The Lancet Neurology最新文献

{"title":"Jeroen Habets","authors":"","doi":"10.1016/s1474-4422(25)00326-6","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00326-6","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":"145077365","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":"Candesartan versus placebo for migraine prevention in patients with episodic migraine: a randomised, triple-blind, placebo-controlled, phase 2 trial","authors":"Lise Rystad Øie, Tore Wergeland, Øyvind Salvesen, G⊘ril Bruvik Gravdahl, Irina Aschehoug, Sasha Gulati, Marte-Helene Bj⊘rk, Christofer Lundqvist, Karl Bj⊘rnar Alstadhaug, Bendik Slagsvold Winsvold, Anne Hege Aamodt, Iben Cornelia Larsen, Magne Geir B⊘e, Mark Braschinsky, Bernd Müller, Kjersti Gr⊘tta Vetvik, Kai Ivar Müller, Kjersti Aaseth, Andrej Netland Khanevski, Ane Bakke Øvrevik, Erling Tronvik","doi":"10.1016/s1474-4422(25)00269-8","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00269-8","url":null,"abstract":"<h3>Background</h3>Effective and well-tolerated preventive treatments for migraine remain few, and the angiotensin receptor blocker candesartan has shown promise in small studies. This study aimed to evaluate the safety, tolerability, and efficacy of candesartan for the preventive treatment of episodic migraine.<h3>Methods</h3>This randomised, triple-blind, placebo-controlled, parallel-group, phase 2 trial was done at nine hospitals across Norway and one large hospital in Estonia, selected for their neurological services and research capacity. Adults aged 18–64 years, experiencing between two and eight migraine attacks (with or without aura) per month were randomly assigned (1:1:1) to receive oral candesartan 16 mg, candesartan 8 mg, or placebo daily for 12 weeks. Acute migraine medication was permitted during the trial but the use of other preventive treatments were prohibited. Participants, site personnel, and the trial statistician were all masked to treatment allocation. The primary endpoint was the change in the mean number of migraine days per 4 weeks from baseline to weeks 9–12, analysed in the intention-to-treat population (participants with at least one post-baseline measurement during the masked treatment period). Safety analyses included all participants who received at least one dose of the trial drug. This trial is registered with ClinicalTrials.gov (NCT04574713; Oct 5, 2020) and is completed.<h3>Findings</h3>Between April 9, 2021, and April 12, 2024, 1340 individuals were assessed for eligibility, 806 were deemed ineligible, and 534 were enrolled in the trial. Of these, 77 were excluded, and 457 participants were randomly assigned to candesartan 16 mg (n=156), candesartan 8 mg (n=150), or placebo (n=151). The mean age of the trial population was 38·7 years (SD 10·0); 391 (86%) participants were female and 66 (14%) were male. The mean number of migraine days was 5·7 (SD 2·5) at baseline. By weeks 9–12, the reduction in migraine days was 2·04 days (95% CI 1·65–2·41 p<0·0001) in the candesartan 16 mg group compared with 0·82 days (0·38–1·23; p=0·0003) in the placebo group ((difference between groups –1·22 [95% CI –1·75 to –0·70]; p<0·0001). The most common adverse event with candesartan 16 mg was dizziness, reported in 46 (30%) of 156 participants, compared with 19 (13%) of 151 in the placebo group. Serious adverse events were reported in four (3%) participants in the candesartan 16 mg group and one (1%) participant in the placebo group. Adverse events leading to discontinuation occurred in four (3%) participants in both the candesartan 16 mg and placebo groups.<h3>Interpretation</h3>Daily administration of candesartan 16 mg is effective and well tolerated as a preventive treatment for episodic migraine. These findings support its role as a clinically meaningful and evidence-based option for migraine prevention. However, further clinical trials and real-world data from registry studies are necessary to assess its long-term effica","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":"145077367","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 EEG and respiratory biomarkers of sudden unexpected death in epilepsy (SUDEP): a case–control study","authors":"Oman Magana-Tellez, Rama Maganti, Norma J Hupp, Xi Luo, Sandhya Rani, Johnson P Hampson, Manuela Ochoa-Urrea, Sudha S Tallavajhula, Rup K Sainju, Daniel Friedman, Maromi Nei, Brian K Gehlbach, Stephan Schuele, Ronald M Harper, Beate Diehl, Lisa M Bateman, Orrin Devinsky, George B Richerson, Samden D Lhatoo, Nuria Lacuey","doi":"10.1016/s1474-4422(25)00273-x","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00273-x","url":null,"abstract":"<h3>Background</h3>Sudden unexpected death in epilepsy (SUDEP) is the most common category of epilepsy-related mortality. Centrally mediated respiratory dysfunction has been observed to lead to death in the majority of cases of SUDEP. SUDEP also mainly occurs during nighttime sleep. This study seeks to identify sleep EEG and sleep-related respiratory biomarkers of SUDEP risk.