Current Opinion In Neurology[JOURNAL]
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200 papers
Mental health and psychological processes associated with cognitive aging and dementia.
Bartrés-Faz D, Marchant NL
Curr Opin Neurol · 2025 Apr · PMID 39916679 · Publisher ↗
PURPOSE OF REVIEW: This review focuses on the role of psychological factors in cognitive aging and dementia, an area that has received less attention compared to other modifiable factors (e.g. sleep, physical activity, a...
PURPOSE OF REVIEW: This review focuses on the role of psychological factors in cognitive aging and dementia, an area that has received less attention compared to other modifiable factors (e.g. sleep, physical activity, and so on) or reduction of disease risk. RECENT FINDINGS: A range of mental health and psychological aspects, including clinical symptoms, stable personality traits, and more specific constructs or processes (e.g. repetitive negative thinking, purpose in life), are associated with cognitive aging and dementia risk. Psychological factors can either serve as protective or risk elements, influencing brain health through general mechanisms, including stress regulation and impact on several biological systems, as well as modulate brain resistance and cognitive resilience to Alzheimer's disease and age-related brain changes. Protective psychological traits are linked to healthier lifestyle habits, while risk factors are associated with negative behaviors, and may impact cognitive function across the lifespan, suggesting benefits for psychological education from early life. SUMMARY: The review emphasizes the need for greater focus on optimizing psychological well being, particularly in at-risk populations, and suggests that interventions should be tailored to individuals' values and life purposes. Additionally, further research is needed to explore the neurobiological mechanisms through which psychologically focused interventions may influence cognitive decline and dementia.
The role of the gut microbiome in Alzheimer's disease pathophysiology.
Borrego-Ruiz A, Borrego JJ
Curr Opin Neurol · 2025 Apr · PMID 39916659 · Publisher ↗
PURPOSE OF REVIEW: The present review aims to provide an overview of the existing understanding of the role of the gut microbiome in the Alzheimer's disease pathophysiology. RECENT FINDINGS: Recent research has highlight...
PURPOSE OF REVIEW: The present review aims to provide an overview of the existing understanding of the role of the gut microbiome in the Alzheimer's disease pathophysiology. RECENT FINDINGS: Recent research has highlighted the significant role of the gut microbiome in the pathogenesis of Alzheimer's disease via the gut-brain axis. However, the precise mechanisms by which gut microbiome and its microbial metabolites influence brain function are not clearly understood. Various factors, such as diet, drugs, lifestyle, stress, and microbial infections can provoke an imbalance in the gut microbiome homeostasis, known as dysbiosis. This dysbiosis impacts intestinal and blood-brain barrier permeability, elevating pro-inflammatory cytokines and contributing to neurodegeneration. Moreover, the gut microbiome generates neurotransmitters, amyloids, neurotoxins, and metabolites, which may play a role in systemic inflammation and in the disruption of physiological barriers. SUMMARY: In the past decade, advancements in microbiome analysis technologies and bioinformatics have significantly enhanced our understanding of the role of the gut microbiome in Alzheimer's disease. The gut microbiome plays a pivotal regulatory role in the progression of Alzheimer's disease, and closely interacts with its pathogenesis, encompassing inflammation, amyloidosis, neurodegeneration, tauopathy, and co-pathologies.
How can you manage an indomethacin-responsive headache in someone who cannot take indomethacin?
Osiowski A, Stolarz K, Taterra D
Curr Opin Neurol · 2025 Jun · PMID 39911098 · Full text
PURPOSE OF REVIEW: Paroxysmal hemicrania and hemicrania continua are rare primary headache disorders which are distinguished by an absolute response to indomethacin. As a matter of importance, no guidelines have been pro...
