Alzheimer's & Dementia最新文献

{"title":"Real-world lecanemab adoption in Japan 1 year after launch: Insights from 311 specialists on infrastructure and reimbursement barriers","authors":"Kenichiro Sato,&nbsp;Yoshiki Niimi,&nbsp;Ryoko Ihara,&nbsp;Atsushi Iwata,&nbsp;Kiyotaka Nemoto,&nbsp;Tetsuaki Arai,&nbsp;Shinji Higashi,&nbsp;Ataru Igarashi,&nbsp;Kensaku Kasuga,&nbsp;Haruhiko Akiyama,&nbsp;Shuichi Awata,&nbsp;Manabu Ikeda,&nbsp;Takeshi Iwatsubo","doi":"10.1002/alz.70652","DOIUrl":"https://doi.org/10.1002/alz.70652","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Lecanemab was approved for early Alzheimer's disease in Japan, with ≈ 6000 patients treated in the first year post approval. This study explores real-world practices, challenges, and potential solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We conducted an anonymized online survey of clinical specialists authorized to prescribe lecanemab, obtaining responses from 311 specialists who collectively treated 3259 patients with lecanemab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>A majority of respondents (79%) reported wait times of ≤ 3 months from first consultation to initial infusion. One fourth reported tight outpatient space and staffing and significantly lower capacity of treatment than anticipated. Safety concerns were limited, with amyloid imaging-related abnormality–related interruptions in 3.5%. More than half highly supported additional reimbursement for infusion-related services and insurance coverage for apolipoprotein E (<i>APOE</i>) testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Early access to lecanemab appears feasible, yet infrastructure and financial hurdles remain. Dedicated reimbursement and insurance coverage for <i>APOE</i> testing may be essential for ensuring safer, more accessible, and sustainable use of this therapy in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Results from an online survey of 311 Japanese specialists prescribing lecanemab in its first year are reported.</li>\u0000 \u0000 <li>Majority of wait times from first consultation to initial infusion were 1 to 3 months.</li>\u0000 \u0000 <li>Tight affordability of infusion space and staffing was reported by one quarter.</li>\u0000 \u0000 <li>Establishing additional medical fee for infusion management was highly expected.</li>\u0000 \u0000 <li>Reimbursement of apolipoprotein E test in Japanese health insurance system was also demanded.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging Chinese and Korean American communities in dementia research: A journey of inclusivity and partnership","authors":"Jing Wang,&nbsp;Xiang Qi,&nbsp;Mary S. Mittelman,&nbsp;Eunjung Ko,&nbsp;Yaolin Pei,&nbsp;I. Tek Leong,&nbsp;SungJi Park,&nbsp;Katherine Wang,&nbsp;Weiyu Mao,&nbsp;Cynthia Epstein,&nbsp;Bei Wu","doi":"10.1002/alz.70664","DOIUrl":"10.1002/alz.70664","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; INTRODUCTION&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The New York University Caregiver Intervention plus Enhanced Support Project is a randomized controlled trial of a family-based psychosocial intervention to enhance social support and reduce cardiometabolic risk for Chinese and Korean American dementia caregivers, using culturally tailored recruitment strategies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; METHODS&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We reviewed reflections from research staff, weekly meeting minutes, debriefing sessions, and progress reports, to identify key challenges and approaches to engaging participants.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; RESULTS&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Key challenges included reluctance to involve family members, dementia stigma, and resistance to involving family. In response, we engaged online communities, partnered with local organizations, participated in events, and adapted recruitment messages to cultural norms. For the Chinese community, we focused on practical skills while for the Korean community, we emphasized caregiving strategies and the personal/social benefits of participation, reducing rejection rates.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; DISCUSSION&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our findings underscore the importance of culturally tailored recruitment strategies in dementia research. Respectful, sensitive, and culturally informed approaches can significantly enhance engagement and participation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Highlights&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Culturally adapted recruitment strategies improve study engagement with Chinese and Korean American dementia caregivers.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Community partnerships with local social services agencies are essential for recruitment success.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Culturally relevant social media applications were integrated to increase accessibility for study participants.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This study uniquely targets and recruits Chinese and Korean American dementia caregivers with metabolic syndrome-related symptoms, incorporating a psychological intervention alongside biomarker data collection.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The iterative adaptation of recruitment methods and tailored messaging to specific ethnic groups ensure the intervention is culturally aligned, enhancing both participation and relevance to the caregivers’ unique health and caregiving contexts.&lt;/l","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid and regional arterial stiffness and dementia-related imaging biomarkers in the Multi-Ethnic Study of Atherosclerosis (MESA)","authors":"Sheina Emrani,&nbsp;Jordan Tanley,&nbsp;Christopher L. Schaich,&nbsp;Sanjiv Shah,&nbsp;Alain G. Bertoni,&nbsp;Claudia Korcarz,&nbsp;Susan R. Heckbert,&nbsp;Mohamad Habes,&nbsp;Samuel N. Lockhart,&nbsp;Julio A. Chirinos,&nbsp;Jingzhong Ding,&nbsp;James H. Stein,&nbsp;Adam D. Gepner,&nbsp;R. Nick Bryan,&nbsp;Ilya M. Nasrallah,&nbsp;José A. Luchsinger,&nbsp;Kathleen M. Hayden,&nbsp;Yongmei Liu,&nbsp;Timothy M. Hughes","doi":"10.1002/alz.70688","DOIUrl":"10.1002/alz.70688","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; INTRODUCTION&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Arterial stiffness measured within various arterial beds may be differentially associated with neuroimaging biomarkers of dementia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; METHODS&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We related carotid and regional (cardio-ankle vascular index [CAVI] and heart-ankle pulse wave velocity [haPWV]) arterial stiffness measures to biomarkers (gray matter volume [GMV], white matter hyperintensity volume [WMHV], and fractional anisotropy [WMFA]) and amyloid positron emission tomography (PET) positivity (centiloid &gt; 12.2), controlling for covariates.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; RESULTS&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;All arterial stiffness measures were associated with higher WMHV. Lower carotid distensibility (increased mechanical stress) was positively associated with WMFA, while Young's elastic modulus and haPWV (greater stiffness) were associated with lower WMFA. Only CAVI was significantly related to amyloid PET positivity, although similar effect sizes were observed for carotid measures. No main associations were observed with GMV. Significant interactions showed men and Black and Hispanic participants had stronger associations between carotid stiffness and GMV.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; CONCLUSIONS&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Carotid stiffness measures were associated with WM injury while regional CAVI measures were associated with amyloid positivity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Highlights&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;We studied differences between carotid ultrasound and regional (cardio-ankle vascular index [CAVI] and heart-ankle pulse wave velocity [haPWV]) measures of arterial stiffness and neuroimaging abnormalities (white matter changes and amyloid positron emission tomography [PET] positivity) in the Multi-Ethnic Study of Atherosclerosis, a diverse cohort of older adults.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Carotid measures were associated with white matter injury, demonstrated usingwhite matter hyperintensity volume and white matter fractional anisotropy, and were not associated with amyloid PET positivity.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Regional measures had variable relationships with white matter injury and CAVI, and in particular, were associated with amyloid deposition.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Black and Hispanic participants had significant associations between arterial stiffness measures and brain volume that were not ","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Natural language processing-based classification of early Alzheimer's disease from connected speech”","authors":"","doi":"10.1002/alz.70827","DOIUrl":"10.1002/alz.70827","url":null,"abstract":"<p>Balabin H, Tamm B, Spruyt L, et al. Natural language processing-based classification of early Alzheimer's disease from connected speech. <i>Alzheimers Dement</i>. 2025;21(2):e14530.</p><p>In Table 1, the table header information was incorrect. The table header should list “<i>n</i> = 63” for the “Amyloid-” column, “<i>n</i> = 14” for the “Amyloid+” column and “<i>n</i> = 37” for the “AD patients” column.