, precision medicine represents a revolutionary paradigm shift in health care, and a possibility to convert NDDs from devastatingly fatal diagnoses to easily managed chronic diseases and render equitable access to innovations possible for the masses. Success will require consistent investment in translational studies, interdisciplinary training, and global regulatory harmonization to translate the promise of precision medicine into tangible improvements in the quality of life for the millions of individuals afflicted with neurodegenerative disorders.}, }
@article {pmid41314753, year = {2025}, author = {Jana, MK and Mukherjee, P and Chatla, SS and Sharma, P and Mistry, J and Swarup, V and Srivastava, AK and Das, S and Gupta, NM and Ahuja, A and Samanta, S and Narayan, M}, title = {Global case studies and collaborative frameworks.}, journal = {Progress in brain research}, volume = {297}, number = {}, pages = {377-426}, doi = {10.1016/bs.pbr.2025.08.013}, pmid = {41314753}, issn = {1875-7855}, mesh = {Humans ; *Neurodegenerative Diseases/therapy/diagnosis ; *Biomedical Research ; *International Cooperation ; }, abstract = {As neurodegenerative diseases (NDDs) like Alzheimer's and Parkinson's continue to rise globally, the need for cross-border collaboration in research and treatment has never been more critical. This chapter explores prominent global case studies and collaborative frameworks that exemplify how united efforts are transforming the landscape of NDD research. By pooling expertise, data, and resources, international initiatives are accelerating discoveries in early diagnosis, biomarker identification, and personalized therapies. Highlighting landmark consortia such as the Alzheimer's Disease Neuroimaging Initiative (ADNI) (n.d.), Parkinson's Progression Markers Initiative (PPMI), and emerging multi-omics collaborations, the chapter illustrates how these partnerships overcome the complexity and heterogeneity of NDDs. It delves into technological innovations like artificial intelligence, blockchain data sharing, and real-time patient monitoring, which empower researchers and clinicians to connect genetic, environmental, and lifestyle factors in a holistic manner. Ethical considerations and data privacy frameworks are underscored as pivotal to fostering trust among participants and bridging disparities between regions with varying access to precision medicine. The chapter also sheds light on successful public-private partnerships and patient-focused global networks that place individuals at the center of discovery and care. Challenges such as standardizing protocols across countries, navigating legal frameworks, and securing sustainable funding are discussed alongside future directions for expanding collaborative reach. Ultimately, this comprehensive overview conveys the unprecedented promise held by global cooperation in combating neurodegenerative diseases-offering hope for improved diagnostics, innovative treatments, and enhanced quality of life for millions worldwide.}, }
@article {pmid41314749, year = {2025}, author = {Priyanka, S and Manjari, T and Hemalatha, S and Ambika, S and Yılmaz, B and Aktürk, B and Arısan, ED and Kumari, A and Manojkumar, Y}, title = {Precision therapeutics for Alzheimer's disease.}, journal = {Progress in brain research}, volume = {297}, number = {}, pages = {247-276}, doi = {10.1016/bs.pbr.2025.08.011}, pmid = {41314749}, issn = {1875-7855}, mesh = {Humans ; *Alzheimer Disease/therapy/genetics/drug therapy ; *Precision Medicine/methods ; Animals ; }, abstract = {Despite extensive research, Alzheimer's disease (AD) a progressive neurodegenerative disorder marked by cognitive decline, neuronal loss, and the build-up of amyloid-beta plaques and tau tangles continues to lack effective treatments. Precision medicine presents a promising shift by customizing interventions to an individual's genetic, molecular, and lifestyle profile. This chapter explores key advancements in precision therapeutics for AD, including biomarker-driven therapies, pharmacogenomics, and targeted disease-modifying agents such as monoclonal antibodies. Recent innovations, including RNA-based therapeutics, stem cell approaches, and CRISPR-mediated gene editing, are also discussed. While precision medicine holds immense promise, challenges in clinical translation, patient stratification, and regulatory pathways must be addressed. By bridging cutting-edge research with clinical applications, this chapter provides insights into the evolving landscape of individualized treatment strategies for AD.}, }
@article {pmid41314745, year = {2025}, author = {Fatima, S and Tiwari, S and Siddiqi, B and Quadri, SN and Abdin, MZ}, title = {Biomarkers: From early detection to treatment personalization.}, journal = {Progress in brain research}, volume = {297}, number = {}, pages = {131-153}, doi = {10.1016/bs.pbr.2025.08.008}, pmid = {41314745}, issn = {1875-7855}, mesh = {Humans ; *Biomarkers/metabolism ; *Neurodegenerative Diseases/diagnosis/therapy/metabolism ; *Precision Medicine/methods ; Early Diagnosis ; }, abstract = {Neurodegenerative disorders (NDs), such as Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS), present increasing issues associated with the unavoidable aging of the world's population. These challenges are further highlighted by the socioeconomic consequences of these diseases. The identification and use of biomarkers for prompt diagnosis, careful observation, and efficient treatment approaches is essential to overcoming these obstacles. The primary methods for diagnosing neurodegenerative illnesses are invasive procedures like lumbar punctures to measure CSF fluid or functional brain imaging methods. Biomarkers for underlying proteinopathy in blood serum and cerebral fluid have been the focus of recent biological research, particularly in vivo. With their ability to provide novel pathways for early detection, illness progression tracking, and individualized treatment plans, biomarkers have become essential instruments in precision medicine. The classification of biomarkers including fluid, digital imaging, and molecular biomarkers is examined in this chapter, with an emphasis on their function in neurodegenerative diseases. In neurodegenerative illnesses and the aging brain, tau, amyloid-β, α-synuclein, and TDP-43 are commonly seen to be deposited together rather than separately. These may be disregarded, and it might be challenging to determine their clinicopathological significance. An overview of illness pathophysiology, diagnostic implications, and the most recent molecular and ultrastructural categories for neurodegenerative disorders are given in this chapter. Addressing these issues through interdisciplinary research and technological advancements will be crucial for the future of biomarker-driven precision medicine. This chapter provides an in-depth overview of the evolving landscape of biomarkers and their transformative impact on the early detection and personalized treatment of neurodegenerative diseases.}, }
@article {pmid41314744, year = {2025}, author = {Gunasekaran, B and Arifin, AH and Yu, WH and Hanafi, S and Rao, KDK and Salvamani, S}, title = {Precision medicine in neurodegenerative diseases: From research to clinical practice.}, journal = {Progress in brain research}, volume = {297}, number = {}, pages = {1-52}, doi = {10.1016/bs.pbr.2025.08.006}, pmid = {41314744}, issn = {1875-7855}, mesh = {Humans ; *Precision Medicine/methods ; *Neurodegenerative Diseases/therapy/genetics/diagnosis ; Biomarkers ; }, abstract = {The chapter outlines how precision medicine is reshaping the way neurodegenerative diseases (NDs) which includes Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and Huntington's disease (HD) are understood, diagnosed, and treated. It discusses the limitations of current therapies, which mainly address symptoms without altering disease progression. Genetic and molecular factors that influence disease development are described, including distinctions between familial and sporadic forms. The chapter also covers the roles of epigenetic changes, gene expression, protein dysfunction, mitochondrial DNA, and non-coding RNAs in NDs. Biomarkers in blood and cerebrospinal fluid, along with imaging techniques and digital tools, are presented as key elements in early diagnosis and disease monitoring. Patient stratification based on clinical features, molecular profiles, and biomarkers helps guide treatment decisions and improve outcomes. The chapter reviews ongoing developments in genotype-based drug design, gene therapy, pharmacogenomics, and personalized lifestyle strategies. Clinical case studies show how these approaches are being used in practice. The chapter also discusses challenges in applying precision medicine, such as trial design, data integration, unequal access, and regulatory hurdles. Finally, it highlights the future tools like single-cell transcriptomics, digital twins, and global research collaborations that aim to bring precision approaches into everyday care.}, }
@article {pmid41314580, year = {2026}, author = {Wang, X and Wang, D and Liu, J and Han, F and Liang, P and Yang, J and Xu, W and Ma, J and Wu, Y and An, X and Xue, Y and Chen, H and Zeng, L and Qu, Y and Ai, J}, title = {Systemic delivery of liposome-loaded microRNA-195 ameliorates spatial memory impairment in a rat model of chronic cerebral hypoperfusion.}, journal = {International journal of biological macromolecules}, volume = {336}, number = {}, pages = {149290}, doi = {10.1016/j.ijbiomac.2025.149290}, pmid = {41314580}, issn = {1879-0003}, mesh = {Animals ; *MicroRNAs/administration & dosage/genetics/chemistry/pharmacology ; Rats ; *Liposomes/chemistry ; Disease Models, Animal ; Male ; *Spatial Memory/drug effects ; Cognitive Dysfunction/drug therapy ; Blood-Brain Barrier/metabolism ; *Memory Disorders/drug therapy ; Rats, Sprague-Dawley ; }, abstract = {Chronic cerebral hypoperfusion (CCH), a subclinical state underlying mild cognitive impairment (MCI), triggers multiple pathological changes associated with Alzheimer's disease (AD) and vascular dementia (VaD), including amyloid-β (Aβ) deposition, tau phosphorylation, microglial activation and neural circuit dysfunction. Developing multitarget therapeutics to effectively prevent the transition from MCI to AD and/or VaD remains an urgent challenge. Herein, we engineered a brain-targeted dual-modified PEGylated nanoliposome (LipTM@miR-195), incorporating mannose (MAN) and the trans-activating protein of HIV type 1 (TAT), which encapsulates polyethyleneimine (PEI) complesed microRNA-195 (miR-195). In a CCH rat model, tail-vein administration of LipTM@miR-195 (0.112 mg/kg) efficiently crossed the blood-brain barrier (BBB) without detectable side effects. Treatment reversed CCH-induced spatial learning and memory deficits, rescued neural circuit dysfunction, and suppressed elevated APP, BACE1, AT8 and CD68 levels. Collectively, these findings provide compelling evidence that LipTM@miR-195 nanoliposome holds therapeutic potential for CCH-induced cognitive impairment, thereby preventing the progression from MCI to AD and/or VaD.}, }
@article {pmid41314098, year = {2025}, author = {Ye, M and Kim, JS and Shim, I}, title = {CB1 receptor activation and inhibition differentially modulate cognitive deficits and neuropathology in 3xTg-AD mice.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {193}, number = {}, pages = {118818}, doi = {10.1016/j.biopha.2025.118818}, pmid = {41314098}, issn = {1950-6007}, mesh = {Animals ; *Receptor, Cannabinoid, CB1/metabolism/agonists/antagonists & inhibitors ; Mice ; *Alzheimer Disease/metabolism/pathology/drug therapy/psychology ; *Piperidines/pharmacology ; Mice, Transgenic ; tau Proteins/metabolism ; Hippocampus/metabolism/drug effects/pathology ; Male ; *Pyrazoles/pharmacology ; Oxidative Stress/drug effects ; Disease Models, Animal ; *Cognitive Dysfunction/metabolism/drug therapy/pathology ; Amyloid beta-Peptides/metabolism ; Phosphorylation ; Maze Learning/drug effects ; Arachidonic Acids ; }, abstract = {Alzheimer's disease (AD) is characterized by amyloid-β (Aβ) deposition, tau hyperphosphorylation, neuroinflammation, oxidative stress, and progressive neuronal loss. The endocannabinoid system regulates synaptic function, inflammation, and redox homeostasis through cannabinoid receptor type 1 (CB1). This study aimed to determine whether pharmacological activation or inhibition of the CB1 receptor differentially modulates Alzheimer's disease-related pathology. 3xTg-AD mice received weekly intraperitoneal injections of the CB1 agonist ACEA (1 mg/kg) or the inverse agonist AM251 (1 mg/kg) from 6 to 12 months of age. Cognitive function was assessed using the Morris Water Maze (MWM) and Y-maze, while hippocampal tissues were analyzed for Aβ, p-Tau, glial markers (GFAP, Iba-1), cytokines (IL-1β, IL-10), oxidative stress markers (SOD, GSH, MDA), and neuronal viability (NeuN). Cerebral glucose metabolism was evaluated using [1] [8]F-FDG positron emission tomography (PET). ACEA administration reduced tau phosphorylation, glial activation, IL-1β expression, and oxidative stress, while increasing IL-10 levels, neuronal preservation, and cerebral glucose metabolism. AM251 treatment aggravated tau pathology, neuroinflammation, oxidative imbalance, and cognitive impairment. Double immunofluorescence demonstrated CB1 receptor colocalization with both Iba-1-positive microglia and GFAP-positive astrocytes, with CB1 predominantly localized to microglia, suggesting a microglia-dependent mechanism underlying CB1-mediated neuroprotection. Aβ levels were not affected by either treatment. Chronic CB1 receptor activation attenuates tau-associated pathology and metabolic dysfunction in 3xTg-AD mice, indicating the therapeutic relevance of CB1 signaling modulation in neurodegenerative disorders.}, }
@article {pmid41313999, year = {2026}, author = {Pei, Z and Zhu, L and Ren, H and Liu, Y and Shi, X and Lin, Y and Wang, J and Li, P and Wang, P and Ji, Y and Zhou, Y and Tang, X and Jiang, X and Tong, X and Guo, Y}, title = {EEG-based stratification in Alzheimer's disease: Cognitive progression, pathological marker associations, and therapeutic interventions.}, journal = {Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology}, volume = {182}, number = {}, pages = {2111440}, doi = {10.1016/j.clinph.2025.2111440}, pmid = {41313999}, issn = {1872-8952}, mesh = {Humans ; *Alzheimer Disease/physiopathology/therapy/diagnosis/psychology ; Male ; Aged ; Female ; *Electroencephalography/methods ; Transcranial Magnetic Stimulation/methods ; Disease Progression ; Retrospective Studies ; Middle Aged ; Aged, 80 and over ; *Cognitive Dysfunction/physiopathology/therapy ; Parkinson Disease/physiopathology/therapy ; *Cognition/physiology ; Biomarkers ; *Brain/physiopathology ; }, abstract = {OBJECTIVE: Clinical cognitive and pathological marker stratification systems have evolved separately, causing mismatches that limit their clinical use. This study retrospectively validated the link between EEG and clinical symptoms, pathological markers, and the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS).
METHODS: This multicenter study involved 308 Alzheimer's patients (AD), 176 with Parkinson's (PD), and 181 normal controls. Resting-state EEG were analyzed to identify four oscillation modes. An EEG-based cognitive risk system was created and validated, also evaluating its effect on rTMS therapy effectiveness.
RESULTS: EEG oscillation changes correlated with cognitive decline, revealing distinct brain network disruptions in AD and PD. These oscillation changes were associated with AD biomarkers, particularly tau hyperphosphorylation. Multicenter validation showed an 83% concordance with the Clinical Dementia Rating Scale, and EEG stratification enhanced rTMS therapeutic efficacy.
CONCLUSIONS: This study showed that EEG-based stratification can assess cognitive function, track disease progression, identify key intervention periods, and improve patient selection for better treatment outcomes in clinical settings.
SIGNIFICANCE: This study demonstrates that EEG can connect disease processes to clinical symptoms at a molecular level, offering a unified framework for improved dementia management. This method allows for dynamic monitoring and precise neuromodulation, enhancing personalized care for neurodegenerative diseases.}, }
@article {pmid41313889, year = {2026}, author = {Jelčić, A and Talić, S and Odak, I and Mlakić, M and Lasić, Z and Roca, S and Šagud, I and Bruketa, T and Bosnar, M and Barić, D and Škorić, I}, title = {Exploring the selective butyrylcholinesterase inhibition potential of phenol carbamates: Experimental and computational study.}, journal = {European journal of medicinal chemistry}, volume = {302}, number = {Pt 3}, pages = {118375}, doi = {10.1016/j.ejmech.2025.118375}, pmid = {41313889}, issn = {1768-3254}, mesh = {*Butyrylcholinesterase/metabolism ; *Cholinesterase Inhibitors/pharmacology/chemistry/chemical synthesis ; *Carbamates/pharmacology/chemistry/chemical synthesis ; Humans ; Structure-Activity Relationship ; Molecular Docking Simulation ; Molecular Structure ; Dose-Response Relationship, Drug ; Acetylcholinesterase/metabolism ; Hep G2 Cells ; *Phenols/chemistry/pharmacology/chemical synthesis ; *Phenol/chemistry/pharmacology ; }, abstract = {A series of fourteen novel phenol carbamates was synthesized and evaluated as potential selective butyrylcholinesterase (BChE) inhibitors targeting cholinergic dysfunction in Alzheimer's disease (AD). The compounds were prepared efficiently from resveratrol analogs via a Wittig reaction followed by carbamoylation, and their structures were confirmed by NMR, MS, and HRMS analyses. All derivatives were screened for inhibitory activity against acetylcholinesterase (AChE) and BChE using a modified Ellman method. None of the compounds inhibited AChE, whereas all selectively inhibited BChE, with IC50 values ranging from 0.045 to 6.840 μM. The most potent inhibitor, compound 13, bearing a pyrrolidine moiety, exhibited an IC50 value of 0.045 μM, outperforming the reference drug galantamine by more than two orders of magnitude. Molecular docking and dynamics simulations confirmed strong π-π and alkyl-π interactions between the ligands and the enzyme's active site, accounting for their high affinity and selectivity. In silico ADME(T) analysis predicted excellent intestinal absorption, blood-brain barrier penetration, and low cytotoxicity, while minor genotoxicity alerts were observed for a few derivatives. In vitro cytotoxicity assays in HepG2 cells confirmed the absence of toxicity at concentrations up to 30 μM. These results highlight methoxy-substituted phenol carbamates, particularly compound 13, as promising lead structures for the design of selective BChE inhibitors and potential therapeutic agents for the treatment of AD.}, }
@article {pmid41313642, year = {2025}, author = {Mangalmurti, A and Zengeler, KE and Hollis, A and Golden, E and Riddlemoser, G and Lukens, JR}, title = {Microglial CLEC7A restrains amyloid beta plaque pathology in a mouse model of Alzheimer's disease.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70943}, pmid = {41313642}, issn = {1552-5279}, support = {ADSF-21-816651/ALZ/Alzheimer's Association/United States ; /NH/NIH HHS/United States ; R01AG071996/AG/NIA NIH HHS/United States ; R01AG087406/AG/NIA NIH HHS/United States ; RF1AG078684/AG/NIA NIH HHS/United States ; //Cure Alzheimer's Fund/ ; //The Steven A Newman AD Award/ ; //Rick Sharp Foundation/ ; //Harrison Family Foundation/ ; T32GM007267//Medical Scientist Training Program/ ; T32AI007496//Immunology Training Program/ ; T32AI007496//National Institute of Allergy and Infectious Diseases/ ; T32GM156694/GM/NIGMS NIH HHS/United States ; }, mesh = {Animals ; *Alzheimer Disease/pathology/metabolism/genetics ; *Plaque, Amyloid/pathology/metabolism ; Disease Models, Animal ; *Microglia/metabolism/pathology ; *Lectins, C-Type/metabolism/genetics ; Mice ; Mice, Transgenic ; Mice, Knockout ; Macrophages/metabolism ; Amyloid beta-Peptides/metabolism ; Humans ; Brain/pathology/metabolism ; }, abstract = {INTRODUCTION: CLEC7A is a surface receptor that is highly upregulated on microglia in many Alzheimer's disease (AD) models. Little is known about the role that microglial CLEC7A signaling plays in AD-related pathogenesis.
METHODS: We utilized an inducible, central nervous system (CNS) macrophage-specific knockout of Clec7a to evaluate the role of CLEC7A in the 5xFAD mouse model of AD at 5 months of age. We used immunofluorescence microscopy, single-nuclei RNA sequencing, along with biochemical assays, to evaluate plaque burden, microglial activity, and neuronal health.
RESULTS: CNS macrophage-targeted deletion of CLEC7A in 5xFAD mice led to a twofold increase in plaque burden, exacerbated neuritic dystrophy, and altered the expression of neuronal health genes, but did not appreciably impact microglial activation, plaque engulfment, or disease-associated microglia acquisition.
DISCUSSION: These findings identify protective roles for CLEC7A in AD-related amyloidosis and suggest that CLEC7A-targeting therapeutics may offer promising strategies for treatment of AD.
HIGHLIGHTS: Conditional loss of CLEC7A in central nervous system (CNS) macrophages of 5xFAD mice results in increased amyloid beta deposition. Loss of CLEC7A does not alter the disease-associated microglia transcriptional program or affect the recruitment of microglia to plaque surfaces. Exacerbation of amyloid deposition with loss of CNS-macrophage CLEC7A is associated with worsened neuronal health highlighted by increased neuritic dystrophy.}, }
@article {pmid41312814, year = {2026}, author = {Akpınar, O and Nazıroğlu, M}, title = {Glutathione and TRPM2 Inhibition Reduce Amyloid-Beta and Lipopolysaccharide-Induced Apoptosis, Inflammation, and Oxidative Stress in Microglial Cells.}, journal = {Cell biology international}, volume = {50}, number = {1}, pages = {e70109}, doi = {10.1002/cbin.70109}, pmid = {41312814}, issn = {1095-8355}, support = {//This study was supported by the Scientific Research Projects Coordination Unit (BAP) of Süleyman Demirel University (project number: TDK-2021-8387). Project owner was Mustafa Nazıroğlu./ ; }, mesh = {*TRPM Cation Channels/antagonists & inhibitors/metabolism ; *Oxidative Stress/drug effects ; *Apoptosis/drug effects ; Lipopolysaccharides/pharmacology ; *Microglia/metabolism/drug effects ; *Amyloid beta-Peptides/metabolism/pharmacology ; *Inflammation/metabolism ; *Glutathione/pharmacology/metabolism ; Reactive Oxygen Species/metabolism ; Animals ; Mice ; Cell Line ; Calcium/metabolism ; }, abstract = {Microglia cells impacted by inflammation and Alzheimer's disease produce toxic reactive oxygen species (ROS), emit signaling molecules, and death as a result of microglia being active due to excessive Ca[2+] entering the cells. The TRPM2 channel plays a crucial role in Ca[2+] permeability, inflammation, ROS, and apoptosis changes in the BV2 microglia cells, while glutathione (GSH) treatment reduces the changes through TRPM2 inhibition. However, the effect of TRPM2 inhibitors and GSH treatment on oxidative stress, inflammation, and apoptotic values in BV2 microglia cells activated with LPS and amyloid-beta (Aβ) has not been investigated yet. The study aimed to assess the effects of TRPM2 inhibition and GSH treatment on the values in BV2 cells activated with LPS and Aβ. BV2 cells were divided into five groups: control (CNT), LPS, Aβ, Aβ + LPS, and Aβ + LPS + GSH. Increased levels of inflammation biomarkers (TNF-α, IL-1β, and IL-6), intracellular Ca[2+] level, cytosolic ROS, mitochondrial membrane dysfunction, cell death, apoptosis, caspases (caspase-3, -8, and -9), and TRPM2 current density were observed in the cells stimulated with LPS and Aβ. These values increased more when LPS and Aβ were incubated together. However, these apoptotic, inflammatory, and oxidant levels decreased in cells treated with GSH and TRPM2 blockers. In conclusion, the involvement of TRPM2 stimulation was demonstrated on Aβ and LPS-induced Ca[2+] entry, oxidative stress, inflammation, and apoptosis parameters in microglia cells. TRPM2 inhibition by GSH treatment seems to be a potential source for the prevention of Aβ and LPS-induced oxidative stress, apoptosis, and inflammation.}, }
@article {pmid41312794, year = {2025}, author = {Healy, M and Thomas, S and Brodtmann, A}, title = {Magnetic resonance imaging eligibility for anti-amyloid monoclonal antibody treatment for Alzheimer disease: a single-centre retrospective review for service planning.}, journal = {Internal medicine journal}, volume = {}, number = {}, pages = {}, doi = {10.1111/imj.70254}, pmid = {41312794}, issn = {1445-5994}, }
@article {pmid41312566, year = {2025}, author = {Kwinta, R and Morawiec, N and Bączyk, J and Kubicka-Bączyk, K and Adamczyk-Sowa, M}, title = {Aging immunity - the role of T and B cells in neurological disorders among older adults.}, journal = {Neurologia i neurochirurgia polska}, volume = {}, number = {}, pages = {}, doi = {10.5603/pjnns.106498}, pmid = {41312566}, issn = {0028-3843}, abstract = {INTRODUCTION: Immunosenescence is a natural process of immune system aging, which leads to significant changes in the functioning of both innate and adaptive immunity. Alterations in T and B lymphocytes can significantly impact the progression of neurological diseases including multiple sclerosis (MS), Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS).
STATE OF THE ART: Immunosenescence affects T and B cell subsets, reducing their proliferative capacity and altering cytokine profiles. In MS, these changes promote disease progression and diminish responses to immunomodulatory therapies. In AD and PD, dysfunctional T and B cells contribute to sustained neuroinflammation, exacerbating neurodegeneration. ALS is similarly associated with altered adaptive immunity.
CLINICAL IMPLICATIONS: Recognizing how immunosenescent T and B cells contribute to disease in older adults is crucial for refining treatment strategies. These age-related immune changes may explain varied responses to therapies and highlight the need for novel approaches targeting the aged immune system in neurodegenerative diseases.
FUTURE DIRECTIONS: Future research should focus on identifying the mechanisms by which immunosenescent lymphocytes modulate neuroinflammation and neurodegeneration in aging populations. Novel biomarkers and immunomodulatory therapies tailored to older adults could significantly improve outcomes in patients with neurological diseases.}, }
@article {pmid41311387, year = {2025}, author = {Zhou, Y and Wang, Y and Yang, H and Zhang, C and Meng, J and Zhang, L and Li, K and Huang, LL and Zhang, X and Luo, H and Zhang, Y}, title = {Sorafenib promotes the E3 ubiquitin ligase FBXW7 to increase tau degradation and ameliorate tauopathies.}, journal = {Acta pharmaceutica Sinica. B}, volume = {15}, number = {11}, pages = {5817-5831}, pmid = {41311387}, issn = {2211-3835}, abstract = {Tauopathies, including Alzheimer's disease (AD), are a series of neurodegenerative diseases characterized by pathological accumulation of the microtubule-associated protein tau. Since the abnormal modification and deposition of tau in nerve cells are crucial for tauopathy etiology, methods for reducing tau levels, such as promoting tau degradation, may become effective strategies for disease treatment. Herein, we identified that sorafenib significantly reduced total tau and phosphorylated tau levels through screening FDA-approved drugs. We showed that sorafenib treatment attenuated cognitive deficits and tau pathologies in PS19 tauopathy model mice. Mechanistically, we found that sorafenib inhibited multiple kinases involved in tau phosphorylation and promoted autophagy. Importantly, we further demonstrated that sorafenib also promoted the expression of the E3 ubiquitin ligase FBXW7, which could bind tau and mediate tau degradation through the ubiquitin-proteasome pathway. Finally, we showed that FBXW7 expression decreased in the brains of AD patients and tauopathy model mice, and that overexpression of FBXW7 in the hippocampus attenuated cognitive deficits and tau pathologies in PS19 mice. These results suggest that sorafenib may be a promising treatment option for tauopathies by promoting tau degradation and reducing tau phosphorylation, and that targeting FBXW7 could also serve as an alternative therapeutic strategy for tauopathies.}, }
@article {pmid41311386, year = {2025}, author = {Zhao, Y and Liu, X and Yang, S and Wang, J and Wu, D and Bu, Y and Xie, X}, title = {Electrochemical biosensors with right-side-out-oriented cell membrane coating for the evaluation of AChE inhibitors as potential anti-Alzheimer's disease agents.}, journal = {Acta pharmaceutica Sinica. B}, volume = {15}, number = {11}, pages = {5988-6000}, pmid = {41311386}, issn = {2211-3835}, abstract = {Biosensors based on acetylcholinesterase (AChE) are crucial for early diagnosis, less invasive treatment, and drug evaluation of Alzheimer's disease (AD). However, existing technologies often suffer from enzyme conformational changes, leading to altered activity and loss and reduced sensor efficacy. To address this challenge, we developed a novel right-side-out-oriented red blood cell membrane-coated electrochemical biosensors (ROCMCBs) to evaluate AChE inhibitors from traditional Chinese medicines (TCMs) as potential anti-AD agents. The developed right-side-out-oriented coating based on immunoaffinity not only fully exposed the binding sites of AChE on the cell membrane but also ensured its conformation and stability as a peripheral membrane-anchoring protein, which was conducive to maintaining its biological activity and producing optimal interaction with drugs. At the same time, the biosensors exhibited a satisfactory sensitivity (limit of detection = 0.41 pmol/L). Ultimately, six potentially active compounds against AD (baicalin, geniposide, gastrodin, berberine, rhynchophylline, and senkyunolide A) were rapidly identified and evaluated from TCMs. This project provides a promising strategy for developing cell membrane-coated electrochemical biosensors. The application of cell membrane-coated electrochemical biosensors with well-defined cell membrane orientation further expands new perspectives and methods for AChE-targeted anti-AD research.}, }
@article {pmid41311299, year = {2025}, author = {Pini, L and Allali, G and Imbimbo, BP and Germani, M and Corbetta, M}, title = {Brain connectivity as a new target for Alzheimer's disease therapy?.}, journal = {Brain : a journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/brain/awaf404}, pmid = {41311299}, issn = {1460-2156}, abstract = {The recent introduction of immunotherapeutic agents targeting amyloid-β (Aβ) has advanced the pharmacological treatment of Alzheimer's disease (AD). Although several anti-Aβ antibodies have dramatically reduced cerebral amyloid plaques, this has not translated into major cognitive or clinical benefits, thus questioning the clinical relevance of these biomarker changes. Indeed, there is an ongoing debate over whether amyloid reduction alone constitutes sufficient evidence of disease modification to justify regulatory approval. Against this backdrop, we propose a third pathway that transcends the binary framework of molecular versus clinical end points by positioning brain connectivity as a system-level intermediate phenotype. This approach is supported by a growing body of evidence. Alterations in brain networks are early, sensitive, and modifiable markers of AD pathology. Connectivity metrics capture the dynamic interplay between genetic and environmental factors, offering a unified model of disease. Advances in precision medicine, such as individualized connectivity 'fingerprints' and the emergence of digital twins, further position brain connectivity as a powerful platform for therapeutic innovation. We argue that adopting brain network analysis as a key outcome measure enables a shift beyond isolated biomarker achievements toward a more integrated, biologically grounded, and clinically meaningful framework for disease modification in AD, bridging the gap between molecular advances and real-world impact.}, }
@article {pmid41311279, year = {2025}, author = {Garland, H and Jacobson, M and Xu, S and Zissimopoulos, J}, title = {A scoping review of population-based dementia registries: advancing research, care, and policy.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70938}, pmid = {41311279}, issn = {1552-5279}, mesh = {Humans ; *Registries ; *Dementia/therapy/epidemiology ; *Health Policy ; }, abstract = {Despite their value for public health, research, and care, population-based registries for Alzheimer's disease and related dementias (ADRD) remain limited. We conducted a scoping review of dementia registry studies through December 2023 and identified population-based dementia registries in Organisation for Economic Co-operation and Development countries. We characterized their structure and scope, assessed key themes, and developed recommendations for registry development. We identified 21 population-based dementia registries from a review of 235 publications. These registries help fill gaps in dementia research by providing longitudinal data, improving case identification, and standardizing outcomes for clinical and policy use. However, many registries lack data on healthcare use and caregiving and have limited geographical coverage, thereby reducing their ability to inform research and public health efforts to address dementia burden in an era of rapidly evolving dementia diagnostics and treatments. As dementia cases rise and advancements in prevention, detection, and treatment accelerate, population-based registries are essential for generating real-world evidence to improve dementia care, policy, and outcomes. HIGHLIGHTS: This scoping review identified 21 population-based dementia registries across OECD countries, highlighting the current landscape and structural gaps. Registries provide critical longitudinal data and standardization for research and policy but often lack information on healthcare use, caregiving, and broad geographic representation. With rising dementia rates and evolving treatments, population-based registries are essential for producing real-world evidence to strengthen care, research, and public health planning.}, }
@article {pmid41311076, year = {2025}, author = {Li, X and Zhang, Y and Gu, Y and Chen, N and Qian, X and Zhang, P and Hao, J and Wang, F}, title = {[Association between Tau protein deposition and brain metabolites: N-acetylaspartate and creatine as potential biomarkers for advanced Alzheimer's disease].}, journal = {Nan fang yi ke da xue xue bao = Journal of Southern Medical University}, volume = {45}, number = {11}, pages = {2350-2357}, pmid = {41311076}, issn = {1673-4254}, mesh = {Humans ; *Alzheimer Disease/metabolism/diagnostic imaging ; *Aspartic Acid/analogs & derivatives/metabolism ; *tau Proteins/metabolism ; *Creatine/metabolism ; *Brain/metabolism ; Biomarkers/metabolism ; Positron-Emission Tomography ; Male ; Female ; Proton Magnetic Resonance Spectroscopy ; Choline/metabolism ; Aged ; Middle Aged ; }, abstract = {OBJECTIVES: To investigate the associations between Tau protein deposition and brain biochemical metabolites detected by proton magnetic resonance spectroscopy ([1]H-MRS) in patients with advanced Alzheimer's disease (AD).
METHODS: From April, 2022 to December, 2024, 64 Tau-positive AD patients and 29 healthy individuals underwent [18]F-APN-1607 PET/MR and simultaneously acquired multi-voxel [1]H-MRS in the Department of Nuclear Medicine, Nanjing First Hospital. Visual analysis and voxel-based analysis of PET/MR data were performed to investigate the Tau protein deposition patterns in AD patients. Valid voxels within the [1]H-MRS field of view were selected, and their standardized uptake value ratio (SUVr) in PET and metabolite levels of N-acetylaspartate (NAA), choline (Cho), creatine (Cr), NAA/Cr, and Cho/Cr were recorded. The Tau-positive (Tau[+]) voxels and Tau-negative (Tau[-]) voxels of the AD patients were compared for PET and [1]H-MRS parameters, and the correlations between the metabolites and Tau PET SUVr within Tau[+] voxels were analyzed.
RESULTS: Significant Tau protein deposition were observed in the AD patients, involving mainly the bilateral frontal lobes (30.07%), parietal lobes (29.96%), temporal lobes (21.07%), and occipital lobes (15.89%). A total of 1422 valid voxels in AD group (including 994 Tau[+] and 428 Tau[-] voxels) and 814 voxels in the control group were selected. The AD patients showed significantly decreased NAA level and increased SUVr compared with the control group (P<0.05). Subgroup analyses revealed that Tau[+] voxels had higher SUVr and lower Cr and Cho/Cr than Tau[-] voxels (P<0.05). Compared with the control group, Tau[+] voxels exhibited higher SUVr and lower Cr (P<0.05), while Tau[-] voxels showed lower NAA (P=0.004). No significant differences were found in Cho or NAA/Cr among the subgroups (P>0.05). Within Tau[+] voxels, NAA, Cho, and Cr were negatively correlated with SUVr (P<0.001).
CONCLUSIONS: The patients with progressive AD have significant Tau protein deposition in the brain, which is correlated with alterations in metabolite levels. Decreased NAA is more prominent in early or pre-tau deposition stages, while Cr changes is more significant in the regions with Tau protein deposition, suggesting the potential of NAA and Cr as biomarkers for Tau protein deposition in AD for disease monitoring and treatment evaluation.}, }
@article {pmid41309432, year = {2026}, author = {Bai, N and Liu, S and Wei, J and Zheng, B and Wang, W and Li, X and Yang, J and Song, X and Wang, L and Yi, F and Cao, L}, title = {Sirtuins in Alzheimer's disease: mechanistic insights and therapeutic opportunities.}, journal = {Trends in pharmacological sciences}, volume = {47}, number = {1}, pages = {100-119}, doi = {10.1016/j.tips.2025.10.016}, pmid = {41309432}, issn = {1873-3735}, mesh = {Humans ; *Alzheimer Disease/drug therapy/metabolism ; Animals ; *Sirtuins/metabolism/antagonists & inhibitors ; }, abstract = {Alzheimer's disease (AD) is an irreversible neurodegenerative disorder characterized by progressive cognitive decline and complex neuropathology. Its main features include amyloid-β (Aβ) plaques, tau neurofibrillary tangles (NFTs), and neuroinflammation. Current therapies provide only limited symptomatic relief and cannot stop disease progression, highlighting the urgent need for disease-modifying strategies. Recent research has revealed multiple roles of sirtuins in AD pathology, positioning them as promising therapeutic targets. Studies using small-molecule compounds to target sirtuins, in both cellular and animal models and clinical analyses of AD patients, demonstrate their therapeutic potential. This review discusses the distinct roles of individual sirtuin isoforms in AD pathogenesis and evaluates the therapeutic evidence for small-molecule sirtuin modulators.}, }
@article {pmid41309190, year = {2025}, author = {Shah, A and Karthikeyan, T and Hashem, S and Kumar, R and Bhat, AA and Macha, MA}, title = {Protein misfolding and neurodegeneration: Mechanisms, implications, and therapeutic strategies.}, journal = {Advances in protein chemistry and structural biology}, volume = {148}, number = {}, pages = {135-177}, doi = {10.1016/bs.apcsb.2025.08.012}, pmid = {41309190}, issn = {1876-1631}, mesh = {Humans ; *Protein Folding ; *Neurodegenerative Diseases/metabolism/pathology/drug therapy/therapy ; *Proteostasis Deficiencies/metabolism/pathology/therapy ; Animals ; Proteostasis ; }, abstract = {Protein misfolding and aggregation play a pivotal role in the development of neurodegenerative diseases such as Alzheimer's, Parkinson's, Huntington's disease, and other related disorders. Proper protein folding is essential for cellular function, but due to the complexity of the folding process and external factors like genetic mutations, oxidative stress, and aging, misfolding is inevitable. These misfolded proteins often aggregate into toxic forms that disrupt cellular processes, leading to neuronal damage and cognitive decline. This chapter provides a comprehensive overview of molecular mechanisms behind protein misfolding, highlighting how these abnormal structures contribute to neurodegeneration. It also explores the role of the proteostasis network and its therapeutic potential in alleviating these processes. Focusing on multitarget therapeutic strategies, the chapter offers insights into promising approaches for addressing the root causes of neurodegenerative diseases while identifying key research gaps that could shape future treatment developments. By blending current knowledge with emerging therapeutic directions, this chapter provides a comprehensive and engaging perspective on combating the challenges of protein misfolding in neurodegeneration.}, }
@article {pmid41307609, year = {2026}, author = {Katayama, S and Tsujimoto, M and Suzuki, K and Ueda, K and Shimoura, K and Suo, S and Hatakeyama, N}, title = {Care Partners' Perceptions of Amyloid-Targeting Therapy and Treat‑to‑Clearance for Alzheimer's Disease in Japan: A Qualitative Study.}, journal = {Neurology and therapy}, volume = {15}, number = {1}, pages = {257-267}, pmid = {41307609}, issn = {2193-8253}, abstract = {INTRODUCTION: Donanemab has been developed as an amyloid-targeting therapy (ATT) for mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD). In registration trials involving donanemab, a treat‑to‑clearance approach was used, in which patients discontinued ATT when amyloid plaque levels decreased below a predefined threshold, which differs from previously available symptomatic treatments for AD. Our study explored care partners' perceptions regarding ATT and treat‑to‑clearance.
METHODS: This was a cross-sectional, qualitative interview study. Care partners of individuals with MCI or mild dementia due to AD participated in online semi-structured interviews about their perceptions regarding the impact of MCI or mild dementia diagnoses due to AD, the burden of supporting, and use/cessation of ATT. The qualitative data from the interviews were analyzed using a thematic approach.
RESULTS: The participants were 22 care partners (5 male/17 female), and their median age was 59 (range 35-81) years. The most common relationships between care partners and the individuals with AD were child (50.0%) and spouse/partner (45.5%); 68.2% of the care partners lived with the individuals with AD. Thematic analysis identified three major classifications (Thoughts regarding therapy; Treat‑to‑clearance; and Burdens of support), along with 15 themes and five sub-themes. Care partners expressed experiencing mental burden and time constraints, while treat‑to‑clearance could save care partners' time by reducing hospital waiting time and alleviating financial burden. Confirming the clearance of amyloid β plaques provided care partners with a sense of relief, while they remained concerned about the potential progression of AD symptoms and sought follow-up care after stopping treatment.
CONCLUSIONS: These results suggest that providing clear explanations and facilitating shared decision-making when introducing ATT, as well as introducing follow-up care and long-term evidence after stopping treatment, are needed.}, }
@article {pmid41307478, year = {2025}, author = {Wang, X and Chen, L and Qiu, J and Wang, K and Xi, P and Cheng, X and He, Z and Jiang, H}, title = {Dipeptidyl Peptidase 4 Mediated Caspase-8 Affects Cognitive Impairment in Mice With Alzheimer's Disease.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {39}, number = {23}, pages = {e71264}, doi = {10.1096/fj.202501322RR}, pmid = {41307478}, issn = {1530-6860}, support = {82204837//MOST | NSFC | National Natural Science Foundation of China-Zhejiang Joint Fund for the Integration of Industrialization and Informatization (NSFC-Zhejiang Joint Fund)/ ; 81760207//MOST | NSFC | National Natural Science Foundation of China-Zhejiang Joint Fund for the Integration of Industrialization and Informatization (NSFC-Zhejiang Joint Fund)/ ; LQ23H290004//Zhejiang Provincial Natural Science Foundation of China/ ; 2024AY10021//Jiaxing Science and Technology Plan Project/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism ; Male ; Mice ; *Dipeptidyl Peptidase 4/metabolism/genetics ; Mice, Inbred C57BL ; *Caspase 8/metabolism/genetics ; *Cognitive Dysfunction/metabolism ; Mice, Knockout ; Amyloid beta-Peptides/toxicity ; Disease Models, Animal ; Pyroptosis ; Dipeptidyl-Peptidase IV Inhibitors/pharmacology ; Maze Learning ; Hippocampus/metabolism ; Neurons/metabolism ; }, abstract = {To investigate the effect of dipeptidyl peptidase 4 (DPP4) on cognitive impairment in Alzheimer's disease (AD), the present study used seven-week-old male C57BL/6J and DPP4 knockout mice. The AD model was induced by microinjection of Aβ25-35 into the lateral ventricle. Morris water maze test showed that DPP4 knockout significantly improved the spatial learning and memory abilities of AD mice. Western blot results showed that DPP4 knockout increased the expression levels of BDNF, CREB and Bcl-2 in the hippocampus of AD mice while the expression levels of Caspase-8, pyroptosis-related proteins NLRP3, Caspase-1, GSDMD, IL-118, IL-1β, and apoptosis-related proteins Caspase-3 and Bax were decreased. Similar results were observed after HT22 neurons were treated with Aβ25-35 and the DPP4 inhibitor sitagliptin (Sit). Moreover, the treatment with a Caspase-8 inhibitor (Z-LETD-FMK) showed that the inhibition of Caspase-8 inhibited the expression of NLRP3 and Caspase-1 in the AD model cells, but had no further inhibitory effect under the treatment of Sit. Our results suggest that DPP4 knockout may ameliorate learning and memory dysfunction in AD model mice by regulating pyroptosis and apoptosis pathways through Caspase-8.}, }
@article {pmid41307069, year = {2025}, author = {Zhang, Y and Qiu, J and Shang, Y and Zhao, X and Yang, S and Chen, Y and Dai, S and Ai, M and Huang, W and Zhang, J and Liu, X}, title = {Impact of DL-3-n-Butylphthalide on Progression in Alzheimer's Disease: A Retrospective Cohort Analysis.}, journal = {Neuropsychiatric disease and treatment}, volume = {21}, number = {}, pages = {2495-2511}, pmid = {41307069}, issn = {1176-6328}, abstract = {OBJECTIVE: To evaluate the efficacy of DL-3-n-butylphthalide (NBP), a synthetic compound that has shown neuroprotective effects, on cognitive function, psychiatric-behavioral symptoms, and daily activities in patients with Alzheimer's disease (AD).
METHODS: This retrospective cohort study included patients with AD treated with or without NBP. Disease deterioration and decline were defined by changes in Clinical Dementia Rating-Sum of Boxes (CDR-SB) over six months. Multivariate logistic regression, inverse probability of treatment weighting (IPTW) and overlap-weighted propensity score matching (PSM) were used to adjust for confounding.
RESULTS: Totally 100 were included in this study, with 39 classified as the NBP group and 61 as the non-NBP group. NBP was associated with lower odds of deterioration (adjusted odds ratio [OR] = 0.19, 95% confidence interval [CI]: 0.04-0.88, p = 0.034) and decline (adjusted OR = 0.10, 95% CI: 0.03-0.49, p = 0.001). In IPTW and PSM analyses, deterioration occurred in 4.31% vs 22.10% and 4.06% vs 24.27%, and decline in 4.31% vs 39.38% and 4.06% vs 44.28% for the NBP and non-NBP groups, respectively.
CONCLUSION: NBP was associated with reduced risks of clinical worsening and helped preserve cognitive and behavioral functions in patients with AD. These results highlight the potential of NBP as a promising therapeutic option in AD management. Future randomized controlled trials are necessary to validate these findings and assess the long-term efficacy of NBP in clinical settings.
SIGNIFICANCE: This real-world study suggests that NBP may slow disease progression and preserve cognitive and behavioral function in AD.}, }
@article {pmid41306895, year = {2025}, author = {Duncan, GB and Dickson, SP and Kaplan, JM and Johnson, SB and Duke, TM and Dayley, CW and Hendrix, SB and Altstiel, LD and Mallinckrodt, CH}, title = {Leveraging recent advances in plasma biomarkers to optimize early proof of concept trials in Alzheimer's disease.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70183}, pmid = {41306895}, issn = {2352-8737}, abstract = {INTRODUCTION: The importance of biomarkers as a primary outcome or as supportive evidence of clinical effect is rising as the field shifts toward disease-modifying treatments and earlier intervention, because they have lower variability and can indicate disease progression earlier than clinical outcomes. This study assessed the performance of plasma pTau 181 and 217 as a predictive biomarker and potential primary endpoint in early-phase Alzheimer's disease (AD) trials.
METHODS: Summary data from recent monoclonal antibody (mAb) trials including plasma pTau 181 and 217 were analyzed to evaluate associations between plasma pTau 181/217 and clinical outcomes. The suitability of plasma pTau 181/217 as a surrogate endpoint for internal decision making was assessed using Prentice criteria. Simulations were conducted to explore the statistical power of using plasma pTau 181/217 as a primary outcome in dose-escalation, proof-of-concept (POC) trial designs. Additional criteria for biomarker validation were applied to simulated data.
RESULTS: A strong group-level correlation (r = 0.781) was observed between treatment effects on plasma pTau 181/217 and Clinical Dementia Rating scale - Sum of Boxes (CDR-SB). Mean change in plasma pTau 181/217 significantly predicted mean change in CDR-SB (p = 0.013). The treatment effect on pTau 181/217 was ∼2.6 times greater than on CDR-SB. Prentice Criteria 1, 2, and 4 were met or reasonably met; Criterion 3 is not applicable in the POC setting.
CONCLUSION: Plasma pTau 181/217 at 6 months shows future promise to reasonably likely predict clinical benefit for drugs that reduce pTau 181/217 levels, supporting its use as a primary endpoint in early-phase trials. With effect sizes similar to those seen with donanemab, adequately powered trials may require as few as 100 participants. Such trials should include prespecified analyses to evaluate individual-level Prentice criteria, and pTau 181/217 results can be used to predict potential Phase 3 clinical outcomes.
HIGHLIGHTS: The group-level correlation between a biomarker treatment effect and clinical endpoint treatment effect is a measurement of the biomarker's ability to predict clinical outcome.The correlation of group level plasma pT217 or pT181 effect size at 6 months with clinical outcome Clinical Dementia Rating scale - Sum of Boxes (CDR-SB) effect size at 12 months was approximately 0.781 with p values of 0.013.Cohen's d effect size of plasma pTau as an outcome was 2.6 times greater than the Cohen's d of CDR-SB, leading to higher power or lower sample sizes.As a primary endpoint, plasma pTau meets or reasonably meets Prentice Criteria 1, 2, and 4, while Criterion 3 was deemed not applicable in the proof-of-concept study setting.}, }
@article {pmid41306402, year = {2025}, author = {Riberas-Sánchez, A and García-Brito, S and Vila-Solés, L and Aldavert-Vera, L and Segura-Torres, P and Huguet, G and Carreras-Badosa, G and Kádár, E}, title = {Intracranial self-stimulation mitigates spatial task deficits, modifies miR-146a and miR-495 serum levels and restores hippocampal NRF2 levels in a rat model of sporadic Alzheimer's disease.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1671196}, pmid = {41306402}, issn = {1663-4365}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is the most prevalent neurodegenerative disease associated with aging. While deep brain stimulation (DBS) shows therapeutic promise, the long-term persistence of its effects remains understudied. Expression patterns of circulating miRNAs, proposed diagnostic biomarkers, and their modulation by DBS are still poorly characterized in longitudinal studies. This study investigates the effect of a 13-week prolonged ICSS treatment on spatial memory and serum miRNA expression in a male rat model of sporadic AD (SAD) by intracerebroventricular injection of streptozotocin (STZ).
METHODS: Morris water maze (MWM) tasks were conducted at 1 and 5 months post-STZ. Serum miRNA levels were quantified by qRT-PCR at 29 (Ser0), 73 (Ser1) and 136 (Ser2) days after STZ administration. Corpus callosum thickness and NRF2 protein levels in the hippocampal CA1 region were assessed using Nissl staining and immunohistochemistry, respectively. Target validation of miR-495 was performed via transfection assays in the human neuroblastoma SH-SY5Y cell line.
RESULTS: MFB-ICSS treatment significantly reduced escape latency in the MWM task in the STZ + ICSS group compared to untreated STZ rats at 5 months post-STZ. At Ser0, levels of miR-16, miR-30c, miR-181, miR-191 and miR-196a were significantly increased in STZ group. In STZ rats, miR-146a and miR-495 levels increased from Ser1 to Ser2, an effect not observed in the Control or STZ + ICSS groups. In SH-SY5Y cells, miR-495 overexpression significantly downregulated both NRF2 mRNA and protein levels. Moreover, STZ exposure increased miR-495 and reduced NRF2 protein levels. MFB-ICSS also reversed the STZ-induced reductions in both CA1 NRF2 levels and corpus callosum thickness.
CONCLUSION: Prolonged MFB-ICSS treatment mitigates cognitive deficits, modulates circulating levels of miRNA-495 and miR-146a, restores hippocampal NRF2 levels, and preserves corpus callosum integrity in the SAD rat model by STZ injection. These findings highlight the therapeutic potential of MFB-ICSS as a non-pharmacological intervention in AD. Furthermore, this study confirms NRF2 as a target of miR-495 in the context of AD.}, }
@article {pmid41306115, year = {2025}, author = {Li, G and Cobb, B and Nelson, TM and Devanarayan, V and Borentain, S and Mielke, MM and Galvin, JE and Kivipelto, M and Tkatch, R and De Santi, S and Frech, F and Vandercappellen, J and Nakamura, Y and Crislip, R and Meyerhoff, J and Mattke, S and Hampel, H}, title = {Risk prediction of mild cognitive impairment using electronic health record data.}, journal = {Alzheimer's & dementia (Amsterdam, Netherlands)}, volume = {17}, number = {4}, pages = {e70209}, pmid = {41306115}, issn = {2352-8729}, abstract = {INTRODUCTION: Mild cognitive impairment (MCI) is underdiagnosed by primary care providers (PCPs), with detection rates as low as 6%-15%. Predictive models support the identification of individuals at risk, enabling timely intervention.
METHODS: This retrospective study was conducted on 271,054 cognitively unimpaired and 14,501 confirmed MCI cohorts from electronic health records. A machine learning model was developed with a data-driven variable selection approach based on demographics and comorbidities.
RESULTS: From 101 variables, 26 were chosen for the final model, achieving an overall area under the curve (AUC) of 86%. Age-stratified AUCs were 79.1% (40-49), 77.0% (50-64), 76.9% (65-79), and 74.4% (≥80), showing the highest predictive performance in younger age groups.
DISCUSSION: Demographic factors and comorbidities can serve as effective predictors for the risk of MCI. The model demonstrates strong predictive performance and assists as a triage tool for PCPs, facilitating the identification of individuals with MCI for early treatment.
HIGHLIGHTS: Predictive algorithms using electronic health records (EHRs) are useful for identifying individuals at risk for mild cognitive impairment (MCI) to triage for further clinical evaluation.A machine learning model was developed using EHR data to predict those at risk for MCI.The model identified 26 variables that were able to distinguish the MCI from non-MCI cohorts.The model accurately detected MCI across the cohort (area under the curve [AUC] = 86%) and trended best for younger age groups (AUC was 77%, 77%, and 74% in 50-64, 65-79, and ≥80 age groups, respectively).Implementation of a triage tool could be used to detect MCI across aging patient populations sooner, leading to a timelier diagnosis, intervention, and treatment management.}, }
@article {pmid41304967, year = {2025}, author = {Akantibila, M and Carabetta, VJ}, title = {Sirtuins as Therapeutic Targets for Treating Cancer, Metabolic Diseases, and Neurodegenerative Diseases.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {11}, pages = {}, pmid = {41304967}, issn = {1424-8247}, support = {R35GM138303/GM/NIGMS NIH HHS/United States ; }, abstract = {Sirtuins are NAD[+]-dependent enzymes that are conserved in all domains of life, including mammals, metazoans, plasmodia, yeast, bacteria, and archaea. In humans, there are seven isoforms (SIRT1 to 7), and they function in cellular homeostasis, aging, DNA repair, survival, metabolism, and stress responses. Recent advances highlight the diverse functions of sirtuins in the pathogenesis and progression of cancer, metabolic diseases, and neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD). To date, there is evidence that all seven isoforms contribute to cancer development, while SIRT1-3 and 6 contribute to metabolic and neurodegenerative diseases. Modulators of sirtuin activity are being actively explored to understand their biological and molecular mechanisms and potential for the treatment of various diseases. In this review, we begin with a broad discussion of post-translational modifications, protein deacetylation, and the mechanism of action of sirtuins. Next, we discuss the role of sirtuins in cancer, including inhibitors and activators of sirtuin activity as cancer therapies. In addition, we discuss the relationship of sirtuins to metabolic diseases and as possible treatment targets. Finally, we discuss the role of sirtuins in AD, PD, and HD, and sirtuin modulators for treating neurodegenerative diseases.}, }
@article {pmid41304930, year = {2025}, author = {Almaghrabi, M}, title = {Multitarget-Directed Ligands for Alzheimer's Disease: Recent Novel MTDLs and Mechanistic Insights.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {11}, pages = {}, pmid = {41304930}, issn = {1424-8247}, support = {447-13-1011//Taibah University/ ; }, abstract = {Alzheimer's disease (AD) is the most prevalent neurodegenerative disease, affecting millions of people and challenging the public health framework globally. While the definitive cause of AD remains unclear, researchers are concentrating their efforts on several prominent theories. Currently, there are very few FDA-approved medications for AD, and these primarily alleviate symptoms rather than alter the disease's progression. In response, research efforts focus on developing new medicines that address the complex nature of AD through multi-targeted approaches. Multitarget-directed ligands (MTDLs) are a promising treatment strategy for AD, despite the significant challenges they pose. This review examines recent advancements in designing prospective targeted MTDLs to combat AD, with a focus on categorizing the lead generation process and investigating the integration methods of key pharmacophores within the 2024-2025 timeframe. The review highlights numerous examples of novel MTDLs that address various AD hallmarks, demonstrating their broad therapeutic potential. These targets and activities include cholinesterase (AChE and/or BuChE) inhibition, monoamine oxidase (MAO-A and/or MAO-B) inhibition, antioxidant activity, amyloid-beta (Aβ) aggregation inhibition, tau protein aggregation inhibition, glycogen synthase kinase 3β (GSK-3β) inhibition, calcium channel blockade, anti-inflammatory activity, and other hallmarks.}, }
@article {pmid41304419, year = {2025}, author = {Ezzaki, C and Chaari, A and Al-Othman, A}, title = {Recent Advances on Chitosan-Based Nanoparticles for Brain Drug Delivery.}, journal = {Polymers}, volume = {17}, number = {22}, pages = {}, pmid = {41304419}, issn = {2073-4360}, abstract = {The blood-brain barrier (BBB) represents a major challenge in effective drug delivery systems intended for treating neurological disorders. It restricts the transport of therapeutic agents to the brain. Chitosan-based nanoparticles (CNPs) can be used for brain drug delivery because of their biocompatibility, biodegradability, and ability to enhance drug permeability across the BBB. This review article discusses the design and application of CNPs for brain-targeted drug delivery, exploring their mechanisms of action, including adsorptive-mediated and receptor-mediated endocytosis. Surface modifications with ligands such as chlorotoxin are discussed for improving specificity and therapeutic results. Findings show that CNPs allow controlled drug release, enhance stability, and reduce side effects, which make them effective for treating multiple neurological conditions, including Alzheimer's disease, Parkinson's disease, brain tumors, and ischemic stroke. CNPs can encapsulate multiple therapeutic agents, such as anti-inflammatory drugs, cytotoxic agents, and genetic materials, and maintain stability under different physiological conditions. Intranasal delivery routes are mainly discussed in this paper for their ability to bypass systemic circulation and achieve direct brain targeting. This review also addresses challenges such as cytotoxicity and the need for optimizing nanoparticle size, charge, and surface properties to improve the therapy results. While CNPs are suitable for brain drug delivery, there is a research gap, which is the lack of systematic studies evaluating their long-term effects on brain tissue and health. Most studies focus on acute therapeutic outcomes and in vitro or short-term in vivo analysis, which do not address some questions about the chronic exposure risks, biodistribution, and clearance pathways of CNPs. This review also explores the use of chitosan-based nanoparticles to deliver drugs to the brain for the treatment of multiple neurological disorders.}, }
@article {pmid41303831, year = {2025}, author = {Uehara, MA and Kalia, S and Garcia Campuzano, M and Moussavi, Z}, title = {ADAS-Cog Trajectories Differ from Expected Decline in Dementia Following Repeated Non-Invasive Interventions over 3 Years.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {11}, pages = {}, pmid = {41303831}, issn = {1648-9144}, support = {RGPIN-2023-04308//Natural Sciences and Engineering Research Council of Canada/ ; IT43832//Mitacs/ ; }, mesh = {Humans ; Male ; Female ; Aged ; *Dementia/therapy/psychology ; Aged, 80 and over ; Transcranial Magnetic Stimulation/methods ; *Cognitive Dysfunction/therapy ; Disease Progression ; Alzheimer Disease/therapy/psychology ; Longitudinal Studies ; Neuropsychological Tests ; Middle Aged ; Mental Status and Dementia Tests ; }, abstract = {Background and Objectives: Non-pharmaceutical interventions such as cognitive training, transcranial electrical stimulation (tES), and repetitive transcranial magnetic stimulation (rTMS) have shown promise in improving cognitive outcomes in Alzheimer's disease (AD) and dementia. However, the long-term effects of repeated non-invasive interventions remain unknown. This study investigated whether repeated non-invasive interventions administered over a span of 1 to 3 years were associated with slower cognitive decline compared to typical AD progression, and whether longer no-treatment intervals between treatments predicted greater post-treatment decline. Materials and Methods: Seventy-three participants living with dementia or AD received 2 to 9 blocks of non-invasive treatments (including tES, rTMS, cognitive training). Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores were collected longitudinally up to 3 years (36 months), across multiple intervention and assessment sessions. A mixed-effects model was used to estimate the rate of cognitive decline, adjusting for baseline age, sex, and baseline cognition (MoCA) with participants being the random effect. The observed rate of change was compared to a meta-analysis estimate of AD progression. Additionally, a linear mixed-effects model using robust sandwich estimation of standard errors was employed to assess whether the no-treatment interval was associated with changes in ADAS-Cog scores. Results: Participants showed a significantly slower rate of cognitive decline than expected from the AD reference rate (p < 0.001), with many demonstrating stabilized ADAS-Cog scores during their respective treatment periods, ranging from 1 to 3 years. Medication analyses revealed no significant effect of AD medications, antidepressants, antihypertensives, or cholesterol-lowering agents on cognitive outcomes. Furthermore, longer no-treatment intervals were significantly associated with greater post-treatment decline (p < 0.001). Conclusions: Repeated non-invasive treatments seem to slow the rate of cognitive decline in individuals living with dementia when administered over a prolonged period. This study provides evidence supporting the feasibility and effects of personalized long-term non-invasive treatment strategies for dementia.}, }
@article {pmid41303478, year = {2025}, author = {Polishchuk, H and Guzik, K and Kantyka, T}, title = {Beyond Hunger: The Structure, Signaling, and Systemic Roles of Ghrelin.}, journal = {International journal of molecular sciences}, volume = {26}, number = {22}, pages = {}, pmid = {41303478}, issn = {1422-0067}, support = {UMO-2016/22/E/NZ5/00332//National Science Centre/ ; }, mesh = {*Ghrelin/metabolism/chemistry ; Humans ; *Signal Transduction ; Animals ; *Receptors, Ghrelin/metabolism/chemistry ; *Hunger/physiology ; }, abstract = {Our understanding of Ghrelin, an endogenous ligand of the growth hormone secretagogue receptor 1a (GHSR1a), has expanded from considering it to be a "hunger hormone" to a pleiotropic regulator of whole-body physiology. This review synthesizes the current advances spanning ghrelin biogenesis, signaling, and systems biology. Physiologically, preproghrelin processing and O-acylation by ghrelin O-acyltransferase (GOAT) generate acyl-ghrelin, a high-potency GHSR1a agonist; des-acyl ghrelin predominates in circulation and exerts context-dependent, GHSR1a-independent, or low-potency effects, while truncated "mini-ghrelins" can act as competitive antagonists. The emergence of synthetic ligands, agonists, antagonists, and reverse-agonists has provided the necessary tools to decipher GHSR1a activity. Recent cryo-EM structures of GHSR1a with peptide and small-molecule ligands reveal a bipartite binding pocket and provide a framework for biased signaling, constitutive activity, and receptor partner selectivity. Beyond the regulation of feeding and growth-hormone release, ghrelin modulates glucose homeostasis, gastric secretion and motility, cardiovascular tone, bone remodeling, renal hemodynamics, and innate immunity. Ghrelin broadly dampens pro-inflammatory responses and promotes reparative macrophage phenotypes. In the emerging scholarship on ghrelin's activity in the central nervous system, ghrelin has been found to influence neuroprotection, stress reactivity, and sleep architecture, and has also been implicated in depression, Alzheimer's disease, and substance-abuse disorders. Practical and transitional aspects are also highlighted in the literature: approaches for ghrelin stabilization; recent GHSR1a agonists/antagonists and inverse agonists findings; LEAP-2-based strategies; and emerging GOAT inhibitors. Together, structural insights and pathway selectivity position the ghrelin system as a druggable axis for the management of inflammatory diseases, neuropsychiatric and addiction conditions, and for obesity treatment in the post-GLP-1 receptor agonist era.}, }
@article {pmid41303365, year = {2025}, author = {Faa, G and Meloni, C and Lastretti, M and Pinna, M and Manchia, M and Paribello, P}, title = {Perturbations of Zinc Homeostasis and Onset of Neuropsychiatric Disorders.}, journal = {International journal of molecular sciences}, volume = {26}, number = {22}, pages = {}, pmid = {41303365}, issn = {1422-0067}, mesh = {Humans ; *Zinc/metabolism ; *Homeostasis ; *Mental Disorders/metabolism/etiology ; Attention Deficit Disorder with Hyperactivity/metabolism ; Animals ; Schizophrenia/metabolism ; Depressive Disorder, Major/metabolism ; Alzheimer Disease/metabolism ; Autism Spectrum Disorder/metabolism ; Parkinson Disease/metabolism ; Bipolar Disorder/metabolism ; }, abstract = {Zinc (Zn[2+]) is a trace element essential for its catalytic, antioxidant, and immunomodulatory roles extending to synaptic signalling in the central nervous system. In this narrative review, we aim to offer the reader evidence linking perturbations of the Zn[2+] homeostasis, including deficiency, excess, or transportation anomalies, to neuropsychiatric conditions such as Alzheimer's disease (AD), Parkinson's disease (PD), autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). A targeted, unsystematic PubMed search followed by an extensive pearl-growing strategy was applied to further augment study selection based on the extensive expertise of study authors. Overall, most of the evidence currently available suggests a modest benefit for a Zn[2+] supplement of around 25-30 mg/day as an augmentation to MDD treatment, with potential benefits of smaller magnitude in paediatric ADHD. Evidence for perturbations of Zn[2+] as a biomarker of risk for these neuropsychiatric disorders remains unconvincing. The role of Zn[2+] supplements in the treatment of the selected conditions remains largely unknown due to the lack of specific, randomised controlled trials conducted to explore their efficacy. The long-term safety, optimal doses for specific applications, and the exploration of possible biomarkers to stratify patient selection to identify the optimal candidate for Zn[2+] supplements remain unanswered questions.}, }
@article {pmid41303334, year = {2025}, author = {Pecoraro, M and Serra, A and Lamberti, MJ and Pascale, M and Franceschelli, S}, title = {New Role of Protein Misfolding Corrector in the ER Stress-Inflammation Axis: Possible Therapeutic Indication in Neuronal and Epithelial Tumor Cells.}, journal = {International journal of molecular sciences}, volume = {26}, number = {22}, pages = {}, pmid = {41303334}, issn = {1422-0067}, support = {ORSA231580//University of Salerno/ ; }, mesh = {Humans ; *Endoplasmic Reticulum Stress/drug effects ; *Inflammation/metabolism/drug therapy ; *Neurons/metabolism/drug effects/pathology ; Protein Folding/drug effects ; Calcium/metabolism ; Cell Line, Tumor ; Thapsigargin/pharmacology ; A549 Cells ; Epithelial Cells/metabolism/drug effects ; Proteostasis Deficiencies/drug therapy/metabolism ; }, abstract = {Protein misfolding diseases are characterized by structurally abnormal proteins that lose their functionality, resulting in cellular and tissue dysfunction. Neurodegenerative diseases, including Parkinson's disease, Alzheimer's disease and Huntington's disease, share a common etiopathogenesis characterize by the accumulation of misfolded proteins. These proteins autonomously aggregate within neuronal cells, triggering inflammation and cell death. The accumulation of misfolded proteins triggers endoplasmic reticulum (ER) stress, leading to alter Ca[2+] homeostasis. This prolonged stress condition induces the cleavage of procaspase 4 which is resident in ER and activates NF-kB pathway activation, leading to inflammatory responses and cell death. In this study, the efficacy of the drug Vx-445 (Elexacaftor), used in the pharmacological treatment of cystic fibrosis, was assessed in human adenocarcinomic basal alveolar epithelial (A549) and neuronal (SH-SY5Y) cell lines, where ER stress was induced by Thapsigargin. The aim was to assess whether the corrector was able to reduce ER stress by restoring cellular homeostasis and, probably, the proper folding of misfolded proteins and reducing the inflammatory response triggered by these events. Therefore, protein levels of IkBα, p-STAT 3 and COXII were analyzed by flow cytofluorimetry, while Ca[2+] content was measured by spectrofluorimetry. The results obtained suggest a significant effect of Vx-445 in restoring cellular homeostasis, leading to reduced expression of inflammation-related proteins, such as IL-6, tested by ELISA. Although preliminary, these results encourage further studies to explore the potential repurpose of Vx-445 as a therapeutic candidate for conditions involving ER stress and chronic inflammatory diseases associated with protein misfolding, beyond its current use in cystic fibrosis.}, }
@article {pmid41301832, year = {2025}, author = {Christodoulou, RC and Papageorgiou, PS and Sarquis, MD and Rivera, L and Morales Gonzalez, C and Eller, D and Rivera, G and Petrou, V and Vamvouras, G and Vassiliou, E and Papageorgiou, SG and Georgiou, MF}, title = {From Lesion to Decision: AI for ARIA Detection and Predictive Imaging in Alzheimer's Disease.}, journal = {Biomedicines}, volume = {13}, number = {11}, pages = {}, pmid = {41301832}, issn = {2227-9059}, abstract = {Background: Alzheimer's disease (AD) remains the leading cause of dementia worldwide, with anti-amyloid monoclonal antibodies (MABs) marking a significant advance as the first disease-modifying therapies. Their use, however, is limited by amyloid-related imaging abnormalities (ARIA), which appear as vasogenic edema or effusion (ARIA-E) and hemosiderin-related changes (ARIA-H) on MRI. Variability in imaging protocols, subtle early findings, and the lack of standardized risk models challenge detection and management. Methods: This narrative review summarizes current artificial intelligence (AI) applications for ARIA detection and risk prediction. A comprehensive literature search across PubMed, Embase, and Scopus identified studies focusing on MRI-based AI analysis, lesion quantification, and predictive modeling. Results: The evidence is organized into six thematic domains: ARIA definitions, imaging challenges, foundations of AI in neuroimaging, detection tools, predictive frameworks, and future perspectives. Conclusions: AI offers promising avenues to standardize ARIA evaluation, improve lesion quantification, and enable individualized risk prediction. Progress will depend on multicenter datasets, shared frameworks, and prospective validation. Ultimately, AI-driven neuroimaging may transform how treatment-related complications are monitored in the era of anti-amyloid therapy.}, }
@article {pmid41301782, year = {2025}, author = {Christodoulou, RC and Vamvouras, G and Papageorgiou, PS and Sarquis, MD and Petrou, V and Rivera, L and Morales, C and Rivera, G and Papageorgiou, SG and Vassiliou, E}, title = {Interpretable Machine Learning for Risk Stratification of Hippocampal Atrophy in Alzheimer's Disease Using CSF Erythrocyte Load and Clinical Data.}, journal = {Biomedicines}, volume = {13}, number = {11}, pages = {}, pmid = {41301782}, issn = {2227-9059}, abstract = {Background/Objectives: Hippocampal atrophy indicates Alzheimer's disease (AD) progression and guides follow-up and trial enrichment. Identifying high-risk patients is crucial for optimizing care, but accessible, interpretable machine-learning models (ML) are limited. We developed an explainable ML model using clinical data and CSF erythrocyte load (CTRED) to classify adults with AD as high- or low-risk based on hippocampal volume decline. Methods: Included ADNI participants with ≥2 MRIs, baseline lumbar puncture, and vital signs within 6 months of MRI (n = 26). The outcome was the Annual Percentage Change (APC) in hippocampal volume, classified as low or high risk. Predictors were standardized; models included SVM, logistic regression, and Ridge Classifier, tuned and tested on a set (n = 6). Thresholds were based on out-of-fold predictions under a 10-90% positive rate. Explainability used PFI and SHAP for per-patient contributions. Results: All models gave identical classifications, but discrimination varied: Ridge AUC = 1.00, logistic = 0.889, and SVM = 0.667. PFI highlighted MAPres and sex as main signals; CTRED contributed, and age had a minor impact. Conclusions: The explainable ML model with clinical data and CTRED can stratify AD patients by hippocampal atrophy risk, aiding follow-up and vascular assessment planning rather than treatment decisions. Validation in larger cohorts is needed. This is the first ML study to use CSF erythrocyte load to predict hippocampal atrophy risk in AD.}, }
@article {pmid41301520, year = {2025}, author = {Lope-Piedrafita, S and Serra-Mir, G and Melón, P and Bonaterra, A and Hernández-Guillamon, M and Villegas, S}, title = {ScFv-h3D6 Prevents Bapineuzumab-Induced Hemorrhagic Events in the APP23 Mouse Model of Alzheimer's Disease.}, journal = {Biomolecules}, volume = {15}, number = {11}, pages = {}, pmid = {41301520}, issn = {2218-273X}, support = {SAF2017-89613R//Ministerio de Economía y Empresa, Spain/ ; PI17-00275//Instituto de Salud Carlos III/ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism/genetics/diagnostic imaging ; *Single-Chain Antibodies/pharmacology ; Mice ; Disease Models, Animal ; Mice, Transgenic ; *Antibodies, Monoclonal, Humanized/adverse effects ; Humans ; Amyloid beta-Peptides/metabolism ; Cerebral Amyloid Angiopathy/drug therapy ; Magnetic Resonance Imaging ; Amyloid beta-Protein Precursor/genetics ; }, abstract = {The occurrence of amyloid-related imaging abnormalities (ARIAs), found in clinical trials for Aβ-immunotherapy, has been related to the antibody's effector function on glial activation by the Fc portion of the antibody. The use of single-chain variable fragments (scFv) has been proposed as a safer therapeutic strategy. Here, the effects of the mice format of bapineuzumap (mAb-m3D6) and its scFv (scFv-h3D6) on the occurrence of ARIAs in the APP23 mouse model of Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA) have been addressed by magnetic resonance imaging (MRI). Results are supported by histological and/or biochemical determinations. Aged APP23 mice showed a significantly higher number of microhemorrhages than non-transgenic mice. mAb-m3D6 produced an increase in the number of new hemorrhagic events, mainly in the cortex, whereas scFv-h3D6 did not. Both mAb-m3D6 and scFv-h3D6 reduced Aβ levels by the same extent. Axonal/myelin damage was found in the frontal corpus callosum of APP23 mice, which did not recover after treatment. In conclusion, the scFv-h3D6 format appears safer than the full-length mAb in the APP23 model of AD and CAA. This finding is highly relevant in light of the new FDA- and EMA-approved mAbs, which exclude APOEε4 allele carriers due to the occurrence of hemorrhages.}, }
@article {pmid41301403, year = {2025}, author = {Zhang, S and Liu, X and Xu, S and Li, W and Song, J and Tian, Q and Du, Y}, title = {Multi-Omics Integration Reveals Electroacupuncture Ameliorates Cognitive Impairment in Alzheimer's Disease via Gut-Brain Axis.}, journal = {Biomolecules}, volume = {15}, number = {11}, pages = {}, pmid = {41301403}, issn = {2218-273X}, support = {82374564//National Natural Science Foundation of China/ ; 81873380//National Natural Science Foundation of China/ ; 82074566//National Natural Science Foundation of China/ ; 2025AFD596//Hubei Provincial Joint Fund Project/ ; }, mesh = {Animals ; *Electroacupuncture/methods ; *Alzheimer Disease/therapy/metabolism/microbiology ; Mice ; *Gastrointestinal Microbiome ; *Cognitive Dysfunction/therapy/metabolism ; Male ; *Brain/metabolism ; Disease Models, Animal ; Metabolomics ; RNA, Ribosomal, 16S/genetics ; Metabolome ; *Brain-Gut Axis ; Multiomics ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) lacks effective therapeutic strategies. Electroacupuncture (EA) offers promising neuroprotective effects, but its underlying mechanisms remain unclear.
OBJECTIVE: To explore the mechanisms of EA's neuroprotective effects on AD via microbiome and metabolome integration.
METHODS: Utilizing a well-established model of AD, Senescence-Accelerated Mouse Prone 8 (SAMP8), EA intervention was performed. 16S ribosomal RNA (rRNA) sequencing and serum metabolomics were conducted on SAMP8 mice, SAMP8 mice after EA intervention, and their normal control group Senescence-Accelerated Mouse Resistant 1 (SAMR1) mice.
RESULTS: SAMP8 mice were subjected to electroacupuncture (EA) treatment at the Baihui (GV20) and Shenshu (BL23) acupoints for 15 min daily over a period of four weeks. EA enhanced cognitive function and reduced neuronal damage in AD models. The treatment lowered pro-inflammatory cytokines (TNF-α, IL-1β) and AD-related pathologies (tau, Aβ1-42). EA also rebalanced gut microbiota by increasing beneficial Gastranaerophilales while decreasing harmful Proteobacteria. Additionally, it restored purine and phenylpropanoid metabolism by regulating key metabolites. Importantly, EA reduced levels of specific metabolites linked to pro-inflammatory bacteria (Sphingomonas, Massilia, Escherichia-Shigella), simultaneously decreasing their abundance. These findings highlight EA's multi-target effects on neuroinflammation, gut microbiota, and metabolic pathways in AD. Notably, the interactions between EA-regulated key metabolites and AD-related targets, predicted via PubChem and ChEMBL databases, remain computational and have not been validated by experimental studies.
CONCLUSIONS: EA exerts neuroprotective effects in AD via modulation of gut microbiota and metabolic pathways, representing a novel non-pharmacological therapeutic strategy.}, }
@article {pmid41301354, year = {2025}, author = {Gao, J and Liu, L and Yang, Z and Fan, J and For The Alzheimer's Disease Neuroimaging Initiative, }, title = {Predictors of Transition from Mild Cognitive Impairment to Normal Cognition and Dementia.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {11}, pages = {}, pmid = {41301354}, issn = {2076-328X}, support = {2024-BS-160//Natural Science Foundation of Liaoning Province/ ; LJ212410165004//Education Department Project of Liaoning Province/ ; 2024BSL004//Ph.D. Start-up Project of Liaoning Normal University/ ; }, abstract = {Mild cognitive impairment (MCI) represents a heterogeneous state between normal aging and dementia, with varied transition pathways. While factors influencing MCI progression are known, their role in cognitive reversal is unclear. This study analyzed 756 Alzheimer's Disease Neuroimaging Initiative (ADNI) participants, classified as progressive MCI (pMCI, N = 272, mean age = 75.10 ± 7.34 years), reversible MCI (rMCI, N = 52, mean age = 69.94 ± 7.98 years) and stable MCI (sMCI, N = 432, mean age = 73.34 ± 7.44 years) based on 36-month follow-up. We compared demographic, lifestyle, clinical, cognitive, neuroimaging, and biomarker data across groups and developed a prediction model. Patients in the rMCI group were significantly younger and had a higher level of education compared with those in the pMCI group. Memory, general cognition, daily functional activities, and hippocampal volume effectively distinguished all three groups. In contrast, Aβ, tau, and other brain regions were able to distinguish only between progressive and non-progressive cases. Informant-reported Everyday Cognition (Ecog) scales outperformed self-reported Ecog scales in differentiating subtypes and predicting progression. Multinomial regression revealed that higher education, larger hippocampal volume, and lower daily functional impairment were associated with reversion, whereas APOE ε4, poorer memory, and greater brain atrophy predicted progression (model accuracy: 78%). The results confirm the significant utility of hippocampal volume, education level, and daily functional activities for assessing baseline disparities and predicting reversion. This study highlights the differential contributions of cognitive abilities and brain regions on MCI reversal, advancing understanding of MCI heterogeneity and providing evidence for precise diagnosis and treatment in early MCI.}, }
@article {pmid41300531, year = {2025}, author = {Valle, ML and Getaneh, B and William, C and Ghiso, J and Rostagno, A}, title = {Antioxidants Trolox and Methazolamide Protect Microvascular Endothelial Cells from Oxidative Damage Induced by Sporadic and Familial Forms of Oligomeric Amyloid-β.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {11}, pages = {}, pmid = {41300531}, issn = {2076-3921}, support = {AG065651//National Institute of Health/ ; }, abstract = {Cerebral amyloid angiopathy (CAA), present in more than 90% of Alzheimer's disease (AD) cases, associates with focal ischemia and neurovascular dysfunction. Genetic variants at positions 21-23 of amyloid beta (Aβ), among them the Dutch mutation (AβE22Q), are primarily linked to CAA and the development of cerebral hemorrhages. An important contributor to CAA pathogenesis is the dysregulation of mitochondria-mediated pathways with concomitant induction of oxidative stress. Using biochemical assays and immunofluorescence microscopy, this work demonstrates the exacerbated formation of reactive oxygen species (ROS) in human brain microvascular endothelial cells after short exposure to soluble oligomers of synthetic homologues of Aβ1-42 and the Dutch variant, inducing lipid peroxidation and protein carbonylation, both markers of oxidative stress. The heterogeneity of the soluble oligomeric assemblies inducing this oxidative response was highlighted by their reactivity with two conformational antibodies recognizing specific and mutually exclusive epitopes associated with either soluble prefibrillar oligomers or soluble fibrillar oligomers. Treatment with the multitarget antioxidants Trolox and methazolamide significantly attenuated the Aβ-mediated ROS production and reduced oxidative stress markers to basal levels. Our data highlight the damaging role of heterogeneous Aβ oligomers and the preventing effect of antioxidants, suggesting ROS modulation as a complementary therapeutic strategy to preserve neurovascular unit integrity.}, }
@article {pmid41300478, year = {2025}, author = {Fu, Y and Zhang, X and Li, L and Jiang, H and Ren, Q and Yi, T and Zhang, Y and Lu, Y}, title = {PPARα-Mediated Fatty Acid Catabolism in Astrocytes Was Involved in Improvement of Cognitive Dysfunction by Phlorizin in APP/PS1 Mice.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {11}, pages = {}, pmid = {41300478}, issn = {2076-3921}, support = {7252230//Yi Lu/ ; }, abstract = {Central lipid metabolism disorders are crucial for the development of Alzheimer's disease (AD). Phlorizin (PHZ) improved lipid metabolism abnormalities in AD nematodes, but its mechanism of action in improving AD-related symptoms and whether it can alleviate AD cognitive impairment remain unclear. To elucidate the effects and mechanisms of PHZ on lipid metabolism disorders in an AD model, gavage administration of PHZ for 8 weeks improved cognitive dysfunction and lipid disorders in APPswe/PSEN1dE9 (APP/PS1) mice. Concurrently, in astrocytes induced by palmitic acid (PA)- mediated lipid metabolic disorder, PHZ treatment improved astrocytic lipid accumulation by upregulating the target peroxisome proliferator-activated receptor α (PPARα) and its downstream pathways, thereby promoting astrocytic fatty acid oxidation. We validated PHZ's strong in vitro binding affinity with PPARα. Co-culture systems of lipid-metabolically disordered astrocytes and neurons further demonstrated that PHZ significantly improved neuronal cell viability and reduced intracellular lipid accumulation, thereby decreasing the expression of enzymes associated with β-amyloid protein (Aβ) production. This study demonstrates that gavage administration of PHZ for 2 months improves cognitive deficits and pathological markers in AD mice. Furthermore, at the cellular level, PHZ may exert its effects by enhancing astrocytic lipid metabolism, thereby preventing neuronal lipotoxicity and mitigating AD progression.}, }
@article {pmid41300346, year = {2025}, author = {Yeasmin, A and Torrente, MP}, title = {Histone Post-Translational Modifications and DNA Double-Strand Break Repair in Neurodegenerative Diseases: An Epigenetic Perspective.}, journal = {Biology}, volume = {14}, number = {11}, pages = {}, pmid = {41300346}, issn = {2079-7737}, support = {1R15NS125394-01/NH/NIH HHS/United States ; }, abstract = {DNA damage is a hallmark of the fatal process of neurodegeneration in the central nervous system (CNS). As neurons are terminally differentiated, they accumulate metabolic and oxidative burdens over their whole life span. Unrepaired DNA develops into DNA double-strand breaks (DSBs), which are repaired through homologous recombination (HR) or non-homologous end joining (NHEJ). Being post-mitotic and unable to normally undergo HR, damage and defective repair is especially burdensome to CNS neurons. Current research has not produced treatment to prevent and halt progression of neurodegeneration. Hence, novel targeting strategies are desperately needed. Recent investigations in histone post-translational modifications (PTMs) reveal new mechanistic insight and highlight unexplored targets to ameliorate neurodegeneration. As various histone PTMs dictate and facilitate DSB repair, they represent an underexploited area in investigating DNA damage and incorrect repair aiding neurodegeneration. Here, we review the histone PTM alterations in several neurodegenerative diseases: Amyotrophic Lateral Sclerosis/Frontotemporal Dementia, Parkinson's Disease, Alzheimer's Diseases, Multiple Sclerosis, and Huntington's Disease. These findings emphasize that histone PTM alterations can enable an aberrant DNA damage response (DDR) leading to neurodegeneration. Further research into the connections between histone PTMs and DNA damage in decaying neurons will illuminate novel targets to dampen the aberrant DDR and promote neuronal survival.}, }
@article {pmid41300191, year = {2025}, author = {Kishimoto, Y and Kubota, T and Nakashima, K and Kirino, Y}, title = {rTg4510 Tauopathy Mice Exhibit Non-Spatial Memory Deficits Prevented by Doxycycline Treatment.}, journal = {Brain sciences}, volume = {15}, number = {11}, pages = {}, pmid = {41300191}, issn = {2076-3425}, support = {20790084//Japan Society for the Promotion of Science/ ; 24590133//Japan Society for the Promotion of Science/ ; 16K08215//Japan Society for the Promotion of Science/ ; }, abstract = {Background: Hyperphosphorylated tau accumulation and neurofibrillary tangles (NFTs) are hallmarks of tauopathies, including Alzheimer's disease (AD), and are strongly associated with cognitive decline. The rTg4510 mouse model, which expresses mutant human tau (P301L), develops progressive tauopathy in the absence of amyloid-β pathology, providing a valuable tool for investigating tau-driven neurodegeneration. Previous studies have demonstrated spatial and object-recognition memory deficits at six months of age, which can be prevented by doxycycline (DOX)-mediated suppression of tau expression. However, it remained unclear whether non-spatial hippocampal learning, particularly temporal associative learning, would be similarly affected. Methods: We evaluated six-month-old rTg4510 mice with or without DOX treatment. To control for potential motor confounds, we first assessed spontaneous home cage activity. We then tested hippocampus-dependent non-spatial learning using two paradigms: trace eyeblink conditioning (500-ms trace interval) and contextual fear conditioning. Results: General motor function remained intact; however, rTg4510 mice without DOX treatment exhibited increased rearing behavior. These mice demonstrated significant deficits in trace eyeblink conditioning acquisition, with particularly clear impairment on the final day of training. Contextual fear conditioning showed milder deficits. Analysis of response peak latency revealed subtle temporal processing abnormalities during early learning. Two months of DOX treatment initiated at four months of age prevented these learning deficits, confirming their association with tau overexpression. Conclusions: Our findings demonstrate that rTg4510 mice exhibit deficits in non-spatial temporal associative learning alongside previously reported spatial and object-recognition impairments. Trace eyeblink conditioning serves as a sensitive behavioral assay for detecting tau-related hippocampal dysfunction, and the prevention of learning deficits by DOX treatment highlights its potential utility as a translational biomarker for evaluating tau-targeted interventions.}, }
@article {pmid41300171, year = {2025}, author = {Costa, ACS and Brandão, AC and Leiva, V and Taylor, HG and Johnson, MW and Salmona, P and Abreu-Silveira, G and Scheidemantel, T and Roizen, NJ and Ruedrich, S and Boada, R}, title = {Baseline Neuropsychological Characteristics of Adolescents and Young Adults with Down Syndrome Who Participated in Two Clinical Trials of the Drug Memantine.}, journal = {Brain sciences}, volume = {15}, number = {11}, pages = {}, pmid = {41300171}, issn = {2076-3425}, support = {R03AG086928/AG/NIA NIH HHS/United States ; 100.10500.100.0001C//University Hospitals Cleveland's Center for Neurodegenerative Disorders/ ; 3U24AG057437//University Hospitals Cleveland's Center/ ; }, abstract = {BACKGROUND/OBJECTIVES: Down syndrome (DS) is a neurodevelopmental and neurodegenerative disorder typically caused by trisomy 21. We recently concluded a two-site (Ohio, USA and São Paulo, Brazil), phase-2, randomized trial to evaluate the efficacy, tolerability, and safety of the drug memantine in enhancing cognitive abilities of adolescents and young adults with DS. This trial was a follow-up study to a pilot trial performed in Colorado, USA. Results of these two clinical trials have been published elsewhere. Here, we present a comparative analysis of the baseline neuropsychological assessments at the three sites of these two studies, including their psychometric properties, and an account of the considerations involved in the test battery design. We compared test results in the different sites as a way of evaluating the replicability and generalizability of the test results. The distribution of the test results at each site was analyzed and combined when no differences were detected between the mean values of these results. We used post-treatment data from the placebo arms of these studies to quantify test-retest reliability.
RESULTS: Most measures had comparable mean values across test sites, and had good-to-excellent feasibility, few floor effects, and good-to-excellent test-retest reliability. A few measures, however, were deemed unsuitable for use in future studies.
CONCLUSIONS: This study demonstrated remarkable consistency of results across studies in two countries with significantly different cultures and levels of socioeconomic development, which provides supporting evidence for the future design and implementation of similar multicenter, international clinical studies involving participants with DS.}, }
@article {pmid41299730, year = {2025}, author = {Seong, WJ and An, SJ and Gim, J and Gupta, DP and Park, J and Kang, S and Lee, KH and Song, GJ}, title = {Adenylate kinase 5, a novel genetic risk factor for Alzheimer's disease, regulates microglial inflammatory activation.}, journal = {Molecular brain}, volume = {18}, number = {1}, pages = {89}, pmid = {41299730}, issn = {1756-6606}, support = {NRF-2022R1A4A1018963//National Research Foundation of Korea/ ; HU23C0199//Korea Dementia Research Center/ ; }, mesh = {*Alzheimer Disease/genetics/enzymology/pathology ; *Microglia/pathology/enzymology/metabolism/drug effects ; Animals ; Humans ; *Adenylate Kinase/genetics/metabolism ; Polymorphism, Single Nucleotide/genetics ; *Inflammation/pathology/genetics/enzymology ; *Genetic Predisposition to Disease ; Risk Factors ; Mice, Inbred C57BL ; Male ; Lipopolysaccharides ; Mice ; Female ; Genome-Wide Association Study ; Phagocytosis/drug effects ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by memory loss, cognitive decline, and neuroinflammation, primarily mediated by microglia. In this study, we investigate the role of adenylate kinase 5 (AK5) in microglial function and its association with AD-related pathology. Analysis of brain tissues from AD patients and AD model mice revealed a significant reduction in AK5 expression. In vitro knockdown of AK5 in microglial cells attenuated lipopolysaccharide-induced pro-inflammatory responses, including decreased nitric oxide and tumor necrosis factor-alpha production, while enhancing phagocytic activity. Moreover, AK5 silencing induced metabolic reprogramming, evidenced by reduced lipid droplet accumulation and adipose triglyceride lipase mRNA levels, alongside increased farnesoid X receptor mRNA expression. Genome-wide association studies further identified two AK5 single nucleotide polymorphisms (SNPs), rs59556669 and rs75224576, significantly associated with hippocampal and amygdala atrophy as well as increased AD risk. Notably, these SNPs were not in linkage disequilibrium with the apolipoprotein E (APOE) locus, suggesting that AK5 may represent an independent genetic risk factor for AD. Collectively, our findings identify AK5 as a key regulator of microglial immune and metabolic function. The presence of AK5 variants may contribute to AD susceptibility, and AK5 expression or genetic status could serve as a potential biomarker for early risk assessment. Further exploration of AK5-targeted interventions may provide new therapeutic avenues for AD prevention or treatment.}, }
@article {pmid41299186, year = {2025}, author = {Targett, IL and Pring, K and Valiente, AIM and Qualtrough, D and Conway, ME and Crompton, LA and Craig, TJ}, title = {Chronic Fatty Acid Exposure Disrupts SH-SY5Y and Neuronal Differentiation and Is a Potential Link Between Type-2 Diabetes and Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {183}, pmid = {41299186}, issn = {1559-1182}, mesh = {Humans ; *Alzheimer Disease/pathology/metabolism/complications ; *Diabetes Mellitus, Type 2/pathology/metabolism ; *Neurons/drug effects/pathology/metabolism ; *Cell Differentiation/drug effects ; Cell Line, Tumor ; *Fatty Acids/toxicity/pharmacology ; Glycogen Synthase Kinase 3 beta/metabolism ; Neurogenesis/drug effects ; Insulin/metabolism ; Signal Transduction/drug effects ; Phosphorylation/drug effects ; }, abstract = {Alzheimer's disease (AD) is the most common cause of dementia, for which there is no curative treatment and few disease-modifying therapies. The vast majority of AD is late onset (LOAD) without a specific genetic cause, although many genetic and non-genetic risk factors have been identified. One of the most significant modifiable risk factors is diet/lifestyle, with type-2 diabetes mellitus (T2DM) increasing LOAD risk by over 50%. Despite the epidemiological data, the reasons for this link are not understood. Here, we investigated whether altered free fatty acid (FFA) levels seen in T2DM can adversely affect neuronal differentiation, a crucial stage in adult hippocampal neurogenesis (AHN), which is defective in LOAD. We show that chronic exposure of the neuroblastoma cell line, SH-SY5Y to T2DM-relevant levels of the FFAs, oleate and palmitate, profoundly affects the differentiation of these cells. This effect is particularly pronounced for the saturated FFA, palmitate, resulting in neuronal cells of altered morphology, lacking expression of key synaptic markers. We further demonstrate that this exposure dysregulates insulin signalling, GSK3β activity, CDK5 levels and CREB phosphorylation. Crucially, these effects were only observed on exposure during differentiation and can be partially replicated in hiPSC-derived forebrain neurones. Although APP expression is increased by palmitate exposure, there was no increase in secreted or intracellular Aβ, and tau phosphorylation was reduced, implying that these defects are separate from the classical hallmarks of AD. We conclude that long-term, chronic exposure of differentiating neurones induces pathological changes that may explain the link between T2DM and LOAD.}, }
@article {pmid41299145, year = {2025}, author = {Hosseini, E and Sahraian, MA and Negah, SS}, title = {Unlocking the Therapeutic Potential of RGMa: A New Frontier in Neurological Disorder Treatment.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {186}, pmid = {41299145}, issn = {1559-1182}, mesh = {Humans ; Animals ; *Nervous System Diseases/metabolism/drug therapy/therapy ; *Nerve Tissue Proteins/metabolism ; GPI-Linked Proteins/metabolism ; }, abstract = {Finding new biomolecules to target upstream signaling in neurological disorders is a state-of-the-art research strategy. Axon guidance molecules (AGMs) play vital roles in development; however, evidence suggests that these molecules are involved in the pathogenesis of several neurological diseases. Recent studies have shown that repulsive guidance molecule A (RGMa), a member of AGMs, can be targeted as a novel therapeutic option. This molecule has been implicated in several diseases, and inhibiting it improves the outcomes. For example, in various pathological conditions such as multiple sclerosis, neuromyelitis optica, optic nerve crush model, focal cerebral ischemia, traumatic brain injury, and vascular dementia the expression of RGMa is significantly elevated. RGMa has been detected on amyloid plaques and in the glial scar in brains impacted by Alzheimer's disease. Furthermore, RGMa is elevated by activated astrocytes after exposure to TGFβ. Since the role of RGMa in the development of neurological disorders is crucial, inhibiting RGMa can lead to positive outcomes such as axonal regeneration, neuronal repair, and behavioral improvement. Our review explores the impact of RGMa and outlines the positive results achieved by targeting it in preclinical studies. Based on this information, it is clear that RGMa has significant potential as both a predictive biomarker and a therapeutic option.}, }
@article {pmid41298976, year = {2025}, author = {Alqahtani, SM and Al-Kuraishy, HM and Al-Gareeb, AI and Albuhadily, AK and Shokr, MM and Alexiou, A and Papadakis, M and Batiha, GE}, title = {Pharmacological modulation of the PI3K/AKT/GSK3β axis: a new frontier in Alzheimer's disease treatment.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41298976}, issn = {1568-5608}, abstract = {Amyloid-beta (Aβ) plaques and the intracellular buildup of hyperphosphorylated tau protein are hallmarks of Alzheimer's disease (AD), a progressive neurodegenerative disease that causes synaptic dysfunction and neuronal death. Glycogen synthase kinase 3 beta (GSK3β), protein kinase B (AKT), and phosphatidylinositol 3-kinase all have aberrant signaling pathways that contribute to the pathophysiology of AD. The PI3K/AKT neuroprotective pathway is seriously inhibited in AD, which leads to brain insulin resistance (BIR) and neurodegeneration. However, AD leads to hyperactivation of GSK3β, which in turn produces tau hyperphosphorylation, Aβ accumulation, and cognitive impairment. BIR and PI3K/AKT/GSK3β signaling in AD have a complicated interaction that is covered in this article. The pathway has both neuroprotective and pathogenic functions. The therapeutic use of GSK3β inhibitors and PI3K/AKT activators to decrease AD pathogenesis is also discussed. Changing these pathways can improve cognitive function, reduce tau and Aβ pathology, and restore insulin signaling, according to preclinical and clinical research. Finding highly specialized treatments with minimal side effects remains a challenge. More research is required to thoroughly assess the safety and efficacy of medications that target specific pathways and to clarify the molecular mechanisms underlying PI3K/AKT/GSK3β dysregulation in AD in order to create novel and effective treatment alternatives.}, }
@article {pmid41298245, year = {2025}, author = {La Joie, R and Cummings, JL and Dage, JL and Galasko, D and Ikonomovic, MD and Karikari, TK and Landau, SM and Llibre-Guerra, JJ and Mummery, CJ and Ossenkoppele, R and Price, JC and Risacher, SL and Smith, R and van Dyck, CH and Carrillo, MC}, title = {Treatment-related amyloid clearance (TRAC): a framework to characterize patients in the era of anti-amyloid therapies.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70997}, pmid = {41298245}, issn = {1552-5279}, mesh = {Humans ; *Alzheimer Disease/drug therapy/metabolism/diagnostic imaging ; Positron-Emission Tomography ; *Amyloid beta-Peptides/metabolism ; Biomarkers/metabolism ; *Brain/metabolism/diagnostic imaging/drug effects ; }, abstract = {Following regulatory approval of anti-amyloid beta (Aβ) therapies, a better characterization of patients receiving these treatments is needed to guide clinical management and inclusion in future trials. This Alzheimer's Association-convened workgroup proposes a terminology, treatment-related amyloid clearance (TRAC), to reflect alterations in disease pathophysiology based on biomarker evidence for clearance of Aβ deposits. TRAC designates biomarker-defined pharmacodynamic changes, rather than direct neuropathological evidence, and applies to individuals with (1) pretreatment biomarker confirmation of cerebral Aβ deposition, (2) treatment with an Aβ-targeting therapy, and (3) a follow-up biomarker test indicative of partial or full clearance of Aβ deposits. The workgroup currently recommends defining TRAC using amyloid-positron emission tomography (PET) and emphasizes the role of quantitative measurements for defining the degree of clearance. This framework is expected to be adapted over time in response to rapidly evolving biomarker and clinical advances and with the accumulation of real-world data on patients receiving anti-Aβ therapies. Highlights TRAC identifies patients with biomarker evidence for clearance of amyloid deposits. TRAC is currently defined using amyloid-PET. Full TRAC means that PET levels dropped below predetermined positivity threshold. Partial TRAC means that PET levels dropped significantly but remain above threshold. This framework is meant to guide future research on patients receiving treatment.}, }
@article {pmid41297852, year = {2026}, author = {Adeyemi, O and Christina, W and Arcila-Mesa, M and Dickson, VV and Ferris, R and Tarpey, T and Fletcher, J and Blaum, C and Chodosh, J}, title = {Enhanced quality in primary care for elders with diabetes and dementia: Protocol for a multisite randomized controlled trial.}, journal = {Contemporary clinical trials}, volume = {160}, number = {}, pages = {108165}, pmid = {41297852}, issn = {1559-2030}, support = {R33 AG057291/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Primary Health Care/standards/organization & administration ; Aged ; *Quality Improvement/organization & administration ; *Dementia/therapy ; *Alzheimer Disease/therapy ; Glycated Hemoglobin ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic ; *Diabetes Mellitus/therapy ; Female ; Male ; Pragmatic Clinical Trials as Topic ; Aged, 80 and over ; }, abstract = {BACKGROUND: The Enhanced Quality in Primary Care for Elders with Diabetes-ADRD (EQUIPED-ADRD) is a quality improvement and pragmatic cluster-randomized controlled trial that uses clinical decision guidelines to streamline the care of older adults with diabetes mellitus and Alzheimer's disease/Alzheimer's disease-related Dementia (DM-AD/ADRD). This study tests whether the EQUIPED-ADRD intervention will increase the proportion of older adults with DM and AD/ADRD with desirable glycemic ranges, and reduce treatment burden, dementia severity, and healthcare utilization among participants and their care partners in the intervention arm compared to those in the control arm.
METHODS: We will recruit older adults (≥65 years) with both DM and AD/ADRD diagnoses, who have care partners, and receive care at the enrolled New York University clinics. The intervention involves the use of panel managers to streamline the integration of clinical decision guidelines among primary care providers and improve the experiences of care partners and patients. Those in the control arm will have no panel management. We will conduct surveys and interviews, and extract data from EMR and Medicare claims to assess the association between the intervention and primary and secondary outcomes. The primary outcome is achieving within-range HbA1c, while the secondary outcomes include measures of healthcare utilization. Patient and care partner treatment burden, dementia symptoms, and care partner diabetes care distress.
CONCLUSIONS: The EQUIPED-ADRD intervention (implemented between 2018 and 2021) will assess the effect of an institutional guideline on the quality of life and health outcomes of older adults with DM-AD/ADRD and their care partners. Clinical Trial NumberNCT03723707.}, }
@article {pmid41297835, year = {2026}, author = {Zhang, X and Dong, Y and Zou, Z and Chen, L and Li, W and Wang, L and Li, K and He, J and Shi, Q}, title = {Association of human plasma and cerebrospinal fluid metabolomes with vascular dementia and its subtypes: A Mendelian randomization study.}, journal = {Brain research}, volume = {1871}, number = {}, pages = {150060}, doi = {10.1016/j.brainres.2025.150060}, pmid = {41297835}, issn = {1872-6240}, mesh = {Humans ; *Dementia, Vascular/cerebrospinal fluid/blood/genetics/metabolism ; Mendelian Randomization Analysis/methods ; *Metabolome/genetics/physiology ; Genome-Wide Association Study ; Male ; Female ; Biomarkers/cerebrospinal fluid/blood ; Aged ; }, abstract = {BACKGROUND AND OBJECTIVE: Vascular dementia (VaD) is one of the most common subtypes of dementia after Alzheimer's disease. Investigating body fluid metabolites is critical for understanding VaD pathophysiology and identifying potential therapeutic targets. This study employs Mendelian randomization (MR) analysis to explore the causal relationship between body fluid metabolites and VaD.
METHODS: Data for VaD were retrieved from the FinnGen database. 1,400 plasma metabolites were collected from the GWAS Catalog. 338 cerebrospinal fluid (CSF) metabolites data were obtained from a subset of participants in the WADRC and WRAP studies. The inverse-variance weighted (IVW) method was used to explore causal relationships between plasma/CSF metabolites and VaD, with supplementary analyses using Weighted mode, MR-Egger, and Weighted median methods. Multiple sensitivity analyses were conducted for robustness.
RESULTS: Following strict validation and FDR correction, significant associations (p_fdr < 0.05) were identified exclusively in plasma metabolites. The most significant metabolite was N-acetyl-aspartyl-glutamate (NAAG), with higher NAAG levels linked to reduced risks of VaD of acute onset and SVaD. Metabolonic lactone sulfate also showed significant associations across multiple disease groups, with elevated levels associated with lower disease risk, supported by FDR correction and sensitivity analyses. No significant CSF metabolites were identified after FDR correction. Disparities between CSF and plasma metabolites in disease-risk expression were observed, with only partial overlap in causal relationships (IVW, p < 0.05).
