20 years of Nature Reviews Neurology

We are celebrating 20 years of Nature Reviews Neurology with our November 2025 issue. On reaching this milestone, we have refined and renewed our mission, and we continue to evolve the journal to support the translation of research into real-world benefits.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Christopher Chen, President of the Asian and Oceanian Association of Neurology.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Amina Gargouri and Riadh Gouider, President and Honorary President of the Pan-Arab Union of Neurological Societies.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Lawrence Tucker and Augustina Charway-Felli, President and Past President, respectively, of the African Academy of Neurology.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Elena Moro, President of the European Academy of Neurology.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Fernando Cendes, Vice President of the Pan American Federation of Neurology.

To mark the 20th anniversary of Nature Reviews Neurology, we have asked leaders of neurological societies across the world to reflect on progress over the past two decades and consider what the future holds for neurology in their region. Here, we speak to Natalia S. Rost, President of the American Academy of Neurology.

Accumulating evidence indicates important roles for microglial activation and neuroinflammation in Alzheimer disease (AD). Here, Leng and Edison describe the interplay between microglial activation and AD-related pathologies and discuss how microglial priming and activation might influence the trajectory of AD.

Ageing is a risk factor for many neurodegenerative diseases, including Alzheimer disease and Parkinson disease. This Review synthesizes current knowledge about the biological processes that underlie normal brain ageing and neurodegeneration, and discusses promising therapeutic strategies based on these mechanisms.

Apolipoprotein E (APOE) is the greatest genetic modulator of sporadic Alzheimer disease risk. This Review provides a comprehensive update on our current knowledge of the genetics of APOE and its role in Alzheimer and other neurodegenerative diseases, and summarizes emerging APOE-targeted therapies designed to prevent or slow down Alzheimer disease.

Neurofilaments have been validated as specific body fluid biomarkers of neuro-axonal injury. In this Review, Khalil and colleagues provide an update on the structure and function of neurofilaments, analytical approaches and challenges in different clinical contexts, and progress towards clinical application of neurofilaments as a biomarker in various neurological disorders.

In this Review, the authors provide an overview of the evidence regarding the use of blood levels of glial fibrillary acidic protein as a biomarker in a range of neurological diseases, including traumatic brain injury, stroke, multiple sclerosis and Alzheimer disease.

In this Review, Cristino, Bisogno and Di Marzo outline the biology of cannabinoids, the endocannabinoid system and the expanded endocannabinoid system and discuss the involvement of these systems and the therapeutic potential of cannabinoids across the spectrum of neurological disease.

Deep brain stimulation (DBS) is a neurosurgical procedure that allows targeted circuit-based neuromodulation and has become a standard of care in a range of movement disorders. This Review discusses the evolution and current status of DBS technology and anticipates future advances.

Here, Rafii and Aisen review recent progress surrounding the approvals of amyloid-targeting monoclonal antibodies, the first disease-modifying therapies for Alzheimer disease. The Review highlights key factors that affect the integration of these treatments into clinical practice and explores future directions.

Amyloid-related imaging abnormalities are the most impactful adverse effect of anti-amyloid-β immunotherapies. Here, the authors review the detection, underlying mechanisms and clinical implications of amyloid-related imaging abnormalities and highlight the need for further research to predict, prevent and treat the condition.

Astrocytes are essential for neuronal survival and function in the CNS but, under pathological conditions, they can adopt potentially harmful reactive states. This Review highlights how ‘omics’ technologies can enable the functional characterization of defined reactive astrocyte states in various pathological scenarios.

Lifestyle and environmental factors, some which are potentially modifiable, have important roles in the risk of multiple sclerosis (MS), and some of these risk factors, such as Epstein–Barr virus infection, smoking and obesity in adolescence, interact with genetic risk factors. Here, Olsson and colleagues summarize recent data on modifiable environmental and lifestyle factors in MS, with a focus on gene–environment interactions.

Treatments that target calcitonin gene-related peptide (CGRP) and its receptor are proving effective for migraine treatment. In this Review, Edvinsson et al. trace the translation of CGRP biology into successful therapies and consider exactly where these drugs act.

In this Review, Vezzani and colleagues discuss inflammatory pathways that are activated in pharmacoresistant epilepsy and can be modulated to therapeutic effect in animal models. They consider how targeting these pathways could overcome limitations of existing anti-epileptic treatments.

Dementia is commonly encountered in advanced stages of Parkinson disease (PD), but evidence is accumulating that cognitive decline can manifest much earlier in the disease course. Aarsland and colleagues review current knowledge regarding cognitive impairment in patients with PD, focusing on cerebrospinal fluid and imaging biomarkers as potential predictors of cognitive decline in this population.

The maternal immune activation (MIA) hypothesis proposes that inflammatory perturbations in utero can affect fetal neurodevelopment. This Review examines the emerging human evidence for an association between MIA and childhood neurodevelopmental disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder and Tourette syndrome.

In this Perspectives article, Roozenbeek et al. discuss issues with epidemiological studies in traumatic brain injury (TBI) and variability in the definition of such injuries. They describe how changing epidemiological patterns have influenced mortality and outcomes following brain injury, and identify the need for standardized epidemiological monitoring in TBI.

