JAMA Neurol
Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Published: February 2020
Importance: There are no disease-modifying treatments for Alzheimer disease (AD), the most common cause of dementia. Minocycline is anti-inflammatory, protects against the toxic effects of β-amyloid in vitro and in animal models of AD, and is a credible repurposed treatment candidate.
Objective: To determine whether 24 months of minocycline treatment can modify cognitive and functional decline in patients with mild AD.
Design, Setting, And Participants: Participants were recruited into a double-blind randomized clinical trial from May 23, 2014, to April 14, 2016, with 24 months of treatment and follow-up. This multicenter study in England and Scotland involved 32 National Health Service memory clinics within secondary specialist services for people with dementia. From 886 screened patients, 554 patients with a diagnosis of mild AD (Standardised Mini-Mental State Examination [sMMSE] score ≥24) were randomized.
Interventions: Participants were randomly allocated 1:1:1 in a semifactorial design to receive minocycline (400 mg/d or 200 mg/d) or placebo for 24 months.
Main Outcomes And Measures: Primary outcome measures were decrease in sMMSE score and Bristol Activities of Daily Living Scale (BADLS), analyzed by intention-to-treat repeated-measures regression.
Results: Of 544 eligible participants (241 women and 303 men), the mean (SD) age was 74.3 (8.2) years, and the mean (SD) sMMSE score was 26.4 (1.9). Fewer participants completed 400-mg minocycline hydrochloride treatment (28.8% [53 of 184]) than 200-mg minocycline treatment (61.9% [112 of 181]) or placebo (63.7% [114 of 179]; P < .001), mainly because of gastrointestinal symptoms (42 in the 400-mg group, 15 in the 200-mg group, and 10 in the placebo group; P < .001), dermatologic adverse effects (10 in the 400-mg group, 5 in the 200-mg group, and 1 in the placebo group; P = .02), and dizziness (14 in the 400-mg group, 3 in the 200-mg group, and 1 in the placebo group; P = .01). Assessment rates were lower in the 400-mg group: 68.4% (119 of 174 expected) for sMMSE at 24 months compared with 81.8% (144 of 176) for the 200-mg group and 83.8% (140 of 167) for the placebo group. Decrease in sMMSE scores over 24 months in the combined minocycline group was similar to that in the placebo group (4.1 vs 4.3 points). The combined minocycline group had mean sMMSE scores 0.1 points higher than the placebo group (95% CI, -1.1 to 1.2; P = .90). The decrease in mean sMMSE scores was less in the 400-mg group than in the 200-mg group (3.3 vs 4.7 points; treatment effect = 1.2; 95% CI, -0.1 to 2.5; P = .08). Worsening of BADLS scores over 24 months was similar in all groups: 5.7 in the 400-mg group, 6.6 in the 200-mg group, and 6.2 in the placebo groups (treatment effect for minocycline vs placebo = -0.53; 95% CI, -2.4 to 1.3; P = .57; treatment effect for 400 mg vs 200 mg of minocycline = -0.31; 95% CI, -0.2 to 1.8; P = .77). Results were similar in different patient subgroups and in sensitivity analyses adjusting for missing data.
Conclusions And Relevance: Minocycline did not delay the progress of cognitive or functional impairment in people with mild AD during a 2-year period. This study also found that 400 mg of minocycline is poorly tolerated in this population.
Trial Registration: isrctn.org Identifier: ISRCTN16105064.
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http://dx.doi.org/10.1001/jamaneurol.2019.3762 | DOI Listing |
Acad Radiol
January 2025
Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China (Q.X.). Electronic address:
Rationale And Objectives: Alzheimer's disease (AD) is the most common pathogenesis of dementia, and mild cognitive impairment (MCI) is considered as the intermediate stage from normal elderly to AD. Early detection of MCI is an essential step for the timely intervention of AD to slow the progression of this disease. Different form previous studies in the whole-brain spontaneous activities, this research aimed to explore the low-frequency amplitude spectrum activities of patients with MCI within the default mode network (DMN), which has been involved in the process of maintaining normal cognitive function.
View Article and Find Full Text PDFMed Dosim
January 2025
Department of Radiation Oncology, Peking University First Hospital, Beijing, China. Electronic address:
This study presents a patient with a PET-CT detected residual lacrimal sac tumor who was treated with intensity modulated proton therapy (IMPT) and concurrent chemotherapy. The patient a 49-year-old male diagnosed with squamous cell carcinoma of the left lacrimal sac had under-went endoscopic surgery. Postoperative PET-CT implied tumor residual in the left lacrimal sac.
View Article and Find Full Text PDFJ Psychiatr Res
January 2025
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. Electronic address:
Background: Microstate characterization of electroencephalogram (EEG) is a data-driven approach to explore the functional changes and interrelationships of multiple brain networks on a millisecond scale. This study aimed to explore the pathological changes of whole-brain functional networks in patients with obsessive-compulsive disorders (OCD) through microstate analysis and further to explore its potential value as an auxiliary diagnostic index.
Methods: Forty-eight OCD patients (33 with more than moderate anxiety symptoms, 15 with mild anxiety symptoms) and 52 healthy controls (HCs) were recruited.
Ophthalmic Plast Reconstr Surg
January 2025
Department of Ophthalmology, Columbia University Medical Center, New York, New York.
Purpose: To report the experience with an alternative to the upper eyelid pentagonal wedge resection technique which results in improved cosmesis due to a greater alignment of incisions with relaxed skin tension lines.
Methods: A retrospective review of all patients who underwent the T-shaped wedge resection by the authors from 2009 to 2017. A horizontal eyelid crease incision is made across the upper eyelid skin.
Background: Radiofrequency-assisted (RF) facial rejuvenation has become a safe and reliable option for "treatment gap" patients, including (1) patients whose skin laxity is not severe enough to warrant a facelift, yet not mild enough to reliably treat with noninvasive procedures; (2) patients who have already undergone a face or neck lift and have recurrent laxity; and (3) patients who would benefit from a traditional face or neck lift but want to avoid surgery and are willing to accept a more modest improvement without extensive surgical scar burden and recovery.
Objectives: In this study we aimed to educate the reader about providing bipolar RF to various anatomic regions of the face.
Methods: A retrospective review of cases was conducted to assess the safety of zone-specific RF-assisted facial rejuvenation in S.
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