Current Opinion in Neurology最新文献

Novel therapies for glioblastoma. 胶质母细胞瘤的新疗法。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-20 DOI: 10.1097/WCO.0000000000001519

Sneha R Gupta, Karisa C Schreck

{"title":"Novel therapies for glioblastoma.","authors":"Sneha R Gupta, Karisa C Schreck","doi":"10.1097/WCO.0000000000001519","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001519","url":null,"abstract":"Purpose of review: Glioblastoma is the most aggressive and treatment-resistant primary brain tumor in adults. Given its clinical severity and biological complexity, research efforts are focused on understanding and targeting intratumoral heterogeneity, adaptive resistance, drug delivery barriers, and the immunosuppressive tumor microenvironment. This review highlights emerging therapeutic approaches for the treatment of glioblastoma including advances in radiation planning, molecularly targeted therapy, immunotherapy, blood-brain barrier modulation, and neuronal signaling.Recent findings: Radiation therapy remains a cornerstone of glioblastoma treatment, and advances in image-guided planning are being developed to refine treatment margins and improve tolerability without compromising efficacy. Blood-brain barrier permeability is being improved through device-assisted approaches, including focused ultrasound in combination with systemic therapies. Molecularly targeted and immunotherapeutic approaches continue to be evaluated, increasingly with biomarker-informed strategies to optimize patient selection. In parallel, drug repurposing, neuronal modulation, and metabolic interventions have shown promising preclinical and retrospective signals and are moving towards prospective studies. Interventions to improve quality of life are also underway with early palliative care showing significant impact for patients with glioblastoma.Summary: As the field moves towards tailored and precision-guided approaches, combination strategies remain central to addressing the multiple mechanisms by which glioblastoma evades treatment.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220081","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}

引用次数: 0

The electrical life of cancer: cancer neuroscience from circuits to patient care. 癌症的电生命：从电路到病人护理的癌症神经科学。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-20 DOI: 10.1097/WCO.0000000000001517

Matilde Pittarello, Abraham Dada, Shawn L Hervey-Jumper

{"title":"The electrical life of cancer: cancer neuroscience from circuits to patient care.","authors":"Matilde Pittarello, Abraham Dada, Shawn L Hervey-Jumper","doi":"10.1097/WCO.0000000000001517","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001517","url":null,"abstract":"Purpose of review: Cancer neuroscience has evolved from a predominantly preclinical, mechanistic discipline into a clinically relevant framework for understanding and treating patients with brain malignancies. This review synthesizes recent advances across glioblastoma (GBM), diffuse midline glioma (DMG), and brain metastases, with particular emphasis on identifying circuit-level, neurotransmitter-mediated, electrophysiologic, and network properties that are emerging as clinically actionable biomarkers and therapeutic targets.Recent findings: Human connectomics and retrograde tracing studies demonstrate that GBM integrates into distributed, brain-wide neural circuits. In DMG, neuron-tumor signaling has expanded beyond glutamatergic mechanisms to include GABAergic and cholinergic neurotransmission, while patterns of neural connectivity have been associated with regional immunosuppression and patient survival. Patch-seq and electrophysiologic profiling have identified distinct functional states of malignant cells, and spatial transcriptomic analyses have linked malignant cell plasticity to neuron-rich invasive niches. Although these discoveries are driving the development of neurophysiologic biomarkers and circuit-directed therapeutic strategies, they have not yet translated into clinical practice. Emerging cellular atlases and mechanistic studies of small cell lung cancer and brain metastases further suggest that neural circuit integration is a broader feature of cancer biology rather than a phenomenon restricted to gliomas.Summary: The field's critical next step is to integrate cancer neuroscience-directed therapeutic strategies with prospectively validated, multimodal biomarkers that account for age and disease-specific neurobiology and reliably distinguish tumor associated states from physiologic aging and adaptive changes within the peritumoral microenvironment.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220045","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}

引用次数: 0

Management of seizures in patients with brain tumors. 脑肿瘤患者癫痫发作的处理。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-20 DOI: 10.1097/WCO.0000000000001523

