Current Neurology and Neuroscience Reports最新文献

{"title":"Stroke, infections, and New Mechanisms: a Narrative Review.","authors":"Jacques Reis, Şerefnur Öztürk, Alain Buguet, Gilles Kauffenstein, Zeliha Tulek","doi":"10.1007/s11910-025-01458-y","DOIUrl":"10.1007/s11910-025-01458-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"74"},"PeriodicalIF":7.4,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REM Sleep Behavior Disorder as a Prodromal Synucleinopathy: Updates on Clinical and Laboratory Biomarkers, and Implications for Neuroprotective Trials.","authors":"Lee E Neilson, Youssef I Khattab, Miranda M Lim","doi":"10.1007/s11910-025-01452-4","DOIUrl":"10.1007/s11910-025-01452-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"73"},"PeriodicalIF":5.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Contribution of Aerospace Medicine Specialty Expertise in the Diagnosis and Treatment of Headache Disorders with Concomitant Clinically Symptomatic Dyscapnia (Respiratory Alkalosis/Acidosis).","authors":"Jan Stepanek","doi":"10.1007/s11910-025-01456-0","DOIUrl":"10.1007/s11910-025-01456-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"72"},"PeriodicalIF":7.4,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ependymoma: Advances in Systems Treatment Strategies.","authors":"Xiaoling Qiu, Zuqing Wu, Haoqun Xie, Shibei Wang, Qunying Yang, Chengcheng Guo","doi":"10.1007/s11910-025-01463-1","DOIUrl":"10.1007/s11910-025-01463-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"71"},"PeriodicalIF":7.4,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal Disorders and Consciousness: A Review.","authors":"Joshua G Berenbaum, Benjamin Morrison, Brenna Hagan, Kathy Y Xie, Katherine W Turk, Andrew E Budson","doi":"10.1007/s11910-025-01464-0","DOIUrl":"10.1007/s11910-025-01464-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"70"},"PeriodicalIF":7.4,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Treatment Paradigms of Meningiomas; a Precision Medicine Perspective.","authors":"Daniela Galluzzo, Casandra Chen, Khaled Alok, Jennifer Moliterno, Sylvia C Kurz","doi":"10.1007/s11910-025-01461-3","DOIUrl":"10.1007/s11910-025-01461-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides a comprehensive overview of the multidisciplinary management strategies available for intracranial meningiomas, with a focus on novel therapies.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"69"},"PeriodicalIF":7.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Protective Ventilation Strategies in Severe Acute Brain Injury.","authors":"Sarah Al Sharie, Rahma Almari, Saif Azzam, Lou'i Al-Husinat, Mohammad Araydah, Denise Battaglini, Marcus J Schultz, Nicolo' Antonino Patroniti, Patricia Rm Rocco, Chiara Robba","doi":"10.1007/s11910-025-01462-2","DOIUrl":"10.1007/s11910-025-01462-2","url":null,"abstract":"<p><strong>Purpose of the review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"68"},"PeriodicalIF":7.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Abnormalities and Risk of Alzheimer's Disease.","authors":"Merve Aktan Süzgün, Qi Tang, Ambra Stefani","doi":"10.1007/s11910-025-01451-5","DOIUrl":"10.1007/s11910-025-01451-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"67"},"PeriodicalIF":5.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Complications of Status Epilepticus.","authors":"Antonio H Iglesias, Alexandra Balabanov, Ashley Raedy","doi":"10.1007/s11910-025-01460-4","DOIUrl":"10.1007/s11910-025-01460-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of review: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recent findings: &lt;/strong&gt;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 outc","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"66"},"PeriodicalIF":7.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiological Mechanisms Fostering Developmental and Epileptic Encephalopathies (DEE): a Complex Interplay between Genetics, Inflammation and Neurodegeneration.","authors":"Antonella Riva, Greta Volpedo, Federico Zara, Anna Fassio, Pasquale Striano, Antonio Falace","doi":"10.1007/s11910-025-01453-3","DOIUrl":"10.1007/s11910-025-01453-3","url":null,"abstract":"<p><strong>Purpose of the review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","PeriodicalId":10831,"journal":{"name":"Current Neurology and Neuroscience Reports","volume":"25 1","pages":"65"},"PeriodicalIF":7.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}