Candesartan versus placebo for migraine prevention in patients with episodic migraine: a randomised, triple-blind, placebo-controlled, phase 2 trial

坎地沙坦与安慰剂用于发作性偏头痛患者的偏头痛预防：一项随机、三盲、安慰剂对照的2期试验

Effective and well-tolerated preventive treatments for migraine remain few, and the angiotensin receptor blocker candesartan has shown promise in small studies. This study aimed to evaluate the safety, tolerability, and efficacy of candesartan for the preventive treatment of episodic migraine. Daily administration of candesartan 16 mg is effective and well tolerated as a preventive treatment for episodic migraine. These findings support its role as a clinically meaningful and evidence-based option for migraine prevention. However, further clinical trials and real-world data from registry studies are necessary to assess its long-term efficacy.

有效的且耐受性良好的偏头痛预防性治疗方法仍然有限，而血管紧张素受体阻滞剂坎地沙坦在小规模研究中显示出了前景。本研究旨在评估坎地沙坦用于发作性偏头痛预防性治疗的安全性、耐受性和有效性。每日服用16毫克坎地沙坦作为发作性偏头痛的预防性治疗方法有效且耐受性良好。这些研究结果支持将其作为临床上有意义且基于证据的偏头痛预防选择。然而，还需要进一步的临床试验和来自登记研究的真实世界数据来评估其长期疗效。

REF: Øie LR, Wergeland T, Salvesen Ø, et al. Candesartan versus placebo for migraine prevention in patients with episodic migraine: a randomised, triple-blind, placebo-controlled, phase 2 trial. Lancet Neurol. 2025;24(10):817-827. doi:10.1016/S1474-4422(25)00269-8 PMID: 40975098

Association between the Edinburgh CT and genetic diagnostic criteria for cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage and recurrent intracerebral haemorrhage: an individual patient data meta-analysis

爱丁堡 CT 标准与脑淀粉样血管病相关性脑叶出血及复发性脑出血的基因诊断标准之间的关联：一项个体患者数据的荟萃分析

Patients with lobar intracerebral haemorrhage and MRI biomarkers of cerebral amyloid angiopathy have a greater risk of recurrent intracerebral haemorrhage than patients without these biomarkers. However, access to MRI is limited. We aimed to determine whether the Edinburgh CT-only and CT-APOE diagnostic criteria for cerebral amyloid angiopathy-related lobar intracerebral haemorrhage are associated with recurrent intracerebral haemorrhage. The Edinburgh CT-only and CT-APOE diagnostic criteria for cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage were associated with a greater incidence of recurrent intracerebral haemorrhage. These findings could aid personalised prediction and targeted secondary prevention in standard clinical practice where brain CT is available.

与无脑淀粉样血管病磁共振成像（MRI）生物标志物的患者相比，患有脑叶脑出血且有脑淀粉样血管病MRI生物标志物的患者复发性脑出血的风险更高。然而，MRI检查的可及性有限。我们旨在确定爱丁堡仅基于计算机断层扫描（CT）和CT联合载脂蛋白E（APOE）的脑淀粉样血管病相关脑叶脑出血诊断标准是否与复发性脑出血相关。爱丁堡仅基于CT和CT联合APOE的脑淀粉样血管病相关脑叶脑出血诊断标准与复发性脑出血的更高发生率相关。这些发现有助于在可进行脑部CT检查的常规临床实践中实现个性化预测和有针对性的二级预防。

REF: Rodrigues MA, Seiffge D, Samarasekera N, et al. Association between the Edinburgh CT and genetic diagnostic criteria for cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage and recurrent intracerebral haemorrhage: an individual patient data meta-analysis. Lancet Neurol. 2025;24(10):828-839. doi:10.1016/S1474-4422(25)00285-6 PMID: 40975099

Sleep EEG and respiratory biomarkers of sudden unexpected death in epilepsy (SUDEP): a case–control study

癫痫患者不明原因猝死（SUDEP）的睡眠脑电图和呼吸生物标志物：一项病例对照研究

Sudden unexpected death in epilepsy (SUDEP) is the most common category of epilepsy-related mortality. Centrally mediated respiratory dysfunction has been observed to lead to death in the majority of cases of SUDEP. SUDEP also mainly occurs during nighttime sleep. This study seeks to identify sleep EEG and sleep-related respiratory biomarkers of SUDEP risk. This study identifies impaired sleep homoeostasis in the form of altered SWA progression during NREM sleep overnight in people with epilepsy who later died of SUDEP, and an increase in respiratory variability during NREM sleep in people with epilepsy who later died of SUDEP and in people with epilepsy at high risk of SUDEP. Multiday polysomnography studies are needed to validate sleep homoeostasis and respiratory variability during sleep as potential biomarkers of SUDEP risk. Further studies are required to explore possible sleep interventions that could mitigate SUDEP risk.

