Advancing Alzheimer Diagnosis and Treatment Through Mechanism-Based Approaches: Takeshi Iwatsubo, MD, PhD

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"I’m a neurologist studying the new pathology and pathophysiology, so it’s very reasonable that pathological buildup like amyloid-β may cause downstream neurodegenerative events, including tau deposition. [Since] there is a target for therapeutics, and simultaneously a target for diagnosis, now it’s becoming very straightforward."

At the recently concluded 18th Clinical Trials on Alzheimer’s Disease (CTAD) Conference, held December 1-4, 2025, in San Diego, California, Takeshi Iwatsubo, MD, PhD, was presented with the Lifetime Achievement Award in Alzheimer’s Disease Therapeutic Research.¹ Iwatsubo, who serves as director of the National Center of Neurology and Psychiatry in Tokyo, Japan, was recognized for his contributions to Alzheimer disease (AD) neuroimaging and neuropathology. Trained in neurology and neuropathology, his research has focused on human neurodegenerative diseases, including AD and Parkinson disease, through multidisciplinary investigative approaches.

In his work, Iwatsubo demonstrated that amyloid-β 42 was the initial species deposited in senile plaque amyloid, characterized the formation of the γ-secretase complex, and identified phosphorylated α-synuclein as a component of Lewy bodies. To date, he has served as the principal investigator of the Japanese Alzheimer’s Disease Neuroimaging Initiative and the Japanese Trial Ready Cohort for Prevention of Alzheimer’s Disease, as well as the principal investigator of the Japanese Registry for Alzheimer’s Disease–Disease Modifying Therapy. His prior honors include the MetLife Award for Medical Research, the Alzheimer’s Association International Conference Lifetime Achievement Award, the Potamkin Prize, and the Medal with Purple Ribbon from the Japanese government.

In an interview with NeurologyLive^® at CTAD 2025, Iwatsubo reflected on receiving the prestigious award and discussed his career-long work in AD disease research, spanning neuropathology, neuroimaging, and biomarker development. He emphasized how advances in understanding amyloid beta and tau pathology have enabled more mechanism-based diagnostic and therapeutic strategies. Although acknowledging progress, Iwatsubo noted that current treatments offer modest clinical benefit, particularly in patients with mild cognitive impairment, underscoring the need for greater efficacy. Looking ahead, he highlighted early and preclinical stages of AD as a critical target for intervention, when brain tissue remains relatively preserved and outcomes may be improved.

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REFERENCES
1. Iwatsubo T. CTAD Lifetime Achievement Award in Alzheimer’s Disease Therapeutic Research. Presented at: CTAD 2025; December 1-4; San Diego, CA.