Pub Date : 2025-06-18DOI: 10.1038/s41582-025-01105-7
Eleanor L. S. Conole, Josephine A. Robertson, Hannah M. Smith, Simon R. Cox, Riccardo E. Marioni
Ageing has profound effects on the human brain across the lifespan. Cognitive testing and brain imaging are currently used to monitor healthy and pathological brain ageing. However, peripheral markers of cognitive function, cognitive ageing and neurological disease could provide a valuable, minimally invasive approach to tracking these processes longitudinally. In this Review, we introduce the concept of DNA methylation-based biomarkers and present current evidence of their potential to address the challenge of monitoring brain ageing and stratifying the risk of neurological disease. We focus on epigenetic clocks, which can be applied across multiple tissues and organs to estimate biological ageing, as well as on blood-based epigenetic scores (EpiScores) that can directly track brain-based phenotypes, such as cognitive function, and risk factors for neurological diseases, such as lifestyle behaviours and proteomic markers of inflammation. We discuss the associations between these epigenetic biomarkers and multiple measures of cognitive health, including cognitive test data, brain MRI measures and dementia. This Review considers how DNA methylation-based biomarkers can be used to monitor brain ageing and stratify neurological disease risk. The authors focus on epigenetic clocks, which can be applied across multiple tissues to estimate biological ageing, and blood-based epigenetic scores, which can track brain-based phenotypes and risk factors for neurological disease.
{"title":"Epigenetic clocks and DNA methylation biomarkers of brain health and disease","authors":"Eleanor L. S. Conole, Josephine A. Robertson, Hannah M. Smith, Simon R. Cox, Riccardo E. Marioni","doi":"10.1038/s41582-025-01105-7","DOIUrl":"10.1038/s41582-025-01105-7","url":null,"abstract":"Ageing has profound effects on the human brain across the lifespan. Cognitive testing and brain imaging are currently used to monitor healthy and pathological brain ageing. However, peripheral markers of cognitive function, cognitive ageing and neurological disease could provide a valuable, minimally invasive approach to tracking these processes longitudinally. In this Review, we introduce the concept of DNA methylation-based biomarkers and present current evidence of their potential to address the challenge of monitoring brain ageing and stratifying the risk of neurological disease. We focus on epigenetic clocks, which can be applied across multiple tissues and organs to estimate biological ageing, as well as on blood-based epigenetic scores (EpiScores) that can directly track brain-based phenotypes, such as cognitive function, and risk factors for neurological diseases, such as lifestyle behaviours and proteomic markers of inflammation. We discuss the associations between these epigenetic biomarkers and multiple measures of cognitive health, including cognitive test data, brain MRI measures and dementia. This Review considers how DNA methylation-based biomarkers can be used to monitor brain ageing and stratify neurological disease risk. The authors focus on epigenetic clocks, which can be applied across multiple tissues to estimate biological ageing, and blood-based epigenetic scores, which can track brain-based phenotypes and risk factors for neurological disease.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 8","pages":"411-421"},"PeriodicalIF":33.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-18DOI: 10.1038/s41582-025-01113-7
Ian Fyfe
Absence of Lewy body pathology in the form of Parkinson disease caused by mutations in the LRRK2 gene does not equate to a lack of α-synuclein pathology, two new studies have shown.
{"title":"α-Synuclein pathology in LRRK2 Parkinson disease","authors":"Ian Fyfe","doi":"10.1038/s41582-025-01113-7","DOIUrl":"10.1038/s41582-025-01113-7","url":null,"abstract":"Absence of Lewy body pathology in the form of Parkinson disease caused by mutations in the LRRK2 gene does not equate to a lack of α-synuclein pathology, two new studies have shown.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"347-347"},"PeriodicalIF":33.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Benefits of oveporexton in narcolepsy type 1","authors":"Heather Wood","doi":"10.1038/s41582-025-01109-3","DOIUrl":"10.1038/s41582-025-01109-3","url":null,"abstract":"The oral orexin receptor 2-selective agonist oveporexton ameliorates the symptoms of narcolepsy type 1, according to a phase II trial.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"348-348"},"PeriodicalIF":33.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-09DOI: 10.1038/s41582-025-01110-w
Heather Wood
A new study suggests a role for apolipoprotein E in the pathogenesis of Alzheimer disease in people with Down syndrome.
