Current Opinion in Neurology最新文献_第2页

Persistent aura without infarction. 持续先兆，无梗死。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-03-10 DOI: 10.1097/WCO.0000000000001357

Maurizio Severino, Mark W Green

{"title":"Persistent aura without infarction.","authors":"Maurizio Severino, Mark W Green","doi":"10.1097/WCO.0000000000001357","DOIUrl":"10.1097/WCO.0000000000001357","url":null,"abstract":"Purpose of review: The scope of this review is to discuss persistent aura without infarction, a rare, highly disabling, yet apparently benign clinical condition, straddling neurology, neuro-ophthalmology, and psychiatry, whose differential diagnosis is essential for an appropriate therapeutic approach and to avoid clinical complications. Here we attempt to report on the available literature, trying to present a summary, despite the scarcity of available literature.Recent findings: Persistent aura without infarction is a diagnostic challenge, likely caused by cortical spreading depression and vasoconstriction, whose clinical features are not always easy to pigeonhole into the available diagnostic criteria. The diagnosis requires the exclusion of cerebral and retinal infarction, structural changes in the brain, epilepsy, and psychiatric symptoms. Triptans may be deleterious, anticoagulants are not indicated, and therapy with acetazolamide, valproic acid, zonisamide, furosemide, cortisone, and ketamine may be beneficial.Summary: Persistent aura without infarction is a challenging diagnosis. However, an approach using zonisamide and ketamine might be beneficial. Randomized and controlled clinical trials are required for a better comprehension of the aetiopathogenesis and therapeutic approach.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"249-253"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584967","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

Advances in neuroimaging of multiple sclerosis. 多发性硬化症神经影像学研究进展。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-03-19 DOI: 10.1097/WCO.0000000000001360

Maria A Rocca, Paolo Preziosa, Massimo Filippi

{"title":"Advances in neuroimaging of multiple sclerosis.","authors":"Maria A Rocca, Paolo Preziosa, Massimo Filippi","doi":"10.1097/WCO.0000000000001360","DOIUrl":"10.1097/WCO.0000000000001360","url":null,"abstract":"Purpose of review: To summarize recent advancements in understanding multiple sclerosis (MS) pathophysiology, predicting disease course, and monitoring treatment responses using MRI.Recent findings: Paramagnetic rim lesions (PRLs) are highly specific to MS and clinically relevant. Detected from the earliest disease phases, PRLs aid in distinguishing MS from other conditions, improving diagnostic accuracy. Moreover, PRLs are associated with more severe disability and measures of brain damage and may predict disease progression. Similarly, slowly expanding lesions (SELs) are associated with more severe disability and predict a more severe disease course. Disease-modifying therapies have limited effectiveness in reducing PRLs or SELs. Choroid plexus (CP) enlargement is associated with structural brain damage and clinical disability and predicts disease evolution. Enlarged perivascular spaces (ePVS) suggest microangiopathic changes rather than direct MS-related inflammation. Glymphatic dysfunction, evaluated using diffusion tensor image analysis along the perivascular space, emerges early in MS and correlates with disability, cognitive impairment, and structural brain damage. Aging and comorbidities exacerbate MS-related damage, complicating diagnosis and treatment. Emerging technologies, such as brain-age paradigms, aim to disentangle aging from MS-specific neurodegeneration.Summary: Advances in MRI have highlighted the clinical significance of chronic inflammation and glymphatic dysfunction as early contributors to MS progression as well as the interplay between aging, comorbidities and MS.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"205-216"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656464","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

Immunology of multiple sclerosis: an update. 多发性硬化免疫学：最新进展。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-04-30 DOI: 10.1097/WCO.0000000000001361

Patricia Kirschner, Marc Pawlitzki, Hans-Peter Hartung, Sven G Meuth

{"title":"Immunology of multiple sclerosis: an update.","authors":"Patricia Kirschner, Marc Pawlitzki, Hans-Peter Hartung, Sven G Meuth","doi":"10.1097/WCO.0000000000001361","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001361","url":null,"abstract":"Purpose of review: The immunological processes that lead to multiple sclerosis (MS) and occur during the progressive phase of the disease are manifold and still not well understood. This review summarizes new insights on this topic that were gained through recent studies with diverse scientific approaches.Recent findings: While genetic risk clearly contributes to MS, external factors play a key role in its pathogenesis as well. Epstein-Barr virus infection correlates significantly with MS risk and seems to be a major causal factor. Even though our knowledge on the human gut microbiome and its connection to the central nervous system is far from being complete, several studies have proven that the gut-brain axis influences neuroinflammation and disease progression in MS. It has become much clearer that MS is not solely a T cell-mediated disease but is also strongly driven by B cells and pathogenic antibodies. Beyond the peripheral immune cells, glial cells and their interactions with neurons are important players contributing to disease activity and progression in MS.Summary: Taken together, recent publications on immunological processes in the context of MS implicate a multitude of noncanonical mechanisms that need to be further explored regarding their interplay and contribution to the degenerative course of the disease.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"38 3","pages":"180-187"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973119","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

