The Lancet Neurology最新文献

{"title":"Blood and CSF biomarkers for multiple sclerosis: emerging clinical applications","authors":"Tanuja Chitnis, Roberta Magliozzi, Ahmed Abdelhak, Jens Kuhle, David Leppert, Bibiana Bielekova","doi":"10.1016/s1474-4422(25)00249-2","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00249-2","url":null,"abstract":"Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), chitinase-3-like protein 1 (CHI3L1), and other protein assays are being developed as diagnostic or prognostic biomarkers in multiple sclerosis. An increase in NfL concentrations reflects axonal damage resulting from the acute new inflammatory disease activity that occurs during a relapse. NfL concentrations can also reflect the occurrence of new MRI lesions. GFAP concentrations are increased in people with progressive forms of multiple sclerosis, and GFAP is an emerging biomarker of progression independent of relapses. CHI3L1 is an emerging biomarker associated with progression independent of relapse activity and several MRI lesion types, including paramagnetic rim lesions. Some biomarkers, particularly NfL, can help monitoring treatment response, and combinations of multivariate biomarkers provide additional accuracy in specific clinical scenarios. In multiple sclerosis, fluid-based biomarkers are quickly emerging as instruments for clinical monitoring of disease course and patients' response to treatment.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Neurol 2025; 24: 850–65","authors":"","doi":"10.1016/s1474-4422(25)00355-2","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00355-2","url":null,"abstract":"<em>Montalban X, Lebrun-Frénay C, Oh J, et al. Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria</em> Lancet Neurol <em>2025;</em> 24: <em>850–65</em>—In this Position Paper, figures 2 and 3 have been swapped so that figure 2 is now: “Diagnostic algorithm for radiologically isolated syndrome and other non-specific presentations” and figure 3 is now: “Diagnostic algorithm for relapsing and progressive presentations of multiple sclerosis”. These corrections have been made to the online version as of Sept 23, 2025.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The quality of life of patients with dementia and their caregivers: important and yet inadequately assessed","authors":"Xin Zhang, Michael Aylwin, David Thomas, Joshua Stott, Sebastian Crutch, Nick C Fox","doi":"10.1016/s1474-4422(25)00351-5","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00351-5","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Neurol 2025; 24: 880–92","authors":"","doi":"10.1016/s1474-4422(25)00349-7","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00349-7","url":null,"abstract":"<em>Saidha S, Green AJ, Leocani L, et al. The use of optical coherence tomography and visual evoked potentials in the 2024 McDonald diagnostic criteria for multiple sclerosis.</em> Lancet Neurol <em>2025;</em> 24: <em>880–92</em>—For this Personal View, the International Multiple Sclerosis Visual System consortium should have been included in the authorship line, and a list of consortium members are included in the appendix. These corrections have been made to the online version as of Sept 18, 2025.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep biomarkers for sudden unexpected death in epilepsy","authors":"Suvasini Sharma, Manar Al-Otaibi","doi":"10.1016/s1474-4422(25)00312-6","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00312-6","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angelo Ruffini: neuroanatomist of embryos and receptors","authors":"Marcello Trucas, Pietro Gobbi, Sabrina Burattini, Samanta Taurone, Marco Artico","doi":"10.1016/s1474-4422(25)00325-4","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00325-4","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI for the diagnosis of multiple sclerosis","authors":"Frederik Barkhof, Daniel S Reich, Jiwon Oh, Maria A Rocca, David K B Li, Pascal Sati, Christina J Azevedo, Francesca Bagnato, Peter A Calabresi, Olga Ciccarelli, Michael G Dwyer, Gabriele C DeLuca, Nicola De Stefano, Christian Enzinger, Massimo Filippi, Cristina Granziera, June Halper, Roland G Henry, Claudio Gasperini, Susan Gauthier, Àlex Rovira","doi":"10.1016/s1474-4422(25)00304-7","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00304-7","url":null,"abstract":"MRI plays an increasingly important role in the diagnosis of multiple sclerosis. We discuss the expanded role of MRI in the 2024 McDonald diagnostic criteria for multiple sclerosis, which include the optic nerve as a fifth anatomical location, in addition to the periventricular, juxtacortical or cortical, infratentorial, and spinal cord regions. The diagnosis of multiple sclerosis can now be confirmed when the criteria of dissemination in space are fulfilled with the detection of typical lesions in at least four locations without additional evidence. We recommend appropriate imaging strategies and MRI acquisition protocols for all aspects of multiple sclerosis diagnosis, including fat-saturated sequences for detection of symptomatic optic nerve lesions. Diagnostic imaging should always cover the brain and spinal cord and include susceptibility-sensitive sequences for the assessment of the central vein sign and paramagnetic rim lesions, which can be especially helpful in cases when conventional imaging findings are insufficient to establish a diagnosis. We discuss how to handle the diagnosis of radiologically isolated presentations of multiple sclerosis, which are included in the 2024 criteria. We present recommendations for image interpretation and avoidance of misdiagnosis, and extend the recommendations to the use of MRI in the diagnosis of multiple sclerosis in older people, children, people with vascular comorbidities or migraine, and people living outside Europe and North America. Finally, we provide recommendations for standardisation of MRI acquisition and communication of results to enable an earlier diagnosis while maintaining high diagnostic specificity.