PURPOSE OF REVIEW: Paroxysmal hemicrania and hemicrania continua are rare primary headache disorders which are distinguished by an absolute response to indomethacin. As a matter of importance, no guidelines have been proposed for alternative therapeutic options in case of indomethacin intolerance. The purpose of this review is to provide an update on the current findings, especially focusing on the past 18 months, in the treatment of both paroxysmal hemicrania and hemicrania continua and to provide proposed management recommendations based on summarized evidence. RECENT FINDINGS: Apart from well recognized gastrolesive effects of indomethacin, a substantial number of patients may suffer from neuropsychiatric adverse reactions. Recent studies demonstrated that melatonin, which has been known for its effectiveness for hemicrania continua, is also useful for paroxysmal hemicrania. Promising nonpharmacological treatment option, which is noninvasive vagus nerve stimulation, has been shown to be beneficial for both indomethacin-responsive headache disorders allowing the reduction of indomethacin dosage. Although the data on substitutive medication choice for indomethacin are currently scarce, the most consistent results have been repeatedly achieved with acemethacin, selective COX-2 inhibitors, and anticonvulsants. However, considering the crucial role of pathophysiology, research investigating the efficacy of drugs targeting the trigemino-vascular system activation, as well as controlled trials assessing the efficacy involving the aforementioned therapeutic options are still vague. SUMMARY: In spite of numerous reports suggesting reliable alternatives to indomethacin, the consensus on pharmacological therapy guidelines for indomethacin-responsive headache disorders has not yet been reached. Further research and agreement from the experts' standpoint are needed for an establishment of reliable treatment recommendations.
Can brain network analyses guide epilepsy surgery?
Makhoul GS, Doss DJ, Englot DJ
Curr Opin Neurol · 2025 Apr · PMID 39886890 · Full text
PURPOSE OF REVIEW: Epilepsy surgery is a potentially curative intervention for medically refractory epilepsy. In the last several decades, epilepsy has been studied as a network disorder. How has this disease model influ...
PURPOSE OF REVIEW: Epilepsy surgery is a potentially curative intervention for medically refractory epilepsy. In the last several decades, epilepsy has been studied as a network disorder. How has this disease model influenced surgical interventions? RECENT FINDINGS: Surgical outcomes for resection are increasingly being tied to network features, such as node hubness score. These findings imply that measuring network features may augment epileptologist seizure onset zone designation for surgical planning. Network models are also leveraged for neuromodulation, specifically in studies with thalamic targets. Recent findings suggest that the thalamus may function as a reasonable target for neuromodulation because of its role in the seizure propagation networks. SUMMARY: In this review, we discuss the degree these models of epilepsy are influencing surgery today and barriers for the widespread adoption of network models when planning epilepsy surgery.
Headache in infections.
Ramesh R, Ranganathan LN
Curr Opin Neurol · 2025 Jun · PMID 39878050 · Publisher ↗
PURPOSE OF REVIEW: This review explores the phenomenology, pathogenesis, and nosology of headaches associated with infections, an often-overlooked yet clinically significant symptom. With the increasing recognition of se...
PURPOSE OF REVIEW: This review explores the phenomenology, pathogenesis, and nosology of headaches associated with infections, an often-overlooked yet clinically significant symptom. With the increasing recognition of secondary headaches in infections, understanding their clinical patterns, mechanisms, and classifications is crucial for accurate diagnosis and management. RECENT FINDINGS: Headaches in infections are ubiquitous but vary in presentation, severity, and underlying mechanisms depending on the causative pathogen. Elevated intracranial pressure, meningeal irritation, and activation of the trigeminovascular system are key contributors to headache generation, which varies depending on each pathogen. Pathogen-specific predilection for one of these mechanisms may subtly alter the clinical phenotype of the headache, which can be used to guide management. Emerging evidence highlights postinfectious headache syndromes, particularly following bacterial meningitis and SARS-CoV-2 infection, underscoring the need for long-term follow-up in these patients. SUMMARY: The diverse presentations of infection-related headaches necessitate a systematic approach to evaluation and management. While the pathophysiology is complex and multifaceted, understanding these mechanisms aids in differentiating primary headaches from those secondary to infections.
Seizure prediction and forecasting: a scoping review.
Cheng JC, Goldenholz DM
Curr Opin Neurol · 2025 Apr · PMID 39831588 · Full text
PURPOSE OF REVIEW: This scoping review summarizes key developments in the field of seizure forecasting. RECENT FINDINGS: Developments have been made along several modalities of seizure forecasting, including long term in...
PURPOSE OF REVIEW: This scoping review summarizes key developments in the field of seizure forecasting. RECENT FINDINGS: Developments have been made along several modalities of seizure forecasting, including long term intracranial and subcutaneous encephalogram, wearable physiologic monitoring, and seizure diaries. However, clinical translation of these tools is limited by various factors. One is the lack of validation of these tools on an external dataset. Moreover, the widespread practice of comparing models to a chance forecaster may be inadequate. Instead, the model should be able to at least surpass a moving average forecaster, which serves as a 'napkin test' (i.e., can be computed on the back of a napkin). The impact of seizure frequency on model performance should also be accounted for when comparing performance across studies. Surprisingly, despite the potential for poor quality forecasts, some individuals with epilepsy still want access to imprecise forecasts and some even alter their behavior based upon them. SUMMARY: Promising advances have been made in the development of tools for seizure forecasting, but current tools have not yet overcome clinical translation hurdles. Future studies will need to address potentially dangerous patient behaviors as well as account for external validation, the napkin test, seizure frequency dependent metrics.
Artificial intelligence and stroke imaging.
Rondina J, Nachev P
Curr Opin Neurol · 2025 Feb · PMID 39760722 · Full text
PURPOSE OF REVIEW: Though simple in its fundamental mechanism - a critical disruption of local blood supply - stroke is complicated by the intricate nature of the neural substrate, the neurovascular architecture, and the...
PURPOSE OF REVIEW: Though simple in its fundamental mechanism - a critical disruption of local blood supply - stroke is complicated by the intricate nature of the neural substrate, the neurovascular architecture, and their complex interactions in generating its clinical manifestations. This complexity is adequately described by high-resolution imaging with sensitivity not only to parenchymal macrostructure but also microstructure and functional tissue properties, in conjunction with detailed characterization of vascular topology and dynamics. Such descriptive richness mandates models of commensurate complexity only artificial intelligence could plausibly deliver, if we are to achieve the goal of individually precise, personalized care. RECENT FINDINGS: Advances in machine vision technology, especially deep learning, are delivering higher fidelity predictive, descriptive, and inferential tools, incorporating increasingly rich imaging information within ever more flexible models. Impact at the clinical front line remains modest, however, owing to the challenges of delivering models robust to the noisy, incomplete, biased, and comparatively small-scale data characteristic of real-world practice. SUMMARY: The potential benefit of introducing AI to stroke, in imaging and elsewhere, is now unquestionable, but the optimal approach - and the path to real-world application - remain unsettled. Deep generative models offer a compelling solution to current obstacles and are predicted powerfully to catalyse innovation in the field.
Cerebral amyloid angiopathy: one single entity?
Koemans EA, van Etten ES
Curr Opin Neurol · 2025 Feb · PMID 39760721 · Publisher ↗
PURPOSE OF REVIEW: Cerebral amyloid angiopathy (CAA) is a common brain disorder among the elderly and individuals with Alzheimer's disease, where accumulation of amyloid-ß can lead to intracerebral hemorrhage and dementi...
PURPOSE OF REVIEW: Cerebral amyloid angiopathy (CAA) is a common brain disorder among the elderly and individuals with Alzheimer's disease, where accumulation of amyloid-ß can lead to intracerebral hemorrhage and dementia. This review discusses recent developments in understanding the pathophysiology and phenotypes of CAA. RECENT FINDINGS: CAA has a long preclinical phase starting decades before symptoms emerge. Its pathophysiology follows consecutive stages of amyloid-ß deposition, decreased vascular reactivity, nonhemorrhagic changes, and ultimately hemorrhages. Although impaired perivascular clearance is the leading hypothesis underlying CAA, several lines of evidence suggest that glymphatic dysfunction also plays a significant role in the disease process. Despite its common pathway, the disease course is variable. Some patients develop more microbleeds, while others develop larger hemorrhages, suggesting a differentiation in vascular remodeling. Some patients with CAA develop a symptomatic immune response, and inflammation could be an important contributor to vascular damage in CAA in general. Furthermore, the prion-like transmission of amyloid-β has been identified as a cause of iatrogenic CAA occurring decades after neurosurgical procedures involving cadaveric dura mater. SUMMARY: Emerging evidence of sporadic, hereditary, inflammatory, and iatrogenic CAA suggests a complex interplay between brain clearance, inflammation and vascular remodeling leading to a diverse clinical phenotype.
