Journal of Neurology最新文献

{"title":"Olfactory function is longitudinally associated with semantic fluency in Parkinson's disease: a cohort study.","authors":"Dareia S Roos, Henk W Berendse, Richard L Doty, Jos W R Twisk, Martin Klein","doi":"10.1007/s00415-025-13337-0","DOIUrl":"10.1007/s00415-025-13337-0","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction is an early, common, and progressive symptom in Parkinson's disease (PD). Whether the decline in olfactory function is longitudinally associated with a deterioration of (non-)motor symptoms remains debated.</p><p><strong>Objectives: </strong>This study aimed to investigate the longitudinal relationship between olfactory function and (non-)motor symptoms, particularly cognitive decline, in PD patients over a ten-year follow-up period.</p><p><strong>Methods: </strong>Ninety patients were assessed at baseline and after approximately ten years. Olfactory function was measured using the 40-item University of Pennsylvania Smell Identification Test (UPSIT®). (non-)Motor symptoms were evaluated using various scales and questionnaires, including the MMSE to assess global cognitive function. Linear regression was used to analyze the change in olfactory function over time in relation to changes in (non-)motor function, and to determine whether baseline olfactory test scores would be associated with (non-)motor function at follow-up. In a subset of 62 patients, in whom comprehensive cognitive testing was performed, we analyzed the longitudinal relationship between olfactory function and performance on specific cognitive tests.</p><p><strong>Results: </strong>Statistically significant associations were found between a decrease in UPSIT® scores and decline in MMSE, and between baseline UPSIT® scores and MMSE performance at follow-up. In the subgroup with comprehensive cognitive testing, a decrease in UPSIT® scores was associated with worsening semantic fluency. Furthermore, an association was found between baseline UPSIT® score and semantic fluency at follow-up.</p><p><strong>Conclusions: </strong>Decline in olfactory function in PD is longitudinally associated with worsening global cognitive function, particularly a deterioration in semantic fluency. Baseline olfactory function may be predictive of later cognitive decline, especially in the semantic domain.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"604"},"PeriodicalIF":4.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines adherence in status epilepticus first steps treatment: factors associated with non-compliance and effect on outcome.","authors":"Valérie Geiser-Micheloud, Andrea O Rossetti, Vincent Alvarez","doi":"10.1007/s00415-025-13349-w","DOIUrl":"https://doi.org/10.1007/s00415-025-13349-w","url":null,"abstract":"<p><strong>Objective: </strong>We investigate adherence to acute-phase treatment guidelines for status epilepticus (SE) in a university and a community hospital, assessing factors influencing compliance and its impact on SE duration and outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed two prospective cohorts, including 452 adults with SE (excluding post-anoxic SE). Adherence was defined as administration of a correctly dosed benzodiazepine (BZD) as first-line therapy, followed by a non-sedative antiseizure medication (ASM) as second-line treatment. We examined associations between adherence, clinical and demographic factors, and discharge outcomes.</p><p><strong>Results: </strong>Only 129/452 (29%) patients received guideline-adherent treatment. A treatment delay > 1 h (p = 0.03) was the only factor significantly associated with non-adherence. Among 323 non-adherent treatment, 283 (89%) received a BZD, but only 66 (28%) at the correct dose. Older age, decreased consciousness, and pre-existing epilepsy influenced BZD treatment patterns. Adherence to treatment sequence did not affect clinical outcomes, but SE duration was significantly shorter in patients treated per guidelines (272 vs. 880 min, p = 0.0003).</p><p><strong>Conclusions: </strong>Adherence to SE treatment guidelines remains low. Guideline-based treatment shortens SE duration but does not significantly impact discharge outcomes. While age, history of epilepsy and consciousness disorders influence BZD use, the lack of clear predictors of overall adherence suggests possible gaps in guideline awareness among healthcare providers.