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[Correspondence] Announcing The Lancet Neurology Commission on Neurorehabilitation

Your Editorial1 underscored the urgent need to address the global burden of neurological disorders through neurorehabilitation, which is one of the four pillars of the neurology quadrangle alongside surveillance, prevention, and acute care.2 The Editorial also introduced The Lancet Neurology Commission on Neurorehabilitation, which seeks to unify global efforts to develop evidence-based pragmatic solutions for improving functioning and quality of life of people living with neurological conditions worldwide.

[Correspondence] Caution on the use of α2δ-ligands in neuropathic pain – Authors' reply

We appreciate the constructive remarks by Chung-Wei Christine Lin and colleagues regarding our systematic review and resulting recommendations.1 Our systematic review and meta-analysis were explicitly scoped to evaluate the safety and efficacy of pharmacotherapy and non-invasive neuromodulation for neuropathic pain as a condition. We combined data from different neuropathic pain aetiologies to inform broad recommendations, while acknowledging that treatment responses might vary according to underlying mechanisms.

[Correspondence] Caution on the use of α2δ-ligands in neuropathic pain

We read with interest the Article by Nadia Soliman and colleagues on neuropathic pain.1 Although, on the basis of their systematic review and meta-analysis, the authors strongly recommended α2δ-ligands as first-line treatments, they noted that the evidence is insufficient to make recommendations for specific populations, as well as the harms associated with pregabalin. We are concerned that this caveat is overshadowed by the headline finding endorsing α2δ-ligands. This endorsement could be particularly problematic if the recommendations in this Article are portrayed as formal guidelines.

[Comment] Progress in Alzheimer's disease: The Lancet Series

The past two decades have seen major advances in Alzheimer's disease research and clinical care, catalysed by the development of CSF and blood biomarkers and PET imaging that reliably detect amyloid β plaques and tau neurofibrillary tangles, the core neuropathological features of the disease. The availability of biomarkers revolutionised the design of longitudinal clinical studies and drug trials, culminating in the development of a new class of therapeutics—anti-amyloid β monoclonal antibodies—that effectively clear amyloid β plaques and modestly slow clinical decline.

[Comment] Brain amyloid on the way to dementia prevention

When the first scientific articles on dementia prevention were published, one of the authors of this Comment was barely in primary school and the other was nowhere near being conceived. Because most cases of dementia, even presenile, were then thought to be caused by circulatory problems (ie, atherosclerotic dementia), the preventive use of anticoagulants was hypothesised.1 Over the years, we have learnt that cognitive impairment develops due to one or, more frequently, several biological and environmental factors.

[Comment] Global burden of headache disorders: innovations, disparities, and priorities for action

In a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), the GBD 2023 Headache Collaborators reinforce headache disorders as being one of the leading causes of non-fatal health loss, affecting nearly 2·9 billion individuals worldwide, with an age-standardised prevalence of 34·6% and causing 541·9 years lived with disability (YLDs) per 100 000 population.1 Migraine alone drives 90% of this burden, with females having a YLD rate more than twice that of males (739·9 vs 346·1 per 100 000).

[Editorial] Celebrating decades of progress in Lewy bodies research

Three decades ago, in October 1995, an international group of researchers convened in Newcastle upon Tyne (England, UK) for the inaugural meeting of the Dementia with Lewy Bodies Consortium. This landmark event laid the foundation for the Consortium's work in establishing clinical and pathological diagnostic criteria. The Consortium's work subsequently expanded to include proposed management guidelines, identification of prodromal forms of the condition, and use of biomarkers to support diagnosis.

[Health Policy] A comparative analysis of food retail policy landscape in four Southeast Asian countries

Changing food retail environment in Southeast Asia has been linked with nutrition transition. While policy on food retail tends to focus on economic considerations, little is known about how nutrition considerations are integrated. This paper examines the landscape of policies addressing food retail and health in Indonesia, Malaysia, the Philippines, and Thailand to inform global nutrition targets. Food retail policy landscapes in the study countries were thematically analyzed using Walt & Gilson's Policy Analysis Triangle framework.

