Search Results (529)

Neurodegenerative diseases (NDDs), including Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), are becoming more prevalent and still lack effective disease-modifying therapies (DMTs). However, translational efficiency remains critically low. For example, a ClinicalTrials.gov analysis of AD programs (2002–2012) estimated ~99.6% attrition, while PD programs (1999–2019) achieved an overall success rate of ~14.9%. In vitro platforms are assessed, ranging from immortalized neuronal lines and primary cultures to human-induced pluripotent stem cell (iPSC)-derived neurons/glia, neuron–glia co-cultures (including neuroinflammation paradigms), 3D spheroids, organoids, and blood–brain barrier (BBB)-on-chip systems. Complementary in vivo toxin, pharmacological, and genetic models are discussed for systems-level validation and central nervous system (CNS) exposure realism. The therapeutic synthesis focuses on AD, covering symptomatic drugs, anti-amyloid immunotherapies, tau-directed approaches, and repurposed drug classes that target metabolism, neuroinflammation, and network dysfunction. This review links experimental models to translational decision-making, focusing primarily on AD and providing a brief comparative context from other NDDs. It also covers emerging targeted protein degradation (PROTACs). Key priorities include neuroimmune/neurovascular human models, biomarker-anchored adaptive trials, mechanism-guided combination DMTs, and CNS PK/PD-driven development for brain-directed degraders. Full article

Transcranial focused ultrasound stimulation (tFUS), an emerging non-invasive neuromodulation technique, has garnered growing attention owing to its high spatial resolution and precise targeting capability for deep brain structures. A body of evidence demonstrates that tFUS can effectively modulate neural activity in specific brain regions, inducing excitatory or inhibitory effects, and it is an important means to reshape neural functions. Ultrasound parameters are crucial in determining the transcranial ultrasound modulation effects. However, there is still controversy over which parameters can regulate neural excitability or inhibition, and there are significant differences in the parameters used in previous studies, which have limited the clinical application of transcranial ultrasound to some extent. Therefore, a systematic clarification of parameter–effect relationships is urgently needed to enable qualitative and quantitative understanding of ultrasound-induced neuromodulation, which is essential for achieving reliable and reproducible outcomes. This paper intends to review the effects of different tFUS parameters and their combinations on the excitability and inhibition of brain neural activities as well as the possible mechanisms. By integrating recent findings from both animal models and human clinical studies, we also discuss critical safety issues related to tFUS, aiming to provide a theoretical basis for future transcranial focused ultrasound modulation treatments for various neurological diseases such as stroke, Parkinson’s disease, dementia, epilepsy, pain disorders, and disorders of consciousness while providing reference value for selecting tFUS treatment regimens. Full article

Neurodegenerative synucleinopathies—including Parkinson’s disease, multiple system atrophy, pure autonomic failure, and dementia with Lewy bodies—often feature cardiovascular autonomic dysfunction. Neurogenic orthostatic hypotension (nOH) is common and symptomatic, while neurogenic supine hypertension (nSH) is less frequent but may carry long-term cardiovascular risks. Lifestyle measures are first-line for managing nSH, yet persistent hypertension unresponsive to nonpharmacological strategies presents a treatment dilemma. Limited trial data and unclear guidelines make it difficult to determine when antihypertensive therapy is appropriate. Evidence from studies on hypertension-mediated organ damage (HMOD)—assessed through markers such as carotid intima-media thickness, pulse wave velocity, left ventricular hypertrophy, estimated glomerular filtration rate, and white matter hyperintensities—suggests that nSH, rather than the underlying neurodegenerative disorder, drives vascular, cardiac, renal, and cerebral injury. Therefore, treatment decisions should be individualized. While antihypertensive therapy may help prevent subclinical organ damage, clinicians must balance this benefit against the risk of worsening nOH and further compromising overall prognosis. Full article

