Expert Review of Neurotherapeutics最新文献

{"title":"HAND-IN (hand function after neuromodulation and intensive training in children with cerebral palsy): study protocol for a randomized, triple-blind, controlled trial with embedded implementation and cost-effectiveness analyses.","authors":"Andréa Vancetto Maglione, Juliana Firmo Dos Santos, Ana Carolina Rodrigues da Silva, Lais Ester Roveron Souto, Gabriela da Silva Matuti, Elcinete Wentz Moura, Maristela Costa Cespedes, Carina Gonçalves Pedroso Uchida, Acary Souza Bulle Oliveira, Sandra Regina Alouche","doi":"10.1080/14737175.2026.2727670","DOIUrl":"10.1080/14737175.2026.2727670","url":null,"abstract":"<p><strong>Aim: </strong>The following clinical trial protocol aims to investigate the additional effects of bilateral transcranial direct current stimulation (tDCS) combined with constraint-induced movement therapy (CIMT) compared to CIMT alone in children and adolescents with spastic hemiparetic cerebral palsy.</p><p><strong>Methods: </strong>This randomized, triple-blind, controlled trial will enroll 32 participants aged 7-16 years with spastic hemiparetic cerebral palsy (MACS I-II). Participants will be allocated to CIMT with sham or active bilateral tDCS (C3-C4, 1 mA, 20 min), with electrode placement guided by transcranial magnetic stimulation mapping. The intervention will last 3 weeks (5 days/week, 3 h/day). Primary outcomes will assess upper limb use (PMAL/TMAL). Secondary outcomes include dexterity (Box and Block Test), strength (dynamometry), functional performance (PAFT), and participation (COPM, GAS). Assessments will occur post-intervention and at 1, 3, and 6 months. Implementation of outcomes and cost-effectiveness will also be evaluated. Once completed, the study team will perform intention-to-treat analyses using linear mixed-effects models.</p><p><strong>Expected results: </strong>The HAND-IN trial will provide evidence on the clinical, implementation, and economic effects of combining CIMT with bilateral tDCS in children with spastic hemiparetic cerebral palsy. If effective, this approach may enhance the durability of upper limb functional gains and support the adoption of neuromodulation in pediatric neurorehabilitation.<b>Trial Registration Number (Brazilian Clinical Trials Record- REBEC)</b>: RBR-2fczbt2 (https://ensaiosclinicos.gov.br/rg/RBR-2fczbt2). Registration on January 15, 2026.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1017-1026"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886848","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}

{"title":"Epilepsy with myoclonic-atonic seizures: a comprehensive review with emphasis on current and emerging pharmacotherapies.","authors":"Debopam Samanta","doi":"10.1080/14737175.2026.2735961","DOIUrl":"https://doi.org/10.1080/14737175.2026.2735961","url":null,"abstract":"<p><strong>Introduction: </strong>Epilepsy with myoclonic-atonic seizures (EMAtS), historically termed Doose syndrome, is a developmental and epileptic encephalopathy characterized by the usually abrupt onset of multiple generalized seizure types, including myoclonic-atonic seizures, in early childhood. Advances in genetic diagnostics, antiseizure treatments, and precision therapies have reshaped understanding and management of EMAtS.</p><p><strong>Areas covered: </strong>This review synthesizes the clinical spectrum of EMAtS, including core clinical features and diagnostic approach based on a literature search of PubMed, Embase, and OVID/MEDLINE. The genetic landscape is discussed to contextualize emerging precision therapies. Treatment is reviewed hierarchically, from valproate, clobazam, levetiracetam and ethosuximide as commonly used first- and second-line agents to the ketogenic diet, cannabidiol, felbamate, and sulthiame for drug-resistant disease. Precision approaches for key genetic etiologies, including<i>SLC2A1, SLC6A1, SYNGAP1, CHD2, STXBP1</i>,and<i>SCN2A</i>, are also reviewed.</p><p><strong>Expert opinion: </strong>Although approximately two-thirds of patients with EMAtS achieve seizure remission, a substantial minority experience drug-resistant seizure, intellectual disability, and behavioral comorbidities, underscoring the importance of timely diagnosis, appropriate pharmacotherapy, and early consideration of the ketogenic diet in drug-resistant cases. As precision therapeutics advance, syndrome-based care will increasingly be complemented by treatments tailored to the specific genetic etiology.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-15"},"PeriodicalIF":4.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008089","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}

