The Lancet Neurology in conversation with

What will Alzheimer’s disease diagnosis look like in 5–10 years?
In this episode of In Conversation With…, Laura Hart is joined by the authors behind The Lancet Neurology Series on Future Directions in Alzheimer’s Disease and Related Disorders: Clifford Jack (Mayo Clinic), Charlotte Teunissen (Amsterdam UMC), Tammie Benzinger (Washington University in St Louis), and Jonathan Graff-Radford (Mayo Clinic). They discuss blood-based biomarkers and plasma p-tau217 testing, amyloid PET and MRI monitoring for ARIA, anti-amyloid therapies, and what it means to screen cognitively unimpaired people for Alzheimer’s disease neuropathological change. The conversation covers the role of primary care in early diagnosis, direct-to-consumer biomarker tests, how to communicate borderline results to healthy people, the AHEAD and TRAILBLAZER-ALZ prevention trials, and whether these pathways can work outside well-resourced health systems.
Click here to read the articles in the series: 
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00246-2/fulltext
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00285-1/fulltext
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00248-6/fulltext
 

For decades, a diagnosis of vanishing white matter disease came with no real treatment — so how is an old blood-pressure pill offering hope? In this episode of In Conversation With…The Lancet Neurology, Deputy Editor Laura Hart speaks with Professor Marjo van der Knaap (Amsterdam UMC) about her clinical trial of guanabenz in children with the leukodystrophy vanishing white matter. They unpack the integrated stress response and eIF2B pathophysiology, why guanabenz moved from mouse models into a paediatric trial, the striking effect of age of onset, unexpected hallucinations as a side-effect, and where combination therapy with eIF2B activators could take the field. Essential listening for neurologists on leukodystrophy, rare paediatric neurological disease, and translating stress-response biology into treatment.
Click here to read the full article:
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00241-3/fulltext

In this episode, Heather Brown, Senior Editor at The Lancet Neurology, chats with Jan Lünemann (University of British Columbia, Canada) and Christian Münz (University of Zürich, Switzerland) about their Rapid Review on Epstein-Barr virus (EBV) and multiple sclerosis (MS). EBV, a common herpesvirus, has been strongly implicated in development of MS, and recent mechanistic advances are providing new insights into how EBV might cause MS in some people but not others. We also discuss the potential for prevention of MS with EBV vaccines, whether therapies targeting EBV might eventually be useful for MS treatment, and important unanswered questions and next steps for the field.
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00177-8/fulltext

In this episode of In Conversation With, Morgane Boillot, Senior Editor at The Lancet Neurology, speaks with connective tissue disorders — including Marfan syndrome — and human genetics expert Hal Dietz from Johns Hopkins Medicine (Baltimore, USA) about the genetics of spontaneous spinal CSF leaks.
Together, they explore the clinical presentation, diagnosis, and current treatment of spontaneous spinal CSF leaks, and discuss genetic findings revealing rare deleterious variants in FBN2, the gene encoding fibrillin-2, in patients with type 1b leaks. The conversation covers translational and mechanistic findings — including CRISPR-Cas9 mouse models and cellular interactions with the extracellular matrix — and what these reveal about the underlying biology of fibrillin-1 and fibrillin-2-related disorders. It also addresses the potential clinical implications of these findings, and Professor Dietz shares his hopes for their use in therapeutic development.
Click here to read the full article:
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00140-7/fulltext

In this episode of In Conversation With, Elena Becker-Barroso, Editor-in-Chief of The Lancet Neurology, speaks with movement disorders specialist Tony Schapira from UCL’s Queen Square Institute of Neurology about GBA1-associated Parkinson’s disease.Together, they explore the genetic, clinical, and biochemical links between GBA1 variants, lysosomal function, Gaucher disease, alpha-synuclein pathology, and Parkinson’s progression. The conversation also highlights current challenges in risk prediction, biomarkers, genetic counselling, clinical management, and emerging therapeutic approaches aimed at modifying or even preventing disease.
Click here to read the full article:
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00090-6/fulltext

Join The Lancet Neurology’s In Conversation With… as editors Elena Becker-Barroso and Laura Hart welcome Henry Brodaty and Alice Powell from the University of New South Wales (Sydney, Australia) to discuss cognitive resilience and ageing.
This episode teases apart cognitive resilience, cognitive reserve, brain maintenance, and brain reserve; explores how social determinants, life-course factors, and vascular health shape resilience; and delves into robust measures, biomarkers, and how pathologies interact with resilience. It also covers multicomponent interventions and their transferability to low-income and middle-income countries, how clinicians should communicate risk, and the key knowledge gaps and priorities for global cognitive resilience research. Don’t miss this timely exploration of dementia prevention and healthy brain ageing.
Click here to read the full article: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00027-X/fulltext

In this episode, Laura Hart and Elena Becker-Barroso speak with Niklas Mattsson-Carlgren (Lund University) about the use of blood biomarkers in the diagnosis and stratification of Alzheimer's disease. They discuss two particular plasma biomarkers—p-tau217 and eMTBR-tau243—including what they measure and how a proposed practical two-step approach that uses p-tau217 as an initial screen in a neurology clinic, and then eMTBR-tau243 for those who test positive, could support diagnostic decisions. Click here to read the full article:https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(26)00029-3/fulltextMedical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.Continue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

In this episode, Senior Editor Morgane Boillot speaks with Professor Cristina Tassorelli (University of Pavia, Italy) about recent advances in migraine prevention. Together with colleagues, Tassorelli has authored a Review in the journal examining the major developments in migraine-specific pharmacological treatments over the past decade, with a particular focus on therapies targeting the CGRP pathway. In this conversation, they explore what these advances mean for people living with migraine and for clinicians, discuss promising emerging targets for prevention and the future of biomarkers, and consider whether it is time to redefine the goals of migraine prevention with greater ambition. Click here to read the full article: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00477-6/fulltextMedical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.Continue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Our Editor-in-Chief, Elena Becker-Barroso, speaks with Inga Zerr (DZNE, Göttingen, Germany) and Simon Mead (UCL London, UK) about the latest advances in prion diseases. In collaboration with other experts, Zerr and Mead have authored a Series in the journal that covers the genetic factors behind these diseases, and new diagnostic and prognostic biomarkers.Click here to read the full articles:https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00451-X/fulltexthttps://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00406-5/fulltextMedical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.Continue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Host Morgane Boillot chats with Dr Julia Greenland about a clinical trial of azathioprine in early Parkinson's disease. Click here to read the full article: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00386-2/fulltextMedical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.Continue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv