Current Opinion in Neurology最新文献_第7页

Converging perspectives in vestibular neurology. 前庭神经学的融合观点。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1097/WCO.0000000000001446

Adolfo Miguel Bronstein

引用次数: 0

Endovascular treatment of distal medium vessel occlusions. 远端中血管闭塞的血管内治疗。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1097/WCO.0000000000001449

Antonio Ciacciarelli, Umberto Pensato, Johanna Maria Ospel

{"title":"Endovascular treatment of distal medium vessel occlusions.","authors":"Antonio Ciacciarelli, Umberto Pensato, Johanna Maria Ospel","doi":"10.1097/WCO.0000000000001449","DOIUrl":"10.1097/WCO.0000000000001449","url":null,"abstract":"Purpose of review: Endovascular treatment (EVT) has dramatically improved outcomes of patients suffering from acute ischemic stroke due to large vessel occlusion (LVO), becoming the standard of care. However, up to one-third of ischemic strokes are caused by distal medium vessel occlusions (DMVO), which are beyond the LVO territory. Medical management, including intravenous thrombolysis, leaves more than half of DMVO patients disabled at 3 months, with mortality exceeding 10%. In face of this grim prognosis, expanding EVT to DMVO has gained considerable interest. This review summarizes the clinical, anatomical, and imaging features of DMVO stroke, discusses recent EVT trial results and their interpretation, and outlines future directions for establishing safe and effective reperfusion strategies in this population.Recent findings: Recent randomized trials investigating EVT for DMVO stroke yielded neutral results overall. However, they provided important insights about patient subgroups likely to benefit from intervention and set key challenges to improving the management of patients with DMVO.Summary: While current evidence does not support routine EVT for DMVO stroke, the field is evolving rapidly. Ongoing advances in device technology, patient selection, and trial design hold promise for refining treatment and improving outcomes in carefully selected patients.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"39 1","pages":"7-16"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917307","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

Update on functional vestibular and gait disorders. 功能性前庭和步态障碍的最新进展。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1097/WCO.0000000000001445

Jeffrey P Staab

{"title":"Update on functional vestibular and gait disorders.","authors":"Jeffrey P Staab","doi":"10.1097/WCO.0000000000001445","DOIUrl":"10.1097/WCO.0000000000001445","url":null,"abstract":"Purpose of review: Three functional neurological disorders are encountered in neuro-otologic practice, persistent postural-perceptual dizziness (PPPD), which is the commonest cause of chronic vestibular and balance symptoms, mal de debarquement (MdDS), a rarer but potentially debilitating disorder, and functional gait disorder, an often overlooked but treatable condition.Recent findings: Recent investigations of PPPD suggested that there may be subtypes or subthreshold variants that merit further investigation. Studies of pathological mechanisms continue to offer new insights into the complex processes that initiate and sustain the disorder, which will require nuanced models to bring together disparate findings. Evidence continues to accumulate in support of vestibulo-ocular reflex readaptation therapy for MdDS, with pilot studies offering refinements and possible alternatives. Functional gait disorder is one of the commonest manifestations of functional neurological disorder, often presenting with other functional neurological symptoms including PPPD. Specialized methods of physical and occupational therapy continue to mature. Optimal outcomes may require short and focused periods of intensive treatment.Summary: Evolving theories and continuing emergence of new data are beginning to make functional vestibular and gait disorders a manageable part of neuro-otologic practice.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"39 1","pages":"48-53"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917275","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

Precision medicine in Moyamoya vasculopathy. 烟雾病的精准医学。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1097/WCO.0000000000001454

Ritik Patel, Muhammad Memon, Johnny A Mendoza, Yusuf K Qadeer, Jonathan A Tangsrivimol, Chayakrit Krittanawong