{"title":"Stereotactic radiosurgery for craniofacial pain disorders: current clinical applications and future perspectives.","authors":"Andrea Franzini, Emanuele Stucchi, Alessandro Grimi, Generoso Farinaro, Ali Baram, Beatrice Claudia Bono, Zefferino Rossini, Maria Pia Tropeano, Piero Picozzi, Federico Pessina","doi":"10.1080/14737175.2026.2735964","DOIUrl":"https://doi.org/10.1080/14737175.2026.2735964","url":null,"abstract":"<p><strong>Introduction: </strong>Stereotactic radiosurgery (SRS) has emerged as a less invasive treatment for various medically refractory craniofacial pain disorders. Advances in neuroimaging, radiosurgical technology, and treatment planning have expanded its application beyond trigeminal neuralgia (TN) to glossopharyngeal neuralgia (GN), trigeminal autonomic cephalalgias (TACs), and neuropathic facial pain (NFP).</p><p><strong>Areas covered: </strong>This review summarizes the current clinical indications, radiosurgical techniques, efficacy, safety, and limitations of SRS for medically refractory craniofacial pain disorders. The available literature on TN, GN, TACs, and NFP is reviewed, with particular emphasis on patient selection, target definition, treatment outcomes, repeat radiosurgery, and treatment-related adverse effects.</p><p><strong>Expert opinion: </strong>SRS is an established treatment for classical, idiopathic, and multiple sclerosis-related TN. In contrast, its application to GN, tumor-related TN, TACs, and NFP remains investigational because of limited and heterogeneous evidence. Future advances in neuroimaging, target localization, and understanding of craniofacial pain pathophysiology, together with well-designed studies, are expected to optimize patient selection and better define the role of SRS for those disorders.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-14"},"PeriodicalIF":4.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001565","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}

{"title":"Profiling zuranolone as a treatment option for postpartum depression.","authors":"Christina Gonzalez-Torres, Verinder Sharma","doi":"10.1080/14737175.2026.2733192","DOIUrl":"https://doi.org/10.1080/14737175.2026.2733192","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum depression is defined as the occurrence of a major depressive episode in the four weeks after delivery; however, up to 50% of cases begin before delivery. First-line treatment for mild postpartum depression is psychotherapy, but patients with limited access to this kind of treatment or moderate to severe illness typically require pharmacotherapy. In general, selective serotonin reuptake inhibitors are considered first-line treatment options. However, the titration of these medications to a therapeutic dosage may take weeks.</p><p><strong>Areas covered: </strong>In this review, the authors conducted a search of the available literature discussing the efficacy and safety of zuranolone, a fast-acting orally bioavailable synthetic neurosteroid that was developed for the treatment of postpartum depression.</p><p><strong>Expert opinion: </strong>Zuranolone is a promising medication in the armamentarium of treatments for postpartum depression. However, evidence for long-term outcomes is limited due to the lack of comparative trials with other active treatments for postpartum depression and the exclusion of lactating populations or those with psychiatric comorbidities. More studies are needed to define the full scope of its clinical applicability.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-11"},"PeriodicalIF":4.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982506","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}

{"title":"Perspectives on the use of lithium as a therapeutic option for bipolar disorder in 2026.","authors":"Robert M Post","doi":"10.1080/14737175.2026.2734453","DOIUrl":"https://doi.org/10.1080/14737175.2026.2734453","url":null,"abstract":"<p><strong>Introduction: </strong>There is a disconnect between the designation of lithium (Li) as the drug of choice for bipolar disorder and its use in only a small minority of patients. Low use is seen especially in the US where less than 20% of bipolar patients are on Li.</p><p><strong>Areas covered: </strong>The literature and prevailing medical and popular opinion tend to overemphasize lithium's side effects and minimize many of its assets. In this review, the author reviews some of these misconceptions and in addition emphasizes new data that Li should be considered a disease-modifying drug (DMD). Like DMDs for other medical illnesses, these agents should be used early in the illness to prevent disease progression and disability.</p><p><strong>Expert opinion: </strong>Presently, Li is rarely used early on in illness and is negligibly used in children. Nevertheless, it is with hope that perspectives on Li like these will help to drive increased and appropriate use in bipolar disorder. That said, it is of this author's opinion that, without major new educational and public health approaches, there is unlikely to be any change in usage, at least in l the near future.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-6"},"PeriodicalIF":4.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976384","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}

{"title":"Capillary blood sampling in neurodegenerative diseases - the future for screening and monitoring brain health?","authors":"Sophie Hicks, Barbara Fernandes Gomes, Amanda Heslegrave","doi":"10.1080/14737175.2026.2734450","DOIUrl":"https://doi.org/10.1080/14737175.2026.2734450","url":null,"abstract":"<p><strong>Introduction: </strong>Blood-based biomarkers are becoming increasingly utilized in the neurodegenerative research field for indicating patient disease status. With increasing emphasis on large-scale prevention trials, developing cost-effective and accessible means of sampling for these biomarkers is imperative. Micro-sampling, in the form of dried blood spots (DBS), dried plasma spots (DPS), and upper-arm devices (UAD), could be a solution.</p><p><strong>Areas covered: </strong>Herein, the authors review recent studies that have explored the validity of DBS, DPS and UAD for detecting neurodegenerative blood biomarkers. Overall, DPS and UAD present most potential, with good to excellent correlation of pTau-217, NfL, and GFAP to concentrations in gold-standard venous plasma or CSF. However, while these results show exciting promise for implementing micro-samples, there are limitations regarding sample variability, storage, and handling.</p><p><strong>Expert opinion: </strong>There is still significant work needed to validate DPS and UAD sampling: current research is fragmented and with varying cohorts, there is no standardized methodology for micro-sample extraction and analysis, and lack of knowledge of the influence of pre-analytical handling means that wide implementation for trials is currently restricted. But current efforts from research groups and industry suggest that capillary micro-samples have great potential for detecting a broad range of biomarkers.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-6"},"PeriodicalIF":4.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976367","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}

