Neurology International最新文献

{"title":"Sleep Disturbances and Obstructive Sleep Apnea in Children and Adolescents with Cerebral Palsy: An Observational Study.","authors":"Isabella Meneses da Silva, Maria Clara Helena do Couto, Sanseray da Silveira Cruz-Machado, Leticia Monteiro de Andrade, Ana Elisa Zuliani Stroppa Marques, Celia Maria Giacheti, Cristiane Rodrigues Pedroni, Luciana Pinato","doi":"10.3390/neurolint17070101","DOIUrl":"10.3390/neurolint17070101","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers.</p><p><strong>Methods: </strong>This observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix^® system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time.</p><p><strong>Results: </strong>According to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO₂, longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group.</p><p><strong>Conclusions: </strong>Children and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA).</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Predictors of Early Spinal Cord Stimulator Removal: A Retrospective Cohort Study.","authors":"Peyton J Murin, Patrick J Murin, Sejal V Jain, Yuri Chaves Martins","doi":"10.3390/neurolint17070100","DOIUrl":"10.3390/neurolint17070100","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulators can offer an effective treatment in chronic pain refractory to conventional medical management. However, with a failure rate of up to 44% and an annual explantation rate of 6-9%, there is a need to better identify patients at high risk for therapeutic failure. The objective of this retrospective cohort study was to determine predictors of early SCS explantation following device placement.</p><p><strong>Methods: </strong>The Medical Informatics Operating room Vitals and Events Repository database was queried for patients with a spinal cord stimulator and at least two years of follow-up (<i>n</i> = 56). A multivariate logistic regression was fitted. Recursive factor elimination with cross-validation and L1 penalization were used to reduce the number of predictors and minimize the risk of overfitting. The model was used to predict risk factors for explantation, odds ratio (OR), 95% confidence interval (CI), and false discovery rate-adjusted <i>p</i>-value.</p><p><strong>Results: </strong>The final model displayed adequate performance with an average precision of 0.769. Sleep disorders were identified as a statistically significant predictor of SCS explantation (OR: 3.88, CI: 1.36-11.04, FDR <i>p</i>-value: 0.0497).</p><p><strong>Conclusions: </strong>While further prospective studies are needed, our study indicates that sleep disorders are a risk factor for spinal cord stimulator explantation and should be considered during pre-operative evaluation.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Genetic Risk Scores for Alzheimer's Disease and Dementia: A Systematic Review.","authors":"Stefanos N Sampatakakis, Niki Mourtzi, Alex Hatzimanolis, Nikolaos Scarmeas","doi":"10.3390/neurolint17070099","DOIUrl":"10.3390/neurolint17070099","url":null,"abstract":"<p><strong>Background: </strong>Research concerning the genetic risk for dementia has recently been headed towards new directions. Novel findings from genome-wide association studies have highlighted the association of Alzheimer's disease incidence with many gene polymorphisms, apart from the Apolipoprotein-E genotype. The identification of additional genetic risk factors has led to the construction of specific genetic risk scores for dementia, considering many different genetic factors and specific biological pathways related to Alzheimer's disease.</p><p><strong>Methods: </strong>We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis method, summarizing existing data regarding genetic risk scores for Alzheimer's disease and dementia, in order to improve the current understanding of the genetic underpinnings of dementia. In specific, five databases (PubMed/MEDLINE, Embase, Scopus, Web of science, and Cochrane Central) were searched using the keywords \"genetic risk score\", \"Alzheimer's disease\", and \"dementia\" with specific inclusion and exclusion criteria.</p><p><strong>Results: </strong>From the 552 articles identified, we finally included 20 studies for the qualitative analysis. These reports were classified in three different categories of genetic scores: \"polygenic risk scores (PRSs)\" (including 11 studies), \"pathway specific polygenic risk scores (p-PRSs)\" (5 studies), and \"complex genetic risk scores\" (4 studies).</p><p><strong>Conclusions: </strong>Existing genetic risk scores have contributed to better dementia prediction and a better understanding of the underlying pathology. Novel approaches integrating multiple polygenic risk scores might ameliorate the accuracy of genetic risk scores. The combination of polygenic risk scores that are specific to related biological pathways or relevant biomarkers is of utmost importance to achieve a better predictive ability.