Background/Objectives: Parkinson’s disease (PD) and Dementia with Lewy Bodies (DLB) are neurodegenerative disorders characterized by the accumulation of misfolded alpha-synuclein protein in the brain. Mutations in the glucocerebrosidase 1 (GBA1) gene have been identified as a significant genetic risk factor for both PD and DLB. GBA1 encodes for the lysosomal enzyme glucocerebrosidase, which is responsible for the breakdown of glucosylceramide (GC). Deficiencies in glucocerebrosidase activity lead to the accumulation of glucosylceramide within lysosomes, contributing to lysosomal dysfunction and impaired protein degradation. The aim of this narrative review is to update the underlying mechanisms by which GBA1 mutations contribute to the pathogenesis of PD and DLB. Methods: A comprehensive literature search was conducted across four major electronic databases (PubMed, Web of Science (Core Collection), Scopus, and Embase) from inception to 8 November 2025. The initial search identified approximately 1650 articles in total, with the number of hits from each database being as follows: PubMed (~450), Web of Science (~380), Scopus (~520), and Embase (~300). Results: The mechanism by which mutations in the GBA1 gene contribute to PD involves both loss-of- function and gain-of-function pathways, which are not mutually exclusive. Typically, GBA1 mutations lead to a loss of function by reducing the activity of the GCase enzyme, impairing the autophagy- lysosomal pathway and leading to α-synuclein accumulation. However, some mutant forms (GBA1L444P) of the GCase enzyme can also acquire a toxic gain of function, contributing to α-synuclein aggregation through mechanisms like endoplasmic reticulum stress and misfolding. While Venglustat effectively reduced GC levels, a key marker associated with GBA1-PD, the lack of clinical improvement led to the discontinuation of its development for this indication. Conclusions: GBA1-mediated lysosomal and lipid dysregulation represents a key pathogenic axis in PD and DLB. Understanding these mechanisms provides crucial insight into disease progression and highlights emerging therapeutic strategies—such as pharmacological chaperones, substrate reduction therapies, and gene-targeted approaches—aimed at restoring GCase function and lysosomal homeostasis to slow or prevent neurodegeneration. Full article

Chronic inflammatory skin diseases and neurodegenerative disorders share overlapping genetic, immunologic, and metabolic pathways that may predispose individuals to cognitive decline. This review synthesizes current human genomic, transcriptomic, and bioinformatic evidence linking psoriasis, rosacea, atopic dermatitis, and bullous pemphigoid with Alzheimer’s and Parkinson’s disease. Literature from PubMed, IEEE Xplore, and Google Scholar was examined, prioritizing studies integrating genomic, transcriptomic, and proteomic analyses. Among inflammatory dermatoses, psoriasis exhibits the strongest overlap with dementia genetics, with shared susceptibility loci including APOE, IL12B, and HLA-DRB5, and transcriptional regulators such as ZNF384 that converge on IL-17/TNF signaling. Rare-variant and pleiotropy analyses further implicate SETD1A and BC070367 in psoriasis–Parkinson’s comorbidity. Rosacea demonstrates upregulation of neurodegeneration-related proteins SNCA, GSK3B, and HSPA8, together with shared regulatory hubs (PPARG, STAT4, RORA) driving NF-κB/IL-17/TNF-dependent inflammation. In atopic dermatitis, rare FLG variants interacting with BACE1 suggest a mechanistic bridge between barrier dysfunction and amyloidogenic processing. Bullous pemphigoid reveals an HLA-DQB1*03:01-mediated immunogenetic link hypothesis and cross-reactive autoantibodies targeting BP180 (collagen XVII) and BP230, highlighting an autoimmune route of neurocutaneous interaction. Other inflammatory and neurodegenerative diseases with currently weak or limited genetic evidence are also discussed, as they may represent emerging biological pathways or potential therapeutic targets within the skin–brain connection in the future. The aim of this work is to help clarify these genetic links and to advocate for the routine cognitive assessment of affected patients, enabling early detection, improved long-term quality of life, and the potential for timely therapeutic intervention. Full article

