Blog – Page 7

New York State Psychiatric Institute and Columbia University Medical Center investigators, with co-authors across additional US centers, report greater cognitive worsening at 78 weeks with valacyclovir than with placebo among adults with early symptomatic Alzheimer’s disease and herpes simplex virus (HSV) seropositivity.

Infectious diseases may contribute to Alzheimer’s disease pathogenesis. HSV-1 can become latent after oral infection, enter the brain via retrograde axonal transport, infiltrate the locus coeruleus, and migrate to the temporal lobe.

β-amyloid plaques and tau neurofibrillary tangles are neuropathological features of Alzheimer’s disease. Animal models connect HSV-1 infection of neuronal and glial cells with a decrease in amyloid precursor protein, an increase in intracellular amyloid β-protein, and phosphorylation of tau protein.

One specific state, referred to as State 4, emerged as a key point of difference between the two groups. This state was characterized by strong connections between the left and right hemispheres of the brain. It specifically involved robust communication between the temporal and parietal regions, which are areas often associated with language and sensory processing.

The data showed that children with autism spent considerably less time in State 4 compared to the typically developing children. They also transitioned into and out of this state less frequently. The reduced time spent in this high-connectivity state was statistically distinct.

The researchers then compared these brain patterns to clinical assessments of the children. They found a correlation between the brain data and the severity of autism symptoms. Children who spent the least amount of time in State 4 tended to have higher scores on standardized measures of autism severity.

In the last few years, progress has been made in the fight against Alzheimer’s disease with a class of therapies called anti-amyloid antibodies (anti-Aβ). These monoclonal anti-Aβs are proteins made in a laboratory to stimulate the immune system to slow the progression of the disease by targeting amyloid plaques in the brain that are characteristic of Alzheimer’s.

Biomarkers, such as measures derived from PET scans that reflect amyloid plaques in the brain, were instrumental in FDA approval of anti-Aβ therapies, like lecanumab (Leqembi) and donanemab (Kisulna), and have been shown to reduce plaques in the brains of Alzheimer’s patients. Yet despite FDA approval, there is still a clinical need to better understand how to monitor the efficacy and safety of these treatments.

To this end, the Alzheimer’s Association convened a workgroup of scientists and clinicians with experience in Alzheimer’s disease, including clinical trials of anti-Aβ therapies and biomarkers, to propose a framework to characterize the response of patients receiving these treatments.