一项新的研究表明载脂蛋白E在唐氏综合症患者阿尔茨海默病的发病机制中起作用。
{"title":"Alzheimer disease in Down syndrome linked to APOE","authors":"Heather Wood","doi":"10.1038/s41582-025-01110-w","DOIUrl":"10.1038/s41582-025-01110-w","url":null,"abstract":"A new study suggests a role for apolipoprotein E in the pathogenesis of Alzheimer disease in people with Down syndrome.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"348-348"},"PeriodicalIF":33.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-09DOI: 10.1038/s41582-025-01107-5
Heather Wood
A new phase III trial has shown that the small-molecule CGRP receptor antagonist ubrogepant can alleviate premonitory symptoms in the prodromal phase of migraine.
一项新的III期试验表明，小分子CGRP受体拮抗剂增祖剂可以缓解偏头痛前驱期的先兆症状。
{"title":"Ubrogepant alleviates migraine premonitory symptoms","authors":"Heather Wood","doi":"10.1038/s41582-025-01107-5","DOIUrl":"10.1038/s41582-025-01107-5","url":null,"abstract":"A new phase III trial has shown that the small-molecule CGRP receptor antagonist ubrogepant can alleviate premonitory symptoms in the prodromal phase of migraine.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"348-348"},"PeriodicalIF":33.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-09DOI: 10.1038/s41582-025-01108-4
Heather Wood
A new study has identified cerebrospinal fluid proteomic signatures that are linked to frontotemporal lobar degeneration — one of the most common causes of early-onset dementia.
一项新的研究发现脑脊液蛋白质组学特征与额颞叶变性有关——额颞叶变性是早发性痴呆的最常见原因之一。
{"title":"FTLD-associated proteomic signatures uncovered","authors":"Heather Wood","doi":"10.1038/s41582-025-01108-4","DOIUrl":"10.1038/s41582-025-01108-4","url":null,"abstract":"A new study has identified cerebrospinal fluid proteomic signatures that are linked to frontotemporal lobar degeneration — one of the most common causes of early-onset dementia.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"348-348"},"PeriodicalIF":33.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-27DOI: 10.1038/s41582-025-01096-5
Annette M. Langer-Gould, Tara J. Cepon-Robins, Jada Benn Torres, E. Ann Yeh, Theresa E. Gildner
Disparities in the incidence, prevalence and outcomes of multiple sclerosis (MS) exist in the USA, often to the detriment of Black and Hispanic people. Despite the common misconception that MS is a disease of white people, the incidence is highest in Black people. Disability accumulates faster and at younger ages in Black and Hispanic people with MS than in their white counterparts, and MS-related mortality in early and mid-adulthood is highest in Black people. These differences are often erroneously interpreted as evidence of innate racial or ethnic variations. In this Perspective, we demonstrate how race and ethnicity — social constructs with a limited biological basis that are often assigned by systems of power — can influence biology through lived experiences, a phenomenon termed ‘embodiment’. We review how downstream consequences of structural racism can lead to biological outcomes strongly associated with MS susceptibility, such as imbalanced immune system development, dysregulated immune responses to the Epstein–Barr virus and childhood obesity. We also consider how inequitable health-care access and quality, combined with the younger age of onset and higher comorbidity burdens, might explain racial and ethnic disparities in MS prognosis. Our proposed conceptual model offers a roadmap for generating knowledge and implementing interventions to narrow racial and ethnic disparities in MS susceptibility and outcomes. Racial and ethnic disparities in MS susceptibility and outcomes are often attributed to immutable factors such as genetic ancestry. In this Perspective, however, the authors argue that structural racism can lead to biological changes by shaping environmental exposures and lived experiences — a phenomenon termed ‘embodiment’.
