Journal of Alzheimer's Disease最新文献

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Machine learning classification of mild Alzheimer's disease using EEG during emotional processing. 轻度阿尔茨海默病情绪处理过程中EEG的机器学习分类。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-02 DOI: 10.1177/13872877261483280
Raquel Sahuquillo, Eloy García-Pérez, Beatriz Navarro, Luz Fernández-Aguilar, María Cruz Martínez-Sáez, Laura Ros, Alejandro L Borja, José M Latorre
{"title":"Machine learning classification of mild Alzheimer's disease using EEG during emotional processing.","authors":"Raquel Sahuquillo, Eloy García-Pérez, Beatriz Navarro, Luz Fernández-Aguilar, María Cruz Martínez-Sáez, Laura Ros, Alejandro L Borja, José M Latorre","doi":"10.1177/13872877261483280","DOIUrl":"https://doi.org/10.1177/13872877261483280","url":null,"abstract":"<p><p>BackgroundMild Alzheimer's disease (AD) is associated with alterations in brain activity, which can be detected using electroencephalography (EEG). Investigating these changes during emotional processing may help identify neurophysiological patterns that differentiate patients with mild AD from healthy controls (HCs).ObjectiveTo investigate whether EEG responses elicited during emotional processing provide biomarkers capable of discriminating patients with AD from HCs. Additionally, to identify the emotional contexts, brain regions, frequency bands, and machine learning models that maximize this discriminative capacity.MethodsA sample of 39 AD patients and 54 HCs watched brief movie clips designed to elicit tenderness, amusement, anger, fear, and sadness, along with an Alzheimer's-related clip, together with neutral clips used as control, baseline, and recovery conditions, while cortical activity was recorded using EEG. The signals were then classified across emotional contexts using LASSO, Random Forest, SVM-RBF, XGBoost, and CatBoost ML models.ResultsEEG signals allowed for discrimination between AD patients and HCs across different emotional contexts, including individual emotions, grouped by valence or arousal, and the Alzheimer's-related stimulus. LASSO achieved the best performance for positive and neutral conditions in the parietal and posterior gamma bands, whereas CatBoost performed best for high-arousal negative emotions such as anger and fear, particularly in frontal gamma and theta bands, respectively.ConclusionsPatients with mild AD show EEG signal patterns that differ from those of HCs across different emotional contexts. These findings highlight the potential of EEG recorded during emotional processing to support the development of objective biomarkers for mild AD.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261483280"},"PeriodicalIF":3.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multi-trajectories of activity participation and risk of mild cognitive impairment in China: A national longitudinal cohort study. 运动参与与轻度认知障碍风险的多重轨迹:一项全国纵向队列研究。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-02 DOI: 10.1177/13872877261483186
Ling Chen, Lei Xiao, Yafang Li
{"title":"Multi-trajectories of activity participation and risk of mild cognitive impairment in China: A national longitudinal cohort study.","authors":"Ling Chen, Lei Xiao, Yafang Li","doi":"10.1177/13872877261483186","DOIUrl":"https://doi.org/10.1177/13872877261483186","url":null,"abstract":"<p><p>BackgroundEngagement in physical, social, and intellectual activities is associated with cognitive health in later life, but how their long-term combinations relate to mild cognitive impairment (MCI), a key preclinical stage of Alzheimer's disease, remains unclear.ObjectiveTo identify multi-activity trajectories and examine their associations with MCI.MethodsData were from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative biennial survey collecting demographic, socioeconomic, health, cognitive, and activity-related information. We included 1884 participants aged ≥60 years in 2020. Group-based multi-trajectory modeling identified physical, social, and intellectual activity patterns using the 2011, 2013, 2015, and 2018 waves. Multivariable logistic regression examined associations with MCI in 2020, with subgroup analyses by sex, baseline age, education, and residence.ResultsFour distinct trajectory groups were identified: Moderate PA-low SI (social and intellectual activity), High PA-low SI, Moderate PA-higher SI, and High PA-moderate SI. The Moderate PA-higher SI group had the lowest MCI prevalence (9.47%) and served as the reference. In the fully adjusted model, MCI odds were highest in the High PA-low SI group (OR = 2.05, 95% CI: 1.34-3.15), followed by the Moderate PA-low SI group (OR = 1.57, 95% CI: 1.08-2.30). The High PA-moderate SI group was not significantly associated with MCI (OR = 1.38, 95% CI: 0.72-2.58).ConclusionsModerate physical activity combined with higher social and intellectual engagement was associated with more favorable cognitive outcomes, supporting integrated, pattern-based lifestyle strategies for early prevention of MCI and Alzheimer's disease.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261483186"},"PeriodicalIF":3.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minor hallucinations as an early marker to differentiate dementia with Lewy bodies from Alzheimer's disease. 轻微幻觉作为区分路易体痴呆和阿尔茨海默病的早期标志。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1177/13872877261468798
