Neurology and Therapy最新文献

{"title":"The Kappa Free Light Chains Index and Central Vein Sign: Two New Biomarkers for Multiple Sclerosis Diagnosis.","authors":"Michael Levraut, Cassandre Landes-Chateau, Lydiane Mondot, Mikael Cohen, Christine Lebrun-Frenay","doi":"10.1007/s40120-025-00737-7","DOIUrl":"10.1007/s40120-025-00737-7","url":null,"abstract":"<p><p>At the last European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting, Montalban and the experts' panel announced the 2024 revision of the McDonald criteria. The optic nerve has been added as a fifth dissemination in space (DIS) criteria topography among the main changes. Multiple sclerosis (MS) can be diagnosed in patients with radiologically isolated syndrome (RIS) if specific biomarkers are added to at least two of the five DIS criteria. Among the particular MS biomarkers, the kappa free light chain index (kFLC index) positivity will be added to oligoclonal band (OCB) detection to fulfill intrathecal immunoglobulin synthesis, and the central vein sign (CVS) will be able to ensure the specificity of the lesions detected on MRI scans. This review summarises the knowledge on the kFLC index and the CVS in people with MS and RIS, allowing them to be incorporated into the proposed revision of the McDonald criteria.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"711-731"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout Among Physicians Treating Patients with Multiple Sclerosis in the United States: A Podcast.","authors":"Mary Rensel, Amy B Sullivan","doi":"10.1007/s40120-025-00738-6","DOIUrl":"10.1007/s40120-025-00738-6","url":null,"abstract":"<p><p>Physician burnout, a growing crisis in the healthcare system of the United States of America (USA), is characterized by long-term job-related stress that manifests as energy depletion, feelings of increased mental distance from or cynicism toward one's job, and reduced professional efficacy. Notably, neurologists rank among those with the highest rates of burnout and the lowest levels of satisfaction with work-life balance. However, data on burnout among physicians treating patients with multiple sclerosis (MS) remain limited. In this podcast, we discuss the findings of a USA-based quantitative survey involving 136 physicians who treat patients with MS (defined as having prescribed ≥ 3 MS disease-modifying therapies over a 12-month period). The survey investigated the prevalence of burnout within this population and its associated risk factors. It included 20 questions, including the Mini Z inventory v3.0, demographic data, professional information, and details about work environment and job support. The results revealed a significant prevalence (approximately 50%) of burnout and job-related stress. Key contributors to job stress included the burden of maintaining electronic medical records and long working hours. Despite high levels of work satisfaction reported by participants, it is concerning that nearly 50% of these physicians had considered switching their field due to burnout or related issues. We also explore the impact of burnout on patient care and management, offering recommendations to address these challenges.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"733-741"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Dopaminergic Stimulation-Based Levodopa Treatment in Patients with Early to Mid-Stage Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Rong Tang, Sunying Zhang, Rui Sun, Jiacheng Xu, Yunxing Hu, Hongyu Tan, Ling Chen","doi":"10.1007/s40120-025-00764-4","DOIUrl":"https://doi.org/10.1007/s40120-025-00764-4","url":null,"abstract":"<p><strong>Introduction: </strong>Despite promising results from continuous dopaminergic stimulation (CDS)-based treatments, the effectiveness of sustained-release formulations of levodopa remains debated. This meta-analysis aims to assess the effectiveness of CDS-based levodopa treatment in patients with early to mid-stage Parkinson's disease (PD).</p><p><strong>Methods: </strong>Comprehensive searches were performed using PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials.gov. The clinical trials were included to compare CDS-based levodopa treatments with intermittent levodopa (IL) treatment in patients with early to mid-stage PD.</p><p><strong>Results: </strong>A total of 18 clinical trials involving 2208 patients were included in this meta-analysis. Results showed that CDS-based levodopa treatments were associated with a significant reduction in Unified Parkinson's Disease Rating Scale (UPDRS) II scores (mean difference (MD) - 0.79, 95% CI - 1.26, - 0.32) and UPDRS III scores (MD - 1.03, 95% CI - 1.98, - 0.08) compared to IL treatments. Additionally, CDS-based treatments increased ON time without troublesome dyskinesia (MD 0.63, 95% CI 0.35, 0.91) and decreased OFF time (MD - 0.60, 95% CI - 1.03, - 0.18). In the subgroup analysis of UPDRS II scores and UPDRS III scores, the MD were - 0.62 (95% CI - 1.27, 0.02) and - 1.20 (95% CI - 4.74, 2.34) for 200 mg and - 1.10 (95% CI - 1.88, - 0.32) and - 1.25 (95% CI - 3.26, 0.76) for a combination of levodopa and other drugs at varying dosages, respectively.</p><p><strong>Conclusion: </strong>Treatment with CDS-based levodopa offers significant benefits in managing motor symptoms and reducing complications in patients with early to mid-stage PD. These therapies provide a promising alternative to traditional IL treatments, potentially leading to improving patient outcomes and quality of life.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disrupting Migraine Dynamics: A Narrative Review of the Consequences of Modern Anti-CGRP Monoclonal Antibody Therapies.","authors":"Dawn C Buse, Jan Versijpt, Hans-Christoph Diener","doi":"10.1007/s40120-025-00769-z","DOIUrl":"https://doi.org/10.1007/s40120-025-00769-z","url":null,"abstract":"<p><p>This article provides an overview of a symposium held as part of the proceedings at the 10th European Academy of Neurology Congress in Helsinki, Finland, on 2 July 2024. Migraine is a common neurological disease and a leading cause of disability worldwide. Anti-calcitonin gene-related peptide (CGRP) therapies are the first to be specifically developed for migraine prevention and are recommended as a first-line option by the American Headache Society and European Headache Federation. Data on the effectiveness of anti-CGRP therapies are now available from clinical trials and real-world studies, and this article briefly reviews these data and discusses what they mean for people with migraine, and how healthcare professionals can take the conversation back to their clinics.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Course in Patients Switched from Natalizumab to Alemtuzumab: An Italian Multicenter, Prospective, Observational Study.","authors":"Simona Malucchi, Paola Perini, Francesca Rinaldi, Marta Radaelli, Maria Malentacchi, Antonio Bertolotto, Alessia Di Sapio","doi":"10.1007/s40120-025-00754-6","DOIUrl":"https://doi.org/10.1007/s40120-025-00754-6","url":null,"abstract":"<p><strong>Introduction: </strong>Natalizumab is a highly efficacious therapy (HET) for patients with relapsing remitting multiple sclerosis (RRMS). Its prolonged use is limited by the risk of progressive multifocal leukoencephalopathy (PML) in patients positive for anti-JCV antibodies. Aims of this work were to evaluate clinical and radiological efficacy at 6 and 12 months after alemtuzumab infusion in patients switching from natalizumab and the safety of this exit strategy.</p><p><strong>Methods: </strong>This real-world, prospective, multicentric, observational study was conducted in three Italian MS centers and included a total of 35 patients with RRMS. Natalizumab treatment occurred from October 2010 to April 2021, whereas switch to alemtuzumab occurred from February 2018 to January 2023. Median washout period between the two drugs was 2 months. Patients underwent brain MRI before alemtuzumab start and then 6 and 12 months after the first alemtuzumab cycle.</p><p><strong>Results: </strong>No clinical relapse occurred during the washout period, nor between the first and second alemtuzumab infusion. Radiological activity was present in 4/35 (11%) and 2/35 (6%) patients, respectively, at 6 and 12 months after the first alemtuzumab administration. Expanded Disability Status Scale (EDSS) increase developed in 4/35 (11%) and 5/35 patients (14%), respectively, at 6 and 12 months. No PML occurred, nor any serious adverse event. For patients in center 1 (17 patients), follow-up continued for a median of 3.5 years; NEDA-3 (No Evidence of Disease Activity) was present in 14/17 patients (82%) at the end of follow-up. Autoimmunity occurred in 23% of patients.</p><p><strong>Conclusions: </strong>Alemtuzumab is a valid exit strategy after natalizumab interruption.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics, Pharmacodynamics, and Safety of Nipocalimab in Healthy Chinese Volunteers: A Single-Dose, Phase I Study.","authors":"Haiyan Li, Juanfang Liu, Xiaohong Wang, Weilong Zhao, Lili Zhang, Xiaoye Niu, Jingyao Liu, Zhongqi Dong","doi":"10.1007/s40120-025-00763-5","DOIUrl":"https://doi.org/10.1007/s40120-025-00763-5","url":null,"abstract":"<p><strong>Introduction: </strong>Nipocalimab is a high-affinity, fully human, immunoglobulin G (IgG) 1 monoclonal antibody that inhibits the neonatal Fc receptor. Nipocalimab is under development for the treatment of various IgG autoantibody- and alloantibody-mediated diseases. This study assessed the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of a single dose of nipocalimab in healthy Chinese volunteers.</p><p><strong>Methods: </strong>In this phase I, open-label study, healthy volunteers received single doses of intravenous (IV) nipocalimab at 15, 30, or 45 mg/kg. The primary objective was to assess the PK following a single administration of nipocalimab. Secondary objectives included the PD effects of nipocalimab on change from baseline in total serum IgG levels, safety, and tolerability.