The 2024 revision of the McDonald criteria for diagnosis of multiple sclerosis marks a substantial departure from previous iterations, establishing a unified framework that integrates presentation, lesion topography and a flexible combination of paraclinical tools. This Clinical Outlook considers the major changes and their clinical implementation, and the implications of the new criteria.

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.

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.

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.

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 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 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 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 Natalia S. Rost, President of the American 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 Amina Gargouri and Riadh Gouider, President and Honorary President of the Pan-Arab Union of Neurological Societies.