Marina Ruiz Piñero, Natalia Pérez Carmona, Belen Piñol Ferrer, Ángel Pérez Sempere, Inmaculada Abellán Miralles
{"title":"Minor hallucinations as an early marker to differentiate dementia with Lewy bodies from Alzheimer's disease.","authors":"Marina Ruiz Piñero, Natalia Pérez Carmona, Belen Piñol Ferrer, Ángel Pérez Sempere, Inmaculada Abellán Miralles","doi":"10.1177/13872877261468798","DOIUrl":"10.1177/13872877261468798","url":null,"abstract":"<p><p>BackgroundEarly differentiation between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains clinically challenging, particularly in the initial stages, when cognitive profiles largely overlap. Accurate diagnosis is increasingly relevant given disease-specific therapeutic implications.ObjectiveTo compare clinical, neuropsychological, and perceptual features of early-stage AD and DLB, with a particular focus on minor hallucinations (MH), and to assess their diagnostic utility in differentiating both conditions.MethodsThis prospective, cross-sectional study included 121 patients with probable AD (n = 60) or DLB (n = 61), all in mild stages (GDS 3-4) and supported by disease-specific biomarkers. Participants underwent standardized clinical assessment, comprehensive neuropsychological evaluation, structured evaluation of psychotic symptoms, and perceptual testing, including the Pareidolia Test. Group comparisons and ROC analyses were performed to assess discriminative accuracy.ResultsGlobal cognition, attention, executive functions, language, and visuospatial abilities largely overlapped between groups. Episodic memory impairment was significantly more severe in AD across all recall measures. In contrast, DLB patients showed a higher prevalence of core clinical features and a markedly higher frequency of MH (54.1% versus 13.3% in AD). Pareidolic responses were significantly more frequent in DLB and showed the highest discriminative accuracy among perceptual measures. The presence of MH demonstrated a high positive predictive value for DLB.ConclusionsIn early disease stages, MH and susceptibility to perceptual distortions differentiate DLB from AD more effectively than standard cognitive testing. Systematic assessment of these phenomena may improve early diagnostic accuracy in routine clinical practice.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"302-312"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuropsychiatric symptoms as early clinical indicators and functional biomarkers of cognitive decline in mild cognitive impairment and early Alzheimer's disease. 神经精神症状作为轻度认知障碍和早期阿尔茨海默病认知能力下降的早期临床指标和功能生物标志物
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-27 DOI: 10.1177/13872877261469114
Donna de Levante Raphael
{"title":"Neuropsychiatric symptoms as early clinical indicators and functional biomarkers of cognitive decline in mild cognitive impairment and early Alzheimer's disease.","authors":"Donna de Levante Raphael","doi":"10.1177/13872877261469114","DOIUrl":"10.1177/13872877261469114","url":null,"abstract":"<p><p>Neuropsychiatric symptoms (NPS) have historically been considered secondary or late-stage features of Alzheimer's disease (AD), yet emerging evidence indicates that apathy, depression, anxiety, irritability, agitation, sleep disturbance, and psychosis frequently arise during prodromal phases, including mild cognitive impairment (MCI), and may precede measurable cognitive decline<b>.</b> This narrative review evaluates NPS as early clinical indicators and potential functional biomarkers of cognitive decline in MCI and early AD, emphasizing neurobiological mechanisms, prognostic significance, and translational relevance. A synthesis of epidemiological, longitudinal, neuroimaging, and biomarker studies published between 2012 and 2025 was conducted across major databases, integrating findings within the mild behavioral impairment (MBI) construct and the AT(N) biomarker framework. Across studies, NPS were found to affect approximately 43-80% of individuals with MCI and 75-90% with early AD, with lifetime prevalence approaching 97% across the disease course. Apathy, depression, anxiety, and irritability are particularly common in early stages and independently predict accelerated cognitive and functional decline, increased caregiver burden, and earlier institutionalization. NPS are associated with early tau pathology, neurotransmitter system dysfunction, and fronto-limbic network degeneration. Disparities in symptom burden, diagnostic access, and clinical outcomes are evident across racial, ethnic, sex-related, and cultural groups. Recognizing NPS as core features of early AD supports their integration into MBI- and AT(N)-informed diagnostic and intervention models to enhance early detection, personalize care, and reduce health inequities.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"5-15"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heterogeneity in the association between antihypertensive medications and Alzheimer's disease and related dementias risk: A multidimensional machine learning analysis to inform drug repurposing. 抗高血压药物与阿尔茨海默病及相关痴呆风险之间关联的异质性:一项多维机器学习分析为药物再利用提供信息