Background: Chronic rhinosinusitis (CRS) affects nearly 9% of the global population with a rising incidence over recent decades. Neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease pose significant global burden, and emerging evidence suggests pathophysiological links through shared bioenergetic dysfunction, peripheral-to-central inflammatory signaling, and altered nasal microbiota. This review evaluates the evidence for CRS as a potentially modifiable peripheral contributor to neurodegenerative disease progression. Methods: A systematic review was conducted using PubMed, Cochrane, Web of Science, Embase, and CENTRAL from January 2000 to July 2025. Search terms included “Chronic Rhinosinusitis,” “Neurodegeneration,” “Mild Cognitive Impairment,” “Alzheimer’s Disease,” “Parkinson’s Disease,” “Bioenergetics,” and “Microbiome.” Clinical and experimental studies exploring epidemiological links, mechanistic pathways, biomarkers, and therapeutic targets were included. Results: Twenty-one studies involving over 100,000 participants met the inclusion criteria. Existing meta-analytic evidence demonstrated significant associations between CRS and cognitive impairment, with patients scoring approximately 9% lower on global cognitive measures than controls. However, other large-scale cohort studies did not pinpoint an increased dementia incidence, suggesting CRS may contribute to early, potentially reversible cognitive decline without directly driving dementia onset. Neuroimaging studies revealed altered frontoparietal connectivity and orbitofrontal hyperactivity in CRS patients. Mechanistic studies support peripheral inflammatory cytokines disrupting the blood–brain barrier, autonomic dysfunction impairing mucociliary clearance, microbiome-driven amyloid cross-seeding, and compromised cerebrospinal fluid clearance via olfactory–cribriform pathways. Discussion: Evidence supports complex, bidirectional relationships between CRS and neurodegeneration characterized by convergent inflammatory, autonomic, and bioenergetic pathways. Therapeutic strategies targeting sinonasal inflammation, microbiome dysbiosis, and mitochondrial dysfunction represent promising intervention avenues. Recognizing CRS as a treatable factor in neurodegenerative risk stratification may enable earlier diagnosis and prevention strategies. Full article

Background and Objectives: The interplay between motor tasks and cognition in Alzheimer’s dementia (AD) remains insufficiently characterised. We hypothesised that prefrontal-mediated cognitive functions could contribute to motor impairments in older adults with AD. Materials and Methods: Cross-sectional data from the National Alzheimer’s Coordinating Centre (NACC) were analysed. Our sample included older adults (≥60 years) with a baseline diagnosis of AD. The Unified Parkinson’s Disease Rating Scale Part-III was used to assess the presence or absence of motor signs. Episodic memory, language, confrontation naming, attention, processing speed, and executive function were assessed using a neuropsychological battery. Binary logistic models examined the relationship between cognitive performance and motor manifestations. Results: Of 44,713 NACC participants, 5124 individuals with complete covariate data were included in the analysis, 1339 with and 3785 without motor signs. Participants were predominantly female (~55%), with an average age of 76.5 ± 7.9 years and mean education of 14.2 ± 3.7 years. The presence of motor manifestations was related to slower processing speed (Trail Making Test—Part A) and impaired executive function (Trail Making Test—Part B). No covariate modified these associations. Among specific motor domains, impaired chair rise was related to executive dysfunction, whereas postural instability, impaired posture–gait, and bradykinesia were related to slower mental processing. Hypophonia, masked facies, resting tremor, action–postural tremor and rigidity were not associated with any cognitive measure. Conclusions: Processing speed and, to a lesser extent, executive function emerged as the main cognitive functions associated with motor manifestations in older adults with AD. Further research is needed to clarify the nature of this association, including potential causal pathways. Full article

Working memory is one of the most vulnerable cognitive domains in neurodegenerative diseases. According to the World Health Organization, around 55 million people worldwide were living with dementia in 2021, a number projected to exceed 150 million by 2050. Impairments in working memory occur in 80–90% of patients with Alzheimer’s disease, 40–60% with Parkinson’s disease, and about 50% with frontotemporal dementia. These deficits include reduced information capacity, slower response times, increased errors in manipulation, and difficulties in maintaining information, making them sensitive indicators of progressive decline. This review aims to systematize current approaches to modeling working memory phenotypes using electroencephalography (EEG). It highlights experimental paradigms applied to probe working memory, methods of EEG signal processing and analysis, and the integration of machine learning and neural network models. Particular emphasis is placed on studies achieving high diagnostic accuracy, with classification rates of 85–90% when distinguishing patients with neurodegeneration from healthy participants. Limitations of existing methods, especially EEG variability, are considered. The review concludes by outlining future directions: integration of multimodal EEG data, application of artificial intelligence, and development of digital cognitive biomarkers for hybrid models capable of predicting cognitive decline and advancing clinical translation. Full article

