Nature Reviews Neurology最新文献

Parkinson disease therapy: current strategies and future research priorities 帕金森病治疗：当前战略和未来研究重点

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-11-04 DOI: 10.1038/s41582-024-01034-x

Fabrizio Stocchi, Daniele Bravi, Aron Emmi, Angelo Antonini

{"title":"Parkinson disease therapy: current strategies and future research priorities","authors":"Fabrizio Stocchi, Daniele Bravi, Aron Emmi, Angelo Antonini","doi":"10.1038/s41582-024-01034-x","DOIUrl":"https://doi.org/10.1038/s41582-024-01034-x","url":null,"abstract":"<p>Parkinson disease (PD) is the fastest growing neurological disorder globally and poses substantial management challenges owing to progressive disability, emergence of levodopa-resistant symptoms, and treatment-related complications. In this Review, we examine the current state of research into PD therapies and outline future priorities for advancing our understanding and treatment of the disease. We identify two main research priorities for the coming years: first, slowing the progression of the disease through the integration of sensitive biomarkers and targeted biological therapies, and second, enhancing existing symptomatic treatments, encompassing surgical and infusion therapies, with the goal of postponing complications and improving long-term patient management. The path towards disease modification is impeded by the multifaceted pathophysiology and diverse mechanisms underlying PD. Ongoing studies are directed at α-synuclein aggregation, complemented by efforts to address specific pathways associated with the less common genetic forms of the disease. The success of these efforts relies on establishing robust end points, incorporating technology, and identifying reliable biomarkers for early diagnosis and continuous monitoring of disease progression. In the context of symptomatic treatment, the focus should shift towards refining existing approaches and fostering the development of novel therapeutic strategies that target levodopa-resistant symptoms and clinical manifestations that substantially impair quality of life.</p>","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":null,"pages":null},"PeriodicalIF":38.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 Digitized Memory Clinic 数字化记忆诊所

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-10-25 DOI: 10.1038/s41582-024-01033-y

Mathias Holsey Gramkow, Gunhild Waldemar, Kristian Steen Frederiksen

{"title":"The Digitized Memory Clinic","authors":"Mathias Holsey Gramkow, Gunhild Waldemar, Kristian Steen Frederiksen","doi":"10.1038/s41582-024-01033-y","DOIUrl":"https://doi.org/10.1038/s41582-024-01033-y","url":null,"abstract":"<p>Several major challenges, including an ageing population and declining workforce and the implementation of recent breakthrough therapies for Alzheimer disease, are prompting a necessary rethink of how people with neurodegenerative dementias are diagnosed and medically managed. Digital health technologies could play a pivotal part in this transformation, with new advances enabling the collection of millions of data points from a single individual. Possible applications include unobtrusive monitoring that aids early detection of disease and artificial intelligence-based health advice. To translate these advances to meaningful benefits for people living with a disease, technologies must be implemented within a system that retains the physician expert as a central figure in decision-making. This Perspective presents a new framework, termed the Digitized Memory Clinic, for the diagnostic pathway of neurodegenerative dementias that incorporates digital health technologies with currently available assessment tools, such as fluid and imaging biomarkers, in an interplay with the physician. The Digitized Memory Clinic will manage people across the entire disease spectrum, from the detection of risk factors for cognitive decline and the earliest symptoms to dementia, and will replace the present paradigm of a pure ‘brick-and-mortar’ memory clinic. Important ethical, legal and societal barriers associated with the implementation of digital health technologies in memory clinics need to be addressed. The envisioned Digitized Memory Clinic aims to improve diagnostics and enable precise disease-tracking prognostication for individuals with memory disorders and to open new possibilities, such as precision medicine for prevention and treatment.</p>","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":null,"pages":null},"PeriodicalIF":38.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Altered muscle cholesterol transport in ALS 渐冻人症中肌肉胆固醇转运的改变

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-14 DOI: 10.1038/s41582-024-01029-8

Heather Wood

引用次数: 0

Lewy body pathology accelerates AD progression 路易体病理学加速了注意力缺失症的进展

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-14 DOI: 10.1038/s41582-024-01028-9

Heather Wood

引用次数: 0

Engineered T cells show therapeutic potential for CNS injury 工程化 T 细胞显示出治疗中枢神经系统损伤的潜力

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-14 DOI: 10.1038/s41582-024-01032-z

