Current Opinion in Neurology最新文献_第10页

Chronic idiopathic axonal neuropathy: antibodies, genetics, and beyond. 慢性特发性轴突神经病：抗体、遗传学及其他。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-10-01 Epub Date: 2025-06-05 DOI: 10.1097/WCO.0000000000001387

Mehmet Can Sari, Ahmet Hoke

{"title":"Chronic idiopathic axonal neuropathy: antibodies, genetics, and beyond.","authors":"Mehmet Can Sari, Ahmet Hoke","doi":"10.1097/WCO.0000000000001387","DOIUrl":"10.1097/WCO.0000000000001387","url":null,"abstract":"Purpose of review: Chronic idiopathic axonal neuropathy (CIAP) remains a diagnostic challenge, with many cases historically classified as idiopathic due to the absence of identifiable genetic, metabolic, or immune-mediated causes. This review examines recent advancements in understanding CIAP, focusing on novel genetic mutations, autoantibodies, and metabolic pathways that challenge the \"idiopathic\" designation. Specifically, we highlight sorbitol dehydrogenase (SORD) deficiency and replication factor C subunit 1 (RFC1) repeat expansions, and comment on the controversy surrounding autoantibody-associated small fiber neuropathy (SFN).Recent findings: Biallelic SORD mutations have emerged as a leading cause of recessive axonal neuropathy, linked to sorbitol accumulation and neurotoxicity, with aldose reductase inhibitors (ARIs) being explored as a potential therapy. RFC1 intronic repeat expansions have been identified as a major genetic contributor to CANVAS and sensory neuropathies, reshaping diagnostic approaches for patients previously classified as idiopathic. Additionally, the identification of autoantibodies such as trisulfated heparin disaccharide (TS-HDS), fibroblast growth factor receptor 3 (FGFR-3), and Plexin D1 in SFN suggests an immune-mediated pathology in a subset of patients but a negative randomized trial of IVIG and lack of specificity of TS-HDS IgM antibody testing questions the relevance of these presumed autoantibodies.Summary: Advances in genetics, immunology, and metabolic neuropathies are redefining CIAP. The identification of SORD deficiency, RFC1 expansions, and autoantibody-associated SFN highlights the need for biomarker-driven approaches and targeted therapies. Future research should focus on expanding genetic screening, optimizing immunotherapy strategies, and investigating novel metabolic contributors to CIAP, ultimately moving toward precise, mechanism-based diagnoses.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"496-500"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233486","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

Controversies in the diagnosis of chronic inflammatory demyelinating polyneuropathy. 慢性炎性脱髓鞘性多神经病变诊断的争议。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI: 10.1097/WCO.0000000000001414

Pietro Emiliano Doneddu, Carla Fasano, Claudia Lozi, Gaia Marenna, Eduardo Nobile-Orazio

{"title":"Controversies in the diagnosis of chronic inflammatory demyelinating polyneuropathy.","authors":"Pietro Emiliano Doneddu, Carla Fasano, Claudia Lozi, Gaia Marenna, Eduardo Nobile-Orazio","doi":"10.1097/WCO.0000000000001414","DOIUrl":"10.1097/WCO.0000000000001414","url":null,"abstract":"Purpose of review: Despite decades of clinical recognition, the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains fraught with uncertainty. This review examines major areas of ongoing controversy in the diagnostic evaluation of CIDP, focusing on recent changes to electrodiagnostic criteria, disease boundaries, and emerging concepts of axonal damage.Recent findings: Recent literature highlights three key areas of diagnostic uncertainty: the evolution and limitations of electrodiagnostic criteria; the diagnostic boundary between CIDP and antimyelin-associated glycoprotein (anti-MAG0 antibody neuropathy; and the recognition of CIDP cases that do not fulfil electrodiagnostic criteria, raising interest in axonal variants and the potential role of biomarkers such as neurofilaments. Across these domains, discrepancies between empirical evidence and expert-based guidelines persist, contributing to misdiagnosis and treatment variability.Summary: Current CIDP criteria, though improved, remain partly based on expert opinion rather than empirical validation. The clinical heterogeneity of CIDP and its overlap with mimicking disorders further complicate diagnosis. A broader, more flexible diagnostic framework - integrating electrophysiology, biomarkers, and treatment response - is essential to enhance diagnostic accuracy and guide therapy. Future research should focus on refining criteria to strengthen electrodiagnostic standards and better accommodate atypical and axonal presentations.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"478-484"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759387","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}