Multiple sclerosis: advances and challenges in diagnosis. 多发性硬化症：诊断的进展与挑战。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1097/WCO.0000000000001366

Silvia Tenembaum, Hans-Peter Hartung

{"title":"Multiple sclerosis: advances and challenges in diagnosis.","authors":"Silvia Tenembaum, Hans-Peter Hartung","doi":"10.1097/WCO.0000000000001366","DOIUrl":"10.1097/WCO.0000000000001366","url":null,"abstract":"Purpose of review: This article explores the most recent developments in multiple sclerosis (MS), including a selection of advances in diagnostic neuroimaging markers. The proposed revision of diagnostic criteria, new concepts on the prodromal period, and differential diagnosis of MS are included as well.Recent findings: Interesting changes have been introduced to the recently proposed 2024 revisions of MS diagnostic criteria. Optic nerve is proposed as the 5 th CNS topography, additional advanced MRI markers are included, as well as specific cases of \"radiologically isolated syndrome\" considered at risk of future relapses.The diagnostic power of the central vein sign, paramagnetic rim lesion, and cortical lesions have been demonstrated in recent lines of research in adult and pediatric patients with MS. The contribution of cortical lesions, slowly expanding lesions, choroid plexus enlargement, paramagnetic rim lesions, leptomeningeal enhancement, in addition to measurement of brain and spinal cord atrophy, have expanded our understanding of early disease progression.Summary: This review highlights a selection of recent studies that have significantly contributed to increase the accuracy of MS diagnosis in both pediatric and adult patients, and demonstrated the potential to improve the early detection of disease progression.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"197-204"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718129","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

Multiple sclerosis in China: the current state of diagnosis and management. 中国多发性硬化症的诊断和治疗现状。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-03-19 DOI: 10.1097/WCO.0000000000001359

Dongmei Jia, Fu-Dong Shi, Wei Jiang

{"title":"Multiple sclerosis in China: the current state of diagnosis and management.","authors":"Dongmei Jia, Fu-Dong Shi, Wei Jiang","doi":"10.1097/WCO.0000000000001359","DOIUrl":"10.1097/WCO.0000000000001359","url":null,"abstract":"Purpose of review: This comprehensive overview summarized the latest advances of multiple sclerosis (MS) in China, including the diagnostic and treatment challenges, research and future directions under health policy recommendations.Recent findings: Given the rising prevalence of MS in China during the past decades, it has emerged as a significant public health concern due to the extensive population and pronounced disparities between urban and rural areas. The clinical manifestations of MS patients in China can be various due to the nation's diversity and evolving environmental factors. Advances in diagnostic practices, including the advances under 7T MRI radiological assessments, have enhanced the precision of MS diagnosis. Despite the introduction of disease-modifying therapeutic agents and the support of healthcare policies offering patients a wider range of treatment options, multiple ongoing research efforts and clinical trials will provide additional evidence. The ongoing China National Registry of Neuro-Inflammatory Diseases study (NCT05154370) holds promise for further enhancing the management of MS patients in China.Summary: Improved recognition and management of MS in China have been facilitated, encompassing both prompt diagnosis and diverse treatment options. Simultaneously, research efforts and large-scale cohort studies have significantly advanced the overall status in this field.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"236-242"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656468","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

Migraine in women: a review. 女性偏头痛：综述。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-06-01 Epub Date: 2025-04-23 DOI: 10.1097/WCO.0000000000001372

M Ghadiri-Sani

{"title":"Migraine in women: a review.","authors":"M Ghadiri-Sani","doi":"10.1097/WCO.0000000000001372","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001372","url":null,"abstract":"Purpose of review: The purpose of this review is to provide an update on the clinical course and management of migraine in women.Recent findings: Migraine is two to three times more prevalent in women who report a longer, more severe attacks with more disability, an increased risk of recurrence, and a longer recovery period. Consequently, women use more acute and preventive medications, have more comorbid conditions and are more likely to run a chronic disease course.Real-life experience and evidence suggest that onabotulinumtoxinA and the newer generation antibody treatments against the calcitonin gene-related peptide (CGRP) ligand and its receptor are highly effective in the management of migraine in women.Pregnancy, breast feeding, and menstrual cycles should be taken into account when treating women with migraine. Topiramate and sodium valproate should be avoided in women of childbearing age (WCBA). Hormonal options can be considered in menstrual or menopausal migraines. NSAIDs and prostaglandins such as mefenamic acid can be used at onset of menstrual migraine. Venlafaxine can be effective in menopausal migraine while also treating the vasomotor symptoms. Migraine usually improves during pregnancy; however, if required nonpharmacological options should be considered.Summary: Effectively managing migraine in women of productive and reproductive age, can reduce the socioeconomic burden of this debilitating disease.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"38 3","pages":"271-276"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977953","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

