Curr Neurol Neurosci Rep [JOURNAL]
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200 papers
Migraine and Trauma-Informed Care: A Review of the Literature and Recommendations for Clinical Practice and Research.
Khanna P, Noel M, Orr SL
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41148457 · Publisher ↗
PURPOSE OF REVIEW: This article reviews recent literature on the association between migraine and trauma, particularly adverse childhood experiences (ACEs). It makes recommendations for research and clinical practice. RE...
PURPOSE OF REVIEW: This article reviews recent literature on the association between migraine and trauma, particularly adverse childhood experiences (ACEs). It makes recommendations for research and clinical practice. RECENT FINDINGS: ACEs are prevalent and associated with lifetime morbidity and mortality. Observational studies have elucidated the association between migraine and ACEs. Emerging literature highlights a dose-dependent relationship between incident migraine and ACEs. ACEs have been linked with migraine-related outcomes in both children and adolescents as well as adults. However, the mechanisms linking ACEs to migraine remain poorly understood. Principles of, and approaches to, trauma-informed care in other populations can be drawn from, expanded, and extended to the context of migraine. We highlight the need for trauma-informed clinical care. We provide specific suggestions for how clinicians can integrate trauma-informed approaches in their clinical practice to improve patient outcomes. Finally, we make recommendations on how the field can advance research.
Stroke, infections, and New Mechanisms: a Narrative Review.
Reis J, Öztürk Ş, Buguet A … +2 more , Kauffenstein G, Tulek Z
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41137964 · Publisher ↗
PURPOSE OF REVIEW: Infections as a risk factor for stroke remain an underrecognized issue within the medical community although this link was identified for more than 60 years. Preceding infections acting as triggers or...
PURPOSE OF REVIEW: Infections as a risk factor for stroke remain an underrecognized issue within the medical community although this link was identified for more than 60 years. Preceding infections acting as triggers or even causal factors for ischemic and hemorrhagic stroke were assessed notably for tropical infections. RECENT FINDINGS: Since the COVID 19 pandemic, the interest for all kind of infectious agents (bacteria, viruses, fungi, parasitosis) is becoming an emerging concern worldwide. Surprisingly, this risk is addressed only in classification of causes concerning young adults and children. In addition, the seasonality of meteorological conditions (temperature, humidity, rain patterns) probably obscured the underlying causes such as epidemic infections and air pollution peaks (which can act in synergy, notably for respiratory infections). Greater recognition of infection-related stroke risk is essential, especially given the potential for increased incidence driven by global warming, the availability of biomarkers for risk assessment, and the opportunities improving preventive and therapeutic strategies.
REM Sleep Behavior Disorder as a Prodromal Synucleinopathy: Updates on Clinical and Laboratory Biomarkers, and Implications for Neuroprotective Trials.
Neilson LE, Khattab YI, Lim MM
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41134495 · Full text
PURPOSE OF REVIEW: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia notable for its association with the later development of diseases with pathological α-synuclein deposition, including Parkinson's...
PURPOSE OF REVIEW: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia notable for its association with the later development of diseases with pathological α-synuclein deposition, including Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), and Multiple System Atrophy (MSA). The goal of this review is to summarize the recent advances in characterizing the clinical deficits, neuroimaging characteristics, and biomarker assay development of individuals with RBD. RECENT FINDINGS: Clinical research indicates that many people with RBD are presenting to clinical attention for reasons other than dream enactment behavior. They experience deficits in neuropsychiatric, autonomic, and motor domains and co-presentation of these features with RBD predict a faster rate of phenoconversion to PD, DLB, or MSA. RBD is considered a prodromal synucleinopathy with early abnormalities in α-synuclein protein pathways, together with inflammation and mitochondrial dysfunction being recognized as key pathophysiological mechanisms. Seed amplification assays for α-synuclein in various tissue types hold tremendous promise for antemortem diagnosis. RBD is clearly an at-risk population for neurodegenerative disease with well-defined measures that can refine enrollment and better target prodromal populations for interventional clinical trials. The first neuroprotective trials are underway.
The Contribution of Aerospace Medicine Specialty Expertise in the Diagnosis and Treatment of Headache Disorders with Concomitant Clinically Symptomatic Dyscapnia (Respiratory Alkalosis/Acidosis).
Stepanek J
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41123745 · Publisher ↗
PURPOSE OF REVIEW: A subset of patients with headache disorders presents with a dyscapnic state typically clinically symptomatic chronic respiratory alkalosis (CSCRA). CSCRA is well described as an important factor in in...
PURPOSE OF REVIEW: A subset of patients with headache disorders presents with a dyscapnic state typically clinically symptomatic chronic respiratory alkalosis (CSCRA). CSCRA is well described as an important factor in increased neuromuscular irritability and reduces tissue oxygen delivery through reduction of cerebral blood flow (vasospasm) and left shift of the oxygen-hemoglobin dissociation curve, as well as increasing metabolic tissue oxygen demand all thought to be important factors in headache disorders. RECENT FINDINGS: Novel testing paradigms that allow assessment of hypoxemia / orthodeoxia-platypnea include hypoxic echocardiography with bubble contrast to diagnose clinically significant right to left shunts (RLS). RLS (commonly through a patent foramen ovale (PFO)) is associated with migraine, particularly migraine with aura. We evaluate patients with an in-depth acid base analysis (including arterial blood gas analysis, comprehensive metabolic profile and urinalysis) and then pursue diagnostic evaluation of potential causative factors. Common causes of CSCRA include sleep disordered breathing, RLS (anatomic and capillary shunting), post-concussive states as well as post-viral or postoperative derangements of acid base status and associated with altered autonomic function. A focused diagnostic approach to discern the root cause for CSCRA may uncover treatable causes such as hypoxemia secondary to RLS or lung disease, sleep disorders and diaphragmatic dysfunction. The time-limited intervention with carbonic anhydrase to normalize acid base status and tissue carbon dioxide stores, as well as rehabilitation measures to normalize breathing patterns serve to normalize the acid base status, reduce neuromuscular irritability and reduce symptoms including headache.
Ependymoma: Advances in Systems Treatment Strategies.
Qiu X, Wu Z, Xie H … +3 more , Wang S, Yang Q, Guo C
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41123729 · Publisher ↗
PURPOSE OF REVIEW: Systemic therapy is particularly important for patients with recurrent or incompletely gross-total resected ependymoma. This study focuses on summarizing the systemic therapeutic strategies including m...
PURPOSE OF REVIEW: Systemic therapy is particularly important for patients with recurrent or incompletely gross-total resected ependymoma. This study focuses on summarizing the systemic therapeutic strategies including molecular targeted therapy, immunotherapy and conventional chemotherapy in recent years, with a view to bringing more advanced treatment options to patients with ependymoma. RECENT FINDINGS: In studies of systemic therapy for ependymoma, chemotherapy, although controversial, remains effective in patients with recurrent ependymoma. In targeted therapy, tyrosine kinase inhibitors, epigenetic agents and PARP inhibitors have shown promising antitumor activity in preclinical studies and some clinical trials. In immunotherapy, strategies such as immunological checkpoint inhibitors and CAR T cells therapy have shown potential therapeutic value in specific patient populations. Chemotherapy remains an important option for patients with recurrent ependymoma, and recent studies have revealed the great potential of targeted therapy and immunotherapy, suggesting that further in-depth studies on the optimization and combined application of targeted drugs and immunotherapy strategies, etc., can be conducted in the future.
Frontal Disorders and Consciousness: A Review.
Berenbaum JG, Morrison B, Hagan B … +3 more , Xie KY, Turk KW, Budson AE
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41108446 · Publisher ↗
PURPOSE OF REVIEW: The frontal cortex plays a key role in many functions considered to be relevant for consciousness. Furthermore, altered consciousness appears to exist in those with disorders that disrupt or damage fro...
PURPOSE OF REVIEW: The frontal cortex plays a key role in many functions considered to be relevant for consciousness. Furthermore, altered consciousness appears to exist in those with disorders that disrupt or damage frontal areas and/or networks. This article reviews recent research discussing the impact of frontal disorders on consciousness. RECENT FINDINGS: Many theories of consciousness have been developed over the last century to help explain the neural correlates of consciousness. Some theories argue that the frontal cortex is necessary for consciousness, while others argue that posterior cortical regions are critical for consciousness. The Memory Theory of Consciousness argues that consciousness requires modality-specific localization throughout the brain. We argue that frontal disorders do not abolish consciousness but they may disrupt conscious abilities such as sustained attention, working memory, problem-solving, complex thought, executive function, response inhibition, decision-making, and goal-oriented behavior. Understanding the role of the frontal cortex in consciousness has significant scientific, clinical, and societal implications.
Evolving Treatment Paradigms of Meningiomas; a Precision Medicine Perspective.
Galluzzo D, Chen C, Alok K … +2 more , Moliterno J, Kurz SC
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41085787 · Publisher ↗
PURPOSE OF REVIEW: This review provides a comprehensive overview of the multidisciplinary management strategies available for intracranial meningiomas, with a focus on novel therapies. RECENT FINDINGS: With the 2021 WHO...
PURPOSE OF REVIEW: This review provides a comprehensive overview of the multidisciplinary management strategies available for intracranial meningiomas, with a focus on novel therapies. RECENT FINDINGS: With the 2021 WHO classification of tumors of the Central Nervous System (CNS) came the introduction of molecular alterations impacting meningioma grading. As with other central nervous system tumors, the medical management of meningiomas is moving in the direction of targeted therapies. However, meningiomas display significant heterogeneity in their natural history and management options for advanced or recurrent tumor types are lacking. Meningioma management has advanced with refined surgical techniques, radiotherapy strategies, and emerging systemic therapies. Maximal safe resection remains the mainstay of treatment; however, several clinical challenges and unanswered questions persist. Ongoing investigations into targeted therapies and immunotherapies offer promising avenues, particularly for high-grade and recurrent cases.
Sleep Abnormalities and Risk of Alzheimer's Disease.
Aktan Süzgün M, Tang Q, Stefani A
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41082137 · Full text
PURPOSE OF REVIEW: This review aimed at investigating sleep abnormalities as risk factors for Alzheimer's disease (AD), with a focus on their potential utility in early disease detection and risk modification. RECENT FIN...
PURPOSE OF REVIEW: This review aimed at investigating sleep abnormalities as risk factors for Alzheimer's disease (AD), with a focus on their potential utility in early disease detection and risk modification. RECENT FINDINGS: Impaired sleep quality, circadian misalignment, and disruptions in sleep architecture are significantly associated with an elevated risk of AD. Moreover, excessive or insufficient sleep, reductions in slow-wave and REM sleep, and fragmented rest-activity rhythms have been linked to early alterations in amyloid-β and tau biomarkers, even in cognitively unimpaired individuals. Various sleep disorders have also been identified as independent contributors to AD risk, particularly among genetically susceptible populations. Sleep and circadian disturbances, as well as changes in sleep architecture, represent easily detectable and modifiable risk factors for Alzheimer's disease. Integrating sleep and sleep-based metrics into preventive strategies may enhance early identification and offer novel avenues for intervention, modulating the risk of Alzheimer's disease.
Brain Protective Ventilation Strategies in Severe Acute Brain Injury.
Sharie SA, Almari R, Azzam S … +7 more , Al-Husinat L, Araydah M, Battaglini D, Schultz MJ, Patroniti NA, Rocco PR, Robba C
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41082009 · Full text
PURPOSE OF THE REVIEW: This narrative review synthesizes ten key evidence-based principles for optimizing ventilatory management in patients with acute brain injury, including traumatic brain injury, stroke, and hypoxic-...
PURPOSE OF THE REVIEW: This narrative review synthesizes ten key evidence-based principles for optimizing ventilatory management in patients with acute brain injury, including traumatic brain injury, stroke, and hypoxic-ischemic encephalopathy. RECENT FINDINGS: We emphasize the need to individualize ventilator settings to preserve intracranial pressure (ICP) and cerebral perfusion pressure (CPP), while maintaining lung-protective strategies. Key recommendations include prioritizing physiological targets over ventilator modes, judicious use of positive end-expiratory pressure (PEEP) with concurrent cerebral monitoring, limiting plateau pressures, and maintaining tidal volumes within protective ranges. Minimizing driving pressure (ΔP) and mechanical power (MP) is emphasized to reduce the risk of ventilator-induced lung injury (VILI). The review underscores the importance of precise control of arterial carbon dioxide (PaCO₂) to regulate cerebral blood flow, avoidance of both hypoxemia and hyperoxia, and the integration of multimodal neuromonitoring to inform ventilatory decisions. Additional considerations include the potential benefits of early tracheostomy in patients requiring prolonged ventilation, as well as the influence of sedation depth, fluid management, and autoregulation monitoring on outcomes. By aligning respiratory support with cerebral pathophysiology, clinicians can mitigate secondary brain injury and enhance recovery in this vulnerable population.
Systemic Complications of Status Epilepticus.
Iglesias AH, Balabanov A, Raedy A
Curr Neurol Neurosci Rep · 2025 Oct · PMID 41068542 · Publisher ↗
PURPOSE OF REVIEW: Refractory status epilepticus (RSE) is a neurological emergency with high mortality and multisystemic comorbidities. Rapid diagnosis and early detection of complications can decrease early mortality an...
PURPOSE OF REVIEW: Refractory status epilepticus (RSE) is a neurological emergency with high mortality and multisystemic comorbidities. Rapid diagnosis and early detection of complications can decrease early mortality and decrease severe long-term effects. Status epilepticus (SE) has multisystemic complications involving essential organs, rapidly inducing neuronal death programming, severe cardiopulmonary insults, hemodynamic collapse and other systems failure. In this review, based on recent basic science research, observational studies and case series, we will go over the concepts of status and categories, common local and systemic physiopathological changes and clinical manifestations of these time sensitive medical complications. More research and updates are needed to establish how medical therapy, with old and new antiseizure medication and ICU interventions can prevent or minimize complications. RECENT FINDINGS: There are many areas of ongoing investigation and can represent more recent developments or evolving understandings: Neuroinflammation: The role of neuroinflammation and inflammatory cytokines (IL-1β and TNF-α) in the induction and exacerbation of status epilepticus is an area of active research. Animal models and serological biomarkers have elucidated the central role of neuroinflammation in initiating and perpetrating the pathogenic process leading to SE. Autoimmune Encephalitis: The association between autoimmune conditions and refractory status epilepticus, particularly NMDA receptor encephalitis, paraneoplastic encephalitis, and lupus vasculitis, and the need for immunotherapy in these cases. Targeting inflammatory pathways and cytokines is essential when treating and mitigating injury induced by SE. Non-Convulsive Status Epilepticus (NCSE): The challenges in diagnosing NCSE, its increasing prevalence, especially in the elderly, and the association with poorer outcomes and specific comorbidities. The use of continuous video EEG and other EEG methods can help detecting NCSE sooner and may improve outcomes and decrease neurological and systemic sequelae of RSE. The Relationship between Seizure Duration and Complications: The duration of status epilepticus is a cardinal point in determining complications. Mortality rates increase significantly as status epilepticus (SE) progresses to super-refractory status epilepticus (SRSE). Status Epilepticus (SE) is a severe neurological emergency characterized by prolonged seizures that disrupt brain function and trigger a cascade of systemic complications. These complications span multiple organ systems, including neurological deficits, cardiac arrhythmias, respiratory failure, renal dysfunction, and gastrointestinal issues, often exacerbated by the metabolic demands of the seizures and the side effects of treatment. Prompt diagnosis and management of underlying causes, along with vigilance for potential complications, are crucial to improving outcomes and reducing the high mortality associated with SE, particularly in its refractory and non-convulsive forms.
Pathophysiological Mechanisms Fostering Developmental and Epileptic Encephalopathies (DEE): a Complex Interplay between Genetics, Inflammation and Neurodegeneration.
Riva A, Volpedo G, Zara F … +3 more , Fassio A, Striano P, Falace A
Curr Neurol Neurosci Rep · 2025 Sep · PMID 41014440 · Publisher ↗
PURPOSE OF THE REVIEW: Preclinical and clinical evidence support the notion that in Developmental and Epileptic Encephalopathies (DEEs) both neurodevelopmental and progressive alterations coexist. Several studies have co...
PURPOSE OF THE REVIEW: Preclinical and clinical evidence support the notion that in Developmental and Epileptic Encephalopathies (DEEs) both neurodevelopmental and progressive alterations coexist. Several studies have contributed to the identification of pathophysiological mechanisms underlying DEEs, allowing novel interpretative meanings regarding the mechanisms involved in the progression of DEE symptomatology. The purpose of this review is to critically discuss emerging evidence linking DEEs, genetics, inflammation, and neurodegeneration. RECENT FINDINGS: In the last two decades, genetic findings have highlighted the role of cellular processes involved in both early neurodevelopment and neurodegeneration. In this scenario, evidence linking both autophagic and synaptic dysfunction to DEE provides the needed bridge between such pivotal processes for neuronal homeostasis and neurodegeneration. Furthermore, genetic defects affecting ion currents and cellular osmolarity, cytoskeletal structure and integrity of myelinated axons, neuronal morphology, and purine metabolism have been found to underlie DEE with progressive course. Recent evidence also demonstrates that neuroinflammation during gestation and in the immature brain can induce immune priming and increase the risk of developing DEEs. The phenotypic evolution of many DEEs beyond early childhood is still poorly understood and hardly preventable. Recent studies showed that DEEs, at least some of them, may be the consequence of early inflammatory and neurodegenerative dysfunctions with a variable severity determined by specific genetic and epigenetic factors. These findings open new avenues for uncovering the underpinnings of DEEs progression and symptomatology.
Paroxysmal Neurology: a Guide to Diagnosing Transient Neurologic Dysfunction in Adults and Adolescents.
Kister I
Curr Neurol Neurosci Rep · 2025 Sep · PMID 40971093 · Publisher ↗
PURPOSE OF REVIEW: To outline a practical and comprehensive approach to evaluating transient neurologic dysfunction (TND) in adults. RECENT FINDINGS: TNDs are a common reason for neurologic consultation. Diagnosis relies...
PURPOSE OF REVIEW: To outline a practical and comprehensive approach to evaluating transient neurologic dysfunction (TND) in adults. RECENT FINDINGS: TNDs are a common reason for neurologic consultation. Diagnosis relies largely on history, as neurologic examination is usually normal in the post-ictal stage. The differential of TNDs is extensive, and testing should be targeted to the more likely etiologies and ones that may portend permanent loss of neurologic function. In addition to the more common causes - transient ischemic attack (TIA), seizures, migraine auras, drug-induced adverse events, hypoglycemia, blood pressure fluctuations, hyperventilation, panic attacks, and paroxysmal vestibular disorders, there are some distinctive TND presentations and special circumstances that may point to the less common etiologies. The article outlines the key features of the common presentations and presents a comprehensive differential diagnosis that includes many rare causes of TNDs in adults and adolescents. The proposed approach relies on carefully elucidating the nature, timeline, and circumstances of the symptoms, gathering examination clues, and seeking to determine whether the event is likely due to neuro-vascular, non-vascular neurologic (paroxysmal or chronic), non-neurologic, or rare neurologic etiologies. Specific diagnoses are listed for each of these categories.
Alien Hand: Current Research Trends.
Mark VW
Curr Neurol Neurosci Rep · 2025 Sep · PMID 40971082 · Full text
PURPOSE OF REVIEW: This article reviews alien hand, a neurological disorder that causes involuntary limb movements that appear to be purposeful. This review outlines the history that identified the three widely accepted...