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12298128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Diagnosis, Pathological Mechanisms, Clinical Impact, and Future Therapeutic Perspectives in Tay-Sachs Disease.","authors":"María González-Sánchez, María Jesús Ramírez-Expósito, José Manuel Martínez-Martos","doi":"10.3390/neurolint17070098","DOIUrl":"10.3390/neurolint17070098","url":null,"abstract":"<p><p>Tay-Sachs disease (TSD) is a rare and severe neurodegenerative disorder inherited in an autosomal recessive manner. It is caused by a deficiency of the enzyme hexosaminidase A, which is responsible for the degradation of GM2 gangliosides-lipids that accumulate in the nerve cells of the central nervous system. The inability to break down these lipids leads to their progressive accumulation, resulting in irreversible brain damage. Mechanistically, TSD is caused by mutations in the <i>HEXA</i> gene, which encodes the alpha subunit of hexosaminidase A. These mutations disrupt enzyme activity and alter cellular pathways involved in lysosomal lipid degradation. Although Tay-Sachs specifically involves the alpha subunit, similar clinical features can be seen in Sandhoff disease, a related disorder caused by mutations in the <i>HEXB</i> gene, which encodes the beta subunit shared by hexosaminidase A and B. Tay-Sachs is classified into three clinical forms according to age of onset and symptom severity: the classic infantile form, which is the most common and severe; a juvenile (subacute) form; and an adult-onset form, which progresses more slowly and tends to present with milder symptoms. Diagnosis is based on enzymatic testing showing reduced or absent hexosaminidase A activity, confirmed by genetic testing. Prenatal diagnosis and genetic counseling play a key role in prevention and reproductive decision-making, especially in high-risk populations. Although no curative treatment currently exists, ongoing research is exploring gene therapy, enzyme replacement, and pharmacological approaches. Certain compounds, such as gemfibrozil, have shown potential to slow symptom progression. Early diagnosis and multidisciplinary care are essential to improving quality of life, although therapeutic options remain limited due to the progressive nature of the disease.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12298450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study of 10 Patients Exhibiting the \"Pseudo Wartenberg Sign\".","authors":"Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields","doi":"10.3390/neurolint17070097","DOIUrl":"10.3390/neurolint17070097","url":null,"abstract":"<p><strong>Background/objectives: </strong>The Wartenberg sign is a diagnostic feature of ulnar nerve neuropathy. It results from unbalanced activity of the abductor digiti minimi (ADM) and extensor digiti minimi (EDM) muscles secondary to weakness of the third palmar interosseous muscle. Rarely, this sign may occur in the absence of an underlying ulnar neuropathy, which we refer to as the \"pseudo Wartenberg sign\" (PWS).</p><p><strong>Methods: </strong>This is a retrospective review of 10 patients manifesting an inability to adduct the little finger towards the ring finger with no evidence of an ulnar neuropathy. We describe the clinical and electrodiagnostic (EDX) findings in these patients and discuss the pathophysiologic basis of PWS.</p><p><strong>Results: </strong>The most common cause was an injury in five (50.0%) patients: avulsion of the third volar interosseous muscle in two (20.0%), contracture of the ADM muscle in one (10.0%), and trauma-related dystonia in two (20.0%). The most frequent mechanism of PWS was focal dystonia of specific hand muscles in seven (70.0%) patients. Needle electromyography (EMG) demonstrated no denervation changes in ulnar nerve-innervated hand muscles; the motor and sensory conduction was normal in the ulnar nerve in all patients. Four (40.0%) patients underwent ultrasound studies, with a hyperechoic, avulsed third volar interosseous muscle in one, a hyperechoic and atrophic ADM muscle in one, normal hypothenar and extensor muscles in one, and a normal hypothenar muscle in one.</p><p><strong>Conclusions: </strong>Neurologists, neurosurgeons, and hand and orthopedic surgeons should be aware of the rare cases in which the inability to adduct the little finger may occur in the absence of ulnar neuropathy and look for other causes like avulsion of the third palmar interosseus muscle or focal hand dystonia.