癫痫患者的不明原因猝死（SUDEP）是与癫痫相关死亡中最常见的类型。在大多数SUDEP病例中，观察到中枢介导的呼吸功能障碍会导致死亡。SUDEP也主要发生在夜间睡眠期间。本研究旨在确定与SUDEP风险相关的睡眠脑电图和睡眠相关呼吸生物标志物。本研究发现，后来死于SUDEP的癫痫患者在夜间非快速眼动（NREM）睡眠期间，慢波活动（SWA）进程改变，表现为睡眠稳态受损；后来死于SUDEP的癫痫患者以及SUDEP高风险癫痫患者在NREM睡眠期间呼吸变异性增加。需要进行多日多导睡眠监测研究，以验证睡眠稳态和睡眠期间的呼吸变异性是否可作为SUDEP风险的潜在生物标志物。还需要进一步研究来探索可能降低SUDEP风险的睡眠干预措施。

REF: Magana-Tellez O, Maganti R, Hupp NJ, et al. Sleep EEG and respiratory biomarkers of sudden unexpected death in epilepsy (SUDEP): a case-control study. Lancet Neurol. 2025;24(10):840-849. doi:10.1016/S1474-4422(25)00273-X PMID: 40975100

Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria

多发性硬化的诊断：2024年麦克唐纳标准修订版

Advances in the understanding of multiple sclerosis and the development of biomarkers of pathophysiology prompted a substantial revision of the 2017 McDonald diagnostic criteria. The new 2024 McDonald criteria provide a unified approach for diagnosing multiple sclerosis in individuals with relapsing or progressive courses throughout the lifespan (ie, from paediatric to late-life presentations). The optic nerve can now serve as a fifth anatomical location within the CNS for diagnosis. The central vein sign, paramagnetic rim lesions, and kappa free-light chain concentrations in CSF can be used, when available, to provide supportive evidence and confer specificity for a diagnosis of multiple sclerosis in specific situations. In certain cases, radiologically isolated syndrome or neurological symptoms that do not constitute a clear attack or progression of disability can fulfil the criteria for a multiple sclerosis diagnosis. We also provide guidance for the diagnosis of multiple sclerosis in older individuals (≥50 years) and those with comorbidities. The 2024 revised criteria should expedite the diagnosis of multiple sclerosis, while maintaining specificity.

对多发性硬化症认识的进展以及病理生理学生物标志物的发展促使对2017年麦克唐纳诊断标准进行了重大修订。新的2024年麦克唐纳标准为诊断具有复发或进展病程的个体（即从儿童期到晚年表现）的多发性硬化症提供了统一的方法。视神经现在可作为中枢神经系统内用于诊断的第五个解剖部位。若有相关检测结果，中枢静脉征、顺磁性边缘病变以及脑脊液中κ游离轻链浓度可在特定情况下为多发性硬化症的诊断提供支持性证据并增强诊断特异性。在某些情况下，放射学孤立综合征或未构成明确发作或残疾进展的神经系统症状也可满足多发性硬化症的诊断标准。我们还为老年人（≥50岁）及合并其他疾病者的多发性硬化症诊断提供了指导。2024年修订后的标准应能在保证特异性的同时加快多发性硬化症的诊断速度。

REF: Montalban X, Lebrun-Frénay C, Oh J, et al. Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria. Lancet Neurol. 2025;24(10):850-865. doi:10.1016/S1474-4422(25)00270-4 PMID: 40975101

2024 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI for the diagnosis of multiple sclerosis

2024年欧洲多发性硬化磁共振成像研究组（MAGNIMS） - 加拿大多发性硬化协作组（CMSC） - 北美免疫介导神经系统疾病学会（NAIMS）关于使用磁共振成像（MRI）诊断多发性硬化症的共识建议

MRI plays an increasingly important role in the diagnosis of multiple sclerosis. We discuss the expanded role of MRI in the 2024 McDonald diagnostic criteria for multiple sclerosis, which include the optic nerve as a fifth anatomical location, in addition to the periventricular, juxtacortical or cortical, infratentorial, and spinal cord regions. The diagnosis of multiple sclerosis can now be confirmed when the criteria of dissemination in space are fulfilled with the detection of typical lesions in at least four locations without additional evidence. We recommend appropriate imaging strategies and MRI acquisition protocols for all aspects of multiple sclerosis diagnosis, including fat-saturated sequences for detection of symptomatic optic nerve lesions. Diagnostic imaging should always cover the brain and spinal cord and include susceptibility-sensitive sequences for the assessment of the central vein sign and paramagnetic rim lesions, which can be especially helpful in cases when conventional imaging findings are insufficient to establish a diagnosis. We discuss how to handle the diagnosis of radiologically isolated presentations of multiple sclerosis, which are included in the 2024 criteria. We present recommendations for image interpretation and avoidance of misdiagnosis, and extend the recommendations to the use of MRI in the diagnosis of multiple sclerosis in older people, children, people with vascular comorbidities or migraine, and people living outside Europe and North America. Finally, we provide recommendations for standardisation of MRI acquisition and communication of results to enable an earlier diagnosis while maintaining high diagnostic specificity.