Recent advances, challenges and perspectives in cerebrovascular disease.
Puy L, Leys D
Curr Opin Neurol · 2025 Feb · PMID 39760720 · Publisher ↗
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Clinical trials in Leber hereditary optic neuropathy: outcomes and opportunities.
Chen BS, Newman NJ
Curr Opin Neurol · 2025 Feb · PMID 39704163 · Publisher ↗
PURPOSE OF REVIEW: Leber hereditary optic neuropathy (LHON) is a mitochondrial DNA disease characterised by sequential bilateral vision loss due to loss of retinal ganglion cells. The purpose of this review is to provide...
PURPOSE OF REVIEW: Leber hereditary optic neuropathy (LHON) is a mitochondrial DNA disease characterised by sequential bilateral vision loss due to loss of retinal ganglion cells. The purpose of this review is to provide an update on the results of recent clinical trials for LHON, focusing on studies of idebenone and lenadogene nolparvovec gene therapy. RECENT FINDINGS: Evidence from three clinical studies (RHODOS, RHODOS-OFU, and LEROS) suggest that idebenone should be started early and continued for at least 24 months. Treatment effect varies according to the stage of LHON and the underlying mutation. Favourable outcomes are associated with the m.11778G>A mutation and chronic eyes with the m.14484T>C mutation. Caution should be taken in subacute/dynamic eyes with the m.3460G>A mutation, due to possible clinical worsening with idebenone. Compared to eyes from an external natural history cohort, pooled data from four clinical studies (RESCUE, REVERSE, RESTORE and REFLECT) show that a single intravitreal injection of lenadogene nolparvovec can result in sustained bilateral visual improvement in m.11778G>A LHON patients aged ≥15 years when treated within 1 year of onset. Although the treatment effect is modest, the final visual acuity of treated patients (∼1.2 logMAR) significantly differs from the published natural history of LHON and the treatment benefit is more pronounced than the effect of idebenone alone in patients with the m.11778G>A mutation. SUMMARY: There is increasing evidence for the potential therapeutic benefit of idebenone and lenadogene nolparvovec gene therapy.
Optical coherence tomography: implications for neurology.
Al-Ani A, Benard-Seguin É, Costello F
Curr Opin Neurol · 2025 Feb · PMID 39704153 · Publisher ↗
PURPOSE OF REVIEW: This article explores the role of optical coherence tomography (OCT) in neurology practice, particularly in diagnosing and monitoring conditions such as papilledema, optic neuritis, and retinal artery...
PURPOSE OF REVIEW: This article explores the role of optical coherence tomography (OCT) in neurology practice, particularly in diagnosing and monitoring conditions such as papilledema, optic neuritis, and retinal artery occlusion. OCT has been increasingly utilized as a noninvasive and effective tool for detecting and monitoring neuroaxonal damage in the visual pathway, which is important for early intervention and improved patient outcomes across a variety of neurologic conditions. RECENT FINDINGS: OCT as an imaging modality continues to demonstrate its utility in quantifying optic nerve and retinal changes reflecting neuroaxonal injury, including, peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell layer thickness (or volume). This review focuses on recent evidence regarding the utilization of this modality in diagnosing, monitoring, and quantifying treatment responses in patients with papilledema, optic neuritis, and retinal artery occlusion. Advances in OCT technology, including deep learning algorithms, continue to enhance the diagnostic accuracy and predictive capabilities in the field of neuro-ophthalmology. SUMMARY: In recent years, OCT has become an essential tool in neuro-ophthalmic assessment, offering precise structural and anatomical assessments that support diagnosis, treatment planning, and monitoring of conditions affecting the visual pathway. Ongoing advances in OCT technology are expected to further enhance its clinical utility.
The optic nerve in spaceflight: novel concepts in the pathogenesis of optic disc edema in microgravity.
Kadipasaoglu CM, Lee VA, Ong J … +1 more , Lee AG
Curr Opin Neurol · 2025 Feb · PMID 39629511 · Publisher ↗
PURPOSE OF REVIEW: Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, a...
PURPOSE OF REVIEW: Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, and hyperopic refractive shift. Although there are numerous neuro-ocular findings in SANS, the purpose of this review is to describe the novel, emerging concepts of the pathogenesis for the ODE specifically in SANS. RECENT FINDINGS: While the initial hypotheses on the pathogenesis of ODE in SANS focused on possible elevated intracranial pressures (i.e., papilledema), the most prominent current hypothesis is microgravity-induced cephalad fluid shift. More recent studies however suggest that the pathogenesis of the ODE in SANS is likely multifactorial including possible underlying metabolic and genetic components. SUMMARY: We review the literature on ODE in SANS including recent work integrating the complex physiologic interactions of microgravity-induced disruption in intracerebral and intraocular fluid dynamics, vascular congestion, cellular stress responses, and genetic predisposition. We believe that the development of ODE in SANS is likely multifactorial in origin, and further understanding of the mechanical, cellular, metabolic, and genetic components is of utmost importance to develop future countermeasures in preparation for possible future crewed missions to the moon, the asteroid belt, and Mars.
Recent advances in portable, low-field magnetic resonance imaging in cerebrovascular disease.
Zabinska J, de Havenon A, Sheth KN
Curr Opin Neurol · 2025 Feb · PMID 39624032 · Publisher ↗
PURPOSE OF REVIEW: This review aims to describe recent advances in low-field (0.064 T) magnetic resonance imaging (LF-MRI) of cerebrovascular disease, including ischemic and hemorrhagic stroke and white matter hyperinten...
PURPOSE OF REVIEW: This review aims to describe recent advances in low-field (0.064 T) magnetic resonance imaging (LF-MRI) of cerebrovascular disease, including ischemic and hemorrhagic stroke and white matter hyperintensities. RECENT FINDINGS: Since 2023, several studies have highlighted the rapidly changing landscape of portable, low-field MRI (LF-MRI) and its applications in stroke and cerebrovascular disease. The advantages of using LF-MRI in these settings are multifold: cheaper and dynamic imaging of this patient population confers closer observation during the acute and chronic stages of cerebrovascular disease. Initial deployments of the device span a variety of acute and emergency settings, including imaging around thrombolytic administration, endovascular reperfusion, intracerebral hemorrhage management, and cardiovascular intensive care. LF-MRI also has an important role in cerebrovascular disease monitoring and prevention, namely white matter hyperintensity (WMH) progression and vascular and Alzheimer's dementia. Early studies suggest reliable sensitivity and specificity for these pathologies. With further improvements to LF-MRI hardware, software and postprocessing on the horizon, we anticipate the device's ability to provide inexpensive and flexible neuroimaging to a wide array of healthcare settings that treat, prevent, and manage cerebrovascular disease. SUMMARY: Recent studies indicate that LF-MRI promotes rapid, cost-effective, and clinically useful neuroimaging at various clinical timepoints throughout stroke and cerebrovascular disease progression and management.
Thyroid eye disease and ocular myasthenia gravis.
Shabto JM, Stevens S, Kazim M
Curr Opin Neurol · 2025 Feb · PMID 39607029 · Publisher ↗
PURPOSE OF REVIEW: An overview of two ocular diseases, which significantly impact quality of life: thyroid eye disease (TED) and ocular myasthenia gravis (OMG). Additionally, we describe the clinical challenge when they...
PURPOSE OF REVIEW: An overview of two ocular diseases, which significantly impact quality of life: thyroid eye disease (TED) and ocular myasthenia gravis (OMG). Additionally, we describe the clinical challenge when they occur simultaneously. We will describe the pathophysiology of both conditions, the currently available diagnostic tools, and the therapies available. RECENT FINDINGS: Recent literature has described newer diagnostic modalities, predictors of disease severity and co-occurrence of TED and OMG, and novel therapies. There is also critical analysis of current therapeutics and risk factors. SUMMARY: The findings from this review suggest a need for heightened clinical awareness and early detection strategies for TED and OMG due to their overlapping clinical presentation. Emerging therapies and diagnostic techniques should be integrated into practice. Further research is warranted to explore the long-term safety and efficacy of novel treatments and the potential genetic links between these conditions.