CONCLUSION: This study identified fluid metabolite biomarkers associated with VaD through Mendelian randomization, offering new insights and strategies for the prediction and treatment of VaD.}, }
@article {pmid41296223, year = {2025}, author = {Bharath, HC and Pradeep, N and Shashidhar, R and Nanjappa, Y}, title = {Synergistic medical genetic evolutionary optimization and deep convolutional generative augmentation with SHAP-driven interpretability for precise Alzheimer's disease severity grading.}, journal = {Brain informatics}, volume = {12}, number = {1}, pages = {31}, pmid = {41296223}, issn = {2198-4018}, abstract = {Alzheimer's disease (AD) diagnosis at an early yet accurate stage is critical to support effective treatment or intervention. Still it is not very feasible due to the presence of image data class imbalance, low interpretability of models, and a high computational cost. This research proposes a novel, end-to-end diagnostic framework that considers a Medical Genetic Algorithm (MedGA)-optimized Convolutional Neural Network (CNN) with a Deep Convolutional Generative Adversarial Network (DCGAN) to generate synthetic MRIs and SHapley Additive Explanations (SHAP) to analyse and interpret the model. The given methodology is trained and tested on the Open Access Series of Imaging Studies (OASIS) dataset. The DCGAN component introduces 700 structurally coherent synthetic images (SSIM = 0.92) into the underrepresented Moderate Dementia class, improving the overall recall by 10% and balancing the dataset. MedGA succeeds in optimizing CNN hyperparameters and resulting in complexity reduction (20%) in networks without loss of testing accuracy (97%) at the four demonstrated stages of AD: Non-Demented, Very Mild Demented, Mild Demented, and Moderate Demented. SHAP analysis emphasises the role of key brain areas, the hippocampus and the amygdala in the results of classification accuracy, leading to 25% greater interpretability and clinician confidence. Comparative evaluation shows that the current framework is exceptionally better in terms of predictive performance and explainability than current state-of-the-art approaches. This combined method provides a powerful and adaptable device to categorize AD at an early age, with promising outcomes in precise diagnosis in health facilities.}, }
@article {pmid41296218, year = {2025}, author = {Vaz, M and Soares Martins, T and Trigo, D and da Cruz E Silva, OAB and Amado, F and Vitorino, R and Henriques, AG}, title = {Aβ Modulates Extracellular Vesicles Proteomic Profile Impacting Phosphorylation Mediators.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {179}, pmid = {41296218}, issn = {1559-1182}, mesh = {*Extracellular Vesicles/metabolism/drug effects ; *Amyloid beta-Peptides/pharmacology ; Phosphorylation/drug effects ; *Proteomics/methods ; Animals ; Mice ; *Proteome/metabolism ; Glycogen Synthase Kinase 3 beta/metabolism ; Cell Line, Tumor ; Alzheimer Disease/metabolism ; Humans ; Protein Interaction Maps/drug effects ; }, abstract = {Alzheimer's disease (AD) is characterized by the formation of senile plaques and neurofibrillary tangles, mainly composed of amyloid-β (Aβ) peptide aggregates and hyperphosphorylated tau protein, respectively. AD pathophysiology is highly complex, involving multiple abnormal cellular pathways linked to disease progression. Recently, extracellular vesicles (EVs) have emerged as potential contributors to disease development. Thus, this study explored the proteome of neuronal EVs under conditions that mimic Alzheimer's disease by employing mass spectrometry in EVs isolated from N2a cells treated with Aβ. Bioinformatic analysis revealed proteins involved in signal transduction, post-translational protein modification, translation, and proteolysis. Furthermore, Aβ treatment led to either an enrichment or scarcity of proteins related to cytoskeletal and mitochondrial dynamics, calcium-dependent signalling, phosphorylation, as well as proteins involved in Aβ production and aggregation. Overlap between EVs' proteome upon Aβ treatment and key AD-related proteins identified glycogen synthase kinase 3β (GSK3β) as a central node in the resulting protein interaction network. Additionally, the GSK3β interactome, derived from the EVs' proteome, highlighted protein phosphatases as relevant EVs' cargo under Alzheimer's disease mimicking conditions. The activity of GSK3β and protein phosphatases in EVs was monitored, revealing significant differences between control and Aβ-treated conditions. These findings support not only that EVs carry key proteins involved in phosphorylation dynamics but also that Aβ treatment alters EVs' proteomic profile, potentially impacting AD development. Proteomic changes in EVs may provide valuable insights into the mechanisms underlying AD and also contribute to the identification of novel potential therapeutic targets.}, }
@article {pmid41296090, year = {2025}, author = {Wang, M and Zeng, Y and Jin, Y and Wu, J and Li, J}, title = {Progress and Perspectives on the Estrogen-Microbiota-Brain Axis in Alzheimer's Disease.}, journal = {Neurochemical research}, volume = {51}, number = {1}, pages = {3}, pmid = {41296090}, issn = {1573-6903}, support = {No. QKHJC-ZK[2022]-260//Guizhou Provincial Science and Technology Projects/ ; NO.gzwjrs2023-005//Guizhou Provincial High level Innovative Talent Fund/ ; }, mesh = {Humans ; *Alzheimer Disease/metabolism/microbiology ; *Estrogens/metabolism ; *Gastrointestinal Microbiome/physiology ; *Brain/metabolism/drug effects ; Animals ; Dysbiosis/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder shaped by genetic, metabolic, environmental, and sex-specific factors. Emerging evidence highlights the estrogen-gut microbiota-brain (EGMB) axis as a critical framework linking endocrine regulation, microbial activity, and cognitive outcomes. Estrogen exerts neuroprotective effects by modulating synaptic plasticity, oxidative stress, amyloid and tau pathology, and neuroinflammation, while its decline during menopause increases AD vulnerability. Parallel to this, gut dysbiosis and altered microbial metabolites, particularly short-chain fatty acids (SCFAs) and secondary bile acids (sBAs), contribute to barrier dysfunction, chronic inflammation, and synaptic impairment. Importantly, estrogen remodels microbial composition and metabolite profiles, whereas microbial β-glucuronidase (β-GUS) activity sustains estrogen bioavailability, establishing a reciprocal regulatory loop. Preclinical studies demonstrate that depletion of gut microbiota diminishes estrogen's protective effects, underscoring the central role of microbial metabolites as signaling bridges.Therapeutically, these insights support the integration of hormone replacement therapy with microbiota-targeted interventions such as probiotics, prebiotics, and fecal microbiota transplantation. Such combined strategies may synergistically enhance neuroprotection, though their efficacy depends on timing, dosage, and individual variability. Future precision approaches integrating multi-omics profiling and sex-specific stratification hold promise for identifying predictive biomarkers and optimizing treatment windows. In summary, the EGMB axis offers a mechanistic foundation for understanding sex differences in AD and a translational framework for developing individualized, multidimensional strategies for early diagnosis, prevention, and therapy.}, }
@article {pmid41295439, year = {2025}, author = {Zachara, R and Gendosz de Carrillo, D and Wlaszczuk, A and Gorzkowska, A and Mazur, W and Jedrzejowska-Szypulka, H}, title = {The Cognitive Changes Among Patients over 65 Years of Age in a Rural Area-The Preliminary Report of Protective and Predisposing Factors.}, journal = {Neurology international}, volume = {17}, number = {11}, pages = {}, pmid = {41295439}, issn = {2035-8385}, support = {PCN-2-042/N/2/I//Medical University of Silesia/ ; }, abstract = {Background: Aβ1-42 and APOE concentrations, as well as Aβ42/40 ratio, may be considered as a link between hypertension (HTN) or diabetes mellitus (DM), brain amyloidosis, and dementia. HTN and DM are associated with cognitive impairment and may contribute to the development of Alzheimer's disease (AD). This preliminary study aimed to evaluate the impact of vascular risk factors on the concentration of biochemical AD markers and cognitive state. As it is a cross-sectional study in nature, causal relationships cannot be established. Methods: The study was conducted in the south of Poland among a rural population over 65 years of age. A total of 58 patients qualified into the study were divided into groups according to the presence of HTN (n = 18) or HTN coexisting with DM (n = 40). A healthy control group was also formed (n = 20), resulting in 78 study participants. The study population was also divided based on M-ACE results, forming a normal cognition group (NC) and a deteriorated cognition group (DC). Biochemical tests, neurological scales assessments, and ultrasound examinations were conducted. Results: Patients who scored in the normal range on the M-ACE had higher Aβ1-42 (median 38.52 vs. 27.35 pg/mL, p = 0.02) and apoE concentrations (median 125.0 vs. 65.73 μg/mL, p = 0.002), and a higher Aβ42/40 ratio (median 0.39 vs. 0.29 p < 0.000) compared to the DC group. Considering the study groups, the highest Aβ42/40 ratio was found among the HC group (median 0.47). The median score for the M-ACE scale was 3 points lower when HTN and DM coexisted, compared to the sole diagnosis of HTN (25 points and 28 points, respectively). A higher number of years of education correlated with better M-ACE results. Lipid and uric acid concentrations were not related to M-ACE or MMSE scores. An inverse relationship connected Aβ1-40 and Aβ1-42 to BMI, the duration of HTN treatment, and glycated hemoglobin. Conclusions: Aβ1-42, APOE, and Aβ42/40 are not only correlated with cognition but also related to patient's disease profile. The coexistence of DM and HTN was associated with the most significant decline in cognitive functioning. However, a higher number of years of education may protect against the development of dementia in old age. The roles of cholesterol and uric acid in cognitive decline are still inconclusive.}, }
@article {pmid41295407, year = {2025}, author = {Dimitrova, D and Kehayova, G and Dimitrova, S and Dragomanova, S}, title = {Marine-Derived Natural Substances with Anticholinesterase Activity.}, journal = {Marine drugs}, volume = {23}, number = {11}, pages = {}, pmid = {41295407}, issn = {1660-3397}, mesh = {*Cholinesterase Inhibitors/pharmacology/chemistry/isolation & purification ; *Biological Products/pharmacology/chemistry/isolation & purification/therapeutic use ; Humans ; *Aquatic Organisms/chemistry ; Animals ; Alzheimer Disease/drug therapy ; Butyrylcholinesterase/metabolism ; Neuroprotective Agents/pharmacology/chemistry/isolation & purification ; Acetylcholinesterase/metabolism ; }, abstract = {Alzheimer's disease continues to be one of the most urgent neurodegenerative conditions, with acetylcholinesterase (AChE) inhibitors serving as a fundamental component of contemporary treatment approaches. Growing evidence underscores that marine ecosystems are a rich source of structurally varied and biologically active natural products exhibiting anticholinesterase properties. This review presents a thorough synthesis of marine-derived metabolites-including those sourced from bacteria, fungi, sponges, algae, and other marine life-that demonstrate inhibitory effects against AChE and butyrylcholinesterase (BuChE). Numerous compounds, such as meroterpenoids, alkaloids, peptides, and phlorotannins, not only show nanomolar to micromolar inhibitory activity but also reveal additional neuroprotective characteristics, including antioxidant effects, anti-amyloid properties, and modulation of neuronal survival pathways. Despite these encouraging findings, the transition to clinical applications is hindered by a lack of comprehensive pharmacokinetic, toxicity, and long-term efficacy studies. The structural variety of marine metabolites provides valuable frameworks for the development of next-generation cholinesterase inhibitors. Further interdisciplinary research is essential to enhance their therapeutic potential and facilitate their incorporation into strategies for addressing Alzheimer's disease and related conditions.}, }
@article {pmid41294911, year = {2025}, author = {Abreu, MM and Hosseine-Farid, M and Silverman, DG}, title = {Total Reversal of ALS Confirmed by EMG Normalization, Structural Reconstitution, and Neuromuscular-Molecular Restoration Achieved Through Computerized Brain-Guided Reengineering of the 1927 Nobel Prize Fever Therapy: A Case Report.}, journal = {Diseases (Basel, Switzerland)}, volume = {13}, number = {11}, pages = {}, pmid = {41294911}, issn = {2079-9721}, abstract = {BACKGROUND: Neurological disorders are the leading cause of disability, affecting over three billion people worldwide. Amyotrophic lateral sclerosis (ALS) is among the most feared and uniformly fatal neurodegenerative diseases, with no therapy capable of restoring lost function.
METHODS: We report the first application of therapeutic fever to ALS using Computerized Brain-Guided Intelligent Thermofebrile Therapy (CBIT[2]). This fully noninvasive treatment, delivered through an FDA-approved computerized platform, digitally reengineers the 1927 Nobel Prize-recognized malarial fever therapy into a modern treatment guided by the Brain-Eyelid Thermoregulatory Tunnel. CBIT[2] induces therapeutic fever through synchronized hypothalamic feedback, activating heat shock proteins, which are known to restore proteostasis and neuronal function.
CASE PRESENTATION: A 56-year-old woman was diagnosed with progressive ALS at the Mayo Clinic, with electromyography (EMG) demonstrating fibrillation and fasciculation indicative of denervation corroborated by neurological and MRI findings; the patient was informed that she had an expected survival of three to five years. A neurologist from Northwestern University confirmed the diagnosis and thus maintained the patient on FDA-approved ALS drugs (riluzole and edaravone). Her condition rapidly worsened despite pharmacological treatment, and she underwent CBIT[2], resulting in (i) electrophysiological reversal with complete disappearance of denervation; (ii) biomarker correction, including reductions in neurofilament and homocysteine, IL-10 normalization (previously linked to mortality), and robust HSP70 induction; (iii) restoration of gait, swallowing, respiration, speech, and cognition; (iv) reconstitution of tongue structure; and (v) return to complex motor tasks, including golf, pickleball, and swimming.
DISCUSSION: This case provides the first documented evidence that ALS can be reversed through digitally reengineered fever therapy aligned with thermoregulation, which induces heat shock response and upregulates heat shock proteins, resulting in the patient no longer meeting diagnostic criteria for ALS and discontinuation of ALS-specific medications. Beyond ALS, shared protein-misfolding pathology suggests that CBIT[2] may extend to Alzheimer's, Parkinson's, and related disorders. By modernizing this Nobel Prize-recognized therapeutic principle with computerized precision, CBIT[2] establishes a framework for large-scale clinical trials. A century after fever therapy restored lost brain function and so decisively reversed dementia paralytica such that it earned the 1927 Nobel Prize in Medicine, CBIT[2] now safely harnesses the therapeutic power of fever through noninvasive, intelligent, brain-guided thermal modulation. Amid a global brain health crisis, fever-based therapies may offer a path to preserve thought, memory, movement, and independence for the more than one-third of humanity currently affected by neurological disorders.}, }
@article {pmid41294858, year = {2025}, author = {Thiyagarajan, S and Leclerc, E and Vetter, SW}, title = {The Receptor for Advanced Glycation End-Products (RAGE) Regulates Cell Adhesion Through Upregulation of ITGA8.}, journal = {Cells}, volume = {14}, number = {22}, pages = {}, pmid = {41294858}, issn = {2073-4409}, support = {U54 GM128729/GM/NIGMS NIH HHS/United States ; 1U54GM128729-20/NH/NIH HHS/United States ; }, mesh = {Humans ; *Cell Adhesion ; *Receptor for Advanced Glycation End Products/metabolism/chemistry/genetics ; *Up-Regulation ; }, abstract = {The Receptor for Advanced Glycation End-Products (RAGE) is a cell surface receptor of the immunoglobulin-like receptor superfamily. RAGE is a pattern-recognition, multi-ligand receptor that binds glycated proteins, specific non-glycated proteins, and nucleic acids. RAGE ligands are typically part of the group of damage-associated molecular patterns (DAMPs) or alarmins. As such, RAGE is a receptor for molecular products of cellular stress, abnormal metabolism, and inflammation. Activation of RAGE by its ligands leads to pro-inflammatory signaling, often resulting in persistent RAGE activation in various disease states. Consequently, RAGE has been investigated as a potential drug target in the treatment of diabetic complications, vascular disease, Alzheimer's disease, and multiple types of cancer. An underexplored aspect of RAGE is its role in cell adhesion. Structural comparison of the extracellular domain of RAGE has revealed structural similarity to the activated leukocyte cell adhesion molecule (ALCAM). The present study reveals the role and mechanism of RAGE in regulating cell adhesion. We investigated the role of individual RAGE domains in cell adhesion to extracellular matrix proteins and the changes in protein expression resulting from RAGE upregulation. Key findings include that RAGE displays substrate-specific adhesion to extracellular matrix proteins, that the intracellular domain of RAGE is required for modulating cell spreading, and that regulation of ITGA8 depends on the cytoplasmic domain of RAGE.}, }
@article {pmid41294748, year = {2025}, author = {Ki, MR and Kim, DH and Abdelhamid, MAA and Pack, SP}, title = {Cancer and Aging Biomarkers: Classification, Early Detection Technologies and Emerging Research Trends.}, journal = {Biosensors}, volume = {15}, number = {11}, pages = {}, pmid = {41294748}, issn = {2079-6374}, support = {RS2021NR060107//the National Research Foundation of Korea/ ; the National Research Foundation of Korea//the National Research Foundation of Korea/ ; }, mesh = {Humans ; *Neoplasms/diagnosis ; *Biomarkers, Tumor ; *Aging ; *Early Detection of Cancer ; Biomarkers ; Biosensing Techniques ; Artificial Intelligence ; }, abstract = {Cancer and aging are two distinct biological processes with shared cellular pathways, such as cellular senescence, DNA damage repair, and metabolic reprogramming. However, the outcomes of these processes differ in terms of proliferation. Understanding biomarkers related to aging and cancer opens a pathway for therapeutic interventions and more effective prevention, detection, and treatment strategies. Biomarkers, ranging from molecular to phenotypic indicators, play an important role in early detection, risk assessment, and prognosis in this endeavor. This review comprehensively examines key biomarkers associated with cancer and aging, highlighting their importance in early diagnostic strategies. The review discusses recent advances in biomarker-based diagnostic technologies, such as liquid biopsy, multi-omics integration, and artificial intelligence, and emphasizes their novel potential for early detection, accurate risk assessment, and personalized therapeutic interventions in cancer and aging science. We also explore the current state of biosensor development and clinical application cases. Finally, we discuss the limitations of current early diagnostic methods and propose future research directions to enhance biomarker-based diagnostic technologies.}, }
@article {pmid41294271, year = {2025}, author = {Gupta, R and Lin, S and DiStefano, MJ and Woo, HYJ and Mao, E and Wilson, R and Amjad, H and Drabo, EF and Segal, JB}, title = {Patient Preferences for Dementia Interventions: A Scoping Review With a Systematic Review of Medications and Choice-Based Methods.}, journal = {Journal of the American Geriatrics Society}, volume = {}, number = {}, pages = {}, doi = {10.1111/jgs.70209}, pmid = {41294271}, issn = {1532-5415}, support = {1R61AG088961-01/AG/NIA NIH HHS/United States ; K23AG064036/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND: Despite emerging treatment options for Alzheimer's disease and related dementias (ADRD), patient preferences for treatment and care remain poorly understood.
METHODS: We searched PubMed, PsycINFO, CINAHL, and EMBASE through November 12, 2024 for studies reporting stated preferences for dementia treatment- and care-related interventions. We synthesized key findings from studies using choice-based preference elicitation methods and those addressing medication preferences.
RESULTS: We screened 8300 abstracts and 82 studies published between 1996 and 2024 were included. Most evaluated preferences for non-pharmacological interventions. Studies were experimental (37; 45.1%), observational (36; 43.9%), and qualitative (21; 25.6%). Six studies used choice-based preference elicitation methods and five assessed preferences for medications. Patients valued memory improvement and emotional or social support, despite highly heterogeneous data.
CONCLUSIONS: This review highlights significant gaps in the literature on treatment preferences-particularly for medications-among older adults with cognitive impairment, underscoring the need for further research, development of validated clinical tools, and appropriate methods to elicit preferences to better align interventions with patient values.}, }
@article {pmid41292987, year = {2025}, author = {Gogola, JV and Wee, SWS and Garcia, AJ}, title = {Repeat Opioid Use Modulates Microglia Activity and Amyloid Beta Clearance in a Mouse Model of Alzheimer's Disease.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41292987}, issn = {2692-8205}, support = {R01 DA061412/DA/NIDA NIH HHS/United States ; R01 HL163965/HL/NHLBI NIH HHS/United States ; R01 HL169679/HL/NHLBI NIH HHS/United States ; }, abstract = {In addition to driving dependency and overdose, illicit use of opioids, such as fentanyl, is linked to the risk for cognitive decline and dementia. Growing evidence also indicates that opioid use is associated with pathological features, paralleled early in Alzheimer's disease (AD), which raises the possibility of the involvement of mechanistic interactions between opioid use and AD progression. Here, we investigate how chronic fentanyl use (i.e., 20 days) influences the neuroimmune state, microglial activity, and amyloid burden in wildtype and APPPS1-21 mice, a transgenic model of AD. In wild-type mice, fentanyl use promoted a pro-inflammatory state without increasing the incidence of disease-associated microglia. In APPPS1-21 mice, chronic fentanyl use led to a shift favoring an anti-inflammatory state, which was associated with increased microglia clustering and activation at Aβ plaques, increased Aβ internalization in plaque-associated activated microglia, decreased soluble Aβ, and decreased plaque burden. Our findings indicate that chronic fentanyl use fundamentally changes the trajectory of neuroimmune activity and features characteristic of early AD by enabling microglia to enhance Aβ clearance. The interactions demonstrate how substance use can reshape the neuroimmune landscape in neurodegenerative disease, emphasizing the importance of tailored treatment strategies.}, }
@article {pmid41292940, year = {2025}, author = {Mayeri, Z and Woods, G and Rane, A and Kifle, A and Chamoli, M and Shukla, S and Walton, CC and Andersen, JK}, title = {A Compound Enhancing Lysosomal Function Reduces Tau Pathology, Microglial Reactivity and Rescues Working Memory in 3xTg AD Mice.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41292940}, issn = {2692-8205}, support = {R01 AG067325/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND: Recent advancements in Alzheimer's disease (AD) therapeutics have validated the use of amyloid beta (Aβ)-clearing antibodies, which reduce Aβ pathology but leave other disease hallmarks largely unaddressed. Since AD involves multiple pathological processes, additional strategies are needed to target complementary mechanisms. One such target is autophagy, a lysosomal mediated degradation pathway essential for cellular homeostasis that removes toxic protein aggregates and damaged organelles. This process is implicated in AD, as impaired lysosomal function promotes Aβ and tau accumulation. Our laboratory recently identified a novel natural mitophagy-inducing compound (MIC) that may serve as a therapeutic intervention for AD.
METHODS: We evaluated the effects of MIC in aged 3xTgAD mice, a transgenic model displaying both Aβ and tau pathology. Mice received either standard diet or diet containing MIC beginning at age 4 months until 20 months on alternating weeks. Age-matched non-transgenic (NonTg) controls were included under standard and MIC-supplemented diets to assess compound effects during normal aging. Neuropathological changes were assessed using immunohistochemistry (IHC) for Aβ, phosphorylated tau (pTau), and microglial reactivity. Cognitive performance was evaluated using the Morris Water Maze (MWM) to assess spatial learning and memory and the Y-maze to measure working memory.
RESULTS: At 20 months of age, our neuropathological assessment showed that 3xTgAD mice fed an MIC-supplemented diet had a significant reduction in pTau accumulation and microglial reactivity, although Aβ burden remained unchanged. At 15 months, MIC diet also improved spatial learning and memory in aged NonTg controls but not in 3xTgAD mice. However, in younger 8-month-old 3xTgAD mice, MIC restored working memory performance to NonTg levels, indicating an age-dependent therapeutic response.
CONCLUSION: MIC emerges as a potential modulator of tau pathology and neuroinflammation. As a naturally derived compound, MIC offers potential for combination therapy with FDA-approved Aβ-clearing antibodies, enabling a multimodal approach to AD treatment that addresses amyloid, tau, and microglia-related pathology.}, }
@article {pmid41292809, year = {2025}, author = {Steigmeyer, AD and Battison, AS and Liebman, IR and van Dyck, CH and Slusher, BS and Arnsten, AFT and Malaker, SA and Datta, D}, title = {Region-specific proteomic analysis of aging rhesus macaques following chronic glutamate-carboxypeptidase-II (GCPII) inhibition elucidates potential treatment strategies for sporadic Alzheimer's disease.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41292809}, issn = {2692-8205}, support = {R01 AG061190/AG/NIA NIH HHS/United States ; P30 AG066508/AG/NIA NIH HHS/United States ; T32 GM067543/GM/NIGMS NIH HHS/United States ; R21 AG079145/AG/NIA NIH HHS/United States ; KL2 TR001862/TR/NCATS NIH HHS/United States ; }, abstract = {Sporadic Alzheimer's disease (sAD) lacks effective preventive therapies, underscoring the need to target pathogenic drivers. Aberrant calcium signaling is an established early event in sAD pathogenesis that is closely linked to neuroinflammation. Aged rhesus macaques are predominantly APOE-ε4 homozygotes and naturally exhibit cognitive decline, calcium dysregulation, amyloid deposition, and tau pathology, which allows for a translationally relevant animal model. We previously identified an evolutionarily expanded role for postsynaptic type 3 metabotropic glutamate receptors (mGluR3) in dorsolateral prefrontal and entorhinal cortex, where they regulate cAMP-calcium opening of K[+] channels to sustain neuronal firing and working memory. mGluR3 signaling is driven by N-acetylaspartylglutamate (NAAG) and constrained by glutamate carboxypeptidase II (GCPII), whose expression rises with age and inflammation. In prior work, chronic inhibition of GCPII with the orally bioavailable inhibitor 2-(3-mercaptopropyl) pentanedioic acid (2-MPPA) improved neuronal firing, working memory, and reduced pT217Tau pathology in aged macaques. Here, we employed liquid chromatography-tandem mass spectrometry (LC-MS/MS) to define the proteomic consequences of chronic 2-MPPA treatment in vulnerable (entorhinal cortex, dorsolateral prefrontal cortex) versus resilient (primary visual cortex) regions. We identified >2,400 proteins across experimental conditions, and label-free quantification revealed region-specific differential expression patterns paralleling known vulnerability gradients in sAD. Gene ontology enrichment of vulnerable regions implicated pathways governing protein deneddylation, amyloid and tau-associated processes, synaptic plasticity, mitochondrial homeostasis, and oxidative stress, revealing putative targets for therapeutic intervention in sAD. These findings demonstrate that GCPII inhibition engages distinct, region-selective molecular programs in the aging primate cortex, consistent with the protection of circuits most vulnerable to sAD. By mapping the proteomic shifts that occur with treatment, we reveal molecular signatures that not only serve as candidate biomarkers but also highlight novel mechanistic pathways contributing to calcium-driven degeneration in sAD. As such, more focused investigations into these pathways of therapeutic interest are warranted, in addition to the analysis of key post-translational modifications and their potential roles in sAD.}, }
@article {pmid41292786, year = {2025}, author = {Dong, Y and Watson, DJ}, title = {Thyrotropin-releasing hormone protects hippocampal neurons against glutamate toxicity via phosphatidylinositol 3-kinase/AKT pathway and new protein synthesis.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.1101/2025.11.11.687668}, pmid = {41292786}, issn = {2692-8205}, abstract = {UNLABELLED: Thyrotropin-releasing hormone is best known as a neuropeptide that stimulates the release of thyroid-stimulating hormone and prolactin in hypothalamic-pituitary-thyroid (HPT) axis. Independent from its activity in the HPT axis, TRH also exerts strong neuroprotective activity against neurodegenerative diseases such as Alzheimer's disease, epilepsy and traumatic brain injury. Although multiple factors have been linked to its neuroprotective action, the cellular mechanism of TRH neuroprotection is still not clear. Here we show that TRH protects hippocampal neurons against glutamate toxicity via phosphatidylinositol 3-kinase (PI3K)/AKT pathway and new protein synthesis. Both adeno-associated virus (AAV) mediated TRH transduction and TRH peptide given exogenously over 24 hours period of time inhibit glutamate-induced lactate dehydrogenase (LDH) release. This effect is not mediated by the decreased intracellular calcium response as TRH treatment (24 hours) has no effect on glutamate-induced increase in intracellular calcium nor the calpain activity. While TRH treatment (10 minutes) significantly inhibits glutamate-induced increase in intracellular calcium, no protective effect is observed when TRH is applied 30 minutes before or after glutamate stimulation. Instead, PI3K inhibitor LY294002 but not mitogen-activated protein kinase (MAPK)/Extracellular signal-regulated kinase (ERK)1/2 inhibitor U0126 completely inhibits the protective effect of TRH. LY294002 also blocks TRH induced AKT activation. In addition, protein synthesis inhibitor cycloheximide inhibits the protective effect of TRH. Taken together, these results suggest PI3K/AKT signaling pathway and new protein synthesis are involved in the protective effect of TRH against glutamate toxicity, thereby providing mechanistic support for its action in neurodegenerative diseases.
HIGHLIGHTS: TRH has strong neuroprotective activity against neurodegenerative diseases such as traumatic brain injury and Alzheimer's disease. Understanding the cellular mechanism for TRH neuroprotection might aid developing novel treatment strategy. In the present study we demonstrate that TRH neuroprotection is mediated via PI3K/AKT signaling pathway and new protein synthesis. This finding provides mechanistic support for the action of TRH in traumatic brain injury and other neurodegenerative diseases.}, }
@article {pmid41292642, year = {2025}, author = {Jiang, C and Krivinko, J and Yu, Z and Sweet, RA and Zeng, L and Wang, H and Ding, Y and Zeng, Z and Kofler, J and Wang, L}, title = {Comparative Mortality Risk of Aripiprazole, Olanzapine, Quetiapine and Risperidone in Alzheimer's Disease: A Real World Cohort Study with Treatment Effect Heterogeneity Analysis.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41292642}, support = {P30 AG066468/AG/NIA NIH HHS/United States ; R01 MH116046/MH/NIMH NIH HHS/United States ; S10 OD028483/OD/NIH HHS/United States ; UL1 TR001857/TR/NCATS NIH HHS/United States ; }, abstract = {BACKGROUND: Second-generation antipsychotics (SGAs) are frequently used off-label to manage behavioral symptoms in Alzheimer's disease (AD), despite ongoing concerns about their safety. Comparative evidence on mortality risk across specific SGAs remains limited.
OBJECTIVE: To compare all-cause mortality among AD patients treated with commonly prescribed SGAs and to explore treatment effect heterogeneity using causal machine learning.
METHODS: We conducted a retrospective cohort study using de-identified electronic health records from the Truveta platform (2018-2024). Patients with incident AD initiating treatment with aripiprazole, risperidone, quetiapine, or olanzapine were identified using an active-comparator, new-user design. Drug exposure was modeled as a time-varying covariate in Cox proportional hazards models, with propensity score matching applied to control for confounding. Causal tree and targeted maximum likelihood estimation (TMLE) were used to identify subgroups with heterogeneous treatment effects.
RESULTS: Among 17,004 AD patients, aripiprazole was associated with significantly lower mortality than olanzapine (HR = 0.667, 95% CI: 0.472-0.941) and quetiapine (HR = 0.677, 95% CI: 0.462-0.990). Quetiapine was also associated with lower mortality than olanzapine (HR = 0.833, 95% CI: 0.702-0.990) and risperidone (HR = 0.830, 95% CI: 0.705-0.978). Causal tree analysis revealed treatment effect heterogeneity by clinical characteristics, particularly among patients using type 2 diabetes (T2DM) medications. In subgroup analyses, aripiprazole remained protective in T2DM users (HR = 0.604 vs. quetiapine and risperidone, p = 0.002).
CONCLUSIONS: Mortality risks vary substantially across SGAs in AD patients. Aripiprazole and quetiapine were associated with lower mortality compared to olanzapine and risperidone. Treatment effect heterogeneity suggests the need for individualized prescribing based on patient characteristics such as comorbid T2DM.}, }
@article {pmid41292493, year = {2025}, author = {Li, Y and Liu, W and Wang, X and Qin, W and Liu, Z and Lyu, D and Li, Y and Li, B and Xu, L and Cao, S and , and Chong, JRF and Lai, MKP and Chen, CLH and Jia, J}, title = {Effect of SSRIs on clinical progression in amnestic mild cognitive impairment stratified by Alzheimer's disease pathology.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70946}, pmid = {41292493}, issn = {1552-5279}, support = {2021ZD0201802//STI2030-Major Projects/ ; Z201100005520016//Beijing Municipal Science & Technology Commission/ ; Z201100005520017//Beijing Municipal Science & Technology Commission/ ; CX23YZ15//Chinese Institutes for Medical Research/ ; 31627803//National Key Scientific Instrument and Equipment Development Project/ ; U20A20354//Key Project of the National Natural Science Foundation of China/ ; 81530036//Key Project of the National Natural Science Foundation of China/ ; NMRC/CG/NUHS/2010//National Medical Research Council/ ; NMRC/CG/013/2013//National Medical Research Council/ ; NMRC/CIRG/1485/2018//National Medical Research Council/ ; CG21APR2010//National Medical Research Council/ ; MOH-000707//National Medical Research Council/ ; 2024KCJY0104//Key Project of the Science and Technology Innovation Elite Program/ ; GZC20240164//Postdoctoral Fellowship Program (Grade C) of China Postdoctoral Science Foundation/ ; 2024M750266//China Postdoctoral Science Foundation/ ; }, mesh = {Humans ; *Cognitive Dysfunction/pathology/drug therapy/diagnostic imaging ; *Selective Serotonin Reuptake Inhibitors/therapeutic use ; *Alzheimer Disease/pathology/drug therapy ; Male ; Female ; Disease Progression ; Aged ; Positron-Emission Tomography ; Amyloid beta-Peptides/metabolism ; *Amnesia/pathology ; Aged, 80 and over ; tau Proteins/metabolism ; Longitudinal Studies ; }, abstract = {INTRODUCTION: This study examined whether selective serotonin reuptake inhibitors (SSRIs) treatment influenced cognitive trajectory and progression to Alzheimer's disease (AD) dementia in amnestic mild cognitive impairment (MCI) patients, stratified by AD pathology.
METHODS: Four hundred fifty-seven amnestic MCI participants in the ADNI database were analyzed. AD pathology was determined by baseline amyloid beta (Aβ) and tau positron emission tomography. Kaplan-Meier survival analysis and Cox proportional hazards models evaluated MCI-to-AD progression. Linear mixed models analyzed longitudinal cognitive trajectories, amyloid accumulation, and cortical thickness.
RESULTS: SSRI treatment showed no significant effect on AD dementia progression (hazard ratio = 1.64, 95% confidence interval: 0.61 to 4.38) or cognitive trajectories, regardless of AD pathology. No significant differences in Aβ accumulation or cortical thickness were observed between SSRI users and non-users. External validation confirmed no significant SSRI effect on AD progression or cognitive decline.
DISCUSSION: SSRI treatment was not associated with long-term cognitive effects in amnestic MCI, irrespective of underlying AD pathology.
HIGHLIGHTS: SSRI treatment was not associated with long-term AD dementia risk in MCI. SSRI treatment had no impact on long-term cognitive performance changes in MCI. SSRI treatment did not affect Aβ accumulation or cortical thickness in MCI. SSRIs had no effect on MCI progression, regardless of underlying AD pathology.}, }
@article {pmid41291954, year = {2025}, author = {Xiao, L and Sharma, P and Yang, X and Abebe, D and Loh, YP}, title = {Neurotrophic factor-α1/carboxypeptidase E regulates critical protein networks to rescue neurodegeneration, defective synaptogenesis and impaired autophagy in Alzheimer's disease mice.}, journal = {Translational neurodegeneration}, volume = {14}, number = {1}, pages = {59}, pmid = {41291954}, issn = {2047-9158}, support = {Intramural research grant//National Institute of Child Health and Human Development/ ; }, mesh = {Animals ; *Alzheimer Disease/metabolism/pathology/genetics/therapy ; Mice ; *Autophagy/physiology ; *Synapses/metabolism/pathology ; Male ; Mice, Transgenic ; *Carboxypeptidase H/genetics/metabolism ; Hippocampus/metabolism/pathology ; Humans ; Disease Models, Animal ; Genetic Therapy/methods ; Proteomics ; Mice, Inbred C57BL ; }, abstract = {BACKGROUND: The global aging population is increasingly inflicted with Alzheimer's disease (AD), but a cure is still unavailable. Neurotrophic factor-α1/carboxypeptidase E (NF-α1/CPE) gene therapy has been shown to prevent and reverse memory loss and pathology in AD mouse models. However, the mechanisms of action of NF-α1/CPE are not fully understood. We investigated if a non-enzymatic form of NF-α1/CPE-E342Q is efficient in reversing AD pathology and carried out a proteomic study to uncover the mechanisms of action of NF-α1/CPE in AD mice.
METHODS: AAV-human NF-α1/CPE or a non-enzymatic form, NF-α1/CPE-E342Q, was delivered into the hippocampus of 3 × Tg-AD male mice. The effects on cognitive function, neurodegeneration, synaptogenesis and autophagy were investigated. A quantitative proteomic analysis of the hippocampus was carried out.
RESULTS: Hippocampal delivery of AAV-NF-α1/CPE-E342Q prevented memory loss, neurodegeneration and microglial activation in 3 × Tg-AD mice, indicating that the action is independent of its enzymatic activity. Quantitative proteomic analysis of the hippocampus of 3 × Tg-AD mice revealed differential expression of > 2000 proteins involving many metabolic pathways after NF-α1/CPE gene therapy. Of these, two new proteins, Snx4 and Trim28, which increase Aβ production and tau levels, respectively, were down-regulated by NF-α1/CPE. Western blot analysis verified their reduction in AAV-NF-α1/CPE-treated 3 × Tg-AD mice compared to untreated mice. Our proteomic analysis indicated synaptic organization as the top signaling pathway altered in response to CPE expression. Synaptic markers PSD95 and Synapsin1 were decreased in 3 × Tg-AD mice and were restored with AAV-NF-α1/CPE treatment. Proteomic analysis hypothesized involvement of autophagic signaling pathway. Indeed, multiple protein markers of autophagy were down-regulated in 3 × Tg-AD mice, accounting for impaired autophagy. NF-α1/CPE gene therapy upregulated the levels of these proteins in 3 × Tg-AD mice, thereby reversing autophagic impairment.
CONCLUSIONS: This study uncovered vast actions of NF-α1/CPE in restoring expression of networks of critical proteins including those necessary for maintaining neuronal survival, synaptogenesis and autophagy, while down-regulating many proteins that promote tau and Aβ accumulation to reverse memory loss and AD pathology in 3 × Tg-AD mice. AAV-NF-α1/CPE gene therapy uniquely targets many metabolic levels, offering a promising holistic approach for AD treatment (Graphical Abstract).}, }
@article {pmid41291841, year = {2025}, author = {Li, L and Xu, F and Duan, H and Qi, J and Zhang, J and Ma, K}, title = {Identification and validation of PANoptosis-related biomarkers in Alzheimer's disease via single-cell RNA sequencing and machine learning.}, journal = {European journal of medical research}, volume = {30}, number = {1}, pages = {1170}, pmid = {41291841}, issn = {2047-783X}, support = {QNYJ2023001//Henan Academy of Medical Sciences/ ; }, mesh = {Humans ; *Alzheimer Disease/genetics/pathology ; *Machine Learning ; Biomarkers/metabolism ; *Single-Cell Analysis/methods ; Sequence Analysis, RNA/methods ; Gene Regulatory Networks ; Gene Expression Profiling ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder with complex underlying mechanisms. PANoptosis, a newly defined form of programmed cell death that integrates pyroptosis, apoptosis, and necroptosis, may play a crucial role in AD pathogenesis. However, the involvement of PANoptosis-related genes in AD remains unclear.
METHODS: We analyzed single-cell RNA-seq data (GSE181279) to identify differentially expressed genes (scDEGs) between AD patients and normal controls. PANoptosis-associated genes (PAGs), curated from published studies, were intersected with differentially expressed genes (DEGs) from GSE85426 to identify differentially expressed PAGs (DE-PAGs). Weighted gene co-expression network analysis was performed to identify key gene modules. Candidate genes were identified by overlapping scDEGs, DEGs, and module genes. Hub genes were screened via three machine learning algorithms: least absolute shrinkage and selection operator (LASSO), support vector machine (SVM), and random forest (RF). Genes with consistent expression across GSE85426 and GSE48350 were considered potential biomarkers. These were evaluated by receiver operating characteristic analysis and incorporated into a nomogram. Gene set enrichment analysis was used to explore associated pathways. Immune infiltration analysis was used to assess the biomarkers' roles in the immune microenvironment and identify potential therapeutic targets. Finally, qRT-PCR was performed to validate biomarker expression in clinical samples.
RESULTS: Overlapping 987 scDEGs, 991 DEGs, and 5327 module genes yielded 27 candidate genes. LASSO, SVM, and RF analyses identified eight hub genes, among which five (BACH2, CKAP4, DDIT4, GGNBP2, and ZFP36L2) were ultimately validated as biomarkers. A nomogram based on these genes showed good predictive performance (area under the curve (AUC) = 0.779). Seven immune cell types differed significantly between the AD and control groups, with T follicular helper cells strongly correlated with most biomarkers except CKAP4 (cor > 0.36, p < 0.001). Several Aβ- and tau-related genes and immune factors also showed significant associations (|cor|> 0.3, p < 0.05). These biomarkers were further linked to AD and other functional pathways. qRT-PCR was used to validate the transcriptomic findings, with the exception of BACH2.
CONCLUSIONS: This study identified five novel PANoptosis-related biomarkers with diagnostic and therapeutic potential in AD. These findings provide a theoretical basis for future clinical research and may contribute to improved AD diagnosis and treatment strategies.}, }
@article {pmid41291238, year = {2025}, author = {Li, H and Yu, C and Markovic, T and Nestler, EJ and Dong, Y}, title = {Chemical strategies for brain delivery of genomic therapy.}, journal = {Nature reviews. Chemistry}, volume = {9}, number = {12}, pages = {841-854}, pmid = {41291238}, issn = {2397-3358}, support = {R35 GM144117/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; *Genetic Therapy/methods ; *Brain/metabolism ; Animals ; Nanoparticles/chemistry ; *Drug Delivery Systems/methods ; Lipids/chemistry ; Polymers/chemistry ; Oligonucleotides/chemistry ; *Gene Transfer Techniques ; }, abstract = {Genomic therapy has emerged as a transformative strategy for the prevention, diagnosis and treatment of a wide array of diseases, including Alzheimer's disease, amyotrophic lateral sclerosis and other CNS-related diseases. Recent developments in chemical strategies and delivery platforms have enhanced the potential of genomic therapies for brain disorders. In this Review, we summarize such strategies, focusing on advances in delivery platforms such as lipid nanoparticles, polymers and oligonucleotide conjugates to facilitate the brain delivery of DNA-based or RNA-based therapeutics into the CNS. We present an overview of the chemical structures and functional moieties of lipids, polymers and oligonucleotides used in these platforms. Lastly, we provide an outlook on future chemical directions to further improve the delivery of genomic medicines to the brain.}, }
@article {pmid41290974, year = {2025}, author = {Salmani, M and Anoush, M and Kalantari-Hesari, A and Jahani-Maleki, A and Nouri, F and Hosseini, MJ and Mohammadi, M}, title = {Protective role of fucoidan against cognitive deficits and redox imbalance in a scopolamine-induced Alzheimer's disease model in rats.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {41813}, pmid = {41290974}, issn = {2045-2322}, mesh = {Animals ; *Polysaccharides/pharmacology ; *Scopolamine/toxicity/adverse effects ; *Alzheimer Disease/chemically induced/drug therapy/metabolism ; Male ; Rats ; Disease Models, Animal ; Oxidative Stress/drug effects ; Rats, Wistar ; *Cognitive Dysfunction/drug therapy/chemically induced/metabolism ; *Neuroprotective Agents/pharmacology ; Hippocampus/drug effects/metabolism ; Oxidation-Reduction/drug effects ; Donepezil/pharmacology ; Prefrontal Cortex/drug effects/metabolism ; Maze Learning/drug effects ; Antioxidants ; }, abstract = {This study examined the neuroprotective impacts of fucoidan on behavioral performance and oxidative damage in an animal model with scopolamine-induced cognitive deficits. Male Wistar rats, aged 8 weeks, were administered scopolamine (2 mg/kg) for 10 days. Fucoidan (15-60 mg/kg) or donepezil (1 mg/kg) was administered prior to behavioral tests over three consecutive weeks. To assess memory and learning, all rats underwent the Morris water maze (MWM) task and the Novel Object Recognition (NOR) test. Following the tests, the hippocampi and prefrontal cortex (PFC) of the rats were collected to evaluate oxidative stress parameters across all treatment groups. A significant decrease in the mean Q2 time was observed during the probe trial in the water maze task after scopolamine injection on the test day. Administration of fucoidan (15-60 mg/kg) or donepezil (1 mg/kg) notably improved cognitive dysfunction (p < 0.001). Biochemical analysis demonstrated a decline in protein carbonyl and malondialdehyde levels, along with an elevation in reduced glutathione and total antioxidant capacity in the fucoidan-treated rats (15-60 mg/kg). It is supposed that cholinergic dysfunction and oxidative stress are key contributors to cognitive deficits, and fucoidan may protect the hippocampus and prefrontal cortex by mitigating oxidative damage biomarkers.}, }
@article {pmid41290806, year = {2025}, author = {Nasiri, H and Khosravi, F and Saberian, P and Kavian, M and Mozafar, M and Torabi, P and Malekzadeh, T and Hadavi, SM and Rezaee, A and Ghorbanalinejad, M and Heidari, Z and Zangene, D and Abdi, M and Houshyar, M and Habibzadeh, A and Bemanalizadeh, M}, title = {White matter hyperintensity burden predicts domain-specific cognitive decline across the Alzheimer's disease continuum.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {41780}, pmid = {41290806}, issn = {2045-2322}, support = {U01 AG024904/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Alzheimer Disease/pathology/diagnostic imaging ; *White Matter/pathology/diagnostic imaging ; Male ; Female ; *Cognitive Dysfunction/pathology/diagnostic imaging ; Aged ; Magnetic Resonance Imaging ; Cross-Sectional Studies ; Aged, 80 and over ; Executive Function ; Neuropsychological Tests ; Neuroimaging ; Cognition ; }, abstract = {White matter hyperintensity (WMH), indicative of cerebral small vessel disease, has emerged as a potential biomarker for cognitive decline in Alzheimer's disease (AD). However, their predictive role across specific cognitive domains within the AD spectrum remains unclear. This study investigates the relationship between WMH volume and cognitive performance in memory, executive function, and language across the AD continuum. A cross-sectional analysis was conducted using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), comprising 557 participants categorized into cognitively normal (CN; n = 158), mild cognitive impairment (MCI; n = 334), and Alzheimer's dementia (AD; n = 65) groups. Cognitive function was assessed using composite scores for memory (ADNI-MEM), executive function (ADNI-EF), and language (ADNI-LAN). WMH volume was quantified through validated Bayesian segmentation of MRI data. Associations between cognitive scores and WMH volume, adjusted for age, gender, APOE ε4 status, and vascular risk factors, were evaluated via multiple linear regression analyses. WMH volume showed numerically progressive increases from CN to MCI and AD groups; however, between-group differences did not reach statistical significance. Within the MCI group, significant negative associations emerged between WMH volume and memory (β=-0.13, adjusted p = 0.045) and language scores (β=-0.12, adjusted p = 0.045). Conversely, these relationships were absent in both the CN and AD groups. WMH volume relates specifically to declines in memory and language abilities, particularly in individuals with MCI. These results support using WMH measurements as early markers to identify cognitive decline in AD, potentially helping to guide earlier diagnosis and treatment decisions.}, }
@article {pmid41290768, year = {2025}, author = {Shafiee, L and Pishva, MS and Hosseinzadegsn, R and Bahadori, Z and Baziyar, P and Mehboodi, M and Khademee, S and Akbari, M and Motamed, M and Nadimi, E}, title = {Hesperetin reduces neuronal death in an SHSY5Y Alzheimer's model by inhibiting inflammation and apoptosis and pyroptosis cell death pathways.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {41901}, pmid = {41290768}, issn = {2045-2322}, mesh = {Humans ; *Hesperidin/pharmacology ; *Pyroptosis/drug effects ; *Alzheimer Disease/metabolism/drug therapy/pathology ; *Apoptosis/drug effects ; Amyloid beta-Peptides/metabolism ; Cell Line, Tumor ; *Inflammation/drug therapy/metabolism/pathology ; *Neurons/drug effects/metabolism/pathology ; Peptide Fragments/metabolism ; Lipopolysaccharides ; Cytokines/metabolism ; }, abstract = {Alzheimer's disease (AD) features amyloid-β (Aβ)1-42 plaques, neuroinflammation, and neuronal loss. Apoptosis and pyroptosis contribute to AD, with inflammatory cytokines involved. Flavonoids like Hesperetin may reduce Aβ1-42 deposition through anti-inflammatory effects. This study introduces a novel method combining LPS and Aβ1-42 to investigate Hesperetin's mechanism for potential AD treatments. Using computational and experimental methods, we evaluated the physicochemical properties and their correlation with protein aggregation at the molecular level. Human neuroblastoma SH-SY5Y cells were induced to differentiate and then exposed to Hesperetin (1 µM and 10 µM), LPS (1 µg/mL), and Aβ1-42 (20 µM) for 24 h. The expression levels of pro- (Bak, Bax, and Caspase-3) and anti-apoptotic genes (Bcl-2), pyroptosis-related genes (Caspase-1, Caspase-4, Caspase-5, NLRP3, and GSDMD), and pro-inflammatory cytokines genes (interleukins 6 and 1β, and TNF-α) were analyzed via qRT-PCR. The obtained simulation of our result clearly showed that Hesperetin led to the disintegration of the cross-linked structure of organized Aβ1-42 fibrils. Increased RMSD, Rg, and SASA values might lead to destabilization of Aβ1-42 fibrils in the presence of Hesperetin. Our experimental study also demonstrated that Hesperetin increased cell viability in SH-SY5Y cells induced by LPS and Aβ1-42. Hesperetin effectively reverses the enhanced apoptosis caused by LPS and Aβ1-42. Our findings indicated that Hesperetin significantly reduced the elevated expression levels of pro-inflammatory cytokines in the SH-SY5Y cells induced by LPS and Aβ1-42. Treatment with Hesperetin led to a notable downregulation of the enhanced expression of pyroptotic-related genes in LPS and Aβ1-42 induced cells. The details of the molecular level along with the investigation of the physicochemical properties of Hesperetin regarding the mechanism of destabilization of Aβ1-42 fibrils introduce it as a promising therapeutic agent for AD management. Our experimental findings also indicate that Hesperetin is a compound that prevents neuronal death by reducing inflammation and inhibiting apoptosis and pyroptosis.}, }
@article {pmid41290365, year = {2025}, author = {Chiotis, K and Wang, Y and La Joie, R and Rabinovici, GD}, title = {The Role of Amyloid-β and Tau PET in the New Era of Alzheimer Disease Therapies.}, journal = {Journal of nuclear medicine : official publication, Society of Nuclear Medicine}, volume = {}, number = {}, pages = {}, doi = {10.2967/jnumed.124.268339}, pmid = {41290365}, issn = {1535-5667}, abstract = {The advent of amyloid-β (Aβ) and tau PET imaging has revolutionized Alzheimer disease (AD) research, enabling in vivo detection of hallmark pathologies and transforming both diagnosis and therapeutic development. These imaging modalities have played a central role in the clinical trials that led to the recent approval of Aβ-targeting therapies, with Aβ PET used for participant selection and treatment monitoring and tau PET increasingly integrated to assess disease staging and prognosis. This continuing-education article reviews the current clinical validation of Aβ and tau PET imaging in AD, outlines the available evidence for the recently approved anti-Aβ therapies, and examines how PET imaging was operationalized in the trials for these novel therapeutic agents. We explore the potential for translating trial-based imaging protocols into clinical practice-particularly how PET quantification beyond binary visual reads can support nuanced decisions regarding patient eligibility, risk stratification, therapeutic monitoring, and duration of treatment. In addition, we discuss the emerging landscape of tau-targeting therapies and the anticipated central role of tau PET in their clinical evaluation. Finally, we identify key knowledge gaps and unmet needs that must be addressed to facilitate broader clinical adoption of PET imaging, including standardization efforts, accessibility and reimbursement, and evidence-based guidelines for interpretation and use.}, }
@article {pmid41289912, year = {2025}, author = {Verma, A and Waiker, DK and Gupta, PS and Shrivastava, SK}, title = {Recent advances in bioisosteric modifications for targeting Alzheimer's disease pathways.}, journal = {Bioorganic chemistry}, volume = {167}, number = {}, pages = {109248}, doi = {10.1016/j.bioorg.2025.109248}, pmid = {41289912}, issn = {1090-2120}, mesh = {Humans ; *Alzheimer Disease/drug therapy/metabolism ; Blood-Brain Barrier/metabolism/drug effects ; Animals ; Molecular Structure ; }, abstract = {The drug development process is highly challenging due to high cost, ethical consideration and takes a long time to reach in to the market for the ultimate benefit of the patients. Considering the global health issues, brain disorders such as Parkinsons disease (PD) and Alzheimer's disease (AD) are major concerns and are difficult to treat because of the complex nature of the disease. The complexity of these diseases, poor efficacy of the current drugs, and their low ability to cross blood brain barrier (BBB) limits the overall biological effectiveness of the treatment. These challenges must be addressed urgently to reduce the burden of these diseases and to improve the quality and expectancy of life. In a drug molecule its molecular properties are the key attributes in determining selectivity, stability, pharmacokinetics and BBB permeability. Any unfavorable changes in these molecular properties may compromise, whereas favorable modification can enhance the overall biological effectiveness of the drug molecule. Bioisosterism is a powerful chemical tool that offers replacement of undesired functional group on the drug molecule with more suitable group resulting in improved pharmacokinetics, minimizing side effects and toxicity, and could tailored it to complex environments such as brain. In this review we present recent bioisosteric replacement approaches which have been employed to optimize the existing molecular properties of the compound to improve their biological effectiveness particularly focusing on AD.}, }
@article {pmid41289288, year = {2025}, author = {Angelvy, P and Badin, M and Pelletier-Visa, M and Givron, P and Pereira, B and Coudeyre, E}, title = {Musical intervention to reduce stress during botulinum toxin injection for spasticity: Protocol for a randomized controlled trial (MUSIBOT).}, journal = {PloS one}, volume = {20}, number = {11}, pages = {e0327259}, pmid = {41289288}, issn = {1932-6203}, mesh = {Humans ; *Music Therapy/methods ; *Muscle Spasticity/drug therapy/psychology ; *Stress, Psychological/therapy/prevention & control/etiology ; *Botulinum Toxins/administration & dosage/adverse effects/therapeutic use ; Adult ; Male ; Female ; Randomized Controlled Trials as Topic ; Prospective Studies ; Heart Rate ; Middle Aged ; Injections, Intramuscular ; }, abstract = {INTRODUCTION: Botulinum toxin injections are a common treatment for managing spasticity resulting from central nervous system damage, including stroke, multiple sclerosis, and traumatic brain injury. However, the injections are associated with perceived pain, and many patients experience significant anticipatory stress regarding future sessions. The intensity of this stress varies among individuals. Music therapy, particularly receptive musical interventions structured around a U-shaped sequence, promotes progressive relaxation through distinct musical phases. This method has demonstrated efficacy in reducing pain and anxiety across various clinical contexts, including chronic and acute pain, Alzheimer's disease, fibromyalgia, and neurologically mediated pain. Given the painful nature of botulinum toxin injections, this study proposes the use of receptive music therapy to improve patient tolerance of the procedure. We hypothesize that receptive musical intervention can reduce injection-induced stress in adults undergoing botulinum toxin treatment. To our knowledge, no studies have specifically investigated the effect of music therapy on stress related to botulinum toxin injections. We aim to conduct a prospective randomized (1:1) controlled trial to evaluate the impact of receptive music intervention on stress levels, measured via heart rate variability (HRV), during botulinum toxin injection sessions. The primary objective is to assess the effect of receptive musical intervention during botulinum toxin injections on injection-induced stress, measured by HRV. Secondary objectives include evaluating the intervention's effects on pain intensity and anxiety levels.
METHODS AND ANALYSIS: Patient satisfaction following the music-assisted injection session will also be assessed. Additionally, the physician's evaluation of the procedure and the patient's perception of time during the session will be recorded.
ETHICS AND DISSEMINATION: All participants will provide written informed consent prior to enrollment. The study has received approval from the relevant institutional ethics committee (Comité de Protection des Personnes - ID: 25.00156.000468, Sud-Méditerranée IV, approved on 3 April 2025). Findings will be disseminated through peer-reviewed publications and presentations at scientific conferences.
TRIAL REGISTRATION: ClinicalTrials.gov NCT06920524.}, }
@article {pmid41287966, year = {2026}, author = {Cui, A and Patel, R and Bosco, P and Akcan, U and Richters, E and Barrilero Delgado, P and Agalliu, D and Sproul, AA}, title = {Generation of hiPSC-Derived Brain Microvascular Endothelial Cells Using Directed Differentiation and Transcriptional Reprogramming.}, journal = {Arteriosclerosis, thrombosis, and vascular biology}, volume = {46}, number = {1}, pages = {210-231}, pmid = {41287966}, issn = {1524-4636}, mesh = {Humans ; *Induced Pluripotent Stem Cells/metabolism ; *Endothelial Cells/metabolism ; *Blood-Brain Barrier/metabolism/cytology ; *Cell Differentiation ; *Microvessels/metabolism/cytology ; Coculture Techniques ; *Cellular Reprogramming ; Pericytes/metabolism ; Astrocytes/metabolism ; *Brain/blood supply ; Transcriptome ; Cells, Cultured ; Amyloid beta-Peptides ; Forkhead Transcription Factors/genetics/metabolism ; Transcription Factors/genetics/metabolism ; }, abstract = {BACKGROUND: Modeling the human blood-brain barrier (BBB) is limited by the lack of robust protocols to generate induced pluripotent stem cell (iPSC)-derived brain microvascular endothelial cells (BMECs). Current methods generate cells that do not fully recapitulate key BMEC functions or the brain endothelial transcriptome identity.
METHODS: To address this gap, we combined directed differentiation of human iPSCs into BBB-primed endothelial cells with overexpression of FOXF2 (forkhead box F2) and ZIC3 (zic family zinc finger 3), transcription factors critical for BMEC identity, to generate reprogrammed BMECs (rBMECs) from 3 iPSC lines. We performed immunofluorescence, functional analyses, and bulk RNA sequencing to characterize these cells. We cocultured rBMECs with iPSC-derived astrocytes and pericytes in the MIMETAS microfluidics platform to assess how 3-dimensional culture influences their BBB properties. Finally, we generated rBMECs expressing familial Alzheimer disease mutation APP V717I to elucidate how this genetic variant affects barrier properties compared with exposure to oAβ42 (oligomeric amyloid-β [1-42] peptide).
RESULTS: Transcriptomic and functional analyses show that rBMECs express a subset of the BBB transcriptome and exhibit stronger paracellular barrier properties, lower caveolar-mediated transport, and comparable PGP (P-glycoprotein) activity compared with primary human BMECs. rBMECs interact with human iPSC-derived pericytes and astrocytes to form a 3D neurovascular system in the MIMETAS microfluidics platform with robust BBB properties. Finally, APP V717I rBMECs show decreased barrier integrity and upregulation of inflammatory markers. In contrast, treatment of control rBMECs with oAβ42 increases inflammatory markers, but does not alter barrier integrity.
CONCLUSIONS: This protocol generates rBMECs with strong BBB properties and a brain-specific transcriptome signature. In addition, the iPSC-derived 3D neurovascular unit system shows some similar properties to the in vivo human BBB. Finally, familial Alzheimer disease mutation APP V717I alters several BBB-related properties of rBMECs and their inflammatory state, independent of Aβ42 (amyloid-β [1-42] peptide).}, }
@article {pmid41287525, year = {2025}, author = {Um, YH and Wynveen, P and Holland, M and Bhatt, K and Vucetic, Z and Engel, B and Carlson, C and Becker, A and Meier, IB and Narayan, VA and Wang, SM and Kang, DW and Kim, S and Kim, S and Kim, D and Choe, YS and Kim, REY and Ha, S and Lim, HK}, title = {Neuroimaging correlates and biomarker performance of a fully automated plasma p-tau217/Aβ42 ratio assay in a clinical cohort with Alzheimer's disease.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70942}, pmid = {41287525}, issn = {1552-5279}, support = {//Korea Creative Content Agency/ ; R2022020030//Korea Ministry of Culture, Sports, and Tourism in 2023/ ; //Basic Medical Science Facilitation Program/ ; //Catholic University of Korea/ ; //Catholic Education Foundation/ ; }, mesh = {Humans ; *Alzheimer Disease/blood/diagnostic imaging/pathology ; *tau Proteins/blood ; *Amyloid beta-Peptides/blood ; Male ; Female ; Biomarkers/blood ; Cross-Sectional Studies ; Aged ; Positron-Emission Tomography ; *Neuroimaging ; *Peptide Fragments/blood ; Phosphorylation ; Cohort Studies ; Aged, 80 and over ; Brain/diagnostic imaging/pathology ; Middle Aged ; }, abstract = {INTRODUCTION: Blood-based biomarkers offer scalable, non-invasive tools for Alzheimer's disease (AD) detection. We investigated the performance of plasma biomarkers associated with AD on the automated Beckman Coulter Access DxI 9000 analyzer.
METHODS: This cross-sectional study included 262 individuals from across the AD continuum. Plasma phosphorylated tau at threonine 217 (p-tau217), amyloid beta (Aβ)42, and their ratio were measured. Diagnostic accuracy for amyloid positron emission tomography (PET) positivity (Centiloid > 20), using a dual cutoff approach, was assessed via receiver operative characteristic curve. Associations with tau PET (n = 76) were also assessed.
RESULTS: The p-tau217/Aβ42 ratio showed the highest diagnostic accuracy for amyloid PET positivity (area under curve = 0.943) and the smallest indeterminate zone (8.0%). It correlated strongly and consistently with tau PET across Braak stages and with AD-related cortical atrophy.
DISCUSSION: The p-tau217/Aβ42 ratio was the most reliable plasma biomarker, closely tracking tau PET. It has potentials for clinical use in diagnosis and treatment monitoring.
HIGHLIGHTS: This is the first validation of the Beckman Coulter plasma immunoassay. The plasma phosphorylated tau at threonine 217 amyloid beta 42 ratio showed the highest accuracy across the full Alzheimer's disease (AD) spectrum. Plasma biomarkers correlated with tau positron emission tomography and AD-related brain atrophy. Glial fibrillary acidic protein offered complementary value reflecting astrocytic activation.}, }
@article {pmid41287056, year = {2025}, author = {Gouilly, D and Da-Costa, A and Vrillon, A and Pistono, A and Goubeaud, M and Bertrand, E and Germain, J and Ainaoui, N and Bras, S and Catala, H and Planton, M and Lemesle, B and Hitzel, A and Salabert, AS and Nogueira, L and Mouton-Liger, F and Méligne, D and Jasse, L and Rafiq, M and Sarton, B and Silva, S and Alam, J and Paquet, C and Tauber, C and Thalamas, C and Payoux, P and Péran, P and Pariente, J}, title = {Inhibition of p38α MAPK increases short-term astrocyte reactivity: the exploratory VIP trial in early Alzheimer's disease.}, journal = {Journal of neuroinflammation}, volume = {22}, number = {1}, pages = {298}, pmid = {41287056}, issn = {1742-2094}, abstract = {BACKGROUND: Neuro-inflammation is an early mechanistic target in Alzheimer’s disease (AD). However, the effect of anti-inflammatory drugs on biomarkers of neuro-inflammation has yet to be described. Biomarkers of neuro-inflammation showed distinct evolution over the course of AD, suggesting that anti-inflammatory interventions could be beneficial or interfere with mechanisms of immune defense.
METHODS: We conducted a pilot and exploratory phase II trial to evaluate the short-term effects of neflamapimod, a drug known to inhibit the neuro-toxic pro-inflammatory properties of the p38α MAPK. Participants with early AD were randomized to receive neflamapimod 40 mg (n = 17) or placebo (n = 16) twice-daily for 12 weeks. The primary endpoint was the treatment-related change in PET imaging of the translocator protein (TSPO) using [18F]-DPA-714. The main secondary endpoints were cerebrospinal fluid (CSF) markers of microglial and astrocyte reactivity. We hypothesized that neuro-inflammation would be reduced at three months in PET and in CSF markers.
RESULTS: Neuro-inflammation was not reduced between the neflamapimod and placebo groups, and no change was observed in [18F]-DPA-714 PET. However, neflamapimod induced a significant increase in CSF GFAP levels compared to placebo. Multivariate analyses based on CSF biomarkers highlighted the contribution of sTREM2 in the pattern of variation that discriminated the two groups (accuracy = 71%). Patients who received neflamapimod and had baseline sTREM2 level above the median had the highest increase in GFAP compared to placebo, suggesting that neflamapimod may exacerbate reactive astrogliosis as a function of the TREM2-related microglial state. Safety analysis showed that three cases of CSF pleocytosis occurred during follow-up in participants receiving neflamapimod.
CONCLUSIONS: Neflamapimod at a dose of 40 mg twice-daily interfered with mechanisms of immune defense in early AD. Although this study is exploratory, our results may provide an explanation for the failure of previous anti-inflammatory interventions in early AD. Biomarkers of neuro-inflammation should be required in the next-generation trials targeting neuro-immune mechanisms in AD.
REGISTRY: ClinicalTrials.gov, Clinical Trial registration number: NCT03435861.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12974-025-03625-x.}, }
@article {pmid41286555, year = {2025}, author = {Zhang, J and Zheng, Z and Liu, Y and Feng, S and Feng, G}, title = {Blood-Brain Barrier-Permeable Dual-Responsive Fluorescent Probe Reveals an Increased Risk of Alzheimer's Disease in Diabetic Patients.}, journal = {Analytical chemistry}, volume = {97}, number = {48}, pages = {26939-26947}, doi = {10.1021/acs.analchem.5c06216}, pmid = {41286555}, issn = {1520-6882}, mesh = {*Alzheimer Disease/diagnostic imaging/metabolism ; *Blood-Brain Barrier/metabolism ; *Fluorescent Dyes/chemistry/metabolism/chemical synthesis ; Animals ; Humans ; Mice ; Optical Imaging ; *Diabetes Mellitus, Experimental/metabolism ; Viscosity ; Mitochondria/metabolism ; }, abstract = {Alzheimer's disease (AD) is a global concern, and revealing its early diagnostic signals is crucial for timely intervention and treatment. Fluorescent probes hold great promise in disease diagnosis due to their high sensitivity and specificity. However, most existing probes struggle to effectively penetrate the blood-brain barrier (BBB), which significantly limits their application in brain disease imaging, including AD. Herein, a novel BBB-permeable fluorescent probe CL was reported. CL contains a quinolinium group and a C12 alkyl chain, enabling it to effectively target mitochondria without being affected by mitochondrial membrane potential. CL exhibits a dual response to viscosity and ONOO[-], displaying sensitive fluorescence responses at 812 and 495 nm, respectively. These characteristics enable CL to simultaneously monitor fluctuations in mitochondrial viscosity and ONOO[-], thereby achieving dual-channel detection and providing more comprehensive pathological information. More importantly, compared with the control probe DL containing a short C1 chain, CL exhibits superior BBB penetration ability and efficient brain imaging performance. Utilizing CL, alterations in viscosity and ONOO[-] in the brains of AD and diabetes mice were successfully monitored. The results not only show that both viscosity and ONOO[-] are important biomarkers of brain diseases but also reveal that diabetes patients have a higher risk of AD, laying a foundation for AD diagnosis and prevention.}, }
@article {pmid41286448, year = {2026}, author = {Albertini, G and Zielonka, M and Cuypers, ML and Snellinx, A and Xu, C and Poovathingal, S and Wojno, M and Davie, K and van Lieshout, V and Craessaerts, K and Wolfs, L and Pasciuto, E and Jaspers, T and Horré, K and Serneels, L and Fiers, M and Dewilde, M and De Strooper, B}, title = {The Alzheimer's therapeutic Lecanemab attenuates Aβ pathology by inducing an amyloid-clearing program in microglia.}, journal = {Nature neuroscience}, volume = {29}, number = {1}, pages = {100-110}, pmid = {41286448}, issn = {1546-1726}, support = {ERC-834682 CELLPHASE_AD//EC | EU Framework Programme for Research and Innovation H2020 | H2020 Priority Excellent Science | H2020 European Research Council (H2020 Excellent Science - European Research Council)/ ; METH/21/05//KU Leuven (Katholieke Universiteit Leuven)/ ; G087523N//Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders)/ ; AARF-22-968623/ALZ/Alzheimer's Association/United States ; }, mesh = {*Microglia/drug effects/metabolism ; Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism ; Humans ; *Amyloid beta-Peptides/metabolism ; Mice ; Plaque, Amyloid/pathology/metabolism/drug therapy ; Phagocytosis/drug effects ; Mice, Transgenic ; *Antibodies, Monoclonal, Humanized/pharmacology ; }, abstract = {Controversies over anti-amyloid immunotherapies underscore the need to elucidate their mechanisms of action. Here we demonstrate that Lecanemab, a leading anti-β-amyloid (Aβ) antibody, mediates amyloid clearance by activating microglial effector functions. Using a human microglia xenograft mouse model, we show that Lecanemab significantly reduces Aβ pathology and associated neuritic damage, while neither fragment crystallizable (Fc)-silenced Lecanemab nor microglia deficiency elicits this effect despite intact plaque binding. Single-cell RNA sequencing and spatial transcriptomic analyses reveal that Lecanemab induces a focused transcriptional program that enhances phagocytosis, lysosomal degradation, metabolic reprogramming, interferon γ genes and antigen presentation. Finally, we identify SPP1/osteopontin as a major factor induced by Lecanemab treatment and demonstrate its role in promoting Aβ clearance. These findings highlight that effective amyloid removal depends on the engagement of microglia through the Fc fragment, providing critical insights for optimizing anti-amyloid therapies in Alzheimer's disease.}, }
@article {pmid41285347, year = {2026}, author = {Li, X and Liu, R and He, Y and Yang, X and Li, T and Feng, Y}, title = {TEMPOL alleviated tau pathology and cognitive deficits induced by P301S-tau.}, journal = {Neuroscience letters}, volume = {871}, number = {}, pages = {138465}, doi = {10.1016/j.neulet.2025.138465}, pmid = {41285347}, issn = {1872-7972}, mesh = {Animals ; Spin Labels ; *Cyclic N-Oxides/pharmacology/therapeutic use ; *tau Proteins/metabolism/genetics ; Mice ; *Cognitive Dysfunction/drug therapy/metabolism/pathology ; Mice, Transgenic ; Male ; Mice, Inbred C57BL ; Phosphorylation/drug effects ; }, abstract = {Alzheimer's disease (AD) is the most frequent of neurodegenerative disease affecting elderly people. However, there is still no curative therapeutic strategies in clinical practice. Here, we studied whether TEMPOL as a free radical scavenger can prevent memory deficits in P301S-tau mice. We found that TEMPOL administration markedly restored learning and memory impairments inducing by P301S-tau. We showed that TEMPOL had a potent capacity of inhibiting the expression of tau protein and its phosphorylation levels. The inflammatory response and synaptic defects induced by P301S-tau was also obviously improved TEMPOL treatment. Furthermore, proteomics showed 121 reversed proteins by TEMPOL treatment were primarily involved in immune system processes, innate immune responses, inflammatory responses, autophagosome assembly, lysosome organization, and autophagy. Taken together, TEMPOL played a critical role in P301S-tau-related cognitive impairments. These findings demonstrate that TEMPOL shows promise as a multi-target therapeutic agent for AD by modulating critical pathways implicated in its pathogenesis.}, }
@article {pmid41285280, year = {2026}, author = {Hu, Q and Xu, K and Ran, Q and Zhang, W and Gan, C and Fang, Q and Hui, A}, title = {Hybrid molecules with dual inhibition of acetylcholinesterase and tau hyperphosphorylation: design, inhibitory activity evaluation, apoptosis assessment, and mechanistic exploration.}, journal = {Chemico-biological interactions}, volume = {423}, number = {}, pages = {111848}, doi = {10.1016/j.cbi.2025.111848}, pmid = {41285280}, issn = {1872-7786}, mesh = {*Cholinesterase Inhibitors/pharmacology/chemistry/metabolism ; Humans ; *tau Proteins/metabolism/antagonists & inhibitors ; *Apoptosis/drug effects ; *Acetylcholinesterase/metabolism/chemistry ; Phosphorylation/drug effects ; Molecular Docking Simulation ; *Drug Design ; Cell Line, Tumor ; Structure-Activity Relationship ; Alzheimer Disease/drug therapy ; Phenothiazines/chemistry/pharmacology ; Tacrine/chemistry ; }, abstract = {A comprehensive therapeutic strategy for Alzheimer's disease (AD) requires simultaneous inhibition of acetylcholinesterase (AChE) and targeting of hyperphosphorylated Tau (P-Tau)-mediated pathogenesis. To address this need, the present study designed a series of hybrid molecules by integrating three pharmacophoric scaffolds with established P-Tau-modulating activity (phenothiazine, dibenzazepine and benzothiazepinones) into AChE-inhibiting frameworks: indanone (derived from the clinical AChE inhibitor Donepezil) or 9-chloro-1,2,3,4-tetrahydroacridine (derived from Tacrine, another clinically approved AChE inhibitor). Following preliminary in silico evaluations including druggability predictions and absorption, distribution, metabolism, excretion, toxicity (ADMET) profiling, twelve compounds (C1-C12) with potential AChE/P-Tau dual-target binding affinity were identified and subsequently synthesized. Among these, four compounds (C5, C6, C7, and C11) exhibited significant AChE inhibitory activity, with IC50 values ranging from 205.3 to 257.1 nM, comparable to that of tacrine (226.0 nM). Notably, the indanone-phenothiazine hybrid compound C11 stood out as the most promising candidate, it achieved the lowest P-Tau/total Tau (T-Tau) ratio (5.30 × 10[-6]) in okadaic acid (OA)-induced SH-SY5Y cells, outperforming hydromethylthionine mesylate (5.40 × 10[-6]), a leading clinical candidate for Tau aggregation inhibition. Beyond its dual inhibitory activities, C11 ameliorated OA-induced cell apoptosis, further supporting its potential as anti-AD agent. Subsequent mechanistic explorations confirmed that C11 alleviated oxidative stress and downregulated Tau phosphorylation at specific pathogenic sites (Ser396, Ser262, Thr181). Concurrently, C11 modulated the expression of glycogen synthase kinase-3β (GSK-3β), a critical kinase driving P-Tau formation. In conclusion, this study identifies novel dual-target inhibitors against AChE and P-Tau, and provides new therapeutic insights into AD treatment.}, }
@article {pmid41284585, year = {2026}, author = {Ismail, Z and Guan, DX and Babulal, GM and Bateman, JR and Cantillon, M and Creese, B and D'Antonio, F and Fischer, CE and Gatchel, JR and Ghahremani, M and Guerrero-Cantera, J and Lanctôt, KL and Mielke, MM and Mortby, ME and Feldman, O and Pereira, AC and Pereiro, AX and Perry, G and Potter, WZ and Rabl, M and Ravona-Springer, R and Rosen, AC and Rouse, HJ and Sankhe, K and Schindler, SE and Udeh-Momoh, CT and Tarawneh, R and Oliveira, FF and , }, title = {Plasma biomarkers in neuropsychiatric syndromes: A narrative review.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {109}, number = {1}, pages = {44-69}, pmid = {41284585}, issn = {1875-8908}, support = {R01 AG068183/AG/NIA NIH HHS/United States ; R01 AG074562/AG/NIA NIH HHS/United States ; R01 AG074302/AG/NIA NIH HHS/United States ; /WT_/Wellcome Trust/United Kingdom ; R01 AG066749/AG/NIA NIH HHS/United States ; RF1 AG083744/AG/NIA NIH HHS/United States ; R01 CA241758/CA/NCI NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; R01 AG067428/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Biomarkers/blood ; *Mental Disorders/blood ; Cognitive Dysfunction/blood ; *Neurodegenerative Diseases/blood ; }, abstract = {Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on the author group's subject area expertise. We found that plasma biomarkers are a burgeoning field, and scalability and accessibility make them well-suited for the study of NPS across the disease continuum. In early-stage NDD, diagnostic biomarkers are best suited for discriminating NDD-related NPS from non-NDD psychiatric syndromes and/or NPS due to other causes. In those with dementia, monitoring and prognostic biomarkers may enable the assessment of treatment response or help predict the risk of worsening symptoms. We conclude that plasma amyloid-β and tau show great promise in assessing NPS, especially during early-stage disease, but inflammatory and genetic biomarkers may also play a role across the disease course. Systematic research is required, keeping in mind the ethical considerations of knowing biomarker status in early-stage disease.}, }
@article {pmid41284069, year = {2025}, author = {Rodrigues, KDC and Oliveira, MDC and de Souza, IC and Igansi, AW and Lopes, AVB and de Oliveira Pacheco, C and Hass, SE and Schumacher, RF and Luchese, C}, title = {Sex-dependent therapeutic effects of nano-curcumin on alzheimer's disease: enhanced cognitive and physiological restoration in female mice.}, journal = {Psychopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41284069}, issn = {1432-2072}, support = {PqG 24/2551-0001249-4//Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul/ ; 160674/2020-4//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; }, abstract = {Curcumin (Cur) is a bioactive compound with neuroprotective and anti-inflammatory effects, though its clinical application is limited by poor bioavailability. This study assessed the impact of nanocapsulated curcumin (NcCur), formulated Eudragit (EUD) polymer, in a sporadic Alzheimer's disease (AD) mouse model induced by intracerebroventricular streptozotocin (STZ), with attention to sex-specific differences. Mice received STZ (3 nmol/3 µL) or 0.9% saline on days 1 and 3, followed by intragastric treatment with Cur or NcCur (10 mg/kg, on alternate days) from day 22 until euthanasia - a dose previously shown to be effective in behavioral and biochemical modulation in rodent models of neurodegeneration. Behavioral assessments included open field, elevated plus maze (EPM), tail suspension (TST), object recognition, Y-maze, and step-down avoidance tasks (SDAT), performed before and after treatment. After euthanasia, thymus, spleen and adrenal glands were weighed; biochemical assays evaluated oxidative stress, monoaminergic and cholinergic enzymes, and Na[+]K[+]-ATPase activity. NcCur improved short- and long-term memory in both sexes, with greater effects in females (42% and 35%) than males (28% and 25%). In the EPM, NcCur increased open arm time more prominently in females (40%) than males (25%), while TST immobility time was reduced similarly in both. Spatial and aversive memory improved in both sexes, but females showed greater performance in the SDAT. Biochemical analyses showed reductions in reactive species in males (45%) and females (55%) with NcCur; Na[+]K[+]-ATPase activity increased in females (60%) and males (50%). AChE activity was restored in both sexes. NcCur reduced MAO-A/B activities more in females (65%/55%) than in males (45%/35%). Thymus and spleen weights were normalized in both sexes, with stronger effects in females. NcCur also mitigated alterations in thymus and spleen relative weights, suggesting immunomodulatory effects. Some biochemical and behavioral responses were more prominent in females, both sexes benefited from treatments. These findings suggest that NcCur enhances Cur therapeutic potential through multimodal actions linked involving modulation of oxidative stress, cholinergic and monoaminergic systems, and immune-related parameters. NcCur emerges as a promising candidate for AD-like intervention in both sexes.}, }
@article {pmid41282905, year = {2025}, author = {Andrews, D and Golchi, S and Collins, DL}, title = {A digital twin methodology using real patient data for sample size reduction in Alzheimer's disease randomized controlled clinical trials.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41282905}, support = {U19 AG024904/AG/NIA NIH HHS/United States ; }, abstract = {INTRODUCTION: Recruitment for Alzheimer's disease randomized controlled trials (RCTs) is difficult and expensive. To reduce RCT sample sizes, our Digital Twin Trial (DTT) methodology combines an interpretable cognitive decline prediction model with prediction-powered inference.
METHODS: For DTT participants, our model identifies similar individuals ("Digital Twins") from a retrospective database and uses their cognitive scores to predict decline. Predictions adjust observed scores, reducing variance within treatment groups. We simulated 18-month DTTs and standard RCTs using mixed effects models of decline in Alzheimer's Disease Neuroimaging Initiative subjects meeting lecanemab's Phase 3 inclusion criteria.
RESULTS: Predicted and observed change in Clinical Dementia Rating Sum-of-Boxes correlated at r = 0.4 . DTTs required 1,855 subjects versus 2,170 for standard RCTs to detect a simulated 25% decline-slowing drug effect at 0.9 power. DTT Type 1 error was consistent with 0.05.
DISCUSSION: DTTs could reduce recruitment and cost burdens. Model interpretability could help clinicians trust individualized prognoses.}, }
@article {pmid41282780, year = {2025}, author = {Yang, B and Earnest, T and Bilgel, M and Albert, MS and Johnson, SC and Davatzikos, C and Erus, G and Masters, CL and Resnick, SM and Miller, MI and Bakker, A and Morris, JC and Benzinger, TLS and Gordon, BA and Sotiras, A}, title = {Predicting future cognitive impairment in preclinical Alzheimer's disease using multimodal imaging: a multisite machine learning study.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41282780}, support = {R01 AG043434/AG/NIA NIH HHS/United States ; T32 EB014855/EB/NIBIB NIH HHS/United States ; P50 AG016574/AG/NIA NIH HHS/United States ; S10 RR022984/RR/NCRR NIH HHS/United States ; RF1 AG059869/AG/NIA NIH HHS/United States ; UL1 TR000448/TR/NCATS NIH HHS/United States ; P01 AG036694/AG/NIA NIH HHS/United States ; U01 AG024904/AG/NIA NIH HHS/United States ; R01 AG067103/AG/NIA NIH HHS/United States ; S10 OD018091/OD/NIH HHS/United States ; P01 AG003991/AG/NIA NIH HHS/United States ; P01 AG026276/AG/NIA NIH HHS/United States ; U19 AG033655/AG/NIA NIH HHS/United States ; R01 EB009352/EB/NIBIB NIH HHS/United States ; RF1 AG027161/AG/NIA NIH HHS/United States ; U01 AG006786/AG/NIA NIH HHS/United States ; S10 OD025200/OD/NIH HHS/United States ; }, abstract = {Predicting the likelihood of developing Alzheimer's disease (AD) dementia in at-risk individuals is important for the design of and optimal recruitment for clinical trials of disease-modifying therapies. Machine learning (ML) has been shown to excel in this task; however, there remains a lack of models developed specifically for the preclinical AD population, who display early signs of abnormal brain amyloidosis but remain cognitively unimpaired. Here, we trained and evaluated ML classifiers to predict whether individuals with preclinical AD will progress to mild cognitive impairment or dementia within multiple fixed time windows, ranging from one to five years. Models were trained on regional imaging features extracted from amyloid positron emission tomography and magnetic resonance imaging pooled across seven independent sites and from two amyloid radiotracers ([[18]F]-florbetapir and [[11]C]-Pittsburgh-compound-B). Out-of-sample generalizability was evaluated via a leave-one-site-out and leave-one-tracer-out cross-validation. Classifiers achieved an out-of-sample receiver operating characteristic area-under-the-curve of 0.66 or greater when applied to all except one hold-out sites and 0.72 or greater when applied to each hold-out radiotracer. Additionally, when applying our models in a retroactive cohort enrichment analysis on A4 clinical trial data, we observed increased statistical power of detecting differences in amyloid accumulation between placebo and treatment arms after enrichment by ML stratifications. As emerging investigations of new disease-modifying therapies for AD increasingly focus on asymptomatic, preclinical populations, our findings underscore the potential applicability of ML-based patient stratification for recruiting more homogeneous cohorts and improving statistical power for detecting treatment effects for future clinical trials.}, }
@article {pmid41282773, year = {2025}, author = {Ackley, SF and La Joie, R and Caunca, M and Mukherjee, S and Choi, SE and Trittschuh, EH and Crane, PK and Hayes-Larson, E and , }, title = {Substituting Blood-Based Biomarkers for Imaging Measures in Alzheimer's Disease Studies: Implications for Sample Size and Bias.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41282773}, support = {U01 AG024904/AG/NIA NIH HHS/United States ; R00 AG075317/AG/NIA NIH HHS/United States ; U24 AG074855/AG/NIA NIH HHS/United States ; R00 AG073454/AG/NIA NIH HHS/United States ; R01 AG082730/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND: Blood-based biomarkers for Alzheimer's disease (AD) pathology are appealing options in large population-based studies due to their low cost, minimal invasiveness, and feasibility of collection in non-clinical settings. Despite these benefits, blood-based biomarkers have lower test-retest reliability than neuroimaging measures like amyloid positron emission tomography (amyloid-PET) Centiloids; trade-offs in power and bias remain unexplored.
METHODS: We use data from Alzheimer's Disease Neuroimaging Initiative (ADNI) and the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) studies, which include both amyloid-PET and blood-based measures, to assess differences in statistical power, required sample size, and bias when replacing a neuroimaging measure with a blood-based measure. We use simulations parameterized based on these studies to show potential implications of using plasma p-tau181 or p-tau217, blood-based AD biomarkers, in place of Centiloids from amyloid-PET, when the biomarker is either the exposure or the outcome in an analysis of interest.
RESULTS: We demonstrated that substituting amyloid-PET Centiloids with a blood-based measure of p-tau can substantially reduce power, requiring 3 to 6 times the sample size to achieve 80% power compared to amyloid-PET. In addition, using a blood-based biomarker as the exposure can introduce significant regression dilution bias, attenuating estimated associations.
CONCLUSIONS: Due to their lower cost and ease of collection compared with neuroimaging, blood-based biomarkers facilitate AD pathology measures on larger, more diverse samples with longitudinal follow-up. Consideration of the sample sizes they necessitate and their potential for bias is critical for the design and interpretation of studies employing these biomarkers.}, }
@article {pmid41282720, year = {2025}, author = {Khorsand, B and Teichrow, D and Ghanbarian, E and Zheng, L and Sajjadi, SA and Glover, CM and Grill, JD and Rabin, LA and Ezzati, A}, title = {Scalable Markers for Early Cognitive Decline: Plasma p-tau217, Subjective Cognitive Concerns, and Digital Testing: Results from the A4/LEARN studies.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41282720}, support = {R01 AG063689/AG/NIA NIH HHS/United States ; U24 AG057437/AG/NIA NIH HHS/United States ; U19 AG010483/AG/NIA NIH HHS/United States ; K23 AG063993/AG/NIA NIH HHS/United States ; R01 AG095017/AG/NIA NIH HHS/United States ; R01 AG080635/AG/NIA NIH HHS/United States ; }, abstract = {BACKGROUND AND OBJECTIVES: Although amyloid positron emission tomography (PET) and Cerebrospinal fluid (CSF) biomarkers remain the standard for confirming Alzheimer's disease (AD) pathology, their use is impractical for screening or routine prognostic assessment. Plasma phosphorylated tau 217 (p-tau217), subjective cognitive concerns, and computerized cognitive testing are non-invasive, scalable, and feasible to implement in large populations. We tested whether these measures independently predict the onset of cognitive impairment and whether combining them improves prognostic accuracy.
METHODS: We analyzed 1,071 cognitively unimpaired adults aged 65-85 years from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial (amyloid-positive; solanezumab or placebo arms) and the parallel Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) cohort (amyloid-negative). At baseline, participants completed plasma p-tau217 measurement, the Cognitive Function Index (CFI), and the Cogstate Computerized Battery (CCB). Over 240 weeks of follow-up, incident impairment was defined as conversion from a Global Clinical Dementia Rating Score (CDR-GS) of 0 to 0.5 or higher. The predictive value of each measure for subsequent decline was examined after adjustment for demographic and genetic covariates.
RESULTS: During the follow-up, 365 of 1,071 participants (34.1%) developed cognitive impairment. Higher plasma p-tau217 (per-standard-deviation increase) was associated with higher odds of converting to CDR-GS>0 across all cohorts: A4-Placebo (HR=1.56; 95% CI, 1.37-1.78), A4-Solanezumab (HR=1.46; 95% CI, 1.29-1.65), LEARN (HR=1.25; 95% CI, 1.05-1.48). Similarly, higher CFI predicted incident impairment: A4-Placebo (HR=1.59; 95% CI, 1.42-1.79), A4-Solanezumab (HR=1.67; 95% CI, 1.47-1.91), LEARN (HR=1.37; 95% CI, 1.12-1.68). Lower CCB also conferred higher risk: A4-Placebo (HR=0.76; 95% CI, 0.65-0.91), A4-Solanezumab (HR=0.73; 95% CI, 0.62-0.87), LEARN (HR=0.68; 95% CI, 0.53-0.87). In models including all three predictors, each remained independently associated with progression.
CONCLUSION: Plasma p-tau217, subjective cognitive concerns, and computerized cognitive testing each independently predicted progression to cognitive impairment in cognitively unimpaired older adults. Together, these non-invasive and scalable measures provide practical tools for risk stratification years before clinical diagnosis. Combining biological, subjective, and digital markers may support earlier detection in clinical care and enhance efficiency in prevention trial enrollment.}, }
@article {pmid41282187, year = {2025}, author = {O'Brien, EK and Cox, T and Fernandez, S and Bourgeat, P and Porter, T and Goudey, B and Doecke, JD and Masters, CL and Fripp, J and Nho, K and Villemagne, VL and Cruchaga, C and Rowe, CC and Saykin, AJ and Dore, V and Laws, SM}, title = {Predicting accumulation and age at onset of amyloid-β from genetic risk and resilience for Alzheimer's disease.}, journal = {Research square}, volume = {}, number = {}, pages = {}, pmid = {41282187}, issn = {2693-5015}, support = {R01 AG043434/AG/NIA NIH HHS/United States ; R01 AG058676/AG/NIA NIH HHS/United States ; P01 AG003991/AG/NIA NIH HHS/United States ; P01 AG026276/AG/NIA NIH HHS/United States ; U19 AG024904/AG/NIA NIH HHS/United States ; R01 EB009352/EB/NIBIB NIH HHS/United States ; UL1 TR000448/TR/NCATS NIH HHS/United States ; }, abstract = {Accumulation of brain amyloid beta (Aβ) is a key pathological hallmark of Alzheimer's disease (AD) and begins many years before cognitive symptoms. Being able to predict the risk of Aβ accumulation, or the age at which this accumulation exceeds a critical threshold, may enable early intervention and treatment to slow or prevent the onset of AD. We utilised published genome-wide association studies (GWAS) to develop polygenic scores (PGS) based on AD risk (PGSrisk) and resilience (PGSresilience). We tested whether these could predict (i) whether an individual was an accumulator of Aβ ('Accumulator Status'), and (ii) in accumulators, the age at which brain Aβ is estimated to exceed a threshold of 20 centiloids (CL)('Estimated Age at onset of Aβ'; AAO-Aβ) among 2175 participants (1158 with AAO Aβ) from the Alzheimer's Dementia Onset and Progression in International Cohorts (ADOPIC) study. Additionally, we conducted genome-wide association studies (GWAS) of these traits and developed phenotype-specific PGSs using cross-validation (CV). Higher PGSrisk was associated with a greater risk of being an accumulator and a younger AAO-Aβ. When stratified by number of APOE ε4 alleles, PGSrisk predicted Accumulator Status in APOE ε4 heterozygotes, and AAO-Aβ in ε4 non-carriers and heterozygotes, with the same directions of effect as were seen in the whole cohort. PGSresilience was not significantly associated with Accumulator Status, but higher PGSresilience was associated with later AAO-Aβ overall and in ε4 heterozygotes. Trait-specific PGSs, developed using CV, were not significantly associated with either trait overall and the direction of association varied across CV folds. Polygenic scores, alongside other risk factors, may be useful for identifying individuals at risk of accumulating Aβ, and predicting the age at which this exceeds a critical threshold. This could provide a window for administering disease-modifying treatment or lifestyle interventions to prevent or delay the onset of AD.}, }
@article {pmid41282120, year = {2025}, author = {Li, M and Niu, S and Xu, Y and Li, J and Hu, X and Liu, D and Atik, M and Xu, X and Wang, L and Ertekin-Taner, N and Tao, C}, title = {Bridging the Computational-Experimental Gap: Leveraging Large Language Model to Prioritize Alzheimer's Therapeutics Based on Comparison of Learning Models.}, journal = {Research square}, volume = {}, number = {}, pages = {}, pmid = {41282120}, issn = {2693-5015}, support = {P30 AG066515/AG/NIA NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; RF1 AG072799/AG/NIA NIH HHS/United States ; P30 AG066508/AG/NIA NIH HHS/United States ; P30 AG066519/AG/NIA NIH HHS/United States ; P30 AG072973/AG/NIA NIH HHS/United States ; P30 AG066462/AG/NIA NIH HHS/United States ; P30 AG066530/AG/NIA NIH HHS/United States ; P30 AG066509/AG/NIA NIH HHS/United States ; P30 AG066546/AG/NIA NIH HHS/United States ; P30 AG072958/AG/NIA NIH HHS/United States ; P30 AG072972/AG/NIA NIH HHS/United States ; P30 AG072979/AG/NIA NIH HHS/United States ; R01 AG084236/AG/NIA NIH HHS/United States ; P20 AG068082/AG/NIA NIH HHS/United States ; P30 AG072975/AG/NIA NIH HHS/United States ; P30 AG066444/AG/NIA NIH HHS/United States ; R01 AG072799/AG/NIA NIH HHS/United States ; P30 AG066507/AG/NIA NIH HHS/United States ; P30 AG072946/AG/NIA NIH HHS/United States ; P30 AG066518/AG/NIA NIH HHS/United States ; P30 AG066511/AG/NIA NIH HHS/United States ; P30 AG086404/AG/NIA NIH HHS/United States ; U24 AG072122/AG/NIA NIH HHS/United States ; P30 AG066512/AG/NIA NIH HHS/United States ; P30 AG072978/AG/NIA NIH HHS/United States ; P30 AG062429/AG/NIA NIH HHS/United States ; R01 AG083039/AG/NIA NIH HHS/United States ; P30 AG062422/AG/NIA NIH HHS/United States ; R01 AG079280/AG/NIA NIH HHS/United States ; P30 AG086401/AG/NIA NIH HHS/United States ; P30 AG072977/AG/NIA NIH HHS/United States ; P30 AG062677/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; P30 AG066506/AG/NIA NIH HHS/United States ; P30 AG066468/AG/NIA NIH HHS/United States ; P30 AG072976/AG/NIA NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; P30 AG072931/AG/NIA NIH HHS/United States ; P30 AG066514/AG/NIA NIH HHS/United States ; P30 AG072959/AG/NIA NIH HHS/United States ; }, abstract = {Alzheimer's Disease (AD)[1] is a progressive neurodegenerative disorder with limited therapeutic options, driving interest in drug repurposing to accelerate treatment discovery. Drug repurposing has emerged as a promising strategy to accelerate therapeutic discovery by repositioning existing drugs for new clinical indications. Recent computational repurposing approaches, including knowledge graph reasoning, transcriptomic signature analysis, and integrative literature mining, have demonstrated strong predictive capabilities[2]. However, these methods often yield divergent drug rankings, which makes it difficult to decide which candidates to advance for experimental follow-up and results in substantial gaps between computational predictions and feasible in vivo validation[2]. To bridge this computational-experimental gap, we proposed an advanced prioritization framework leveraging large language models (LLMs). Our method systematically evaluated three state-of-the-art (SOTA) and representative computational methods (TxGNN[3], Composition-based Graph Convolutional Network (CompGCN)[4], and a regularized logistic regression (RLR)[5], to analyze both their predictive performance and pharmaceutical class distributions. By integrating the strengths and divergences of these models, we generated a unified, streamlined list of 90 candidate drugs for further prioritization. We then utilized an LLM-based agent to perform evidence synthesis from biomedical literature abstracts for each candidate. This process mimics expert manual curation but significantly reduces human effort and time by efficiently distilling vast textual data into actionable insights. Applying consistent and transparent selection criteria, we obtained a refined and prioritized list of drug candidates suitable for subsequent in vivo experimental validation. The robustness and clinical relevance of our framework were validated using real-world data from Alzheimer's patient cohorts, clinical trial registries, and expert pharmacological reviews. This comprehensive validation confirmed that our LLM-driven approach enhances efficiency, consistency, scalability, and generalizability. By integrating computational predictions with scalable evidence synthesis and multifaceted validation, our framework facilitated rapid and informed prioritization of repurposed drugs. Our framework can potentially accelerate the translational pathway toward viable AD therapeutics. Moreover, the versatility of our framework can also be applied to drug repurposing efforts for other diseases beyond AD.}, }
@article {pmid41281734, year = {2025}, author = {Wang, D and Florian, H and Lynch, SY and Robieson, W and Zhuang, R and Kusiak, C and Ross, JL and Walsh, JR and Graff, O}, title = {Using AI-generated digital twins to boost clinical trial efficiency in Alzheimer's disease.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70181}, pmid = {41281734}, issn = {2352-8737}, abstract = {INTRODUCTION: Machine learning models leverage baseline data to create artificial intelligence (AI)-generated digital twins (DTs)-individualized predictions of each participant's clinical outcomes if they had received placebo. Incorporating DTs may increase statistical power or reduce required sample sizes in Phase 2 or 3 trials, and therefore improve efficiency in Alzheimer's disease (AD) trials. Here we demonstrate these properties using data from an AD Phase 2 clinical trial (AWARE, NCT02880956).
METHODS: A conditional restricted Boltzmann machine (CRBM) model was trained on historical clinical trials and observational data from 6736 unique subjects after data harmonization to generate DTs of participants from the AWARE trial. The AWARE trial enrolled 453 subjects with mild cognitive impairment (MCI) or mild AD. DTs were assessed as prognostic covariates to evaluate gains in variance and sample size reduction.
RESULTS: Positive partial correlation coefficients were found between DTs and change score from baseline in key cognitive assessments ranging from 0.30 to 0.39 at Week 96 in the AWARE trial. These correlations were consistent with validation results from three independent trials, which ranged from 0.30 to 0.46. Total residual variance was reduced by ~9% to 15% with DTs. While maintaining statistical power, DTs could reduce total sample size by ~9% to 15%, and control arm sample size by 17% to 26% in future AD trials.
DISCUSSION: Efficiency was improved in AD clinical trials using machine learning models to generate prognostic DTs by including them in statistical analysis modeling. This methodology aligns with regulatory guidance and represents an application of machine learning models suitable for the analysis of pivotal trial data. Validated DTs have the potential to improve clinical development efficiency in AD and in other neurological indications.
HIGHLIGHTS: Digital twins (DTs) were generated by artificial intelligence (AI) models trained on historical datasets.Use of digital twin (DT) as a covariate in the analysis model can reduce treatment effect variability.By coupling DT with the analysis model, trial sample size can be reduced.DT technology was accepted by the U.S. Food and Drug Administration and European Medicines Agency for applications in clinical trials.}, }
@article {pmid41281561, year = {2025}, author = {Melamed, I and Buckley, C and Bayko, ME and Williams, JL and Or-Geva, N}, title = {Does C1 esterase inhibitor play a role in post COVID-19 neurological symptoms? A randomized, double-blind, placebo-controlled, crossover, proof-of-concept study.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1523814}, pmid = {41281561}, issn = {1664-2295}, abstract = {BACKGROUND: Many patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection experience neurologic changes post-infection, which has been hypothesized to be due to dysregulation in the infectious-immune axis that leads to a neuro-immune response. This immune dysfunction has been termed "Alzheimer's of the Immune System" or AIS and there are several immune factors that may play a key role. These include, among others, complement activation due to low levels of C1-esterase inhibitor (C1-INH) and function, and a decrease in signaling of Toll-like receptor (TLR)-3. We propose that C1-INH replacement may upregulate the immune dysfunction, thereby improving neurological symptoms.
METHODS: In this randomized, double-blind, placebo-controlled, crossover, proof-of-concept study, adults experiencing SARS-CoV-2 post-viral fatigue syndrome for >4 weeks post-recovery from coronavirus disease 2019 (COVID-19) infection were randomized 1:1 to two arms: Arm 1 (C1-INH for 8 weeks, then placebo for 8 weeks) or to Arm 2 (placebo for 8 weeks, then C1-INH for 8 weeks). Patients were assessed for adult executive function, abnormal cognitive decline, depression [Beck Depression Inventory-II (BDI-II)], migraine, fatigue [Fatigue Severity Scale (FSS)] and pain (Short-form McGill Pain Questionnaire). Percent change in TLR signaling in response to zymosan was compared with controls at baseline, Week 8 and Week 16. Safety was assessed throughout.
RESULTS: At this interim analysis, 36 patients with SARS-CoV-2 post-viral fatigue syndrome had completed the two 8-week treatment periods. In Arm 1, trends toward improvements from baseline at Week 8 of C1-INH therapy were observed in BDI-II score (-8.7 points), mean FSS score (0.6 points), and mean McGill Pain Questionnaire score (-0.4 points). These improvements were either sustained or worsened at Week 16, following crossover to placebo. The outcomes in Arm 2 were compatible with those in Arm 1. Patients with SARS-CoV-2 post-viral fatigue syndrome had low levels of TLR-related signaling biomarkers compared with healthy controls.
CONCLUSION: This proof-of-concept study demonstrates sustained dysregulation of the immune system after COVID-19 infection. Improvements in depression, fatigue, and pain were observed with C1-INH treatment in patients with SARS-CoV-2 post-viral fatigue syndrome, indicating C1-INH may be a potential therapeutic target.
CLINICAL TRIAL REGISTRATION: The study was registered on September 21, 2024, with the identifier number NCT04705831.}, }
@article {pmid41281560, year = {2025}, author = {Sun, Q and Wang, F}, title = {Using artificial intelligence and radiomics to analyze imaging features of neurodegenerative diseases.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1624867}, pmid = {41281560}, issn = {1664-2295}, abstract = {INTRODUCTION: Neurodegenerative diseases such as Alzheimer's and Parkinson's are characterized by complex, multifactorial progression patterns that challenge early diagnosis and personalized treatment planning.
METHODS: To address this, we propose an integrated AI-radiomics framework that combines symbolic reasoning, deep learning, and multi-modal feature alignment to model disease progression from structural imaging and behavioral data. The core of our method is a biologically informed architecture called NeuroSage, which incorporates radiomic features, clinical priors, and graph-based neural dynamics. We further introduce a symbolic alignment strategy (CAIS) to ensure clinical interpretability and cognitive coherence of the learned representations.
RESULTS AND DISCUSSION: Experiments on multiple datasets-including ADNI, PPMI, and ABIDE for imaging, and YouTubePD and PDVD for behavioral signals-demonstrate that our approach consistently outperforms existing baselines, achieving an F1 score of 88.90 on ADNI and 85.43 on PPMI. These results highlight the framework's effectiveness in capturing disease patterns across imaging and non-imaging modalities, supporting its potential for real-world neurodegenerative disease monitoring and diagnosis.}, }
@article {pmid41281523, year = {2025}, author = {Li, YP and Niu, Y and Ding, H and Chen, Z and Zhang, Q}, title = {Potential role of meningeal lymphatic drainage in repetitive transcranial magnetic stimulation-induced cognitive improvement: A call for further research.}, journal = {World journal of psychiatry}, volume = {15}, number = {11}, pages = {111985}, pmid = {41281523}, issn = {2220-3206}, abstract = {Mild cognitive impairment (MCI), which is a high-risk transitional phase leading to Alzheimer's disease, is characterized by mild memory deficits and specific cognitive dysfunctions. Without effective intervention, a significant proportion of patients with MCI progress to dementia. However, current pharmacological treatments are characterized by side effects and poor patient compliance. Therefore, it is necessary to develop effective, noninvasive alternative treatments. Repetitive transcranial magnetic stimulation (rTMS) is becoming a widely studied noninvasive treatment for central nervous system disease. The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues. Recently, a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction. Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.}, }
@article {pmid41281504, year = {2025}, author = {Teixeira, AL and Kim, Y and Cordeiro, TM and de Erausquin, GA and Rocha, NP}, title = {Agitation in Alzheimer's disease: From assessment to therapeutics.}, journal = {World journal of psychiatry}, volume = {15}, number = {11}, pages = {109581}, pmid = {41281504}, issn = {2220-3206}, abstract = {Agitation is a neuropsychiatric syndrome characterized by excessive motor and/or verbal behaviors, with or without aggressive behaviors. The prevalence of agitation in Alzheimer's disease varies from 5% to over 50%. Multiple factors have been implicated in its pathophysiology, including disease stage, comorbidity with other symptoms (e.g., psychosis, anxiety/depression), and psychosocial factors. Ruling out delirium and identifying environmental triggers are fundamental steps in the management of agitation in Alzheimer's disease. For establishing an effective therapeutic plan, it is important to define duration, severity, and potential for harm. While non-pharmacological approaches are considered the first line of intervention, pharmacological agents are frequently used in the treatment of agitation. Antipsychotics are commonly used in acute agitation. For chronic agitation, serotonin-selective reuptake inhibitors, especially citalopram and escitalopram, are often preferred due to safety concerns associated with the long-term use of antipsychotics. Promising novel strategies, such as new compounds and neuromodulation, are likely to be incorporated into agitation therapeutics in the next few years.}, }
@article {pmid41281281, year = {2025}, author = {Jing, S and Wang, Y and Liu, Y and Luo, Y and Wen, X and Ma, Y and Zhu, H and Chen, G and Ouyang, X}, title = {Folic acid as a potential therapeutic agent for Alzheimer's disease: Effects on inflammatory cytokines, amyloid deposition, and neurotransmitter metabolism.}, journal = {Journal of medical biochemistry}, volume = {44}, number = {7}, pages = {1551-1557}, pmid = {41281281}, issn = {1452-8258}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a degenerative disease of the central nervous system characterized by neuroinflammation and amyloid deposition. Folic acid (FA), a B vitamin, may improve the course of AD by modulating inflammation and neuroprotection. This study aimed to investigate the effects of FA supplementation on serum inflammatory cytokines (IL-1b, IL-6, TNF-a), amyloid (Ab1-42), Tau proteins, and neurotransmitters (GABA, 5-HT, Ach) in AD patients.
METHODS: We conducted a follow-up-controlled trial; 114 AD patients were included and randomly divided into a control group (donepezil treatment) and an experimental group (donepezil + FA treatment) for 3 months. Inflammatory factors, Ab1-42, Tau, neurotransmitter levels and nutritional status were assessed before and after treatment.
RESULTS: The total effective rate of the experimental group (89.47%) was significantly higher than that of the control group (75.44%), and the levels of inflammatory factors (IL-1b, IL-6, and TNF-a), Ab1-42, and Tau were significantly lower (P<0.05), and neurotransmitters (GABA, 5-HT, and Ach) and nutritional indexes (albumin and hemoglobin) were substantially higher.
