Safety and efficacy of direct versus conventional transfer to angiography suite in patients with severe acute stroke treated with thrombectomy (DIRECT ANGIO) in France: a multicentre, open-label, blinded-endpoint, randomised controlled trial

法国急性重症卒中患者行血栓切除术时直接转运至血管造影室与常规转运的安全性和有效性研究（DIRECT ANGIO）：一项多中心、开放标签、终点盲法的随机对照试验

Direct transfer to angiography suite (DTAS) for patients with suspected stroke primarily admitted to an endovascular-capable centre could accelerate in-hospital workflow and improve outcome. We aimed to assess the safety and efficacy of DTAS for patients with acute severe neurological deficit highly suggestive of ischaemic stroke due to a large vessel occlusion (ASND-LVO). DTAS for patients with ASND-LVO was associated with an increased risk of symptomatic intracranial haemorrhage without evidence of a beneficial effect on functional outcome at 90 days. However, because the trial was stopped early for safety reasons, the small sample size limits the precision of the effect estimates on the primary outcome and all secondary and safety outcomes. Therefore, further clinical trials are required to firmly conclude on the safety and efficacy of DTAS for patients with suspected acute ischaemic stroke due to a large vessel occlusion.

对于疑似卒中且最初被收治到具备血管内治疗能力中心的患者，直接转送至血管造影室（DTAS）可加快院内诊疗流程并改善预后。我们旨在评估DTAS对高度提示因大血管闭塞导致缺血性卒中的急性严重神经功能缺损患者（ASND - LVO）的安全性和有效性。对ASND - LVO患者采用DTAS会增加症状性颅内出血的风险，且无证据表明其对90天功能结局有益。然而，由于该试验因安全原因提前终止，样本量较小限制了对主要结局以及所有次要结局和安全性结局效应估计的准确性。因此，需要开展进一步的临床试验，以明确DTAS对疑似因大血管闭塞导致的急性缺血性卒中患者的安全性和有效性。

REF: Gory B, Maïer B, Pop R, et al. Safety and efficacy of direct versus conventional transfer to angiography suite in patients with severe acute stroke treated with thrombectomy (DIRECT ANGIO) in France: a multicentre, open-label, blinded-endpoint, randomised controlled trial. Lancet Neurol. 2026;25(4):346-356. doi:10.1016/S1474-4422(26)00056-6 PMID: 41864232

Integration of plasma eMTBR-tau243 and p-tau217 in the diagnosis and stratification of Alzheimer's disease: a prospective cohort study

血浆eMTBR - tau243和p - tau217在阿尔茨海默病诊断和分层中的整合研究：一项前瞻性队列研究

Alzheimer's disease pathology can be accurately identified with blood biomarkers (core 1 biomarkers), including plasma p-tau217 tests. Biomarkers that change longitudinally after diagnosis (core 2 biomarkers) can increase confidence that Alzheimer's disease pathology is contributing to cognitive symptoms. Plasma eMTBR-tau243 reflects tau tangle pathology and is a promising core 2 biomarker. We aimed to examine whether, among patients positive for plasma p-tau217, plasma eMTBR-tau243 improves classification of established Alzheimer's disease and predicts cognitive decline and tau tangle accumulation. Plasma %p-tau217 can confirm Aβ-positivity, while eMTBR-tau243 can confirm clinically symptomatic Alzheimer's disease. Initial testing with %p-tau217 followed by eMTBR-tau243 in %p-tau217-positive patients could help assess whether Alzheimer's disease pathology is causing symptoms. Plasma eMTBR-tau243 might also help in determining the severity of tau tangle burden, which could be useful in guiding therapeutic decisions.

阿尔茨海默病的病理特征可以通过血液生物标志物（核心1类生物标志物）准确识别，包括血浆磷酸化tau蛋白217（p - tau217）检测。诊断后会随时间变化的生物标志物（核心2类生物标志物）可以增强阿尔茨海默病病理特征与认知症状相关的可信度。血浆可提取微管结合区域tau蛋白243（eMTBR - tau243）反映了tau蛋白缠结病理特征，是一种有前景的核心2类生物标志物。我们旨在研究在血浆p - tau217呈阳性的患者中，血浆eMTBR - tau243是否能改善已确诊阿尔茨海默病的分类，并预测认知衰退和tau蛋白缠结的累积情况。血浆p - tau217百分比可以确认β淀粉样蛋白（Aβ）阳性，而eMTBR - tau243可以确认临床症状性阿尔茨海默病。先进行p - tau217百分比检测，再对p - tau217百分比阳性的患者进行eMTBR - tau243检测，有助于评估阿尔茨海默病病理特征是否导致了症状。血浆eMTBR - tau243可能还有助于确定tau蛋白缠结负担的严重程度，这对指导治疗决策可能有用。

