Current Opinion in Neurology最新文献_第3页

Medical management of refractory trigeminal neuralgia. 难治性三叉神经痛的医学处理。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-06-01 Epub Date: 2026-04-29 DOI: 10.1097/WCO.0000000000001480

Jennifer I Stern, Chia-Chun Chiang, Carrie E Robertson

引用次数: 0

Mechanisms of paraneoplastic neurological syndromes. 副肿瘤神经综合征的机制。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-06-01 Epub Date: 2026-04-14 DOI: 10.1097/WCO.0000000000001488

Amy Kunchok, Alberto Vogrig, Francesc Graus

{"title":"Mechanisms of paraneoplastic neurological syndromes.","authors":"Amy Kunchok, Alberto Vogrig, Francesc Graus","doi":"10.1097/WCO.0000000000001488","DOIUrl":"10.1097/WCO.0000000000001488","url":null,"abstract":"Purpose of review: This review describes the mechanisms of paraneoplastic neurological syndromes (PNS) and the recent advances underlying these.Recent findings: This review covers advances in the understanding of the immunobiology of PNS. Specifically, evidence that PNS associated with antibodies against intracellular antigens are T-cell mediated processes, of interferon-γ signaling, major histocompatibility complex (MHC) class I upregulation, and granzyme mediated neuronal death. In contrast, PNS with antibodies against neuronal surface antigens are antibody-mediated and cause reversible neuronal dysfunction. Further, the perennial question of why only few patients develop these disorders is emerging from studies of tumor genomics and host HLA associations. Finally, immune checkpoint inhibitors have demonstrated the role of immune tolerance breakdown in the development of these disorders.Summary: These advancements in understanding of mechanisms of PNS have several implications for clinical practice and research. For clinical practice, these findings may lead to prognostication of risk of PNS in cancer patients and potential novel therapeutic approaches. For research, these findings have important implications for understanding tumor immunology, and immune tolerance.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"370-377"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670972","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

Big data in multiple sclerosis. 多发性硬化症中的大数据。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-06-01 Epub Date: 2026-04-01 DOI: 10.1097/WCO.0000000000001479

Maria Trojano, Pietro Iaffaldano

{"title":"Big data in multiple sclerosis.","authors":"Maria Trojano, Pietro Iaffaldano","doi":"10.1097/WCO.0000000000001479","DOIUrl":"10.1097/WCO.0000000000001479","url":null,"abstract":"Purpose of review: This review summarizes recent key advancements in multiple sclerosis (MS) achieved through the utilization of big data from diverse sources and advanced analytical techniques.Recent findings: Real-world evidence (RWE) derived from MS big data has significantly enhanced treatment strategies, redefined the concept of disease progression, refined prognostic models, and facilitated personalized medicine. RWE has highlighted the long-term benefits of early intensive treatment compared to escalation strategies, the unfavorable risk profile associated with treatment de-escalation and the importance of managing treatments during pregnancy. Additionally, it has revealed similarities and differences in the effectiveness and safety of specific high-efficacy therapies, as well as key predictors for switching treatments. RWE has also emphasized the central role of progression independent of relapse activity as a significant driver of disability and predictor of unfavorable long-term outcomes in both adult and pediatric onset MS. A data-driven approach utilizing artificial intelligence and big data has established a comprehensive framework for understanding the disease's evolution. Multimodal big data frameworks - encompassing clinical data, MRI, genomics, biomarkers, and app-based metrics - have demonstrated their ability to enhance diagnostic performance and risk stratification in MS.Summary: Big data approaches are transforming MS research and clinical practice by providing stronger RWE to guide therapeutic decision-making, refining models of disease progression, and developing more precise prognostic tools.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"253-261"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590646","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

Paroxysmal movement disorders: an update on genetics, mechanisms, and emerging therapeutic strategies. 阵发性运动障碍：遗传学、机制和新兴治疗策略的最新进展。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-07 DOI: 10.1097/WCO.0000000000001495

Maria Makrygianni, Robert Erro, Maria Stamelou

引用次数: 0

The monoaminergic systems as drivers of Alzheimer's disease pathophysiology and symptomatology. 单胺能系统作为阿尔茨海默病病理生理学和症状学的驱动因素。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1097/WCO.0000000000001455