PURPOSE OF REVIEW: This article reviews alien hand, a neurological disorder that causes involuntary limb movements that appear to be purposeful. This review outlines the history that identified the three widely accepted forms of alien hand and their distinct clinical and neuroimaging findings. This material summarizes behavioral disturbances that can occur with alien hand but are seldom addressed in a single review article, including propensity for self-injury, pathological sexual behavior, alien hand activities during sleep, and communication disturbances of alien Quality. The article then presents other paroxysmal, involuntary disturbances that are not usually considered to be alien hand, despite their appearing to be purposeful. Finally, this article reviews all PubMed-listed articles from 2020 to mid-2025 that addressed either alien hand or limb, or anarchic hand, for trends in understanding and treating this illness. RECENT FINDINGS: Meritorious advances in recent years included proposed checklists for the component behaviors for diagnosing alien hand, structured interviews for querying the patients' experiences, and demonstrating white matter cerebral damage that extends far beyond the lesion boundaries that are identifiable on conventional structural brain MRI. This review summarizes the diversity of the presentations of alien hand. Many behaviors that are encompassed by alien hand are not so far explained by clinical or experimental brain MRI findings.
Stroke Care in Conflict and War Zones -Peace Saves Lives!
Ozturk S, Sunguc C
Curr Neurol Neurosci Rep · 2025 Sep · PMID 40965790 · Publisher ↗
PURPOSE OF REVIEW: Cardiovascular conditions and related risk factors are an important and common group of diseases. Stroke is a disease that requires rapid diagnosis and treatment, and there are significant inequalities...
PURPOSE OF REVIEW: Cardiovascular conditions and related risk factors are an important and common group of diseases. Stroke is a disease that requires rapid diagnosis and treatment, and there are significant inequalities in stroke diagnosis, treatment and follow-up between countries, regions, societies and economic levels. This inequality becomes even more evident in regions where war and turmoil continue. What is the goal of your paper? What questions did you seek to answer? This review aims to explore whether war and armed conflicts impact stroke and care and describe potential mechanisms and solutions. RECENT FINDINGS: There is some evidence for a relationship between war and stroke epidemiology, clinical presentations, and health system barriers in current and post-conflict settings. Summarize the latest research on your topic. There is increasing research focusing on this subject. War and conflict zones have impact on stroke related to decreased access to stroke care facilities and increassed harmful effects of environmental factors, such as infections and stress. What answers did you find? What are the major takeaways/conclusions of your examination? What's the impact on future research? War imposes a significant neurological burden through direct injury, psychological trauma, infections, and disrupted care. Addressing this requires integrated care models, research investment, and international cooperation to mitigate the long-term disability in post-conflict populations. New systems must be established to reduce war related stroke burden to develop rapid-response neurology and stroke care units in conflict zones, improve tele-stroke and neurology for remote care delivery, and long-term registries for war-related stroke and other neurological outcomes. There is urgent need for stroke surveillance, prevention, and care strategies tailored to war-affected populations.
Exercise and Cognition in Multiple Sclerosis in 2025: Forward Momentum or Going Nowhere Fast?
Sandroff BM, Motl RW
Curr Neurol Neurosci Rep · 2025 Sep · PMID 40932601 · Publisher ↗
PURPOSE OF REVIEW: There is increasing interest in the study of exercise training as an approach to treat the cognitive consequences of multiple sclerosis (MS). The current paper reviews recent research on exercise train...
PURPOSE OF REVIEW: There is increasing interest in the study of exercise training as an approach to treat the cognitive consequences of multiple sclerosis (MS). The current paper reviews recent research on exercise training effects on cognition in MS, and provides several future directions for guiding, and perhaps optimizing, research in this area. RECENT FINDINGS: Overall, the newest evidence in this field is associated with substantial heterogeneity in study characteristics (i.e., sample sizes, demographic/clinical characteristics, exercise interventions, control/comparator conditions). The studies further focused on different primary outcomes, such that cognition is inconsistently included as a primary outcome. As a result, the study results were heterogeneous overall. Collectively, evidence on exercise training as an approach to improve cognition in persons with MS over the past two decades is mixed, and the efficacy or effectiveness of such an approach has not yet been established. Based on recently published studies, we believe that future research will involve stronger, better-designed RCTs that evaluate exercise, as a standalone and/or combinatory approach for improving cognition in MS, that are founded upon hypothesized mechanisms-of-action regarding adaptations in the central nervous system.
Pharmacological Strategies for the Treatment of Restless Legs Syndrome.
Anguizola D, Garcia Aragón A, Lopez Jimenez A … +2 more , Sainz V, Garcia-Borreguero D
Curr Neurol Neurosci Rep · 2025 Aug · PMID 40828344 · Publisher ↗
PURPOSE OF REVIEW: Restless legs syndrome (RLS) significantly impacts patients’ quality of life and requires effective management strategies. While dopaminergic agonists have been widely used in the past, concerns about...
PURPOSE OF REVIEW: Restless legs syndrome (RLS) significantly impacts patients’ quality of life and requires effective management strategies. While dopaminergic agonists have been widely used in the past, concerns about symptom augmentation highlight the need for alternative therapies. RECENT FINDINGS: Non-dopaminergic agents, such as α2δ ligands and iron supplementation, are viable alternatives with favorable safety profiles. A comprehensive approach that includes non-pharmacological measures, individualized treatment plans, and regular monitoring for iron deficiency is essential for optimal symptom management. We present a treatment plan using iron replacement and long-term use of non-dopaminergic agents. Dopamine agonists are reserved for specific, time-limited situations only, while opioids should be kept for treatment-resistant cases. As research advances, future RLS management will likely be individualized, further enhancing therapeutic outcomes and ultimately improving patients’ overall quality of life.
On Neurocardiology Updates: an Interdisciplinary Field at the Intersection of Neurology and Cardiology.
Bhatti MQ, Chapman R, Kulik T … +10 more , Di Napoli M, Bhatia K, Elkind MSV, Selim M, McCullough LD, Cáceres E, Flaherty JD, Zoghi M, Al Qassab O, Divani AA
Curr Neurol Neurosci Rep · 2025 Aug · PMID 40810888 · Publisher ↗
PURPOSE OF REVIEW: This review examines the evolving field of neurocardiology, tracing its development from early homeostatic theories to modern understandings of the bidirectional neural networks that link the heart and...
PURPOSE OF REVIEW: This review examines the evolving field of neurocardiology, tracing its development from early homeostatic theories to modern understandings of the bidirectional neural networks that link the heart and brain. We propose an integrative framework to explain neuro-cardiac interactions in health and disease, with a focus on clinical applications and emerging therapies. RECENT FINDINGS: The neuro-cardiac axis comprises hierarchical neural networks, from the intrinsic cardiac nervous system to subcortical and cortical brain regions. This structure underlies a range of clinical syndromes. Acute brain injuries can induce cardiac dysfunction via autonomic dysregulation, as seen in neurogenic stunned myocardium (NSM), while cardiac disease contributes to cerebral small vessel disease (CSVD) and cognitive decline. Cardioception-the brain's processing of cardiac signals-is increasingly recognized as a key mediator of autonomic control and emotional experience. Clinical trials highlight the value of targeted interventions, including extended cardiac monitoring to detect occult atrial fibrillation, improved risk stratification for managing patent foramen ovale, and intensive vascular risk control for cerebrovascular protection. Growing awareness of neuro-cardiac pathways is reshaping clinical care. Understanding how brain insults provoke cardiac dysfunction via disrupted autonomic outflow is critical, particularly in NSM. Meanwhile, cardioception is gaining relevance as a therapeutic target in the regulation of emotions and the autonomic nervous system. Conversely, cardiac pathology promotes stroke, CSVD, and cognitive impairment not only through embolism but also through altered perfusion and autonomic imbalance. Comprehensive management of modifiable vascular risks confers dual protection for the heart and brain. Interdisciplinary collaboration is increasingly vital for managing disorders along the heart-brain continuum. Translating insights from neurocardiac mechanisms into precision therapies marks a new frontier. Advances in neuroimaging, artificial intelligence, and neuromodulation offer opportunities for personalized care. The ongoing development of cross-specialty training and integrated research platforms will be essential for translating scientific progress into improved outcomes in neurocardiac disorders.