{"title":"Precision medicine in Moyamoya vasculopathy.","authors":"Ritik Patel, Muhammad Memon, Johnny A Mendoza, Yusuf K Qadeer, Jonathan A Tangsrivimol, Chayakrit Krittanawong","doi":"10.1097/WCO.0000000000001454","DOIUrl":"10.1097/WCO.0000000000001454","url":null,"abstract":"Purpose of review: Moyamoya vasculopathy is a progressive cerebrovascular steno-occlusive disease with variable presentation. As revascularization techniques, antiplatelet therapies, and imaging-based artificial intelligence (AI) diagnostics continue to advance, there is an emerging opportunity to refine patient stratification by integrating genetic profiling, neuroimaging phenotypes, and circulating biomarkers.Recent findings: The RNF213 locus (particularly p.R4810K) represents the primary susceptibility allele in East Asian cohorts, with secondary contributors including ACTA2 and GUCY1A3 showing incomplete penetrance. Emerging. data reveal dysregulated lipid metabolism, impaired arginine-arginine-nitric oxide (NO) and methionine signaling, heightened oxidative stress, and ferroptotic pathways. Proteomic studies identify disrupted angiogenic and cytoskeletal programs with potential biomarker utility in cerebrospinal fluid and serum. Current diagnostic standards employ MRI/MRA and digital subtraction angiography. Observational data support antiplatelet agents, including cilostazol, in reducing stroke recurrence and mortality. Direct and combined bypass approaches demonstrate superior outcomes in adult hemorrhagic disease, whereas indirect revascularization predominates in pediatric populations. Emerging AI-integrated diagnostic algorithms incorporating imaging and multiomic data exhibit promising diagnostic accuracy.Summary: Systematic integration of genotypic and multiomic profiling with hemodynamic assessment could enhance prognostic precision, optimize surgical timing, and guide antiplatelet selection in Moyamoya. Next step priorities include studying ethnically diverse multicenter registries and rigorous trials evaluating targeted and regenerative therapeutic strategies. Digital subtraction angiography (DSA)-guided diagnosis and individualized revascularization strategies remain the clinical standard.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"26-39"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699940","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 cortical vestibular system: insights from electroencephalography. 皮层前庭系统：来自脑电图的见解。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1097/WCO.0000000000001448

Adolfo M Bronstein, Jasmine L Mirdamadi, Toby J Ellmers

{"title":"The cortical vestibular system: insights from electroencephalography.","authors":"Adolfo M Bronstein, Jasmine L Mirdamadi, Toby J Ellmers","doi":"10.1097/WCO.0000000000001448","DOIUrl":"10.1097/WCO.0000000000001448","url":null,"abstract":"Purpose of review: Although electroencephalography (EEG) is central to epilepsy diagnosis, its role in patients presenting with dizziness or balance disorders has historically been negligible. This review provides a timely synthesis of recent methodological and conceptual advances demonstrating how modern EEG analyses can probe cortical contributions to vestibular and balance function.Recent findings: While vestibular epilepsy remains rare, EEG is increasingly being applied to investigate cortical dynamics during vestibular stimulation, postural control, and balance perturbations. Contemporary analytic techniques have revealed that alpha-band and beta-band EEG activity reflect key aspects of vestibular perception, adaptation, and postural control. Findings in patients with higher order vestibular dysfunction link symptoms to abnormal oscillatory patterns corresponding to disrupted sensory integration and maladaptive attentional engagement. Advances in mobile EEG approaches now permit reliable signal acquisition during movement and direct vestibular stimulation, allowing quantification of ecologically relevant cortical responses such as the perturbation-evoked potential.Summary: EEG provides a powerful, accessible, and scalable tool to characterize cortical contributions to vestibular processing and balance. These developments highlight its emerging value for identifying neurophysiological biomarkers of vestibular dysfunction, improving diagnostic precision, and informing targeted rehabilitation strategies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"92-98"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630395","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

Recent advances in stroke biomarkers - implications for prognosis and treatment. 脑卒中生物标志物的最新进展-对预后和治疗的影响。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1097/WCO.0000000000001450