<h3>Methods</h3>In this case–control study, we compared demographic, clinical, EEG, and respiratory data from people with epilepsy who later died of SUDEP (the SUDEP group) with data from age and sex-matched living people with epilepsy, classified as high risk of SUDEP (with ≥1 generalised tonic-clonic seizure [GTCS] per year), low risk of SUDEP (no history of GTCS), and non-epilepsy controls. These data were prospectively collected as part of a multicentre National Institutes of Health study. We analysed sleep macroarchitecture and microarchitecture features and measured sleep homoeostasis by calculating overnight change in slow wave activity (SWA; 0·5–4·0 Hz) in non-rapid eye movement (NREM) sleep during seizure-free nights using linear regression models. We also analysed sleep respiratory metrics, including inter-breath interval variability. We used receiver operating characteristic analysis to assess the individual discriminative performance of demographic, clinical, sleep EEG, and sleep-related respiratory features to predict the risk of SUDEP.<h3>Findings</h3>Between Sept 1, 2011, and Oct 15, 2022, 41 participants who later died of SUDEP and 123 matched controls (41 people living with epilepsy at hight risk of SUDEP, 41 people living with epilepsy at low-risk of SUDEP, and 41 non-epilepsy controls) were enrolled. The SUDEP group showed an abnormal lack of overnight decline and an increase in the slope of SWA power compared with the other groups (SUDEP group mean 0·005 standardised error of the mean [SEM] 0·003; high-SUDEP risk group –0·005, 0·002; low-SUDEP risk group –0·003, 0·002; non-epilepsy controls –0·007, 0·003; p=0·017). The overnight increase in the SWA slope was more pronounced in males compared with females (males mean 0·012, SEM 0·001; females 0·001, 0·002; p=0·005). The variability of the inter-breath interval was significantly higher in the SUDEP (coefficient of variation mean 0·15, SD 0·09; SD mean 0·54 s SD 0·35 s) and high-SUDEP risk groups (0·11, 0·03; 0·46 s, 0·19 s) compared with low-SUDEP risk group (0·08, 0·03; 0·30 s, 0·14 s) and non-epilepsy controls (0·08, 0·02; 0·31 s, 0·11 s; p<0·0001). The coefficient of variation of inter-breath interval had the greatest predictive power of SUDEP risk (between-group point estimate difference 0·30, AUC 0·80; 95% CI 0·70-0·90; p<0·0001).<h3>Interpretation</h3>This study identifies impaired sleep homoeostasis in the form of altered SWA progression during NREM sleep overnight in people with epilepsy who later died of SUDEP, and an increase in respiratory variability during NREM sleep in people with epileps","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077370","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 temporal order of genetic, environmental, and pathological risk factors in Parkinson's disease: paving the way to prevention","authors":"Cornelis Blauwendraat, Huw R Morris, Kendall Van Keuren-Jensen, Alastair J Noyce, Andrew B Singleton","doi":"10.1016/s1474-4422(25)00271-6","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00271-6","url":null,"abstract":"Genetics research in Parkinson's disease has identified over 100 risk loci, yet translating these findings into understanding of disease mechanisms, clinical and pathological heterogeneity, and disease progression remains a challenge. This task requires exploring how genetic risk factors operate over time, interact with environmental factors, and contribute to the diverse ways in which disease manifests. The development of α-synuclein seeding amplification assays (SAAs) offers the opportunity to understand Parkinson's disease pathogenesis and heterogeneity, and drive the development of new disease-modifying and prevention interventions. Emerging biomarker tools, such as α-synuclein SAAs, hold great promise in uncovering the pathological underpinnings of Parkinson's disease and related disorders. Integrating α-synuclein SAAs with genetic data will redefine Parkinson's disease biology and, importantly, identify the temporal sequence of genetic risk, whether that be as a driver of an initiating pathological event or as a response to an initiating stochastic, environmental, or other genetic event. Furthermore, studying genetic and environmental influences in individuals who are asymptomatic but have detectable α-synuclein pathology will provide actionable insights for disease prevention and therapeutic interventions.