Nature Reviews Neurology is interviewing individuals who are driving efforts to address disparities in neurology through a broad spectrum of diversity, equity and inclusion initiatives. We spoke with neuroimmunologist William L. Conte from the USA about his work to promote inclusive care for LGBTQ+ people with multiple sclerosis.

The FDA recently approved efgartigimod for the treatment of chronic inflammatory demyelinating polyradiculopathy, providing an alternative to the immunoglobulin therapy that has been the standard treatment for years. The approval has the potential to improve access to treatment and outcomes, but many challenges remain in implementing trial findings into clinical practice.

Risk of clinical milestones in Parkinson disease (PD) is associated with reduced glymphatic drainage, according to new research. The study of 175 people with PD showed that lower glymphatic function, measured by diffusion tensor imaging analysis of the perivascular space, was associated with increased risk of recurrent falls, wheelchair dependence and dementia. The study adds to growing evidence for

A recent analysis of dementia risk scores across diverse populations found that the validity of scores can differ between ethnic groups. The widely investigated Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score, which estimates 20-year dementia risk at midlife on the basis of age, sex, education, systolic blood pressure, body mass index, cholesterol level and physical

A new study of a Taiwanese cohort found a high prevalence of resolved hepatitis B virus (HBV) infection in people with neuromyelitis optica spectrum disorder (NMOSD). Resolved HBV was found in 63.4% of people with NMOSD, compared with 16.4% in healthy controls, equating to a 5.7-fold increased risk of NMOSD following HBV infection. Furthermore, resolved HBV was associated with later onset of NMOSD

Sex differences in Alzheimer disease could be influenced by differences in immune responses, new research suggests.

Transplantation of genetically modified oligodendrocyte progenitor cells (OPCs) into a mouse model of MS improves remyelination, new research has demonstrated. The researchers used CRISPR in human embryonic stem cell-derived OPCs to delete neuropilin 1, a receptor for SEMA3A that is highly expressed in demyelinated lesions in people with MS and is chemorepulsive to OPCs. Transplantation of the modified

A recent report has identified a population of brain-enriched myelin-associated protein 1 (BCAS1)-expressing oligodendrocytes in the cerebral cortex that seem to contribute to remyelination in multiple sclerosis (MS). Analysis of cortical tissue from patients in the early stages of MS and mouse models of demyelination revealed that BCAS1+ oligodendrocytes were abundant and adopted an activated, myelinating

A paper recently published in Brain indicates that muscle cholesterol transport is dysregulated in amyotrophic lateral sclerosis (ALS). In skeletal muscle tissue biopsies from patients with ALS, the researchers found evidence of lysosomal cholesterol accumulation, which increased with disease severity and was associated with overexpression of the lysosomal cholesterol transporter genes NPC1 and NPC2

A study in a mouse model of spinal cord injury helps to elucidate the neuroprotective mechanisms of autoimmune T cells during the early stages of injury, which could be harnessed through T cell therapy to improve long-term outcomes.

Two new studies have produced evidence of a prodromal phase that precedes the clinical onset of neuromyelitis optica spectrum disorder (NMOSD). In the first study, Rotstein et al. reported an increase in health-care use by patients in the 5 years leading up to a clinical diagnosis of NMOSD, and in the second study, Lee et al. found that one in seven people with NMOSD presented with neurological symptoms

The presence of Lewy body (LB) pathology in addition to Alzheimer disease (AD) pathology is associated with acceleration of AD-related disease progression, according to new research. In a study involving 795 participants with mild cognitive impairment or dementia, individuals with AD+LB+ biomarker profiles in their cerebrospinal fluid showed more rapid cognitive decline and greater cortical hypometabolism

Treatment options for migraine have expanded rapidly over the past few years. The latest success in a phase II trial of a new class of drugs for migraine holds the promise of another alternative, with important implications for our understanding of migraine and its clinical management.

Although lecanemab has been licensed for use in the UK, the systems to deliver this or similar disease-modifying therapies do not exist. These systems need to be developed urgently, but not at the expense of post-diagnostic care.

New research adds to growing evidence of altered tau phosphorylation in multiple sclerosis.

Metabolic rewiring of a population of tumour-associated macrophages facilitates progression of glioblastoma, new research has revealed. A multi-omics approach demonstrated that the macrophages develop a lipid-laden phenotype, in which they accumulate cholesterol after uptake of myelin debris. Transfer of this accumulated cholesterol to glioblastoma cells helps to meet the high metabolic requirements

After a stroke, circulating, cell-free DNA causes inflammasome activation in atherosclerotic plaques that can lead to recurrent stroke, work in a mouse model has shown. In a model of stroke-induced recurrent ischaemia, increased inflammation in plaques in the common carotid artery resulted from activation of the AIM2 inflammasome by cell-free DNA that primarily originated from neutrophil extracellular

Adaptive deep brain stimulation (DBS) improves motor symptoms and quality of life in people with Parkinson disease compared with continuous DBS, the results of a pilot trial suggest. The study included four people with Parkinson disease, each of whom received continuous and adaptive DBS at different times to enable comparison of the effects. Adaptive stimulation was personalized according to motor

A pro-inflammatory serum profile has been associated with frontotemporal lobar degeneration (FLTD) in new research, increasing the likelihood that blood-based biomarkers can be used for assessment of neuroinflammation in people with dementia. The researchers analysed cytokines in the serum of 214 people with syndromes associated with FTLD and 29 healthy individuals. Their analysis identified a profile

Progressive multiple sclerosis poses a considerable challenge in the evaluation of disease progression and treatment response owing to its multifaceted pathophysiology. Traditional clinical measures such as the Expanded Disability Status Scale are limited in capturing the full scope of disease and treatment effects. Advanced imaging techniques, including MRI and PET scans, have emerged as valuable

Correction to: Nature Reviews Neurology https://doi.org/10.1038/s41582-024-00944-0, published 18 March 2024.