Laparoscopic Surgery in Patients With Distal T4a Gastric Cancer

Mini-invasive techniques have become increasingly popular and even routine for gastric cancer (GC) surgery in many centers. In this issue of JAMA Surgery, Dat and colleagues report results from their randomized clinical trial (RCT) comparing laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) with D2 lymphadenectomy for clinical T4a GC. The protocol of the study was previously published. The study setting is important and clinically relevant. The authors show comparable but not superior short-term outcomes between the operative techniques and recommend LDG to be feasible and safe as an alternative to ODG for qualified and experienced surgeons.

Total Pancreatectomy—Still a Last-Resort Procedure

Total pancreatectomy (TP) may be performed for both benign and malignant indications. TP is becoming increasingly common, especially at specialized high-volume centers and for patients deemed high risk for postoperative pancreatic fistula (POPF). Although technically feasible, TP carries profound metabolic and quality-of-life consequences that distinguish it from other pancreatic resections. Despite this, quality metrics and reference values for postoperative outcomes and complications have yet to be established. These metrics, usually established based on low-risk populations, are vital for comparing surgical outcomes across settings, identifying gaps between actual and ideal outcomes, assessing cost-effectiveness, and evaluating quality improvement initiatives. Benchmarks have been determined for other pancreatic procedures, including pancreaticoduodenectomy (PD).

[Personal View] Autism in schizophrenia and its original link to self-disorder: returning a borrowed concept

Autism was introduced by Eugen Bleuler in 1910 as a defining feature of schizophrenia, and it remained so for 80 years. However, the concept was borrowed by Leo Kanner and Hans Asperger to describe another condition (infantile autism) and eventually awareness of autistic features in schizophrenia declined. Today, autistic features are by default considered indicative of autism spectrum disorder, and patients with schizophrenia, who exhibit autistic features, risk being misdiagnosed with autism spectrum disorder and receiving inadequate treatment.

[Review] Postpartum anxiety: a state-of-the-art review

Although there has been increasing interest in the study of postpartum anxiety in recent years, it remains an emerging field. We present a state-of-the-art review of postpartum anxiety, with the aim of comprehensively surveying postpartum anxiety literature and presenting a synthesis of the complete body of knowledge around postpartum anxiety. We found an estimated global prevalence of 12·3% for postpartum anxiety. Postpartum anxiety is associated with primiparity and younger maternal age. Multiple screening tools are validated for use in postpartum anxiety, although none of these tools are validated for ongoing assessment.

[Articles] Metformin for overweight and obese children and adolescents with bipolar spectrum and related mood disorders treated with second-generation antipsychotics: a randomised, pragmatic trial

Although its effect on weight is modest, we conclude that for most patients, the benefits of metformin outweigh the risks. The findings from this trial suggest that clinicians should consider prescribing metformin for young people with bipolar spectrum disorder and related mood disorders who are overweight or obese and are treated with second-generation antipsychotics.

[Insight] Bon voyage

I had put the kids to bed and was cleaning up the kitchen when I received the text from Lisa. It was a link to an untitled document, in response to a “Happy 40th Birthday!” message I had sent earlier in the day. I opened the document with one hand while unloading the dishwasher with the other.

[Correspondence] Lifestyle interventions in mental health care in the Philippines

In their third report, entitled Implementing lifestyle interventions in mental health care, the Lancet Psychiatry Physical Health Commission discussed the fact that people with mental illness face higher rates of physical health issues, which contribute to a 13–15-year reduction in life expectancy.1 Although lifestyle interventions can improve physical and mental health, they are not consistently included in mental health services.1 Tailoring these interventions to socioeconomic conditions is crucial, particularly in low-income and middle-income countries (LMICs), where mental health systems are often underdeveloped and underfunded.