{"title":"Can early diagnosis of Leigh syndrome impact prognosis?","authors":"Célia Nogueira, Laura Vilarinho","doi":"10.1080/14737175.2026.2725112","DOIUrl":"https://doi.org/10.1080/14737175.2026.2725112","url":null,"abstract":"","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-4"},"PeriodicalIF":4.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905612","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}

{"title":"The promise and challenges of focused ultrasound therapy in the management of Parkinson's disease.","authors":"Fabio Paio, Michele Tinazzi, Stefano Tamburin","doi":"10.1080/14737175.2026.2725110","DOIUrl":"https://doi.org/10.1080/14737175.2026.2725110","url":null,"abstract":"","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-5"},"PeriodicalIF":4.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879596","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}

{"title":"Comparing synthetic and biological therapy for the treatment of cluster headache: what is needed and when?","authors":"Brendan A Parr, William B Young, Stephen D Silberstein","doi":"10.1080/14737175.2026.2706794","DOIUrl":"10.1080/14737175.2026.2706794","url":null,"abstract":"<p><strong>Introduction: </strong>Cluster headache is an extremely painful and severely disabling primary headache disorder that, despite its profound impact on quality of life, remains underdiagnosed and undertreated. Effective management requires a structured approach across the cluster cycle, but practical, timeline-based guidance integrating established and emerging therapies is lacking.</p><p><strong>Areas covered: </strong>The authors present a treatment framework organized by clinical timeline: inter-cycle period, cycle onset, active cycle, and resolution, addressing acute abortive, bridge, and prophylactic therapies with evidence quality, dosing, and monitoring. Both established synthetic agents and recently recognized biologic therapies are examined, with particular focus on anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies and forward-looking targets such as PACAP and 5-HT2A. References were identified through searches of PubMed and clinical trial registries from inception to June 2026.</p><p><strong>Expert opinion: </strong>Anti-CGRP monoclonal antibodies are a meaningful advance, best positioned as an adjunct to established prophylaxis rather than a replacement. PACAP-targeted therapy is a promising direction whose role in cluster headache remains to be defined. The serotonergic agent psilocybin warrants closer attention, as its early therapeutic signal merits rigorous investigation despite the legal and historical barriers constraining its study.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"881-893"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577628","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}

{"title":"Sleep and circadian disruption as transdiagnostic drivers of psychosis: a unified mechanistic framework.","authors":"Sasha D'Ambrosio, Simone Cavallotti, Renata Del Giudice, Clarissa Dibenedetto, Armando D'Agostino","doi":"10.1080/14737175.2026.2718395","DOIUrl":"10.1080/14737175.2026.2718395","url":null,"abstract":"<p><strong>Introduction: </strong>Psychosis is increasingly understood as a disorder of brain systems that are also central to sleep regulation. Indeed, sleep disturbances are both highly prevalent in psychotic disorders and are likely to contribute to the emergence and maintenance of psychotic experiences.</p><p><strong>Areas covered: </strong>This narrative review, based on a comprehensive search of MEDLINE/PubMed, Embase, PsycINFO, and Web of Science (March 2026), examines the bidirectional relationship between sleep dysfunction and psychosis, the shared biological mechanisms underlying both, the utility of sleep assessment as an early warning marker for relapse, and the current gaps in sleep-targeted intervention evidence.</p><p><strong>Expert opinion: </strong>Sleep dysfunction constitutes a transdiagnostic pathway to psychosis, with varying temporal profiles across diagnoses: organic and substance-induced psychoses emerge acutely over hours to days with rapid reversibility; mood- and trauma-related psychoses develop subacutely over days to weeks; schizophrenia spectrum disorders show insidious onset over years with chronic persistence. Across these presentations, disturbances in sleep continuity, architecture, and circadian regulation may act as mechanistic drivers rather than epiphenomena, interacting with disorder-specific vulnerabilities to shape the timing, severity, and course of psychosis. Translating this understanding into practice requires routine sleep-circadian assessment from the earliest clinical stages, integration of scalable interventions into transdiagnostic care pathways, and recognition of sleep as both a clinically relevant outcome and a stratification variable in future psychosis trials. This framework positions sleep-circadian dysfunction not only as a marker of risk and progression, but also as a promising modifiable target for prevention, early intervention, and relapse reduction across psychotic disorders.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"853-872"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759234","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}