Current Opinion in Neurology最新文献_第4页

Cardiovascular and bone health comorbidities in epilepsy. 癫痫的心血管和骨骼健康合并症

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.0000000000001473

Ann Subota, Colin B Josephson

{"title":"Cardiovascular and bone health comorbidities in epilepsy.","authors":"Ann Subota, Colin B Josephson","doi":"10.1097/WCO.0000000000001473","DOIUrl":"10.1097/WCO.0000000000001473","url":null,"abstract":"Purpose of review: Epilepsy increases risk of cardiovascular morbidity and mortality, and growing evidence suggests broader systemic effects, including on bone health. This review examines the evolving concepts of the \"epilepsy-heart syndrome' and the impact that both epilepsy and antiseizure medications (ASMs) have on cardiovascular and both health, highlighting why timely recognition is clinically and scientifically imperative.Recent findings: Epilepsy promotes myocardial injury through catecholamine surges, hypoxemia, and ischemia, resulting in arrhythmias, diastolic dysfunction, and accelerated atherosclerosis. Conversely, cardiovascular disorders and metabolic dysregulation predispose to epilepsy, reinforcing a bidirectional relationship. Enzyme-inducing ASMs increase lipid levels, attenuate statin efficacy, and increase risks of long-term cardiovascular disease. Both enzyme-inducing and noninducing ASMs contribute to reduced bone mineral density and potentially to increased fracture risk via altered vitamin D metabolism and hormonal effects.Summary: Epilepsy is a multisystem disorder that encompasses cardiovascular disease and skeletal fragility. Although formal guidelines are currently lacking, clinicians should consider integrating cardiovascular screening, rational ASM selection, and proactive bone-health surveillance into routine epilepsy management. Research should focus on longitudinal, mechanistic, and interventional studies to improve cardiovascular and bone health and to validate emerging screening and management guidelines to improve overall health in epilepsy.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"107-115"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275995","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

Epilepsy advances in 2025. 2025年癫痫病将有所进展。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1097/WCO.0000000000001474

Philippe Ryvlin, Daniel Friedman

引用次数: 0

Peripheral alterations of mitochondrial function and mitophagy in Alzheimer's disease: from fundamental research to clinical perspectives. 阿尔茨海默病线粒体功能和线粒体自噬的外周改变：从基础研究到临床观点

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1097/WCO.0000000000001457

Fanny Eysert, Gaëlle Deportes, Elodie Delaquaize, Mounia Chami

{"title":"Peripheral alterations of mitochondrial function and mitophagy in Alzheimer's disease: from fundamental research to clinical perspectives.","authors":"Fanny Eysert, Gaëlle Deportes, Elodie Delaquaize, Mounia Chami","doi":"10.1097/WCO.0000000000001457","DOIUrl":"10.1097/WCO.0000000000001457","url":null,"abstract":"Purpose of review: Alzheimer's disease (AD) is commonly defined by its hallmark brain pathologies, yet mounting evidence shows that metabolic impairment particularly linked to mitochondrial dysfunction, is a central and systemic feature of the disease. This review highlights consistent abnormalities in mitochondrial function, and turnover (mitophagy) across multiple AD-derived peripheral cells, including skin fibroblasts, lymphocytes, platelets, and peripheral blood mononuclear cells. We also report on potential peripheral AD biomarkers linked to mitochondria dysfunction in AD.Recent findings: Mitochondrial abnormalities in peripheral cells from individuals with AD robustly correlate with disease development. These mitochondrial dysfunctions mostly include reduced respiratory chain activity, increased accumulation of reactive oxygen species (ROS), altered mitochondrial membrane potential, and consequently decreased ATP production. Studies have also identified a complex pattern of mitochondrial hyperactivity and hypoactivity in peripheral cells of AD patients that appears to depend on the stage of AD and whether the disease is sporadic or familial. Furthermore, multiple steps of the mitophagy pathway are disrupted in peripheral cells as AD progresses. Finally, biochemical and proteomic analyses of peripheral fluids further support the loss of mitochondrial homeostasis in AD patients.Summary: Collectively, the reviewed findings support mitochondrial homeostasis disruption as a core pathophysiological component of AD and a promising target for biomarker development and therapeutic intervention.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"185-191"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099935","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

SUDEP update 2026: recent advances in experimental and clinical research. SUDEP更新2026：实验和临床研究的最新进展。

