Neurología Cognitiva

Temporal dynamics of white matter hyperintensities related to Alzheimer's disease in adults with Down syndrome

Sun, 01 Feb 2026 00:00:00 GMT

Temporal dynamics of white matter hyperintensities related to Alzheimer's disease in adults with Down syndrome Morcillo Nieto, Alejandra O.; Rozalem Aranha, Mateus; Maure Blesa, Lucia; Rodríguez-Baz, Íñigo; Arriola-Infante, José Enrique; Franquesa Mullerat, Maria; Zsadanyi, Sara E.; Vaqué Alcázar, Lídia; Allende Parra, José; Zhao, Zili; Arranz, Javier; Videla, Laura; Barroeta, Isabel; Del Hoyo Soriano, Laura; Benejam, Bessy; Fernández, Susana; Sanjuan Hernandez, Aida; Pertierra, Lucía; Giménez, Sandra; Alcolea, Daniel Introduction: White matter hyperintensities (WMH) are common in Down syndrome (DS), yet their longitudinal evolution and associations with Alzheimer's disease (AD) remain unclear. Methods: Longitudinal MRI study, including 80 DS adults and 53 euploid controls. WMH were segmented on serial FLAIR using a longitudinal pipeline. We assessed the effects of demographic, genetic factors, AD clinical stage, AD-related fluid, and cerebrovascular biomarkers on annual WMH volume changes. Results: In DS, annual WMH changes were relatively stable until age 40, and then exhibited fluctuations, with a significant decrease at the group level. Declines were larger in symptomatic cases, particularly in periventricular and fronto-parieto-occipital regions. Higher baseline WMH and microbleeds presence related to greater WMH reduction. Visual ratings and adjustment for white matter volume supported the robustness of the results. Discussion: WMH trajectories were heterogeneous in DS and declined over time with AD symptoms. This unexpected reduction may reflect different underlying pathological processes, including neurodegeneration or neuroinflammation.

Teleneuropsychology in Latin America : Experiences and challenges during the COVID-19 pandemic

Fri, 06 Mar 2026 00:00:00 GMT

Teleneuropsychology in Latin America : Experiences and challenges during the COVID-19 pandemic Olavarría, Loreto; Dechent, Claudia; Parra Rodriguez, Mario Alfredo; Crivelli, Lucía; Custodio Capuñay, Nilton Santos; Dozzi Brucki, Sonia María; Okada de Oliveira, Maira; Robert, Phillip; Quiroz, Yakeel T.; Antivilo Bruna, Andrés; Arboleda Ramírez, Alejandra; Lillo, Patricia; Carello, María Agostina; Torralba, Teresa; Ramos, Teresita; Duran Aniotz, Claudia; Allegri, Ricardo Francisco; Slachevsky, Andrea La pandemia de COVID-19 aceleró el uso de la teleneuropsicología (TeleNP) para ofrecer servicios neuropsicológicos remotos en entornos con acceso limitado a clínicas. Objetivo: Examinar las prácticas de TeleNP en América Latina (AL), centrándose en las percepciones de los clínicos sobre su utilidad, validez y barreras. Métodos: Se realizó una encuesta descriptiva, exploratoria y de corte transversal entre noviembre de 2020 y enero de2021 entre profesionales de la salud que ejercen la neuropsicología en AL. El instrumento, validado mediante un proceso Delphi, evaluó los antecedentesprofesionales, el uso de TeleNP, los perfiles de los pacientes, las pruebas aplicadas y las ventajas y desafíos percibidos. Resultados: Participaron un totalde 212 clínicos de 10 países (edad media=42,7 años; experiencia=12,3 años). Los participantes fueron principalmente psicólogos (75,9%), aunquetambién se incluyeron neurólogos, geriatras, psiquiatras y terapeutas del lenguaje. La adopción de TeleNP aumentó de un uso regular de 4,2% y un usoocasional de 13,7% antes de la pandemia a un 58% en el momento de la encuesta, con una variación significativa entre países (χ2=79,0; gl=30; p<0.001).La TeleNP se utilizó principalmente para entrevistas con pacientes (90%) e informantes (89,5%), cribado (screening) (71,8%) y, en la mitad de los casos,evaluaciones más exhaustivas. Las ventajas reportadas fueron la mejora de acceso (81,5%), la reducción de los costos de transporte (79,8%), la comodidaddel paciente (66,1%) y la facilidad de programación de citas (66,1%). La principal barrera identificada fue la limitada conectividad de los pacientes (84,7%).El conocimiento normativo fue heterogéneo: el 36,7% informó tener autorización para la TeleNP en su país, el 23,5% informó no tener autorización y el39,8% no estaba seguro. Conclusión: La adopción de TeleNP en AL aumentó durante la pandemia y se percibe como una modalidad válida y accesiblepara abordar las disparidades geográficas en la atención neuropsicológica. Sin embargo, la implementación heterogénea, la incertidumbre regulatoria y laslimitaciones tecnológicas siguen siendo desafíos importantes, lo que subraya la necesidad de directrices estandarizadas.

