Current Opinion in Neurology最新文献_第8页

Neuro-vestibular rehab: new developments. 神经前庭康复：新进展。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2026-02-01 Epub Date: 2025-11-06 DOI: 10.1097/WCO.0000000000001441

Yoav Gimmon, Carlos R Gordon

{"title":"Neuro-vestibular rehab: new developments.","authors":"Yoav Gimmon, Carlos R Gordon","doi":"10.1097/WCO.0000000000001441","DOIUrl":"10.1097/WCO.0000000000001441","url":null,"abstract":"Purpose of review: This review highlights recent advances in neuro-vestibular rehabilitation, with emphasis on vestibular adaptation and emerging mobile technologies. It summarizes developments in promoting vestibular plasticity and discusses novel tools such as virtual reality, wearable sensors, and telehealth platforms that enhance access, engagement, and outcomes. The scope is broad, focusing on general principles rather than specific populations.Recent findings: New methods to enhance vestibulo-ocular reflex (VOR) adaptation include incremental adaptation devices and gamified exercises. Inducing VOR gain-down adaptation temporarily increases postural sway, which normalizes via sensory reweighting, demonstrating central compensation. Portable tools like StableEyes show promise in boosting VOR gain with brief sessions. Concurrently, technology-driven approaches are gaining traction. Gamified mobile applications and wearable sensors allow home-based rehabilitation with remote supervision and monitoring, showing promising results in conditions like multiple sclerosis. Virtual reality interventions and telehealth models accelerated during the COVID-19 era, expanding therapy delivery to underserved populations. Adjunctive methods such as vibrotactile feedback and galvanic vestibular stimulation are emerging as complementary therapies.Summary: Recent developments are advancing vestibular rehabilitation by refining adaptive training techniques and leveraging digital tools to overcome barriers in access and adherence. These innovations point to a more personalized, technology-enabled approach to optimizing neuro-vestibular recovery.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"39 1","pages":"83-87"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917342","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

Emerging targeted therapies in meningiomas. 新兴的脑膜瘤靶向治疗。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-10-08 DOI: 10.1097/WCO.0000000000001430

Erika Yamazawa, Emily Sullivan, Hiroaki Wakimoto, Priscilla K Brastianos

{"title":"Emerging targeted therapies in meningiomas.","authors":"Erika Yamazawa, Emily Sullivan, Hiroaki Wakimoto, Priscilla K Brastianos","doi":"10.1097/WCO.0000000000001430","DOIUrl":"10.1097/WCO.0000000000001430","url":null,"abstract":"Purpose of review: Patients with grade 2 and 3 meningioma have high recurrence rates and limited treatment options after failure of radiation and surgery. Recent advances in molecular profiling of these tumors have enabled the investigation of novel targeted therapeutic approaches.Recent findings: Innovative treatment strategies under investigation for recurrent high-grade meningiomas include targeted therapies, immunotherapy, and radionuclide-based approaches. Inhibition of angiogenesis, histone deacetylases, FAK, mTOR, and CDK4/6 pathways has shown early signs of activity in small clinical trials of patients with recurrent meningiomas. Immunotherapy, such as immune checkpoint inhibition (ICI), has also demonstrated prolonged disease control in a subset of patients. Larger randomized studies are needed for further investigation of the efficacy and safety of these newer therapies in patients with high-grade and recurrent meningioma.Summary: Emerging molecularly driven treatment strategies show promise for the treatment of patients with high-grade meningiomas. Larger trials that incorporate molecular testing are warranted to fully evaluate their therapeutic potential.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"711-718"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257619","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

Kunming Locomotor Training: neurological, functional, and autonomic outcomes in complete spinal cord injury. 昆明运动训练：完全性脊髓损伤的神经、功能和自主神经预后。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-10-23 DOI: 10.1097/WCO.0000000000001439

