Your search for: 'author:("Huisa, Branko")' has returned 3 results. (0.009s) Save search

Authors: Huisa, Branko N. | Thomas, Ronald G. | Jin, Shelia | Oltersdorf, Tilman | Taylor, Curtis | Feldman, Howard H.

Article Type: Research Article

Abstract: Background: Acetylcholinesterase inhibitors (AChEIs) and memantine are commonly prescribed medications for Alzheimer’s disease (AD). Their concurrent use in AD randomized clinical trials (RCTs) is generally allowed but their effect in outcome measures is unsettled. Objective: To evaluate whether use of AChEIs and/or memantine across AD RCTs are associated with different rates of cognitive/functional decline. Methods: We pooled data from 5 RCTs of mild to moderate AD conducted by the Alzheimer’s Disease Cooperative Study (ADCS) between 2002-2013. 1,423 participants with MMSE of 14–26 and completion of 12–18 months follow-up visits were analyzed. Trials did not randomize with respect to AChEIs or …memantine. We defined 4 groups: AChEI (27%), memantine (16%), AChEIs+memantine (46%), and non-users (11%). Outcome measures were change in ADAS-cog-11, ADCS-ADL, and MMSE from baseline to 18 months. Fisher’s exact test, Wilcoxon signed rank, and Spearman’s tests were used to identify confounding variables. Mixed model repeated measures were used for adjustments and pairwise tests for comparing change in scores. Results: Age, apolipoprotein E, and initial MMSE were identified as covariates. Memantine and/or AChEIs users had greater impairment at entry than non-users. There was a significant decline on the ADAS-cog-11 in the memantine (estimate –4.2 p  < 0.0001) and AChEIs+memantine groups (estimate –3.5 p  < 0.0001) than non-users, while there was significantly more decline in MMSE (estimate 2.5 p  < 0.0001) and ADCS-ADL in the AChEIs+memantine group (estimate 4.3 p  < 0.0001) Conclusion: Memantine monotherapy or combined with AChEIs are associated with more rapid cognitive and functional decline than non-users. We postulated a potential selection bias by indication. Show more

Keywords: Acetylcholinesterase inhibitors, Alzheimer’s disease, memantine, randomized clinical trials

DOI: 10.3233/JAD-180684

Citation: Journal of Alzheimer's Disease, vol. 67, no. 2, pp. 707-713, 2019

Authors: Soria, Jose A. | Huisa, Branko N. | Edland, Steven D. | Litvan, Irene | Peavy, Guerry M. | Salmon, David P. | Hansen, Lawrence A. | Galasko, Douglas R. | Brewer, James B. | González, Hector M. | Rissman, Robert A.

Article Type: Research Article

Abstract: Clinical, neuropsychological, and neurological procedures used to diagnose Alzheimer’s disease (AD) and related dementias were largely developed and validated in well-educated, non-Latino, English-speaking populations. Sociocultural and genetic differences in Latinos might influence the accuracy of clinical diagnosis of AD and other dementias. We aim to compare the accuracy of the clinical diagnosis of AD and related dementias in Latinos with the corresponding neuropathological diagnosis. From the UCSD Alzheimer’s Disease Research Center longitudinal cohort, we selected all Latino participants who had autopsy neuropathological studies from 1991 to 2017. Participants underwent annual neurological clinical evaluations, standard neuropsychological tests, neuroimaging, and genotyping of …Apolipoprotein E. We calculated the sensitivity and specificity of the clinical diagnosis of AD against the primary pathological diagnosis. Of the 34 participants with a primary neuropathological diagnosis of AD, 33 (97.1%) were correctly clinically diagnosed as having AD at the last clinical evaluation, and 1 was incorrectly diagnosed with dementia with Lewy bodies. Of the 19 participants without a primary neuropathological diagnosis of AD, 8 were incorrectly clinically diagnosed with probable AD at the last clinic evaluation. The clinical diagnosis of AD at the last clinical evaluation had 97.1% sensitivity and 57.9% specificity for autopsy-verified AD. In this Latino cohort, clinicians predicted AD pathological findings with high sensitivity but moderate specificity. Tangle-only dementia was the most common misdiagnosis. Our study suggests that current procedures and instruments to clinically determine AD in Latinos have high sensitivity compared with neuropathology, but specificity needs to be improved. Show more

Keywords: Alzheimer’s disease, dementia, Latino, Lewy bodies, neuropathology

DOI: 10.3233/JAD-180789

Citation: Journal of Alzheimer's Disease, vol. 66, no. 4, pp. 1539-1548, 2018

Authors: Swerdlow, Neal R. | Kotz, Juliana E. | Joshi, Yash B. | Talledo, Jo | Sprock, Joyce | Molina, Juan L. | Huisa, Branko | Huege, Steven F. | Romero, Jairo Alberto | Walsh, Michael J. | Delano-Wood, Lisa | Light, Gregory A.

Article Type: Short Communication

Abstract: Memantine’s benefits in Alzheimer’s disease (AD) are modest and heterogeneous. We tested the feasibility of using sensitivity to acute memantine challenge to predict an individual’s clinical response. Eight participants completed a double-blind challenge study of memantine (placebo versus 20 mg) effects on autonomic, subjective, cognitive, and neurophysiological measures, followed by a 24-week unblinded active-dose therapeutic trial (10 mg bid). Study participation was well tolerated. Subgroups based on memantine sensitivity on specific laboratory measures differed in their clinical response to memantine, some by large effect sizes. It appears feasible to use biomarkers to predict clinical sensitivity to memantine.

Keywords: Alzheimer’s disease, event-related potentials, memantine, neurocognition, prepulse inhibition

DOI: 10.3233/JAD-215029

Citation: Journal of Alzheimer's Disease, vol. 84, no. 4, pp. 1431-1438, 2021