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As the COVID-19 pandemic developed and neurological manifestations were reported, concern grew that SARS-CoV-2 might directly invade neuronal cells. However, research throughout the year to address this concern has revealed a different story with inflammatory processes at its centre.
This year, the COVID-19 pandemic has altered neurological care in many ways. However, evidence indicates that people from marginalized ethnic and socioeconomic groups have been affected by these changes more than others, highlighting and amplifying existing health-care disparities.
The COVID-19 pandemic has posed unique risks to people with Alzheimer disease and dementia. Research from 2020 has shown that these people have a relatively high risk of contracting severe COVID-19, and are also at risk of neuropsychiatric disturbances as a result of lockdown measures and social isolation.
From the interruption of clinical trials by shelter-in-place orders to the challenges involved in safely collecting biofluid samples, drug development for neurological disease was hit hard by the COVID-19 pandemic this year. However, the field has responded with innovative solutions, and 2021 could see the therapeutic pipeline flowing again.
Many neurologists have used telemedicine during the COVID-19 pandemic. Studies have shown that videolinks in acute care can save personal protective equipment and protect staff. Furthermore, the telephone can provide supra-hospital care in Parkinson disease and manage patients with amyotrophic lateral sclerosis well. The primacy of face-to face care has been dented.
Deep brain stimulation (DBS) is a neurosurgical procedure that allows targeted circuit-based neuromodulation and has become a standard of care in a range of movement disorders. This Review discusses the evolution and current status of DBS technology and anticipates future advances.
In this Review, Wolf et al. provide an overview of the hypomyelinating leukodystrophies and discuss how identification of the genes involved in these disorders have provided insight into the clinical presentations of these disorders and into myelin biology.
The identification of pathogenic targets in amyotrophic lateral sclerosis means that effective therapies are increasingly likely. In this Review, Kiernan et al. discuss advances towards therapy and the innovations needed in clinical trials to facilitate the translation into treatments for patients.
New tools are being developed for the standardization and digitization of clinical data from patients with multiple sclerosis. In this Perspective, D’Souza and colleagues address the multifaceted impact of these tools on patient care and highlight the challenges and opportunities they create.
