by Simone Salemme
Each month the eanNews editorial team reviews the scientific press for recently published papers of outstanding interest to neurologists. Below we present our selection for April 2026.
For our Paper of the Month, go here: Research Paper of the Month: Efficacy and safety of minocycline in patients with acute ischaemic stroke (EMPHASIS) – eanNews
Integration of plasma eMTBR-tau243 and p-tau217 in the diagnosis and stratification of Alzheimer’s disease: a prospective cohort study
Blood biomarkers are increasingly used to identify Alzheimer’s disease (AD) pathology, but a key practical challenge remains: a positive ‘core 1’ biomarker (e.g., p-tau217) can confirm amyloid-related biology without necessarily indicating that AD pathology is the main driver of current cognitive symptoms. In this prospective memory-clinic cohort study, Mattsson-Carlgren and colleagues evaluated whether adding plasma eMTBR-tau243—a candidate ‘core 2’ biomarker reflecting tau tangle pathology—can improve the classification of clinically symptomatic AD among individuals already positive for plasma p-tau217.
The authors analysed 572 consecutively recruited patients (subjective cognitive decline, mild cognitive impairment, or dementia) from BioFINDER-2 (Sweden), with validation in an independent US cohort (Knight ADRC). Among p-tau217–positive patients (61% of the cohort), 97% were amyloid-positive by CSF/PET, yet only 57% met criteria for established AD—highlighting the risk of over-attribution when relying on p-tau217 alone. When eMTBR-tau243 was added within the p-tau217–positive group, diagnostic performance for established AD improved substantially (accuracy 81%, PPV 84%, NPV 77%). eMTBR-tau243 positivity also tracked clinically meaningful disease biology: it was associated with worse longitudinal cognitive decline and faster tau accumulation on tau-PET, and helped identify individuals with high tau-PET burden (among p-tau217 positives, accuracy 87%, NPV 90% for high tau load).
Overall, this work provides a pragmatic two-step blood-based workflow: use p-tau217 first to confirm amyloid-related pathology, and then eMTBR-tau243 to increase confidence that tau tangle pathology (and therefore AD) is driving symptoms and to stratify tau burden—potentially supporting more nuanced clinical decision-making and therapeutic targeting.
Click here to read the paper: Integration of plasma eMTBR-tau243 and p-tau217 in the diagnosis and stratification of Alzheimer’s disease: a prospective cohort study – The Lancet Neurology
Tavapadon as Adjunctive Treatment for Parkinson Disease The TEMPO-3 Randomized Clinical Trial
Motor fluctuations are common in levodopa-treated Parkinson disease (PD), and currently available dopamine agonists—often targeting D2/D3 receptors—can add motor benefit at the cost of adverse events. Tavapadon is an investigational, once-daily, selective D1/D5 agonist developed to improve motor control while potentially limiting D2/D3-associated harms.
In the double-blind, placebo-controlled TEMPO-3 phase 3 trial (148 sites, 14 countries), 507 adults with PD and motor fluctuations on stable oral levodopa were randomised to flexible-dose tavapadon (5–15 mg once daily) or placebo for 27 weeks. The primary endpoint was change at week 26 in daily “good-on-time” (on-time without troublesome dyskinesia), with off-time as the key secondary endpoint.
Tavapadon met both endpoints: compared with placebo it increased good-on-time by +1.10 hours/day (1.70 vs 0.60; P<.001) and reduced off-time by −0.94 hours/day (−1.88 vs −0.93; P<.001), with early and sustained separation. Nominal improvements were also reported in MDS-UPDRS parts II and III, while PDQ-39 and EQ-5D-5L did not differ between groups.
Adverse events were more frequent with tavapadon than placebo (71.7% vs 55.1%) and discontinuations due to adverse events were higher (17.1% vs 9.1%); most events were mild to moderate, with nausea (14.3%), dyskinesia (10.0%), and dizziness (7.6%) most common. Over 27 weeks, there were no notable signals for increased somnolence or impulse-control disorders versus placebo, although longer-term data will be important.
Click here to read the paper: Tavapadon as Adjunctive Treatment for Parkinson Disease: The TEMPO-3 Randomized Clinical Trial | Neurology | JAMA Neurology | JAMA Network
Meat Consumption and Cognitive Health by APOE Genotype
Dietary recommendations for dementia prevention are typically ‘one size fits all,’ yet genetic heterogeneity—especially APOE ε4 status—may modify dietary effects. In this population-based Swedish cohort (SNAC-K), Norgren and colleagues tested whether higher meat consumption is associated with better cognitive outcomes specifically among individuals with APOE ε3/ε4 or ε4/ε4 genotypes (APOE34/44), using a design framed around causal-inference principles.
The study included 2,157 adults aged ≥60 years without dementia at baseline (mean age 71.2; 62% women) followed for up to 15 years. Meat intake (grams per total kilocalories) was assessed using validated food-frequency questionnaires; cognitive change was modelled as global cognitive trajectory, and incident dementia was analysed with competing-risk models. APOE34/44 genotypes accounted for 26.4% of the cohort.
Among participants with APOE34/44, higher total meat consumption (top vs bottom quintile) was associated with better cognitive trajectories (β=0.32 per 10 years) and lower dementia risk (subdistribution HR 0.45). In contrast, no corresponding associations were observed in participants with other genotypes. Importantly, in the highest meat-consumption quintile, cognitive decline and dementia risk appeared similar across APOE strata, suggesting that higher meat intake may offset the expected ε4-associated disadvantage.
A consistent adverse signal emerged for processed meat: a higher processed-to-total meat ratio was associated with increased dementia risk (sHR 1.14) without clear APOE interaction. Analyses also suggested no substantial difference between unprocessed red meat and poultry in relation to outcomes. Overall, the study raises the provocative possibility that optimal dietary patterns for brain health may differ by APOE genotype—while reinforcing that processed meat remains an unfavourable component irrespective of genotype.
Click here to read the paper: Meat Consumption and Cognitive Health by APOE Genotype | Geriatrics | JAMA Network Open | JAMA Netw…
