New biologics are rapidly opening up target-specific therapeutic opportunities for myasthenia gravis (MG) — an autoimmune disease caused by antibodies against neuromuscular junction proteins. Two recent trials have now demonstrated the efficacy and tolerability of the complement C5 inhibitor zilucoplan and the FcRn inhibitor rozanolixizumab in patients with generalized MG.

A new study using the UK Biobank database has shown that people with epilepsy are at an increased risk of developing dementia. The results demonstrate that this risk is multiplied in individuals who also have high cardiovascular risk, highlighting the importance of addressing modifiable cardiovascular risk factors.

In this Perspective, Owolabi et al. propose strategies to improve brain health and address the growing global burden of neurological disorders. They present a new framework — the neurological quadrangle — which aims to provide equitable and effective surveillance, prevention, acute care and rehabilitation of neurological disorders globally.

Neurological diseases associated with specific pathogenic gene variants can show considerable phenotypic variation. This Review explores the mechanisms that underlie this phenomenon, including environmental, genetic and epigenetic factors that influence the expressivity and penetrance of pathogenic variants.