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 : 2025-05-22 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":"https://doi.org/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":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-22","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

Brain age prediction from MRI scans in neurodegenerative diseases. 神经退行性疾病的MRI扫描预测脑年龄。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-05-22 DOI: 10.1097/WCO.0000000000001383

Anthi Papouli, James H Cole

{"title":"Brain age prediction from MRI scans in neurodegenerative diseases.","authors":"Anthi Papouli, James H Cole","doi":"10.1097/WCO.0000000000001383","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001383","url":null,"abstract":"Purpose of review: This review explores the use of brain age estimation from MRI scans as a biomarker of brain health. With disorders like Alzheimer's and Parkinson's increasing globally, there is an urgent need for early detection tools that can identify at-risk individuals before cognitive symptoms emerge. Brain age offers a noninvasive, quantitative measure of neurobiological ageing, with applications in early diagnosis, disease monitoring, and personalized medicine.Recent findings: Studies show that individuals with Alzheimer's, mild cognitive impairment (MCI), and Parkinson's have older brain ages than their chronological age. Longitudinal research indicates that brain-predicted age difference (brain-PAD) rises with disease progression and often precedes cognitive decline. Advances in deep learning and multimodal imaging have improved the accuracy and interpretability of brain age predictions. Moreover, socioeconomic disparities and environmental factors significantly affect brain aging, highlighting the need for inclusive models.Summary: Brain age estimation is a promising biomarker for identify future risk of neurodegenerative disease, monitoring progression, and helping prognosis. Challenges like implementation of standardization, demographic biases, and interpretability remain. Future research should integrate brain age with biomarkers and multimodal imaging to enhance early diagnosis and intervention strategies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110050","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

Barriers to clinical genetic testing in movement disorders. 运动障碍临床基因检测的障碍。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-05-22 DOI: 10.1097/WCO.0000000000001381

Dennis Yeow, Laura I Rudaks, Kishore R Kumar

{"title":"Barriers to clinical genetic testing in movement disorders.","authors":"Dennis Yeow, Laura I Rudaks, Kishore R Kumar","doi":"10.1097/WCO.0000000000001381","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001381","url":null,"abstract":"Purpose of review: The number of known genetic movement disorders and potential treatments for these disorders have grown rapidly over the last few decades. Despite this, genetic testing for movement disorders remains relatively underutilized in clinical practice. In this review, we explore a number of barriers that prevent more routine and widespread use of genetic testing for movement disorders.Recent findings: Cost and limited health insurance coverage as well as difficulty accessing genetic testing and counselling are major barriers to genetic testing and disproportionately affect low- and middle-income countries and specific sociodemographic groups. Clinician misperceptions and limited knowledge about genetic testing for movements disorders as well as patient and clinician concerns about the potential for genetic discrimination are further obstacles. Despite these barriers, several recent international collaborative studies have demonstrated the feasibility of delivering clinical genetic testing and genetic counselling for movement disorders on a large scale.Summary: Concerted action at multiple organizational levels (government, specialty societies, health insurance organizations, etc.) is required in order to address the identified barriers and improve utilization of genetic testing in movement disorders on a global scale.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110034","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

Disparities in Huntington's disease care and research. 亨廷顿舞蹈病治疗和研究的差异。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-05-21 DOI: 10.1097/WCO.0000000000001376

Ashley Madera, Clare Schrodt, Adys Mendizabal

{"title":"Disparities in Huntington's disease care and research.","authors":"Ashley Madera, Clare Schrodt, Adys Mendizabal","doi":"10.1097/WCO.0000000000001376","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001376","url":null,"abstract":"Purpose of review: Disparities in care and outcomes are well described in common neurologic disorders; however, less is known about disparities in rare diseases such as Huntington's disease (HD). This review summarizes HD epidemiology in the US and globally while highlighting disparities in HD diagnosis and outcomes across various HD groups. The review also discusses how the lack of diversity in HD research threatens the validity of clinical trials and raises concerns about global accessibility to emerging therapies.Recent findings: Global HD prevalence and incidence vary worldwide, though the highest numbers are reported in Latin American cluster regions. Within North America, there are disparities in diagnosis and outcomes among Black and Latino patients. Socioeconomic status, educational attainment, and sex were also associated with differences in diagnosis, access, and outcomes. Many of the recent studies in this review used the ENROLL-HD longitudinal study. Yet, the dataset is 90% White Non-Hispanic, leading to an incomplete understanding of how HD manifests in diverse groups.Summary: Racial, sex, and socioeconomic disparities exist in HD care and research. Addressing these disparities is imperative in improving access to HD care, clinical trial participation, and disease-specific outcomes for all patients with HD in the US and worldwide.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110052","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