</p><p>Table 1\u0000\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elecsys CSF AD immunoassays: Sample stability for a new pre-analytical protocol for fresh CSF","authors":"Ekaterina Manuilova,&nbsp;Isabelle Schrurs,&nbsp;Sandra Rutz,&nbsp;Silja McIlwrick,&nbsp;Oliver Goldhardt,&nbsp;Patrick Sommer,&nbsp;Timo Grimmer","doi":"10.1002/alz.70797","DOIUrl":"10.1002/alz.70797","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Amyloid beta 1–42 (Aβ42), tau phosphorylated at threonine-181 (p-tau181), and total tau (t-tau) are cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We prospectively examined storage time, temperature, and freeze/thaw effects on Aβ42, p-tau181, and t-tau stability in fresh CSF samples using Elecsys^® CSF immunoassays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>All three biomarkers were stable at 2–8°C for ≤15 days, and −25°C to −15°C for ≤8 weeks, and after one freeze/thaw cycle. p-Tau181 and t-tau were also stable at 15–25°C for ≤8 days and at −25°C to −15°C for 12–15 weeks. Aβ42 recovery declined slightly after storage at 15–25°C for ≤8 days and −25°C to −15°C for 12–15 weeks, and one freeze/thaw cycle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>For optimal immunoassay performance, it is recommended to store CSF samples at 15–25°C for ≤5 days, 2–8°C for ≤15 days, and −25°C to −15°C for ≤8 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Cerebrospinal fluid (CSF) biomarkers aid in Alzheimer's disease diagnosis.</li>\u0000 \u0000 <li>Fresh CSF stored at 15–25°C for ≤5 days is optimal for Elecsys CSF immunoassays.</li>\u0000 \u0000 <li>Fresh CSF stored at 2–8°C for ≤15 days is optimal for Elecsys CSF immunoassays.</li>\u0000 \u0000 <li>Fresh CSF stored at −25°C to −15°C for ≤8 weeks is optimal for Elecsys CSF immunoassays.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of metabolic syndrome in Down syndrome and association with dementia","authors":"Dina Dass,&nbsp;Lam-Ha T. Dang,&nbsp;Laura Xicota,&nbsp;Sharon Krinsky-McHale,&nbsp;Balaji Kannappan,&nbsp;Adam M. Brickman,&nbsp;Bradley T. Christian,&nbsp;Elizabeth Head,&nbsp;Sid E. O'Bryant,&nbsp;Mark Mapstone,&nbsp;Benjamin Handen,&nbsp;Karen Marder,&nbsp;Joseph H. Lee,&nbsp;Alzheimer Biomarker Consortium – Down syndrome (ABC-DS)","doi":"10.1002/alz.70799","DOIUrl":"10.1002/alz.70799","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>In the neurotypical population, metabolic syndrome (MetS) is associated with Alzheimer's disease (AD). However, this has not been well studied in adults with Down syndrome (DS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>The prevalence of MetS and its subcomponents was examined in adults with DS using the Alzheimer Biomarkers Consortium – Down Syndrome data (ABC-DS, <i>N</i> = 389). Logistic regression was used to examine the relationship between MetS and AD at baseline visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Prevalence of MetS, diabetes, hypertension, and hyperlipidemia was low with DS, even though the prevalence of obesity was elevated. Obesity was positively associated with AD in adults with DS (odds ratio = 2.79, <i>P </i>= 0.021), but there was no association between MetS and AD in DS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>The prevalence of MetS was low in adults with DS. Although MetS was not associated with AD, obesity, a subcomponent of MetS, was associated with AD in adults with DS. This may inform targeted treatments in the future.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>There was a low prevalence of metabolic syndrome (MetS) in adults with Down syndrome (DS).</li>\u0000 \u0000 <li>Overall MetS was not associated with dementia in adults with DS.</li>\u0000 \u0000 <li>Obesity, a subcomponent of MetS, had a high prevalence in adults with DS.</li>\u0000 \u0000 <li>Obesity was positively associated with dementia in adults with DS.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70799","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of regional white matter hyperintensity patterns on cognitive trajectories in NACC","authors":"Lindsay J. Rotblatt,&nbsp;Lauren Edwards,&nbsp;Fareshte Erani,&nbsp;Caitlin M. Terao,&nbsp;Katherine J. Bangen,&nbsp;Kelsey R. Thomas","doi":"10.1002/alz.70764","DOIUrl":"10.1002/alz.70764","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>White matter hyperintensities (WMHs) are a biomarker of small vessel cerebrovascular changes that can emerge early in Alzheimer's disease. While global WMHs correlate with cognitive decline, the impact of regional WMHs remains understudied. We examined associations of regional WMH distributions with longitudinal cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>National Alzheimer's Coordinating Center cohort participants (<i>n </i>= 1047; cognitively normal, mild cognitive impairment, dementia) completed neuropsychological and neuroimaging assessments. Hierarchical cluster analysis identified baseline regional WMH patterns, and linear mixed-effects models assessed 2 year change in cognitive domain by cluster.