Hui Zhu, Kwok-Fai So, Xiaoqing Feng, Fang Niu, James David Guest

{"title":"Kunming Locomotor Training: neurological, functional, and autonomic outcomes in complete spinal cord injury.","authors":"Hui Zhu, Kwok-Fai So, Xiaoqing Feng, Fang Niu, James David Guest","doi":"10.1097/WCO.0000000000001439","DOIUrl":"10.1097/WCO.0000000000001439","url":null,"abstract":"Purpose of review: Recovery after spinal cord injury (SCI) is variable, and the contribution of locomotor training to neurological and functional outcomes remains debated. This review summarizes post-SCI locomotor recovery patterns, compares training modalities, and presents recovery findings from the Kunming Locomotor Training (KLT) program, one of the largest reported series of patients with initial complete (AIS A) injuries.Recent findings: Several months of intensive task-specific overground training yielded substantial gains in neurological, locomotor, and autonomic outcomes. In a retrospective cohort of 485 AIS A patients, 47% improved their AIS grade, while nearly all showed some locomotor recovery measured by the Kunming Locomotor Scale (KLS). A ≥4-point KLS gain strongly predicted AIS conversion (sensitivity 83%, specificity 82%). Recovery probability was highest with lower thoracic and lumbar injuries. Improvements, including ambulation with assistive devices, and significant bladder and bowel recovery occurred even without AIS change. These outcomes reinforce the importance of active, patient-driven training.Summary: KLT experience indicates that prolonged, intensive overground locomotor training can promote neurological and functional recovery in individuals with initially complete injuries. KLS provides a sensitive measure of functional progress. These findings underscore the clinical value of task-specific stepping and provide a new benchmark for evaluating sustained rehabilitation strategies and research into post-SCI recovery.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"644-653"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12594139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376484","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

Neuroimaging endpoints for clinical trials in gliomas: the neuro-oncologist perspective. 神经胶质瘤临床试验的神经影像学终点：神经肿瘤学家的观点。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-08-07 DOI: 10.1097/WCO.0000000000001419

Vihang Nakhate, Gilbert Youssef, Aleksandra B Lasica, Patrick Y Wen

{"title":"Neuroimaging endpoints for clinical trials in gliomas: the neuro-oncologist perspective.","authors":"Vihang Nakhate, Gilbert Youssef, Aleksandra B Lasica, Patrick Y Wen","doi":"10.1097/WCO.0000000000001419","DOIUrl":"10.1097/WCO.0000000000001419","url":null,"abstract":"Purpose of review: Accurate and reliable determination of tumor response and progression on neuroimaging is critical to identify effective therapies for glioma in clinical trials. In this article, we review response assessment criteria for adult glioma including their evolution over time, current recommendations, limitations, and future directions.Recent findings: Response Assessment in Neuro-Oncology (RANO) 2.0 delineates unified magnetic resonance imaging (MRI)-based criteria informed by patient data to evaluate endpoints of tumor response and tumor progression. The positron emission tomography (PET) RANO 1.0 criteria propose endpoints for tumor progression and response on amino acid PET imaging.Summary: The RANO 2.0 criteria provide standardized recommendations to assess tumor response and progression across adult glioma clinical trials regardless of tumor grade, contrast enhancement, molecular profile or treatment modality. Additional validation and exploratory studies can facilitate future refinements to the criteria and possible incorporation of novel neuroimaging endpoints. Advanced imaging modalities such as perfusion MRI and amino acid PET may help overcome some limitations of MRI-based response assessment.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"726-733"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793687","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

Neurotoxicity from chimeric antigen receptor T-cells: an update on diagnosis and treatment. 嵌合抗原受体t细胞的神经毒性：诊断和治疗的最新进展。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-08-01 DOI: 10.1097/WCO.0000000000001420

Renata Ursu, Stefania Cuzzubbo, Antoine F Carpentier

{"title":"Neurotoxicity from chimeric antigen receptor T-cells: an update on diagnosis and treatment.","authors":"Renata Ursu, Stefania Cuzzubbo, Antoine F Carpentier","doi":"10.1097/WCO.0000000000001420","DOIUrl":"10.1097/WCO.0000000000001420","url":null,"abstract":"Purpose of review: Chimeric antigen receptor (CAR) T-cell therapies are increasingly used in hematologic malignancies and are now being investigated in autoimmune disorders. This review aims to summarize the spectrum of neurological complications associated with CAR-T.Recent findings: While early-onset neurotoxicity is well characterized, other neurological syndromes are increasingly reported. Neurological complications can be provisionally classified into three categories: early-onset immune effector cell-associated neurotoxicity syndrome (ICANS); delayed-onset neurological syndromes specific to single CAR T-cell types; and tumour inflammation-associated neurotoxicity (TIAN). Other postinfusion neurological syndromes have also been observed but with uncertain links to CAR T-cells. Management must be tailored to preserve both neurological function and CAR T-cell efficacy. Ongoing efforts target biomarker development, and risk-adapted strategies, especially in steroid-refractory cases.Summary: As CAR T-cell indications broaden, clinicians must recognize diverse neurological toxicities and implement individualized, evidence-based interventions to improve neurological outcomes.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"688-694"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759388","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 of the mesencephalic locomotor region or lateral hypothalamus for facilitation of walking after spinal cord injury. 中脑运动区或外侧下丘脑深部脑刺激对脊髓损伤后行走的促进作用。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-10-23 DOI: 10.1097/WCO.0000000000001437

