Author

A. Giugno

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Sep 2026

Alzheimer's Co-Pathology Burden on Basal Forebrain Atrophy and Cognitive Impairment in Dementia with Lewy Bodies: A Cross-Sectional Pilot Study.

OBJECTIVE Dementia with Lewy Bodies (DLB) is the second most common neurodegenerative dementia after Alzheimer's disease (AD), with significant pathological overlap between the two conditions. However, the impact of Alzheimer's co-pathology on basal forebrain (BF) atrophy and its relationship with neurodegeneration and cognitive decline in patients with DLB remains underexplored. METHODS Forty patients with DLB and 14 healthy controls (HCs) were included from the Centre for Neurodegenerative Diseases, University of Bari. Participants underwent neuropsychological evaluations, 3T magnetic resonance imaging (MRI) scans, and Alzheimer's biomarkers assessment. Patients with DLB were grouped by AD co-pathology using in vivo biomarkers. BF and hippocampal volumes and mean cortical thickness values were analyzed using analysis of covariance (ANCOVA), adjusted for age, sex, and total intracranial volume. Mediation analyses were conducted to examine the indirect effects of Alzheimer's pathology and BF atrophy on neurodegeneration (hippocampal volume and cortical thickness) and cognitive function (Mini-Mental State Examination [MMSE]). RESULTS Patients with DLB exhibited significant BF atrophy compared with HCs (p < 0.001). AD co-pathology was associated with greater BF atrophy (p = 0.046) and reduced mean cortical thickness (p = 0.025). Significant correlations were found between BF volume and the pTAU181/Aβ1-42 ratio (p = 0.009) and between BF volume and MMSE scores (p = 0.016). Mediation analysis revealed that BF atrophy mediated the relationship between the pTau/Aβ42 ratio and neurodegeneration, and that the BF has a direct association with cognitive impairment. INTERPRETATION AD co-pathology in DLB exacerbates BF atrophy, correlating with cognitive decline. These results emphasize the need to consider AD co-pathology in evaluating neurodegeneration in DLB, suggesting future studies should explore targeted interventions to address this pathological overlap. ANN NEUROL 2026.

Daniele Urso, Thomas Giannelli, B. Tafuri et al. · Annals of Neurology · 0 citations

Open access Aug 2026

Impact of Age on the Diagnostic Yield of Routine EEG in People With Childhood or Juvenile Absence Epilepsy: A Cross-Sectional Study.

BACKGROUND We aimed to identify the proportion of individuals with a confirmed diagnosis of childhood absence epilepsy (CAE) or juvenile absence epilepsy (JAE) who show a negative routine EEG (rEEG), and to determine the main factors associated with this finding. METHODS Individuals with CAE or JAE underwent both an rEEG and a 24-h ambulatory EEG (24-h-aEEG). Participants were classified as 'rEEG positive' if generalised spike-wave discharges (GSWs) and/or typical absences (TAs) were observed, and as 'rEEG negative' if no such features were detected. 24-h-aEEG recordings served as the ground truth to confirm the diagnosis in cases with a negative rEEG. RESULTS Eighty-two individuals [40/82 (48.8%) females; mean age 12.5 ± 5.6 years] were included, of whom 39/82 (47.6%) were not receiving anti-seizure medications (ASMs) at the time of the EEG. Overall, 31/82 (37.8%) had a negative rEEG, including 10/39 (25.6%) in the cohort of ASM-naïve individuals. Compared with rEEG-positive participants, those in the rEEG-negative group had a later age at epilepsy onset (12.1 ± 4.5 years; p < 0.001) and were older at the time of EEG (16.5 ± 5.3 years; p < 0.0001). Older age at EEG emerged as significantly associated with a negative rEEG (OR = 1.23; 95% CI = 1.03-1.46; p = 0.019), independent of age at onset, epilepsy syndrome (CAE or JAE) and ASM exposure. Sensitivity analyses confirmed the association between older age and rEEG negativity across all cohorts: ASM-naïve individuals (OR = 1.41; 95% CI = 1.12-1.78), CAE (OR = 1.27; 95% CI = 1.02-1.58), and JAE (OR = 1.36; 95% CI 1.09-1.69) groups. Youden's exploratory analysis identified ≥ 14 years as the optimal threshold for predicting a rEEG negative. CONCLUSION Age significantly reduces the diagnostic yield of rEEG in CAE and JAE, regardless of ASM treatment.

F. Fortunato, A. Giugno, M. Sturniolo et al. · Annals of Clinical and Trans... · 0 citations