Background: Tremor-dominant Parkinson’s disease (TDPD) is the most common subtype of PD. Tremor is difficult to treat and less than 50% of patients respond to dopaminergic medications. Magnetic resonance guided focused ultrasound (MRgFUS) thalamotomy is an incisionless noninvasive method for treating pharmacoresistant tremor in PD patients, but its effect on progression of PD is unknown. In this study, we investigate the efficacy of MRgFUS thalamotomy on progression of motor and non-motor symptoms, using a levodopa equivalent daily dose (LEDD) requirement. Methods: A total of 21 PD patients with ineffective tremor correction by medical therapy underwent MRgFUS thalamotomy. Assessments of motor and non-motor symptoms, adverse events (AE), changes in LEDD, and evolution of FUS (focused ultrasound) lesion were performed on the day before surgery, and then 2 days, as well as 3, 6, and 12 months, after the procedure. Results: On the 2nd day after FUS thalamotomy, 11 patients were tremor-free and, in 10 patients, tremor decreased by 80–90% with a concomitant reduction in hypokinesia and rigidity. By the end of the 12th month, 5 patients remained tremor-free; in 11 patients, mild/moderate tremor re-emerged; and in 5 patients, there was a relapse of severe tremor. Quality of life (QoL) and activities of daily living (ADL) improved significantly at 3 months and remained stable thereafter. Cognitive function improved in patients with baseline MoCA score < 26 points at 3 months after FUS. Anxiety progressed between baseline and end of follow-up. By the end of the follow-up period, LEDD was lowered or stable in 9 patients. Four patients had persistent mild AE. Conclusions: This open label study suggests a beneficial effect of MRgFUS in reducing tremor, hypokinesia, and rigidity and improving QoL, ADL, and cognitive function in TDPD patients in the short term, although long-term data needs to be collected in further studies. Full article

 This narrative literature review synthesizes recent evidence on glycosphingolipid (GSL) dysregulation in dementia, emphasizing discoveries enabled by mass spectrometry (MS) and systems biology. Focusing on the research published within the last decade, we selected studies that are relevant to GSL alterations in dementia and notable for their methodological advances. The findings were conceptually integrated to emphasize key molecular, analytical, and systems-level aspects across the major dementia types. The results from MS-based glycolipidomics in Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson’s disease dementia, and Huntington’s disease consistently indicate altered GSL metabolism and shared molecular vulnerabilities in neuronal lipid regulation. At the same time, distinct GSL signatures differentiate individual dementias, reflecting the disease-specific mechanisms of neurodegeneration. The literature also reveals that recent advances in high-resolution MS and integrative analytical workflows have shifted GSL research from descriptive to mechanistic, facilitating the detailed mapping of species linked to neuroinflammation, protein aggregation, and synaptic dysfunction. Systems-level analyses combining MS data with other omics approaches increasingly depict GSLs as active regulators of neuronal function rather than inert membrane components. At the same time, emerging trends position GSLs as promising early biomarkers and potential therapeutic targets, while the growing use of artificial intelligence in MS data analysis is accelerating the detection of their subtle patterns, improving cross-disease comparisons. Together, these results reinforce the major role of MS-based platforms in discovering dementia-associated GSLs, identifying therapeutic targets, and influencing future strategies for diagnosis and treatment.  Full article

Platelets are increasingly recognized as multifunctional cells with roles extending beyond hemostasis to immune regulation, inflammation, and neurodegeneration. Here, we performed RNA-Seq profiling of platelets from patients with idiopathic REM sleep behavior disorder (IRBD), dementia with Lewy bodies (DLB), Parkinson disease (PD), Alzheimer disease (AD), and healthy controls (CTRLs) to explore disease-specific transcriptomic signatures. Across all groups, the RNA class distribution was similar, dominated by mRNAs (78–80%) and long non-coding RNAs (lncRNAs; 15–16%). DLB platelets displayed a reduced proportion of lncRNAs, suggesting an impaired RNA regulation, whereas IRBD concentrated the highest number of disease-specific lncRNAs, half of which were Y-linked, consistent with the male predominance observed in alpha-synucleinopathies. Differential expression analysis (DEA) revealed extensive transcriptomic remodeling in IRBD and DLB, particularly affecting RNA processing, cytoskeletal organization, and platelet activation pathways, while PD and AD showed minimal changes. These findings suggest a progressive impairment of platelet activation and signaling across the DLB continuum, potentially mirroring neuronal dysfunction. The limited transcriptional deregulation in PD may reflect its pronounced biological heterogeneity, consistent with recent multidimensional disease models. Overall, our study highlights platelets as accessible indicators of early and disease-stage-specific molecular alterations in α-synucleinopathies. Full article

