Current Opinion In Neurology[JOURNAL]
Sun
200 papers
Neuroglia's signaling: orchestrating neuronal gamma synchrony?
Andersen M, Hirase H, Kjaerby C … +1 more , Nedergaard M
Curr Opin Neurol · 2025 Aug · PMID 40471684 · Full text
PURPOSE OF REVIEW: Gamma oscillations (30-80 Hz) play a crucial role in sensory processing and cognitive functions, with disruptions in these rhythms linked to neurological disorders such as schizophrenia and Alzheimer's...
PURPOSE OF REVIEW: Gamma oscillations (30-80 Hz) play a crucial role in sensory processing and cognitive functions, with disruptions in these rhythms linked to neurological disorders such as schizophrenia and Alzheimer's disease. This review highlights the emerging role of astrocytes in regulating gamma oscillations, emphasizing their contribution to the inhibitory tone and extracellular ion homeostasis. RECENT FINDINGS: Recent studies suggest that astrocytes facilitate gamma synchrony, while dysfunction in astrocytic activity - such as impaired Ca 2+ signaling - is associated with deficits in gamma oscillations and increased network hyperexcitability. Thus, astrocytic dysfunction may contribute to the pathophysiology of gamma-related disorders. SUMMARY: By examining the role of astrocytes in maintaining neuronal network stability, this review highlights new aspects of neuroglia signaling.
Enzyme replacement therapies in adults with Pompe disease: from trials to real-world data.
van der Beek NAME, Potters LH, Schoser B
Curr Opin Neurol · 2025 Oct · PMID 40471681 · Full text
PURPOSE OF REVIEW: To review the clinical trial results and emerging real-world data of two new enzyme replacement therapies (ERTs) for late-onset Pompe disease and to compare these effects in the context of what has bee...
PURPOSE OF REVIEW: To review the clinical trial results and emerging real-world data of two new enzyme replacement therapies (ERTs) for late-onset Pompe disease and to compare these effects in the context of what has been achieved over the last two decades in advancing care for Pompe disease. RECENT FINDINGS: Randomized controlled trials (RCTs) of avalglucosidase alfa and cipaglucosidase alfa plus miglustat have demonstrated that both treatments are at least as efficacious as alglucosidase alfa and possess a comparable safety profile. Several post hoc analyses of the trial data have shown that these newer ERTs result in a greater percentage of patients achieving meaningful improvements and larger reductions in biomarker levels. The first real-world data on switching from alglucosidase alfa to avalglucosidase alfa has shown that the switch is safe and may alter individual disease trajectories. SUMMARY: The advent of two next-generation enzyme replacement therapies marks a new era in treating patients diagnosed with Pompe disease. Clinical trials and early real-world data suggest that they may be superior to alglucosidase alfa, the standard of care for the past 20 years, although head-to-head comparisons between all three treatments are lacking. More data will become available over the next 5 years, leading to better guidelines for starting, stopping and switching therapies based on a more personalized assessment of outcomes.
Inclusion body myositis - what are new lines of pathogenesis and therapy?
Krause K, Ruck T, Kleefeld F
Curr Opin Neurol · 2025 Oct · PMID 40471678 · Publisher ↗
PURPOSE OF REVIEW: Although inclusion body myositis (IBM) is considered a rare disease, it is the most prevalent inflammatory myopathy in adults over 50 years of age. Its complex pathophysiological background includes in...
PURPOSE OF REVIEW: Although inclusion body myositis (IBM) is considered a rare disease, it is the most prevalent inflammatory myopathy in adults over 50 years of age. Its complex pathophysiological background includes inflammatory and degenerative features, but it remains poorly understood. As a result, no effective therapy is currently available. In this review, we provide an update on the relevant contemporary literature addressing the clinical and pathophysiological aspects of IBM. RECENT FINDINGS: Recent studies have investigated drugs for IBM, including the immunosuppressant sirolimus, but haven't shown satisfactory results. Some advancements have been made in investigating IBM pathophysiology: a cell culture model recapitulating key disease features has been established. Multiple studies have used RNA sequencing to elucidate disease-specific pathways, including selective type 2 fiber vulnerability. The importance of TDP-43 deposition and subsequent mis-splicing as a disease mechanism has been demonstrated. Further studies have shown the value of patient-reported outcome measures (PROM) and quantitative MRI as investigation tools. Research has also investigated and demonstrated the complex genetic susceptibility related to IBM. SUMMARY: In conclusion, significant discoveries have been made in the past year that enhance our clinical and pathophysiological insights into IBM. Due to the persistent lack of effective therapeutic options, additional research is essential - not only to investigate potential treatments but also to reveal the disease's underlying mechanisms.
Recent progress in the molecular understanding and treatments of facioscapulohumeral muscular dystrophy.
Augustinus R, Voet N, de Greef JC … +1 more , Voermans NC
Curr Opin Neurol · 2025 Oct · PMID 40471677 · Publisher ↗
PURPOSE OF REVIEW: Facioscapulohumeral muscular dystrophy (FSHD) is a progressive inherited myopathy, for which there is currently no cure available. This review focuses on the recent progress in the molecular understand...
PURPOSE OF REVIEW: Facioscapulohumeral muscular dystrophy (FSHD) is a progressive inherited myopathy, for which there is currently no cure available. This review focuses on the recent progress in the molecular understanding and treatments of FSHD. RECENT FINDINGS: Recent studies on the molecular understanding of FSHD highlight its multifaceted complexity and suggest new targets for therapeutic intervention. Preclinical models, such as the 3D skeletal muscle, provide an easier way to study molecular pathways and serve as a platform for drug screenings. New insights on training and the new international guideline contribute to optimal symptomatic treatment. In parallel, research is advancing with generic and targeted molecular therapies aiming to inhibit DUX4 activity or its downstream effects. SUMMARY: FSHD is caused by abnormal expression of the DUX4 gene. Our understanding of the molecular mechanisms underlying DUX4 and DUX4 target gene expression remains incomplete. However, advancements continue to clarify the roles of key proteins and genes, which might be of interest for future therapeutic therapies. Current therapies, treatments, and clinical trials for FSHD focus on molecular approaches, gene therapy, and symptom management. These developments indicate a growing focus on precision treatments and functional assessments, paving the way for improved FSHD management.
Novel techniques for the diagnosis of neurological infections.
Alam AM, Houlihan CF, Bharucha T
Curr Opin Neurol · 2025 Aug · PMID 40471671 · Full text
PURPOSE OF REVIEW: On World Encephalitis Day 19th February 2025, Encephalitis International launched the World Health Organization technical brief on encephalitis, highlighting the growing public health challenge and nee...
PURPOSE OF REVIEW: On World Encephalitis Day 19th February 2025, Encephalitis International launched the World Health Organization technical brief on encephalitis, highlighting the growing public health challenge and need for improved diagnostics. This review summarizes the published literature over the last 18 months on novel methods of identifying the aetiology of neurological infections and existing research gaps. RECENT FINDINGS: There is an increased availability and sensitivity of multiplex polymerase chain reaction assays and untargeted metagenomic sequencing in clinical practice. This is contributing to increasing diagnostic yield in suspected neurological infections. Preliminary results suggest that novel serological methods such as phage immunoprecipitation sequencing (Phip-seq) may be useful where molecular approaches are negative. SUMMARY: Significant progress in improving diagnostics has been made in the last decade. Going forward, multicentre studies and meta-analyses are needed to achieve adequate power in ascertaining the role of novel diagnostic methods in neurological infections. Studies need to investigate the impact on patient management and cost-effectiveness. The role of other omics methods in identifying host biomarkers for utilization in diagnostic algorithms needs further work.
Recent advances in the genetics of Parkinson's disease in underrepresented populations.
Marconi GA, Teixeira-Dos-Santos D, Schuh AFS
Curr Opin Neurol · 2025 Aug · PMID 40471658 · Publisher ↗
PURPOSE OF REVIEW: The aim of this study is to highlight recent key developments in Parkinson's disease genetics research in underrepresented populations, point out gaps related to ethnic and geographical diversity, and...
PURPOSE OF REVIEW: The aim of this study is to highlight recent key developments in Parkinson's disease genetics research in underrepresented populations, point out gaps related to ethnic and geographical diversity, and suggest future directions for increasing representation in genetics. RECENT FINDINGS: Genome-wide association studies (GWAS) involving non-European ancestries have identified population-specific risk variants, even with relatively small sample sizes compared to European GWAS. Polygenic risk scores derived from European cohorts often fail to generalize to non-European populations. Additionally, the prevalence of variants in Parkinson's disease genes, such as LRRK2 and GBA1 , varies across populations. Monogenic studies in regions like African and Latin America face significant challenges, including limited research infrastructure and underrepresentation in genetic studies, hindering a comprehensive understanding of Parkinson's disease's genetic diversity. SUMMARY: Expanding Parkinson's disease genetics research to include diverse populations is essential to enhance disease understanding, uncover novel therapeutic targets, and ensure equitable access to precision medicine. Addressing participation barriers in underrepresented regions and investing in infrastructure development is essential for future progress.
Brain health in HIV: pathogenesis, classification, and treatment.
Holroyd KB, Winston A, Nightingale S
Curr Opin Neurol · 2025 Aug · PMID 40466022 · Publisher ↗
PURPOSE OF REVIEW: An update on brain health and cognitive function in persons living with HIV, with a focus on pathogenesis, classification and treatment. RECENT FINDINGS: Criteria for HIV-associated neurocognitive diso...
PURPOSE OF REVIEW: An update on brain health and cognitive function in persons living with HIV, with a focus on pathogenesis, classification and treatment. RECENT FINDINGS: Criteria for HIV-associated neurocognitive disorders overestimate prevalence of cognitive impairment and should no longer be used. Instead, HIV-associated brain injury should be considered as one cause of cognitive impairment in persons living with HIV, along with other non-HIV factors. The most widely used cardiovascular risk calculators and stroke categorization tools are not based on data including persons with HIV and appear to underestimate cardiovascular risk. A statin should be considered in all persons living with HIV over the age of 40 and assists in preventing cerebrovascular disease. SUMMARY: HIV is a neurotropic virus which penetrates the central nervous system (CNS) within days of infection, establishing a reservoir. Cerebrospinal fluid (CSF) HIV RNA escape can cause progressive neurologic symptoms and is treatable by targeting the CSF HIV genotypic resistance profile. As the population of persons living with HIV ages, it is important to address noncommunicable sequelae such as multifactorial causes of cognitive impairment and cerebrovascular disease. Strategies for HIV cure need to address barriers and risks posed by the CNS HIV reservoir.
MRI protocols and sequences for amyloid-related imaging abnormalities monitoring in Alzheimer's disease patients treated with monoclonal antibodies.
Agosta F, Cecchetti G, Spinelli EG … +3 more , Ghirelli A, Rugarli G, Filippi M
Curr Opin Neurol · 2025 Aug · PMID 40466018 · Publisher ↗
PURPOSE OF REVIEW: This review provides an updated overview of amyloid-related imaging abnormalities (ARIA) associated with antiamyloid monoclonal antibodies (mAbs) in Alzheimer's disease (AD). Following regulatory appro...
PURPOSE OF REVIEW: This review provides an updated overview of amyloid-related imaging abnormalities (ARIA) associated with antiamyloid monoclonal antibodies (mAbs) in Alzheimer's disease (AD). Following regulatory approvals for both lecanemab and donanemab in the United States, and pending decisions in Europe, standardized understanding of ARIA definitions, risk factors, and optimal MRI surveillance is increasingly important to guide treatment and ensure safety. RECENT FINDINGS: ARIA, including vasogenic edema (ARIA-E) and microhemorrhages/siderosis (ARIA-H), are a frequent adverse event in patients receiving antiamyloid mAbs, particularly among APOE ε4 homozygotes. Incidence varies by agent and trial design. While often asymptomatic and self-limiting, ARIA can occasionally present with symptoms or recur. MRI, especially FLAIR and susceptibility-sensitive imaging, is essential for baseline risk stratification and monitoring. Key imaging biomarkers include microbleeds and superficial siderosis. Recent guidelines support genotyping and risk-adapted MRI protocols before and during therapy. SUMMARY: ARIA reflect vascular vulnerability during amyloid clearance in AD. Their management requires close collaboration between neurologists and neuroradiologists, with harmonized MRI protocols and risk mitigation strategies critical for safe and effective use of disease-modifying therapies.
Viral encephalitis - update on pathogenesis and treatment.
Matthews R, Sargent BF, McKeever S … +3 more , Huang Y, Ellul MA, Michael BD
Curr Opin Neurol · 2025 Aug · PMID 40466008 · Publisher ↗
PURPOSE OF REVIEW: Viral encephalitis is a potentially devastating condition of cerebral inflammation manifest as a combination of fever, altered mentation, and sometimes focal neurological signs and seizures. In this re...
PURPOSE OF REVIEW: Viral encephalitis is a potentially devastating condition of cerebral inflammation manifest as a combination of fever, altered mentation, and sometimes focal neurological signs and seizures. In this review we explore the new developments in understanding of the epidemiology, pathogenesis and treatment options. RECENT FINDINGS: The WHO technical brief is a landmark document which sets the stage for the advancement of the surveillance, prevention and management of viral encephalitis. Adjunctive dexamethasone given in herpes simplex virus encephalitis is not associated with a worse outcome or CSF viral persistence but may not significantly improve overall outcome. Simple interventions in resource limited settings can significantly increase the proportion of patients with a syndrome or aetiological diagnosis of viral encephalitis. SUMMARY OF IMPLICATIONS: This review highlights ongoing research further elucidating the underlying pathophysiological mechanisms of brain injury, paving the way for adjunctive targeted immunotherapy which can ameliorate those aspects of the inflammatory response contributing to brain injury. Nevertheless, large-scale networks are required to establish the prospective, adaptive platform trials necessary. Pending this, as laid out in the WHO Technical Brief on encephalitis, preventive measures have the potential to save lives, including surveillance, vector control, and uptake of established and emerging vaccines.
Sex and gender differences in neurological infections.
Dias SP, Akhvlediani T, Bernard-Valnet R … +6 more , Bigi S, Eikeland R, Pal PK, Pfausler B, Sellner J, Infectious Diseases Scientific Panel of the European Academy of Neurology
Curr Opin Neurol · 2025 Aug · PMID 40465968 · Publisher ↗
PURPOSE OF REVIEW: Neurological infections are a significant cause of morbidity and mortality. This review aims to summarize current insights and developments for sex and gender differences in the epidemiology, clinical...
PURPOSE OF REVIEW: Neurological infections are a significant cause of morbidity and mortality. This review aims to summarize current insights and developments for sex and gender differences in the epidemiology, clinical presentation, and prognosis of neurological infections. RECENT FINDINGS: Sex refers to the biological and physiological factors that define males and females. Gender, on the other hand, refers to characteristics that are socially constructed. Both aspects are central to infectious disease pathogenesis, and clinical and scientific evidence of their relevance in neuroinfections is emerging. Indeed, differences in exposure to pathogens and genetic and hormonal factors modulate immune responses and modify the susceptibility, clinical course, and response to the treatment of neurological infections. SUMMARY: Recognizing and addressing sex and gender differences in neurological infections is crucial for tailoring diagnostic, therapeutic, and preventive strategies. Our review underscores the importance of considering sex and gender in clinical practice and research to improve patient care and outcomes.
Editorial improving movement disorders healthcare across the globe.
Sharma N
Curr Opin Neurol · 2025 Aug · PMID 40462703 · Full text
Abstract loading — click title to view on PubMed.
Barriers to clinical genetic testing in movement disorders.
Yeow D, Rudaks LI, Kumar KR
Curr Opin Neurol · 2025 Aug · PMID 40396552 · Full text
PURPOSE OF REVIEW: The number of known genetic movement disorders and potential treatments for these disorders have grown rapidly over the last few decades. Despite this, genetic testing for movement disorders remains re...
PURPOSE OF REVIEW: The number of known genetic movement disorders and potential treatments for these disorders have grown rapidly over the last few decades. Despite this, genetic testing for movement disorders remains relatively underutilized in clinical practice. In this review, we explore a number of barriers that prevent more routine and widespread use of genetic testing for movement disorders. RECENT FINDINGS: Cost and limited health insurance coverage as well as difficulty accessing genetic testing and counselling are major barriers to genetic testing and disproportionately affect low- and middle-income countries and specific sociodemographic groups. Clinician misperceptions and limited knowledge about genetic testing for movements disorders as well as patient and clinician concerns about the potential for genetic discrimination are further obstacles. Despite these barriers, several recent international collaborative studies have demonstrated the feasibility of delivering clinical genetic testing and genetic counselling for movement disorders on a large scale. SUMMARY: Concerted action at multiple organizational levels (government, specialty societies, health insurance organizations, etc.) is required in order to address the identified barriers and improve utilization of genetic testing in movement disorders on a global scale.
Imaging and neuromodulation in Parkinson's disease.
Boutet A, Germann J, Fasano A
Curr Opin Neurol · 2025 Aug · PMID 40396550 · Publisher ↗
PURPOSE OF REVIEW: Imaging plays a key role in neuromodulation for Parkinson's disease, particularly for deep brain stimulation (DBS), which is the most frequently employed neuromodulatory treatment. Its role is rapidly...
PURPOSE OF REVIEW: Imaging plays a key role in neuromodulation for Parkinson's disease, particularly for deep brain stimulation (DBS), which is the most frequently employed neuromodulatory treatment. Its role is rapidly expanding due to improving neuroradiological techniques. RECENT FINDINGS: Imaging is crucial at each stage of DBS care: pre, intra-, and postoperative, with roles now going beyond the traditional surgical planning and lead localization. Imaging opens the door to patient selection informed by their unique preoperative features and individualized electrode placement due to the direct visualization of targets. Imaging also permits intra-operative localization of electrodes with widely accessible fluoroscopy and offers the possibility of visualizing the orientation of segmented contacts. Advanced imaging techniques have defined anatomical sweets spots and efficacious connectomes associated with best outcomes after DBS. They also offer opportunities to develop new biomarker of successful stimulation, which is critical to the future of DBS programming. SUMMARY: Imaging should be thought as a powerful tool to push the neuromodulation field towards new boundaries focusing on personalized electrode implantation and stimulation titration. This will improve patient outcomes and inform alternative neuromodulation modalities, for which the data remain limited.
Brain age prediction from MRI scans in neurodegenerative diseases.
Papouli A, Cole JH
Curr Opin Neurol · 2025 Aug · PMID 40396549 · Full text
PURPOSE OF REVIEW: This review explores the use of brain age estimation from MRI scans as a biomarker of brain health. With disorders like Alzheimer's and Parkinson's increasing globally, there is an urgent need for earl...
PURPOSE OF REVIEW: This review explores the use of brain age estimation from MRI scans as a biomarker of brain health. With disorders like Alzheimer's and Parkinson's increasing globally, there is an urgent need for early detection tools that can identify at-risk individuals before cognitive symptoms emerge. Brain age offers a noninvasive, quantitative measure of neurobiological ageing, with applications in early diagnosis, disease monitoring, and personalized medicine. RECENT FINDINGS: Studies show that individuals with Alzheimer's, mild cognitive impairment (MCI), and Parkinson's have older brain ages than their chronological age. Longitudinal research indicates that brain-predicted age difference (brain-PAD) rises with disease progression and often precedes cognitive decline. Advances in deep learning and multimodal imaging have improved the accuracy and interpretability of brain age predictions. Moreover, socioeconomic disparities and environmental factors significantly affect brain aging, highlighting the need for inclusive models. SUMMARY: Brain age estimation is a promising biomarker for identify future risk of neurodegenerative disease, monitoring progression, and helping prognosis. Challenges like implementation of standardization, demographic biases, and interpretability remain. Future research should integrate brain age with biomarkers and multimodal imaging to enhance early diagnosis and intervention strategies.
Disparities in Huntington's disease care and research.
Madera A, Schrodt C, Mendizabal A
Curr Opin Neurol · 2025 Aug · PMID 40395201 · Full text
PURPOSE OF REVIEW: Disparities in care and outcomes are well described in common neurologic disorders; however, less is known about disparities in rare diseases such as Huntington's disease (HD). This review summarizes H...