Two decades after antisense oligonucleotides (ASOs) were initially identified as agents capable of modulating RNA processing and protein expression, the first antisense oligonucleotide (ASO) therapies have now been approved for the treatment of neurological disease. Here, Rinaldi and Wood discuss our current understanding of ASO pharmacology, and the future prospects for ASO-mediated treatment of neurological disease

In this Review of adult diffuse gliomas, Molinaro et al. discuss the latest epidemiological data and highlight advances from the past decade, including the identification of genetic and other risk factors for glioma included in the 2016 WHO integrated classification system.

Effective drug treatments for intracerebral haemorrhage (ICH) are still lacking. However, therapies that target microglial phenotype switching might soon become available for affected patients. Here, Wang and colleagues summarize key advances in understanding of microglial function after ICH, including modulators of microglial function and interactions with other cells.

Increasing evidence suggests that Alzheimer disease (AD) is not simply a CNS disorder, but involves interactions between systemic and brain-related factors. Wang and colleagues review the role of amyloid-β (Aβ) in AD, highlighting systemic abnormalities linked to Aβ metabolism and discussing how these abnormalities might influence central pathways of Aβ production and clearance.

Approximately half of the people currently with multiple sclerosis (MS) are ≥50 years of age, yet guidelines for management of MS in older age are lacking. This Consensus statement presents the outcomes of an International Advisory Committee on Clinical Trials (IACCT) in MS workshop on ageing and MS, including recommendations for advancing research, care and awareness.

Freezing of gait is a debilitating motor symptom that commonly occurs in Parkinson disease, atypical parkinsonism and other neurodegenerative conditions, the management of which is complex. This Expert Recommendation provides updated, state-of-the-art recommendations for the management of freezing of gait, based on the latest insights into the pathophysiology of the condition.

Autologous haematopoietic stem cell transplantation (AHSCT) is a treatment option for some forms of multiple sclerosis (MS), but uncertainties remain about its implementation in clinical practice and treatment protocols need to be optimized. This Consensus Statement provides guidance and recommendations for the use of AHSCT in MS and neuromyelitis optica spectrum disorders.

Major advances have been made in disease-modifying therapies for multiple sclerosis, but people with Parkinson disease still lack such treatment options. Drawing on discussions from a symposium held in November 2022, this Roadmap proposes areas for exploration in Parkinson disease using lessons learned from therapeutic development in multiple sclerosis.

Myelin oligodendrocyte glycoprotein antibody-associated disease is an immune-mediated demyelinating disease that is distinct from multiple sclerosis but shares some of its characteristics. This Expert Recommendation, based on a Magnetic Resonance Imaging in MS workshop, proposes a diagnostic algorithm for the differential diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease and multiple sclerosis, using serological, imaging and clinical features.

Anti-amyloid treatments for early symptomatic Alzheimer disease have greatly increased the need for biomarker confirmation of amyloid pathology and blood biomarker tests offer an accessible and scalable biomarker test. This Consensus Statement provides recommendations for the minimum acceptable performance of blood biomarker tests for clinical use.

Current approaches to classifying cognitive impairment in people living with HIV can overestimate disease burden and lead to ambiguity around disease mechanisms. In this Consensus Statement, the International HIV-Cognition Working Group have outlined six recommendations towards a new approach, intended to better represent changes in the spectrum of HIV disease in the modern era of antiretroviral therapy.

In this Roadmap, Marrie and colleagues set out the steps needed to improve our understanding of the multiple sclerosis (MS) prodrome and develop standardized criteria for identifying individuals with prodromal MS, thereby facilitating trials of interventions that could slow progression to classical MS.

Evidence is accumulating that both central and peripheral immune responses are dysregulated in Alzheimer disease (AD). This roadmap reviews the current status of this research and provides a new research prospectus to advance our understanding of peripheral–central immune crosstalk in AD.

In this Consensus Statement, which is endorsed by the European Headache Federation and the European Academy of Neurology, an expert panel provides recommendations for the diagnosis and management of migraine to support clinical decision-making by general practitioners, neurologists and headache specialists.

Malformations of cortical development (MCDs) are neurodevelopmental disorders that result from abnormal development of the cerebral cortex in utero. In this Consensus Statement, the international MCD network Neuro-MIG provides recommendations to aid both expert and non-expert clinicians in the diagnostic work-up of MCDs.

In 2018, the Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain workshop convened to discuss strategies to facilitate the development of biomarkers and end points for pain. The outcomes of this workshop are outlined in this Consensus Statement.

In this Consensus statement, the Magnetic Resonance Imaging in MS (MAGNIMS) study group reviews the application of brain and spinal cord atrophy in clinical practice in the management of MS and makes consensus statements and recommendations for future research.

In this Consensus Statement, Leonhard et al. provide a globally applicable guideline for the diagnosis and management of Guillain–Barré syndrome, including information on early recognition of the disease, prediction of clinical course and outcome, and management of complications and sequelae.

Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of such uses of brain imaging.

The central vein sign (CVS) has been proposed as a novel MRI biomarker to improve the accuracy and speed of multiple sclerosis (MS) diagnosis. This Consensus Statement from the NAIMS Cooperative provides a roadmap to help radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS.