Neurological Surgery最新文献_第2页

[Precautions for Neurosurgeons in Administering Anti-Amyloid β Antibody Therapy]. 神经外科医生应用抗β淀粉样蛋白抗体治疗的注意事项

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530051000

Fumio Shichijo

{"title":"[Precautions for Neurosurgeons in Administering Anti-Amyloid β Antibody Therapy].","authors":"Fumio Shichijo","doi":"10.11477/mf.030126030530051000","DOIUrl":"https://doi.org/10.11477/mf.030126030530051000","url":null,"abstract":"In Japan, anti-amyloid β (Aβ) monoclonal antibodies, including lecanemab and donanemab, have recently been approved as disease-modifying therapies for early-stage Alzheimer's disease (AD). These drugs, developed based on the amyloid cascade hypothesis, target toxic Aβ aggregates: lecanemab selectively binds to soluble protofibrils, while donanemab targets Aβ plaques. The Ministry of Health, Labour and Welfare (MHLW) has issued Optimal Use Guidelines that specify criteria for administration: informed consent from both patients and caregivers; cognitive assessments (MMSE and CDR); confirmation of Aβ pathology via amyloid PET or cerebrospinal fluid (CSF) testing; and MRI screening to assess the risk of amyloid-related imaging abnormalities (ARIA). ARIA is a significant adverse event and requires regular MRI monitoring. Initial administration is limited to certified facilities staffed by experienced specialists and equipped with the necessary diagnostic infrastructure. After six months, treatment may be continued at collaborating institutions. The APOEε4 genotype is a known risk factor for ARIA but is not covered by insurance. Caution is advised when co-administering anticoagulants or antiplatelet agents. The guidelines also require the use of official treatment cards to inform healthcare providers. This article summarizes the clinical precautions, diagnostic requirements, and facility standards necessary for implementing anti-Aβ antibody therapy in accordance with current MHLW Guidelines in Japan.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 5","pages":"1000-1012"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Medical Consultations and Neuropsychological Tests]. [医学咨询和神经心理测试]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050884

Hideharu Karasawa

引用次数: 0

[An Overview of Medical Fees and Patient Cost-Sharing in Dementia Care in Japan]. [日本痴呆症护理中的医疗费用和患者费用分担概况]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530051013

Makoto Nakane

引用次数: 0

[Current Status and Future Perspectives of Biomarkers in Alzheimer's Disease Diagnosis]. [生物标志物在阿尔茨海默病诊断中的现状和未来展望]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050923

Takanobu Ishiguro, Kensaku Kasuga

{"title":"[Current Status and Future Perspectives of Biomarkers in Alzheimer's Disease Diagnosis].","authors":"Takanobu Ishiguro, Kensaku Kasuga","doi":"10.11477/mf.030126030530050923","DOIUrl":"https://doi.org/10.11477/mf.030126030530050923","url":null,"abstract":"Alzheimer's disease (AD) is the most common cause of dementia, characterized by the pathological accumulation of amyloid-β (Aβ) and phosphorylated tau in the brain. Recent advances in biomarker technology have significantly improved AD diagnosis and treatment. Cerebrospinal fluid biomarkers and amyloid positron emission tomography imaging are now available in clinical settings and serve as key tools in identifying early-stage AD, especially when considering anti-Aβ monoclonal antibody therapies. In 2024, the Alzheimer's Association proposed revised diagnostic criteria that integrate both biomarker-based and clinical staging systems. This framework introduces a classification of \"core biomarkers\" that reflect AD-specific pathology and defines biological and clinical symptom stages. Furthermore, blood-based biomarkers, such as plasma p-tau217 and MTBR-tau243, are gaining attention as minimally invasive tools for early diagnosis and disease staging. As these biomarkers become more accessible, proper interpretation within a clinical context remains essential. In Japan, biomarker testing is currently recommended only for symptomatic individuals, and its use requires careful judgment regarding indications and relevance to the clinical setting. This review outlines the evolution of diagnostic criteria, current and emerging biomarkers, and their implications for personalized AD care while emphasizing the need for expert clinical interpretation to ensure responsible and patient-centric use.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 5","pages":"923-931"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Dementia and Mild Cognitive Impairment: An Overview]. [痴呆和轻度认知障碍：综述]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050844

Kenji Wada

引用次数: 0

[Pharmacological Interventions in Dementia]. [痴呆症的药物干预]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050943

Miho Ota, Tetsuaki Arai

{"title":"[Pharmacological Interventions in Dementia].","authors":"Miho Ota, Tetsuaki Arai","doi":"10.11477/mf.030126030530050943","DOIUrl":"https://doi.org/10.11477/mf.030126030530050943","url":null,"abstract":"Pharmacological interventions for dementia include medications aimed at alleviating its core symptom: cognitive dysfunction. These medicines are known as anti-dementia drugs. As our understanding of Alzheimer's disease (AD) has advanced, the amyloid hypothesis stating that amyloid proteins are involved in the pathogenesis of AD has been proposed. To date, anti-dementia drugs such as cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists have focused on symptomatic treatment. In recent years, based on the amyloid hypothesis, the development of medicines that target either (1) the enzyme that produces amyloid beta (Aβ) or (2) Aβ itself, has been promoted as a treatment strategy for AD. In 2021, the first drug targeting Aβ, aducanumab, was launched in the USA. In Japan, lecanemab and donanemab are now available as monoclonal antibodies targeting Aβ. Additionally, medications have been used to manage the behavioral and psychological symptoms of dementia (BPSD), Parkinsonism, and rapid eye movement sleep behavior disorder. Furthermore, dementia is a major risk factor for delirium, which often occurs during the course of dementia. In this study, we introduce pharmacotherapy with anti-dementia drugs, BPSD treatment, and delirium.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 5","pages":"943-950"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Neuroimaging in Dementia Diagnosis:Up to Date]. [神经影像学在痴呆诊断中的应用：最新进展]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050893