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043023","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":"Promises, hopes, and dreams in Parkinson's disease research","authors":"Tiago F Outeiro","doi":"10.1016/s1474-4422(25)00311-4","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00311-4","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043106","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":"Blood phosphorylated tau for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis","authors":"Joseph Therriault, Wagner S Brum, Lydia Trudel, Arthur C Macedo, Fernando Valentim Bitencourt, Carolina Castro Martins-Pfeifer, Martin Nakouzi, Ilaria Pola, Matthew Wong, Przemysław R Kac, Ana Paula Real, Chloë Witherow, Thomas K Karikari, Alexis Moscoso, Eduardo R Zimmer, Michael Schöll, Tharick Pascoal, Andrea L Benedet, Nicholas J Ashton, Suzanne E Schindler, Pedro Rosa-Neto","doi":"10.1016/s1474-4422(25)00227-3","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00227-3","url":null,"abstract":"<h3>Background</h3>Plasma phosphorylated tau (p-tau) biomarkers show promise to transform the clinical management of Alzheimer's disease by providing more accessible and cost-effective diagnostic tools. p-tau biomarkers have emerged as leading contenders for clinical implementation; however, there have been no comprehensive meta-analyses of their diagnostic performance. We aimed to evaluate the diagnostic performance of plasma p-tau biomarkers and individual p-tau assays to identify biologically defined Alzheimer's disease.<h3>Methods</h3>For this systematic review and meta-analysis, we searched Embase, MEDLINE, PubMed, Scopus, and Web of Science for articles published from July 1, 1984 up to Dec 9, 2024, that reported on the discriminative accuracy of plasma p-tau biomarkers for amyloid-PET, tau-PET, CSF, and neuropathological reference standards. We included cohort, case-control, cross-sectional, and randomised controlled studies that recruited adults from any setting. Articles were excluded if they did not contain data on a p-tau blood biomarker, did not contain an appropriate biological reference standard, did not report diagnostic accuracy data, included participants younger than 18 years, or reported duplicate or overlapping data from another publication. Summary data were independently extracted by eight authors. Risk of bias was assessed using QUADAS-2. The primary outcome was the diagnostic performance of plasma p-tau biomarkers for Alzheimer's disease. We used a bivariate random-effects meta-analysis to estimate pooled sensitivity, specificity, diagnostics odds ratio and area under the receiver operating characteristic curve. We assessed the certainty of evidence using GRADE. This study was done following PRISMA-DTA guidelines and is registered with PROSPERO as CRD42023422143.<h3>Findings</h3>Of the 6429 studies identified by our search, 312 studies were assessed for eligibility, with 113 studies included in the final analysis, comprising 29 625 unique individuals. Plasma p-tau217 was the highest-performing biomarker for identifying biologically defined Alzheimer's disease, with pooled sensitivity of 88·1% (95% CI 86·7–89·5, moderate certainty of evidence), specificity of 88·7% (87·4–89·9, moderate certainty of evidence), area under the receiver operating characteristic curve (AUROC) of 91·1% (88·9–92·4, moderate certainty of evidence), and diagnostic odds ratio of 50·7 (40·6–63·4). p-tau181 pooled sensitivity was 80·5% (78·4–82·4, low certainty of evidence), specificity was 76·4% (74·1–78·6, low certainty of evidence), AUROC was 81·5% (80·2–82·9, low certainty of evidence), and diagnostic odds ratio was 13·4 (11·4–16·7). p-tau205 pooled sensitivity was 76·6% (70·7–81·6, moderate certainty of evidence), specificity was 86·0% (78·6–91·2, moderate certainty of evidence), AUROC was 85·1% (80·7–89·6, moderate certainty of evidence), and diagnostic odds ratio was 20·2 (10·5–38·7). p-tau212 pooled sensitivity was 84·5% (75·5–90·6, moderate ce","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840053","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":"Overcoming the deployment gap in ethical AI for neurology","authors":"Adrián Noriega de la Colina","doi":"10.1016/s1474-4422(25)00267-4","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00267-4","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840154","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":"Hans Berger and the EEG","authors":"Emmanuel Drouin, Antoine Dampierre, Laurent Tatu","doi":"10.1016/s1474-4422(25)00280-7","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00280-7","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840049","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 Bern Declaration on Brain Health: a decalogue to launch an international alliance","authors":"Claudio L A Bassetti, Indrit Bègue, Christopher Chen, Facundo Manes, Matilde Leonardi, Alfred K Njamnshi","doi":"10.1016/s1474-4422(25)00286-8","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00286-8","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840047","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":"Neurorehabilitation as a forerunner in the paradigm shift towards systems medicine","authors":"Alessandra Del Felice, Antonio Luigi Bisogno, Margherita Bertuccelli, Nick S Ward, Maurizio Corbetta","doi":"10.1016/s1474-4422(25)00281-9","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00281-9","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840050","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}