Nature Reviews Neurology最新文献_第6页

Dementia is a neglected noncommunicable disease and leading cause of death 痴呆症是一种被忽视的非传染性疾病，也是导致死亡的主要原因

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-13 DOI: 10.1038/s41582-024-01051-w

Lewis Arthurton, Paola Barbarino, Robert Anderson, Ben Schlaepfer, Nazak Salehi, Martin Knapp

引用次数: 0

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-10 DOI: 10.1038/s41582-024-01053-8

Steven M. Greenberg, Francesco Bax, Susanne J. van Veluw

{"title":"Amyloid-related imaging abnormalities: manifestations, metrics and mechanisms","authors":"Steven M. Greenberg, Francesco Bax, Susanne J. van Veluw","doi":"10.1038/s41582-024-01053-8","DOIUrl":"10.1038/s41582-024-01053-8","url":null,"abstract":"Three monoclonal antibodies directed against specific forms of the amyloid-β (Aβ) peptide have been granted accelerated or traditional approval by the FDA as treatments for Alzheimer disease, representing the first step towards bringing disease-modifying treatments for this disease into clinical practice. Here, we review the detection, underlying pathophysiological mechanisms and clinical implications of amyloid-related imaging abnormalities (ARIA), the most impactful adverse effect of anti-Aβ immunotherapy. ARIA appears as regions of oedema or effusions (ARIA-E) in brain parenchyma or sulci or as haemorrhagic lesions (ARIA-H) in the form of cerebral microbleeds, convexity subarachnoid haemorrhage, cortical superficial siderosis or intracerebral haemorrhage. Analysis of the radiographic appearance of ARIA, its clinical risk factors and underlying neuropathology, and results from animal models point to a central role for cerebral amyloid angiopathy — a condition characterized by cerebrovascular Aβ deposits — as a key component, either as a direct target for antibody-mediated inflammation or as recipient of Aβ mobilized from plaques in the Alzheimer brain parenchyma. The great majority of ARIA occurrences are associated with mild or no clinical symptoms. However, ~5% of all ARIA events are severe enough to result in hospitalization, permanent disability or death and thus raise challenging clinical questions regarding patient selection and use of concomitant agents. Therefore, identifying novel approaches to predicting, modelling, preventing and treating ARIA remains a key step towards allowing safe use of anti-Aβ immunotherapy for the world’s rapidly ageing population. Amyloid-related imaging abnormalities are the most impactful adverse effect of anti-amyloid-β immunotherapies. Here, the authors review the detection, underlying mechanisms and clinical implications of amyloid-related imaging abnormalities and highlight the need for further research to predict, prevent and treat the condition.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 4","pages":"193-203"},"PeriodicalIF":28.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961274","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

Sleep and circadian disturbances in children with neurodevelopmental disorders 神经发育障碍儿童的睡眠和昼夜节律紊乱

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-08 DOI: 10.1038/s41582-024-01052-9

Oliviero Bruni, Maria Breda, Valeria Mammarella, Maria Paola Mogavero, Raffaele Ferri

{"title":"Sleep and circadian disturbances in children with neurodevelopmental disorders","authors":"Oliviero Bruni, Maria Breda, Valeria Mammarella, Maria Paola Mogavero, Raffaele Ferri","doi":"10.1038/s41582-024-01052-9","DOIUrl":"10.1038/s41582-024-01052-9","url":null,"abstract":"Sleep is essential for brain development and overall health, particularly in children with neurodevelopmental disorders (NDDs). Sleep disruptions can considerably impact brain structure and function, leading to dysfunction of neurotransmitter systems, metabolism, hormonal balance and inflammatory processes, potentially contributing to the pathophysiology of NDDs. This Review examines the prevalence, types and mechanisms of sleep disturbances in children with NDDs, including autism spectrum disorder, attention-deficit hyperactivity disorder and various genetic syndromes. Common sleep disorders in these populations include insomnia, hypersomnia, circadian rhythm disorders, sleep-related breathing disorders and parasomnias, with underlying factors often involving genetic, neurobiological, environmental and neurophysiological influences. Sleep problems such as insomnia, night awakenings and sleep fragmentation are closely linked to both internalizing symptoms such as anxiety and depression, and externalizing behaviours such as hyperactivity and aggression. Assessment of sleep in children with NDDs presents unique challenges owing to communication difficulties, comorbid conditions and altered sensory processing. The Review underscores the importance of further research to unravel the complex interactions between sleep and neurodevelopment, advocating for longitudinal studies and the identification of predictive biomarkers. Understanding and addressing sleep disturbances in NDDs is crucial for improving developmental outcomes and the overall quality of life for affected individuals and their families. In this Review, the authors provide a comprehensive overview of the prevalence and impact of various sleep disturbances in children with neurodevelopmental disorders. The authors discuss potential underlying mechanisms of sleep disorders in this population, with clues from genetic disorders, and highlight the complex bidirectional relationship between sleep and neurodevelopment.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 2","pages":"103-120"},"PeriodicalIF":28.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935824","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