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Gene-Informed Regional Brain Targets for Clinical Screening for Major Depression.","authors":"G Lorenzo Odierna, Christopher F Sharpley, Vicki Bitsika, Ian D Evans, Kirstan A Vessey","doi":"10.3390/neurolint17060096","DOIUrl":"10.3390/neurolint17060096","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Major Depression (MD) is a common disorder that has significant social and economic impacts. Approximately 30% of all MD patients are refractory to common treatments, representing a major obstacle to managing the impacts of depression. One potential explanation for the incomplete treatment efficacy in MD is a substantial divergence in the mechanisms and brain networks involved in different subtypes of the disorder. The aim of this study was to identify novel brain regional targets for MD clinical screening using a gene-informed approach. <b>Methods:</b> A new analysis pipeline, called \"Analysis Tool for Local Association of Neuronal Transcript Expression\" (ATLANTE), was generated and validated. The pipeline identifies brain regions based on the shared high expression of user-generated gene lists; in this study, the pipeline was applied to discover brain regions that may be significant to MD. <b>Results:</b> Nine discrete brain regions of interest to MD were identified, including the temporal pole, anterior transverse temporal gyrus (Heschl's gyrus), olfactory tubercle, ventral tegmental area, postcentral gyrus, CA1 of the hippocampus, olfactory area, perirhinal gyrus, and posterior insular cortex. The application of network and clustering analyses identified genes of special importance, including, most notably, PRKN. <b>Conclusions:</b> This study provides two major insights. The first is that several brain regions have unique MD-associated genetic architectures, indicating a potential explanation for subtype-specific dysfunction. The second insight is that the PRKN gene, which is strongly associated with Parkinson's disease, is a key player amongst the MD-associated genes. These findings reveal novel targets for the clinical screening of depression and reinforce a mechanistic connection between MD and Parkinson's disease.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Decades of Huntington's Disease in Varna, Bulgaria: A Retrospective Single-Centre Study of Clinical Trends and Challenges.","authors":"Mariya Levkova, Mihael Tsalta-Mladenov, Milena Stoyanova, Mari Hachmeriyan, Lyudmila Angelova, Ara Kaprelyan","doi":"10.3390/neurolint17060095","DOIUrl":"10.3390/neurolint17060095","url":null,"abstract":"<p><p><b>Background</b>: Huntington's disease (HD) is a progressive, autosomal dominant neurodegenerative disorder caused by an expanded CAG repeat in the <i>HTT</i> gene. Despite advances in understanding its molecular basis, epidemiological data in many countries, including Bulgaria, remain limited. This study aims to present clinical and genetic findings from a 20-year single-centre cohort. <b>Methods</b>: A retrospective review was conducted of patients evaluated for HD at the University Hospital \"St. Marina\" in Varna between 2004 and 2024. Data included demographics, CAG repeat length, clinical features, imaging, and psychiatric assessments. Statistical analysis focused on correlations between variables, with significance set at <i>p</i> < 0.05. <b>Results</b>: Out of 79 referred individuals, 43 were molecularly confirmed. The mean age of onset was 43 years, with a four-year diagnostic delay. The average CAG repeat length was 44.6, though two symptomatic patients had reduced penetrance alleles (38 and 39 repeats). Cognitive and psychiatric symptoms were each present in 72% of cases. Depression was significantly more prevalent in women (<i>p</i> = 0.011). Most patients had a positive family history, predominantly maternal. <b>Conclusions</b>: Our findings highlight diagnostic delays, gender-specific psychiatric vulnerabilities, and the importance of personalized care. Improved access to genetic counselling and early diagnosis are essential for optimizing outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Approaches to Pain Management in Postoperative Spinal Surgery Patients: Advanced Strategies and Future Directions.","authors":"Dhruba Podder, Olivia Stala, Rahim Hirani, Adam M Karp, Mill Etienne","doi":"10.3390/neurolint17060094","DOIUrl":"10.3390/neurolint17060094","url":null,"abstract":"<p><p>Effective postoperative pain management remains a major clinical challenge in spinal surgery, with poorly controlled pain affecting up to 50% of patients and contributing to delayed mobilization, prolonged hospitalization, and risk of chronic postsurgical pain. This review synthesizes current and emerging strategies in postoperative spinal pain management, tracing the evolution from opioid-centric paradigms to individualized, multimodal approaches. Multimodal analgesia (MMA) has become the cornerstone of contemporary care, combining pharmacologic agents, such as non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and gabapentinoids, with regional anesthesia techniques, including erector spinae plane blocks and liposomal bupivacaine. Adjunctive nonpharmacologic modalities like early mobilization, cognitive behavioral therapy, and mindfulness-based interventions further optimize recovery and address the biopsychosocial dimensions of pain. For patients with refractory pain, neuromodulation techniques such as spinal cord and peripheral nerve stimulation