</p><p><strong>Results: </strong>A total of 30 healthy Chinese volunteers (mean age 31.0 years, 93.3% men) received single doses of IV nipocalimab. Following a single infusion of nipocalimab, mean exposure increased as the dose of nipocalimab increased. Maximum serum nipocalimab concentrations increased proportionally with doses, whereas the area under the concentration-time curve increased by greater than a dose-proportional manner. Nipocalimab led to dose-dependent reductions in serum IgG levels from baseline; this decrease was sustained over a longer period of time with higher dose levels. Nipocalimab was generally well tolerated, with an acceptable safety profile, across all three doses; most of the treatment-emergent adverse events (TEAEs) were mild. Higher doses of nipocalimab were not associated with increased frequency of TEAEs.</p><p><strong>Conclusion: </strong>Our findings add to the evidence on the safety, tolerability, and PD of nipocalimab in the Chinese population, and support for the treatment of pathogenic IgG-mediated diseases in this population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05151692.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Immune Reconstitution Therapy with Cladribine Tablets in the Management of Relapsing Multiple Sclerosis in Older Patients.","authors":"Raed Alroughani, Jihad Inshasi, Samar Farouk, Abdullah Al-Asmi, Ali Hassan, Anu Jacob, Areen T Said, Beatrice Benedetti, Dirk Deleu, Iman Al-Lawati, Miklos Szolics, Mohammad Abouelnaga, Mona Thakre, Mustafa Shakra, Pournamy Sarathchandran, Amir Boshra","doi":"10.1007/s40120-025-00767-1","DOIUrl":"https://doi.org/10.1007/s40120-025-00767-1","url":null,"abstract":"<p><p>The pathophysiology and presentation of relapsing multiple sclerosis (RMS) differ importantly between younger and older patients. Older patients usually suffer fewer MS relapses but present with a chronically inflammatory phenotype (inflammaging) associated with accelerated age-related changes to the adaptive and innate immune systems (immunosenescence). The efficacy of most disease-modifying therapies (DMTs) appears to decline with increasing age, likely because of a shift away from focal inflammation as the main driving force for progression of MS. These observations led to suggestions that DMT may be withdrawn for an older person with very stable MS. However, this approach risks the resumption of MS disease activity. In contrast, analyses of evaluations of immune reconstitution therapy with cladribine tablets (CladT) show that this high-efficacy DMT appears to be effective and well tolerated irrespective of age. Achieving long-term freedom from MS disease activity for an older patient with MS is feasible using this approach. Switching to CladT is a rational option for reducing the dual burdens of continuous treatment (including side effects associated with continuous immunosuppression with some DMTs) and monitoring for older people with RMS. This includes possible use as an \"exit therapy\", beyond which some patients may not need pharmacological therapy for their RMS in the future.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Patients Don't Say and Physicians Don't Ask: A Needs Assessment in Myasthenia Gravis Integrating Patient and Healthcare Professional Perspectives.","authors":"Cornelia Reyes Acosta, Ivo Vlaev, Alexis Rodriguez, Allison Foss, Ashwin Pinto, Channa Hewamadduma, John Vissing, Nicholas J Silvestri, Sophie Lehnerer, Marc De Backer, Natasha Monin, Sophie Barry, Ina Weisshardt","doi":"10.1007/s40120-025-00751-9","DOIUrl":"10.1007/s40120-025-00751-9","url":null,"abstract":"<p><strong>Introduction: </strong>Myasthenia gravis (MG) is a rare, autoimmune neuromuscular disease characterized by unpredictable fluctuating muscle weakness. This unpredictability makes effective patient-healthcare professional (HCP) dialogue essential for optimal diagnosis and management, with communication as a key component of shared decision-making (SDM). We designed a needs assessment to understand the differences between HCP and patient communication needs and perspectives on the impact of MG.</p><p><strong>Methods: </strong>A mixed-methods approach was utilized, comprising a survey and semi-structured interviews with HCPs and patients with MG. Quantitative data from the survey were extracted and analyzed to understand trends of knowledge, skills, and attitudes toward patient-HCP dialogue and SDM in MG. Interviews were transcribed and analyzed using principles of thematic analysis to identify perspectives on the impact of MG and challenges in communication.</p><p><strong>Results: </strong>Completed survey data were collected from 47 HCPs and 122 patients. There were discrepancies and areas of alignment in the priorities each group placed on knowledge, skills, and attitudes in MG management. Patients valued HCPs' listening skills and knowledge of treatment history, whereas HCPs prioritized knowing what matters to a patient with MG, including providing support to the patient and their family/carer. Both groups agreed on the necessity of a compassionate and informed approach to care. Interviews (10 HCPs; 10 patients) revealed key themes, including the multifaceted way in which symptoms impact patients' lives and challenges patients face while communicating their experiences.