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[In Context] Krithi Irmady

Krithi Irmady is an Assistant Professor at Rockefeller University, New York, NY, USA. She studied medicine in Mysore, India, and completed her doctorate at the University of Heidelberg in Germany. She trained in Adult Neurology at Yale University (New Haven, CT), and Movement Disorders at Columbia University (New York, NY, USA). Her research focuses on RNA dysregulation in Parkinson's disease, with the goal of developing novel therapies and peripheral biomarkers.

[In Context] Aseptic meningitis

In 1932, the Guy's Hospital (London, UK) physician John Ryle lectured on meningitis and meningism. By meningitis he meant the pathological state that involved inflammation, usually infective, of the meninges; and by meningism, he meant a clinical condition comprising Kernig's sign and neck rigidity but lacking final proof of bacteria in the CSF. Ryle argued that meningism was always indicative of irritation of the meninges or a mild meningitis, even if it was aseptic, giving as examples the aseptic meningitis of subarachnoid haemorrhage and the meningism seen in cases of pneumonia and otitis media, which he speculated was due to the “chemical products of fever or contiguous infection”.

[In Context] Ian McKeith: pioneer, collaborator, runner

Ian McKeith has always liked running. When I spoke to him, he had just completed the Great North Run, the world's most populous half-marathon, which takes place annually in northeast England. The first time he ran it was in 1982. Now, just into his seventies, he says: “it took me twice as long as it did when I was 28 years old. But I'm lucky still to be able to do it.” McKeith, Emeritus Professor of Old Age Psychiatry at Newcastle University (Newcastle upon Tyne, UK) ran to raise funds for the Lewy Body Society, a charity he helped establish 20 years ago.

[Corrections] Correction to Lancet Neurol 2025; 24: 969–75

Blauwendraat C, Morris HR, Keuren-Jensen KV, Noyce AJ, Singleton AB. The temporal order of genetic, environmental, and pathological risk factors in Parkinson's disease: paving the way to prevention. Lancet Neurol 2025; 24: 969–75—In this Personal View, figures 1 and 2 were transposed. This correction has been made to the online version as of Nov 12, 2025.

[Corrections] Correction to Lancet Neurol 2025; 24: 512–23

Manley GT, Dams-O’Connor K, Alosco ML, et al. A new characterisation of acute traumatic brain injury: the NIH-NINDS TBI Classification and Nomenclature Initiative. Lancet Neurology 2025; 24: 512–23—In this Policy Review, Rachel Sayko Adam's name was listed incorrectly in the appendix. This correction has been made to the online version as of Nov 12, 2025.

[Corrections] Correction to Lancet Neurol 2020; 19: 391–401

Zhang C, Zhang M, Qui W, et al. Safety and efficacy of tocilizumab versus azathioprine in highly relapsing neuromyelitis optica spectrum disorder (TANGO): an open-label, multicentre, randomised, phase 2 trial. Lancet Neurol 2020; 19: 391–401—In the Declaration of interest section of this Article, statements have been corrected for Fu-Dong-Shi. These corrections have been made to the online version as of Nov 12, 2025.

[Correspondence] Focused ultrasound pallidothalamic tractotomy for Parkinson's disease: the field is moving fast

In our Personal View on focused ultrasound, we covered pallidothalamic tractotomy as a potentially effective treatment for Parkinson's disease.1 However, we labelled this approach as experimental. Notably, a week before our publication, the US Food and Drug Administration (FDA) approved staged bilateral pallidothalamic tractotomy for use in patients with Parkinson's disease, therefore validating its clinical application. This regulatory decision was based on the results of a multicentre, uncontrolled trial applying unilateral and staged bilateral tractotomy (NCT04728295), whose findings have not been published yet.

[Correspondence] The Fit4MedRob rehabilitation initiative

We, also on behalf of the Fit4MedRob Consortium, read with great interest your Editorial on neurorehabilitation,1 and strongly endorse its call to centre rehabilitation on individual needs and to close the post-discharge care gap across the continuum of care. In this spirit, we wish to draw attention to Fit for Medical Robotics (Fit4MedRob)—an Italian initiative funded by the Italian Ministry of University and Research (total cost of approximately €120 million) that directly addresses the priorities highlighted by the Editorial.

[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.