offer promising results. Advances in artificial intelligence (AI), biomarker discovery, and nanotechnology are poised to enhance personalized pain protocols through predictive modeling and targeted drug delivery. Enhanced recovery after surgery protocols, which integrate many of these strategies, have been shown to reduce opioid use, hospital length of stay, and complication rates. Nevertheless, variability in implementation and the need for individualized protocols remain key challenges. Future directions include AI-guided analytics, regenerative therapies, and expanded research on long-term functional outcomes. This review provides an evidence-based framework for pain control following spinal surgery, emphasizing integration of multimodal and innovative approaches tailored to diverse patient populations.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Motor Preparation on Walking Ability in Active Ankle Dorsiflexion.","authors":"Hiroki Ito, Hideaki Yamaguchi, Ryosuke Yamauchi, Ken Kitai, Kazuhei Nishimoto, Takayuki Kodama","doi":"10.3390/neurolint17060093","DOIUrl":"10.3390/neurolint17060093","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to examine the influence of brain activity during motor preparation on walking ability, focusing on motor control during active ankle dorsiflexion.</p><p><strong>Methods: </strong>Participants were classified into high- and low-corticomuscular coherence (CMC), an index of neuromuscular control based on the median value. Biomechanical and neurophysiological indices of active ankle dorsiflexion and walking ability were compared between the two groups. Additionally, a machine learning model was developed to accurately predict the CMC classification using brain neural activity during motor preparation.</p><p><strong>Results: </strong>The Cz-TA CMC (beta frequency band) during active ankle dorsiflexion successfully detected significant differences in the maximum dorsiflexion angle, inversion angular velocity, brain activity localization, and variations in Cz beta power values during the transition from motor preparation to execution. Furthermore, CMC identified significant differences in dorsiflexion angle changes after toe-off and inversion angles at initial contact during gait. A support-vector machine model predicting high or low CMC demonstrated high accuracy (Accuracy: 0.96, Precision: 0.92-1.00, Recall: 0.91-1.00, F1 Score: 0.95-0.96) during motor execution based on beta power values from -500 to 0 ms prior to the initiation of active ankle dorsiflexion (representing motor preparation).</p><p><strong>Conclusions: </strong>These findings highlight that the motor preparation processes of the brain during active ankle dorsiflexion are involved in walking ability and can be used to predict it. This indicator is independent of disease severity and holds the potential to provide a clinically versatile evaluation method.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Diseases Deserve Global Solutions: Alzheimer's Disease.","authors":"Emma Twiss, Carley McPherson, Donald F Weaver","doi":"10.3390/neurolint17060092","DOIUrl":"10.3390/neurolint17060092","url":null,"abstract":"<p><p>Alzheimer's Disease (AD) is a global issue, with increasing incidence and prevalence as the world's population ages and life expectancy increases. Projections indicate that by 2050, over 150 million individuals worldwide will be personally living with AD, an impending crisis made worse by the absence of cure therapies. Moreover, the risk factor relationship of dementia with rising global temperatures and air pollution further necessitates the urgency of a coordinated international response. With an extensive economic and emotional burden, AD is no longer just a disease; it is a worldwide societal crisis. This review presents five calls to action to address the AD global health emergency. First, AD research must be approached as an internationally performed activity, involving standardized data sharing, collaborative innovation, and improved access to pharmaceutical studies in low- and middle-income countries (LMICs), alongside increased diversity, inclusion, and equity in research. Second, there must be a commitment to develop universally accessible, affordable, and non-invasive diagnostic tools for AD. Third, advancements in AD therapeutics should prioritize the development of affordable agents, allowing for widespread geographic distribution. Fourth, we identify focus areas for global dementia risk reduction: sleep, head injury prevention, exercise, learning, and diet (SHIELD risk reduction strategy). Fifth, improving care for individuals with AD requires eliminating stigma through educational programs for both the public and caregivers. The escalating AD crisis demands an unprecedented global coalition in research, diagnostics, therapeutics, prevention, and education to avoid a future where the disease becomes the defining crisis of our era.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}