Glioblastoma (GBM) remains one of the most aggressive forms of brain cancer, with a median survival of approximately 15 months. The tumor microenvironment (TME) plays a pivotal role in GBM progression, making it a promising target for therapeutic interventions. Wolf et al. explored the potential of engineered materials to dissect and reconstruct the GBM microenvironment, demonstrating that manipulating the TME could enhance therapeutic efficacy (ref: Wolf doi.org/10.1038/s41578-019-0135-y/). In a complementary study, Wang et al. utilized genetically engineered mouse models to classify GBM into distinct molecular subtypes based on cell lineage, revealing unique transcriptional profiles that could inform personalized treatment strategies (ref: Wang doi.org/10.1016/j.ccell.2020.06.003/). Furthermore, Bell et al. conducted a comprehensive genomic analysis within the NRG Oncology/RTOG 9802 trial, highlighting the prognostic significance of WHO-defined molecular subgroups in low-grade glioma, which could influence treatment decisions (ref: Bell doi.org/10.1200/JCO.19.02983/). These findings underscore the importance of understanding the TME and molecular characteristics of GBM to improve patient outcomes. In addition to the TME, recent studies have focused on the metabolic characteristics of gliomas. Miller et al. investigated the activation of sirtuin enzymes in IDH-mutant tumors, which are known to have altered metabolic states, suggesting that targeting NAD+ metabolism could be a viable therapeutic approach (ref: Miller doi.org/10.1093/neuonc/). Batich et al. reported promising long-term survival rates in glioblastoma patients receiving dendritic cell vaccines targeting cytomegalovirus, indicating that immunotherapeutic strategies may also play a critical role in managing this challenging disease (ref: Batich doi.org/10.1158/1078-0432.CCR-20-1082/). Collectively, these studies highlight the multifaceted nature of glioblastoma research, emphasizing the need for integrated approaches that consider both the tumor microenvironment and molecular characteristics to develop effective therapies.

Neuroinflammation is increasingly recognized as a critical factor in the pathology of various central nervous system (CNS) disorders. Pasciuto et al. demonstrated that CD4 T cells are essential for the fetal-to-adult transition of microglia, suggesting that these immune cells play a significant role in maintaining CNS homeostasis and may influence neuroinflammatory responses (ref: Pasciuto doi.org/10.1016/j.cell.2020.06.026/). This finding is particularly relevant in the context of neurodegenerative diseases, where dysregulation of immune responses can exacerbate neuronal damage. Schultheiβ et al. provided insights into the adaptive immune response in COVID-19 patients, revealing distinct B and T cell receptor signatures associated with disease severity, which may inform therapeutic strategies for managing neuroinflammatory complications in COVID-19 (ref: Schultheiβ doi.org/10.1016/j.immuni.2020.06.024/). Moreover, the interplay between neuroinflammation and cerebrovascular health has been highlighted in studies examining the impact of COVID-19 on stroke risk. Merkler et al. found that among patients hospitalized for COVID-19, the incidence of acute ischemic stroke was 1.6%, indicating a potential link between viral infection and cerebrovascular events (ref: Merkler doi.org/10.1001/jamaneurol.2020.2730/). This is further supported by Hernández-Fernández et al., who reported high morbidity and mortality associated with cerebrovascular disease in COVID-19 patients, emphasizing the need for vigilant monitoring of neurological symptoms in this population (ref: Hernández-Fernández doi.org/10.1093/brain/). These studies collectively underscore the importance of understanding neuroinflammatory mechanisms and their implications for CNS disorders, particularly in the context of emerging infectious diseases.

Advancements in neurosurgical techniques are crucial for improving patient outcomes in neuro-oncology. Hollon et al. introduced intraoperative stimulated Raman histology (SRH) combined with deep neural networks for the rapid detection of glioma recurrence, demonstrating its potential to enhance diagnostic accuracy during surgery (ref: Hollon doi.org/10.1093/neuonc/). This innovative approach allows for near-real-time assessment of tumor margins, which is vital for achieving complete resection and minimizing recurrence rates. Additionally, Jaeckle et al. analyzed the efficacy of various treatment modalities in patients with oligodendroglioma, revealing that those treated with radiotherapy in combination with temozolomide had significantly better progression-free survival compared to those receiving temozolomide alone (ref: Jaeckle doi.org/10.1093/neuonc/). Furthermore, the integration of novel therapeutic strategies such as exosome engineering for targeted drug delivery has shown promise. Zhan et al. demonstrated the potential of engineered blood exosomes for efficient gene and chemotherapy combination therapy, highlighting their ability to enhance therapeutic efficacy while reducing systemic toxicity (ref: Zhan doi.org/10.7150/thno.45028/). These innovations reflect a growing trend towards personalized and minimally invasive approaches in neurosurgery, aiming to improve treatment outcomes while preserving neurological function. Collectively, these studies illustrate the dynamic landscape of neurosurgical techniques and their implications for advancing neuro-oncology.