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-28 DOI: 10.1177/13872877261469115
Xiangxiang Jiang, Gang Lv, Amber Burroughs, Minghui Li, Jing Yuan, Z Kevin Lu
{"title":"Heterogeneity in the association between antihypertensive medications and Alzheimer's disease and related dementias risk: A multidimensional machine learning analysis to inform drug repurposing.","authors":"Xiangxiang Jiang, Gang Lv, Amber Burroughs, Minghui Li, Jing Yuan, Z Kevin Lu","doi":"10.1177/13872877261469115","DOIUrl":"10.1177/13872877261469115","url":null,"abstract":"<p><p>BackgroundAlzheimer's disease and related dementias (ADRD) place an immense burden on patients, families, and health systems in the United States. Hypertension is highly prevalent in ADRD patients, and antihypertensive medications (AHMs) may confer neuroprotective benefits. However, evidence of association between AHM use and ADRD risk remains limited, especially by drug classes and across population subgroups.ObjectiveThis study aimed to evaluate the association between antihypertensive medications (AHMs) use and ADRD risk, and assess heterogeneity by drug classes and demographics.MethodsWe analyzed 2015-2019 Medicare Current Beneficiary Survey data linked with Medicare claims. ADRD was identified by International Classification of Diseases (ICD) codes, anti-dementia drug use, and survey responses. This study included AHMs from 8 classes. Double/debiased machine learning was employed, adjusting for factors from environmental, sociocultural, behavioral, and biological domains.ResultsAmong 144,788,079 weighted Medicare beneficiaries, 75.44% used AHMs. Overall, AHM use was associated with a 5% reduction in ADRD risk (Effect: 0.95; 95% CI: 0.94-0.95). Heterogeneity in protective effects was observed for most AHM classes, except vasodilators and centrally acting alpha-adrenergic agonists, which were linked to increased ADRD risk (p < 0.001). Disparities were found across age and sex groups, with greater effects in older adults, and were observed for all racial and ethnic groups (p < 0.05) except Hispanics.ConclusionsThis study found that AHM use was associated with reduced ADRD risk, with notable heterogeneity across subgroups, highlighting the importance of integrating hypertension care into cognitive health to develop equitable and personalized strategies.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"345-352"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"From theory to methodology": Evaluating a workshop for designing mechanistic interventions for dementia dyads. “从理论到方法论”:评估痴呆二联体设计机械干预的研讨会。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-23 DOI: 10.1177/13872877261467779
Claire L Szapary, Maggie Syme, Karen S Lyons, Joan K Monin, Talea Cornelius, Kathi L Heffner, Ana-Maria Vranceanu
{"title":"\"From theory to methodology\": Evaluating a workshop for designing mechanistic interventions for dementia dyads.","authors":"Claire L Szapary, Maggie Syme, Karen S Lyons, Joan K Monin, Talea Cornelius, Kathi L Heffner, Ana-Maria Vranceanu","doi":"10.1177/13872877261467779","DOIUrl":"10.1177/13872877261467779","url":null,"abstract":"<p><strong>Background: </strong>Coping with the challenges of Alzheimer's disease and related dementias is a shared experience, impacting individuals living with the disease, their care partners, and their relationship. As the number of people affected by dementia continues to rise, so does the demand for evidence-based psychosocial interventions that support the well-being of both members of the dyad. However, the current dyadic dementia intervention (DDI) landscape remains limited in scope and rigor, often lacking strong relational theoretical underpinnings and clear mechanisms of action.</p><p><strong>Objective: </strong>To address this gap, a four-hour workshop was offered at the 2024 Gerontological Society of America Annual Scientific Meeting to equip researchers with the knowledge, confidence, and skills necessary to conduct methodologically rigorous DDI studies.</p><p><strong>Methods: </strong>The first hour of the workshop included didactic presentations on dyadic theory, intervention design, statistics, and dementia-specific considerations. Attendees then participated in small-group, problem-based experiential activities, applying the learned content to their own research projects with individualized feedback from workshop leaders.</p><p><strong>Results: </strong>Participants, primarily from the disciplines of nursing, psychology, and the social sciences, reported significant improvements in perceived knowledge and confidence from pre- to post-workshop and rated the experience as highly satisfactory.</p><p><strong>Conclusions: </strong>These findings suggest that a workshop combining didactic instruction with experiential, problem-based learning is both feasible and effective in strengthening researchers' self-efficacy and skills to advance DDI research.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"216-223"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
