NR Times explores the latest research developments impacting on neuro-rehab.

Biomarker test can detect Alzheimer’s pathology earlier

A newly developed biomarker test can detect small amounts of tau protein and its misfolded pathological forms that litter the brain, cerebrospinal fluid and potentially blood, years before tau tangles show up in brain scans of patients with Alzheimer’s disease. 

The test, developed at the University of Pittsburgh School of Medicine, can identify these very early stages of tau tangle formation up to a decade before any tau clumps can show up on a brain scan.

The researchers say that the early detection of tau tangles is key to more successful therapies for Alzheimer’s disease “since trials show that patients with little-to-no quantifiable insoluble tau tangles are more likely to benefit from new treatments than those with a significant degree of tau brain deposits.”

Mathematical framework uncovers how the brain makes decisions

A new mathematical model has shed light on how the brain processes different cues, such as sights and sounds, during decision making. 

The findings from Princeton neuroscientists may one day improve how brain circuits go awry in neurological disorders, such as Alzheimer’s.

Instead of a complex recurrent neural network model, the researchers propose a sort of trees instead of the forest approach. Using their new model, Langdon and Engel found that when motion was the important cue for participants to track, prefrontal cortex cells that process shape shut off neighbouring cells that pay attention to colour. The opposite was true when asked to discriminate red versus green.

The latent circuit model makes predictions about how choices should change when the strength of connections between different latent nodes is altered. This is powerful because it allows researchers to validate if latent connectivity structure is actually needed to support task performance. Indeed, the authors found that task performance suffered in predictable ways when removing specific connections in the circuit. 

By revealing the mathematical computations performed by the brain to help people make decisions, these findings may lend itself to better understanding challenging conditions.

Cardiometabolic trajectories preceding dementia

In a new study of older individuals, decline in body mass index, waist circumference, and high-density lipoprotein (HDL) occurred up to a decade before dementia diagnosis – findings which provide insights into cardiometabolic changes preceding dementia and the potential for early monitoring and intervention.

The researchers wrote: “In this matched case-control study, 1078 dementia cases had a faster decline in body mass index and waist circumference up to 11 years before diagnosis, as well as higher levels of high-density lipoprotein approximately 5 years before diagnosis compared with 4312 controls. Trajectories of blood pressure, triglyceride levels, and glucose levels preceding dementia diagnosis were similar between cases and controls.

“These findings suggest that weight loss and lipid change may be early indicators associated with underlying cognitive impairments, suggesting the importance of dynamic management of cardiometabolic health.”

ALS survival may be cut short by living in disadvantaged communities

Living in a disadvantaged community may decrease the length of time a person can survive with amyotrophic lateral sclerosis (ALS) by over 30 per cent, a new study suggests.

While most people survive with ALS around two to four years, some people can live significantly longer. In the study of more than 1,000 patients with ALS seen between 2012 and mid-2024, people from the most disadvantaged neighborhoods had up to a 37 per cent shorter survival time compared to those from the most resourced areas.

The researchers say the results show a significant link between adverse social determinants of health and shorter survival in patients with ALS.

Mitochondria’s role in shaping memory circuits

Neuroscientists have uncovered a mitochondrial process that supports the brain cells critical for learning, memory, and social recognition. The research in mouse models examines the hippocampal CA2 region, a specialised area in the brain’s memory center essential for social recognition memory.

The study reveals the critical role of the mitochondrial calcium uniporter (MCU), a protein that regulates calcium flow into mitochondria, in enabling neurons to strengthen connections. This process, known as synaptic plasticity, is fundamental to cognitive function and adaptive learning.

The researchers say the findings highlight a distinct mitochondrial mechanism that helps explain how CA2 neurons function, which may contribute to its role in social cognition and its vulnerability in certain neurological disorders.

Researchers outline new research priorities in neuropalliative care

Neurologists Winnie Lau and David Hwang from the International Neuropalliative Care Society have highlighted needed research in the emerging field of neuropalliative care.

They have included three priority areas of research including: patient- and care partner–centered symptoms and outcomes specific to neurologic illness and tools for their assessment; development of effective neuropalliative care interventions and delivery models; and, methods to support the ability to foster, deliver, and measure goal-concordant care over time.

Overlap between mitochondrial disease and neuroinflammation

A new research paper has explored the overlap between mitochondrial disease and neuroinflammation.

The researchers write: “Recent studies have highlighted the coexistence of these two conditions, particularly in females, suggesting that mitochondrial variants in LHON may predispose individuals to develop MS [multiple sclerosis] or affect its progression. Similar to MS, LHON-MS presents with visual impairment, neurological deficits, white matter lesions, and brain atrophy, which further supports a shared underlying pathophysiology. 

“While MS is not inherently a mitochondrial disorder, its neuroinflammatory processes can lead to mitochondrial dysfunction. Reciprocally, mitochondrial impairment may be exacerbated in LHON-MS. Therefore, the role of mitochondrial dysfunction in these diseases is central, with impaired mitochondrial function contributing to cellular damage and neuroinflammation. This review explores the intersections of MS and LHON, emphasising the need for further research to better understand mitochondrial dysfunction in these disorders.”

Stroke patient rehabilitation: Effects of perturbation training

A new study has explored the rehabilitation effects of this combined perturbation training combined with hip unloading gait strategies on walking disabilities in post-stroke patients, with the goal of providing new methodological guidance for clinical rehabilitation.

The study found that, compared to other types of unloading perturbation training methods, hip unloading training exhibits unique superiority.

The authors write: “Perturbation training significantly improved the balance and walking efficiency of stroke patients, especially those with severe balance issues, outperforming traditional rehabilitation methods. The unloading group also showed a positive trend, although it did not reach statistical significance. This demonstrates the potential value of perturbation training in stroke rehabilitation.”

Self-assembling cerebral blood vessels

A 3D model accurately mimicking the Blood-Brain Barrier (BBB) in a laboratory environment has been successfully developed by researchers.

The research team developed a cerebrovascular-specific bioink using “decellularized extracellular matrix” (CBVdECM), derived from porcine brain and blood vessels. Additionally, the team applied 3D bioprinting technology to construct a tubular vascular model that precisely replicates the anatomical structure and function of the human BBB.

The researchers say the study provides a crucial platform for investigating the pathological mechanisms of neuroinflammation and developing novel therapeutic strategies.