Current Opinion in Neurology最新文献_第5页

Brain health in HIV: pathogenesis, classification, and treatment. HIV的脑健康：发病机制、分类和治疗。

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.0000000000001390

Kathryn B Holroyd, Alan Winston, Sam Nightingale

{"title":"Brain health in HIV: pathogenesis, classification, and treatment.","authors":"Kathryn B Holroyd, Alan Winston, Sam Nightingale","doi":"10.1097/WCO.0000000000001390","DOIUrl":"10.1097/WCO.0000000000001390","url":null,"abstract":"Purpose of review: An update on brain health and cognitive function in persons living with HIV, with a focus on pathogenesis, classification and treatment.Recent findings: Criteria for HIV-associated neurocognitive disorders overestimate prevalence of cognitive impairment and should no longer be used. Instead, HIV-associated brain injury should be considered as one cause of cognitive impairment in persons living with HIV, along with other non-HIV factors. The most widely used cardiovascular risk calculators and stroke categorization tools are not based on data including persons with HIV and appear to underestimate cardiovascular risk. A statin should be considered in all persons living with HIV over the age of 40 and assists in preventing cerebrovascular disease.Summary: HIV is a neurotropic virus which penetrates the central nervous system (CNS) within days of infection, establishing a reservoir. Cerebrospinal fluid (CSF) HIV RNA escape can cause progressive neurologic symptoms and is treatable by targeting the CSF HIV genotypic resistance profile. As the population of persons living with HIV ages, it is important to address noncommunicable sequelae such as multifactorial causes of cognitive impairment and cerebrovascular disease. Strategies for HIV cure need to address barriers and risks posed by the CNS HIV reservoir.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"373-379"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224668","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

Challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders. 神经精神多动运动障碍差异研究的挑战。

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.0000000000001379

Marisela E Dy-Hollins, Adys Mendizabal, Alexander C Tsai

{"title":"Challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders.","authors":"Marisela E Dy-Hollins, Adys Mendizabal, Alexander C Tsai","doi":"10.1097/WCO.0000000000001379","DOIUrl":"10.1097/WCO.0000000000001379","url":null,"abstract":"Purpose of review: The purpose of this review is to highlight challenges in studying disparities in neuropsychiatric hyperkinetic movement disorders, specifically Tourette syndrome and Huntington's disease.Recent findings: We highlight racial and ethnic disparities in understudied movement disorders, particularly the neuropsychiatric hyperkinetic movement disorders, Tourette syndrome and Huntington's disease. These diagnoses are likely under-recognized and under-diagnosed in racial and ethnic minority groups, leading to disparities in access to subspecialty care and treatment. Factors contributing to disparities are complex and likely include patient mistrust of the medical community, stigma, and structural racism. Application of health disparities research frameworks used in other disciplines may have utility in the study of inequities in neurology.Summary: There are significant challenges in studying disparities in Tourette syndrome and Huntington's disease. We also highlight frameworks used in neurology as well as recommendations from the National Institute of Neurological Disorders and Stroke around training in health disparities and recommendations in reducing disparities in neurological disorders across the life span.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"343-348"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076580","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 : 2025-08-01 Epub 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":"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":"337-342"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial improving movement disorders healthcare across the globe. 社论：改善全球运动障碍医疗保健。

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.0000000000001386

Nutan Sharma

引用次数: 0

Recent advances in the genetics of Parkinson's disease in underrepresented populations. 在代表性不足的人群中帕金森病遗传学的最新进展。

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.0000000000001391

Gabriel Alves Marconi, Daniel Teixeira-Dos-Santos, Artur Francisco Schumacher Schuh

{"title":"Recent advances in the genetics of Parkinson's disease in underrepresented populations.","authors":"Gabriel Alves Marconi, Daniel Teixeira-Dos-Santos, Artur Francisco Schumacher Schuh","doi":"10.1097/WCO.0000000000001391","DOIUrl":"10.1097/WCO.0000000000001391","url":null,"abstract":"Purpose of review: The aim of this study is to highlight recent key developments in Parkinson's disease genetics research in underrepresented populations, point out gaps related to ethnic and geographical diversity, and suggest future directions for increasing representation in genetics.Recent findings: Genome-wide association studies (GWAS) involving non-European ancestries have identified population-specific risk variants, even with relatively small sample sizes compared to European GWAS. Polygenic risk scores derived from European cohorts often fail to generalize to non-European populations. Additionally, the prevalence of variants in Parkinson's disease genes, such as LRRK2 and GBA1 , varies across populations. Monogenic studies in regions like African and Latin America face significant challenges, including limited research infrastructure and underrepresentation in genetic studies, hindering a comprehensive understanding of Parkinson's disease's genetic diversity.Summary: Expanding Parkinson's disease genetics research to include diverse populations is essential to enhance disease understanding, uncover novel therapeutic targets, and ensure equitable access to precision medicine. Addressing participation barriers in underrepresented regions and investing in infrastructure development is essential for future progress.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"349-354"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224671","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

Neuro-infectious disorders - reasons to be cheerful but it is a long and winding road. 神经传染性疾病——有理由感到高兴，但这是一条漫长而曲折的道路。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-08-01 Epub Date: 2025-07-03 DOI: 10.1097/WCO.0000000000001400

