No Shinkei Geka. Neurological Surgery[JOURNAL]
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200 papers
[Emerging Targeted Therapies and Ongoing Clinical Trials in Pediatric Brain Tumors].
Terashima K
No Shinkei Geka · 2025 Nov · PMID 41362032 · Publisher ↗
Recent advances in molecular profiling have transformed pediatric brain tumors management. The use of targeted agents is guided by actionable alterations including the BRAF V600E mutation, NTRK fusions, NF1 pathway activ...
Recent advances in molecular profiling have transformed pediatric brain tumors management. The use of targeted agents is guided by actionable alterations including the BRAF V600E mutation, NTRK fusions, NF1 pathway activation, and H3 K27M mutation. Dabrafenib plus trametinib has shown superiority over chemotherapy in pediatric low-grade gliomas and activity against high-grade diseases. Larotrectinib and entrectinib provide tumor-agnostic options for NTRK-fusion-positive tumors with central nervous system penetration. Selumetinib offers clinical benefits in NF1-associated plexiform neurofibromas and shows promise for treating NF1-related low-grade gliomas. Tovorafenib, a type II RAF inhibitor active in BRAF-altered tumors (including BRAFKIAA1549 fusion), achieved robust responses, thereby leading to FDA approval. ONC201 (dordaviprone) has received accelerated approval for the treatment of H3 K27M-mutant diffuse midline gliomas, with Japanese trials and patient-initiated programs expanding access. Abemaciclib, a CDK4/6 inhibitor, is under phase II evaluation for pediatric high-grade glioma and diffuse midline glioma, including sites in Japan. Neurosurgeons play a pivotal role in securing high-quality biopsies, thus enabling comprehensive molecular diagnostics and facilitating enrollment in international trials. This review summarizes current targeted therapies and ongoing studies and outlines practical considerations for integrating precision oncology into pediatric neuro-oncology in Japan.
[Endoscopic Treatment of Pediatric Brain Tumors].
Takeuchi K
No Shinkei Geka · 2025 Nov · PMID 41362031 · Publisher ↗
Endoscopy provides a bright, wide field of view in deep surgical corridors, and preserves image quality under continuous irrigation ("underwater" conditions). Pediatric patients tolerate limited blood loss and are vulner...
Endoscopy provides a bright, wide field of view in deep surgical corridors, and preserves image quality under continuous irrigation ("underwater" conditions). Pediatric patients tolerate limited blood loss and are vulnerable to retraction injuries; therefore, meticulous hemostasis and brain-sparing techniques are mandatory. As hydrocephalus commonly accompanies pediatric brain tumors, treatment should address both tumor control and cerebrospinal fluid diversion within the same operation. Endoscopy enables access through minimal corridors, and is particularly effective for deep-seated lesions. Safe application requires rigorous preoperative planning and simulation to delineate the lesion, feeding and draining vessels, critical white matter tracts, and deep venous structures near the intended corridor. Patient positioning and operating room setup must be optimized in advance. When underwater techniques are anticipated, the angle of the tubular retractor (cannula/cylinder) should allow the maintenance of a stable fluid column. This article provides a practice-oriented overview of the endoscopic management of pediatric intraventricular and intraparenchymal tumors, emphasizing the importance of planning, workflow discipline, and strategies that minimize blood loss and parenchymal injury, while integrating diagnosis, cytoreduction, and CSF pathway reconstruction.
[Endoscopic Transnasal Surgery for Pediatric Brain Tumors].
Hasegawa H
No Shinkei Geka · 2025 Nov · PMID 41362030 · Publisher ↗
Pediatric brain tumors differ from their adult counterparts in terms of tumor biology, anatomical constraints, and surgical challenges. Endoscopic transnasal skull base surgery (ETS) has been widely adopted in adults, an...