Hyun Yong Koh, Steven Tobochnik

{"title":"Management of seizures in patients with brain tumors.","authors":"Hyun Yong Koh, Steven Tobochnik","doi":"10.1097/WCO.0000000000001523","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001523","url":null,"abstract":"Purpose of review: Discoveries relating to the cancer neuroscience of gliomas have reframed brain tumor-related epilepsy (BTRE) as the product of reciprocal interactions at the neural-tumor interface. This framework provides the rationale for targeted strategies to optimize both seizure control and brain tumor survival outcomes.Recent findings: Feedforward dynamics involving hyperexcitability and cellular proliferation in glioma-infiltrated cortex drive synaptic remodeling of neural circuits that correlate with shorter survival. Seizure assessment metrics demonstrate that worsening seizure control may precede or align with progressive disease. In this context, early evidence indicates a potential role for targeted tumor-directed therapy in addition to antiseizure medications (ASMs) for optimizing seizure control. Noncontrolled studies evaluating ASM tapering strategies in BTRE suggest that tumor stability is more important for seizure control than the duration of seizure freedom.Summary: BTRE involves dynamic and fluctuating seizure risk driven by tumor biology, tumor-directed therapy, and treatment response. Hyperexcitability at the cellular level and clinical seizure activity are increasingly understood as a reflection of tumor biology and a potentially modifiable target to improve outcomes. The addition of seizure assessments as secondary endpoints in brain tumor clinical trials may lead to a refined individualized and disease-specific approach to ASM management.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220050","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}

引用次数: 0

Myotonic dystrophy type 1 - updates on mechanisms of multisystemic manifestations, genetically targeted therapeutics, and preparing for a postapproval world. 1型肌强直性营养不良-多系统表现机制的最新进展，基因靶向治疗，并为批准后的世界做准备。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI: 10.1097/WCO.0000000000001509

Samuel Carrell, Adam D Comer, Nicholas E Johnson

{"title":"Myotonic dystrophy type 1 - updates on mechanisms of multisystemic manifestations, genetically targeted therapeutics, and preparing for a postapproval world.","authors":"Samuel Carrell, Adam D Comer, Nicholas E Johnson","doi":"10.1097/WCO.0000000000001509","DOIUrl":"10.1097/WCO.0000000000001509","url":null,"abstract":"Purpose of review: Myotonic dystrophy type (DM1) is the most prevalent muscular dystrophy and manifests throughout the lifespan with signs and symptoms in all major organ systems. There are significant updates on therapeutic development and trials focused on muscle disease in DM1, as well as updates on the mechanism and progression of disease in nonmuscle tissues, changes or updates on clinical management, and the societal burden associated with a varied and prevalent disorder.Recent findings: Evidence of improvement with strength and myotonia with genetically targeted treatments in early phase trials. Preparation for natural history studies to evaluate the impact of therapeutics on the heart and central nervous system (CNS), and expansion to early onset forms of DM1. Improvements in our understanding of mechanisms of CNS, cardiac, gastrointestinal, and liver manifestations. Evolving approaches to cardiac monitoring and respiratory care. DM1 is genetically more common than recognized clinically, and how this may affect societal disease burden.Summary: This review highlights genetically targeted therapeutics showing impact for muscle manifestations of DM1, ongoing efforts now shifting to expand to other target tissues and the younger population, and, in preparation for a clinically available medicine, our understanding of societal burden and population genetics of DM1.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"477-482"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789253","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}

引用次数: 0

Paradigm shift in the pathomechanisms and treatment of inclusion body myositis: at the crossroads of cell-autonomous muscle degeneration and immune activation. 包涵体肌炎的病理机制和治疗的范式转变：在细胞自主肌肉变性和免疫激活的十字路口。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI: 10.1097/WCO.0000000000001511

