Jin San Lee

Background/Objectives: Whether high-sensitivity C-reactive protein (hsCRP) and vitamin D (Vit D) provide complementary prognostic information for acute ischemic stroke is unclear. We examined the separate and joint associations of serum hsCRP and Vit D levels with short-term functional outcomes after acute ischemic stroke. Methods: We retrospectively analyzed 192 patients with brain magnetic resonance imaging-confirmed acute ischemic stroke admitted to a single tertiary center. Stroke severity at admission was graded using the National Institutes of Health Stroke Scale. Physical and cognitive recovery were assessed using the Berg Balance Scale (BBS), Manual Function Test (MFT), Korean Mini-Mental State Examination (K-MMSE), and Korean version of the modified Barthel Index, while disability was graded using the modified Rankin Scale (mRS) at discharge. Results: Among 192 patients stratified into low- (3.0 mg/L, n = 59) hsCRP groups, serum 25-hydroxyvitamin D fell stepwise as hsCRP rose, and high hsCRP was independently associated with poorer BBS, MFT, K-MMSE, and mRS outcomes. Patients with both high hsCRP and Vit D deficiency (<20 ng/mL) formed the highest-risk group (adjusted odds ratio up to 12.54), with the risk increasing stepwise as the number of adverse markers increased. No significant multiplicative interaction was observed, whereas a significant additive interaction was found only for cognitive impairment. Conclusions: Patients with both elevated hsCRP and Vit D deficiency showed the highest odds of poor short-term outcomes. A simple count of these adverse markers may help identify patients at higher risk after acute ischemic stroke and may help define a subgroup for further evaluation in prospective intervention trials of Vit D supplementation.

Https://dnd.or.kr ► This corrects the article "Nationwide Survey on the Awareness of Mild Cognitive Impairment" in volume 24 on page 198.

Background: Mild cognitive impairment (MCI) represents the symptomatic pre‐dementia stage of Alzheimer’s disease (AD). Given the increasing prevalence of AD and its socioeconomic burden, delaying the progression of MCI to AD is critical. Modulating the microbiota‐gut‐brain (MGB) axis has emerged as a promising therapeutic approach. This study aimed to evaluate the efficacy and safety of MT104, a dietary supplement containing Cuscuta seeds and heat‐killed probiotics, in regulating the MGB axis in patients with MCI. Method: This multicenter, randomized, double‐blind, placebo‐controlled study involved participants randomly assigned in a 1:1 ratio to receive MT104 or placebo. Cognitive function was assessed using the Korean‐Montreal Cognitive Assessment (K‐MoCA) and Korean‐Mini Mental State Examination at baseline and after 12 weeks of treatment. Visuospatial and memory functions were evaluated using the Rey Complex Figure Test and Seoul Verbal Learning Test (SVLT). Statistical analyses included t‐tests, Mann–Whitney U tests, analysis of covariance (ANCOVA), and ranked ANCOVA. Result: The mean changes in verbal memory function, as measured by SVLT delayed recall, showed clinically significant improvement in the MT104 group compared with the placebo group in the intention‐to‐treat and per‐protocol groups. The global cognition, as measured by the K‐MoCA, also significantly improved in the per‐protocol group. Additionally, there were no significant findings regarding the safety profile of MT104. Conclusion: MT104 improved memory performance and global cognition in patients with MCI without safety concerns. These findings support the potential of dietary therapeutic strategies to reduce the risk of progression from MCI to AD dementia. Further studies are needed to confirm these results and explore the long‐term benefits of MT104.

Mild cognitive impairment (MCI), particularly due to Alzheimer’s disease (AD), is an important stage for early intervention. We aim to assess awareness among the general population of MCI and AD, and evaluate their willingness to pay for treatment that delays the progression to dementia. A nationwide cross-sectional telephone survey was conducted from August 29 to 31, 2022, targeting adults aged ≥18 years in the Republic of Korea. In toto, 1,006 respondents were randomly selected via a proportional allocation based on age, sex, and region. The survey consisted of 11 questions covering demographic information, awareness of MCI and AD, understanding of diagnostic procedures, such as amyloid positron emission tomography (PET), and willingness to pay for disease-modifying treatment. Among the respondents, 41.3% had heard of MCI, but only 12.0% were well informed. Some 77.0% stated that if they experienced cognitive decline, they would visit a hospital. Only 12.4% of respondents knew the important role of amyloid PET in diagnosing MCI due to AD. Regarding the treatment costs of disease-modifying drugs, 42.1% were willing to pay <600,000 KRW (approximately 420 USD) per month, while 18.4% were unwilling to pay. Older age and lower socioeconomic status were significantly associated with decreased willingness to pay (p<0.001). Public awareness of MCI is limited, and willingness to pay decreases with older age and lower socioeconomic status. Targeted education and strategies are therefore required to increase awareness and reduce disparities.

Kim Y, et al. Dement Neurocogn Disord. 2025 Jan;24(1):1-23. https://doi.org/10.12779/dnd.2025.24.1.1

Byeon G, et al. Dement Neurocogn Disord. 2025 Jan;24(1):24-43. https://doi.org/10.12779/dnd.2025.24.1.24

Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (¹⁸F-FDG PET) in differentiating these subtypes for precise treatment and management. A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of ¹⁸F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88–0.98) and specificity was 0.84 (95% CI, 0.70–0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70–0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80–0.91) and the specificity was 0.88 (95% CI, 0.80–0.91). The studies mostly used case-control designs with visual and quantitative assessments. ¹⁸F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

Vitamin D (Vit D) affects musculoskeletal performance and central nervous system neuroprotection. We aimed to investigate the association between serum Vit D levels and short-term functional outcomes in patients with acute ischemic stroke. This study involved patients with acute ischemic stroke confirmed on brain MRI. The National Institutes of Health Stroke Scale (NIHSS) was used to assess initial stroke severity upon admission. We evaluated the functional outcomes using the Berg Balance Scale (BBS), Manual Function Test (MFT), Korean Mini-Mental State Examination (K-MMSE), Korean version of the modified Barthel Index (K-MBI) within three weeks from the onset of stroke, and modified Rankin Scale (mRS) score at discharge. Overall, 192 patients were finally included and divided into three groups: Vit D sufficient (n = 28), insufficient (n = 49), and deficient (n = 115). Multivariate analysis showed that the Vit D deficient group presented with a higher risk of initially severe stroke (p = 0.025) and poor functional outcomes on the BBS (p = 0.048), MFT (p = 0.017), K-MMSE (p = 0.001), K-MBI (p = 0.003), and mRS (p = 0.032) compared to the Vit D sufficient group. Vit D deficiency may be associated with severe initial stroke and poor short-term post-stroke functional outcomes.