CONCLUSIONS: FA supplementation can effectively delay AD progression by inhibiting neuroinflammation, reducing amyloid deposition, regulating neurotransmitter metabolism and improving nutritional status.}, }
@article {pmid41280486, year = {2025}, author = {Taube, PS and Fernandes, D and Vasconcelos, AA and Costa, JAS and de Araujo, MP and Lima, AKO and Wahab, N and Dos Santos, EKL and de Oliveira, MI and da Silva, JP and Andriani, KF and da Silva Oliveira, TP and Sampaio, MC and de Campos Braga, H and de Araújo, ACS and Gul, K}, title = {Perspectives and state-of-the-art use of metal-derived, porous nanomaterials and metallo-drugs for biomedical applications.}, journal = {3 Biotech}, volume = {15}, number = {12}, pages = {416}, pmid = {41280486}, issn = {2190-572X}, abstract = {Due to a combination of genetic, environmental, and behavioral factors, the number of infectious and non-infectious diseases affecting humans has been rising. Many illnesses are in the forefront of research and development such as neoplasms of different forms, chronic conditions related to inflammation and lifestyle (e.g., cancer, diabetes mellitus, Alzheimer's and Parkinson's diseases) and infectious diseases that are difficult to treat (e.g., due to drug resistance). Due to current challenges in diagnosis and treatment of diseases and health conditions, the field of nanotechnology has witnessed numerous advancements. In particular, metal-based, porous nanomaterials and metallo-drugs have gained attention due to their ability to be used for various diagnostic and therapeutic applications. These systems exhibit excellent physicochemical properties, with amenable functionalization and varying optical, scattering and electronic properties, enabling for both imaging and therapy of diseases (i.e., theranostics), involving techniques such as photoacoustic imaging, magnetic resonance imaging (MRI), computed tomography (CT), photothermal therapy (PTT), photodynamic therapy (PDT) and radiotherapy. This review discusses the important aspects of metal nanoparticles, porous-based materials and metallo-drugs for biomedical applications, exploring their physical and chemical characteristics, cellular/molecular processes and biopotencies that make them effective in treating a variety of illnesses or diseases.}, }
@article {pmid41280332, year = {2025}, author = {Wu, Z and Yu, S and Tian, D and Cheng, L and Jing, J}, title = {Microglial TREM2 and cognitive impairment: insights from Alzheimer's disease with implications for spinal cord injury and AI-assisted therapeutics.}, journal = {Frontiers in cellular neuroscience}, volume = {19}, number = {}, pages = {1705069}, pmid = {41280332}, issn = {1662-5102}, abstract = {Cognitive impairment is a frequent but underrecognized complication of neurodegenerative and traumatic central nervous system disorders. Although research on Alzheimer's disease (AD) revealed that microglial triggering receptor expressed on myeloid cells 2 (TREM2) plays a critical role in inhibiting neuroinflammation and improving cognition, its contribution to cognitive impairment following spinal cord injury (SCI) is unclear. Evidence from AD shows that TREM2 drives microglial activation, promotes pathological protein clearance, and disease-associated microglia (DAM) formation. SCI patients also experience declines in attention, memory, and other functions, yet the specific mechanism of these processes remains unclear. In SCI, microglia and TREM2 are involved in inflammation and repair, but their relationship with higher cognitive functions has not been systematically examined. We infer that TREM2 might connect injury-induced neuroinflammation in the SCI with cognitive deficits, providing a new treatment target. Artificial intelligence (AI) offers an opportunity to accelerate this endeavor by incorporating single-cell transcriptomics, neuroimaging, and clinical data for the identification of TREM2-related disorders, prediction of cognitive trajectories, and applications to precision medicine. Novel approaches or modalities of AI-driven drug discovery and personalized rehabilitation (e.g., VR, brain-computer interface) can more precisely steer these interventions. The interface between lessons learned from AD and SCI for generating new hypotheses and opportunities for translation.}, }
@article {pmid41280310, year = {2025}, author = {Inamdar, A and Bugadannavar, P and Palled, M and Umarani, S and Salve, P and Gurupadayya, B and Patil, P and Sharma, H}, title = {Biological determinants of blood-based biomarker levels in Alzheimer's disease: role of nutrition, inflammation, and metabolic factors.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1614962}, pmid = {41280310}, issn = {1663-4365}, abstract = {OBJECTIVES: The review discusses the effect of biological determinants such as nutritional deficiency, systemic inflammation, and metabolic disorders affect blood-based biomarker (BBBM) levels, influencing their use in diagnosing, prognosticating, and treatment in Alzheimer's disease (AD). While the individual contributions of neuroinflammation, brain insulin resistance, and micronutrient deficiencies to AD pathology are well-established, a significant knowledge gap exists in understanding their intricate, synergistic interactions. This review proposes a novel integrated framework of bidirectional crosstalk where these three factors create a self-perpetuating cycle of neurodegeneration.
METHODS: A comprehensive literature review was conducted, including all aspects of epidemiological and biological context associated with vitamins, micronutrients, and dietary patterns; inflammatory cytokines; insulin resistance; metabolic syndrome; and hormonal changes. Emerging integrative approaches such as multi-omics, AI modeling, and systems biology were also reviewed for their possible refinement in biomarker interpretation.
RESULTS: The results prove that the deprivation of vitamins E, D, B12, and antioxidants contributes to oxidative stress and subsequent neuroinflammation that changes levels of blood-based biomarkers. A chronic state of inflammation caused by cytokines like IL-6, IL-18, and TNF-α represents a major link to the formation of increased amyloid plaques and tau tangles. Metabolically deregulated states, such as insulin resistance, dyslipidemia, and thyroid imbalance, further alter variability in biomarkers. All these factors would act together to affect the expression of key biomarkers-Aβ, p-tau, and neurofilament light chain (NFL). Individualized interpretation, stratified clinical trials, and digital monitoring tools are potentially effective for achieving better diagnostic precision and boosting treatment efficacy.
CONCLUSION: To a large extent, factors must all be understood thoroughly from multiple biological angles to improve early diagnosis, risk prevention, and treatment personalization in AD. Future studies should develop integrative models that consider nutrition, metabolism, and inflammation to address and fully exploit biomarker utility as well as support precision medicine approaches.}, }
@article {pmid41280213, year = {2025}, author = {Ali, SH and Osmaniye, D and Kaplancıklı, ZA}, title = {Synthesis and biological evaluation of novel hydrazone derivatives for the treatment of Alzheimer's disease.}, journal = {RSC advances}, volume = {15}, number = {53}, pages = {45729-45743}, pmid = {41280213}, issn = {2046-2069}, abstract = {In recent years, Alzheimer's disease has emerged as a silent epidemic neurodegenerative disorder. Due to its complex pathophysiology, there has been significant scientific interest in developing effective treatments that go beyond symptomatic relief. The main aim is to improve patients' quality of life and lower the death rate associated with Alzheimer's disease. Since this has not yet been achieved, continued research on Alzheimer's disease remains a global priority. In this study, a total of 27 hybrid molecules (D1a-D1i, D2a-D2i, and D3a-D3i) were designed based on the molecular scaffold of donepezil, a well-known acetylcholinesterase inhibitor (AChEI). These hybrids incorporate dihydrothiazolyl hydrazone and phenyl piperidine moieties. All compounds were synthesized and characterized using IR, NMR, and HRMS spectroscopy, and subsequently evaluated for acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibition using the in vitro Ellman method. Evaluation of biological activity revealed that compound D1f exhibited the highest inhibitory activity against the AChE enzyme, with an IC50 of (0.039 ± 0.001 Mm). In contrast, none of the compounds showed significant inhibitory activity against the BChE enzyme. Cytotoxicity testing of compound D1f on NIH3T3 fibroblast cells demonstrated non-cytotoxic effects (IC50 = 3.324 ± 0.155 µM) and the highest selectivity index (SI = 85.231), respectively. Molecular docking and molecular dynamics simulations verified the stable binding affinity and favorable interactions of compound D1f within the active site of acetylcholinesterase (AChE). The results further demonstrated that the AChE enzyme preserved its structural integrity and compactness throughout its interaction with D1f. Collectively, these observations highlight D1f as a promising lead molecule for subsequent optimization and development of novel anti-Alzheimer's therapeutic agents.}, }
@article {pmid41280038, year = {2025}, author = {Terzioglu, G and Karp, ES and Heuer, SE and Haage, VC and De Jager, PL and Young-Pearse, TL}, title = {INPP5D/SHIP1 is a dual regulator of endo-lysosome function and selective phagocytosis in human microglia.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, pmid = {41280038}, issn = {2692-8205}, support = {R01 AG055909/AG/NIA NIH HHS/United States ; U01 AG072572/AG/NIA NIH HHS/United States ; }, abstract = {INPP5D, the gene encoding SHIP1, is genetically associated with Alzheimer's disease (AD) risk and plays a central role in regulating immune function. Here, we aimed to elucidate the mechanism by which SHIP1 mediates its role in suppressing inflammatory pathways, with a focus on human microglia. Our findings illuminate an essential role for SHIP1 in endosome maturation and lysosomal function. We show that SHIP1 localizes to both the plasma membrane and to endo-lysosomal compartments and binds to the CapZ family of proteins, which are important for endosome maturation. Reduction of SHIP1 levels via genome editing impairs endosome maturation and lysosomal function, leading to lipid droplet accumulation and leakage of lysosomal cathepsin B into the cytosol, which in turn activates the NLRP3 inflammasome. CITE-seq profiling of SHIP1-deficient microglia revealed a shift from an immune-responsive state toward a DAM-like, phagocytic state, accompanied by impaired response to LPS and enhanced phagocytosis of synaptic material and apoptotic neurons via TREM2. While amyloid-β uptake was not affected, amyloid-β accumulated intracellularly due to defective lysosomal degradation, further driving lipid droplet formation. Together, these results identify SHIP1 as a regulator of endo-lysosomal function and selective phagocytosis of lipid-rich substrates in microglia. These findings have important implications for therapeutic hypotheses that target SHIP1 for treatment of AD, autoimmune diseases, and cancer.}, }
@article {pmid41279689, year = {2025}, author = {Schurman, CA and Kaur, G and Kaya, S and Bons, J and Aguirre, CG and Liu, Q and King, CD and Wilson, KA and Baker, HL and Hady, M and Luna, NM and Bieri, G and Villeda, SA and Ellerby, LM and Schilling, B and Alliston, T}, title = {Alzheimer's disease risk factor APOE4 exerts dimorphic effects on female bone.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.1101/2025.10.16.682922}, pmid = {41279689}, issn = {2692-8205}, abstract = {Individuals diagnosed with Alzheimer's disease (AD) are at an increased risk of bone fractures. Conversely, a diagnosis of osteoporosis in women is the earliest known predictor for AD. However, mechanisms responsible for the coupled decline in cognitive and skeletal health remain unclear. Proteomic analysis of cortical bone from aged mice revealed neurological disease-associated proteins that are highly enriched in aged mouse bones, including apolipoprotein E (Apoe) and amyloid precursor protein. Further, Apoe localized specifically to bone-embedded osteocytes with expression twice as high in aged female bone as in young or male counterparts. In humans, APOE allele variants carry differing AD risk with age. To investigate APOE allelic roles in bone, we utilized a humanized APOE knock-in mouse model that expresses either the protective APOE2, the neutral APOE3, or the AD risk factor APOE4, and analyzed bone and hippocampus from the same mice. APOE4 exerted strong sex-specific effects on the bone transcriptome and proteome, relative to APOE2 or APOE3. Interestingly, the APOE4-associated perturbation in the female bone proteome was more pronounced than the corresponding alterations observed in the hippocampus. APOE4 protein causes bone fragility in females, but not males, even without changes in cortical bone structure. These bone quality deficits arose from suppression of osteocyte perilacunocanalicular remodeling. We find that APOE4 is a new molecular culprit capable of disrupting osteocyte maintenance of bone quality as early as midlife in a manner that disproportionately affects females. These findings highlight osteocytes as potential targets for early diagnosis of age-related cognitive impairment, and treatment for bone fragility, in females.}, }
@article {pmid41279475, year = {2025}, author = {Veerareddy, V and Wang, Z and Kashyap, PC and Kandimalla, KK}, title = {Butyrate regulates the blood-brain barrier transport and intra-endothelial accumulation of Alzheimer's disease Amyloid-beta peptides.}, journal = {bioRxiv : the preprint server for biology}, volume = {}, number = {}, pages = {}, doi = {10.1101/2025.10.24.684335}, pmid = {41279475}, issn = {2692-8205}, abstract = {Alzheimer's disease (AD) is characterized by the pathological deposition of amyloid beta (Aꞵ) proteins as amyloid plaques, tau aggregates, and cerebrovascular dysfunction that drive disease progression. Butyrate, a gut microbial metabolite, has been found to be reduced in AD patients; butyrate supplementation improved cognition and decreased amyloid burden in animal models. However, the precise underlying mechanisms are unclear. Our previous studies have demonstrated that insulin signaling impacts Aꞵ transport kinetics at the blood-brain barrier (BBB). In this study, we investigated the effect of butyrate treatment on intra-endothelial Aꞵ accumulation and BBB integrity by modulating the insulin signaling pathway. The effect of butyrate on Aꞵ accumulation was assessed by flow cytometry in BBB cell culture models. Insulin signaling activation and the expression of various receptors and transporters at the BBB were evaluated by Western blots and confocal microscopy. The roles of various molecular mediators were confirmed using specific inhibitors (MK2206, Trametinib, Rapamycin, VX-745). The effect of butyrate on the expression of BBB receptors and transporters that play a critical role in Aꞵ trafficking was examined in mouse brains colonized with butyrate-producing bacteria via immunohistochemistry. Butyrate significantly decreased Aβ42 accumulation in endothelial cells. This effect was associated with insulin signaling pathway activation, particularly AKT and ERK phosphorylation. Inhibitor studies established the critical role of these specific arms, as co-incubation with MK2206 (AKT inhibitor) or Trametinib (ERK inhibitor) reversed the protective effect of butyrate and increased Aβ42 accumulation. However, mTOR and p38 inhibitors did not show a similar effect. In addition, butyrate restored P-glycoprotein efflux transporter expression and claudin-5 tight junction protein levels that were reduced with Aβ treatment. These effects were supported by in vivo work, which demonstrated the upregulation of Tissue Inhibitor of Metalloproteinases-2 (TIMP-2). This protein is associated with AKT activation and extracellular matrix stabilization in mice colonized with butyrate-producing bacteria. In conclusion, we have demonstrated that butyrate decreases Aβ42 uptake at the BBB endothelium by activating the AKT and ERK arms of the insulin signaling pathway. These changes may also improve the integrity of BBB tight junctions by increasing claudin-5 expression and extracellular matrix, and by upregulating TIMP-2 expression. This study highlights butyrate's potential as a therapeutic modulator of AD-related BBB dysfunction.}, }
@article {pmid41278376, year = {2025}, author = {Li, J and Zhang, J and Xu, X and Xiao, L and Ling, Y and Liu, S and Gao, Y and Zhao, L and Jia, H}, title = {Quality and reliability of Alzheimer's disease videos on Douyin and Bilibili: A cross-sectional content analysis study.}, journal = {Digital health}, volume = {11}, number = {}, pages = {20552076251398464}, pmid = {41278376}, issn = {2055-2076}, abstract = {BACKGROUND: Alzheimer's disease (AD) poses a significant public health challenge to China's aging population. Patients and their families increasingly turn to short-video platforms such as Douyin and Bilibili for information. However, there is currently a lack of systematic analysis regarding the quality and reliability of advertising content on these platforms, creating a critical gap in understanding this emerging information ecosystem.
AIM: Systematically evaluate the quality and reliability of videos on Douyin and Bilibili, analyzing the relationship between content themes, upload sources, and user engagement metrics.
METHODS: Using "Alzheimer's disease" as the keyword, we retrieved the top 100 videos from multiple platforms. Videos were categorized by uploader type and content. Two qualified researchers assessed their reliability and quality using the JAMA, the modified DISCERN instrument (mDISCERN), and Global Quality Score (GQS) scale. Data analysis employed nonparametric statistical methods. Apply relevance and logistic regression analysis to discuss factors that may influence video quality.
RESULTS: This study analyzed a total of 171 videos. Results indicate that compared to Douyin, videos on the Bilibili platform scored higher across multiple quality evaluation metrics (GQS: 2.0(1.0-2.0) vs 1.0(1.0-2.0); mDISCERN: 2.0(2.0-2.0) vs. 2.0(2.0-2.0); JAMA: 2.0(1.0-2.0) vs. 1.0 (1.0-2.0); p < 0.001). This disparity may be attributed to Bilibili's longer video format, which allows for more in-depth content, and its user base that tends to favor detailed, knowledge-oriented media. Regarding uploader identity, videos posted by professionals (e.g. physicians) demonstrated superior quality compared to nonprofessional sources (e.g. patients). However, patient-uploaded videos exhibited stronger engagement metrics (e.g. likes, comments). Content-wise, videos focusing on disease prevention and treatment consistently achieved the highest overall quality (all comparisons p < 0.05). Correlation analysis indicated that while interaction metrics showed strong internal correlations, they did not significantly correlate with JAMA, mDISCERN, or GQS scores. Ordered logistic regression analysis indicates that uploader identity, content classification, and presentation format are the three key factors influencing video quality.
CONCLUSION: This study reveals a pronounced "quality-dissemination paradox" in AD content across mainstream short-video platforms: While scientifically rigorous content published by medical professionals receives high quality ratings, it significantly underperforms in user engagement metrics compared to nonprofessional content centered on patient narratives and lived experiences. This highlights a severe disconnect between scientific rigor and public participation within algorithmic dissemination ecosystems. To address this, platforms should optimize algorithms to enhance the visibility of authoritative content, encourage collaboration between professional and nonprofessional creators to boost content appeal, and strengthen health media literacy education for the public-particularly older adults-to improve their ability to discern information.}, }
@article {pmid41278202, year = {2025}, author = {Larriba-González, T and García-Martín, M and Ojeda-Hernández, DD and Rincón-Cerrada, P and Martín-Blanco, L and Benito-Martín, MS and Selma-Calvo, B and de la Fuente-Martín, S and Matias-Guiu, JA and Matias-Guiu, J and Gómez-Pinedo, U}, title = {Modeling neurodegenerative diseases with brain organoids: from development to disease applications.}, journal = {Frontiers in cell and developmental biology}, volume = {13}, number = {}, pages = {1663286}, pmid = {41278202}, issn = {2296-634X}, abstract = {Organoids derived from stem cells have significantly advanced disease modeling, particularly in neurodegenerative disorders, while advancing personalized and regenerative medicine. These three-dimensional structures reproduce key aspects of human brain organization and functionality, while remaining simplified models that do not yet recapitulate full neural circuitry or disease progression, providing an improved platform for studying disease mechanisms, drug responses, and potential therapeutic strategies. This review explores the methodologies used in organoid development, including the differentiation of stem cells and culture techniques that enable the formation of self-organizing tissues. Organoids have been successfully used to model key cellular and molecular aspects of neurodegenerative diseases such as Alzheimer's and Parkinson's, offering insights into early disease mechanisms and potential novel treatment strategies. Key findings highlight that organoids provide more physiologically relevant data than traditional two-dimensional cultures and animal models, making them valuable tools for preclinical research and personalized treatment approaches. However, challenges remain, including variability in organoid generation, lack of vascularization, and difficulties in large-scale production for clinical applications. For the effective integration of organoids into biomedical and clinical applications, future research should prioritize improving reproducibility, standardization, and vascularization methods. Addressing these limitations will enhance their translational potential, leading to more effective treatments for neurodegenerative disorders and broader applications in precision medicine.}, }
@article {pmid41278077, year = {2025}, author = {Arai, H}, title = {Underestimated Centiloid Values in Amyloid PET: A Technical Report on Clinically Relevant Quantification Errors.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97398}, pmid = {41278077}, issn = {2168-8184}, abstract = {Quantitative amyloid positron emission tomography (PET) interpretation using the Centiloid scale is increasingly adopted worldwide to guide eligibility and continuation of anti-amyloid monoclonal antibody therapy. However, discrepancies between visual and quantitative assessments occasionally occur, potentially leading to critical misjudgments in clinical decision-making. We present a representative 18F-florbetapir case in which cortical amyloid deposition was visually evident, yet the calculated Centiloid value was 0, falsely indicating a negative scan. This underestimation likely results from reference region selection: using the whole cerebellum (including white matter) lowers standardized uptake value ratios by approximately 7% compared with cerebellar gray matter, thereby decreasing Centiloid values. Consequently, patients with substantial amyloid burden may be incorrectly deemed ineligible for initiation or continuation of anti-amyloid therapy. Clinicians should therefore interpret Centiloid-based quantification with caution, always corroborating it with expert visual reads. Harmonization of reference region definitions and standardized reporting are urgently needed to prevent inappropriate treatment decisions and ensure the safe, effective use of disease-modifying therapies in Alzheimer's disease.}, }
@article {pmid41278048, year = {2025}, author = {Lin, WC and Wu, A and Chen, NC and Ha, B}, title = {Observations of Triple Network Model Connectivity Changes by Functional Magnetic Resonance Imaging in a Single Early-Stage Dementia Participant Pre- and Post-craniosacral Therapy: A Case Report.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97329}, pmid = {41278048}, issn = {2168-8184}, abstract = {Resting-state functional magnetic resonance imaging (rs-fMRI) is a noninvasive imaging technique that measures spontaneous brain activity to map functional connectivity within and between brain networks characterized as the triple network model (TNM). In Alzheimer's disease (AD), rs-fMRI has been used to detect early network disruptions, track disease progression, and evaluate therapeutic interventions. While craniosacral therapy (CST) has shown clinical benefits for conditions like chronic pain and migraine, its impact on TNM connectivity in AD, as evidenced by rs-fMRI, has not been explored. This case report involves a 79-year-old man with early-stage AD who presented with mild delusions, anxiety, irritability, and nighttime behaviors and a Mini-Mental State Examination (MMSE) score of 24 and a Clinical Dementia Rating (CRD) of 0.5, indicating a mild neurocognitive disorder. Preliminary rs-fMRI data revealed changes in the default mode network (DMN), salience network (SN), and central executive network (CEN) following CST. These changes suggest greater connectivity within the CEN and SN, alongside reduced variability in the DMN following CST. These observations suggest potential reorganization of TNM dynamics. The clinical relevance of these findings remains under evaluation. The observations from this single case report limit the ability to draw definitive conclusions about the impact of CST on TNM connectivity in early-stage AD. A further study is needed to determine if the TNM changes observed by rs-fMRI can be replicated in additional participants and if the changes are correlated with clinical outcomes. Further studies with larger cohorts, extended treatment durations, and longer follow-up periods are needed to explore the potential clinical benefits of CST in this population.}, }
@article {pmid41277450, year = {2025}, author = {Wharton, T and Paulson, D and McClure, NV and Laird, RD and Campos, BM and Churchill, EG and Lysandrou, AE and Maynard, M}, title = {Pilot trial of the Florida-Resources for Enhancing Alzheimer's Caregiver Health (FL-REACH) intervention in an outpatient memory disorders clinic.}, journal = {Aging & mental health}, volume = {}, number = {}, pages = {1-9}, doi = {10.1080/13607863.2025.2585507}, pmid = {41277450}, issn = {1364-6915}, abstract = {OBJECTIVES: Translation of the foundational REACH II intervention for caregivers of persons with Alzheimer's disease and related dementias (ADRD) into practice has been limited. Most interventions generally focus on later-stage caregiving. The FL-REACH intervention was adapted from REACH II, addressing issues of implementation burden and shifting focus to prolonging in-home care through intervention delivered soon after diagnosis. Goals of this single-arm pilot study were to examine effectiveness of a six-session intervention delivered through an outpatient memory disorders clinic to caregivers of those diagnosed with mild to moderate stage memory disorders.
METHOD: Dementia caregivers were recruited from the AdventHealth Maturing Minds Program. The COVID-19 pandemic compelled transition of the intervention delivery from the clinic environment to online.
RESULTS: Dementia knowledge, caregiver burden, and caregiver preparedness all improved from baseline to post-treatment. Participants who completed the intervention online were disproportionately male, and more socioeconomically and ethnically diverse than those who completed the intervention in person.
CONCLUSION: Results support use of the FL-REACH intervention program and suggest that memory disorders clinics create a valuable opportunity for enrollment in dementia caregiver interventions that provide training and skills development early in the disease trajectory.}, }
@article {pmid41277070, year = {2025}, author = {Casagrande, LR and Medeiros, EB and Venturini, LM and Zaccaron, RP and da Costa, C and Bittencourt, JVS and Modolon, HB and Lidio, AV and Arcaro, S and Budni, J and Gu, Y and Thirupathi, A and Lock Silveira, PC}, title = {Neuromodulation with low-intensity pulsed ultrasound (Lipus) combined with curcumin-gold nanoparticles (Cur-AuNPs) in an Alzheimer's disease model.}, journal = {Drug delivery}, volume = {32}, number = {1}, pages = {2577826}, pmid = {41277070}, issn = {1521-0464}, mesh = {Animals ; *Alzheimer Disease/drug therapy/therapy/metabolism ; *Curcumin/administration & dosage/pharmacology/chemistry ; *Gold/chemistry/administration & dosage ; Mice ; *Metal Nanoparticles/chemistry/administration & dosage ; Male ; Disease Models, Animal ; Amyloid beta-Peptides ; Maze Learning/drug effects ; Ultrasonic Waves ; Peptide Fragments ; Hippocampus/metabolism/drug effects ; Blood-Brain Barrier/metabolism ; }, abstract = {Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disorder that requires innovative therapeutic strategies. This is the first study to evaluate the synergistic effects of LIPUS and CUR-AuNPs in an AD model, which aimed to investigate the effects of these therapies on learning, memory and neuroinflammation in mice with β-amyloid peptide (βA1-42)-induced AD. Sixty mice were divided into five groups: control, βA1-42, βA1-42 + LIPUS, βA1-42 + CUR-AuNPs, and βA1-42 + LIPUS + CUR-AuNPs. Treatments began 24 hours after induction and continued for 17 days using intranasal CUR-AuNPs (25 μg/mL) and transcranial LIPUS (0.8 W/cm[2], 1 MHz). The results demonstrated that the isolated therapies reversed memory deficits in the Y-maze and radial maze tests. However, the combined therapy group was able to reverse these deficits only in the radial maze. Electron microscopy confirmed the ability of CUR-AuNPs to cross the blood‒brain barrier, especially in the combined group, and no liver toxicity was observed. All the treated groups presented increased BDNF in the hippocampus and cortex. IL-1β and IL-6 levels are reduced in the cortex, while IL-1β and TNF-α levels are decreased in the hippocampus. IL-10 increased only in the hippocampus, while GSH levels increased in both regions. Combination therapy also reduced nitrite concentrations in the hippocampus and cortex and NFκB expression in the hippocampus. APP expression decreased exclusively in the LIPUS group in the hippocampus. These results suggest that although single treatments are effective, their combination enhances neuroprotective responses through the modulation of inflammation, oxidative stress, and neurotrophic signaling, suggesting promising potential for AD treatment.}, }
@article {pmid41276859, year = {2025}, author = {Noguchi-Shinohara, M and Yoshinobu, T and Ozaki, T and Muramatsu, D and Shima, A and Sakashita, Y and Tada, Y and Yamaguchi, H and Komatsu, J and Ikeda, T and Ono, K}, title = {Higher phosphorylated tau levels predict cognitive decline and amyloid-related imaging abnormalities during lecanemab treatment: clinical practice data.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {251}, pmid = {41276859}, issn = {1758-9193}, mesh = {Humans ; Female ; Male ; Aged ; *tau Proteins/metabolism/cerebrospinal fluid ; *Cognitive Dysfunction/drug therapy/diagnostic imaging/metabolism ; Magnetic Resonance Imaging ; Phosphorylation ; *Alzheimer Disease/drug therapy/diagnostic imaging ; Biomarkers/cerebrospinal fluid/blood ; Middle Aged ; Aged, 80 and over ; Brain/diagnostic imaging ; Positron-Emission Tomography ; Neuropsychological Tests ; *Plaque, Amyloid/diagnostic imaging/drug therapy ; }, abstract = {BACKGROUND: Lecanemab was recently approved for the treatment of patients with early Alzheimer's disease (AD) and demonstrated reduced senile amyloid plaque and less decline on the measures of cognition and function in clinical trials. However, the real-world data on its efficacy and safety remain limited. We aimed to evaluate the effectiveness and tolerance of lecanemab treatment and determine biomarkers at baseline that could predict cognitive deterioration and the occurrence of amyloid-related imaging abnormaities (ARIA) in real-world clinical practice.
METHODS: To determine the indication for lecanemab, the patients were evaluated through neurological examinations, cognitive assessments, blood test, head magnetic resonance imaging (MRI), amyloid positron emission tomography, lumbar puncture, genetic testing, and clinical conferences. The Mini-Mental State Examination (MMSE) was used to assess cognition, and the MRI scans were used for safety monitoring of ARIA.
RESULTS: Between January 2024 and October 2025, 234 patients were screened, 100 initiated lecanemab treatment. The mean age was 72.7 years, and 68 (68.0%) patients were female. Among the 71 patients surveyed via MRI prior to the 14th infusion, 12 (16.9%) had ARIA detected. Compared with those of patients without ARIA, the baseline cerebrospinal fluid (CSF)-ptau181 levels of patients with ARIA significantly increased. When the patients were divided into high and low CSF-ptau181 groups according to the cutoff value (78.6 pg/ml) which derived from ROC analysis for ARIA prediction, the MMSE scores of the high ptau group were significantly declined compared to that of the low ptau group at 6 and 12 months after baseline. The infusion-reactions occurred only in 6.0% of patients. The longitudinal observation revealed that the plasma thrombomodulin levels significantly decreased after 6 months of lecanemab treatment.
CONCLUSION: Lecanemab was generally well tolerated by most patients with early AD and treatment appeared to be more effective and safer in patients with low CSF-ptau181 levels. Our results suggest an association between lecanemab treatment and reduced markers of vascular endothelial injury.}, }
@article {pmid41276781, year = {2025}, author = {Gürbüz, P and Doğan, ŞD and Gündüz, MG and Martínez-González, L and Pérez, C and Martinez, A}, title = {Screening Natural Phenolic Compounds for Blood-Brain Barrier Permeability, Alongside GSK-3β, CK-1δ, and AChE Inhibition, for the Treatment of Alzheimer's Disease.}, journal = {Drug development research}, volume = {86}, number = {8}, pages = {e70193}, doi = {10.1002/ddr.70193}, pmid = {41276781}, issn = {1098-2299}, support = {//The present study was supported by the Research Foundation of Erciyes University (Grant No: TSA-2022-11539)./ ; }, mesh = {*Alzheimer Disease/drug therapy ; *Blood-Brain Barrier/metabolism/drug effects ; Humans ; *Glycogen Synthase Kinase 3 beta/antagonists & inhibitors/metabolism ; *Cholinesterase Inhibitors/pharmacology/chemistry/pharmacokinetics ; *Neuroprotective Agents/pharmacology/pharmacokinetics/chemistry ; Molecular Docking Simulation ; *Phenols/pharmacology/chemistry ; Acetylcholinesterase/metabolism ; Permeability ; }, abstract = {Alzheimer's Disease (AD) is a neurological disorder characterized by progressive cognitive impairment and memory loss. In vitro artificial membrane permeability assays targeting the blood-brain barrier (BBB), such as the parallel artificial membrane permeability assay (PAMPA), are useful for pre-evaluating the BBB penetration of molecules during the early stages of drug development. Inhibitors of glycogen synthase kinase-3β (GSK-3β), casein kinase-1δ (CK-1δ), and acetylcholinesterase (AChE) exhibit neuroprotective effects, indicating a potential therapeutic approach for AD. This study aimed to assess the ability of 23 phenolic compounds derived from natural sources to penetrate the central nervous system (CNS) and examine their potential neuroprotective effects. Following the prediction of BBB penetration of the compounds by PAMPA, neuroprotective effects of CNS+ compounds were evaluated through in vitro inhibition of GSK-3β, CK-1δ, and AChE. Based on the data obtained, five flavonoids (hispidulin, nepetin, platanoside, apigenin, and kaempferol) and two furanocoumarins (isopimpinellin and bergapten) were predicted to penetrate the CNS. Apigenin (API) and kaempferol (KEM) exhibited the most potent dual inhibitory activity against CK-1δ and GSK-3β. Furthermore, API and KEM did not exhibit cytotoxic effects in SH-SY5Y cells. Molecular modeling studies, including molecular docking, molecular dynamics simulations, and dynophore analysis, were performed to understand the binding mechanism of these most potent compounds to their target enzymes. Overall, the current study offers a rational approach to designing new molecules inspired by natural compounds to treat Alzheimer's Disease.}, }
@article {pmid41276735, year = {2025}, author = {Aghababaee, L and Farrokhi, K and Karimi-Jafari, MH and Shahpasand, K and Riazi, GH}, title = {Cross-Talk Between Tau O-GlcNAcylation and the Formation of the Early Driver of Neurodegeneration (Cis P-Thr231-Pro Tau) in Primary Cortical Neurons.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {158}, pmid = {41276735}, issn = {1559-1182}, mesh = {*tau Proteins/metabolism ; *Neurons/metabolism/pathology/drug effects ; Animals ; *Cerebral Cortex/pathology/metabolism ; Phosphorylation/drug effects ; *Acetylglucosamine/metabolism ; Cells, Cultured ; *Nerve Degeneration/metabolism/pathology ; Thiazoles/pharmacology ; Humans ; Pyrans ; }, abstract = {Tau is a microtubule-associated protein. Hyperphosphorylation of tau at neurotoxic sites, particularly at Thr231 within the Thr231-Pro motif, is a pathological hallmark of Alzheimer's disease (AD) and other tauopathies. Phosphorylated tau at Thr231 exists in two distinct conformations: cis and trans. The Cis pThr231-Pro Tau confomer is neurotoxic and promotes neurodegeneration. Furthermore, tau is subject to O-linked N-acetylglucosamine (O-GlcNAc) modification, and it has been suggested that O-GlcNAcylation of tau can influence tau phosphorylation. In this study, we utilized Thiamet G, an O-GlcNAcase (OGA) inhibitor, to elevate tau O-GlcNAcylation levels. Our findings demonstrate that treatment of nutrient-deprived primary cortical neurons with this OGA inhibitor increased tau O-GlcNAcylation, inhibited the formation of the neurotoxic Cis p-Tau conformation, and reduced neuronal cell loss. Additionally, we observed that the Trans p-Tau conformation represents a normal conformer under physiological conditions. Collectively, our data support tau O-GlcNAcylation as a promising therapeutic strategy for Alzheimer's disease and other tauopathies.}, }
@article {pmid41276485, year = {2026}, author = {Terao, I and Kodama, W}, title = {Comparative Efficacy and Tolerability of Multiple Antipsychotics Across Varying Doses for Neuropsychiatric Symptoms of Dementia Including Alzheimer's Disease: A Dose-Response Model-Based Network Meta-Analysis.}, journal = {Acta psychiatrica Scandinavica}, volume = {153}, number = {2}, pages = {82-94}, doi = {10.1111/acps.70051}, pmid = {41276485}, issn = {1600-0447}, mesh = {Humans ; *Antipsychotic Agents/administration & dosage/adverse effects/pharmacology ; *Alzheimer Disease/drug therapy ; Dose-Response Relationship, Drug ; *Dementia/drug therapy ; Risperidone/administration & dosage/adverse effects ; Randomized Controlled Trials as Topic ; Aripiprazole/administration & dosage/adverse effects ; Olanzapine/administration & dosage ; Thiophenes ; Quinolones ; }, abstract = {BACKGROUND: Antipsychotics are widely used for neuropsychiatric symptoms (NPSs) in dementia including Alzheimer's disease (AD), yet balancing efficacy and safety remains a major clinical challenge.
METHODS: Relevant randomized controlled trials were identified through a comprehensive literature search of CENTRAL, PubMed, CINAHL, and ClinicalTrials.gov. We conducted a dose-response model-based network meta-analysis to evaluate the efficacy as the change in overall NPS severity and the tolerability as treatment discontinuation due to adverse events of aripiprazole, brexpiprazole, risperidone, quetiapine and olanzapine at varying doses in patients with dementia including AD.
RESULTS: Twenty trials involving 5844 participants were included. Most of the included antipsychotics exhibited a generally positive dose-response relationship with respect to both efficacy and tolerability, except for olanzapine, which showed a bell-shaped curve in terms of efficacy. Only aripiprazole 10 mg, brexpiprazole 1-2.5 mg, risperidone 1-2 mg, and olanzapine 2.5-5 mg were significantly more effective than placebo. Tolerability did not significantly decrease compared to placebo for aripiprazole up to 10 mg, brexpiprazole up to 3 mg, risperidone up to 1 mg, olanzapine up to 2.5 mg and at 15 mg, and quetiapine up to 200 mg. Furthermore, significant differences in efficacy and tolerability were observed between certain doses of several antipsychotics.
CONCLUSIONS: Aripiprazole 10 mg, brexpiprazole 1-2.5 mg, risperidone 1 mg, and olanzapine 2.5 mg were both effective and well tolerated, indicating their potential as favorable treatment options. As the present model incorporates several sources of uncertainty, its findings should be interpreted with caution and regarded as a provisional framework to support clinical decision-making.}, }
@article {pmid41276165, year = {2025}, author = {Bei, Y and Zhong, D and Lu, J and Qiu, Y and Bowen, TS and Chen, N and Dun, Y and Gao, F and Huang, Y and Li, G and Li, J and Li, J and Liu, F and Liu, W and Ma, X and Rosenzweig, A and Spanos, M and Tian, Z and Yin, P and Wang, R and Wang, Y and Xu, D and Xu, L and Zhang, L and Zhang, J and Zhang, X and Zhou, Q and Qiao, Y and Xu, M and Xiao, J}, title = {Expert consensus statement for basic research of animal exercise intervention studies in chronic disease prevention and treatment: A joint position paper of the Exercise Science branch of the Biophysical Society of China and the Metabolism and Genetics branch of the Genetics Society of China.}, journal = {Journal of sport and health science}, volume = {}, number = {}, pages = {101103}, doi = {10.1016/j.jshs.2025.101103}, pmid = {41276165}, issn = {2213-2961}, abstract = {Chronic diseases, broadly defined as long-duration conditions that require sustained medical care and/or limit activities of daily living, are a major problem that threatens human health and imposes large social and economic burdens. Physical activity has many beneficial effects for human health and is among the most cost-effective ways to prevent and treat chronic diseases. Animal exercise intervention studies are widely used and provide valuable scientific evidence about the cellular and molecular mechanisms underlying the effects of exercise training in a variety of chronic disease models. This consensus statement will provide expert opinions and recommendations for the appropriate design and application of animal exercise intervention studies and models in fundamental investigations of prevention and treatment of chronic diseases, especially focusing on cardiovascular and cerebrovascular diseases (coronary artery disease and stroke), metabolic diseases (obesity and type 2 diabetes mellitus), chronic respiratory diseases (chronic obstructive pulmonary disease), and neurological diseases (Alzheimer's disease). This statement highlights various exercise models (as determined by frequency, intensity, time, and type of exercise intervention) utilized for each disease. Additionally, it includes a list of functional, structural, biochemical, and disease-specific evaluation metrics of exercise effects, followed by outlined recommendations for the exercise study design and evaluations for the mentioned chronic diseases. This consensus aimed to offer practical recommendations for better design and conduct of fundamental research in animal exercise intervention studies to improve our understanding of the effects of exercise on chronic diseases, and to further develop physical exercise or exercise-mimetic interventions for disease prevention and treatment.}, }
@article {pmid41275722, year = {2026}, author = {Xu, Y and Li, N and Li, X and Cui, X and Ju, R and Li, M and Zhao, J and Han, F}, title = {Integrated analysis strategies reveal the pharmacodynamic substances and action mechanisms of Huangqi San in the treatment of Alzheimer's disease.}, journal = {Journal of pharmaceutical and biomedical analysis}, volume = {270}, number = {}, pages = {117251}, doi = {10.1016/j.jpba.2025.117251}, pmid = {41275722}, issn = {1873-264X}, mesh = {*Alzheimer Disease/drug therapy/metabolism ; Animals ; *Drugs, Chinese Herbal/pharmacology ; Rats ; PC12 Cells ; Molecular Docking Simulation/methods ; Amyloid beta-Peptides/toxicity ; Network Pharmacology/methods ; Oxidative Stress/drug effects ; Cell Survival/drug effects ; Signal Transduction/drug effects ; *Neuroprotective Agents/pharmacology ; Peptide Fragments/toxicity ; Phosphatidylinositol 3-Kinases/metabolism ; Rats, Sprague-Dawley ; Proto-Oncogene Proteins c-akt/metabolism ; Male ; Chromatography, High Pressure Liquid/methods ; Astragalus propinquus ; }, abstract = {Alzheimer's disease (AD), as a neurodegenerative disorder characterized primarily by memory impairment in its early stages, imposes a heavy burden on society and medical resources. This study aims to investigate the therapeutic effect of Huangqi San (HQS) on AD and elucidate its potential mechanism of action. This study analyzed the rat serum after treated by HQS using UHPLC-Q-Exactive Orbitrap MS, and identified the potential active components of HQS. Subsequently, key targets and pathways were identified through network pharmacology and molecular docking techniques, and were verified in PC12 cells damaged by Aβ25-35. The verification methods included cell viability assays, analysis of inflammatory/oxidative stress markers, and regulation of the PI3K/AKT/MAPK pathway. The results showed that a total of 40 serum adsorption components and 70 common targets were identified. Network analysis revealed that the PI3K-AKT, MAPK and Rap1 signaling pathways were at the core of the network. Molecular docking demonstrated strong binding affinity between 10 core components (e.g., isoliquiritigenin, moracin M) and pivotal targets (BCL2, MAPK3, PTGS2). In vitro validation showed HQS significantly attenuated Aβ25-35-induced neurotoxicity by enhancing cell viability, suppressing apoptosis, reducing pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) and oxidative markers (MDA, ROS, CYP2E1) while elevating GSH-Px activity. Moreover, HQS can bidirectionally regulate PI3K/AKT/MAPK pathways via upregulating PI3K/AKT/ERK1/2 and inhibiting JNK/p38 phosphorylation. In conclusion, this study innovatively established HQS as a multi-component/multi-target candidate drug for the treatment of AD. Its mechanism of action is related to its synergistic regulation of PI3K/AKT/MAPK-mediated neuroprotection. This comprehensive approach provides an example for interpreting complex traditional Chinese herbal preparations.}, }
@article {pmid41275266, year = {2025}, author = {Roach, JC and Glusman, G and Rapozo, MK and Merrill, DA and Bramen, J and Hodes, JF and Siddarth, P and Meysami, S and Elhelou, SHK and Glatt, RM and Edens, L and Funk, C and Kelly, D and Shankle, WR and Bredesen, D and Raji, CA and Hood, L}, title = {Multidomain therapy for Alzheimer's disease: a scoping review of cognitive decline trials.}, journal = {Molecular neurodegeneration}, volume = {20}, number = {1}, pages = {125}, pmid = {41275266}, issn = {1750-1326}, abstract = {BACKGROUND: Alzheimer’s disease (AD) leading to cognitive decline and dementia results from the interplay of multiple interacting dysfunctional biological systems. These systems can be categorized by domain, such as inflammation, cardiovascular health, proteostasis, or metabolism. Specific causes of AD differ between individuals, but each individual is likely to have causes stemming from multiple domains. Personalized multidomain therapy has been proposed as a standard of care for AD.
OBJECTIVES: We sought to enumerate and describe prospective randomized controlled trials (RCTs) for multidomain interventions for AD, and to extract their inclusion criteria, trial design parameters (length, number of participants), and outcome measures. We sought to clarify gaps and opportunities in research and clinical translation.
METHODS: We conducted a scoping review using the standardized PRISMA-ScR methodological framework.
ELIGIBILITY CRITERIA: We include all cohort studies and RCTs for multidomain (also known as multimodal, multicomponent, multidimensional, or multisystem) therapy of any stage of AD, published for all dates through July 28, 2025.
RESULT: There have been 23 studies (completed or reported as ongoing) of multidomain interventions for AD, including 19 RCTs. Of the 15 completed RCTs, 12 demonstrate benefit from their intervention in at least one arm.
CONCLUSIONS: Although these RCTs differ widely in their parameters, the majority support the use of multidomain therapy, and show effect sizes greater than reported for unimodal therapies, including pharmaceuticals. Multidomain therapy should be the standard of care for AD. Multidomain interventions (also known as treatments) should be employed widely, early, and first-line. Treatment or prevention is likely to be most effective at early, presymptomatic stages, but is worthwhile at all stages of disease. In order to influence multiple domains, multiple modes of therapy are likely necessary in all patients. Some individual modes, such as particular lifestyle interventions, may target multiple domains. Nevertheless, most patients will benefit from multiple modes of intervention (multimodal intervention) that together target multiple domains. Standard-of-care guidelines should explicitly include multidomain interventions. Future clinical trials must be designed to iteratively improve multidomain therapies. Payors should embrace reimbursement for effective multidomain intervention, including personalized coaching.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13024-025-00912-2.}, }
@article {pmid41274321, year = {2026}, author = {Chu, CT and Uruno, A and Suzuki, T and Taguchi, K and Baird, L and Katsuoka, F and Yamamoto, M}, title = {NRF2 activation by CDDO-Im regulates inflammatory and autophagy pathways in human microglial cells.}, journal = {Free radical biology & medicine}, volume = {243}, number = {}, pages = {318-337}, doi = {10.1016/j.freeradbiomed.2025.11.046}, pmid = {41274321}, issn = {1873-4596}, mesh = {Humans ; *NF-E2-Related Factor 2/metabolism/genetics ; *Microglia/drug effects/metabolism/pathology ; *Autophagy/drug effects ; *Oleanolic Acid/analogs & derivatives/pharmacology ; Amyloid beta-Peptides/metabolism/pharmacology ; *Alzheimer Disease/pathology/genetics/metabolism/drug therapy ; *Inflammation/metabolism/pathology/genetics ; Interferon-gamma/pharmacology ; Oxidative Stress/drug effects ; Signal Transduction/drug effects ; Cell Line ; }, abstract = {Alzheimer's disease (AD) is characterized by amyloid-beta (Aβ) plaques and neurofibrillary tangles, accompanied by elevated oxidative stress and inflammation. Microglia, the resident macrophages in the brain, play a key protective role by clearing plaques and damaged neurons. NRF2 (Nuclear factor erythroid 2-related factor 2) is a master regulator of cytoprotection against oxidative stress, whose activation alleviates oxidative damage, neuroinflammation, and cognitive deficits in AD models. However, direct targets of NRF2 in microglia remain unclear. In this study, we demonstrate that NRF2 activation by CDDO-Im significantly suppresses inflammation in human microglial cells (HMC3) stimulated by IFN-γ or Aβ. Through integrative RNA-sequencing and ChIP-sequencing analysis of NRF2, we identified five representative direct NRF2 target genes involved in inflammation (e.g., IL6, CDK6) and another five related to autophagy (e.g., TFE3, SQSTM1). Importantly, we also found that CDDO-Im treatment enhances autophagy as evidenced by an increased LC3-II/LC3-I ratio. Public single-cell transcriptomic data further underscored the critical role of microglia in NRF2-mediated autophagy regulation within AD brains. Together, our findings reveal new direct NRF2 target genes, highlight the dual role of NRF2 in suppressing inflammation and enhancing autophagy, and thus provide novel insights for therapeutic interventions in AD.}, }
@article {pmid41274317, year = {2026}, author = {Anbaraki, A and Ghasemi, A and Seyedarabi, A and Yousefi, R and Saboury, AA}, title = {Dual glycation and oxidation of tau protein: impact of methylglyoxal and hydrogen peroxide on tau structure and fibril assembly.}, journal = {Free radical biology & medicine}, volume = {243}, number = {}, pages = {207-219}, doi = {10.1016/j.freeradbiomed.2025.11.044}, pmid = {41274317}, issn = {1873-4596}, mesh = {*Hydrogen Peroxide/pharmacology ; *Pyruvaldehyde/pharmacology ; *tau Proteins/chemistry/metabolism ; Humans ; Glycosylation ; Oxidation-Reduction ; Oxidative Stress ; *Alzheimer Disease/metabolism/pathology/genetics ; Protein Processing, Post-Translational ; *Diabetes Mellitus, Type 2/metabolism/pathology ; }, abstract = {Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) indicate overlapping pathogenic mechanisms including, protein glycation and oxidative stress. Tau protein, a key player in AD pathology, undergoes various post-translational modifications, disturbing its physiological function and facilitating its aggregation/fibrillation. Nevertheless, the cumulative influence of glycation and oxidation on the structural integrity and fibrillation of tau remains inadequately elucidated. In this study, we examined the effects of methylglyoxal (MGO)-induced glycation and hydrogen peroxide (H2O2)-mediated oxidation, individually or in combination, on tau structure, fibrillation and cytotoxicity. Structural and morphological alterations were evaluated using SDS-PAGE, fluorescence spectroscopy, circular dichroism, dynamic light scattering, Fourier transform infrared spectroscopy, and atomic force microscopy. Fibrillation kinetics were monitored under two conditions: (i) pre-fibrillation modification and (ii) simultaneous modification and fibrillation. Our results indicated that the co-treatment with MGO and H2O2 synergistically altered tau structure. Moreover, the fibrillation kinetics of pre-modified tau samples with MGO indicated a reduction in fibrillation through the generation of oligomeric species. Conversely, the fibrillation kinetics of pre-modified tau samples with H2O2 and both compounds increased tau fibrillation. On the other hand, simultaneous modification and fibrillation of tau samples with MGO and H2O2 resulted in an increase in tau fibrillation and structural changes. Collectively, our results indicated that co-treatment with MGO and H2O2 synergistically enhanced tau fibrillation and produced more ordered fibril structures with increased cytotoxicity toward SH-SY5Y cells. These findings provide mechanistic insights into how glycation and oxidative stress cooperatively modulate tau fibrillation and offer a molecular basis for the pathological link between diabetes and AD.}, }
@article {pmid41274188, year = {2026}, author = {Khan, Y and Naeem, MU and Arooj, K and Naseem, M and Adnan, R and Azmatullah, }, title = {A comprehensive computational and experimental study of novel imidazole linked thiadiazole based amide derivatives as cholinesterase duel-target inhibitor for the treatment of Alzheimer's disease.}, journal = {Computational biology and chemistry}, volume = {120}, number = {Pt 1}, pages = {108789}, doi = {10.1016/j.compbiolchem.2025.108789}, pmid = {41274188}, issn = {1476-928X}, mesh = {*Cholinesterase Inhibitors/chemistry/pharmacology/chemical synthesis ; *Thiadiazoles/chemistry/pharmacology/chemical synthesis ; *Imidazoles/chemistry/pharmacology ; *Alzheimer Disease/drug therapy/metabolism ; *Acetylcholinesterase/metabolism ; *Butyrylcholinesterase/metabolism ; Humans ; Molecular Docking Simulation ; Structure-Activity Relationship ; *Amides/chemistry/pharmacology/chemical synthesis ; Molecular Structure ; Dose-Response Relationship, Drug ; }, abstract = {The thiadiazole scaffold has gained prominence in modern drug discovery due to its remarkable structural adaptability. Its unique framework enables interactions with a wide spectrum of biological targets, making it a valuable pharmacophore for therapeutic development. Reflecting its growing clinical importance, efficient synthetic access to thiadiazole derivatives has become a focal point for medicinal chemists seeking to exploit its multifunctional activity. In our study, we synthesized a streamlined and high-throughput synthetic protocol to generate a novel library of imidazole linked thiadiazole analogues. All newly imidazole linked thiadiazole analogues were spectroscopically characterized by [1]HNMR and [13]CNMR spectroscopy and high-resolution electron impact mass spectrometry (HRMS). Biological screening across a panel of key metabolic enzymes revealed potent inhibitory action against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Remarkably, a majority of tested compounds outperformed standard inhibitors donepezil exhibited compounds 1, 2, 4 and 8 showing lower IC50 values of 5.32 ± 0.87 µM (AChE), 6.09 ± 0.97 µM (BuChE), 7.40 ± 0.76 µM (AChE), 6.97 ± 0.56 µM (BuChE), 7.56 ± 0.54 µM (AChE), 7.03 ± 0.39 µM (BuChE), and 5.13 ± 0.28 µM (AChE), 5.33 ± 0.61 µM (BuChE) respectively. Detailed structure-activity relationship (SAR) analyses revealed that strategic substitution patterns modulate inhibitory efficacy and selectivity. Complementing these findings, molecular docking study illuminated key interactions within the catalytic pockets of (AChE) and (BuChE), identifying critical amino acid residues mediating ligand engagement. Hence, our integrated synthetic, biochemical, and computational approach identifies compounds 1, 2, 4 and 8 as a promising lead compound that possess favorable pharmacological attributes for further preclinical development in metabolic disease interventions.}, }
@article {pmid41273473, year = {2025}, author = {Yang, Z and Peng, X and Zhang, X and Guo, H and Li, Z and Wu, X and Zhao, M and Ruganzu, JB and Zhai, C and Ji, S and Yang, W}, title = {Tanshinone IIA Promotes Hippocampal Neurogenesis in ApoE[-/-] Mice Through cAMP/PKA/CREB/BDNF Signaling Pathway.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {144}, pmid = {41273473}, issn = {1559-1182}, support = {2023-JC-YB-735//the Natural Science Basic Research Plan in Shaanxi Province of China/ ; }, mesh = {Animals ; *Neurogenesis/drug effects ; *Brain-Derived Neurotrophic Factor/metabolism ; *Hippocampus/drug effects/metabolism ; *Signal Transduction/drug effects ; *Cyclic AMP Response Element-Binding Protein/metabolism ; *Cyclic AMP/metabolism ; *Cyclic AMP-Dependent Protein Kinases/metabolism ; *Abietanes/pharmacology ; *Apolipoproteins E/deficiency ; Cell Proliferation/drug effects ; Mice ; Neural Stem Cells/drug effects/metabolism ; Mice, Knockout ; Mice, Inbred C57BL ; Male ; Phosphorylation/drug effects ; }, abstract = {New cells are generated from neural stem cells (NSCs) in the subgranular zone (SGZ) of the dentate gyrus of the hippocampus throughout life to shape brain function. Apolipoprotein E (ApoE) deficiency impairs hippocampal dentate gyrus development by affecting the neural progenitor pool over time. Impaired adult hippocampal neurogenesis has been reported in human ApoE4 and ApoE-knockout (ApoE[-/-]) mice. The ApoE gene is the strongest genetic risk factor for late-onset Alzheimer's disease (AD). Our previous studies indicated that tanshinone IIA (tan IIA) has a broad range of pharmacological actions on AD. Here, we aimed to investigate the effects of 2 weeks of tan IIA (15 mg/kg, intraperitoneally, once daily) treatment on hippocampal neurogenesis in 1- and 3-month-old ApoE[-/-] mice. The results showed that tan IIA treatment significantly promoted cell proliferation and increased the density of immature neurons in the hippocampus. Mechanistically, tan IIA treatment elevated the levels of cyclic adenosine monophosphate (cAMP), cAMP/protein kinase A (PKA), and cAMP response element binding protein (CREB) phosphorylation, and subsequently increasing the production of brain-derived neurotrophic factor (BDNF). Furthermore, tan IIA is capable of promoting NSCs proliferation, differentiation, and survival in vitro. Collectively, the above findings indicated that tan IIA stimulates neurogenesis in the adult hippocampus of ApoE[-/-] mice possibly through the cAMP/PKA/CREB/BDNF signaling pathway. These results suggested that tan IIA may have neuroprotective effects against neurogenesis decline in ApoE[-/-] mice.}, }
@article {pmid41273462, year = {2025}, author = {Su, Y and Zhang, D and Li, Y and Gu, H and Li, W and Zhou, W and Zhao, N and Huang, X}, title = {Caenorhabditis Elegans Ortholog of TNF Alpha-Induced Protein 1 is Upregulated by TOL-1 and Exacerbates Amyloid-Beta-Associated Pathology.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {146}, pmid = {41273462}, issn = {1559-1182}, support = {KC-23236341//Yunnan University Graduate Research Innovation Fund/ ; No. 202403AC100007//Yunnan Fundamental Research Projects/ ; No. 32170184//Natural Science Foundation Program of China/ ; }, mesh = {*Caenorhabditis elegans/metabolism/genetics ; Animals ; *Amyloid beta-Peptides/metabolism/toxicity ; *Caenorhabditis elegans Proteins/metabolism/genetics ; *Up-Regulation ; Animals, Genetically Modified ; *Toll-Like Receptors/metabolism ; Humans ; Alzheimer Disease/pathology/metabolism ; }, abstract = {Neuroinflammation has been recognized as a central pathological mechanism in Alzheimer's disease (AD), modulated by diverse molecular pathways. Among these, the tumor necrosis factor superfamily (TNFSF) pathway serves as a pivotal mediator of inflammatory responses in higher organisms, representing a potential therapeutic target for AD treatment. Notably, TNF alpha-induced protein 1 (TNFAIP1) is significantly upregulated following amyloid-beta1-42 (Aβ1-42) accumulation in the postmortem brains of patients with AD and in transgenic Caenorhabditis elegans models. However, the regulatory mechanism of its ortholog F22E5.6 in C. elegans and its role in Aβ neurotoxicity remain elusive due to the absence of the core TNFSF members in this model. Through systematic screening of TNFSF orthologs, the trf-1 gene that encodes the adapter protein, TNF receptor-associated factor (TRAF), has been identified as a critical regulator in Aβ1-42-induced F22E5.6 overexpression of C. elegans. In this genetic model, the only Toll-like receptor TOL-1 in C. elegans serves as a potential receptor to activate TRF-1 and to transmit this signal to the SRC-2/PMK-3 axis, thereby executing the effects on mitochondrial homeostasis disequilibrium. These findings reveal the regulatory mechanism on Aβ1-42-induced F22E5.6/TNFAIP1 overexpression and its involvement in AD model of C. elegans, providing a clue to resolve the paradox of TNFSF-mediated inflammation in organisms lacking the canonical TNFSF pathway.}, }
@article {pmid41272752, year = {2025}, author = {Saraswathi, TS and Mothilal, M and Bukke, SPN and Thalluri, C and Chettupalli, AK}, title = {Recent advances in potential drug nanocarriers for CNS disorders: a review.}, journal = {Biomedical engineering online}, volume = {24}, number = {1}, pages = {137}, pmid = {41272752}, issn = {1475-925X}, mesh = {Humans ; *Central Nervous System Diseases/drug therapy ; *Drug Carriers/chemistry ; *Nanoparticles/chemistry ; Animals ; Blood-Brain Barrier/metabolism ; }, abstract = {BACKGROUND: Neurological disorders, including Parkinson's and Alzheimer's disease, impose a significant burden on individuals and healthcare systems. Effective treatment is often hindered by the restrictive nature of the blood-brain barrier (BBB), limiting drug access to the central nervous system (CNS).
AIM: The purpose of this review is to provide an overview of existing methods to deliver therapeutics to the CNS across the BBB with an emphasis on drug delivery systems that utilize nanotechnology.
METHOD/SOURCE: We performed a thorough review of the published literature on recently emerging trends in pharmacology and nanomedicine that have attempted to deliver drugs to the CNS by addressing the challenge of delivering therapeutics across the BBB.
RESULT/FINDING: Nanoparticles and nanocarriers have shown promise for crossing the blood-brain barrier (BBB), improving drug bioavailability in the brain, and facilitating targeted delivery. Several systems applying nanomaterials, including polymeric nanoparticles, liposomes, solid-lipid nanoparticles, and quantum dots, have successfully advanced through preclinical or early clinical studies. However, demonstrated evidence of the implementation and uptake of nanoparticles in specific antitumor and neurotherapeutic indications have several significant challenges, primarily due to safety, biocompatibility, and scalability.
CONCLUSION: The combination of traditional pharmacology and nanotechnology provides valuable opportunities for drug delivery to the CNS. Gains in the design of nanocarrier systems have great potential for addressing the limits of BBBs and for improving therapeutic outcomes in neurological disease, but more research is necessary for the development of translational clinical studies.}, }
@article {pmid41272481, year = {2025}, author = {Li, Q and Degan, S and Galeffi, F and Colton, CA and Turner, DA}, title = {Dysregulated microvascular reactivity in hippocampus and cortex in CVN Alzheimer's disease mouse model.}, journal = {Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism}, volume = {}, number = {}, pages = {271678X251383112}, pmid = {41272481}, issn = {1559-7016}, support = {I21 RX004081/RX/RRD VA/United States ; R01 AG074999/AG/NIA NIH HHS/United States ; R01 AG081774/AG/NIA NIH HHS/United States ; R21 AG051103/AG/NIA NIH HHS/United States ; }, abstract = {Microvascular reactivity in acute cortical and hippocampal brain slices and hippocampal synaptic- evoked cerebral blood flow (CBF) in vivo were analyzed in a mouse model of Alzheimer's disease (AD, CVN). Microvessels underwent initial vasoconstriction (2 µM noradrenaline) then treatment with either 0.5 mM glutamate or 100 µM NMDA. In acute brain slices from young mice (<20 weeks) the glutamate and NMDA treatment led to dilation of capillaries in cortex and hippocampus, but not in aged CVN mice (>30 weeks, with AD pathology). Furthermore, 1 mM adenosine restored pre-constricted capillaries to control levels in WT but not in aged CVN brain slices. Stimulation of endothelial ET-1 receptors (10 nM ET-1) showed enhanced vasoconstriction in hippocampal capillaries of aged CVN slices, but blockade of both ET-1A/1B receptors did not alter basal capillary tone in aged CVN slices. Stimulation-evoked hippocampal CBF in vivo was significantly reduced in aged CVN mice. These results provide evidence for a progressive, complex age- and AD pathology-related impairment of vascular reactivity and vasodilation in the CVN model. The dysregulation of NVC function and reduced functional hyperemia in aged CVN AD mice may underscore dynamic hypoperfusion and metabolic insufficiency, which could accelerate progression in AD.}, }
@article {pmid41272422, year = {2025}, author = {Wilson, RF and Harrison, DD and Amoakohene, E and Lyons, BH}, title = {Homicides among people with disabilities, United States, 2003-2022.}, journal = {Injury epidemiology}, volume = {12}, number = {1}, pages = {88}, pmid = {41272422}, issn = {2197-1714}, abstract = {BACKGROUND: People with disabilities (PwD) are at an increased risk of experiencing nonfatal violence; however, the risk of fatal violence victimization (i.e., homicide) among this population is less well established.
METHODS: We used National Violent Death Reporting System (NVDRS) data for homicide victims with disabilities for 2003 to 2022 in 50 states, the District of Columbia, and Puerto Rico. NVDRS is a surveillance system that collects data on violent deaths, linking information from death certificates, coroner or medical examiner records, and law enforcement reports. NVDRS does not currently include standard variables on disability status or disability type; these decedent characteristics were identified using a literal text search of textual data. Descriptive statistics were used to characterize homicides among PwD.
RESULTS: From 2003 to 2022, NVDRS collected 1,498 homicides among people with disabilities. The largest proportion of victims had a neurological disability (36.7%), followed by cognitive disability (35.5%), physical disability (22.4%), or unspecified disability type (5.4%); 18.2% had multiple disability types. Those aged ≥ 65 years accounted for 45.1% of all victims; the largest proportion of victims were ≥ 75 years old (29.7%). A firearm was used in 38.5% of these homicides. The top three precipitating circumstances of these homicides were: caregiver abuse and neglect (27.0%), argument (26.0%), and intimate partner violence (IPV; 24.0%). Caregiver abuse or neglect precipitated 38.1% of homicides among female victims, versus 19.1% of male victims. IPV precipitated 43.7% of female homicides, versus 9.1% of male homicides. Half (49.5%) of all victims had a mental health problem at the time of death; 23.3% had a history of ever being treated for a mental health problem; 17.8% were receiving mental health treatment at the time of death.
CONCLUSION: This study characterized homicides among PwD. Older adults accounted for nearly half of all victims, and mental health conditions such as dementia and Alzheimer's disease were frequently present among decedents, especially female victims. Among older adults and child victims, caregiver abuse/neglect was common. Our results underscore the importance of supporting caregivers of PwD, creating protective environments for PwD, systematically collecting data on violence against PwD, and tailoring prevention strategies to address the needs of PwD.}, }
@article {pmid41272400, year = {2026}, author = {Shao, S and Lu, H and Zu, R and Chen, Y and Peng, Z and Peng, Q and Ma, H and Sun, Y}, title = {Pharmacological Regulation of Mitophagy by Natural Plant Products as a Therapeutic Target for Alzheimer's Disease.}, journal = {Phytotherapy research : PTR}, volume = {40}, number = {1}, pages = {248-266}, doi = {10.1002/ptr.70131}, pmid = {41272400}, issn = {1099-1573}, support = {CMC 2021//Horizontal research project of Chengdu Medical College/ ; 242102311258//Scientific and Technological Project of Henan Province/ ; 2021LHPG-08//Joint Fund of Chengdu Medical College and Chengdu Pidu District People's Hospital/ ; 231111312900//Henan Province key research and development project/ ; No. 2022M711080//Postdoctoral Foundation of China/ ; No. 32301030//The National Natural Science Foundation of China/ ; No. 82274612//The National Natural Science Foundation of China/ ; No. 82305087//The National Natural Science Foundation of China/ ; 2024KYCX003//Henan University of Chinese Medicine/ ; }, mesh = {*Alzheimer Disease/drug therapy ; Humans ; *Mitophagy/drug effects ; *Biological Products/pharmacology/therapeutic use ; Animals ; Mitochondria/drug effects/metabolism ; }, abstract = {Alzheimer's disease (AD), a prevalent senile dementia, is characterized by the progressive decline in cognitive function, accumulation of tau tangles and Aβ plaques. Despite significant research efforts in the field of AD, effective therapeutic drugs for its prevention and treatment remain elusive. Consequently, a more comprehensive understanding of the molecular mechanisms underlying the pathological processes of AD is crucial for novel therapeutic strategies. Mitophagy, the selective degradation of mitochondria through autophagy, is an essential mechanism for maintaining mitochondrial homeostasis in terms of both quantity and quality. Mitophagy plays a crucial role in numerous cellular processes, including inflammation, differentiation, and apoptosis. Recent studies have increasingly demonstrated that mitophagy is extensively characterized in AD and may represent a novel therapeutic strategy for its treatment. Notably, a number of natural plant products (NPPs) have been demonstrated to modulate mitophagy and intervene in the pathological process of AD. For instance, NPPs such as urolithin A and β-asarone have been reported to enhance mitophagy by activating the PINK1/Parkin pathway, thereby alleviating Aβ-induced neurotoxicity. The distinctive multi-target properties and favorable safety profiles of NPPs endow them with significant research potential and developmental value, establishing them as a vital resource for novel drug discovery. This review explores the mechanistic hypotheses linking mitophagy to AD pathology and provides a systematic overview of recent advances in representative NPPs that regulate mitophagy to alleviate AD-related impairments, offering new perspectives for the development of therapeutic strategies against AD.}, }
@article {pmid41272336, year = {2025}, author = {Tang, C and Ding, Y and Yang, S and Lei, X and Zhang, M and Xu, B and He, D}, title = {Dual Mechanisms of Cognitive Function and Pathological Improvements by the Selective S1PR1/5 Modulator Siponimod in 3xTg-AD Mice.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {133}, pmid = {41272336}, issn = {1559-1182}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism/physiopathology ; *Cognition/drug effects ; Microglia/drug effects/metabolism/pathology ; *Benzyl Compounds/pharmacology/therapeutic use ; Mice ; Mice, Transgenic ; *Azetidines/pharmacology/therapeutic use ; *Sphingosine-1-Phosphate Receptors/metabolism ; Disease Models, Animal ; Molecular Docking Simulation ; Signal Transduction/drug effects ; Male ; Cell Line ; Myelin Sheath/metabolism/drug effects ; *Sphingosine 1 Phosphate Receptor Modulators/pharmacology/therapeutic use ; }, abstract = {Alzheimer's disease (AD) is characterized by progressive cognitive decline, with neuroinflammation and myelin dysfunction as crucial pathological mechanisms. Siponimod, a selective S1PR1/5 modulator, shows promising therapeutic potential through enhanced brain penetration and improved pharmacokinetic properties compared to first-generation modulators. Network pharmacology and molecular docking analyses were utilized to comprehensively elucidate the underlying mechanisms of Siponimod in the context of AD. Specifically, network pharmacology identified key targets and pathways associated with Siponimod, while molecular docking facilitated predictions of binding affinities to these targets. For in vitro assessments, BV2 microglia cells were used to investigate the effects of Siponimod after stimulation with LPS, focusing on inflammatory responses and cellular signaling pathways. Concurrently, in vivo studies employed the 3xTg-AD mouse model to investigate behavioral outcomes related to cognitive function, alongside evaluations of neuroinflammation and the integrity of myelin sheaths. Siponimod treatment resulted in a significant reduction in pro-inflammatory cytokines and ROS production in BV2 microglia cells, thereby indicating its robust anti-inflammatory and antioxidant properties. In the 3xTg-AD mouse model, administration of Siponimod led to marked improvements in cognitive performance as assessed through various behavioral tests. Additionally, there was a noteworthy decrease in Aβ plaque deposition, coupled with evidence of myelin repair, which was reflected in the increased expression of myelination-related proteins, namely OLIG2 and MBP. Furthermore, Siponimod was found to activate the PI3K-AKT signaling pathway, which plays a crucial role in promoting neuroprotection and enhancing cellular resilience against neurodegenerative processes. This study demonstrates that Siponimod effectively treats AD through dual mechanisms: reducing neuroinflammation and promoting myelin repair via the S1PR1/5 and PI3K-AKT signaling pathway. These findings suggest Siponimod's potential as a promising therapeutic agent for AD treatment.}, }
@article {pmid41271757, year = {2025}, author = {Rabiei, K and Petrella, JR and Lenhart, S and Liu, C and Hao, W and , }, title = {Data-driven modeling of amyloid-β targeted antibodies for Alzheimer's disease.}, journal = {NPJ systems biology and applications}, volume = {11}, number = {1}, pages = {134}, pmid = {41271757}, issn = {2056-7189}, support = {R35 GM146894/GM/NIGMS NIH HHS/United States ; P30AG072958/NH/NIH HHS/United States ; U01 AG024904/AG/NIA NIH HHS/United States ; 1R35GM146894/GM/NIGMS NIH HHS/United States ; P30 AG072958/AG/NIA NIH HHS/United States ; DMS-2052676//National Science Foundation/ ; }, mesh = {*Alzheimer Disease/drug therapy/metabolism ; *Amyloid beta-Peptides/metabolism/immunology/chemistry/antagonists & inhibitors ; Humans ; *Antibodies, Monoclonal/therapeutic use/pharmacology ; Kinetics ; }, abstract = {Alzheimer's disease (AD) is characterized by the accumulation of amyloid beta, which is strongly associated with disease progression and cognitive decline. Despite the approval of monoclonal antibodies targeting Aβ, optimizing treatment strategies while minimizing side effects remains a challenge. This study develops a mathematical framework to model Aβ aggregation dynamics, capturing the transition from monomers to higher-order aggregates, including protofibrils, toxic oligomers, and fibrils, using mass-action kinetics and coarse-grained modeling. Parameter estimation, sensitivity analysis, and data-driven calibration ensure model robustness. An optimal control framework is introduced to identify the optimal dose of the drug as a control function that reduces toxic oligomers and fibrils while minimizing adverse effects, such as amyloid-related imaging abnormalities (ARIA). The results indicate that Donanemab achieves the most significant reduction in fibrils. These findings provide a quantitative basis for optimizing AD treatments, providing valuable insight into the balance between therapeutic efficacy and safety.}, }
@article {pmid41271117, year = {2026}, author = {Yin, C and Tang, X and Zeng, J and Wang, Z and Mi, J and Liang, Y and Qin, D and Feng, Q and Wu, A}, title = {Next-generation biosensor technologies for Alzheimer's disease: Innovations in diagnosis, monitoring, and treatment.}, journal = {Ageing research reviews}, volume = {114}, number = {}, pages = {102954}, doi = {10.1016/j.arr.2025.102954}, pmid = {41271117}, issn = {1872-9649}, mesh = {Humans ; *Alzheimer Disease/diagnosis/therapy ; *Biosensing Techniques/methods/trends ; Biomarkers ; Artificial Intelligence ; Animals ; }, abstract = {Alzheimer's disease (AD), the most prevalent neurodegenerative disorder, remains a global health crisis due to the lack of early diagnostic tools, dynamic monitoring strategies, and effective therapies. Current diagnostic methods such as cerebrospinal fluid (CSF) analysis and neuroimaging, while accurate, are invasive, expensive, and unsuitable for routine screening, highlighting the pressing need for alternative approaches. This review comprehensively examines the transformative role of next-generation biosensors in revolutionizing AD management. By leveraging breakthroughs in nanotechnology, materials science, and artificial intelligence (AI), modern biosensors enable ultrasensitive, non-invasive detection of AD biomarkers, including amyloid-β (Aβ), Tau proteins, and neurofilament light chain (NfL), across diverse biofluids such as blood, saliva, and tears. We critically evaluate electrochemical, optical, and acoustic biosensing platforms, highlighting their integration into wearable and portable devices for real-time disease monitoring and personalized therapeutic interventions. Emerging trends such as AI-driven analytics, CRISPR-based diagnostics, and closed-loop neuromodulation systems are explored for their potential to decode disease progression and optimize treatment responses. Challenges in clinical translation, including sensor stability, regulatory hurdles, and ethical considerations, are addressed to pave the way for scalable, patient-centric solutions. By synthesizing cutting-edge advancements and interdisciplinary insights, this review charts a roadmap for biosensor technologies to shift AD care from reactive to proactive, ultimately improving quality of life for patients and caregivers.}, }
@article {pmid41270999, year = {2026}, author = {Parveen, N and Qais, FA and Faheem, M}, title = {Molecular insights into diosgenin's role in preventing protein aggregation in neurodegenerative diseases.}, journal = {Biochimica et biophysica acta. Proteins and proteomics}, volume = {1874}, number = {1}, pages = {141116}, doi = {10.1016/j.bbapap.2025.141116}, pmid = {41270999}, issn = {1878-1454}, mesh = {*Diosgenin/chemistry/pharmacology/metabolism ; Humans ; *Protein Aggregates/drug effects ; *Neurodegenerative Diseases/metabolism/drug therapy/pathology ; Molecular Dynamics Simulation ; *Serum Albumin, Human/chemistry/metabolism ; *Protein Aggregation, Pathological/metabolism/prevention & control ; Protein Binding ; Hydrogen Bonding ; }, abstract = {Neurodegenerative disorders (ND) such as Parkinson's and Alzheimer's progressively impair the nervous system, leading to cognitive deterioration and motor dysfunction. A primary factor in these diseases is the accumulation of misfolded protein aggregates, which interfere with cellular processes and ultimately result in neuronal death. Preventing the formation of these toxic aggregates has the potential to protect neurons and slow the advancement of disease. This study examined the impact of diosgenin on protein aggregation, utilizing human serum albumin (HSA) as model protein. Diosgenin reduced ThT fluorescence by 64.35 % and decreased turbidity by 62.61 %, indicating a notable suppression of protein aggregation. The % α-helix in HSA experienced a decline from 57.68 % to 8.82 %, but diosgenin treatment restored it to 43.89 %. Binding studies demonstrated that diosgenin interacts with HSA with -11.0 kcal/mol binding energy, facilitated by van der Waals, hydrophobic and hydrogen bonding interactions, and stability of HSA-diosgenin complex was also validated using molecular simulations. To further elucidate the aggregation inhibition mechanism by diosgenin, advanced molecular dynamics simulations were employed. Diosgenin increased the solvent accessibility of the HSA282-292 oligomers, reduced β-sheet formation, and prevented H-bond interactions, key factors in aggregate formation. Molecular simulation of Aβ oligomers (Aβ16-22) also showed the diosgenin prevents oligomerization and β-sheet formation. We show that diosgenin presents a promising alternative due to its ability to stabilize protein structures and inhibit protein aggregation, making it a potential therapeutic candidate for NDs. However, further experimental validation in animal models is necessary to confirm diosgenin's anti-aggregation effects, particularly of amyloid-forming proteins.}, }
@article {pmid41270820, year = {2026}, author = {Mayr, D and Preishuber-Pflügl, J and Koller, A and Migschitz, SM and Michael, J and Altendorfer, B and Rabl, R and Amschl, D and Hitzl, W and Aigner, L and Reitsamer, HA and Trost, A}, title = {The effect of CysLTR1 inhibition on cells of the retinal neurovascular unit in 5xFAD Alzheimer mice.}, journal = {Experimental eye research}, volume = {262}, number = {}, pages = {110763}, doi = {10.1016/j.exer.2025.110763}, pmid = {41270820}, issn = {1096-0007}, mesh = {Animals ; *Alzheimer Disease/drug therapy/metabolism/pathology ; Mice ; Disease Models, Animal ; Male ; *Retinal Vessels/pathology/drug effects/metabolism ; Female ; *Receptors, Leukotriene/metabolism ; Mice, Transgenic ; *Quinolines/pharmacology ; Cyclopropanes ; Sulfides ; *Acetates/pharmacology ; *Leukotriene Antagonists/pharmacology ; Pericytes/pathology/drug effects ; Mice, Inbred C57BL ; }, abstract = {Alzheimer's disease (AD) is a multifactorial neurodegenerative disease that affects both the brain and the retina. Many cerebral-associated AD pathologies, including neuroinflammation and vascular changes, have been reported to manifest in the retina. Furthermore, the neurovascular unit (NVU), composed of vascular cells, glia and neurons, regulates blood flow and neuronal metabolic activity and has been described to be dysfunctional in AD brains and retinas. As leukotrienes are modulators of both neuroinflammation and the vasculature, their receptors have been recognized as potential targets for ameliorating AD pathology. Therefore, the present study investigated the effects of the cysteinyl leukotriene receptor 1 (CysLTR1) antagonist montelukast (MTK) on retinal NVU cells in the 5xFAD mouse model of AD. Retinal analyses were performed in male and female 8-month-old 5xFAD mice and after 13-weeks of treatment with low and high doses of MTK or vehicle, and in age-matched controls. The retinal pericyte (PC) coverage was unchanged in AD, but CysLTR1 inhibition resulted in increased PC coverage in AD mice. Furthermore, an AD-associated decrease in capillary diameter was observed, which was not affected by CysLTR1 inhibition. The number of retinal microglial cells was increased in AD, independent of treatment. In addition, the astrocyte area and retinal ganglion cell density were not affected by either AD or CysLTR1 inhibition. In conclusion, the present study revealed minor AD-associated changes in retinal NVU cells in the 5xFAD mouse model. MTK treatment increased dose-independently PC coverage, but it remains to be clarified whether this affects the vessel tightness and blood flow.}, }
@article {pmid41270732, year = {2025}, author = {Wang, JL and Sha, XY and Shao, Y and Zhang, ZH and Huang, SM and Lin, H and Gan, SY and Zhang, N and Xia, XY and Sun, YN and Ding, JH and Zhao, RQ and Cheng, J and Shang, P and Wang, JP and Liu, YJ and Yang, F and Xiao, P and Wang, LW and Zhao, DY and Tang, Y and Tie, L and Du, Y and Zhang, Y and He, JF and Sun, JP}, title = {Elucidating pathway-selective biased CCKBR agonism for Alzheimer's disease treatment.}, journal = {Cell}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cell.2025.10.034}, pmid = {41270732}, issn = {1097-4172}, abstract = {Expressed in the entorhinal cortex (EC), the cholecystokinin (CCK) B receptor (CCKBR) plays an important role in memory and learning. Here, we identify that CCKBR-Gs and -Gq signaling, rather than CCKBR-Gi signaling, are beneficial for Alzheimer's disease (AD) treatment. Clinically, patients with more severe AD associated with lower CCKBR-Gq activity. The cryo-electron microscopy (cryo-EM) structures of CCKBR in complex with the endogenous agonist sulfated CCK8 (CCK8s) and 3 different G protein subtypes revealed that distinct receptor conformations contribute to selective G protein bias. Leveraging these structural insights, we rationally develop synthetic CCKBR agonists, including a Gi-biased agonist (z-44) and a Gq-biased agonist (3r1). Notably, 3r1 demonstrates therapeutic potential by ameliorating cognitive decline in 5×FAD mice, reducing the number of amyloid-β plaques, and promoting long-term potentiation (LTP) via upregulation of the α-secretase (ADAM10) and the calcium signaling molecule PLCB4. Our findings suggest that synthetic biased agonists targeting CCKBR-Gq signaling have therapeutic potential for AD.}, }
@article {pmid41270541, year = {2026}, author = {Zhang, M and Liu, X and Ren, Y and Li, L and Wang, R and Sun, L and Ma, Q}, title = {Decoding alzheimer's: The role of EEG rhythms and aperiodic components in cognitive decline.}, journal = {Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology}, volume = {181}, number = {}, pages = {2111437}, doi = {10.1016/j.clinph.2025.2111437}, pmid = {41270541}, issn = {1872-8952}, mesh = {Humans ; *Alzheimer Disease/physiopathology/diagnosis/psychology ; Male ; Female ; *Cognitive Dysfunction/physiopathology/diagnosis ; Aged ; *Electroencephalography/methods ; Aged, 80 and over ; *Theta Rhythm/physiology ; *Alpha Rhythm/physiology ; Middle Aged ; *Brain/physiopathology ; }, abstract = {OBJECTIVE: To investigate detailed alterations in brain electrical activity and their relationship with cognitive decline in Alzheimer's disease (AD) using electroencephalogram (EEG) power spectrum analysis.
METHODS: EEG data from 80 AD patients and 80 healthy control (HC) were analyzed, focusing on theta and alpha band powers, aperiodic offset, and exponent. Topographic and gender-specific analyses were conducted to explore associations with disease progression and cognitive impairment.
RESULTS: AD patients showed increased theta and alpha band powers, with theta band power exhibiting statistically significant differences. Globally elevated theta band power correlated with cognitive impairment severity. Higher aperiodic offsets and exponents were observed in AD patients, exhibiting upward trends with disease progression. Male AD patients displayed more pronounced EEG abnormalities and unique Montreal Cognitive Assessment (MOCA) score patterns.
CONCLUSIONS: Our findings highlight the critical role of theta band power in AD pathology and suggest potential EEG biomarkers for neurodegenerative changes. Gender-specific differences emphasize the importance of personalized approaches in AD diagnosis and treatment.
SIGNIFICANCE: This study provides novel neurophysiological insights into AD, underscoring the clinical utility of EEG markers and the necessity for gender-specific considerations in precision medicine for AD.}, }
@article {pmid41269690, year = {2025}, author = {Brickman, AM and Muller, C and Warren, JR and Grodsky, E and Kim, S and Culbertson, MJ and Thyagarajan, B and Manly, JJ}, title = {Alzheimer Disease Blood Biomarker Concentrations Across Race and Ethnicity Groups in Middle-Aged Adults.}, journal = {JAMA network open}, volume = {8}, number = {11}, pages = {e2545046}, pmid = {41269690}, issn = {2574-3805}, mesh = {Female ; Humans ; Male ; Middle Aged ; *Alzheimer Disease/blood/ethnology ; Amyloid beta-Peptides/blood ; Biomarkers/blood ; Black or African American/statistics & numerical data ; Cohort Studies ; *Ethnicity/statistics & numerical data ; Glial Fibrillary Acidic Protein/blood ; Hispanic or Latino/statistics & numerical data ; Neurofilament Proteins/blood ; tau Proteins/blood ; United States/epidemiology ; White/statistics & numerical data ; }, abstract = {IMPORTANCE: The incidence and prevalence of clinical Alzheimer disease (AD) are higher among Black and Latinx older adults than among White older adults. Past studies that compared plasma AD biomarker concentrations among groups minoritized by their race and ethnicity yielded inconsistent findings; however, these efforts did not include population representative samples or statistical procedures to ensure population representation.
OBJECTIVE: To examine race and ethnicity differences in plasma AD biomarker concentrations and in the association between biomarkers and medical conditions in a US population-representative cohort of middle-aged adults (approximately 58 years of age).
Data for this cohort study came from the High School and Beyond sample, a nationally representative cohort of high school sophomores and seniors who were recruited in 1980. In 2021, a subset of participants provided blood samples that were assayed for amyloid-β (Aβ42/Aβ40 ratio), phosphorylated tau-181 (pTau-181), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP). The analyses for the present study were conducted between July 2, 2024, and August 26, 2025, using data collected during the 2021 follow-up study.
EXPOSURES: Race and ethnicity groups and common medical conditions.
MAIN OUTCOMES AND MEASURES: General linear models with Wald tests were used to compare biomarker concentrations between race and ethnicity groups and to test interactions with common medical conditions using unadjusted biomarker values and models adjusted to ensure population representation with inverse probability weighting and multiple imputation.
RESULTS: The sample included 4340 adults (mean [SD; range] age, 58.1 [1.1; 56-63] years; 2400 [55.3%] women); 630 (14.4%) were Black, 900 (20.7%) were Latinx, and 2610 (60.1%) were White. Black participants had a lower Aβ42/Aβ40 ratio (d = -0.002; 95% CI, -0.004 to -0.000; P = .04) and lower NfL concentrations (d = -1.16; 95% CI, -2.15 to -0.16; P = .02) than White participants, but these differences were attenuated when models were adjusted for population representation (d = 0.000; 95% CI, -0.002 to 0.002; P = .85 for Aβ ratio; d = -0.88; 95% CI, -1.78 to 0.02; P = .05 for NfL). Latinx participants had lower GFAP concentrations than White participants (d = -3.87; 95% CI, -7.30 to -0.45; P = .03), but these differences were also attenuated when models were adjusted for population representation (d = 3.36; 95% CI, -3.13 to 9.86; P = .31). In general, estimated biomarker means were similar between race and ethnicity groups. History of type 2 diabetes was associated with increased NfL concentration (d = 0.19; 95% CI, 0.07 to 0.30; P = .04), and high body mass index was associated with lower Aβ42/Aβ40 ratio (d = -0.13; 95% CI, -0.21 to -0.06; P = .02); whereas high cholesterol was associated with lower pTau-181 concentration (d = -0.18; 95% CI, -0.25 to -0.10; P = .01) and high BMI was associated with lower GFAP concentration (d = -0.30; 95% CI -0.44 to -0.16; P = .01). No differences in associations between morbidities and AD biomarker concentrations were detected across race and ethnicity groups.
CONCLUSIONS AND RELEVANCE: In this cohort of middle-aged adults, the use of appropriate statistical estimation to ensure population representation indicated that blood-based AD biomarker concentrations were not distinguishable among race and ethnicity groups. Common medical conditions were associated with plasma biomarker concentrations similarly across race and ethnicity groups. These results highlight the importance of considering population representation and comorbid conditions in AD research to ensure accurate characterization of disease pathophysiology and improve precision of diagnostic and treatment strategies for populations that experience AD disparities.}, }
@article {pmid41269403, year = {2025}, author = {Jin, J and Hand, R and Meltzer, M and Abate, C and Geva, M and Hayden, MR and Ross, CA}, title = {Sigma-2 Receptor Antagonism Enhances the Neuroprotective Effects of Pridopidine, a Sigma-1 Receptor Agonist, in Huntington's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {121}, pmid = {41269403}, issn = {1559-1182}, mesh = {*Receptors, sigma/antagonists & inhibitors/agonists/metabolism ; *Huntington Disease/drug therapy/pathology/metabolism ; Animals ; *Neuroprotective Agents/pharmacology/therapeutic use ; Sigma-1 Receptor ; *Piperidines/pharmacology/therapeutic use ; Mice ; Humans ; Neurons/drug effects/metabolism/pathology ; Huntingtin Protein/metabolism ; }, abstract = {Pridopidine is a selective sigma-1 receptor (S1R) agonist in clinical development for Huntington's Disease (HD) and Amyotrophic Lateral Sclerosis (ALS). Activation of the S1R by pridopidine is neuroprotective in multiple preclinical models of neurodegenerative disease. The sigma-2 receptor (S2R) is evolutionarily and structurally unique from the S1R. Nevertheless, the S1R and S2R share an overlapping yet distinct ligand binding profile. Inhibition of the S2R is neuroprotective and S2R antagonists are in clinical development for Alzheimer's Disease (AD), ⍺-synucleinopathies, and dry age-related macular degeneration. In this study, we hypothesized that simultaneous activation of the S1R by pridopidine and inhibition of the S2R by the selective S2R antagonist FA10 might provide enhanced protection against mutant huntingtin (mHTT) expression in an in vitro model of neurodegeneration. Consistent with previous studies, pridopidine reduced neuronal cell death in a mouse primary neuron mHTT model. Similarly, we found that inhibition of the S2R by FA10 was also sufficient to protect against mHTT induced neurodegeneration in this model. The combination treatment of pridopidine and FA10 achieved greater efficacy than either compound alone, even at lower concentrations. The combination of these compounds may allow for lower efficacious doses leading to improved safety profiles and reduced off-target effects. This novel combinatorial approach, in which the S1R is activated while simultaneously inhibiting the S2R may prove to be a highly effective therapeutic strategy for HD and other neurodegenerative diseases.}, }
@article {pmid41268794, year = {2026}, author = {Zhang, H and Ya, J and Liao, X and Du, X and Zhao, C and Ren, J and Qu, X}, title = {In Situ Activatable Hydrogen-Bonded Organic Framework-Based Nanozyme as NADH Peroxidase Mimic Restoring Homeostasis for Treatment of Alzheimer's Disease.}, journal = {Small (Weinheim an der Bergstrasse, Germany)}, volume = {22}, number = {3}, pages = {e09547}, doi = {10.1002/smll.202509547}, pmid = {41268794}, issn = {1613-6829}, support = {2022YFA1205804//National Key R&D Program of China/ ; T249526//National Natural Science Foundation of China/ ; 22437006//National Natural Science Foundation of China/ ; 22237006//National Natural Science Foundation of China/ ; }, mesh = {*Alzheimer Disease/drug therapy/therapy/pathology ; Animals ; *Homeostasis/drug effects ; NAD/metabolism ; Amyloid beta-Peptides/metabolism ; Mice ; Copper/chemistry ; Hydrogen Bonding ; Humans ; *Metal-Organic Frameworks/chemistry ; Reactive Oxygen Species/metabolism ; Microglia/metabolism/drug effects ; }, abstract = {Nicotinamide adenine dinucleotide (NAD) serves as a vital regulator in metabolic networks, and the decrease in the level of its oxidized form, NAD+, is closely related to Alzheimer's disease (AD). However, unsatisfactory efficacy, non-targeted and imprecise treatment, along with interconnected pathogenic factors in AD, constrain the therapeutic efficacy of current AD therapeutic strategies. Herein, in lieu of complex multi-module treatments for pathogenesis, a bespoke in situ activatable hydrogen-bonded organic framework (HOF)-based nanozyme (denoted as NADH@Pre-Cu-HOF@KD8) has been constructed to modulate multiple interconnected homeostatic imbalances in AD. Benefiting from the specific organic monomers, 2,2'-bipyridine-5,5'-dicarboxylic acid, NADH@Pre-Cu-HOF@KD8 can sequester neurotoxic Cu[2+] from amyloid-β (Aβ)-Cu[2+] by competitive binding. The segregation of Cu[2+] from Aβ mitigated the generation of reactive oxygen species, Aβ toxicity, and alleviated the activation of microglia cells. Moreover, HOF-based nanozyme possessed NADH peroxidase (NPX)-like catalytic activity after binding Cu[2+], which can reduce oxidative stress and elevate compromised NAD+ levels, thereby restoring mitochondrial impairment and adenosine triphosphate (ATP) production. Spatiotemporally precise intervention is enabled through targeted delivery mediated by peptide modification and lesion-specific activation. Notably, cognitive deficits, neuropathology, and homeostatic markers in a 3xTg-AD mouse model are ameliorated upon treatment. By employing a facile HOF platform to modulate multiple interconnected pathological homeostatic imbalances in AD-copper toxicity, NAD[+] depletion, oxidative stress, and Aβ toxicity-this strategy offers a paradigm for ameliorating AD-associated homeostatic imbalances.}, }
@article {pmid41268790, year = {2025}, author = {Coburn, MA and Eskandari-Sedighi, G and Hasselmann, J and England, W and Shabestari, SK and Mansour, K and McQuade, A and Mgerian, MA and Chadarevian, JP and Tu, C and Silva, J and Beck, J and Keulen, Z and Spitale, RC and Davtyan, H and Blurton-Jones, M}, title = {Human microglia differentially respond to β-amyloid, tau, and combined Alzheimer's disease pathologies in vivo.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70930}, pmid = {41268790}, issn = {1552-5279}, support = {//Cure Alzheimer's Fund/ ; Discovery23-10//Alzheimer Society of Canada/ ; //The Larry L. Hillblom Foundation : 2024-A-023-FEL and 2025-A-175-FEL/ ; A2025007F//BrightFocus Postdoctoral Fellowship Program in Alzheimer's/ ; P30CA-062203//NIH / ; 1S10RR025496-01//NIH / ; 1S10OD010794-01//NIH / ; 1S10OD021718-01//NIH / ; 2024-A-023-FEL//NIH / ; NS082174//NIH Training Grant/ ; AG000096//NIH Training Grant/ ; //Susan Scott Foundation/ ; ADSF-21-829655-C/ALZ/Alzheimer's Association/United States ; }, mesh = {*Microglia/metabolism/pathology ; *Alzheimer Disease/pathology/metabolism ; Animals ; Humans ; Mice ; *Amyloid beta-Peptides/metabolism ; Disease Models, Animal ; *tau Proteins/metabolism ; Plaque, Amyloid/pathology/metabolism ; Mice, Transgenic ; Neurofibrillary Tangles/pathology/metabolism ; }, abstract = {INTRODUCTION: Recent studies have identified important species-dependent differences in the response of microglia to β-amyloid (Aβ) pathology. Yet, whether human microglia also interact differently with the pathognomonic combination of amyloid and tau pathologies that occur in Alzheimer's disease (AD) remains unclear.
METHODS: We generated a xenotolerant mouse model of AD that develops both plaque and tangle pathologies, transplanted stem cell-derived microglial progenitors and examined the interactions between human microglia and AD pathologies with scRNA sequencing, immunohistochemistry, and in vitro modeling.
RESULTS: The combined amyloid and tau pathologies induced robust type-I interferon and proinflammatory cytokine responses, as well as an increased adoption of a distinct "rod" morphology in human microglia. The rod morphology could be induced with type-I interferon treatment in vitro.
DISCUSSION: We provide new insights into human microglial responses to combined AD pathologies and a novel platform to investigate and manipulate human microglia in vivo.
HIGHLIGHTS: Amyloid pathology promotes the rapid development of neurofibrillary tangles and neuronal loss in a novel chimeric model of AD. Combined Alzheimer's disease pathologies lead to an expansion of disease-associated microglia (DAM) and exacerbate Interferon-responsive and cytokine/chemokine-enriched states in xenotransplanted human microglia. The combination of amyloid and tau promotes the development of a distinctive rod microglial phenotype that closely correlates with tau pathology and neurodegeneration. Rod morphology and transcriptional changes can be modeled in vitro by treatment of induced pluripotent stem cells (iPSC) -microglia with type-I interferons.}, }
@article {pmid41268620, year = {2026}, author = {Sun, L and Wang, J and Zhang, L}, title = {The Role of Sphingomyelin Synthase 2 in Lipid Metabolism and Its Implications in Diseases.}, journal = {Cell biology international}, volume = {50}, number = {1}, pages = {e70103}, doi = {10.1002/cbin.70103}, pmid = {41268620}, issn = {1095-8355}, support = {//This study was supported by National Natural Science Foundation of China (82272306), Taishan Scholars Program (tstp20221142), and Joint Innovation Team for Clinical & Basic Research [202409]./ ; }, mesh = {Humans ; *Transferases (Other Substituted Phosphate Groups)/metabolism ; *Lipid Metabolism/physiology ; Animals ; Signal Transduction ; Neoplasms/metabolism ; Sphingomyelins/metabolism ; *Nerve Tissue Proteins/metabolism ; Inflammation/metabolism ; }, abstract = {Sphingomyelin synthase 2 (SMS2) is a crucial enzyme predominantly localized to the plasma membrane, playing an essential role in sphingomyelin metabolism and signaling. SMS2 catalyzes the final step in the biosynthesis of sphingomyelin by transferring phosphocholine from phosphatidylcholine to ceramide, resulting in the production of sphingomyelin and diacylglycerol. This enzymatic activity dynamically regulates the intracellular levels of ceramide, diacylglycerol, and phosphatidylcholine, thereby influencing several critical cellular processes. SMS2 is integral to multiple signaling pathways, including TGF-β/Smad, NF-κB, and CXCL12/CXCR4, which are involved in cancer progression and platelet activation. SMS2 displays versatile enzymatic activities, including phospholipase C activity and ceramide phosphoethanolamine synthesis. Dysregulation of SMS2 is associated with various pathological conditions, such as skin barrier dysfunction, skeletal disorders, inflammatory diseases, and different types of cancer. Targeting SMS2 through inhibition or modulation demonstrates therapeutic potential in treating multiple conditions, including pancreatic cancer, Alzheimer's disease, and atherosclerosis, by impacting tumor growth dynamics and cellular migration. Given its multifaceted role in diverse pathological processes and its promise as a therapeutic target, further research on SMS2 is essential for the development of innovative treatment strategies aimed at cancer therapy, inflammation regulation, and overcoming drug resistance.}, }
@article {pmid41268264, year = {2025}, author = {Chen, J and Zhao, J and Fan, Y and Jin, Y and Mi, R and Wang, H and Yu, S and Feng, X and Zhang, Y and Ren, G}, title = {Predictive value of beta amyloid, phosphorylated Tau, neurofilament light chain, and glial fibrillary acidic protein for depression in Alzheimer's disease.}, journal = {American journal of translational research}, volume = {17}, number = {10}, pages = {7789-7802}, pmid = {41268264}, issn = {1943-8141}, abstract = {OBJECTIVES: To investigate differences in biochemical markers and their association with depressive symptoms in patients with Alzheimer's disease (AD) with and without concurrent depression.
METHODS: In this retrospective case-control study, 329 AD patients admitted to Beijing Panjiayuan TCM-Western Integrated Hospital between May 2019 and May 2022 were included. Patients were categorized into a comorbid depression group (n=167) and a non-depression group (n=162) based on Cornell Scale for Depression in Dementia (CSDD) scores. Biochemical markers, including β-amyloid proteins (Aβ1-42, Aβ1-40), phosphorylated Tau proteins (p-Tau181, p-Tau217), neurofilament light chain protein (NfL), glial fibrillary acidic protein (GFAP), and inflammatory cytokines, were measured and statistically analyzed.
RESULTS: High-density lipoprotein cholesterol (HDL-C) was significantly lower in the comorbid depression group (P<0.001). Levels of Aβ1-42 (P=0.012), Aβ1-40 (P=0.006), p-Tau181 (P=0.003), p-Tau217 (P=0.003), NfL (P<0.001), and GFAP (P=0.008) were significantly elevated in the depression group compared to the non-depression group. Additionally, interleukin-10 (P=0.004) and interleukin-6 (P=0.047) levels were higher, while interleukin-1β (P<0.001) was lower in the comorbid depression group. Receiver operating characteristic curve identified HDL-C (area under the curve [AUC]=0.602), p-Tau217 (AUC=0.595), NfL (AUC=0.692), GFAP (AUC=0.580), and IL-1β (AUC=0.600) as significant predictors of depression severity.
CONCLUSIONS: Specific biochemical markers, including HDL-C, Aβ42/40, p-Tau217, NfL, GFAP, and IL-1β, are independently associated with depression in AD patients. A combined biomarker model may improve prediction of comorbid depression in AD and provide guidance for personalized treatment.}, }
@article {pmid41268048, year = {2025}, author = {Moczygemba, W and Bradley, D and Carmona, R and Celano, V and Farley, L and Valverde, S and Sampley, A and Stratton, L}, title = {Perspectives on meaningful dementia treatment and care from those with lived experience.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70175}, doi = {10.1002/trc2.70175}, pmid = {41268048}, issn = {2352-8737}, abstract = {UNLABELLED: The ongoing conversations surrounding the importance of minimal clinically important differences and descriptions of meaningful impacts must include the voices of those living with Alzheimer's disease and related dementias. To provide this perspective, members of the Alzheimer's Association Early Stage Advisory Group were asked to describe what matters most to them, their experiences with treatment, how they define meaningful care, and what would provide them with feelings of progress and hope. Responses offer differing yet complementary definitions of a quality life, ways in which clinicians and providers can recognize and support the person behind the diagnosis, and how participating in clinical trials can bring hope - both now and for the future. By centering on the lived experiences and perspectives of those people living with dementia, this article provides insight for those seeking to develop novel treatments and provide care and support, both now and in the future.
HIGHLIGHTS: Maintaining independence, purposeful living, and social connection are among what matter most to those living with dementia.Meaningful treatment and care are person-centered and responsive to the needs and wants of the person living with dementia.Participating in clinical trials can have meaningful physical, cognitive, and psychosocial impacts for those living with dementia.}, }
@article {pmid41267904, year = {2025}, author = {Zhao, F and Li, Y and Yi, C and Li, X and Huang, G and Chen, X and Li, Y and Zhang, J}, title = {Global, regional, and national burdens of early-onset Alzheimer's disease and other dementias in women, 1990 to 2021.}, journal = {Journal of Alzheimer's disease reports}, volume = {9}, number = {}, pages = {25424823251395223}, pmid = {41267904}, issn = {2542-4823}, abstract = {BACKGROUND: Alzheimer's disease and other dementias disproportionally impacts women. Novel treatment makes understanding of early-onset cases unprecedentedly important.
OBJECTIVE: We aimed to examine Alzheimer's disease and other dementias incidence, DALYs, trends, and risk factors among women aged under 65 years from 1990 to 2021.
METHODS: Using Global Burden of Diseases Study, we estimated the trend of Alzheimer's diseases and other dementias age-standardized incidence and disability-adjusted life-years (DALYs) among women aged under 65 years by social development index (SDI) worldwide during 1990 to 2021.
RESULTS: Globally, in 2021 there were 4.3 million prevalent cases among middle-aged women, with the incident cases doubled from 0.4 million to 0.8 million during 1990-2021. The largest increases in incidence and DALYs were found in high-middle SDI countries (0.27%/year) and low-middle SDI countries (0.19%/year), respectively. The incidence rate doubled once with every five years of age increase. The two contributors, which were high body mass index and high fasting plasma glucose, rapidly grew from 1990 to 2021.
CONCLUSIONS: The substantial increase of early-onset Alzheimer's disease and other dementias among middle-aged women requires attention, especially targeted at the increasing reversible lifestyle risk factors.}, }
@article {pmid41267515, year = {2025}, author = {Ünal, D and Sarıköse Özgüven, A}, title = {Exosomes: New biomarker and therapeutic candidates in autism spectrum disorder research.}, journal = {Acta neuropsychiatrica}, volume = {38}, number = {}, pages = {e6}, doi = {10.1017/neu.2025.10047}, pmid = {41267515}, issn = {1601-5215}, mesh = {*Exosomes/metabolism ; Humans ; *Autism Spectrum Disorder/metabolism/diagnosis/therapy ; Biomarkers/metabolism ; Animals ; Mice ; Disease Models, Animal ; Cytokines/metabolism ; DNA, Mitochondrial ; }, abstract = {BACKGROUND: There is no recognised cure or specific biomarker for autism spectrum disorder (ASD). Exosomes are small vesicles that carry proteins, lipids and nucleic acids. They have been investigated for diseases such as Parkinson’s and Alzheimer’s. As the conclusions were on the biological utility of exosomes as a non-invasive brain biopsy, some animal, human and in vitro exosome studies have also been presented in the ASD field. The purpose of this review is to compile the studies that have established a relationship between ASD and exosomes so far and discuss their potential for linking the gap between the laboratory and clinic.
METHODS: In this systematic review, 31 PubMed articles were identified using the keywords ‘exosomal’, ‘exosome and ‘autism spectrum disorder’. After excluding 16 reviews, 4 irrelevant studies and 1 preprint, and adding 5 relevant articles, 15 research articles were included based on PRISMA criteria. The articles were investigated and reviewed by both authors. Their methodology and results are also discussed according to two main streams in studies.
RESULTS: Numerous studies have identified potential biomarkers, including mitochondrial DNA (mtDNA7S), cytokines including IL-1β, TNF-α and IL-6, and different types of RNAs by comparing the exosomal contents of ASD patients or models with controls. In studies that focused on treatment, behavioural improvements were shown in ASD model mice.