Current gaps in acute reperfusion therapies.
Nguyen TN, Xiong Y, Li S … +2 more , Abdalkader M, Chen HS
Curr Opin Neurol · 2025 Feb · PMID 39607026 · Publisher ↗
PURPOSE OF REVIEW: Advances in intravenous thrombolysis and endovascular thrombectomy have significantly reduced disability and improved outcomes associated with acute ischemic stroke. RECENT FINDINGS: An expansion of in...
PURPOSE OF REVIEW: Advances in intravenous thrombolysis and endovascular thrombectomy have significantly reduced disability and improved outcomes associated with acute ischemic stroke. RECENT FINDINGS: An expansion of indications for reperfusion therapies in select groups of patients to permit treatment in an extended time window, with large ischemic core, and with simplified imaging protocols have enabled a broader group of patients access to disability-sparing therapy. Cerebroprotection has had renewed development in the era of acute reperfusion. SUMMARY: In this review, we highlight recent developments in stroke reperfusion research and related questions that are under study or remain unanswered.
The atypical faces of optic neuritis: neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.
Poonja S, Rattanathamsakul N, Chen JJ
Curr Opin Neurol · 2025 Feb · PMID 39564614 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this article is to provide a review of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), with a focus on what re...
PURPOSE OF REVIEW: The purpose of this article is to provide a review of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), with a focus on what renders optic neuritis "atypical" in these two conditions. Clinical features, diagnostic criteria, and epidemiology are outlined. Acute treatments for optic neuritis, as well as immunotherapy for NMOSD and MOGAD are discussed. RECENT FINDINGS: Updates in NMOSD and MOGAD are highlighted, with an emphasis on novel work including the new 2023 MOGAD diagnostic criteria, our evolving understanding on the epidemiology of these conditions, and recently FDA-approved NMOSD treatments. Pipeline therapies are also discussed. SUMMARY: A thorough history and examination, supported by ancillary testing, continues to be the mainstay of optic neuritis diagnosis. Stratifying typical versus atypical optic neuritis is paramount. Within the atypical category, NMOSD and MOGAD are important considerations. Clues can point towards these diagnoses and guide steps for treatment, which is increasingly becoming targeted to individual diseases, as the pathophysiology is different for these disorders.
Acute stroke care in low and middle-income countries.
Martins SCO, Matuja SS
Curr Opin Neurol · 2025 Feb · PMID 39508402 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this article is to discuss the global impact of stroke, the disparities and barriers to implement stroke care, and the global efforts to improve access to acute treatments in low and mid...
PURPOSE OF REVIEW: The purpose of this article is to discuss the global impact of stroke, the disparities and barriers to implement stroke care, and the global efforts to improve access to acute treatments in low and middle-income countries (LMICs). RECENT FINDINGS: Disparities in access to stroke care are influenced by socioeconomic inequalities, geographic disparities, and limited healthcare infrastructure, particularly in LMICs. Effective stroke care requires a coordinated approach involving emergency services, rapid diagnosis, timely treatment, and early rehabilitation. However, there are significant delays in implementing evidence-based practices, particularly in areas where stroke care resources are scarce.Key barriers include geographic disparities, economic constraints, insufficient healthcare infrastructure, low public awareness, and weak policy frameworks. Addressing these challenges requires strengthening health systems, promoting universal health coverage, enhancing public and healthcare provider education, leveraging technology like telemedicine, and fostering international collaboration. Global efforts, including initiatives by the World Stroke Organization, focus on improving stroke care through infrastructure development, workforce training, and policy advocacy. SUMMARY: These recommended strategies aim to make stroke care accessible and effective for everyone, regardless of location or socioeconomic status, ultimately helping to reduce the global burden of stroke.
Current trend in air pollution exposure and stroke.
Gabet S, Puy L
Curr Opin Neurol · 2025 Feb · PMID 39508397 · Full text
PURPOSE OF REVIEW: Stroke is the second leading cause of death worldwide, and exposure to particulate air pollution is now recognized as one of the major modifiable risk factors. However, air pollution can vary in terms...