Background/Objectives: Mild cognitive impairment (MCI) is common in Parkinson’s disease (PD) and often precedes dementia. Non-invasive brain stimulation (NIBS) techniques such as transcranial random noise stimulation (tRNS) targeting dorsolateral prefrontal cortex (DLPFC) may offer additional benefits for cognitive and motor functions in PD-MCI patients. Methods: Using a randomized, double-blind, cross-over study, participants with PD-MCI completed two stimulation sessions (real vs. sham) 7 days apart. Cognitive and motor outcomes (MoCA, FAB, FAS, MDS-UPDRS motor) were assessed pre- and post-stimulation; stimulation was administered “online” during executive training. Scores before and after the sessions have been compared, as well as their variations between the two groups. Results: Ten subjects were in the study. Patients undergoing real tRNS showed improvements in global cognition and executive functioning compared to those undergoing sham stimulation, as demonstrated by significant increase in MoCA and FAB scores. In contrast, the motor examination showed no significant differences. Conclusions: This preliminary study showed that a single session of DLPFC-tRNS stimulation produced domain-specific cognitive benefits in PD-MCI patients. Studies with multiple stimulation sessions and larger samples are needed to confirm the effect of this non-pharmacological therapeutic option in PD-MCI. Full article

Background: Neurological disorders are the leading cause of disability, affecting over three billion people worldwide. Amyotrophic lateral sclerosis (ALS) is among the most feared and uniformly fatal neurodegenerative diseases, with no therapy capable of restoring lost function. Methods: We report the first application of therapeutic fever to ALS using Computerized Brain-Guided Intelligent Thermofebrile Therapy (CBIT²). This fully noninvasive treatment, delivered through an FDA-approved computerized platform, digitally reengineers the 1927 Nobel Prize-recognized malarial fever therapy into a modern treatment guided by the Brain–Eyelid Thermoregulatory Tunnel. CBIT² induces therapeutic fever through synchronized hypothalamic feedback, activating heat shock proteins, which are known to restore proteostasis and neuronal function. Case presentation: A 56-year-old woman was diagnosed with progressive ALS at the Mayo Clinic, with electromyography (EMG) demonstrating fibrillation and fasciculation indicative of denervation corroborated by neurological and MRI findings; the patient was informed that she had an expected survival of three to five years. A neurologist from Northwestern University confirmed the diagnosis and thus maintained the patient on FDA-approved ALS drugs (riluzole and edaravone). Her condition rapidly worsened despite pharmacological treatment, and she underwent CBIT², resulting in (i) electrophysiological reversal with complete disappearance of denervation; (ii) biomarker correction, including reductions in neurofilament and homocysteine, IL-10 normalization (previously linked to mortality), and robust HSP70 induction; (iii) restoration of gait, swallowing, respiration, speech, and cognition; (iv) reconstitution of tongue structure; and (v) return to complex motor tasks, including golf, pickleball, and swimming. Discussion: This case provides the first documented evidence that ALS can be reversed through digitally reengineered fever therapy aligned with thermoregulation, which induces heat shock response and upregulates heat shock proteins, resulting in the patient no longer meeting diagnostic criteria for ALS and discontinuation of ALS-specific medications. Beyond ALS, shared protein-misfolding pathology suggests that CBIT² may extend to Alzheimer’s, Parkinson’s, and related disorders. By modernizing this Nobel Prize-recognized therapeutic principle with computerized precision, CBIT² establishes a framework for large-scale clinical trials. A century after fever therapy restored lost brain function and so decisively reversed dementia paralytica such that it earned the 1927 Nobel Prize in Medicine, CBIT² now safely harnesses the therapeutic power of fever through noninvasive, intelligent, brain-guided thermal modulation. Amid a global brain health crisis, fever-based therapies may offer a path to preserve thought, memory, movement, and independence for the more than one-third of humanity currently affected by neurological disorders. Full article

