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Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease classically thought to impact the motor system, but research is now investigating the contribution of non-motor symptoms. Here, the authors explore evidence that highlights the extent to which nutrition and metabolism might contribute to ALS pathogenesis, and discuss the effectiveness of modifying energy balance in ALS.
The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and European Academy of Neurology (EAN) joint consensus statement on vaccination in people with multiple sclerosis provides highly relevant clinical guidance on immunization strategies in today’s era of effective immunotherapies. Nevertheless, several open questions remain to be addressed.
Ditans are a recently developed drug class for the treatment of acute migraine. In this Review, the authors provide an overview of ditan development, from the initial rationale to the clinical studies that led to the recent FDA approval of the first ditan.
Smouldering inflammation encompasses all non-relapsing aspects of inflammatory pathobiology in multiple sclerosis. Here, Bittner and colleagues describe the mechanisms that underlie CNS-compartmentalized smouldering inflammation and review evidence indicating that immunometabolic reprogramming driven by the CNS tissue microenvironment shapes these inflammatory responses. Potential treatments are also discussed.
Artificial intelligence-based tools have the potential to transform health care, enabling faster and more accurate diagnosis, personalized treatment plans, new therapeutic approaches and effective disease monitoring. Artificial intelligence shows particular promise for the management of rare neurological disorders by augmenting knowledge and facilitating the sharing of expertise among physicians.
Data-driven approaches hold considerable promise for medical breakthroughs in the precision and cost-effectiveness of the prevention, diagnosis and treatment of neurodegenerative diseases. The scientists and health care professionals who will be responsible for providing the evidence to support these approaches must also consider the ethical challenges involved in the care of people with intellectual impairments.
Growing evidence indicates a central role for meningeal inflammation in driving multiple sclerosis (MS) pathology. In this Review, the authors summarize current knowledge regarding structural, cellular and molecular changes to the meninges in MS and discuss the clinical and therapeutic implications.
Artificial intelligence has emerged as a powerful tool for predicting protein structure. This technology is now being applied to improve our understanding of protein aggregation in neurodegenerative and other neurological disorders, and could potentially improve disease management by enabling precision medicine.
Deep brain stimulation (DBS) is a well-established approach for treating movement disorders such as Parkinson disease, dystonia and essential tremor. However, the outcomes are variable, and researchers are now exploring artificial intelligence-based strategies to help improve DBS procedures.
The overarching theme of the ninth Congress of the European Academy of Neurology (1–4 July 2023) is ‘neurology beyond big data’. The Congress provides an opportunity for neurologists, neuroscientists and other experts to discuss how the power of neurological data might be harnessed to advance discovery and improve patient outcomes and brain health.
Digital technologies for data collection and remote monitoring can offer several indubitable advantages in neurological disorders. However, an equitable future for the use of digital technology in neurology will be possible only with global, collaborative and multidisciplinary planning that should be promptly prepared and implemented.
Current approaches to classifying cognitive impairment in people living with HIV can overestimate disease burden and lead to ambiguity around disease mechanisms. In this Consensus Statement, the International HIV-Cognition Working Group have outlined six recommendations towards a new approach, intended to better represent changes in the spectrum of HIV disease in the modern era of antiretroviral therapy.