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Five WMH clusters emerged. Compared to those with low WMH burden, participants in the mild occipital and high parieto-occipital clusters had faster memory decline; mild fronto-parietal and high parieto-occipital clusters showed faster executive decline; and mild and high fronto-parietal and high parieto-occipital clusters had faster language decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Regional WMH distributions showed distinct trajectories. Posterior WMHs were most associated with memory decline, while even mild WMHs accelerated decline in some domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Hierarchical cluster analysis identified five white matter hyperintensity (WMH) patterns.</li>\u0000 \u0000 <li>Posterior WMHs were most related to memory decline.</li>\u0000 \u0000 <li>Mild frontal and elevated posterior patterns were associated with executive function decline.</li>\u0000 \u0000 <li>Multiple WMH patterns were associated with language decline.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging of vacuolar tauopathy: Response to letter","authors":"Ryohei Watanabe,&nbsp;John D. Papatriantafyllou,&nbsp;Kengo Maeda,&nbsp;Ilya M. Nasrallah,&nbsp;Edward B. Lee","doi":"10.1002/alz.70817","DOIUrl":"10.1002/alz.70817","url":null,"abstract":"<p>Dear Editor,</p><p>We thank Kobayashi and colleagues for their thoughtful letter and for sharing their valuable longitudinal radiologic–pathologic observations in a case of vacuolar tauopathy (VT) due to valosin-containing protein (<i>VCP</i>) p.Asp395Gly.<span>¹</span> Their case shows ribbon-like cortical hyperintensity on diffusion-weighted imaging (DWI) with later emergence of fluid-attenuated inversion recovery (FLAIR) changes—an evolution they note parallels patterns described in Creutzfeldt–Jakob disease (CJD)—thereby providing helpful time course context. Indeed, one of the cases we described (Case 5) underwent a brain biopsy, in part to rule out prion disease.<span>²</span></p><p>In our series of cases, VT was associated with occipital cortical diffusion abnormalities, and this signal correlated with the presence of neocortical microvacuolization across three autopsy-confirmed cases.<span>²</span></p><p>Interestingly, Kobayashi and colleagues highlighted the variability in the timing of DWI and FLAIR changes.<span>¹</span> In our series, DWI changes were often detected early, including at the initial presentation, whereas in their case, DWI changes appeared 3 years after the initial visit, with FLAIR changes occurring later.</p><p>We note that there is significant technical variability across all of the neuroradiologic assessments for these VT cases where more standardized, longitudinal imaging would be helpful. We appreciate the contribution by Kobayashi et al.; their time series strengthens the association of cortical ribboning as a characteristic imaging signature of VT.</p><p>E.B.L. received consulting fees from Eli Lilly, unrelated to this study. I.M.N. served on a scientific advisory board for Eisai, unrelated to this study. All other authors declare no conflicts of interest. Author disclosures are available in the Supporting Information.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing language challenges in bilingual neuropsychological assessments at the South Texas Alzheimer's Disease Research Center (ADRC)","authors":"Stephanie Santiago-Mejias,&nbsp;Gabrielle Hromas,&nbsp;Ashley LaRoche,&nbsp;David A. Gonzalez,&nbsp;Robin C. Hilsabeck,&nbsp;Katya Rascovsky,&nbsp;Silvia Mejia Arango,&nbsp;Amy Werry-McFarlin,&nbsp;Claudia L. Satizabal,&nbsp;Hector Trevino,&nbsp;Monica Goss,&nbsp;Jennifer Del Bosque,&nbsp;Amaya Seidl,&nbsp;Roberto Garcia,&nbsp;Marialy Salinas Valdez,&nbsp;Angel Velarde,&nbsp;Jessica Zapata,&nbsp;Samantha Gates,&nbsp;Patricia Hernandez,&nbsp;Juan Toranzo,&nbsp;Marucela Uscamayta Ayvar,&nbsp;Denisse Garcia Cisneros,&nbsp;Vanessa M. Young,&nbsp;Sudha Seshadri,&nbsp;Anna Campbell Sullivan","doi":"10.1002/alz.70800","DOIUrl":"10.1002/alz.70800","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> INTRODUCTION</h3>\u0000 \u0000 <p>Neuropsychological assessment of bilingual (English/Spanish) individuals presents challenges that can impact test validity. Language proficiency influences cognitive performance, yet clear guidelines for determining the appropriate test language are lacking. We describe our experiences at the South Texas Alzheimer's Disease Research Center (STAC) in addressing these challenges within the context of National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) assessments and broader Alzheimer's Disease Research Center (ADRC) protocols. We outline steps toward a structured language assessment approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> METHODS</h3>\u0000 \u0000 <p>We implemented a process to assess language proficiency, integrating self-reported and objective measures, including the language dominance index (LDI). Case examples illustrate the impact of language on cognitive testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> RESULTS</h3>\u0000 \u0000 <p>Challenges included discrepancies between self-reported and objective language proficiency, language switching during assessments, and resistance to testing in the dominant language.