Treatments to Reduce Alzheimer’s Disease

Posted on March 18, 2026 by Patrick Hercules

Alzheimer’s disease is a degenerative brain disease and the most common type of dementia. It causes a slow decline in memory, thinking, and reasoning skills. Age is the biggest risk factor for the disease, followed by sex and family history.

There is currently no cure for Alzheimer’s disease. However, there is progress in Alzheimer’s and dementia research that is creating promising new treatments for those living with the disease.

The U.S. Food and Drug Administration (FDA) has approved medications for Alzheimer’s disease, which fall into two categories:

· Drugs that change disease progression in people living with early Alzheimer’s

· Drugs that temporarily ease some symptoms of Alzheimer’s

Drugs that change disease progression target the underlying biology of the disease process by aiming to slow the decline of memory and thinking, as well as function.

Anti-amyloid treatments work by removing a protein that accumulates into plaques in the brain, called beta-amyloid. Each treatment works differently and targets beta-amyloid at a different stage of plaque formation.

These treatments change the course of the disease significantly for those who are in the early stages by giving them more time to be able to participate in daily activities and live independently.

The two treatment therapies that change disease progression are Donanemab and Lecanemab.

Donanemab is an anti-amyloid antibody intravenous (IV) infusion therapy that is delivered every four weeks to treat early Alzheimer’s disease, which includes people who are living with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s who have been diagnosed with elevated beta-amyloid in the brain.

Donanemab was the third therapy that demonstrated that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

Lecanemab was the second therapy to demonstrate that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

It is important to note that anti-amyloid treatments do have side effects, such as allergic reactions, amyloid-related abnormalities (ARIA), infusion-related reactions, headaches, and falls.

As Alzheimer’s progresses, brain cells die, and the connections among those cells are lost. When this occurs, it causes cognitive and noncognitive symptoms to worsen.

Although these medications don’t stop the damage that Alzheimer’s disease causes to brain cells, they may lessen or stabilize symptoms for a limited time by affecting specific chemicals involved in delivering messages among and between the brain’s nerve cells.

The medications that are prescribed to treat symptoms related to memory and thinking include:

Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment, and other thought processes. These medications prevent the breakdown of a chemical messenger important for memory and learning, called acetylcholine. Cholinesterase inhibitors support communication between nerve cells. The most prescribed cholinesterase inhibitors include:

· Benzgalantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Donepezil treats mild-to-severe dementia due to Alzheimer’s disease

· Galantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Rivastigmine treats mild-to-moderate dementia due to Alzheimer’s disease as well as mild-to-moderate dementia due to Parkinson’s disease

Possible side effects for these medications include:

· Headache

· Dizziness

· Diarrhea

· Increased frequency of bowel movements

· Nausea

· Vomiting

· Loss of appetite

Glutamate regulators are medications prescribed to improve memory, attention, reasoning, language, and the ability to perform simple tasks. This medication regulates the activity of glutamate, a different chemical messenger that helps the brain process information.

Memantine is a glutamate regulator that treats moderate-to-severe Alzheimer’s disease. It can cause side effects that include headaches, constipation, confusion, and dizziness.

A cholinesterase inhibitor combined with a glutamate regulator, such as donepezil and memantine, treats moderate-to-severe Alzheimer’s disease. Possible side effects can include nausea, vomiting, loss of appetite, confusion, dizziness, increased frequency of bowel movements, and constipation.

Alzheimer’s disease doesn’t just impact memory and thinking. It also impacts a person’s quality of life by affecting a variety of behavioral and psychological symptoms that come with dementia, such as agitation, hallucinations and delusions, and sleep disturbances. Some medications focus on treating these non-cognitive symptoms for a time; however, it is important to try non-drug strategies to manage behaviors before adding medications.

The FDA has approved only one drug to manage symptoms of insomnia that has been tested in people who are living with dementia, and one that treats agitation.

Orexin receptor antagonists are prescribed to address symptoms of insomnia and inhibit the activity of a type of neurotransmitter involved in the sleep-wake cycle called orexin.

Suvorexant treats insomnia and has been shown in clinical trials to be effective for people who are living with mild to moderate Alzheimer’s disease. Possible side effects can include a risk of impaired alertness and motor function, worsening depression or suicidal thinking, complex sleep behaviors, sleep paralysis, and compromised respiratory function.

Atypical antipsychotics are a group of antipsychotic drugs that target the serotonin and dopamine chemical pathways in the brain. These drugs are mainly used to treat schizophrenia and bipolar disorder, as well as add-on therapies for major depressive disorder. The FDA requires that all atypical antipsychotics carry a safety warning that the medication has been associated with an increased risk of death in older patients who are experiencing dementia related psychosis.

