Review Articles

Clinical diagnostic criteria for Parkinson disease (PD) have limitations, but no validated biomarker-based diagnostic framework currently exists. In this Review, Tolosa et al. examine progress towards biomarker-based diagnosis of PD, focusing on α-synuclein seed amplification assays alongside molecular, imaging and genetic markers.

This Review explores how individual-level and neighbourhood-level social factors, including income, education, health-care access and neighbourhood deprivation, contribute to disparities in cognitive and neurobehavioural outcomes in people with epilepsy. The authors propose a new framework that integrates biological and social factors to better explain the heterogeneity of these outcomes.

We are witnessing a worldwide resurgence in vaccine-preventable neurological diseases owing to gaps in vaccination coverage caused by multiple factors, including vaccine hesitancy and geopolitical conflicts. This Review highlights ongoing challenges to controlling vaccine-preventable neurological diseases such as measles, poliomyelitis, Japanese encephalitis and meningitis and considers how collaborative global strategies can facilitate effective immunization policies.

Emerging evidence suggests that a better understanding of the heterogeneity in symptoms and survival among people with glioma requires a network-based approach. This Review describes three major types of network scaffolds relevant in glioma — symptom networks, the connectome and tumour biology networks — and explores the interactions between each scaffold.

Cognitive impairment is one of a range of non-motor symptoms that people with Parkinson disease (PD) can experience in addition to the hallmark motor symptoms of the disease. In this Review, Oikonomou et al. outline the epidemiology and natural history of cognitive decline in PD and related disorders, and discuss the key underlying pathophysiological factors and mechanisms.

Growing evidence indicates important roles for microglial phagocytosis in Alzheimer disease. This Review summarizes the latest insights into the mechanisms by which microglial phagocytosis can affect Alzheimer disease pathology and how this process might be harnessed for therapeutic interventions.

Restless legs syndrome and periodic limb movements are increasingly recognized as risk factors for stroke and other cerebrovascular and cardiovascular diseases and vice versa. This Review explores the shared pathophysiological mechanisms that could underly this bidirectional relationship.

This article reviews the epidemiology and clinical characteristics of multiple sclerosis (MS) in Latin America and how they might be influenced by genetic, environmental and socioeconomic factors that are unique to this region. The authors also describe diagnostic criteria, differential diagnosis and current approaches to MS treatment and management in Latin American countries.

Genome-wide association studies have identified genetic modifiers, mostly DNA repair genes, that significantly influence the onset and progression of Huntington disease, pointing to somatic CAG repeat expansions as a key pathological driver. Here, Tabrizi and colleagues review the evidence for this paradigm and discuss the potential for therapeutic interventions.

Fatigue is a burdensome symptom that is commonly encountered in people with neurological or non-neurological diseases, but it is poorly understood and lacks a common definition and conceptualization. This Review presents new a conceptual model of fatigue that is designed to improve communication between experts from different methodological and medical backgrounds.

Many autoimmune and genetic causes of sporadic late-onset cerebellar ataxia (SLOCA) can now be identified, but some individuals remain categorized as having idiopathic SLOCA. Wirth and colleagues discuss advanced genomic techniques that might identify additional ‘missing’ SLOCA causes, potential prognostic biomarkers and progress towards effective treatments.

Myotonic dystrophy type 1 (DM1) is the most prevalent muscular dystrophy in adulthood and among the most clinically diverse monogenic diseases. This Review summarizes the latest insights into the molecular underpinnings of DM1, highlighting the implications for therapy development.

Non-invasive brain stimulation (NIBS) shows considerable promise as a therapeutic strategy for neurological and psychiatric disorders. This Review explores the role of NIBS techniques, including repetitive transcranial magnetic stimulation and transcranial electrical stimulation, for treating cognitive impairments, speech and language difficulties, and motor control deficits in people with neurodegenerative or brain lesion disorders.

This Review considers the aetiology of health disparities in neurology at an individual, interpersonal, community and societal level, and suggests practical interventions to address the multifactorial issues.

Management of autoimmune neuropathies has remained unchanged for much of the past 30 years, but recent advances are changing the rate of progress. In this Review, the authors summarize the latest developments, including discoveries in disease mechanisms, new diagnostic guidelines, identification of new biomarkers and the status of promising clinical trials.

The neuronal ceroid lipofuscinoses, or Batten disease, are a group of fatal inherited neurodegenerative lysosomal storage disorders. Despite having defined genetic causes, the underlying disease mechanisms remain poorly understood and treatments are limited. Cooper and colleagues highlight recent advances in understanding the cell biology and disease pathogenesis, which could inform future therapeutic development.

Spreading depolarization is widely accepted as the cause of migraine aura, but its relationship with migraine headache is less clear. In this Review, Harriott and Ayata review the evidence that links spreading depolarization with the headache phase of migraine with aura, and consider the potential of therapeutic targeting of spreading depolarization in migraine.

Neurodegenerative diseases such as Alzheimer disease, Parkinson disease, frontotemporal lobar degeneration and multiple system atrophy are characterized pathologically by deposition of specific proteins in the brain. This article reviews the latest advances in the development of PET radiotracers for neurodegenerative proteinopathies and highlights the diagnostic and therapeutic applications of this technology.

Low-income and middle-income countries bear a high burden from dementia that is not reflected in research. This Review outlines the reasons for this disparity and explores the challenges and opportunities of dementia research in low-income and middle-income countries.

Here, Rafii and Aisen review recent progress surrounding the approvals of amyloid-targeting monoclonal antibodies, the first disease-modifying therapies for Alzheimer disease. The Review highlights key factors that affect the integration of these treatments into clinical practice and explores future directions.