Pediatric brain tumors differ from their adult counterparts in terms of tumor biology, anatomical constraints, and surgical challenges. Endoscopic transnasal skull base surgery (ETS) has been widely adopted in adults, and is also increasingly being applied in children as a minimally invasive approach to sellar and parasellar lesions. In pediatric cases, ETS provides a direct ventral corridor; however, it is associated with unique limitations. These include underdeveloped paranasal sinuses restricting surgical space, adherence to postoperative rest is difficult, and the skull base or midfacial growth plates, particularly the sphenooccipital synchondrosis, may be affected. Furthermore, agitation and crying may cause abrupt intracranial pressure elevation, thereby jeopardizing skull base reconstruction. Despite these challenges, advances in endoscopic equipment, navigation, and multilayer reconstruction have enabled outcomes comparable to those in adults. Pediatric ETS is applied to a wide spectrum of tumors, including craniopharyngiomas, pituitary neuroendocrine tumors, chordomas, Rathke's cleft cysts, germ cell tumors, and optic pathway gliomas. In the era of targeted therapy, minimally invasive biopsy for molecular diagnosis has gained new clinical value for ETS. Perioperative management must address pediatric-specific risks, such as limited blood volume, higher cerebrospinal fluid leak rates, and long-term craniofacial development. Ultimately, pediatric ETS requires a multidisciplinary approach involving neurosurgeons, endocrinologists, otolaryngologists, anesthesiologists, oncologists, nurses, and other allied specialists, to achieve comprehensive care.
[Current Imaging Approaches for Pediatric Brain Tumors].
Miyake K
No Shinkei Geka · 2025 Nov · PMID 41362029 · Publisher ↗
After leukemia, pediatric brain tumors are the second most common childhood malignancies and are associated with significant neurologic and developmental sequelae, rendering accurate and early diagnosis critical. The 202...
After leukemia, pediatric brain tumors are the second most common childhood malignancies and are associated with significant neurologic and developmental sequelae, rendering accurate and early diagnosis critical. The 2021 World Health Organization classification for central nervous system tumors emphasizes the utility of molecular pathology in distinguishing between pediatric and adult brain tumors. Imaging studies, including magnetic resonance imaging (T1-, T2-, diffusion-, and perfusion-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy) and positron emission tomography using fluorodeoxyglucose or amino acid tracers, integrate structural assessment with functional and quantitative techniques, enabling the evaluation of cellularity, perfusion, and metabolism. Characteristic imaging patterns support diagnosis and prognosis across tumor types, including diffuse gliomas (adult- and pediatric-type, low- and high-grade subtypes), circumscribed astrocytic gliomas, ependymomas, glioneuronal tumors, choroid plexus tumors, embryonal tumors (e.g., medulloblastoma), pineal region tumors, craniopharyngiomas, nerve sheath tumors, germ cell tumors, meningiomas, Langerhans cell histiocytosis, hamartomas, and cavernous malformations. Molecular features increasingly guide treatment strategies. Emerging technologies, such as radiomics and artificial intelligence (AI), are improving tumor classification, segmentation, and recurrence prediction, with advances such as federated learning and explainable AI supporting privacy-preserving and interpretable models. Imaging also plays roles beyond detection, including surgical planning, treatment monitoring, and prognostication. Future integration of multimodal imaging and AI is expected to improve precision, standardization, and individualized pediatric neuro-oncology care through rapid, noninvasive diagnostics.
[Cancer Genome Profiling of Pediatric Brain Tumor].
Watanabe Y, Takahashi M
No Shinkei Geka · 2025 Nov · PMID 41362028 · Publisher ↗
Precision medicine in pediatric brain tumors aims to transcend traditional organ-based therapy by customizing treatment according to each patient's tumor molecular and genomic profiles. By leveraging comprehensive genomi...
Precision medicine in pediatric brain tumors aims to transcend traditional organ-based therapy by customizing treatment according to each patient's tumor molecular and genomic profiles. By leveraging comprehensive genomic profiling and expert panel reviews, actionable mutations may direct the use of targeted therapies or immunotherapies. In July 2025, three oncology societies in Japan released a joint briefing report outlining 12 reform proposals to optimize the cancer gene panel testing system. Included among these are timing restrictions on testing, loosening the expert panel criteria. These reforms are designed to enhance test utility, improve patient access, and ultimately improve survival outcomes of pediatric patients with brain tumors.