CONCLUSION: Since there are presently no reliable biomarkers or effective treatments for ASD, exosome-based research offers a promising avenue for early diagnosis and the creation of tailored therapies.}, }
@article {pmid41265552, year = {2026}, author = {Sardari, M and Hosseinzadeh Sahafi, O and Rezayof, A}, title = {Mitochondria serve as indispensable components of neuron-glia crosstalk in the trajectory of Alzheimer's disease.}, journal = {Brain research}, volume = {1870}, number = {}, pages = {150040}, doi = {10.1016/j.brainres.2025.150040}, pmid = {41265552}, issn = {1872-6240}, mesh = {*Alzheimer Disease/metabolism/pathology ; Humans ; *Mitochondria/metabolism/pathology ; *Neurons/metabolism/pathology ; *Neuroglia/metabolism/pathology ; Animals ; }, abstract = {Alzheimer's disease (AD) is a multiplex and progressive neurodegenerative disorder commonly recognized by the accumulation of amyloid-β (Aβ) plaques, neurofibrillary tangles (NFTs), and dysfunction in the cholinergic and glutamatergic systems. At the early stages of AD, mitochondrion operates as a neuroprotective organelle in both neuronal and glial cells by compensating energy fluctuations. As the disease progresses, mitochondrial function in both neurons and glial cells deteriorates, culminating in impaired cellular metabolism and glial hyperactivation. This time-dependent hyperactivation of microglia and astrocytes sequentially promotes the release of pro-inflammatory cytokines, elevates reactive oxygen species, disrupts calcium homeostasis, and increases oxidative stress. Altogether, these processes drive neuroinflammation, which both influences and is influenced by mitochondrial activity. Additionally, mitochondrial dysfunction across the disease trajectory hampers communication between neurons and glial cells, promoting excitotoxicity in neurons. This review emphasizes the vital role of mitochondrial dynamics in AD pathophysiology across different stages and explores how cell-specific targeting of mitochondrial activity could mitigate neuroinflammation, restore neuronal function, and offer potential treatment benefits. Enhancing mitochondrial function in healthy neurons and glial cells, particularly in microglia as a compensatory mechanism, especially at the early stage of the disease or restoring mitochondrial function of surviving neurons at the later stages, may promote neuroprotection and improve neuron-glia interactions, thus offering a potential strategy for AD treatment.}, }
@article {pmid41265341, year = {2026}, author = {Yuan, X and Gao, L and Peng, Y and She, T and Wang, J}, title = {A deep representation learning algorithm on drug-target interaction to screen novel drug candidates for Alzheimer's disease.}, journal = {Artificial intelligence in medicine}, volume = {171}, number = {}, pages = {103301}, doi = {10.1016/j.artmed.2025.103301}, pmid = {41265341}, issn = {1873-2860}, mesh = {*Alzheimer Disease/drug therapy/genetics ; Humans ; Molecular Docking Simulation ; *Algorithms ; *Deep Learning ; *Drug Discovery/methods ; }, abstract = {Alzheimer's disease (AD) is a serious neurodegenerative brain disorder with complex pathophysiology. While currently available drugs can provide symptomatic benefits, they often fail to cure the disease. Thus, there is an urgent need to explore new therapeutic agents. In this study, we developed DTIP (Drug-Target Interaction Prediction), a machine learning-based approach to search novel drugs for AD by utilizing the information of drug-target interaction (DTI). By training a Skip-gram model on drug-target sequences derived from known DTI information, the algorithm learned the drug-target relationship embeddings and to predict potential drug candidates for diseases like AD. For AD, we compiled 917 risk genes and identified 292 potential drugs via the new algorithm. We further performed molecular docking by AutoDock Vina and conducted Inverted Gene Set Enrichment Analysis (IGSEA) on these drug candidates. Our results identified that several drugs could be promising for AD treatment, including human C1-esterase inhibitor, quetiapine, dasatinib, miconazole, aniracetam, chlorpromazine, hypericin, entrectinib, torcetrapib, bosutinib, sunitinib, aniracetam, rosiglitazone, tarenflurbil, milrinone, and MITO-4509. Results from this study also provided insights for understanding the molecular mechanisms underlying AD. As a systematic and versatile method, our approach can also be applied to identify efficacious therapies for other complex diseases.}, }
@article {pmid41265212, year = {2025}, author = {Patel, Y and Sharma, P and Kumar, A and Parmar, HS and Inwati, GK}, title = {Design, Ssynthesis, and biological evaluation of β-secretase inhibitors: An integrated study of molecular docking, dynamics, pharmacokinetics, quantum chemistry, and in-vitro analysis for Alzheimer's disease.}, journal = {Bioorganic chemistry}, volume = {167}, number = {}, pages = {109267}, doi = {10.1016/j.bioorg.2025.109267}, pmid = {41265212}, issn = {1090-2120}, mesh = {*Amyloid Precursor Protein Secretases/antagonists & inhibitors/metabolism ; *Alzheimer Disease/drug therapy/metabolism ; Molecular Docking Simulation ; Humans ; *Aspartic Acid Endopeptidases/antagonists & inhibitors/metabolism ; *Drug Design ; Structure-Activity Relationship ; Molecular Structure ; *Enzyme Inhibitors/chemical synthesis/pharmacology/chemistry/pharmacokinetics ; Dose-Response Relationship, Drug ; Molecular Dynamics Simulation ; *Protease Inhibitors/chemical synthesis/chemistry/pharmacology/pharmacokinetics ; Quantum Theory ; }, abstract = {Present paper elicits the synthesis of a series of 2,2-dimethyl-2H-[1,3]dioxino[4,5-b]pyrrol-4(7H)-one derivatives as novel selective BACE1 inhibitors for the treatment of Alzheimer's disease (AD). A four-component, solvent-free condensation process, catalyzed by 10 mol% NiCl2·6H2O strategy was explored to achieve their synthesis. The structures of the synthesized compounds were ascertained using different spectroscopic techniques, including FT-IR, [1]H NMR, [13]C NMR, mass spectrometry, and elemental analysis. In silico molecular docking and molecular dynamics simulations suggest that these compounds exhibit strong potential as β-secretase (BACE1) inhibitors, demonstrating high interaction and binding energies compared to reference inhibitors AZD3293 and E2602. Notably, compounds 5p displayed significant inhibitory interactions, effectively suppressing the catalytic dyad (Asp A:228 and Asp A:32) of BACE1. To further validate the computational findings, in vitro BACE1 enzymatic inhibition assays were performed on the most interactive molecule 5p. Additionally, ADMET descriptors and density functional theory (DFT) calculations were employed to assess the pharmacokinetics, chemical stability, and binding affinity of the synthesized compounds. The findings from this study pave the way for future in vivo investigations to assess the reversal of Alzheimer's disease phenotypes, along with comprehensive safety and toxicity evaluations.}, }
@article {pmid41264165, year = {2025}, author = {Gao, H and Cheng, F and Zhang, Z and Yan, B and Liao, P and Zhang, S and Li, D and Chen, F and Lei, P}, title = {Breaking the Alzheimer's Treatment Stalemate: Synergistic Application Strategies of Nanomaterials and Pharmaceutical Agents.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {107}, pmid = {41264165}, issn = {1559-1182}, support = {grant no. 82271401//National Natural Science Foundation of China/ ; }, mesh = {*Alzheimer Disease/drug therapy/diagnosis ; Humans ; *Nanostructures/therapeutic use ; Animals ; Drug Delivery Systems/methods ; Nanomedicine/methods ; }, abstract = {Alzheimer's disease (AD), the leading cause of dementia, is characterized by amyloid beta accumulation and tau pathology propagation. Nanomedicine, a discipline enabling targeted drug delivery with precision, holds significant promise in the treatment of neurodegenerative diseases. This review explores the diagnostic and therapeutic applications of nanomaterials in neurodegenerative diseases, particularly AD, emphasizing their properties and their role in modulating pathogenic proteins. Advances in the development of novel anti-AD nanomedicines and their clinical progress are also highlighted. Despite the growing potential of nanotechnology in AD therapy, a definitive cure remains elusive. The review further addresses the current challenges in the field of AD nanomedicines and outlines future research directions to propel their development.}, }
@article {pmid41262573, year = {2025}, author = {Demsey, LL and Burch, D and Lin, E and Quach, D and Podvin, S and Boyarko, B and Levey, AI and Weinshenker, D and Edland, S and Galasko, D and Jacobs, H and Bang, A and Neil, A and Silverman, J and Feldman, HH and Hook, V}, title = {Atomoxetine Drug Properties for Repurposing as a Candidate Alzheimer's Disease Therapeutic Agent.}, journal = {ACS pharmacology & translational science}, volume = {8}, number = {11}, pages = {3757-3772}, pmid = {41262573}, issn = {2575-9108}, abstract = {Ongoing Alzheimer's disease (AD) drug development research addresses the need for therapeutic agents that can ameliorate cognitive symptoms and attenuate the course of AD synaptic deficits and neurodegeneration. There is growing interest in evaluating FDA-approved drugs for repurposing as candidate AD therapeutics. Such drugs have the advantage that data are available about their pharmaceutical properties, including doses, pharmacokinetics, pharmacodynamics, biomarkers, metabolism, and safety, to inform the design of clinical drug trials. Importantly, the suitability of such drugs with properties needed for AD requires evaluation. In the early stage of AD, degeneration of the locus coeruleus (LC) brain region results in the reduction of noradrenergic neurons and the loss of the neurotransmitter norepinephrine (NE) that regulates cognition and degeneration. Elevation of extracellular NE through inhibition of the NE transporter (NET) is hypothesized to ameliorate AD deficits. Notably, the NET reuptake inhibitor atomoxetine, an FDA-approved drug for the treatment of attention deficit hyperactivity disorder (ADHD), provides an attractive candidate as an AD therapeutic agent because it may attenuate cognitive decline in AD patients, positively impact AD biomarkers, and reduce neuropathology. The goal of this review is to assess atomoxetine for repurposing in AD based on its ability to improve cognition, regulate NE, impact AD biomarkers, and preserve LC neuronal function, with suitable pharmacokinetics, drug metabolism, and safety based on analysis of clinical and preclinical studies. Evidence for neuroprotective effects of atomoxetine in the early stage of AD at clinically safe doses with suitable pharmaceutical properties supports its candidacy as a repurposed drug for AD therapeutics.}, }
@article {pmid41262391, year = {2025}, author = {Latella, D and Calderone, A and Casella, C and De Luca, R and Gangemi, A and Impellizzeri, F and Caliri, S and Quartarone, A and Calabrò, RS}, title = {Cognitive behavioral therapy for insomnia in neurodegenerative disorders-targeting sleep disturbances in Alzheimer's and Parkinson's disease: a scoping review.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1700496}, pmid = {41262391}, issn = {1664-1078}, abstract = {INTRODUCTION: Insomnia is highly prevalent in neurodegenerative disorders, yet pharmacological options carry safety and tolerability concerns. This scoping review mapped contemporary evidence for cognitive behavioral therapy for insomnia (CBT-I) across Alzheimer's disease (AD), mild cognitive impairment (MCI), and Parkinson's disease (PD).
METHODS: Following a preregistered protocol (OSF DOI: 10.17605/OSF.IO/8VP3F), we searched PubMed, Cochrane Library, Web of Science, and Scopus for studies published 2015-2025. We screened English-language studies in adults and applied dual independent review with consensus resolution. Of 105 records, 70 were screened after de-duplication, and 8 met eligibility criteria.
RESULTS: Across randomized trials, pilot and feasibility studies, and single-case experimental designs, CBT-I-delivered in person or via telehealth-consistently reduced insomnia severity and improved sleep quality, with frequent ancillary gains in mood, anxiety, and daytime functioning. Remote and digitally augmented delivery appeared feasible and acceptable for cognitively vulnerable adults and caregivers. Early signals suggested potential cognitive benefits in prodromal populations (AD/MCI), and exploratory observations linked improved sleep with plausible neurobiological mechanisms such as amyloid-beta dynamics. In PD, findings aligned with a mechanistic pathway in which presleep cognitive arousal, safety behaviors, and dysfunctional sleep beliefs are modifiable targets. Non-pharmacological comparators (e.g., mindfulness, therapeutic exercise, neuromodulation) also showed benefits, helping contextualize where CBT-I may offer disorder-relevant leverage on insomnia outcomes.
DISCUSSION: The overall strength of evidence is tempered by small samples, heterogeneity in comparators and dosing, short follow-up, and inconsistent reporting of clinically meaningful change. Priorities include multicenter randomized trials with standardized sleep and cognitive endpoints, longer observation, head-to-head comparative effectiveness with economic evaluation, adaptive protocols tailored to PD-specific disruptors, and mechanistic studies integrating digital phenotyping and biomarkers to test durability and downstream clinical impact.}, }
@article {pmid41262225, year = {2025}, author = {Bayram, E}, title = {Sex and gender differences in Lewy body dementia: a narrative review.}, journal = {Equity neuroscience}, volume = {1}, number = {2}, pages = {}, pmid = {41262225}, issn = {3050-8401}, support = {R00 AG073453/AG/NIA NIH HHS/United States ; }, abstract = {Lewy body dementia (LBD), including Parkinson's disease dementia and dementia with Lewy bodies, is one of the most prevalent and burdensome type of dementias. Clinical diagnostic accuracy during life remains limited and there are currently only symptomatic therapy options without disease modification. However, recent advances in biomarkers and clinical trials are promising. Literature so far showed sex and gender differences in older adults without cognitive changes, people with all-cause dementia, Alzheimer's disease, and Parkinson's disease. While the number of studies in LBD are lower, understanding sex and gender differences and the underlying reasons can improve both diagnosis and treatment for LBD. Accordingly, the aim of this narrative review is to provide a summary of the literature for sex and gender differences in LBD. Majority of the studies for LBD investigating sex/gender differences so far focused on sex, with sex and gender terms being misused at times. Experiences of people in non-binary categories for sex or gender have yet to be investigated. While more research is needed, findings so far outline sex differences in prevalence, risk factors, biomarkers, symptoms, progression, treatment, daily life, and pathology for LBD. Sex-specific risk factors have also been reported, emphasizing the value of sex-stratified analyses and investigating female/male-specific factors such as sex hormones, menopause, and sex chromosomes. Lack of adequate research representation for females and women, as well as people from non-binary categories, is an important limitation that should be addressed to obtain more applicable findings in LBD.}, }
@article {pmid41261421, year = {2025}, author = {Etani, H and Takatori, S and Wang, W and Omi, J and Amiya, Y and Akahori, A and Watanabe, H and Sonn, I and Okano, H and Hara, N and Hasegawa, M and Miyashita, A and Kikuchi, M and Ikeuchi, T and Morishima, M and Saito, Y and Murayama, S and Saito, T and Saido, TC and Takai, T and Ohwada, T and Aoki, J and Tomita, T}, title = {Selective agonism of GPR34 stimulates microglial uptake and clearance of amyloid β fibrils.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {248}, pmid = {41261421}, issn = {1758-9193}, mesh = {*Microglia/metabolism/drug effects ; Animals ; *Amyloid beta-Peptides/metabolism ; Humans ; Mice ; *Receptors, G-Protein-Coupled/agonists/metabolism ; Alzheimer Disease/metabolism/pathology ; Phagocytosis/drug effects ; Mice, Transgenic ; Male ; Mice, Inbred C57BL ; Cells, Cultured ; }, abstract = {BACKGROUND: Microglia play a crucial role in brain homeostasis through phagocytosis of amyloid-β (Aβ) fibrils, a hallmark of Alzheimer disease (AD) pathology. The balance between Aβ production and clearance is critical for AD pathogenesis, with impaired clearance mechanisms potentially contributing to disease progression. G-protein coupled receptor 34 (GPR34), a microglia-enriched Gi/o-coupled receptor, is highly expressed in homeostatic microglia and may regulate phagocytic functions, yet its role in Aβ clearance remains poorly understood.
METHODS: Using flow cytometry-based assays, we investigated the effect of a selective GPR34 agonist (M1) on Aβ uptake in mouse primary microglia and human induced pluripotent stem cell-derived microglia. We evaluated uptake specificity across different Aβ species and phagocytic substrates, and measured intracellular cyclic adenosine monophosphate (cAMP) levels to determine the signaling mechanism. We performed in vivo studies using human amyloid precursor protein knock-in mice with intrahippocampal M1 injections. Additionally, we analyzed GPR34 expression in Japanese AD patient brain samples using single-nucleus RNA sequencing and examined age-dependent expression changes across multiple datasets.
RESULTS: M1 specifically enhanced uptake of Aβ fibrils through reduction of intracellular cAMP levels, without affecting monomeric or oligomeric Aβ internalization. Gpr34 knockdown experiments confirmed GPR34 as the molecular target of M1. An intrahippocampal injection of M1 significantly increased microglial Aβ uptake in vivo, an effect that required functional TREM2 signaling. GPR34 expression was significantly reduced in microglia from AD patients and showed age-dependent decline in both humans and mice.
CONCLUSIONS: Our findings identify GPR34 as a promising therapeutic target for enhancing microglial Aβ clearance and highlight the potential of GPR34 agonists for AD treatment. The age-dependent decline in GPR34 expression may contribute to reduced Aβ clearance efficiency in aging brains, exacerbating amyloid accumulation. Pharmacological activation of GPR34 represents a novel strategy to counteract impaired Aβ clearance in both aging and AD brains, potentially modifying disease progression through enhancement of microglial phagocytic function.}, }
@article {pmid41261317, year = {2025}, author = {Zhou, R and Tian, G and Yu, J and Wang, R and Peng, N and Guo, X and Li, R}, title = {Echinacoside Improves Memory Function and Bone Mineral Density in the Aged SAMP8 Mouse Model.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {102}, pmid = {41261317}, issn = {1559-1182}, mesh = {Animals ; Male ; Mice ; *Bone Density/drug effects ; *Aging/drug effects/pathology ; Disease Models, Animal ; *Memory/drug effects ; *Glycosides/pharmacology/therapeutic use ; Osteoporosis/drug therapy ; }, abstract = {Alzheimer's disease (AD) and osteoporosis (OP) are prevalent age-related degenerative diseases that often coexist. Echinacoside (ECH) has been extensively studied for its potential to mitigate AD and bone mineral density (BMD) loss. This study aimed to evaluate the simultaneous therapeutic effects of ECH on AD-OP comorbidity using the senescence-accelerated mouse-prone 8 (SAMP8) model, which exhibits both age-related memory deficits and bone metabolism abnormalities. Six-month-old male SAMP8 mice (n = 8-9) were used as the model group, while age-matched senescence-accelerated mouse resistant 1 (SAMR1) mice served as normal controls. SAMP8 mice were administered ECH intragastrically (100 mg/kg/day) for 10 weeks, while control groups received saline. Behavioral tests, including the open field test (OFT), novel object recognition test (NORT), and Morris Water Maze (MWM), assessed locomotor ability, emotionality, and cognitive functions. Bone microstructure was evaluated using micro-computed tomography (micro-CT), and pathological changes in the brain were analyzed via Western blotting and immunofluorescence. As compared to SAMR1 mice, SAMP8 mice exhibited significant locomotor activity issues, impaired memory (P < 0.05), glial activation (P < 0.01), reduced trabecular bone number (P = 0.007), and altered trabecular separation (P = 0.040). ECH treatment improved memory function and inhibited glial activation (P < 0.05). Bone-related parameters showed that ECH intervention had a trend of improvement in bone health, but this did not reach statistical significance. The SAMP8 model exhibits key features of both AD and OP, making it a valuable tool for investigating their comorbidity and underlying mechanisms. ECH improves cognitive functions and alleviates bone loss, indicating its potential as a therapeutic candidate for AD-OP comorbidity.}, }
@article {pmid41261299, year = {2025}, author = {Zhang, R and Wu, K and Yang, Q and Kong, M and Guo, L and You, Q}, title = {Hyperprolactinemia and Brain Health: Exploring the Gut-Brain Axis and Therapeutic Strategies.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {101}, pmid = {41261299}, issn = {1559-1182}, mesh = {Humans ; *Hyperprolactinemia/therapy/metabolism ; *Brain/pathology/metabolism ; Animals ; *Gastrointestinal Tract ; Gastrointestinal Microbiome/physiology ; Prolactin/metabolism ; *Brain-Gut Axis/physiology ; }, abstract = {Prolactin is a pituitary anterior lobe hormone that plays a crucial role in milk secretion from the mammary glands. Hyperprolactinemia is a common endocrine disorder characterized by abnormally elevated levels of prolactin in the serum. Recent research findings indicate that prolactin also exerts important physiological effects beyond lactation, including effects on brain health and the central nervous system. The gut-brain axis has become an important area of neuroscience research, providing insights into the complex interactions between the gastrointestinal system and the central nervous system. Future research may involve developing new probiotic therapies or optimizing the gut microbiota through dietary and lifestyle interventions. In addition, understanding the mechanisms by which hyperprolactinemia contributes to various neurological disorders and targeting prolactin for treatment are crucial areas of research. Therefore, this study aimed to investigate the correlation between hyperprolactinemia and brain health from the perspective of the gut-brain axis, with the goal of discovering new approaches for preventing and treating neurodegenerative and mental health conditions. This synthesis highlights potential strategies for future therapeutic interventions.}, }
@article {pmid41261295, year = {2025}, author = {Kritika, and Sood, R and Sanjay, and Lee, HJ}, title = {Nobiletin Reduces LPS-Induced Neuroinflammation through TLR4/MyD88/NF-κB and Oxidative Stress via Nrf2/HO-1 Signaling in Human Microglial HMC3 Cells.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {103}, pmid = {41261295}, issn = {1559-1182}, support = {GCU-202401020001//Gachon University research fund of 2023 (GCU-202401020001)/ ; (project No. RS-2022-RD010230)//Cooperative Research Program for Agriculture Science and Technology Development (project No. RS-2022-RD010230), Rural Development Administration, Republic of Korea./ ; }, mesh = {Humans ; *Oxidative Stress/drug effects ; *Myeloid Differentiation Factor 88/metabolism ; *NF-E2-Related Factor 2/metabolism ; *Toll-Like Receptor 4/metabolism ; *Signal Transduction/drug effects ; Lipopolysaccharides ; *NF-kappa B/metabolism ; *Microglia/drug effects/metabolism/pathology ; *Heme Oxygenase-1/metabolism ; *Flavonols/pharmacology ; *Neuroinflammatory Diseases/metabolism/drug therapy/chemically induced/pathology ; *Flavones/pharmacology ; Cell Line ; Inflammation/metabolism/drug therapy ; Reactive Oxygen Species/metabolism ; }, abstract = {Neuroinflammation and oxidative stress (OS) are the major contributors to the onset and progression of neurodegenerative diseases (NDs), where microglial activation and dysregulated inflammatory signaling exacerbate neuronal injury. Nobiletin (NOB), a polymethoxylated flavonoid abundant in citrus fruits, has been reported to possess excellent bioactivities; however, its effects in combating inflammation and OS in human microglial cells (HMC3) have not been comprehensively examined. In this study, we investigated the effects of NOB on lipopolysaccharide (LPS)-induced inflammatory and oxidative responses in HMC3 cells. The HMC3 cells exposed to LPS (1 µg/mL) in the presence/absence of NOB (5, 10, 20, and 40 µM) for 24 h showed that NOB could attenuate LPS-induced cytotoxicity. NOB treatment attenuated LPS-induced upregulation of pro-inflammatory cytokines including interleukin (IL)-1β, and IL-6, and suppressed activation of the toll-like receptor 4/myeloid differentiation primary response 88/nuclear factor kappa-light-chain-enhancer of activated B (TLR4/MyD88/NF-κB) pathway. NOB enhanced the protein expression levels of TLR10, a negative regulator of TLR4-mediated inflammatory signaling. In addition, NOB increased the nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) expression, along with other antioxidants including catalase (CAT), glutathione peroxidase (GPx), and superoxide dismutase (SOD), leading to reduced intracellular reactive oxygen species (ROS). These findings suggest that NOB has promising anti-inflammatory and antioxidant effects in an in vitro model of LPS-induced neuroinflammation, potentially through modulation of TLR4/MyD88/NF-κB and Nrf2/HO-1 signaling pathways. However, further in vivo studies are needed to validate these effects and explore NOB's potential as a candidate for therapeutic development in NDs.}, }
@article {pmid41261258, year = {2025}, author = {Rahmani, D and Chodari, L and Kakallahpour, M and Niknam, Z}, title = {Therapeutic Potential of Sodium Butyrate in Neurological and Psychiatric Disorders.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {90}, pmid = {41261258}, issn = {1559-1182}, mesh = {Humans ; *Mental Disorders/drug therapy ; Animals ; *Butyric Acid/therapeutic use/pharmacology ; *Nervous System Diseases/drug therapy ; Histone Deacetylase Inhibitors/therapeutic use/pharmacology ; }, abstract = {Neurodegenerative diseases (NDDs), such as Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD), are characterized by progressive neuronal loss associated with neuroinflammation, oxidative stress, and epigenetic dysregulation. Emerging evidence suggests that histone deacetylases (HDACs) are overexpressed in these conditions, making HDAC inhibitors (HDACIs) like sodium butyrate (NaB) promising candidates for therapeutic intervention. In addition, NaB has shown beneficial effects in various psychiatric disorders, including depression, anxiety, and schizophrenia, suggesting a broader neurotherapeutic potential. This review synthesizes findings from various in vitro and in vivo studies investigating the mechanisms and therapeutic applications of NaB, in both neurological and psychiatric disorders. We focus on its role as an HDACI, its impact on histone acetylation and gene expression, its ability to modulate gut microbiota, and its capacity to cross the blood-brain barrier (BBB) to exert neuroprotective effects. NaB demonstrates anti-inflammatory, antioxidant, anti-apoptotic, and neurotrophic properties, contributing to improved cognitive, motor, and behavioral outcomes in multiple models of central nervous system (CNS) dysfunction. Accumulating evidence supports its efficacy not only in NDDs but also in mental health disorders, highlighting its potential as a complementary treatment alongside conventional therapies. Given its multifaceted mechanisms and favorable safety profile, NaB holds promise as a novel therapeutic agent across a spectrum of neurological and psychiatric conditions. Further clinical investigation is warranted to fully establish its translational value.}, }
@article {pmid41261002, year = {2026}, author = {Canney, M and Bouchoux, G and Carpentier, A and De Rossi, P}, title = {Repeated blood-brain barrier opening using low-intensity pulsed ultrasound mitigates amyloid pathology.}, journal = {Ultrasound in medicine & biology}, volume = {52}, number = {2}, pages = {418-430}, doi = {10.1016/j.ultrasmedbio.2025.10.008}, pmid = {41261002}, issn = {1879-291X}, mesh = {Animals ; *Blood-Brain Barrier/metabolism ; Mice ; *Ultrasonic Waves ; Disease Models, Animal ; *Alzheimer Disease/pathology/therapy/metabolism ; Microbubbles ; *Amyloid beta-Peptides/metabolism ; Mice, Inbred C57BL ; Brain ; Ultrasonic Therapy/methods ; }, abstract = {OBJECTIVE: The delivery of large molecules to the pathological brain is one of the main obstacles in the development of disease-modifying drugs. This is partly due to the presence of the blood-brain barrier (BBB), which blocks the free passage of lipophobic molecules and those larger than 400 Da. One strategy to bypass this natural barrier is to use low-intensity pulsed ultrasound to oscillate circulating micro-sized microbubbles, which then exert mechanical stress on the vessel walls. This procedure allows for temporary disruption of the BBB and enhanced local delivery of therapeutics from the blood to the brain parenchyma. In this study, the effect of repeated BBB opening on neuroinflammation in a healthy mouse model was first explored, followed by the effect of repeated opening on amyloid-beta (Aβ) pathology in an Alzheimer's disease model.
METHODS: A cohort of wild-type mice was used to determine the effect of a single BBB opening session mediated by ultrasound/microbubbles (US/MBs) on the inflammatory profile via real-time quantitative polymerase chain reaction on brain extracts at 2, 4, 8 and 15 d post-opening. A second cohort of ARTE10 mice, a mouse model for Aβ pathology, was treated with a different sequence of repeated US/MB-mediated BBB opening to explore the effect on Aβ pathology. Tissues were also analyzed for immune cell infiltration, microglia and astrocyte activation, as well as inflammatory response.
RESULTS: Our results demonstrate that opening the BBB leads to a mild inflammatory response in wild-type animals. However, repeated opening of the BBB in the ARTE10 model resulted in a mild decrease in Aβ pathology, along with a mild increase in growth factor.
CONCLUSION: Altogether, this study suggests that sonication is not only a safe method to deliver therapeutics to the brain but could also have synergistic effects in the treatment of neurodegenerative disease.}, }
@article {pmid41260559, year = {2025}, author = {Peng, D and Wu, L and Zhang, L and Chen, H and Hu, B and Zhang, Q and Huang, Y}, title = {haFGF14-154 attenuates Aβ1-42-induced neurotoxicity by facilitating BDNF maturation in a neuron-astrocyte co-culture system.}, journal = {Molecular and cellular neurosciences}, volume = {135}, number = {}, pages = {104056}, doi = {10.1016/j.mcn.2025.104056}, pmid = {41260559}, issn = {1095-9327}, mesh = {*Alzheimer Disease/drug therapy ; *Neurons/cytology ; *Astrocytes/cytology ; Coculture Techniques ; Signal Transduction ; Brain-Derived Neurotrophic Factor/genetics/metabolism ; *Fibroblast Growth Factors/pharmacology ; Peptides/pharmacology ; *Neuroprotective Agents/pharmacology ; Male ; Animals ; Mice ; Cells, Cultured ; Amyloid beta-Peptides/metabolism ; Up-Regulation/drug effects ; Apoptosis/drug effects ; }, abstract = {haFGF14-154 improves cognitive impairment in animal models of Alzheimer's disease (AD), but the effects and mechanisms of astrocytes on the neuroprotection mediated by haFGF14-154 remain unclear. Here, a neuron-astrocyte co-culture system was established to investigate the functions of astrocytes. The results showed that astrocytes strengthened the protective effect of haFGF14-154 on Aβ1-42-treated neurons. This enhanced protective function of haFGF14-154 correlates with phenotypic transition in astrocytes, as demonstrated by the suppression of Aβ1-42-induced A1-like genes and the elevation of A2-like markers in vitro. These observations are consistent with the reduction of GFAP and C3 levels in the hippocampus and prefrontal cortex of APP/PS1 mice treated with haFGF14-154. haFGF14-154 modified the function of astrocytes by activating the AKT/CREB/BDNF pathway, thereby promoting neurite growth. Moreover, haFGF14-154 up-regulated the expression of Furin and MMP9 in astrocytes, leading to the processing of pro-BDNF. This effect was replicated in APP/PS1 mice administered with haFGF14-154. Compared to the Aβ group, the BDNF level in the co-culture system supernatant was increased, while the IL-1β level was decreased following haFGF14-154 treatment. Additionally, haFGF14-154 inhibited neuronal apoptosis in the co-culture system, as evidenced by a decrease in pro-BDNF/P75[NTR], an increase in Bcl-2, and a reduction of Bad and Cleaved-caspase-3. In conclusion, current results demonstrate that astrocytes are crucial for mediating the protective effect of haFGF14-154 against neuronal damage, and underline the importance of the AKT/CREB/BDNF pathway in promoting neurite growth and attenuating neuronal apoptosis.}, }
@article {pmid41260522, year = {2025}, author = {Park, JK and Kim, HG and Lee, JS and Joo, JH and Yoo, HR}, title = {Traditional herbal medicine Ga-Mi Gongjindan improves muscarinic cholinergic dysfunction through regulation of BDNF/CREB signaling pathway using a scopolamine-induced cognitive impairment of mouse model.}, journal = {Brain research bulletin}, volume = {233}, number = {}, pages = {111644}, doi = {10.1016/j.brainresbull.2025.111644}, pmid = {41260522}, issn = {1873-2747}, mesh = {Animals ; *Brain-Derived Neurotrophic Factor/metabolism/drug effects ; Scopolamine/pharmacology ; *Cognitive Dysfunction/drug therapy/chemically induced/metabolism ; Mice ; Signal Transduction/drug effects ; Mice, Inbred C57BL ; Male ; Cyclic AMP Response Element-Binding Protein/metabolism ; Hippocampus/metabolism/drug effects ; Disease Models, Animal ; Neuroprotective Agents/pharmacology ; Maze Learning/drug effects ; Oxidative Stress/drug effects ; Medicine, Korean Traditional ; }, abstract = {BACKGROUND: Neurodegenerative diseases, such as Alzheimer's disease (AD), are characterized by progressive memory loss and cognitive dysfunction, often linked to cholinergic system deterioration and hippocampal oxidative stress. Current pharmacological treatments offer only modest symptomatic relief and are often accompanied by adverse effects. In traditional Korean medicine, Ga-Mi Gongjindan (GJD), a modified formulation of Gongjindan, has long been used for enhancing cognitive function, but its neuropharmacological basis remains largely unexplored.
OBJECTIVE: This study aimed to investigate the neuroprotective potential and underlying mechanisms of GJD in a murine model of scopolamine-induced cognitive impairment, which mimics aspects of muscarinic cholinergic dysfunction observed in Alzheimer's disease (AD).
METHODS: C57BL/6 J mice were administered GJD or tacrine (positive control) for 14 days. Cognitive impairment was induced by a single intraperitoneal injection of scopolamine (2 mg/kg), and behavioral analysis was assessed using the Morris Water Maze. Hippocampal tissues were analyzed for markers of oxidative stress, inflammation, cholinergic function, and neurotrophic signaling by focusing on the BDNF/CREB signaling pathway.
RESULTS: GJD treatment significantly improved spatial learning and memory performance. It restored cholinergic function by reducing acetylcholinesterase (AChE) activity and increasing choline acetyltransferase (ChAT) levels. GJD also suppressed oxidative stress and neuroinflammation and markedly enhanced hippocampal expression of brain-derived neurotrophic factor (BDNF), cAMP response element-binding protein (CREB), and their receptors (TrkA, TrkB, and M1 mAChR).
CONCLUSION: GJD exerted significant neuroprotective effects in a scopolamine-induced model of cognitive dysfunction, potentially via modulation of cholinergic and BDNF/CREB signaling pathways. These findings provide a scientific rationale for the traditional use of GJD in cognitive disorders and support its further development as a candidate for treating neurodegenerative diseases such as AD.}, }
@article {pmid41260370, year = {2026}, author = {Xiao, K and Sayed, H and Xing, J and Zhang, XY and Ai, J and Kirichek, E and Le, GH and Wong, S and Valentino, K and Teopiz, KM and Vinberg, M and Rosenblat, JD and Lo, HKY and Zhang, MC and McIntyre, RS}, title = {The effects of Lithium on Beta-amyloid deposition and tau phosphorylation: A systematic review.}, journal = {Journal of affective disorders}, volume = {395}, number = {Pt A}, pages = {120721}, doi = {10.1016/j.jad.2025.120721}, pmid = {41260370}, issn = {1573-2517}, mesh = {Humans ; Phosphorylation/drug effects ; *tau Proteins/metabolism/drug effects ; Animals ; *Amyloid beta-Peptides/metabolism/drug effects ; *Alzheimer Disease/drug therapy/metabolism ; Disease Models, Animal ; *Lithium/pharmacology ; *Lithium Compounds/pharmacology ; Neuroprotective Agents/pharmacology ; }, abstract = {BACKGROUND: Lithium demonstrates neuroprotective and neurotrophic effects, and preclinical studies indicate lithium reduces intracerebral amyloid deposition and tau phosphorylation. This systematic review evaluates lithium's effects on beta-amyloid, tau, and cognitive deficits in major neurocognitive disorders.
METHODS: A systematic review of primary research was conducted using Embase, PsycInfo, MEDLINE, and PubMed databases from inception to September 2024, following PRISMA criteria. Animal and adult human studies evaluating lithium monotherapy's effects on Alzheimer's Disease (AD) were included.
RESULTS: Long-term low-dose lithium treatment demonstrates inconsistent effects on lowering intracerebral amyloid deposition and reversing AD-related cognitive deficits in preclinical and clinical trials. Lithium was reported to slows amyloid plaque formation in pre-plaque stages through increasing heat shock proteins and suppressing protein synthesis in preclinical trials. Intracerebral lithium reduced phosphorylated tau through promoting tau ubiquitination and inhibiting CDK5 signalling in preclinical trials.
LIMITATIONS: A comprehensive animal model that accurately represents human AD symptoms and progression, as well as more clinical trials are needed. Several included studies utilize peripheral lithium administration, which complicates assessment of effective intracerebral concentrations.
CONCLUSIONS: Lithium potentially reduces intracerebral amyloid deposition and tau phosphorylation in AD animal models and may reverse associated cognitive deficits. Further research should seek to replicate similar findings in larger samples and explore lithium's optimal dosage range in promoting intracerebral amyloid clearance.}, }
@article {pmid41260286, year = {2026}, author = {Altındağ, F and Bayır, MH and Alhalboosi, JKI and Yıldızhan, K}, title = {Syringic acid mitigates scopolamine-induced cognitive impairment by regulating PSD-95 and GSK-3β and by preventing neurodegeneration in an Alzheimer-like rat model.}, journal = {Experimental neurology}, volume = {396}, number = {}, pages = {115556}, doi = {10.1016/j.expneurol.2025.115556}, pmid = {41260286}, issn = {1090-2430}, mesh = {Animals ; *Disks Large Homolog 4 Protein/metabolism/biosynthesis ; *Glycogen Synthase Kinase 3 beta/metabolism/biosynthesis ; Rats ; Male ; *Cognitive Dysfunction/chemically induced/metabolism/drug therapy/prevention & control ; *Alzheimer Disease/metabolism/chemically induced/pathology/drug therapy/prevention & control ; *Gallic Acid/analogs & derivatives/pharmacology/therapeutic use ; Scopolamine/toxicity ; Disease Models, Animal ; Hippocampus/drug effects/pathology/metabolism ; *Nerve Degeneration/prevention & control/metabolism ; Rats, Sprague-Dawley ; Neuroprotective Agents/pharmacology ; Rats, Wistar ; }, abstract = {Alzheimer's disease (AD) is a disorder characterized by progressive cognitive impairment. Syringic acid (SA) is a phenolic compound with many beneficial effects, such as antioxidant, anti-inflammatory, anti-diabetic, anti-carcinogenic, and neuroprotective. Our study aimed to investigate the effects of SA (50 mg/kg/day) on scopolamine (SCO)-induced AD-like condition in rats. Immunohistochemical evaluation was performed using antibodies to postsynaptic density protein 95 (PSD-95), Glycogen synthase kinase-3β (GSK-3β), TNF-α, and caspase-3. The hippocampus was stained with Hematoxylin-Eosin, and the total number of hippocampal neurons and hippocampal volume were calculated using the stereological method. The Y-maze task behavioral test was performed. SCO decreased PSD-95 expression while increasing GSK-3β, TNF-α, and caspase-3 expression. SA treatment increased PSD-95 expression while decreasing GSK-3β, TNF-α, and caspase-3 expression. Compared to the control group, the number of hippocampal neurons was significantly decreased in the Alzheimer's group, but the number of neurons in the SA group was significantly higher than in the Alzheimer's group. Hippocampal volume was lower in the Alzheimer's group, although there was no statistical difference between the groups. SA also improved SCO-induced cognitive impairment. Our study findings suggest that SA may mitigate SCO-induced cognitive impairment in the AD rat model, modulating PSD-95 and GSK-3β and decreasing neuroinflammation and apoptosis.}, }
@article {pmid41260167, year = {2026}, author = {Wang, X and Li, W and Liu, X and Liang, J and Wang, L and Liu, G and Liu, Y and Song, M and Li, Z and Guo, Y and Li, S and Fu, N and Zhang, B}, title = {Celastrol as a neuroprotective drug: current status and challenges.}, journal = {International immunopharmacology}, volume = {168}, number = {Pt 2}, pages = {115846}, doi = {10.1016/j.intimp.2025.115846}, pmid = {41260167}, issn = {1878-1705}, mesh = {*Pentacyclic Triterpenes/therapeutic use/pharmacology ; Animals ; *Neuroprotective Agents/therapeutic use/pharmacology ; Humans ; Disease Models, Animal ; Autophagy/drug effects ; Tripterygium ; *Neurodegenerative Diseases/drug therapy ; *Triterpenes/therapeutic use/pharmacology ; Mice ; }, abstract = {Neurological disorders are increasing worldwide, imposing a major social and economic burden. Therefore, there is an urgent need to explore effective treatment methods to alleviate neurological disorders. Celastrol, derived from the traditional Chinese medicine Tripterygium wilfordii Hook. f., has been shown in multiple studies to exhibit promising neuroprotective effects in neurodegenerative, including Parkinson's disease, Alzheimer's disease, and spinal cord injury. The targets or pathways through which celastrol exerts its neuroprotective effects are diverse. This paper primarily focuses on in vivo animal models (such as Parkinson's disease mouse models, Alzheimer's disease mouse models) and in vitro cell models (such as neuronal cell lines, primary cultured neurons) experiments to comprehensively summarize the molecular mechanisms underlying celastrol's neuroprotective effects. Celastrol exerts its neuroprotective effects through pathways such as reducing inflammation, activating the autophagy-lysosome pathway, and inhibiting ferroptosis. Additionally, we discuss the current challenges faced by celastrol and potential strategies to address them. Collectively, these findings highlight celastrol as a promising therapeutic candidate, although further pharmacokinetic optimization and clinical validation are essential.}, }
@article {pmid41259985, year = {2026}, author = {Lin, C and Li, Q and Liu, G and Xi, Z and Yan, X and Li, S and He, L and Bai, P}, title = {Fe3O4@MoS2@Au-Ag microsphere-based ultrasensitive immunobiosensor for the early diagnosis of Alzheimer's disease.}, journal = {Talanta}, volume = {299}, number = {}, pages = {129127}, doi = {10.1016/j.talanta.2025.129127}, pmid = {41259985}, issn = {1873-3573}, mesh = {*Alzheimer Disease/diagnosis/blood ; *Gold/chemistry ; Humans ; *Amyloid beta-Peptides/blood/immunology ; *Biosensing Techniques/methods ; *Molybdenum/chemistry ; *Silver/chemistry ; *Microspheres ; *Disulfides/chemistry ; Early Diagnosis ; *Peptide Fragments/blood ; Limit of Detection ; Metal Nanoparticles/chemistry ; *Ferrosoferric Oxide/chemistry ; Immunoassay/methods ; }, abstract = {Alzheimer's Disease (AD), a most common neurodegenerative disease, has aroused people's great attention. Amyloid-β 1-42 (Aβ42) from serum/plasma has been listed as Core 1 biomarker in diagnostic guide and explore an ultrasensitive detection method of Aβ42 is of great significance for early AD diagnosis and treatment. Herein, an ultrasensitive fluorescent biosensor for Aβ42 detection is designed, which is composed of Fe3O4@MoS2 microsphere and Au-Ag alloy. Compared with typical single gold nanoparticles in traditional fluorescent biosensor, alloy nanoparticles can generate a stronger electromagnetic field to enhance the fluorescence of quantum dots via surface plasmon resonance, achieve the effect of signal amplification. Importantly, our design significantly improved the limit of detection to 11 ag/mL, with a linear response ranging from 0.1 to 10[4] fg/mL. Moreover, by replacing the detection antibody in the biosensor, it can also be applied to other common AD biomarkers, such as Aβ40 (linear range: 0.1 to 10[5] fg/mL, LOD: 61 ag/mL) and total Tau protein (linear range: 0.1 to 10[5] fg/mL, LOD: 40 ag/mL). The biosensor exhibited excellent performance in both spiked and real serum samples. This fluorescent biosensor based on Au-Ag alloy strategy with ultra-sensitivity and good selectivity, provides a reliable solution for AD's early diagnosis.}, }
@article {pmid41258757, year = {2025}, author = {Saini, TC and Randhawa, S and Bathla, M and Nisha, A and Teji, N and Acharya, A}, title = {Nanoengineered Polyphenol-Quantum Dot Conjugates Inhibit Biofilm Protein-Aβ42 Heterotypic Fibrillogenesis, Restore Synaptic Transmission, and Suppress Apoptosis in Alzheimer's Disease.}, journal = {ACS chemical neuroscience}, volume = {16}, number = {23}, pages = {4458-4478}, doi = {10.1021/acschemneuro.5c00467}, pmid = {41258757}, issn = {1948-7193}, mesh = {*Amyloid beta-Peptides/metabolism ; *Biofilms/drug effects ; *Alzheimer Disease/metabolism/drug therapy ; *Apoptosis/drug effects/physiology ; Humans ; *Polyphenols/pharmacology/chemistry ; *Peptide Fragments/metabolism ; Animals ; *Quantum Dots/chemistry ; Escherichia coli ; Caenorhabditis elegans ; Cell Line, Tumor ; Bacterial Proteins/metabolism ; }, abstract = {The gut microbiota influences neurodegenerative disease progression, including Alzheimer's disease (AD), through microbial metabolites like amyloids in bacterial biofilms, such as the curli protein in Eshcherichia coli biofilm. In this context, the study focuses on two key aspects, namely, (i) how cross-kingdom bacterial biofilm proteins accelerate Aβ42 aggregation and induce neurotoxicity and (ii) whether a nanochaperone with hydrophobic sheets and hydrophilic polyphenolic moieties could inhibit cross-seeded aggregation. Considering this, we chemically synthesized and further characterized gallic acid-conjugated molybdenum disulfide quantum dots (GA@MoS2 QDs, ∼9.6 ± 4.2 nm) using spectroscopy and microscopy techniques, which showed ∼1.84-fold reduction in E. coli biofilm thickness, indicating interaction with biofilm components. The presence of the curli protein in E. coli was confirmed by dot blot and MALDI-TOF studies. Subsequent biophysical studies showed that isolated E. coli biofilm protein accelerated Aβ42 aggregation (heterotypic) by ∼6.76-fold, while GA@MoS2 QDs reduced this heterotypic aggregation by ∼9.49-fold reduction in Aβ42+ECBFP fluorescence relative to Aβ42 aggregates. In vitro studies with SH-SY5Y cells showed that heterotypic protein aggregation led to increased ROS production, intracellular calcium influx, and apoptosis induction, which were mitigated by GA@MoS2 QDs. The neuroprotective effect of GA@MoS2 QDs was also studied on Caenorhabditis elegans. Overall, the present studies suggested that the bacterial amyloid proteins may play a crucial role in Aβ42 aggregation, suggesting that targeting coaggregation could provide a novel therapeutic approach for the treatment of early onset AD.}, }
@article {pmid41258645, year = {2025}, author = {Katsuse, K and Kakinuma, K and Niimi, Y and Iseki, C and Kawakami, N and Ota, S and Kawamura, A and Ogawa, N and Yano, S and Kakumoto, T and Takao, H and Hamada, M and Kanno, S and Toda, T and Suzuki, K}, title = {Lecanemab for posterior cortical atrophy: Two contrasting cases.}, journal = {The Clinical neuropsychologist}, volume = {}, number = {}, pages = {1-23}, doi = {10.1080/13854046.2025.2590527}, pmid = {41258645}, issn = {1744-4144}, abstract = {OBJECTIVE: This study aimed to evaluate the clinical implications, limitations, and potential risks of lecanemab treatment for posterior cortical atrophy (PCA) by conducting a comparative analysis of two cases.
METHOD: We retrospectively analyzed two patients with biomarker-confirmed PCA-pure who met the eligibility criteria for lecanemab. Clinical history, neuropsychological profiles, imaging findings, and treatment outcomes for more than 1 year were comprehensively reviewed.
RESULTS: At treatment initiation, Patients 1 and 2 were one year post-onset and five years post-onset, respectively, with comparable baseline Mini-Mental State Examination (25-26) and Clinical Dementia Rating (0.5) scores. Patient 1, who exhibited prominent agraphia with left-dominant parieto-occipital atrophy, began lecanemab early and maintained stable daily functioning despite a gradual decline in reading, figure copying, and visual cancelation tasks. Patient 2, with right-dominant posterior atrophy and more severe visuospatial deficits, including simultanagnosia and prosopagnosia, developed parkinsonism and hallucinations after treatment initiation, followed by rapid functional decline, possibly due to mixed pathology, ultimately leading to treatment discontinuation. Patient 1 reported high treatment satisfaction, whereas Patient 2 expressed regret.
CONCLUSION: These cases raise concerns regarding the direct application of treatment eligibility criteria developed for typical Alzheimer's disease to PCA. Clinical decision-making in PCA requires visual cognition-specific assessments that are less vulnerable to floor effects and tailored to phenotypic heterogeneity and hemispheric lateralization. Coexisting pathologies may influence the treatment response and complicate the interpretation of outcomes. A tailored, multimodal approach that integrates longitudinal neuropsychological assessments with advanced imaging is essential to ensure appropriate use of disease-modifying therapies for PCA.}, }
@article {pmid41258002, year = {2025}, author = {Yang, C and Wang, P and Zhu, Z and Wu, H and Su, Q and Zhu, S and Shao, Y and Lin, H and Biswal, BB}, title = {Individualized functional connectome biomarkers predict clinical symptoms after rTMS treatment in Alzheimer's disease.}, journal = {Translational psychiatry}, volume = {15}, number = {1}, pages = {511}, pmid = {41258002}, issn = {2158-3188}, mesh = {Humans ; *Alzheimer Disease/therapy/physiopathology/diagnostic imaging ; *Connectome/methods ; *Transcranial Magnetic Stimulation ; Male ; Female ; Aged ; Magnetic Resonance Imaging ; Biomarkers ; *Brain/physiopathology ; *Nerve Net/physiopathology/diagnostic imaging ; Middle Aged ; *Cerebral Cortex/physiopathology/diagnostic imaging ; }, abstract = {Pharmacological treatments for Alzheimer's disease (AD) often show limited effectiveness, prompting growing interest in non-drug approaches such as repetitive transcranial magnetic stimulation (rTMS). However, the effects of rTMS can vary widely between individuals with AD, highlighting the need to better understand brain characteristics that may influence treatment response. In this study, we applied a personalized method to divide each participant's brain cortex into functionally meaningful regions based on their brain activity patterns, rather than relying on a standard brain template. Using this individualized brain mapping approach, we examined how rTMS changes functional connectivity (FC) across the brain. We further used support vector regression to estimate whether these individualized FC patterns could predict the severity of clinical symptoms. The results showed that rTMS significantly increased whole-brain individualized FC strength during resting state, with the most prominent effects observed in the default mode and visual networks (Cohen's d > 0.27, corrected p < 0.05). Importantly, the personalized FC features served as predictive biomarkers, demonstrating greater accuracy in forecasting clinical outcomes compared to the conventional group-based approach. These findings suggest that individualized brain connectivity holds significant potential for guiding personalized therapeutic strategies and improving treatment efficacy in AD.}, }
@article {pmid41257439, year = {2025}, author = {Vázquez-Oliver, A and Pérez-García, S and Romero-Pérez, R and Pizarro, N and Galarraga-Shinin, D and Molina-Porcel, L and de la Torre, R and Maldonado, R and Ozaita, A}, title = {Targeting dysregulated CB1 receptors in a Down syndrome mouse model improves neurological outcomes.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70874}, pmid = {41257439}, issn = {1552-5279}, support = {RTI2018-099282-B-I00//Ministerio de Ciencia, Innovación y Universidades/ ; PID2021-123482OB-I00-/MICIN/AEI/10.13039/501100011033/FEDER//Ministerio de Ciencia, Innovación y Universidades/ ; PID2020- 120029GB-I00/MICIN/AEI/10.13039/501100011033//Ministerio de Ciencia, Innovación y Universidades/ ; 1896_GRT-2019B//Fondation Jérôme Lejeune/ ; #2416_GRT-2024B//Fondation Jérôme Lejeune/ ; CA2018010//Bright Focus foundation/ ; RD16/0017/0020//Ministerio de Sanidad, Servicios Sociales e Igualdad/ ; 2017SGR-669//Departament de Recerca i Universitats, Generalitat de Catalunya/ ; 2017SGR-138//Departament d'Economia i Coneixement, Generalitat de Catalunya/ ; //Institució Catalana de Recerca i Estudis Avançats, ICREA-Acadèmia 2021/ ; }, mesh = {Animals ; *Down Syndrome/metabolism/drug therapy ; *Receptor, Cannabinoid, CB1/metabolism/antagonists & inhibitors ; Mice ; Disease Models, Animal ; *Hippocampus/metabolism/drug effects ; *Rimonabant/pharmacology ; Humans ; Male ; Female ; Alzheimer Disease/metabolism ; *Cannabinoid Receptor Antagonists/pharmacology ; Mice, Transgenic ; Middle Aged ; }, abstract = {INTRODUCTION: Down syndrome (DS) is the most common genetic cause of intellectual disability, affecting cognitive function and increasing the risk of early-onset Alzheimer's disease (AD). The endocannabinoid system may serve as a therapeutic target for cognitive deficits by inhibiting cannabinoid type-1 receptor (CB1R) function.
METHODS: CB1R expression was analyzed in the hippocampi of aged DS-associated AD (DSAD) individuals and middle-aged Ts65Dn mice. Long-term oral treatment with the CB1R antagonist rimonabant was used to assess its effects on memory and neuroinflammation in the Ts65Dn mouse model of DS.
RESULTS: CB1R expression was significantly increased in both aged DSAD subjects (specifically in the dentate gyrus and CA2 posterior hippocampal subregions) and Ts65Dn mice. Long-term rimonabant treatment improved memory performance, normalized microglial morphology, and reduced plasma inflammatory markers in trisomic mice without preventing neuron decline.
DISCUSSION: These findings suggest that sustained CB1R inhibition may enhance cognitive function by modulating neuroinflammation, highlighting its therapeutic potential for cognitive impairments in DS.
HIGHLIGHTS: Cannabinoid type-1 receptor (CB1R) expression is increased in the posterior hippocampus of aged Down syndrome (DS) subjects and Ts65Dn mice. Long-term rimonabant treatment enhances memory in middle-aged Ts65Dn mice. CB1R inhibition shifts neuroinflammatory features in Ts65Dn mice. CB1R inhibition does not halt noradrenergic/cholinergic neurodegeneration in Ts65Dn. CB1R inhibition presents potential for memory improvement in DS-related deficits.}, }
@article {pmid41257084, year = {2025}, author = {Elshahary, A and Safwan, H and Abdelwaly, A and Arafa, RK and Helal, MA}, title = {Discovery of indole- and quinolone-based inhibitors of the mTOR/Akt/Pi3K pathway for the potential treatment of autism and certain types of cancer.}, journal = {RSC medicinal chemistry}, volume = {}, number = {}, pages = {}, pmid = {41257084}, issn = {2632-8682}, abstract = {Mammalian target of rapamycin (mTOR) is a serine/threonine kinase that belongs to the PI3K-related protein kinase family. It is an integral part of two functionally distinct protein complexes: mTOR complex 1 and mTOR complex 2. Its signaling pathway is linked to cell survival, growth, proliferation, and motility. Deregulation of the mTOR pathway has been reported in many types of cancer. Hence, mTOR is an attractive target for the treatment of certain cancers such as renal cell carcinoma and pancreatic tumors. In addition, hyperactivity in mTOR-mediated signaling is associated with the pathogenesis of autism spectrum disorder (ASD) and Alzheimer's disease. Recently, mTOR inhibitors have been considered as emerging pharmacotherapy for these disorders. In this research, we have used molecular modeling techniques to design three series of compounds, indoles, β-carbolines, and 4-aminoquinolines, targeting the ATP site of the mTOR kinase. Based on insights from molecular docking, we developed twenty eight derivatives of these scaffolds to explore the SAR and optimize their affinities. The prepared compounds were evaluated for their inhibitory activity against mTOR as well as other closely related kinases such as PI3K and AKt. To our delight, twenty compounds have shown sub-micromolar activities towards the mTOR kinase. Compounds HA-2l and HA-2c showed a superior IC50 of 66 and 75 nM, respectively, for mTOR, while being selective against AKt and Pi3K. Upon optimization, these selective inhibitors could be useful for the management of ASD due to their relatively higher safety and, hence, suitability for long-term use. On the other hand, derivatives HA-1e, HA-2g, and HA-3d exhibited high affinities for the three enzymes, suggesting their potential utility as anticancer agents. Also, the cytotoxicity of the most active compounds was assessed using different cell-lines. Compounds HA-2g, HA-2l, and HA-3d showed sub-micromolar inhibition, in the range of 0.610-0.780 μM, against the tested cancer cell lines MDA-MB231 and HCT-116. The discovery of a clinically useful mTOR inhibitor would represent a new hope for patients of two important non-communicable diseases, cancer and ASD.}, }
@article {pmid41257022, year = {2025}, author = {Abdel-Magid, AF}, title = {Inhibitors of Stearoyl-Coenzyme A Desaturase 1 and 5 May Provide a Novel Therapeutic Strategy for the Treatment of Neurological Disorders and Brain Cancer.}, journal = {ACS medicinal chemistry letters}, volume = {16}, number = {11}, pages = {2191-2193}, pmid = {41257022}, issn = {1948-5875}, abstract = {The invention in this patent application relates to heterocyclic compounds represented herein generally by formula 1. These compounds are inhibitors of stearoyl-coenzyme A desaturases (SCD1 and/or SCD5) and may provide a useful treatment for neurological disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD) as well as primary brain cancer such as glioblastoma (GBM).}, }
@article {pmid41257016, year = {2025}, author = {Song, Z and Liang, SH}, title = {Novel 2H‑Pyrazolo[3,4‑d]thiazole Compounds Targeting NLRP3 for the Treatment of Neurodegenerative Diseases.}, journal = {ACS medicinal chemistry letters}, volume = {16}, number = {11}, pages = {2200-2201}, pmid = {41257016}, issn = {1948-5875}, abstract = {The invention discloses novel NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inhibitors featuring a 2H-pyrazolo-[3,4-d]-thiazole scaffold. These NLRP3 inhibitors exhibit significant potential as therapeutic candidates for neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease.}, }
@article {pmid41256885, year = {2025}, author = {Cottrell, S and Yoon, S and Wei, X and Dickson, A and Wei, GW}, title = {Computational Drug Repurposing for Alzheimer's Disease via Sheaf Theoretic Population-Scale Analysis of snRNA-seq Data.}, journal = {ArXiv}, volume = {}, number = {}, pages = {}, pmid = {41256885}, issn = {2331-8422}, support = {R01 AI164266/AI/NIAID NIH HHS/United States ; }, abstract = {Single-cell and single-nucleus RNA sequencing (scRNA-seq /snRNA-seq) are widely used to reveal heterogeneity in cells, showing a growing potential for precision and personalized medicine. Nonetheless, sustainable drug discovery must be based on a population-level understanding of molecular mechanisms, which calls for the population-scale analysis of scRNA-seq/snRNA-seq data. This work introduces a sequential target-drug selection model for drug repurposing against Alzheimer's Disease (AD) targets inferred from population-level snRNA-seq studies of AD progression in microglia cells as well as different cell types taken from an AD affected brain vascular tissue atlas, involving hundreds of thousands of nuclei from multi-patient and multi-regional studies. We utilize Persistent Sheaf Laplacians (PSL) to facilitate a Protein-Protein Interaction (PPI) analysis of AD targets inferred from differential gene expression (DEG), and then use a machine learning models to predict repurpose-able DrugBank compounds for molecular targeting. We screen the efficacy of different DrugBank small compounds and further examine their central nervous system (CNS)-relevant ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity), resulting in a list of lead candidates for AD treatment. The list of significant genes establishes a target domain for effective machine learning based AD drug repurposing analysis of DrugBank small compounds to treat AD related molecular targets.}, }
@article {pmid41256774, year = {2025}, author = {Yu, J and Bao, X and Shan, C and Yu, Z and Yu, Y and Wang, H and Zhang, Y}, title = {Traditional Chinese medicine's holistic approach: regulating microglia-driven neuroinflammation for the resolution of Alzheimer's disease.}, journal = {Frontiers in cellular neuroscience}, volume = {19}, number = {}, pages = {1691253}, pmid = {41256774}, issn = {1662-5102}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by cognitive dysfunction, motor abnormalities, and memory disorders, with a persistently high and rising incidence. The pathological features of AD include the extracellular deposition of the amyloid beta peptide (Aβ), the accumulation of neurofibrillary tangles (NFTs), and neuroinflammation. Microglia (MG), the main immune cells in the central nervous system (CNS), can transform into different phenotypes. An imbalance in their phenotypic transformation may induce neuroinflammation and lead to neurological diseases, playing a central role in the onset and progression of AD.
PURPOSE: This article aims to briefly review the key role of microglia-mediated neuroinflammation in the pathogenesis of AD and to summarize and analyze the strategies of traditional Chinese medicine (TCM) for targeting microglia in AD treatment.
METHODS: Literature review and analysis were conducted to summarize the role of microglia-mediated neuroinflammation in AD pathogenesis and to collate TCM therapeutic strategies aimed at modulating microglia.
RESULTS AND CONCLUSION: Microglia-mediated neuroinflammation plays a central role in the pathological progression of AD. TCM demonstrates potential in intervening in AD neuroinflammation by regulating the microglial phenotype and function. These related therapeutic strategies warrant further summary and analysis.}, }
@article {pmid41256155, year = {2025}, author = {Su, CW and Chen, K and Wu, T and Reiman, EM and Wang, Q and , }, title = {TAS2R38-Linked MGAM Expression in Alzheimer's Disease: A Novel Target for Precision Drug Repurposing.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41256155}, support = {U01 AG046152/AG/NIA NIH HHS/United States ; P30 AG066508/AG/NIA NIH HHS/United States ; P30 AG072973/AG/NIA NIH HHS/United States ; P30 AG066462/AG/NIA NIH HHS/United States ; R01 AG032990/AG/NIA NIH HHS/United States ; P30 AG072958/AG/NIA NIH HHS/United States ; P30 AG072972/AG/NIA NIH HHS/United States ; R01 AG018023/AG/NIA NIH HHS/United States ; U01 AG049505/AG/NIA NIH HHS/United States ; P20 AG068082/AG/NIA NIH HHS/United States ; P30 AG072975/AG/NIA NIH HHS/United States ; P30 AG066444/AG/NIA NIH HHS/United States ; P30 AG066507/AG/NIA NIH HHS/United States ; P30 AG072946/AG/NIA NIH HHS/United States ; P30 AG066518/AG/NIA NIH HHS/United States ; P50 AG016574/AG/NIA NIH HHS/United States ; P30 AG066511/AG/NIA NIH HHS/United States ; P30 AG086404/AG/NIA NIH HHS/United States ; U24 AG072122/AG/NIA NIH HHS/United States ; P30 AG066512/AG/NIA NIH HHS/United States ; U01 AG049507/AG/NIA NIH HHS/United States ; U01 AG052411/AG/NIA NIH HHS/United States ; U01 AG032984/AG/NIA NIH HHS/United States ; P30 AG066515/AG/NIA NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; U01 AG046170/AG/NIA NIH HHS/United States ; U01 AG024904/AG/NIA NIH HHS/United States ; U24 AG061340/AG/NIA NIH HHS/United States ; P30 AG072978/AG/NIA NIH HHS/United States ; R01 AG017917/AG/NIA NIH HHS/United States ; P30 AG062429/AG/NIA NIH HHS/United States ; P30 AG066519/AG/NIA NIH HHS/United States ; UF1 AG047133/AG/NIA NIH HHS/United States ; P30 AG062422/AG/NIA NIH HHS/United States ; R01 AG079280/AG/NIA NIH HHS/United States ; P30 AG086401/AG/NIA NIH HHS/United States ; P30 AG010161/AG/NIA NIH HHS/United States ; P30 AG066530/AG/NIA NIH HHS/United States ; R01 AG033193/AG/NIA NIH HHS/United States ; R01 NS080820/NS/NINDS NIH HHS/United States ; U01 AG049508/AG/NIA NIH HHS/United States ; U01 AG052410/AG/NIA NIH HHS/United States ; P30 AG066509/AG/NIA NIH HHS/United States ; P30 AG066546/AG/NIA NIH HHS/United States ; U01 AG052409/AG/NIA NIH HHS/United States ; U01 AG046139/AG/NIA NIH HHS/United States ; P30 AG072977/AG/NIA NIH HHS/United States ; P30 AG062677/AG/NIA NIH HHS/United States ; P01 AG003949/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; P30 AG066506/AG/NIA NIH HHS/United States ; P30 AG066468/AG/NIA NIH HHS/United States ; P30 AG072976/AG/NIA NIH HHS/United States ; U01 AG049506/AG/NIA NIH HHS/United States ; U24 NS072026/NS/NINDS NIH HHS/United States ; P30 AG019610/AG/NIA NIH HHS/United States ; P30 AG072931/AG/NIA NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; P50 AG025711/AG/NIA NIH HHS/United States ; P30 AG066514/AG/NIA NIH HHS/United States ; P30 AG072959/AG/NIA NIH HHS/United States ; P01 AG017216/AG/NIA NIH HHS/United States ; U01 AG006786/AG/NIA NIH HHS/United States ; R01 AG036836/AG/NIA NIH HHS/United States ; P30 AG072979/AG/NIA NIH HHS/United States ; R01 AG015819/AG/NIA NIH HHS/United States ; }, abstract = {OBJECTIVE: TAS2R38 is a taste receptor implicated in innate immunity. Identifying its genetic connection with Alzheimer's disease (AD) could aid in developing new drugs or repurposing existing ones for treatment.
METHODS: We examined the relationship between TAS2R38 taster variants and AD risk using linear mixed-effects models, utilizing data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 2,342). We investigated molecular mechanisms of the association by identifying expression quantitative trait loci (eQTLs) using RNA-seq data from postmortem tissues from the Religious Orders Study/Memory and Aging Project (ROSMAP) (n = 947). We evaluated whether FDA-approved drugs targeting the identified gene could reduce dementia risk using 1:1 propensity score-matched groups in the National Alzheimer's Coordinating Center (NACC) study, comparing cognitive performance between drug-taking and non-taking patients with linear mixed-effects models (n = 76).
RESULTS: TAS2R38 supertasters were linked to reduced AD risk with advancing age in various AD biomarkers (P < 0.001). eQTL analysis connected the nontaster allele to increased expression of the gene MGAM in AD-affected brain regions (P < 0.001). Elevated MGAM expression was also associated with more severe Tau burdens (P < 0.05). A significant group difference was observed in clinical dementia rating (CDR) progression (P < 0.001) in various domains for individuals taking MGAM-inhibiting diabetes drugs (Acarbose and Miglitol) compared to the non-taking group.
INTERPRETATION: The genetic association between TAS2R38 and AD biomarkers implicates MGAM as a novel drug target with existing FDA-approved inhibitors. This supports the potential of TAS2R38 haplotypes in guiding precision drug repurposing strategies for AD, warranting clinical trials.}, }
@article {pmid41256144, year = {2025}, author = {Yakoub, Y and Qiu, T and Peyrot, C and Salvadó, G and Villeneuve, S and Binette, AP}, title = {Trajectories of plasma biomarkers, amyloid-beta burden and cognitive decline in Alzheimer's disease: A Longitudinal ADNI Study.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41256144}, support = {U19 AG024904/AG/NIA NIH HHS/United States ; U24 AG021886/AG/NIA NIH HHS/United States ; }, abstract = {As novel amyloid-β targeted therapies emerge, plasma biomarkers have promising potential to serve as screening tools and as surrogate measures for treatment outcomes. Understanding longitudinal trajectories of these biomarkers and how their changes relate to changes in AD pathology and cognition is needed to help track treatment response and guide patient care. We analyzed data from 394 individuals in the ADNI-FNIH dataset who had plasma biomarkers available across 14 assays, Aβ-PET scans and cognitive assessments over a 10-year period. Plasma p-tau217, regardless of the assay used, had the greatest rate of change over time. This increase was related to concurrent increase in Aβ-PET burden only in individuals with low levels of Aβ. The rate of p-tau217 change, rather than its baseline level, was the strongest predictor of future Aβ-PET positivity. On the other hand, in individuals with elevated levels of Aβ, higher rate of change in p-tau217 was associated with faster cognitive decline. These findings highlight a "dual" role of plasma p-tau217 rate of change, being either predictive of accumulating Aβ pathology at early stages and of cognitive decline at later stages of the AD continuum.}, }
@article {pmid41256136, year = {2025}, author = {Tang, AS and Zeng, BZD and Rankin, KP and Miller, B and Gorno-Tempini, ML and Seeley, WW and Rosen, HJ and Rabinovici, GD and Oskotsky, TT and Sirota, M and Pinheiro-Chagas, P}, title = {Characterizing Dementia Phenotypes from Unstructured EHR Notes with Generative AI and Interpretable Machine Learning.}, journal = {medRxiv : the preprint server for health sciences}, volume = {}, number = {}, pages = {}, pmid = {41256136}, support = {P50 AG023501/AG/NIA NIH HHS/United States ; T32 GM007618/GM/NIGMS NIH HHS/United States ; R01 AG060393/AG/NIA NIH HHS/United States ; P30 AG062422/AG/NIA NIH HHS/United States ; P01 AG019724/AG/NIA NIH HHS/United States ; F30 AG079504/AG/NIA NIH HHS/United States ; }, abstract = {Dementia encompasses diverse clinical syndromes where diseases of the brain can manifest as impaired cognitive abilities, such as in Alzheimer's disease (AD) and behavioral-variant frontotemporal dementia (bvFTD). The diversity of symptom presentations often results in challenges in diagnosis. Crucial clinical information remains in unstructured narrative notes within electronic health records (EHRs). We leverage large language models (LLMs) for symptom phenotyping from notes in UCSF Information Commons, focusing on patients with expert dementia syndrome diagnosed from a multidisciplinary team of specialists from the UCSF Memory and Aging Center. We developed a pipeline to extract findings in a validated structured output, clustered into symptom groups, and then classified patients into syndromes with traditional machine learning paradigms. From over 9,000 cross-referenced patients and over 350,000 specialty-related notes, matched cohorts of bvFTD (122 patients) and AD (170) syndromes were identified. From notes, 12,637 distinct symptom phrases were extracted, with clustering analysis revealing 51 symptom groups. A logistic regression model separated AD and bvFTD with an AUC of 0.83. Disinhibition and obsessive-compulsive behaviors favored bvFTD, while anxiety and visuospatial abnormalities favored AD. This novel approach, combining LLM-based structured information extraction with traditional interpretable prediction paradigms, demonstrates a promising approach for enhanced symptom characterization in dementia. Our findings suggest potential future applications in improving diagnostic accuracy, developing prediction models, and optimizing treatment strategies in dementia care.}, }
@article {pmid41255958, year = {2025}, author = {Biswas, P and Rahman, MH and Tabassum, A and Shoyshob, TZ and Jalouli, M and Islam Tareq, MM and Imtiaz, M and Dona, HA and Harrath, AH and Rahman, MA}, title = {Novel Drug Targets for Neurodegenerative Diseases of Elderly People to Develop Effective Therapeutics: A Comprehensive Analysis.}, journal = {Advances in pharmacological and pharmaceutical sciences}, volume = {2025}, number = {}, pages = {8847508}, pmid = {41255958}, issn = {2633-4690}, abstract = {Neurodegenerative diseases (NDs) represent an increasingly important burden of disease, particularly in the aging population. The etiology of NDs like Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD) is associated with progressive neuronal degeneration and a paucity of effective therapies. Accumulating evidence suggests that common and intersecting genetic and pathological pathways play a critical role in disease onset and progression, revealing new opportunities for target discovery. Here, we review promising therapeutic targets based on the convergence of genetics, molecular pathology, and cellular signaling in neurodegeneration. This narrative will focus on key proteins (amyloid-beta [Aβ], tau, and α-synuclein) and enzymes (acetylcholinesterase and asparagine endopeptidase [AEP]), including their pathological significance and therapeutic implications. N-Methyl-D-aspartate receptors (NMDARs) and cholinergic receptor subtypes are highlighted as important regulators of neurotoxicity, synaptic transmission, and inflammation. Emerging advances in genomics, neuroimaging, and drug delivery are poised to advance precision medicine strategies for early diagnosis and intervention. Important challenges remain, including the complexity of the blood-brain barrier (BBB), pathology heterogeneity, and the need for new biomarkers. We propose that a shift from phenotype-driven diagnoses to mechanistic, genetically informed approaches may improve treatment efficacy. Target identification, validation, and targeted delivery are critical considerations for the success of future therapeutic development. This integrated view will help to inform and improve drug discovery and personalized medicine approaches in the field of neurodegeneration.}, }
@article {pmid41255128, year = {2025}, author = {Nilsson, P and Sörgjerd, K and Kakiya, N and Sasaguri, H and Watamura, N and Johansson, L and Shimozawa, M and Tsubuki, S and Zhou, Z and Loera-Valencia, R and Takamura, R and Sekiguchi, M and Pegel, A and Schulz, S and Saito, T and Iwata, N and Winblad, B and Saido, TC}, title = {Somatostatin receptor subtypes 1 and 4 regulate neprilysin, the major amyloid-β degrading enzyme in brain.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {13872877251392782}, doi = {10.1177/13872877251392782}, pmid = {41255128}, issn = {1875-8908}, abstract = {BackgroundAlzheimer's disease (AD) brains are characterized by increased levels of the pathogenic amyloid-β (Aβ) peptide, which accumulates into extracellular plaques. Finding a way to lower Aβ levels is fundamental for the prevention and treatment of AD. Neprilysin is the major Aβ degrading enzyme which is regulated by the neuropeptide somatostatin.ObjectiveWe here aimed at identifying the subtype specificity of the five somatostatin receptors (SSTs) expressed in the brain, involved in the regulation of neprilysin.MethodsWe used a combination of in vitro and in vivo approaches using a battery of generated Sst double knockout (dKO) mice. We investigated SST specificity of neprilysin regulation using primary neuronal cultures in combination with SST agonist treatments and neprilysin activity measurements. Brains from Sst dKO mice were analyzed for neprilysin and Aβ by biochemical and immunohistological means. Amyloid-beta precursor protein (App) knock-in mice were treated with SST1,4 agonist and its effects on neprilysin and Aβ were assessed by immunostaining and ELISA.ResultsWe show that neprilysin is regulated by SST1 and SST4 in a redundant manner. Sst1 and Sst4 dKO mice exhibit a specific decrease of presynaptic neprilysin in the Lacunosum molecular layer. Moreover, a genetic deficiency of Sst1 and Sst4 in App knock-in mice aggravates the Aβ pathology in hippocampus. As a first proof of concept towards an Aβ-lowering strategy involving neprilysin, we demonstrate that treatment with an SST1,4 agonist ameliorates the Aβ pathology.ConclusionsSST1 and SST4 redundantly regulate neprilysin in the hippocampus where it controls Aβ metabolism.}, }
@article {pmid41254914, year = {2025}, author = {Mackey-Alfonso, SE and Barrientos, RM}, title = {Neuroinflammatory mechanisms linking high-fat diets to Alzheimer's disease vulnerability: Beyond the amyloid hypothesis.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70911}, pmid = {41254914}, issn = {1552-5279}, support = {RFAG028271/AG/NIA NIH HHS/United States ; R21AG071133/AG/NIA NIH HHS/United States ; R03 AG067061/AG/NIA NIH HHS/United States ; //Ohio State University Presidential Fellowship/ ; R21 AG071133/AG/NIA NIH HHS/United States ; R03AG067061/AG/NIA NIH HHS/United States ; }, mesh = {*Alzheimer Disease/metabolism/etiology/pathology ; Humans ; *Diet, High-Fat/adverse effects ; *Neuroinflammatory Diseases/metabolism ; Amyloid beta-Peptides/metabolism ; Toll-Like Receptor 4/metabolism ; Animals ; Brain/metabolism/pathology ; }, abstract = {As global life expectancy increases, Alzheimer's disease (AD) incidence is rising rapidly. While research has long focused on amyloid beta (Aβ) and tau pathology, recent controversies and limited clinical success of Aβ-targeting therapies have challenged their centrality in AD. Emerging evidence highlights neuroinflammation as an earlier and potentially more critical driver of disease, particularly in response to environmental and lifestyle factors. High saturated fat diets (HFD) are strongly associated with increased AD risk in both clinical and preclinical studies. This review examines how HFD promotes AD vulnerability via neuroinflammatory mechanisms, including toll-like receptor 4 activation and complement system overactivation, which contribute to synaptic loss and cognitive decline-often independent of Aβ burden and metabolic dysfunction. Short-term HFD exposure can rapidly induce neuroinflammation and impair memory, underscoring the direct impact of diet on brain health. These insights support a shift toward targeting immune pathways and synaptic preservation in AD prevention and treatment. HIGHLIGHTS: High saturated fat diets (HFDs) increases Alzheimer's disease risk independently of obesity or insulin resistance. Neuroinflammation is a key driver of HFD-induced cognitive decline. Toll-like receptor 4 (TLR4) activation links saturated fats to synaptic loss and memory deficits. HFDs promote complement-mediated microglial synaptic engulfment. Short-term HFD exposure rapidly impairs memory and increases brain inflammation.}, }
@article {pmid41254870, year = {2025}, author = {Rathod, SS and Agrawal, YO}, title = {β-Caryophyllene Ameliorates STZ-Induced Alzheimer's Disease-Like Conditions in Rats via Modulation of Brain-Derived Neurotrophic Factor, Synaptic Plasticity, and Neuroinflammation.}, journal = {The European journal of neuroscience}, volume = {62}, number = {10}, pages = {e70317}, doi = {10.1111/ejn.70317}, pmid = {41254870}, issn = {1460-9568}, mesh = {Animals ; *Brain-Derived Neurotrophic Factor/metabolism ; *Neuronal Plasticity/drug effects ; Male ; *Polycyclic Sesquiterpenes/pharmacology ; *Alzheimer Disease/drug therapy/chemically induced/metabolism ; Rats ; Rats, Sprague-Dawley ; Streptozocin/toxicity ; *Neuroinflammatory Diseases/drug therapy/metabolism ; Hippocampus/drug effects/metabolism ; *Neuroprotective Agents/pharmacology ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, synaptic dysfunction, and neuroinflammation. Synaptic plasticity and neuroinflammation are hallmarks of AD, with their dysregulation forming a self-reinforcing cycle that aggravates neurodegeneration. Proinflammatory cytokines impair synaptic signaling by suppressing brain-derived neurotrophic factor (BDNF) expression and neuroplasticity markers, further compromising synaptic plasticity. β-Caryophyllene (BCP), a natural bicyclic sesquiterpene with anti-inflammatory and neuroprotective properties, may counteract these pathological processes. This study evaluated the effect of BCP in mitigating streptozotocin (STZ)-induced AD-like conditions in male Sprague-Dawley rats. Two doses of STZ (3 mg/kg) on Days 1 and 3 were administered intracerebroventricularly to induce AD-like pathology. Rats received BCP (10, 20 mg/kg, i.p.) or rivastigmine (2.5 mg/kg) for 28 days. Cognitive performance was assessed using the Barnes maze and novel object recognition tests. Hippocampal tissues were analyzed for BDNF expression, synaptic plasticity markers (e.g., synaptophysin, neural cell adhesion molecule [NCAM], and ciliary neurotrophic factor [CNTF]), neuroinflammatory markers (e.g., IL-1β, TNF-α, IL-6, COX2, and NF-κB), and oxidative stress markers. Histological (hematoxylin and eosin) and Golgi-Cox staining techniques were employed to evaluate neuronal integrity and synaptic organization. STZ-induced rats exhibited significant cognitive deficits, synaptic loss, and increased neuroinflammation. BCP treatment improved spatial learning and memory retention, increased BDNF expression, and restored synaptic plasticity markers. Furthermore, BCP attenuated neuroinflammation by reducing proinflammatory cytokine levels. Histopathology confirms normal hippocampal neuronal architecture in BCP-treated groups. These findings highlight the ability of BCP to modulate BDNF signaling, synaptic plasticity, and neuroinflammatory pathways, underscoring its potential as a multitarget therapeutic candidate for AD.}, }
@article {pmid41254247, year = {2025}, author = {Kochman, U and Sitka, H and Kuźniar, J and Czaja, M and Kozubek, P and Beszłej, JA and Leszek, J}, title = {Targeted Nanoparticles for Drug Delivery Across the Blood-Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {75}, pmid = {41254247}, issn = {1559-1182}, mesh = {*Blood-Brain Barrier/metabolism/drug effects ; *Alzheimer Disease/drug therapy/metabolism/pathology ; Humans ; *Nanoparticles/metabolism/chemistry ; Animals ; *Drug Delivery Systems/methods ; Drug Carriers ; }, abstract = {Alzheimer's disease (AD) presents important challenges for treatment. One significant factor that may reduce the effectiveness of therapy is the limited drug delivery to the brain due to the blood-brain barrier (BBB). Advancements in nanotechnology are offering innovative solutions to bypass this obstacle. This review highlights the role of targeted nanoparticles (NPs) as effective drug carriers across the BBB for both early and late stages of AD. The distinct pathophysiological traits of these stages-such as amyloid aggregation, abnormal accumulation of tau protein, neuroinflammation, and oxidative stress-are examined for their impact on therapy. The analysis includes lipid-based, polymeric, and inorganic NPs, exploring their unique properties for drug delivery. Strategies to target NPs to brain tissues affected by AD are discussed, emphasizing surface modifications to enhance BBB permeability. Uptake mechanisms like receptor-mediated and adsorptive-mediated transcytosis are detailed alongside safety, toxicity, and biocompatibility evaluations to assess clinical feasibility. Key findings indicate that targeted NPs significantly improve brain drug bioavailability and enable stage-specific therapeutic interventions, addressing challenges unique to early and late AD. Future research should focus on optimizing NP design for enhanced targeting specificity and minimizing long-term toxicity, ultimately paving the way for personalized nanomedicine approaches in AD treatment.}, }
@article {pmid41252538, year = {2025}, author = {Depp, C and Holden, J and Granholm, E}, title = {Digital Measurement of Subjective Experiences in Alzheimer Disease and Related Dementias (AD/ADRD).}, journal = {JMIR aging}, volume = {8}, number = {}, pages = {e71920}, pmid = {41252538}, issn = {2561-7605}, mesh = {Humans ; *Alzheimer Disease/psychology/diagnosis ; Caregivers/psychology ; Quality of Life ; Wearable Electronic Devices ; *Dementia/psychology ; }, abstract = {Symptoms such as loss of pleasure, agitation, and sadness are subjective experiences that contribute significantly to caregiver burden and health care costs in Alzheimer disease and related dementias (AD/ADRD). However, traditional self-report measures of subjective experiences are limited in AD/ADRD due to cognitive impairments and awareness. Passive sensing, which collects data without active participant input, has emerged as a promising approach to quantify aspects of subjective experiences. Smartphones, wearables, and in-home sensors can quantify mobility, physiology, speech, and social interaction markers of constructs relevant to AD/ADRD. Available research indicates potential but is largely at the proof-of-concept stage. In this Commentary, we discuss several roadblocks to future translation of passive sensing in measuring subjective experiences in AD/ADRD, including technical implementation, data harmonization, validation, ethical and privacy principles. Addressing these challenges could lead to transformative applications to care for AD/ADRD, enabling precise monitoring of behavioral symptoms and related treatment targets, ultimately improving quality of life for persons with AD/ADRD and their caregivers.}, }
@article {pmid41252423, year = {2025}, author = {Aggarwal, G and Salas, J and Vellas, B and Nguyen, AD and Butler, AA and , }, title = {High circulating adropin levels predict long-term blood pressure variability in old adults: evidence from the Multidomain Alzheimer Prevention Trial.}, journal = {American journal of physiology. Heart and circulatory physiology}, volume = {329}, number = {6}, pages = {H1684-H1692}, doi = {10.1152/ajpheart.00763.2025}, pmid = {41252423}, issn = {1522-1539}, support = {ANR-23-IAHU-0011//Agence Nationale de la Recherche (ANR)/ ; }, mesh = {Humans ; Female ; Male ; Aged ; *Blood Pressure/drug effects ; Intercellular Signaling Peptides and Proteins/blood ; Biomarkers/blood ; *Hypertension/blood/physiopathology/diagnosis/drug therapy ; *Alzheimer Disease/prevention & control/blood/physiopathology ; Aged, 80 and over ; Blood Proteins ; Time Factors ; *Peptides/blood ; Age Factors ; }, abstract = {Hypertension and elevated visit-to-visit variability in blood pressure (BP) increase the lifetime risk of cardiovascular, kidney, and neurodegenerative diseases. Adropin, a hepatokine with autocrine/paracrine actions, contributes to cardiometabolic cross talk and mediates cellular stress responses across metabolic and cardiovascular tissues. Human cross-sectional and exercise studies suggest links between adropin, endothelial function, and vascular elasticity. Whether circulating adropin levels reflect risk of poor BP control remains unclear. We examined relationships between plasma adropin concentrations, BP, and visit-to-visit BP variability in older, community-dwelling participants from the Multidomain Alzheimer Prevention Trial (MAPT: n = 443; means ± SD age, 75.9 ± 4.5 yr; 60% female). BP and heart rate while in the supine position were assessed every 6 mo for 5 yr (8.1 ± 1.3 measurements/participant). Multivariate regression modeling revealed a positive association between adropin and variation independent of the mean (VIM) in systolic BP (R = 0.329, F7,429 = 7.454, P < 0.001). Predictors included adropin (β = 0.165, P < 0.001), age (β = 0.146, P < 0.005), sex (male = 1, female = 0; β = -0.130, P = 0.005), and antihypertensive medication use (yes = 1, no = 0; β = 0.188, P < 0.001). Stratification by medication use suggested that the association between adropin and systolic BP VIM is confined to participants on antihypertensive therapy (R = 0.347, F6,188 = 4.302, P < 0.001; adropin, β = 0.233, P = 0.001). However, analysis by grouping participants in tertiles ranked by adropin or systolic BP VIM suggests that, although the relationship is notably weaker, it is not absent for participants not on antihypertensive medications. In conclusion, elevated plasma adropin concentrations associate with systolic BP variability in older adults with hypertension. These findings identify adropin as a potential biomarker of poor BP control.NEW & NOTEWORTHY This study identifies circulating levels of the hepatokine adropin as a novel biomarker of blood pressure (BP) variability in older adults. Using longitudinal data from the Multidomain Alzheimer Prevention Trial, we show that higher adropin levels predict greater systolic BP variability, particularly in participants receiving antihypertensive therapy. These findings link a hepatokine with cardiovascular risk and suggest that adropin measurement may improve stratification of individuals at risk for poor BP control and treatment resistance.}, }
@article {pmid41251074, year = {2025}, author = {Joshi, S and Chutia, P and Tripathi, SM}, title = {Paratonia in dementia: diagnosis and management strategies.}, journal = {Neurodegenerative disease management}, volume = {}, number = {}, pages = {1-4}, doi = {10.1080/17582024.2025.2591413}, pmid = {41251074}, issn = {1758-2032}, abstract = {Paratonia is a type of hypertonia with involuntary resistance to passive movement depending on the pace and force being applied. People with paratonia may find it challenging to modify their movements and posture. Limited awareness among healthcare professionals can lead to a delay in diagnosis and inadequate treatment. Here, we present two cases diagnosed with dementia due to Alzheimer's disease. The two patients developed stiffness in their bodies as the dementia progressed. Paratonia was diagnosed using the Paratonia Assessment Inventory. Severity of paratonia was assessed using the Modified Ashworth scale for paratonia (MAS-P). The caregiver's primary concern was the stiffness of the body, which created difficulties in routine care. Amantadine was initiated in both patients. Both patients demonstrated improvement in paratonia following amantadine treatment, with reduced stiffness and greater ease in caregiving tasks. The present case series highlights the role of amantadine in the management of paratonia and can contribute to the development of more treatment options.}, }
@article {pmid41251026, year = {2025}, author = {Ahmad, N and Ambreen, N and Ayaz, M and Zainab, and Alam, A and Ahmad, I and Elhenawy, AA and Zghab, I and Shah, SAA and Ahmad, M}, title = {Synthesis, In Vitro Cholinesterase Inhibition, Molecular Docking, Density Functional Theory Analysis of Benzimidazole Based Hydrazone Schiff Bases.}, journal = {Journal of molecular recognition : JMR}, volume = {38}, number = {6}, pages = {e70012}, doi = {10.1002/jmr.70012}, pmid = {41251026}, issn = {1099-1352}, mesh = {*Cholinesterase Inhibitors/chemistry/chemical synthesis/pharmacology ; Schiff Bases/chemistry/chemical synthesis/pharmacology ; Molecular Docking Simulation ; *Hydrazones/chemistry/chemical synthesis/pharmacology ; *Benzimidazoles/chemistry/chemical synthesis/pharmacology ; Butyrylcholinesterase/chemistry/metabolism ; Acetylcholinesterase/chemistry/metabolism ; Molecular Dynamics Simulation ; Density Functional Theory ; Humans ; }, abstract = {Acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) are the main therapeutic targets for the treatment of neurodegenerative diseases, predominantly Alzheimer's disease. This work reports the synthesis, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibitory activities of synthesized hydrazone Schiff base derivatives of benzimidazole. The compounds have been structurally deduced by means of HR-ESI-MS, [1]H-NMR and [13]C-NMR techniques and finally assessed for their in vitro AChE and BuChE inhibitory activities. All the compounds attributed notable inhibitory potential with IC50 values ranging from 34.7 ± 0.02 to 185.2 ± 2.47 μM for AChE and 40.8 ± 0.32 to 188.8 ± 2.47 μM for BuChE enzymes. The molecular docking and TD-DFT studies attributed that the compound with methoxy groups, specifically compound (7) displays increased electronic properties and strong dual binding to AChE and BuChE enzymes. Molecular dynamics (MD) simulations for the most active compound (7) were performed, which showed that compound (7) exploits the integral flexibility of AChE and BuChE to encourage conformational variations that lock both enzymes into a two-site inhibitory state. These compounds presented orbitals and favorable electrostatic profiles that improve the inhibitory potential. The results authenticate the SAR trends and highlight the significance of methoxy groups in planning potent cholinesterase inhibitors.}, }
@article {pmid41250246, year = {2025}, author = {Shang, J and Zhong, S and Shang, L and Zeng, Q and Zhao, S and Luo, X and Li, K and Zhang, X and Huang, P and Yan, Y and Liu, Z and Zhang, B and Chen, Y}, title = {Real-world application of lecanemab in early-stage alzheimer's disease: a single-center prospective cohort analysis.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {249}, pmid = {41250246}, issn = {1758-9193}, support = {82402209//National Natural Science Foundation of China/ ; 82271936//National Natural Science Foundation of China/ ; 82202090//National Natural Science Foundation of China/ ; 82271268//National Natural Science Foundation of China/ ; 82371190//National Natural Science Foundation of China/ ; LQ24H180002//Natural Science Foundation of Zhejiang Province/ ; LY24H090007//Natural Science Foundation of Zhejiang Province/ ; 2025C02113//Key Research and Development Program of Zhejiang Province/ ; }, abstract = {BACKGROUND AND OBJECTIVES: Lecanemab (Leqembi®) has been approved for the treatment of early Alzheimer’s disease (AD) patients. However, the safety and efficacy of lecanemab in clinical practice in Asia population remain unclear.
This prospective cohort study was conducted in a single center in Eastern China, including 76 early-stage AD participants treated with lecanemab. All participants underwent at least 1 lecanemab infusion.
RESULTS: The mean age was 66 years (65.53 ± 9.31), and 51 (67.1%) participants being female. A total of 49 (64.5%) participants were ApoE-ε4 carriers, including 34 (44.7%) heterozygotes and 15 (19.7%) homozygotes. Infusion-related side effects (IRSE), primarily occurred after the first infusion, were observed in 14 participants (18.4%). The most common IRSE were fever and fatigue. Until 9 Aug 2025, 58 participants had received treatment for more than 3 months, 44 for more than 6 months and 12 for more than 12 months. Amyloid-related imaging abnormalities (ARIA) were observed in 11 participants. Specifically, solitary ARIA-H (hemorrhage) was detected in 7 participants, while ARIA-E (edema) with or without cerebral micro-hemorrhage was identified in 4. Notably, all the 11 participants with ARIA were asymptomatic. Participants with isolated ARIA-H exhibited higher baseline Fazekas scores of PVWMHs (p = 0.008). Participants with a Clinical Dementia Rating Scale Global Score (CDR-GS) of 1 had a more rapid decline in Mini-Mental State Global Score (MMSE) scores as compared to those with a CDR-GS of 0.5. Following 12 months of lecanemab therapy, amyloid PET exhibited a significant reduction in brain amyloid burden.
CONCLUSION: These data support that lecanemab appears to be generally tolerated in Asian population. The IRSE and ARIA-E events were less common than the Clarity AD study.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13195-025-01886-5.}, }
@article {pmid41250235, year = {2025}, author = {Corbett, A and Sultana, J and Stych, K and Mills, R and Cummings, JL and Williams, G and Ismail, Z and Soto-Martin, M and Mintzer, J and Gauthier, S and Greig, NH and Noble, W and Killick, R and Lai, MKP and Routledge, C and Walsh, F and Fillit, H and Aarsland, D and Lane, R and Mills, K and Ballard, C}, title = {Drug repurposing for Alzheimer's disease: a Delphi consensus and stakeholder consultation.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {237}, pmid = {41250235}, issn = {1758-9193}, support = {P20 GM109025/GM/NIGMS NIH HHS/United States ; R01 NS139383/NS/NINDS NIH HHS/United States ; R25 AG083721/AG/NIA NIH HHS/United States ; R35 AG071476/AG/NIA NIH HHS/United States ; }, mesh = {*Drug Repositioning/methods ; *Alzheimer Disease/drug therapy ; Humans ; Delphi Technique ; Consensus ; Stakeholder Participation ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is an escalating global challenge, with more than 40 million people affected, and this number is projected to increase to more than 100 million by 2050. While amyloid-targeting antibody treatments (lecanemab and donanemab) are a significant step forward, the benefits of these therapies remain limited. This highlights the necessity for safe and effective compounds that offer greater therapeutic benefits to the majority of individuals with or at risk of AD. Drug repurposing allows for a cost-effective, time-efficient strategy to accelerate the availability of treatments, owing to the availability of safety information.
METHOD: This study focuses on the third iteration of the Delphi consensus programme aimed at identifying new high-priority drug candidates for repurposing in AD. An international expert panel comprising academics, clinicians and industry representatives was convened. Through a combination of anonymized drug nominations, systemic evidence reviews, iterative consensus rankings, and lay advisory inputs, drug candidates were evaluated and ranked based on rational, non-clinical, and clinical evidence and overall safety profiles.
RESULTS: Among the 80 candidates that were nominated by the expert panel, seven underwent review, with only three candidates meeting the following consensus criteria of relevant mechanisms for targeting neurodegenerative pathways, non-clinical efficacy, and tolerability in older individuals. The three agents were: [1] the live attenuated herpes zoster (HZ) vaccine (Zostavax) [2], sildenafil, a phosphodiesterase-5 (PDE-5) inhibitor, and [3] riluzole, a glutamate antagonist. The HZ vaccine additionally offers potential for population-level dementia risk reduction.
CONCLUSION: This Delphi consensus identified three high-priority drug repurposing candidates for AD with favourable safety profiles and mechanistic plausibility, which are considered suitable for pragmatic clinical trials, including remote or hybrid designs. The PROTECT platform, which supports international cohorts in the UK, Norway, and Canada, offers a well-established means to conduct such trials effectively, thus helping to accelerate the evaluation and potential deployment of these drug candidates to benefit individuals with or at risk for AD.}, }
@article {pmid41249122, year = {2025}, author = {Diamandis, N and van den Anker, JN and Denisova, K}, title = {Effect of Alzheimer's disease medications on neurocognitive outcomes in children and adolescents with autism spectrum disorder and low IQ: a scoping review.}, journal = {Translational psychiatry}, volume = {15}, number = {1}, pages = {475}, pmid = {41249122}, issn = {2158-3188}, support = {R01 MH121605/MH/NIMH NIH HHS/United States ; R01MH121605//U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)/ ; 614242//Simons Foundation/ ; }, mesh = {Humans ; Child ; Adolescent ; *Autism Spectrum Disorder/drug therapy/complications/psychology ; *Alzheimer Disease/drug therapy/complications ; *Intellectual Disability/complications ; Young Adult ; *Cholinesterase Inhibitors/therapeutic use/pharmacology ; Child, Preschool ; }, abstract = {BACKGROUND: Individuals with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) are particularly vulnerable to poor developmental trajectories. These individuals are at increased risk of Alzheimer's disease (AD) relative to those without comorbid ID and the general population. Considering that there could be an important mechanistic link underlying ASD and AD, individuals with these conditions may stand to benefit from similar psychopharmacological treatments.
METHODS: This scoping review aimed to evaluate and synthesize the evidence on the effect of AD medications on neurocognitive outcomes in children and adolescents with ASD and low intelligence quotient (IQ). We performed the search according to PRISMA guidelines from inception to May 21[st], 2025 in four databases: PubMed, PsycInfo, Scopus, and Web of Science. We included studies of children and adolescents (2 - 21 years) with ASD and low IQ (<85) treated with at least one Food and Drug Administration (FDA)-approved AD medication (donepezil, galantamine, rivastigmine, benzgalantamine, memantine, aducanumab, lecanemab or donanemab) and investigating neurocognitive outcomes.
RESULTS: Twelve studies met the eligibility criteria. Six studies reported on neurocognitive outcomes from N-methyl-D-aspartate (NMDA) receptor antagonist treatment and six studies from cholinesterase inhibitor treatment. Among studies reporting on cholinesterase inhibitors, significant improvement was detected in language (60% of five reporting studies), executive function (100% of two reporting studies), complex attention (100% of one reporting study), and general cognitive ability (50% of two reporting studies). Among the NMDA receptor antagonist studies, evidence of improvement was detected in language (60% of five reporting studies), executive function (75% of four reporting studies), learning and memory (100% of two reporting studies), perceptual-motor functioning (66.6% of three reporting studies), complex attention (100% of one reporting study), and general cognitive ability (50% of two reporting studies). Across studies, treatment with either a cholinesterase inhibitor or an NMDA receptor antagonist was associated with improvements in language, executive function, complex attention, and general cognitive ability. A pattern of significance was detected with age, in that younger children may benefit more from these medications than adolescents.
CONCLUSION: This scoping review identified promising evidence of neurocognitive improvement in children and adolescents with ASD and low IQ following treatment with either a cholinesterase inhibitor or an NMDA receptor antagonist. Considering the lack of FDA-approved treatments for the cognitive deficits associated with ASD and an absence of medications approved to treat core features of ASD, our findings highlight an opportunity for innovative directions in autism research and treatment.}, }
@article {pmid41249052, year = {2025}, author = {Szatmari, EM and Moran, C and Cohen, SJ and Bashtovyy, D and Jacob, A and Bunner, W and Phipps, M and Lora, JC and Stackman, RW and Yasuda, R}, title = {Lack of ADAP1/Centaurin-α1 Ameliorates Cognitive Impairment and Neuropathological Hallmarks in a Mouse Model of Alzheimer's Disease.}, journal = {eNeuro}, volume = {12}, number = {11}, pages = {}, pmid = {41249052}, issn = {2373-2822}, support = {R15 NS125564/NS/NINDS NIH HHS/United States ; }, mesh = {Animals ; *Alzheimer Disease/pathology/metabolism/genetics ; Disease Models, Animal ; Mice ; *Cognitive Dysfunction/metabolism/pathology/genetics ; Mice, Knockout ; Male ; Plaque, Amyloid/pathology/metabolism ; *GTPase-Activating Proteins/genetics/metabolism ; Spatial Memory/physiology ; *Brain/pathology/metabolism ; *Adaptor Proteins, Signal Transducing/genetics ; }, abstract = {ArfGAP, with dual PH domain-containing protein 1/Centaurin-α1 (ADAP1/CentA1), is a brain-enriched and highly conserved Arf6 GTPase-activating and Ras-anchoring protein. CentA1 is involved in dendritic outgrowth and arborization, synaptogenesis, and axonal polarization by regulating the actin cytoskeleton dynamics. CentA1 upregulation and association with amyloid plaques in the human Alzheimer's disease (AD) brain suggest the role of this protein in AD progression. To understand the role of CentA1 in neurodegeneration, we crossbred CentA1 knock-out (KO) mice with the J20 mouse model of AD. We evaluated AD-associated behavioral and neuropathological hallmarks and gene expression profiles in J20 and J20 crossed with CentA1 KO (J20xKO) male mice to determine the impact of eliminating CentA1 expression on AD-related phenotypes. Spatial memory assessed by the Morris water maze test showed significant impairment in J20 mice, which was rescued in J20xKO mice. Moreover, neuropathological hallmarks of AD, such as amyloid plaque deposits and neuroinflammation, were significantly reduced in J20xKO mice. To identify potential mediators of AD phenotype rescue, we analyzed differentially expressed genes between genotypes. We found that changes in the gene profile by deletion of CentA1 from J20 (J20xKO vs J20) were anticorrelated with changes caused by APP overexpression (J20 vs wild type), consistent with rescue of J20 phenotypes by CentA1 KO. In summary, our data indicate that CentA1 is required for the progression of AD phenotypes in this model and that targeting CentA1 signaling might have therapeutic potential for AD prevention or treatment.}, }
@article {pmid41249005, year = {2026}, author = {Shepard, CD and Chang, X and Seidler, PM and Curran, SP}, title = {Polyphyletic screen defines distinct classes of plant-derived natural products that oppose tauopathy.}, journal = {Life science alliance}, volume = {9}, number = {2}, pages = {}, pmid = {41249005}, issn = {2575-1077}, support = {P30 AG068345/AG/NIA NIH HHS/United States ; P40 OD010440/OD/NIH HHS/United States ; R01 AG058610/AG/NIA NIH HHS/United States ; }, mesh = {Caenorhabditis elegans/metabolism ; Animals ; tau Proteins/metabolism ; *Biological Products/pharmacology ; *Tauopathies/drug therapy/metabolism ; Humans ; Alzheimer Disease/drug therapy/metabolism ; Disease Models, Animal ; Protein Aggregation, Pathological/drug therapy ; Naphthoquinones/pharmacology ; Amyloid beta-Peptides/metabolism ; Brain/metabolism ; Protein Aggregates/drug effects ; Animals, Genetically Modified ; }, abstract = {Alzheimer's disease (AD) is a debilitating neurodegenerative disease hallmarked by the presence of amyloid-β (Aβ) plaques and tau fibrils but with limited treatment options. Here, we describe two plant-derived natural products with distinct mechanisms of action on tau fibril disaggregation and prionogenic seeding. We first characterized the effects of oolonghomobisflavan A (OFA) and oolonghomobisflavan B (OFB) treatments, which alter the transcriptional landscape toward enhanced proteostasis and reverse the shortened lifespan in a Caenorhabditis elegans model expressing pathogenic human tau ("hTau-expressing"), but increase healthspan. Mechanistically, OFA treatment reduced the burden of tau protein aggregation and promoted tau disaggregation in hTau-expressing C. elegans and also inhibited seeding in assays using ex vivo brain-derived paired helical filament tau protein fibrils from Alzheimer's disease brain donors. We leveraged this finding to develop a facile screening approach for compounds, like OFA, that could mitigate tau aggregation, which revealed plumbagin (PB) as a potent inhibitor of tau monomer aggregation which is mechanistically distinct from the tau fibril disaggregase activity associated with OFA. Collectively, this study reveals a new strategy for identifying therapeutic compounds that target tauopathy and provides mechanistic insight supporting the neuroprotective effects of plant-derived natural products.}, }
@article {pmid41248588, year = {2025}, author = {Mondal, P and Banerjee, P and Basuli, K}, title = {CPMFD: An algorithm for Classification of Point Mutations together with Frameshift Determination in related mRNA sequences.}, journal = {Mutation research}, volume = {831}, number = {}, pages = {111918}, doi = {10.1016/j.mrfmmm.2025.111918}, pmid = {41248588}, issn = {1873-135X}, mesh = {*Algorithms ; *RNA, Messenger/genetics ; *Point Mutation ; *Frameshift Mutation ; Animals ; Plasmodium falciparum/genetics ; Humans ; Pan troglodytes/genetics ; beta-Globins/genetics ; Mutation, Missense ; Haplotypes ; }, abstract = {Mutations are responsible for the genetic origin of various diseases. Existing techniques for mutation identification often fails to detect the full spectrum of mutations in complex genomes hindering progress in diagnosis, treatment and prevention of diseases. Here we propose an algorithm to identify the location and type of mutation occurring in a mutated string with respect to a reference mRNA sequence. In addition to identifying insertion and deletion, by constructing suitable rational combinations of the prime numbers, our algorithm is able to classify point mutations in a novel way by distinguishing missense mutation from silent mutation. Amino acid transformation at each missense mutation site is identified. Moreover, the method allows to locate regions in the sequence undergoing frameshift. It turns out to be efficient when applied on sample dataset. Application of this framework to two haplotypes of the Plasmodium falciparum datasets exhibits different mutation profile to develop similar chloroquine resistance. Despite the overwhelming similarity between the β-globin genes of pygmy and common chimpanzees, our algorithm is able to pinpoint the minute details of the mutations occurring in them differentiating the two species. Additionally, in Alzheimer datasets, the method meticulously identifies true variations in related genes.}, }
@article {pmid41248418, year = {2025}, author = {Sahin-Lodge, Z and Pisani, S and Nderitu, P and Guu, TW and Aarsland, D and Jackson, TL and Ffytche, D and Venkataraman, AV}, title = {Using retinal diagnostics as a biomarker for neurodegenerative diseases: protocol for a systematic review.}, journal = {BMJ open}, volume = {15}, number = {11}, pages = {e106531}, pmid = {41248418}, issn = {2044-6055}, mesh = {Humans ; Systematic Reviews as Topic ; *Neurodegenerative Diseases/diagnosis/diagnostic imaging ; Biomarkers ; Tomography, Optical Coherence ; *Retina/diagnostic imaging/pathology ; Research Design ; Electroretinography ; *Retinal Diseases/diagnosis ; }, abstract = {INTRODUCTION: Retinal neurodegeneration has recently been shown to occur in tandem with neurodegenerative disease. In the expectation that disease-modifying treatments for Alzheimer's disease (AD) and Parkinson's disease (PD) will soon become available, it will be important to have clinically useful biomarkers for neurodegenerative disease subtyping to guide early diagnosis, inform on prognosis and stratify subgroups for treatment. Understanding differences in detectable retina changes in individuals with different neurodegenerative disease subtypes is therefore fundamental. The emerging field of oculomics posits that systemic and neurodegenerative disease can be characterised using detectable ocular biomarkers within retinal diagnostics. The aim of this review is to compare the performance of common retinal imaging modalities in neurodegenerative disease detection and subtyping.
METHODS AND ANALYSIS: This protocol has been reported in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. A comprehensive literature search will be conducted in PubMed, Web of Science and Scopus. Eligible studies will have reported using retinal diagnostic tools defined as optical coherence tomography (OCT), OCT angiography (OCTA), colour fundus photography (CFP) and electroretinography (ERG) in individuals with neurodegenerative diseases, including AD, PD, dementia with Lewy bodies, frontotemporal dementia, vascular dementia and mild cognitive impairment. There will be no time restrictions placed in these searches. Studies not written in English, not peer-reviewed and grey literature will be excluded. Screening for eligible studies and data extraction will be conducted by two independent reviewers, using predefined inclusion criteria. Any disagreements between the reviewers will be settled by discussion, and if required, third senior reviewer arbitration. The systematic review primary outcome is the performance of retinal diagnostics, namely OCT, OCTA, CFP and ERG in the detection and subtyping of aforementioned neurodegenerative diseases. The secondary outcome is to evaluate the association between changes in retinal diagnostic features (eg, retinal layer thicknesses) and neurodegenerative disease subtypes. The quality of the included studies will be assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluations) tool. A narrative synthesis approach will be used to analyse the results, with meta-analysis performed if there is sufficient data.
ETHICS AND DISSEMINATION: Ethical approval for this manuscript is not required, as this is a protocol for a systematic review and therefore no data are to be collected. Findings for this systematic review will be disseminated as a peer-reviewed publication and presentations at national and international symposiums including International Lewy Body Dementia Conference, International Congress of Parkinson's Disease and Movement Disorders, The Association for Research in Vision and Ophthalmology.