Alternating hemiplegia of childhood: challenges in a changing climate 儿童交替性偏瘫：气候变化中的挑战

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-07 DOI: 10.1038/s41582-024-01054-7

Katherine Behl

引用次数: 0

Inclusion in neurological research: empowering people living with neurological diseases 纳入神经学研究：增强神经学疾病患者的权能

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-07 DOI: 10.1038/s41582-024-01047-6

Maria Teresa Ferretti, Maria Bonaria Uccheddu, Richelle Flanagan, Iracema Leroi, Elena Moro

{"title":"Inclusion in neurological research: empowering people living with neurological diseases","authors":"Maria Teresa Ferretti, Maria Bonaria Uccheddu, Richelle Flanagan, Iracema Leroi, Elena Moro","doi":"10.1038/s41582-024-01047-6","DOIUrl":"10.1038/s41582-024-01047-6","url":null,"abstract":"The value of involving people living with diseases in the research process is increasingly recognized by professional associations and regulatory agencies alike. Patient contributions range from disease prevention and diagnosis to medication planning, and from advocacy to guideline production and clinical trial design. Thanks to the efforts of activists and advocates, new models of patient inclusion in medical research are being developed to replace outdated non-participative and tokenistic paradigms. New modalities of patient participation in research — for example, the introduction of patient experts, who work closely with researchers and clinicians — have progressively empowered individuals who are living with diseases. In this Perspective, we provide an overview of the current status of patient involvement in medical research, with a specific focus on neurology. We also discuss the existing and future roles of patient experts in neurological research. The importance of active involvement of people living with diseases in various aspects of medicine, including disease management and follow-up, regulatory issues, health advocacy and clinical research, is increasingly recognized. This Perspective reviews the current status of patient involvement in neurological and other medical research, highlighting the role of patient experts.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 3","pages":"159-170"},"PeriodicalIF":28.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935808","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

Targeting common disease pathomechanisms to treat amyotrophic lateral sclerosis 针对常见疾病病理机制治疗肌萎缩侧索硬化症

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2025-01-02 DOI: 10.1038/s41582-024-01049-4

Kiterie M. E. Faller, Helena Chaytow, Thomas H. Gillingwater

{"title":"Targeting common disease pathomechanisms to treat amyotrophic lateral sclerosis","authors":"Kiterie M. E. Faller, Helena Chaytow, Thomas H. Gillingwater","doi":"10.1038/s41582-024-01049-4","DOIUrl":"10.1038/s41582-024-01049-4","url":null,"abstract":"The motor neuron disease amyotrophic lateral sclerosis (ALS) is a devastating condition with limited treatment options. The past few years have witnessed a ramping up of translational ALS research, offering the prospect of disease-modifying therapies. Although breakthroughs using gene-targeted approaches have shown potential to treat patients with specific disease-causing mutations, the applicability of such therapies remains restricted to a minority of individuals. Therapies targeting more general mechanisms that underlie motor neuron pathology in ALS are therefore of considerable interest. ALS pathology is associated with disruption to a complex array of key cellular pathways, including RNA processing, proteostasis, metabolism and inflammation. This Review details attempts to restore cellular homeostasis by targeting these pathways in order to develop effective, broadly-applicable ALS therapeutics. This Review explores several key dysregulated pathways in ALS (RNA processing, proteostasis, metabolism and inflammation) as well as evolving efforts to develop effective therapeutics to restore cellular homeostasis. The authors also detail strategies that are likely to be required to improve clinical studies moving forwards.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 2","pages":"86-102"},"PeriodicalIF":28.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911515","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

Immune mechanisms and shared immune targets in neurodegenerative diseases 神经退行性疾病的免疫机制和共享免疫靶点

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-12-16 DOI: 10.1038/s41582-024-01046-7

Howard L. Weiner

{"title":"Immune mechanisms and shared immune targets in neurodegenerative diseases","authors":"Howard L. Weiner","doi":"10.1038/s41582-024-01046-7","DOIUrl":"10.1038/s41582-024-01046-7","url":null,"abstract":"The immune system plays a major part in neurodegenerative diseases. In some, such as multiple sclerosis, it is the primary driver of the disease. In others, such as Alzheimer disease, amyotrophic lateral sclerosis and Parkinson disease, it has an amplifying role. Immunotherapeutic approaches that target the adaptive and innate immune systems are being explored for the treatment of almost all neurological diseases, and the targets and approaches are often common across diseases. Microglia are the primary immune cells in the brain that contribute to disease pathogenesis, and are consequently a common immune target for therapy. Other therapeutic approaches target components of the peripheral immune system, such as regulatory T cells and monocytes, which in turn act within the CNS. This Review considers in detail how microglia, monocytes and T cells contribute to the pathogenesis of multiple sclerosis, Alzheimer disease, amyotrophic lateral sclerosis and Parkinson disease, and their potential as shared therapeutic targets across these diseases. The microbiome is also highlighted as an emerging therapeutic target that indirectly modulates the immune system. Therapeutic approaches being developed to target immune function in neurodegenerative diseases are discussed, highlighting how immune-based approaches developed to treat one disease could be applicable to multiple other neurological diseases. The immune system plays a major part in neurodegenerative diseases. In this Review, Weiner considers the contributions of several components of the immune system in multiple neurodegenerative diseases and their potential as shared therapeutic targets across these diseases.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 2","pages":"67-85"},"PeriodicalIF":28.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831960","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