[Molecular Classification of Medulloblastoma].
Suzuki H
No Shinkei Geka · 2025 Nov · PMID 41362027 · Publisher ↗
Medulloblastoma is the most common malignant brain tumor in children. Advances in sequencing technologies have allowed the identification of four major molecular subgroups, each defined by distinct genetic alterations, b...
Medulloblastoma is the most common malignant brain tumor in children. Advances in sequencing technologies have allowed the identification of four major molecular subgroups, each defined by distinct genetic alterations, biological features, and clinical courses. Recent studies have shown that medulloblastomas arise following disruptions in normal neurodevelopment, in which genetic abnormalities impair differentiation and lead to the persistence and malignant transformation of normally eliminated progenitor cells. Subgroup-specific cell of origin have since been identified. In Group 3 and Group 4, which were previously poorly understood, genetic alterations were shown to impair neuronal differentiation, revealing their pathogenesis. In SHH medulloblastomas, mutations in genes associated with RNA biology, including and U1 snRNA, highlight alternative mechanisms of tumor development. Each subgroup can be further divided into subtypes that enable finer distinctions between clinical outcomes, support treatment intensification in high-risk patients, and de-escalation strategies in favorable groups. Although medulloblastoma is one of the best-studied pediatric brain tumors, its complexity continues to present challenges, and a deeper understanding of its molecular heterogeneity is essential to advance risk-adapted and targeted therapies.
[Molecular Genetic Analysis of Childhood Brain Tumors].
Fukuoka K
No Shinkei Geka · 2025 Nov · PMID 41362026 · Publisher ↗
Clinicians commonly encounter cases of childhood brain tumors that are difficult to diagnose pathologically in a clinical setting. In such situations, molecular genetic analysis is essential for the diagnosis and clinica...
Clinicians commonly encounter cases of childhood brain tumors that are difficult to diagnose pathologically in a clinical setting. In such situations, molecular genetic analysis is essential for the diagnosis and clinical management of pediatric brain tumors. This analysis supports pathological diagnosis, identifies potential targets for molecular therapy, and predicts patient prognosis. According to the updated World Health Organization classification of central nervous system (CNS) tumors, molecular genetic analysis is essential for diagnosing several brain tumors, including High-Grade Astrocytoma with Piloid Features (HGAP) and diffuse glioneuronal tumors with oligodendroglioma-like features and nuclear clusters (DGONC). Comprehensive Genomic Profiling (CGP) was first made available for molecular analysis in our country in 2019. Herein, we describe the clinical importance of detecting molecular alterations in pediatric brain tumors. This article also provides a comprehensive review of molecular classification using DNA methylation analysis, which has recently emerged as a diagnostic tool for CNS tumors.
[Pathological Characteristics of Pediatric CNS Tumors].
Yamazaki A, Nobusawa S
No Shinkei Geka · 2025 Nov · PMID 41362025 · Publisher ↗
Over the past decade, molecular biology techniques have identified numerous key genetic mutations in brain tumors. This has improved understanding of disease pathogenesis, and facilitated prognostic prediction, and the d...
Over the past decade, molecular biology techniques have identified numerous key genetic mutations in brain tumors. This has improved understanding of disease pathogenesis, and facilitated prognostic prediction, and the development of effective targeted molecular therapies. In 2021, the World Health Organization published the fifth edition of its classification of CNS tumors(WHO 5), recommending a reporting format based on an integrated diagnosis combining histopathological and molecular genetic information. The classification of pediatric brain tumors has also advanced significantly, clarifying the disease backgrounds specific to childhood and differences in prevalence. The WHO 5 classification represents a significant advancement in selecting optimal treatments and recognizing patient groups that share similar clinical characteristics. However, some challenges remain for its implementation in routine clinical practice, including establishing access to molecular genetic testing. Herein, we reviewed the tumor types listed in the WHO 5 edition that predominantly affect children and adolescents, referring to recently published reports and concepts.
