Letters to the Editor

3 February 2019

Can Tau Formation be Independent of Amyloid-β in Alzheimer’s Disease?

I read the article on the possibility of sparing Alzheimer’s disease (AD) by nonsteroidal anti-inflammatory drugs [1] with great interest. It is stated that AD is characterized by the start of amyloid-β (Aβ) deposition in brain with consequent decreases in the cerebrospinal fluid (CSF), and therapeutic opportunities at this initial stage are at their highest. It is also stressed that biomarker studies suggest that phase 2 (Braak staging) sets in about 5 years later.

4 December 2018

Chronic Traumatic Encephalopathy

Recently, Zuckerman et al. [1] presented an interesting history of chronic traumatic encephalopathy (CTE), previously referred to as dementia pugilistica [2], beginning from Hippocrates up to recent publications, with emphasis on contact sports and American football. With regard to CTE in boxers, except for the first report of "punch drunk" [3] and a few others [4], they unfortunately did not refer to a number of other important contributions about brain damage in boxers, many of them having been mentioned previously [5].

16 August 2018

Effective discrimination with the recency ratio between Alzheimer’s disease and dementia with Lewy bodies

Despite neuropsychological differences between individuals with Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB), overlap in performance has been observed, including analogous scores in memory tests (Rey Auditory Verbal Learning, AVLT; e.g., [1]). All the while, differential diagnosis remains a costly exercise.

23 April 2018

Response to McGeer et al.: Alzheimer’s Disease Can Be Spared by Nonsteroidal Anti-Inflammatory Drugs

In their recent publication, McGeer and colleagues [1] recommend a simple diagnostic test at age 55 to identify people who, as they elsewhere describe, are “fated to develop Alzheimer’s” [2], further suggesting that they could benefit from a daily dose of a generic anti-inflammatory drug for prevention. However, their paper presents no real data (positive and negative predictive values) on how the test would perform if used clinically.

19 March 2018

Is LMTM the Norwegian Blue of Alzheimer's Therapy?

Treatment and interpretation of LMTM trial data by Wilcock and colleagues [1] is reminiscent of the Monty Python sketch in which the demise of an obviously dead parrot is disputed by a desperate shop owner who describes it as merely resting, stunned or pining for the fjords. This phase 3 trial of 18 months' treatment in patients with mild Alzheimer's disease (AD) followed a 15-month study in mild to moderate patients that showed no treatment benefits for LMTM [2]. The latest trial was also apparently negative.

21 February 2018

The Semmelweis Reflex, Medical Bilingualism, and treatment of MCI and Early Alzheimer’s Dementia

I recently attended the Annual Mild Cognitive Impairment Symposium in Miami, where a presentation on the future treatment of dementia focused solely on pharmaceuticals. As a psychopharmacologist, I was familiar with the data. I questioned why the presenter did not include Functional Medicine (FM, a translational medicine approach which converts preclinical research into clinical treatments for chronic diseases) in the future of MCI and AD treatment, since efficacy has been documented in early studies [1,2].

2 January 2018

Atrial Fibrillation and Dementia: What is the Link?

Regarding atrial fibrillation (AF), post-stroke cognitive impairment (PSCI), and post-stroke dementia (PSD), a recently published article in October 2017 by Chander and colleagues [1] reported that AF is a significant and independent risk factor for PSCI even after correction of other risk factors and that we should do follow up for patients with AF regardless of infarction type. This agrees with a meta-analysis done in 2012 [2]. Also in a systemic review done in 2017 [3], stroke patients with AF have a risk of dementia which is 1.68 times compared with patients without AF.


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