Pub Date : 2026-01-22DOI: 10.1016/s1474-4422(25)00476-4
Amza Ali, Sanjay M Sisodiya
{"title":"Resilience of epilepsy care in the climate crisis","authors":"Amza Ali, Sanjay M Sisodiya","doi":"10.1016/s1474-4422(25)00476-4","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00476-4","url":null,"abstract":"","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/s1474-4422(25)00425-9
Keith Vossel, Emily L Johnson, Benjamin Cretin, Riki Matsumoto
An estimated 60% of patients with Alzheimer's disease develop epilepsy or subclinical epileptiform activity over the course of the disease. New-onset seizures in cognitively healthy adults also increase the risk of developing dementia. Epileptic activity, including both seizures and subclinical epileptiform discharges, can hasten the onset of Alzheimer's disease and accelerate cognitive decline. Studies are investigating whether antiseizure medications could improve cognitive outcomes, particularly in patients with Alzheimer's disease with epileptic activity. Detection of epileptic activity in people with Alzheimer's disease requires high clinical vigilance and neurophysiological monitoring. Evaluation and treatment of late-onset epilepsy or Alzheimer's disease-associated epileptic activity should be informed by clinical advances. Epilepsy management is especially important in patients receiving anti-amyloid monoclonal antibodies, which can increase seizure risk. Recent insights support the concept of an epileptic subtype of Alzheimer's disease, position epileptic activity as a modifiable risk factor in Alzheimer's disease, highlight innovations for earlier identification of epileptic activity, and provide evidence supporting the need for early detection and targeted treatment across the stages of Alzheimer's disease.
{"title":"Epileptic activity in Alzheimer's disease: emerging insights and therapeutic implications","authors":"Keith Vossel, Emily L Johnson, Benjamin Cretin, Riki Matsumoto","doi":"10.1016/s1474-4422(25)00425-9","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00425-9","url":null,"abstract":"An estimated 60% of patients with Alzheimer's disease develop epilepsy or subclinical epileptiform activity over the course of the disease. New-onset seizures in cognitively healthy adults also increase the risk of developing dementia. Epileptic activity, including both seizures and subclinical epileptiform discharges, can hasten the onset of Alzheimer's disease and accelerate cognitive decline. Studies are investigating whether antiseizure medications could improve cognitive outcomes, particularly in patients with Alzheimer's disease with epileptic activity. Detection of epileptic activity in people with Alzheimer's disease requires high clinical vigilance and neurophysiological monitoring. Evaluation and treatment of late-onset epilepsy or Alzheimer's disease-associated epileptic activity should be informed by clinical advances. Epilepsy management is especially important in patients receiving anti-amyloid monoclonal antibodies, which can increase seizure risk. Recent insights support the concept of an epileptic subtype of Alzheimer's disease, position epileptic activity as a modifiable risk factor in Alzheimer's disease, highlight innovations for earlier identification of epileptic activity, and provide evidence supporting the need for early detection and targeted treatment across the stages of Alzheimer's disease.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/s1474-4422(25)00495-8
Bernard P L Chan
No Abstract
没有抽象的
{"title":"Reducing door-in-door-out time to improve stroke outcome","authors":"Bernard P L Chan","doi":"10.1016/s1474-4422(25)00495-8","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00495-8","url":null,"abstract":"No Abstract","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"264 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/s1474-4422(25)00378-3
Lili Song, Yu Mao, Else Charlotte Sandset, Nyika D Kruyt, Paul J Nederkoorn, Xia Wang, Sonali R Gnanenthiran, Craig S Anderson
Background
Patients with acute ischaemic stroke often present with elevated blood pressure. Evidence has emerged that challenges the longstanding recommendation across clinical guidelines that blood pressure should be controlled to a systolic pressure of less than 185 mm Hg before initiating reperfusion therapy in these patients.
Recent
developments Major clinical trials (INTERACT4, MR-ASAP, and RIGHT-2) and an observational study (TRUTH) indicate that intensively lowering blood pressure before initiating reperfusion therapy for acute ischaemic stroke is associated with increased risk of death and disability. Similar evidence has reshaped our approach to blood pressure management in patients who receive successful endovascular thrombectomy for acute ischaemic stroke from large-vessel occlusion. The underlying mechanisms of cerebral ischaemia are likely to involve alterations in cerebral blood flow through collateral vessels and the microcirculation.
Where
next? Current evidence underscores the harms of more intensive lowering of blood pressure to a systolic target of less than 140 mm Hg both before and after reperfusion therapy for acute ischaemic stroke. Despite the challenges in obtaining the necessary randomised evidence, such efforts are now required to establish whether elevated blood pressure should be controlled at all with this disease or left to decrease naturally.
{"title":"Early blood pressure management in acute ischaemic stroke before and after reperfusion treatment","authors":"Lili Song, Yu Mao, Else Charlotte Sandset, Nyika D Kruyt, Paul J Nederkoorn, Xia Wang, Sonali R Gnanenthiran, Craig S Anderson","doi":"10.1016/s1474-4422(25)00378-3","DOIUrl":"https://doi.org/10.1016/s1474-4422(25)00378-3","url":null,"abstract":"<h3>Background</h3>Patients with acute ischaemic stroke often present with elevated blood pressure. Evidence has emerged that challenges the longstanding recommendation across clinical guidelines that blood pressure should be controlled to a systolic pressure of less than 185 mm Hg before initiating reperfusion therapy in these patients.<h3>Recent</h3>developments Major clinical trials (INTERACT4, MR-ASAP, and RIGHT-2) and an observational study (TRUTH) indicate that intensively lowering blood pressure before initiating reperfusion therapy for acute ischaemic stroke is associated with increased risk of death and disability. Similar evidence has reshaped our approach to blood pressure management in patients who receive successful endovascular thrombectomy for acute ischaemic stroke from large-vessel occlusion. The underlying mechanisms of cerebral ischaemia are likely to involve alterations in cerebral blood flow through collateral vessels and the microcirculation.<h3>Where</h3>next? Current evidence underscores the harms of more intensive lowering of blood pressure to a systolic target of less than 140 mm Hg both before and after reperfusion therapy for acute ischaemic stroke. Despite the challenges in obtaining the necessary randomised evidence, such efforts are now required to establish whether elevated blood pressure should be controlled at all with this disease or left to decrease naturally.","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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