PROSPERO REGISTRATION NUMBER: CRD42023434024.}, }
@article {pmid41248283, year = {2025}, author = {Akhter, F and Akhter, A and Zhu, X and Schiff, H and Maffei, A and Douglas, JT and Zhou, Q and Zhao, Z and Zhu, D}, title = {Amyloid-beta glycation induces neuronal mitochondrial dysfunction and Alzheimer's pathogenesis via VDAC1-dependent mtDNA efflux.}, journal = {Proceedings of the National Academy of Sciences of the United States of America}, volume = {122}, number = {47}, pages = {e2505046122}, pmid = {41248283}, issn = {1091-6490}, mesh = {Animals ; *Voltage-Dependent Anion Channel 1/metabolism/genetics ; *Alzheimer Disease/metabolism/pathology/genetics ; Mice ; Humans ; *Mitochondria/metabolism/pathology ; *Neurons/metabolism/pathology ; *Amyloid beta-Peptides/metabolism ; *DNA, Mitochondrial/metabolism/genetics ; Nucleotidyltransferases/metabolism/genetics ; Membrane Proteins/metabolism/genetics ; Receptor for Advanced Glycation End Products/metabolism/genetics ; Glycation End Products, Advanced/metabolism ; Mice, Transgenic ; Glycosylation ; Male ; }, abstract = {Glycation, the nonenzymatic attachment of reactive dicarbonyls to proteins, lipids, or nucleic acids, contributes to the formation of advanced glycation end-products (AGEs). In Alzheimer's disease (AD), amyloid-beta (Aβ) undergoes posttranslational glycation to produce glycated Aβ (gAβ), yet its pathological role remains poorly understood. Here, we demonstrate that gAβ promotes neuronal mitochondrial DNA (mtDNA) efflux via a VDAC1-dependent mechanism, activating the innate immune cGAS-STING pathway. Using aged AD mice and human AD brain samples, we observed cGAS-mtDNA binding and cGAS-STING activation in the neuronal cytoplasm. Knockdown of RAGE, cGAS, or STING, as well as pharmacological inhibition of VDAC1, protected APP mice from mitochondrial dysfunction and Alzheimer's-like pathology. Neuron-specific cGAS knockdown confirmed its pivotal role in driving neuroinflammation and cognitive deficits. Treatment with ALT-711, an AGE cross-link breaker, alleviated gAβ-associated pathology. Furthermore, RAGE inhibition in APP knock-in mice suppressed innate immune activation and disease-associated gene expression, as revealed by spatially resolved transcriptomics. Collectively, our findings establish a mechanistic link between gAβ and innate immune activation, identifying VDAC1, the AGE-RAGE axis, and the cGAS-STING pathway as promising therapeutic targets in AD.}, }
@article {pmid41247815, year = {2025}, author = {Rathnam, M and Hunter, H and Paul, PS and Schirrmacher, R and Serpe, MJ and Kar, S}, title = {Native PEG-PLGA Attenuates β-Amyloid Aggregation and Toxicity under In Vitro Conditions.}, journal = {ACS chemical neuroscience}, volume = {16}, number = {23}, pages = {4446-4457}, pmid = {41247815}, issn = {1948-7193}, mesh = {*Amyloid beta-Peptides/metabolism/toxicity ; *Polyethylene Glycols/pharmacology/chemistry ; Animals ; Nanoparticles/chemistry ; *Peptide Fragments/metabolism/toxicity ; *Neurons/drug effects/metabolism ; Mice ; Cells, Cultured ; Cell Survival/drug effects ; Polylactic Acid-Polyglycolic Acid Copolymer ; Humans ; Alzheimer Disease/metabolism ; Polyesters ; }, abstract = {Self-aggregation of amyloid-β (Aβ) peptide plays a key role in the pathogenesis of Alzheimer's disease (AD), the most prevalent cause of dementia affecting the elderly population. The development of an effective treatment for AD pathology remains elusive due to the presence of the blood-brain barrier (BBB) and the heterogeneous nature of disease progression. Recently, we reported that FDA-approved native poly(d,l-lactic-co-glycolic acid) (PLGA) nanoparticles without any conjugated/encapsulated agent can attenuate Aβ aggregation/toxicity in cellular and animal models of AD. Given the limitation associated with the fast clearance of the native PLGA by the reticuloendothelial system (RES), in the present study, we synthesized PEGylated native PLGA nanoparticles (PEG-PLGA-1) to reduce their clearance via the RES and evaluated their effects on Aβ aggregation/toxicity after biochemical and structural characterization. Determined with Thioflavin T kinetic assay, dynamic light scattering and fluorescence imaging, it was revealed that the native PEG-PLGA-1, which exhibits increased stability, not only inhibits the aggregation of Aβ peptides, but also triggers the disassembly of Aβ aggregates. Additionally, we showed that PEG-PLGA-1 are nontoxic and can significantly enhance the viability of mouse primary cortical cultured neurons against Aβ-mediated toxicity. Collectively, these results suggest that native PEG-PLGA-1 nanoparticles can inhibit Aβ aggregation and trigger disassembly of Aβ aggregates and can protect neurons against Aβ-mediated toxicity, thus suggesting their unique therapeutic potential in the treatment of AD pathology.}, }
@article {pmid41247623, year = {2025}, author = {Dosseto, A and Tonge, K and Karl, T}, title = {Cannabidiol Modulates Brain Copper Homeostasis in Wild-Type-Like But Not Alzheimer's Disease Transgenic Female Mice: Implications for Neuroprotective Therapy.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {57}, pmid = {41247623}, issn = {1559-1182}, mesh = {Animals ; *Copper/metabolism ; Mice, Transgenic ; *Alzheimer Disease/metabolism/drug therapy/pathology ; Female ; *Cannabidiol/pharmacology/therapeutic use ; *Homeostasis/drug effects ; *Brain/metabolism/drug effects/pathology ; *Neuroprotective Agents/pharmacology/therapeutic use ; Mice ; Iron/metabolism ; Mice, Inbred C57BL ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by cognitive decline, synaptic dysfunction, and neuroinflammation. Disrupted metal homeostasis-especially copper (Cu), zinc (Zn), and iron (Fe)-is implicated in AD pathogenesis, contributing to amyloid-beta (Aβ) aggregation and oxidative stress. Cannabidiol (CBD), a non-toxic phytocannabinoid with antioxidant and neuroprotective properties, has unclear effects on brain metal regulation. Using high-resolution laser ablation-inductively coupled plasma mass spectrometry (LA‑ICP‑MS), we quantified regional metal distributions in sagittal brain sections from 12‑month‑old female wild‑type (WT) and APP/PS1 transgenic mice treated chronically with CBD or vehicle. CBD significantly elevated whole‑brain Cu in WT mice but not in APP/PS1 mice. Although Zn and Fe concentrations did not differ significantly, effect-size trends revealed regional differences in Cu and Zn patterns across treatment groups, particularly in the hippocampus. Correlation analysis revealed coordinated inter‑regional metal regulation in WT and vehicle‑treated APP/PS1 groups, which was disrupted in CBD‑treated APP/PS1 mice. Additionally, CBD‑treated WT mice exhibited increased variance in cerebellar Cu, suggesting individual differences in response. These findings suggest that CBD influences Cu homeostasis in WT animals, though not significantly altered in transgenic animals under the conditions tested. Our results support integrating spatially resolved metallomics into preclinical AD frameworks and highlight the utility of metrics beyond mean concentration-such as regional ratios, correlation structures, and variability-for detecting subtle treatment effects.}, }
@article {pmid41247384, year = {2025}, author = {Schönberger, A and Schild, AK and Steinmetz, A and Simandi, F and Benson, GS and Hausner, L and Schöttler, M and Hennig, B and Knudsen, A and Maier, F and Frölich, L and Jessen, F}, title = {[Optimization of the work of outpatient memory clinics under aspects of value-based healthcare-An approach from the Center for Memory Disorders of the University Hospital Cologne].}, journal = {Der Nervenarzt}, volume = {}, number = {}, pages = {}, pmid = {41247384}, issn = {1433-0407}, abstract = {BACKGROUND: Memory clinics in Germany are facing major challenges due to increasing numbers of patients and the first available disease-modifying treatments for Alzheimer's disease. Capacities for counselling, biomarker-based diagnostics, drug administration and follow-up examinations must be achieved, which creates the need for modified workflows. Value-based healthcare (VBHC) aims at optimizing the value for patients (outcome in relation to costs) and can serve as a framework for a patient-oriented increase in efficacy.
OBJECTIVE: This project applied approaches of VBHC to analyze and improve the diagnostic processes in our memory clinic in order to achieve a better value for patients and care partners with a more efficient use of existing resources.
METHODS: In a first survey among memory clinic patients and relatives the essential aspects in relation to VBHC were collated and based on the results the existing workflow processes were modified. These modifications were evaluated by a second survey and analysis particularly of process-oriented aspects.
RESULTS: The first survey revealed a general satisfaction with the presentation in the memory clinic. The main point of criticism was the duration of the diagnostic process. After the modification the duration and extent of the diagnostics could be reduced. The second evaluation showed improved patient and care partner satisfaction. The respondents considered the modified trajectories to be better and resources were conserved.
CONCLUSION: In our memory clinic an improvement in the sense of VBHC could be achieved through an increased satisfaction with the treatment (outcome) and reduced personnel binding times (costs). This approach can serve as a model for other memory clinics for the development of a more efficient and patient-centered care.}, }
@article {pmid41246746, year = {2025}, author = {Bethea, JP and Sharma, H and Doberstein, N and Shenker, T and Gregory, B and Hoffman, R and Aizenman, D and Guirguis, G and Hoffmann, J and Tazani, S and Harris, Z and Costin, J}, title = {Application of Osteopathic Manipulative Treatment (OMT) in Neurodegenerative Disorders: A Scoping Review.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e94748}, pmid = {41246746}, issn = {2168-8184}, abstract = {Neurodegenerative diseases are comprised of a host of chronic conditions that impair the central nervous system. Osteopathic manipulative treatment (OMT) consists of many non-invasive modalities that can be used to treat a wide variety of ailments and conditions. OMT is reported to increase the range of motion and lymphatic flow, as well as decrease pain in a wide array of disorders. However, the efficacy of using OMT in neurodegenerative disorders has not been well established. The objective of this scoping review is to map the evidence that pertains to the application of OMT in treating neurodegenerative disorders and identify the gaps in the literature on this subject. This study was designed according to the Joanna Briggs Institute (JBI) guidelines for scoping reviews to gather information on OMT's potential efficacy in managing Parkinson's disease (PD), Alzheimer's disease (AD) dementia, amyotrophic lateral sclerosis (ALS), and Huntington's disease (HD). Peer-reviewed literature was collected through the Excerpta Medica database (EMBASE), Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science. The criteria were limited to papers in English published between 1999 and 2023. The following search string was utilized: "osteopathic manipulative treatment" OR "osteopathic manipulation" AND "neurodegenerative disorders" OR "Alzheimer's disease" OR "dementia" OR "amyotrophic lateral sclerosis" OR "Parkinson's disease" OR "Huntington's chorea". One hundred and forty-three articles were identified following final screening and critical appraisal, with eleven articles selected for analysis in this study. Data from the selected articles demonstrated that OMT can possibly attenuate symptoms in patients diagnosed with neurodegenerative diseases. Studies in rats showed that OMT techniques were found to alter cholinergic neuronal genes, improve spatial learning and memory, reduce amyloid β protein levels, modulate synaptic transmission, and increase levels of the cytokines IL-1, IL-10, IL-13, RANTES, IL-17A, and EOTAXIN effects in AD dementia. ALS patients demonstrated a high level of satisfaction with OMT and did not report any adverse effects, though there was no decrease in pain or increased quality of life reported. PD patients reported improved postural stability, balance, and gait after OMT. No results were returned regarding OMT's effects on HD. Preliminary results in human PD and ALS patients who received OMT as an adjunct to traditional treatment regimens showed promising results, though few studies were found that address the topic, and the sample sizes of the studies that were found were small. There were no studies of the effects of OMT on human patients with AD or HD found, though preclinical studies in rats supported their trial in subsequent human studies. While current research on the impact of OMT on these neurodegenerative diseases is promising, there remain large gaps in the literature. Further research is necessary to support the use of and long-term efficacy of OMT in neurodegenerative diseases.}, }
@article {pmid41246229, year = {2025}, author = {Şahin, TÖ and Cemali, Ö and Özdemir, M and Ayten, Ş and Ağagündüz, D}, title = {Flavonoids and phenolic compounds: a promising avenue for neurodegenerative disease therapy.}, journal = {Turkish journal of biology = Turk biyoloji dergisi}, volume = {49}, number = {5}, pages = {635-659}, pmid = {41246229}, issn = {1303-6092}, abstract = {BACKGROUND/AIM: Neurodegenerative diseases such as Alzheimer's, Parkinson's, Huntington's, and ALS are characterized by a progressive loss of nerve cells, for which no definitive cure currently exists. These conditions share common pathological mechanisms, including chronic neuroinflammation, oxidative stress, protein aggregation, and mitochondrial dysfunction. Flavonoids and other plant-derived phenolic compounds have recently attracted attention for the treatment of such conditions due to their antiinflammatory and antioxidant properties. This review explores the neuroprotective mechanisms of flavonoids and evaluates their potential for the prevention and treatment of neurodegenerative diseases.
MATERIALS AND METHODS: A literature search of the Web of Science, PubMed, and ScienceDirect databases was conducted to evaluate the therapeutic potential of flavonoids and phenolic compounds against neurodegenerative diseases. The search terms included "polyphenols", "flavonoids", and related compounds, along with "Alzheimer's", "Parkinson's", "Huntington's", and "Amyotrophic lateral sclerosis". Eligible studies included clinical trials, randomized controlled trials, and in vitro and in vivo research published in English. Priority was given to studies from the last decade, although older but significant publications were also included.
RESULTS: The findings of multiple studies report the ability of flavonoid compounds such as quercetin, myricetin, apigenin, and epigallocatechin gallate (EGCG) to modulate critical signaling pathways, reduce oxidative stress, prevent the accumulation of neurotoxic proteins, and support mitochondrial function. These bioactive molecules have exhibited significant potential in slowing disease progression and preserving neuronal integrity. Their therapeutic application, however, has been limited by their poor bioavailability, low stability, and rapid metabolism.
CONCLUSION: Flavonoids have shown promise as naturally derived agents with multi-targeted activity against neurodegenerative processes. Enhancing their absorption and stability through novel delivery systems and structural modifications could significantly improve their clinical efficacy. When administered early or as a complementary therapy, flavonoids can be considered a safe and effective approach to the management of neurodegenerative diseases.}, }
@article {pmid41245880, year = {2025}, author = {Mahdavi, SA and Maghooli, K and Farokhi, F}, title = {A Fuzzy Cognitive Map-based Framework for Alzheimer's Disease Diagnosis Using Multimodal Magnetic Resonance Imaging-Positron Emission Tomography Registration.}, journal = {Journal of medical signals and sensors}, volume = {15}, number = {}, pages = {31}, pmid = {41245880}, issn = {2228-7477}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive and irreversible brain disorder, characterized by a gradual decline in cognitive and memory function, with memory loss being one of the most prominent symptoms. Accurate and early diagnosis of AD is essential for effective management and treatment. Structural magnetic resonance imaging (sMRI) and positron emission tomography (PET) are widely utilized neuroimaging modalities for diagnosing AD due to their ability to provide complementary structural and functional insights into brain abnormalities.
METHODS: This study introduces a novel computer-aided diagnosis system that integrates sMRI and PET data using Fuzzy Cognitive Maps (FCM) to improve diagnostic accuracy. The research is conducted using the ADNI dataset, where preprocessing of sMRI and PET images is performed using FSL and statistical parametric mapping tools, respectively. In a key innovation, features extracted from both modalities are fused and dimensionality reduction is achieved through an Autoencoder model. The reduced feature set is then classified using FCM, Support Vector Machine, k-Nearest Neighbors, and Multilayer Perceptron.
RESULTS: The FCM-based approach demonstrates superior performance, achieving the highest accuracy of 93.71%, surpassing other classifiers tested.
CONCLUSIONS: This study underscores the effectiveness of integrating FCM with multimodal neuroimaging data and highlights its potential for enhancing the early and reliable diagnosis of AD.}, }
@article {pmid41245492, year = {2025}, author = {Hines, D and Tobey, H and Dugan, P and Boehringer, S and Helm, R and Anandakrishnan, R and Werre, S and VandeVord, P and Costa, BM}, title = {A preliminary study on the effect of quantified cranial osteopathic manipulation on wild-type and transgenic rat models of Alzheimer's disease.}, journal = {Journal of Alzheimer's disease reports}, volume = {9}, number = {}, pages = {25424823251393742}, pmid = {41245492}, issn = {2542-4823}, abstract = {Alzheimer's disease is a chronic progressive neurodegenerative disorder that impairs the meningeal lymphatics, glymphatic system, and compartmental fluid exchange, leading to a decline in cognitive function. Due to the lack of non-pharmacological and physiological treatments, cranial osteopathic manipulation (COM) poses a potential minimally invasive therapeutic choice. To understand the treatment and related effects objectively, we have established a technique to quantify the force applied during COM on an animal model of AD for the first time. Our results indicate that quantified COM can be applied to rodents to study behavioral and biochemical phenotype changes.}, }
@article {pmid41245147, year = {2025}, author = {Pluta, R}, title = {Direct and indirect role of non-coding RNAs in company with amyloid and tau protein in promoting neuroinflammation in post-ischemic brain neurodegeneration.}, journal = {Frontiers in cellular neuroscience}, volume = {19}, number = {}, pages = {1670462}, pmid = {41245147}, issn = {1662-5102}, abstract = {Post-ischemic brain neurodegeneration with subsequent neuroinflammation is a major cause of mortality, permanent disability, and the development of Alzheimer's disease type dementia in the absence of appropriate treatment. The inflammatory response begins immediately after ischemia and can persist for many years. Post-ischemic neuroinflammation plays a dual role: initially, it is essential for brain repair and maintenance of homeostasis, but when it becomes uncontrolled, it causes secondary damage and worsens neurological outcome. Neuroinflammation is a complex phenomenon involving interactions between infiltrating immune cells from the peripheral circulation and resident immune cells in ischemic brain areas. This review focuses on the complex relationship between non-coding RNAs, amyloid accumulation, tau protein modifications, and the development of neuroinflammation in the post-ischemic brain. In particular, it clarifies whether the cooperation of non-coding RNAs with amyloid and tau protein enhances neuroinflammation and whether the vicious cycle of neuroinflammatory responses affects the production, behavior, and aggregation of these molecules. Ultimately, elucidating these interactions is critical, as they may contribute to resolving the phenomenon of post-ischemic brain neurodegenerative mechanisms. Furthermore, this review highlights the role of neuroinflammation as a functionally complex immune response regulated/mediated by transcription factors and cytokines. Additionally, it examines how the presence of non-coding RNAs, amyloid aggregation, and modified tau protein may shape the inflammatory landscape. This review aims to advance our understanding of post-ischemic neuroinflammation and its implications for long-term brain health.}, }
@article {pmid41244831, year = {2025}, author = {Ye, S and Zhang, S and Zhang, L and Peng, G and Xie, M and Huang, X and Hu, Y}, title = {Screening and experimental validation of modified Gandou Decoction-targeted inhibitors for alleviating AD components via network pharmacology, machine learning, and molecular dynamics simulation.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1685866}, pmid = {41244831}, issn = {1663-9812}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disease characterized by abnormal accumulation of β-amyloid (Aβ) and hyperphosphorylation of the Tau protein. Currently, there is a lack of effective and safe therapeutic approaches. In Traditional Chinese medicine (TCM), Gandou Decoction has shown significant efficacy in improving cognitive decline and dementia-related symptoms, but its specific mechanism remains unclear.
METHODS: This study systematically analyzed the active components and anti-AD mechanism of Modified Gandou Decoction (MGD) by integrating network pharmacology, machine learning, molecular docking, molecular dynamics (MD) simulation, and in vitro experimental validation. Obtain the components of Chinese medicines in MGD from TCMSP and screen them via ADMET; obtain AD targets by combining databases and select core targets through machine learning; verify their effects through various analyses and experiments.
RESULTS: A total of 21 potential active molecules of MGD and 68 intersection targets were screened out. Among them, 8 core targets (EIF2AK2, PPARG, BACE1, ESR1, GSK3B, ACE, CASP3, MAPK14) were confirmed to be significantly associated with AD pathology by gene expression difference analysis (P ≤ 0.05). KEGG enrichment analysis showed that MGD mainly intervenes in the amyloid production pathway, the MAPK pathway, and the IL-17 pathway. Molecular docking demonstrated that the majority of the 21 potential active compounds exhibited strong binding affinities to the 8 core targets. Moreover, some potential active molecules exhibited better binding energy and similar binding modes compared with known inhibitors when binding to the corresponding target proteins. Molecular dynamics simulation showed that Alisol B, a potential active component of MGD, could stably bind to BACE1, EIF2AK2, and CASP3. In vitro cell experiments confirmed that Alisol B could significantly reverse okadaic acid-induced damage in SH-SY5Y cells (p < 0.001).
CONCLUSION: MGD exerts its anti-AD effect through its potential active component Alisol B, which binds to target proteins BACE1, EIF2AK2, and CASP3, and synergistically inhibits Aβ production, Tau phosphorylation, and neuroinflammatory processes through multiple pathways. This study provides a foundation for developing MGD-derived natural products for AD treatment, although the precise mechanisms require further experimental validation.}, }
@article {pmid41243261, year = {2025}, author = {Bramen, JE and Siddarth, P and Popa, ES and Kress, GT and Rapozo, MK and Hodes, JF and Ganapathi, AS and Sparks, WM and Tongson, YM and Torres, AM and Meysami, S and Slyapich, CB and Glatt, RM and Pierce, K and Miller, KJ and Elhelou, SH and Porter, VR and Wong, C and Kim, M and Panos, S and Hirsch, DA and Raji, CA and Bookheimer, SY and Hood, L and Roach, JC and Merrill, DA}, title = {A multi-modal medical management and lifestyle intervention increase cerebral blood flow and lowers diabetic risk in persons with early Alzheimer's disease: Mid-trial results from the PREVENTION trial.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {108}, number = {4}, pages = {1819-1833}, pmid = {41243261}, issn = {1875-8908}, support = {P41 EB015909/EB/NIBIB NIH HHS/United States ; }, mesh = {Humans ; Male ; *Alzheimer Disease/therapy/physiopathology/diagnostic imaging/complications ; Female ; *Cerebrovascular Circulation/physiology ; Aged ; *Diabetes Mellitus/prevention & control ; Magnetic Resonance Imaging ; *Life Style ; Middle Aged ; Exercise Therapy/methods ; Combined Modality Therapy ; Aged, 80 and over ; Exercise ; }, abstract = {BackgroundMedical and lifestyle management are crucial for Alzheimer's disease (AD). Cerebral blood flow (CBF), vital for brain health, and influenced by modifiable risk factors, is reduced in AD and may become uncoupled from metabolism due to neurovascular dysfunction in later stages.ObjectiveThis mid-trial analysis tested the hypothesis that a coached, multi-modal intervention (PREVENTION) improved ASL-MRI-measured CBF and diabetic risk (QUICKI) in patients with early AD.MethodsThe control arm received recommendations and medical management for one year; the active arm additionally received coaching, exercise training, and supplementation. We hypothesized that those in (1) the active arm and (2) with higher intervention adherence would have improved post-trial QUICKI and CBF, particularly in regions relevant to exercise, cardiovascular, diabetic, and AD risk. Post-trial CBF was analyzed using a linear model including arm, baseline CBF, adherence, age, education, and depressive symptoms. Change in QUICKI was analyzed using mixed effects general linear models, including arm, adherence, time, and interactions between time and treatment group and time and adherence, controlling for age.ResultsThe active arm (n = 18) showed greater post-trial CBF in regions related to exercise, cardiovascular, diabetic, and AD risk, compared to control (n = 20), but did not differ in global CBF, QUICKI, or adherence. Higher adherence scores were associated with greater regional post-trial CBF and improvement in QUICKI, but not global CBF.ConclusionsIn this small sample, we found evidence that a multi-modal intervention focused on medical management, exercise, and a carbohydrate-restricted diet improved diabetic risk and CBF in patients with AD.}, }
@article {pmid41242500, year = {2025}, author = {Gungor, D and Muratoglu, S and Aytekin, E and Reçber, T and Telli, G and Akdag, Y and Sahin, S and Gulsun, T}, title = {Assessment of intranasal permeability and pharmacological activity of glyburide-loaded nanosuspension formulation for Alzheimer's disease.}, journal = {Journal of pharmaceutical sciences}, volume = {115}, number = {2}, pages = {104064}, doi = {10.1016/j.xphs.2025.104064}, pmid = {41242500}, issn = {1520-6017}, abstract = {Glyburide is an anti-diabetic drug with promising potential implications for Alzheimer's disease. This study evaluated the permeability and activity of glyburide via intranasal administration in Alzheimer's disease using both in vivo and ex vivo studies. A glyburide nanosuspension, was used as the drug delivery system. Stability studies demonstrated that the nanosuspension formulation presented suitable stability during in vitro and in vivo studies. The chosen in vivo glyburide dose demonstrated a non-toxic profile via MTT. Additionally, the in vitro permeability of the nanosuspension was assessed. Pharmacological activity was further evaluated through in vivo behavioural tests, including the Morris water maze and novel object recognition tests, and amyloid-beta levels were measured in mice brain tissues with ELISA. Ex vivo quantification of glyburide concentration in various tissues was also conducted. In vitro permeability studies showed that the nanosuspension formulation significantly enhanced permeability of glyburide. In vivo behavioural tests demonstrated that the nanosuspension formulation yielded favourable and promising outcomes even it was administered intranasally. This study suggests that, through the solubility enhancement provided by nanocrystal technology increased the bioavailability of glyburide comparing the intranasal administration of glyburide, leading to improve in vivo activity compared to the raw glyburide suspension in the treatment of Alzheimer's disease.}, }
@article {pmid41242034, year = {2026}, author = {Bruyère, O and Leroy, L and Olivier, C and Demonceau, C and Buckinx, F and Blavier, M and Lekeu, F}, title = {Exploring the knowledge, attitudes, and practices of physical therapists in care facilities assisting individuals with Alzheimer's disease.}, journal = {Geriatric nursing (New York, N.Y.)}, volume = {67}, number = {}, pages = {103710}, doi = {10.1016/j.gerinurse.2025.103710}, pmid = {41242034}, issn = {1528-3984}, mesh = {Humans ; *Alzheimer Disease/nursing/therapy ; *Physical Therapists/psychology ; *Health Knowledge, Attitudes, Practice ; *Nursing Homes ; Surveys and Questionnaires ; Female ; Male ; Belgium ; Aged ; Middle Aged ; }, abstract = {INTRODUCTION: Physical therapists (PTs) in nursing homes often treat patients with Alzheimer's disease. This study evaluated their knowledge, attitudes, and practices (KAP) concerning Alzheimer's care.
METHODS: A KAP survey-based questionnaire was administered to PTs in Belgian nursing homes and long-term care facilities, focusing on their understanding of Alzheimer's, care approaches, and practical care aspects.
RESULTS: The survey, completed by 133 PTs, revealed strong knowledge and positive attitudes. PTs adapted communication methods, managed treatment refusals, and prioritized fall prevention and safety. Care practices focused on maintaining patient autonomy through exercises for strength, balance, and coordination. Techniques like massage or aromatherapy were less commonly used, despite potential benefits. Notably, knowledge, experience, or exposure to Alzheimer's patients did not significantly influence attitudes or practices.
CONCLUSION: Targeted practical training in dementia care techniques is needed to enhance caregiving skills, despite a solid foundation in knowledge and attitudes. Future research should examine diverse samples and evaluate training impact on practices.}, }
@article {pmid41241266, year = {2026}, author = {Sharma, A and Singh, TG}, title = {Next-generation neurotherapeutics: mechanistic insights on monoclonal antibodies in Alzheimer's disease.}, journal = {Brain research}, volume = {1870}, number = {}, pages = {150047}, doi = {10.1016/j.brainres.2025.150047}, pmid = {41241266}, issn = {1872-6240}, mesh = {*Alzheimer Disease/drug therapy/immunology/metabolism/therapy ; Humans ; *Antibodies, Monoclonal/therapeutic use ; Animals ; Amyloid beta-Peptides/metabolism/immunology ; tau Proteins/immunology ; }, abstract = {Monoclonal antibodies (mAbs) for Alzheimer's disease (AD) present a fundamental translational challenge, as demonstrated by amyloid-beta (Aβ)-targeting mAbs that successfully employed Fragment crystallizable gamma receptor (FcγR)/Immunoreceptor tyrosine-based activation motif (ITAM)-mediated microglial phagocytosis yet achieved only modest cognitive improvements while introducing significant Amyloid-related imaging abnormalities (ARIA) risk, thereby highlighting inherent single-therapy limitations. Building on these findings, tau-directed antibodies show preclinical promise by targeting pathological seeding and propagation, but face translational challenges including limited extracellular accessibility and variable efficacy across disease stages, necessitating expansion beyond single-target approaches. Consequently, the translational field is advancing toward innovative multi-mechanistic strategies, including synaptic restoration through anti-PrP and neurotrophic receptor agonists that provide functional benefits independent of plaque reduction, neuroinflammation modulation via anti-CD33 and complement inhibitors requiring careful patient selection due to variable outcomes, and emerging anti-TREM2 and anti-APOE4 mAbs enabling precision medicine tailored to individual genetic profiles. Importantly, comparative studies also reveal that combination therapies-especially dual Aβ/tau targeting-demonstrate superior synergistic effectiveness, driving next-generation engineering advances including Fc modifications that reduce ARIA risk, nanobodies/single-chain variable fragments (scFvs) with enhanced blood-brain barrier (BBB) penetration, cell-penetrating formats for intracellular tau access, and pH-sensitive glycoengineering for optimized tissue-specific binding. Ultimately, successful clinical translation depends on integrating biomarker-guided patient selection, optimized dosing strategies, and disease-stage-appropriate timing, with future progress anticipated through bispecific/multispecific antibodies targeting complementary pathways alongside personalized biomarker approaches, collectively providing realistic potential for achieving genuine neuroprotection and meaningful disease modification beyond symptomatic treatment in AD patients.}, }
@article {pmid41240919, year = {2025}, author = {Kaila, LV and Ikeda, M and Sultana, J and Chouliaras, L and O'Brien, JT and Taylor, JP}, title = {The evolving therapeutic landscape of dementia with Lewy bodies.}, journal = {The Lancet. Neurology}, volume = {24}, number = {12}, pages = {1038-1052}, doi = {10.1016/S1474-4422(25)00323-0}, pmid = {41240919}, issn = {1474-4465}, mesh = {Humans ; *Lewy Body Disease/therapy/diagnosis ; }, abstract = {Dementia with Lewy bodies has a complex clinical presentation, with symptoms spanning cognitive, neuropsychiatric, motor, autonomic, and sleep domains. The disorder causes high morbidity, is associated with high caregiver burden, and can result in considerable health-care costs. Although symptomatic treatments remain scarce, emerging evidence supports a multipronged approach that integrates pharmacological and non-pharmacological interventions that target different signs and symptoms. Novel frameworks, such as the DIAMOND Lewy toolkit, provide structured management guidance. Beyond symptom control, research is at a turning point, with increasing focus on disease-modifying therapies. Ongoing clinical trials are exploring many therapeutic targets, including α-synuclein aggregation and neuroinflammation. Other potential targets in the treatment of dementia with Lewy bodies include amyloid β, given that the presence of Alzheimer's disease copathology is common in patients with this disease.}, }
@article {pmid41240389, year = {2025}, author = {Jahanmehr, D and Ahmadi, A and Fadaei, M and Sangi Nasab Lahijan, A and Shafiee Sabet, M and Kalantari Dehaghi, H and Asadi-Golshan, R}, title = {The Ketogenic Diet: A Possible Intervention for Improving Hippocampal Function in Neurological Disorders.}, journal = {Nutrition reviews}, volume = {}, number = {}, pages = {}, doi = {10.1093/nutrit/nuaf210}, pmid = {41240389}, issn = {1753-4887}, abstract = {With a focus on the hippocampus, in this review we examined the emerging role of the ketogenic diet (KD) in treating neurological disorders. There are multiple pathways through which various versions of the KD influence the hippocampus: energy metabolism shifts, neurotransmitter modulation, neuroinflammation control, and synaptic plasticity and epigenetic regulation modifications. Both animal studies and clinical research, with emphasis on epilepsy and Alzheimer disease, have revealed the therapeutic potential of KDs. By modifying energy metabolism and lowering neuroinflammation, KDs may have therapeutic uses such as treatment of epilepsy and Alzheimer disease. In addition, ketones may stabilize hippocampal neuronal networks and reduce amyloid-beta toxicity. Individualized factors and the duration and timing of KD intervention play critical roles in achieving optimal outcomes, such as enhanced hippocampal function and neuroprotection. While preclinical studies have demonstrated enhanced hippocampal synaptic plasticity and neuroprotection, the long-term neurological and metabolic effects of KDs require further clinical validation. There are still a number of important research gaps, especially with regard to the application of animal findings to humans. Future studies should concentrate on long-term human trials using standardized designs to investigate how KDs can affect the nervous system.}, }
@article {pmid41240365, year = {2025}, author = {Zammit, MD and Bruzzone, H and Cody, KA and Morse, J and Wilson, R and Bettcher, BT and McLachlan, MJ and McVea, AK and DiFilippo, AH and Carey, FJ and Janelidze, S and Hansson, O and Price, JC and Laymon, CM and Minhas, DS and Luo, W and Rosas, HD and Lai, F and Lee, JH and Lao, PJ and Ances, BM and Krinsky-McHale, SJ and Hom, CL and Hartley, SL and Zaman, SH and Johnson, SC and Cohen, AD and Head, E and Mapstone, ME and Handen, BL and Christian, BT and Tudorascu, DL and Langhough, RE and Betthauser, TJ and , }, title = {The tau biomarker cascade is condensed in Down syndrome compared to sporadic Alzheimer's disease.}, journal = {Brain : a journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/brain/awaf428}, pmid = {41240365}, issn = {1460-2156}, abstract = {Characterizing the timing and progression of Alzheimer's disease biomarker onset in Down syndrome (DS) and contrasting potential timing differences with neurotypical adults is needed to identify optimal Alzheimer's disease therapeutic treatment windows in DS. In this study, 198 adults with DS from the Alzheimer Biomarker Consortium - Down Syndrome and 172 neurotypical adults from the Wisconsin Registry for Alzheimer's Prevention with available longitudinal beta-amyloid PET, tau PET and plasma p-tau217 analyzed on Lilly MSD were included. Individuals with DS had a significantly higher lifetime risk of beta-amyloid plaque onset. Temporal modeling of longitudinal biomarker measures revealed earlier age at positivity of beta-amyloid plaques, p-tau217 and neurofibrillary tau tangles in DS relative to the neurotypical cohort. The onset of p-tau217 and tau PET positivity in DS occurred nearly simultaneously, roughly 4-6 years following beta-amyloid onset, whereas the neurotypical group displayed greater temporal latency between positivity of the two biomarkers. The early and simultaneous onset of these biomarkers in DS highlights the necessity for early therapeutic interventions in this population. This work, combined with the upcoming anti-amyloid safety and efficacy clinical trials for DS will help identify optimal treatment windows for these individuals.}, }
@article {pmid41240244, year = {2025}, author = {Jayathilaka, NS and Weththasinghe, AV and Amarasekara, CI and Amasha, EADH and Wijekoon, KJ and Firdous, SM}, title = {Targeting the Gut-Brain Axis Through Insulin-like Growth Factors: Therapeutic Implications and Future Directions.}, journal = {Journal of molecular neuroscience : MN}, volume = {75}, number = {4}, pages = {150}, pmid = {41240244}, issn = {1559-1166}, mesh = {Humans ; Animals ; *Brain/metabolism ; Gastrointestinal Microbiome ; *Somatomedins/metabolism ; *Neurodegenerative Diseases/metabolism/drug therapy/therapy ; *Insulin-Like Growth Factor I/metabolism ; *Brain-Gut Axis ; *Gastrointestinal Tract/metabolism ; Insulin-Like Peptides ; }, abstract = {The gut-brain axis represents a sophisticated bidirectional communication network connecting the gastrointestinal tract and central nervous system through neural, endocrine, and immune pathways. Insulin-like growth factors (IGFs), particularly IGF-1 and IGF-2, function as pivotal mediators within this communication framework. These polypeptide growth factors regulate intestinal barrier integrity, microbiota homeostasis, neurogenesis, and synaptic plasticity mechanisms. Clinical evidence from 1989 to 2024 demonstrates that gut microbiota-derived short-chain fatty acids enhance IGF-1 production through novel molecular mechanisms. This narrative review examines IGF roles in gut-brain communication and evaluates therapeutic potential for neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and depression, as well as inflammatory bowel disorders. Current clinical trials investigating IGF-based interventions show preliminary promising results, though studies remain limited in scope and patient numbers. Key therapeutic challenges include delivery mechanisms across biological barriers, oncogenic safety concerns related to cell proliferation, and substantial individual variability in treatment responses. Future directions emphasize development of tissue-specific IGF modulators, microbiome-targeted interventions, and precision medicine approaches utilizing advanced biomarkers. Understanding IGF-mediated gut-brain communication presents therapeutic opportunities for complex pathological conditions simultaneously affecting gastrointestinal and neurological systems.}, }
@article {pmid41240183, year = {2025}, author = {García-Castro, P and Conejo, NM and González-Pardo, H}, title = {Transcranial photobiomodulation therapy in older women regarding cognitive functions: a systematic review.}, journal = {Lasers in medical science}, volume = {40}, number = {1}, pages = {480}, pmid = {41240183}, issn = {1435-604X}, mesh = {Humans ; *Low-Level Light Therapy/methods ; Female ; *Cognition/radiation effects ; Aged ; *Cognitive Dysfunction/therapy ; Animals ; Alzheimer Disease/therapy ; }, abstract = {Transcranial photobiomodulation therapy (tPBM) is a promising non-invasive treatment that uses red or near-infrared light to modulate biological functions and elicit therapeutic effects. This systematic review aimed to summarise the evidence on the effectiveness of tPBM in improving cognitive function in older women, in experimental animal models and in humans, by analyzing the optimal tPBM parameters and behavioral and neurobiological outcomes. tPBM offers advantages specific to older women as a non-invasive brain stimulation technique, applied to a sensitive population with increased risk of ageing-related brain dysfunction due to increased life expectancy. A comprehensive literature search was conducted in PubMed, Scopus, and PsycINFO databases, and only seven articles on older women were included in the review. Studies have shown that tPBM significantly improves cognitive impairment in Alzheimer's disease and related dementias, stroke, cognition and Parkinson's disease in older women. Despite the heterogeneity in the application parameters and limited number of studies, tPBM therapy was preliminarily found to be a safe, feasible, and effective non-pharmacological therapy for several neurological and mental health conditions in older women. Further research is required to establish standardized protocols for optimal therapeutic applications.}, }
@article {pmid41239797, year = {2025}, author = {Garg, N and Dhankhar, S and Dhariya, A and Parkash, C and Chauhan, S and Singh, TG}, title = {Role of Liposomes in the Treatment of Neurodegenerative Disorders: A Comprehensive Review.}, journal = {Central nervous system agents in medicinal chemistry}, volume = {25}, number = {4}, pages = {496-512}, pmid = {41239797}, issn = {1875-6166}, mesh = {Humans ; *Liposomes/metabolism/chemistry ; *Neurodegenerative Diseases/drug therapy/metabolism ; Animals ; *Drug Delivery Systems/methods ; *Neuroprotective Agents/administration & dosage/therapeutic use ; Blood-Brain Barrier/metabolism/drug effects ; }, abstract = {The complex etiology and limited therapy options of neurodegenerative illnesses pose daunting challenges to modern medicine. Nonetheless, novel treatment approaches have exciting new possibilities because of developments in nanotechnology. Liposomes have garnered a lot of interest as a potential treatment for neurological illnesses due to the fact that they are able to adapt to their role as nanocarriers. This review article discusses various uses of liposomes, including their ability to help treat neurodegenerative diseases such as Alzheimer's, Parkinson's, and Huntington's disease, as well as their diagnostic and neuroprotective uses. Liposomes allow for the targeted delivery of medicines to specific brain areas with minimal systemic side effects since they encapsulate and carry therapeutic molecules across the blood-brain barrier. Due to the fact that they are biocompatible, have surface features that can be adjusted, and have the ability to co-deliver many drugs, liposomes are excellent candidates for combination therapy and personalized medicine procedures. In spite of this, there is a growing body of research that suggests liposomes could serve as a versatile platform for the improvement of neurodegenerative disease treatment. This is a positive sign for the future results of patients and their quality of life.}, }
@article {pmid41239092, year = {2025}, author = {Kong, W and Miao, X and Dang, R and Jiang, P and Feng, L}, title = {Mechanisms and Clinical Significance of Endosomal Toll-Like Receptors in Neurological Diseases.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {54}, pmid = {41239092}, issn = {1559-1182}, support = {82373585//National Natural Science Foundation of China/ ; 2023M741364//the China Postdoctoral Science Foundation/ ; ZR2022MH007//the Natural Science Foundation of Shandong Province/ ; 2022YXNS124//the Jining Key R&D Projects/ ; 2022YXNS137//the Jining Key R&D Projects/ ; 202304040457//the Medical and Health Science and Technology Development Project of Shandong Province/ ; }, mesh = {Humans ; *Toll-Like Receptors/metabolism ; *Endosomes/metabolism ; Animals ; *Nervous System Diseases/metabolism ; Signal Transduction ; Clinical Relevance ; }, abstract = {Neurological diseases such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and epilepsy constitute a major global public health burden, affecting millions of patients. Recent studies have shown that the complex interactions between the immune system and the nervous system play a significant role in these diseases, especially Toll-like receptors (TLRs), among which endosomal TLRs (TLR3, TLR7, TLR8, and TLR9) are crucial in neuroinflammation and disease progression. This review systematically elaborates on the biological characteristics of endosomal TLRs, their distribution, and signaling pathways within the central nervous system, with a particular focus on their "double-edged sword" effect in specific disease contexts: on the one hand, they may provide neuroprotection, while on the other hand, they can exacerbate neural injury and neurodegeneration during immune dysregulation. Furthermore, this article evaluates the potential and challenges of utilizing endosomal TLRs as early diagnostic biomarkers. It summarizes research progress in targeted regulatory strategies as emerging therapeutic approaches, along with the encountered bottlenecks in clinical translation. The review aims to systematically integrate fundamental mechanistic research with clinical application prospects, emphasizing the critical importance of in-depth elucidation of the mechanistic roles of endosomal TLRs in neurological disorders and their translational value in diagnosis and treatment. Clinical trial number: not applicable.}, }
@article {pmid41239049, year = {2025}, author = {Ma, H and Cong, C}, title = {Insights and advances of theranostic nanoscale metal-organic frameworks.}, journal = {Mikrochimica acta}, volume = {192}, number = {12}, pages = {809}, pmid = {41239049}, issn = {1436-5073}, mesh = {*Metal-Organic Frameworks/chemistry ; Humans ; *Theranostic Nanomedicine/methods ; Contrast Media/chemistry ; Animals ; }, abstract = {As one class of multifunctional materials, metal-organic frameworks (MOFs) with virtues like large surface area, high porosity, and tailorability have been found in many applications. Particularly, the investigation on health is rapidly growing. Accurate diagnosis and efficient treatment of diseases are increasingly important but challenging. Nanoplatforms based on MOFs are receiving much attention, which has made significant progress in imaging and drug delivery during the past few years. This review article will summarize and discuss the latest development of nanoscale MOFs in the following topics: contrast agents for magnetic resonance imaging (MRI); X-ray computed tomography imaging (CT); optical imaging (OI); photoacoustic imaging (PAI); photothermal imaging (PTI); positron emission tomography (PET); single-photon emission computed tomography (SPECT); and multimodal imaging (MI). In addition, targeting drug delivery by MOFs to treat diseases will be categorized into the followings: cancers; lung diseases; bone diseases; diabetes; infections; wound healing; bowel diseases; Alzheimer's disease; ocular diseases; and atherosclerosis.}, }
@article {pmid41238774, year = {2025}, author = {Cerman, J and Škorvagová, A and Vyhnálek, M and Veverová, K and Dvořák, K and Kozák, Š and Kavka, A and Hort, J}, title = {Concordance between amyloid PET and CSF biomarkers in clinical setting: a cross-platform comparison and in-depth analysis of discordant cases.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {39963}, pmid = {41238774}, issn = {2045-2322}, mesh = {Humans ; *Biomarkers/cerebrospinal fluid ; *Alzheimer Disease/cerebrospinal fluid/diagnostic imaging/diagnosis/metabolism ; Male ; *Amyloid beta-Peptides/cerebrospinal fluid/metabolism ; Female ; *Positron-Emission Tomography/methods ; Aged ; tau Proteins/cerebrospinal fluid ; Middle Aged ; Peptide Fragments/cerebrospinal fluid ; *Amyloid/metabolism ; Aged, 80 and over ; Enzyme-Linked Immunosorbent Assay ; Apolipoprotein E4/genetics ; }, abstract = {Reliable detection of amyloid pathology is essential for Alzheimer's disease (AD) diagnosis and treatment. We directly compared routine ELISA assays and the automated Lumipulse platform against quantitative amyloid PET in a real-world memory clinic cohort. In 153 participants, flutemetamol amyloid PET and CSF biomarkers were assessed across platforms. Concordance with PET and predictors of discordance were evaluated. PET visual reads and Centiloids showed near-perfect agreement (AUC = 0.99). The p-tau181/Aβ42 ratio achieved the highest concordance with PET (OPA 87% ELISA, 92% Lumipulse), while the Lumipulse Aβ42/40 ratio reached 93%. About 6% of participants showed consistent discordance between CSF and PET, associated with APOE ε4 and mixed or non-AD pathologies. Automated CSF assays align strongly with amyloid PET and support biomarker standardization. Persistent discrepancies between CSF and PET likely reflect underlying biological heterogeneity such as mixed or non-AD pathologies and APOE ε4 carriage.}, }
@article {pmid41238601, year = {2025}, author = {Alzarea, SI}, title = {Identification of novel neuraminidase 1 modulators as potential therapeutics for Alzheimer's disease using virtual screening and molecular dynamics simulations.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {39901}, pmid = {41238601}, issn = {2045-2322}, support = {KSRG-2024-340//King Salman Center for Disability Research/ ; }, mesh = {*Neuraminidase/antagonists & inhibitors/metabolism/chemistry ; *Alzheimer Disease/drug therapy/enzymology/metabolism ; Molecular Dynamics Simulation ; Molecular Docking Simulation ; Humans ; *Enzyme Inhibitors/pharmacology/chemistry ; Drug Evaluation, Preclinical ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder caused by the accumulation of β-amyloid (Aβ) plaques and neurofibrillary tangles, resulting in neuronal dysfunction and cognitive decline. The neuraminidase isoenzyme NEU1 is a most ubiquitous mammalian enzyme, involved in various cellular mechanisms. The deficiency of NEU1 has been implicated in the pathophysiology of AD, significantly in amyloid precursor protein (APP) metabolism and Aβ clearance. Despite extensive research, no potent NEU1 modulator has been developed to regulate its activity for therapeutic intervention in AD. The present work aims to identify potential NEU1 modulators from a library of seaweed Metabolites Database through molecular docking, ADMET analysis, and molecular dynamics (MD) simulations. A library of 1,077 seaweed metabolites was screened, identifying 20 active compounds, of which 4 met Lipinski's Rule of Five criteria. ADMET profiling revealed favorable pharmacokinetic properties for BE003, BS032, and RG007, with good blood-brain barrier permeability and bioavailability. Molecular docking demonstrates that BE003, BS032, RG007, and BD039 metabolites exhibited the highest binding affinities for the NEU1 active site. Additionally, MD simulation and MM-GBSA validated the stability of the metabolite-protein complex, with BE003 demonstrating the most stable interactions. Comparative docking against a natural substrate (Neu5Ac) and a NEU1 inhibitor (17f) revealed that BE003 shares significant interaction, RMSD stability profiles with the substrate and loop conformational dynamics while differing from the inhibitor. Our findings emphasize the potential of this modulator as a novel therapeutic target against NEU1 in AD treatment. Further experimental validation and preclinical studies are needed to confirm its efficacy in modulating NEU1 activity.}, }
@article {pmid41238155, year = {2026}, author = {Heath, AM and Mojabi, FS and Kraybill, EP and Beard, C and Venkataramanan, V and Cuéllar, V and Piekarski, D and McNerney, MW}, title = {Comparison of treatment schedules on cognitive effects of rTMS in the 3xTg-AD model of Alzheimer's disease.}, journal = {Experimental neurology}, volume = {396}, number = {}, pages = {115551}, doi = {10.1016/j.expneurol.2025.115551}, pmid = {41238155}, issn = {1090-2430}, mesh = {Animals ; *Alzheimer Disease/therapy/genetics/complications/pathology/psychology ; *Transcranial Magnetic Stimulation/methods ; Mice ; Mice, Transgenic ; Disease Models, Animal ; Male ; Mice, Inbred C57BL ; Maze Learning/physiology ; Brain-Derived Neurotrophic Factor/metabolism ; tau Proteins/genetics/metabolism ; Amyloid beta-Protein Precursor/genetics ; *Cognition Disorders/etiology/therapy ; Memory, Short-Term/physiology ; Presenilin-1/genetics ; Choline O-Acetyltransferase/metabolism ; Cognition/physiology ; }, abstract = {Repetitive transcranial magnetic stimulation (rTMS) is a promising non-invasive therapy for improving cognition in Alzheimer's disease (AD), but the optimal treatment parameters have yet to be elucidated. One important parameter is the treatment schedule. In this study, we used an established rodent low intensity rTMS stimulation protocol to compare cognitive and biochemical effects of an intensive treatment protocol (daily for 12 days) to a distributed protocol (twice a week for six weeks) in 12-month-old 3xTg-AD mice and B6 controls. We found that both protocols improved object place memory function, but only the distributed protocol improved working memory as measured with the Y-Maze. We did not find any effect of either rTMS protocol on BDNF or amyloid pathology, although these measures correlated well with activity and cognitive performance, suggesting rTMS improvement was independent of these mechanisms. Intensive rTMS increased choline acetyltransferase-positive neurons in the anterior bed nucleus of the stria terminalis (BNST), which may be due to the function of this region in mediating cognitive and limbic circuitry. These results indicate that while both treatment protocols can improve specific aspects of recognition memory, only distributed rTMS improves working memory function, possibly due to causing less cognitive fatigue and physiological stress. Future studies should examine region specific changes relating working memory function and stress related signaling to further understand the mechanisms behind this important rTMS treatment parameter.}, }
@article {pmid41238102, year = {2026}, author = {Long, J and Liu, S and Shi, Y and Zhang, C and Qin, L and Ai, Q}, title = {Targeting lipid metabolism in neurodegenerative diseases: From experimental to clinical.}, journal = {Metabolism: clinical and experimental}, volume = {175}, number = {}, pages = {156436}, doi = {10.1016/j.metabol.2025.156436}, pmid = {41238102}, issn = {1532-8600}, mesh = {Humans ; *Neurodegenerative Diseases/metabolism/drug therapy ; *Lipid Metabolism/drug effects/physiology ; Animals ; Brain/metabolism ; }, abstract = {The human brain, despite accounting for only 2 % of total body weight, exhibits an exceptionally high lipid content (approximately 20 % of its mass), highlighting the critical role of lipid metabolism in maintaining neural homeostasis and function. Neurodegenerative diseases-including Alzheimer's disease (AD), Parkinson's disease (PD), stroke, Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS)-are characterized by progressive neuronal dysfunction and myelin degeneration. These conditions predominantly affect aging populations and represent a growing global health challenge. While aging remains the primary risk factor, compelling evidence now underscores the involvement of dysregulated lipid metabolism in their pathogenesis. However, the precise mechanisms linking dynamic lipid metabolic alterations to disease progression remain incompletely elucidated. This review systematically examines the multifaceted contributions of lipid metabolism to neurodegenerative processes and critically assesses emerging therapeutic strategies that target lipid pathways for the treatment of neurodegenerative disorders.}, }
@article {pmid41238077, year = {2025}, author = {Ancy, A and Mohan, S}, title = {Development and optimization of flavonoid-enriched solid lipid nanoparticles of Peperomia pellucida for enhanced brain delivery in Alzheimer's disease: A Quality by Design approach.}, journal = {Annales pharmaceutiques francaises}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pharma.2025.11.003}, pmid = {41238077}, issn = {2772-803X}, abstract = {OBJECTIVES: The Peperomia pellucida plant exhibits notable neuroprotective potential but has low oral bioavailability in the brain. Herein, we aimed to enhance the oral bioavailability and brain distribution of P. pellucida, by formulating its flavonoid-enriched fraction into solid lipid nanoparticles as a potential therapeutic approach for Alzheimer' disease.
MATERIALS AND METHODS: Flavonoid-enriched solid lipid nanoparticles of P. pellucida were formulated using an ultrasonication method. A Box-Behnken design was utilized to optimize particle size, entrapment efficiency, and burst release. The optimized formulation was identified via numerical and graphical optimization, and validated through reproducibility studies. Further characterization included scanning electron microscopy and in vivo drug release studies in rats.
RESULTS: Glycerol tripalmitate-based solid lipid nanoparticles exhibited superior entrapment efficiency and reduced burst release. The mean particle size of the solid lipid nanoparticles ranged 110-884nm, with entrapment efficiency ranging 55-94%. Oral administration of the optimized formulation significantly improved bioavailability in rats and enhanced drug distribution in the cortex and hippocampus of the brain.
CONCLUSION: The results highlight the potential of solid lipid nanoparticles as an effective delivery system for the flavonoid-enriched fraction of P. pellucida, enhancing its therapeutic impact in the treatment of Alzheimer's disease.}, }
@article {pmid41237463, year = {2025}, author = {Cho, E and Yi, JH and Jeon, SJ and Kim, DH and Kwon, H and Jeon, J and Kwon, KJ and Jang, DP and Moon, M and Shin, CY and Kim, DH}, title = {Increases in brain catecholamine levels counteract memory deficits and reduces Aβ deposition in 5XFAD male mice.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {193}, number = {}, pages = {118764}, doi = {10.1016/j.biopha.2025.118764}, pmid = {41237463}, issn = {1950-6007}, mesh = {Animals ; Male ; *Memory Disorders/metabolism/drug therapy ; *Amyloid beta-Peptides/metabolism ; Mice ; Norepinephrine/metabolism ; Bupropion/pharmacology ; *Alzheimer Disease/metabolism/drug therapy ; Hippocampus/metabolism/drug effects/physiopathology ; Mice, Transgenic ; Dopamine/metabolism ; Disease Models, Animal ; *Catecholamines/metabolism ; *Brain/metabolism/drug effects ; Memory/drug effects ; Long-Term Potentiation/drug effects ; }, abstract = {Alzheimer's disease (AD) is a degenerative brain disease that presents with neurological symptoms and memory loss, with no clear treatment. Catecholamines, including dopamine, epinephrine, and norepinephrine, can inhibit or degrade the abnormal aggregation of proteins that cause diseases; however, developing these catecholamines as medication is difficult. This study aimed to demonstrate that increasing the levels of catecholamines in the brain may help improve symptoms of AD. We tested whether an increase in catecholamines by bupropion, a dopamine and norepinephrine re-uptake inhibitor, improves the symptoms of AD. Dopamine and norepinephrine showed similar effects in inhibiting amyloid β (Aβ) aggregation and the decomposition of Aβ aggregates as curcumin, a positive control. Dopamine and norepinephrine blocked Aβ aggregates-induced abnormal hippocampal long-term potentiation. The intraperitoneal administration of bupropion increased the concentrations of dopamine and norepinephrine in the hippocampus from 1 to 6 h after administration. In the Aβ-induced memory decline model, bupropion showed a dose-dependent improvement in learning and memory. In 5XFAD mice administered bupropion for 2 months, significant improvements in memory and Aβ deposition were also found compared to vehicle-treated 5XFAD mice. These results suggest that the symptoms of AD can be improved or delayed by increasing the amount of dopamine and norepinephrine using bupropion.}, }
@article {pmid41237058, year = {2026}, author = {Xu, F and Wang, J and Gao, P and Li, D and Liu, X}, title = {Neuroprotective Effects of Triterpenoids From Rosa laevigata Root: Identification, Molecular Docking, and In Vitro Evaluation for Alzheimer's Disease Treatment.}, journal = {Chemistry & biodiversity}, volume = {23}, number = {1}, pages = {e02742}, doi = {10.1002/cbdv.202502742}, pmid = {41237058}, issn = {1612-1880}, mesh = {*Neuroprotective Agents/pharmacology/chemistry/isolation & purification ; Humans ; *Molecular Docking Simulation ; *Alzheimer Disease/drug therapy/metabolism ; Plant Roots/chemistry/metabolism ; *Triterpenes/pharmacology/chemistry/isolation & purification ; Acetylcholinesterase/metabolism ; *Cholinesterase Inhibitors/chemistry/pharmacology/isolation & purification ; *Rosa/chemistry ; Cell Survival/drug effects ; Hydrogen Peroxide/antagonists & inhibitors/pharmacology ; Cell Line, Tumor ; Structure-Activity Relationship ; Antioxidants/pharmacology/chemistry/isolation & purification ; Molecular Structure ; Dose-Response Relationship, Drug ; }, abstract = {This study investigates the neuroprotective effects of triterpenoid compounds from Rosa laevigata Michx. roots against Alzheimer's disease (AD). A total of 62 compounds were identified using ultra-performance liquid chromatography-Orbitrap-tandem mass spectrometry analysis, which included 55 triterpenoids and seven flavonoids. Among 15 isolated compounds, compound 13 demonstrated the strongest acetylcholinesterase (AChE) inhibitory activity, with an IC50 of 3.38 µmol/L, and a maximum inhibition rate of 87.20%. Compound 13 exhibited favorable and stable binding with AChE in molecular docking studies, whilst demonstrating mixed-type inhibition in enzyme kinetics. In the H2O2-induced SH-SY5Y cell model, compound 13 exhibited 84.45% viability at 25 µmol/L, surpassing Trolox's 74.16%. Research indicates that R. laevigata Michx. root triterpenes exert neuroprotective effects through AChE inhibition and antioxidant activity, with compound 13 potentially serving as a multi-target lead compound for treating AD.}, }
@article {pmid41236865, year = {2025}, author = {Hanyu, H and Koyama, Y and Momose, T and Watanabe, S}, title = {Patient With Mild Alzheimer's Disease Homozygous for ApoE ε4 Showing Improved Cognition, No Brain Volume Loss, and Complete Amyloid Clearance After Lecanemab Treatment.}, journal = {Geriatrics & gerontology international}, volume = {25}, number = {12}, pages = {1968-1970}, pmid = {41236865}, issn = {1447-0594}, }
@article {pmid41236362, year = {2025}, author = {Zide, BS and Barker, MS and Silverman, HE and Manoochehri, M and Fremont, R and Stein, C and Kunicki, ZJ and Lee, S and Devanand, DP and Huey, ED}, title = {Feasibility and tolerability of low-dose lithium for the treatment of agitation and abnormal motor behaviors in Frontotemporal Dementia.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {8}, pages = {827-837}, doi = {10.1080/09540261.2025.2572365}, pmid = {41236362}, issn = {1369-1627}, mesh = {Humans ; Female ; *Psychomotor Agitation/drug therapy/etiology ; *Frontotemporal Dementia/complications/drug therapy ; Middle Aged ; Feasibility Studies ; Male ; Double-Blind Method ; Aged ; }, abstract = {Agitation and abnormal motor behaviors are common, distressing symptoms of Frontotemporal Dementia (FTD). While these symptoms currently lack efficacious and safe pharmacological treatments, case reports in FTD and a clinical trial in Alzheimer's disease suggest that patients may benefit from lithium treatment. We designed a randomized, double-blind, placebo-controlled, 12-week clinical trial to evaluate low-dose lithium for the treatment of agitation and abnormal motor behaviors in FTD. However, the trial did not meet its recruitment target (n = 60). This report assesses the trial's feasibility and tolerability using recruitment, study completion, and safety metrics. Sixteen adults with FTD (median age 59.5 years; 69% female) were enrolled from 2017 to 2021. Fourteen participants (88%) completed the trial. The majority of participants on lithium were taking the maximum daily dose by Week 12 (600 mg), had median (interquartile range) final serum lithium levels of 0.42 (0.37-0.57), and reported minimal side effects, including drowsiness, diarrhea, constipation and insomnia. Preliminary data from intended efficacy outcomes showed no median pre-post changes between treatment groups. Low-dose lithium is feasible and well-tolerated in an FTD population. Further systematic study of lithium and its efficacy to treat agitation and abnormal motor behaviors in FTD is warranted.}, }
@article {pmid41235150, year = {2025}, author = {Nigdelioglu Dolanbay, S}, title = {Monoterpene-rich essential oil from Artemisia santonicum L. exerts neuroprotective effects in Aβ-induced SH-SY5Y cells: Modulation of tau pathology, neuroinflammation, oxidative stress, and synaptic-metabolic pathways.}, journal = {Toxicology research}, volume = {14}, number = {6}, pages = {tfaf155}, pmid = {41235150}, issn = {2045-452X}, abstract = {Understanding the complex biological mechanisms of ad requires innovative treatment approaches for this disease. In this context, natural compounds, especially monoterpenes, attract attention with their potential for biological activity. In this study, the therapeutic potential of monoterpene rich essential oil obtained from Artemisia santonicum L. for the treatment of ad was comprehensively evaluated. GC-MS analysis showed that the major monoterpenes were limonene, camphor, pinene, terpineol, and carvone in essential oil obtained from A. santonicum L. Possible common targets of monoterpenes with ad were predicted and their PPI networks were analyzed. Furthermore, gene set enrichment analysis was applied to understand the functional roles of these possible common targets and their relationships with biological pathways. Molecular docking studies revealed the binding affinities and interaction abilities of monoterpenes with the predicted possible common targets. The monoterpene rich essential oil obtained from A. santonicum L. used in our study provides a neuroprotective effect by targeting the pathological mechanisms of ad. We designed in vitro experiments to elucidate the mechanism of the mentioned neuroprotective effect. Within the scope of the study, neuroprotective effect analyses were performed to evaluate cell viability rates and in vitro AChE enzyme activity, while the ELISA method was used to determine phosphorylated tau levels and to assess neuroinflammatory responses. In addition, apoptosis levels, MMP changes and intracellular ROS accumulation were examined by flow cytometry analyses. These comprehensive analyses aimed to reveal the molecular mechanisms of the neuroprotective effect of monoterpene rich essential oil obtained from A. santonicum L. and to shed light on its potential therapeutic applications in ad.}, }
@article {pmid41235113, year = {2025}, author = {Zampieri, TT and Higa, GSV and Borges, FS and Viana, FJC and Cruvinel, E and Bentivoglio, LE and Lugao, AB and Ulrich, H and Britto, LR and Katti, KV and Chesne, AM and de Pasquale, R}, title = {Exposure to β-hydroxybutyrate reduces the operating set point and increases excitability in hippocampal circuitry of healthy mice.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1557612}, pmid = {41235113}, issn = {1663-9812}, abstract = {The ketogenic diet is a therapeutic strategy applied to reduce brain hyperexcitability in conditions such as epilepsy, Parkinson's and Alzheimer's disease, migraines, and autism. This diet reduces circulating glucose levels and increases ketone bodies, with β-hydroxybutyrate (BHB) being one of the leading promoters of the beneficial effects. BHB was previously reported as a mediator of cognitive restoration and memory formation. Herein, we investigate the effect of exogenous BHB on hippocampal neuronal excitability and synaptic plasticity mechanisms, regardless of the pathological or neurodegenerative conditions. Electrophysiological experiments were conducted to explore both passive and active neuronal properties, including action potential firing and spontaneous and evoked postsynaptic responses. Electrical stimulation along the CA3-CA1 pathway enabled the assessment of both short- and long-term synaptic plasticity, as well as the mechanisms mediated by AMPA and NMDA receptors. Experiments were conducted in hippocampal slices treated with 3-β-hydroxybutyrate glycerides (DHB) and niacin (HCAR2 agonist). Although DHB incubation did not alter passive membrane properties, it significantly increased neuronal excitability, reflected in an elevated firing rate upon depolarizing stimulation and enhanced spontaneous excitatory postsynaptic currents in CA1 pyramidal neurons, which were dependent on synaptic inputs. DHB treatment led to a reduction in long-term potentiation (LTP) in CA1 neurons, suggesting a metaplastic effect independent of NMDA receptor activation. Importantly, these DHB-induced neuronal alterations were found to be independent of HCAR2 receptor activation, supporting the involvement of distinct intracellular pathways and long-term modulatory mechanisms. Our findings indicate that DHB exerts a modulatory effect on hippocampal neural activity by enhancing excitability and concurrently promoting a compensatory reduction in LTP, suggesting a homeostatic balancing mechanism.}, }
@article {pmid41234939, year = {2025}, author = {Wang, R and Peng, S and Zhu, J and Xu, Y and Wang, M and Zhang, L and Qiu, Y and Hou, D and Wang, Q and Liu, R}, title = {Innovations in Alzheimer's disease diagnostic technologies: clinical prospects of novel biomarkers, multimodal integration, and non-invasive detection.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1651708}, pmid = {41234939}, issn = {1664-2295}, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the deposition of β-amyloid (Aβ) plaques and the formation of neurofibrillary tangles composed of hyperphosphorylated tau protein, ultimately leading to cognitive decline and neuronal loss. Current diagnostic methods, including clinical evaluations, neuroimaging examinations, and cerebrospinal fluid biomarker testing, face challenges such as insufficient sensitivity and specificity, as well as operational complexity. In recent years, significant advancements have been made in diagnostic technologies, with the emergence of new biomarkers and detection methods, including blood-based Aβ and tau protein detection, ocular biomarker testing, and non-invasive screening through urine or breath analysis. These innovative developments, combined with multimodal diagnostic technologies that integrate imaging, genomics, and proteomics, have opened new possibilities for the early diagnosis and precise staging of Alzheimer's disease. Furthermore, advancements in microfluidic chips and biosensor technologies have enhanced the capability for rapid, efficient, and cost-effective diagnosis. As research continues to evolve, the gradual application of these advanced technologies in clinical practice is expected to revolutionize the management of Alzheimer's disease, facilitating early intervention and the formulation of individualized treatment strategies.}, }
@article {pmid41234220, year = {2025}, author = {Fujishiro, H and Kawakami, I and Oshima, K and Torii, Y and Arafuka, S and Iritani, S and Ikeda, K}, title = {Systematized delusions in a patient with covert hepatic encephalopathy: A clinicopathological insight into prodromal dementia with Lewy bodies.}, journal = {PCN reports : psychiatry and clinical neurosciences}, volume = {4}, number = {4}, pages = {e70247}, pmid = {41234220}, issn = {2769-2558}, abstract = {BACKGROUND: Late-onset psychosis is an early clinical manifestation of psychiatric-onset prodromal dementia with Lewy bodies (DLB); however, its underlying neuropathology remains poorly understood. Clinicopathological correlations are often limited by the gap between symptom onset and the autopsy.
CASE PRESENTATION: A 66-year-old man with autopsy-confirmed DLB presented with persistent systematized delusions. After treatment for liver cirrhosis during hospitalization, the patient's physical symptoms improved; however, persecutory delusions developed. The patient was clinically diagnosed with covert hepatic encephalopathy (HE). The delusions were atypical for covert HE, suspecting delusional disorder. His systematized delusions persisted for 3 months until his death, without the development of cognitive decline or Parkinsonism during his lifetime. An autopsy revealed an early transitional type of Lewy body disease with minimal Alzheimer's type II astrocytes indicative of HE. Severe neuronal loss was observed in the locus coeruleus (LC), while the substantia nigra (SN) and nucleus basalis of Meynert (nbM) were preserved. Abundant alpha-synuclein-positive structures were identified in the LC, periaqueductal gray matter, nbM, amygdala, and thalamus, with sparse involvement of the SN, neocortex, peripheral autonomic nervous system, including the heart and gastrointestinal tract.
CONCLUSION: Selective Lewy body involvement, sparing the SN and neocortex, may explain the isolated psychiatric symptoms in the absence of Parkinsonism or dementia. Systemic conditions such as covert HE may have contributed to the emergence of persistent delusions. This case highlights the need for multidisciplinary approaches that integrate psychosomatic assessments with neuropathological investigations to evaluate late-onset psychosis.}, }
@article {pmid41233409, year = {2025}, author = {Lai, Y and Zhao, H}, title = {Therapeutic efficacy of rehmannioside A on 5×FAD mice in Alzheimer's disease.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {39825}, pmid = {41233409}, issn = {2045-2322}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism ; Mice ; Oxidative Stress/drug effects ; Disease Models, Animal ; *Neuroprotective Agents/pharmacology/therapeutic use ; Hippocampus/drug effects/metabolism/pathology ; Male ; *Saponins/pharmacology/therapeutic use ; Amyloid beta-Peptides/metabolism ; Memory/drug effects ; Mice, Transgenic ; Plaque, Amyloid/drug therapy/pathology ; Drugs, Chinese Herbal ; }, abstract = {Alzheimer's disease (AD), characterized by Aβ plaques and cognitive decline, remains a significant therapeutic challenge due to limited efficacy of current pharmacotherapies, while Rehmannioside A (ReA) has shown promising neuroprotective effects against neurodegenerative diseases. This research focuses on investigating the therapeutic effects of ReA on 5×FAD mice, emphasizing its potential application in AD treatment. The 5×FAD mice were divided into experimental groups and treated with ReA at varied dosages or donepezil for a twelve-week continuous treatment period. A series of evaluation methods, including behavioral tests, histopathological analysis, Western blotting, and measurement of oxidative and inflammatory markers, were implemented. The findings demonstrated that optimal ReA doses significantly improved learning, memory, and cognitive functions in 5×FAD mice, reduced Aβ plaque accumulation in the hippocampus, decreased microglial cell counts, increased PSD 95 and synapsin-1 protein expression, mitigated oxidative stress and inflammation, and showed no harmful effects on liver or kidney function. ReA's diverse biological activities suggest its potential in reducing neural damage. More extensive studies are needed to fully understand its molecular mechanisms in AD, which could lead to the development of innovative and effective treatments for this severe neurodegenerative condition.}, }
@article {pmid41233403, year = {2025}, author = {Kovač, V and Huntosova, V and Fedorova, V and Georgiou, N and Lai, JZ and Chien, FC and Chen, SJ and Dolenec, F and Siposova, K}, title = {Unraveling the structure-activity relationships of organometallic ferrocene-pyrazole and ferrocene-pyrimidine curcumin analogues in amyloid-β aggregation and glioblastoma treatment.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {39867}, pmid = {41233403}, issn = {2045-2322}, support = {HRZZ-IP-2020-02-9162//Hrvatska Zaklada za Znanost/ ; No. 09-I02-03-V01-00021//NextGenerationEU/ ; SAS-NSTC-JRP-2024-03_SUPRA-SIGHT//Slovenská Akadémia Vied/ ; 2/0034/22//Vedecká Grantová Agentúra MŠVVaŠ SR a SAV/ ; No.101007642; PhytoApp//European Union's Horizon 2020 Research and Innovation programme/ ; }, mesh = {Humans ; *Ferrous Compounds/chemistry/pharmacology ; *Glioblastoma/drug therapy/metabolism/pathology ; *Metallocenes/chemistry/pharmacology ; *Curcumin/pharmacology/chemistry/analogs & derivatives ; *Amyloid beta-Peptides/metabolism/chemistry ; *Pyrazoles/chemistry/pharmacology ; *Pyrimidines/chemistry/pharmacology ; Structure-Activity Relationship ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Apoptosis/drug effects ; Protein Aggregates/drug effects ; Cell Survival/drug effects ; *Protein Aggregation, Pathological/drug therapy/metabolism ; }, abstract = {Neurodegenerative and oncological disorders, such as Alzheimer's disease (AD) and glioblastoma (GBM), are major global health challenges. Recent evidence indicates shared molecular mechanisms between these diseases, including dysregulated oxidative stress, mitochondrial dysfunction, and protein aggregation. We hypothesized that ferrocene-containing curcumin derivatives could exert dual-functional effects by simultaneously modulating amyloid-β (Aβ) aggregation and inhibiting glioblastoma cell proliferation. This study explores organometallic ferrocene compounds linked to four pyrazole and two pyrimidine analogues of curcumin with different substituents for their effects on amyloid-β-peptide (Aβ) aggregation and glioblastoma. To test this, pyrazole (FcPy-Cur-H, FcPy-Cur-COPh, FcPy-Cur-COFc, FcPy-Cur-Me) and pyrimidine (FcPyn-Cur-O, FcPyn-Cur-S) analogues were synthesized and evaluated. Thioflavin T fluorescence, atomic force microscopy, and single-molecule localization microscopy revealed structure-dependent inhibition of Aβ fibrillogenesis, with FcPyn-Cur-O, FcPyn-Cur-S, and FcPy-Cur-H showing the strongest anti-amyloidogenic activity. Concurrently, these derivatives reduced U87MG glioblastoma cell viability in a dose-dependent manner, inducing apoptotic features, mitochondrial disruption, and α-tubulin destabilization. Our results demonstrate that specific structural modifications of ferrocene-curcumin analogues enhance their dual anti-amyloidogenic and anticancer activities, highlighting the therapeutic potential of multifunctional compounds. This study provides a conceptual advance by combining neurodegenerative and oncological targets within a single chemical framework, offering a promising strategy for the development of multitargeted therapeutics for complex brain disorders.}, }
@article {pmid41233387, year = {2025}, author = {Park, JS and Kim, S and Jeong, D and Choi, JP and Jeong, H and Park, AJ and Kim, YS and Lee, J and Kim, SH}, title = {Dementia in older adults with schizophrenia: a 12-year analysis of prevalence, incidence, and treatment patterns in South Korea.}, journal = {Schizophrenia (Heidelberg, Germany)}, volume = {11}, number = {1}, pages = {134}, pmid = {41233387}, issn = {2754-6993}, abstract = {Older adults with schizophrenia face a significantly elevated risk of dementia. However, recent trends remain unclear within South Korea's rapidly aging schizophrenia population. This study aimed to quantify the burden of dementia in older schizophrenia patients by examining prevalence, incidence, dementia subtypes, pharmacologic treatment, and healthcare utilization. Using nationwide Health Insurance Review and Assessment (HIRA) data from 2010 to 2021, we identified 220,378 individuals aged ≥50 with schizophrenia. Dementia was diagnosed in 14.6% of patients, with 20.7% of cases occurring before age 60. Patients with dementia were more likely to be female and to have a higher comorbidity burden. Age-standardized all-cause dementia prevalence rose from 11.8% (2010) to 15.8% (2021) in those aged ≥50, and from 24.2% to 32.8% in those aged ≥65-exceeding estimates in the general population. In contrast, incidence declined from 3.4% to 1.7% over the same period. Alzheimer's disease (AD) was the most prevalent subtype (12.2%), followed by vascular dementia (VD, 2.4%), and frontotemporal dementia (0.5%). A lower AD/VD prevalence ratio in schizophrenia (5.3 vs. 8.6 in the general population) suggests a relatively higher burden of vascular pathology. Cognitive enhancer prescriptions increased from 62% to 77% in patients with dementia, compared to 4% to 10% in those without dementia. In 2021, those with dementia were more likely to live in nursing homes (68% vs. 56%) and had greater annual increases in psychiatric hospitalization duration (+2.30 vs. +1.11 days/year). These findings underscore growing care demands and need for integrated treatment strategies for aging schizophrenia patients with dementia.}, }
@article {pmid41233182, year = {2025}, author = {Nakayama, H}, title = {[Brain Pathology of Cognitive Dysfunction in Aged Non-human Animals].}, journal = {Brain and nerve = Shinkei kenkyu no shinpo}, volume = {77}, number = {11}, pages = {1241-1247}, doi = {10.11477/mf.188160960770111241}, pmid = {41233182}, issn = {1881-6096}, mesh = {Animals ; *Cognitive Dysfunction/pathology ; *Brain/pathology/metabolism ; *Aging/pathology ; Humans ; Alzheimer Disease/pathology ; Cats ; Amyloid beta-Peptides/metabolism ; }, abstract = {Cognitive dysfunction, characterized by the deposition of amyloid β (Aβ), such as senile plaque (SP) and cerebral amyloid angiopathy (CAA), and phosphorylated tau are observed in several animal species, including primates, dogs, and cats, suggesting that these disorders are universal age-related phenomena in vertebrates. Additionally, argyrophilic neurofibrillary tangles positive for phosphorylated tau have been observed in primates, marine mammals, and felines. Recent findings regarding the pathology of cognitive dysfunction in aged non-human animals provide valuable information from a comparative perspective for advancing research on the pathogenesis, diagnosis, and treatment of Alzheimer's disease.}, }
@article {pmid41233181, year = {2025}, author = {Yoshiyama, K}, title = {[Agitation].}, journal = {Brain and nerve = Shinkei kenkyu no shinpo}, volume = {77}, number = {11}, pages = {1231-1240}, doi = {10.11477/mf.188160960770111231}, pmid = {41233181}, issn = {1881-6096}, mesh = {Humans ; *Dementia/therapy/complications ; *Psychomotor Agitation/therapy/etiology ; }, abstract = {Agitation is a behavioral and psychological symptom of dementia (BPSD); however, until recently, there has been no consensus-based definition. When initiating therapeutic interventions, the type of dementia that is the cause of the BPSD must be considered and treatment must be tailored accordingly. As with other types of BPSD, non-pharmacological interventions are considered the first-line treatment for agitation, unless the symptoms present an exceptional level of urgency. Person-centered care is effective as a non-pharmacological intervention for agitation. Other examples include music therapy, animal-assisted therapy, and aromatherapy; however, these are not very effective for agitation. Useful information on non-pharmacological interventions for agitation can be obtained from the website "Ninchisho Chienowa-net," which is a web-based system that collects information on the coping strategies of caregivers for BPSD. If non-pharmacological interventions are ineffective or the symptoms are urgent, pharmacological treatment should be considered. Brexpiprazole has been approved as effective for agitation in Alzheimer's disease. For the treatment of agitation, medications other than brexpiprazole are frequently used in clinical settings and may offer some degree of efficacy.}, }
@article {pmid41232717, year = {2025}, author = {Castellano Candalija, A and Díez Porres, L and Notario Leo, H and Roca Martiartu, A and Mayoral Canalejas, N and Alonso Babarro, A}, title = {Prevalence and decision-making in advanced dementia.}, journal = {Revista clinica espanola}, volume = {225}, number = {10}, pages = {502388}, doi = {10.1016/j.rceng.2025.502388}, pmid = {41232717}, issn = {2254-8874}, mesh = {Humans ; Female ; Aged, 80 and over ; Male ; Retrospective Studies ; Prevalence ; *Dementia/epidemiology/therapy/diagnosis ; *Decision Making ; *Clinical Decision-Making ; Aged ; Hospitalization/statistics & numerical data ; }, abstract = {INTRODUCTION: Dementia is a chronic neurodegenerative disease with a high prevalence and economic cost. Our objective was to evaluate the prevalence of advanced dementia (AD) in patients hospitalized in the Internal Medicine service; to analyze the therapeutic and diagnostic measures implemented, the degree of adequacy of the therapeutic effort and the information of the family.
METHODOLOGY: Descriptive study that included a retrospective analysis of medical records and a telephone interview with family. Patients with GDS 6-7 dementia admitted to Internal Medicine were included, for 3 weeks in 3 different months.
RESULTS: 194 (22%) patients with dementia were included. The prevalence of admissions with AD was 11%. The median age was 87.5 years (QR 81.75-93), 65% women. 45% came from residence for the elderly. The most frequent etiology was Alzheimer's (48%). The most frequent cause of admission was infection (72%). 37% died. Regarding the measures implemented: 100% were treatment intravenous; 89% received anticoagulation; 26% received artificial nutrition; 81% received pharmacological restraint and 63% physical restraint; and 48% underwent invasive diagnostic tests. Regarding adequacy: lipid-lowering treatment was withdrawn in 19%, antidementia drugs in 23%, anticoagulation in 21%; cardiopulmonary resuscitation was not performed in 30%, adequacy of care in 34%, and 13% were assessed by Palliative Care. A telephone interview was conducted with 55 patients. 42% were not aware of any complications. Care planning was carried out in 2 patients.
CONCLUSIONS: The prevalence of admission to AD is high, and almost half of the patients come from residence for the elderly. Associated mortality is high and therapeutic adequacy and planning are very scarce.}, }
@article {pmid41232709, year = {2025}, author = {Zhou, W and Qu, R and Luo, W and Zhang, H and Gong, L and , }, title = {Identification of cognitive brain diseases using a dual-branch siamese network on structural magnetic resonance imaging data.}, journal = {Neuroscience}, volume = {591}, number = {}, pages = {83-92}, doi = {10.1016/j.neuroscience.2025.11.011}, pmid = {41232709}, issn = {1873-7544}, mesh = {Humans ; *Magnetic Resonance Imaging/methods ; *Alzheimer Disease/diagnostic imaging ; Aged ; *Cognitive Dysfunction/diagnostic imaging ; Male ; Female ; *Brain/diagnostic imaging/pathology ; *Neural Networks, Computer ; *Neuroimaging/methods ; Aged, 80 and over ; }, abstract = {Early diagnosis of Alzheimer's Disease is crucial for optimizing treatment efficacy, as delayed detection often limits therapeutic outcomes. Traditional diagnostic approaches, such as cognitive assessments, PET scans, and lumbar punctures, are often invasive, costly, and less accessible. To address these limitations, we propose a Dual-Branch Siamese Network aimed at enhancing the classification accuracy of Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Normal individuals using structural MRI data. Our model integrates neuroimaging features from both Subcortical Segmentation and Cortical Parcellation, leveraging their complementary strengths to improve diagnostic precision. Experimental evaluations demonstrate that our model achieves a classification accuracy of 93% on the original dataset. To further validate the model's generalizability, we tested the trained model on a separate independent test set from the new ADNI4 database (N=191). On this independent cohort, the model achieved a robust classification accuracy of 88.48%, demonstrating its potential for real-world application. Additionally, by implementing network pruning, we reduced the model's complexity by 60% without sacrificing accuracy, thereby enhancing its feasibility for clinical use. Compared to other methods, such as convolutional neural networks and ensemble learning systems, our model demonstrates superior accuracy in multi-class classification and remains competitive in binary classification tasks. Notably, our pruned model balances accuracy with efficiency, outperforming other models in terms of computational feasibility without compromising diagnostic precision. These findings highlight the potential of our approach to facilitate early diagnosis and intervention for neurodegenerative diseases like Alzheimer's Disease.}, }
@article {pmid41232397, year = {2025}, author = {Zuo, Y and Ding, X and Sun, Y and Wang, L and Song, Y and Zhao, Z and Liu, C}, title = {Critical nodes in precision diagnosis and treatment of Alzheimer's disease: exploration of multidimensional biomarkers and prospects for targeted intervention.}, journal = {Journal of the neurological sciences}, volume = {479}, number = {}, pages = {123734}, doi = {10.1016/j.jns.2025.123734}, pmid = {41232397}, issn = {1878-5883}, mesh = {Humans ; *Alzheimer Disease/diagnosis/therapy/metabolism ; Biomarkers/metabolism ; *Precision Medicine/methods ; tau Proteins/metabolism ; }, abstract = {Alzheimer' s disease (AD), characterized by cognitive decline and progressive neurodegeneration, remains a major clinical and scientific challenge due to its complex pathophysiology and marked heterogeneity. Important signs of the disease, like the buildup of β-amyloid, changes in Tau proteins, inflammation in the brain, and problems with mitochondria, form the basis for developing targeted treatments. This review summarizes recent advances in the identification of therapeutic targets and multi-dimensional biomarkers, such as liquid, imaging, and multi-omics-based markers. These biomarkers hold potential for early diagnosis, disease subtyping, and therapeutic response monitoring. We suggest that combining biomarkers and treatment targets could be a key approach to improving personalized care for AD.}, }
@article {pmid41232357, year = {2025}, author = {Castillo-Moral, Á and Tchoumtchoua, J and Leonard, K and Del Bas, JM and Ortega, N and Escoté, X and Teichenné, J}, title = {Neuroprotective effects of polyphenol-rich extracts obtained from agricultural by-products in an induced cognitive decline model of zebrafish larvae and in human neurons.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {193}, number = {}, pages = {118776}, doi = {10.1016/j.biopha.2025.118776}, pmid = {41232357}, issn = {1950-6007}, mesh = {Animals ; Zebrafish ; Humans ; *Neuroprotective Agents/pharmacology/isolation & purification ; *Polyphenols/pharmacology/isolation & purification ; *Plant Extracts/pharmacology/isolation & purification ; Larva/drug effects ; *Neurons/drug effects/metabolism/pathology ; *Cognitive Dysfunction/drug therapy/chemically induced/prevention & control ; Disease Models, Animal ; Cell Line, Tumor ; Aluminum Chloride ; }, abstract = {Neurodegenerative diseases are closely associated with chronic neuroinflammation and oxidative stress, which contribute to progressive neuronal dysfunction and cell death. Due to their antioxidant and anti-inflammatory properties, polyphenols have gained attention as potential neuroprotective agents. Agricultural by-products represent a promising and sustainable source of polyphenols, yet their neuroprotective value remains underexplored. In this study, we evaluated four polyphenol-rich extracts derived from red onion peels (ROPE), olive pruning (OPE), vineyard pruning (VPE) and chicory leaves (CLE), obtained by subcritical water extraction. Their effects were tested in two complementary models of neurodegeneration: in vitro human neurons (SH-SY5Y cells) exposed to D-galactose and a basic cognitive decline model of zebrafish larvae exposed to aluminium chloride (AlCl3). All extracts exhibited anti-inflammatory effects in vitro, significantly reducing IL-1β and IL-8 mRNA expression, at doses ranging 12.5-50 μg/mL in cell medium. In the zebrafish model, treatment with 100 μg/mL ROPE or VPE in medium restored the normal sensorimotor pattern in the Dark-Light-Dark test, while ROPE treatment additionally rescued basal startle responses and enhanced habituation indexes, even surpassing healthy control larvae. Overall, these results highlight the potential of polyphenol-rich agri-food extracts, particularly ROPE, as neuroprotective and cognitive-enhancing compounds and support their further investigation as natural and sustainable interventions to slow or prevent neurodegenerative processes.}, }
@article {pmid41230868, year = {2025}, author = {Cavagnero, PS and Sánchez, Y and Fell, B and Ramírez Molina, O and Gavilán, J and Polo, EA and Fuentealba, J and Gutierrez, M and Jiménez, CA and López, JJ}, title = {Neuroprotective Activity of 3-((6-(Phenylethynyl)pyridin-3-yl)oxy)quinuclidine: A Potential Ligand for the Treatment of Alzheimer's Disease.}, journal = {ACS chemical neuroscience}, volume = {16}, number = {23}, pages = {4502-4510}, pmid = {41230868}, issn = {1948-7193}, mesh = {*Neuroprotective Agents/pharmacology ; Animals ; *Alzheimer Disease/drug therapy/metabolism ; *Quinuclidines/pharmacology/chemistry ; Rats ; PC12 Cells ; Amyloid beta-Peptides/metabolism ; Cell Survival/drug effects ; Ligands ; alpha7 Nicotinic Acetylcholine Receptor/metabolism ; Peptide Fragments ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder marked by the accumulation of β-amyloid (Aβ) peptides, which disrupt neuronal homeostasis through their neurotoxic effects. Aβ aggregates interfere with synaptic function by interacting with nicotinic acetylcholine receptors (nAChRs), particularly the α7 subtype, thereby impairing cholinergic signaling, which is crucial for cognition and memory. Pharmacological advancements have identified Positive Allosteric Modulators (PAMs) as promising therapeutic agents to counteract Aβ neurotoxicity. PAMs enhance nAChR activity by binding to allosteric sites, thereby reducing Aβ-induced neurotoxicity without competing with acetylcholine. This study evaluates 3-((6-(phenylethynyl)pyridine-3-yl)oxy)quinuclidine (EQ-04), a novel PAM with high selectivity for the α7 nAChR subtype, demonstrating neuroprotective potential. In vitro analyses using PC-12 cells evaluated the cytotoxic and neuroprotective properties of EQ-04. Cytotoxicity assays confirmed EQ-04's safety, showing no adverse effects on cell viability across concentrations. EQ-04 significantly enhanced cell viability by 37% at 1 nM against Aβ toxicity and inhibited Aβ aggregation. These findings highlight the potential of EQ-04 as a neuroprotective agent for Alzheimer's disease (AD) therapy, warranting further investigation into its pharmacokinetics and in vivo efficacy.}, }
@article {pmid41230514, year = {2025}, author = {Wang, X and Liu, Y and Fan, S and Zhao, H and Sun, C and Liu, L and Wang, X and Zou, L}, title = {Combined 64-channel EEG and PET evaluation of lecanemab efficacy: Two case reports.}, journal = {Journal of Alzheimer's disease reports}, volume = {9}, number = {}, pages = {25424823251395615}, pmid = {41230514}, issn = {2542-4823}, abstract = {Lecanemab, an anti-amyloid-β (Aβ) monoclonal antibody, has shown potential in slowing Alzheimer's disease (AD) progression. We report divergent responses in two AD patients with similar backgrounds following lecanemab treatment. Subject 1 showed worsened daily functioning, increased Aβ/tau deposition, and elevated electroencephalogram (EEG) slow/fast wave ratios (>30%) in right fronto-occipital regions (Fp2/F8/O1). Subject 2 improved cognitively, with modest Aβ reduction, marked tau suppression, and mixed EEG frontal declines (F3/F7/O1/Pz) and parietal/occipital gains (P3/P4/T3/T6). EEG alterations corresponded with positron emission tomography findings, suggesting its potential for therapeutic monitoring. Multimodal analysis revealed region-specific lecanemab effects, supporting EEG's role in evaluating treatment efficacy.}, }
@article {pmid41230033, year = {2025}, author = {Oviedo, DC and Haughbrook, R and Culjat, C and Ramirez Surmeier, L and Tratner, AE and Carreira, MB and Villarreal, AE and Harmon, SL and Batista, OI and Meng, Z and Millender, E and Xavier Hall, CD and Britton, GB}, title = {Ethical disclosure of biomarkers for Alzheimer risk in Latin American participants.}, journal = {Frontiers in dementia}, volume = {4}, number = {}, pages = {1672075}, pmid = {41230033}, issn = {2813-3919}, abstract = {INTRODUCTION: In recent years, the disclosure of Alzheimer's disease (AD) biomarkers has become increasingly common, offering critical insights into disease risk and progression. However, in low-resource settings, where healthcare access, provider training, and patient support are often limited, disclosing AD biomarkers presents unique ethical, logistical, and psychological challenges.
OBJECTIVE: This perspective explores the implications of AD biomarker disclosure in these settings, highlighting the potential risks of patient distress, misinformation, and inadequate follow-up care. For this purpose, we conducted a review of available literature, peer-reviewed studies, regional reports, and policy documents addressing AD in Latin America. Our literature search prioritized diagnostic advances, biomarker disclosure, treatment access, and health system challenges, providing a focused evidence base to frame the discussion of regional gaps and opportunities.
DISCUSSION: We discuss strategies to support responsible disclosure practices, including culturally sensitive participant education, enhanced provider training, and policy adaptations to improve accessibility and support systems. Ultimately, we advocate for a careful, context-specific approach to AD biomarker disclosure that prioritizes patient well-being and equity in low-resource environments.}, }
@article {pmid41229208, year = {2025}, author = {Bosire, EN and Kamau, LW and Kiio, C and Blackmon, K and Taylor, ON and Shah, J and Sokhi, D and Mbugua, S and Meier, I and Hooker, J and Narayan, V and Merali, Z and Udeh-Momoh, C}, title = {Community perceptions and willingness to donate biospecimen for Alzheimer's disease research in Nairobi, Kenya.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {108}, number = {4}, pages = {1537-1548}, doi = {10.1177/13872877251389227}, pmid = {41229208}, issn = {1875-8908}, mesh = {Humans ; Kenya ; Female ; Male ; *Alzheimer Disease/psychology/diagnosis ; Middle Aged ; Focus Groups ; Aged ; Adult ; *Biomedical Research ; *Perception ; Biological Specimen Banks ; Aged, 80 and over ; *Tissue Donors/psychology ; *Health Knowledge, Attitudes, Practice ; }, abstract = {BackgroundBiomarkers play a critical role in understanding disease mechanisms and advancing diagnostic and treatment options for Alzheimer's disease and related dementias (AD/ADRD). However, in many African countries, biomarker research is limited by insufficient knowledge, infrastructure, funding, and trained personnel.ObjectiveThis study explored community perceptions and willingness to donate biospecimens for AD/ADRD research in Kenya.MethodsEight focus group discussions were conducted in the informal settlements of Mathare and Kibera in Nairobi, Kenya, stratified by age and gender (n = 81). Data were transcribed verbatim and thematically analyzed using QSR Nvivo 14.ResultsParticipants generally expressed a positive attitude toward brain health research and donating biospecimens. Willingness to participate was influenced by altruism, perceived benefits, and improved understanding of AD/ADRD. Non-invasive samples such as saliva, blood, and stool were widely accepted due to perceptions of safety and familiarity. However, several barriers were identified, including cultural beliefs (e.g., fear of witchcraft linked to donating hair), religious beliefs, fear of invasive procedures (spinal taps), and low awareness about biospecimen research. To address these barriers, participants recommended community sensitization, inclusive and transparent research processes, clear communication of benefits, involvement of family members in consenting, and assurance of safety measures for managing potential risks.ConclusionsCommunity willingness to donate biospecimens for AD/ADRD research in Kenya is shaped by a complex interplay of cultural, ethical, and practical considerations. Culturally sensitive, community-driven approaches are essential to enhance participation in AD/ADRD biomarker research in Kenya and similar low-resource settings.}, }
@article {pmid41229078, year = {2025}, author = {Zhang, N and Liu, Y and Guan, Y}, title = {Piceatannol ameliorates the memory ability and cognitive behavior in Alzheimer's disease mice.}, journal = {Neurological research}, volume = {}, number = {}, pages = {1-10}, doi = {10.1080/01616412.2025.2581245}, pmid = {41229078}, issn = {1743-1328}, abstract = {OBJECTIVE: To investigate the effects of different doses of Piceatannol (PIC) on oxidative stress and cognitive function in a mouse model of Alzheimer's disease (AD).
METHODS: Firstly, a mouse model was established by inducing 70 days with D-gal and AlCl3. Sixty male mice are randomly divided into a normal control group (Control), an AD group (AD Model), positive control group (treated with donepezil), an AD model+low-dose group (PIC-L) receiving low-dose piceatannol treatment, an AD model+medium-dose group (PIC-M) receiving medium-dose piceatannol treatment, and an AD model+high-dose group (PIC-H) receiving high-dose piceatannol treatment, with 10 mice in each group. After 35 days of establishing an AD mouse model, different doses of piceatannol are continuously applied for treatment.
RESULTS: After 2 days of treatment, the AD Model had a longer escape latency than the Control. The escape latency time of PIC-L, PIC-M, and PIC-H was below AD Model, (p < 0.05). After treatment for 4d and 5d, the escape latency time of PIC-L, PIC-M, and PIC-H was below the AD Model, and the PIC-H group was even lower, with statistical significance (p < 0.05). PIC-L, PIC-M, and PIC-H crossed the platform more frequently than the AD Model, (p < 0.05). The SOD and GSH-Px levels in AD Model were below the Control, (p < 0.05). The MDA of AD Model exceeded the Control, (p < 0.05). The SOD, and GSH-Px in PIC-L, PIC-M, PIC-H exceeded the AD Model, (p < 0.05).