Brian R Noga, Jeffrey Serville, James D Guest

{"title":"Deep brain stimulation of the mesencephalic locomotor region or lateral hypothalamus for facilitation of walking after spinal cord injury.","authors":"Brian R Noga, Jeffrey Serville, James D Guest","doi":"10.1097/WCO.0000000000001437","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001437","url":null,"abstract":"Purpose of review: Spinal cord injury (SCI) causes profound gait impairment and autonomic dysfunction. Deep brain stimulation (DBS) of supraspinal locomotor centers may strengthen spared descending motor and autonomic pathways to improve walking. Preclinical and clinical studies have targeted the cuneiform nucleus (CnF) and pedunculopontine nucleus (PPN) of the mesencephalic locomotor region (MLR) and the lateral hypothalamus. To summarize recent progress in DBS as a strategy to facilitate locomotion with a particular focus on SCI.Recent findings: DBS of the CnF, PPN, and lateral hypothalamus enhances gait and cardiorespiratory function in animal models and early human trials. Directional electrodes and individualized programming appear to reduce risks and optimize efficacy. Evidence suggests DBS can amplify supraspinal command circuits, supporting locomotor facilitation after injury.Summary: DBS of MLR and lateral hypothalamus circuits represent a promising therapeutic approach for gait recovery in SCI. Key priorities for future clinical trials include stratification by injury severity, monitoring of autonomic outcomes, and assessment of long-term effects on mobility and quality of life. Integration with physiotherapy may further augment recovery. Collectively, current findings support DBS as an emerging intervention to restore locomotor function following SCI. The use of DBS for motor recovery after SCI is investigational.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"38 6","pages":"667-677"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444196","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

Electrical and optogenetic spinal cord stimulation for movement recovery after spinal cord injury. 电和光遗传脊髓刺激对脊髓损伤后运动恢复的影响。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-10-03 DOI: 10.1097/WCO.0000000000001431

Richard P Henderson, Sarah E Mondello, Chet T Moritz

{"title":"Electrical and optogenetic spinal cord stimulation for movement recovery after spinal cord injury.","authors":"Richard P Henderson, Sarah E Mondello, Chet T Moritz","doi":"10.1097/WCO.0000000000001431","DOIUrl":"10.1097/WCO.0000000000001431","url":null,"abstract":"Purpose of review: In this review, we discuss electrical and optogenetic technologies for stimulating the spinal cord to improve movement after spinal cord injury (SCI).Recent findings: Paralysis or paresis following SCI severely impairs control and movement of the extremities. Restoring movement in the upper and lower extremities is a top priority for this population. Invasive and noninvasive electrical stimulation of the spinal cord can modulate the activity of spinal circuits, resulting in improvements in motor and sensory function. More recently, optogenetic stimulation has emerged as another technique capable of modulating spinal circuity to facilitate movement recovery in animal models. Recent studies are offering new insights into the effects of parameter selection, multisite stimulation, and the combined effects of stimulation and wearable robotic exoskeletons, all with the goal of restoring movement after SCI.Summary: Modulating the activity of the spinal cord via electrical and optogenetic stimulation is a promising intervention for improving movement after SCI. Future studies should determine optimal stimulation parameters, synergistic effects when combined with wearable robotics, and the safety of optogenetics in the human spinal cord. Such work will best position these emerging technologies for clinical translation.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"654-659"},"PeriodicalIF":4.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257679","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

Rare gliomas: standard treatment approaches and new target therapies. 罕见胶质瘤：标准治疗方法和新的靶向治疗。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-09-24 DOI: 10.1097/WCO.0000000000001428