Hadi Manji

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 : 2025-08-01 Epub Date: 2025-05-21 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":"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":"316-321"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers to providing movement disorders care in India. 印度提供运动障碍护理的障碍。

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.0000000000001375

Heli Shah, Prashanth Lingappa Kukkle

{"title":"Barriers to providing movement disorders care in India.","authors":"Heli Shah, Prashanth Lingappa Kukkle","doi":"10.1097/WCO.0000000000001375","DOIUrl":"10.1097/WCO.0000000000001375","url":null,"abstract":"Purpose of review: Movement disorders (MD) represent a growing healthcare challenge in India, where a diverse population and limited resources complicate diagnosis and management. This review aims to identify and categorize the systemic, socio-economic, cultural, educational, and infrastructural barriers impeding timely and effective MD care, drawing on literature spanning rural and urban contexts.Recent findings: Recent studies show low awareness of MD treatments - such as deep brain stimulation and botulinum toxin therapy - among both patients and clinicians. Socio-economic disparities, particularly in rural areas, combine with limited specialist availability and fragmented referral systems exacerbate care gaps. Meanwhile, gender biases, stigma, and reliance on alternative medicine further delay appropriate interventions. India's partial insurance coverage and insufficient policy frameworks constrain long-term management, although select government initiatives and community-level strategies offer promise. Technological approaches, including telemedicine, show potential for expanding care access.Summary of findings: Multiple interwoven factors hinder optimal MD care in India, diminishing patient outcomes and quality of life. Targeted educational campaigns, enhanced specialist training, improved insurance coverage, and robust policy guidance are crucial. By addressing these issues in a coordinated manner, India can significantly improve the delivery and effectiveness of MD care across its diverse regions.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"361-369"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076577","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

Deep brain stimulation access in 2025: geographic, gender, racial, and socioeconomic disparities re-examined. 2025年的深部脑刺激：重新审视地理、性别、种族和社会经济差异。

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.0000000000001377

Jonathon Cavaleri, Kristen Stefanescu, Darrin Lee, Xenos Mason

{"title":"Deep brain stimulation access in 2025: geographic, gender, racial, and socioeconomic disparities re-examined.","authors":"Jonathon Cavaleri, Kristen Stefanescu, Darrin Lee, Xenos Mason","doi":"10.1097/WCO.0000000000001377","DOIUrl":"10.1097/WCO.0000000000001377","url":null,"abstract":"Purpose of review: This review highlights recent studies examining disparities in access to deep brain stimulation (DBS), an effective but resource-intensive therapy for neurological and neuropsychiatric disorders. As DBS indications expand, understanding barriers to equitable provision is increasingly urgent to ensure that all eligible patients can benefit.Recent findings: Emerging literature confirms persistent disparities in DBS utilization based on geography, gender, race, and socioeconomic status. Geographic disparities reflect regional differences in healthcare infrastructure, with limited access in both rural areas of high-income countries and throughout low-income and middle-income nations. Women remain less likely than men to receive DBS for movement disorders, influenced by referral patterns, social support, and patient preference. Racial and ethnic minority patients - particularly Black and Hispanic individuals - consistently receive DBS at lower rates, in part due to reduced referrals. Socioeconomic factors, including insurance status and household income, strongly predict DBS access, favoring privately insured and wealthier patients.Summary: These findings underscore the need for systemic changes in referral practices, institutional policies, and healthcare funding to reduce structural barriers to DBS. Future research should focus on intersectional factors driving disparities and evaluate targeted interventions to promote equitable access.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"330-336"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076581","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

Viral encephalitis - update on pathogenesis and treatment. 病毒性脑炎的发病机制和治疗进展。

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.0000000000001384

Rachael Matthews, Brendan F Sargent, Steven McKeever, Yun Huang, Mark A Ellul, Benedict D Michael

{"title":"Viral encephalitis - update on pathogenesis and treatment.","authors":"Rachael Matthews, Brendan F Sargent, Steven McKeever, Yun Huang, Mark A Ellul, Benedict D Michael","doi":"10.1097/WCO.0000000000001384","DOIUrl":"10.1097/WCO.0000000000001384","url":null,"abstract":"Purpose of review: Viral encephalitis is a potentially devastating condition of cerebral inflammation manifest as a combination of fever, altered mentation, and sometimes focal neurological signs and seizures. In this review we explore the new developments in understanding of the epidemiology, pathogenesis and treatment options.Recent findings: The WHO technical brief is a landmark document which sets the stage for the advancement of the surveillance, prevention and management of viral encephalitis. Adjunctive dexamethasone given in herpes simplex virus encephalitis is not associated with a worse outcome or CSF viral persistence but may not significantly improve overall outcome. Simple interventions in resource limited settings can significantly increase the proportion of patients with a syndrome or aetiological diagnosis of viral encephalitis.Summary of implications: This review highlights ongoing research further elucidating the underlying pathophysiological mechanisms of brain injury, paving the way for adjunctive targeted immunotherapy which can ameliorate those aspects of the inflammatory response contributing to brain injury. Nevertheless, large-scale networks are required to establish the prospective, adaptive platform trials necessary. Pending this, as laid out in the WHO Technical Brief on encephalitis, preventive measures have the potential to save lives, including surveillance, vector control, and uptake of established and emerging vaccines.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"388-396"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224673","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