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Alberto J Espay Profile picture
Alberto J Espay
@AlbertoEspay
Professor of #neurology @uofcincy. Walking the talk: there is no #Parkinsons but people with Parkinson's. Author, #BrainFables.
Feb 24 • 5 tweets • 3 min read
Why do we describe 20 years of biomarker data as “divergence” and summarize the findings as what "goes up" when? What we lose matters. CSF Aβ42 levels remain high in controls but drop by ~300 pg/ml before #Alzheimers begins. @NEJM (1/5) nejm.org/doi/full/10.10…


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Image (2/5) The Jia et al @NEJM data align with the finding that in a PET-positive sporadic cohort (ADNI), normal cognition correlates with higher levels of CSF Aβ42 across all brain amyloid levels. At any PET level, lower Aβ42 levels are associated with AD. thelancet.com/journals/eclin…
Apr 27, 2023 • 4 tweets • 4 min read
@MadhavThambiset was the voice of reason at the #AANAM. He delivered a Neurology Year in Review Plenary about the dubious record of the anti-proteinopathy framework inspiring therapies in #Alzheimers, #Parkinsons, and #ALS --Some highlights (1/4) Image (2/4) Unblinding due to infusion-related reactions or ARIA-H was not accounted for in the sensitivity analysis of the #lecanemab trial. This and other issues have led to an inflated sense of efficacy and underestimated risk for anti-amyloid therapies. ImageImageImage
Jan 17, 2022 • 12 tweets • 4 min read
The success of #COVID19 vaccines required heavy investments into #HIV research and the resourcefulness and creativity of many. The 60-year history summarized by @nytimes highlights important lessons. (1/12)

nytimes.com/2022/01/15/hea… (2/12) 1st milestone: 1960 – “Molecule X” carried copies of DNA segments to ribosomes to make proteins. It is posited to be the "messenger" RNA, or mRNA. Could this molecule be instructed to make tiny pieces of viruses to strengthen the immune system?
Mar 13, 2021 • 8 tweets • 4 min read
#Donanemab for #Alzheimer, misleadingly spun as positive: “donanemab resulted in a better […] ability to perform activities of daily living than placebo at 76 weeks”. The data suggest otherwise. (1/8)

#EliLilly @NEJM #ADPD2021

nejm.org/doi/full/10.10… (2/8) First off, donanemab accomplished exactly what it was designed for: At 76 weeks, the reduction in the amyloid plaque level as assessed by florbetapir PET was 85.06 centiloids greater in the donanemab group than in the placebo group (−84.13 vs. 0.93 centiloids)