Akihiko Shiino

{"title":"[Neuroimaging in Dementia Diagnosis:Up to Date].","authors":"Akihiko Shiino","doi":"10.11477/mf.030126030530050893","DOIUrl":"https://doi.org/10.11477/mf.030126030530050893","url":null,"abstract":"With the clinical application of monoclonal antibody therapy for Alzheimer's disease (AD), diagnostic techniques are shifting toward molecular-targeted imaging. The development of tracers for positron emission tomography (PET) targeting abnormal proteins associated with the disease, such as amyloid-beta and tau, has enabled the detection of neuropathological changes in AD in vivo. This study will contribute to the clinical diagnosis, staging, and monitoring of potential therapeutic approaches for AD. In general outpatient care, imaging modalities that employ widely available techniques such as magnetic resonance imaging or single-photon emission computed tomography remain necessary. This article provides a synopsis of the American College of Radiology recommendations concerning the clinical utility of neuroimaging techniques and reviews the temporal progression of in vivo pathologies derived from amyloid and tau PETs. We investigated the methods for distinguishing between the AD continuum and SNAP in patients with mild cognitive impairment using the ADNI database. Accurate assessment of the \"cortical signature\" is essential for the diagnosis of AD. Voxel-based morphometry is a useful tool because cortical atrophy is associated with the extension of tau PET lesions. Confirmation of cortical atrophy in conjunction with hippocampal atrophy offers diagnostic insights that facilitate the identification of AD.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 5","pages":"893-922"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Molecular Genetics and Protein Molecules in Dementia]. [痴呆症的分子遗传学和蛋白质分子]。

Neurological Surgery Pub Date : 2025-09-01 DOI: 10.11477/mf.030126030530050873

Maria Kano, Taisuke Tomita

{"title":"[Molecular Genetics and Protein Molecules in Dementia].","authors":"Maria Kano, Taisuke Tomita","doi":"10.11477/mf.030126030530050873","DOIUrl":"https://doi.org/10.11477/mf.030126030530050873","url":null,"abstract":"Alzheimer's disease (AD), the most common cause of dementia, is marked by the pathological accumulation of misfolded proteins in the brain. Its key pathological features include extracellular amyloid β (Aβ) plaques and intracellular tau neurofibrillary tangles, both of which contribute to synaptic dysfunction and neuronal death. Familial AD is linked to mutations in the APP, PSEN1, or PSEN2 genes, which promote increased Aβ production or aggregation. In contrast, frontotemporal dementia (FTD), including FTDP-17, is associated with MAPT mutations that lead to tau fibril accumulation independent of Aβ pathology. Recent advances in cryo-electron microscopy (cryo-EM) have revealed disease-specific conformations of Aβ and tau fibrils at atomic resolution, highlighting the role of structural polymorphism in disease progression. Aβ contributes to synaptic deficits and activates glial cells, thereby initiating neuroinflammatory responses. Genetic risk factors such as APOE and TREM2 influence these pathological processes. Transgenic mouse models carrying familial mutations have replicated certain aspects of AD pathology. However, most models fail to fully reproduce the human-like filament structures or the sequential progression from Aβ to tau pathology. Novel knock-in models, combined with cryo-EM-based validation, now provide a more accurate platform for studying disease mechanisms and developing targeted therapies.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 5","pages":"873-882"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Management of Vestibular Schwannoma by Otolaryngologists]. [耳鼻喉科医师治疗前庭神经鞘瘤]。

Neurological Surgery Pub Date : 2025-07-01 DOI: 10.11477/mf.030126030530040707

Naoki Oishi

引用次数: 0

[Radiomics in Practice and Its Basic Theory for Neurosurgeons]. [放射组学在实践中的应用及其神经外科基础理论]。

Neurological Surgery Pub Date : 2025-07-01 DOI: 10.11477/mf.030126030530040819

Manabu Kinoshita, Haruhiko Kishima

{"title":"[Radiomics in Practice and Its Basic Theory for Neurosurgeons].","authors":"Manabu Kinoshita, Haruhiko Kishima","doi":"10.11477/mf.030126030530040819","DOIUrl":"10.11477/mf.030126030530040819","url":null,"abstract":"Medical images, including magnetic resonance imaging scans, are composed of numerical data, making them well-suited for machine learning and statistical approaches such as deep learning and radiomics. While qualitative analysis of neurological images may have been sufficient for research a decade ago, current standards increasingly demand some level of quantitative analysis. Although the term \"radiomics\" may imply complex mathematical processing or advanced programming, its foundational concepts are surprisingly accessible, with origins tracing back to 1973. The mathematical formulas used in radiomic feature are generally within the scope of high school-level mathematics. This paper provides a framework for individuals keen on integrating radiomics into their analytical methodologies, structured in the following manner: In Section II a detailed, methodical example of the procedures involved in conducting radiomic analysis is provided. Section III provides a brief overview of the historical development of radiomics. Sections IV and V explore the two image feature concepts that underpin radiomics: the gray level co-occurrence matrix and the gray level run length matrix, providing readers a deeper understanding of the significance of the calculated image features.","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"53 4","pages":"819-834"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0