{"title":"Embodiment of structural racism and multiple sclerosis risk and outcomes in the USA","authors":"Annette M. Langer-Gould, Tara J. Cepon-Robins, Jada Benn Torres, E. Ann Yeh, Theresa E. Gildner","doi":"10.1038/s41582-025-01096-5","DOIUrl":"10.1038/s41582-025-01096-5","url":null,"abstract":"Disparities in the incidence, prevalence and outcomes of multiple sclerosis (MS) exist in the USA, often to the detriment of Black and Hispanic people. Despite the common misconception that MS is a disease of white people, the incidence is highest in Black people. Disability accumulates faster and at younger ages in Black and Hispanic people with MS than in their white counterparts, and MS-related mortality in early and mid-adulthood is highest in Black people. These differences are often erroneously interpreted as evidence of innate racial or ethnic variations. In this Perspective, we demonstrate how race and ethnicity — social constructs with a limited biological basis that are often assigned by systems of power — can influence biology through lived experiences, a phenomenon termed ‘embodiment’. We review how downstream consequences of structural racism can lead to biological outcomes strongly associated with MS susceptibility, such as imbalanced immune system development, dysregulated immune responses to the Epstein–Barr virus and childhood obesity. We also consider how inequitable health-care access and quality, combined with the younger age of onset and higher comorbidity burdens, might explain racial and ethnic disparities in MS prognosis. Our proposed conceptual model offers a roadmap for generating knowledge and implementing interventions to narrow racial and ethnic disparities in MS susceptibility and outcomes. Racial and ethnic disparities in MS susceptibility and outcomes are often attributed to immutable factors such as genetic ancestry. In this Perspective, however, the authors argue that structural racism can lead to biological changes by shaping environmental exposures and lived experiences — a phenomenon termed ‘embodiment’.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"370-382"},"PeriodicalIF":33.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-23DOI: 10.1038/s41582-025-01098-3
Guida Landouré, Abdoulaye Yalcouyé, Salimata Diarra, Alassane dit Baneye Maiga, Mohamed E. Dembélé, Cheick A. K. Cissé, Abdoulaye Bocoum, Lassana Cissé, Salia Bamba, Oumar Samassékou, Kenneth H. Fischbeck, Barrington G. Burnett
Hereditary neurological diseases (HNDs), referring to monogenic forms of neurological diseases, can cause substantial debilitation in affected individuals. They particularly impact developing nations, where the burden of disease is reflected in a high number of disability-adjusted life years lost. In African populations, despite rich genetic diversity, high fertility rates and prevalent consanguinity, genetic research remains under-explored. However, studying these communities holds the promise of uncovering key genes and variants that are essential for understanding both normal and abnormal nervous system functions. The rise of advanced sequencing technologies has enabled the identification of the causative factors underlying numerous hereditary diseases. Yet, many people with HNDs, especially in under-studied African populations, still lack a molecular diagnosis. Initiatives such as H3Africa, backed by the US National Institutes of Health, the Wellcome Trust and the Alliance for Accelerating Excellence in Science in Africa, are helping to bridge this gap by empowering African scientists to lead groundbreaking genetic research. This Review highlights the spectrum of HNDs observed in African populations and explores the unique challenges and opportunities in this field. By reflecting on the current state of neurogenetics in Africa and outlining future directions, we aim to inspire progress towards improved health care for those affected by HNDs on the continent. Genetic studies in Africa can provide a unique window into hereditary neurological diseases (HNDs). This Review highlights the benefits and challenges of conducting genetic research in Africa and summarizes the insights into HNDs gained from previous studies on the continent.
