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**TP-MDNP** is an investigational, blood-brain barrier-penetrating terpolymer-based manganese dioxide nanoparticle platform developed at the University of Toronto for Alzheimer’s disease. The polymer-lipid nanoparticle carries manganese dioxide, which reacts within the oxidatively stressed and hypoxic brain microenvironment to reduce reactive oxygen species, generate oxygen, and release paramagnetic manganese ions that enhance T1-weighted MRI contrast. In transgenic Alzheimer’s disease and tauopathy mouse models, intravenously administered TP-MDNP enabled MRI detection of neuroinflammation and reduced oxidative stress, hypoxia-associated carbonic anhydrase 9, and phosphorylated tau. It remains a preclinical theranostic nanomedicine; no human clinical development or marketed product has been identified. ([alz-journals.onlinelibrary.wiley.com](https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz70859_104173))
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