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"602"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic visual acuity in bilateral vestibulopathy and healthy age-sex-matched participants.","authors":"Meichan Zhu, Lisa van Stiphout, Benjamin Volpe, Miranda Janssen, Mustafa Karabulut, Angélica Pérez Fornos, Nils Guinand, Kenneth Meijer, Raymond van de Berg, Christopher McCrum","doi":"10.1007/s00415-025-13269-9","DOIUrl":"10.1007/s00415-025-13269-9","url":null,"abstract":"<p><strong>Objectives: </strong>Dynamic visual acuity (DVA) can be assessed on a treadmill while walking at different speeds and is used to assess people with bilateral vestibulopathy (BVP). However, the effects and interactions of age, BVP, and walking speed on DVA loss and assessment dropout are unclear. Our objective was to investigate the effects of BVP, age, and walking speed on DVA loss and assessment dropout in participants with BVP and healthy age-sex-matched participants.</p><p><strong>Methods: </strong>41 participants with BVP and 41 age-sex-matched healthy participants completed a treadmill-based DVA assessment, including a static condition at 0 km/h and walking conditions at 2, 4, and 6 km/h. DVA loss was measured as the visual acuity difference between static and walking conditions. The drop-out rate, handrail use, and DVA loss were examined in relation to BVP, age, and walking speed.</p><p><strong>Results: </strong>Age significantly increased the odds of dropping out (odds ratio = 1.160, p < 0.001), while BVP did not increase the odds of dropping out (odds ratio = 0.792, p = 0.733). A significant Group*Speed (p = 0.004) interaction effect was found for DVA loss, with DVA loss being significantly worse in people with BVP across all walking speeds, getting progressively worse as speed increased, which was not seen in the healthy participants. Age did not have a significant effect on DVA loss (p = 0.06).</p><p><strong>Conclusion: </strong>BVP does not appear to restrict the ability to walk at the higher speeds of a DVA assessment and cause an increase in dropout rate, whereas age does. BVP significantly impacts DVA, with increasing impact at increasing walking speeds.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"603"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing caloric and self-experienced dizziness symptoms: diagnostic value and implications in functional dizziness.","authors":"Jörn K Pomper, Saskia Rabe, Uwe Ilg, Stephan Wolpert","doi":"10.1007/s00415-025-13334-3","DOIUrl":"https://doi.org/10.1007/s00415-025-13334-3","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic value of dizziness symptom quality is limited by variability in patient self-reports. Comparing it to the experience during standardized caloric stimulation could help control for individual differences in dizziness experience and reporting. As a nonphysiological stimulus, caloric testing may serve as a proxy for acute peripheral vestibular disorder. We hypothesized that dizziness of peripheral origin would be perceived as more similar to caloric stimulation than nonperipheral dizziness.</p><p><strong>Methods: </strong>Patients with peripheral (n = 49) and nonperipheral dizziness (n = 34) were compared. Using newly developed questionnaires, participants rated the intensity of 30 symptoms during both dizziness and caloric stimulation, compared symptom intensity between the two, and rated overall similarity.</p><p><strong>Results: </strong>Peripheral patients did not perceive caloric stimulation as more similar to their symptoms than nonperipheral patients. This also held for the functional dizziness subgroup (n = 14). However, exploratory analyses suggest symptom-specific group differences based on the directional intensity difference. For example, peripheral patients reported stronger spinning during their dizziness, whereas nonperipheral patients reported stronger spinning during caloric stimulation. These group differences outperformed those based on the dizziness ratings alone, which likely reflects pronounced caloric symptoms in the nonperipheral group, especially in functional dizziness, rather than stable individual differences. Peripheral patients also reported stronger caloric symptoms than controls without dizziness (n = 20). Symptom-specific group differences were not accounted for by slow-phase velocity of caloric nystagmus.