Many atypical antipsychotic medications are used “off-label” to treat dementia-related behaviors, and there is only one FDA-approved atypical antipsychotic to treat agitation associated with dementia due to Alzheimer’s disease. It is important to try non-drug strategies to help manage non-cognitive symptoms such as agitation before adding any medications.

Brexpiprazole treats agitation associated with dementia due to Alzheimer’s disease. Possible side effects may include weight gain, sleepiness, common cold symptoms, dizziness, and restlessness.

If you or a loved one is experiencing any symptoms of Alzheimer’s disease or would like to learn more about treatment options, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Botox for Migraines

Posted on March 14, 2026 by Patrick Hercules

Chronic migraines are a severe, recurring type of headache that is often debilitating. Migraines have four phases, which are prodrome, aura, migraine headache, and postdrome.

Although the exact cause of migraines is unknown, researchers believe genetics is a factor.

There are a few conditions and lifestyle factors that can trigger a migraine, including:

Anxiety

Bipolar disorder

Depression

Epilepsy

Sleep disorders

Caffeine or withdrawal from caffeine

Taking certain medications or taking them too often

Migraines are more likely to occur in the morning, making it common to wake up with a migraine. Some people have a predictable pattern of migraines, such as just before a menstrual period. Other people may have trouble recognizing what triggers their migraines.

There is no cure for migraines, but they can be managed and prevented with over-the-counter triptans and pain relievers.

Another treatment that can be used for chronic migraines is Botox. Botox for migraines is a type of botulinum toxin that may prevent chronic migraines and is only recommended by a healthcare provider if a person has 15 or more headaches per month.

Although Botox is mostly known for its cosmetic use, it has medical benefits, such as blocking pain signals before they reach the brain, as certain nerves are highly active during a migraine.

To prevent this from happening, a healthcare provider injects Botox into specific muscles in the head, neck, and shoulders using a tiny needle. These areas connect to the nerves that send pain signals during a migraine. Botox travels along these connected nerves towards the brainstem and blocks the release of chemicals that trigger pain. This may reduce how often a person gets a migraine or make their symptoms less severe when they experience one.

Before receiving Botox for migraine treatment, you will meet with your healthcare provider, who will explain the risks and benefits of it and make sure that it is a safe option for you. If you agree to move forward, you will sign a consent form.

It is important to let your healthcare provider know about any medications and supplements that you are currently taking, as Botox may interact with different types, such as muscle relaxants.

Botox has many side effects, including:

Mild pain and bruising at the injection site

Neck pain and stiffness

Headache

Flu-like symptoms

Temporary changes in appearance

These side effects are usually minimal and will clear up. Let your healthcare provider know if you are experiencing any severe pain or discomfort.

The main benefits of Botox for migraines are that it reduces:

The severity of migraines

The frequency of migraines

The duration of migraines

Botox for migraines has other benefits, including:

It’s effective with long-term use and has minimal complications

It can be combined with other migraine medications

The side effects may be better tolerated than other medications available

Chronic migraines can be painful and debilitating, and trying to find the right treatment to provide relief can be difficult and frustrating. If you are suffering from chronic migraines and haven’t found the right treatment options to relieve your symptoms, discuss Botox treatment for migraines with your healthcare provider.

If you are experiencing any symptoms of chronic migraines and are interested in Botox for migraines, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Chronic Traumatic Encephalopathy (CTE)

Posted on August 5, 2025 by Patrick Hercules

Chronic traumatic encephalopathy (CTE) is a degenerative brain condition that happens after repeated head injuries. CTE usually affects athletes who play contact sports or military personnel.

CTE causes neurodegeneration, which means it permanently destroys nerve cells in your brain. Over time, this damage can cause changes in your behavior and mental abilities. It has been associated with second impact syndrome, when a second head injury occurs before symptoms of a previous head injury have fully resolved.

Experts are still trying to understand how repeated head injuries and other factors might contribute to the changes in the brain that result in CTE. Researchers are looking at how the number of head injuries someone experiences and how bad the injuries are may affect the risk of CTE.

There are no specific symptoms that have been linked to CTE, as it shares symptoms with other brain conditions that cause neurodegeneration. It can affect your:

Cognitive function, which can cause:

Memory loss

Trouble solving problems or making plans

Trouble making a choice or judging what you should do next

Mild cognitive impairment

Mood and personality, which can cause:

Anxiety

Depression

Mood swings, especially acting or feeling more aggressive or impulsive

Personality changes

Thoughts of self-harm, suicide, or suicidal behavior

Motor function, which can cause:

Balance issues

Loss of coordination

Tremors, twitches, or other muscle movements you can’t control

There is no way to diagnose CTE in a living person. The only way healthcare providers can confirm CTE is by examining samples of a person’s brain with a microscope during their autopsy.