[Bypass Surgery for Common Carotid Artery Occlusion].
Sanada Y, Takahashi JC
No Shinkei Geka · 2025 Sep · PMID 41047656 · Publisher ↗
Bypass surgery for common carotid artery occlusion presents significant challenges. In cases of internal carotid artery occlusion, superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass is the standard ap...
Bypass surgery for common carotid artery occlusion presents significant challenges. In cases of internal carotid artery occlusion, superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass is the standard approach, as the STA blood flow remains intact. However, in common carotid artery occlusion, the STA blood flow is generally insufficient for a donor artery, necessitating alternative and more complex surgical strategies. This paper discusses the surgical approach for common carotid artery occlusion, focusing on donor artery selection and the relevant surgical anatomy.
[An Overview of Medical Fees and Patient Cost-Sharing in Dementia Care in Japan].
Nakane M
No Shinkei Geka · 2025 Sep · PMID 41047655 · Publisher ↗
In Japan, dementia-related medical services are covered by the universal health insurance system, with patient co-payments based on age and income. The reimbursement system includes specific fees for dementia care such a...
In Japan, dementia-related medical services are covered by the universal health insurance system, with patient co-payments based on age and income. The reimbursement system includes specific fees for dementia care such as early diagnosis, cognitive assessments, and multidisciplinary consultations. These fee structures aim to promote timely and efficient diagnosis and treatment of dementia. Ongoing challenges include balancing quality of care with healthcare sustainability.
[Precautions for Neurosurgeons in Administering Anti-Amyloid β Antibody Therapy].
Shichijo F
No Shinkei Geka · 2025 Sep · PMID 41047654 · Publisher ↗
In Japan, anti-amyloid β (Aβ) monoclonal antibodies, including lecanemab and donanemab, have recently been approved as disease-modifying therapies for early-stage Alzheimer's disease (AD). These drugs, developed based on...
In Japan, anti-amyloid β (Aβ) monoclonal antibodies, including lecanemab and donanemab, have recently been approved as disease-modifying therapies for early-stage Alzheimer's disease (AD). These drugs, developed based on the amyloid cascade hypothesis, target toxic Aβ aggregates: lecanemab selectively binds to soluble protofibrils, while donanemab targets Aβ plaques. The Ministry of Health, Labour and Welfare (MHLW) has issued Optimal Use Guidelines that specify criteria for administration: informed consent from both patients and caregivers; cognitive assessments (MMSE and CDR); confirmation of Aβ pathology via amyloid PET or cerebrospinal fluid (CSF) testing; and MRI screening to assess the risk of amyloid-related imaging abnormalities (ARIA). ARIA is a significant adverse event and requires regular MRI monitoring. Initial administration is limited to certified facilities staffed by experienced specialists and equipped with the necessary diagnostic infrastructure. After six months, treatment may be continued at collaborating institutions. The APOEε4 genotype is a known risk factor for ARIA but is not covered by insurance. Caution is advised when co-administering anticoagulants or antiplatelet agents. The guidelines also require the use of official treatment cards to inform healthcare providers. This article summarizes the clinical precautions, diagnostic requirements, and facility standards necessary for implementing anti-Aβ antibody therapy in accordance with current MHLW Guidelines in Japan.
[Cognitive Dysfunction and Treatable Dementia in Patients with Brain Tumor: Clinical Perspective from Awake Neurosurgery].
Kinoshita M, Nakajima R, Nakada M
No Shinkei Geka · 2025 Sep · PMID 41047653 · Publisher ↗
Brain tumors are an uncommon but treatable cause of dementia, accounting for 0.8% of cases in Japan. Cognitive impairment in patients with brain tumors may result from focal neurological symptoms, increased intracranial...
