Although lecanemab has been licensed for use in the UK, the systems to deliver this or similar disease-modifying therapies do not exist. These systems need to be developed urgently, but not at the expense of post-diagnostic care.

Stiff-person syndrome is an autoimmune neuronal hyperexcitability disorder that causes limb stiffness, painful spasms and falls, and increased awareness of the disease is creating diagnostic and management challenges. In this Review, Dalakas provides an overview of the current clinical and mechanistic understanding of stiff-person syndrome and related disorders and discusses current and emerging therapeutic interventions.

Myelin oligodendrocyte glycoprotein antibody-associated disease is an immune-mediated demyelinating disease that is distinct from multiple sclerosis but shares some of its characteristics. This Expert Recommendation, based on a Magnetic Resonance Imaging in MS workshop, proposes a diagnostic algorithm for the differential diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease and multiple sclerosis, using serological, imaging and clinical features.

In recent years, we have seen a shift towards defining sporadic neurodegenerative diseases as a biological continuum. Here, we discuss the risks associated with this shift, emphasize the importance of maintaining a strong connection between disease definitions and subsequent clinical outcomes, and suggest clinicobiological frameworks to disentangle multiple discrete nosological entities.

A study in a mouse model of spinal cord injury helps to elucidate the neuroprotective mechanisms of autoimmune T cells during the early stages of injury, which could be harnessed through T cell therapy to improve long-term outcomes.

Although lecanemab has been licensed for use in the UK, the systems to deliver this or similar disease-modifying therapies do not exist. These systems need to be developed urgently, but not at the expense of post-diagnostic care.