</p><p><strong>Conclusion: </strong>This needs assessment indicated general alignment between patients and HCPs on MG symptoms; however, notable disparities were found in relation to the perceived impact of these symptoms on patients' lives, and communication. While some HCPs expected patients to volunteer information on symptoms and MG-related challenges, patients expected their HCPs to ask. This highlights a need for improved communication strategies, which will foster SDM approaches.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Patient Experience of Advanced Parkinson's Disease: Qualitative Research with Patients and Expert Clinicians to Identify Symptoms and Associated Health-Related Quality of Life Impacts.","authors":"Nicola Williamson, Thomas Morel, Helena Bradley, Aoife Lydon, Molly Clifford, Patrick Cronin, Milton Biagioni","doi":"10.1007/s40120-025-00747-5","DOIUrl":"https://doi.org/10.1007/s40120-025-00747-5","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) is a progressive neurodegenerative condition, characterized by motor symptoms (MS) and non-motor symptoms (NMS). Currently, there is no global definition of advanced PD, but those in advanced stages experience diverse and severe symptomatology, and significant impacts to their health-related quality of life (HRQoL). This qualitative interview study aimed to explore the experience of symptoms and HRQoL impacts of advanced PD from the patient and clinician perspective and identify key concepts for assessment in PD clinical trials.</p><p><strong>Methods: </strong>A targeted review of literature and qualitative concept elicitation interviews conducted with people with advanced PD (N = 20) and expert clinicians (N = 3) in the US aimed to identify symptoms of advanced PD and their impact on HRQoL. People with advanced PD (PwP) were defined as those diagnosed ≥ 5 years, experiencing ON/OFF motor fluctuations despite levodopa therapy, and classified as modified Hoehn and Yahr stages 2-4.</p><p><strong>Results: </strong>In total, 65 symptoms (48 NMS, 17 MS) were identified across the reviewed literature and qualitative interviews. The most frequently reported MS included tremor, rigidity, balance issues, and slowness of movement. Several NMS were also frequently reported by participants, including fatigue, cognitive dysfunction (e.g., difficulty thinking), neuropsychiatric symptoms (e.g., apathy), pain, sleep problems, urinary dysfunction, autonomic dysfunction, excessive daytime sleepiness, gastrointestinal dysfunction, and sensory dysfunction. Participants reported these to impact HRQoL, including daily activities, emotional functioning, physical functioning, social functioning, work/study, and financial well-being.</p><p><strong>Conclusion: </strong>The study provides in-depth insights into the symptoms and HRQoL impacts experienced by those with advanced PD. A comprehensive conceptual model of the patient experience of advanced PD was developed to support the identification of relevant concepts for assessment in PD clinical trials.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network Meta-analysis of Randomized Controlled Trials Assessing Neuromodulation Therapies for Painful Diabetic Neuropathy.","authors":"Li Li, Xueqin Luo, Yong Liu, Yongjie Jiang, Yankun Chen, Yangmei Chen, Jinping Wang","doi":"10.1007/s40120-025-00759-1","DOIUrl":"https://doi.org/10.1007/s40120-025-00759-1","url":null,"abstract":"<p><strong>Introduction: </strong>Neuromodulation therapies (including non-invasive and invasive neuromodulation) are being used to treat painful diabetic neuropathy (PDN).</p><p><strong>Methods: </strong>A systematic search of the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases was conducted, from their inception until 1 October 2024, to identify randomized controlled trials (RCTs) on neuromodulation therapies for PDN. Data were collected on pain intensity of various adjunctive therapies for PDN, including transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation, repetitive transcranial magnetic stimulation, pulsed electromagnetic field therapy, spinal cord stimulation (SCS), transcranial direct current stimulation, frequency rhythmic electrical modulation system, mesodiencephalic modulation, and sham.</p><p><strong>Results: </strong>The data from an aggregate of 12 separate studies, comprising a total sample size of 922 participants, was subject to analysis. All seven neuromodulation therapies exhibited better outcomes in pain intensity compared to the Sham intervention, with TENS achieving the highest ranking, followed by SCS. At the final follow-up time point, statistically significant reductions in pain intensity (vs. Sham) was only observed for SCS.</p><p><strong>Conclusion: </strong>The results of this network meta-analysis should facilitate the development of clinical guidance and enhance the decision-making process for both patients and healthcare professionals, thereby identifying the most appropriate PDN treatment options.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42024597208.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}