CONCLUSION: PIC significantly improved memory and cognition in AD mice, elevated serum SOD and GSH-Px, lowered MDA, and attenuated oxidative tissue injury with minimal organ toxicity.}, }
@article {pmid41228597, year = {2025}, author = {Gomes, ACC and Almeida, A and Freire, CSR and Ferreira, BL}, title = {Chitosan (Nano)formulations as Therapeutic Tools for Neurodegenerative Diseases: A Comprehensive Review.}, journal = {Polymers}, volume = {17}, number = {21}, pages = {}, pmid = {41228597}, issn = {2073-4360}, support = {UIDB/50011/2020 (DOI 10.54499/UIDB/50011/2020)//FCT/MCTES (PIDDAC)/ ; UIDP/50011/2020 (DOI 10.54499/UIDP/50011/2020)//FCT/MCTES (PIDDAC)/ ; LA/P/0006/2020 (DOI 10.54499/LA/P/0006/2020)//FCT/MCTES (PIDDAC)/ ; (UIDP/50017/2020+UIDB/50017/2020+LA/P/0094/2020)//FCT/MCTES (PIDDAC)/ ; 2022.10449.BD (https://doi.org/10.54499/2022.10449.BD)//Fundação para a Ciência e Tecnologia/ ; DOI 10.54499/ND/00464/2017/CP1459/CT0033//Fundação para a Ciência e Tecnologia/ ; DOI: 10.54499/DL57/2016/CP1482/CT0019//National funds (OE), through FCT/ ; }, abstract = {According to the World Health Organization, Alzheimer's disease and other forms of dementia were the seventh leading cause of death in 2021. The prevalence of these disorders is predictable to increase with life expectancy, and their control is hampered by several factors, including late diagnosis due to the lack of specific biomarkers and the absence of disease-modifying treatments, as currently available therapies can only lighten some of the symptoms. Nanotechnology could be the key to overcoming some of the limitations associated with neurodegenerative diseases, as nanomaterials have excellent properties compared to their bulk counterparts and can be used as drug delivery systems, diagnostic tools and platforms for tissue regeneration. Chitosan is a biopolymer with numerous properties that impart it with great potential for biomedical applications, in particular its ability to cross the blood-brain barrier and its versatility in nanoscale design. In this context, the aim of this review is to provide an in-depth analysis of the latest developments and future opportunities for chitosan (nano)formulations for the treatment and management of neurodegenerative diseases.}, }
@article {pmid41228523, year = {2025}, author = {Liu, Y and Dong, Y and Cao, Z and Ji, Y and Cheng, X and Zheng, X}, title = {The Multi-Dimensional Action Map of Resveratrol Against Alzheimer's Disease: Mechanism Integration and Treatment Strategy Optimization.}, journal = {Nutrients}, volume = {17}, number = {21}, pages = {}, pmid = {41228523}, issn = {2072-6643}, support = {//the Youth Talent Cultivation Fund Project of Dalian Medical University./ ; }, mesh = {*Resveratrol/pharmacology/therapeutic use ; *Alzheimer Disease/drug therapy/metabolism ; Humans ; Oxidative Stress/drug effects ; *Antioxidants/pharmacology/therapeutic use ; *Neuroprotective Agents/pharmacology/therapeutic use ; Animals ; Plaque, Amyloid/drug therapy ; Energy Metabolism/drug effects ; Mitochondria/drug effects/metabolism ; Neurofibrillary Tangles/drug effects/metabolism ; }, abstract = {Alzheimer's disease (AD) represents a prevalent neurodegenerative disorder marked by a gradual decline in cognitive and behavioral functions. Despite advancements in elucidating several potential mechanisms underlying the pathogenesis of AD, there remains a limitation in effective supplements or medications for its intervention. Resveratrol, a natural antioxidant, has emerged as a significant player in the treatment of AD. This article reviews the role of resveratrol in four key aspects: amyloid plaque deposition and neurofibrillary tangles, inflammatory response and oxidative stress, energy metabolism and mitochondrial homeostasis, and neuroprotection and regeneration. Furthermore, we also explore treatment strategies to enhance the therapeutic effect of resveratrol.}, }
@article {pmid41228437, year = {2025}, author = {Kim, G and Lee, HG and Kwon, S}, title = {Current Utilization and Research Status of the Herbal Medicine Guibi-Tang and Its Variants for Cognitive Impairment: A Scoping Review.}, journal = {Nutrients}, volume = {17}, number = {21}, pages = {}, pmid = {41228437}, issn = {2072-6643}, support = {RS-2022-KH127675//Korea Health Industry Development Institute/Republic of Korea ; }, mesh = {Aged ; Humans ; Middle Aged ; Cognition/drug effects ; *Cognitive Dysfunction/drug therapy ; *Drugs, Chinese Herbal/therapeutic use/adverse effects ; }, abstract = {Background/Objectives: Guibi-tang (GBT) and its variant Kami-guibi-tang (KGBT) are traditional East Asian multi-herb formulas prescribed for memory loss, insomnia, and fatigue. Preclinical data suggest multimodal neuroprotective actions, including cholinergic signaling modulation and activation of the cAMP response element-binding protein (CREB)/extracellular signal-regulated kinase (ERK) pathway; however, clinical evidence for cognitive disorders remains scattered. This scoping review aimed to map the breadth, design characteristics, efficacy signals, and safety profile of GBT and KGBT across the full spectrum of cognitive impairment. Methods: Following the Arksey-O'Malley framework and PRISMA-ScR guidelines, seven databases were searched (MEDLINE, Embase, Cochrane Library, China National Knowledge Infrastructure, ScienceON, Scopus, Citation Information by the National Institute of Informatics) from inception to 31 January 2025, for human studies evaluating GBT or KGBT in subjective cognitive decline, mild cognitive impairment (MCI), dementia, or post-stroke cognitive impairment (PSCI). Two reviewers independently screened, extracted, and charted data on study design, participants, interventions, outcomes, and adverse events. Results: Fifteen studies met the inclusion criteria-nine randomized controlled trials, one crossover trial, and five observational reports-enrolling 555 participants (age range, 59-87 years). All were conducted in the Republic of Korea, Japan, or China. GBT or KGBT, given as monotherapy or adjunctive therapy for 4 weeks to 9 months, produced modest but consistent improvements in global cognition (Mini-Mental State Examination/Montreal Cognitive Assessment), memory domains, activities of daily living, and neuropsychiatric symptoms across MCI, Alzheimer's disease, and PSCI cohorts. Reported adverse event rates were comparable to or lower than those of placebo, usual care, or conventional drugs, and no serious treatment-related toxicity was identified. Conclusions: Current evidence-although limited by small sample sizes, heterogeneous formulations, short follow-up durations, and regional concentration-indicates that GBT and KGBT are well tolerated and confer clinically meaningful cognitive and functional benefits. Standardized, multicenter, placebo-controlled trials with biomarker end points are warranted to confirm long-term efficacy, clarify mechanisms, and guide integrative clinical use.}, }
@article {pmid41227390, year = {2025}, author = {Habib, SA and Kamal, MM and Aly, MH and Ghaiad, HR and Rizk, SM and Banks, WA and Erickson, MA}, title = {Streptozotocin Causes Blood-Brain Barrier and Astrocytic Dysfunction In Vitro.}, journal = {Cells}, volume = {14}, number = {21}, pages = {}, pmid = {41227390}, issn = {2073-4409}, support = {ACOS Research Fund//VA Puget Sound Health Care System/ ; Graduate Scholarship//United States Agency for International Development/ ; }, mesh = {*Blood-Brain Barrier/drug effects/pathology/metabolism ; *Astrocytes/drug effects/pathology/metabolism ; Humans ; *Streptozocin/pharmacology/toxicity ; Endothelial Cells/drug effects/metabolism/pathology ; Induced Pluripotent Stem Cells/drug effects/metabolism ; Glucose Transporter Type 1/metabolism ; Cells, Cultured ; }, abstract = {Streptozotocin (STZ) is an alkylating agent that has neurotoxic effects when injected into the cerebral ventricles (ICV) and also models many other features of Alzheimer's disease. However, the mechanisms of STZ neurotoxicity are not well understood. In this study, we hypothesized that some of the neurotoxic effects of STZ could be due to direct activities on brain endothelial cells and astrocytes, which are key in forming and supporting the functions of the blood-brain barrier (BBB), respectively. To test this hypothesis, we characterized the changes induced by STZ either in cultures of human-induced pluripotent stem cell (iPSC)-derived brain endothelial-like cells (iBECs), which form an in vitro BBB model, or in primary human astrocytes. We found that STZ at a dosage of 5 mM caused a delayed reduction in the transendothelial electrical resistance (TEER) of iBECs at 7-11 days post-treatment, indicating induction of BBB leakage. Additionally, we observed significant increases in albumin leakage across the monolayer, altered iBEC morphology, and reductions in tight junction proteins, suggesting that STZ causes BBB disruption. We further found that the BBB glucose transporter GLUT-1 was reduced in iBECs, as was the total number of iBECs. In astrocytes, the 5 mM dose of STZ reduced the GFAP signal and total number of cells, suggesting that STZ has anti-proliferative and/or toxic effects on astrocytes. Together, these data support that STZ's neurotoxic effects could be due, in part, to its direct toxic activities on brain endothelial cells and astrocytes.}, }
@article {pmid41226838, year = {2025}, author = {Zhao, Y and Wang, Z and Xi, E and Yang, F and Gao, N}, title = {Hydrophobic Drug Delivery Platforms Based on Covalent Organic Frameworks for Combined Treatment of Alzheimer's Disease.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226838}, issn = {1422-0067}, support = {2022YFB3805902//the National Key R&D Program of China/ ; 22077118//National Natural Science Foundation of China/ ; B18012//the "111" project/ ; 20210101353JC//the National Natural Science Foundation of Jilin Province/ ; }, mesh = {*Alzheimer Disease/drug therapy ; Animals ; *Curcumin/chemistry/administration & dosage/pharmacology/therapeutic use ; Hydrophobic and Hydrophilic Interactions ; Mice ; *Drug Delivery Systems/methods ; *Metal-Organic Frameworks/chemistry ; *Drug Carriers/chemistry ; Humans ; Disease Models, Animal ; }, abstract = {Alzheimer's disease (AD) is a complex neurodegenerative disease. The pathogenesis of AD remains incompletely understood. It is characterized by a variety of neuropathological changes, including neuroinflammation, neuronal loss and synaptic damage. Multiple pathological changes make achieving good therapeutic effects with a single drug treatment difficult, and using multiple drugs for combination therapy is currently the most effective method. Currently, the mainstay drugs used for AD treatment are hydrophobic drugs, such as curcumin, donepezil, and resveratrol. Because hydrophobic drugs cannot dissolve in bodily fluids and often aggregate or precipitate, their efficacy is greatly reduced. Therefore, there is an urgent need for a drug carrier that can effectively load and continuously release drugs. However, currently, there are few drug carriers that can achieve efficient co-loading of multiple hydrophobic drugs. Therefore, three of two-dimensional imine covalent organic frameworks (COFs) with different monomers were synthesized through rational design and screening. These three synthesized COFs are simultaneously loaded with curcumin (CUR) and benzofurazan (BZ) to achieve combined therapy. The results indicate that among this series of synthesized COFs, the COF synthesized from 4,4',4″-(1,3,5-Triazine-2,4,6-triyl) trianiline and benzene-1,3,5-tricarboxaldehyde (COF-TB) exhibits optimal hydrophobic drug-loading capacity, enabling effective co-loading of CUR and BZ (BC@COF-TB). After treatment with BC@COF-TB, the cognitive function of 5×FAD mice was significantly improved. The COF platform provides a new way to deliver hydrophobic drugs for AD treatment.}, }
@article {pmid41226821, year = {2025}, author = {Paszternák, A and Varga, K and Gyöngyössy, R and Tarnóczi, K and Sikur, N and Szökő, É and Tábi, T}, title = {Resveratrol Analogs Ameliorate Mitochondrial Impairment and Insulin Resistance in a Streptozotocin-Induced In Vitro Model of Alzheimer's Disease.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226821}, issn = {1422-0067}, support = {2024-2.1.1-EKÖP-2024-0004 (203)//National Research, Development and Innovation Office/ ; EFOP-3.6.3.-VEKOP-16-2017-00009//National Research, Development and Innovation Office/ ; }, mesh = {*Resveratrol/pharmacology/analogs & derivatives ; *Insulin Resistance ; Humans ; *Alzheimer Disease/metabolism/drug therapy/chemically induced/pathology ; *Mitochondria/drug effects/metabolism/pathology ; Streptozocin/toxicity ; Cell Line, Tumor ; *Neuroprotective Agents/pharmacology/chemistry ; Autophagy/drug effects ; Oxidative Stress/drug effects ; Stilbenes/pharmacology/chemistry ; Antioxidants/pharmacology ; }, abstract = {Alzheimer's disease (AD) is characterized by mitochondrial dysfunction, oxidative stress, insulin resistance, and aberrant protein aggregation. Neurodegeneration model with neuronal insulin resistance was induced in SH-SY5Y human neuroblastoma cells by streptozotocin (STZ). We evaluated the neuroprotective effects of resveratrol (RZV) and three structural analogs: oxyresveratrol (OXI), monomethyl resveratrol (MONO), and trimethyl resveratrol (TRI). Mitochondrial function, plasma membrane integrity, oxidative stress) and autophagy were studied by fluorescent assays. Phosphorylated GSK3 levels were measured by ELISA as an indicator of insulin sensitivity. TRI exhibited significant mitochondrial protective effects and strongly induced autophagy. OXI demonstrated excellent antioxidant activity but showed no detectable mitochondrial protective or autophagy-inducing effects. RZV and MONO exhibited moderate antioxidant effects along with strong insulin-sensitizing and autophagy-inducing properties. Insulin sensitivity was most potently restored by RZV (IC50 = 54 pM) and MONO (IC50 = 50 pM), whereas TRI (IC50 = 160 pM) was less potent, and OXI (IC50 = 97 pM) showed moderate potency. Our findings suggest that the neuroprotective effects of resveratrol analogs significantly depend on their molecular structure and that they exert their beneficial effects through distinct mechanisms. This research may contribute to the development of novel, multi-target compounds for the treatment of neurodegenerative diseases.}, }
@article {pmid41226793, year = {2025}, author = {Machowska, M and Leszek, J and Rączy-Krzemianowska, M and Tomasiewicz, B and Hurkacz, M and Rąpała, M and Piechota, J and Głowacka, K and Wiela-Hojeńska, A}, title = {ABC Transporters, APOE, CYP46A1, and LRP1 Gene Polymorphisms as Markers of Dementia Development in Patients with Hyperlipidemia.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226793}, issn = {1422-0067}, support = {RPDS.01.02.01-02-0002/20//Regional Operational Programme of the Lower Silesian Voivodeship 2014-2020, co-financed by the European Union, European Regional Development Fund/ ; }, mesh = {Humans ; *Hyperlipidemias/genetics/complications ; Male ; Female ; *Apolipoproteins E/genetics ; *Dementia/genetics/etiology ; Aged ; *Polymorphism, Single Nucleotide ; *ATP Binding Cassette Transporter 1/genetics ; Genetic Predisposition to Disease ; *Low Density Lipoprotein Receptor-Related Protein-1/genetics ; Genotype ; Middle Aged ; Alleles ; Gene Frequency ; Biomarkers ; Alzheimer Disease/genetics ; Aged, 80 and over ; *ATP-Binding Cassette Transporters/genetics ; Case-Control Studies ; }, abstract = {In an aging society, solving problems associated with the diagnosis and treatment of dementia-related diseases represents a serious challenge. The aim of the study was to evaluate the possibility of applying molecular biology methods to test polymorphisms recognized in the global literature as potentially useful in assessing the risk of developing dementia in a group of patients with hyperlipidemia. A sample of 203 patients: 109 diagnosed with both dementia and hyperlipidemia, 94 with hyperlipidemia, and 101 individuals as an allele frequency control group-were genotyped. Additional data about cognitive decline and neuropsychological assessment were collected. Among all the studied polymorphisms, the frequency of the ABCA1 rs2230806 polymorphism differed between the analyzed groups. The GG genotype (p = 0.0002, RR = 3.22, CI = 1.63 ÷ 6.37) and the G allele (p = 0.0007, RR = 1.53, CI = 1.19 ÷ 1.97) were more frequent in patients diagnosed with dementia, specifically in those with Alzheimer's disease. Furthermore, the GG genotype was more common in individuals with a shorter disease duration and lower scores on the Montreal Cognitive Assessment (MoCA) scale, and consequently, with greater cognitive function deficits during early stages of the diagnostic process. ABCA1 rs2230806 genotyping is a potential marker for the early identification of dementia risk in patients with hyperlipidemia, which supports the validity of exploring options for incorporating diagnostics based on molecular biology methods.}, }
@article {pmid41226707, year = {2025}, author = {Hale, HK and Elias, KM and Ho, S and Kwakye, GF}, title = {Methylene Blue Attenuates 3-Nitropropionic Acid-Induced Oxidative Stress and Mitochondrial Dysfunction in Striatal Cells: Therapeutic Implications in Huntington's Disease Neuropathology.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226707}, issn = {1422-0067}, support = {Research and Professional Development Portfolio//Oberlin College Arts and Sciences Dean's Office (GFK)/ ; Endowed Professor Research Portfolio//Robert W. & Eleanor H. Biggs Endowed Professor of Neuroscience (GFK)/ ; }, mesh = {*Oxidative Stress/drug effects ; *Huntington Disease/drug therapy/metabolism/pathology ; *Nitro Compounds/toxicity ; *Propionates/toxicity ; *Methylene Blue/pharmacology ; *Mitochondria/drug effects/metabolism/pathology ; Animals ; *Corpus Striatum/drug effects/metabolism/pathology ; Humans ; Reactive Oxygen Species/metabolism ; *Neuroprotective Agents/pharmacology ; Huntingtin Protein/genetics/metabolism ; Cell Survival/drug effects ; Membrane Potential, Mitochondrial/drug effects ; Mice ; }, abstract = {There are no disease-modifying treatments available for Huntington's disease (HD), a neurodegenerative disease caused by a genetic mutation in the Huntingtin gene. Previous research suggests that disruptions in the bioenergetics of the mitochondria and increased oxidative stress are potential inducers of HD. Therapies that enhance antioxidant pathways intend to target and attenuate the overproduction of reactive oxygen species associated with mitochondrial dysfunction. We have investigated the effect of Methylene Blue (MB) as a potential therapy for HD. MB is a small molecule demonstrated to exhibit neuroprotective effects in other neurodegenerative disease models, including Parkinson's and Alzheimer's, by attenuating the oxidative stress pathways implicated in their pathophysiology. We used an established striatal cell model of HD expressing wild-type (STHdh[Q7/Q7]) or mutant (STHdh[Q111/Q111]) HTT and a chemical inducer of HD, 3-Nitropropionic acid (3-NPA), to determine the HD-specific mechanisms regulated by 3 h of MB pre-treatment. Upon 24 h of exposure to 3-NPA, mutant HD cells exhibited a significant concentration-dependent decrease in cell survival and a concomitant increase in cell death compared to wild-type, confirming that 3-NPA exacerbates mutant HTT neurotoxicity. Examination of mitochondrial membrane potential and mitochondrial function in the striatal cells by JC-1 and ATP assays, respectively, revealed MB mediated neuroprotection against 3-NPA-induced reduction in mitochondrial activity. Immunoblotting analysis revealed that MB restores baseline expression of oxidative-stress-related proteins, including HO1 and p62, in both wild-type and mutant cells exposed to 3-NPA. Our findings establish a novel neuroprotective role of MB in both genetic and pharmacological models of HD, suggesting that MB might be a promising therapeutic candidate for altering the underlying pathophysiology of HD by improving mitochondrial function.}, }
@article {pmid41226670, year = {2025}, author = {Bayo Jimenez, MT and Rivas-García, L and Sánchez-González, C and Grosso, G and Lipari, V and Vera-Ramírez, L and Battino, M and Giampieri, F and Quiles, JL and Forbes-Hernández, TY}, title = {Natural Products in Alzheimer's Disease: A Systematic Review of Clinical Trials and Underlying Molecular Mechanisms.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226670}, issn = {1422-0067}, support = {PID2019-106778RB-I00//MCIN/AEI/10.13039/501100011033 FEDER "Una manera de hacer Europa/ ; Visiting Scholars 2022//Universidad de Granada/ ; }, mesh = {Aged ; Humans ; *Alzheimer Disease/drug therapy/metabolism ; *Biological Products/therapeutic use/pharmacology ; Clinical Trials as Topic ; Cognitive Dysfunction/drug therapy ; *Neuroprotective Agents/therapeutic use/pharmacology ; *Plant Extracts/therapeutic use/pharmacology ; }, abstract = {This systematic review included 31 clinical trial articles examining the effects of natural compounds on Alzheimer's disease (AD) and mild cognitive impairment (MCI), involving 3582 participants aged 50-90. Treatment durations ranged from 8 weeks to 2 years, with an average of 12.5 months. Notably, 11 studies focused on herbal extracts highlighting their prominence in current research. These extracts showed potential cognitive and neuroprotective benefits, although results varied across compounds and study designs. Other natural compounds-including flavonoids, polyphenols, omega-3 fatty acids, Aloe vera, Spirulina, and citrus phytochemicals-may provide cognitive and neuroprotective benefits, with ginseng and Ginkgo biloba combinations also showing promise. Curcumin and Melissa officinalis had limited effects, resveratrol showed mixed outcomes with some side effects, and matcha green tea may improve cognition and sleep quality. Despite generally favorable results, the studies varied considerably in design and quality; nonetheless, herbal extracts represent a prominent category of natural interventions in AD and MCI, underscoring the need for further large-scale, high-quality clinical trials to confirm their therapeutic potential.}, }
@article {pmid41226604, year = {2025}, author = {Hu, C and Lin, M and Wang, C and Zhang, S}, title = {Current Understanding of Protein Aggregation in Neurodegenerative Diseases.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226604}, issn = {1422-0067}, support = {32170784, 32170707//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Neurodegenerative Diseases/metabolism/therapy/pathology ; Animals ; *Protein Aggregates ; *Protein Aggregation, Pathological/metabolism ; Autophagy ; Protein Folding ; }, abstract = {Protein aggregates are central to the pathogenesis of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. This comprehensive review explores the mechanisms of protein misfolding and aggregation, their prion-like propagation, and the critical role of oligomeric species in neurotoxicity. It further examines cellular clearance pathways, including the ubiquitin-proteasome system and autophagy, alongside the regulatory functions of molecular chaperones. The review also covers advanced diagnostic imaging and biomarker techniques, as well as emerging therapeutic strategies such as pharmacological agents, gene therapy, and immunotherapy. Controversies regarding the toxicity of aggregates and future directions, including novel degradation technologies and targeted therapeutic approaches, are discussed. By integrating current knowledge, this review aims to provide a broad yet detailed overview of the field, highlighting both established concepts and promising avenues for research and treatment.}, }
@article {pmid41226584, year = {2025}, author = {Costea, D and Dobrin, N and Tataru, CI and Toader, C and Șerban, M and Covache-Busuioc, RA and Munteanu, O and Diaconescu, IB}, title = {The Glymphatic-Venous Axis in Brain Clearance Failure: Aquaporin-4 Dysfunction, Biomarker Imaging, and Precision Therapeutic Frontiers.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226584}, issn = {1422-0067}, mesh = {Humans ; *Glymphatic System/metabolism/diagnostic imaging ; *Aquaporin 4/metabolism ; Biomarkers/metabolism ; Animals ; *Brain/metabolism/diagnostic imaging/blood supply ; *Neurodegenerative Diseases/metabolism/therapy/diagnostic imaging ; Precision Medicine ; }, abstract = {The identification of brain clearance failure as a precursor to a large variety of neurodegenerative diseases has shifted fluid dynamics from a secondary to a tertiary target of brain health. The identification of the glymphatic system, detailing cerebrospinal fluid entry along perivascular spaces and exit via perivenous and meningeal lymphatic pathways, provided a challenge to previous diffusion models and established aquaporin-4-dependent astroglial polarity as a governing principle of solute transport. Multiple lines of evidence now support a coupled glymphatic-venous axis, wherein vasomotion, venous outflow, and lymphatic drainage are functionally interrelated. Failure of any axis will cascade and affect the entire axis, linking venous congestion, aquaporin-4 disassembly, and meningeal lymphatic failure to protein aggregation, neuroinflammation, edema, and intracranial hypertension. Specific lines of evidence from diffusion tensor imaging along vascular spaces, clearance MRI, and multi-omic biomarkers can provide a measure of transport. Therapeutic strategies are rapidly advancing from experimental strategies to translational approval, including behavioral optimization, closed-loop sleep stimulation, vascular and lymphatic therapies, focused ultrasound, pharmacological polarity recoupling, and regenerative bioengineering. Novel computational approaches, such as digital twin dynamic modeling and adaptive trial designs, suggest that clearance measures may serve as endpoints to be approved by the FDA. This review is intended to bridge relevant mechanistic and translational reviews, focusing on impaired clearance as an exploitable systems defect rather than an incapacitating secondary effect. Improving our understanding of the glymphatic-venous axis Injury may lead to future target strategies that advance cognitive resilience, alleviate disease burden, and improve quality of life. By clarifying the glymphatic-venous axis, we provide a mechanistic link between impaired interstitial clearance and the pathological accumulation of amyloid-β, tau, and α-synuclein in neurodegenerative diseases. The repair of aquaporin-4 polarity, venous compliance, and lymphatic drainage might therefore open new avenues for the diagnosis and treatment of Alzheimer's and Parkinson's disease, supplying both biomarkers of disease progression and new targets for early intervention. These translational implications not only locate clearance failure as an epiphenomenon of neurodegeneration but, more importantly, as a modifiable driver of the course of neurodegeneration.}, }
@article {pmid41226231, year = {2025}, author = {Ananda, SH and Kuragano, M and Tokuraku, K}, title = {Elucidation of the Neuroprotective Effects of Astaxanthin Against Amyloid β Toxicity in the SH-SY5Y Human Neuroblastoma Cell Line.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {21}, pages = {}, pmid = {41226231}, issn = {1420-3049}, support = {SUNBOR GRANT//Suntory Foundation for Life Sciences/ ; JPMJPF2213//Japan Science and Technology Agency/ ; JP24K08627//JSPS KAKENHI/ ; }, mesh = {Humans ; Xanthophylls/pharmacology/chemistry ; *Amyloid beta-Peptides/metabolism/toxicity ; *Neuroprotective Agents/pharmacology ; Cell Line, Tumor ; *Neuroblastoma/metabolism/pathology/drug therapy ; Apoptosis/drug effects ; Cell Movement/drug effects ; Cell Survival/drug effects ; Alzheimer Disease/drug therapy/metabolism ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disorder characterized by memory loss and cognitive decline, primarily due to amyloid β (Aβ) aggregation in the brain. Astaxanthin (AxN), a xanthophyll carotenoid derived from Haematococcus pluvialis, possesses antioxidant and neuroprotective properties. This study investigated the neuroprotective effects of AxN against Aβ aggregation in human neuroblastoma SH-SY5Y cells. Initially, AxN inhibited Aβ aggregation in DMEM/F12 culture medium but not in PBS, suggesting a medium-dependent effect. Using quantum dot nanoprobes, Aβ aggregation was visualized in the presence of SH-SY5Y cells. AxN treatment (0.032-20 µM) significantly reduced Aβ aggregation and accumulation on SH-SY5Y cells. AxN also prevented Aβ-induced early apoptotic cell death but was less effective against late necrosis. Furthermore, a wound-healing assay showed that AxN restored the impaired cell motility caused by Aβ aggregation. Thioflavin T staining confirmed the reduction in Aβ fibril formation around the cells following AxN treatment. In conclusion, our study suggests that AxN prevents Aβ aggregation and accumulation on the cell surface, thereby restoring cell motility and preventing early apoptosis in neuronal cells.}, }
@article {pmid41226137, year = {2025}, author = {Guaya, D and Espinoza, LC and Jaramillo-Fierro, X and Gualotuña Campoverde, D and Sosa, L and Calpena, AC}, title = {Zinc-Modified Mordenite Zeolite as a Molecular Carrier for Donepezil: A Framework for Drug Delivery Applications.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {21}, pages = {}, pmid = {41226137}, issn = {1420-3049}, support = {PROY_INV_QU_2022_3585//Universidad Técnica Particular de Loja (UTPL)/ ; }, mesh = {*Zeolites/chemistry ; *Donepezil/chemistry/pharmacology/administration & dosage ; *Zinc/chemistry ; *Drug Carriers/chemistry ; *Drug Delivery Systems ; Adsorption ; Drug Liberation ; Kinetics ; Cholinesterase Inhibitors/chemistry ; Hydrogen Bonding ; }, abstract = {The development of advanced drug delivery systems is essential for improving therapeutic efficacy, particularly in the treatment of neurodegenerative disorders such as Alzheimer's disease. This study investigates zinc-modified mordenite zeolite (MR-ZN) as a novel platform for the controlled delivery of donepezil (DPZ), a cholinesterase inhibitor. Natural mordenite was modified with zinc, enhancing its surface area from 62.1 to 85.4 m[2]/g and improving its adsorption properties. Donepezil was successfully loaded at two doses (10 mg and 23 mg), achieving high loading efficiencies of 95% and 94%, respectively. Adsorption kinetics followed a pseudo-second-order model (R[2] > 0.99), indicating that chemisorption predominates through coordination between DPZ functional groups and Zn[2+] sites, while complementary physisorption via hydrogen bonding and van der Waals interactions also contributes to molecular stabilization within the zeolite framework. In vitro release studies under simulated gastrointestinal conditions demonstrated sustained and pH-responsive release profile with 80% and 82% of donepezil released after 24 h for 10 mg and 23 mg formulations, respectively. Density Functional Theory (DFT) calculations revealed favorable adsorption energy (-26.4 kJ/mol), while Bader and Electron Localization Function (ELF) analyses confirmed hydrogen bonding and electrostatic interactions without compromising the zeolite framework. These findings validate MR-ZN as structurally stable, efficient, cost-effective and biocompatible matrix for oral drug delivery. The combination of experimental data and theoretical modeling supports its potential to improve bioavailability and therapeutic performance in neurodegenerative treatment.}, }
@article {pmid41225966, year = {2025}, author = {Hayat, MT and Allawi, YM and Alamro, W and Sultan, SM and Abadleh, A and Kang, H and Zreikat, AI}, title = {A Hybrid Convolutional Neural Network-Long Short-Term Memory (CNN-LSTM)-Attention Model Architecture for Precise Medical Image Analysis and Disease Diagnosis.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {21}, pages = {}, pmid = {41225966}, issn = {2075-4418}, support = {PNURSP2025R829//Princess Nourah bint Abdulrahman University/ ; }, abstract = {Background: Deep learning (DL)-based medical image classification is becoming increasingly reliable, enabling physicians to make faster and more accurate decisions in diagnosis and treatment. A plethora of algorithms have been developed to classify and analyze various types of medical images. Among them, Convolutional Neural Networks (CNNs) have proven highly effective, particularly in medical image analysis and disease detection. Methods: To further enhance these capabilities, this research introduces MediVision, a hybrid DL-based model that integrates a vision backbone based on CNNs for feature extraction, capturing detailed patterns and structures essential for precise classification. These features are then processed through Long Short-Term Memory (LSTM), which identifies sequential dependencies to better recognize disease progression. An attention mechanism is then incorporated that selectively focuses on salient features detected by the LSTM, improving the model's ability to highlight critical abnormalities. Additionally, MediVision utilizes a skip connection, merging attention outputs with LSTM outputs along with Grad-CAM heatmap to visualize the most important regions of the analyzed medical image and further enhance feature representation and classification accuracy. Results: Tested on ten diverse medical image datasets (including, Alzheimer's disease, breast ultrasound, blood cell, chest X-ray, chest CT scans, diabetic retinopathy, kidney diseases, bone fracture multi-region, retinal OCT, and brain tumor), MediVision consistently achieved classification accuracies above 95%, with a peak of 98%. Conclusions: The proposed MediVision model offers a robust and effective framework for medical image classification, improving interpretability, reliability, and automated disease diagnosis. To support research reproducibility, the codes and datasets used in this study have been publicly made available through an open-access repository.}, }
@article {pmid41225766, year = {2025}, author = {Jeon, SY and Byun, MS and Choi, HJ and Kim, YH and Gwag, CH and Oh, Y and Park, JE and Yi, D and Jung, G and Ahn, H and Sohn, BK and Jung, JH and Chang, YY and Kong, N and Choi, H and Kang, KM and Sohn, CH and Lee, DY}, title = {Eligibility for lecanemab and donanemab in Korea under Appropriate Use Recommendations.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70875}, pmid = {41225766}, issn = {1552-5279}, support = {//New Faculty Startup Fund from Seoul National University/ ; //National Research Foundation of Korea/ ; RS-2022-00165636//Ministry of Science and ICT, South Korea/ ; 2014M3C7A1046042//Ministry of Science and ICT, South Korea/ ; //Korea Health Technology R&D Project/ ; //Korea Health Industry Development Institute/ ; HI18C0630//Ministry of Health and Welfare, Republic of Korea/ ; HI19C0149//Ministry of Health and Welfare, Republic of Korea/ ; //Korea Dementia Research Project/ ; //Korea Dementia Research Center (KDRC)/ ; //Ministry of Health & Welfare and Ministry of Science and ICT/ ; RS-2023-KH136195//Republic of Korea/ ; //Basic Science Research Program through the NRF/ ; RS-2023-00210380//Ministry of Education/ ; U01AG072177//National Institute of Aging/ ; //National Institute of AGING/ ; RS-2023-KH136195//Korea Dementia Research Center/ ; HI18C0630//Ministry of Health and Welfare/ ; HI19C0149//Ministry of Health and Welfare/ ; //Seoul National University/ ; }, mesh = {Humans ; Republic of Korea ; Male ; Female ; Magnetic Resonance Imaging ; Aged ; *Alzheimer Disease/drug therapy/diagnostic imaging ; Mental Status and Dementia Tests ; Aged, 80 and over ; Brain/diagnostic imaging ; Middle Aged ; Antibodies, Monoclonal, Humanized ; }, abstract = {INTRODUCTION: Appropriate Use Recommendations (AURs) guide real-world use of lecanemab and donanemab in early symptomatic Alzheimer's disease (AD), but their applicability to Asian populations with diverse education backgrounds remains unclear.
METHODS: Among 2726 participants who visited a Korean memory clinic, 1005 amyloid-positive participants with magnetic resonance imaging (MRI) and Clinical Dementia Rating data were included. Eligibility for lecanemab and donanemab was assessed using AUR criteria, including age, Mini-Mental State Examination (MMSE), brain MRI, apolipoprotein E genotype (for donanemab), and anticoagulant use, applying both raw and z-score-based MMSE thresholds.
RESULTS: Among 1005 amyloid-positive participants, 24.6% were eligible for lecanemab and 28.0% for donanemab (9.1% and 10.3% of the initial sample). Applying MMSE z-scores increased eligibility to 38.4% and 33.7%, respectively. Over a third of participants were excluded due to MRI findings, mainly vascular lesions associated with increased amyloid-related imaging-abnormality risks.
DISCUSSION: Incorporating demographically adjusted MMSE z-score threshold improves real-world eligibility and promotes equitable access to anti-amyloid therapies.
HIGHLIGHTS: About a fourth of A+ patients in Korea met AUR criteria for anti-amyloid therapy. Donanemab eligibility slightly exceeded lecanemab despite narrower age criteria. MMSE z-score adjustment increased eligibility in older, less-educated individuals. Over 30% of eligible patients were excluded due to ARIA-related MRI findings. Culturally adapted cognitive thresholds are essential for equitable treatment access.}, }
@article {pmid41224179, year = {2025}, author = {Tigro, H and Moëlo, C and Pelcman, J and Paslawski, W and Chen, G and Poska, H and Shimmo, R and Svenningsson, P and Kronqvist, N and Johansson, J}, title = {Bri2 BRICHOS, a molecular chaperone-like domain that can cross brain vascular endothelial cells and deliver proteins into neurons.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {388}, number = {Pt 2}, pages = {114403}, doi = {10.1016/j.jconrel.2025.114403}, pmid = {41224179}, issn = {1873-4995}, mesh = {Animals ; Humans ; *Endothelial Cells/metabolism ; *Neurons/metabolism ; Blood-Brain Barrier/metabolism ; Brain/metabolism/blood supply ; Mice ; *Molecular Chaperones/administration & dosage/metabolism ; Adaptor Proteins, Signal Transducing ; Protein Domains ; Recombinant Fusion Proteins/administration & dosage/pharmacokinetics ; Astrocytes/metabolism ; Drug Delivery Systems ; }, abstract = {The transport of biological drugs from the bloodstream into the central nervous system is hindered by the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier, creating a need for efficient and safe delivery systems to the brain parenchyma. Recombinant human (rh) BRICHOS, a chaperone-like domain from the protein Bri2, can access the brain after systemic injection and has shown therapeutic efficiency in Alzheimer model mice. Here, we show that rh Bri2 BRICHOS and cargo proteins fused to it are efficiently transcytosed over human BBB models made of cerebral microvascular endothelial cells and astrocytes. Moreover, intravenously injected protein fused with Bri2 BRICHOS can access the brain parenchyma of mice and enter neurons and astrocytes. Our results suggest that rh Bri2 BRICHOS can be harnessed to deliver cargo from the bloodstream into neurons.}, }
@article {pmid41224085, year = {2026}, author = {Gharedaghi, P and Faridi, N and Wang, P and Bathaie, SZ}, title = {Natural C20 carotenoids protect dPC12 cells from Aβ-induced cell cycle re-entry, Tau phosphorylation, and Nrf2 activation via the Akt/GSK-3β pathway.}, journal = {Journal of ethnopharmacology}, volume = {358}, number = {}, pages = {120816}, doi = {10.1016/j.jep.2025.120816}, pmid = {41224085}, issn = {1872-7573}, mesh = {*Carotenoids/pharmacology ; Animals ; *Glycogen Synthase Kinase 3 beta/metabolism ; *Proto-Oncogene Proteins c-akt/metabolism ; Rats ; Phosphorylation/drug effects ; *NF-E2-Related Factor 2/metabolism ; *tau Proteins/metabolism ; PC12 Cells ; *Amyloid beta-Peptides/toxicity ; *Neuroprotective Agents/pharmacology ; Signal Transduction/drug effects ; Vitamin A/analogs & derivatives ; Apoptosis/drug effects ; Cell Cycle/drug effects ; Crocus/chemistry ; }, abstract = {Saffron has been known to improve mood and memory since ancient times. Crocin and Crocetin, bioactive C20 carotenoids, were isolated from saffron stigma and demonstrated multiple biological and pharmacological effects.
AIM OF THE STUDY: We recently demonstrated the effect of Crocin/Crocetin on apoptosis inhibition in an amyloid beta oligomer (AβO)-induced Alzheimer's disease (AD) model using neuronally differentiated PC12 (dPC12) cells. This study investigates their neuroprotective effects on the Akt/GSK-3β pathway in these cells, focusing on NRF2 activity, NQO1 expression, and Tau phosphorylation.
METHODS: dPC12 cells were exposed to AβO to mimic the AD condition. The cells were treated with Crocin/Crocetin before and after to produce preventive and therapeutic modalities. The expression of key pathway markers was evaluated using Western blot and immunocytochemistry. Flow cytometry was employed to assess cell cycle arrest and apoptosis.
RESULTS: Crocin/Crocetin significantly attenuated AβO-induced toxicity in dPC12 cells in both modalities mentioned. The named carotenoids significantly suppressed GSK3β kinase activity and reduced Tau phosphorylation (p-Thr231). Furthermore, they increased AKT phosphorylation, promoted NRF2 translocation into the nucleus, and induced NQO1 expression. These effects were observed in a time-dependent manner. Flow cytometry analyses revealed the involvement of both cell cycle arrest and apoptosis in response to AβO treatment. Crocin and Crocetin inhibited this response.
CONCLUSIONS: Collectively, Crocin/Crocetin effectively mitigated AβO-induced injury in dPC12 cells. Although Crocetin was more effective than Crocin and improved at lower concentrations, both carotenoids exhibited neuroprotective effects against AβO toxicity in preventive and therapeutic modalities via activating the Akt/GSK-3β signaling pathway.}, }
@article {pmid41224062, year = {2025}, author = {Tiwari, P and Tiwari, S}, title = {Comparative anti-amyloidogenic potential of pristine and nitrogen doped graphene quantum dots against amyloid beta protein.}, journal = {International journal of biological macromolecules}, volume = {333}, number = {Pt 2}, pages = {148951}, doi = {10.1016/j.ijbiomac.2025.148951}, pmid = {41224062}, issn = {1879-0003}, mesh = {*Fullerenes/chemistry/pharmacology ; *Nitrogen/chemistry ; *Graphite/chemistry/pharmacology ; *Amyloid beta-Peptides/antagonists & inhibitors ; *Quantum Dots/chemistry ; *Peptide Fragments/antagonists & inhibitors/chemistry ; Protein Folding/drug effects ; Microscopy, Atomic Force ; *Amyloid/antagonists & inhibitors/chemistry ; Alzheimer Disease/metabolism ; Circular Dichroism ; Benzothiazoles/chemistry ; Cell Line, Tumor ; Humans ; Apoptosis/drug effects ; }, abstract = {This study investigates the effect of nitrogen doping of graphene quantum dots (GQDs) upon their ability to inhibit the fibrillation of amyloid beta fragments containing 1-42 amino acids (Aβ). Misfolded aggregates of Aβ have been implicated in the pathogenesis of Alzheimer's disease, the most prevalent form of dementia. We employed spectroscopic and microscopic techniques to characterize both quantum dots. Anti-amyloidogenic potential was assessed using circular dichroism spectroscopy and the thioflavin T binding. Atomic force microscopy was utilized to characterize the morphological and nanomechanical properties of Aβ fibrils following treatment with the quantum dots. We observed that nitrogen doping significantly alters the absorbance and fluorescence emission profiles, likely due to an increased surface charge density induced by the incorporation of nitrogen atoms. N-GQDs exhibited superior anti-amyloidogenic activity in comparison to pristine quantum dots. This effect varied in accordance to the dose. Using the data of MTT, trypan blue exclusion, differential staining and apoptosis assays on SH-SY5Y neuroblastoma cells, we infer that adsorption of Aβ on doped quantum dots was accompanied with reduction in the stiffness of fibrils and their toxicity to the cells.}, }
@article {pmid41223445, year = {2025}, author = {Vlachos, I}, title = {Spectral brain connectivity in dementia: coherence, imaginary coherence and partial coherence analysis of EEG signals.}, journal = {Journal of neural engineering}, volume = {22}, number = {6}, pages = {}, doi = {10.1088/1741-2552/ae1ea1}, pmid = {41223445}, issn = {1741-2552}, mesh = {Humans ; Male ; *Electroencephalography/methods ; Female ; Aged ; *Alzheimer Disease/physiopathology/diagnosis ; Middle Aged ; *Brain/physiopathology ; *Nerve Net/physiopathology ; *Frontotemporal Dementia/physiopathology/diagnosis ; *Dementia/physiopathology/diagnosis ; Aged, 80 and over ; }, abstract = {Objective.As the prevalence of dementia continues to rise, the need for accurate and early diagnostic tools becomes increasingly critical. Despite diverse underlying causes, dementia types share common cognitive symptoms, making accurate diagnosis essential for effective treatment.Approach: This study investigates electroencephalographic (EEG)-based spectral brain connectivity in individuals with Alzheimer's disease (AD,N=36), frontotemporal dementia (FTD,N=23), and healthy controls (HCs,N=29), with the dual aim of identifying condition-specific connectivity patterns and evaluating three coherence-based connectivity measures: coherence, imaginary coherence, and partial coherence. Resting-state, eyes-closed EEG data (19 channels) were analyzed, and connectivity was estimated across frequencies to assess both global and local network alterations.Main results.The results indicate that dementias (both AD and FTD) are characterized by decreased connectivity in higher frequency bands and increased connectivity in lower frequencies, reflecting respectively impaired neural communication and neurodegeneration. Moreover, the severity of cognitive impairment correlates with the spatial extent and magnitude of connectivity disruptions. Notably, partial coherence-unlike coherence and imaginary coherence-effectively distinguishes between the AD and FTD groups, suggesting that direct connectivity measures may provide more discriminative information for differential diagnosis.Significance.These findings highlight the potential of EEG-based spectral connectivity analysis, particularly partial coherence, as a non-invasive tool to aid in the diagnosis and differential diagnosis of dementia subtypes, supporting early clinical decision-making.}, }
@article {pmid41223194, year = {2025}, author = {Yoo, SS and Reddy, A and Carroll, W and Ploypradith, K}, title = {Repeated application of transcranial ultrasound maintains spatial and recognition memory in 5xFAD mice with reduction of amyloid-β burden.}, journal = {PloS one}, volume = {20}, number = {11}, pages = {e0336114}, pmid = {41223194}, issn = {1932-6203}, mesh = {Animals ; *Amyloid beta-Peptides/metabolism ; *Alzheimer Disease/therapy/metabolism/pathology ; Mice ; Male ; Mice, Transgenic ; *Spatial Memory ; *Recognition, Psychology ; Disease Models, Animal ; Hippocampus/metabolism/pathology ; Maze Learning ; *Ultrasonic Therapy/methods ; }, abstract = {Pharmacological removal of amyloid beta protofibrils has emerged as a promising therapeutic strategy to delay the onset of Alzheimer's disease (AD) symptoms. As a non-pharmacological and noninvasive alternative, transcranial application of low-intensity ultrasound through intact skull can induce convective acoustic streaming, which has been shown to enhance cerebrospinal fluid solute transport and facilitate the clearance of interstitial solutes. This has led to the development of device-based approaches aimed at removing the precursors of amyloid beta (Aβ) plaques and mitigating cognitive decline in AD. We applied non-thermal, non-cavitational ultrasound (400 kHz frequency) in a pulsed mode (75 ms pulse duration, 2 Hz repetition rate) to the hippocampal region of male 5xFAD mice for 30 minutes weekly, starting at 10 weeks of age and continuing for 15 weeks (until 6 months of age). Spatial and recognition memory performance was assessed monthly using the Y-maze spontaneous alternation (SA) and novel object recognition (NOR) tests. A control group of age-matched mice underwent the same procedures with receiving zero acoustic output. Mice subjected to transcranial ultrasound (tUS) treatment maintained both SA and NOR performance throughout the entire experimental period, whereas mice that received sham tUS exhibited a progressive decline in memory beginning at 3-4 months of age. Congo Red staining of the brain sections revealed a significant (> 40%) reduction in Aβ plaques in the sonicated group. Histological analysis confirmed that repeated ultrasound exposure did not cause any detectable tissue damage. These findings suggest that low intensity tUS may serve as a novel, noninvasive therapeutic strategy to delay the onset of AD symptoms through the reduction of Aβ burden.}, }
@article {pmid41223122, year = {2025}, author = {Wiest, R and Radojewski, P and Lieb, JM and Psychogios, M and Benzinger, TLS and Franceschi, AM and Wanke, I and Draganski, B and Kurz, FT and Lövblad, KO}, title = {Clinical practice recommendations of the Swiss Society for Neuroradiology*: Neuroimaging standards for enrollment and disease monitoring in Anti-Amyloid Immunotherapies.}, journal = {Neuro-degenerative diseases}, volume = {}, number = {}, pages = {1-24}, doi = {10.1159/000549521}, pmid = {41223122}, issn = {1660-2862}, abstract = {INTRODUCTION: The Swiss Society for Neuroradiology (SSNR) has established clinical practice recommendations to guide the use of neuroimaging techniques in the enrollment and disease monitoring of patients undergoing anti-amyloid immunotherapies for Alzheimer's disease (AD). In Switzerland, anti-amyloid immunotherapy (AAT) has not been approved by Swissmedic ahead of this publication. This paper therefore reflects the existing international standards of care and will be updated after market clearance of AATs in Switzerland.
BACKGROUND AND RATIONALE: Neuroimaging is a key requirement to assess therapeutic responses and manage potential adverse effects, particularly amyloid-related imaging abnormalities (ARIA). The SSNR recommendations specify the appropriate use of MRI biomarkers to support therapy inclusion, routine monitoring and decision-making in case of manifestations of ARIA-E and ARIA-H during treatment.
CONCLUSIONS: This paper reviews the required image protocols and neuroimaging criteria for patient eligibility and discusses the key findings of ARIA-E and ARIA-H. These findings are required to be recognized by the practicing radiologist to ensure patient safety. The practice recommendations of the SSNR align with previous published recommendations of the American Society of Neuroradiology and the European Society of Neuroradiology. We also provide practical recommendations for workflows and candidate selection to continue or discontinue therapy.}, }
@article {pmid41221473, year = {2025}, author = {Perez, FP and Bandeira, J and Morisaki, J and Kanakri, H and Rizkalla, M}, title = {Electromagnetic Field Stimulation Effects on Intrinsically Disordered Proteins and Their Role in Aging and Neurodegeneration.}, journal = {Journal of biomedical science and engineering}, volume = {18}, number = {10}, pages = {408-438}, pmid = {41221473}, issn = {1937-6871}, support = {UL1 TR000006/TR/NCATS NIH HHS/United States ; }, abstract = {There is increasing evidence from preclinical studies. There is growing evidence from preclinical studies in cell cultures and small organisms that exposure to Electromagnetic Fields (EMFs) produces beneficial biological effects. However, controversy persists due to the absence of a clearly defined mechanism. Classical physics, constrained by the non-ionizing nature of these exposures, cannot account for these effects, which do not involve the breaking of chemical bonds to induce conformational changes in proteins. Emerging studies suggest that these effects are mediated through quantum mechanical phenomena-specifically, quantum tunneling and particle-wave duality-acting on the water surrounding proteins at their interfaces. Furthermore, we present evidence of EMF-induced conformational changes in Intrinsically Disordered Proteins (IDPs), including beta-amyloid, tau, alpha-synuclein, and Heat Shock Factor 1 (HSF1). These findings offer a new framework for understanding EMF bioeffects and open promising avenues for research in biophysics and quantum biology. In this context, we address the challenge of reproducibility by examining how variables such as frequency, intensity, Specific Absorption Rate (SAR), and exposure time windows interact, along with how parameters like polarization, phase, pulse modulation, and scheduling influence outcomes. Experimental data identify specific RF frequencies and SAR levels that activate proteostasis and autophagy in cell cultures and small animal models, with potential applications in human treatments that remain consistent with safety thresholds established by regulatory agencies.}, }
@article {pmid41220866, year = {2025}, author = {Kim, J and Kim, GH and Kang, K and Kim, HJ and Suh, J and Yoon, B and Cho, H and Pyun, JM and Park, YH and Choe, HK and Kim, YK and Lee, KH and Kim, JG and Yang, SJ and Baek, MJ and Chin, J and Jang, H and Moon, SY and , }, title = {Executive Summary of 2025 International Conference of the Korean Dementia Association and International Congress of the Asian Society Against Dementia (IC-KDA/ASAD 2025): A Report From the Academic Committee of the Korean Dementia Association.}, journal = {Dementia and neurocognitive disorders}, volume = {24}, number = {4}, pages = {209-232}, pmid = {41220866}, issn = {2384-0757}, abstract = {The International Conference of the Korean Dementia Association (IC-KDA) 2025 was held jointly with the 19th International Congress of the Asian Society Against Dementia (ASAD) in Seoul, South Korea (May 8-10, 2025), under the theme "Breaking Barriers of Dementia: From Research to Real-world Practice." The program opened with a Pre-Conference Symposium on "Dementia Treatment Update: Lecanemab and NPH" featuring 14 speakers, followed by the main meeting comprising 3 plenary sessions (5 speakers), 7 luncheon-symposium presentations, 16 parallel symposia (48 speakers), a special symposium (2 speakers), and 4 oral-presentation sessions (20 presenters). The congress was attended by 1,052 participants from 27 countries and included 213 poster presentations. Scientific highlights spanned the continuum from discovery to implementation: plasma and imaging biomarkers, retinal and electroencephalogram/voice-based digital biomarkers, and multimodal neuroimaging for risk stratification and outcome prediction; updates on anti-amyloid monoclonal antibodies (MABs) (lecanemab, donanemab), safety/amyloid-related imaging abnormalities management, and real-world data frameworks; mechanistic and multi-omics insights (genetics, metabolomics, epigenomics, transcriptomics); neuroinflammation and glia-mediated pathways; young-onset dementia cohorts across Asia-Pacific; vascular cognitive impairment trials and pathophysiology; neuropsychiatric symptoms and evidence-based behavioral and psychological symptoms of dementia care; lifestyle and multidomain prevention (Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay-based interventions); dementia-friendly communities and caregiver support; and emerging neuromodulation modalities (low-intensity ultrasound, photobiomodulation, vagus nerve stimulation). Together, the joint IC-KDA & ASAD 2025 meeting emphasized precision medicine and implementation science, bridging laboratory advances with clinical practice and health-system delivery to improve outcomes for people living with dementia and their caregivers.}, }
@article {pmid41220257, year = {2025}, author = {Wang, HJ and Ruthirakuhan, M and Andreazza, AC and Beroncal, EL and Black, SE and Gallagher, D and Herrmann, N and Kiss, A and Verhoeff, NPLG and Lanctôt, KL}, title = {Identifying a combination of biomarkers to predict treatment response to nabilone for agitation in Alzheimer's disease - an exploratory post hoc analysis.}, journal = {Neurodegenerative disease management}, volume = {}, number = {}, pages = {1-10}, doi = {10.1080/17582024.2025.2587549}, pmid = {41220257}, issn = {1758-2032}, abstract = {BACKGROUND: To identify if a combination of blood-based biomarkers related to inflammation and oxidative stress predict treatment response to nabilone for Alzheimer's disease (AD)-associated agitation.
RESEARCH DESIGN AND METHODS: Agitation was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Serum concentrations of 13 markers were quantified. Univariable and multivariable regression were used to determine differences in CMAI change given nabilone and placebo. A model combining biomarkers with clinical predictors was also evaluated.
RESULTS: Overall, 38 participants enrolled in the original trial (76% male, mean ± SD age 87 ± 10). Nabilone was more efficacious in participants with higher IL-6, higher 8-ISO, higher 24S-OHC, and lower clusterin. Participants in the first tertile (T1) of index scores demonstrated better response to nabilone compared to placebo with a mean difference in CMAI change of -20.6 (95%CI: -30.3, -10.4). During the nabilone phase, 83% of participants in T1 were responders versus 38% in T2 + 3 (Fisher's p = .01). In the combined model, T1 showed better response to nabilone with a mean difference in CMAI change of -26.4 (95%CI: -34.0, -19.6). The proportion of responders was significantly higher in T1 (91%, n = 11) compared to T2 + 3 (32%, n = 19) (Fisher's p = .002).
CONCLUSION: A combination of biomarkers could help characterize responders and non-responders to nabilone.}, }
@article {pmid41219714, year = {2025}, author = {Blasi, V and Isernia, S and Rossetto, F and Pagliari, C and Borgnis, F and Pirastru, A and Marzulli, M and Foglia, E and Garagiola, E and Baglio, F}, title = {Study protocol for a randomized controlled trial assessing clinical efficacy of digital cognitive rehabilitation for preclinical and mild clinical stages of alzheimer's disease continuum: the MI-RICORDO project.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {1075}, pmid = {41219714}, issn = {1471-244X}, support = {FP-1321//THCS Horizon Europe Programme/ ; }, mesh = {Humans ; *Alzheimer Disease/rehabilitation ; *Cognitive Dysfunction/rehabilitation ; Single-Blind Method ; Magnetic Resonance Imaging ; Female ; Male ; Randomized Controlled Trials as Topic ; Aged ; Neuronal Plasticity ; *Cognitive Behavioral Therapy/methods ; Treatment Outcome ; Cognitive Training ; }, abstract = {BACKGROUND: Early or preclinical stages of AD continuum may benefit from lifestyle interventions and cognitive rehabilitation strategies that can delay or prevent progression to dementia. In this context, digital health technologies offer a disruptive potential to expand access to cognitive rehabilitation and meet the increasing demand for early interventions. This study protocol outlines a randomized controlled trial (RCT) designed to evaluate the efficacy and efficiency of a personalized, multidomain digital cognitive rehabilitation approach compared to conventional paper-and-pencil therapy. A secondary objective is to investigate the structural and functional neuroplasticity mechanisms associated with both interventions, using advanced magnetic resonance imaging techniques.
METHODS: The study presents a single-blinded (assessors) 1:1 parallel-arm RCT design involving 102 patients with Subjective Cognitive Decline, o Mild Cognitive Impairment or early-stage dementia. For the experimental intervention group (EG) the digital therapeutic RICORDO-DTx will be employed, while the control group (CG) will perform an unstructured pencil-paper stimulation program. Both interventions will last 5 weeks with 3 session/week. Outcome measures will evaluate efficacy as changes in: behavioural and cognitive abilities, patients' engagement, and structural and functional neuroplasticity mechanisms by means of Magnetic Resonance Imaging. Additional evaluation will include efficiency measures related to usability, acceptability, safety, sustainability and user experience. Patients will be evaluated at baseline (T0), after treatment (T1) and at follow up six months post baseline (T2). Data analyses will involve repeated measures ANOVA models on primary and secondary outcome measures to compare efficacy of intervention between EG and CG. Finally, efficiency measures will be reported with descriptive statistics.
CONCLUSIONS: The expected results lay on the ability of RICORDO DTx, to adapt task difficulty automatically based on patients' performance and perceived difficulty. This adaptive approach is anticipated to yield superior treatment outcomes relative to traditional pencil-and-paper exercises.
TRIAL REGISTRATION: ClinicalTrials.gov NCT07064226. Date of registration 30th July 2025.}, }
@article {pmid41219645, year = {2025}, author = {Hoang, VD and Nguyen, HMT and Nguyen, TA and Garg, S}, title = {Pharmaceutical Formulations and Analytical Methods of Donepezil.}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {28}, pmid = {41219645}, issn = {1530-9932}, support = {R01AG064688 (Hinton/Nguyen MPI)//the National Institute of Aging (NIA) of the National Institutes of Health (NIH)/ ; }, mesh = {*Donepezil/chemistry ; Chemistry, Pharmaceutical/methods ; Humans ; Alzheimer Disease/drug therapy ; *Cholinesterase Inhibitors/chemistry/administration & dosage ; Drug Compounding/methods ; Drug Delivery Systems/methods ; *Indans/chemistry ; *Piperidines/chemistry ; Tandem Mass Spectrometry/methods ; Nanoparticles/chemistry ; }, abstract = {Donepezil is a selective acetylcholinesterase inhibitor widely prescribed for the symptomatic treatment of Alzheimer's disease. As therapeutic needs grow and delivery systems evolve, ensuring product quality, efficacy, safety and patient compliance becomes increasingly important. Meanwhile, pharmaceutical formulation innovations can improve clinical outcomes and usability, and analytical methods help ensure accurate assessment of drug behavior and quality control. This narrative review first provides a concise overview of donepezil's physicochemical properties and synthesis, then focuses on two interrelated domains: (i) pharmaceutical formulations and (ii) analytical methodologies. The former highlights advancements in novel delivery systems-such as liposomes, nanoparticles, microneedles, nasal gels, and long-acting injectable depots-developed to enhance brain targeting, prolong drug release, and reduce systemic side effects. The latter reviews validated analytical methods for quantifying and characterizing donepezil in pharmaceutical and biological matrices, with emphasis on RP-HPLC, LC-MS/MS, chiral separations, and emerging electrochemical and spectroscopic techniques. These analytical strategies are essential for evaluating formulation performance, monitoring drug stability, and ensuring regulatory compliance. Collectively, this review underscores that progress in both formulation design and analytical science is vital to optimizing donepezil-based therapies for Alzheimer's disease management.}, }
@article {pmid41219231, year = {2025}, author = {Mahadik, N and Paruchuri, SN and Arif, R and Coutts, AS and Barron, GA and Kong Thoo Lin, P and Chatterjee, S and Thompson, CJ}, title = {Evaluation of the toxicity and efficacy of a multi-target polymer-drug nano-polyplex in SH-SY5Y cells and Drosophila model of tauopathy.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {39454}, pmid = {41219231}, issn = {2045-2322}, support = {C23-1720928079//Royal Society of Chemistry/ ; C23-1720928079//Royal Society of Chemistry/ ; C23-1720928079//Royal Society of Chemistry/ ; C23-1720928079//Royal Society of Chemistry/ ; C23-1720928079//Royal Society of Chemistry/ ; }, mesh = {Animals ; *Tauopathies/drug therapy/metabolism/pathology ; Humans ; Disease Models, Animal ; tau Proteins/metabolism ; Cell Survival/drug effects ; *Acrylic Resins/chemistry ; Drosophila melanogaster ; Drosophila ; Cell Line, Tumor ; Phosphorylation/drug effects ; *Polymers/chemistry ; *Nanoparticles/chemistry ; }, abstract = {Hyperphosphorylated tau contributes to synaptic damage and neuronal dysfunction in neurodegenerative diseases such as Alzheimer's disease (AD), making it a key therapeutic target. This study evaluated the toxicity and therapeutic potential of a novel polymer-drug nano-polyplex, N5NM15, and polyacrylic acid (PAA) in Drosophila tauopathy models and undifferentiated human SH-SY5Y cells. Cellular uptake was demonstrated by N5NM15, and SH-SY5Y cell viability was significantly enhanced (45%, p ≤ 0.0001) under okadaic acid-induced stress, and total tau levels were reduced (1.43-fold, p ≤ 0.01). In comparison, PAA had a modest effect on decreasing tau phosphorylation (1.3-fold) at the pSer202/pThr205 site. Toxicity studies in Drosophila revealed that N5NM15 (3.5:1 and 44:12.5 µg/mL) and PAA (44 µg/mL) were toxic to adult flies expressing the eye-specific driver (GMR-GAL4) but were well-tolerated in flies overexpressing the pan-neuronal driver ELAV-GAL4. Furthermore, treatment with N5NM15 and PAA did not improve the ommatidial arrangement, eye bristle count, or eye length in tauopathy models. Climbing and survival assays indicated a potential mild protective effect at a lower concentration (3.5:1 µg/mL) at the early stage of the disease, but at a higher dose (44:12.5 µg/mL) was significantly toxic, in both wild-type (p ≤ 0.0001) and tauopathy models (p < 0.05). These findings highlight the need for N5NM15 and PAA dose optimisation and reformulation with non-toxic buffers to enhance therapeutic potential while minimising adverse effects in normal and Drosophila tauopathy models for AD treatment.}, }
@article {pmid41219110, year = {2025}, author = {Rose, DK and Lyketsos, CG and Rosenberg, PB and Nowrangi, MA}, title = {Neuropsychiatric symptoms in Alzheimer's disease: Bridging mechanisms, management, and emerging innovations.}, journal = {Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics}, volume = {}, number = {}, pages = {e00788}, doi = {10.1016/j.neurot.2025.e00788}, pmid = {41219110}, issn = {1878-7479}, abstract = {Neuropsychiatric symptoms (NPS) are among the most distressing and functionally disruptive features of Alzheimer's disease (AD), affecting the vast majority of individuals across the disease continuum. These symptoms, ranging from apathy and depression to agitation and psychosis, not only worsen quality of life but also predict faster decline, earlier institutionalization, and heightened caregiver burden. Yet, despite their clinical significance, NPS remain under-recognized and undertreated. This review synthesizes current understanding of the biological underpinnings of NPS in AD, highlighting network-level dysfunction, neurotransmitter imbalances, neuroinflammation, and emerging roles for tau pathology and circadian disruption. We critically examine current treatment paradigms, noting that pharmacologic interventions offer benefit but often carry significant risks. In contrast, non-pharmacological approaches, particularly those that integrate caregiver training, environmental design, and sensory engagement, hold promise but are inconsistently applied in routine care. Emerging innovations, including neuromodulation, repurposed agents (e.g., beta-blockers, cannabinoids), and digital therapeutics such as virtual reality and AI-enabled monitoring tools, offer new therapeutic avenues. We call for a paradigm shift toward person-centered, mechanistically-informed care that aligns intervention strategies with biological drivers of NPS. Future progress hinges on inclusive clinical trials, implementation of first-line behavioral strategies, and development of biomarker-guided, precision approaches to symptom management. Effective care for NPS in AD demands integration, not substitution, of pharmacologic and non-pharmacologic strategies, grounded in a deeper understanding of both disease biology and lived patient experience.}, }
@article {pmid41219002, year = {2026}, author = {Radhakrishna, BK and Kaladiyil, AP and Chakraborty, A and Gautam, V and Muddashetty, RS}, title = {Group 1 mGluR stimulation rescues APOE4-mediated translation defects in neurons.}, journal = {Life science alliance}, volume = {9}, number = {2}, pages = {}, pmid = {41219002}, issn = {2575-1077}, mesh = {Animals ; *Apolipoprotein E4/metabolism/genetics ; *Receptors, Metabotropic Glutamate/metabolism ; *Neurons/metabolism/drug effects ; Rats ; Rats, Sprague-Dawley ; *Protein Biosynthesis/drug effects ; Neuronal Plasticity ; TOR Serine-Threonine Kinases/metabolism ; Phosphorylation ; Cells, Cultured ; Alzheimer Disease/metabolism/genetics ; Humans ; Ribosomal Protein S6/metabolism ; }, abstract = {The E4 isoform of apolipoprotein (APOE4) is the most recognized risk factor for Alzheimer's disease, implicated in early neurodegeneration and impaired synaptic plasticity. In neurons, exposure to APOE4 disrupts basal and NMDAR-mediated calcium signaling, further disrupting protein synthesis response. Group 1 mGluRs, a major class of glutamate receptors, also play a critical role in synaptic plasticity through activity-dependent protein synthesis. In this study, we examine neuronal protein synthesis response to mGluR stimulation in the background of APOE4 treatment. In DIV15 primary cortical neurons from Sprague-Dawley rat embryos, exposure to APOE4 induces inhibition of protein synthesis, which is rescued by stimulation of mGluRs for 5 min. mGluR stimulation also rescued the APOE4-induced reduction in synaptic activity as measured by the multi-electrode array. This mGluR-mediated rescue is driven by phosphorylation of RPS6, downstream of the mammalian target of rapamycin (mTOR) pathway as it is abolished by rapamycin treatment. This p-RPS6-driven rescue is independent of calcium-mediated translation inhibition induced by APOE4, demonstrating a specific and independent role of mTORC1 activity in maintaining mGluRs' translation capacity under APOE4 exposure. The potential of mGluR-mediated response to compensate for the effect of APOE4 suggests a dynamic mechanism for the induction of plasticity in human APOE4 carriers. This study provokes a critical need to explore the altered synaptic dynamics in the presence of APOE4 and its impact on cognition.}, }
@article {pmid41218737, year = {2026}, author = {Ahangaran, S and Pourgholaminejad, A and Nosrati, R and Babaei, P}, title = {TLR4 inhibition attenuates facilitatory effects of JQ1 on learning & memory via polarization of microglia, and BDNF expression in Alzheimer's disease model.}, journal = {Behavioural brain research}, volume = {499}, number = {}, pages = {115919}, doi = {10.1016/j.bbr.2025.115919}, pmid = {41218737}, issn = {1872-7549}, mesh = {Animals ; *Brain-Derived Neurotrophic Factor/metabolism/drug effects ; *Alzheimer Disease/metabolism/drug therapy ; *Microglia/drug effects/metabolism ; Male ; *Toll-Like Receptor 4/antagonists & inhibitors/metabolism ; Rats, Wistar ; Rats ; *Azepines/pharmacology/administration & dosage ; *Triazoles/pharmacology/administration & dosage ; Disease Models, Animal ; Hippocampus/drug effects/metabolism ; Sulfonamides/pharmacology/administration & dosage ; Amyloid beta-Peptides ; Avoidance Learning/drug effects ; Maze Learning/drug effects ; Cell Cycle Proteins ; Bromodomain Containing Proteins ; Nuclear Proteins ; Transcription Factors ; }, abstract = {OBJECTIVE: Neuroinflammation is a core event in the pathogenesis of Alzheimer's disease (AD), which is mediated by microglia. The present study aimed to investigate the effect of co-inhibition of Toll-like receptor (TLR4) and chromatin reader of BRD4 on cognition deficit, polarization of microglia, and Brain-derived neurotrophic factor in the hippocampus.
METHODS: Forty male Wistar rats were randomly divided into five groups: saline +saline, Aβ+saline, Aβ+JQ1(BRD4 inhibitor), Aβ+TAK242 (TLR4 inhibitor), Aβ+JQ1 +TAK-242, and received the related treatments. Then cognitive functions were assessed by passive avoidance learning (PAL) and Morris water maze (MWM) tests and the polarization of microglia and BDNF level in the hippocampus, were measured using flow cytometry and western blotting, respectively.
RESULTS: Chronic intracerebroventricular administration of JQ1, either alone or in combination with TAK-242, significantly reduced escape latency and increased the time spent in the target quadrant (TTS) during the probe test of the Morris Water Maze (MWM), compared with the Aβ + saline group (p < 0.05). In contrast, TAK-242 alone prolonged escape latency and reduced TTS (p < 0.05). Moreover, JQ1 treatment markedly elevated the M2/M1 microglial polarization and the mBDNF/proBDNF ratio in the hippocampus (p < 0.05), suggesting that JQ1 promotes neuroprotective and facilitatory effects on cognitive function in AD model.
CONCLUSION: Our results indicate that JQ1 successfully improves learning and memory in the rat model of AD, primarily by inducing the transcription of mature BDNF expression and suppressing inflammatory factors related to the M1 microglia. In contrast, co-treatment with a TLR4 inhibitor attenuates both spatial and aversive memories, probably through a decrease in BDNF expression.}, }
@article {pmid41218709, year = {2026}, author = {Ruoff, LK and Bänfer, IWH and Liedtke, DE and China, SE and Wiltfang, J and Bayer, TA and Bock, SF and Spandau, F and Bouter, C and Beindorff, N and Bouter, Y}, title = {Long-term thiethylperazine treatment in the Tg4-42 mouse model of Alzheimer's disease mouse: Therapeutic potential vs. adverse effects.}, journal = {Pharmacology, biochemistry, and behavior}, volume = {258}, number = {}, pages = {174127}, doi = {10.1016/j.pbb.2025.174127}, pmid = {41218709}, issn = {1873-5177}, mesh = {Animals ; *Alzheimer Disease/drug therapy/metabolism ; Mice ; Mice, Inbred C57BL ; Disease Models, Animal ; Male ; Mice, Transgenic ; *Piperazines/adverse effects/therapeutic use/pharmacology/administration & dosage ; Anxiety/drug therapy ; Maze Learning/drug effects ; Memory/drug effects ; Amyloid beta-Peptides/metabolism ; Behavior, Animal/drug effects ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline and behavioral impairments. Thiethylperazine, a dopamine receptor antagonist with antiemetic and antidopaminergic properties, has been proposed as a potential therapeutic agent for AD. However, its impact on cognitive function in AD remains unclear.
AIMS: This study investigated the long-term effects of thiethylperazine on memory, anxiety-like behavior, motor function, and AD pathology in Tg4-42 mice, a model characterized by Aβ4-42 overexpression and progressive neurodegeneration. Additionally, the impact of prolonged thiethylperazine treatment on behavioral outcomes and cerebral glucose metabolism in healthy adult C57BL/6J wild-type (WT) mice were examined.
METHODS: Tg4-42 and WT mice were treated daily with 10 mg/kg thiethylperazine for 6 months, starting at 10 weeks of age. Memory, anxiety-related, and motor tests were performed at 7.5 months. Immunohistochemical analyses were conducted to quantify effects on Aβ pathology, neurogenesis, neuron number, and neuroinflammation. Additionally, [18]F-FDG-PET imaging was used to evaluate metabolic activity in WT mice following treatment.
RESULTS: Thiethylperazine improved recognition memory in Tg4-42 mice in the Novel Object Recognition test and exhibited anxiolytic properties. However, it impaired spatial learning in the Morris Water Maze (MWM), reduced locomotion, and failed to mitigate motor impairments. No effects on neuron loss or neuroinflammation were observed. In WT mice, thiethylperazine altered learning processes in the MWM, as indicated by shifts in search strategies, induced hypometabolism and increased neurogenesis.
CONCLUSION: Although thiethylperazine offers mild cognitive benefits in Tg4-42, its adverse effects on learning strategies and locomotion raise questions about its potential as a therapeutic option for AD.}, }
@article {pmid41216966, year = {2025}, author = {Hovde, MJ and Maaser-Hecker, A and Bae, JS and Tanzi, RE}, title = {Inhibition of Acyl-CoenzymeA: Cholesterol Acyltransferase 1 promotes shedding of soluble triggering receptor on myeloid cells 2 (TREM2) and low-density lipoprotein receptor 1 (LRP1)-dependent phagocytosis of amyloid beta protein in microglia.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70879}, pmid = {41216966}, issn = {1552-5279}, support = {//NIH/ ; T32 AG000222-31//Cure Alzheimer's Fund/ ; //Freedom Together Fund/ ; T32AG000222/AG/NIA NIH HHS/United States ; T32 AG000222/AG/NIA NIH HHS/United States ; }, mesh = {*Microglia/metabolism/drug effects ; Animals ; *Amyloid beta-Peptides/metabolism ; *Low Density Lipoprotein Receptor-Related Protein-1/metabolism/genetics ; *Receptors, Immunologic/metabolism/genetics ; Humans ; Mice, Knockout ; *Phagocytosis/physiology/drug effects ; *Membrane Glycoproteins/metabolism/genetics ; Mice ; *Sterol O-Acyltransferase/antagonists & inhibitors/metabolism ; *Acetyl-CoA C-Acetyltransferase/antagonists & inhibitors/metabolism ; }, abstract = {INTRODUCTION: Lipid regulation is crucial role in Alzheimer's disease (AD) pathogenesis. In AD, microglia show elevated sterol O-acyltransferase 1/Acyl-coenzymeA: Choleseterol Acyltransferase 1 (SOAT1) expression, encoding Acyl-coenzymeA: Cholesterol Acyltransferase 1 (ACAT1), which produces cholesteryl esters (CEs) in lipid droplets. Inhibiting ACAT1 has been shown to reduce amyloid beta (Aβ) pathology, though the mechanism is unclear.
METHODS: We inhibited ACAT1 using avasimibe (AV) in wild-type, triggering receptor expressed on myeloid cells 2 (TREM2) knockout (KO), and low-density lipoprotein receptor related protein 1 (LRP1) KO mouse BV2 and human induced pluripotent stem cell-derived microglia and measured the impact on Aβ uptake to determine the mechanism through which the inhibition of ACAT1 enhances Aβ uptake.
RESULTS: ACAT1 inhibition increased LRP1 levels and soluble TREM2 (sTREM2) release via enhanced TREM2 cleavage by ADAM metallopeptidase domain 10/17 (ADAM10/17). KO of TREM2 or blockade of sTREM2 release prevented AV-enhanced Aβ uptake. This effect was rescued by recombinant sTREM2, but only when LRP1 was present.
DISCUSSION: ACAT1 inhibition promotes microglial Aβ uptake in a sTREM2- and LRP1-dependent manner, offering insights into novel therapeutic strategies for AD.
HIGHLIGHTS: Inhibition of ACAT1, the major enzyme that catalyzes cholesterol storage via esterification enhances microglia-mediated Aβ uptake. Increased Aβ uptake is dependent on the presence of both TREM2 and LRP1. Inhibition of ACAT1 increases cleavage of TREM2 via ADAM10/17 to release sTREM2. Treatment of microglial cells with sTREM2 rescues Aβ uptake in TREM2 KO BV2 cells. Inhibition of ACAT1 promotes Aβ uptake through increased shedding of TREM2, which enhances Aβ uptake through a LRP1-dependent mechanism.}, }
@article {pmid41216919, year = {2025}, author = {Heikal, SA and Fawi, G and Khedr, EM and Othman, M and Moustafa, SA and Elsheikh, NG and Tawfik, HM and Elfarrash, S and Salama, S and Ali, EM and Hassanin, HI and Salama, M}, title = {The Egyptian Dementia Network (EDN): Baseline characteristics from the first dementia registry in an African Arab country.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70770}, pmid = {41216919}, issn = {1552-5279}, support = {//100 PhDs for Africa programme/ ; //UM6P- EPFL Excellence in Africa Initiative/ ; //American University in Cairo, Research Support/ ; }, mesh = {Humans ; *Registries ; Egypt/epidemiology ; Female ; Male ; *Dementia/epidemiology ; Aged ; Middle Aged ; Aged, 80 and over ; Comorbidity ; }, abstract = {INTRODUCTION: Dementia is a growing public health challenge in low- and middle-income countries (LMICs) like Egypt, where data are scarce. The Egyptian Dementia Network (EDN) registry addresses this gap by capturing epidemiological, clinical, and environmental data across Egypt.
METHODS: In this multicenter study, 662 participants from six governorates were enrolled using standardized tools.
RESULTS: The cohort had advanced age (mean 68.3 years), low education (65.9% illiterate), and high comorbidities including hypertension (55%) and diabetes (23%). Alzheimer's disease (62%) and vascular dementia (23%) predominated. Only 24.4% received pharmacological treatment and 2.1% psychosocial support, highlighting care gaps. Household insecticide exposure (20.4%) was notable.
DISCUSSION: EDN demonstrates the feasibility of implementing a national dementia registry in LMICs, generating baseline insights into demographic, clinical, and environmental risks. In addition, registry-linked biosamples have enabled pilot multi‑omics and exposome analyses, underscoring its potential as a scalable scientific platform for future dementia research.
HIGHLIGHTS: Established Egypt's first national, multicenter dementia registry. Aimed to characterize dementia profiles and care gaps across diverse regions. Identified late-stage diagnosis and limited access to dementia interventions. Uncovered unique environmental risk factors relevant to the Egyptian context. Provides a foundation for policy, research, and improved dementia care in Egypt.}, }
@article {pmid41216806, year = {2025}, author = {Oveisgharan, S and Yu, L and Wang, Y and Yang, J and Vialle, R and Lopes, KP and Tasaki, S and Young-Pearse, TL and De Jager, PL and Petyuk, VA and Schneider, JA and Seyfried, NT and Bennett, DA}, title = {Amyloid beta binding partners in the brain tissue of older adults.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70882}, pmid = {41216806}, issn = {1552-5279}, support = {P30 AG072975/AG/NIA NIH HHS/United States ; U01 AG046152/AG/NIA NIH HHS/United States ; R01 AG088643/AG/NIA NIH HHS/United States ; R01AG088643/NH/NIH HHS/United States ; U01 AG072572/AG/NIA NIH HHS/United States ; R01 AG017917/AG/NIA NIH HHS/United States ; P30AG72975/NH/NIH HHS/United States ; P30 AG010161/AG/NIA NIH HHS/United States ; U01AG072572/NH/NIH HHS/United States ; R01AG17917. R01AG015819/NH/NIH HHS/United States ; R01AG088643/AG/NIA NIH HHS/United States ; P30AG10161/NH/NIH HHS/United States ; U01AG046152/NH/NIH HHS/United States ; R01 AG015819/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *Amyloid beta-Peptides/metabolism ; Male ; Female ; tau Proteins/metabolism ; Aged ; Aged, 80 and over ; *Alzheimer Disease/pathology/metabolism ; *Brain/metabolism/pathology ; Neurofibrillary Tangles/pathology/metabolism ; rac1 GTP-Binding Protein/metabolism ; Sodium-Potassium-Exchanging ATPase/metabolism ; }, abstract = {INTRODUCTION: The mechanism linking extracellular amyloid beta (Aβ) with intraneuronal tau tangles, pathological hallmarks of Alzheimer's disease (AD), is not understood; it was tested in the current study through Aβ binding partners.
METHODS: Data were from decedents of community-based clinical-pathological studies. Of 52 Aβ binding partners, suggested by non-human studies, levels of 34 together with total Aβ protein were quantified in the dorsolateral prefrontal cortex. Post mortem pathological assessment immunohistochemically quantified Aβ load and tau tangle density.
RESULTS: The strongest mediations between Aβ and tau tangles were observed for Ras-related C3 botulinum toxin substrate 1 (RAC1) and sodium/potassium-transporting ATPase subunit alpha-3 (ATP1A3), which collectively mediated 10.1% of the association between Aβ and tau tangles. In contrast, Aβ mediated >70% of the associations of matrix proteins with tau tangles.
DISCUSSION: Identification of Aβ binding partners that mediate the association between Aβ and tau tangles may provide new targets for AD treatment.
HIGHLIGHTS: RAC1 linked Aβ with tau tangles. ATP1A3 linked Aβ with tau. RAC1 and ATP1A3 collectively mediated 10.1% of the association between Aβ and tau. Aβ mediated >70% of the associations of matrix proteins, such as APOE, with tau.}, }
@article {pmid41216805, year = {2025}, author = {Lopergolo, D and Gasparini, D and Bianchi, S and Pucci, B and Tripodi, D and Leoni, V and Chincarini, A and Sestini, S and Zetterberg, H and De Stefano, N and Mignarri, A}, title = {Miglustat in Alzheimer's Disease Associated With Heterozygous NPC1 Mutation: Exploratory Case Series and Preliminary Findings.}, journal = {European journal of neurology}, volume = {32}, number = {11}, pages = {e70419}, pmid = {41216805}, issn = {1468-1331}, support = {2023-00356//Swedish Research Council/ ; 2022-01018//Swedish Research Council/ ; 2019-02397//Swedish Research Council/ ; 101053962//European Union's Horizon Europe research and innovation programme/ ; #ALFGBG-71320//Swedish State Support for Clinical Research/ ; 201809-2016862//Alzheimer Drug Discovery Foundation (ADDF), USA/ ; ADSF-21-831376-C//AD Strategic Fund and the Alzheimer's Association/ ; ADSF-21-831381-C//AD Strategic Fund and the Alzheimer's Association/ ; ADSF-21-831377-C//AD Strategic Fund and the Alzheimer's Association/ ; ADSF-24-1284328-C//AD Strategic Fund and the Alzheimer's Association/ ; 22HLT07//European Partnership on Metrology/ ; //Bluefield Project/ ; //Cure Alzheimer's Fund/ ; //Olav Thon Foundation/ ; //Erling-Persson Family Foundation/ ; }, mesh = {Aged ; Female ; Humans ; Male ; Middle Aged ; *1-Deoxynojirimycin/analogs & derivatives/therapeutic use/pharmacology/analogs & derivatives ; *Alzheimer Disease/genetics/drug therapy/diagnostic imaging ; Brain/diagnostic imaging/metabolism/drug effects ; *Enzyme Inhibitors/therapeutic use ; Heterozygote ; Intracellular Signaling Peptides and Proteins ; *Membrane Glycoproteins/genetics ; Mutation/genetics ; Niemann-Pick C1 Protein ; }, abstract = {INTRODUCTION: Several studies have previously demonstrated an increased risk of dementia and brain amyloid deposition in individuals with heterozygous NPC1 mutations. Moreover, in a recent study, we identified the first family with autosomal dominant late-onset Alzheimer's disease (AD) caused by a heterozygous NPC1 mutation. Unfortunately, there are currently no effective treatments available for this condition. Miglustat, which impacts the metabolism of oxysterols, has been shown to exert an anti-amyloidogenic effect in a human cellular model of AD.
METHODS: In our exploratory uncontrolled study, three patients from the previously published family were orally treated with miglustat for 12 months. They underwent monthly clinical evaluations and routine blood tests. Additionally, neuropsychological evaluations, brain amyloid-PET imaging, and biochemical analyses on plasma and CSF were performed.
RESULTS: All three patients achieved clinical stability, showed a sustained reduction in serum oxysterol levels, and experienced a marked decrease in brain amyloid burden.
DISCUSSION: Based on our preliminary observations and hypothesis-generating findings, along with the growing evidence suggesting AD as a lipid disorder, miglustat should be further tested in a larger cohort of heterozygous NPC1 mutated patients and probably evaluated as a potential disease-modifying treatment for AD.}, }
@article {pmid41216328, year = {2025}, author = {Mohammadi, S and Zarei, S}, title = {Predicting Alzheimer's disease from environmental risk factors: An fMRI-based functional connectivity and advanced machine learning approach.}, journal = {Journal of environmental health science & engineering}, volume = {23}, number = {2}, pages = {39}, pmid = {41216328}, issn = {2052-336X}, abstract = {Alzheimer's disease (AD) is a prevalent and severe neurodegenerative disorder influenced by both genetic and environmental factors-such as air pollution, toxic elements, pesticides, and infectious agents. In recent years, machine learning techniques have become essential in biomedical research, advancing fields like drug delivery and medical imaging through predictive modeling and pattern recognition. Functional connectivity derived from functional magnetic resonance imaging (fMRI) serves as a promising noninvasive biomarker for AD by mapping the brain's connectome and revealing neural network disruptions. In this study, we employed the Robust Multitask Feature Extraction Method to evaluate six supervised machine learning algorithms logistic regression, naïve Bayes, support vector machine, random forest, XGBoost, and CatBoostmfor AD diagnosis. A dataset of 140 fMRI images from an equal number of AD patients and healthy individuals (mean age 67.3 ± 6.7 years) was analyzed. The XGBoost algorithm demonstrated exceptional performance, achieving an accuracy of 98.2%, a recall of 96.6%, perfect precision (100%), an F1-Score of 98.2%, and a Matthews correlation coefficient of 0.96 effectively minimizing false positives and negatives. Although CatBoost and Random Forest also yielded robust results, logistic regression and naïve Bayes showed lower reliability. Overall, XGBoost emerges as a robust solution for the early and precise prediction of Alzheimer's disease, carrying significant implications for proactive patient care and treatment strategies. Beyond these findings, emerging research is exploring multimodal imaging techniques-such as PET and EEG and deeper neural network architectures to further enhance early diagnostic accuracy and treatment personalization in AD.}, }
@article {pmid41215663, year = {2026}, author = {Guo, Z and Ni, H and Lu, Y and Cui, Z and Wang, Y and Zhu, Z and Wei, X and Xia, C and Xu, M and Du, L and Yang, Y and Shu, S and Wang, K and Wang, Z and Shan, C and Wang, D}, title = {TNEA Regulates Hippocampal Oscillation by Improving Inhibitory Synaptic Plasticity to Ameliorates Cognitive Impairment in Alzheimer's Disease.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {13}, number = {3}, pages = {e10885}, pmid = {41215663}, issn = {2198-3844}, support = {62127810//National Natural Science Foundation of China/ ; 82272612//National Natural Science Foundation of China/ ; 82374581//National Natural Science Foundation of China/ ; 21DZ2271000//Shanghai Key Laboratory of Health Identification and Assessment/ ; YC-2023-0604//Pudong New Area of Highland Discipline development program/ ; PWRq2023-36//Pudong New Area Outstanding Young Medical Professionals Training Program/ ; YC-2024-0104//Pudong Traditional Chinese Medicine Standardization & Capacity Building Project/ ; }, mesh = {Animals ; *Alzheimer Disease/therapy/physiopathology ; *Neuronal Plasticity/physiology ; Mice ; *Cognitive Dysfunction/therapy/physiopathology ; Disease Models, Animal ; *Hippocampus/physiopathology ; Mice, Transgenic ; Interneurons ; Male ; Theta Rhythm/physiology ; }, abstract = {Three-needle electroacupuncture (TNEA) has demonstrated efficacy in improving cognitive function in both Alzheimer's disease (AD) model animals and patients, although its underlying mechanism remains unclear. Here this work investigates the potential connection between cognitive-enhancing effect and TNEA in 5×familial Alzheimer disease(5xFAD) mice model, a model characterized by Amyloid-beta (Aβ) pathology. This work finds alterations in gamma/theta oscillations and deficits in inhibitory monosynaptic transmission in the hippocampal CA1 region of AD. Parvalbumin-positive (PV[+]) interneurons are crucial for generating gamma oscillations and modulating theta oscillation, thereby maintaining the excitation-inhibition (E/I) balance in local neural circuits. In 5xFAD mice, TNEA modulated PV[+] interneuron function, enhancing gamma oscillations during quiescent states. Furthermore, during the novel object recognition test (NORT), TNEA increased theta oscillation power by strengthening presynaptic inhibitory interneurons involved in monosynaptic connections. Collectively, these findings suggest TNEA is a viable minimally invasive treatment approach for AD.}, }
@article {pmid41215623, year = {2025}, author = {Li, LL and Wang, RZ and Wang, Z and Hu, H and Xu, W and Zhu, L and Sun, Y and Chen, KL and Chen, SF and He, XY and Yuan, MY and Huang, YY and Liu, X and Liu, P and Ye, QY and Wang, J and Ju, ZZ and Zhang, W and Hu, B and Guo, Y and Cao, XY and Li, YX and Zuo, CT and Cheng, W and Jiang, T and Tan, L and Chen, XC and Zhao, QH and Cui, M and Peng, GP and Xin, JW and Yu, JT}, title = {Safety and short-term outcomes of lecanemab for Alzheimer's disease in China: a multicentre study.}, journal = {Brain : a journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1093/brain/awaf427}, pmid = {41215623}, issn = {1460-2156}, abstract = {Lecanemab is a newly approved monoclonal antibody targeting amyloid plaques for the treatment of early Alzheimer's disease. This study aimed to evaluate the safety and short-term biomarkers and cognition changes of lecanemab in Chinese clinical practice. This multicenter real-world study involved patients receiving lecanemab treatment across seven hospitals in China. Patients underwent comprehensive assessments before treatment. Lecanemab was administered via intravenous infusion every 2 weeks. Treatment-related symptoms were monitored through self-report, and amyloid-related imaging abnormalities were assessed via magnetic resonance imaging. Amyloid and tau biomarker changes were measured using positron emission tomography imaging or plasma testing. Follow-up cognitive assessments were evaluated after 6 months of treatment. Short-term outcomes were analyzed using linear mixed-effect models, without an untreated control group. A total of 407 patients who received at least one lecanemab infusion were involved in this study, with a mean follow-up time of 5.6±3.39 months. The mean age was 68.08 years, with 67.57% of patients being female. Of the participants, 56.51% were APOE ε4 carriers, and 83.19% were at biological stage C. During the study period, 22.22% of the patients experienced treatment-related symptoms, and 12.15% developed at least one amyloid-related imaging abnormality. Only four symptomatic and seven severe amyloid-related imaging abnormality cases were reported. APOE ε4 status was not related to adverse events in the Chinese population. Patients with a higher number of microhemorrhages at baseline were more likely to develop adverse events. No significant differences in adverse events were observed between the moderate Alzheimer's disease dementia group and the mild cognitive impairment group. By the end of the research period, 9.38% of the patients withdrew from lecanemab. After 6 months of treatment, favourable short-term outcomes in biomarkers and stable cognitive function were observed. This study demonstrates that lecanemab treatment is feasible and well-tolerated among the Chinese population, with lower rates of adverse events and favourable short-term outcomes observed. Administration of lecanemab in moderate AD dementia population was relatively safe and further studies are warranted.}, }
@article {pmid41213497, year = {2025}, author = {Hu, K and Li, C and Liu, Y and Pan, C and Xie, P and Wen, L and Xu, H and Tang, Y and Zheng, P and Huang, Y}, title = {Arabinoxylan ameliorates memory deficits and amyloid pathology in male 5 × FAD mice via modulation of gut microbiota structure.}, journal = {Neuroscience}, volume = {591}, number = {}, pages = {52-62}, doi = {10.1016/j.neuroscience.2025.11.010}, pmid = {41213497}, issn = {1873-7544}, mesh = {Animals ; *Gastrointestinal Microbiome/drug effects/physiology ; Male ; Mice ; *Alzheimer Disease/metabolism/pathology ; *Memory Disorders/metabolism/drug therapy/pathology ; *Xylans/pharmacology ; Hippocampus/metabolism/drug effects ; Amyloid beta-Peptides/metabolism ; Disease Models, Animal ; Mice, Transgenic ; Dysbiosis ; Mice, Inbred C57BL ; Fatty Acids, Volatile/metabolism ; Brain/metabolism/drug effects ; }, abstract = {Alzheimer's disease (AD), a prevalent neurodegenerative disorder, is primarily characterized by β-amyloid (Aβ) deposition. Current therapies alleviate symptoms but lack agents capable of modifying disease progression. Meanwhile, cross-regional studies indicate that AD patients exhibit disrupted gut microbiota composition, which is closely associated with cerebral molecular dysregulation. Building on this gut-brain connection, this study aimed to attenuate AD progression by targeting gut microbiota through microbially metabolized carbohydrates. Specifically, using 5 × FAD mice modeling AD pathology, we conducted 16S rRNA sequencing, targeted metabolomics of microbiota-derived metabolites, and bulk RNA sequencing experiments to investigate gut-brain axis alterations. Our results show that AD mice exhibited gut dysbiosis, depletion of short chain fatty acids (SCFAs), and transcriptomic dysregulation in the hippocampus, particularly affecting aging and synaptic plasticity-related genes. Dietary intervention with arabinoxylan significantly increased SCFAs-producing bacteria (Oscillospiraceae and Eubacterium_coprostanoligenes_group), elevated butyric acid, and thereby reversed expression levels of these aging and synaptic plasticity-related genes. Mechanistically, arabinoxylan alleviated AD-like symptoms by modulating the microbiota-gut-brain (MGB) axis; this beneficial effect occurred through enrichment of probiotic bacteria that produce SCFAs to regulate hippocampal synaptic plasticity genes. Collectively, this work proposes arabinoxylan as a novel prebiotic strategy and identifies candidate therapeutic targets for AD treatment.}, }
@article {pmid41213496, year = {2026}, author = {Abdulkhaliq, AA and Alasiri, G and Almoghrabi, Y and Kim, B and Khan, J and Ajoolabady, A and Ren, J and Tuomilehto, J and Borai, A and Pratico, D}, title = {Role of TREM2 in neuroinflammation.}, journal = {Experimental neurology}, volume = {396}, number = {}, pages = {115547}, doi = {10.1016/j.expneurol.2025.115547}, pmid = {41213496}, issn = {1090-2430}, mesh = {Humans ; *Receptors, Immunologic/metabolism ; Animals ; *Membrane Glycoproteins/metabolism ; *Neuroinflammatory Diseases/metabolism/pathology ; Microglia/metabolism ; Signal Transduction/physiology ; }, abstract = {Triggering receptor expressed on myeloid cells 2 (TREM2) is cell surface transmembrane receptor of the TREM family, predominantly expressed on microglia within the central nervous system (CNS). Accumulating evidence has highlighted a critical role for microglial TREM2 in modulating inflammatory signaling pathways, thereby influencing the course of neuroinflammation - a central pathological hallmark of various neurodegenerative and CNS disorders. In this review, we aim to elucidate the molecular mechanisms by which TREM2 regulates neuroinflammatory processes, with a particular focus on the most recent advances in the field. A deeper understanding of TREM2-mediated signaling may uncover novel therapeutic targets and pathways with significant translational potential for treatment of CNS diseases.}, }
@article {pmid41213450, year = {2025}, author = {Huang, Y and Han, M and Fu, Y and Wang, G and Kong, L and Mo, J and Cao, D and Chu, Z and Li, W}, title = {HY-021068 improves neuronal ferroptosis by activating Nrf2 signaling in APP/PS1 Mice and Aβ1-42-induced HT22 cells.}, journal = {European journal of pharmacology}, volume = {1008}, number = {}, pages = {178349}, doi = {10.1016/j.ejphar.2025.178349}, pmid = {41213450}, issn = {1879-0712}, mesh = {Animals ; *Ferroptosis/drug effects ; *NF-E2-Related Factor 2/metabolism ; *Amyloid beta-Peptides ; Mice ; Signal Transduction/drug effects ; *Neurons/drug effects/metabolism/pathology ; *Peptide Fragments/pharmacology/toxicity ; *Alzheimer Disease/drug therapy/metabolism/pathology ; *Neuroprotective Agents/pharmacology/therapeutic use ; Mice, Transgenic ; Cell Line ; Amyloid beta-Protein Precursor/genetics ; Presenilin-1/genetics ; Reactive Oxygen Species/metabolism ; Male ; }, abstract = {Alzheimer's disease (AD) is a progressive neurodegenerative disorder with an unclear pathogenesis and no effective treatment methods. HY-021068 (HY), a novel class I drug, exhibits significant neuroprotective properties in ischemic brain injury. Recent studies suggest that neuronal ferroptosis may be a critical contributor to the onset and progression of AD. However, it is still unclear whether HY treatment has protective effects on AD by inhibiting ferroptosis. In this study, APP/PS1 double transgenic mice were used to investigate the effect and mechanism of HY in AD. In vitro, HT22 cells were stimulated with Amyloid β1-42 (Aβ1-42) (5 μM) to elucidate the therapeutic effect of HY and its potential mechanism. The present study indicated that HY treatment significantly improved cognitive dysfunction, enhanced synaptic integrity by upregulating PSD95 and Synapsin I, and reduced Aβ plaque load, APP, beta-secretase 1 (BACE1) expression, and Tau hyperphosphorylation. Furthermore, HY increased glutathione peroxidase 4 (Gpx4) and Cystine/glutamate transporter (xCT) levels, while reduced DMT1 and transferrin receptor expression, eventually inhibiting neuronal ferroptosis. Mechanistically, HY decreased reactive oxygen species (ROS) accumulation and activated the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway by elevating Nrf2, heme oxygenase 1 (HO1), and NAD(P)H quinone oxidoreductase 1 (NQO1) expression. The in vitro study also suggested that the Nrf2 inhibitor ML385 markedly diminished the protective effects of HY, while the Nrf2 activator dimethyl fumarate (DMF) resulted in a significant enhancement of HY's therapeutic effects in Aβ1-42-induced HT22 cells. Molecular docking and cellular thermal shift assay showed that HY had an interaction with Nrf2. These results suggested that HY could ameliorate AD-related cognitive decline and neuronal ferroptosis through activating Nrf2 pathway, positioning it as a promising therapeutic strategy for AD.}, }
@article {pmid41213069, year = {2025}, author = {Lin, Y and Zhao, H and Meng, D and Wang, M}, title = {The Role of T Cells in Alzheimer's Disease.}, journal = {Critical reviews in immunology}, volume = {45}, number = {6}, pages = {53-67}, doi = {10.1615/CritRevImmunol.2025061107}, pmid = {41213069}, issn = {2162-6472}, mesh = {Humans ; *Alzheimer Disease/immunology/metabolism/pathology/etiology ; *T-Lymphocytes/immunology/metabolism ; Animals ; *Brain/immunology/pathology/metabolism ; tau Proteins/metabolism ; Blood-Brain Barrier/immunology ; Amyloid beta-Peptides/metabolism ; Plaque, Amyloid/immunology ; }, abstract = {Alzheimer's disease (AD) is a global neurodegenerative disorder characterized by progressive cognitive decline. Its core pathology involves neurofibrillary tangles mediated by hyperphosphorylated tau protein and senile plaques formed by extracellular deposits of β-amyloid. As the global incidence of AD continues to rise, human health faces a serious threat. However, the complexity of its pathogenesis poses significant challenges to current prevention and treatment strategies. Recent studies reveal that T cells, as key components of the adaptive immune system, exhibit abnormalities in both quantity and function within the brains of AD patients. They infiltrate brain parenchyma through multiple pathways-including the blood-brain barrier, choroid plexus, and meningeal lymphatics-and are deeply involved in AD pathology. In this review, we first introduce recent discoveries in the pathogenesis of AD, including tau protein, β-amyloid plaques, and neuroinflammation. We then describe the immune mechanisms and infiltration pathways of T cells in AD. Finally, we focus on the mechanisms by which different T cell subtypes contribute to brain damage in AD, aiming to provide a theoretical foundation for developing AD therapies guided by neuroimmune homeostasis.}, }
@article {pmid41212646, year = {2026}, author = {Song, W and Fang, M and Geng, Z and Pang, X and Yang, C and Chen, M and Song, B and Hu, C and Hu, Y and Hu, W and Zhou, S and Yan, Y and Wu, X and Wang, K}, title = {Mechanistic study of Alzheimer's disease with behavioral and psychological symptoms based on electroencephalography microstates.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {109}, number = {1}, pages = {447-457}, doi = {10.1177/13872877251393715}, pmid = {41212646}, issn = {1875-8908}, mesh = {Humans ; *Alzheimer Disease/psychology/physiopathology/complications ; Male ; Female ; *Electroencephalography/methods ; Aged ; Neuropsychological Tests ; *Behavioral Symptoms/physiopathology/etiology ; Aged, 80 and over ; *Brain/physiopathology ; Middle Aged ; }, abstract = {BackgroundBehavioral and psychological symptoms of dementia (BPSD) are common in Alzheimer's disease (AD), yet their mechanisms remain unclear.ObjectiveWe aim to explore the possible neurophysiological mechanisms of BPSD using high temporal resolution electroencephalography (EEG) microstate technology, laying the foundation for clinical evaluation and subsequent treatment.MethodsWe enrolled 52 AD patients (25 with BPSD, 27 without) and 29 age- and gender-matched healthy controls (HC). All participants underwent various neuropsychological assessments and resting-state EEG recordings. Resting-state EEG data were analyzed employing microstate analysis techniques, with a focus on four key microstate parameters: duration, occurrence, coverage, and transition probability. Inter-group comparisons were performed using post-hoc tests, with statistical significance determined through False Discovery Rate (FDR) correction. Furthermore, the correlations between the indicators and neuropsychological assessment scores were analyzed.ResultsCompared to the HC and non-BPSD groups, the BPSD group showed an increase in the transition rate from microstate A to microstate C. Compared to the HC group, the BPSD group showed an extension in the duration of microstate A and a decrease in the frequency of microstate D. Compared to the HC group, the non-BPSD group showed prolonged durations (A, B, mean) and reduced occurrences (C, D, mean).The partial correlation analysis with years of education as a covariate showed that in the BPSD group, the duration of microstate A was correlated with the severity of the Neuropsychiatric Inventory (NPI) and the Hamilton Anxiety Scale (HAMA).ConclusionsAD with and without BPSD exhibits different altered brain dynamics.}, }
@article {pmid41212436, year = {2025}, author = {Vizuete, AFK and Moreira, AP and Zin, LEF and de Oliveira Marques, C and Pacheco, RF and Leal, MB and Menezes, L and Gonçalves, CA}, title = {Neuroprotective Roles of Metformin in a Streptozotocin-Induced Dementia Model in Rats.}, journal = {Neurotoxicity research}, volume = {43}, number = {6}, pages = {48}, pmid = {41212436}, issn = {1476-3524}, mesh = {Animals ; *Metformin/pharmacology/therapeutic use/administration & dosage ; Streptozocin/toxicity ; *Neuroprotective Agents/pharmacology/therapeutic use/administration & dosage ; Rats ; Male ; *Dementia/chemically induced/drug therapy/metabolism/prevention & control ; Rats, Wistar ; Disease Models, Animal ; }, abstract = {Alzheimer's disease (AD) is the leading cause of dementia in humans, with high social and economic costs. AD is predominantly a sporadic disorder, and its risk increases with age and in individuals with type 2 diabetes mellitus (T2DM). Metformin is considered the first line drug for treatment of T2DM and has a plethora of effects in the peripheral and nervous system. However, the neuroprotective mechanism of action of this drug is still under debate. In order to assess the effects of metformin in dementia, we investigated the optimal time to start metformin treatment in animals that were submitted to intracerebroventricular (ICV) administration of streptozotocin (STZ) (3 mg/kg) to induce a sporadic AD-like rodent model of dementia. We used two protocols of metformin administration: early metformin (50 mg/Kg/daily) treatment (2 days after STZ model induction, lasting 28 days) and late metformin (50 mg/Kg/daily) treatment (20 weeks after STZ model induction, lasting 28 days). Both time points improved cognitive behavior in STZ rats, as evaluated by the novel object recognition and Morris's water maze tasks. Moreover, both treatments reduced neuroinflammatory parameters, such as TLR4, RAGE, TNF-α and NF-κB protein expression, induced in STZ animals. Metformin downregulated the methylglyoxal/RAGE/NOX‑2 signaling pathway by restoring glyoxalase 1 activity and GSH levels, which are impaired in the STZ-induced dementia model. Our data contribute to understanding the neuroprotective role of metformin, particularly in conditions involving insulin resistance, such as diabetic encephalopathy and AD.}, }
@article {pmid41212353, year = {2025}, author = {Shademan, B and Yousefi, H and Sharafkhani, R and Nourazarian, A}, title = {LPS-Induced Neuroinflammation Disrupts Brain-Derived Neurotrophic Factor and Kinase Pathways in Alzheimer's Disease Cell Models.}, journal = {Cellular and molecular neurobiology}, volume = {45}, number = {1}, pages = {102}, pmid = {41212353}, issn = {1573-6830}, support = {(IR.KHOY.REC.1402.030//Khoy University of Medical Sciences/ ; }, mesh = {*Brain-Derived Neurotrophic Factor/metabolism ; Humans ; *Lipopolysaccharides/toxicity/pharmacology ; *Alzheimer Disease/metabolism/pathology ; Cell Line, Tumor ; *Signal Transduction/drug effects ; *Neuroinflammatory Diseases/metabolism/pathology/chemically induced ; Neurons/metabolism/drug effects/pathology ; *Inflammation/pathology/metabolism ; *Models, Biological ; *Protein Kinases/metabolism ; Cell Survival/drug effects ; }, abstract = {Alzheimer's disease (AD) leads to a progressive loss of cognitive abilities and memory. A critical factor now recognized as driving AD pathology is neuroinflammation-inflammation occurring in the nervous system, which contributes to neuronal harm and communication breakdowns. our research investigated the specific effects of neuroinflammation on neuronal signaling pathways. In this study, we primarily employed the SH-SY5Y neuroblastoma cell line as an in vitro neuronal model to investigate inflammatory responses relevant to AD etiology, alongside supplementary observations in primary neurons and 3D spheroids for comparative analysis. Our analysis focused on modifications of key molecules, including the neuroprotective protein Brain-Derived Neurotrophic Factor (BDNF), pro-inflammatory cytokines such as IL-6 and TNF-α, and crucial regulatory kinases. Our results demonstrated that LPS treatment dramatically lowered the vitality and decreased BDNF levels in the SH-SY5Y cells. Furthermore, we observed a considerable elevation in the pro-inflammatory cytokines IL-6 and TNF-α, coupled with elevated levels of COX-2 and iNOS. Gene expression data validated that LPS treatment altered the expression of essential signaling kinases (Protein Kinase A (PKA), Protein Kinase B (AKT), and Mitogen-Activated Protein Kinase (MAPK)). Our first comparative analysis revealed that 3D spheroid cultures may elicit more pronounced inflammatory responses than standard 2D cultures; nevertheless, our detailed investigation primarily focused on the SH-SY5Y model. This study revealed that LPS-induced neuroinflammation affects neuronal signaling in vitro, thereby revealing a relationship between inflammation and neuronal dysfunction in cellular models of neuroinflammation. These findings highlight pathways that may be relevant to AD pathophysiology; however, further in vivo studies are necessary to demonstrate their translational relevance to humans.}, }
@article {pmid41211282, year = {2025}, author = {Olaolorun, F and Howes, MR and Elufioye, T and Odeku, OA and Olopade, J and Chazot, P}, title = {Iron chelation as a therapeutic target in vanadium neurotoxicity and Parkinson's disease: role of medicinal plants.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1667943}, pmid = {41211282}, issn = {1664-2295}, abstract = {Bioprospecting plant natural products has yielded significant success in the development of symptomatic treatment of neurodegenerative diseases, including the two most common, Alzheimer's and Parkinson's diseases (PD). Dysregulation of iron has been strongly implicated in the pathophysiology of these serious intractable diseases. A series of Nigerian endemic plants' methanolic extracts were explored using a Ferrozine binding iron chelation assay. This identified Spondias purpurea L. (SP) leaves as a potential therapeutic candidate and this was determined by evaluation of oxidative stress in 6-hydroxydopamine (6-OHDA)-exposed monoamine cell culture and Drosophila models of PD and vanadium neurotoxicity. SP treatment protected CAD cells against 6-OHDA toxicity and improved survival in PINK-1 mutant flies, though it had little effect on motor deficits. Furthermore, SP treatment reduced the vanadium-induced reactive oxygen species, and notably, staggered SP treatment significantly extended lifespan in vanadium-treated flies. Overall, Spondias purpurea L. leaf methanolic extract exhibited iron-chelating, antioxidant, neuroprotective, and life-extending properties, relevant to Parkinson's disease and vanadium-induced toxicity.}, }
@article {pmid41211099, year = {2025}, author = {Viani, A and Custo, A and d'Angremont, E and Garibotto, V and Frisoni, GB and Gutman, BA and Lorenzi, M}, title = {Disease Progression Modeling and Stratification for detecting sub-trajectories in the natural history of pathologies: Application to Alzheimer's disease trajectory modeling.}, journal = {Imaging neuroscience (Cambridge, Mass.)}, volume = {3}, number = {}, pages = {}, pmid = {41211099}, issn = {2837-6056}, abstract = {Quantifying the progression of degenerative diseases remains crucial for early diagnosis, prevention, and treatment. However, accurately modeling disease biomarker evolution is hindered by substantial variability in disease trajectories among individuals, driven by demographic, genetic, and lifestyle factors. This variability gives rise to heterogeneous phenotypic manifestations, underscoring the need for stratification based on underlying disease subtypes. Recent advances have shown promise in unsupervised stratification of disease trajectories. Yet, current approaches face significant challenges related to robustness, biomarker specificity, interpretability, and temporal resolution of clustering results. To address these challenges, we introduce Disease Progression Modeling and Stratification (DPMoSt), a new probabilistic model designed to optimize clusters of continuous trajectories along a long-term disease time axis. This approach allows for the determination of subtype-specific biomarkers, improving the accuracy of patient stratification and generalization on external cohorts. We demonstrate DPMoSt on both synthetic and real-world data for the modeling of Alzheimer's disease (AD) evolution. In the synthetic experiments, DPMoSt shows high accuracy in reconstructing trajectory subtypes and identifying the biomarkers' specificity for the clustering problem. Our experiments in the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset demonstrate the ability of DPMoSt to identify AD subtypes associated with accelerated cognitive decline and higher prevalence of the APOE4 variants. This result was validated on the external memory clinic cohort of the Geneva University Hospitals, confirming the association between cognitive decline and APOE4 in the pathological subtype. These results highlight the robustness of DPMoSt as well as its potential for broader applicability, offering a powerful tool for studying disease progression and subtype differentiation across diverse populations.}, }
@article {pmid41209367, year = {2025}, author = {Xie, Z and Hu, J and Stallings-Smith, S and Kulshreshtha, A and Hong, YR}, title = {Rural-urban differences in modifiable dementia risk factors among U.S. populations aged 45 years or older.}, journal = {Journal of Alzheimer's disease reports}, volume = {9}, number = {}, pages = {25424823251395318}, pmid = {41209367}, issn = {2542-4823}, abstract = {BACKGROUND: Alzheimer's disease and related dementias (ADRD) have become a significant public health concern, and the burden is disproportionately concentrated in rural areas.
OBJECTIVE: To examine rural-urban differences in the prevalence of modifiable dementia risk factors and their treatment among U.S. adults aged 45 years and older, and to investigate how these disparities vary by age group and geographic region.
METHODS: This cross-sectional study analyzed nationally representative data from the 2023 National Health Interview Survey in 2025. Prevalence of 11 modifiable dementia risk factors (hypertension, high cholesterol, diabetes, obesity, hearing loss, visual impairment, traumatic brain injury, low education, depression, social isolation, smoking) and 7 corresponding treatments were assessed via self-report. Adjusted rate ratios (aRR) were estimated using robust Poisson regression models.
RESULTS: The study population consisted of 16,981 individuals (mean age: 62.4, 51.6% female, 68.7% non-Hispanic White, 15.5% in rural areas). Rural residents had significantly higher prevalence of hypertension (aRR, 1.11; 95% CI, 1.06-1.17), obesity (aRR, 1.22; 95% CI, 1.15-1.30), diabetes (aRR, 1.29; 95% CI, 1.15-1.45), and hearing loss (aRR, 1.22; 95% CI, 1.12-1.34) compared to urban residents. Disparities were most significant among adults aged 45-64 years and in South/Midwest regions. Treatment rates for cardiometabolic conditions were high (>85%) and similar across regions, but treatment for sensory/behavioral risk factors remained low.
CONCLUSIONS: Rural U.S. adults face higher burden of modifiable dementia risk factors, particularly cardiometabolic and sensory impairments. Targeted public health strategies are needed to address structural inequities and improve dementia prevention in rural communities.}, }
@article {pmid41208730, year = {2026}, author = {Ke, J and Ding, J and Xu, Y and Yu, C and Hong, Y and Li, S and Meng, T and Ping, Y and Yuan, H and Hu, F}, title = {Engineering microglial exosome-mediated microRNA-124-3p delivery for Alzheimer's disease combinational therapy.}, journal = {Biomaterials science}, volume = {14}, number = {1}, pages = {186-197}, doi = {10.1039/d5bm01080b}, pmid = {41208730}, issn = {2047-4849}, mesh = {*MicroRNAs/genetics/administration & dosage/metabolism ; *Alzheimer Disease/drug therapy/therapy/metabolism/pathology ; *Exosomes/metabolism/chemistry ; Animals ; *Microglia/metabolism ; Mice ; Humans ; Blood-Brain Barrier/metabolism ; Disease Models, Animal ; Amyloid beta-Peptides/metabolism ; }, abstract = {Currently, single-target therapy and difficulty in brain drug delivery gravely impede the treatment of Alzheimer's disease (AD). The promising development of microRNA-124-3p (miR-124-3p) serves as a possibility for multiple therapeutic approaches for AD. However, the effective delivery of miR-124-3p to AD-affected brain regions remains a major challenge, primarily due to the blood-brain barrier (BBB) and the inherent instability of therapeutic miR-124-3p. Herein, we engineered miR-124-3p-enriched microglial exosomes (Exo-124-3p) as a biomimetic nanomedicine for the multifunctional treatment of AD. Exo-124-3p can traverse the BBB and facilitate activated-microglia targeting. Subsequently, the on-demand release of miR-124-3p from Exo-124-3p decreased the aggregation of β-amyloid (Aβ) plaques, attenuated the activation of microglia/astrocytes, and exhibited a valuable neuroprotective effect, thereby remolding the AD focal microenvironment. Notably, the in vivo results demonstrated that Exo-124-3p significantly improved the cognitive function in an AD mouse model. Mechanistically, it was elucidated that Exo-124-3p can bind to the 3'UTR region of MEKK3, ultimately inhibiting the MEKK3/NF-κB signaling pathway, thereby ameliorating AD neuroinflammation. Consequently, this study not only provides a promising therapeutic approach for AD combinational therapy, but also advances the development of miRNA delivery in other brain diseases.}, }
@article {pmid41208522, year = {2025}, author = {Wrigley, S and Huynh, ALH and Amadoru, S and Zeimer, H and Tan, I and Woodward, M and Braitberg, G and Yates, PA}, title = {Monoclonal Antibody Therapies in Alzheimer's Disease: A Guide for Emergency Physicians.}, journal = {Emergency medicine Australasia : EMA}, volume = {37}, number = {6}, pages = {e70167}, pmid = {41208522}, issn = {1742-6723}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; *Antibodies, Monoclonal/therapeutic use/adverse effects ; Emergency Service, Hospital/organization & administration ; Australia ; *Emergency Medicine/methods ; }, abstract = {Whilst the advent of novel disease-modifying medications for Alzheimer's disease represents potential benefit for patients and caregivers, they may be associated with adverse events that present important considerations for emergency and primary care. This article seeks to highlight some of the challenges Emergency Departments may encounter in relation to clinical presentations of people being treated with novel anti-amyloid monoclonal antibodies in the Australian context. Given the potential for harm if not recognised and managed appropriately, it is imperative that emergency clinicians are aware of possible treatment-related adverse events and have access to appropriate decision-making support and resources.}, }
@article {pmid41208074, year = {2025}, author = {Gupta, RA and Rajni, and Shah, K and Dewangan, HK}, title = {Review on Molecular Targeting, Pharmacological Action, and Advanced Biopharmaceutical Aspects for the Management of Alzheimer's Disease.}, journal = {Current pharmaceutical design}, volume = {}, number = {}, pages = {}, doi = {10.2174/0113816128387875250805042824}, pmid = {41208074}, issn = {1873-4286}, abstract = {Alzheimer's disease (AD) is an ongoing progressive neurodegenerative disorder that predominantly affects elderly individuals. A systematic literature search was conducted using electronic databases such as PubMed, Scopus, Web of Science, and Google Scholar. Peer-reviewed articles, clinical trial reports, and experimental studies published in English within the last 15 years were considered. The keywords used for the search included "Alzheimer's disease," "amyloid-beta," "tau protein," "neuroinflammation," "immunotherapy," "drug repurposing," and "experimental treatment strategies." It is the most common form of dementia, ultimately leading to death in advanced stages. Recent advances in AD have featured the expected role of antiamyloid, anti-tau, and anti-inflammatory therapies. Nonetheless, these treatments are still in various stages of preclinical and clinical trials. Moreover, drug repurposing is another promising avenue to identify effective therapeutic alternatives for Alzheimer's disease. This review highlights the underlying pathophysiological mechanisms of AD along with the limits of existing treatments. It also includes two methodologies, specifically; active immunotherapy and passive immunotherapy. Active immunotherapy tactics include the administration of antigens to stimulate antibody production. Additionally, this study discusses several experimental drugs and novel pharmaceutical approaches for AD.}, }
@article {pmid41206815, year = {2025}, author = {Tian, S and Liu, Y and Hu, H and Li, S}, title = {Tau Liquid-Liquid Phase Separation in Alzheimer's Disease: Mechanisms, Pathogenesis, and Therapeutic Implications.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {18}, pmid = {41206815}, issn = {1559-1182}, support = {U24A20806//National Natural Science Foundation of China/ ; 82404605//National Natural Science Foundation of China/ ; U23A20510//National Natural Science Foundation of China/ ; BX20220048//National Postdoctoral Program For Innovative Talents/ ; 2022MD723713//China Postdoctoral Science Foundation/ ; }, mesh = {*Alzheimer Disease/metabolism/therapy/pathology ; Humans ; *tau Proteins/metabolism/chemistry/isolation & purification ; Animals ; Neurofibrillary Tangles/metabolism/pathology ; *Liquid-Liquid Extraction/methods ; Phase Separation ; }, abstract = {Tau protein undergoes liquid-liquid phase separation (LLPS), forming dynamic condensates that act as intermediates in the transition to neurofibrillary tangles in Alzheimer's disease (AD). This review highlights tau's dynamic and reversible LLPS behavior, an underexplored aspect of tau's role, particularly as an early pathogenic driver in AD. We summarize the molecular mechanisms and regulatory factors governing tau LLPS, with a focus on its physiological functions in microtubule stability, synaptic activity, and cellular stress responses. Additionally, we discuss how metal ions, RNA, and neurodegenerative cofactors influence tau's phase behavior in a cell-type-specific manner. Emerging strategies targeting tau LLPS-such as nanobodies, AAV-based delivery, engineered degradation platforms, and CRISPR tools-show promise for early, reversible intervention. We also explore the potential of LLPS-informed biomarkers for diagnosing and monitoring disease progression. Overall, LLPS provides a dynamic, targetable framework linking early AD pathogenesis with therapeutic innovation, opening opportunities for earlier intervention and more effective treatment strategies.}, }
@article {pmid41206776, year = {2025}, author = {Mulet I Piera, X and Del Campo-Montoya, R and Cuadrado-Tejedor, M and Garcia-Osta, A and Garbayo, E and Blanco-Prieto, MJ}, title = {Intranasal delivery of lipid-based nanoparticles for the treatment of neurodegenerative diseases: advances, challenges and future perspectives.}, journal = {Expert opinion on drug delivery}, volume = {}, number = {}, pages = {1-19}, doi = {10.1080/17425247.2025.2587903}, pmid = {41206776}, issn = {1744-7593}, abstract = {INTRODUCTION: Neurodegenerative diseases such as Parkinson's or Alzheimer's disease urgently require new therapeutic approaches. Despite significant efforts, no disease-modifying therapies targeting specific molecular pathways have demonstrated consistent clinical efficacy. This challenge has shifted attention toward drug delivery strategies that improve bioavailability, targeting, and patient accessibility. Intranasal delivery has emerged as a promising, non-invasive approach that bypasses the blood-brain barrier, and improves patient compliance. Lipid-based systems, especially following the success of COVID-19 vaccines, have gained attention as versatile platforms for delivering RNAs. Their ability to encapsulate diverse payloads and tunable composition makes them ideal candidates for targeting neurodegenerative disorders via the intranasal route.