Exploring the role of sex hormones and gender diversity in multiple sclerosis 探讨性激素和性别多样性在多发性硬化症中的作用

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-12-11 DOI: 10.1038/s41582-024-01042-x

Cassie Nesbitt, Anneke Van Der Walt, Helmut Butzkueven, Ada S. Cheung, Vilija G. Jokubaitis

{"title":"Exploring the role of sex hormones and gender diversity in multiple sclerosis","authors":"Cassie Nesbitt, Anneke Van Der Walt, Helmut Butzkueven, Ada S. Cheung, Vilija G. Jokubaitis","doi":"10.1038/s41582-024-01042-x","DOIUrl":"10.1038/s41582-024-01042-x","url":null,"abstract":"Sex and sex hormones are thought to influence multiple sclerosis (MS) through effects on inflammation, myelination and neurodegeneration, and exogenous hormones have been explored for their therapeutic potential. However, our understanding of how sex hormones influence MS disease processes and outcomes remains incomplete. Furthermore, our current knowledge is derived primarily from studies that focus exclusively on cisgender populations with exclusion of gender-diverse people. Gender-affirming hormone therapy comprising exogenous sex hormones or sex hormone blocking agents are commonly used by transgender and gender-diverse individuals, and it could influence MS risk and outcomes at various stages of disease. A better understanding of the impact and potential therapeutic effects of both endogenous and exogenous sex hormones in MS is needed to improve care and outcomes for cisgender individuals and, moreover, for gender-diverse populations wherein an evidence base does not exist. In this Perspective, we discuss the effects of endogenous and exogenous sex hormones in MS, including their potential therapeutic benefits, and examine both established sex-based dimorphisms and the potential for gender-diverse dimorphisms. We advocate for future research that includes gender-diverse people to enhance our knowledge of the interplay of sex and sex hormones in MS, leading to the development of more effective and inclusive treatment strategies and improvement of care for all individuals with MS. Evidence for the effects of sex hormones on inflammation, myelination and neurodegeneration has implications for both cisgender and gender-diverse individuals with multiple sclerosis. Here, the authors summarize what is known about the effects of endogenous and exogenous sex hormones, and they highlight the need for future research inclusive of gender-diverse individuals.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 1","pages":"48-62"},"PeriodicalIF":28.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804830","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

Addressing disparities in neurology by enhancing inclusive practice 通过加强包容性实践解决神经病学的差异

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-12-11 DOI: 10.1038/s41582-024-01048-5

Lisa Kiani

引用次数: 0

The global and regional burden of diabetic peripheral neuropathy 糖尿病周围神经病变的全球和区域负担

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-12-05 DOI: 10.1038/s41582-024-01041-y

Masha G. Savelieff, Melissa A. Elafros, Vijay Viswanathan, Troels S. Jensen, David L. Bennett, Eva L. Feldman

{"title":"The global and regional burden of diabetic peripheral neuropathy","authors":"Masha G. Savelieff, Melissa A. Elafros, Vijay Viswanathan, Troels S. Jensen, David L. Bennett, Eva L. Feldman","doi":"10.1038/s41582-024-01041-y","DOIUrl":"10.1038/s41582-024-01041-y","url":null,"abstract":"Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage arising as a complication of type 1 or type 2 diabetes in up to 50% of patients. DPN poses a substantial burden on patients, who can experience impaired gait and loss of balance, predisposing them to falls and fractures, and neuropathic pain, which is frequently difficult to treat and reduces quality of life. Advanced DPN can lead to diabetic foot ulcers and non-healing wounds that often necessitate lower-limb amputation. From a socioeconomic perspective, DPN increases both direct health-care costs and indirect costs from loss of productivity owing to neuropathy-related disability. In this Review, we highlight the importance of understanding country-specific and region-specific variations in DPN prevalence to inform public health policy and allocate resources appropriately. We also explore how identification of DPN risk factors can guide treatment and prevention strategies and aid the development of health-care infrastructure for populations at risk. We review evidence that metabolic factors beyond hyperglycaemia contribute to DPN development, necessitating a shift from pure glycaemic control to multi-targeted metabolic control, including weight loss and improvements in lipid profiles. Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage that frequently arises as a complication of type 1 or type 2 diabetes, and even prediabetes. This Review highlights the global and regional burden of DPN and explores risk factors, including metabolic factors beyond hyperglycaemia, that could guide treatment and prevention strategies.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 1","pages":"17-31"},"PeriodicalIF":28.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776958","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