Zhang, Dilliott et al. examine a unique family with early- and late-onset Alzheimer’s disease phenotypes, as well as disease-discordant monozygotic triplets. The triplets and the patient with early-onset disease are carriers of the APOE ε4-allele plus rare substitutions in other genes. Epigenetic analyses suggest accelerated ageing in the early-onset patient.

alzheimer's disease (ad) is a neurodegenerative disorder characterized by cognitive decline and brain neuronal loss. A pioneering field of research in AD is brain stimulation via electromagnetic fields (EMFs), which may produce clinical benefits. Noninvasive brain stimulation techniques, such as transcranial magnetic stimulation (TMS), have been developed to treat neurological and psychiatric disorders. The purpose of the present review is to identify neurobiological changes, including inflammatory, neurodegenerative, apoptotic, neuroprotective and genetic changes, which are associated with repetitive TMS (rTMS) treatment in patients with AD. Furthermore, it aims to evaluate the effect of TMS treatment in patients with AD and to identify the associated mechanisms. The present review highlights the changes in inflammatory and apoptotic mechanisms, mitochondrial enzymatic activities, and modulation of gene expression (microRNA expression profiles) associated with rTMS or sham procedures. At the molecular level, it has been suggested that EMFs generated by TMS may affect the cell redox status and amyloidogenic processes. TMS may also modulate gene expression by acting on both transcriptional and post-transcriptional regulatory mechanisms. TMS may increase brain cortical excitability, induce specific potentiation phenomena, and promote synaptic plasticity and recovery of impaired functions; thus, it may re-establish cognitive performance in patients with AD. Contents1. introduction 2. TMS 3. ad and niBS by TMS 4. Neurobiological changes associated with TMS in AD 5. Potential side effects associated with TMS treatment 6. discussion 7. conclusion

Background: There are few Arabic language functional scales for patients with dementia. The Bristol Activity of Daily Living Scale (BADLS) was designed and validated for use in patients with dementia. Objective: Our study aimed to translate, cross-culturally adapt, and validate the BADLS to the Arabic language for people with neurocognitive decline and dementia. Methods: The original BADLS scale was translated to the Arabic language followed by face validity assessment through a pilot testing in five Arabic countries. The Arabic BADLS was assessed in a sample of 139 participants and their caregivers for concurrent and convergent validity. Results: The Arabic BADLS had excellent internal consistency, Cronbach’s alpha 0.95 (95% CI 0.93–0.96). Likewise, the Arabic BADLS had strong convergent validity with the Montreal Cognitive Assessment (r = –0.82, p <  0.001). Conclusion: The Arabic BADLS is a valid scale that can used to assess the functional performance of people living with dementia.

Introduction:The prevalence of dementia is expected to increase exponentially in developing countries over the next few decades. 1, 2 Arabic language is widely spoken across the middle east and north Africa, where dementia diagnosis remains challenging. 3 Many factors contribute to the underdiagnosis of dementia in Arabic speaking countries including the lack of validated functional assessment tools for patients with cognitive impairment. 2, 4 The aim of this study is to translate, cross culturally adapt and validate the widely used Bristol Activity Of Daily Living Scale (BADLS) 5 to the Arabic language. Methods: First the BADLS was translated to the Arabic language by two independent bilingual experts. The Arabic version was then back translated to English by two independent translators. Then reviewed by expert panel including the original author to keep original meanings, check accuracy and standardization. A pilot study was done for Cognitive Debriefing. Expert panel discussion was done to review cognitive debriefing and finalize. Criterion validity is tested against the validated Arabic version of the Katz Index of Independence in Activities of Daily Living and the Arabic version of the Montreal Cognitive Assessment (MOCA) test. Conclusion:To our knowledge this is the first study to translate the BADLS to the Arabic language. The Arabic BADLS will enable the early and accurate diagnosis of dementia for Arabic speaking patients and caregivers. References: 1. Livingston G, Hunt-

Alzheimer Disease (AD) constitutes a major global healthcare problem. Standard AD pharmacotherapies offer only modest transient cognitive and behavioral benefits. Aducanumab, an amyloid monoclonal antibody, was the first disease modifying agent to be approved for AD treatment. However, concerns about its efficacy and side effects led regulatory institutions around the world to restrict its use. Lecanemab was the second amyloid antibody to receive accelerated approval for use in early AD. This review and consensus statement was prepared by the Saudi Chapter of Cognitive and Behavioral Neurology to review the current developments in AD immunotherapies from a Saudi perspective. We outline recommendations with regards to offering aducanumab and other future immunotherapies to Saudi AD patients. We describe resources,