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.0000000000001463

Philippe Ryvlin, Sylvain Rheims

{"title":"SUDEP update 2026: recent advances in experimental and clinical research.","authors":"Philippe Ryvlin, Sylvain Rheims","doi":"10.1097/WCO.0000000000001463","DOIUrl":"10.1097/WCO.0000000000001463","url":null,"abstract":"Purpose of review: This review summarizes experimental and clinical research advances in the field of sudden unexpected death in epilepsy (SUDEP) over the past 3 years.Recent findings: Novel animal models of SUDEP have been developed, highlighting the prevalence of peri-ictal respiratory dysfunction.The circumstances of SUDEP in genetic developmental and epileptic encephalopathies were found similar to those reported in more common epilepsies. Accordingly, most caregivers of patients with Dravet syndrome report using nocturnal monitoring devices and having averted critical incidents through such monitoring.Several prospective studies have identified novel SUDEP risk factors, including peri-ictal apnea, disrupted sleep homoeostasis, extratemporal epilepsies and elevated BMI. Retrospective analyses have additionally demonstrated associations between SUDEP and reduced polygenic risk scores for intelligence and longevityMultiple surveys highlight substantial gaps in SUDEP communication, with many people with epilepsy (PWE) and caregivers remaining insufficiently informed. This calls for action, given the accumulating evidence that optimizing seizure control is likely to reduce SUDEP risk.Summary: Recent advances in SUDEP research further support a central role for seizure-related respiratory dysfunction. Greater efforts are needed to improve communication with PWE and caregivers regarding SUDEP risk factors, and to promote optimized monitoring and therapeutic strategies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"123-130"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282775","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

AI in epilepsy neuroimaging. AI在癫痫神经影像学中的应用。

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.0000000000001465

Sophie Adler, Konrad Wagstyl

{"title":"AI in epilepsy neuroimaging.","authors":"Sophie Adler, Konrad Wagstyl","doi":"10.1097/WCO.0000000000001465","DOIUrl":"10.1097/WCO.0000000000001465","url":null,"abstract":"Purpose of review: Recent advances in the capabilities and usability of artificial intelligence (AI) architectures coupled with increased availability of neuroimaging datasets has fuelled a rapid expansion in AI applications to epilepsy neuroimaging. This review summarizes the main applications of AI in epilepsy neuroimaging and suggests future directions for the field.Recent findings: A range of different machine learning approaches, from multi-layer perceptrons to volumetric and graph-based convolutional neural networks, have been utilized for prediction of whether people will have epilepsy, detection of structural epilepsy lesions, localization of seizure onset zones, segmentation of resection cavities after epilepsy surgery as well as for image enhancement.Summary: AI in epilepsy neuroimaging research has primarily focussed on lesion detection and localization, with a number of open and validated tools now available for evaluation across diverse settings. Additional applications of AI in epilepsy neuroimaging are either at earlier stages of development or emerging as new challenges. As these tools and their supporting evidence mature, further work addressing the hurdles of clinical integration is required.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"131-137"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146224923","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

Novel pharmacological therapies in development. 新型药物疗法正在开发中。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1097/WCO.0000000000001456

Piero Perucca, Emilio Perucca

{"title":"Novel pharmacological therapies in development.","authors":"Piero Perucca, Emilio Perucca","doi":"10.1097/WCO.0000000000001456","DOIUrl":"10.1097/WCO.0000000000001456","url":null,"abstract":"Purpose of review: To review progress in developing new pharmacological treatments for epilepsy, focusing on agents in clinical development.Recent findings: Over 30 different treatments are currently in clinical development, including novel small molecules, nucleic acid-based therapies, stem cells, microbiome-targeting bacteria, and repurposed drugs originally approved for other indications. Most of these treatments target rare epilepsies, particularly the developmental and epileptic encephalopathies, reflecting a development shift from common epilepsies to rare drug-resistant syndromes where unmet therapeutic needs are greatest. Most compounds are still in early development, and publicly accessible data consist mainly of conference reports and congress abstracts. For only two compounds (the K v 7 activator azetukalner and the inhaled emergency treatment Staccato alprazolam) has evidence of efficacy been obtained from relatively large, well designed randomized placebo-controlled trials.Summary: New paradigms in drug discovery have brought to development innovative treatments with diverse targets and mechanisms of action. Many of these treatments are etiology-targeting and have the potential for disease-modifying effects. Although high-quality evidence is awaited, there is hope that over the next few years much needed life-changing therapies will be widely available for millions of people with disabling, drug-resistant epilepsies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"138-149"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099965","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

Idiopathic generalised epilepsies in 2026. 2026年的特发性全身性癫痫。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-01-23 DOI: 10.1097/WCO.0000000000001458

Eva Breuer, Bernd J Vorderwülbecke, Martin Holtkamp

{"title":"Idiopathic generalised epilepsies in 2026.","authors":"Eva Breuer, Bernd J Vorderwülbecke, Martin Holtkamp","doi":"10.1097/WCO.0000000000001458","DOIUrl":"10.1097/WCO.0000000000001458","url":null,"abstract":"Purpose of review: One in five patients with epilepsy has idiopathic generalized epilepsy (IGE). Novel definitions of seizure types, recent data on pharmacotherapy, and new studies on psychiatric and cognitive comorbidities will be critically discussed.Recent findings: Epileptic seizures have been re-classified by the International League Against Epilepsy (ILAE), acknowledging absence-to-tonic-clonic seizures and generalized negative myoclonic seizures. Differing from the classical ILAE definition of IGE subtypes, current evidence underlines that IGEs represent rather a neurobiological continuum than separate syndromes. Valproate is still the most efficacious compound to suppress myoclonic and tonic-clonic seizures, but novel data confirm the high risk for both anatomical and neurodevelopmental teratogenicity. However, switching from valproate to other antiseizure medications commonly results in seizure recurrence or worsening. As compared to the general population, persons with IGE have a two- to fourfold increased risk of psychiatric disorders, the lifetime risk is 30-50%. Bidirectional associations between IGE and psychiatric conditions suggest that the latter are integral components of a broader IGE endophenotype.Summary: Valproate continues to be the most efficacious treatment for IGE but also the most teratogenic, leaving women who plan to become pregnant in a dilemma. Psychiatric comorbidities are frequent in IGE and thus require special attention and a holistic treatment approach.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"150-157"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050834","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

