Lecanemab and donanemab are the first disease-modifying therapies for early Alzheimer's disease. These humanized IgG1 antibodies promote the clearance of aggregated amyloid-beta peptides and, in the pivotal CLARITY AD and TRAILBLAZER-ALZ 2 trials, significantly delayed cognitive and functional decline, with an approximately 30% relative risk reduction for the clinical stage progression; however, the clinical meaningfulness remains contested: critics point to the small between-group difference in relation to the total score. This is weighed against the first disease-modifying effect and the first pharmacotherapy for mild cognitive impairment due to Alzheimer's disease. A prerequisite is the biological diagnosis: the reference standard is cerebrospinal fluid (CSF) and amyloid positron emission tomography (PET), potentially complemented in the future by blood biomarkers such as plasma p-Tau217. Amyloid-related imaging abnormalities (ARIA) are the key adverse event, manageable through patient selection, ApoE-epsilon 4 genotyping and magnetic resonance imaging (MRI) monitoring. The indications and follow-up belong in specialized centers.
Around 1900, what did "home" mean to people who, marginalized from the rest of civil society, were permanently confined within psychiatric institutions? Where did they feel they belonged (emotionally); did memories of family, landscape and politically defined territories dominate or was it the appropriation of the institutional space? An exploration of the Heidelberg Prinzhorn Collection, a collection unique in the world, provides a multifaceted answer to these questions. The historical collection contains paintings, drawings, texts, sculptures and musical compositions by psychiatric patients from institutions in German-speaking countries dating from around 1840 to the Nazi era. An interdisciplinary research project at the intersection of art history and the history of psychiatry, based at the Heidelberg Special Research Field (SFB) 1671 "Home(s). Phenomena-Practices-Representations", aims to re-examine the phenomenon of institutional psychiatry from its subjective, emotional perspective by focusing on "Home(s)" or "Heimat(en)". Based on the works and other sources it explores the motives of patient artists in the context of (the search for) affiliation, taking as its starting point the situation of exclusion from conventional "homely" connections. The examination of their artistic strategies is also conducted on the assumption that it will enable statements to be made about notions of home and affiliation within the "matrix" of mainstream society from which the patient-artists originated. This essay presents the initial findings based on three examples of different historical approaches to the subject.