Naoki Suzuki, Rumiko Izumi, Kensuke Ikeda

{"title":"Paradigm shift in the pathomechanisms and treatment of inclusion body myositis: at the crossroads of cell-autonomous muscle degeneration and immune activation.","authors":"Naoki Suzuki, Rumiko Izumi, Kensuke Ikeda","doi":"10.1097/WCO.0000000000001511","DOIUrl":"10.1097/WCO.0000000000001511","url":null,"abstract":"Purpose of review: Inclusion body myositis (IBM) is the most prevalent acquired myopathy in adults over 50 years of age, yet effective disease-modifying therapy has remained elusive. The longstanding debate over whether degeneration or inflammation is the primary driver has now given way to a model of bidirectional interplay. This review critically appraises advances published between January 2025 and June 2026, encompassing molecular pathomechanisms, early diagnostic strategies, disease-modifying therapies, and rehabilitation.Recent findings: A pivotal mechanistic advance is the demonstration that TDP-43 nuclear depletion in IBM myonuclei generates cryptic exon-derived neoantigens that directly activate CD8 + T cells, molecularly unifying cell-autonomous degeneration and adaptive immune activation. In parallel, mitochondrial DNA leakage activates the cGAS-STING innate immune pathway prior to T cell infiltration. An endogenous compensatory mechanism involving the NORAD-Pumilio regulatory axis has also been identified. Clinically, preliminary data from the Phase 2/3 MUSCLE trial suggest a potential 50% slowing of progression in mild-to-moderate IBM with the anti-KLRG1 antibody ulviprubart, pending full peer-reviewed publication, while novel diagnostic and rehabilitation strategies further advance personalized care.Summary: A molecular cascade from cell-autonomous TDP-43 dysfunction to cryptic epitope-driven immune activation could underlie the pathogenesis of IBM. Personalized multidisciplinary care integrating early diagnosis, targeted disease-modifying therapy, and advanced rehabilitation represents the emerging treatment paradigm.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"461-467"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789290","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}

引用次数: 0

Myopathies in the therapeutic era: measurement as the rate-limiting step. 治疗时代的肌病：测量作为限速步骤。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-09-03 DOI: 10.1097/WCO.0000000000001514

Shahram Attarian

引用次数: 0

Editorial introduction. 编辑介绍。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-09-03 DOI: 10.1097/WCO.0000000000001516

引用次数: 0

A global comparison of clinical guidelines for the diagnosis and management of migraine: similarities, differences, and gaps. 偏头痛诊断和治疗临床指南的全球比较：相似点、差异和差距。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI: 10.1097/WCO.0000000000001510

Fred Cohen

{"title":"A global comparison of clinical guidelines for the diagnosis and management of migraine: similarities, differences, and gaps.","authors":"Fred Cohen","doi":"10.1097/WCO.0000000000001510","DOIUrl":"10.1097/WCO.0000000000001510","url":null,"abstract":"Purpose of review: To compare international clinical guidelines for migraine diagnosis and management, identifying consensus, differences, and gaps.Recent findings: Assessed guideline repositories and society websites from 2012 to 2025 for recommendations from American, British, Italian, Japanese, French, and International Headache Society (IHS) guidelines. All guidelines base diagnosis on International Classification of Headache Disorders (ICHD-3) and recommend early acute therapy with analgesics and NSAIDs. Triptans are universally endorsed for moderate-to-severe attacks, while gepants and ditans appear in newer guidelines but remain inaccessible in many countries. Preventive therapy is advised for frequent or disabling attacks; recommended first-line agents include beta-blockers (propranolol), antiseizure medications (ASMs) (topiramate, valproate), and tricyclic antidepressants (amitriptyline). Calcitonin gene-related peptide (CGRP) monoclonal antibodies and gepants are positioned as first-line by American and Japanese guidelines but restricted in Britain and France. OnabotulinumtoxinA is reserved for chronic migraine after several failed oral preventives. Nonpharmacological interventions such as neuromodulation and behavioral therapies are increasingly incorporated. Differences stem primarily from drug availability and insurance coverage. Evidence gaps persist for pediatric, geriatric, and pregnant populations and long-term safety of emerging therapies.Summary: Despite shared principles, migraine guidelines diverge in thresholds and access to newer treatments; global collaboration is needed to address gaps and ensure equitable care. This review provides a global perspective overall.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"491-497"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789268","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}

