#Neurology professor @uofcincy, advocate of precision medicine in neurodegeneration, author #BrainFables. More active on LinkedIn.
Cincinnati, OH
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How does physics inform neurodegeneration? Supersaturation lowers the nucleation barrier for the precipitation of monomeric proteins into their pathological state. In normal aging, replacement matches loss; in accelerated aging, it does not. (1/4)
onlinelibrary.wiley.com/doi/…
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By enshrining a culture in which pathology is disease and disease is pathology, we are entering a dystopian world in which a positive test of pathology can brand people as having a disease they may never actually suffer from. lnkd.in/p/gVdZRUM9
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Lecanemab improves amyloid biomarkers but worsens neuronal/synaptic biomarkers. Should we question whether successful amyloid removal improves the biology that matters most? My take on the new study: lnkd.in/p/gfzXAHdj
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The words of the Parkinson's literature:
“Accumulation”
“Replication”
"Prion-like"
“Propagation”
“Strains”
"Seeding"
They shape what we believe and do. Our patients’ lives depend on the language we adopt.
With Andrew Lees (@ajlees), in @GreenJournal:
doi.org/10.1212/WNL.00000000…
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The “too late” defense of anti-amyloid trials has been tested in 6 preclinical #Alzheimer's trials (amyloid-positive, cognitively normal people). They range from futility to worsening. When does “early is better” become unfalsifiable?
lnkd.in/p/gYsFkWW5
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With lecanemab, the real-world harms are clearly observed and include death; the cognitive benefit is counterfactual.
Here is the latest real-world report exemplifying this mismatch.
linkedin.com/posts/alberto-e…
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Less tau accumulation yet more clinical deterioration.
PROSPECT-ALZ offers a striking test of what happens when biomarkers move in the “right” direction but patients don't quite follow.
What does it take to falsify the tau-toxicity hypothesis?
linkedin.com/posts/alberto-e…
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What is p-tau217 accurate for?
Detecting amyloid/tau pathology is not the same as predicting who will develop Alzheimer’s dementia.
My take on Jeanne Lenzer’s newest investigation.
linkedin.com/posts/alberto-e…
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Is the post–18-month steepening in the lecanemab and donanemab trials simply #Alzheimers natural “waterfall”? Unlikely, but let's assume it is true. What does that imply for claims of disease modification? lnkd.in/p/gzErdGEB
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After 18 months, the curves got steeper—not flatter. Our analysis of long-term lecanemab and donanemab data challenges the “longer is better” narrative in @Alzheimers treatment and underscores the need for access to participant-level trial data.
neurologyopen.bmj.com/conten…
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(2/2) - My related LinkedIn comments: linkedin.com/posts/alberto-e… and the Medscape News report: medscape.com/viewarticle/ant…
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A provocative thought from a Sunday conversation:
What if amyloid is to dementia what gastric acid was to ulcers?
Are we living through the Billroth stage of Alzheimer’s therapeutics?
lnkd.in/p/ghn8Pv6d
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Research for the sake of research: sophisticated analytics to show that patients are different from one another. By publishing such papers, we fuel an academic culture that rewards paper counts over knowledge that ultimately matters to patients.
movementdisorders.onlinelibr…
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What Does α-Syn-SAA-Negative Parkinson's Disease Reveal About the Proposed “Biological Definition” of Parkinson's Disease?linkedin.com/posts/alberto-e…
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Do Lewy bodies cause Lewy body disease? linkedin.com/posts/alberto-e…
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Tominersen fails again. Does it say anything about the 'toxic mHTT' hypothesis inspiring Huntington's disease research?
linkedin.com/posts/alberto-e…
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Looking forward to this first Masterclass program in India, alongside dear friends. If the past is any indication, I’ll walk away with new lessons to help me care for my patients.
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Alberto J Espay retweeted
Congratulations our @UCMovDis fellow, Dr. Amanda Lin on her new book on #FND.
FND has been the central focus of her work since before residency.
Link: a.co/d/09XOE4z9
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Today in history (1633): Galileo gives the thumbs-up to geocentrism and saves his life.
I, too, give this thumbs-up: pathology is the center of the neurodegenerative disease universe, and everything else revolves around it.
(More thoughts on LinkedIn.)
linkedin.com/posts/alberto-e…
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#Parkinsons with and without detectable pathological α-synuclein (αSyn-SAA) are remarkably similar. What does that mean for the idea that α-syn aggregates "biologically define" PD? My take on a new #PPMI analysis:
linkedin.com/posts/alberto-e…
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A community-recruited cohort provides evidence against the “positive AD biomarker = Alzheimer's disease” equivalence. linkedin.com/posts/alberto-e…
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