Alberto J Espay
@AlbertoEspay
#Neurology professor @uofcincy. I continue to try Bluesky since Nov 13, 2024 to foster a more collegial exchange of ideas. @albertoespay.bsky.social.
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/10.1002/bi…
Great to see our fellows discuss the latest movement disorders literature and plan the next research study over a game of pickleball on a Sunday morning. @UCincyMedicine @AlbertoEspay
Team @UCMovDis #Pickleball 🏓
15 years (and 12 editions) later, here we are again for our annual 4-day intensive course on the diagnosis and treatment of #movementdisorders. This year we're in charming Milan, hosted by the conference centre of @HumanitasMilano More info here: mdscourse.com
I am pleased to announce multiple good news items about 'Surfing the Brain'. 1/5
The new Parkinson's staging: an engineered illusion. linkedin.com/pulse/cui-bono…
Biomarker fetishism alert: A new @JAMANeuro paper claims higher education worsens your Alzheimer’s biomarker profile—without mentioning cognition even once. Readers beware: more such articles will continue to pollute the literature as “objective.” jamanetwork.com/journals/jaman…
No 'validation' but refutation: The pathology-based #Parkinsons staging ('NSD-ISS') is not unidirectional, doesn't reflect natural history, and does not correlate with any established fluid biomarkers of PD progression, such as NfL, Aβ42, or p-tau. …mentdisorders.onlinelibrary.wiley.com/doi/10.1002/md…
High p-tau217 in #Alzheimers? It's a cause. High p-tau217 in premature infants? It's protective. Same protein change, different stories. If we didn't conflate marker with maker, we could just conclude that high p-tau217 is a homeostatic response. neurosciencenews.com/newborn-alzhei…
Brilliant thread on the inability to translate changes in a cognitive endpoint (CDR-SB) into "time saved" in #Alzheimers trials by @ProfRobHoward. NICE's non-approval of lecanemab and donanemab is a triumph of reason over hype. Neither of these therapies is "better than nothing".
As part of the media reporting of NICE’s decision not to approve lecanemab/donanemab for the NHS, I was asked why I didn’t consider giving patients “another 4 to 6 months” to be a worthwhile benefit. There wasn’t time on BBC Breakfast to explain the problematic nature of this.
Myokymia? The tongue movements are more consistent with myorhythmia, a phenotype previously described for IgLON5. …mentdisorders.onlinelibrary.wiley.com/doi/10.1002/md…
Case report: a man who tested positive for IgLON5-IgG antibody after intermittent episodes of paresthetic feeling involving the throat and jaw, associated with subtle dysarthria & dysphagia, & upper-extremity paresthesia with piloerection of the forearms. ja.ma/3HpdAvk
Brain pathologies are markers of brain reactivity, not makers of disease. Yet the century-old 'pathology is disease' fixation leads to the false dichotomy between "primary" pathology and "co-pathology." It also leads to confusing articles like this one. jamanetwork.com/journals/jaman…
Should we stop embarking on epidemiology-inspired disease-modifying clinical trials in #Parkinsons? I think so. But the 'disagree' side remains popular. This 2024 PSG debate ('opponent' Michael Schwarzschild) has just been published in @ParkinsonismD. authors.elsevier.com/c/1lFg54pqQOo-…
The @alzassociation Workgroup created a 2-dimensional "biological-clinical staging framework" in 2024. New #ADNI data showed it only explains progression in one-third of participants. The framework is divorced from reality. Can we move away from it? neurology.org/doi/10.1212/WN…