Molecular and genetic research is pivotal in advancing our understanding of neuro-oncology, particularly in identifying therapeutic targets and prognostic markers. Tolaney et al. conducted a Phase II study of abemaciclib in patients with brain metastases from hormone receptor-positive breast cancer, although the study did not meet its primary endpoint, it provided valuable insights into the intracranial response rates and potential treatment strategies for this patient population (ref: Tolaney doi.org/10.1158/1078-0432.CCR-20-1764/). In a related study, Oh et al. utilized integrated pharmaco-proteogenomics to classify IDH wild-type glioblastomas into distinct subgroups, revealing significant molecular heterogeneity that could inform personalized treatment approaches (ref: Oh doi.org/10.1038/s41467-020-17139-y/). Additionally, Zhang et al. explored the dual inhibition of PFKFB3 and VEGF in glioblastoma, demonstrating that this strategy normalizes tumor vasculature and enhances chemotherapy efficacy, thereby providing a promising avenue for improving treatment outcomes in this aggressive malignancy (ref: Zhang doi.org/10.7150/thno.44427/). These findings underscore the importance of molecular profiling in neuro-oncology, as they not only enhance our understanding of tumor biology but also pave the way for the development of targeted therapies that can significantly improve patient prognosis.

The field of neurodegenerative diseases is increasingly focusing on multifactorial approaches to risk reduction and prevention. Kivipelto et al. highlighted the establishment of the World-Wide FINGERS Network, which aims to implement multidomain lifestyle interventions to mitigate the risk of dementia, particularly in the context of Alzheimer's disease (ref: Kivipelto doi.org/10.1002/alz.12123/). This initiative builds on the positive outcomes of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), suggesting that comprehensive lifestyle changes can have a significant impact on cognitive health. In the context of Parkinson's disease, Foltynie et al. demonstrated that the Lee Silverman Voice Treatment (LSVT) LOUD program not only improves speech amplitude but also enhances intelligibility, thus addressing a critical aspect of communication difficulties faced by patients (ref: Foltynie doi.org/10.1016/j.eclinm.2020.100456/). This finding emphasizes the importance of targeted therapeutic interventions in managing cognitive and communicative deficits in neurodegenerative disorders. Collectively, these studies illustrate the potential for integrated approaches in addressing the complex challenges posed by neurodegenerative diseases, highlighting the need for continued research into effective prevention and treatment strategies.

The intersection of cerebrovascular disorders and emerging health crises, such as COVID-19, has garnered significant attention in recent research. Hernández-Fernández et al. reported a cerebrovascular disease incidence of 1.4% among COVID-19 patients, with high morbidity and mortality rates, underscoring the need for heightened awareness and monitoring of neurological complications in this population (ref: Hernández-Fernández doi.org/10.1093/brain/). This study highlights the critical role of neuroimaging and clinical assessment in understanding the impact of viral infections on cerebrovascular health. Merkler et al. conducted a comparative analysis of ischemic stroke rates in COVID-19 patients versus those with influenza, finding that 1.6% of COVID-19 patients experienced acute ischemic strokes, suggesting a potential link between the virus and increased stroke risk (ref: Merkler doi.org/10.1001/jamaneurol.2020.2730/). Additionally, the emerging spectrum of neurological manifestations associated with COVID-19, as discussed by Paterson et al., emphasizes the necessity for multidisciplinary approaches to address the neurological implications of the pandemic (ref: Paterson doi.org/10.1093/brain/). These findings collectively underscore the importance of understanding the complex relationship between infectious diseases and cerebrovascular disorders, particularly in the context of public health emergencies.

Pediatric neurosurgery and tumor studies are increasingly utilizing advanced techniques to better understand and treat childhood brain tumors. Gojo et al. applied single-cell RNA sequencing to pediatric ependymomas, revealing significant intratumoral heterogeneity and developmental trajectories that could inform targeted therapies (ref: Gojo doi.org/10.1016/j.ccell.2020.06.004/). This study highlights the importance of molecular characterization in tailoring treatment strategies for pediatric patients, who often present unique challenges compared to adults. Moreover, the integration of machine learning and deep learning techniques in clinical practice is exemplified by the work of Kong et al., who developed an automatic diagnosis and severity-classification model for acromegaly using facial photographs, showcasing the potential for technology to enhance diagnostic accuracy in pediatric endocrinology (ref: Kong doi.org/10.1186/s13045-020-00925-y/). These advancements reflect a growing trend towards personalized medicine in pediatric neurosurgery, emphasizing the need for continued research and innovation to improve outcomes for young patients with brain tumors.

Clinical trials play a crucial role in advancing treatment strategies for neuro-oncology, with recent studies providing valuable insights into therapeutic efficacy and patient outcomes. Bell et al. conducted a post hoc analysis of the NRG Oncology/RTOG 9802 trial, demonstrating the prognostic significance of WHO-defined molecular subgroups in patients with low-grade glioma, which could guide treatment decisions and improve survival rates (ref: Bell doi.org/10.1200/JCO.19.02983/). This study emphasizes the importance of molecular profiling in clinical trials to enhance personalized treatment approaches. In another significant trial, Tolaney et al. evaluated the efficacy of abemaciclib in patients with brain metastases from hormone receptor-positive breast cancer, although the study did not meet its primary endpoint, it provided critical data on intracranial response rates that could inform future therapeutic strategies (ref: Tolaney doi.org/10.1158/1078-0432.CCR-20-1764/). Additionally, Zhan et al. explored the engineering of blood exosomes for targeted gene and chemotherapy delivery, highlighting innovative approaches to enhance treatment efficacy while minimizing side effects (ref: Zhan doi.org/10.7150/thno.45028/). Collectively, these studies underscore the dynamic landscape of clinical trials in neuro-oncology, emphasizing the need for continued research to develop effective and personalized treatment strategies.