</p><p><strong>Conclusions: </strong>This study highlights the potential diagnostic value of comparing symptoms with caloric stimulation and provides further support for motion perception overestimation in functional dizziness.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"600"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of intracerebral hemorrhage associated with dual antiplatelet treatment.","authors":"Andrea Morotti, Jawed Nawabi, Qi Li, Maddalena Toffali, Andrea Dell'Orco, Francesco Berinato, Federico Mazzacane, Giorgio Busto, Anna Cavallini, Eugenio Magni, Maurizio Paciaroni, Michele Laudisi, Ilaria Casetta, Raffaele Ornello, Francesca Gabriele, Matteo Paolucci, Stefano Forlivesi, Alessandro Marè, Giovanni Merlino, Enrico Fainardi, Andrea Zini, Alessandro Padovani","doi":"10.1007/s00415-025-13339-y","DOIUrl":"https://doi.org/10.1007/s00415-025-13339-y","url":null,"abstract":"<p><strong>Background: </strong>Antiplatelet treatment is associated with hematoma expansion (HE) and poor outcome in intracerebral hemorrhage (ICH). We aimed to describe the characteristics of ICH associated with dual antiplatelet treatment (DAPT), compared with single (SAPT) and no antiplatelet treatment (NAPT).</p><p><strong>Methods: </strong>A retrospective analysis of ICH patients admitted at nine academic stroke centers in Italy, Germany, and China was conducted. The main outcomes of the analysis were HE (hemorrhage growth > 33% and/or > 6 mL) and poor prognosis at 3 months (modified Rankin Scale 4-6). To account for potential confounders we calculated every patients' predicted probability of the outcome of interest, using logistic regression estimates and summarizing the predicted probability as a continuous variable ranging from 0 to 1.</p><p><strong>Results: </strong>A total of 1644 patients were included, of whom 463 (28.2%) were on SAPT and 25 (1.5%) on DAPT (aspirin plus clopidogrel). DAPT-associated ICH had the highest risk of HE (expressed as mean predicted probability (95% confidence interval, CI): NAPT 0.23 (95% CI 0.23-0.24), SAPT 0.31 (95% CI 0.30-0.32), DAPT 0.42 (95% CI 0.35-0.49), p < 0.001. DAPT patients had also the highest risk of poor outcome: NAPT 0.48 (95% CI 0.47-0.50), SAPT 0.55 (95% CI 0.52.0.57), DAPT 0.70 (95% CI 0.60-0.79), p < 0.001. Among patients on SAPT, the comparison between ICH associated with aspirin (n = 420) and clopidogrel (n = 43) showed similar rates of HE, and poor outcome (all p > 0.1).</p><p><strong>Conclusion: </strong>DAPT is associated with higher risk of HE and poor outcome in acute ICH. These findings might inform clinical practice and future trials.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"601"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tick-induced neurological disorders.","authors":"Juan Carlos García-Moncó, Jorge L Benach","doi":"10.1007/s00415-025-13347-y","DOIUrl":"https://doi.org/10.1007/s00415-025-13347-y","url":null,"abstract":"<p><p>Diseases transmitted by ticks have been increasing in frequency and distribution, partly due to climate change. In the last decades, new tick-borne pathogens have been discovered that cause prominent neurologic disease. In this review, the impacts created by these discoveries insofar as nervous system involvement will be addressed. The effects of climate change ensure that this is a timely topic of medical importance. Tick bite paralysis causes direct neurological injury through a neurotoxin that leads to a dangerous clinical condition. Several pathogens can be transmitted by ticks of the genus Ixodes (I. scapularis in North America, and I. ricinus in Eurasia), either singly or as co-infections. Of these, two arboviruses (tick-borne encephalitis virus and Powassan virus) cause direct neurological injury. The neurological manifestations of the borrelioses, Lyme disease, and relapsing fevers involve the central and peripheral nervous systems. A hemoprotozoan, Babesia microti, causes significant neurological involvement. Anaplasma phagocytophilum, a bacterial agent that infects neutrophils, is an infrequent cause of neurological injury. Both A. phagocytophylum and B. microti can cause severe illness in elderly and immunosuppressed patients, so their impact on morbidity and mortality can be high. Another feature for increased severity is that the Ixodes-transmitted pathogens can cause polymicrobial infections. The rickettsiae are prominent causes of neurological disease. Ehrlichia spp. infect monocytes and can cause diverse forms of neurological injury. The rickettsial agents of Rocky Mountain Spotted Fever and Mediterranean fever infect the endothelium, which leads to multiple organ involvement, including the nervous system.