Brain tumors are an uncommon but treatable cause of dementia, accounting for 0.8% of cases in Japan. Cognitive impairment in patients with brain tumors may result from focal neurological symptoms, increased intracranial pressure, or involvement of critical regions such as the prefrontal cortex and limbic system. Bilateral or midline lesions, including medial frontal gliomas, meningiomas, or suprasellar tumors affecting limbic circuits, often produce more prominent cognitive symptoms than unilateral lesions. Awake surgery has become a key technique for preserving higher cognitive functions by enabling intraoperative mapping of cortical and subcortical networks, particularly in lower-grade gliomas with potential for neuroplasticity. However, when preoperative deficits are already severe or bilateral damage is present, postoperative cognitive impairment may persist and affect daily functioning. In this report, we discuss the clinical manifestations of tumor-related cognitive dysfunction, including misdiagnoses as dementia, and illustrate how white matter tractography and awake surgery contribute to understanding and preserving cognitive networks. We also present cases of glioma patients whose cognitive function improved following awake surgery, and others in whom functional impairment remained due to surgical limitations or limited plasticity. Comprehensive preoperative assessment and tailored surgical planning are essential for optimizing both survival and neurocognitive outcomes in patients with brain tumors.
[Stroke and Cognitive Decline:The Influence of Cerebrovascular Surgery on Cognitive Function].
Inoue T, Tsunoda S, Segawa M … +10 more , Umakoshi M, Noda R, Matsufuji H, Sakakura Y, Iwaki Y, Yamamoto M, Mizuno R, Kawashima M, Akabane A, Ochiai C
No Shinkei Geka · 2025 Sep · PMID 41047652 · Publisher ↗
The accumulation of cerebrovascular events, such as cerebral infarction, hemorrhage, and subarachnoid hemorrhage, can result in cognitive decline. Therefore, successful preventive cerebrovascular surgery may contribute t...
The accumulation of cerebrovascular events, such as cerebral infarction, hemorrhage, and subarachnoid hemorrhage, can result in cognitive decline. Therefore, successful preventive cerebrovascular surgery may contribute to reducing the future occurrence of cognitive decline, whereas perioperative adverse effects may cause cognitive decline. We investigated the influence of cerebrovascular surgery (carotid endarterectomy, extracranial-intracranial bypass, and aneurysmal clipping) on cognitive function. Here, we present and discuss our case series.
[Epilepsy and Dementia].
Akamatsu N
No Shinkei Geka · 2025 Sep · PMID 41047651 · Publisher ↗
Older adults have a higher prevalence of both dementia and epilepsy. Epilepsy and dementia have a bidirectional relationship. Epidemiological studies have shown that elderly patients with epilepsy have approximately twic...
Older adults have a higher prevalence of both dementia and epilepsy. Epilepsy and dementia have a bidirectional relationship. Epidemiological studies have shown that elderly patients with epilepsy have approximately twice the risk of developing dementia compared to controls. Conversely, patients with dementia have twice the risk of developing epilepsy compared to controls. Seizure types in older adults with newly diagnosed epilepsy include focal-onset generalized tonic-clonic seizures and focal impaired awareness seizures without convulsions. The differential diagnosis between epilepsy and dementia can be challenging. Temporal lobe epilepsy may be overlooked in patients visiting dementia clinics. In some cases, temporal lobe epilepsy with frequent seizures may be misdiagnosed as dementia. Additionally, temporal lobe epilepsy in patients already diagnosed with dementia may go unrecognized. Diagnostic difficulties may also arise due to a lack of medical history or absence of eyewitness accounts. In older adults with newly diagnosed epilepsy, antiseizure medications are highly effective in controlling seizures. Accurate diagnosis is essential for effective seizure management and an improved quality of life.
[Hydrocephalus and Dementia].
Miyajima M, Kawai Y, Bandai H
No Shinkei Geka · 2025 Sep · PMID 41047650 · Publisher ↗
Idiopathic normal pressure hydrocephalus (iNPH), also known as Hakim's disease, is a major cause of reversible dementia in adults. iNPH primarily affects frontal lobe-related cognitive functions, including attention, exe...