Jessica Seetge, Johannes Frenger, Mira Katan, Gerrit M Grosse

{"title":"Recent advances in stroke biomarkers - implications for prognosis and treatment.","authors":"Jessica Seetge, Johannes Frenger, Mira Katan, Gerrit M Grosse","doi":"10.1097/WCO.0000000000001450","DOIUrl":"10.1097/WCO.0000000000001450","url":null,"abstract":"Purpose of review: To summarize recent advances in blood-based biomarkers for acute ischemic stroke relevant to diagnosis, etiological assessment, risk prediction, and outcome prognostication, and to outline future directions for clinical implementation.Recent findings: Novel biomarkers enhance differentiation of ischemic from hemorrhagic stroke and large vessel occlusion detection, optimizing triage via point-of-care testing. Specific biomarkers improve etiological classification and identification of mechanisms like cardioembolic sources and atrial cardiopathy, enabling targeted secondary prevention. Circulating markers stratify risks of vascular recurrence and infections, linking inflammatory, thrombotic, and endothelial pathways. Prognostic biomarkers refine predictions of functional outcomes, mortality, and reperfusion responses.Summary: To translate these promising findings into clinical care and to identify novel molecular targets, standardized sample collection, rigorous external validation, and multiomics/panel integration will be required. In this sense, blood-based-biomarkers have the potential to sustainably improve diagnostics, prognosis and treatment in stroke care.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"17-25"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630360","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

Advances in imaging analysis of the inner ear in patients with Meniere's disease. 梅尼埃病内耳影像学分析进展。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-03 DOI: 10.1097/WCO.0000000000001440

Michihiko Sone, Tadao Yoshida, Shinji Naganawa

{"title":"Advances in imaging analysis of the inner ear in patients with Meniere's disease.","authors":"Michihiko Sone, Tadao Yoshida, Shinji Naganawa","doi":"10.1097/WCO.0000000000001440","DOIUrl":"10.1097/WCO.0000000000001440","url":null,"abstract":"Purpose of review: Visualization of endolymphatic hydrops using MRI has become a cutting-edge method not only for diagnosing Meniere's disease but also for pathophysiological elucidation of the disease. Here, we review recent advances in imaging analysis of the inner ear in Meniere's disease, which could provide additional information over previous findings.Recent findings: In addition to identification of endolymphatic hydrops on MRI, high-intensity signals in the perilymph, which represent alterations in vascular permeability in the blood-perilymph barrier (BPB), might be a key to elucidating the pathophysiology of Meniere's disease. Moreover, high-intensity signals in the endolymphatic duct, which indicate disturbances of the lymph-capillary system, might provide new information for elucidating the pathogenesis of hearing loss and dizziness/vertigo not associated with endolymphatic hydrops.Summary: Presence of endolymphatic hydrops is not necessarily the cause of symptoms related to Meniere's disease. Alteration of the BLB might lead to additional disturbances in ears with Meniere's disease and induce clinical symptoms. Disturbances of the lymph-capillary system in endolymphatic duct might induce audio-vestibular symptoms in ears without endolymphatic hydrops. Further development of MRI evaluation of inner ear conditions is desirable not only for accurate diagnosis and elucidation of the pathophysiology of the diseases, but also for early medical intervention to prevent their progression.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"88-91"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437572","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

Acute vertigo: stroke or not? 急性眩晕：是不是中风？

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-24 DOI: 10.1097/WCO.0000000000001444

Diego Kaski

{"title":"Acute vertigo: stroke or not?","authors":"Diego Kaski","doi":"10.1097/WCO.0000000000001444","DOIUrl":"10.1097/WCO.0000000000001444","url":null,"abstract":"Purpose of review: Acute vertigo accounts for about 4% of emergency department visits in both the United States and Europe. Despite this frequency, the management of dizziness, vertigo, and balance disorders remains fragmented, with no established international care pathway. The acute vestibular syndrome (AVS) is particularly challenging, and timely recognition is essential to avoid potentially devastating outcomes. This review is timely, because misdiagnosis rates remain unacceptably high, especially for posterior circulation strokes presenting with dizziness.Recent findings: The literature highlights a wide differential diagnosis for AVS, ranging from benign peripheral vestibular disorders to life-threatening central causes. Distinguishing stroke from peripheral disorder remains a key clinical dilemma, compounded by the limitations of early neuroimaging - MRI can yield false negatives within 48 h. Up to 35% of posterior circulation strokes with dizziness are initially missed, often by nonspecialists unfamiliar with targeted bedside tests.Summary: A structured bedside approach, focusing on key clinical features and targeted examination, can improve diagnostic accuracy and reduce delays in appropriate treatment. Incorporating such strategies into standard practice could address a major gap in acute neurology care and improve patient outcomes.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"65-71"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556486","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