PURPOSE OF REVIEW: Disparities in care and outcomes are well described in common neurologic disorders; however, less is known about disparities in rare diseases such as Huntington's disease (HD). This review summarizes HD epidemiology in the US and globally while highlighting disparities in HD diagnosis and outcomes across various HD groups. The review also discusses how the lack of diversity in HD research threatens the validity of clinical trials and raises concerns about global accessibility to emerging therapies. RECENT FINDINGS: Global HD prevalence and incidence vary worldwide, though the highest numbers are reported in Latin American cluster regions. Within North America, there are disparities in diagnosis and outcomes among Black and Latino patients. Socioeconomic status, educational attainment, and sex were also associated with differences in diagnosis, access, and outcomes. Many of the recent studies in this review used the ENROLL-HD longitudinal study. Yet, the dataset is 90% White Non-Hispanic, leading to an incomplete understanding of how HD manifests in diverse groups. SUMMARY: Racial, sex, and socioeconomic disparities exist in HD care and research. Addressing these disparities is imperative in improving access to HD care, clinical trial participation, and disease-specific outcomes for all patients with HD in the US and worldwide.
Challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders.
Dy-Hollins ME, Mendizabal A, Tsai AC
Curr Opin Neurol · 2025 Aug · PMID 40377705 · Full text
PURPOSE OF REVIEW: The purpose of this review is to highlight challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders, specifically Tourette syndrome and Huntington's disease. RECENT FINDIN...
PURPOSE OF REVIEW: The purpose of this review is to highlight challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders, specifically Tourette syndrome and Huntington's disease. RECENT FINDINGS: We highlight racial and ethnic disparities in understudied movement disorders, particularly the neuropsychiatric hyperkinetic movement disorders, Tourette syndrome and Huntington's disease. These diagnoses are likely under-recognized and under-diagnosed in racial and ethnic minority groups, leading to disparities in access to subspecialty care and treatment. Factors contributing to disparities are complex and likely include patient mistrust of the medical community, stigma, and structural racism. Application of health disparities research frameworks used in other disciplines may have utility in the study of inequities in neurology. SUMMARY: There are significant challenges in studying disparities in Tourette syndrome and Huntington's disease. We also highlight frameworks used in neurology as well as recommendations from the National Institute of Neurological Disorders and Stroke around training in health disparities and recommendations in reducing disparities in neurological disorders across the life span.
Update on the clinical and therapeutic aspects of myotonic dystrophy type 1.
Takahashi MP
Curr Opin Neurol · 2025 Oct · PMID 40377703 · Publisher ↗
PURPOSE OF REVIEW: Myotonic dystrophy type 1 (DM1) is a genetically mediated, multisystemic neuromuscular disorder with significant phenotypic heterogeneity. This review aimed to summarize recent advances in clinical und...
PURPOSE OF REVIEW: Myotonic dystrophy type 1 (DM1) is a genetically mediated, multisystemic neuromuscular disorder with significant phenotypic heterogeneity. This review aimed to summarize recent advances in clinical understanding, natural history, and therapeutic development, with a focus on cardiac, respiratory, cognitive, and pediatric aspects of DM1. RECENT FINDINGS: Longitudinal studies are refining the natural history of both adult and pediatric DM1. Advances in biomarker discovery, including composite ribosomal nucleic acid splicing metrics and imaging findings, are improving disease monitoring and treatment assessment. Cardiac risk stratification is evolving, although respiratory management remains challenging due to adherence issues. Increasing attention is being given to cognitive and behavioral impairments, particularly in congenital and childhood-onset DM1. Although disease-modifying therapies remain in development, real-world data on symptomatic treatments such as mexiletine and nonpharmacological interventions, including exercise and cognitive behavioral therapy, provide valuable clinical insights. SUMMARY: Recent literature highlights substantial progress in understanding DM1 across different age groups and organ systems. Although no approved disease-modifying therapies exist, ongoing clinical trials and biomarker advancements offer hope. This review synthesizes these developments to inform clinical management and guide future research efforts.
New approaches to lesion assessment in multiple sclerosis.
Preziosa P, Filippi M, Rocca MA
Curr Opin Neurol · 2025 Aug · PMID 40377692 · Publisher ↗
PURPOSE OF REVIEW: To summarize recent advancements in artificial intelligence-driven lesion segmentation and novel neuroimaging modalities that enhance the identification and characterization of multiple sclerosis (MS)...