Idiopathic normal pressure hydrocephalus (iNPH), also known as Hakim's disease, is a major cause of reversible dementia in adults. iNPH primarily affects frontal lobe-related cognitive functions, including attention, executive function, and working memory, even in early stages. Although memory impairment is also present, recognition memory is often preserved, distinguishing iNPH from Alzheimer's disease (AD). Behavioral and psychological symptoms of dementia (BPSD), especially apathy, depression, and anxiety, are common in iNPH and are generally less active than those seen in AD. Neuropsychological assessments reveal significant impairments in frontal lobe tests such as the Frontal Assessment Battery and Trail Making Test-B. Shunt surgery leads to substantial improvement in attention and executive function, reflecting the reversible nature of iNPH. However, memory functions, particularly delayed recall, show limited recovery, indicating possible overlap with neurodegenerative mechanisms. Early surgical intervention is associated with better outcomes, while delayed treatment or advanced brain atrophy may reduce effectiveness. Comprehensive cognitive evaluation is essential for assessing treatment response, planning rehabilitation, and providing appropriate patient and family guidance.
[Cognitive Dysfunction Due to Traumatic Brain Injury].
Maeda T, Yoshino A
No Shinkei Geka · 2025 Sep · PMID 41047649 · Publisher ↗
Traumatic brain injury (TBI)-associated dementia refers to cognitive dysfunction resulting from brain injury caused by head trauma. With advances in medical care, the survival rate of TBI patients has increased. Addition...
Traumatic brain injury (TBI)-associated dementia refers to cognitive dysfunction resulting from brain injury caused by head trauma. With advances in medical care, the survival rate of TBI patients has increased. Additionally, the growing elderly population has led to a rise in cases of cognitive dysfunction following TBI. As a result, the assessment and management of such conditions have become urgent issues. Accurate diagnosis of TBI-related cognitive impairment requires objective evaluation, primarily through radiological neuroimaging. This paper provides an overview of cognitive dysfunction caused by traumatic brain injury and discusses relevant conditions encountered in neurosurgical practice.
[Non-Pharmacological Treatment for the Patients with Neurocognitive Disease:Considering Useful Non-Pharmacological Treatments for Neurocognitive Disease].
Ikota T
No Shinkei Geka · 2025 Sep · PMID 41047648 · Publisher ↗
Recent studies have reported the types, evidence levels, and recommendation levels of non-pharmacological therapies for neurocognitive diseases. (1) An overview of non-pharmacological therapies for neurocognitive disease...
Recent studies have reported the types, evidence levels, and recommendation levels of non-pharmacological therapies for neurocognitive diseases. (1) An overview of non-pharmacological therapies for neurocognitive disease, including exercise, occupational, cognitive stimulation (including so-called "brain training"), music, and reminiscence, was introduced, and the evidence levels were reported. Exercise and occupational therapies were found to have a high level of evidence and strong recommendations. (2) As a dementia rehabilitation method, rather than relying on a single program, a complex program that combines exercise therapy and multiple occupational therapies in a variety of ways is more effective. Thus, "short-term intensive dementia rehabilitation" was recommended. (3) The theoretical background of the effectiveness of exercise therapy was considered and the ideal form of exercise for the senior generation was described. (4) Team Orange's activities for preventing individuals with dementia from becoming isolated and lonely were described.
[Pharmacological Interventions in Dementia].
Ota M, Arai T
No Shinkei Geka · 2025 Sep · PMID 41047647 · Publisher ↗
Pharmacological interventions for dementia include medications aimed at alleviating its core symptom: cognitive dysfunction. These medicines are known as anti-dementia drugs. As our understanding of Alzheimer's disease (...