Lisa Kiani

引用次数: 0

Evidence for an NMOSD prodrome NMOSD 前驱症状的证据

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-14 DOI: 10.1038/s41582-024-01030-1

Heather Wood

引用次数: 0

BCAS1+ oligodendrocytes aid remyelination in MS BCAS1+ 少突胶质细胞有助于多发性硬化症的髓鞘再形成

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-14 DOI: 10.1038/s41582-024-01031-0

Heather Wood

引用次数: 0

Coeliac disease as a model for understanding multiple sclerosis 将乳糜泻作为理解多发性硬化症的模型

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-08 DOI: 10.1038/s41582-024-01025-y

Natalia Drosu, Kjetil Bjornevik, Marianna Cortese, Michael Levy, Ludvig M. Sollid

{"title":"Coeliac disease as a model for understanding multiple sclerosis","authors":"Natalia Drosu, Kjetil Bjornevik, Marianna Cortese, Michael Levy, Ludvig M. Sollid","doi":"10.1038/s41582-024-01025-y","DOIUrl":"10.1038/s41582-024-01025-y","url":null,"abstract":"The genetic architecture of multiple sclerosis (MS) is similar to that of coeliac disease, with human leukocyte antigen (HLA) being the greatest genetic determinant in both diseases. Furthermore, similar to the involvement of gluten in coeliac disease, Epstein–Barr virus (EBV) infection is now widely considered to be an important environmental factor in MS. The molecular basis for the HLA association in coeliac disease is well defined, and B cells have a clear role in antigen presentation to gluten-specific CD4+ T cells. By contrast, the mechanisms underlying the HLA association of MS are unknown but accumulating evidence indicates a similar role of B cells acting as antigen-presenting cells. The growing parallels suggest that much could be learned about the mechanisms of MS by using coeliac disease as a model. In this Perspective article, we discuss the insights that could be gained from these parallels and consider the possibility of antiviral treatment against EBV as a therapy for MS that is analogous to the gluten-free diet in coeliac disease. In this Perspective, the authors discuss how our understanding of coeliac disease could provide insights into the mechanisms of multiple sclerosis, the involvement of Epstein–Barr virus and the possibility of antiviral treatment against the virus as a therapy for multiple sclerosis.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":null,"pages":null},"PeriodicalIF":28.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Systemic determinants of brain health in ageing 老龄化过程中大脑健康的系统性决定因素

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-07 DOI: 10.1038/s41582-024-01016-z

Eric E. Smith, Geert Jan Biessels, Virginia Gao, Rebecca F. Gottesman, Arthur Liesz, Neal S. Parikh, Costantino Iadecola

{"title":"Systemic determinants of brain health in ageing","authors":"Eric E. Smith, Geert Jan Biessels, Virginia Gao, Rebecca F. Gottesman, Arthur Liesz, Neal S. Parikh, Costantino Iadecola","doi":"10.1038/s41582-024-01016-z","DOIUrl":"10.1038/s41582-024-01016-z","url":null,"abstract":"Preservation of brain health is a worldwide priority. The traditional view is that the major threats to the ageing brain lie within the brain itself. Consequently, therapeutic approaches have focused on protecting the brain from these presumably intrinsic pathogenic processes. However, an increasing body of evidence has unveiled a previously under-recognized contribution of peripheral organs to brain dysfunction and damage. Thus, in addition to the well-known impact of diseases of the heart and endocrine glands on the brain, accumulating data suggest that dysfunction of other organs, such as gut, liver, kidney and lung, substantially affects the development and clinical manifestation of age-related brain pathologies. In this Review, a framework is provided to indicate how organ dysfunction can alter brain homeostasis and promote neurodegeneration, with a focus on dementia. We delineate the associations of subclinical dysfunction in specific organs with dementia risk and provide suggestions for public health promotion and clinical management. Peripheral organ dysfunction can have considerable effects on brain health, contributing to neurodegeneration and dementia. This Review explores how clinical and subclinical dysfunction of specific organ systems can impact brain health and discusses the implications for dementia prevention.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":null,"pages":null},"PeriodicalIF":28.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Continuing evolution of migraine-specific therapies — targeting migraine with precision and persistence 偏头痛特效疗法的不断发展--精准、持久地治疗偏头痛

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-10-07 DOI: 10.1038/s41582-024-01026-x

Dimos D. Mitsikostas, Alan Rapoport

引用次数: 0