磁共振成像（MRI）在多发性硬化症的诊断中发挥着越来越重要的作用。我们探讨了MRI在2024年麦克唐纳多发性硬化症诊断标准中的扩展作用，该标准除了脑室周围、近皮质或皮质、幕下和脊髓区域外，还将视神经列为第五个解剖部位。现在，当空间播散标准得到满足，即至少在四个部位检测到典型病变且无需额外证据时，即可确诊多发性硬化症。我们针对多发性硬化症诊断的各个方面推荐了合适的成像策略和MRI采集方案，包括用于检测有症状视神经病变的脂肪抑制序列。诊断性成像应始终涵盖大脑和脊髓，并包括磁敏感加权序列，以评估中央静脉征和顺磁性边缘病变，这在常规影像学检查结果不足以确诊的情况下尤其有用。我们讨论了如何处理2024年标准中纳入的多发性硬化症影像学孤立表现的诊断问题。我们提出了影像解读建议以及避免误诊的方法，并将这些建议扩展到老年人、儿童、有血管合并症或偏头痛的人群以及欧洲和北美以外地区人群的多发性硬化症MRI诊断中。最后，我们为MRI采集的标准化以及结果沟通提供了建议，以便在保持高诊断特异性的同时实现更早诊断。

REF: Barkhof F, Reich DS, Oh J, et al. 2024 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI for the diagnosis of multiple sclerosis. Lancet Neurol. 2025;24(10):866-879. doi:10.1016/S1474-4422(25)00304-7 PMID: 40975102

The use of optical coherence tomography and visual evoked potentials in the 2024 McDonald diagnostic criteria for multiple sclerosis

光学相干断层扫描和视觉诱发电位在2024年多发性硬化症麦克唐纳诊断标准中的应用

The 2024 revisions of the McDonald diagnostic criteria include the optic nerve as a fifth anatomical location within the CNS for the diagnosis of multiple sclerosis, in addition to periventricular, juxtacortical or cortical, infratentorial, and spinal cord lesions. Demonstration of dissemination in space can now be achieved with the detection of typical lesions in at least two of these five locations. We review the evidence supporting the use of optical coherence tomography (OCT) and visual evoked potentials (VEPs) to show optic nerve involvement in the diagnosis of multiple sclerosis. We also report consensus recommendations for their use. Provided there is no better explanation for optic nerve involvement and that rigorous quality control is applied, OCT-derived peripapillary retinal nerve fibre layer inter-eye differences of 6 μm or greater or composite macular ganglion cell and inner plexiform layer inter-eye differences of 4 μm or greater support optic nerve injury. Delayed VEP latency, which depends on technical and methodological factors, and is centre and device dependent, supports demyelinating optic nerve injury when done with appropriate technical knowledge and interpretation.

2024年修订的麦克唐纳诊断标准将视神经列为中枢神经系统（CNS）内用于诊断多发性硬化症的第五个解剖部位，此外还有脑室周围、皮质下或皮质、幕下和脊髓病变部位。现在，通过检测这五个部位中至少两个部位的典型病变，即可证明存在空间多发性。我们回顾了支持使用光学相干断层扫描（OCT）和视觉诱发电位（VEP）来显示视神经受累以诊断多发性硬化症的证据。我们还报告了关于使用这些检查的共识性建议。如果视神经受累没有更好的解释，并且实施了严格的质量控制，OCT测得的视盘周围视网膜神经纤维层双眼差值达到6μm或更大，或者黄斑神经节细胞与内丛状层组合厚度双眼差值达到4μm或更大，则提示视神经损伤。视觉诱发电位潜伏期延长（其受技术和方法因素影响，且因检测中心和设备而异），在具备适当的技术知识和解读能力的情况下，可提示脱髓鞘性视神经损伤。

REF: Saidha S, Green AJ, Leocani L, et al. The use of optical coherence tomography and visual evoked potentials in the 2024 McDonald diagnostic criteria for multiple sclerosis. Lancet Neurol. 2025;24(10):880-892. doi:10.1016/S1474-4422(25)00275-3 PMID: 40975103