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Updated: May 9, 2025

Selection of Aptamers for Amyloid β-Protein, the Causative Agent of Alzheimer's Disease
Published on: May 13, 2010
Antiamyloid Monoclonal Antibodies in Alzheimer's Disease, Part 1: Patient Selection
James R Bateman1, Tara C Carlisle1, Yanghong Yang1
1Department of Neurology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, N.C. (Bateman, Flashman); Department of Neurology, Behavioral Neurology Section, University of Colorado School of Medicine, Aurora (Carlisle, Pressman); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, and Department of Neurology, SUNY Downstate Medical Center, New York City (Yang); Departments of Neurology and Psychiatry and Psychology, Mayo Clinic, Jacksonville, Fla. (Lachner); Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore (Stockbridge); Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston (Chemali); Sakina Mental Health Services, SEHA, Abu Dhabi, United Arab Emirates (Alzbeidi); Department of Psychiatry, Atlantic Health System-Overlook Medical Center, Summit, N.J., and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City (Osibajo); Lower Merion Counseling Services, Lower Merion, Pa. (Bobrin); Department of Neurology, University of Texas Health Rio Grande Valley, Harlingen (Martinez-Menendez); Department of Neurology, Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio (Teixeira); Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston (Daffner).
Abstract:
The availability of monoclonal antibodies directed against amyloid beta, for use as disease-modifying therapies for Alzheimer's disease (AD), represented a major shift in the field of AD research and treatment. U.S. Food and Drug Administration approvals for the monoclonal antibody-based medications lecanemab and, more recently, donanemab provide clinicians with two antiamyloid therapy (AAT) options for targeting early symptomatic AD. The emergence of AAT has made careful biomarker-informed diagnosis of AD paramount, which was once reserved for highly specialized centers and research settings. Patient selection is complex, and although appropriate-use recommendations have been published, clinicians caring for patients with AD across the United States face uncertainty when trying to align clinical trial criteria, appropriate-use recommendations, and real-world patients in the clinic. Practical issues in patient selection as well as health care and systemic challenges in the implementation of AAT are considered in part 1 and part 2, respectively, of this two-part Treatment in Behavioral Neurology & Neuropsychiatry commentary on these therapies from the American Neuropsychiatric Association Dementia Special Interest Group.
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