Antisense oligonucleotide treatment has therapeutic potential in a severe form of Charcot–Marie–Tooth disease, according to a new study.

A single-cell transcriptomic atlas of six anatomical regions in the aged human brain with and without Alzheimer disease (AD) provides clues to cellular vulnerability to disease, a study in Nature reports. Various region-specific subtypes of excitatory and inhibitory neurons were reduced in brains from people with AD and shared elevated expression of genes in the reelin signalling pathway. In addition

A new study suggests that glial cells in both Huntington disease (HD) and schizophrenia share abnormal gene transcription patterns. RNA sequencing of glial progenitor cells derived from human pluripotent stem cells revealed preserved gene sets between the diseases that were distinct from healthy control donors. A large proportion of genes that were supressed in both diseases are involved in synaptic

Seropositivity towards rubella virus (RV) increases the risk of developing multiple sclerosis (MS), according to new research. The case–control, Swedish biobank study analysed seropositivity towards RV in vaccinated and unvaccinated individuals before the clinical onset of MS. The results showed that people with MS had higher seroreactivity to RV than people without MS. Moreover, RV seropositivity

New research demonstrates that speech dysfunction detected via smartphone voice calls can be used to identify people with isolated rapid eye movement sleep behaviour disorder (iRBD). Using a smartphone app to collect voice recordings, a sample duration of 8 min was sufficient to differentiate between people with iRBD and healthy volunteers; a significant difference between the groups was found in monopitch

The importance of diet for brain health is increasingly recognized by neurologists, but many neurological disorders impair the ability of individuals to eat healthily. A new initiative known as ‘Food Is Medicine’ has the potential to facilitate healthier eating among people with neurological disorders to improve and maintain brain health.

Epstein–Barr virus (EBV) infection in adulthood is a well-established risk factor for multiple sclerosis (MS), and new research indicates that human herpesvirus 6A (HHV-6A) further increases the risk of developing the disease. Grut et al. tested serum samples from 670 presymptomatic individuals who subsequently developed MS and 670 matched control individuals. In participants over 24.9 years of age

A new study shows that transplantation of bone marrow from young mice can reduce amyloid pathology and ameliorate cognitive deficits in a mouse model of Alzheimer disease (AD). Aged (9-month-old) APP/PS1 mice received bone marrow from 2-month-old or 9-month-old APP/PS1 mice. The young bone marrow transplants led to reductions in cerebral amyloid plaque burden (attributed to increased amyloid-β clearance

People with diabetes mellitus (DM) have an increased probability of progressing to Alzheimer disease (AD) in the first year after a diagnosis of mild cognitive impairment (MCI), a study based on data from the AD Neuroimaging Initiative has shown. Propensity score matching was performed in 306 people with MCI, 102 of whom also had DM. By the end of the 12-month follow-up period, 8.82% of the DM group

Concentrations of TDP-43 and tau in extracellular vesicles extracted from blood show potential as biomarkers for frontotemporal dementia, amyotrophic lateral sclerosis and progressive supranuclear palsy.

A variant of the RAB32 gene is a risk factor for developing Parkinson disease (PD), according to a report published in Nature Genetics. Exome-wide analyses of 2,184 individuals with familial PD and 69,775 control individuals revealed that the p.S71R variant of RAB32 was present in around 0.7% of the PD group, compared with 0.004% of control individuals, and it segregated with PD in three families.

Immunological profiling has revealed biological signatures of multiple sclerosis (MS) that could help with early, accurate diagnosis of the disease and with identifying disease subtypes that could inform treatment decisions. The findings are important steps along the path towards precision medicine for people with MS.

Spinal cord stimulation is an invasive therapy for chronic neuropathic pain, usually used as a last-resort treatment when all other treatments have been tried and failed. The clinical value of the therapy has been much debated in recent years; here, we summarize the therapy and discuss the core controversies. Spinal cord stimulation is seen as a last-resort therapy for the treatment of chronic pain

Similar to any innovation that disrupts the status quo, the advent of magnetic resonance-guided focused ultrasound in neurology was accompanied by controversy and debate. However, evidence suggests that this therapeutic tool, which is already widely used to treat tremor and Parkinson disease, is gaining acceptance and will become a viable therapeutic option for various other neurological conditions

Advanced sensory feedback from upper limb prostheses would provide multiple benefits to people with upper limb amputations, but achieving functional and natural-feeling sensation is technologically challenging. Advances are being made with invasive and non-invasive stimulation approaches, but considerable challenges need to be addressed with technological innovation.

Neuromodulation represents a promising approach for promoting neural plasticity following a brain injury, especially for non-communicative patients with prolonged disorders of consciousness. However, so far, the outcomes have been limited and inconsistent, driving researchers to explore alternative strategies to improve the efficacy of brain stimulation techniques.