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"599"},"PeriodicalIF":4.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragile X-associated tremor/ataxia syndrome: a case report with atypical spinal cord atrophy and altered somatosensory evoked potentials.","authors":"Giulia Rugarli, Giorgio Maria Agazzi, Roberto Santangelo, Matteo Zavarella, Sonia Calloni, Sebastiano Galantucci, Nicoletta Anzalone, Federica Agosta, Maria Antonietta Volontè, Massimo Filippi","doi":"10.1007/s00415-025-13333-4","DOIUrl":"https://doi.org/10.1007/s00415-025-13333-4","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"595"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based study of severe, less common comorbidities in Duchenne muscular dystrophy.","authors":"Lisa Wahlgren, Sara Nordström, Már Tulinius, Anna-Karin Kroksmark, Kalliopi Sofou","doi":"10.1007/s00415-025-13323-6","DOIUrl":"https://doi.org/10.1007/s00415-025-13323-6","url":null,"abstract":"<p><strong>Background: </strong>Since the increasing longevity and the advent of new therapeutic modalities in Duchenne muscular dystrophy (DMD), comprehensive clinical surveillance is of paramount importance. Our study aimed to examine the occurrence of severe, less common comorbidities among patients with DMD and their impact on life expectancy and overall disease burden.</p><p><strong>Methods: </strong>This was a retrospective, nationwide study of all male patients with DMD who were followed at a medical clinic in Sweden, born and deceased during the period 1970-2019. Data regarding cause-of-death and comorbidities were retrieved by the medical records and the Cause of death Registry. The assessed variables were defined as 'severe' when depicting comorbidities with potentially serious, life-threatening outcomes.</p><p><strong>Results: </strong>Of the 129 included patients, approximately 56% presented with at least one severe complication or event, the most common being gastrointestinal complications and life-threatening arrhythmias, with incidence rates of 56.8 and 48.3/10,000 person-years, respectively. Acute kidney injury with an incidence of 16.6/10,000 person-years, was primarily seen within the months preceding death. Vascular events occurred in 10.7% of the patients, mainly cerebrovascular events and venous thromboembolism -including fatal post-traumatic pulmonary embolism-, each with an incidence of 23.5/10,000 person-years. Fracture occurrence, predominantly seen among non-ambulatory patients, had an incidence of 310/10,000 person-years. We further studied cumulative incidences and associations with loss of ambulation and glucocorticoids.</p><p><strong>Conclusion: </strong>Our study provides new insights into severe comorbidities in DMD, emphasizing the need for lifelong disease monitoring, especially considering that many complications are subject to prevention and, if detected early, to successful treatment.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"596"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life measures in Parkinson's disease: a systematic literature review of patient-reported outcomes measures (PROMs) and their psychometric properties.","authors":"Alberto de la Cuadra-Grande, Javier Rejas, Miguel Ángel Casado, Manuel Monroy, Miguel Ruiz","doi":"10.1007/s00415-025-13348-x","DOIUrl":"10.1007/s00415-025-13348-x","url":null,"abstract":"<p><strong>Background: </strong>Quality-of-life (QoL) measures are key for monitoring health of patients with Parkinson's disease (PD).</p><p><strong>Objective: </strong>This systematic review aimed to gather evidence on the psychometric properties of available patient-reported outcomes measures (PROMs) for assessing QoL in people with PD (PwPD).