Reviews & Analysis

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.

Low-income and middle-income countries and other under-represented populations remain largely excluded from Parkinson disease research despite the growing disease burden. Here the authors detail diversity gaps across Parkinson disease research and outline priority actions to address them.

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.

Translation of evidence about dementia risk into effective public health policy is a challenge. In this Consensus Statement, Demnitz-King and colleagues present 56 policy recommendations for dementia prevention, providing policymakers with a foundation for designing and implementing evidence-based dementia prevention strategies, prioritizing clear communication, targeted intervention and sustained research investment.

Freezing of gait (FOG) is among the most debilitating symptoms of Parkinson disease. This Consensus Statement from the International Consortium for Freezing of Gait presents new guidelines for the definition and assessment of FOG, with the aim of harmonizing the study and management of the condition.

Emerging genomic studies across Africa are revealing how decades of population bias have constrained understanding of disease mechanisms. New evidence in Parkinson disease genetics illustrates how overlooking Africa’s vast genetic diversity not only limits scientific insight but also slows the development of medical and biotechnological innovations that are vital for advancing global health.

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.

Multiple sclerosis is among the most common causes of disability in the young and its prevention is a feasible, albeit ambitious, goal. In this Perspective, Dobson et al. discuss the challenges in developing and testing preventive interventions in MS and propose strategies and solutions.

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.

Advances in biomarkers, blood tests and disease-modifying therapies have created a credible path to clinical prevention of Alzheimer disease (AD). In this Perspective, the authors discuss promising approaches to the prevention of AD and highlight strategic gaps.

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.

This Perspective centres on alterations in the fatty acid-ome as the critical feature of lipid aberration in α-synucleinopathies, specifically Parkinson disease. Here, the authors explain the biological and genetic basis for their hypothesis, with an emphasis on the transient binding of α-synuclein to fatty acids of various lipids.

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.