REF: Mattsson-Carlgren N, Palmqvist S, Horie K, et al. Integration of plasma eMTBR-tau243 and p-tau217 in the diagnosis and stratification of Alzheimer's disease: a prospective cohort study. Lancet Neurol. 2026;25(4):357-367. doi:10.1016/S1474-4422(26)00029-3 PMID: 41864233

Complications, outcomes, and implications of a prolonged vegetative state in anti-NMDA receptor encephalitis: a retrospective international cohort study

抗N - 甲基 - D - 天冬氨酸受体脑炎长期植物状态的并发症、结局及意义：一项回顾性国际队列研究

In anti-NMDA receptor (NMDAR) encephalitis, delayed recovery and slow improvement makes it difficult to assess treatment refractoriness, leaving a knowledge gap about prolonged impaired consciousness. We aimed to assess treatment response, long-term outcomes, and their predictors in patients with NMDAR encephalitis and a prolonged vegetative state. In people with NMDAR encephalitis and prolonged impairment of consciousness, full or substantial recovery was reached in approximately two-thirds of cases. Consequently, early assessment of treatment response or refractoriness might underestimate delayed improvement, prolonged therapy needs, or spontaneous recovery. Futility decisions should therefore be individualised with multidisciplinary input and based on extended follow-up.

在抗N - 甲基 - D - 天冬氨酸受体（NMDAR）脑炎中，恢复延迟和改善缓慢使得评估治疗抵抗性变得困难，导致对意识长期受损情况存在认知空白。我们旨在评估NMDAR脑炎且处于长期植物状态患者的治疗反应、长期结局及其预测因素。在NMDAR脑炎且意识长期受损的患者中，约三分之二的病例实现了完全或显著恢复。因此，早期评估治疗反应或抵抗性可能会低估延迟改善、长期治疗需求或自发恢复情况。所以，是否放弃治疗的决策应结合多学科意见并基于长期随访进行个体化制定。

REF: Guasp M, Simabukuro MM, Muñoz-Sánchez G, et al. Complications, outcomes, and implications of a prolonged vegetative state in anti-NMDA receptor encephalitis: a retrospective international cohort study. Lancet Neurol. 2026;25(4):368-378. doi:10.1016/S1474-4422(26)00030-X PMID: 41864234

Stroke in China: advances in prevention and management on the path to a healthy China

中国的卒中：迈向健康中国征程中的预防与管理进展

The incidence and mortality of stroke have decreased in China in the past decade; however, the prevalence of stroke continues to rise because of population ageing. In alignment with the Healthy China 2030 blueprint, there has been a strategic reorientation of health-care services towards the prevention of major diseases, including stroke. Along with the establishment of a nationwide network of stroke centres to enhance the delivery of stroke care and research, progress has also been made in understanding stroke aetiology, screening for and control of risk factors, and promoting early diagnosis and treatment. Evidence from high-quality randomised trials in China supports the wide adoption of reperfusion therapies for ischaemic stroke, early blood pressure lowering after intracerebral haemorrhage, individualised approaches to secondary prevention, and the research evaluation of traditional Chinese medicine and neuroprotective agents. Future efforts should focus on promoting a healthy lifestyle, public education on awareness of stroke prevention and timely access to stroke services, training of stroke clinicians on evidence-based stroke care, and improvements in both pre-hospital and post-hospital stroke services. The incidence and mortality of stroke have decreased in China in the past decade; however, the prevalence of stroke continues to rise because of population ageing. In alignment with the Healthy China 2030 blueprint, there has been a strategic reorientation of health-care services towards the prevention of major diseases, including stroke. Along with the establishment of a nationwide network of stroke centres to enhance the delivery of stroke care and research, progress has also been made in understanding stroke aetiology, screening for and control of risk factors, and promoting early diagnosis and treatment. Evidence from high-quality randomised trials in China supports the wide adoption of reperfusion therapies for ischaemic stroke, early blood pressure lowering after intracerebral haemorrhage, individualised approaches to secondary prevention, and the research evaluation of traditional Chinese medicine and neuroprotective agents. Future efforts should focus on promoting a healthy lifestyle, public education on awareness of stroke prevention and timely access to stroke services, training of stroke clinicians on evidence-based stroke care, and improvements in both pre-hospital and post-hospital stroke services.