引用次数: 0

Heterogeneity of frequencies of motor neuron disease across ethnicities and geographical areas: focus on Arabic countries in the Mediterranean area. 不同种族和地理区域运动神经元疾病频率的异质性：重点关注地中海地区的阿拉伯国家。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-10-01 Epub Date: 2025-08-22 DOI: 10.1097/WCO.0000000000001415

Giancarlo Logroscino, Stefano Giannoni-Luza, Daniele Urso, Nabila Hamdi

{"title":"Heterogeneity of frequencies of motor neuron disease across ethnicities and geographical areas: focus on Arabic countries in the Mediterranean area.","authors":"Giancarlo Logroscino, Stefano Giannoni-Luza, Daniele Urso, Nabila Hamdi","doi":"10.1097/WCO.0000000000001415","DOIUrl":"10.1097/WCO.0000000000001415","url":null,"abstract":"Purpose of review: Although amyotrophic lateral sclerosis (ALS) epidemiology has been increasingly characterized in many regions, data from Arabic countries remain limited. This review aims to summarize the current knowledge on the burden of ALS in Arabic Mediterranean countries, with a particular focus on Egypt.Recent findings: ALS exhibits significant geographic and ethnic variability in terms of incidence, phenotype, and genetic background. Data from the Global Burden of Disease Study 2021 show that Egypt has one of the lowest age-standardized rates of ALS incidence, prevalence, and mortality in the Mediterranean basin. During the past three decades, Egypt has seen a notable decline in ALS-related Disability-Adjusted Life Years and deaths, in contrast to neighboring countries. A national registry has recently been initiated to enhance epidemiological surveillance in the country.Summary: ALS in Arabic Mediterranean countries presents a distinct epidemiological profile. These differences likely reflect a combination of genetic, demographic, and healthcare-related factors. Strengthening national registries and promoting regional collaborations will be crucial for gaining a deeper understanding of the determinants of ALS in these underrepresented populations.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"588-595"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946152","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}

引用次数: 0

Biomarkers in inflammatory neuropathies: where are we? 炎症性神经病变的生物标志物：进展如何？

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-10-01 Epub Date: 2025-06-12 DOI: 10.1097/WCO.0000000000001406

Milou R Michael, Luuk Wieske, Filip Eftimov

{"title":"Biomarkers in inflammatory neuropathies: where are we?","authors":"Milou R Michael, Luuk Wieske, Filip Eftimov","doi":"10.1097/WCO.0000000000001406","DOIUrl":"10.1097/WCO.0000000000001406","url":null,"abstract":"Purpose of review: This review provides an overview of recent advances in fluid-based biomarker research in inflammatory neuropathies, with a particular focus on disease activity monitoring. It explores challenges along the biomarker pipeline and outlines the stage of development of emerging disease activity biomarkers.Recent findings: Numerous biomarkers have recently been investigated for diagnostic, prognostic and monitoring purposes. Neurofilament light chain has been studied furthest but its clinical utility is limited in most patients. Other recent work has identified new biomarkers reflecting nerve damage, including peripherin, periaxin and Contactin-1. Additionally, potential immunological markers of disease activity have been explored, some more generic (such as chemokines) and others highly disease specific (such as autoantibody titers). Additional candidates have emerged through unbiased high-throughput discovery studies.Summary: Current fluid-based biomarkers can be grouped into nerve damage or immunological biomarkers. Most have not proceeded beyond discovery and validation stages, except for Neurofilament Light Chain. Biomarker development is challenging due to the inherent rarity and heterogeneity of inflammatory neuropathies, and, in the case of disease activity biomarkers, a lack of reference standard.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"459-470"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274394","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

New approaches to lesion assessment in multiple sclerosis. 多发性硬化症病变评估的新方法。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-05-16 DOI: 10.1097/WCO.0000000000001378

Paolo Preziosa, Massimo Filippi, Maria A Rocca

{"title":"New approaches to lesion assessment in multiple sclerosis.","authors":"Paolo Preziosa, Massimo Filippi, Maria A Rocca","doi":"10.1097/WCO.0000000000001378","DOIUrl":"10.1097/WCO.0000000000001378","url":null,"abstract":"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.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"306-315"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076599","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

