Alzheimer’s disease accounts for approximately 50% to 80% of all causes of dementia. Co-existence of AD with other diseases causing dementia poses a diagnostic challenge, as we are still far from diagnosing AD accurately in order to manage it appropriately. Neuroimaging techniques, not only help diagnose AD but also consistently feature in diagnostic and research criteria for AD as biomarkers. Molecular biomarkers including positron emission tomography (PET) and single-photon emission computed tomography (SPECT), and structural biomarkers including magnetic resonance imaging (MRI), have been used in various therapeutic and prognostic studies in AD. This review highlights the recent advances in neuroimaging biomarkers, including molecular biomarkers (PET and SPECT tracers) and structural biomarkers (MRI), for AD. For the purpose of this review, molecular biomarkers have been further subcategorized into non-specific radiotracers (FDG-PET and blood flow SPECT) and specific amyloid- and tau-related radiotracers. The aim of this review is to discuss the recent advances and evidence of molecular and structural biomarkers of AD.

Alzheimer’s disease accounts for approximately 50% to 80% of all causes of dementia. Co-existence of AD with other diseases causing dementia poses a diagnostic challenge as we are still far from diagnosing AD accurately and hence to manage it appropriately. Neuroimaging techniques, not only help diagnose AD but also consistently features in diagnostic and research criteria for AD as biomarkers. Molecular biomarkers including Positron emission tomography (PET) and Single Photon emission computed tomography (SPECT) and structural biomarkers including Magnetic Resonance Imaging (MRI) have been used in various therapeutic and prognostic studies in AD. This review highlights the recent advances in the neuroimaging biomarkers including molecular biomarkers (PET and SPECT) and structural biomarkers (MRI) for AD. For the purpose of this review, molecular biomarkers have been further subcategorized into non-specific radiotracers (FDG-PET and SPECT) and specific amyloid and tau related radiotracers. The aim of this review is to discuss the recent advances and evidences on molecular and structural biomarkers of AD.

This case series elucidates pathological signs for diagnosis in two patients with Dementia. The first case highlights the term 'Smartphone sign', a novel psychopathology uncovered based on the existing 'TV sign', a rare type of delusional misidentification syndrome (DMS). The second case had symptoms consistent with the 'TV sign'. The possible underlying cause of these signs was hypothesized based on psychopathology, brain region, sensory system, cognition, and environmental factors. Moreover, the treatment outcome in terms of cognition and behavior on low doses of Risperidone and Escitalopram shows promising results and paves the way for the treatment of other DMS.

Paratonia is a type of hypertonia with involuntary resistance to passive movement depending on the pace and force being applied. People with paratonia may find it challenging to modify their movements and posture. Limited awareness among healthcare professionals can lead to a delay in diagnosis and inadequate treatment. Here, we present two cases diagnosed with dementia due to Alzheimer's disease. The two patients developed stiffness in their bodies as the dementia progressed. Paratonia was diagnosed using the Paratonia Assessment Inventory. Severity of paratonia was assessed using the Modified Ashworth scale for paratonia (MAS-P). The caregiver's primary concern was the stiffness of the body, which created difficulties in routine care. Amantadine was initiated in both patients. Both patients demonstrated improvement in paratonia following amantadine treatment, with reduced stiffness and greater ease in caregiving tasks. The present case series highlights the role of amantadine in the management of paratonia and can contribute to the development of more treatment options.

Parkinsonian symptoms are one of the core features of Dementia with Lewy bodies (DLB), which has a prevalence of more than 80%. Management of DLB poses unique challenges as the treatment of one condition leads to the worsening of another. Rivastigmine's efficacy and tolerability for cognitive and neuropsychiatric symptoms are well-studied. However, its effect on parkinsonian symptoms of DLB is inconclusive. In this case series, we elucidated five clinically diagnosed subjects of DLB with varying severity of parkinsonian motor symptoms. Beyond the cardinal signs of parkinsonism (tremor, rigidity, bradykinesia); rigidity, hypomimia, and gait disturbances were common in all the subjects. All five subjects on Rivastigmine dosage of 3-4.5 mg/day showed a greater than 50% reduction in the Unified Parkinson's Disease rating scale part III without any untoward side effects. Hypomimia, stiffness, gait, and postural abnormalities were the motor signs that were substantially improved while resting tremors showed the least improvement. The study findings focus on the need to reflect upon the non-cholinergic deficiency hypothesis in developing motor symptoms in DLB. The distinct pathophysiology of DLB and the complex interactions of cholinergic and dopaminergic neurons in the striatum can explain the improvement in parkinsonian symptoms with Rivastigmine. This case series highlights the positive effect of low-dose Rivastigmine on parkinsonian motor symptoms of DLB prompting the need for further multicentric trials.

1. Punding is a term used to represent a prolonged, complex stereotypical, purposeless behavior observed originally in stimulant users, especially amphetamine addicts [1,2]. The characteristics of ...