{"title":"Advancing neurogenetics in Africa: past achievements, current developments and shaping the future","authors":"Guida Landouré, Abdoulaye Yalcouyé, Salimata Diarra, Alassane dit Baneye Maiga, Mohamed E. Dembélé, Cheick A. K. Cissé, Abdoulaye Bocoum, Lassana Cissé, Salia Bamba, Oumar Samassékou, Kenneth H. Fischbeck, Barrington G. Burnett","doi":"10.1038/s41582-025-01098-3","DOIUrl":"10.1038/s41582-025-01098-3","url":null,"abstract":"Hereditary neurological diseases (HNDs), referring to monogenic forms of neurological diseases, can cause substantial debilitation in affected individuals. They particularly impact developing nations, where the burden of disease is reflected in a high number of disability-adjusted life years lost. In African populations, despite rich genetic diversity, high fertility rates and prevalent consanguinity, genetic research remains under-explored. However, studying these communities holds the promise of uncovering key genes and variants that are essential for understanding both normal and abnormal nervous system functions. The rise of advanced sequencing technologies has enabled the identification of the causative factors underlying numerous hereditary diseases. Yet, many people with HNDs, especially in under-studied African populations, still lack a molecular diagnosis. Initiatives such as H3Africa, backed by the US National Institutes of Health, the Wellcome Trust and the Alliance for Accelerating Excellence in Science in Africa, are helping to bridge this gap by empowering African scientists to lead groundbreaking genetic research. This Review highlights the spectrum of HNDs observed in African populations and explores the unique challenges and opportunities in this field. By reflecting on the current state of neurogenetics in Africa and outlining future directions, we aim to inspire progress towards improved health care for those affected by HNDs on the continent. Genetic studies in Africa can provide a unique window into hereditary neurological diseases (HNDs). This Review highlights the benefits and challenges of conducting genetic research in Africa and summarizes the insights into HNDs gained from previous studies on the continent.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"383-393"},"PeriodicalIF":33.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-22DOI: 10.1038/s41582-025-01094-7
Raquel N. Taddei, Karen E. Duff
Preservation of synapses is crucial for healthy cognitive ageing, and synapse loss is one of the closest anatomical correlates of cognitive decline in Alzheimer disease, dementia with Lewy bodies and frontotemporal dementia. In these conditions, some synapses seem particularly vulnerable to degeneration whereas others are resilient and remain preserved. Evidence has highlighted that vulnerability and resilience are intrinsically distinct phenomena linked to specific brain structural and/or functional signatures, yet the key features of vulnerable and resilient synapses in the dementias remain incompletely understood. Defining the characteristics of vulnerable and resilient synapses in each form of dementia could offer novel insight into the mechanisms of synapse preservation and of synapse loss that underlies cognitive decline, thereby facilitating the discovery of targeted biomarkers and disease-modifying therapies. In this Review, we consider the concepts of synapse vulnerability and resilience, and provide an overview of our current understanding of the associations between synaptic protein changes, neuropathology and cognitive decline. We also consider how understanding of the underlying mechanisms could identify novel strategies to mitigate the cognitive dysfunction associated with dementias. In this Review, Taddei and Duff consider the concepts of synapse vulnerability and resilience, and how an understanding of the mechanisms that underlie these states could identify novel strategies to mitigate the cognitive dysfunction associated with dementias.
{"title":"Synapse vulnerability and resilience across the clinical spectrum of dementias","authors":"Raquel N. Taddei, Karen E. Duff","doi":"10.1038/s41582-025-01094-7","DOIUrl":"10.1038/s41582-025-01094-7","url":null,"abstract":"Preservation of synapses is crucial for healthy cognitive ageing, and synapse loss is one of the closest anatomical correlates of cognitive decline in Alzheimer disease, dementia with Lewy bodies and frontotemporal dementia. In these conditions, some synapses seem particularly vulnerable to degeneration whereas others are resilient and remain preserved. Evidence has highlighted that vulnerability and resilience are intrinsically distinct phenomena linked to specific brain structural and/or functional signatures, yet the key features of vulnerable and resilient synapses in the dementias remain incompletely understood. Defining the characteristics of vulnerable and resilient synapses in each form of dementia could offer novel insight into the mechanisms of synapse preservation and of synapse loss that underlies cognitive decline, thereby facilitating the discovery of targeted biomarkers and disease-modifying therapies. In this Review, we consider the concepts of synapse vulnerability and resilience, and provide an overview of our current understanding of the associations between synaptic protein changes, neuropathology and cognitive decline. We also consider how understanding of the underlying mechanisms could identify novel strategies to mitigate the cognitive dysfunction associated with dementias. In this Review, Taddei and Duff consider the concepts of synapse vulnerability and resilience, and how an understanding of the mechanisms that underlie these states could identify novel strategies to mitigate the cognitive dysfunction associated with dementias.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"21 7","pages":"353-369"},"PeriodicalIF":33.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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