Characterization of individuals fulfilling clinical criteria for limbic-predominant age-related TDP43 encephalopathy (LATE) in a tertiary memory clinic

Wed, 07 Jan 2026 00:00:00 GMT

Characterization of individuals fulfilling clinical criteria for limbic-predominant age-related TDP43 encephalopathy (LATE) in a tertiary memory clinic Groot, Colin; Calandri, Ismael Luis; Bader, Ilse; Bocancea, Diana I.; de Bruin, Hannah; Carrigan, Maria; Kamps, Suzie; de Koning, Lotte A.; Mastenbroek, Sophie E.; Rikken, Roos M.; van Tol, Bastiaan G. J.; Vermeiren, Marie R.; Wesseling, Alex; Xia, Ye; Teunissen, Charlotte E.; van de Giessen, Elsmarieke; Barkhof, Frederik; Jonkman, Laura E.; van der Lee, Sven J.; de Boer, Casper Background Limbic-predominant age-related TDP-43 encephalopathy (LATE) clinically mimics and often co-occurs with Alzheimer's disease (AD). Expert consensus criteria have been proposed for the LATE clinical diagnosis, integrating clinical and radiological features, and AD biomarkers. Here, we applied the newly proposed criteria in a tertiary memory clinic population. Method We included participants from the Amsterdam Dementia Cohort aged >50 years who received a diagnosis of MCI or dementia between 1997-2024. Following the LATE consensus criteria scheme (Figure 1), we categorized participants as “Probable LATE”, “Possible LATE” or “Possible LATE-AD” (i.e. LATE clinical and radiological profile with AD biomarker profile). Participants not fulfilling criteria for LATE but fulfilling NIA-AA criteria for AD were categorized as AD. We compared the LATE groups with AD on cognitive decline (N = 1046, N Mean time=2.7[1.8] years) and atrophy (N = 208, Mean time=2.1[1.6]) using linear-mixed effects models, and on mortality rates using Cox proportional hazard models. Result Of the 3367 individuals, 1920 were classified into one of the four groups. Fifty-one (1.5%) were classified as Probable LATE, 102 (3.0%) as Possible LATE, 122 (3.6%) as Possible LATE-AD, and 1645 (48.8%) as AD (Table 1). Compared to AD, Probable LATE showed an attenuated cognitive decline (b[SE] for MMSE=0.12[0.05], p = 0.02) and lower mortality rates (HR[95% CI]=0.75[0.58-0.95], p = 0.02), while individuals with Possible LATE-AD had faster cognitive decline (b for MMSE=-0.12[0.05], p = 0.01) and higher mortality rates (HR=1.55[1.25-1.92], p <0.001, Figure 2). Compared to AD, Probable LATE had, at baseline, lower hippocampal volumes (b=-0.83[0.27], p <0.01), and higher inferior-temporal to hippocampal volume ratios (b=0.81[0.27], p <0.01). Furthermore, in Probable LATE, atrophy in a whole-brain region-of-interest was slower compared to AD (b=0.14[0.08], p = 0.04). Possible LATE-AD had, at baseline, thinner whole-brain cortex (b=-0.69[0.30], p = 0.02), lower hippocampal volumes (b=-1.54[0.31], p <0.01), and higher inferior-temporal to hippocampal volume ratios (b=1.73[0.30], p <0.01) than AD, but there was no difference in atrophy rates between Possible LATE-AD and the other groups (Figure 3). Conclusion In a tertiary memory clinic population, the newly proposed clinical LATE criteria reveal clinical and atrophy trajectories that are distinct from AD, especially for Probable LATE and Possible LATE-AD. Differential clinical and biological disease trajectories highlight the relevance of the LATE classification for diagnostic and prognostic purposes

Regional effects of gantenerumab on neuroimaging biomarkers in the DIAN-TU-001 trial

Tue, 01 Jul 2025 00:00:00 GMT

Regional effects of gantenerumab on neuroimaging biomarkers in the DIAN-TU-001 trial McCullough, Austin; Chen, Charles D.; Gordon, Brian A.; Joseph-Mathurin, Nelly; Jack Jr, Clifford R; Koeppe, Robert; Hornbeck, Russ; Koudelis, Deborah; McKay, Nicole S.; Hobbs, Diana A.; Flores, Shaney; Keefe, Sarah J.; Aggarwal, Neelum T.; Allegri, Ricardo Francisco; Berman, Sarah B.; Bird, Thomas; Black, Sandra E.; Brooks, William S.; Chhatwal, Jasmeer P.; Day, Gregory S.; DIAN‐TU Study Team Introduction: Monoclonal anti-amyloid therapies are now accessible, but how these treatments influence changes within the brain is still not clear. We investigated overall and regional change in amyloid removal, glucose metabolism, and atrophy in trial participants with dominantly inherited Alzheimer's disease (DIAD). Methods: In the DIAN-TU-001 trial, 92 carriers received gantenerumab or placebo and underwent serial neuroimaging assessments including [11C]-Pittsburgh compound-B (PiB) positron emission tomography (PET), [18F]-fluoro-2-deoxyglucose (FDG) PET, and magnetic resonance imaging (MRI). Results: Gantenerumab significantly reduced PiB-PET uptake overall and in most regions and showed no changes in FDG-PET or MRI measures. Drug effects were associated with baseline PiB-PET uptake, and the largest effects occurred in medial regions. Discussion: Treated DIAD participants, and especially those with higher amyloid burden, showed a decrease in PiB-PET uptake, which was more pronounced in the basal ganglia and medial frontal structures. These results may inform patient response and future drug trial design. Highlights: Gantenerumab unevenly decreased Aβ burden as measured by PiB-PET across brain regions. The strongest decrease in PiB-PET uptake was in basal ganglia and medial frontal structures. Variable drug effect on Aβ was partly due to the amount of burden present before treatment. There was no regional effect on FDG-PET metabolism or MRI volumetrics after 4 years.