Even though a healthcare provider may not be able to definitively diagnose CTE while a person is alive, they can still make an educated assumption by building a diagnosis using a few factors, including:

A physical exam

A neurological exam

The symptoms a person is experiencing

A person’s medical history, especially if they have had head injuries

Experiencing CTE symptoms doesn’t automatically mean a person has it. There are a lot of conditions that can cause similar symptoms. A healthcare provider will use tests to help diagnose or rule out these other issues. Tests include:

Blood tests

CT scan

Lumbar puncture

PET scan

There is no treatment for CTE because there is currently no cure for it. Unfortunately, if a person has CTE, their symptoms will continue to get worse. Avoiding head injuries is the only way to lower your risk of developing CTE. Wear the right protective equipment for all activities and sports, especially helmets or protective headwear.

If you are experiencing any symptoms of CTE, you can schedule an appointment with a doctor at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001. If you are experiencing an emergency, call 911.

Foot Drop

Posted on December 13, 2024 by Patrick Hercules

Foot drop or drop foot, is a general term for difficulty lifting the front part of the foot. It happens when you can’t raise the front part of your foot due to weakness or paralysis of the muscles that lift it.

Foot drop may cause a person to drag their feet on the floor when they walk. To avoid this, a person with foot drop may raise the thigh more than usual when walking as though they were climbing stairs. This way of walking, called steppage gait, causes the foot to slap against the floor with each step, sometimes causing the skin on the top of the foot and toes to feel numb.

Foot drop isn’t a disease. It is more a sign of an underlying neurological, muscular, or anatomical problem. Foot drop has several possible causes, typically due to an issue with your nerves and/or muscles. The most common causes are lumbar radiculopathy and peroneal nerve injury. Other causes include:

Brain conditions
Motor neuron conditions
Peripheral neuropathies
Muscle conditions

To diagnose foot drop, a healthcare provider will perform a physical exam, which may show:

Loss of muscle control in your lower leg(s) and foot/feet
Muscle atrophy in your foot or leg
Difficulty lifting your foot and toes

Your healthcare provider may also order any of the following tests to find the underlying cause of foot drop, including:

Imaging tests such as X-rays, ultrasound, and/or an MRI to look for compression or damage in your legs, spine, or brain
Certain blood tests, such as a blood sugar test to check for diabetes and diabetes-related neuropathy
Nerve conduction tests to examine how your nerves are functioning
Electromyography to measure the electrical activity in your leg muscles

Foot drop treatment depends on what is causing it. Sometimes foot drop is temporary, but it can be permanent. If the cause is a chronic condition like multiple sclerosis or ALS, foot drop may be permanent. Possible treatments for foot drop include:

Physical and occupational therapy to help stretch and strengthen your muscles and help you walk better
Braces, splints, or shoe inserts to help support your ankle and foot and keep it in a more natural position

In some cases, people need surgery to relieve pressure on their peroneal nerve or to repair it. If you have chronic foot drop, your healthcare provider may suggest fusing your ankle or foot bones. Or you may have tendon surgery in which a surgeon transfers a tendon from your other leg to the muscle in your affected leg to help it pull your foot up.

If you are experiencing any symptoms of foot drop, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Pinched Nerve

Posted on October 15, 2024 by Xavia Malcolm

A pinched nerve is a non-medical term used to describe a compressed nerve. A pinched nerve sensation occurs when surrounding tissues place too much pressure on a nerve. As a result, a person may experience short-term or long-term tingling, numbness, pain, or muscle weakness in the affected area.

There are several types of pinched nerves characterized by the location of the compressed nerve and the part of the body it serves. This includes the pinching of a root nerve in the spine which causes tingling and pain in other parts of the body. This is known as radiculopathy.

A common type of radiculopathy is sciatica which causes pain along the sciatic nerve in the lower back and down the legs. Other conditions that can develop as a result of a pinched nerve are:
• Radial tunnel syndrome which occurs when the radial nerve in the elbow is affected
• Carpal tunnel syndrome which occurs when the median nerve in the wrist is affected
• Tarsal tunnel syndrome which occurs when the tibial nerve in the heel is affected

Some people are more at risk of experiencing a pinched nerve than others. They include those who:
• Were assigned female at birth
• Have rheumatoid arthritis
• Have diabetes
• Have thyroid disease
• Have bone spurs
• Are pregnant
• Are obese
• Are age 50 and older
• Perform activities that require repetitive movement of the wrist, shoulders, or hands

Most cases of a pinched nerve are mild and symptoms may go away in a few days or weeks. Your doctor may recommend treatment that involves over-the-counter medications, physical therapy, resting the affected area, pausing certain activities, or applying heat and ice.