APOE4-specific glymphatic effects on clinical progression in the Alzheimer's Disease Neuroimaging Initiative with pathological correlates in the A4 study. A4研究中apoe4特异性淋巴对阿尔茨海默病临床进展的影响
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-23 DOI: 10.1177/13872877261469565
Mohamed Saadawy, Mehvish Majeed, Eslam Saadawy
{"title":"<i>APOE4</i>-specific glymphatic effects on clinical progression in the Alzheimer's Disease Neuroimaging Initiative with pathological correlates in the A4 study.","authors":"Mohamed Saadawy, Mehvish Majeed, Eslam Saadawy","doi":"10.1177/13872877261469565","DOIUrl":"10.1177/13872877261469565","url":null,"abstract":"<p><p>BackgroundThe <i>APOE</i> ε4 allele is the strongest genetic risk factor for late-onset Alzheimer's disease (AD). However, some carriers show \"clinical resilience\", maintaining their cognition despite high risk.ObjectiveWe hypothesized that the glymphatic system, the brain's waste clearance pathway, may attenuate <i>APOE</i> ε4-mediated neurodegeneration, and tested this in two independent cohorts.MethodsWe analyzed 625 cognitively normal older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) discovery cohort and 447 amyloid-positive participants from the preclinical Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) validation cohort. Glymphatic function was estimated using the analysis of diffusional kurtosis imaging along the perivascular space (DTI-ALPS) index in ADNI and choroid plexus (CP) <sup>18</sup>F-Flortaucipir PET uptake in the A4 study. Primary outcomes were clinical conversion to dementia (ADNI) and hippocampal tau pathology (A4).ResultsIn the discovery cohort, we observed a trend toward ALPS × <i>APOE4</i> interaction (p = 0.057, not reaching conventional statistical significance). Carriers with preserved function (high ALPS) showed a reduced conversion risk (hazard ratio = 0.52, 95% CI: 0.27-0.99) compared to those with low function. In the validation cohort, glymphatic interface dysfunction (higher CP tau) strongly predicted hippocampal tau burden (p < 0.0001). However, the gene-specific interaction was not replicated (p = 0.928); clearance failure predicted pathology regardless of genotype. Exploratory fluid biomarker analyses in ADNI did not reveal significant interactions.ConclusionsThese findings suggest that preserved glymphatic function is associated with clinical resilience in <i>APOE</i> ε4 carriers, though the interaction was borderline (p = 0.057) and should be considered hypothesis-generating. The strong pathological associations with clearance integrity highlight a biologically plausible mechanism in AD pathogenesis that warrants further investigation.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"336-344"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative risk of amyloid-related imaging abnormalities with anti-amyloid-β monoclonal antibodies: A systematic review and penalized likelihood network meta-analysis of randomized trials. 淀粉样蛋白相关影像学异常与抗淀粉样蛋白-β单克隆抗体的比较风险:随机试验的系统评价和惩罚似然网络荟萃分析
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-11 DOI: 10.1177/13872877261466097
Arkansh Sharma, Vinay Suresh, Pavan Raju Kola, Rishu Raj, Fnu Javairia, Allimuthu Nithyanandam, Anmol Kaur, Himanshu Arora, Olivier Uwishema, Dhanya Gorty, Nitya Beriwal, Amogh Verma, Khalid Qidwai, Hardeep Singh Malhotra, Ravindra Kumar Garg
{"title":"Comparative risk of amyloid-related imaging abnormalities with anti-amyloid-β monoclonal antibodies: A systematic review and penalized likelihood network meta-analysis of randomized trials.","authors":"Arkansh Sharma, Vinay Suresh, Pavan Raju Kola, Rishu Raj, Fnu Javairia, Allimuthu Nithyanandam, Anmol Kaur, Himanshu Arora, Olivier Uwishema, Dhanya Gorty, Nitya Beriwal, Amogh Verma, Khalid Qidwai, Hardeep Singh Malhotra, Ravindra Kumar Garg","doi":"10.1177/13872877261466097","DOIUrl":"10.1177/13872877261466097","url":null,"abstract":"<p><p>BackgroundAnti-amyloid-β monoclonal antibodies represent a new class of disease-modifying therapies for Alzheimer's disease (AD). Their clinical adoption is complicated by amyloid-related imaging abnormalities (ARIA), encompassing vasogenic edema (ARIA-E) and hemorrhagic changes (ARIA-H). The comparative ARIA risk across agents and the influence of genetic factors remain incompletely characterized.ObjectiveTo quantify