DNA damage is a hallmark of the fatal process of neurodegeneration in the central nervous system (CNS). As neurons are terminally differentiated, they accumulate metabolic and oxidative burdens over their whole life span. Unrepaired DNA develops into DNA double-strand breaks (DSBs), which are repaired through homologous recombination (HR) or non-homologous end joining (NHEJ). Being post-mitotic and unable to normally undergo HR, damage and defective repair is especially burdensome to CNS neurons. Current research has not produced treatment to prevent and halt progression of neurodegeneration. Hence, novel targeting strategies are desperately needed. Recent investigations in histone post-translational modifications (PTMs) reveal new mechanistic insight and highlight unexplored targets to ameliorate neurodegeneration. As various histone PTMs dictate and facilitate DSB repair, they represent an underexploited area in investigating DNA damage and incorrect repair aiding neurodegeneration. Here, we review the histone PTM alterations in several neurodegenerative diseases: Amyotrophic Lateral Sclerosis/Frontotemporal Dementia, Parkinson’s Disease, Alzheimer’s Diseases, Multiple Sclerosis, and Huntington’s Disease. These findings emphasize that histone PTM alterations can enable an aberrant DNA damage response (DDR) leading to neurodegeneration. Further research into the connections between histone PTMs and DNA damage in decaying neurons will illuminate novel targets to dampen the aberrant DDR and promote neuronal survival. Full article

Background/Objectives: The role of α-synuclein (α-syn) in the pathogenesis of Parkinson’s disease (PD) or neurodegenerative diseases such as Lewy body dementia (LBD) and multiple system atrophy (MSA) is commonly accepted. Through different physiological dysfunctions, abnormal forms of α-syn are generated. These abnormal aggregates accumulate and alter pre- and postsynaptic transmission, in particular that of dopamine. Thus, the development of a diagnostic biomarker of synucleinopathies remains crucial and challenging. The development of an α-syn positron emission tomography (PET) radiopharmaceutical may be suitable to early diagnose and stratify patients, follow up disease progression, and evaluate future therapies. Methods: To develop a selective α-syn PET tracer, we synthesized an original series based on alkynyl(aza)indoles. Fifteen final ligands were synthesized bearing indoles or azaindoles from one side of the alkyne and a substituted phenyl ring for the opposite side of the alkyne. The final ligands were tested to determine Ki and/or Kd toward α-syn, tau, and Aβ. Results: The SAR showed that the indole series exhibited moderate to low affinity for α-syn and, moreover, lower Ki toward Aβ and tau (i.e., compound 39, Ki_(αsyn) 21.7 nM, Ki_(Aβ) 64.4 nM, Ki_(Tau) 27.6 nM), highlighting the low potency of these series to afford an α-syn tracer. The introduction of a nitrogen on the different positions of the phenyl to obtain the corresponding azaindoles resulted for most of the compounds in better affinity for α-syn and selectivity towards Aβ compared to the indole analogs (i.e., compound 43, Ki_(αsyn) 4.7 nM, Ki_(Aβ) 24.4 nM, and Ki_(Tau) 4.61 nM). A fluorinated azaindole derivative was prepared with a view to obtaining a ¹⁸F tracer and exhibited the highest affinity for α-syn but without selectivity against tau and Aβ. The radiosynthesis of [¹⁸F]45 was performed in a two-step procedure starting from the tosylated and protected precursor. [¹⁸F]45 was obtained in 85 ± 5 min with a radiochemical yield of 32 ± 3%. Molar activity, determined from a calibration with stable 45, was around 130 GBq/µmole. The dynamic PET imaging showed that [¹⁸F]45 was able to cross the blood–brain barrier, but non-specific uptake was observed, confirming the in vitro results. Conclusions: Although promising nanomolar affinity for the target, the new tracer showed mainly non-specific in vivo uptake in the rat brain, indicating that further pharmacomodulations on the azaindole series are required. Full article