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[In Context] A Ferrier sesquicentenary

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 8%

October 2026 marks 150 years since the publication of The Functions of the Brain,1 a landmark book by the Scottish neurologist David Ferrier (1843–1928) that gave experimental grounding to the doctrine of cortical localisation.

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[In Context] Katrin Andreasson: rethinking neurodegeneration

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 15%

For a self-described “late bloomer”, Katrin “Kati” Andreasson certainly appears to have made up for lost time. Now the Edward F and Irene Thiele Pimley Professor of Neurology and Neurological Sciences at Stanford University (Palo Alto, CA, USA), last year she received the Inge Grundke-Iqbal Award for Alzheimer's Research, in recognition of an article on which she was senior author. Published in 2024, the paper linked astrocytic support for neuronal glucose metabolism to memory decline and amyloid β and tau pathologies in experimental models of Alzheimer's disease.

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[Correspondence] Staged bilateral focused ultrasound pallidothalamic tractotomy for Parkinson's disease – Authors' reply

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 12%

We thank the correspondents for their thoughtful engagement with our findings regarding staged bilateral pallidothalamic tractotomy for patients with Parkinson's disease.1 Their comments add context to the scientific discussion, and we address the principal themes below.

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[Correspondence] Staged bilateral focused ultrasound pallidothalamic tractotomy for Parkinson's disease

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 14%

Arif Dalvi and colleagues have reignited one of the oldest debates in functional neurosurgery by applying one of its newest technologies. Their study demonstrates that unilateral magnetic resonance-guided focused ultrasound (MRgFUS) pallidothalamic tractotomy can provide meaningful and durable improvement in Parkinson's disease motor symptoms, whereas staged bilateral lesioning had comparatively modest additional benefit at the cost of substantially higher rates of persistent impairment affecting speech, gait, and balance.

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[Correspondence] Staged bilateral focused ultrasound pallidothalamic tractotomy for Parkinson's disease

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 13%

Arif Dalvi and colleagues report important prospective evidence on the use of MRI-guided focused ultrasound pallidothalamic tractotomy in Parkinson's disease.1 Their findings on second-side treatment raise the question of how adverse events should be interpreted in the context of bilateral homologous lesioning (ie, repeating the same target in both hemispheres) and whether the same irreversible target should be repeated contralaterally.

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[Correspondence] Staged bilateral focused ultrasound pallidothalamic tractotomy for Parkinson's disease

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 14%

On July 3, 2025, the US Food and Drug Administration approved staged, bilateral focused ultrasound pallidothalamic tractotomy for advanced Parkinson's disease with medication-refractory motor complications, on the basis of results from a then-unpublished single-arm trial.1 We cautioned then that a symmetrical lesioning procedure was being licensed ahead of its evidence.2 The results presented by Arif Dalvi and colleagues1 support that caution was warranted: modest gains in off-medication motor scores after treatment of the second side (a 19% improvement over the plateau reached after unilateral treatment) were accompanied by persistent moderate or severe adverse events at 12 months in ten (25%) of the 40 bilaterally treated patients, one of whom had severe persistent anarthria.

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[Comment] From syndrome to antibody-defined autoimmune encephalitides

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 81%

About two decades after the initial description of anti-NMDA receptor encephalitis, autoimmune encephalitis has expanded from being considered a neurological rarity to become one of the most rapidly advancing disciplines in clinical neuroimmunology. The diagnostic criteria for autoimmune encephalitis proposed by Francesc Graus and colleagues1 in 2016 provided a pivotal clinical framework, prioritising early recognition and treatment based on clinical and paraclinical features independent of autoantibody detection, with antibody testing used to refine disease subtyping and provide additional diagnostic evidence in clinically uncertain cases.

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[Comment] APOE, p-tau217, and cognitive impairment in diverse cohorts

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 48%

The neuropathology of Alzheimer's disease, including amyloid plaques and tau neurofibrillary tangles, accumulates silently for many years before cognitive symptoms become clinically apparent.1 These changes can be detected with biomarkers such as plasma tau phosphorylated at position 217 (p-tau217). Blood tests that incorporate p-tau217 are now clinically available to aid diagnosis in patients with cognitive concerns. In cognitively unimpaired individuals, clinical biomarker testing is currently not recommended,2 but multiple research studies have shown that elevated plasma p-tau217 is associated with an increased risk of future cognitive impairment.

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[Comment] Progress in exon skipping for Duchenne muscular dystrophy

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 32%

Duchenne muscular dystrophy is a progressive muscle-wasting disease caused by an absence or very low expression of dystrophin. Antisense oligonucleotides can enable patients to produce partially functional dystrophin proteins, and the US Food and Drug Administration (FDA) has granted accelerated approval to four such antisense oligonucleotides.1 Approvals were based on demonstration of increased dystrophin levels (measured as percentage of expression in healthy controls) in treated patients in a clinical trial setting, although increases were small (˜1 percentage point).

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[Editorial] Neurotrauma as a chronic disease: a call for integrated care

The Lancet Neurology - Current Issue Published 31 Oct 2026 Relevancy: 65%

Almost a deacade ago, a Lancet Neurology Commission described why traumatic brain injury (TBI) “is not a single event, but can be a chronic and often progressive disease with long-term consequences”. TBI and spinal cord injury (SCI) can impose a heavy burden of disability and multisystem morbidity, yet health-care systems remain structurally mismatched to these patients’ needs. A Policy View in this issue proposes a new framework for TBI and SCI that could help close this gap. Should TBI and SCI in adults be reconceived as chronic diseases rather than acute conditions? The arguments set out in this Policy View make a compelling case for change.

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