Heidi I L Jacobs

{"title":"The monoaminergic systems as drivers of Alzheimer's disease pathophysiology and symptomatology.","authors":"Heidi I L Jacobs","doi":"10.1097/WCO.0000000000001455","DOIUrl":"10.1097/WCO.0000000000001455","url":null,"abstract":"Purpose of review: To summarize recent animal, postmortem and in vivo human studies examining the role of the noradrenergic and serotonergic system in the pathophysiology and symptomatology of Alzheimer's disease (AD).Recent findings: Early in adulthood, the locus coeruleus and raphe nucleus accumulate tau, undergo morphological changes, and exhibit hyperexcitability, which contributes to the development of neuropsychiatric symptoms. As cortical AD pathology increases, these nuclei become hypoactive, but elevated neurotransmitter levels persist in the cortex, presumably driving amyloid-related hyperexcitability and contributing to tau spreading and cognitive decline.Summary: The pathologic changes occurring within these monoaminergic systems temporally align with the observation that neuropsychiatric symptoms precede cognitive changes in AD, indicating that these systems link the earliest pathobiology of the disease to the evolution of the symptoms. The proposed monoaminergic framework intends to guide researchers into investigating the temporal dynamics between monoaminergic changes, AD pathology, and symptoms, with the ultimate goal of evaluating and developing effective precision therapeutic approaches taking into account the disease stage and symptom profile.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"192-199"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060486","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

Integration over reduction: multimodal PET and fluid biomarkers in Alzheimer's disease and beyond. 整合超过还原：阿尔茨海默病及其他疾病的多模态PET和液体生物标志物。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-23 DOI: 10.1097/WCO.0000000000001462

Marina Bluma, Konstantinos Chiotis, Agneta Nordberg

{"title":"Integration over reduction: multimodal PET and fluid biomarkers in Alzheimer's disease and beyond.","authors":"Marina Bluma, Konstantinos Chiotis, Agneta Nordberg","doi":"10.1097/WCO.0000000000001462","DOIUrl":"10.1097/WCO.0000000000001462","url":null,"abstract":"Purpose of review: Biomarker-based Alzheimer's disease (AD) diagnosis has shifted clinical practice from syndromic, dementia-stage diagnosis to a biologically defined framework anchored in amyloid positron emission tomography (PET) and cerebrospinal fluid (CSF) assays. However, binary amyloid/tau status does not capture disease complexity, stage, and the impact of co-existing neuropathologies. Here, we review in vivo human PET-fluid biomarker studies in AD and related neurological disorders.Recent findings: We highlight how PET readouts of aggregated pathology and fluid biomarkers reflect related yet non-identical processes, and what relevant insights for staging and prognosis can be derived from it. We review recent efforts to infer tau stage from plasma and CSF markers, emphasizing stage-dependent relationships between soluble p-tau, amyloid burden, and tau-PET signal, and associated limitations that are partly driven by the lack of standardized tau PET staging methods. Finally, we examine how co-pathologies and biological modifiers - including age, APOE ε4, sex, and neuroinflammatory states - shape PET-fluid coupling and contribute to disease course. The reviewed evidence supports a complementary, multimodal biomarker approach that integrates PET with CSF and plasma measures.Summary: To maximize insights from multimodal signals, harmonized integration frameworks - supported by neuropathology-anchored and real-world validation and explicitly accounting for modifiers such as age, sex, and APOE ε4 - will be essential.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"176-184"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270096","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

Clinical amyloid and tau positron emission tomography imaging in Alzheimer's disease: image interpretation in the era of anti-amyloid therapies. 阿尔茨海默病的临床淀粉样蛋白和tau正电子发射断层成像：抗淀粉样蛋白治疗时代的图像解释。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-19 DOI: 10.1097/WCO.0000000000001471

Gregory Mathoux, Elif Harput, Débora E Peretti, Cecilia Boccalini, Valentina Garibotto

{"title":"Clinical amyloid and tau positron emission tomography imaging in Alzheimer's disease: image interpretation in the era of anti-amyloid therapies.","authors":"Gregory Mathoux, Elif Harput, Débora E Peretti, Cecilia Boccalini, Valentina Garibotto","doi":"10.1097/WCO.0000000000001471","DOIUrl":"10.1097/WCO.0000000000001471","url":null,"abstract":"Purpose of review: The introduction of disease-modifying anti-amyloid therapies has shifted the role of positron emission tomography (PET) imaging in Alzheimer's disease from confirming diagnosis to actively guiding clinical decision-making within the AT(N) framework.Recent findings: Amyloid PET has become central for confirming treatment eligibility, quantifying biological response, and supporting PET-guided strategies for treatment duration, particularly through standardized visual interpretation and Centiloid-based quantification. Tau PET provides complementary information by reflecting disease stage and the burden of pathology most closely associated with cognitive impairment, thereby helping to contextualize expected clinical benefit. Recent clinical trials have integrated PET imaging to monitor therapeutic effects and to support translation into routine clinical practice.Summary: This review focuses on practical aspects of visual interpretation and semi-quantitative analysis of amyloid and tau PET, discusses tracer-specific considerations and ongoing harmonization efforts, and summarizes the expanding clinical role of PET imaging. Together, amyloid and tau PET support a more biologically grounded and individualized approach to Alzheimer's disease care in the era of disease-modifying therapies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"161-167"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146224974","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