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the Edinburgh CT and genetic diagnostic criteria for cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage and recurrent intracerebral haemorrhage: an individual patient data meta-analysis","authors":"Mark A Rodrigues, David Seiffge, Neshika Samarasekera, Tom J Moullaali, Joanna M Wardlaw, Stefanie Schreiber, Tyler P Behymer, Vivek Khandwala, Robert J Stanton, Vaibhav Vagal, Daniel Woo, Marialuisa Zedde, Rosario Pascarella, Andreas Charidimou, Andrew Warren, Steven M Greenberg, Sebastian Eppinger, Thomas Gattringer, Barbara Casolla, Charlotte Cordonnier, Costanza Rossi","doi":"10.1016/s1474-4422(25)00285-6","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00285-6","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Patients with lobar intracerebral haemorrhage and MRI biomarkers of cerebral amyloid angiopathy have a greater risk of recurrent intracerebral haemorrhage than patients without these biomarkers. However, access to MRI is limited. We aimed to determine whether the Edinburgh CT-only and CT-&lt;em&gt;APOE&lt;/em&gt; diagnostic criteria for cerebral amyloid angiopathy-related lobar intracerebral haemorrhage are associated with recurrent intracerebral haemorrhage.&lt;h3&gt;Methods&lt;/h3&gt;We did a meta-analysis of individual patient data from cohort studies identified at the 2018 International cerebral amyloid angiopathy conference in Lille, France, assessing patients with lobar intracerebral haemorrhage with available diagnostic CT imaging that had been, or could be, rated for the Edinburgh cerebral amyloid angiopathy criteria imaging features, and with follow-up data for recurrent intracerebral haemorrhage and death. Eligible patients were aged 16 years or older with first or recurrent spontaneous lobar intracerebral haemorrhage diagnosed by non-contrast brain CT, with no evidence of an underlying cause other than cerebral small vessel disease. Collaborators provided individual patient-level data. The primary outcome was first recurrent intracerebral haemorrhage occurring at least 30 days after the index event, analysed using primary two-stage (cohort-level) and secondary one-stage (pooled) meta-analyses with multivariable regression models with a competing risk of death, adjusted for age, sex, and CT small vessel disease score. Pooled analyses were adjusted for previous intracerebral haemorrhage, dementia, hypertension, and cohort clustering. All analyses were done in R Project for Statistical Computing (version 4.5.0).&lt;h3&gt;Findings&lt;/h3&gt;We included eight cohorts from Austria, France, Germany, Italy, the UK, and the USA, with 1705 eligible patients for the CT-only criteria. In the primary two-stage meta-analysis of the CT-only criteria (562 patients from three European cohorts, median age 76 years [IQR 68–82], 282 [50%] female and 280 [50%] male), 69 patients had a recurrent intracerebral haemorrhage over 1381 person-years’ follow-up. The proportion with recurrent intracerebral haemorrhage during 5-year follow-up in the intermediate-risk and high-risk CT-only cerebral amyloid angiopathy criteria group was 48 (16%) of 307 patients compared with 21 (8%) of 255 patients in the low-risk group (adjusted sub-distribution hazard ratio [HR] 1·79, 95% CI 1·05–3·05, p=0·032). In the one-stage meta-analysis of the CT-only criteria (1620 patients with lobar intracerebral haemorrhage from eight cohorts, median age 73 years [IQR 62–80], 763 [47%] female and 857 [53%] male), 171 patients had a recurrent intracerebral haemorrhage over 3208 person-years’ follow-up. Cumulative 5-year incidence of recurrent intracerebral haemorrhage in the low-risk CT-only cerebral amyloid angiopathy criteria group was 45 (12%) of 727 patients compared with 54 (16%) of 513 patients in the","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria","authors":"Xavier Montalban, Christine Lebrun-Frénay, Jiwon Oh, Georgina Arrambide, Marcello Moccia, Maria Pia Amato, Lilyana Amezcua, Brenda Banwell, Amit Bar-Or, Frederik Barkhof, Helmut Butzkueven, Olga Ciccarelli, Jeremy Chataway, Jeffrey A Cohen, Giancarlo Comi, Jorge Correale, Florian Deisenhammer, Massimo Filippi, Julie Fiol, Mark S Freedman, Alan J Thompson","doi":"10.1016/s1474-4422(25)00270-4","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00270-4","url":null,"abstract":"Advances in the understanding of multiple sclerosis and the development of biomarkers of pathophysiology prompted a substantial revision of the 2017 McDonald diagnostic criteria. The new 2024 McDonald criteria provide a unified approach for diagnosing multiple sclerosis in individuals with relapsing or progressive courses throughout the lifespan (ie, from paediatric to late-life presentations). The optic nerve can now serve as a fifth anatomical location within the CNS for diagnosis. The central vein sign, paramagnetic rim lesions, and kappa free-light chain concentrations in CSF can be used, when available, to provide supportive evidence and confer specificity for a diagnosis of multiple sclerosis in specific situations. In certain cases, radiologically isolated syndrome or neurological symptoms that do not constitute a clear attack or progression of disability can fulfil the criteria for a multiple sclerosis diagnosis. We also provide guidance for the diagnosis of multiple sclerosis in older individuals (≥50 years) and those with comorbidities. The 2024 revised criteria should expedite the diagnosis of multiple sclerosis, while maintaining specificity.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NINDS at the forefront of epilepsy research for 75 years","authors":"","doi":"10.1016/s1474-4422(25)00324-2","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00324-2","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}