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Unraveling the clinical-pathological correlations of subjects with isolated and mixed neurodegenerative processes in the National Alzheimer's Coordinating Center dataset.
J Neuropathol Exp Neurol
December 2024
Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Although Alzheimer disease neuropathologic change (ADNC) is the most common pathology underlying clinical dementia, the presence of multiple comorbid neuropathologies is increasingly being recognized as a major contributor to the worldwide dementia burden. We analyzed 1051 subjects with specific combinations of isolated and mixed pathologies and conducted multivariate logistic regression analysis on a cohort of 4624 cases with mixed pathologies to systematically explore the independent cognitive contributions of each pathology. Alzheimer disease neuropathologic change and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) were both associated with a primary clinical diagnosis of Alzheimer disease (AD) and were characterized by an amnestic dementia phenotype, while only ADNC associated with logopenic variant primary progressive aphasia (PPA).
View Article and Find Full Text PDFIdentification and diagnosis of ultra-rapid progressive dementia: evidence from a prospective cohort study and systematic literature review.
J Neurol
December 2024
Department of Neurology, Mayo Clinic in Florida, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA.
Background And Objectives: The term rapid progressive dementia (RPD) may be applied to patients who develop dementia within 1 year or complete incapacitation within 2 years of the first symptom of impairment. However, in select cases, cognitive impairment may emerge abruptly, with symptoms evolving across hours or days. We sought to determine the frequency, etiologies, and factors that associated with ultra-RPD.
View Article and Find Full Text PDFLATE, Hippocampal Sclerosis, and Primary Age-related Tauopathy.
Continuum (Minneap Minn)
December 2024
Article Synopsis
- Alzheimer’s disease (AD) is the most common cause of dementia, but there are other conditions like LATE (limbic-predominant age-related TDP-43 encephalopathy) that also produce similar symptoms, particularly in older adults.
- Recent research shows that LATE can coexist with AD and may occur in individuals with cognitive impairment, leading to difficulty in clinical diagnosis due to the lack of direct biomarkers for TDP-43 pathology.
- Understanding and recognizing non-AD conditions like LATE and primary age-related tauopathy is crucial for neurologists, especially for patients over 75 experiencing slow cognitive decline.
Caregiver perspectives enable accurate diagnosis of neurodegenerative disease.
Alzheimers Dement
November 2024
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Article Synopsis
- Caregiver histories are valuable for diagnosing neurodegenerative diseases; the study analyzed 4952 caregiver questionnaires from 2481 participants.
- Using advanced machine learning, researchers achieved high diagnostic accuracy (mean AUC 0.83) between different diseases, while observing changes in symptoms over time.
- The findings stress the importance of structured caregiver reports for diagnosing dementia and suggest the Cambridge Behavioural Inventory can effectively track disease progression in clinical settings.
New criteria to predict LATE-NC in the clinical setting: Probable/Possible LATE and LANS.
J Neuropathol Exp Neurol
January 2025
Sanders-Brown Center on Aging, Division of Neuropathology, Department of Pathology, University of Kentucky, Lexington, KY 40536, United States.
This review discusses terminology recently proposed for the classification of dementia and, more specifically, nosology related to aging-associated TDP-43 pathology: limbic-predominant age-related TDP-43 encephalopathy (LATE), and limbic-predominant amnestic neurodegenerative syndrome (LANS). While the "gold standard" for these clinical conditions is still LATE neuropathologic changes (LATE-NC), clinical criteria and biomarkers are evolving. The newly proposed clinical rubrics are discussed with emphasis on the need for terminology that acknowledges the distinctions between clinical syndrome-, molecular biomarker-, and pathologically defined disease concepts.
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