Francesco Bruno, Alessia Pellerino, Edoardo Pronello, Roberta Rudà

{"title":"Rare gliomas: standard treatment approaches and new target therapies.","authors":"Francesco Bruno, Alessia Pellerino, Edoardo Pronello, Roberta Rudà","doi":"10.1097/WCO.0000000000001428","DOIUrl":"10.1097/WCO.0000000000001428","url":null,"abstract":"Purpose of review: Rare gliomas, including circumscribed astrocytic, glioneuronal, and neuronal central nervous system (CNS) tumours, though collectively uncommon, present significant clinical challenges due to their heterogeneity and limited therapeutic evidence. Conventional management has relied predominantly on surgery and radiotherapy. Advances in molecular profiling have revealed actionable targets, prompting a timely reassessment of treatment paradigms. This review aims to describe current standard treatments and recent advances in molecularly targeted approaches for rare gliomas.Recent findings: Gross total surgical resection remains the primary therapeutic modality for rare gliomas, providing optimal tumour control and symptom relief. Radiotherapy offers additional benefit in case of subtotal resection or recurrent disease, particularly in WHO grade 3 tumours. In contrast, conventional chemotherapy has shown limited efficacy and is typically reserved for refractory or progressive cases.The discovery of actionable molecular alterations in a substantial subset of rare gliomas has led to increasing integration of targeted therapies into clinical management. Notable recent advances include the use of BRAF/MAPK pathway inhibitors (e.g., dabrafenib/trametinib, tovorafenib), NTRK inhibitors (e.g., larotrectinib, entrectinib), FGFR inhibitors (e.g., erdafitinib, pemigatinib), and mTOR inhibitors (e.g., everolimus), which have demonstrated meaningful clinical activity in select patient populations.Summary: Precision oncology is rapidly transforming the treatment landscape for rare CNS tumours. Integration of targeted therapies into clinical protocols - ideally guided by multidisciplinary molecular tumour boards - is increasingly warranted. Future research must optimise timing, combination strategies, and overcome resistance, while new biomarkers and liquid biopsy tools are needed to guide the choice of therapy and monitor response in this underserved population.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"695-705"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130229","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 role of amino acid PET in the era of checkpoint inhibitors and targeted therapy for brain tumor treatment. 氨基酸PET在检查点抑制剂时代和脑肿瘤靶向治疗中的作用。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-08-13 DOI: 10.1097/WCO.0000000000001425

Norbert Galldiks, Jana-Marie Peplinski, Manuel Kraft, Philipp Lohmann, Jan-Michael Werner

引用次数: 0

Overlapping mechanisms of epidural spinal cord stimulation for pain control and movement recovery. 硬膜外脊髓刺激对疼痛控制和运动恢复的重叠机制。

IF 4.7 2区医学

Current Opinion in Neurology Pub Date : 2025-12-01 Epub Date: 2025-10-10 DOI: 10.1097/WCO.0000000000001433

Evan F Joiner, Marom Bikson, Jason B Carmel

{"title":"Overlapping mechanisms of epidural spinal cord stimulation for pain control and movement recovery.","authors":"Evan F Joiner, Marom Bikson, Jason B Carmel","doi":"10.1097/WCO.0000000000001433","DOIUrl":"10.1097/WCO.0000000000001433","url":null,"abstract":"Purpose of review: Spinal cord stimulation (SCS) for pain control and movement recovery have developed under parallel conceptual frameworks. SCS for pain has traditionally targeted the dorsal columns, while SCS for movement recovery has targeted the large-diameter afferent fibers near the dorsal root entry zone. We review the evidence to support these parallel mechanistic frameworks and explore potential mechanistic overlap between the two fields.Recent findings: Recent advances in closed-loop stimulation for pain and dorsal root (DR) stimulation for movement recovery speak to the value of these parallel mechanistic models in each field. However, review of the devices, electrode placement, and stimulation parameters used in both fields reveals overlap in the doses of SCS considered effective in each. Furthermore, evidence from finite element modeling suggests overlapping recruitment of dorsal column and dorsal root fibers from both midline and lateral stimulation.Summary: There is evidence to support overlapping mechanisms of SCS for pain and movement recovery. The implications of potential mechanistic overlap warrant further investigation.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"660-666"},"PeriodicalIF":4.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273899","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