Decoding Alzheimer's disease through down syndrome: insights from a genetically defined population. 通过唐氏综合症解码阿尔茨海默病：来自基因定义人群的见解。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-02-18 DOI: 10.1097/WCO.0000000000001461

Jason K Russell, Zinayida Schlachetzki, Michael S Rafii

{"title":"Decoding Alzheimer's disease through down syndrome: insights from a genetically defined population.","authors":"Jason K Russell, Zinayida Schlachetzki, Michael S Rafii","doi":"10.1097/WCO.0000000000001461","DOIUrl":"10.1097/WCO.0000000000001461","url":null,"abstract":"Purpose of review: This review explores Alzheimer's disease (AD) in individuals with Down syndrome (DS), a genetically defined population with near-universal development of AD neuropathology by age 40. We examine the genetic basis of DS-AD, epidemiology, biomarker trajectories, and clinical trial innovations, highlighting how insights from DS research inform broader AD pathogenesis, early detection, and therapeutic strategies.Recent findings: Advances in biomarker research, including longitudinal studies such as ABC-DS, have mapped predictable trajectories of amyloid, tau, and neurodegeneration in DS-AD, aligning closely with clinical staging. Plasma and CSF biomarkers (Aβ42, p-tau, NfL, GFAP) and neuroimaging modalities (amyloid/tau PET, MRI) demonstrate early and sequential changes decades before dementia onset. Revised AD diagnostic criteria now classify DS individuals as Stage 0 from birth, acknowledging genetic determinism and enabling earlier intervention. Comparative analyses between DS-AD, autosomal-dominant AD, and sporadic AD reveal shared pathological features but distinct timing and distribution of amyloid and tau. Clinical trials targeting amyloid and APP pathways in DS are underway, leveraging predictable disease progression to accelerate therapeutic development.Summary: Studying AD in DS provides a unique lens into the natural history of Alzheimer's disease, offering critical insights into genetic drivers, biomarker evolution, and therapeutic opportunities. The genetically defined and biologically concordant nature of DS-AD enables precise staging and early intervention strategies that can be translated to sporadic and familial AD. Continued investment in DS research will advance biomarker validation, refine clinical trial design, and inform personalized treatment approaches for the broader AD population.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"210-216"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218914","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

Cognitive neurodegenerative diseases at a crossroads: implementing recent advances while continuing the search for effective therapeutic strategies. 处于十字路口的认知神经退行性疾病：在继续寻找有效治疗策略的同时实施最新进展。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1097/WCO.0000000000001470

Julien Lagarde

引用次数: 0

Blood-based biomarkers of Alzheimer's disease: potential utility in clinical practice. 基于血液的阿尔茨海默病生物标志物：在临床实践中的潜在效用

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.0000000000001475

Xuemei Zeng, Nya Nicholson, Thomas K Karikari

{"title":"Blood-based biomarkers of Alzheimer's disease: potential utility in clinical practice.","authors":"Xuemei Zeng, Nya Nicholson, Thomas K Karikari","doi":"10.1097/WCO.0000000000001475","DOIUrl":"10.1097/WCO.0000000000001475","url":null,"abstract":"Purpose of review: Blood-based biomarkers (BBMs) for Alzheimer's disease are beginning to enter clinical practice. As this integration advances, it is essential to critically examine their strengths, limitations, and readiness for broader clinical application.Recent findings: Evidence increasingly supports the utility of BBMs for clinical management of Alzheimer's disease, with phosphorylated tau species, Aβ42/40 ratio, GFAP, and NfL among the most studied. Plasma p-tau forms have emerged as the most promising markers, showing strong correlations with amyloid plaque deposition and predictive value for disease progression. The WHO and the Global CEO Initiative have outlined minimum performance criteria for clinical use. While no BBM meets these benchmarks with a single cutpoint, adopting a two-cutpoint approach by introducing an intermediate category has enabled some assays to achieve the required accuracy. Several assays are now commercially available, and two have recently received FDA clearance to assist in confirming or ruling out amyloid-beta pathology.Summary: BBMs could transform Alzheimer's disease diagnostics by enabling scalable, minimally invasive approaches for early detection and monitoring. As implementation advances, assay harmonization, assessment of demographic and physiological influences, and real-world validation across diverse populations remain essential to ensure reliability and equitable access.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"168-175"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275956","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