Progress in the identification of unstable carotid artery plaque. 不稳定颈动脉斑块鉴别研究进展。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1097/WCO.0000000000001451

Luca Saba

{"title":"Progress in the identification of unstable carotid artery plaque.","authors":"Luca Saba","doi":"10.1097/WCO.0000000000001451","DOIUrl":"10.1097/WCO.0000000000001451","url":null,"abstract":"Purpose of review: Ischemic stroke remains a leading cause of death and disability worldwide, with carotid atherosclerosis as a major underlying mechanism. For decades, treatment decisions were based primarily on luminal stenosis, overlooking the biological complexity of plaque instability. This review summarizes recent progress in the imaging-based identification and risk stratification of unstable cerebrovascular plaque, emphasizing the transition from geometric to biological evaluation.Recent findings: Advances in CT, MRI, and ultrasound have enabled in vivo visualization of key features associated with plaque vulnerability, including intraplaque hemorrhage, fibrous cap rupture, neovascularization, inflammation, and perivascular fat alterations. Dual-energy and photon-counting CT now provide spectral and spatial information capable of tissue differentiation at submillimeter scales. MRI offers superior soft-tissue characterization, while contrast-enhanced ultrasound reveals microvascular activity and flow dynamics. The recent introduction of standardized interpretative systems, such as Plaque-reporting and data system (RADS), allows integration of multimodal findings into a unified risk framework.Summary: Contemporary imaging has transformed the assessment of carotid atherosclerosis from a static measurement of stenosis into a dynamic, biology-driven discipline. The combination of advanced imaging, quantitative analysis, and emerging molecular and genetic correlates promises to refine individualized risk prediction and guide targeted prevention strategies for cerebrovascular disease.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"1-6"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699991","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

Vestibular migraine. Clinical and diagnostic challenges, and emerging therapeutic approaches. 前庭偏头痛。临床和诊断的挑战，以及新兴的治疗方法。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1097/WCO.0000000000001447

Maria Dolores Villar-Martinez, Ahmed Abdalla, Peter J Goadsby

{"title":"Vestibular migraine. Clinical and diagnostic challenges, and emerging therapeutic approaches.","authors":"Maria Dolores Villar-Martinez, Ahmed Abdalla, Peter J Goadsby","doi":"10.1097/WCO.0000000000001447","DOIUrl":"10.1097/WCO.0000000000001447","url":null,"abstract":"Purpose of review: Vestibular migraine (VM) is a prevalent yet underdiagnosed cause of vestibular symptoms, which overlaps with other vestibular and migraine-related conditions. This review focuses on detailed clinical phenomenology, alongside comorbidities, and the appraisal of emerging therapies.Recent findings: Recent work shows that migraine-associated features such as allodynia, photophobia, and movement sensitivity sharpen clinical discrimination. Premonitory and cognitive symptoms, including brain fog and executive slowing, are increasingly recognized. Chronobiological factors such as menstrual cycle and menopause modulate susceptibility. Oculomotor assessment and neuroimaging point to disturbed integration across vestibular, sensorimotor, and visual networks rather than focal lesions. Comorbid persistent postural-perceptual dizziness, dysautonomia, and autoimmune tendencies complicate diagnosis and management. Early trials support calcitonin gene-related peptide (CGRP) monoclonal antibodies and onabotulinumtoxin-A, with lifestyle interventions, and nutraceuticals commonly being used, although clinical trial designs and endpoints remain heterogeneous.Summary: VM reminds us that bedside examination remains the anchor: a detailed history, eye-movement examination, and context refine diagnosis. Objective markers and interdisciplinary strategies assist rather than replace clinical judgement. Further studies should integrate multimodal assessment and phenotype-guided treatment stratification.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"42-47"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647771","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