AREAS COVERED: This review discusses recent advances in intranasal delivery for the treatment of neurodegenerative disorders, emphasizing on lipid-based nanoparticles. It addresses formulation challenges such as stability, targeting efficiency, and compatibility with nasal physiology, and outlines key design parameters affecting brain delivery. Future directions are explored to advance formulation development and clinical translation.
EXPERT OPINION: Intranasal lipid-based drug delivery represents a promising strategy to bypass the blood-brain barrier in neurogenerative disorder treatment. Although regulatory gaps and the absence of long-term safety evaluation, intranasal administration offers clear advantages for CNS targeting underscoring strong potential for future clinical translation.}, }
@article {pmid41205639, year = {2026}, author = {Bhosale, S and Chakor, R and Lohidasan, S and Sivakkumar, S and Sathiyanarayanan, A}, title = {Neuroprotective and nootropic effects of a standardised Siddha polyherbal formulation, Bhiramiyadhi bhavanai choornam, against β-amyloid-Induced neurodegeneration.}, journal = {Journal of ethnopharmacology}, volume = {357}, number = {}, pages = {120850}, doi = {10.1016/j.jep.2025.120850}, pmid = {41205639}, issn = {1872-7573}, mesh = {Animals ; Rats, Wistar ; Male ; *Amyloid beta-Peptides/toxicity ; *Neuroprotective Agents/pharmacology/therapeutic use ; Rats ; *Nootropic Agents/pharmacology/therapeutic use ; Brain-Derived Neurotrophic Factor/metabolism ; Oxidative Stress/drug effects ; Peptide Fragments/toxicity ; Brain/drug effects/metabolism/pathology ; Acetylcholinesterase/metabolism ; *Plant Extracts/pharmacology ; Plants, Medicinal ; Disease Models, Animal ; Behavior, Animal/drug effects ; Cytokines/metabolism ; }, abstract = {Bhiramiyadhi bhavanai choornam (BBC) is a traditional Siddha polyherbal formulation composed of 15 medicinal plants. The classical text claims that regular intake of BBC strengthens cognitive function, improves memory, boosts morale, enhances longevity, and promotes overall physical vitality.
AIM OF THE STUDY: The present investigation focused on standardising Bhiramiyadhi bhavanai choornam and assessing its neuroprotective effect against β-amyloid-induced neurodegeneration in Wistar rats.
MATERIALS AND METHODS: Standardisation of BBC was carried out following the AYUSH guidelines. A validated HPTLC method was developed for the marker compounds ascorbic acid, gallic acid, quercetin, piperine, and asiaticoside. Experimental neurodegeneration was induced by intracerebroventricular injection of Aβ1-42 in male Wistar rats. The effects of BBC were evaluated using behavioural paradigms, such as the Morris water maze, locomotor activity, social recognition, and novel object recognition tests. Biochemical assessments included acetylcholinesterase activity, brain-derived neurotrophic factor (BDNF), oxidative stress and antioxidant indices, and inflammatory cytokines. Brain histopathology was performed to assess neuronal architecture and the deposition of amyloid plaques.
RESULTS AND DISCUSSION: The HPTLC method developed provided accurate and reliable chemical profiling of BBC. Treatment with BBC significantly improved cognitive and memory performance in Aβ1-42-treated rats. It enhanced brain BDNF levels, improved antioxidant defence mechanism, reduced acetylcholinesterase activity, and suppressed oxidative stress and inflammatory cytokines. Histological studies further confirmed its protective effect by attenuating neuronal damage and plaque formation.
CONCLUSION: A validated HPTLC method was developed for the standardisation of BBC. Pharmacological findings indicate its strong neuroprotective and nootropic activities, highlighting its potential for Alzheimer's disease and related neurodisorders.}, }
@article {pmid41205178, year = {2025}, author = {Royo Marco, A and Bruch, KR and Cowan, MN and Dill, JG and Moore, KA and Bolte, AC and Lukens, JR}, title = {Therapeutic VEGFC treatment provides protection against traumatic-brain-injury-driven tauopathy pathogenesis.}, journal = {Cell reports}, volume = {44}, number = {11}, pages = {116521}, pmid = {41205178}, issn = {2211-1247}, support = {R01 NS106383/NS/NINDS NIH HHS/United States ; }, mesh = {Animals ; *Tauopathies/pathology/metabolism/drug therapy/etiology ; *Brain Injuries, Traumatic/complications/pathology/drug therapy/metabolism ; *Vascular Endothelial Growth Factor C/therapeutic use/metabolism/pharmacology/genetics ; Mice ; Disease Models, Animal ; tau Proteins/metabolism ; Mice, Transgenic ; Brain/pathology/metabolism ; Male ; Mice, Inbred C57BL ; Humans ; }, abstract = {Traumatic brain injury (TBI) increases one's risk of developing Alzheimer's disease and tauopathy. Yet, the mechanisms linking TBI to neurodegenerative disease remain poorly defined. Mounting recent evidence indicates that defects in brain lymphatic drainage contribute to multiple neurodegenerative diseases. Here, we investigated whether promoting brain lymphatic drainage recuperation following TBI via treatment with the lymphangiogenic factor vessel endothelial growth factor C (VEGFC) mitigates the ability of TBI to exacerbate tauopathy. In this study, we show that a single mild TBI leads to worsened neuropathology, brain macrophage activation, and neurodegeneration in the PS19 mouse model of tauopathy. Moreover, we find that viral-vector-based delivery of VEGFC into the meningeal compartment 24 h post-TBI ameliorates tau-mediated neurodegenerative disease pathogenesis. Findings from these studies offer new insights into how TBI leads to the development of tauopathy later in life and suggest that VEGFC-based treatments might offer a therapeutic strategy to limit tauopathy after sustaining a head injury.}, }
@article {pmid41205008, year = {2025}, author = {Jana, K and Ghosh, S and Parua, P and Debnath, B and Halder, J and Sahoo, RK and Rai, VK and Pradhan, D and Dash, P and Das, C and Kar, B and Ghosh, G and Rath, G}, title = {Insights into the Versatile Role of Extracellular Vesicles in the Treatment of CNS Disorders.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {14}, pmid = {41205008}, issn = {1559-1182}, mesh = {Humans ; *Extracellular Vesicles/metabolism ; Animals ; *Central Nervous System Diseases/therapy/metabolism ; Drug Delivery Systems/methods ; Blood-Brain Barrier/metabolism ; }, abstract = {E xtracellular vesicles (EVs) are lipid bilayer-enclosed nanocarriers composed primarily of phospholipids and membrane proteins. They are released by cells into the surrounding extracellular environment and vary in size, composition, and biogenesis pathways. Beyond their natural role in intercellular communication, mediating the transfer of proteins, lipids, and nucleic acids (like mRNA and miRNA) between cells, EVs have emerged as a highly versatile and promising therapeutic platform for a range of challenging disorders, particularly those affecting the central nervous system (CNS) and various cancers. The CNS presents unique therapeutic challenges, notably the formidable blood-brain barrier (BBB), which restricts the entry of most conventional drugs. EVs, however, possess an inherent capacity to traverse this barrier, either naturally or through engineered modifications. This characteristic positions them as ideal nanocarriers for delivering therapeutic payloads such as neurotrophic factors, gene therapy constructs, or anti-inflammatory agents directly to target neural cells for conditions like Alzheimer's disease, Parkinson's disease, stroke recovery, multiple sclerosis, and even glioblastoma. Their biocompatibility and low immunogenicity further reduce systemic side effects, making them a safer alternative to synthetic delivery systems. This review outlines recent progress in extraction techniques using EVs for treating neurological disorders. It covers clinical applications in neurodegenerative, infectious diseases, inflammatory, genetic, and oncological diseases and highlights current limitations and considerations for advancing future research in this evolving field.}, }
@article {pmid41204969, year = {2025}, author = {Phuong, HT and Tomas, RF and Akmese, C and Mijares, A and Gerstin, IM and Guo, S and Bell, LR and Ellwood, R and Yegorova, S and Ng, SK and Massey, G and Phillips, J and Melloni, A and Pletnikova, O and Lou, X and Clark, HB and Troncoso, JC and Hyman, BT and Prokop, S and Ranum, LPW and Nguyen, L}, title = {PolyGR-containing aggregates link with pathology and clinical features of Alzheimer's disease.}, journal = {Acta neuropathologica}, volume = {150}, number = {1}, pages = {49}, pmid = {41204969}, issn = {1432-0533}, support = {P30 AG066507/AG/NIA NIH HHS/United States ; R00 AG065511/AG/NIA NIH HHS/United States ; P50 AG047266/AG/NIA NIH HHS/United States ; P30 AG066506/AG/NIA NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; K99 AG065511/AG/NIA NIH HHS/United States ; RF1 NS126536/NS/NINDS NIH HHS/United States ; RF1 NS098819/NS/NINDS NIH HHS/United States ; }, mesh = {Humans ; *Alzheimer Disease/pathology/metabolism ; Male ; Female ; Aged ; Aged, 80 and over ; *Brain/pathology/metabolism ; tau Proteins/metabolism ; Plaque, Amyloid/pathology/metabolism ; Middle Aged ; Amyloid beta-Peptides/metabolism ; Protein Aggregates ; *Protein Aggregation, Pathological/pathology/metabolism ; Neurofibrillary Tangles/pathology/metabolism ; }, abstract = {Alzheimer's disease is the most common form of dementia; however, its molecular mechanisms are not fully understood. We recently identified polymeric glycine-arginine-containing (polyGR+) aggregates as a novel type of proteinopathy in AD autopsy brains. Here, we performed a comprehensive analysis to study if polyGR+ aggregates are associated with AD neuropathological changes (ADNC) and clinical features of AD cases. We show polyGR+ aggregates are detected in ~ 60% of AD postmortem brains from three AD cohorts but not age-similar controls or disease controls with primary age-related tauopathy (PART). A subtype of polyGR+ aggregates with a clustered-punctate morphology that is positive for the markers of dystrophic neurites is associated with earlier onset and shortened survival in AD cases. Increased levels of Aβ plaques and phosphorylated tau (pTau) tangles are detected in the hippocampus of AD autopsy brains with high levels of polyGR+ aggregates compared to AD autopsy brains with minimal polyGR+ staining. In addition to ADNC, a subset of polyGR+ aggregates coexists with limbic-predominant age-related TDP-43 encephalopathy neuropathological changes (LATE-NC) or Lewy body pathology (LBP). Hippocampal polyGR+ aggregate levels are ~ 3.8- and ~ 3.71-fold higher in late-onset AD cases who experienced stroke or high blood pressure, respectively. In SH-SY5Y cells, hydrogen peroxide treatment which mimics oxidative stress leads to increased levels of polyGR+ proteins produced by the CASP8 GGGAGA repeat expansion, which was recently shown to associate with increased AD risk. In addition, we show the accumulation of pTau induced by CASP8 polyGR+ protein aggregates is elevated upon hydrogen peroxide treatment. In summary, our results demonstrate polyGR+ aggregates are a frequent and understudied type of proteinopathy in AD autopsy brains and that polyGR proteinopathy is associated with ADNC.}, }
@article {pmid41204210, year = {2025}, author = {Afxenti, S and Zachariou, M and Athieniti, E and Lambrianides, A and Pantzaris, M and Spyrou, GM}, title = {Integrating imaging and omics for enhanced subtyping of mild cognitive impairment associated with Alzheimer's disease.}, journal = {Journal of translational medicine}, volume = {23}, number = {1}, pages = {1240}, pmid = {41204210}, issn = {1479-5876}, support = {This research was supported by the Muscular Dystrophy Association Cyprus/Telethon Cyprus.//This research was supported by the Muscular Dystrophy Association Cyprus/Telethon Cyprus./ ; }, mesh = {Humans ; *Cognitive Dysfunction/diagnostic imaging/complications/classification ; *Alzheimer Disease/diagnostic imaging/complications/cerebrospinal fluid ; Male ; *Neuroimaging ; Female ; Aged ; Magnetic Resonance Imaging ; *Proteomics ; Biomarkers/metabolism ; Cluster Analysis ; }, abstract = {BACKGROUND: Mild Cognitive Impairment (MCI), considered the prodromal stage of Alzheimer's disease (AD), is a heterogeneous condition characterised by mild but measurable cognitive decline. However, not all individuals with MCI follow the same trajectory-some remain stable, while others progress rapidly to AD. Understanding variation in clinical, molecular, and imaging features is crucial for reducing disease heterogeneity, improving prognosis, and developing targeted interventions. This study aims to increase MCI subtyping resolution by generating enriched individual-level profiles through the integration of imaging and omics data, facilitating precision medicine approaches for AD prevention and treatment.
METHODS: We used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), including structural MRI, CSF peptidomics/proteomics, and clinical indices. Using a multi-modal integration and clustering framework, we identified distinct MCI subgroups, characterised by clinical and neuropsychological scores, AD biomarkers, biological pathway enrichments, and imaging patterns. We further employed supervised multi-modal integration and correlation analyses to explore the links between imaging, peptidomic/proteomic and clinical features within each subgroup. Additionally, we labelled individuals by future conversion to AD and analysed longitudinal cognitive function (CDRSB and MMSE scores). Finally, we performed in silico drug repurposing to identify candidate drugs targeting each subgroup's molecular profile.
RESULTS: (1) Multi-modal integration revealed two distinct MCI subgroups. (2) The Resilient Neuronal Hyperplasticity subgroup was characterised by elevated markers of neuronal plasticity, minimal brain atrophy and cortical thinning, better clinical scores, and upregulated peptide/protein markers associated with less severe structural changes. In contrast, the Vulnerable Neurodegenerative subgroup exhibited AD-like disturbances, pronounced atrophy and cortical thinning, primarily affecting executive functions, and downregulation of peptide/protein markers linked to significant structural changes. (3) Future conversion analysis revealed the second subgroup predominantly comprised fast converters, while the first predominantly consisted of stable individuals. (4) Longitudinal cognitive analysis showed a more pronounced decline in the second subgroup compared to the first. (5) Drug repurposing identified both shared and subgroup-specific candidate compounds aligned with the underlying pathologies.
CONCLUSIONS: This study delineates two MCI subgroups, using multi-modal integration, offering insights into disease heterogeneity and laying the foundation for precision medicine and AI-driven strategies in MCI and AD research and clinical care.}, }
@article {pmid41203507, year = {2025}, author = {Zhang, YP and Kedia, S and Klenerman, D}, title = {Rethinking neurodegeneration through a co-proteinopathy lens.}, journal = {Trends in neurosciences}, volume = {48}, number = {12}, pages = {952-963}, doi = {10.1016/j.tins.2025.10.006}, pmid = {41203507}, issn = {1878-108X}, mesh = {Humans ; *Neurodegenerative Diseases/metabolism/pathology ; Animals ; tau Proteins/metabolism ; alpha-Synuclein/metabolism ; Amyloid beta-Peptides/metabolism ; }, abstract = {Neurodegenerative diseases have long been considered distinct proteinopathies: amyloid-β and tau in Alzheimer's disease, α-synuclein in Parkinson's disease, and TDP-43 in amyotrophic lateral sclerosis. This single-protein paradigm has guided therapeutic development for decades; yet clinical outcomes remain modest. Mounting evidence, however, reveals that protein aggregates rarely occur in isolation; instead, they coexist, colocalise, and modulate each other's pathogenicity. Here, we propose a co-proteinopathy framework that views neurodegeneration as an interactive network of misfolded proteins rather than as isolated disorders. Adopting this framework demands multiplexed quantification of protein aggregates and disease models that better reflect the biological complexity of human neurodegeneration. The co-proteinopathy perspective offers a more realistic foundation for next-generation approaches to neurodegeneration research and treatment.}, }
@article {pmid41202963, year = {2025}, author = {Padhy, DS and Dhanve, P and Chaturvedi, K and Banerjee, S}, title = {Ambroxol rescues cognitive impairment by ameliorating oxidative stress and autophagic dysfunction in the streptozotocin-induced Alzheimer's disease model.}, journal = {European journal of pharmacology}, volume = {1008}, number = {}, pages = {178334}, doi = {10.1016/j.ejphar.2025.178334}, pmid = {41202963}, issn = {1879-0712}, mesh = {Animals ; *Ambroxol/pharmacology/therapeutic use ; *Oxidative Stress/drug effects ; *Alzheimer Disease/drug therapy/chemically induced/metabolism/pathology ; Streptozocin ; Male ; Rats ; Disease Models, Animal ; *Autophagy/drug effects ; *Cognitive Dysfunction/drug therapy/metabolism/chemically induced/pathology ; Hippocampus/drug effects/metabolism/pathology ; Behavior, Animal/drug effects ; Maze Learning/drug effects ; Rats, Wistar ; *Neuroprotective Agents/pharmacology/therapeutic use ; }, abstract = {Alzheimer's disease (AD) is the most prevalent neurodegenerative disease, contributing to the majority of dementia cases worldwide. Due to its multifaceted and complex pathogenesis, drugs that completely halt the disease progression are still elusive. Several reports suggest that repurposing a clinically approved drug could be an excellent strategy to tackle this devastating disease. Ambroxol, a US-FDA and EMA-approved generic mucolytic drug, possess ameliorative action on various neurological ailments. However, its role as a disease-modifying drug targeting AD is yet to be studied. In this study, we elucidate the therapeutic potential of ambroxol in the streptozotocin (STZ)-induced AD model by assessing the behavioural, biochemical, and histological parameters. Intracerebroventricular (ICV) administration of STZ (3 mg/kg) was performed to mimic the AD pathology in rats. Ambroxol was administered (p.o.) at doses of 500 and 1000 mg/kg for three weeks. On day 21, behavioural tests, including the Y-maze test, novel object recognition test, and passive avoidance test, were performed to assess memory function. Subsequently, the animals were euthanised and the hippocampus was collected for biochemical, molecular and histological analysis. Three weeks of ambroxol treatment improved the cognitive performance in ICV-STZ-treated rats. Ambroxol treatment reduces oxidative stress by upregulating heme oxygenase-1 (HO-1) and lowering inducible nitric oxide synthase (iNOS) levels in the hippocampus of diseased rats. It also attenuates inflammatory and autophagic dysfunction, facilitating the clearance of amyloid beta (Aβ) aggregates in the hippocampus of ICV-STZ rats. The findings of this study suggest that ambroxol could be a viable repurposed drug candidate for AD treatment.}, }
@article {pmid41202483, year = {2026}, author = {Yuan, C and Li, L and Lin, HY and Aubry, AV and Parise, LF and Morel, C and Chen, F and Wong, J and Russo, SJ and Wang, J}, title = {Targeting neuronal activity and neuroinflammation for the treatment of Alzheimer's disease in a mouse model.}, journal = {Neurobiology of aging}, volume = {157}, number = {}, pages = {111-118}, doi = {10.1016/j.neurobiolaging.2025.10.006}, pmid = {41202483}, issn = {1558-1497}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/psychology/metabolism ; Disease Models, Animal ; *Neurons/physiology/drug effects ; Amyloid beta-Peptides/metabolism ; Mice, Transgenic ; *Caffeic Acids/pharmacology/therapeutic use/administration & dosage ; tau Proteins/metabolism ; *Neuroinflammatory Diseases/drug therapy ; Microglia/physiology ; *Glucosides/pharmacology/therapeutic use/administration & dosage ; Brain/pathology/metabolism ; Cognition/drug effects ; Mice ; Male ; }, abstract = {Alzheimer's disease (AD) is characterized by progressive cognitive decline driven by complex pathological processes, including tau hyperphosphorylation (p-Tau), amyloid-beta (Aβ) accumulation, and neuroinflammation. In this study, we investigated the effects of two bioactive compounds, dihydrocaffeic acid (DHCA) and malvidin-glucoside (Mal-gluc), targeting inflammation and neuronal activity, respectively, on cognitive function and AD pathology in a mouse model of AD. Our results demonstrate that chronic DHCA/Mal-gluc treatment significantly improves recognition memory in 3xTg-AD mice without reducing p-Tau or Aβ burden. Employing a newly developed whole-brain cFOS and IBA-1 mapping technique, we found that this combination treatment enhances neuronal activity and promotes microglial homeostasis across multiple brain regions in 3xTg-AD mice. These findings underscore the potential of restoring neuronal function and immune homeostasis as a therapeutic approach for AD. Future study will explore the underlying mechanisms and evaluate whether DHCA/Mal-gluc, combined with currently approved Aβ monoclonal therapy, can synergistically prevent or delay AD onset and progression.}, }
@article {pmid41202479, year = {2025}, author = {Samsami, S and Parvar, MD and Mehralitabar, H and Dehghanbanadaki, N and Naderi-Manesh, H}, title = {In silico investigation of CNS-11 as a potential inhibitor of Aβ42 aggregation and its protofibril disassembly.}, journal = {Biochemical and biophysical research communications}, volume = {790}, number = {}, pages = {152899}, doi = {10.1016/j.bbrc.2025.152899}, pmid = {41202479}, issn = {1090-2104}, mesh = {*Amyloid beta-Peptides/chemistry/metabolism/antagonists & inhibitors ; *Peptide Fragments/chemistry/metabolism/antagonists & inhibitors ; Molecular Dynamics Simulation ; Humans ; Protein Aggregates/drug effects ; Protein Aggregation, Pathological ; Alzheimer Disease/metabolism/drug therapy ; Computer Simulation ; Protein Multimerization/drug effects ; }, abstract = {Amyloidogenic peptide aggregation and fibril formation are key components in neurodegenerative diseases such as Alzheimer's disease (AD). One effective strategy for treating these conditions involves preventing amyloid peptide aggregation by using interfering agents, such as small molecules, at the onset of amyloid peptide assembly. Another approach could involve destabilizing the formed fibrils using small molecules as well. In this study, we utilized both all-atom and coarse-grained molecular dynamics (MD) simulation methods to investigate the aggregation mechanistic details of amyloid-β42 (Aβ42) peptides, the impact of CNS-11 (a small molecule inhibitor with proven Tau fibrils decomposing agent) on this Aβ42 aggregation, and the destabilization effect of CNS-11 on an Aβ42 fiber section, alongside the Aβ42 fiber section itself. Our results demonstrated that Aβ42 monomers in the free state strongly tend to dimerize and form beta-sheets by integrating the hydrophobic sections of the Aβ42 peptides. Still, as CNS-11 was added to the system, the ligand formed a hydrophobic core composed of CNS-11 and Aβ42 peptides surrounding this core, resulting in an amorphous and significantly disordered structure. Additionally, CNS-11 could interact with the Aβ42 pre-formed fiber section, partially destabilizing it through interactions with the buried hydrophobic core. Moreover, simulating the Aβ42 fiber section revealed that the N-terminal region of these peptide aggregates is naturally flexible and capable of becoming disorganized even without the addition of external disrupting agents. This study provides comprehensive insights into the molecular-level mechanisms underlying the dual effects of CNS-11 on amyloid beta aggregation and fibril degradation. This study can provide a computational framework with the potential to be applied to various small molecules, exploring their potential in the prevention and treatment of Alzheimer's disease.}, }
@article {pmid41201547, year = {2025}, author = {Akkaya, EC and Ilgin, R and Adil, H and Çelik, A}, title = {Magnesium L-Threonate Reduces Hippocampal Amyloid-β Load without Cognitive Improvement in a PTU-induced Hypothyroidism Model in Young Rats.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {8}, pmid = {41201547}, issn = {1559-1182}, support = {TSA-2024-565//Usak University Research Foundation/ ; }, mesh = {Animals ; *Hippocampus/metabolism/drug effects/pathology ; *Amyloid beta-Peptides/metabolism ; *Hypothyroidism/chemically induced/drug therapy/metabolism ; *Cognition/drug effects ; Disease Models, Animal ; Male ; Rats ; Rats, Wistar ; Brain-Derived Neurotrophic Factor/metabolism ; Maze Learning/drug effects ; }, abstract = {The brain is among the most critical target organs for thyroid hormones. Therefore, both congenital and acquired hypothyroidism can have significant neuropsychiatric consequences. Learning and memory problems, concentration disorders, and some psychiatric disorders such as depression can be observed in diseases causing acquired hypothyroidism. Although thyroid hormone therapy is the standard treatment, it does not always fully reverse these neuropsychiatric complications. Several studies have demonstrated the positive effects of magnesium L-threonate (MgT) supplementation on cognitive functions. Research suggests that MgT may help alleviate cognitive deficits, particularly in neurodegenerative conditions like Alzheimer's disease, where it has been associated with improvements in memory and reductions in hippocampal amyloid-β accumulation. However, there is limited data on the effect of MgT supplementation on hypothyroid conditions in the brain. The purpose of this study was to evaluate the effects of MgT supplementation on cognitive functions in hypothyroid rats. We report that while MgT supplementation did not significantly improve cognitive performance in behavioral tasks or inflammatory markers in hypothyroid rats, it did increase hippocampal BDNF levels in euthyroid animals and reduced hippocampal amyloid-β load under both euthyroid and hypothyroid conditions. The reduction in amyloid beta load under hypothyroid conditions suggests that MgT may exert partial therapeutic effects even in the absence of thyroid hormone replacement. These findings highlight the need for further studies to evaluate the therapeutic potential of MgT, particularly in combination with thyroid hormone replacement.}, }
@article {pmid41200978, year = {2025}, author = {Zhang, Y and Fan, J and Nan, S and Pan, J and Guo, W and Zhang, Y}, title = {Rubiadin Alleviates Alzheimer's Disease Pathology via NF-κB Pathway Regulation.}, journal = {Journal of integrative neuroscience}, volume = {24}, number = {10}, pages = {33497}, doi = {10.31083/JIN33497}, pmid = {41200978}, issn = {0219-6352}, support = {20210101293JC//Natural Science Foundation of Jilin Province/ ; }, mesh = {Animals ; *Alzheimer Disease/drug therapy/metabolism/pathology ; Mice ; *NF-kappa B/metabolism/drug effects ; Disease Models, Animal ; *Neuroprotective Agents/pharmacology/administration & dosage ; *Signal Transduction/drug effects ; Mice, Transgenic ; Male ; Amyloid beta-Peptides/metabolism ; Plaque, Amyloid/metabolism/drug therapy ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a severe neurodegenerative disorder that impacts the global impact on the population. Nevertheless, the intricate nature of its pathogenesis has posed significant challenges to drug discovery in this field. This study aimed to verify the therapeutic potential of rubiadin (RB) on AD through both in vivo and in vitro experiments, thereby facilitating translational research for the advancement of AD treatment.
METHODS: We investigated the neuroprotective effects of RB on AD using both in vivo and in vitro models. Immunohistochemistry and western blot analysis were employed to evaluate inflammatory factors and the Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway in Mo/HuAPP695swe (APP)/PS1-dE9 (PS1) mice and N2a cells.
RESULTS: RB enhanced the memory performance of APP/PS1 mice in various tests, including the Morris water maze, step-down and step-through passive avoidance tasks, and novel object recognition. RB reduced the accumulation of Amyloid-beta (Aβ) plaques, as shown by immunohistochemical analysis. It also decreased the expression levels of pro-inflammatory cytokines interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α), while increasing the release of IL-4. Additionally, RB inhibited the NF-κB pathway, as demonstrated by western blot. Moreover, a cell viability test showed that RB protected N2a cells against toxicity caused by Aβ1-42 through a cell viability test. Western blot analysis revealed that neuroinflammation and the NF-κB pathway were inhibited by RB treatment in Aβ1-42-induced N2a cells. Accordingly, RB suppressed the nuclear translocation of NF-κB in Aβ1-42-induced N2a cells.
CONCLUSIONS: Our results provide experimental evidence supporting the preclinical research and future clinical applications of RB, thereby facilitating the development of new drugs for AD clinical therapy.}, }
@article {pmid41200903, year = {2025}, author = {Chockchowwat, W and Hannongbua, S and Saparpakorn, P}, title = {Role of triterpenoid derivatives from Centella asiatica as quantum chemical calculations.}, journal = {Journal of biomolecular structure & dynamics}, volume = {}, number = {}, pages = {1-17}, doi = {10.1080/07391102.2025.2578225}, pmid = {41200903}, issn = {1538-0254}, abstract = {To date, the treatment for Alzheimer's disease (AD) has focused on the cholinergic hypothesis, particularly through the inhibition of acetylcholinesterase (AChE). Asiatic acid, madecassic acid, asiaticoside, and madecassoside, which are triterpenoid derivatives from Centella asiatica, have previously been reported to exhibit the AChE inhibitory activity. This study aimed to investigate their binding modes and to determine efficient computational methods for analyzing their interactions with AChE. Molecular dynamics simulations demonstrated that most of their equilibrated structures remained within the AChE binding site. Principal component analysis and free energy landscape (FEL) confirmed their stability of the binding. Among the evaluated methods, the MM-(ALPB)SA binding energies, when combined with ligand surface binding efficiency index, showed the best correlation with experimental binding free energy. Density functional theory (DFT) calculations revealed the common key interaction between triterpenoids and AChE, including hydrogen bonds (Tyr124, Arg296, Tyr337, and Tyr341), H-π (Tyr341) and van der Waals (Trp86) interactions. Additionally, pharmacokinetics and drug-likeness predictions indicated that madecassic acid and asiatic acid are promising candidates for drug development. This study highlights the potential of triterpenoid derivatives in AChE inhibition and provides valuable insights into their binding efficiency, which could contribute to future drug discovery targeting Alzheimer's disease.}, }
@article {pmid41200863, year = {2025}, author = {Wang, C and Shao, X and Cao, X and Fan, T and Li, Z and Wang, K and Li, M and Wang, X and Guan, P and Hu, X}, title = {Silver-functionalized carbon dots regulate amyloid aggregation and microbial infection.}, journal = {Nanoscale}, volume = {17}, number = {45}, pages = {26429-26441}, doi = {10.1039/d5nr03379a}, pmid = {41200863}, issn = {2040-3372}, mesh = {*Silver/chemistry/pharmacology ; *Amyloid beta-Peptides/chemistry/metabolism ; *Carbon/chemistry/pharmacology ; Humans ; Alzheimer Disease/drug therapy/metabolism/pathology ; Peptide Fragments/chemistry/metabolism ; *Anti-Bacterial Agents/pharmacology/chemistry ; *Quantum Dots/chemistry ; *Amyloid/chemistry/metabolism ; Animals ; Protein Aggregates/drug effects ; Cell Survival/drug effects ; }, abstract = {Amyloid accumulation and microbial infections are major risk factors for Alzheimer's disease (AD). However, most of the current drugs are limited to single-target therapeutic strategies against amyloid or microbial infections, resulting in poor clinical treatment effects. Herein, we propose a novel multi-targeted strategy that can achieve multiple effects of inhibition of amyloid aggregation, depolymerization of mature amyloid fibrils, and anti-microbial infection. Experiments conducted in vitro have shown that silver-functionalized carbon dots (Ag@TACDs), at concentrations as low as 10 μg mL[-1], significantly impact the misfolding of Aβ42 and the depolymerization of Aβ42 fibrils. Moreover, Ag@TACDs exhibit outstanding ability to resist bacterial infections. At the same time, Ag@TACDs have good biocompatibility, enhance cell activity, and alleviate the cytotoxicity caused by Aβ42 oligomers. Our approach provides an effective strategy for the design of multi-target inhibitors for Alzheimer's disease.}, }
@article {pmid41199875, year = {2025}, author = {Chande, K and Nirmal, R and Varpe, N and Doke, R and Vinchurkar, K and Singh, S}, title = {Alkaloid's undiscovered neuroprotective potential: a multi-target strategy to fight against neurodegenerative illnesses.}, journal = {3 Biotech}, volume = {15}, number = {12}, pages = {409}, pmid = {41199875}, issn = {2190-572X}, abstract = {Neurodegeneration (ND) refers to the progressive decline of neurons, leading to Alzheimer's disease, Parkinson's disease, multiple sclerosis, and Huntington's disease. These conditions are marked by gradual neuronal loss and cognitive impairment, with limited treatment options currently available. The available strategies only provide symptomatic relief and having more side effects, however none of them able to halt the disease progression, so there is strong need to develop alternative therapeutic strategies with no or less toxicity. Alkaloids, a class of naturally occurring compounds, exhibit diverse biological activities, including antioxidant and neuroprotection. Emerging research suggests that these molecules can influence key signaling pathways associated with neurodegeneration, potentially offering therapeutic benefits. By targeting multiple aspects of disease progression and modulating neuroinflammatory responses, alkaloids interact with critical molecular components such as transcription factors, receptors, and enzymes essential for neuronal survival and homeostasis. This review underscores the therapeutic potential of alkaloids in ND treatment and emphasizes the need for further research to explore their clinical applications. Future studies should aim to identify neuroprotective alkaloids, elucidate their mechanisms of action, and assess their effectiveness in treating neurodegenerative diseases. A deeper understanding of their interactions with key disease pathways is crucial for the development of effective therapeutic strategies.}, }
@article {pmid41199470, year = {2025}, author = {Shao, Y and Liu, L and Zhu, S and Zhu, Z and Wang, P and Biswal, BB and Lin, H}, title = {Fornix Mediates Information Propagation in Brain Networks Following DLPFC-Targeted rTMS in Alzheimer's Disease: A Randomized Controlled Trial.}, journal = {CNS neuroscience & therapeutics}, volume = {31}, number = {11}, pages = {e70630}, pmid = {41199470}, issn = {1755-5949}, support = {CFH2022-2-2014//Capital's Funds for Health Improvement and Research/ ; 2022YFC2402205//National Key R&D Program of China/ ; 51977205//National Natural Science Foundation of China/ ; NSFC62401106//National Natural Science Foundation of China/ ; NSFC62171101//National Natural Science Foundation of China/ ; NSFC-AF 82211530041//NSFC Projects of International Cooperation and Exchanges/ ; 2024NSFSC1661//Sichuan Science and Technology Program/ ; }, mesh = {Humans ; *Alzheimer Disease/therapy/diagnostic imaging/physiopathology ; Male ; Female ; *Transcranial Magnetic Stimulation/methods ; Aged ; *Fornix, Brain/diagnostic imaging/physiopathology/physiology ; *Dorsolateral Prefrontal Cortex/diagnostic imaging/physiopathology/physiology ; Diffusion Tensor Imaging ; Middle Aged ; *Nerve Net/diagnostic imaging/physiopathology ; White Matter ; Aged, 80 and over ; Neural Pathways ; }, abstract = {AIMS: Repetitive transcranial magnetic stimulation (rTMS) could improve the clinical manifestations in Alzheimer's disease (AD), but its impact on deep brain tissue related to memory remains unclear. This study explored whether rTMS targeting cortical gray matter could regulate the white matter (WM) and exert modulatory effects on the network through WM bundles.
METHODS: Seventy-three AD patients underwent 14-day rTMS over the left dorsolateral prefrontal cortex (44 real, 25 sham). Granger causality analysis assessed changes in effective connectivity (EC) between the fornix and whole-brain voxels. Furthermore, the effects of rTMS treatment on fiber tracking parameters were analyzed.
RESULTS: After rTMS therapy, patients with AD showed increased EC based on fornix in the real-stimulation group. Functional network projections indicated that these clusters belonged to the frontoparietal network, the somatomotor network, as well as three white matter networks. Additionally, increased EC associated with fornix exhibited lateralization on the right side. Diffusion tensor imaging results showed no significant differences after the 14-day rTMS treatment.
CONCLUSION: In conclusion, a 14-day rTMS treatment in AD could regulate fornical function by increasing cortical-fornix EC, indicating neuroplasticity changes in response to therapy.
TRIAL REGISTRATION: Chinese Clinical Trial Registry (https://www.chictr.org.cn/index.html; ChiCTR2200062564).}, }
@article {pmid41198610, year = {2025}, author = {Pirraglia, E and Osorio, RS and Glodzik, L and Ashebir, Y and Shao, Y}, title = {Subtypes of multiple-etiology dementias and the heterogeneous impact of APOE variants.}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70872}, pmid = {41198610}, issn = {1552-5279}, support = {R01 HL111724/HL/NHLBI NIH HHS/United States ; P30 AG066519/AG/NIA NIH HHS/United States ; P30 AG072973/AG/NIA NIH HHS/United States ; P30AG066530/AG/NIA NIH HHS/United States ; P30 AG072979/AG/NIA NIH HHS/United States ; P30AG072979/AG/NIA NIH HHS/United States ; P20 AG068082/AG/NIA NIH HHS/United States ; P30 AG072975/AG/NIA NIH HHS/United States ; P30AG062429/AG/NIA NIH HHS/United States ; P30 AG066444/AG/NIA NIH HHS/United States ; P30 AG066507/AG/NIA NIH HHS/United States ; P30 AG072946/AG/NIA NIH HHS/United States ; P30AG072972/AG/NIA NIH HHS/United States ; P30 AG066518/AG/NIA NIH HHS/United States ; P30AG062422/AG/NIA NIH HHS/United States ; P20AG068024/AG/NIA NIH HHS/United States ; P20 AG068053/AG/NIA NIH HHS/United States ; R01 NS104364/NS/NINDS NIH HHS/United States ; R01 AG067523/AG/NIA NIH HHS/United States ; P30AG072976/AG/NIA NIH HHS/United States ; P30 AG066511/AG/NIA NIH HHS/United States ; U24 AG072122/AG/NIA NIH HHS/United States ; P30 AG066512/AG/NIA NIH HHS/United States ; P30AG072973/AG/NIA NIH HHS/United States ; P30AG066518/AG/NIA NIH HHS/United States ; U01 OH012486/OH/NIOSH CDC HHS/United States ; R01 AG066870/AG/NIA NIH HHS/United States ; P30 AG066515/AG/NIA NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; P30AG072947/AG/NIA NIH HHS/United States ; R01AG066870/AG/NIA NIH HHS/United States ; P30AG066515/AG/NIA NIH HHS/United States ; P30AG066509/AG/NIA NIH HHS/United States ; P30AG079280/AG/NIA NIH HHS/United States ; P30AG062677/AG/NIA NIH HHS/United States ; P30 AG066508/AG/NIA NIH HHS/United States ; P30AG072946/AG/NIA NIH HHS/United States ; P30AG072959/AG/NIA NIH HHS/United States ; P30 AG072978/AG/NIA NIH HHS/United States ; P30 AG062429/AG/NIA NIH HHS/United States ; R01NS104364/NH/NIH HHS/United States ; P30 AG062422/AG/NIA NIH HHS/United States ; R01 AG079280/AG/NIA NIH HHS/United States ; P30AG066511/AG/NIA NIH HHS/United States ; U24 AG072122/NH/NIH HHS/United States ; P30AG066444/AG/NIA NIH HHS/United States ; P20AG068077/AG/NIA NIH HHS/United States ; P30AG066468/AG/NIA NIH HHS/United States ; P30AG072977/AG/NIA NIH HHS/United States ; R21 AG067549/AG/NIA NIH HHS/United States ; P30 AG066462/AG/NIA NIH HHS/United States ; P20AG068053/AG/NIA NIH HHS/United States ; R01 AG056531/AG/NIA NIH HHS/United States ; P30 AG066530/AG/NIA NIH HHS/United States ; P30AG072975/AG/NIA NIH HHS/United States ; P30AG066508/AG/NIA NIH HHS/United States ; P01 AG060882/AG/NIA NIH HHS/United States ; P30AG066462/AG/NIA NIH HHS/United States ; R01AG067523/AG/NIA NIH HHS/United States ; P30AG066506/AG/NIA NIH HHS/United States ; P30AG066546/AG/NIA NIH HHS/United States ; P30 AG066509/AG/NIA NIH HHS/United States ; P30AG066519/AG/NIA NIH HHS/United States ; P30AG066514/AG/NIA NIH HHS/United States ; P20 AG068077/AG/NIA NIH HHS/United States ; R01AG056531/AG/NIA NIH HHS/United States ; R01 AG056031/AG/NIA NIH HHS/United States ; P30AG062421/AG/NIA NIH HHS/United States ; P30 AG066546/AG/NIA NIH HHS/United States ; R01HL111724/NH/NIH HHS/United States ; P30AG072958/AG/NIA NIH HHS/United States ; P30AG072978/AG/NIA NIH HHS/United States ; P30 AG072977/AG/NIA NIH HHS/United States ; P30 AG062677/AG/NIA NIH HHS/United States ; P20 AG068024/AG/NIA NIH HHS/United States ; P30 AG072958/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; P30 AG066468/AG/NIA NIH HHS/United States ; P30 AG066506/AG/NIA NIH HHS/United States ; P20AG068082/AG/NIA NIH HHS/United States ; R21AG067549/AG/NIA NIH HHS/United States ; P30 AG072976/AG/NIA NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; P30 AG072931/AG/NIA NIH HHS/United States ; U01OH012486//Centers for Disease Control and Prevention (CDC)/ ; P30 AG072972/AG/NIA NIH HHS/United States ; P30AG066507/AG/NIA NIH HHS/United States ; R01AG056031/AG/NIA NIH HHS/United States ; P30 AG066514/AG/NIA NIH HHS/United States ; P30 AG072959/AG/NIA NIH HHS/United States ; P30AG072931/AG/NIA NIH HHS/United States ; P30AG062715/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; Male ; Female ; *Dementia/genetics/mortality/pathology/classification ; *Apolipoproteins E/genetics ; *Alzheimer Disease/pathology/genetics/mortality ; Aged ; Aged, 80 and over ; Autopsy ; *Apolipoprotein E4/genetics ; Brain/pathology ; Mixed Dementias ; }, abstract = {INTRODUCTION: Multiple-etiology dementias (MEDs) are frequently identified at autopsy but often missed in clinical diagnosis, limiting the efficiency of dementia research and treatment. This study aimed to characterize subtypes of MEDs, evaluate clinical underdiagnosis, and assess the heterogeneous impact of apolipoprotein E (APOE) variants on mortality across MED subtypes.
METHODS: Data from the National Alzheimer's Coordinating Center (NACC) repository, which includes standardized clinical and autopsy assessments, were analyzed using competing risks survival models.
RESULTS: Pure Alzheimer's disease (AD) neuropathology was rare, whereas mixed neuropathologies were common and frequently misdiagnosed as AD alone. APOE ε4 decreased mortality risk in decedents without AD neuropathology and increased mortality in decedents with mixed AD neuropathology, but not in those with AD alone. APOE ε2 increased mortality in decedents having vascular neuropathology with cerebral amyloid angiopathy.
DISCUSSION: Heterogeneity in MEDs remains substantially underrecognized clinically. The effects of APOE variants vary by dementia subtype, emphasizing the need for refined diagnostic tools and personalized dementia treatment and care approaches.
HIGHLIGHTS: Autopsy data revealed that pure Alzheimer's disease (AD) neuropathology is rare, whereas mixed pathologies are highly prevalent and frequently misdiagnosed as AD alone in clinical settings, underscoring the limitations of current diagnostic practices. Comprehensive neuropathological characterization of multiple-etiology dementia (MED) subtypes is crucial for uncovering the true complexity of dementia, which is often masked in clinical assessments. This approach enables a more accurate understanding of disease mechanisms and progression. We found that apolipoprotein E (APOE) ε4 was associated with increased mortality risk in AD with co-pathologies, but not in pure AD without other neuropathologies. Conversely, APOE ε4 was associated with decreased mortality risk in decedents who did not have AD neuropathology. APOE ε2 was protective in some AD-related subtypes but was associated with higher mortality risk in cerebral amyloid angiopathy with other vascular neuropathologies, highlighting the heterogeneous impact of genetic risk factors across subtypes. The differential effects of APOE variants across MED subtypes emphasize the need to evaluate biomarkers and risk factors within the context of underlying neuropathological profiles rather than broad clinical categories. These findings reinforce the need to develop and implement more refined, subtype-specific biomarkers and diagnostic protocols to enable precision prevention and personalized treatment strategies for the diverse forms of MED.}, }
@article {pmid41198603, year = {2025}, author = {Crowley, P and Henry, AL and Flanagan, E and Antonsdottir, I and Bentley, A and Blackman, J and Bliwise, DL and Bubu, OM and Buysse, DJ and Camargos, EF and Cassidy-Eagle, E and Cote, K and Coulthard, E and D'Rozario, AL and Espie, CA and Falck, RS and Gabb, VG and Harvey, AG and Hmwe, NTT and Hoyos, CM and Jobbins, L and Kennelly, S and Kent, BA and Köpke, S and Krystal, A and Leroi, I and Liguori, C and Lim, YY and Lorenz, R and Lucey, BP and Mander, B and Moline, M and Naismith, SL and Ogunniyi, A and Rapaport, P and Reynolds, CF and Richards, K and Siengsukon, CF and Sindi, S and Singer, CM and Wirz-Justice, A and Yaffe, K and O'Caoimh, R}, title = {Development of a core outcome set for clinical trials of interventions to improve sleep in people with cognitive impairment-the Sleep in Cognitive Impairment Core Outcome Set (SCICOS).}, journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association}, volume = {21}, number = {11}, pages = {e70890}, pmid = {41198603}, issn = {1552-5279}, support = {HRB DTICTN-2021-003//Dementia Trials Ireland, Health Research Board Clinical Trial Network/ ; HRB DTICTN-2021-003/HRBI_/Health Research Board/Ireland ; }, mesh = {Humans ; *Cognitive Dysfunction/complications/therapy ; *Sleep Wake Disorders/therapy/etiology/complications ; *Clinical Trials as Topic ; *Outcome Assessment, Health Care ; Delphi Technique ; *Sleep ; }, abstract = {INTRODUCTION: Sleep disturbances are common in older people with cognitive impairment, potentially contributing to negative outcomes. A core outcome set (COS) is required to reduce heterogeneity in clinical trials and promote the development of high-quality evidence to support clinical management.
METHODS: A multi-stage mixed methods study was conducted in accordance with The Core Outcome Set Standards for Development.
RESULTS: A systematic review identified 287 sleep outcomes from previous clinical trials. Qualitative interviews ensured the COS was informed by what matters most to people with cognitive impairment and their caregivers. A modified Delphi process identified nine outcomes for the COS: total sleep time, sleep onset latency, wakefulness after sleep onset, number of night-time awakenings, sleep efficiency, and measures of sleep quality, daytime sleepiness, cognition, and mood.
DISCUSSION: This COS will support researchers to produce more reliable and coherent trial data to guide the management of sleep disturbances in people with neurodegenerative cognitive impairment.
HIGHLIGHTS: Evidence is lacking regarding the treatment of sleep disturbances in people with cognitive impairment. Heterogeneity of reported outcomes in clinical trials limits data synthesis. A qualitative analysis established what matters most to people with cognitive impairment and their caregivers when determining treatment effectiveness. A Delphi panel of experts agreed upon a core outcome set. This core outcome set will improve the reliability and comparability of data from future trials.}, }
@article {pmid41198506, year = {2025}, author = {Lafon, PA and Prézeau, L and Pin, JP and Rondard, P}, title = {Nanobodies: a new paradigm for brain disorder therapies.}, journal = {Trends in pharmacological sciences}, volume = {46}, number = {11}, pages = {1049-1051}, doi = {10.1016/j.tips.2025.10.004}, pmid = {41198506}, issn = {1873-3735}, mesh = {Humans ; *Single-Domain Antibodies/therapeutic use/immunology ; Animals ; *Brain Diseases/drug therapy/immunology/therapy ; Alzheimer Disease/drug therapy/immunology ; }, abstract = {Camelid-derived nanobodies offer a promising alternative to conventional antibodies for the treatment of brain disorders. Their current development in models of schizophrenia or Alzheimer's disease highlights their strong therapeutic potential. Optimizing their delivery and ensuring their safety are major challenges, but their modularity and low immunogenicity make them promising candidates for neurotherapy.}, }
@article {pmid41198224, year = {2025}, author = {Yadav, D and Knight-Greenfield, A and Moirano, J and Nordvig, A and Salgado, MW and Hamed, M and Lin, M and RoyChoudhury, A and Blum, S and Keil, SA and Intorcia, B and Ebani, EJ and Osborne, J and Chiang, G and Ivanidze, J}, title = {Amyloid PET Z-score Quantification and correlation with visual semiquantitative grading.}, journal = {AJNR. American journal of neuroradiology}, volume = {}, number = {}, pages = {}, doi = {10.3174/ajnr.A9079}, pmid = {41198224}, issn = {1936-959X}, abstract = {BACKGROUND AND PURPOSE: Amyloid PET imaging plays a crucial role in the diagnosis of Alzheimer's disease (AD) and determines eligibility for anti-amyloid therapies. While visual interpretation using Regional Cortical Tracer Uptake (RCTU) and Brain Amyloid Plaque Load (BAPL) scores remains standard in clinical practice, it is subject to inter-reader variability and may not fully depict the amyloid distribution pattern. RCTU scoring evaluates cortical tracer uptake quantified as 1: no uptake, 2: focal and 3: diffuse uptake, while BAPL provides an overall summary score of amyloid plaque load depending on highest RCTU score. Quantitative techniques such as Centiloid scale or Z-scores may assist in diagnosis, grading and treatment monitoring. This study evaluates the feasibility of a Z-score quantification generated from normative database comparison and its correlation with visual RCTU grading.
MATERIALS AND METHODS: We retrospectively analyzed 100 patients who underwent [F18]-Florbetaben PET imaging between August and October 2024 for cognitive impairment. Visual interpretation was performed using RCTU scoring and overall BAPL score. Quantitative Z-scores were calculated for four cortical regions (frontal, parietal, posterior cingulate/precuneus, and lateral temporal) using a normative database. Correlation between visual and quantitative scores was assessed using Spearman's correlation. Z-score differences among RCTU categories were evaluated with Kruskal Wallis and Mann Whitney tests.
RESULTS: Among 100 patients (median age 78), 31 were amyloid negative (BAPL1), and 69 were amyloid positive (11 BAPL2, and 58 BAPL3). A total of 400 cortical regions were evaluated (143 RCTU1, 46 RCTU2, 211 RCTU3). Strong positive correlations were observed between RCTU and Z-scores in all regions (ρ = 0.78-0.88, p < 0.0001). The regional Z-scores showed significant differences between RCTU1 and RCTU2, RCTU1 and RCTU3, as well as between RCTU2 and RCTU3 across all four regions (p<0.05 for all comparisons. Pooled regional analysis also showed statistically significant differences in Z-scores between all RCTU groups (p < 0.0001).
CONCLUSIONS: Quantitative regional Z-scores derived from amyloid PET imaging demonstrate a strong correlation with visual assessment (RCTU score), validating their feasibility in clinical interpretation. These findings support the integration of quantitative tools into routine practice to enhance diagnostic confidence, reduce reader variability, and monitoring for amyloid-targeted therapies.
ABBREVIATIONS: AD = Alzheimer's Disease; RCTU = Regional Cortical Tracer Uptake; BAPL = Brain Amyloid Plaque Load; PiB = Pittsburgh Compound B; SUVR = Standardized Uptake Value Ratio; SPM = Statistical Parametric Mapping; SSP = Stereotactic Surface Projections.}, }
@article {pmid41197936, year = {2025}, author = {Choi, H and Hwang, S and Cho, H and Ahn, S and Yun, HY and Song, JS}, title = {Memantine modulates neuroinflammation and motor coordination in a Parkinson's disease model.}, journal = {Brain research}, volume = {1869}, number = {}, pages = {150034}, doi = {10.1016/j.brainres.2025.150034}, pmid = {41197936}, issn = {1872-6240}, mesh = {Animals ; *Memantine/pharmacology ; Mice ; Mice, Transgenic ; Microglia/drug effects/metabolism ; *Neuroinflammatory Diseases/drug therapy ; Disease Models, Animal ; *Parkinson Disease/drug therapy ; Male ; Mice, Inbred C57BL ; Excitatory Amino Acid Antagonists/pharmacology ; }, abstract = {Memantine, an NMDA receptor antagonist clinically approved for Alzheimer's disease, has been implicated in modulating neuroinflammatory responses beyond its anti-excitotoxic actions. To explore its potential relevance in Parkinson's disease, this study evaluated memantine's effects in both LPS-activated microglial cells and a synucleinopathy mouse model. In BV-2 cells, memantine elicited a modest but measurable attenuation of TNF-α and IL-6 secretion, which was accompanied by downregulation of TLR4 and IκB signaling. In vivo, 5-month oral administration of memantine to mThy1-αSyn transgenic mice led to moderate improvements in motor function as assessed by beam-walk performance. Immunohistochemical analyses revealed decreased microglial activation in the cerebral cortex; however, phosphorylated α-synuclein accumulation and tyrosine hydroxylase expression remained unaffected. Furthermore, spatial working memory was not improved by treatment. Taken together, these findings suggest that memantine may exert beneficial effects on neuroinflammatory processes and behavioral deficits in PD-relevant models. However, its impact on the hallmark neuropathology of PD appears limited.}, }
@article {pmid41197760, year = {2026}, author = {Yao, M and Li, Z and Lin, Y and Cai, H and Sun, C and Liu, L and Long, Y and Ge, Z}, title = {Hyperbaric oxygen therapy ameliorates Alzheimer's disease pathology by restoration of mitophagy and suppressing neuroinflammation in 5xFAD mice.}, journal = {Experimental neurology}, volume = {396}, number = {}, pages = {115534}, doi = {10.1016/j.expneurol.2025.115534}, pmid = {41197760}, issn = {1090-2430}, mesh = {Animals ; *Alzheimer Disease/therapy/pathology/genetics/metabolism ; *Hyperbaric Oxygenation/methods ; Mice, Transgenic ; Mice ; *Mitophagy/physiology ; *Neuroinflammatory Diseases/therapy/pathology ; Male ; Amyloid beta-Protein Precursor/genetics ; Amyloid beta-Peptides/metabolism ; Disease Models, Animal ; }, abstract = {Alzheimer's disease (AD) is characterized by amyloid-β (Aβ) accumulation, synaptic dysfunction, and chronic neuroinflammation. Here, we demonstrate that hyperbaric oxygen therapy (HBOT) has multiple therapeutic effects in 5xFAD transgenic mice. HBOT significantly improved cognitive function. Treated mice increasingly moved to the center of the open field in Y-maze tests and preferred a new arm. Longitudinal [18]F-AV-45 PET-MR scans showed progressive reduction in amyloid tracer uptake, which was corroborated by histologically verified reduced plaque burden and upregulation of LRP1, a key Aβ clearance transporter. HBOT preserved neuronal density and enhanced synaptic proteins. Mechanistically, HBOT promoted mitochondrial quality control by upregulating PINK1 and parkin expression, enhancing autophagosome formation, and modulating mitophagy-associated pathways. The transition of microglia to a surveillance phenotype was reflected in decreased soma area and increased branching. The coordinated improvement in amyloid clearance, mitochondrial quality control and synaptic maintenance, and modulation of neuroinflammation suggest that the ability of HBOT to simultaneously act on multiple pathological cascades-in combination with its noninvasive nature and favorable safety profile-makes it a uniquely promising therapeutic strategy. Furthermore, these results suggest that HBOT may be particularly effective at an early stage of the disease. These studies will be critical in establishing the clinical applicability of HBOT in the treatment of Alzheimer's disease.}, }
@article {pmid41197747, year = {2026}, author = {Ozturk, B and Demir, H and Silindir-Gunay, M and Akdag, Y and Sahin, S and Gulsun, T}, title = {Application of artificial neural network to determine optimum formulation development and in vitro characterization of methylene blue and galantamine loaded polymeric nanoparticles for the treatment of Alzheimer's disease.}, journal = {European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences}, volume = {216}, number = {}, pages = {107364}, doi = {10.1016/j.ejps.2025.107364}, pmid = {41197747}, issn = {1879-0720}, mesh = {*Methylene Blue/chemistry/administration & dosage ; *Galantamine/chemistry/administration & dosage ; *Neural Networks, Computer ; *Alzheimer Disease/drug therapy ; *Nanoparticles/chemistry ; Polylactic Acid-Polyglycolic Acid Copolymer/chemistry ; Poloxamer/chemistry ; Particle Size ; Cholinesterase Inhibitors/chemistry/administration & dosage ; Drug Carriers/chemistry ; Chemistry, Pharmaceutical ; Glutathione/chemistry ; }, abstract = {Alzheimer's disease is a major neurodegenerative disorder characterized by complex pathophysiology and currently lacks a curative treatment. This study aims to develop and characterize methylene blue and galantamine co-loaded PLGA nanoparticles, surface-modified with poloxamer 188 and GSH, to increase blood residence time and improve brain-targeted delivery. The nanoparticles were prepared using the double emulsion solvent evaporation method, and their physicochemical properties were characterized by TEM, FT-IR, DSC, XRD, and [13]C NMR. Artificial neural network modeling was used to optimize the formulation parameters, including PLGA %, PVA %, and sonication time, for predicting particle size and encapsulation efficiencies of methylene blue and galantamine. Results showed that the optimized nanoparticles had particle sizes <200 nm, appropriate zeta potential, and high encapsulation efficiencies. DSC, FT-IR, XRD, and NMR analyses confirmed the absence of crystalline peaks for methylene blue and galantamine, indicating successful encapsulation. Artificial neural network models demonstrated high predictive accuracy, serving as a valuable tool for formulation optimization. This dual-drug, surface-modified nanoparticle approach offers promising potential for multi-target therapy in Alzheimer's disease.}, }
@article {pmid41196512, year = {2025}, author = {Li, Y and Fan, H and Han, X and Ni, M and Hou, X and Xia, H and Shi, Y and Zhang, L and Sun, J}, title = {RRBP1 Inhibition Reduces Microglial M1 Polarization and Inflammation-Mediated Neuronal Loss and Oxidative Stress by Regulating ERK Pathway in Alzheimer's Disease.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {5}, pmid = {41196512}, issn = {1559-1182}, support = {No. ZC23456043 and No. ZC2020259//The 23456 Talent Project of Henan Provincial People's Hospital/ ; }, mesh = {*Oxidative Stress/drug effects/physiology ; *Microglia/metabolism/pathology/drug effects ; *Alzheimer Disease/pathology/metabolism ; Animals ; Humans ; *Neurons/metabolism/pathology/drug effects ; *Inflammation/pathology/metabolism ; *MAP Kinase Signaling System/drug effects/physiology ; Mice ; *Cell Polarity/drug effects ; Cell Line ; Reactive Oxygen Species/metabolism ; Amyloid beta-Peptides ; Cell Line, Tumor ; Apoptosis/drug effects ; }, abstract = {Ribosome-binding protein 1 (RRBP1) regulates ribosome assembly and stability to modify several important biological processes such as mitochondrial function, stress, cell differentiation, immunity, and axonal structure. This study aimed to investigate RRBP1 inhibition on microglial polarization and inflammation, and its mediated neuronal loss and oxidative stress in Alzheimer's disease (AD). Mouse microglia (BV-2), mouse hippocampal neuron (HT-22), human microglia (HMC3), and human neuroblastoma (SH-SY5Y) cell lines were cultured. A classical culture system containing BV-2 and HT-22, as well as HMC3 and SH-SY5Y, under β-amyloid treatment was applied to mimic AD cellular models. RRBP1 siRNA and control siRNA were transfected into BV-2 and HMC3 cells with no transfection as normal control; moreover, the ERK pathway was inactivated by PD98059 reagent. Microglial M1 phonotype marker (iNOS) and inflammatory cytokines (TNF-α and IL-1β levels) were decreased, while microglial M2 phonotype marker (ARG1) and pERK/ERK were increased by RRBP1 inhibition in BV-2 and HMC3 cells. Then microglial RRBP1 inhibition further elevated cell viability and superoxide dismutase (SOD), while reducing the cell apoptosis rate and reactive oxygen species (ROS) in HT-22 and SH-SY5Y cells. pERK/ERK was lowered after PD98059 treatment, which attenuated the effect of RRBP1 inhibition on microglial M1/M2 phenotypes and inflammatory cytokines in BV-2 and HMC3 cells, and further weakened the effect of microglial RRBP1 inhibition on cell viability, apoptosis rate, ROS, and SOD in HT-22 and SH-SY5Y cells. RRBP1 inhibition represses microglial M1 polarization and inflammation-mediated neuronal loss and oxidative stress by modifying the ERK pathway in AD.}, }
@article {pmid41196470, year = {2025}, author = {Vaja, R and Vohra, M and Ramachandran, AV and Baxi, D}, title = {Development of a Novel Aluminium Chloride-Induced Zebrafish Model of Alzheimer's Disease: Involvement of Oxidative Stress, Cholinergic Dysfunction, and Gut Pathophysiology.}, journal = {Neurotoxicity research}, volume = {43}, number = {6}, pages = {46}, pmid = {41196470}, issn = {1476-3524}, mesh = {Animals ; Zebrafish ; *Oxidative Stress/drug effects/physiology ; *Alzheimer Disease/chemically induced/physiopathology/pathology/metabolism ; *Disease Models, Animal ; Female ; Male ; *Aluminum Chloride/toxicity ; Brain/pathology/drug effects/metabolism ; }, abstract = {Alzheimer's Disease (AD) is a progressive and fatal neurodegenerative disorder (NDD), and the leading cause of dementia globally, with females being more susceptible than males. Existing animal models for AD are primarily pharmacologically induced or transgenic, yet many fail to recapitulate the full spectrum of human AD pathology and thereby elucidating its sex-based differences. This underscores the need for a cost-effective and robust experimental model that reliably mimics the multifactorial nature of AD taking into account the differences that arise due to sex. In recent years, the zebrafish (Danio rerio) has emerged as a promising model organism for studying central nervous system (CNS) disorders, including AD, owing to its high genetic and physiological homology to humans, transparent embryonic development, and amenability to high-throughput screening. This study aims to establish a novel chronic neurotoxicity induced ZF model, using AlCl3 as an inducing neurotoxic agent. The hypothesis centers on AlCl3-induced oxidative stress, cholinergic pathway dysfunction, and gut pathophysiological changes as drivers of AD-like pathology. Adult zebrafish, of both sexes were exposed to chronic AlCl3 treatment over a 28-day period. Post-treatment assessments included histopathological, biochemical, and behavioural analyses to evaluate changes in brain and gut tissues, oxidative stress biomarkers, and cognitive performance. Zebrafish exposed to AlCl3 exhibited distinct pathological changes in both brain and gut tissues compared to controls. In the brain, hallmarks such as pyknotic neurons, neuronal vacuolisation, and neural tissue necrosis was observed. Gut tissue displayed significant abnormalities, including reduced villi number, epithelial cell loss, and fused or shortened villi. Biochemical analyses revealed elevated oxidative stress, evidenced by altered levels of catalase (CAT), glutathione (GSH), and lipid peroxidation (LPO). Additionally, disruption of the cholinergic system was evident. Behavioural analyses using locomotor tracking revealed marked cognitive deficits, including reduced average speed, decreased distance travelled, and increased immobility. Lastly, our sex specific differences revealed that females were more affected by the biochemical, histological and neurobehavioural parameters as compared to males, thereby indicating that females pose a greater susceptibility towards developing AD. The AlCl3 -induced zebrafish model successfully replicates key features of human neurotoxicity, which may lead to AD like features including oxidative stress, cholinergic dysfunction, neurodegeneration, and gut-brain axis alterations. This novel and cost-effective model provides a comprehensive platform for exploring sex-mediated neurotoxicity experimental animal model and offers potential utility for screening therapeutic interventions and understanding disease-modifying mechanisms. Keywords: Alzheimer's Disease, Chronic Neurotoxicity, Gut-brain axis, Zebrafish, Sex differences, Alumnium chloride.}, }
@article {pmid41196440, year = {2025}, author = {Li, S and Gao, Y and Zhang, X and Lang, J and Liu, X and Zhang, Y and Zhang, J and Zhao, Y and Chang, C and Gao, X and Zhou, J and Yu, D and Yang, G}, title = {Bicyclol improves cognition deficits and inhibits oxidative stress-induced neuronal cell apoptosis in alzheimer's disease via Nrf2/HO-1 pathway.}, journal = {Metabolic brain disease}, volume = {40}, number = {8}, pages = {310}, pmid = {41196440}, issn = {1573-7365}, support = {Grant No. 20220997//the Medical Science Research Project of Hebei Provincial Health Commission/ ; Grant No. 82471453//the National Natural Science Foundation of China/ ; Grant No. H2022206231//the Hebei Natural Science Foundation/ ; }, mesh = {Animals ; *Apoptosis/drug effects ; *NF-E2-Related Factor 2/metabolism ; *Oxidative Stress/drug effects ; *Alzheimer Disease/drug therapy/metabolism ; *Biphenyl Compounds/pharmacology/therapeutic use ; Mice ; *Neurons/drug effects/metabolism ; *Heme Oxygenase-1/metabolism ; *Cognitive Dysfunction/drug therapy/metabolism ; Neuroprotective Agents/pharmacology/therapeutic use ; Signal Transduction/drug effects ; Male ; Mice, Transgenic ; Disease Models, Animal ; Antioxidants/pharmacology ; Amyloid beta-Peptides ; Membrane Proteins ; }, abstract = {Alzheimer's disease (AD) is identified as the prevalent neurodegenerative condition globally, ultimately resulting in dementia. Currently, the mechanisms that contribute to AD are not well comprehended, and there are few therapeutic alternatives available. Bicyclol, a substance extracted from the Chinese herb Schisandra Chinensis, has shown remarkable antioxidant, anti-inflammatory, anti-apoptotic, and neuroprotective characteristics. However, there is a shortage of research focusing on the therapeutic effects of bicyclol on AD as well as the molecular pathways that may be involved. This study sought to evaluate the effects of bicyclol on cognitive impairments in a mouse model of AD, explore its neuroprotective benefits associated with antioxidant functions and apoptosis suppression, and reveal the mechanisms involved. In this study, APP/PS1 mice underwent a 2-month treatment with bicyclol administered via gavage, after which their cognitive abilities were evaluated through behavioral assessments. The apoptosis of cortical neurons was evaluated using TUNEL staining and immunofluorescence techniques. N2A cells, which were exposed to Aβ1-42 oligomers, received a pretreatment with bicyclol, and their viability was subsequently measured. The expression levels of proteins such as nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NAD(P) H-quinine oxidoreductase-1 (NQO1), BCL2 associated X Protein (Bax), B-cell lymphoma-2 (Bcl-2), and Cleaved caspase-3 were quantified in vitro and in vivo using western blotting and qPCR methods. Moreover, N2A cells lacking Nrf2 were utilized to investigate the underlying mechanisms through which bicyclol exerts its effects in Alzheimer's disease. Bicyclol has been shown to enhance cognitive function while simultaneously reducing the levels of cortical Aβ1-40 and Aβ1-42, and it also protects against neuronal degeneration in the APP/PS1 mouse model. Moreover, it increases the activity of cortical SOD and GSH-Px, concurrently decreasing levels of ROS and MDA in vivo. Additionally, bicyclol significantly lessened oxidative stress and apoptosis induced by Aβ1-42 in N2A cells. It further elevated the expression of proteins such as Nrf2, HO-1, and NQO1, along with mRNA levels in both in vitro and in vivo experiments. Furthermore, the silencing of Nrf2 via siRNA transfection counteracted the regulatory effects of bicyclol on apoptotic markers including Bax, Bcl-2, and Cleaved caspase-3 in vitro. Our study provides compelling evidence that bicyclol effectively alleviates cognitive impairments observed in APP/PS1 mice. Furthermore, our findings indicate that bicyclol plays a significant role in reducing oxidative stress-induced injury and neuronal apoptosis. This protective effect is associated with the activation of the Nrf2/HO-1 signaling pathway. These results suggest that bicyclol has the potential to be developed as a therapeutic agent for the treatment of Alzheimer's disease, highlighting its promise in addressing the cognitive decline associated with this debilitating condition.}, }
@article {pmid41196439, year = {2025}, author = {Yadav, P and Dabas, A and Singh, R}, title = {Six-membered N-heterocyclic alkaloids as ChE inhibitors in alzheimer's disease treatment.}, journal = {Metabolic brain disease}, volume = {40}, number = {8}, pages = {309}, pmid = {41196439}, issn = {1573-7365}, mesh = {*Alzheimer Disease/drug therapy/enzymology ; *Cholinesterase Inhibitors/therapeutic use/pharmacology ; Humans ; *Alkaloids/therapeutic use/pharmacology/chemistry ; Animals ; Butyrylcholinesterase/metabolism ; Acetylcholinesterase/metabolism ; *Heterocyclic Compounds/therapeutic use/pharmacology ; }, abstract = {Cholinesterase (ChE) refers to a group of enzymes that play a critical role in the hydrolysis of choline-based esters, particularly acetylcholine, a key neurotransmitter presents in the nervous system. The two types of cholinesterase are acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), each with distinct functions and locations found within the body. Cholinesterase inhibitors (ChEIs) have been utilized to treat Alzheimer's disease (AD). AD is a progressive neurodegenerative disorder characterized by memory loss, impacting on the quality of life. Many studies have highlighted the potential of alkaloids as inhibitors of cholinesterase enzymes. There are various alkaloids which have potential to treat AD with their different modes of actions. This review summarizes more than 14 well-known alkaloids possessing six-membered N-heterocycles as AChE and BuChE inhibitors, such as berberine, boldine, crytolepine, harmine, huperzine A, 6-hydroxycrinamine, nicotine, piperine, salsoline, skimmianine, trigonelline, valerianofal A, 7'-multijuguinone, and 12'-hydroxy-7'-multijuguinone, hamayne, and lycorine.}, }
@article {pmid41195067, year = {2025}, author = {Ye, K and Li, L and Guan, L and Qin, MM and Xu, XY and Wu, J and Huang, LZ and Gao, JJ}, title = {Exploring the molecular mechanisms of Pueraria in Alzheimer's disease treatment using machine learning and network pharmacology.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1683852}, pmid = {41195067}, issn = {2296-861X}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder, characterized by amyloid-β deposition, tau pathology, neuroinflammation, and metabolic dysfunction. While conventional treatments have been widely studied, food-based interventions are emerging as potential neuroprotective strategies. Pueraria, a nutrient-rich food, has shown promise in promoting brain health, but its mechanisms in AD prevention and management remain insufficiently understood.
METHODS: In this study, we utilized network pharmacology, transcriptomics, and machine learning to investigate the neuroprotective effects of Pueraria. Through analysis of five transcriptomic datasets (GSE5281, GSE29378, GSE36980, GSE37263, and GSE138260), we identified genes associated with AD and screened 15 active compounds from Pueraria lobata using HERB and TCMSP databases. Machine learning models prioritized key targets, and molecular docking simulations assessed the binding affinities of Pueraria compounds to these targets. In vivo validation was performed in AD model mice to evaluate the cognitive-enhancing effects of Pueraria.
RESULTS: We identified 45 overlapping targets between Pueraria and AD, primarily related to synaptic plasticity and neurotransmission. Among these, PFKFB3 emerged as a key mediator of Pueraria's neuroprotective effects. Molecular docking confirmed strong binding affinities between Pueraria compounds and PFKFB3, supporting their functional role. Experimental data showed that Pueraria improved cognitive function in AD mice, underscoring its potential as a neuroprotective agent.
CONCLUSION: This study highlights Pueraria as a promising functional food for AD prevention and management, emphasizing the potential of plant-based dietary interventions for brain health. Our findings provide a basis for further exploration of food-derived neuroprotective strategies.}, }
@article {pmid41193962, year = {2025}, author = {Jahani, S and Roshanaei, G and Tapak, L and , }, title = {Assessing the accuracy of survival machine learning and traditional statistical models for Alzheimer's disease prediction over time: a study on the ADNI cohort.}, journal = {BMC medical research methodology}, volume = {25}, number = {1}, pages = {250}, pmid = {41193962}, issn = {1471-2288}, mesh = {Humans ; *Alzheimer Disease/diagnosis/diagnostic imaging ; *Machine Learning ; Male ; Female ; Aged ; *Cognitive Dysfunction/diagnosis/diagnostic imaging ; Disease Progression ; *Models, Statistical ; Aged, 80 and over ; Neuroimaging/methods ; Prognosis ; Cohort Studies ; Proportional Hazards Models ; Survival Analysis ; }, abstract = {BACKGROUND: Mild cognitive impairment (MCI) represents a transitional stage to Alzheimer's disease (AD), making progression prediction crucial for timely intervention. Predictive models integrating clinical, laboratory, and survival data can enhance early diagnosis and treatment decisions. While machine learning approaches effectively handle censored data, their application in MCI-to-AD progression prediction remains limited, with unclear superiority over classical survival models.
METHODS: We analyzed 902 MCI individuals from Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset with 61 baseline features. Traditional survival models (Cox proportional hazards, Weibull, elastic net Cox) were compared with machine learning techniques (gradient boosting survival, random survival forests [RSF]) for progression prediction. Models were evaluated using C-index and IBS.
RESULTS: Following feature selection, 14 key features were retained for model training. RSF achieved superior predictive performance with the highest C-index (0.878, 95% CI: 0.877-0.879) and lowest IBS (0.115, 95% CI: 0.114-0.116), demonstrating statistically significant superiority over all evaluated models (P-value < 0.001). RSF demonstrated effective risk stratification across individual biomarker categories (genetic, imaging, cognitive) and achieved optimal patient separation into three distinct prognostic groups when combining all features (p < 0.0001). SHAP-based feature importance analysis of RSF revealed cognitive assessments as the most influential predictors, with Functional Activities Questionnaire (FAQ) achieving the highest importance score (1.098), followed by Logical Memory Delayed Recall Total (LDELTOTAL) (0.906) and Alzheimer's Disease Assessment Scale (ADAS13) (0.770). Among neuroimaging biomarkers, Fluorodeoxyglucose (FDG) emerged as the leading predictor (0.634), ranking fifth overall. Feature importance ranking differed between classical and machine learning approaches, with FDG maintaining consistent importance across all models. RSF demonstrated excellent predictive calibration with positive net benefit across risk thresholds from 0.2 to 0.8.
CONCLUSIONS: The RSF model outperformed other methods, demonstrating superior potential for improving prognostic accuracy in medical diagnostics for MCI to AD progression.}, }
@article {pmid41193931, year = {2025}, author = {Nagarajan, R and Zhang, H and Lyu, J and Kambali, M and Wang, M and Rudolph, U}, title = {Intranasal Insulin Mitigates Memory Impairment and Neuroinflammation in a Mouse Model of Hippocampal Aging.}, journal = {Pharmacology research & perspectives}, volume = {13}, number = {6}, pages = {e70186}, pmid = {41193931}, issn = {2052-1707}, support = {R01 GM128183/GM/NIGMS NIH HHS/United States ; R35 GM153232/GM/NIGMS NIH HHS/United States ; R35GM153232/GM/NIGMS NIH HHS/United States ; R01GM128183/GM/NIGMS NIH HHS/United States ; }, mesh = {Animals ; Administration, Intranasal ; *Insulin/administration & dosage/pharmacology ; Mice ; *Memory Disorders/drug therapy ; Disease Models, Animal ; *Hippocampus/drug effects/metabolism ; *Aging/drug effects ; *Neuroinflammatory Diseases/drug therapy ; Male ; Somatostatin/metabolism ; Mice, Inbred C57BL ; Mice, Transgenic ; }, abstract = {Aging is a complex process that frequently includes cognitive decline with memory loss. In the hippocampus, the number of somatostatin-positive (Sst[+]) GABAergic interneurons in the hilar region of the dentate gyrus decreases with age. We previously showed that selective ablation of Sst[+] dentate hilar interneurons is sufficient to induce cognitive dysfunction, resulting in a model of hippocampal aging (pseudo-aged mice). Brain insulin levels and insulin receptor expression also decline with age, and intranasal insulin (INS) has shown promise in improving learning and memory in Alzheimer's disease. Here, we investigated the effects of INS in pseudo-aged mice with genetically ablated dentate hilar Sst[+] interneurons, which were generated by bilateral injection of AAV5-EF1α-mCherry-flex-dtA into the dentate hilus of Sst-IRES-Cre mice (3-5 months old). Following a 3-week recovery period post-injection, INS was administered daily for 9 days. INS treatment in pseudo-aged mice improved working memory in the Y-maze, recognition memory in the novel object recognition test, and non-declarative associative memory in trace fear conditioning. At the molecular level, INS reversed the increase in Iba-1 and pTBK1 expression, indicating attenuation of microglial activation and cGAS-STING pathway signaling, and restored hippocampal BDNF levels. No significant effects of INS were observed in control mice. These findings indicate that INS alleviates memory impairment and reduces neuroinflammation in this hippocampal aging model. Together, the results suggest that intranasal insulin may provide a non-invasive therapeutic approach for mitigating age-related cognitive decline by modulating neuroinflammatory and neurotrophic mechanisms.}, }
@article {pmid41192715, year = {2025}, author = {Wang, J and Du, Z and Wang, W and Liang, Z and Hou, Y and Liu, Q and Wang, J and Wang, S and He, M and Li, Z and Yang, R and Wang, K and Zhao, L and Wei, Y and Huang, D}, title = {Lactoferrin-driven delivery of Kaixinsan nanomedicine for Alzheimer's disease neuroprotection: Mechanistic insights from bioinformatics and multi-target validation.}, journal = {International journal of biological macromolecules}, volume = {333}, number = {Pt 1}, pages = {148746}, doi = {10.1016/j.ijbiomac.2025.148746}, pmid = {41192715}, issn = {1879-0003}, mesh = {*Lactoferrin/chemistry ; *Alzheimer Disease/drug therapy/metabolism/pathology ; Animals ; *Neuroprotective Agents/pharmacology/chemistry ; Mice ; Computational Biology/methods ; Blood-Brain Barrier/metabolism/drug effects ; Humans ; *Neuroprotection/drug effects ; *Nanomedicine ; Caenorhabditis elegans ; Oxidative Stress/drug effects ; Signal Transduction/drug effects ; Drug Delivery Systems ; }, abstract = {Alzheimer's disease (AD) is a common neurodegenerative disorder characterised by neurapoptosis and neuroinflammation-induced neuronal damage. However, the exact pathogenic mechanism of AD is still controversial, and the existing treatment methods are only effective for the early stage of the disease. Kaixinsan (KXS), a classic anti-amnestic traditional Chinese medicine, can effectively reduce oxidative stress and provide neuroprotection to the brain, but the exact molecular mechanism remains unclear. Herein, we synthesised a biomimetic KXS-delivery system (LTF@GO-PEG/KXS, LGPK), which significantly enhanced the blood-brain barrier (BBB) penetration efficiency was significantly improved, attributed to lactoferrin (LTF)-mediated receptor binding. LGPK exhibits excellent neuroprotection and repolarizes BV2 microglia from pro-inflammatory to anti-inflammatory phenotypes. Further bioinformatics analysis and western blot results indicated that LGPK could inhibit the progression of AD by inhibiting the production of amyloid precursor protein (APP) and hyperphosphorylated Tau (p-Tau), and downregulating TNF/NF-κB signalling pathways. In vivo studies using a transgenic Caenorhabditis elegans strain confirmed that LGPK both suppresses Aβ fibrillogenesis and attenuates oxidative stress, thereby highlighting its potential as a combination therapy for AD. Mechanistic investigations indicated that these neuroprotective effects were mediated through the suppression of the TNF/NF-κB signalling pathway, along with profound alterations in alternative splicing (AS) events. Collectively, these findings highlight LGPK as a promising multi-target nanomedicine for AD treatment by enhancing brain-targeted delivery and exerting combined anti-neuroapoptosis and anti-inflammatory.}, }
@article {pmid41192695, year = {2026}, author = {Kong, M and Xu, Z and Lu, H and Chen, Y and Zhang, Y and Jiang, X and Wang, P}, title = {ShengHui Decoction mitigates oxidative stress and neuroinflammation in AlCl3-induced AD zebrafish via activating Nrf2/HO-1 and inhibiting NF-κB signaling pathway.}, journal = {Journal of ethnopharmacology}, volume = {356}, number = {}, pages = {120785}, doi = {10.1016/j.jep.2025.120785}, pmid = {41192695}, issn = {1872-7573}, mesh = {Animals ; Zebrafish ; *Oxidative Stress/drug effects ; Aluminum Chloride/toxicity ; NF-E2-Related Factor 2/metabolism ; NF-kappa B/metabolism ; *Drugs, Chinese Herbal/pharmacology/therapeutic use ; Signal Transduction/drug effects ; *Alzheimer Disease/drug therapy/chemically induced/metabolism ; Disease Models, Animal ; Zebrafish Proteins/metabolism ; Heme Oxygenase-1/metabolism ; *Neuroinflammatory Diseases/drug therapy ; }, abstract = {ShengHui decoction (SHD), a traditional Chinese herbal formula, has long been used clinically to mitigate Alzheimer's disease (AD), demonstrating significant efficacy in alleviating cognitive impairment. However, its molecular mechanisms remain insufficiently understood.
AIM OF THE STUDY: To clarify the effects of SHD on oxidative stress-related markers and inflammatory cytokines in an aluminum chloride (AlCl3)-induced zebrafish model of AD and as well as uncover its underlying mechanisms in alleviating oxidative stress and neuroinflammation.
MATERIALS AND METHODS: Ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was employed to identify the bioactive constituents of SHD. Behavioral tests and histopathological analyses were then conducted to evaluate the effects of SHD (0.74, 1.48, and 2.96 mg/mL) on apoptosis and amyloid-beta (Aβ) deposition in an AlCl3-induced AD zebrafish model. Biochemical assays and enzyme-linked immunosorbent assay were used to quantify superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-1 beta (IL-1β), and IL-18. Western blot analysis was performed to determine the protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NAD(P)H quinone dehydrogenase 1 (NQO1), nuclear factor-kappa B p65 (NF-κB p65), phosphorylated NF-κB p65 (p-NF-κB p65), and NOD-like receptor family pyrin domain containing 3 (NLRP3).
RESULTS: UPLC-MS/MS profiling identified phenolic acids, saponins, lignans/coumarins, flavonoids, and aliphatic alcohols as the main constituents of SHD. SHD significantly ameliorated cognitive deficits and histopathological abnormalities in AlCl3-induced zebrafish. Moreover, SHD attenuated oxidative stress by upregulating Nrf2, HO-1, and NQO1 expression, while downregulating AlCl3-induced levels of NF-κB p65, p-NF-κB p65, NLRP3 and pro-inflammatory factors.
CONCLUSIONS: SHD effectively improved cognitive performance and reduced AD-like pathological lesions in AlCl3-induced zebrafish. Importantly, SHD exhibits both antioxidant and anti-inflammatory activities by activating the Nrf2/HO-1 axis and inhibiting NF-κB signaling, thereby alleviating oxidative stress and neuroinflammatory responses in AD. These findings provide experimental evidence supporting SHD as a potential therapeutic agent for AD, and substantiate the traditional Chinese medicine principle of tonifying the kidney and replenishing essence in the treatment of AD.}, }
@article {pmid41192434, year = {2025}, author = {Wagemann, O and Tesky, VA and Schall, A and Nübling, G and Wlasich, E and Hüer, T and Walendzik, A and Weitzel, M and Giebel, GD and Raszke, P and Wasem, J and Pantel, J and Levin, J}, title = {[A review and guideline for the adequate and interdisciplinary (socio-)medical care of people with Down syndrome and dementia development].}, journal = {Fortschritte der Neurologie-Psychiatrie}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-2708-3648}, pmid = {41192434}, issn = {1439-3522}, support = {Projekt-Nr. 01VSF21030//Innovationsfonds des Gemeinsamen Bundesausschusses/ ; 022_EKEA.133//Else-Kröner-Fresenius-Stiftung/ ; }, abstract = {Alzheimer's disease (AD) is one of the most common neurodegenerative disorders in older age. Individuals with Down syndrome (DS) are at significantly increased risk due to trisomy 21 and the resulting overexpression of the amyloid precursor protein. Prevalence rates of AD-related dementia in DS (DSAD) reach up to 88% beyond the age of 65. Despite this, structured diagnostic and therapeutic guidelines for DSAD are lacking.A narrative review of current literature on etiology, diagnosis, treatment, and care pathways for DSAD was conducted. Currently employed dementia diagnostic standards were evaluated in regard to the specific needs of individuals with DS.Established diagnostic methods are applicable to individuals with DS but require adaptations regarding symptom recognition, test administration, and interpretation. Early awareness among caregivers and healthcare providers, as well as timely referral to specialized centers, is essential for accurate diagnosis and treatment planning.Improving care for individuals with DSAD requires close coordination between general healthcare services and specialized centers. This review highlights the medical, diagnostic, and structural challenges in suspected DSAD and provides practical recommendations for patient care. The proposed guideline aims to reduce uncertainties in clinical practice and support sustainable, needs-based care.}, }
@article {pmid41192010, year = {2025}, author = {Yang, M and Wang, Z and Zhou, Q and Zhang, Q and Li, Y and Wang, Z}, title = {The adjunctive efficacy of repetitive transcranial magnetic stimulation with non-pharmacological interventions in cognitive disorders: A meta-analysis of randomized sham-controlled trials.}, journal = {Asian journal of psychiatry}, volume = {114}, number = {}, pages = {104758}, doi = {10.1016/j.ajp.2025.104758}, pmid = {41192010}, issn = {1876-2026}, mesh = {Humans ; *Randomized Controlled Trials as Topic ; *Cognitive Dysfunction/therapy ; *Transcranial Direct Current Stimulation/methods ; Combined Modality Therapy ; *Transcranial Magnetic Stimulation/methods ; *Alzheimer Disease/therapy ; *Tai Ji ; *Outcome Assessment, Health Care ; *Cognitive Behavioral Therapy/methods ; }, abstract = {OBJECTIVE: This meta-analysis aimed to systematically evaluate the specific, adjunctive efficacy of repetitive transcranial magnetic stimulation (rTMS) when combined with non-pharmacological interventions-namely, transcranial direct current stimulation (tDCS), Tai Chi, or cognitive training (CT)-in patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI). The goal is to isolate the net therapeutic contribution of rTMS beyond the effects of the base interventions alone.
METHODS: A comprehensive search of Chinese and English databases was conducted from their inception until April 26, 2025. Randomized controlled trials (RCTs) that compared "a non-pharmacological intervention plus active rTMS" versus "the same non-pharmacological intervention plus sham rTMS".This "add-on" study design was selected to precisely isolate the effect of rTMS. The risk of bias was assessed using the PEDro scale and Cochrane tools. Statistical analyses were performed using Review Manager 5.4 software.
RESULTS: 9 studies involving 391 participants were included. The pooled analysis revealed that the adjunctive use of rTMS was significantly superior to the sham control in improving global cognitive function at the immediate post-treatment assessment (SMD=0.38, 95 %CI[0.20,0.56], P < .001, n = 9). This benefit was consistent across the MMSE (SMD=0.38, n = 6), MoCA (SMD=0.37, n = 2), and ADAS-cog (SMD=0.39, n = 3) scores. Subgroup analysis suggested that the rTMS-tDCS combination might offer a short-term advantage in improving MMSE scores (MD=4.67, P = .008). Furthermore, the adjunctive effect of rTMS was sustained, as particularly evidenced by the ADAS-cog at follow-up (SMD=0.74, P = .02). The pooled analysis indicated that rTMS combined with non-pharmacological therapy demonstrated a short-term, sustained (4-8weeks) improvement in global cognitive function (SMD=0.34, 95 % CI[0.07, 0.60], P = .01). Subgroup analysis revealed that this sustained benefit reached statistical significance on the ADAS-cog scale (SMD = 0.41, 95 %CI[0.01, 0.81], P = .04) but showed a non-significant positive trend on the MMSE (SMD=0.26, 95 %CI[-0.19, 0.72], P = .26). However, a key limitation was that most studies did not systematically report outcomes related to activities of daily living or behavioral function.
CONCLUSION: The evidence indicates that rTMS as an adjunct to non-pharmacological interventions provides a significant specific effect on global cognitive function in patients with AD and MCI shortly after treatment, which may be sustained in the short-term. However, long-term follow-up data are extremely limited, and the effect on activities of daily living remains to be validated. The combination of rTMS and tDCS shows promise,but conclusions are constrained by the small number of studies,limited sample sizes,and heterogeneity in intervention protocols. Future large-scale studies incorporating long-term, standardized follow-up and assessments of daily living abilities are warranted to confirm the specific clinical value of rTMS as an augmentative therapy.}, }
@article {pmid41191186, year = {2025}, author = {Zhang, Y and Liu, S and Xu, K and Shen, Y and Liu, Z and Wang, Y and Bai, Y and Wang, S}, title = {Repetitive transcranial magnetic stimulation for cognitive and emotional symptoms in neurodegenerative diseases: a systematic review and dose-response meta-analysis.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {46}, number = {12}, pages = {6243-6259}, pmid = {41191186}, issn = {1590-3478}, support = {2023ZX06C16//Heilongjiang Province Key Research and Development Project: Evidence-based Evaluation Study on the Interventions of Traditional Chinese Medicine at Key Stages of the Whole Cycle of Parkinson's Disease/ ; }, mesh = {Humans ; *Transcranial Magnetic Stimulation/methods ; *Parkinson Disease/therapy/complications/psychology ; *Affective Symptoms/therapy/etiology ; *Alzheimer Disease/therapy/psychology ; *Neurodegenerative Diseases/therapy/complications/psychology ; *Cognitive Dysfunction/therapy/etiology ; }, abstract = {OBJECTIVE: We summarized the existing clinical evidence of repetitive transcranial magnetic stimulation (rTMS) for cognitive and emotional symptoms in Parkinson's disease (PD) and alzheimer's disease (AD), and conducted a series of dose-response meta-analyses to determine the magnitude and curve relationship between pulse quantity changes and treatment effect sizes.
METHODS: We retrieved existing evidence from 5 databases and collected relevant results data on rTMS treatment for cognitive and emotional symptoms in PD and AD. We analyzed the data using R software to evaluate the effect size using MD or SMD and 95% confidence intervals (CI), used heterogeneity tests to evaluate the differences in efficacy among the evidence, and used restricted cubic splines (RCS) to fit the dose-response curve.
RESULTS: A total of 17 studies were included in this study. We found that the total pulse quantity showed a significant bell-shaped curve in MoCA (χ[2] = 6.82, df = 2, p = 0.03), HAMA (χ[2] = 9.16, df = 2, p = 0.01), and ADL (χ[2] = 8.22, df = 2, p = 0.01), with optimal effects achieved at 16153, 12138, and 17,237 pulses respectively-indicating that clinical application should control pulses within these ranges to avoid insufficient or excessive doses weakening efficacy. A significant upward curve was observed in MMSE (χ[2] = 12.94, df = 2, p = 0.001), meaning higher pulse counts (up to the 80,000-pulse upper limit in this study) may further improve basic cognitive function, providing a reference for dose adjustment in patients with cognitive impairment.
CONCLUSION: Our meta-analysis results show that rTMS exhibits significant efficacy in cognitive and emotional symptoms of PD and AD. The dose-response results show that the total pulse quantity in MoCA, HAMA, and ADL of PD and AD patients presents a typical bell-shaped curve, and a typical upward curve in MMSE. This indicates that there is a curve relationship between pulse stimulation quantity and efficacy, and the pulse stimulation quantity should be emphasized in the clinical application of rTMS.}, }
@article {pmid41191158, year = {2025}, author = {Pal, B and Panda, S and Bashir, B and Vishwas, S and Chaitanya, M and Hussain, MS and Gupta, G and Kumbhar, P and Gupta, S and Singh, SK}, title = {Nanomedicine-enabled neuroprotection: therapeutic role of berberine in neurodegenerative diseases.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {49}, pmid = {41191158}, issn = {1573-4978}, mesh = {Humans ; *Berberine/therapeutic use/pharmacology ; *Neurodegenerative Diseases/drug therapy/metabolism ; *Neuroprotective Agents/therapeutic use/pharmacology ; *Nanomedicine/methods ; Animals ; *Neuroprotection/drug effects ; Nanoparticles/chemistry ; Oxidative Stress/drug effects ; Blood-Brain Barrier/metabolism/drug effects ; }, abstract = {Neurodegenerative diseases (NDs), including Alzheimer's, Amyotrophic lateral sclerosis, Huntington's, and Parkinson's, present an increasingly widespread health burden globally with limited curative or treatment modalities, mostly having symptomatic attenuation. Berberine (BBR) is an isoquinoline alkaloid that occurs naturally and has been proposed as a potential neuroprotectant, since it has been found to exert multiple effects to modulate most of the pathological hallmarks of NDs, including neuroinflammation, oxidative stress, mitochondrial dysfunction, and protein aggregation. Although it shows promise, the practical utilization of BBR is marred by low oral bioavailability, high rate of oxidation, and low blood-brain barrier permeability. To combat these issues, recent developments in nanotechnology, especially in the use and creation of lipidic, inorganic, and polymeric nano-particles, have dramatically altered the pharmacokinetics and pharmacodynamics of BBR. This article summarizes recent advances in BBR-based nanoformulations and emphasizes the translational potential of BBR-based nanopreparations to improve treatment response in NDs. It also describes the molecular foundation of the neuroprotective effects of BBR and its possible place in clinical practice. Future nanocarrier development and investigation of BBR mechanisms will be essential to the development of the next generations of therapeutics in NDs.}, }
@article {pmid41189798, year = {2025}, author = {Sudevan, ST and Oh, JM and Prabhakaran, P and Abdelgawad, MA and Ghoneim, MM and Al-Serwi, RH and Kim, H and Mathew, B}, title = {Inhibition of monoamine oxidase by fluorobenzyloxy chalcone derivatives.}, journal = {RSC advances}, volume = {15}, number = {50}, pages = {42376-42394}, pmid = {41189798}, issn = {2046-2069}, abstract = {Inhibition of monoamine oxidase-B (MAO-B) decelerates the breakdown of dopamine in the brain, consequently augmenting dopaminergic neurotransmission, which is a critical pathway for ameliorating motor symptomatology of Parkinson's disease (PD). Chalcones are widely recognized as the lead inhibitors of MAO-B and hold significant therapeutic value for PD. Inspired by safinamide's pharmacophoric features, the study focuses on designing, synthesizing, and evaluating a novel series of fluorinated benzyloxy chalcone derivatives as selective MAO-B inhibitors. Thirteen fluorobenzyloxy chalcone derivatives were synthesized and evaluated for their inhibition of monoamine oxidase (MAO). All compounds showed better inhibition of MAO-B than of MAO-A. Compound (E)1-(4-bromophenyl)-3-(2-((3-fluorobenzyl)oxy)phenyl)prop-2-en-1-one (FBZ13) most potently inhibited MAO-B with an IC50 value of 0.0053 μM, followed by (E)3-(2-((3-fluorobenzyl)oxy)phenyl)-1-(thiophen-2-yl)prop-2-en-1-one (FBZ6) (IC50 = 0.023 μM). The IC50 value of FBZ13 was 4.0 times lower than that of reference drug safinamide. All compounds showed weak MAO-A inhibition, FBZ13 and FBZ6 displayed exceptionally high selectivity for MAO-B. Kinetic studies confirmed that these two compounds function as competitive and reversible MAO-B inhibitors. Additionally, PAMPA results indicated excellent membrane permeability and CNS bioavailability for FBZ13 and FBZ6, highlighting their promise as central nervous system-active agents. In vitro antioxidant assays evaluated the activities of enzymes (SOD, CAT, GSH, and GPx) in human neuroblastoma cells exposed to lipopolysaccharide (LPS). Treatment with compounds FBZ6 and FBZ13 (10 μM each) significantly enhanced enzyme activities, mitigating LPS-induced oxidative stress. Lead compounds were stabilized in protein-ligand complexes by the π-π stacking, which enabled them to bind to the active site of hMAO-B effectively. These results suggest that FBZ6 and FBZ13 are potent reversible selective MAO-B inhibitors, and they can be used as potential agents for the treatment of neurological disorders such as Alzheimer's diseases and PD.}, }
@article {pmid41189652, year = {2025}, author = {Guo, H and Yang, Z and Zhang, G and Lv, L and Zhao, X}, title = {Meta analysis of the diagnostic efficacy of transformer-based multimodal fusion deep learning models in early Alzheimer's disease.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1641548}, pmid = {41189652}, issn = {1664-2295}, abstract = {INTRODUCTION: This study aims to systematically evaluate the diagnostic efficacy of Transformer-based multimodal fusion deep learning models in early Alzheimer's disease (AD) through a Meta-analysis, providing a scientific basis for clinical applications.
METHODS: Following PRISMA guidelines, databases such as PubMed and Web of Science were searched, and 20 eligible clinical studies (2022-2025) involving 12,897 participants were included. Study quality was assessed using the modified QUADAS-2 tool, statistical analyses were performed with Stata 16.0, effect sizes were pooled via random-effects models, and subgroup analyses, sensitivity analyses, and publication bias tests were conducted.
RESULTS: Results showed that Transformer-based multimodal fusion models exhibited excellent overall diagnostic performance, with a pooled AUC of 0.924 (95% CI: 0.912-0.936), sensitivity of 0.887 (0.865-0.904), specificity of 0.892 (0.871-0.910), and accuracy of 0.879 (0.858-0.897), significantly outperforming traditional single-modality methods. Subgroup analyses revealed that: Three or more modalities achieved a higher AUC (0.935 vs. 0.908 for two modalities, p =0.012). Intermediate fusion strategies (feature-level, AUC=0.931) significantly outperformed early (0.905) and late (0.912) fusion (p <0.05 for both). Multicenter data improved AUC (0.930 vs. 0.918 for single-center, p =0.046), while sample size stratification (<200 vs. ≥200 cases) showed no significant difference (p =0.113). Hybrid Transformer models (Transformer +CNN) trended toward higher AUC (0.928 vs. pure Transformer 0.917, p =0.068) but did not reach statistical significance.
DISCUSSION: Notable studies included Khan et al.'s (2024) Dual-3DM[3]AD model (AUC=0.945 for AD vs. MCI) and Gao et al.'s (2023) generative network (AUC=0.912 under data loss), validating model robustness and feature complementarity. Sensitivity analysis confirmed stable results (AUC range: 0.920-0.928), and Egger's test (p =0.217) and funnel plot symmetry indicated no significant publication bias. Limitations included a high proportion of single-center data and insufficient model interpretability. Future research should focus on multicenter data integration, interpretable module development, and lightweight design to facilitate clinical translation. Transformer-based multimodal fusion models demonstrate exceptional efficacy in early AD diagnosis, with multimodal integration, feature-level fusion, and multicenter data application as key advantages. They hold promise as core tools for AD "early diagnosis and treatment" but require further optimization for cross-cohort generalization and clinical interpretability.}, }
@article {pmid41189641, year = {2025}, author = {Nasrallah, IM and Polacek, C and Frech, FH and Tariot, PN and Vawter, J and Zabar, Y and Divers, C and Shang, WY and Geldmacher, DS and Towman, M and Reiter, H and Marshall, CD and Baldivieso, V and Jones, DR and Musiek, ES and Toyosaki, H and Tousi, B}, title = {Early Alzheimer's disease patient care pathway and health system readiness: A framework for integrated care.}, journal = {Alzheimer's & dementia (New York, N. Y.)}, volume = {11}, number = {4}, pages = {e70162}, pmid = {41189641}, issn = {2352-8737}, abstract = {UNLABELLED: Alzheimer's disease (AD) is often underdiagnosed, especially at early stages when symptoms are mild, and patients may benefit from new and recently approved anti-amyloid therapies. An updated patient care pathway may facilitate timely diagnosis and intervention. We conducted a scan of published information and convened an expert panel of health care professionals to gain insights on early AD care pathways. We developed an Early AD Patient Care Pathway as an implementation guide that includes new diagnostic and treatment modalities and addresses needs and opportunities. The Early AD Patient Care Pathway focuses on patient identification, assessment, diagnosis, treatment, and management and monitoring. Operational readiness considerations aid pathway implementation and include evaluating and addressing gaps in program and business planning, technology, education and resources, access and reimbursement, and care coordination. The pathway is adaptable to health system needs and may be further tested and refined for sustainability.
HIGHLIGHTS: We analyzed published information and insights from subject matter experts on care pathways for early Alzheimer's disease.We identified opportunities to improve screening of at-risk patients, make appropriate specialist referrals, and ensure timely access and care coordination for diagnosis, treatment, and monitoring as a means of incorporating the latest diagnostics and therapy options.We developed a care pathway that promotes an integrated approach to patient care and is adaptable to various healthcare settings with input from subject matter experts.}, }
@article {pmid41189609, year = {2025}, author = {Perneczky, R and Quevenco, FC and Hendrix, J and Epelbaum, S and Teunissen, C and van der Flier, WM and Suárez-Calvet, M and Shi, J and Mielke, MM and Iwatsubo, T and Palmqvist, S and Hansson, O}, title = {How can Alzheimer's disease blood-based biomarkers reach clinical practice?.}, journal = {Alzheimer's & dementia (Amsterdam, Netherlands)}, volume = {17}, number = {4}, pages = {e70207}, pmid = {41189609}, issn = {2352-8729}, abstract = {INTRODUCTION: Alzheimer's disease (AD) diagnosis has been based largely on clinical symptoms, despite their limited sensitivity and specificity. Biomarker use was proposed to support a more accurate and timely diagnosis. However, neuroimaging or cerebrospinal fluid (CSF) is rarely used in primary care due to their perceived invasiveness, cost, and need for appropriate infrastructure. Blood-based biomarkers (BBMs) could represent an economical, minimally invasive alternative, but barriers exist to a seamless translation to the clinic.
METHODS: Ten international experienced AD clinicians and biomarker experts participated in a diagnostic roundtable to discuss the implementation of BBMs for diagnosing early symptomatic AD.
RESULTS: The participants proposed an optimal AD diagnostic pathway and highlighted three main gaps to implementing BBMs for early symptomatic AD diagnosis: limited real-world data, resource gaps, and system barriers.
DISCUSSION: Although BBMs could streamline the AD diagnostic pathway, further real-world evidence and collaboration among multiple stakeholders are needed.