PURPOSE OF REVIEW: To summarize recent advancements in artificial intelligence-driven lesion segmentation and novel neuroimaging modalities that enhance the identification and characterization of multiple sclerosis (MS) lesions, emphasizing their implications for clinical use and research. RECENT FINDINGS: Artificial intelligence, particularly deep learning approaches, are revolutionizing MS lesion assessment and segmentation, improving accuracy, reproducibility, and efficiency. Artificial intelligence-based tools now enable automated detection not only of T2-hyperintense white matter lesions, but also of specific lesion subtypes, including gadolinium-enhancing, central vein sign-positive, paramagnetic rim, cortical, and spinal cord lesions, which hold diagnostic and prognostic value. Novel neuroimaging techniques such as quantitative susceptibility mapping (QSM), χ-separation imaging, and soma and neurite density imaging (SANDI), together with PET, are providing deeper insights into lesion pathology, better disentangling their heterogeneities and clinical relevance. SUMMARY: Artificial intelligence-powered lesion segmentation tools hold great potential for improving fast, accurate and reproducible lesional assessment in the clinical scenario, thus improving MS diagnosis, monitoring, and treatment response assessment. Emerging neuroimaging modalities may contribute to advance the understanding MS pathophysiology, provide more specific markers of disease progression, and novel potential therapeutic targets.
Neuromuscular sarcopenia: what do we know?
Drey M
Curr Opin Neurol · 2025 Oct · PMID 40377685 · Publisher ↗
PURPOSE OF REVIEW: Sarcopenia is a common and relevant health problem in the treatment of geriatric patients. After many years of dealing with the definition of this phenomenon, the focus in the future must be on underly...
PURPOSE OF REVIEW: Sarcopenia is a common and relevant health problem in the treatment of geriatric patients. After many years of dealing with the definition of this phenomenon, the focus in the future must be on underlying and treatable pathomechanisms. RECENT FINDINGS: The article describes the initial state with regard to the definition of sarcopenia and derives from this the focus on subgroups of sarcopenia with treatable pathomechanisms. One subgroup of neuromuscular sarcopenia, which focuses on the degeneration of the neuromuscular junction, is discussed. In this context, the proteoglycan agrin with its ability to cluster acetylcholine receptors in the postsynaptic membrane of the muscle plays a role. Inactivation of agrin leads to destabilization of the neuromuscular junction and thus to sarcopenia. The resulting neuronal 22 kDa C-terminal agrin fragment should serve as a biomarker of neuromuscular sarcopenia. SUMMARY: The neuronal C-terminal agrin fragment must be established as a biomarker for neuromuscular sarcopenia, taking renal function into account as the fragment accumulates in renal insufficient patients. On this basis, treatment with agrin could be a therapeutic option for this subgroup of sarcopenia.
Deep brain stimulation access in 2025: geographic, gender, racial, and socioeconomic disparities re-examined.
Cavaleri J, Stefanescu K, Lee D … +1 more , Mason X
Curr Opin Neurol · 2025 Aug · PMID 40377666 · Publisher ↗
PURPOSE OF REVIEW: This review highlights recent studies examining disparities in access to deep brain stimulation (DBS), an effective but resource-intensive therapy for neurological and neuropsychiatric disorders. As DB...
PURPOSE OF REVIEW: This review highlights recent studies examining disparities in access to deep brain stimulation (DBS), an effective but resource-intensive therapy for neurological and neuropsychiatric disorders. As DBS indications expand, understanding barriers to equitable provision is increasingly urgent to ensure that all eligible patients can benefit. RECENT FINDINGS: Emerging literature confirms persistent disparities in DBS utilization based on geography, gender, race, and socioeconomic status. Geographic disparities reflect regional differences in healthcare infrastructure, with limited access in both rural areas of high-income countries and throughout low-income and middle-income nations. Women remain less likely than men to receive DBS for movement disorders, influenced by referral patterns, social support, and patient preference. Racial and ethnic minority patients - particularly Black and Hispanic individuals - consistently receive DBS at lower rates, in part due to reduced referrals. Socioeconomic factors, including insurance status and household income, strongly predict DBS access, favoring privately insured and wealthier patients. SUMMARY: These findings underscore the need for systemic changes in referral practices, institutional policies, and healthcare funding to reduce structural barriers to DBS. Future research should focus on intersectional factors driving disparities and evaluate targeted interventions to promote equitable access.
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