Update on pediatric autoimmune encephalitis-associated epilepsy. 小儿自身免疫性脑炎相关癫痫的最新进展

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-23 DOI: 10.1097/WCO.0000000000001472

Celia Greenlaw, Coral M Stredny

{"title":"Update on pediatric autoimmune encephalitis-associated epilepsy.","authors":"Celia Greenlaw, Coral M Stredny","doi":"10.1097/WCO.0000000000001472","DOIUrl":"10.1097/WCO.0000000000001472","url":null,"abstract":"Purpose of review: Autoimmune encephalitis-associated epilepsy (AEAE) is initially caused by an aberrant innate and/or adaptive immune system, and then the seizure nidus persists from the ensuing structural damage resulting in chronic, often drug-resistant epilepsy. Early identification and targeted immunomodulation may help improve long-term outcomes in some cases. This review summarizes current advances in understanding the diagnosis, treatment, and long-term outcomes for pediatric patients with AEAE.Recent findings: Enhanced recognition of the role of immune dysfunction in seizures has led to diagnostic and treatment advances. Predictive scores may help identify appropriate patients faster, allowing for earlier initiation of immunotherapy. Biomarkers are emerging to aide in diagnosis and prognostication, including EEG features and biochemical markers, such as neurofilament light chain and cytokines. Novel intrathecal and cytokine-targeted therapies may improve outcomes. Children are at a higher risk for developing AEAE after some types of autoimmune encephalitis compared to adults, but predicting those at risk for epilepsy remains a challenge. Long-term outcomes in children with AEAE are often poor, with refractory seizures and cognitive decline.Summary: Pediatric AEAE is associated with significant morbidity, and research is underway to improve outcomes for these patients by determining risk factors, identifying biomarkers, and developing targeted therapeutic approaches.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"116-122"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275978","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

Cerebellar involvement and stimulation in epilepsy. 癫痫的小脑受累和刺激。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-23 DOI: 10.1097/WCO.0000000000001464

Harley Mocker, Jacob Pellinen, Christopher Elder

{"title":"Cerebellar involvement and stimulation in epilepsy.","authors":"Harley Mocker, Jacob Pellinen, Christopher Elder","doi":"10.1097/WCO.0000000000001464","DOIUrl":"10.1097/WCO.0000000000001464","url":null,"abstract":"Purpose of review: This review discusses the current state of the evidence related to the relationship between the cerebellum and epilepsy, highlighting evidence on neurostimulation of the cerebellum for treatment of epilepsy, and placing current knowledge into historical context.Recent findings: The cerebellum plays an important role in certain epilepsy types, both as a key part of epileptic networks and an area that can give rise to seizures. Cerebellar stimulation as a potential treatment for drug-resistant epilepsy is a recurring, albeit niche, topic of interest. Over decades of intermittent, often highly limited investigations into this area of research, there are still more questions than answers. However, more recent preclinical insights point the way towards leveraging modern surgical techniques and technology in investigating cerebellar stimulation as a potential viable treatment approach to select types of epilepsy.Summary: Cerebellar stimulation holds promise for improving seizure control in people with specific types of drug-resistant epilepsy. Future studies should leverage new preclinical data, along with modern technology, neurosurgical techniques, and clinical trial design, to help determine the optimal stimulation parameters, optimal stimulation targets, and optimal patient-selection for this promising area of investigation.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"101-106"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276018","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

A critical appraisal of the link between apolipoprotein E and Tau. 载脂蛋白E和Tau之间联系的关键评估。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1097/WCO.0000000000001459

Sudeshna Das, Bradley T Hyman, Alberto Serrano-Pozo

{"title":"A critical appraisal of the link between apolipoprotein E and Tau.","authors":"Sudeshna Das, Bradley T Hyman, Alberto Serrano-Pozo","doi":"10.1097/WCO.0000000000001459","DOIUrl":"10.1097/WCO.0000000000001459","url":null,"abstract":"Purpose of review: The apolipoprotein E ( APOE ) genotype has traditionally been associated with Alzheimer's disease (AD) and, more specifically, with the severity of cerebral β-amyloidosis in the form of Aβ plaques and cerebral amyloid angiopathy (CAA). However, a growing body of research has examined its potential impact on Tau pathology.Recent findings: Here we critically review the evidence supporting a differential effect of APOE alleles on Tau in the context of AD and non-AD tauopathies, from genetic, neuropathological, and biomarker studies to preclinical studies in mouse models and human inducible pluripotent stem-cells (hiPSCs)-derived brain cells.Summary: Genetic, neuropathological, and preclinical studies in transgenic mice have yielded somewhat conflicting results, whereas most multitracer PET imaging studies on individuals along the normal aging to AD dementia continuum support an Aβ-independent effect of the APOE ε4 allele on the tauopathy of AD. More clinical and preclinical research is needed to elucidate the link between APOE and Tau.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"200-209"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218968","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