在过去十年里，中国中风的发病率和死亡率有所下降；然而，由于人口老龄化，中风的患病率仍在持续上升。为契合《“健康中国2030”规划纲要》，医疗服务已进行战略调整，转向包括中风在内的重大疾病预防。随着全国性中风中心网络的建立以提升中风治疗和研究水平，在了解中风病因、筛查和控制危险因素以及促进早期诊断和治疗方面也取得了进展。中国高质量随机试验的证据支持广泛采用缺血性中风再灌注疗法、脑出血后早期降压、个性化二级预防方案，以及对中医药和神经保护剂的研究评估。未来的工作应聚焦于倡导健康的生活方式、开展公众中风预防意识教育并确保及时获得中风治疗服务、对中风临床医生进行循证中风治疗培训，以及改善院前和院后的中风服务。 在过去十年里，中国中风的发病率和死亡率有所下降；然而，由于人口老龄化，中风的患病率仍在持续上升。为契合《“健康中国2030”规划纲要》，医疗服务已进行战略调整，转向包括中风在内的重大疾病预防。随着全国性中风中心网络的建立以提升中风治疗和研究水平，在了解中风病因、筛查和控制危险因素以及促进早期诊断和治疗方面也取得了进展。中国高质量随机试验的证据支持广泛采用缺血性中风再灌注疗法、脑出血后早期降压、个性化二级预防方案，以及对中医药和神经保护剂的研究评估。未来的工作应聚焦于倡导健康的生活方式、开展公众中风预防意识教育并确保及时获得中风治疗服务、对中风临床医生进行循证中风治疗培训，以及改善院前和院后的中风服务。

REF: Wu S, Wang Y, Liu J, et al. Stroke in China: advances in prevention and management on the path to a healthy China. Lancet Neurol. 2026;25(4):379-395. doi:10.1016/S1474-4422(26)00009-8 PMID: 41864235

Traumatic brain injury in China: an update on epidemiology, care pathways, and clinical research

中国创伤性脑损伤：流行病学、诊疗路径和临床研究的最新进展

The burden of traumatic brain injury (TBI) remains a challenge worldwide, and also in China. Since 2019, considerable changes in the epidemiology and characteristics of TBI have occurred, driven by social and economic factors, such as population ageing and the increasing use of mopeds for road transportation. Concurrently, substantial progress has been made in clinical research, including the implementation of high-quality studies on innovative treatments, such as long-term mild hypothermia for severe TBI, right median nerve stimulation for awakening patients in coma after a brain injury, and middle meningeal artery embolisation for chronic subdural haematoma. However, challenges remain, including in the establishment of training for neurosurgical residents, regional disparities in access to specialised healthcare, and low participation in international research networks. Clinical and other innovations provide opportunities for improving TBI care and research in China. Advances in China could offer guidance for the transition between TBI care in low-resource setting and highly specialised centres.

创伤性脑损伤（TBI）负担在全球范围内仍是一项挑战，在中国也是如此。自2019年以来，受人口老龄化和道路运输中助力车使用增加等社会经济因素的推动，TBI的流行病学和特征发生了显著变化。与此同时，临床研究取得了重大进展，包括开展了关于创新治疗的高质量研究，如针对严重TBI的长期亚低温治疗、针对脑损伤后昏迷患者的右侧正中神经刺激促醒治疗，以及针对慢性硬膜下血肿的脑膜中动脉栓塞治疗。然而，挑战依然存在，包括神经外科住院医师培训体系的建立、获得专科医疗服务的地区差异，以及参与国际研究网络的程度较低等问题。临床及其他方面的创新为中国改善TBI治疗和研究提供了机遇。中国取得的进展可为资源匮乏地区与高度专业化中心之间的TBI治疗过渡提供指导。

REF: Feng JF, Huang XJ, Yang XF, et al. Traumatic brain injury in China: an update on epidemiology, care pathways, and clinical research. Lancet Neurol. 2026;25(4):396-405. doi:10.1016/S1474-4422(25)00492-2 PMID: 41864236

