Nature Reviews Neurology最新文献

{"title":"Multisystemic aspects of neurology","authors":"","doi":"10.1038/s41582-026-01196-w","DOIUrl":"10.1038/s41582-026-01196-w","url":null,"abstract":"In this issue of Nature Reviews Neurology, we launch a Collection that explores the multisystemic nature of neurological disease and highlights the importance of collaboration between neurology and other clinical specialties.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"199-199"},"PeriodicalIF":33.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41582-026-01196-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards holistic patient care at the neurology–urology interface","authors":"Heather Wood, Jalesh N. Panicker","doi":"10.1038/s41582-026-01195-x","DOIUrl":"10.1038/s41582-026-01195-x","url":null,"abstract":"Nature Reviews Neurology is interviewing leading experts who are working at the interface between neurology and other clinical specialties. We spoke with uro-neurologist Jalesh N. Panicker about his work on urogenital dysfunction in people with neurological disease and initiatives to promote collaboration between the neurology and urology fields.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"204-205"},"PeriodicalIF":33.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585358","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}

{"title":"Domestic violence and chronic traumatic encephalopathy — an under-recognized link","authors":"María E. Garay-Serratos","doi":"10.1038/s41582-026-01202-1","DOIUrl":"10.1038/s41582-026-01202-1","url":null,"abstract":"In this World View, María E. Garay-Serratos recounts how her mother developed chronic traumatic encephalopathy following decades of domestic violence. She describes her quest to obtain a conclusive diagnosis for her mother and calls for increased awareness of and research into the link between domestic violence and chronic traumatic encephalopathy.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 6","pages":"325-326"},"PeriodicalIF":33.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599254","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}

{"title":"Urogenital dysfunction in neurological diseases","authors":"Ryuji Sakakibara, Tatsuya Yamamoto, Tomoyuki Uchiyama","doi":"10.1038/s41582-025-01181-9","DOIUrl":"10.1038/s41582-025-01181-9","url":null,"abstract":"Neural damage at any level of the neuraxis can lead to urogenital dysfunction, involving the lower urinary tract (LUT) and/or the sexual organs. The LUT consists of the bladder and the urethra (plus the prostate in males); LUT dysfunction can manifest as an underactive bladder, leading to urinary retention, or as an overactive bladder, leading to urinary incontinence. Manifestations of sexual dysfunction include loss of libido and dysfunction of erection, ejaculation and orgasm. In this Review, we address the physiology and innervation of the LUT and the sexual organs and discuss various aspects of urogenital dysfunction in CNS (brain and spinal cord) disorders including stroke, Alzheimer disease, white matter disease, normal-pressure hydrocephalus, Parkinson disease, dementia with Lewy bodies, multiple system atrophy, spinal cord injury, multiple sclerosis and spina bifida. We also review advances in the management of urogenital dysfunction in patients with neurological disorders. In this Review, the authors outline the physiology and innervation of the lower urinary tract and sexual organs and discuss various aspects of urogenital dysfunction in CNS (brain and spinal cord) disorders. Advances in the management of urogenital dysfunction in patients with neurological disorders are also discussed.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"226-238"},"PeriodicalIF":33.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585371","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}

{"title":"Promoting collaboration at the brain–heart interface","authors":"Heather Wood, Luciano Sposato","doi":"10.1038/s41582-026-01192-0","DOIUrl":"10.1038/s41582-026-01192-0","url":null,"abstract":"Nature Reviews Neurology is interviewing leading experts who are working at the interface between neurology and other clinical specialties. We spoke with stroke neurologist Luciano Sposato about his work on brain–heart interactions and initiatives to promote collaboration between the neurology and cardiology fields.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"202-203"},"PeriodicalIF":33.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585357","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}

{"title":"Glymphatic dysfunction: a unifying hypothesis for delirium","authors":"Hans Christian Boesen, Ting Du, Steven A. Goldman, Maiken Nedergaard","doi":"10.1038/s41582-026-01194-y","DOIUrl":"10.1038/s41582-026-01194-y","url":null,"abstract":"Delirium is a common and severe neuropsychiatric syndrome with lasting cognitive consequences, yet its pathophysiology remains poorly understood. We hypothesize that impaired glymphatic flow represents a central mechanism by which delirium evolves. This hypothesis builds on recent evidence showing that major delirium risk factors, such as ageing, dementia, cardiovascular disease and renal failure, are all associated with reduced glymphatic clearance. Similarly, common delirium triggers, including infection, surgery and sleep deprivation, have been shown to impair glymphatic function. In addition, standard intensive care interventions linked to delirium, such as sedation, opioid administration and noradrenaline, are known to suppress glymphatic clearance. Collectively, these effects could lead to the accumulation of neurotoxic metabolites and pro-inflammatory cytokines, disrupting neural network activity and precipitating delirium. Recognizing glymphatic impairment as a causal contributor to delirium could open new research and therapeutic avenues aimed at preserving brain fluid clearance in critically ill patients. Delirium presents a major challenge in intensive care and postoperative settings; however, the pathophysiology is poorly understood. In this Perspective, Nedergaard and colleagues examine the evidence for impaired glymphatic flow as a central mechanism in the development of delirium and discuss potential strategies to mitigate delirium risk.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 5","pages":"309-323"},"PeriodicalIF":33.1,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577929","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}

{"title":"Gut macrophages involved in Parkinson disease pathogenesis","authors":"Ian Fyfe","doi":"10.1038/s41582-026-01198-8","DOIUrl":"10.1038/s41582-026-01198-8","url":null,"abstract":"Macrophages in the gastrointestinal system have a key role in the development and propagation of α-synuclein pathology in body-first Parkinson disease, according to new research.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"207-207"},"PeriodicalIF":33.1,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478595","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}

{"title":"Maintaining and regaining episodic memory in Alzheimer disease: a circuit-based perspective","authors":"Emrah Düzel, Michael R. Kreutz","doi":"10.1038/s41582-026-01189-9","DOIUrl":"10.1038/s41582-026-01189-9","url":null,"abstract":"Losing track of personal experiences is a defining feature of Alzheimer disease (AD), arising from the spread of AD pathology through the brain circuits that support episodic memory. In this Review, we explore strategies to improve the function of episodic memory circuits in AD by leveraging the optimized use of neural resources. We introduce the circuit utilization framework, which builds on evidence that synaptic dysfunction, maladaptive responses and deficient adaptive plasticity contribute to episodic memory impairment. The circuit utilization framework posits that by optimizing the utilization of circuit resources, episodic memory function can be partially regained. Our focus includes mitigation of hypoactive and hyperactive synaptic dysfunction, reduction of maladaptive processes and enhancement of brain and cognitive reserve. The circuit utilization framework is grounded in circuit-specific hypotheses that link the component processes of episodic memory to clinical symptoms of memory impairment and AD progression. Its overarching aim is to guide the development of interventions that support episodic memory in people with AD, complementing disease-modifying treatments such as anti-amyloid antibody therapies. Impairment of episodic memory — the ability to recollect personal experiences — is an early symptom of Alzheimer disease (AD) and profoundly affects life participation and independence. This Review introduces the circuit utilization framework, which posits that episodic memory impairment in AD includes a regainable component stemming from suboptimal utilization of brain circuits.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 5","pages":"292-308"},"PeriodicalIF":33.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465234","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}

{"title":"Uncovering a barrier at the base of the choroid plexus","authors":"Heather Wood","doi":"10.1038/s41582-026-01197-9","DOIUrl":"10.1038/s41582-026-01197-9","url":null,"abstract":"A new study has identified a previously unrecognized subset of brain fibroblasts that form a barrier at the base of the choroid plexus. In the healthy brain, this barrier restricts the movement of small molecules and immune cells, but it breaks down under inflammatory conditions.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"206-206"},"PeriodicalIF":33.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446968","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}

{"title":"Tsunamis hiding in plain sight: spreading depression in clinical neurology","authors":"Cenk Ayata, Anders Hougaard, Steven J. Schiff, Michel D. Ferrari, Jeffrey L. Noebels, H. Christoph Diener, Martin Lauritzen","doi":"10.1038/s41582-026-01191-1","DOIUrl":"10.1038/s41582-026-01191-1","url":null,"abstract":"Spreading depression is a neurophysiological phenomenon that is observed in the central nervous system of many species, from insects to humans. In essence, spreading depression is a slowly propagating wave of mass depolarization (that is, spreading depolarization), aptly termed a ‘brain tsunami’, which successively engulfs contiguous brain regions, causing transient neuronal hyperexcitability at its leading edge, followed by complete but reversible neuronal silence lasting minutes. This wave cannot be detected in routine scalp EEG recordings, which contributes to its under-recognized status as a disease biomarker. Here, we present an evidence-based view of spreading depression as a probable cause of characteristic neurological signs and symptoms in numerous neurological conditions. Although migraine aura is a widely recognized manifestation of spreading depression, the clinical signs and symptoms of spreading depressions arising from structural brain pathology have remained an orphan concept with no established name or place in clinical terminology. Therefore, clinicians have long used the term ‘migraine aura’ to describe the transient neurological manifestations of spreading depression that occur entirely outside of the context of a migraine attack. As migraine is a primary headache disorder not caused by known structural pathology, this terminology is not only erroneous but could also lead to serious misdiagnoses. Consequently, we advocate for the clinical adoption of the more specific mechanistic term spreading depression to describe these clinical episodes. We believe it is imperative to recognize spreading depression as a generic mechanism underlying certain inherited or acquired neurological deficits and to differentiate between structural and non-structural aetiologies, as is done in seizure disorders. Spreading depression is a slowly propagating wave of mass depolarization that successively engulfs contiguous brain regions, causing transient neuronal hyperexcitability at its leading edge, followed by complete but reversible neuronal silence lasting minutes. Here, the authors present an evidence-based view of spreading depression as a probable cause of characteristic neurological signs and symptoms in numerous neurological conditions.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"22 4","pages":"251-266"},"PeriodicalIF":33.1,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147393832","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}