Sex and gender differences in neurological infections. 神经系统感染的性别差异。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-06-04 DOI: 10.1097/WCO.0000000000001389

Sara P Dias, Tamar Akhvlediani, Raphael Bernard-Valnet, Sandra Bigi, Randi Eikeland, Pramod K Pal, Bettina Pfausler, Johann Sellner

{"title":"Sex and gender differences in neurological infections.","authors":"Sara P Dias, Tamar Akhvlediani, Raphael Bernard-Valnet, Sandra Bigi, Randi Eikeland, Pramod K Pal, Bettina Pfausler, Johann Sellner","doi":"10.1097/WCO.0000000000001389","DOIUrl":"10.1097/WCO.0000000000001389","url":null,"abstract":"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.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"429-435"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224672","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

Emerging neuroinfectious diseases: public health implications. 新出现的神经传染病：公共卫生影响。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-06-11 DOI: 10.1097/WCO.0000000000001401

Carla Y Kim, Kathryn B Holroyd, Kiran T Thakur

{"title":"Emerging neuroinfectious diseases: public health implications.","authors":"Carla Y Kim, Kathryn B Holroyd, Kiran T Thakur","doi":"10.1097/WCO.0000000000001401","DOIUrl":"10.1097/WCO.0000000000001401","url":null,"abstract":"Purpose of review: Direct neurological consequences from emerging and re-emerging infectious diseases such as poliomyelitis, West Nile virus and Zika virus, and those with indirect neurological effects such as COVID-19 and Influenza, are major contributors to the profound impact of infectious diseases on global human health. Here, we highlight select infections of the nervous system of public health significance and discuss some of the key factors of emergence. We focus on vector-borne infections including Oropouche virus and West Nile virus, those transmitted by other nonvector animal species including Nipah and Hendra virus, and vaccine preventable infections including neurological effects of Measles virus.Recent findings: Currently, the emergence of Oropouche virus, Avian Influenza, and the re-emergence of Measles outbreaks across Europe and America, are examples of current emerging infectious disease outbreaks. As pathogens spread to new areas, we will continue to see a rise in populations at risk of severe neurological effects. The recent resurgence of measles virus cases exemplifies the importance of strong vaccination programs and preventive public health measures to mitigate the impact of preventable re-emerging infections in vulnerable populations.Summary: Neuroinfectious diseases will continue to drive significant morbidity and mortality on global populations as risk factors remain high, and global public health initiatives are hampered by inadequate governmental support.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"436-442"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274395","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 impact of climate change on neuroinfectious diseases. 气候变化对神经传染病的影响。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-06-05 DOI: 10.1097/WCO.0000000000001398

Simeona Jacinto

引用次数: 0

Imaging and neuromodulation in Parkinson's disease. 帕金森病的影像学和神经调节。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/WCO.0000000000001380

Alexandre Boutet, Jürgen Germann, Alfonso Fasano

{"title":"Imaging and neuromodulation in Parkinson's disease.","authors":"Alexandre Boutet, Jürgen Germann, Alfonso Fasano","doi":"10.1097/WCO.0000000000001380","DOIUrl":"10.1097/WCO.0000000000001380","url":null,"abstract":"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.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"322-327"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110054","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

MRI protocols and sequences for amyloid-related imaging abnormalities monitoring in Alzheimer's disease patients treated with monoclonal antibodies. 单克隆抗体治疗阿尔茨海默病患者中淀粉样蛋白相关成像异常监测的MRI方案和序列

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-06-04 DOI: 10.1097/WCO.0000000000001388

Federica Agosta, Giordano Cecchetti, Edoardo G Spinelli, Alma Ghirelli, Giulia Rugarli, Massimo Filippi

{"title":"MRI protocols and sequences for amyloid-related imaging abnormalities monitoring in Alzheimer's disease patients treated with monoclonal antibodies.","authors":"Federica Agosta, Giordano Cecchetti, Edoardo G Spinelli, Alma Ghirelli, Giulia Rugarli, Massimo Filippi","doi":"10.1097/WCO.0000000000001388","DOIUrl":"10.1097/WCO.0000000000001388","url":null,"abstract":"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.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"289-297"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224669","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