Central Nervous System Tumors in Adolescents and Young Adults.
Godoy-Santin J, Suthakaran A, Bennett J … +1 more , Lim-Fat MJ
Curr Neurol Neurosci Rep · 2025 Aug · PMID 40794377 · Publisher ↗
PURPUSE OF REVIEW: Brain tumors in adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, represent a heterogeneous group with a broad prognostic spectrum and unique clinical challenges. As many...
PURPUSE OF REVIEW: Brain tumors in adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, represent a heterogeneous group with a broad prognostic spectrum and unique clinical challenges. As many AYAs experience prolonged survival, treatment decisions must balance efficacy with the risk of long-term side effects. This review outlines the initial diagnostic approach and highlights recent therapeutic advances. RECENT FINDINGS: Advances in molecular diagnostics have refined tumor classification, enabled risk stratification, and supported the development of novel therapies. In selected tumors, targeted therapies are increasingly replacing conventional chemotherapy and radiation. Despite progress, treatment options for high-grade gliomas remain limited. A deeper understanding of oncogenic pathways has led to promising targeted therapies. However, more studies are needed to define optimal treatment combinations, sequencing, and strategies to overcome resistance. Multidisciplinary care is essential to address both oncologic outcomes and survivorship.
Psychedelics and Headache Disorders: an Update.
Im JJH, Sandoe CH
Curr Neurol Neurosci Rep · 2025 Aug · PMID 40782223 · Publisher ↗
PURPOSE OF REVIEW: Psychedelics are often queried as a potential therapeutic option in a multitude of conditions, including pain and mental health disorders, with a growing body of patient reports and scientific publicat...
PURPOSE OF REVIEW: Psychedelics are often queried as a potential therapeutic option in a multitude of conditions, including pain and mental health disorders, with a growing body of patient reports and scientific publications describing potential benefit. This article reviews recent research on psychedelic compounds for treatment of headache disorders. RECENT FINDINGS: Observational data, case reports, and a few recent small, controlled trials suggest symptom benefit at sub-hallucinogenic doses for both migraine and cluster headache. There have not been new completed studies of psychedelics in other headache disorders. Safety signals also tend to be favorable, although there are continuing concerns for systemic and psychiatric effects in varying doses, preparations and clinical contexts. While available studies on psychedelics suggest potential benefit in cluster headache and migraine, access remains complex due to legal considerations, and additional studies are needed to confirm their effectiveness and to ensure safety before they can be recommended for use.
Dizziness: When Is It Migraine, and When Is It Not?
Baron R, Steenerson KK
Curr Neurol Neurosci Rep · 2025 Aug · PMID 40762746 · Publisher ↗
PURPOSE OF REVIEW: Dizziness is a frequent neurologic symptom in patients with headache, which overlaps with many etiologies beyond vestibular migraine. This review aims to help neurologists distinguish when dizziness is...
PURPOSE OF REVIEW: Dizziness is a frequent neurologic symptom in patients with headache, which overlaps with many etiologies beyond vestibular migraine. This review aims to help neurologists distinguish when dizziness is due to vestibular migraine (VM) versus other vestibular syndromes. RECENT FINDINGS: VM is now recognized as the most common cause of spontaneous episodic vertigo, with expanding diagnostic criteria, new pathophysiological insights involving CGRP, and emerging treatment strategies including anti-CGRP therapies. It overlaps with benign paroxysmal positional vertigo (BPPV), Meniere's disease, persistent postural-perceptual dizziness (PPPD), and cerebrovascular events. Novel tools such as the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI) and frameworks like Timing, Triggers And Targeted Examination (TiTrATE) enhance diagnostic accuracy and patient outcomes. Differentiating VM from other causes of dizziness relies on a detailed clinical history, neurological examination, and increasingly, awareness of VM's protean features and comorbidities. Recognition is essential as treatments can differ significantly across etiologies. Future research should target biomarkers, subtypes and comparative treatment trials for VM and its mimics.
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