In February, two neurological experts from Columbia and Weill Cornell Medicine published editorials in the New England Journal of Medicine in response to critical research in the fields of Alzheimer’s disease and acute ischemic stroke. These commentaries provide support toward advancing novel and innovative approaches to neurological care.
The importance of biomarkers that confirm the sequence of biological changes in Alzheimer’s
Richard Mayeux, MD, MSc, Chair of the Department of Neurology and Neurologist-in-Chief at NewYork-Presbyterian/Columbia, published an editorial titled “Alzheimer’s Disease Biomarkers — Timing Is Everything.” In his commentary, Dr. Mayeux discusses how the emergence of biomarkers have played a crucial role in improving diagnostic accuracy of Alzheimer’s disease and determining when the biological processes begin. He highlights several important studies but places emphasis on the importance of a newly published study reviewing biomarker changes in Chinese participants in the 20 years between normal cognition and the diagnosis of Alzheimer’s disease.
Dr. Mayeux writes, “The remarkable longitudinal study spanning 20 years, the results of which are reported by Jia et al. in this issue of the Journal, not only confirms the hypotheses of previous investigators but extends and validates the sequence of changes in sporadic Alzheimer’s disease… The importance of the work by Jia et al. cannot be overstated. Knowledge of the timing of these physiological events is critical to provide clinicians with useful starting points for prevention and therapeutic strategies.”
Read the full editorial on the New England Journal of Medicine.
Does tenecteplase work for all stroke patients?
In an editorial titled “Tenecteplase for Stroke — Opening the Window,” NewYork-Presbyterian/Weil Cornell Medicine neurologist Dana Leifer, MD, reviews findings from several critical studies including the WAKE-UP (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke) Trial and the TIMELESS (Thrombolysis in Imaging Eligible, Late Window Patients to Assess the Efficacy and Safety of Tenecteplase) Trial which looked respectively at tenecteplase in patients with wake up strokes with an unknown time of onset but within 4.5 hours of discovery of symptoms or with strokes between 4.5-24 hours after onset. Dr. Leifer suggests that, while tenecteplase is safe and effective in many patients, it may not be beneficial for all stroke patients depending on the window.
He writes that the TIMELESS "trial results tentatively suggest that pretreatment with tenecteplase before thrombectomy may be beneficial in patients with occlusions in the M1 segment when administered in the 4.5-to-24-hour window, but they also suggest that tenecteplase is probably unlikely to help patients who present with large-vessel occlusions and do not undergo thrombectomy.”
Read the full editorial on the New England Journal of Medicine.
The publication of these two editorials reaffirms NewYork-Presbyterian’s commitment to pursuing a greater understanding of disorders of the brain and spine and providing the most up-to-date life-changing and life-saving medical interventions to patients with these conditions.
