Recent advancements in neurosurgery have focused on enhancing the functionality and reliability of brain-computer interfaces (BCIs) and improving surgical outcomes for epilepsy and glioblastoma patients. Silversmith et al. developed a plug-and-play BCI using a 128-channel chronic electrocorticography (ECoG) implant, demonstrating stable performance in a paralyzed individual without the need for daily recalibration, which is a significant limitation in current BCI technology (ref: Silversmith doi.org/10.1038/s41587-020-0662-5/). In parallel, Wang et al. introduced an innovative electric-field-responsive contrast agent that significantly improves the visualization of epileptic foci in mouse models, potentially aiding in the surgical excision of drug-resistant epilepsy lesions (ref: Wang doi.org/10.1038/s41551-020-00618-4/). Additionally, Wong et al. presented a microfluidic cell-migration assay that accurately predicts progression-free survival in glioblastoma patients, achieving an impressive 86% accuracy in categorizing patient outcomes based on cellular behavior (ref: Wong doi.org/10.1038/s41551-020-00621-9/). These studies collectively highlight the integration of novel technologies in neurosurgery, aiming to enhance patient outcomes and streamline surgical processes.

The exploration of tumor biology has led to significant insights into treatment strategies for various cancers, particularly glioblastoma and triple-negative breast cancer (TNBC). Johnson et al. developed a gene expression-based prognostic signature for IDH wild-type glioblastoma, utilizing data from multiple clinical trials to enhance predictive accuracy for patient outcomes (ref: Johnson doi.org/10.1093/neuonc/). In TNBC, Li et al. identified circular HER2 RNA as a potential therapeutic target, demonstrating sensitivity to Pertuzumab, which could pave the way for more effective treatments in this challenging cancer subtype (ref: Li doi.org/10.1186/s12943-020-01259-6/). Furthermore, the study by Lou et al. on circular RNA CDR1as revealed its role in stabilizing the p53 protein, thereby inhibiting gliomagenesis through a novel mechanism that does not involve miRNA sponging (ref: Lou doi.org/10.1186/s12943-020-01253-y/). These findings underscore the importance of understanding molecular mechanisms in developing targeted therapies and improving patient prognoses.

Research into neuroinflammation and neurodegeneration has unveiled critical pathways linking cellular dysfunction to inflammatory responses. Chakravarti et al. demonstrated that telomere dysfunction activates the YAP1 transcription factor, leading to increased production of pro-inflammatory factors like IL-18, which may contribute to inflammatory diseases (ref: Chakravarti doi.org/10.1038/s41467-020-18420-w/). Additionally, studies by Gong et al. and Gupta et al. explored the therapeutic potential of stem cell-derived extracellular vesicles (SC-EVs) in rejuvenating senescent stem cells, indicating a promising avenue for combating age-related disorders (ref: Gong doi.org/10.1080/20013078.2020.1800971/; ref: Gupta doi.org/10.1080/20013078.2020.1800222/). These findings highlight the intricate relationship between cellular aging, inflammation, and potential therapeutic interventions, emphasizing the need for further exploration of these mechanisms in neurodegenerative conditions.

Stroke management has evolved significantly, particularly in understanding the impact of treatment timing and techniques on patient outcomes. Akbik et al. analyzed national registry data to reveal that in-hospital stroke patients experience longer delays in receiving reperfusion therapies compared to out-of-hospital patients, which correlates with worse functional outcomes (ref: Akbik doi.org/10.1001/jamaneurol.2020.3362/). Kaesmacher et al. further examined the effects of pre- and in-hospital delays on reperfusion success, finding that each hour of delay significantly reduces the likelihood of achieving optimal reperfusion results (ref: Kaesmacher doi.org/10.1161/STROKEAHA.120.030208/). Moreover, Yang et al. compared intraarterial versus intravenous tirofiban as adjuncts to endovascular thrombectomy, providing insights into optimizing treatment protocols for acute ischemic stroke (ref: Yang doi.org/10.1161/STROKEAHA.120.029994/). These studies collectively emphasize the critical role of timely intervention and treatment strategies in improving outcomes for stroke patients.

Advancements in neuroimaging techniques are enhancing diagnostic capabilities and patient care in neurosurgery. Sheth et al. introduced a portable low-field magnetic resonance imaging (MRI) system that allows for bedside assessments of brain injury in critically ill patients, addressing the need for timely neuroimaging in intensive care settings (ref: Sheth doi.org/10.1001/jamaneurol.2020.3263/). Additionally, Topalovic et al. developed a mobile deep brain recording and stimulation platform that integrates with virtual and augmented reality, facilitating real-time monitoring of brain activity in freely moving subjects (ref: Topalovic doi.org/10.1016/j.neuron.2020.08.021/). Stib et al. leveraged deep learning to create a convolutional neural network for detecting large vessel occlusions in multiphase CT angiography, potentially expediting diagnosis and treatment for stroke patients (ref: Stib doi.org/10.1148/radiol.2020200334/). These innovations underscore the transformative impact of technology on neuroimaging and diagnostics, ultimately aiming to improve patient outcomes.

The intersection of genetics and molecular mechanisms is pivotal in understanding neurosurgical conditions and developing targeted therapies. Lou et al. highlighted the role of circular RNA CDR1as in gliomagenesis, demonstrating its ability to stabilize the p53 protein and inhibit tumor growth through a novel mechanism (ref: Lou doi.org/10.1186/s12943-020-01253-y/). Zhang et al. identified long non-coding RNA LPP-AS2 as a key player in glioma tumorigenesis, elucidating its regulatory effects on the EGFR/PI3K/AKT pathway (ref: Zhang doi.org/10.1186/s13046-020-01695-8/). Additionally, Davis et al. explored the impact of ghrelin signaling on feeding behavior and metabolism, revealing its significance in neurodevelopmental processes (ref: Davis doi.org/10.1016/j.cub.2020.08.069/). These studies collectively emphasize the importance of genetic and molecular research in advancing neurosurgical practices and improving therapeutic strategies.

Improving patient outcomes and quality of life remains a central focus in neurosurgery, with recent studies exploring various interventions and their impacts. Austevoll et al. conducted a comparative effectiveness study on microdecompression versus decompression with instrumented fusion for lumbar degenerative spondylolisthesis, finding that microdecompression alone was noninferior in improving patient-reported outcomes (ref: Austevoll doi.org/10.1001/jamanetworkopen.2020.15015/). Cristini et al. performed a systematic review and meta-analysis on the effects of exercise on sleep quality in Parkinson's disease, demonstrating significant improvements in subjective sleep quality through exercise interventions (ref: Cristini doi.org/10.1016/j.smrv.2020.101384/). Furthermore, Lauria et al. examined the role of SMN-primed ribosomes in spinal muscular atrophy, highlighting the importance of ribosome function in maintaining motor neuron health (ref: Lauria doi.org/10.1038/s41556-020-00577-7/). These findings underscore the multifaceted approach required to enhance patient care and quality of life in neurosurgical populations.