引用次数: 0

Recent advances in adult-onset disorders of muscle lipid metabolism. 成人发病的肌肉脂质代谢紊乱的最新进展。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-09-03 DOI: 10.1097/WCO.0000000000001512

Teerin Liewluck, Pascal Laforêt

{"title":"Recent advances in adult-onset disorders of muscle lipid metabolism.","authors":"Teerin Liewluck, Pascal Laforêt","doi":"10.1097/WCO.0000000000001512","DOIUrl":"10.1097/WCO.0000000000001512","url":null,"abstract":"Purpose of review: To summarize recent advances in adult-onset disorders of muscle lipid metabolism, with particular emphasis on fatty acid β-oxidation disorders (FAODs), multiple acyl-CoA dehydrogenase deficiency (MADD) and MADD-like disorders, and neutral lipid storage disease with myopathy (NLSDM).Recent findings: Recent studies in FAODs have provided new insights into long-term outcomes, exercise physiology, prognostic biomarkers, and the impact of newborn screening (NBS) on disease management. In MADD, growth differentiation factor 15 (GDF15) has emerged as a potential biomarker. Major advances have occurred in MADD-like disorders, including the identification of COASY as a novel disease gene and the recognition of sertraline-associated acquired MADD-like disorder, challenging the traditional view of FAODs as exclusively genetic diseases. In NLSDM, recent cohort studies have expanded the phenotypic spectrum, highlighted cardiomyopathy as a major determinant of morbidity and mortality, and revealed a critical role of adipose triglyceride lipase (ATGL) in maintaining mitochondrial network integrity and function.Summary: Advances in clinical phenotyping, metabolic biomarkers, molecular genetics, and NBS have substantially improved the diagnosis and understanding of adult-onset disorders of muscle lipid metabolism. The recognition of sertraline-associated MADD-like disorder has established that lipid storage myopathies can also arise through acquired toxic mechanisms. Collectively, these developments are expected to facilitate earlier diagnosis, improve disease classification, and support the development of targeted therapeutic strategies for these rare but often treatable disorders.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"468-476"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825998","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}

引用次数: 0

Biomarkers in facioscapulohumeral muscular dystrophy. 面肩肱肌营养不良的生物标志物。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI: 10.1097/WCO.0000000000001513

Emmanuelle Salort-Campana, David Bendahan, Frederique Magdinier, Shahram Attarian

{"title":"Biomarkers in facioscapulohumeral muscular dystrophy.","authors":"Emmanuelle Salort-Campana, David Bendahan, Frederique Magdinier, Shahram Attarian","doi":"10.1097/WCO.0000000000001513","DOIUrl":"10.1097/WCO.0000000000001513","url":null,"abstract":"Purpose of review: Facioscapulohumeral muscular dystrophy is one of the most frequent myopathies. Its clinical presentation and genetic background are unique. FSHD needs reliable and measurable biomarkers to monitor the disease and assess the efficacy of therapeutic approaches. The purpose of this review is to summarize and focus on the most recent evidence regarding the different available biomarkers at the level of muscle imaging, circulating molecules and muscle-based markers that currently are the main potential candidates in FSHD.Recent findings: A large phase III trial testing losmapimod (a small molecule inhibitor of p38α MAPK, which regulates DUX4 expression) in FSHD patients failed to demonstrate clear clinical benefits, highlighting concerns about trial readiness. KHDC1L, a recently identified direct transcriptional target of DUX4, is a candidate circulating protein biomarker directly associated with DUX4 activity, although independent replication and analytical validation are still awaited. Quantitative muscle MRI and, increasingly, quantitative muscle ultrasound provide complementary imaging biomarkers that are now being compared head-to-head. Artificial intelligence-based tools are increasingly being used to capture disease heterogeneity and support patient stratification.Summary: Facing the genetic and phenotypic complexity of FSHD, robust biomarkers must be used to assess the efficacy of the experimental treatments, and individuals must be selected and stratified to minimize variability, in order to prepare for future clinical trials.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"450-460"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789261","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}

引用次数: 0