NeurologyLive® Year in Review 2022: Top Stories in Alzheimer Disease and Dementia

In 2022, the NeurologyLive^® staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is Alzheimer disease and dementia, a field that experienced massive shifts in the therapeutic paradigm in the past 12 months, among other progress. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2022.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. Distinguishing Characteristics Identified Between Dementia With Lewy Bodies and Early-Onset Alzheimer Disease

For patients with early-onset dementia of an undifferentiated etiology, new research published in JAMA Neurology by Simon Kang Seng Ting, MD, and colleagues has identified characteristics that may differentiate early-onset dementia with Lewy bodies from early-onset Alzheimer disease cases, such as increased psychotics features, cognitive fluctuations, motor changes, and apathy.

2. Roche Announces Phase 3 SKYLINE Trial of Gantenerumab in Alzheimer Disease

Roche announced earlier this year that it will be conducting a new phase 3 clinical trial, called SKYLINE (NCT05256134), which will evaluate its subcutaneous investigational antiamyloid antibody, gantenerumab, as a preventive treatment for patients with early signs of Alzheimer disease. The trial design was presented at the 2022 International Conference on Alzheimer’s and Parkinson’s Diseases, on March 18, 2022, in Barcelona, Spain.

3. Emerging Tools for Early Detection of Alzheimer Disease

Alzheimer disease is the most common cause of dementia, accounting for 60% to 70% of cases, and with worldwide population growth and aging, the prevalence of the disease is increasing dramatically. Michael Irizarry, MD, MPH, and Larisa Reyderman, PhD, wrote about one of the frustrating aspects of this disease for patients and families—as well as for their healthcare professionals—the diagnosis itself.

4. Ultraprocessed Food Consumption Association With Increased Risk of Cognitive Decline

Findings from the Brazilian Longitudinal Study of Adult Health, published by Claudia K. Suemoto, MD, PhD, MS, and colleagues in JAMA Neurology showed that consumption of ultraprocessed foods greater than 19.9% of total daily calories was associated with a faster decline in global cognitive performance and executive function.

5. Cognitive and Functional Decline Occurs Faster in Lewy Body Dementia vs Pure Alzheimer Disease

Using autopsy-confirmed cases of pure Alzheimer disease, mixed Alzheimer disease and dementia with Lewy bodies, or pure dementia with Lewy bodies, findings of a recent study from Yian Gu, MD, PhD, MS, and colleagues published in Neurology showed different disease trajectories prior to death, with the pure dementia with Lewy bodies group experiencing nearly double the rate of both cognitive and functional decline than pure Alzheimer disease.

6. Alzheimer Disease Agent Lecanemab Shows Reduction in CDR-Sum of Boxes in Clarity AD

Eisai and Biogen announced late in the year that lecanemab, previously known as BAN2401, reduced the decline in Clinical Dementia Rating-Sum of Boxes by 27% compared with placebo from baseline to month 18 for participants with early Alzheimer disease, according to positive topline results from the phase 3 Clarity AD trial (NCT03887455)of the humanized monoclonal antibody that eliminates toxic amyloid-ß protofibrils.

7. Biogen Terminates Phase 4 ICARE-AD Trial of Aducanumab in Alzheimer Disease

An update to the ICARE-AD clinical trial (NCT05097131) National Institutes of Health study records this summer revealed the phase 4 postmarketing study of aducanumab (Aduhelm; Biogen) was been terminated, with Biogen noting in the details that the termination was “a result of the national policy for coverage,” as the expectation was that “there will be limited aducanumab-avwa prescription and usage in routine clinical practice making the study not feasible for enrollment.”

8. Questions Arise Around Possible Research Misconduct and the Validity of Aß as a Therapeutic Target

In late July, the Alzheimer disease clinical community was lit ablaze with controversy with the publication of a multimonth report from Science bringing to light potentially dubious research practices of Sylvain Lesné, PhD, MSCI, related to an amyloid-ß oligomer that many now claim does not exist, known as Aß*56—the consequences of which could have had downstream effects totaling millions of dollars invested and thousands of hours of research wasted.

9. Noninvasive Brain Stimulation Shows Potential to Slow Cognitive and Functional Decline in Mild-to-Moderate Alzheimer Disease

Findings from a 24-week phase 2 study (NCT03778151) published in Brain by Giacomo Koch, MD, PhD, and colleagues showed that treatment with precision-delivered noninvasive brain stimulation (PC-rTMS) targeted to patients’ precuneus has the potential to slow the progression of cognitive decline and functional decline in patients with mild-to-moderate dementia due to Alzheimer disease.

10. Brexpiprazole Demonstrates Positive Impact on Alzheimer Agitation, NDA Submission on the Horizon

Positive results from a phase 3 study (NCT03548584) announced by Otsuka Pharmaceuticals and Lundbeck showed that brexpiprazole (Rexulti) met statistically significant changes in Cohen-Mansfield Agitation Inventory total score compared with placebo for the treatment of agitation amongst patients with Alzheimer disease dementia, with the expectation of filing a supplemental new drug application using these findings and 2 previously successful studies.