PURPOSE OF REVIEW: Stroke is the second leading cause of death worldwide, and exposure to particulate air pollution is now recognized as one of the major modifiable risk factors. However, air pollution can vary in terms of physicochemical composition and exposition specificities. Therefore, its relationships with stroke outcomes remain under intense investigation. RECENT FINDINGS: This review highlights, alongside particles, that short-term and long-term exposure to nitrogen dioxide (NO 2 ) and ozone is likely to be also linked to stroke-related morbidity and mortality. Moreover, air pollution may increase the risk of transitioning from a healthy status to incident stroke and morbimortality after stroke. Additionally, relationships may vary depending on the air pollution mixture (e.g., particle-related components, pollutant interactions), pollutant sources (e.g., traffic-related or not), stroke etiology (ischemic or hemorrhagic), or exposed individual's characteristics (e.g., age, sex, genetic predisposition, weight status). Nonlinear dose-response functions and short-term effect lags have been reported, but these features need further refinement. SUMMARY: The relationship between stroke and air pollution is now well established. Nonetheless, future research should further consider the physicochemical properties of air pollutants, multiple exposures, and individual vulnerabilities. Moreover, advanced statistical methods should be more commonly used to better describe the relationship shapes.
An update on the role of focused ultrasound in neuro-oncology.
Epstein JE, Pople CB, Meng Y … +1 more , Lipsman N
Curr Opin Neurol · 2024 Dec · PMID 39498847 · Publisher ↗
PURPOSE OF REVIEW: Brain tumor treatment presents challenges for patients and clinicians, with prognosis for many of the most common brain tumors being poor. Focused ultrasound (FUS) can be deployed in several ways to ci...
PURPOSE OF REVIEW: Brain tumor treatment presents challenges for patients and clinicians, with prognosis for many of the most common brain tumors being poor. Focused ultrasound (FUS) can be deployed in several ways to circumvent these challenges, including the need to penetrate the blood-brain barrier and spare healthy brain tissue. This article reviews current FUS applications within neuro-oncology, emphasizing ongoing or recently completed clinical trials. RECENT FINDINGS: Most clinical interest in FUS for neuro-oncology remains focused on exploring BBB disruption to enhance the delivery of standard-of-care therapeutics. More recently, the application of FUS for radiosensitization, liquid biopsy, and sonodynamic therapy is garnering increased clinical attention to assist in tumor ablation, early detection, and phenotypic diagnosis. Preclinical studies show encouraging data for the immunomodulatory effects of FUS, but these findings have yet to be tested clinically. SUMMARY: FUS is a burgeoning area of neuro-oncology research. Data from several forthcoming large clinical trials should help clarify its role in neuro-oncology care.
CAR T-cell therapy for gliomas.
Song KW, Scott BJ
Curr Opin Neurol · 2024 Dec · PMID 39498846 · Publisher ↗
PURPOSE OF REVIEW: To review the landscape of chimeric antigen receptor T-cell (CAR T) therapy for gliomas as seen in recently published trials and discuss on-going challenges with new cancer immunotherapy treatments. RE...
PURPOSE OF REVIEW: To review the landscape of chimeric antigen receptor T-cell (CAR T) therapy for gliomas as seen in recently published trials and discuss on-going challenges with new cancer immunotherapy treatments. RECENT FINDINGS: Given how CAR T therapy has revolutionized the treatment of several hematologic malignancies, there has been increasing interest in using immunotherapy, and particularly CAR T therapy for gliomas. Within the past decade, several first in human trials have published early patient experiences showing treatment is generally well tolerated but with limited efficacy, which may be improving with newer evolutions in CAR T design to overcome known resistance mechanisms in glioma treatment. SUMMARY: CAR T therapy is a promising avenue of treatment for high-grade gliomas, which have a universally poor prognosis as well as limited therapeutics. There are a growing number of CAR T clinical trials for CNS tumors and thus, an understanding of their treatment strategies, toxicity management, and overcoming resistance mechanisms will be important for both clinical practice and to identify areas for future research.
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