HIGHLIGHTS: Early symptomatic Alzheimer's disease (AD) diagnosis improves treatment strategy and lowers costs.Currently available biomarkers are not widely used across all clinical settings.Blood-based biomarkers (BBMs) could be a cost-effective, minimally invasive alternative.BBMs could accelerate an accurate AD diagnosis.There are barriers to the inclusion of BBMs in clinical practice.}, }
@article {pmid41189255, year = {2025}, author = {Sleiay, M and Almohammad, TY and Sleiay, B and Sadeq, D and Salibie, N and Alkarkoukly, M and Alsleba, AA and Albalkhi, S and Alchalabi, E and Kilooh, T and Alsmadi, N and Alobeid, A and Esber, H and Mousa, A and Hasan, Z and Alabdullah, Y and Tannous, E and Hamsho, RM and Abu Ras, N and Khanje, L and Khanje, K and Othman, AA}, title = {Assessing Alzheimer's disease knowledge in the Syrian population using the ADKS: A cross-sectional study.}, journal = {Medicine}, volume = {104}, number = {42}, pages = {e45045}, pmid = {41189255}, issn = {1536-5964}, mesh = {Humans ; Cross-Sectional Studies ; *Alzheimer Disease/psychology ; Female ; Syria ; *Health Knowledge, Attitudes, Practice ; Male ; Adult ; Surveys and Questionnaires ; Middle Aged ; Young Adult ; Adolescent ; }, abstract = {Alzheimer disease (AD), a leading neurodegenerative disorder, disproportionately affects women and presents increasing global socioeconomic challenges. Despite growing identification of modifiable risk factors, public knowledge about AD's causes and progression remains limited in many regions. This study assesses AD knowledge among Syrian adults using the Alzheimer Disease Knowledge Scale (ADKS) and examines demographic correlations. This study evaluates the level of AD knowledge in the Syrian population and identify demographic factors associated with knowledge levels. A cross-sectional study was conducted from June to August 2024 using the validated Arabic version of the ADKS. The questionnaire (30 true/false items across 7 domains) was distributed electronically to Syrian adults (≥18 years). Descriptive statistics, t tests, 1-way analysis of variance, Pearson correlation, and Welch t test were performed using Statistical Package for the Social Sciences version 27. Ethical approval was granted by Aleppo University (No. 2408), and informed consent was obtained. A total of 685 participants responded (69.5% aged 18-25; 72.3% university-educated). While knowledge was high in domains related to life impact and treatment, substantial gaps were observed in understanding preventive drugs (20.4% correct) and caregiving strategies (11.1%). Higher knowledge scores were significantly associated with higher education levels, accessing healthcare-related information, and having relatives with AD (P < .001). This first Syrian study utilizing the ADKS revealed moderate public knowledge of AD (mean score: 18.79/30). Key knowledge gaps in caregiving and treatment underscore the need for targeted educational campaigns. Outreach led by healthcare professionals is essential to enhance awareness, promote early diagnosis, and support caregivers of individuals with AD.}, }
@article {pmid41188985, year = {2025}, author = {Abouelmagd, ME and Almosilhy, NA and Makhlouf, HA and Hassan, AK and Osman, ASA and Hindawi, MD and Elshahat, A and Alnajjar, AZ and Mustafa, MMM and Abdelsalam, OK and Mady, A and Shaheen, A and Barrett, MJ and Negida, A}, title = {Comparative safety of cholinesterase inhibitors and memantine for dementia: a protocol for a network meta-analysis of randomized controlled trials.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {213}, pmid = {41188985}, issn = {2046-4053}, mesh = {Humans ; *Memantine/therapeutic use/adverse effects ; *Cholinesterase Inhibitors/adverse effects/therapeutic use ; Systematic Reviews as Topic ; Network Meta-Analysis as Topic ; Randomized Controlled Trials as Topic ; *Dementia/drug therapy ; Meta-Analysis as Topic ; Alzheimer Disease/drug therapy ; }, abstract = {BACKGROUND: Dementia is a growing public health concern, affecting over 55 million people worldwide, with Alzheimer's disease (AD) being the most prevalent cause. Cholinesterase inhibitors (ChEIs) and memantine remain the mainstay pharmacological treatment for AD and other dementias, despite their modest benefits and potential adverse effects. The safety profiles of these medications, particularly at different doses and formulations, remain inadequately explored, necessitating a comprehensive evaluation.
METHODS: This systematic review and network meta-analysis (NMA) will assess the safety of ChEIs (donepezil, galantamine, rivastigmine) and memantine in dementia treatment. We will include randomized controlled trials (RCTs) with ≥ 3 months of follow-up, evaluating adverse events (AEs), serious adverse events (SAEs), and treatment discontinuation rates. A comprehensive literature search will be conducted in PubMed, Scopus, Web of Science, and Cochrane Library, with additional searches in Google Scholar and reference lists of included studies. Data extraction will follow a standardized approach, and study quality will be assessed using the Cochrane risk-of-bias tool-2. A Frequentist or Bayesian NMA framework will be used to compare safety profiles, with heterogeneity assessed using the I[2] test.
DISCUSSION: By addressing gaps in prior NMAs, this study aims to provide an in-depth evaluation of safety outcomes associated with different ChEI and memantine doses and formulations across various dementia types. The findings will support clinicians in making informed treatment decisions and guide future research and policy development for dementia management.
PROSPERO (CRD42025642902).}, }
@article {pmid41186822, year = {2025}, author = {Voronova, AD and Karsuntseva, EK and Shishkina, VS and Fursa, GA and Chadin, AV and Shport, SV and Stepanova, OV and Chekhonin, VP}, title = {Cell Therapy Is a New Treatment Option to Prevent Neurodegenerative Changes and Restore Cognitive Functions in Alzheimer's Disease (Review).}, journal = {Bulletin of experimental biology and medicine}, volume = {179}, number = {4}, pages = {507-517}, pmid = {41186822}, issn = {1573-8221}, mesh = {*Alzheimer Disease/therapy/pathology/physiopathology ; Humans ; *Cognition/physiology ; Animals ; *Cell- and Tissue-Based Therapy/methods ; Brain/pathology ; Disease Models, Animal ; }, abstract = {This review considers cell therapy and possible mechanisms underlying beneficial effects of cells in prevention of neurodegenerative changes as a promising approach to the treatment of Alzheimer's disease. The results of using various types of cells in experimental models of Alzheimer's disease and their effect on the regeneration of the brain and recovery of cognitive functions are presented.}, }
@article {pmid41186808, year = {2025}, author = {Jafni, S and Nagakanni, M and Indhirakumar, B and Rani, RKS and Preethi, S and Hemamalini, V and Vanathi, G and Saraswathy, SD and Devi, KP}, title = {Synergistic neuroprotective effects of Vitexin and Thymol against Okadaic acid-induced neurotoxicity: Computational and In vitro evaluation.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {43}, pmid = {41186808}, issn = {1573-4978}, support = {CRG/2022/000847-G//Anusandhan National Research Foundation (ANRF)/ ; }, mesh = {*Neuroprotective Agents/pharmacology ; *Apigenin/pharmacology/metabolism ; *Thymol/pharmacology/metabolism ; Molecular Docking Simulation ; Drug Synergism ; Animals ; Mice ; Molecular Dynamics Simulation ; Neurons/drug effects/metabolism ; Blood-Brain Barrier/metabolism/drug effects ; Cell Survival/drug effects ; Alzheimer Disease/drug therapy/metabolism ; Cell Line, Tumor ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by dementia and inexorable loss of neurons. Despite extensive research, the currently approved drugs offer only limited efficacy which highlights the need for exploring novel synergistic natural compounds capable of mitigating multiple targets of AD.
METHODS AND RESULTS: This study evaluated the neuroprotective potential of the synergistic combination of Vitexin and Thymol using computational and in vitro model systems in N2a cells. Computational pharmacokinetic screening revealed the blood-brain barrier (BBB) permeability of thymol and 0.55 bioavailability score for Vitexin. Molecular docking studies showed higher binding affinity of Vitexin with JNK and Thymol with COX-1 and CAMK-II and 100 ns molecular dynamics simulation exhibited stable binding with sustained hydrogen bond and hydrophobic interactions. Based on the IC50 values [Vitexin (135.24 µg/ml, 312.9 µM) and Thymol (36.91 µg/ml, 245.7 µM)] and combination index (CI < 1) determined by the acetylcholinesterase (AChE) inhibition assay and checkerboard assay (performed with 15 different combinations) respectively, the effective combination (Vitexin 45.08 µg/ml; Thymol 7.382 µg/ml; CI = 0.53) was fixed for further studies. In okadaic acid (OA) induced neurotoxicity model, pre-treatment with the combination significantly increased the cell viability (88.36 ± 3.73%) (n = 3). Real-time PCR results revealed the upregulation of PP1 gene expression and modulation of MAPK family (MEK1/2, ERK1/2 and JNK), and other tau related kinases (GSK3β, CAMKII and P70 s6).
CONCLUSION: The above findings demonstrate that the combination of Vitexin and Thymol effectively protect the neuronal cells from OA induced cytotoxicity and modulate the hyperactivation of kinases, suggesting its potential in preventing tau hyperphosphorylation in AD conditions.}, }
@article {pmid41185525, year = {2026}, author = {Liu, Q and Feng, E and Li, S and Zhu, Y and He, X and Xu, X and Zheng, T and Tian, Y}, title = {High-Efficient Raman Enhancement on Organic Semiconductor-Stabilized Perovskite Heterostructures for Guiding Early Theranostics of Alzheimer's Disease.}, journal = {Angewandte Chemie (International ed. in English)}, volume = {65}, number = {1}, pages = {e18319}, doi = {10.1002/anie.202518319}, pmid = {41185525}, issn = {1521-3773}, support = {2024YFC3406405//National Key Research and Development Program of China/ ; 22222405//National Natural Science Foundation of China/ ; 22393930//National Natural Science Foundation of China/ ; }, mesh = {*Semiconductors ; *Titanium/chemistry ; *Spectrum Analysis, Raman ; *Oxides/chemistry ; *Alzheimer Disease/diagnosis ; *Calcium Compounds/chemistry ; Humans ; *Theranostic Nanomedicine ; }, abstract = {Perovskites have recently emerged as attractive optoelectronic semiconductors due to tunable bandgap, large absorption coefficient, and long carrier lifetime, making it ideal as a kind of chemical-mechanism based surface-enhanced Raman scattering (SERS) substrates. However, perovskites generally demonstrate poor stability at ambient conditions, limiting their applications for SERS bioanalysis. Herein, we created a perovskite-based heterostructure through effectively passivating defects at the interface with hydrophobic organic semiconductors, which simultaneously enhanced the stability and efficiency of perovskite SERS substrate. The significant enhancement factor of 10[7] was mainly stemmed from the resonance Raman effect and the highly-efficient charge transfer process driven by a novel light-induced hot electron transfer mechanism in plasmon-free substrates previously never reported. This system was subsequently developed as an integrated theranostic SERS platform for miR-146a monitoring with a detection limit down to 0.2 fM, successfully guiding the early theranostics to enhance the therapeutic efficiency for Alzheimer's disease (AD). This work brings new light into the design of efficient and stable semiconductor SERS substrate and opens novel diagnosis and treatment options for AD.}, }
@article {pmid41185054, year = {2025}, author = {Leung, LY and Tam, HL and Asiamah, N and Ho, JK}, title = {Effect of melatonin on cognitive function in adults with cognitive impairment: a multi-dimensional meta-analysis of randomized trials.}, journal = {Alzheimer's research & therapy}, volume = {17}, number = {1}, pages = {238}, pmid = {41185054}, issn = {1758-9193}, mesh = {Humans ; *Melatonin/therapeutic use/pharmacology ; *Cognitive Dysfunction/drug therapy/psychology ; Randomized Controlled Trials as Topic ; *Cognition/drug effects ; }, abstract = {BACKGROUND: Cognitive impairment leads to poor daily social and occupational functions and sleep disturbances. Approximately two-thirds of all individuals with mild cognitive impairment (MCI) experience sleep problems that further reduce cognitive function. Melatonin, a hormone secreted by the pineal gland, has proven effective in mitigating sleep problems and cognitive function in individuals with MCI. The current review investigated the efficacy of melatonin in improving cognitive function in adults with cognitive impairment.
METHODS: Seven databases were systematically searched for relevant randomized controlled trials published (in English or Chinese) until April 2025. Two reviewers independently selected studies, assessed quality (using the Physiotherapy Evidence Database scale), and extracted data.
RESULTS: In total, 394 potentially eligible articles were identified. Finally, 8 studies (518 participants) were included. Five, one, and two studies had good, excellent, and low quality, respectively. Pooled results indicated that melatonin significantly improved cognitive function in adults with cognitive impairment (mean difference [MD]: 1.08; p < 0.0001). Subgroup analyses by treatment duration, administration time, and cognitive impairment level revealed that the effects of melatonin were significant when it was administered for 13-24 weeks (MD: 2.04; p < 0.00001), between the times of 20:30 and 21:00 (MD: 2.2; p < 0.00001), and to individuals with MCI (MD: 2.63; p < 0.000001).
CONCLUSIONS: Our findings suggest that melatonin is relatively safe for individuals with cognitive impairment. Thus, we recommend it for adults with MCI. It should be administered between 20:30 and 21:00 for 13-24 weeks.}, }
@article {pmid41184619, year = {2025}, author = {Choe, K and Ali, J and Park, HY and Jang, SH and Choi, EY and Kang, MH and Park, TJ and Kim, MO}, title = {The mGluR2/3 agonist xanthurenic acid improves memory, attention, and synaptic deficits by modulating glutamate release in Alzheimer's disease model.}, journal = {Acta pharmacologica Sinica}, volume = {}, number = {}, pages = {}, pmid = {41184619}, issn = {1745-7254}, abstract = {Amyloid-beta (Aβ) aggregation is the key component of neuritic plaques that drives Alzheimer's disease (AD) progression and cognitive decline. Although synaptic dysfunction strongly correlates with cognitive impairment, its underlying mechanisms remain unclear. Recently, the kynurenine pathway (KP) of tryptophan metabolism has emerged as a key contributor to AD pathology, and xanthurenic acid (XA), a naturally occurring end-product of the KP, has been implicated in neuroprotection. In this study, we investigated the neuroprotective effects of intranasally administered XA in an Aβ-induced AD mouse model. AD-like pathology was induced in mice by intracerebroventricular injection of Aβ1-42. The mice received daily intranasal instillation of XA (0.5 μg/5 μL per nostril) for 6 weeks. After XA treatment was completed, the cognitive performance was assessed in behavioral tests, then the mice were euthanized, and the brain were collected for molecular and biochemical analyses. We showed that XA treatment significantly improved the cognitive function of AD mice, and reduced AD-related pathological markers such as APP, Aβ and BACE-1 in the cortex, hippocampus and olfactory bulb. XA treatment also attenuated Aβ-induced oxidative stress through upregulation of the Nrf2/HO-1/SOD1 and key enzymatic antioxidants (GSH, GST, CAT, SOD), while concurrently reducing lipid peroxidation. Furthermore, XA treatment preserved synaptic integrity, evidenced by restoring both pre- and postsynaptic markers (SNAP-25, SYP, SNAP-23, PSD-95) and enhancing signaling via the cAMP-PKA-CREB pathway. Notably, XA differentially modulated metabotropic glutamate receptors, decreasing mGluR2 and increasing mGluR3 expression. In vitro experiments were conducted in APPswe/ind-transfected SH-SY5Y neuroblastoma cells. XA (3-100 µM) dose-dependently improved the cell viability while reducing cytotoxicity and apoptosis. Overall, these results demonstrate that XA confers multifaceted neuroprotection by modulating Aβ pathology, oxidative stress, synaptic function, and glutamatergic signaling, suggesting its potential as a novel therapeutic strategy to mitigate cognitive decline and pathological progression in AD.}, }
@article {pmid41184442, year = {2025}, author = {Garnier-Crussard, A and Landeau, B and Mezenge, F and Gonneaud, J and Roquet, D and Cotton, F and Chetelat, G}, title = {Heterogeneity of white matter hyperintensities in Alzheimer's disease captured by multimodal neuroimaging.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {38433}, pmid = {41184442}, issn = {2045-2322}, support = {667696//European Union's Horizon 2020 Research and Innovation Program/ ; 667696//European Union's Horizon 2020 Research and Innovation Program/ ; }, mesh = {Humans ; *Alzheimer Disease/diagnostic imaging/pathology/metabolism ; *White Matter/diagnostic imaging/pathology/metabolism ; Aged ; Male ; Female ; *Neuroimaging/methods ; *Multimodal Imaging/methods ; Positron-Emission Tomography ; Aged, 80 and over ; Magnetic Resonance Imaging ; Fluorodeoxyglucose F18 ; }, abstract = {White matter hyperintensities (WMH) are common in older adults and are associated with cognitive disorders. They typically arise from small vessel disease, leading to demyelination and axonal loss. WMH are thus considered markers of cerebrovascular changes. However, other pathophysiological processes can lead to WMH, particularly in Alzheimer's disease (AD). Understanding the diverse origins of WMH could enhance the diagnosis and treatment of AD patients. We hypothesize that multimodal neuroimaging could help understand the heterogeneity of WMH and pinpoint their specific origin. We included 142 older adults from the community and memory clinic (with an emphasis on patients within the Alzheimer's continuum), and tested if multimodal neuroimaging signal within regional WMH (including T1w, T2w, [18]F-florbetapir [AV45] and [18]F-fluorodeoxyglucose [FDG] PET), is associated with amyloid load and cognition. We showed that intra-WMH T1w and T2w signal in the parietal and frontal lobes were linked to amyloid status; intra-WMH T2w signal in all regions negatively correlated with amyloid load, while intra-WMH T1w signals in the parietal lobe positively correlated with amyloid load; finally, intra-WMH T1w signal negatively correlated with cognition while T2w and marginally AV45 signals positively correlated with cognition. This study demonstrates the potential of multimodal neuroimaging to unravel the heterogeneity of WMH, which could enhance their interpretation and improve clinical decision-making.}, }
@article {pmid41183995, year = {2025}, author = {Okamura, N and Nakayama-Naono, R and Harada, R}, title = {[In vivo imaging of Alzheimer's disease lesion].}, journal = {Nihon yakurigaku zasshi. Folia pharmacologica Japonica}, volume = {160}, number = {6}, pages = {398-403}, doi = {10.1254/fpj.25055}, pmid = {41183995}, issn = {0015-5691}, mesh = {Animals ; Humans ; *Alzheimer Disease/diagnostic imaging ; Amyloid beta-Peptides/metabolism ; Positron-Emission Tomography ; }, abstract = {In the development of Alzheimer's disease (AD) therapeutics, positron emission tomography (PET) imaging techniques play an important role in the selection of patients for administration and objective evaluation of treatment effects. The clinical implementation of amyloid-β (Aβ) and tau PET agents is progressing, with the aim of noninvasively visualizing brain lesions in AD. Furthermore, the development of PET agents for imaging neuroinflammation is advancing. Near-infrared fluorescence (NIRF) imaging has attracted attention as an alternative technology to nuclear imaging. Near-infrared light in the wavelength range of 650-900 nm, known as the optical window, is absorbed less by living tissue compared to visible light. Therefore, by using probes that emit NIRF, it is possible to noninvasively measure the distribution of probes within the body. Indocyanine green (ICG), a non-specific NIRF probe, is already being used in surgical procedures, but NIRF probes specifically for AD lesions are still in the developmental stage. The characteristics required for NIRF Aβ probe include high binding affinity and selectivity for Aβ, excitation and fluorescence wavelengths in the optical window, and blood-brain barrier permeability. Numerous NIRF probes for Aβ have been developed, reaching levels suitable for use in animal experiments. In recent years, research has also progressed on the development of multi-target fluorescence imaging probes that can identify multiple targets with a single probe by utilizing differences in fluorescence wavelengths according to the binding targets.}, }
@article {pmid41183202, year = {2025}, author = {Yang, X and Lee, JY and Moghadam, F and Steiner, J and Kim, SK and Ganjur, N and de Almenara, AJ and Stoltz, BM and Loh, YP and Goddard, WA}, title = {Predicted molecules followed by experimental validation for protecting human neurons from oxidative stress-induced cytotoxicity.}, journal = {Proceedings of the National Academy of Sciences of the United States of America}, volume = {122}, number = {45}, pages = {e2505359122}, pmid = {41183202}, issn = {1091-6490}, support = {no numbef//HHS | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)/ ; R01HL155532 R35HL150807 and R35GM145239//HHS | NIH (NIH)/ ; CAP23011-200//National Research Council of Science and Technology (NST)/ ; }, mesh = {Humans ; *Oxidative Stress/drug effects ; *Neurons/drug effects/metabolism/pathology ; *Neuroprotective Agents/pharmacology/chemistry ; Animals ; }, abstract = {Alzheimer neurodegenerative disease (AD) has had a major impact worldwide, with no effective drugs for treatment. We discovered and reported earlier that neurotrophic factor-α1 (NF-α1)/carboxypeptidase E (CPE) reversed neurodegeneration and cognitive dysfunction in AD mouse models. We then predicted computationally and validated experimentally that CPE interacts with a pharmacophore of six residues on the 5-HT1E receptor (HTR1E) to activate the ERK-BCL2 signaling pathway leading to protection of human neurons against oxidative stress-induced cell death. We now report using this pharmacophore for in silico virtual screening of ~6 million small molecules to discover candidates with similar binding and neuroprotective properties as CPE. This in silico search identified a molecule (Z124) that was verified experimentally to bind to HTR1E with protective efficacy comparable to NF-α1/CPE but requiring a higher concentration. Next, we carried out R-group design optimization based on Z124 to identify 4 compounds predicted to have much better efficacy than Z124. These compounds were synthesized and tested for neuroprotective activity. All four compounds showed binding to HTLA-HTR1E cells comparable to CPE. We determined the Kd for two of these compounds: R9, 1.38 ± 0.2 nM, and R10, 2.1 ± 0.2 nM, to be over 15 times better than CPE. Furthermore, all four new compounds showed protective activity against oxidative stress-induced cytotoxicity in human HEK293 cells stably transfected with HTR1E, as well as human primary neurons. Mechanistically, R9 and R10 activated ERK phosphorylation and increased the mitochondria prosurvival protein, BCL2, making them excellent candidates for further development as a drug to treat neurodegenerative diseases.}, }
@article {pmid41183099, year = {2025}, author = {Liu, J and Zhang, ZZ and Yu, GR and Han, X}, title = {Quercetin Targets HSP90α and Regulates Keap1/Nrf2 Pathway to Inhibit Crosstalk between Apoptosis and Ferroptosis in Oxidatively Stressed Neurons.}, journal = {Journal of biochemical and molecular toxicology}, volume = {39}, number = {11}, pages = {e70583}, doi = {10.1002/jbt.70583}, pmid = {41183099}, issn = {1099-0461}, support = {//This study was supported by the National Key Research and Development Program of China (2022YFC3501400) and Jiangsu Province Graduate Practice and Innovation Program (SJCX25_0998)./ ; }, mesh = {*Quercetin/pharmacology ; *HSP90 Heat-Shock Proteins/metabolism ; *NF-E2-Related Factor 2/metabolism ; *Kelch-Like ECH-Associated Protein 1/metabolism ; *Ferroptosis/drug effects ; *Oxidative Stress/drug effects ; *Neurons/metabolism/pathology/drug effects ; *Apoptosis/drug effects ; *Signal Transduction/drug effects ; Humans ; Animals ; }, abstract = {The rising incidence and mortality rates associated with Alzheimer's disease (AD) have garnered significant attention. The interplay between ferroptosis and apoptosis, both of which are driven by oxidative stress, contributes to neuronal death and accelerates the progression of AD. In this study, we observed that neuronal cells exhibited characteristics of both ferroptosis and apoptosis following exposure to a specific concentration of hydrogen peroxide; both processes could be effectively inhibited by quercetin. To further investigate the precise mechanisms, we conducted target enrichment analysis utilizing databases pertinent to quercetin, AD, oxidative stress, ferroptosis, and apoptosis. Our findings identified HSP90AA1 as a potential key target through which quercetin disrupts the interplay between ferroptosis and apoptosis. We subsequently focused on HSP90α, encoded by HSP90AA1, and validated its role in ferroptosis and apoptosis using HSP90α and Nrf2 inhibitors. Our results demonstrate that under oxidative stress conditions, quercetin induces the activation of HSP90α. This activated chaperone binds to kelch-like ECH-associated protein 1 (Keap1), which disrupts the Keap1-Nrf2 complex and facilitates the release of nuclear factor erythroid 2-related factor 2 (Nrf2). The liberated Nrf2 translocates to the nucleus, initiating the expression of cytoprotective genes. Once in the nucleus, Nrf2 activates the Glutathione peroxidase 4 (GPX4) pathway and the expression of B-cell lymphoma-2 (Bcl-2) family proteins to inhibit ferroptosis and apoptosis. This study elucidates the crosstalk mechanism by which quercetin modulates neuronal ferroptosis and apoptosis under oxidative stress, providing new insights and potential therapeutic targets for the prevention and treatment of AD.}, }
@article {pmid41182777, year = {2026}, author = {Thomas, ML and Edland, SD and Duehring, J}, title = {The MMSE can yield biased and imprecise estimates of change: A novel IRT analysis of latent change scores from the A4 clinical trial.}, journal = {Psychological assessment}, volume = {38}, number = {1}, pages = {64-70}, pmid = {41182777}, issn = {1939-134X}, support = {R01 MH121546/MH/NIMH NIH HHS/United States ; //National Institutes of Health; National Institute of Mental Health/ ; }, mesh = {Humans ; *Alzheimer Disease/drug therapy/diagnosis ; Male ; Female ; *Mental Status and Dementia Tests/standards/statistics & numerical data ; Aged ; *Psychometrics ; Aged, 80 and over ; }, abstract = {The measurement precision of change scores has previously been investigated from the perspective of classical test theory. However, the measurement precision of change scores has not been thoroughly explored from an item response theory (IRT) perspective. In this study, we provide, to our knowledge, one of the first direct investigations of change score precision within an IRT framework. Specifically, using archival data from the antiamyloid treatment in asymptomatic Alzheimer's trial, we examined standard error of estimate for change scores on the mini-mental state examination, one component of the preclinical Alzheimer cognitive composite used to measure change between intervention arms. Multidimensional two-parameter IRT models were fitted to the mini-mental state examination item data with one latent dimension reflecting baseline ability and a second reflecting change in ability over time (i.e., latent change scores). Results showed that standard error depended on change magnitude and that change scores were expected to be biased toward zero when baseline performance scores were near ceiling. The results demonstrate why measures with pronounced ceiling effects should not be used to assess change in clinical trials or other longitudinal studies, and should be used cautiously in clinical settings. This study also demonstrates how IRT can be used to evaluate change score precision. (PsycInfo Database Record (c) 2026 APA, all rights reserved).}, }
@article {pmid41182353, year = {2025}, author = {Cai, Y and Huang, S and Dong, Y and Li, S and Jin, X}, title = {PIWI-Interacting RNAs in brain health and disease: biogenesis, mechanisms, and therapeutic horizons.}, journal = {Psychopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41182353}, issn = {1432-2072}, support = {81971083//National Natural Science Foundation of China/ ; 25JCLZJC00190//Tianjin Natural Science Foundation Project/ ; }, abstract = {PIWI-interacting RNAs (piRNAs), a class of small non-coding RNAs originally identified for their role in transposon silencing in germ cells, have recently been recognized as pivotal regulators of gene expression in the central nervous system. Beyond their canonical functions in genome defense, emerging evidence highlights piRNAs as key modulators of neuronal development, synaptic plasticity, axonal regeneration, and neuroimmune interactions-processes central to brain function and dysfunction. This review provides a comprehensive overview of piRNA biogenesis, molecular mechanisms, and regulatory pathways relevant to neurobiology. We focus on the growing body of evidence implicating piRNA dysregulation in major neurological and neuropsychiatric disorders, including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, stroke, glioma, autism spectrum disorder, and schizophrenia. Importantly, we discuss the neuropharmacological implications of piRNA pathways as novel targets for therapeutic intervention and their potential utility as biomarkers for early diagnosis and treatment stratification. By integrating mechanistic insights with emerging translational evidence, this review highlights piRNAs as promising molecular targets in the development of next-generation neurotherapeutics aimed at modifying disease progression and improving brain health.}, }
@article {pmid41181807, year = {2025}, author = {Richardson, DL and Whitney, E}, title = {Deep Brain Stimulation: Overview and Applications in the Context of Neuropsychiatric Conditions.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e93661}, pmid = {41181807}, issn = {2168-8184}, abstract = {Deep brain stimulation (DBS) is a neuromodulatory therapy involving the implantation of electrodes into brain structures in order to help normalize brain activity in a variety of neurological disorders. The mechanisms of DBS operate at micro-, meso-, and macroscale levels to influence neuronal signaling, synaptic reorganization, and network-wide connectivity between brain regions. Recent advances in connectomics and sensing technologies have allowed for more precise and adaptive stimulation strategies, increasing the potential to target complex, heterogeneous neuropsychiatric conditions. DBS has already been well-explored as a treatment for obsessive-compulsive disorder. Emerging research has explored the use of DBS for other neuropsychiatric conditions as well, including autism spectrum disorder (ASD), treatment-refractory depression (TRD), and dementia associated with Alzheimer's disease (AD). DBS for ASD shows promise in reducing self-injurious behaviors and aggression by targeting the nucleus accumbens (NAc), amygdala, and posteromedial hypothalamus. In TRD, DBS to the subcallosal cingulate gyrus (SCG), medial forebrain bundle (MFB), and ventral capsule/ventral striatum (VC/VS) has demonstrated significant antidepressant effects. For dementia and AD, DBS targeting the fornix and nucleus basalis of Meynert (NBM) has shown promise in slowing cognitive decline. Despite the variety of targets, connectomic analyses reveal overlapping cortical-subcortical network dysfunctions across these disorders. These findings offer insight into shared neurobiological mechanisms of these disorders, as well as guide refinement of therapeutic targets for future study. Overall, DBS for neuropsychiatric conditions remains in its early stages, hindered by disorder heterogeneity and challenges in identifying optimal brain targets. Advances in functional neuroimaging, closed-loop stimulation, and machine learning-driven connectomic approaches can aid in target selection as well as better understanding the neuroanatomy and physiology underlying these complex conditions, which, in turn, lead to improved patient outcomes. Further research is necessary to establish standardized protocols and expand the therapeutic applications of DBS in neuropsychiatry.}, }
@article {pmid41180952, year = {2025}, author = {Zammit, M and Price, J and Christian, B and Rafii, M and , }, title = {A comparison of multiple amyloid PET radiotracers for Down syndrome clinical trials.}, journal = {Brain communications}, volume = {7}, number = {6}, pages = {fcaf406}, pmid = {41180952}, issn = {2632-1297}, support = {UL1 TR001857/TR/NCATS NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; P30 AG066519/AG/NIA NIH HHS/United States ; P30 AG072973/AG/NIA NIH HHS/United States ; P50 AG016573/AG/NIA NIH HHS/United States ; P50 AG005133/AG/NIA NIH HHS/United States ; UL1 TR001414/TR/NCATS NIH HHS/United States ; UL1 TR002373/TR/NCATS NIH HHS/United States ; UL1 TR001873/TR/NCATS NIH HHS/United States ; R01 AG080766/AG/NIA NIH HHS/United States ; P50 AG005681/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; P30 AG066468/AG/NIA NIH HHS/United States ; UL1 TR002366/TR/NCATS NIH HHS/United States ; UL1 TR002345/TR/NCATS NIH HHS/United States ; R61 AG066543/AG/NIA NIH HHS/United States ; RF1 AG094739/AG/NIA NIH HHS/United States ; }, abstract = {Adults with Down syndrome carry high risk of developing Alzheimer's disease and efforts to include this population in clinical trials remain limited. A barrier to recruitment for anti-amyloid trials includes the availability of the same amyloid PET radiotracer to multiple treatment centres. The objective of the study is to compare longitudinal rates of change between different amyloid PET radiotracers, particularly Pittsburgh compound B and florbetapir, in Down syndrome and to compare the estimated age at amyloid-positivity derived from these radiotracers. Two hundred thirty-seven adults with Down syndrome from the Trial Ready Cohort-Down syndrome and Alzheimer's Biomarker Consortium-Down syndrome studies were imaged using T1-weighted MRI and using PET images of Pittsburgh compound B, florbetapir, NAV4694 or flutemetamol to screen for amyloid plaque burden. Currently, Pittsburgh compound B and florbetapir have longitudinal data from these cohorts, while NAV4694 has one individual with longitudinal scans and flutemetamol has no available longitudinal data. Pittsburgh compound B displayed a greater effect size to measure amyloid change compared to florbetapir. NAV4694 and Pittsburgh compound B, which are structurally similar compounds, displayed similar sensitivity to measure longitudinal amyloid increase. The estimated age at amyloid onset showed no significant difference between Pittsburgh compound B, florbetapir, NAV4694 or flutemetamol. The findings suggest that different amyloid PET radiotracers provide consistent estimates of amyloid onset age for adults with Down syndrome. Multicentre studies of Alzheimer's disease therapeutics can utilize multiple amyloid PET radiotracers to facilitate recruitment; however, these radiotracers have different sensitivity to detect longitudinal change.}, }
@article {pmid41180843, year = {2025}, author = {Ceccarelli, MC and Lai, L and Carmignani, A and Battaglini, M and Ciofani, G}, title = {Polydopamine nanoparticles as immunomodulators: inhibition of M1 microglial polarization.}, journal = {Frontiers in bioengineering and biotechnology}, volume = {13}, number = {}, pages = {1672520}, pmid = {41180843}, issn = {2296-4185}, abstract = {Neuroinflammation is a central feature of numerous neurodegenerative diseases, including Alzheimer's and Parkinson's disease, where excessive activation of microglia can contribute to neuronal damage. The pro-inflammatory M1 phenotype of microglia is characterized by increased production of reactive oxygen species (ROS), overexpression of surface markers such as CD40 and CD86, and secretion of cytokines like IL-6, IL-8, and TNF-α, all of which exacerbate oxidative stress and neurodegeneration. The development of strategies to control and tune microglial pro-inflammatory activation is therefore critical for reducing the progression of these conditions. In this study, the potential of polydopamine nanoparticles (PDNPs) as novel immunomodulatory agents for attenuating M1 microglial polarization was investigated. PDNPs were synthesized via a simple and reproducible protocol and thoroughly characterized in terms of size, morphology, hydrodynamic diameter, and surface charge, confirming their uniformity and stability. Biocompatibility assays showed that PDNPs are well tolerated by human microglial clone 3 (HMC3) cells, with minimal cytotoxicity even at relatively high concentrations. Confocal microscopy and flow cytometry analyses demonstrated efficient internalization of PDNPs by microglia, with preferential accumulation in lysosomal compartments and negligible mitochondrial localization. To mimic neuroinflammatory conditions, HMC3 cells were stimulated with interferon-gamma (IFN-γ), which significantly increased intracellular ROS levels, surface expression of CD40 and CD86, and secretion of pro-inflammatory cytokines. The co-treatment with PDNPs effectively mitigated these effects by reducing oxidative stress, suppressing the upregulation of M1 markers, and decreasing cytokine release, thereby preventing the shift toward a pro-inflammatory state. The results of this work demonstrate that PDNPs not only exhibit excellent biocompatibility and cellular uptake but also provide a robust means of counteracting IFN-induced microglial activation. These results establish PDNPs as promising nanoplatforms for modulating neuroinflammation and microglial activation. This study highlights the potential of PDNPs for future applications in the treatment of neurodegenerative diseases.}, }
@article {pmid41179212, year = {2025}, author = {Yuan, C and Lv, S and Han, Y and Li, Y and Xian, Z and Liu, G and Xiao, S}, title = {Quercetagitrin Ameliorates Alzheimer-Like Pathologies Associated with TNFα/NFκB Pathway in APP/PS1 Mice.}, journal = {ACS omega}, volume = {10}, number = {42}, pages = {49816-49827}, pmid = {41179212}, issn = {2470-1343}, abstract = {Background: Alzheimer's disease (AD) is a neurodegenerative disease with two pathological features in the brain: amyloid β (Aβ) plaques and tau tangles. Neuroinflammation plays an important role in the development of AD, closely related to both Aβ and tau pathologies. Tumor necrosis factor α (TNFα) and nuclear factor-κB (NFκB) behave as key regulators of neuroinflammation in AD. It is pressing to develop effective AD drugs. Objective: This study aimed to explore the effects and mechanisms of quercetagitrin in AD using a combination of network pharmacology analyses and in vivo experiments. Methods: The potential target of quercetagitrin in AD was predicted by network pharmacology. The interaction between the compound and the target protein was measured by molecular docking. The in vivo effects were performed in APP/PS1 mice via mouse behavior tests, Western blotting, ThS staining, immunohistochemical staining, and immunofluorescence staining. Results: First, network pharmacology analyses were conducted to predict the primary target of the compound, which is TNFα. Then, molecular docking showed that quercetagitrin interacts with TNFα with a high affinity. Finally, the level of TNFα was reduced, and the activation of NFκB signaling was inhibited by quercetagitrin in APP/PS1 mice. Meanwhile, quercetagitrin treatment ameliorated Aβ pathology, cognitive impairments, and neuroinflammation in the AD mice. Conclusions: These findings demonstrate quercetagitrin as a potential therapeutic drug for AD.}, }
@article {pmid41179172, year = {2025}, author = {da Silva, LRG and de Sá, CB and do Amaral, BS and Romeiro, NC and Cass, QB and Valverde, AL}, title = {Affinity Selection-Mass Spectrometry for the Identification of Ligands of Acetylcholinesterase from Topsentia ophiraphidites and Docking Studies for the Dereplicated Ligands.}, journal = {ACS omega}, volume = {10}, number = {42}, pages = {50275-50284}, pmid = {41179172}, issn = {2470-1343}, abstract = {Acetylcholinesterase (AChE) inhibition has been successful for the treatment of Alzheimer's disease and still stands as an important target in the search for novel ligands. In this context, affinity selection-mass spectrometry (AS-MS) has been acknowledged as a high-throughput screening (HTS) technique for large molecular libraries in drug discovery programs and natural product investigations. In this work, an AS-MS assay with AChE immobilized onto magnetic beads (AChE-MB) has been used to search for ligands in samples of the sponge Topsentia ophiraphidites collected in the archipelago of Fernando de Noronha, Brazil. Ligand dereplication disclosed 6-desmethyl-6-ethyl-9,10-dihydrospongosoritin A, 3,5-dibromo-O-methyltyrosine, 3-bromo-5-iodo-O-methyltyrosine, and 3,5-di-iodo-O-methyltyrosine as AChE ligands, which showed affinity ratios of 1.84, 1.34, 1.26, and 1.20, respectively, in the AS-MS assay. As a complementary approach, molecular docking analysis with human AChE has been carried out for the disclosed dereplicated ligands, in which the (R, R) stereoisomer of 6-desmethyl-6-ethyl-9,10-dihydrospongosoritin A stood out, performing important intermolecular interactions with the active sites of AChE, especially with the peripheral anionic site, at the entrance of the gorge. The results stimulate further investigations of these ligands in other pharmacological assays in order to better understand their mechanisms of action.}, }
@article {pmid41178976, year = {2025}, author = {Bae, HJ and Kim, SI and Kim, SY and Cho, YE and Sung, S and Lim, S and Cho, K and Park, SJ and Lim, S}, title = {Lacticaseibacillus rhamnosus CBT LR5 with skim milk alleviates scopolamine-induced cognitive impairment in mice.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1672153}, pmid = {41178976}, issn = {1664-302X}, abstract = {INTRODUCTION: Emerging evidence highlights the gut-brain axis as a pivotal pathway linking gastrointestinal health with cognitive function, particularly in neurodegenerative conditions such as Alzheimer's disease (AD).
METHODS: This study investigated the cognitive-enhancing effects of the probiotic strain Lacticaseibacillus rhamnosus CBT LR5 (LR5), alone or in combination with skim milk, in a mouse model of scopolamine-induced cognitive impairment. The cognitive functions were evaluated using the novel object recognition test (NOR) and the passive avoidance test (PAT).
RESULTS: The results demonstrated that the oral administration of LR5, especially when combined with skim milk, significantly ameliorated scopolamine-induced cognitive deficits. Mechanistically, treatment with LR5 combined with skim milk restored the diversity and composition of the gut microbiota increased the abundance of beneficial genera, such as Muribaculaceae and enhanced intestinal barrier integrity by increasing the expression of tight junction proteins, including claudin-1, occludin, and zonula occludens-1. Additionally, this combination reduced systemic inflammation by lowering serum TNF-α and PGE2 levels and promoted increased expression of BDNF by activating the CREB-BDNF-TrkB signaling pathway in hippocampal and cortical tissues. Furthermore, correlation analyses revealed significant associations between specific gut bacterial genera, such as Lacticaseibacillus, Turicibacter, Cryptobacteroides, Ruminococcus, and Muribaculaceae, and cognitive or inflammatory biomarkers.
DISCUSSION: Collectively, these findings suggest that the synergistic effects of L. rhamnosus CBT LR5 combined with skim milk may represent an effective dietary intervention for cognitive enhancement, potentially through gut microbiota modulation, improved barrier integrity, reduced inflammation, and enhanced neurotrophic signaling.}, }
@article {pmid41178777, year = {2025}, author = {Yigitturk, G and Cavusoglu, T}, title = {A Review of The Place of Adipose-Derived Stem Cells among Stem Cell Applications in Neurodegenerative Diseases.}, journal = {Current topics in medicinal chemistry}, volume = {}, number = {}, pages = {}, doi = {10.2174/0115680266363649250620113954}, pmid = {41178777}, issn = {1873-4294}, abstract = {Treatment of neurodegenerative diseases aims to slow disease progression, alleviate symptoms, and improve life quality. Adipose-Derived Stem Cells (ADSCs) have emerged as a promising treatment for neurodegenerative diseases that can be easily obtained from adipose tissues. Their abundance, accessibility, and potential for multilinear differentiation make them an attractive candidate for regenerative medicine. ADSCs can release neurotrophic factors, modulate neuroinflammation, and potentially differentiate into neurons, giving hope for neuronal repair and replacement. Preclinical studies have shown the efficacy of several neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and spinal cord injuries. ADSC has demonstrated the potential to improve functional results, promote neurogenesis, induce tissue integrity, and reduce neuron loss. Clinical trials are still underway, but evidence of the effectiveness of ADSC in neurodegeneration is still being developed. The first clinical studies focused on safety and feasibility and achieved promising results. Optimizing cell transmission, controlling tumor growth, standardizing treatment protocols and such challenges remain. Current research is aimed at addressing these obstacles and transforming ADSC therapy into a widespread clinical practice. This review focuses on the characteristics, problems, and future approaches of ADSC in the context of neurodegenerative diseases and therapeutic processes.}, }
@article {pmid41178581, year = {2026}, author = {Şen, İ and Yeşildal, TK and Abdulqadir, AH and Yaman, İ and Tosun, SN and Zengin, G and Cakmak, YS}, title = {Comprehensive evaluation of Onosma rostellatum: antioxidant, enzyme inhibitory and anticancer properties of root and leaf extracts.}, journal = {Journal of the science of food and agriculture}, volume = {106}, number = {3}, pages = {1662-1673}, doi = {10.1002/jsfa.70284}, pmid = {41178581}, issn = {1097-0010}, support = {//Türkiye Bilimsel ve Teknolojik Araştırma Kurumu/ ; }, mesh = {*Plant Extracts/chemistry/pharmacology/isolation & purification ; *Antioxidants/chemistry/pharmacology/isolation & purification ; Plant Leaves/chemistry ; Humans ; Plant Roots/chemistry ; *Enzyme Inhibitors/chemistry/pharmacology ; alpha-Amylases/antagonists & inhibitors/chemistry ; *Antineoplastic Agents, Phytogenic/chemistry/pharmacology ; Phenols/chemistry ; Cell Line, Tumor ; alpha-Glucosidases/chemistry ; *Bignoniaceae/chemistry ; }, abstract = {BACKGROUND: The incidence and mortality of diseases such as cancer, Alzheimer's, and diabetes have increased in recent years. Along with limited treatment success, severe side effects of synthetic drugs are a major concern. Therefore, natural bioactive compounds are gaining attention as alternative therapeutic agents due to their efficacy and lower toxicity. This study investigated the protective and therapeutic potential of extracts of different parts of Onosma rostellatum, a plant used in traditional medicine, in terms of their antioxidant, enzyme inhibitory and anticancer activities.
RESULTS: Antioxidant, enzyme inhibition, anticancer activities and phenolic composition of the extracts were evaluated. Methanol leaf extract showed the strongest activity in antioxidant assays, with the highest 2,2-diphenyl-1-picrylhydrazyl (46.59 ± 0.03 g Trolox equivalents (TE) kg[-1]) and ferric reducing antioxidant power (90.74 ± 0.59 g TE kg[-1]) activities, while the root methanol extract exhibited the strongest 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid radical scavenging activity (453.86 ± 2.20 g TE kg[-1]) and the highest cupric reducing antioxidant capacity value (243.64 ± 0.49 g TE kg[-1]). The aqueous leaf extract demonstrated superior metal-chelating ability (32.59 ± 0.13 g ethylenediaminetetraacetic acid kg[-1]). Leaf extracts displayed the highest copper ion reducing capacity (94.64 ± 0.23 g TE kg[-1]). Ethyl acetate leaf extracts showed the most significant inhibition against α-amylase and α-glucosidase. High-performance liquid chromatographic analysis revealed rosmarinic acid and quercetin as major phenolic constituents. In cell culture experiments, the ethyl acetate leaf extract demonstrated the most potent anticancer effect, with an IC50 value of 167.2 ± 0.32 μg mL[-1] after 72 h.
CONCLUSION: Onosma rostellatum extracts possess strong antioxidant, enzyme inhibitory and anticancer activities, largely associated with their phenolic components. These findings highlight the potential of this plant as a natural source of therapeutic agents. © 2025 Society of Chemical Industry.}, }
@article {pmid41178110, year = {2025}, author = {Polk, S and Rassaeikashuk, M and Thilagavathi, R and Selvam, C}, title = {Targeting Poly (ADP-Ribose) Polymerase-1 for the Treatment of Neurodegenerative Diseases.}, journal = {Chemical biology & drug design}, volume = {106}, number = {5}, pages = {e70189}, doi = {10.1111/cbdd.70189}, pmid = {41178110}, issn = {1747-0285}, mesh = {Humans ; *Neurodegenerative Diseases/drug therapy/metabolism/pathology/enzymology ; *Poly (ADP-Ribose) Polymerase-1/metabolism/antagonists & inhibitors ; alpha-Synuclein/metabolism ; Animals ; *Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use/chemistry/pharmacology ; tau Proteins/metabolism ; Amyloid beta-Peptides/metabolism ; }, abstract = {Poly (ADP-ribose) Polymerase 1 (PARP1) has many functions that intertwine with the pathology of many diseases. Because of PARP1's function in DNA repair and cell death, neurodegeneration research is another pathology that PARP1 included. By PARylation, PARP1 acts as a direct and indirect modulator of amyloid β, α-Synuclein (α-syn), tau protein, and other proteins indicated in neurodegenerative diseases. PARylation influences the function, activation, and localization of these proteins. This review paper overviews neurodegeneration and the significant diseases resulting from neurodegeneration and compiles mechanisms and functions Poly (ADP-ribose) Polymerase-1 has in neurodegenerative diseases.}, }
@article {pmid41177743, year = {2025}, author = {Pereira da Silva, AM and de Deus, O and Ribeiro, FV and Tudella, GCN and Cabeça, LS and Silva, LL and Han, ML and Franco, JO and Costa, JGP and Santos do Nascimento, MDV and Andrade Fernandes, JV and Franco, ES and de Sousa Maia, MB}, title = {Efficacy and Safety of Lithium for Behavioral and Cognitive Symptoms in Alzheimer's Disease Dementia: A Systematic Review With Frequentist and Bayesian Meta-Analysis.}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jagp.2025.10.001}, pmid = {41177743}, issn = {1545-7214}, abstract = {BACKGROUND: Alzheimer's disease (AD) dementia is the leading cause of cognitive decline in late life, yet treatment options remain limited. Lithium, widely used in bipolar disorder, has been suggested to exert neuroprotective effects through inhibition of GSK-3β and modulation of amyloid and tau pathology. We aimed to evaluate the efficacy and safety of lithium in AD dementia.
METHODS: This systematic review and meta-analysis was prospectively registered in PROSPERO and conducted following PRISMA guidelines. We searched PubMed, Embase, and Cochrane Library through April 2025 for randomized controlled trials (RCTs) comparing lithium with placebo or standard therapy in patients with AD dementia or amnestic mild cognitive impairment. Outcomes included cognition (MMSE, ADAS-Cog, memory tasks), function (CDR-SB, conversion to AD), neuropsychiatric symptoms (NPI), CSF biomarkers, and safety (adverse events [AEs], serious AEs [SAEs]). Random-effects meta-analyses were complemented by Bayesian methods and trial sequential analyses.
RESULTS: Six RCTs involving 394 participants (196 lithium, 198 placebo) met inclusion criteria. Lithium did not significantly improve global cognition (MMSE: MD -1.61, 95% CI -4.11 to 0.88; ADAS-Cog: MD -1.82, -3.05 to -0.60; both with high heterogeneity). Memory outcomes were mixed, with possible benefit for figure recall but not delayed verbal recall. No consistent benefits were observed for episodic memory, functional outcomes (CDR-SB), neuropsychiatric symptoms, or CSF biomarkers. Safety analyses showed no increased risk of SAEs; drug-related AEs were more frequent but heterogeneous across trials.
CONCLUSIONS: Lithium demonstrated an acceptable safety profile within the dosing regimens studied. However, current evidence does not support consistent cognitive or functional benefits in AD dementia. Larger, well-designed RCTs are warranted to clarify its potential therapeutic role.}, }
@article {pmid41177416, year = {2025}, author = {Bashir, B and Gulati, M and Vishwas, S and Hussain, MS and Gupta, G and Kumar, P and Negi, P and Mittal, N and Dua, K and Singh, SK}, title = {Bridging the gap in the management of Alzheimer's disease using fecal microbiota transplantation.}, journal = {Molecular and cellular neurosciences}, volume = {135}, number = {}, pages = {104052}, doi = {10.1016/j.mcn.2025.104052}, pmid = {41177416}, issn = {1095-9327}, mesh = {Humans ; *Alzheimer Disease/therapy/microbiology ; *Fecal Microbiota Transplantation/methods ; *Gastrointestinal Microbiome ; Animals ; }, abstract = {Alzheimer's disease (AD) is a neurodegenerative disease that greatly impairs the health status of human beings and creates significant burdens on individuals, families, and society. AD is characterized by the buildup of pathological proteins and glial cell dysregulated activity. Additional hallmark features include oxidative stress, neuroinflammation, impaired autophagy, cellular senescence, mitochondrial dysfunction, epigenetic alterations, reduced neurogenesis, increased blood-brain barrier permeability, and age-inappropriate intestinal dysbiosis. There is significant evidence that shows that microbiota in the gut affects the development and progression of AD. As a result, gut microbiota modulation has been identified as a new method of clinical management of AD, and more and more efforts have been devoted to identifying new methodologies for its prevention and treatment. This paper will discuss the role of gut microbiome in the etiopathogenesis of AD and consider the possibilities of fecal microbiota extract (FME) supplementation, commonly referred to as fecal microbiota transplantation (FMT). It is both a prophylactic and curative approach. The FMT therapy is grounded on the premise that anti-inflammatory effects, modifications of amyloid β, improved synaptic plasticity, short-chain fatty acids, and histone acetylation are the principles behind the enhancement of AD. The current review will present an overview of the linkage between FMT and AD as well. It further examines and evaluates the effects of FMT on aging-based mechanisms that support the development of AD. It also provides a broad description of the recent clinical and preclinical evidence on the application of FMT to AD.}, }
@article {pmid41177383, year = {2025}, author = {Gu, T and Ma, S and Liu, W and Wang, L}, title = {Pregnane X receptor activation regulate amyloid transport to improve cognition functions in Alzheimer's disease.}, journal = {European journal of pharmacology}, volume = {1007}, number = {}, pages = {178310}, doi = {10.1016/j.ejphar.2025.178310}, pmid = {41177383}, issn = {1879-0712}, mesh = {Animals ; *Alzheimer Disease/metabolism/drug therapy/physiopathology/pathology/psychology ; *Pregnane X Receptor/agonists/metabolism ; Humans ; *Amyloid beta-Peptides/metabolism ; Mice ; *Cognition/drug effects ; Male ; Endothelial Cells/metabolism/drug effects ; Mice, Inbred C57BL ; Brain/metabolism/drug effects/blood supply ; Low Density Lipoprotein Receptor-Related Protein-1/metabolism ; *Peptide Fragments/metabolism ; Cerebrovascular Circulation/drug effects ; ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism ; Disease Models, Animal ; }, abstract = {OBJECTIVES: To explore the concept about nuclear receptor pregnane X receptor (PXR) activation could be beneficial for the Alzheimer's disease (AD) treatment, as well as the underlying mechanism.
METHODS: For in vitro experiments, human brain microvascular endothelial cells (hCMEC/D3) were exposed to Aβ42 and hyperforin (HPF), a human PXR agonist followed by measurement of P-glycoprotein(P-gp)and low-density lipoprotein receptor-related protein 1 (LRP1) expression. Further, 7 months old 5 × FAD mice were used for in vivo experiments. Due to the species-difference characteristics of PXR, these mice were treated with pregnenolone carbonitrile (PCN, a rodent PXR agonist) rather than hPXR agonist, or corn oil for 28 days. Meanwhile, untreated C57BL/6 mice were used as the control group. The improvements of animal behavior were evaluated by Morris water maze and novel arm exploration test. The pathological profiles were assessed by immunohistochemistry and transmission electron microscopy. The cerebral blood flow (CBF) and Aβ transporters were analyzed by speckle contrast imaging and Western blot respectively.
RESULTS: In vitro experiments showed that the P-gp and LRP1 levels in hCMEC/D3 were reduced due to exposure of Aβ42, while HPF can restore their expression levels. 5 × FAD mice treated with the PCN improved cognitive functions and cerebral blood flow. These functional improvements were associated with a reduction in amyloid plaques, cerebral amyloid angiopathy, neuroinflammation and a recovery of blood-brain barrier transport function. The underlying mechanisms could be that PXR activation up-regulates the expression of P-gp and LRP1 and inhibits inflammation via STAT3, and increases the clearance of Aβ42 in the brain.
CONCLUSIONS: These results demonstrate the beneficial impact of PXR activation on cognitive functions, parenchymal amyloid plagues and cerebral angiopathy, and highlights the therapeutic potential of PXR agonists for treatment of AD patients.}, }
@article {pmid41176545, year = {2025}, author = {El Hajj, W and Pujo-Menjouet, L and Tine, LM and Volpert, V}, title = {Modelling of anti-inflammatory treatment in the Alzheimer disease: optimal regimen and outcome.}, journal = {Bulletin of mathematical biology}, volume = {87}, number = {12}, pages = {171}, pmid = {41176545}, issn = {1522-9602}, support = {Project-ANR-21-CE15-0011//PrionDiff/ ; }, mesh = {*Alzheimer Disease/drug therapy/immunology ; Humans ; *Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/therapeutic use ; Mathematical Concepts ; Cytokines/metabolism ; *Models, Biological ; Treatment Outcome ; Computer Simulation ; Microglia/drug effects ; Disease Progression ; Inflammation Mediators/metabolism/antagonists & inhibitors ; }, abstract = {The application of non-steroidal anti-inflammatory drugs (NSAIDs) for Alzheimer's disease is considered to be a promising therapeutic approach. Epidemiological studies suggest potential benefits of NSAIDs; however, these findings are not consistently supported by clinical trials. This long-standing discrepancy has persisted for decades and remains a significant barrier to developing effective treatment strategies. To assess the efficacy of NSAIDs in Alzheimer's disease, we have developed a mathematical model based on a system of ordinary differential equations. The model captures the dynamics of key players in disease progression, including A β -monomers, oligomers, pro-inflammatory mediators (M1 microglial cells and pro-inflammatory cytokines), and anti-inflammatory mediators (M2 microglial cells and anti-inflammatory cytokines). The effects of NSAIDs are modeled through a reduction in the production rate of inflammatory cytokines (IC). While a single NSAID administration temporarily reduces IC levels, their concentration eventually returns to baseline due to drug elimination. The return time depends on the drug dose, resulting in a patient-specific return time function. By analyzing this function, we propose an optimal treatment regimen and identify conditions under which NSAID treatment is most effective in reducing IC levels. Our results suggest that NSAID efficacy in Alzheimer's disease is influenced by the stage of the disease (with earlier intervention being more effective), patient-specific parameters, and the treatment regimen. The approach developed here can also be generalized to evaluate the efficacy of anti-inflammatory treatments for other diseases.}, }
@article {pmid41175945, year = {2025}, author = {Fujii, K and Takeuchi, T and Fujino, Y and Tanaka, N and Fujino, N and Takeda, A and Minakawa, EN and Nagai, Y}, title = {Oral administration of arginine suppresses Aβ pathology in animal models of Alzheimer's disease.}, journal = {Neurochemistry international}, volume = {191}, number = {}, pages = {106082}, doi = {10.1016/j.neuint.2025.106082}, pmid = {41175945}, issn = {1872-9754}, mesh = {Animals ; *Alzheimer Disease/drug therapy/pathology/metabolism/genetics ; *Amyloid beta-Peptides/metabolism/antagonists & inhibitors/genetics ; Administration, Oral ; *Arginine/administration & dosage ; Mice ; Disease Models, Animal ; Mice, Transgenic ; Humans ; *Peptide Fragments/metabolism/antagonists & inhibitors ; Mice, Inbred C57BL ; Dose-Response Relationship, Drug ; Male ; }, abstract = {Although amyloid β (Aβ)-targeting antibody therapies for Alzheimer's disease (AD) have recently been developed, their clinical efficacy remains limited, and issues such as high cost and adverse effects have been raised. Therefore, there is an urgent need for the establishment of safe and cost-effective therapeutic approaches that inhibit Aβ aggregation or prevent its accumulation in the brain. In this study, we report that arginine, a clinically approved and safe chemical chaperone, suppresses Aβ aggregation both in vitro and in vivo. We demonstrated using an in vitro assay that arginine inhibits the aggregation formation of the Aβ42 peptide in a concentration-dependent manner. In a Drosophila model of AD expressing the Aβ42 peptide with an Arctic mutation E22G, the oral administration of arginine dose-dependently reduced Aβ42 accumulation and rescued Aβ42-mediated toxicity. In an App[NL-G-F] knockin mouse model harboring human APP familial mutations, the oral administration of arginine suppressed Aβ plaque deposition and reduced the level of insoluble Aβ42 in the brain. The arginine-treated App[NL-G-F] knockin mice also showed the improvement of behavioral abnormalities and the reduced expression of the neuroinflammation-associated cytokine genes. These results indicate that the oral administration of arginine not only reduced Aβ deposition, but also ameliorated Aβ-mediated neurological phenotypes in animal models of AD. These findings identify arginine as a safe and cost-effective drug candidate that suppresses Aβ aggregation, and highlight its repositioning potential for rapid clinical translation for AD treatment. Arginine is also potentially applicable to a wide range of neurodegenerative diseases caused by protein misfolding and aggregation.}, }
@article {pmid41175916, year = {2025}, author = {Vanya, and Kumari, S and Bagri, K and Deshmukh, R}, title = {Tangles and Plaques: A deep dive into the pathological hallmarks of Alzheimer's disease.}, journal = {Neuroscience}, volume = {590}, number = {}, pages = {170-185}, doi = {10.1016/j.neuroscience.2025.10.050}, pmid = {41175916}, issn = {1873-7544}, mesh = {Humans ; *Alzheimer Disease/pathology/metabolism/genetics ; *Plaque, Amyloid/pathology/metabolism ; Animals ; *Neurofibrillary Tangles/pathology/metabolism ; Amyloid beta-Peptides/metabolism ; tau Proteins/metabolism ; *Brain/pathology/metabolism ; Blood-Brain Barrier/pathology/metabolism ; }, abstract = {Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder. In AD, there is a gradual impairment of memory and cognitive function that interferes with daily living. The pathophysiology of AD revolves around complex interactions between amyloid-β (Aβ) overproduction and accumulation, followed by tau hyperphosphorylation, which together promote a cascade of neuronal dysfunction and degeneration. AD has two forms, sporadic and familial, with genetic variants such as triggering receptor expressed on myeloid cells-2 (TREM2). Various other variants also lead to impaired amyloid clearance and altered immune responses. Along with these genetic factors, aging remains the primary risk factor, and environmental as well as lifestyle factors can act synergistically to accelerate disease onset and progression. Although significant advances have been made in the last five decades, there has been only limited progress in the treatment because of a poor understanding of the molecular basis of AD. This makes current treatments largely focus on symptomatic management. This narrative review provides an updated synthesis of Alzheimer's disease pathophysiology, focusing on Aβ and tau pathology, glial activation, neuroinflammatory cascades, disrupted neurogenesis, and blood-brain barrier dysfunction. A focus and deeper understanding can help to develop new strategies that might work beyond the present conventional treatment. Due to the increasing global prevalence of AD, it is important to continue research into these mechanisms for the development of more effective interventions and improved patient outcomes.}, }
@article {pmid41175892, year = {2025}, author = {Prajapati, P and Desai, A and Shah, P and Pulusu, V and Haque, A and Kalam, MA and Shah, S}, title = {Comparative in-vivo and in-vitro characterization of Donepezil loaded Lactoferrin linked PEG coated and uncoated nanocarriers as intranasal drug delivery system.}, journal = {Journal of liposome research}, volume = {35}, number = {4}, pages = {619-635}, doi = {10.1080/08982104.2025.2573681}, pmid = {41175892}, issn = {1532-2394}, mesh = {*Lactoferrin/chemistry ; *Donepezil/administration & dosage/chemistry/pharmacokinetics ; Animals ; Administration, Intranasal ; *Polyethylene Glycols/chemistry ; Rats ; *Drug Carriers/chemistry ; *Nanoparticles/chemistry ; Male ; *Drug Delivery Systems ; Alzheimer Disease/drug therapy ; Micelles ; Molecular Docking Simulation ; Particle Size ; }, abstract = {Alzheimer's disease treatment faces challenges with conventional oral formulations of donepezil (DNP). This study aims to develop and characterize DNP-loaded Lactoferrin (LCF)-linked PEG-coated nano-carriers for intranasal delivery. The formulation was developed using a Quality by Design (QbD) approach integrated with molecular docking. A novel micelle-enhanced spectrofluorimetric method was developed and validated for in-vitro and in-vivo characterization of the nano-carriers. The method was optimized using Analytical Quality by Design (AQbD) principles. In-vivo pharmacokinetic and bio-distribution studies were conducted in rats to compare the developed formulation with uncoated NLCs and conventional dosage forms. The LCF-PEG-coated NLCs showed improved brain targeting efficiency compared to uncoated NLCs and conventional formulations. The spectrofluorimetric method demonstrated high sensitivity and reliability for both in-vitro and in-vivo analyses. The developed DNP-loaded LCF-PEG-coated NLCs show promise as an effective intranasal delivery system for Alzheimer's disease treatment. The novel spectrofluorimetric method offers a sustainable and efficient alternative to conventional LC-MS/MS techniques for characterizing DNP formulations.}, }
@article {pmid41175671, year = {2025}, author = {Träuble, J and Hiscox, LV and Johnson, CL and Aviles-Rivero, A and Schönlieb, CB and Kaminski Schierle, GS}, title = {Brain age prediction and early neurodegeneration detection using contrastive learning on brain biomechanics: a retrospective, multicentre study.}, journal = {EBioMedicine}, volume = {121}, number = {}, pages = {105996}, pmid = {41175671}, issn = {2352-3964}, mesh = {Humans ; *Brain/diagnostic imaging/pathology/physiopathology ; Middle Aged ; Male ; Female ; Aged ; Adult ; Magnetic Resonance Imaging ; Aged, 80 and over ; Adolescent ; *Neurodegenerative Diseases/diagnosis/diagnostic imaging ; Young Adult ; Retrospective Studies ; Biomechanical Phenomena ; Cognitive Dysfunction/diagnostic imaging ; Elasticity Imaging Techniques/methods ; *Aging ; Alzheimer Disease/diagnostic imaging/diagnosis ; }, abstract = {BACKGROUND: One of the main reasons why drugs for neurodegenerative diseases often fail is that treatment typically begins only after symptoms have appeared-by which point significant, and possibly irreversible, damage may have already occurred. Non-invasive imaging techniques, such as Magnetic Resonance Imaging (MRI), have previously been explored for presymptomatic diagnosis, but with limited success. More recently, Magnetic Resonance Elastography (MRE)-a technique capable of mapping the brain's biomechanical properties, including stiffness and damping ratio-has shown promise in detecting early changes. However, current studies have been limited by small sample sizes, and a lack of robust algorithms capable of accurately interpreting data under such constraints.
METHODS: We developed a self-supervised contrastive regression framework trained on 3D MRE-derived stiffness and damping ratio maps from 311 healthy individuals (aged 14-90) and evaluated its performance against structural 3D T1-weighted MRI. Brain age predictions were used to compute brain age gaps (BAGs), quantifying deviations from normative ageing trajectories. We applied the models to Alzheimer's disease (AD, n = 11) and mild cognitive impairment (MCI, n = 20) cohorts, and analysed whole-brain and region-specific predictions using occlusion-based saliency maps and subcortical segmentation.
FINDINGS: Self-supervised models using MRE achieved a mean absolute error (MAE) of 3.51 years in brain age prediction-significantly outperforming MRI (MAE: 4.79 years, p < 0.05) under matched conditions. The greater age sensitivity of MRE translated into improved differentiation of Alzheimer's disease (AD) and mild cognitive impairment (MCI) from healthy individuals. Stiffness was the dominant ageing biomarker in AD (BAG increase: +9.2 years, p < 0.05), whereas damping ratio revealed early MCI-related changes (BAG increase: +6.3 years, p < 0.05). Region-wise analysis identified the caudate (stiffness) and thalamus (damping ratio) as key markers for AD and MCI, respectively. Notably, some cognitively normal individuals exhibited biomechanical profiles resembling patients with MCI or AD, suggesting that these individuals may share some biomechanical characteristics with clinical populations.
INTERPRETATION: In our controlled experimental setting, MRE combined with contrastive learning provides a sensitive, non-invasive biomarker of brain ageing and neurodegeneration, outperforming MRI and differentiating disease stage-specific biomechanical signatures. Regional BAG profiling may have the potential to identify at-risk, cognitively normal individuals, which could facilitate timely intervention trials in the future, pending longitudinal validation.
FUNDING: Gates Cambridge Trust; Cambridge Centre for Data-Driven Discovery (Schmidt Sciences); Wellcome Trust; NIH (R01-AG058853, U01-NS112120); UK EPSRC; UK MRC; Alzheimer's Research UK; Michael J. Fox Foundation; Infinitus China Ltd.}, }
@article {pmid41175292, year = {2026}, author = {Pennington, B and Davis, S and Cranmer, H}, title = {Caring for and Caring about in Economic Evaluation: Modelling the Family and Caregiving Effects.}, journal = {PharmacoEconomics}, volume = {44}, number = {1}, pages = {13-23}, pmid = {41175292}, issn = {1179-2027}, support = {NIHR300160//NIHR/ ; }, mesh = {*Caregivers/economics/psychology ; Humans ; Quality of Life ; *Models, Economic ; Cost-Benefit Analysis ; Alzheimer Disease/economics/therapy ; *Family ; Muscular Dystrophy, Duchenne/economics/therapy ; Cost of Illness ; Muscular Atrophy, Spinal/economics ; }, abstract = {Current methods for modelling spillover effects on carers in economic evaluation include four main methods: (absolute) utilities, disutilities, increments and multipliers. Each of these approaches assumes that the spillover effect is one-dimensional. We aimed to develop a new approach that better reflects the complexity of caring and the nuances of how a new treatment may impact the caregiver. We propose a new method based on the established concepts of the 'family effect' (or caring about someone) and the 'caregiving effect' (providing care for someone). These effects can be disentangled through analysis of carer-patient dyads or using patient and carer (dis)utilities and estimates from the literature. We consider case studies in Duchenne Muscular Dystrophy, Spinal Muscular Atrophy and Alzheimer's Disease. Our approach models a small carer health-related quality of life (HRQoL) gain for each intervention, whereas the utility approach consistently models a substantial carer HRQoL gain, and the disutility approach models a carer HRQoL loss in two case studies. Our method allows explicit consideration of the benefits to carers of extending patient survival or improving patient health, with the negative HRQoL impact of increased caregiving burden. We propose that our method can be used with published data at present, and further research should analyse the family and caregiving effects in different conditions.}, }
@article {pmid41174898, year = {2025}, author = {Wang, C and Guo, R and Wang, X and Li, H and Zhong, T}, title = {Post-Translational Modifications of Tubulin in Oocyte Maturation and Female Infertility.}, journal = {Cytoskeleton (Hoboken, N.J.)}, volume = {}, number = {}, pages = {}, doi = {10.1002/cm.70062}, pmid = {41174898}, issn = {1949-3592}, support = {82101864//National Natural Science Foundation of China/ ; ZR2025MS508//Natural Science Foundation of Shandong Province/ ; 2023KJ262//Shandong Provincial Youth Innovation Technology Support Program/ ; 2023YXNS228//Key R&D Plan of Jining City/ ; 2023-1-43//Ji'nan Municipal Health Commission Science and Technology Plan Project/ ; 202412//High-Level Talents in the Medical and Health Industry in Ji'nan/ ; }, abstract = {Microtubules are critical components of the cytoskeleton that are extensively involved in various cellular and biological processes. The execution of these functions is intricately linked to post-translational modifications of tubulin. Post-translational modifications of tubulin include acetylation, tyrosination, de-tyrosination, glutamylation, SUMOylation, and so on. These modifications are closely associated with a wide range of biological processes. Accumulating evidence indicates that aberrant microtubule modifications are implicated in various diseases, including cancer, Alzheimer's disease, neurodevelopmental disorders, cardiac atrial hypertrophy, and even infertility. Aneuploid oocytes are a common cause of infertility, spontaneous abortion, trisomy syndrome, and other congenital abnormalities. The occurrence of aneuploidy is often closely associated with defects in spindle assembly, which are influenced by a series of tubulin modifications. In this review, we aimed to summarize the factors that affect tubulin modification and explore the key mechanisms underlying aneuploidy in human oocytes, thereby providing new insights and strategies for the treatment of infertility and prevention of congenital defects in newborns.}, }
@article {pmid41174000, year = {2025}, author = {Zhao, Q and Gou, C and Luo, G and Dai, S and Wang, D and Zhang, S and Wang, F and Xu, H and Han, Y and Wang, S}, title = {Combined multi-omics and brain pathology reveal novel biomarkers for alzheimer's disease.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {38239}, pmid = {41174000}, issn = {2045-2322}, support = {81260199, 81660228, and 82160261//National Natural Science Foundation of China/ ; L-2019019//Yunnan Province Talent Training Program/ ; RLMY20200005//Yunnan High-Level Talent Training Support Program Famous Doctor Special Project/ ; 202303AC100026//Yunnan Province Key Research and Development Program/ ; 202401AY070001-008//Kunming Medical University Joint Special Key Project/ ; }, mesh = {*Alzheimer Disease/pathology/metabolism/genetics ; Animals ; *Biomarkers/metabolism ; Mice ; Proteomics/methods ; Protein Interaction Maps ; *Hippocampus/metabolism/pathology ; Transcriptome ; Gene Expression Profiling ; *Brain/pathology/metabolism ; Disease Models, Animal ; Mice, Transgenic ; Amyloid beta-Protein Precursor/genetics/metabolism ; Multiomics ; }, abstract = {Alzheimer's disease (AD) is a complex disorder with significant genetic contributions, yet only a limited number of risk loci have been conclusively identified. This research aimed to discover novel potential biomarkers for AD through multi-omics and brain pathology analysis. In this study, we investigated hippocampal molecular alterations in APP/PS1 mouse using transcriptomics and data-independent acquisition (DIA) proteomics. To further validate the involvement of differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) in AD pathology and potential drug treatment, we performed an integrative analysis incorporating pathological data and protein-protein interaction networks. We identified 263 DEGs and 448 DEPs. Integrative transcriptomic and proteomic analyses revealed five co-upregulated DEGs/DEPs and one co-downregulated DEG/DEP. Comparison of KEGG pathway enrichment between the two datasets showed significant involvement in the complement and coagulation cascade, as well as neurodegeneration-multiple diseases. Furthermore, mRNA levels of LY86, CD180, and C1QB were strongly associated with amyloid-β plaque load in the AD mouse hippocampus. Protein-protein interaction analysis suggested that APP, LY86, CD180, and C1QB could serve as potential therapeutic targets for AD. The study identified three novel AD loci (EGFL8, ERMN, and CD180), with CD180 showing association with AD at both the expression and pathological levels, highlighting their potential roles in disease progression and therapeutic intervention.}, }
@article {pmid41173323, year = {2025}, author = {Morrow, CB and Sah, E and Onyike, CU}, title = {Examining neuropsychiatric symptoms and functional decline in behavioral variant frontotemporal dementia.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {8}, pages = {772-780}, pmid = {41173323}, issn = {1369-1627}, support = {P30 AG066515/AG/NIA NIH HHS/United States ; P30 AG062421/AG/NIA NIH HHS/United States ; P30 AG066508/AG/NIA NIH HHS/United States ; P30 AG066519/AG/NIA NIH HHS/United States ; P30 AG072973/AG/NIA NIH HHS/United States ; P30 AG066462/AG/NIA NIH HHS/United States ; P30 AG066509/AG/NIA NIH HHS/United States ; P30 AG066546/AG/NIA NIH HHS/United States ; P30 AG072958/AG/NIA NIH HHS/United States ; P30 AG072972/AG/NIA NIH HHS/United States ; P30 AG072979/AG/NIA NIH HHS/United States ; P20 AG068082/AG/NIA NIH HHS/United States ; P30 AG072975/AG/NIA NIH HHS/United States ; P30 AG066444/AG/NIA NIH HHS/United States ; P30 AG066507/AG/NIA NIH HHS/United States ; P30 AG072946/AG/NIA NIH HHS/United States ; P30 AG066518/AG/NIA NIH HHS/United States ; P30 AG066511/AG/NIA NIH HHS/United States ; P30 AG086404/AG/NIA NIH HHS/United States ; U24 AG072122/AG/NIA NIH HHS/United States ; P30 AG066512/AG/NIA NIH HHS/United States ; P30 AG072978/AG/NIA NIH HHS/United States ; P30 AG062429/AG/NIA NIH HHS/United States ; P30 AG062422/AG/NIA NIH HHS/United States ; R01 AG079280/AG/NIA NIH HHS/United States ; P30 AG086401/AG/NIA NIH HHS/United States ; P30 AG066530/AG/NIA NIH HHS/United States ; K23 AG088248/AG/NIA NIH HHS/United States ; P30 AG072977/AG/NIA NIH HHS/United States ; L30 AG083912/AG/NIA NIH HHS/United States ; P30 AG062677/AG/NIA NIH HHS/United States ; P30 AG062715/AG/NIA NIH HHS/United States ; P30 AG066506/AG/NIA NIH HHS/United States ; P30 AG066468/AG/NIA NIH HHS/United States ; P30 AG072976/AG/NIA NIH HHS/United States ; P30 AG072947/AG/NIA NIH HHS/United States ; P30 AG072931/AG/NIA NIH HHS/United States ; P30 AG066514/AG/NIA NIH HHS/United States ; P30 AG072959/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; Male ; Female ; *Frontotemporal Dementia/physiopathology/complications ; Aged ; Middle Aged ; Apathy ; *Behavioral Symptoms/physiopathology/etiology ; }, abstract = {AIM: Neuropsychiatric symptoms (NPS) are core features of behavioral variant frontotemporal dementia (bvFTD), but their association with functional decline is incompletely understood.
METHODS: Participants (N = 219) were individuals enrolled in Alzheimer's Disease Research Centers between 2005 and 2024 with early-stage bvFTD (CDR ≤ 0.5). Functional status was coded as a binary variable based on the Functional Activities Questionnaire. Behavioral data were derived from the Neuropsychiatric Inventory Questionnaire and Clinician Judgement of Symptoms. Descriptive statistics and Cox proportional hazard analyses were used to characterize functional impairments and their association with NPS.
RESULTS: Impairments in transactions (47%) and verbal communication (44%) were common at baseline, while impairments in self-care and incontinence (<10%) were rare. Apathy (65%), disinhibition (55%), depression, anxiety, irritability, and agitation were common at baseline (>40%). Psychosis was rare at baseline (<10%). By visit 4, impairments in transactions (81%), meal-preparation (65%), self-care (55%) and verbal communication (61%) were common. Emergence of apathy, disinhibition, depression, anxiety, and irritability were associated with an increased hazard of impairments in ambulation, meal preparation, self-care, and transactions.
CONCLUSION: NPS in bvFTD are frequent, occur early, and are associated with functional decline. Timely recognition and treatment of NPS may mitigate their impact on function.}, }
@article {pmid41173224, year = {2026}, author = {Zheng, M and Zhang, Q and Siebert, HC and Loers, G and Wen, M and Wang, Q and Zhang, R and Han, J and Zhang, N}, title = {Semaglutide attenuates Alzheimer's disease model progression by targeting microglial NLRP3 inflammasome-mediated neuroinflammation and ferroptosis.}, journal = {Experimental neurology}, volume = {396}, number = {}, pages = {115537}, doi = {10.1016/j.expneurol.2025.115537}, pmid = {41173224}, issn = {1090-2430}, mesh = {Animals ; *NLR Family, Pyrin Domain-Containing 3 Protein/metabolism/antagonists & inhibitors ; *Alzheimer Disease/metabolism/drug therapy/pathology ; Mice ; *Microglia/drug effects/metabolism ; *Ferroptosis/drug effects/physiology ; *Neuroinflammatory Diseases/metabolism/drug therapy/pathology ; Mice, Transgenic ; *Inflammasomes/metabolism/drug effects ; *Glucagon-Like Peptides/pharmacology/therapeutic use ; Disease Progression ; Disease Models, Animal ; Mice, Inbred C57BL ; Male ; Glucagon-Like Peptide 1 ; }, abstract = {Microglial activation driven by NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome signaling exacerbates Alzheimer's disease (AD) pathology through enhanced neuroinflammation and amyloid beta (Aβ) accumulation. Semaglutide (SEM) has attracted growing attention for its potential therapeutic effects in AD, while its underlying mechanisms remain unclear. In this study, we investigated the neuroprotective effects of SEM in both APP/PS1 transgenic mice and LPS + ATP-stimulated BV2 microglia. Our results demonstrate that SEM treatment rescued APP/PS1 mice from cognitive impairment and suppressed Aβ aggregation and tau hyper-phosphorylation in the hippocampus of APP/PS1 mice. Furthermore, we found that SEM inhibited microglial NLRP3 activation, promoted microglial M2 polarization and alleviated ferroptosis via NLRP3/nuclear factor kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1)/ cystine/glutamate antiporter SLC7A11 (xCT)/glutathione peroxidase 4 (GPX4) pathways in APP/PS1 mice and LPS + ATP-stimulated BV2 microglia. These findings were further corroborated by microglia-specific NLRP3 knockdown, which reduced Aβ deposition, promotied M2 polarization, attenuated neuroinflammation, and suppressed ferroptosis. Our findings provide further theoretical support for the clinical application of SEM in AD treatment, while also establishing a scientific foundation for AD therapeutic strategies targeting the microglial NLRP3 pathway.}, }
@article {pmid41172319, year = {2025}, author = {Avdeenko, TA and Guseinova, NM and Dzhafarzade, FY and Zagorul'ko, AA}, title = {[Modern therapeutic strategies for the treatment of Alzheimer's disease (literature review).].}, journal = {Advances in gerontology = Uspekhi gerontologii}, volume = {38}, number = {3}, pages = {441-449}, pmid = {41172319}, issn = {1561-9125}, mesh = {*Alzheimer Disease/therapy/drug therapy/metabolism ; Humans ; *Cholinesterase Inhibitors/therapeutic use ; Amyloid beta-Peptides/metabolism ; *Diabetes Mellitus, Type 2/complications/drug therapy/metabolism ; Immunotherapy/methods ; tau Proteins/metabolism ; Calcium Channel Blockers/therapeutic use ; Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors ; }, abstract = {The article analyzes contemporary literature data on standard and alternative therapeutic methods for Alzheimer's disease (AD). The main approaches currently include the use of cholinesterase inhibitors and NMDA receptor antagonists, which help slow disease progression and improve patients' quality of life. Due to their insufficient effectiveness, there is a search for new treatment methods based on the connection between AD and other conditions. This article will examine the cross-mechanisms of pathogenesis linking type 2 diabetes and AD, as well as analyze new therapeutic approaches, including intranasal insulin administration and the use of insulin sensitizers. Neurodegenerative processes, including AD, are based on a violation of intracellular calcium metabolism, which suggested the potential efficiency of calcium channel blocker drugs currently used in the treatment of arterial hypertension. Key hypotheses regarding the pathogenesis of AD include the amyloid hypothesis, based on the accumulation of beta-amyloid, and the tau hypothesis, related to hyperphosphorylated tau protein aggregation. Alternative mechanisms such as neuroinflammation are also discussed. In this context, an innovative method for treating AD is immunotherapy, aimed at eliminating beta-amyloid that causes neurodegeneration. Thus, the necessity for integrating various hypotheses for a more comprehensive understanding of pathology and developing effective therapeutic strategies is emphasized. The article highlights the importance of further research in this field.}, }
@article {pmid41170731, year = {2026}, author = {Duan, T and Mao, H and Jiang, X and Tian, Y and Zhang, J and Tan, J}, title = {Harnessing copper: Innovative approaches to combat neurodegenerative diseases and cancer (Review).}, journal = {International journal of molecular medicine}, volume = {57}, number = {1}, pages = {}, pmid = {41170731}, issn = {1791-244X}, mesh = {Humans ; *Copper/metabolism ; *Neurodegenerative Diseases/metabolism/drug therapy ; *Neoplasms/metabolism/drug therapy ; Animals ; Chelating Agents/therapeutic use ; }, abstract = {Copper is an important trace element in the human body and plays an essential role in cells, where it is involved in synthesizing copper‑dependent enzymes, including superoxide dismutase, cytochrome c oxidase, tyrosinase, lysyl oxidase, dopamine‑β‑hydroxylase and other related copper‑containing enzymes. Copper overload or deficiency affects cell activity, leading to the development of neurodegenerative diseases or cancer. Neurodegenerative diseases, including Alzheimer's, Parkinson's and Huntington's disease, as well as cancer, represent significant chronic health burdens. The complexity of their pathophysiological mechanisms, coupled with the limitations of current targeted therapies, complicates the development of effective treatments. This review provides a comprehensive overview of the current understanding of copper's regulatory mechanisms in health and disease, with particular emphasis on its roles in neurodegenerative disorders and cancer. Recent advances in copper‑targeted therapeutic strategies, including copper chelators, ionophores and copper‑based nanoparticles, were highlighted. Furthermore, the clinical potential, key challenges and future prospects of these interventions were assessed. By synthesizing recent preclinical and clinical evidence, this review aims to contribute novel perspectives for improving the treatment of copper‑associated diseases.}, }
@article {pmid41170545, year = {2025}, author = {Li, XJ and Zheng, B and Lan, P and Zhang, WX and Li, YP and He, Z}, title = {[Research progress in the role of HCN channels in Alzheimer's disease].}, journal = {Sheng li xue bao : [Acta physiologica Sinica]}, volume = {77}, number = {5}, pages = {867-875}, doi = {10.13294/j.aps.2025.0078}, pmid = {41170545}, issn = {0371-0874}, mesh = {Humans ; *Alzheimer Disease/physiopathology ; *Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/physiology ; Animals ; Amyloid beta-Peptides/metabolism ; }, abstract = {Alzheimer's disease (AD) is the commonest neurodegenerative disease that causes memory decline, cognitive dysfunction and behavior disorders in the aged people. Primary pathological hallmarks of AD include amyloid-β (Aβ), neurofibrillary tangles (NFTs), gliosis, and neuronal loss. Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels have important physiological functions, especially in aspects of controlling the resting membrane potential, pacemaker activity, memory formation, sleep and arousal. This article reviews the structure, distribution, regulation of HCN channels and the role of HCN channels in the pathological mechanisms of AD, aiming to provide drug therapeutic targets for the prevention and treatment of AD.}, }
@article {pmid41170438, year = {2025}, author = {Zhang, X and Huang, X and Chang, M}, title = {Association between periodontal disease and Alzheimer's disease: a scoping review.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1588008}, pmid = {41170438}, issn = {1663-4365}, abstract = {BACKGROUND: Alzheimer's disease (AD) is the most common type of dementia, with mild cognitive impairment (MCI) as its early reversible stage. Periodontal disease (PD) is a chronic inflammatory condition associated with systemic diseases. Recent studies suggest a potential link between PD and AD/MCI. This scoping review evaluates the existing evidence on the association between PD and AD and explores possible mechanisms.
METHODS: A literature search was conducted in PubMed, Embase, and Cochrane databases (September 2025), covering studies from 2004 to 2025. Human clinical studies, animal models, and in vitro experiments were included, while reviews were excluded. Two independent researchers performed study selection, data extraction, and quality assessment.
RESULTS: A total of 52 studies were included after screening 1,369 records. Among them, 25 clinical studies examined the PD-AD association, including case-control, cohort, and cross-sectional studies. Additionally, 24 studies investigated underlying mechanisms, and 3 animal studies assessed PD-related interventions for AD. Evidence suggests PD increases the risk of AD and accelerates cognitive decline. Potential mechanisms include amyloid-β (Aβ) and tau protein aggregation, neuroinflammation triggered by Porphyromonas gingivalis (Pg) infection, and gut-brain axis dysregulation. Periodontal treatment and probiotics may have protective effects against AD-related pathology.
CONCLUSIONS: PD may be a modifiable risk factor for AD, and periodontal interventions could contribute to AD prevention and management. Further clinical studies are needed to confirm the therapeutic potential of targeting oral microbiota in AD.}, }
@article {pmid41170189, year = {2025}, author = {Pakdel, M and Asle-Rousta, M and Sadegh, M and Eidi, A}, title = {Linalool vs linalool-loaded chitosan nanoparticles in an Aβ-induced rat model of Alzheimer's disease: A molecular, biochemical, histological, and behavioral study.}, journal = {Iranian journal of basic medical sciences}, volume = {28}, number = {11}, pages = {1495-1504}, pmid = {41170189}, issn = {2008-3866}, abstract = {OBJECTIVES: Recent studies have increasingly focused on applying nanotechnology to treat neurodegenerative diseases. In this study, we compared the effects of the monoterpene linalool and linalool-loaded chitosan nanoparticles on key pathological features of Alzheimer's disease (AD), including oxidative stress, neuroinflammation, neuronal death, amyloid plaque deposition, alterations in tryptophan metabolism, and memory deficit in a rat model of AD.
MATERIALS AND METHODS: An intracerebroventricular injection of Aβ42 (10 µg) was used to induce the AD model. Linalool (25 mg/kg) and nano-linalool (25 mg/kg) were administered orally once daily for 30 consecutive days.
RESULTS: Both linalool and nano-linalool significantly reduced malondialdehyde levels and enhanced superoxide dismutase activity in the hippocampus. They also decreased the mRNA levels of monocyte chemoattractant protein-1, inhibited the up-regulation of beta-secretase, reduced amyloid plaque deposition, and attenuated pyramidal neuron death in the CA1 region. Additionally, treatment with both compounds down-regulated indoleamine 2,3-dioxygenase, lowered kynurenine levels, and increased serotonin concentrations in the hippocampus. Although both treatments improved learning and spatial memory in Aβ-injected rats, nano-linalool's effectiveness was more significant than that of linalool in modulating the molecular, biochemical, and histological parameters.
CONCLUSION: Encapsulating linalool in chitosan nanoparticles enhances its effectiveness in improving molecular, biochemical, and histological changes in the hippocampus of rat models of AD.}, }
@article {pmid41169672, year = {2025}, author = {Teipel, S and Baena, A and He, B and Martinez, L and Aguillon, D and Quiroz, YT and Grazia, A}, title = {Thalamus not basal forebrain is atrophied in non-demented PSEN1 E280A carriers.}, journal = {Alzheimer's & dementia (Amsterdam, Netherlands)}, volume = {17}, number = {4}, pages = {e70206}, pmid = {41169672}, issn = {2352-8729}, abstract = {INTRODUCTION: A previous study of non-demented presenilin-1 (PSEN1) E280A carriers found basal forebrain and hippocampus, but not the thalamus, to be preserved. This study tested the hypothesis of preservation in an independent PSEN1 E280A sample and explored associations with amyloid and tau pathology.
METHODS: We analyzed multimodal neuroimaging data from 57 individuals in the Colombia-Boston (COLBOS) cohort (non-carriers: 30 and carriers: 27). We used Bayesian multiple regression with priors to test our hypothesis.
RESULTS: Carrier status had no effect on basal forebrain (Bayes factor [BF10] = 0.54) and hippocampal volume (BF10 = 1.05). However, smaller volumes were found in the thalamus of mutation carriers (BF10 = 8.74). We found evidence against an effect of amyloid and tau pathology on basal forebrain, but evidence for an effect on the thalamus.
DISCUSSION: Our results support the preservation of the cholinergic basal forebrain and hippocampus, while highlighting early thalamic involvement in PSEN1 E280A carriers. This has implications for future selection of treatment targets.
HIGHLIGHTS: Basal forebrain volume preserved in non-demented presenilin-1 (PSEN1) E280A carriers.Hippocampal volume preserved in non-demented PSEN1 E280A carriers.Thalamic atrophy observed in non-demented PSEN1 E280A carriers.No link between amyloid/tau pathology and basal forebrain volume.Tau burden linked to hippocampal and thalamic volume loss.}, }
@article {pmid41169223, year = {2025}, author = {Chen, Z and Wang, X and Wang, S and Wu, Z and Wang, H and Chiu, K and Zheng, X and So, KF}, title = {Lycium barbarum glycopeptide protects neurons from amyloid-beta toxicity.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00501}, pmid = {41169223}, issn = {1673-5374}, abstract = {Oligomeric amyloid-beta deposition within neurons and its associated neurotoxicity are among the most direct indicators of the onset of Alzheimer's disease. Investigations into strategies aimed at reducing amyloid-beta accumulation or promoting its clearance in neurons are currently being carried out. Lycium barbarum glycopeptide is rich in biologically active compounds and possesses antioxidant, anti-inflammatory, and neuroprotective properties. This study verified that the oligomer amyloid-beta1-42 induced toxic effects in mouse N2a neuroblastoma cells, resulting in elevated levels of reactive oxygen species and increased expression of the inflammatory enzyme inducible nitric oxide synthase. Lycium barbarum glycopeptide counteracted these effects by alleviating cell damage, enhancing cell viability, reducing the levels of reactive oxygen species and inducible nitric oxide synthase expression, and up-regulating the mRNA levels of antioxidant enzymes, including superoxide dismutase 1, superoxide dismutase 2, and glutathione peroxidase 4. Lycium barbarum glycopeptide also activated the phosphoinositide 3-kinase/Akt/p70S6K signaling pathway and promoted the expression of brain-derived neurotrophic factor, thus exerting neuroprotective effects. These findings indicate that Lycium barbarum glycopeptide may be a promising candidate for the treatment of Alzheimer's disease.}, }
@article {pmid41169221, year = {2025}, author = {Zhang, Z and Deng, W and Hu, L and Hu, Y and Zhang, S and Xiong, Y and Liu, X and Yu, P and Yu, S and Yuan, L and Zhang, J}, title = {Zinc homeostasis imbalance: Potential therapeutic value in neurodegenerative diseases.}, journal = {Neural regeneration research}, volume = {}, number = {}, pages = {}, doi = {10.4103/NRR.NRR-D-25-00632}, pmid = {41169221}, issn = {1673-5374}, abstract = {Zinc homeostasis genes are a general term for a family of genes responsible for regulating the concentration of intracellular and extracellular zinc ions, including the SLC39 (ZIP) family, the SLC30 (ZnT) family, and the metallothionein family. As an essential trace element, zinc is involved in biomolecular synthesis, energy metabolism, redox regulation, and gene expression. Recent studies have shown that abnormal expression of zinc homeostasis genes mediates neuronal apoptosis through multiple pathways, including oxidative stress and neuroinflammation. Imbalance in zinc homeostasis can result in the pathological development of various neurodegenerative disorders, including the deposition of amyloid-β in Alzheimer's disease and the aberrant aggregation of α-synuclein in Parkinson's disease. Therefore, regulating the expression of zinc homeostasis genes to restore normal zinc levels in vivo may be an effective strategy for treating neurodegenerative diseases. This review comprehensively summarizes the current status of research exploring zinc homeostasis genes across various family subtypes, as well as the altered expression of these genes in different neurodegenerative diseases and the underlying mechanisms. Finally, we propose zinc chelator supplementation as a novel interventional therapy for neurodegenerative diseases. This proposal includes an evaluation of the feasibility, safety, and limitations of this treatment, providing an innovative perspective for the clinical management of neurodegenerative diseases in the future.}, }
@article {pmid41169131, year = {2025}, author = {Mikellides, G and Emam Jomeh, AA and Roy, EA and Kyriazis, M}, title = {Repetitive Transcranial Magnetic Stimulation in Dementia.}, journal = {Current aging science}, volume = {}, number = {}, pages = {}, doi = {10.2174/0118746098392580251003064940}, pmid = {41169131}, issn = {1874-6128}, abstract = {Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive neuromodulatory technique that is increasingly being investigated for its therapeutic potential in cognitive impairment associated with dementia and Alzheimer's disease. This narrative review synthesizes and critically appraises the current evidence surrounding rTMS, with particular focus on clinical efficacy, neurobiological mechanisms, and emerging innovations. High-frequency stimulation over the Dorsolateral Prefrontal Cortex (DLPFC) has consistently demonstrated improvements in memory, executive function, and attention, likely mediated by enhanced synaptic plasticity, increased neurotrophic factor expression, and modulation of large-scale brain networks, such as the default mode and fronto-parietal networks. Recent high-quality studies have built upon earlier research to highlight the comparative efficacy of target-specific stimulation, including precuneus- and parietal-based protocols, as well as multi- site strategies that engage language and associative regions. It also examines the use of TMSEEG and DMN connectivity as predictors of treatment response, supporting a shift toward personalized, biomarker-guided rTMS paradigms. Moreover, the synergistic potential of combining rTMS with cognitive training and pharmacotherapy is explored as a promising avenue for multimodal treatment. While preliminary results are encouraging, heterogeneity in study design and stimulation parameters continues to limit the generalizability of the findings. Standardization of protocols, longterm efficacy validation, and large-scale clinical trials remain critical to translating rTMS into routine dementia care.}, }
@article {pmid41168999, year = {2026}, author = {Zhang, J and He, Y and Yang, P and Zhang, H and Tong, Y and Jiang, L and Li, Z and Yan, M and Li, X and Yang, Q and Yang, J and Yuan, Z and Zhang, J and Cheng, J}, title = {Microglial Rack1 Deficiency Alleviates Alzheimer's Disease Pathology through Enhancing IGF1-Mediated Astrocytic Phagocytosis.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {13}, number = {3}, pages = {e15877}, pmid = {41168999}, issn = {2198-3844}, support = {82071218//National Nature Science Foundation of China/ ; 82271237//National Nature Science Foundation of China/ ; 81930029//National Nature Science Foundation of China/ ; }, mesh = {Animals ; *Receptors for Activated C Kinase/metabolism/genetics/deficiency ; *Microglia/metabolism ; *Alzheimer Disease/metabolism/pathology/genetics ; Mice ; *Phagocytosis/genetics/physiology ; *Astrocytes/metabolism/pathology ; *Insulin-Like Growth Factor I/metabolism/genetics ; Disease Models, Animal ; Humans ; Mice, Knockout ; Male ; Signal Transduction ; Receptor, IGF Type 1/metabolism ; Female ; Neoplasm Proteins ; }, abstract = {Alzheimer's disease (AD) is the most common neurodegenerative disorder. Microglia make significant contributions to neuroinflammation and the progression of AD. However, the regulatory role of microglial activation and the communication between microglia and astrocytes in AD are largely unknown. Here, it is found that Rack1 levels are elevated in microglia of patients with AD and AD model mice. The conditional knockout of Rack1 in microglia reduced Aβ aggregation, alleviated neuroinflammation, and rescued cognitive impairments in AD model mice. Mechanistically, the knockout of Rack1 in microglia decreased the number of microglia while increasing both the numbers and phagocytic activities of astrocytes by upregulating the levels of IGF1. The inhibition of IGF1R blocked microglial Rack1 deficiency-induced astrocyte proliferation and astrocyte-mediated phagocytosis both in vitro and in vivo. Collectively, the results demonstrated that microglial Rack1 contributes to AD pathology, at least partially through influencing IGF1-IGF1R signaling between microglia and astrocytes, thus providing a potential target for AD treatment.}, }
@article {pmid41167569, year = {2026}, author = {Xiong, R and Liu, H and Zhang, S and Wang, L and Zhang, P and Wang, Y and Ou, X and Wu, A and Lai, X}, title = {Acorus tatarinowii Schott attenuates Alzheimer's disease via neuronal ferroptosis inhibition: A synergistic network pharmacology and multi-omics profiling study.}, journal = {Journal of ethnopharmacology}, volume = {356}, number = {}, pages = {120829}, doi = {10.1016/j.jep.2025.120829}, pmid = {41167569}, issn = {1872-7573}, mesh = {Animals ; *Ferroptosis/drug effects ; *Alzheimer Disease/drug therapy/metabolism ; Mice ; *Acorus/chemistry ; *Neurons/drug effects/metabolism/pathology ; Network Pharmacology ; Mice, Transgenic ; Male ; Amyloid beta-Peptides ; Disease Models, Animal ; Cell Line ; NF-E2-Related Factor 2/metabolism ; *Drugs, Chinese Herbal/pharmacology ; Rhizome ; *Neuroprotective Agents/pharmacology ; *Plant Extracts/pharmacology ; Mice, Inbred C57BL ; Multiomics ; }, abstract = {The dried rhizome of Acorus tatarinowii Schott (ATR) is the most widely used traditional Chinese medicine for the treatment of dementia due to its effect of opening orifices and eliminating phlegm (Kai-Qiao-Huo-Tan in Chinese), reviving the mind and enhancing intelligence (Xing-Shen-Yi-Zhi in Chinese), but its mechanism remains not fully understood.
AIM OF THE STUDY: To reveal the mechanism of ATR in the treatment of Alzheimer's disease (AD), which is a major type of dementia.
MATERIALS AND METHODS: The effects of ATR on cognitive function and neuronal loss in APP/PS1 mice were evaluated by the novel object recognition test, nesting test, hematoxylin-eosin staining, and Nissl staining. The underlying mechanisms were studied by serum metabolomics, transcriptomics, network pharmacology, RT-PCR, Western blot, immunofluorescence, and immunohistochemistry.
RESULTS: ATR significantly improved cognitive function, neuronal loss, and altered lipid metabolism in APP/PS1 mice. In β-amyloid (Aβ)1-42 and ferric citrate (FC)-induced HT22 cells, ATR significantly improved the cell viability, reduced the intracellular free iron, reactive oxygen species, and lipid peroxidation, and transcriptome analysis showed that the mechanism was related to ferroptosis and iron metabolism. Network pharmacology analysis indicated that ATR may regulate Nrf2 signaling. Both in vitro and in vivo results showed that ATR increased the mRNA and protein expression of Nrf2 and GPX4. ATR also reduced brain iron deposition, downregulated TFR1, and upregulated FPN1 expression in APP/PS1 mice.
CONCLUSIONS: ATR ameliorated AD by improving iron metabolism and inhibiting neuronal ferroptosis through activation of the Nrf2/GPX4 axis, which provided modern medical evidence for the use of ATR to improve AD.}, }
@article {pmid41166911, year = {2025}, author = {Barth, SW and Efferth, T}, title = {Network pharmacology to elucidate the role of phytotherapy in neurocognitive disorders.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {148}, number = {}, pages = {157031}, doi = {10.1016/j.phymed.2025.157031}, pmid = {41166911}, issn = {1618-095X}, mesh = {Animals ; Humans ; Alzheimer Disease/drug therapy ; *Network Pharmacology ; *Neurocognitive Disorders/drug therapy ; *Phytotherapy ; Systems Biology ; }, abstract = {BACKGROUND: To date, there are no entirely satisfactory drugs available to treat neurocognitive disorders. In light of the increasing incidences of these disorders in societies with aging populations, there is an urgent need to further improve treatment options.
HYPOTHESIS: Phytotherapy modulates diseases and symptoms by addressing multiple rather than single targets. Therefore, phytotherapy might be suited to treat complex diseases such as neurocognitive disorders.
METHODS AND BACKGROUND: We performed a systematic review of the literature with defined search terms using the PubMed database. The search terms were: [(network pharmacology) OR (systems pharmacology) OR (microarray) OR (proteomic) OR (metabolomic) OR (transcriptomic) OR (RNA-seq)] AND [Alzheimer) OR (dementia)]. These search strings were connected with [(herbal) OR (botanical)] for polyherbal formulations and [(phytochemical) OR (natural product)] for single-herb preparations. Systems biology focuses on the human organism as dynamic networks that cooperate in an orchestrated manner in the healthy as well as in the diseased body. The diseasome concept integrates disease phenotypes with hierarchical networks across various biological levels-organ networks, cellular networks, and signaling networks. Network pharmacology aims to interfere with such networks to treat complex, multifactorial diseases. Diseases may be caused by exposure to external factors harmful to health (exposomes). Phytotherapy might beneficially influence diseasomes thus restoring disturbed networks. Here, the "phytome" which integrates herbal drug ingredients into the exposome may be a rich source with which to counteract diseased networks.
RESULTS: Our literature search identified 642 hits. The final number of papers included was 41. Using sophisticated animal models (transgenic mice, injection of amyloid β fragments or specific chemicals, surgical interventions) conditions have been generated that resemble Alzheimer's disease, vascular dementia, and other types of dementia. Brain tissues (mainly hippocampus and cortex), blood serum, urine, and feces were investigated using metabolomic, proteomic, and transcriptomic methods. In these experimental dementia models, specific signaling networks were reported to be affected: they regulate pathophysiological mechanisms of inflammation, signal processing and transmission, neuroplasticity, vascular function and blood, cellular integrity and metabolism as well as cellular redox balance. About two dozen polyherbal formulations (mainly derived from traditional Chinese medicine) were used for treatment in these models and partially or fully restored not only the diseased networks (diseasomes) but also the disease symptoms. Another dozen mono-herbal preparations were used to treat dementia in experimental models, and similar beneficial effects were observed.
CONCLUSION: The selected 41 papers from the literature provided a good basis for a detailed analysis of the role of network pharmacology in understanding the multimodal modes of action of herbal preparations in neurocognitive disorders. Complex signaling networks add valuable new information to classical pharmacology. The understanding of phytopharmaceuticals' modes of action underpin the necessity to expand the search from classic pharmacological models to complex network interactions.}, }
@article {pmid41166828, year = {2026}, author = {Gomes, LS and Schüler, MCGM and Giannini, GB and Zapp, E and de Oliveira, AS and Nascimento, V}, title = {Multifunctional Carvacrol-based Organoselenium hybrids as anticholinesterase and antioxidant candidates for Alzheimer's therapy.}, journal = {Bioorganic & medicinal chemistry}, volume = {132}, number = {}, pages = {118447}, doi = {10.1016/j.bmc.2025.118447}, pmid = {41166828}, issn = {1464-3391}, mesh = {*Cholinesterase Inhibitors/chemistry/pharmacology/chemical synthesis ; *Antioxidants/chemistry/pharmacology/chemical synthesis ; *Alzheimer Disease/drug therapy/metabolism ; Acetylcholinesterase/metabolism ; *Cymenes/chemistry/pharmacology ; *Organoselenium Compounds/chemistry/pharmacology/chemical synthesis ; Humans ; Molecular Docking Simulation ; Structure-Activity Relationship ; Molecular Structure ; Dose-Response Relationship, Drug ; *Neuroprotective Agents/pharmacology/chemistry/chemical synthesis ; Animals ; Electrophorus ; }, abstract = {BACKGROUND: Alzheimer's Disease (AD) is a progressive neurodegenerative disorder with no curative treatment available. Acetylcholinesterase (AChE) inhibition remains a validated approach for symptomatic management. Natural compounds such as carvacrol and selenium-based organochalcogenides are promising due to their antioxidant and neuroprotective properties.
OBJECTIVES: This study aimed to design, synthesize, and evaluate twelve selenium-containing carvacrol derivatives as multifunctional anti-Alzheimer agents.
METHODS: The compounds were synthesized via copper-catalyzed azide-alkyne cycloaddition (CuAAC), forming triazole-linked hybrids. Structural characterization was performed using NMR and HRMS. Biological evaluation included in vitro AChE inhibition assays (IC50 determination), antioxidant profiling by cyclic voltammetry, and cytotoxicity screening. Computational studies involved molecular docking (GOLD software), DFT calculations, and ADMET predictions using pkCSM and SwissADME platforms.
RESULTS: Compounds 18e and 18h showed the most potent AChE inhibition (IC50 = 75 and 93 nM, respectively), exhibiting strong interactions with key residues such as Trp286 and Tyr341. Electrochemical assays identified 18l, 18f, and 18c as the most antioxidant derivatives, based on their low oxidation energy. ADMET predictions indicated high intestinal absorption (>95 %), BBB permeability, and no violations of Lipinski's rules. A strong correlation (R[2] = 0.9377) between docking scores and experimental IC50 values supported the reliability of the in silico screening.
CONCLUSION: The synthesized selenium-carvacrol hybrids exhibit a favorable combination of enzyme inhibition, antioxidant capacity, and pharmacokinetic properties. Compounds 18e and 18h demonstrated the most potential and represent valuable leads for future in-depth pharmacological studies and rational optimization in the context of Alzheimer's therapy.}, }
@article {pmid41166555, year = {2025}, author = {}, title = {Erratum.}, journal = {Neuro-degenerative diseases}, volume = {25}, number = {4}, pages = {228}, doi = {10.1159/000548755}, pmid = {41166555}, issn = {1660-2862}, abstract = {
In the article "Active Immunization Targeting Amyloid β for the Treatment of Alzheimer's Disease" [Neurodegener Dis. 2025;
The original online article has been updated to reflect this.