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> DISCUSSION</h3>\u0000 \u0000 <p>Language assessment improves test validity and research consistency. Future efforts should refine bilingual assessment methods and establish standardized protocols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Systematic test language selection may improve accuracy in bilingual assessments.</li>\u0000 \u0000 <li>Discrepancies in reported versus objective language proficiency challenge bilingual assessments.</li>\u0000 \u0000 <li>Language evaluation guidelines are needed to improve test validity and data consistency.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creutzfeldt–Jakob disease-like imaging in valosin-containing protein D395G mutation","authors":"Ryota Kobayashi,&nbsp;Masafumi Kanoto,&nbsp;Shinobu Kawakatsu,&nbsp;Akihito Suzuki","doi":"10.1002/alz.70816","DOIUrl":"10.1002/alz.70816","url":null,"abstract":"&lt;p&gt;Dear Editor:&lt;/p&gt;&lt;p&gt;We read the recent study by Watanabe et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; on vacuolar tauopathy associated with a &lt;i&gt;D395G&lt;/i&gt; mutation in the valosin-containing protein (VCP), published in this journal, with great interest. Based on five cases with the VCP &lt;i&gt;D395G&lt;/i&gt; mutation, the authors reported that a ribbon-like hyperintensity in the occipital cortex on diffusion-weighted magnetic resonance imaging (DWI) may be a characteristic neuroradiological finding associated with this mutation.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Their analysis of three autopsy cases revealed that DWI hyperintensity typically corresponded to vacuolar changes in brain tissue.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We previously reported the clinical course and pathological findings of a Japanese individual with the VCP &lt;i&gt;D395G&lt;/i&gt; mutation.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Motivated by the findings of Watanabe et al.,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; we retrospectively reviewed the longitudinal changes in fluid-attenuated inversion recovery (FLAIR) imaging and DWI in our case. The patient, who presented with typical behavioral variant frontotemporal dementia symptoms, showed no signal abnormalities in the occipital cortex on either FLAIR imaging or DWI at the initial visit (Figure 1A). However, a magnetic resonance imaging (MRI) scan conducted 3 years after the initial visit showed a ribbon-like hyperintensity in the occipital cortex on DWI, with no apparent changes on FLAIR imaging (Figure 1B). A subsequent MRI scan conducted 10 years after the initial visit revealed slight hyperintensity in the occipital cortex on FLAIR imaging, in addition to a persistent ribbon-like hyperintensity on DWI (Figure 1C). The areas of hyperintensity on FLAIR imaging and DWI roughly corresponded to regions with vacuolar changes in brain tissue (Figure 1D,E).&lt;/p&gt;&lt;p&gt;In Creutzfeldt–Jakob disease (CJD), hyperintensity on FLAIR imaging and DWI are characteristic imaging features,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; with DWI demonstrating higher diagnostic sensitivity.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; In early-stage CJD, vacuolar change is the predominant neuropathological feature and is thought to underlie the high sensitivity of DWI.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; As the disease progresses, reactive astrogliosis becomes more prominent and may contribute to hyperintensity on FLAIR imaging.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; In our case, the MRI obtained after 3 years demonstrated DWI hyperintensity only, whereas the scan after 10 years showed hyperintensity on both DWI and FLAIR imaging. Histological examination revealed vacuolar changes that correlated with the DWI hyperintensity, as well as mild neuronal loss and reactive gliosis (Figure 1D-G). These findings suggest that in VCP &lt;i&gt;D395G&lt;/i&gt;-associated vacuolar tauopathy, severe vacuolar change in the occipital cortex may initially present as DWI hyperintensity, followed later by FLAIR imaging hyperintensity as reactive astrogliosis develops. This temporal imaging evolution parallels the","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 10","pages":""},"PeriodicalIF":11.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}