</p><p><strong>Methods: </strong>A search of PROMs was conducted in PubMed (MEDLINE), Embase, Scopus, Web of Science, PSICDOC, and 'gray literature' (April 2024, PROSPERO-ID: CRD42024526458). After screening and data extraction, in a two-phase procedure conducted by independent reviewers, a critical assessment of feasibility, validity (content, structural, known-group, and criterion) and reliability (internal consistency, test-retest, and measurement error) was conducted based on the COSMIN criteria for good psychometric properties.</p><p><strong>Results: </strong>The search identified 83 eligible studies from which 29 PROMs were gathered (15 PD-specific and 14 generic/unspecific PROMs validated for PD). All PROMs proved their feasibility and included common dimensions between them, suggesting adequate content validity. Among the 29 PROMs, 17 reported data on structural validity (58.6%), 20 on known-group validity (69.0%), 25 on criterion validity (86.2%), 23 on internal consistency (79.3%), 11 on test-retest validity (37.9%), and 4 on measurement error (13.8%). According to the COSMIN criteria, 6 PROMs have the potential to be the most suitable QoL measure for PwPD: PDQ-39, PDQ-8, PDQL, PDQUALIF, PIMS, and Neuro-QOL.</p><p><strong>Conclusions: </strong>Several PROMs are feasible, valid, and reliable for measuring QoL in PwPD. However, further research ensuring their psychometric properties and cross-cultural adaptations are needed to recommend their use.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"598"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating ¹⁸F-Florzolotau tau PET for Alzheimer's disease diagnosis with ¹⁸F-Flortaucipir as reference.","authors":"Qi Zhang, Jiaying Lu, Luyao Wang, Fangyang Jiao, Min Wang, Kuangyu Shi, Chuantao Zuo, Jiehui Jiang","doi":"10.1007/s00415-025-13342-3","DOIUrl":"https://doi.org/10.1007/s00415-025-13342-3","url":null,"abstract":"<p><strong>Introduction: </strong>Tau protein aggregation is a hallmark of Alzheimer's disease (AD) pathology. Semi-quantitative analysis using regions of interest (ROIs)-based standardized uptake value ratios (SUVRs) serves as a major Tau positron emission tomography (PET) biomarker for AD diagnosis and staging. This study aims to evaluate the diagnostic performance of the second-generation tau tracer ¹⁸F-Florzolotau, including the impact of semi-quantitative reference region and ROIs methodology and partial volume error (PVE) correction. Data from the FDA-approved tracer ¹⁸F-Flortaucipir provide benchmark context, aiming to evaluate the performance.</p><p><strong>Methods: </strong>A total of 842 participants from two cohorts underwent tau PET imaging with either ¹⁸F-Flortaucipir (n = 741) or ¹⁸F-Florzolotau (n = 101). The ¹⁸F-Flortaucipir cohort contains 384 normal controls, 292 patients with mild cognitive impairment, and 65 AD dementia. The ¹⁸F-Florzolotau cohort contains 27 normal controls, 26 patients with mild cognitive impairment and 48 AD dementia. SUVRs were calculated across four ROIs using six semi-quantitative methods varying by reference region and PVE-correction application. Diagnostic performance was assessed using the area under the curve (AUC) from receiver operating characteristic analysis. Partial correlations between SUVRs and clinical severity were evaluated.</p><p><strong>Results: </strong>¹⁸F-Florzolotau demonstrated high diagnostic accuracy (AUC: 0.96-0.98) for AD dementia and strong clinical correlations (|r|= 0.61-0.74). Performance varied with semi-quantitative methodology. The optimal approach used inferior cerebellar gray matter as the reference region, achieving the highest AUC and strong clinical correlations for ¹⁸F-Florzolotau. Results for ¹⁸F-Flortaucipir (AUC: 0.78-0.87; |r|= 0.29-0.45) provided consistent methodological insights supporting the choice of inferior cerebellar gray methodology.</p><p><strong>Conclusions: </strong>¹⁸F-Florzolotau shows excellent diagnostic performance for AD dementia. The semi-quantitative methodology impacts results, with inferior cerebellar gray as the recommended reference region for optimizing ¹⁸F-Florzolotau SUVR analysis in AD dementia. These findings support the clinical utility of ¹⁸F-Florzolotau tau PET in AD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 9","pages":"597"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}