Do not ignore the symptoms of a pinched nerve if they last longer than normal. Chronic pain, numbness, tingling, or other associated symptoms can indicate a serious problem.

Early detection can help you avoid complications. Your doctor can diagnose a pinched nerve by ordering imaging tests such as MRI, blood tests, spinal tap, or a nerve conduction study. Surgery is often used as a last resort to treat long-lasting symptoms.

An untreated neurological condition can significantly interfere with your ability to function daily, but with the help of our expert team of neurologists, you can get the treatment you need to prevent disability and maintain a high-quality, active life. To schedule an appointment, please email [email protected].

Essential Tremors

Posted on July 18, 2024 by Patrick Hercules

Essential tremors are a neurological condition that causes involuntary and rhythmic shaking. It affects any part of the body but mostly occurs in the hands.

Essential tremors are normally not dangerous but can worsen and become severe in some people. It is sometimes confused with Parkinson’s disease.

The symptoms of essential tremors include:

They start gradually and are more noticeable on one side of the body.
They worsen with movement.
They occur in the hands first, affecting one or both hands.
They cause a “yes-yes” or “no-no” motion of the head.
They may be aggravated by emotional stress, fatigue, caffeine, or extreme temperature changes.

About half the people with essential tremors appear to have an altered gene that causes them. This is called familial tremor. It is unclear what causes essential tremors in people without familial tremors.

There are a couple of known risk factors for essential tremors including:

Altered gene
Age- Essential tremors, which are more common in people 40 and older.

Complications caused by essential tremors include difficulty:

Holding a cup or glass without spilling.
Eating without shaking.
Putting on makeup or shaving.
Talking, if the voice box or tongue is affected.
Writing clearly.

There are no medical tests to diagnose essential tremors. It is often a matter of ruling out other conditions that could be causing symptoms. A healthcare provider may do this by reviewing your medical history, family history, and symptoms, and completing a physical examination. Some tests used to do this include:

Neurological examination that tests the functionality of your nervous system
- Tendon reflexes.
- Muscle strength and tone.
- Ability to feel certain sensations.
- Posture and coordination.
- Way of walking.
Laboratory tests- blood and urine may be tested for several factors including:
- Thyroid disease.
- Metabolic problems.
- Medicine side effects.
- Levels of chemicals that may cause tremors.
Performance tests- a healthcare provider may ask you to:
- Drink from a glass.
- Hold your arms outstretched.
- Write words or a sentence.
- Draw a spiral.

People with mild symptoms of essential tremors don’t require treatment. But if it is causing difficulty in performing daily activities treatment options may include:

Medicines
- Beta-blockers
- Anti-seizure medications
- Tranquilizers
- Botox injections
Physical or occupational therapy
Nerve stimulation devices
Surgery
- Deep brain stimulation
- Focused ultrasound thalamotomy

You can receive pain management treatments such as nerve blocks at Jamaica Hospital Medical Center. To schedule an appointment with a pain specialist, please call (718) 206-7246.

Meet Our Doctors: Dr. Morteza Modaber

Posted on January 29, 2024 by Jacob Lobosco

We are pleased to introduce Dr. Morteza Modaber, the new Director of Neurology for both Jamaica Hospital and Flushing Hospital Medical Center.

Dr. Modaber obtained his medical degree at Shahid Behesti University of Medical Sciences in Tehran, Iran, before coming to practice medicine in the United States. After four years of neuromodulation research at the University of California, Los Angeles, he completed an internship program in internal medicine at SUNY Upstate Medical University from 2016 to 2017. He then completed a residency program in neurology at the Zucker School of Medicine at Hofstra/Northwell from 2017 to 2020, where he also completed a fellowship program in vascular neurology.

Part of what Dr. Modaber finds so engaging about his new role is the opportunity it offers to serve unmet needs for patients living in Queens. “There’s a massive need in the Queens community for neurological care,” said Dr. Modaber. “There isn’t enough access to medical professionals with a neurological background. I’m very excited to be able to help provide that care.”

Both the community he serves and the people that he works with bring joy and purpose to Dr. Modaber’s career. “Our hospitals and the communities they serve are melting pots of different cultures and different groups of people from a variety of backgrounds. I’m very happy to be working in an environment where diversity is celebrated,” said Dr. Modaber.

As Director of Neurology, Dr. Modaber plans to expand the Neurology Department in ways that will allow it to provide comprehensive neurological care to the Queens community. “I want to be able to offer people in Queens the best neurological care they can get in New York without having to take a long trip to Manhattan, Long Island, or somewhere else to get it,” said Dr. Modaber. “We’ve been recruiting a lot of highly-skilled people and are well on our way to achieving that goal.”

We are proud to welcome Dr. Modaber to our team and look forward to the work that he and the rest of the Neurology Department will do to provide high-quality neurological care to our community.