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Low-resource settings lag behind the rest of the world in achieving good health, in part owing to poor translation of clinical evidence into practice. Focusing on neurological disorders — in particular, stroke — this Comment identifies barriers to translation at the individual, provider and health systems levels and proposes theory-driven mitigating solutions.
Effective translation of evidence from clinical trials into clinical practice requires the enrolment of diverse, representative trial populations. However, this diversity is still often lacking, with negative clinical implications for under-served groups. Changes are needed to research practices and the broader research landscape to correct this problem.
The past 5–10 years have seen rapid advances in digital sensors and imaging-based technologies for the diagnosis of neurological conditions. However, the majority of these technologies are in the early stages of development — now is the time to consider how we validate these tools and safely integrate them into clinical practice.
A growing number of clinical practice guidelines are being developed for neurological diseases, and they have the potential to benefit patients, clinicians, policymakers and payers. However, the effectiveness of these guidelines has not been evaluated, so we do not yet know whether they improve patient outcomes in a real-world setting.
The prominence of gastrointestinal dysfunction among the non-motor features of Parkinson disease (PD) indicates a close bidirectional link between the brain and the gut. This Review discusses the proposed roles of gut-related factors in PD development, progression and treatment responses, and as therapeutic targets.
Neurological diseases cause a massive burden, which will increase as populations age. Rapid advances in our understanding of disease mechanisms must be translated into human benefits. We cannot stop once technologies have been developed, but must ensure that evidence and pipelines are in place for their implementation to reduce burden and inequalities.
The fifth edition of the WHO classification of CNS tumours was published in 2021. Here, Horbinski and colleagues summarize the main changes in this new edition and discuss how each change will affect post-surgical treatment, clinical trial enrolment and cooperative studies.
A new study has shown that a modulator of metabotropic glutamate receptor 5 can reverse synapse loss in mouse models of Alzheimer disease and has the potential to be developed as a disease-modifying treatment for this condition.
In this Review, Oh and Bar-Or provide an overview of selected emerging therapies for multiple sclerosis with the potential to limit non-relapsing, progressive disease injury and to promote tissue repair, thereby addressing crucial unmet therapeutic needs.
In this Perspective, the authors present their vision for a closed-loop system for automatic symptom monitoring and levodopa administration in individuals with Parkinson disease. The system would capitalize on the ongoing advances in wearable sensor technology, drug delivery systems and machine learning.
A new genome-wide association study has identified 41 previously unknown loci associated with Alzheimer disease. However, these data provide limited insight into disease mechanisms or benefits for clinical prediction of Alzheimer disease.
New research shows that meningeal lymphatic vessels can drain viruses from the CNS, with important implications for our understanding of CNS infections.
A new study provides evidence that inflammation protects against the development of chronic pain in people with acute back pain, and that anti-inflammatory drugs used to treat acute pain could do more harm than good in the long term.