Biomarkers for advancing diagnosis and prognosis in stroke

用于改善中风诊断和预后的生物标志物

The complexity and incomplete understanding of the pathophysiology of stroke poses substantial challenges to personalised medicine and the development of novel therapies, as reflected in the neutral results of many randomised trials. Current clinical algorithms lack the precision to diagnose stroke before hospital admission, predict disease progression and recovery, or assess recurrence risk. Biomarkers are urgently needed, yet the absence of a robust evidence base hinders their clinical translation. To lay the groundwork for addressing this knowledge gap, an international multidisciplinary panel of stroke experts conducted a literature review that informed a Delphi consensus process. The stroke experts panel proposes 17 research priorities and five minimum reporting datasets for stroke biomarker studies, each corresponding to a key domain of stroke care: prehospital diagnosis, ischaemic stroke progression, atrial cardiopathy, plaque vulnerability, and intracerebral haemorrhage. This framework will promote consistency and collaboration towards the discovery, validation, and clinical translation of biomarkers to improve stroke care.

中风病理生理学的复杂性以及人们对其了解的不全面，给个性化医疗和新型疗法的开发带来了巨大挑战，许多随机试验的阴性结果就反映了这一点。目前的临床算法在入院前诊断中风、预测疾病进展和恢复情况或评估复发风险方面缺乏精准度。人们迫切需要生物标志物，但由于缺乏有力的证据基础，阻碍了其临床转化。为填补这一知识空白奠定基础，一个由中风领域专家组成的国际多学科小组开展了文献综述，并在此基础上进行了德尔菲共识流程。中风专家小组提出了17项研究重点和5个中风生物标志物研究的最低报告数据集，每个都对应中风护理的一个关键领域：院前诊断、缺血性中风进展、心房病、斑块易损性和脑出血。这一框架将促进在生物标志物的发现、验证和临床转化方面的一致性与合作，以改善中风护理。

REF: Tiedt S, Bustamante A, Cameron A, et al. Biomarkers for advancing diagnosis and prognosis in stroke. Lancet Neurol. 2026;25(4):406-420. doi:10.1016/S1474-4422(25)00480-6 PMID: 41864237

Hand prostheses with somatosensory feedback: functional and clinical benefits

具备躯体感觉反馈的手部假肢：功能及临床益处

The loss of a hand can disrupt body movements, perception of self and the surrounding world, and the emotional fabric of touch. Advances in neuroprosthetics now make restoration of tactile, proprioceptive, and thermal sensations feasible through interfaces with peripheral nerves, the spinal cord, or skin. These somatosensory neuroprostheses not only improve the manipulation of objects and motor learning after amputation, but can also reduce phantom limb pain and enhance embodiment of the artificial limb. The combination of multiple sensory channels-such as touch and temperature-can resemble a natural and emotionally resonant experience for prosthetic users, supporting both their agency and social connection. However, clinical translation remains insufficient. Progress will depend on accessible, cost-effective, and user-centred solutions that are validated through clinical trials. By restoring the sensory richness of the human hand, multimodal feedback can shift prosthetic care beyond mechanical replacement towards truly restoring the sense of self and connection that touch provides.

手部缺失会扰乱身体动作、自我及对周围世界的感知，还会影响触觉带来的情感体验。目前，神经假肢技术的进步使得通过与周围神经、脊髓或皮肤建立接口来恢复触觉、本体感觉和热感觉成为可能。这些躯体感觉神经假肢不仅能改善截肢后物体的操作和运动学习，还能减轻幻肢痛并增强对假肢的认同感。将多种感觉通道（如触觉和温度觉）相结合，能让假肢使用者获得类似自然且富有情感共鸣的体验，既有助于他们自主行动，也有利于社交互动。然而，该技术的临床转化仍显不足。其发展将依赖于通过临床试验验证的、可及的、经济实惠且以用户为中心的解决方案。通过恢复人类手部丰富的感觉，多模态反馈可使假肢护理从单纯的机械替代转变为真正恢复触觉所赋予的自我感知和连接感。

REF: Shokur S, Bassolino M, Kang N, Ackerley R, Micera S. Hand prostheses with somatosensory feedback: functional and clinical benefits. Lancet Neurol. 2026;25(4):421-432. doi:10.1016/S1474-4422(25)00493-4 PMID: 41864238