Pharmacological interventions for dementia include medications aimed at alleviating its core symptom: cognitive dysfunction. These medicines are known as anti-dementia drugs. As our understanding of Alzheimer's disease (AD) has advanced, the amyloid hypothesis stating that amyloid proteins are involved in the pathogenesis of AD has been proposed. To date, anti-dementia drugs such as cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists have focused on symptomatic treatment. In recent years, based on the amyloid hypothesis, the development of medicines that target either (1) the enzyme that produces amyloid beta (Aβ) or (2) Aβ itself, has been promoted as a treatment strategy for AD. In 2021, the first drug targeting Aβ, aducanumab, was launched in the USA. In Japan, lecanemab and donanemab are now available as monoclonal antibodies targeting Aβ. Additionally, medications have been used to manage the behavioral and psychological symptoms of dementia (BPSD), Parkinsonism, and rapid eye movement sleep behavior disorder. Furthermore, dementia is a major risk factor for delirium, which often occurs during the course of dementia. In this study, we introduce pharmacotherapy with anti-dementia drugs, BPSD treatment, and delirium.
[Early Diagnosis and Prevention of Dementia Through Brain Dock].
Ikawa F
No Shinkei Geka · 2025 Sep · PMID 41047646 · Publisher ↗
The Japan Brain Dock Society, established in 1992, embodies two primary objectives: the detection of unruptured cerebral aneurysms and white matter lesions. In 2018, in response to the needs of an increasingly aging soci...
The Japan Brain Dock Society, established in 1992, embodies two primary objectives: the detection of unruptured cerebral aneurysms and white matter lesions. In 2018, in response to the needs of an increasingly aging society, the Society broadened its mission to include dementia prevention, adopting the subtitle "A Medical Society for the Prevention of Stroke and Dementia." Although brain dock examinations are not covered by public health insurance and are offered as self-funded services, they have become widely accepted as a form of preventive medicine in Japan. This acceptance is supported by high public health awareness and proactive participation from municipalities and corporations. Among OECD countries, Japan has the highest number of MRI units per capita, ensuring easy access to neuroimaging and facilitating the detection of asymptomatic brain diseases. Consequently, Japan has already amassed a substantial volume of brain dock data. Recent rapid advances in artificial intelligence (AI) are now being applied to the brain dock field, particularly for the early diagnosis of dementia. This article explores how brain dock programs are integrating AI technologies and how they are expected to contribute to the early detection and prevention of dementia.
[Current Status and Future Perspectives of Biomarkers in Alzheimer's Disease Diagnosis].
Ishiguro T, Kasuga K
No Shinkei Geka · 2025 Sep · PMID 41047645 · Publisher ↗
Alzheimer's disease (AD) is the most common cause of dementia, characterized by the pathological accumulation of amyloid-β (Aβ) and phosphorylated tau in the brain. Recent advances in biomarker technology have significan...
Alzheimer's disease (AD) is the most common cause of dementia, characterized by the pathological accumulation of amyloid-β (Aβ) and phosphorylated tau in the brain. Recent advances in biomarker technology have significantly improved AD diagnosis and treatment. Cerebrospinal fluid biomarkers and amyloid positron emission tomography imaging are now available in clinical settings and serve as key tools in identifying early-stage AD, especially when considering anti-Aβ monoclonal antibody therapies. In 2024, the Alzheimer's Association proposed revised diagnostic criteria that integrate both biomarker-based and clinical staging systems. This framework introduces a classification of "core biomarkers" that reflect AD-specific pathology and defines biological and clinical symptom stages. Furthermore, blood-based biomarkers, such as plasma p-tau217 and MTBR-tau243, are gaining attention as minimally invasive tools for early diagnosis and disease staging. As these biomarkers become more accessible, proper interpretation within a clinical context remains essential. In Japan, biomarker testing is currently recommended only for symptomatic individuals, and its use requires careful judgment regarding indications and relevance to the clinical setting. This review outlines the evolution of diagnostic criteria, current and emerging biomarkers, and their implications for personalized AD care while emphasizing the need for expert clinical interpretation to ensure responsible and patient-centric use.
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