the pooled incidence of ARIA-E and ARIA-H associated with anti-amyloid-β immunotherapies and to compare relative risks across agents using network meta-analytic modeling.MethodsFollowing PRISMA guidelines (PROSPERO: CRD420250653157), we searched PubMed, EMBASE, Scopus, Web of Science, and Ovid through January 2026 for Phase II/III randomized controlled trials of anti-amyloid-β immunotherapies in AD. Random-effects models estimated pooled prevalence and odds ratios (ORs). A penalized likelihood network meta-analysis addressed sparse events. <i>APOE</i> ε4-stratified analyses and Bayesian sensitivity models were also performed.ResultsTwenty-two trials (up to 23,120 participants) were included. Pooled ARIA-E prevalence was 6.8% and ARIA-H was 15.8%, with substantial heterogeneity. Anti-amyloid-β therapy significantly increased odds of ARIA-E (OR 7.93; 95% CI 4.50-13.98) and ARIA-H (OR 1.87; 95% CI 1.28-2.72) versus placebo. The highest ARIA-E risk was seen with donanemab and aducanumab, followed by gantenerumab and lecanemab. <i>APOE</i> ε4 carriage significantly elevated ARIA-E (OR 2.28) and ARIA-H (OR 2.07) risk, with a clear gene-dose effect in homozygotes.ConclusionsARIA risk varies substantially across anti-amyloid-β therapies and is strongly modulated by <i>APOE</i> ε4 status. These findings support genotype-informed risk stratification and individualized MRI monitoring to optimize the benefit-risk balance of disease-modifying therapies in AD.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"65-82"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical dissociation and electromyographic convergence of paratonia in cognitive impairment including Alzheimer's disease: Evidence for a shared central inhibitory mechanism. 认知障碍包括阿尔茨海默病的临床解离和肌电图趋同:共同中枢抑制机制的证据。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-17 DOI: 10.1177/13872877261468799
Lucio Marinelli, Luca Puce, Daniele Diotti, Antonio Currà, Lucilla Vestito, Laura Mori, Marta Ponzano, Andrea Cervia, Filippo Cotellessa, Cristina Schenone, Fiammetta Monacelli, Carlo Trompetto
{"title":"Clinical dissociation and electromyographic convergence of paratonia in cognitive impairment including Alzheimer's disease: Evidence for a shared central inhibitory mechanism.","authors":"Lucio Marinelli, Luca Puce, Daniele Diotti, Antonio Currà, Lucilla Vestito, Laura Mori, Marta Ponzano, Andrea Cervia, Filippo Cotellessa, Cristina Schenone, Fiammetta Monacelli, Carlo Trompetto","doi":"10.1177/13872877261468799","DOIUrl":"10.1177/13872877261468799","url":null,"abstract":"<p><p>BackgroundDespite a shared conceptual framework linking both components to impaired inhibitory control, clinical evidence suggests that facilitatory and oppositional paratonia are not equally related to cognitive deterioration, with facilitatory paratonia showing a stronger association with cognitive impairment. Whether this apparent divergence reflects true neurophysiological differences or arises from limitations intrinsic to clinical assessment remains unclear. Electromyography (EMG)-based assessment offers a direct approach to quantify involuntary muscle activation and reduce measurement-related confounding factors.ObjectiveTo determine whether the reported clinical divergence between facilitatory and oppositional paratonia reflects distinct neurophysiological mechanisms or is primarily driven by measurement-related factors.MethodsEighty-six participants (46 cognitively impaired and 40 cognitively healthy) underwent clinical and EMG-based assessment of paratonia during passive elbow movements. Associations with global cognitive status (Mini-Mental State Examination) and discriminative performance between cognitively impaired and healthy subjects were evaluated.ResultsClinically assessed facilitatory paratonia showed stronger associations with cognitive status and better discriminative performance than oppositional paratonia. In contrast, EMG-based assessment revealed comparable associations with cognitive status and similar discriminative performance for both paratonia components.ConclusionsEMG assessment reveals a neurophysiological convergence between facilitatory and oppositional paratonia, supporting a shared central inhibitory mechanism. Our findings indicate that the apparent clinical distinction between facilitatory and oppositional paratonia does not reflect a true pathophysiological separation, but is largely driven by limitations inherent to clinical assessment. In this context, facilitatory paratonia emerges as the most informative bedside marker of cognitive impairment.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"313-320"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic light scattering spectroscopy and the Centiloid scale. 动态光散射光谱和厘体比例尺。
IF 3.4 3区 医学
Journal of Alzheimer's Disease Pub Date : 2026-09-01 Epub Date: 2026-07-08 DOI: 10.1177/13872877261467030
Jeffrey N Weiss, Daryl Eber, Rebel Cole
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