Recent advancements in neurosurgical techniques have focused on integrating innovative technologies to enhance patient outcomes and improve diagnostic capabilities. One notable study demonstrated that adapted large language models (LLMs) can outperform medical experts in clinical text summarization, significantly alleviating the burden on clinicians by efficiently analyzing and summarizing vast amounts of data from electronic health records (ref: Van Veen doi.org/10.1038/s41591-024-02855-5/). This highlights the potential of artificial intelligence in streamlining clinical workflows. Additionally, the development of soft neural probes, which are integrated through high-resolution printing of liquid electronics on the cranium, has shown promise in long-term neural activity recording. In-vivo studies indicated that these probes could record neural activities for up to 33 weeks, providing a novel approach to studying brain functions without the constraints of bulky electronics (ref: Park doi.org/10.1038/s41467-024-45768-0/). Furthermore, the application of a genetic risk score model has improved the prediction of multiple sclerosis diagnoses in patients presenting with optic neuritis, emphasizing the importance of genetic factors in clinical decision-making (ref: Loginovic doi.org/10.1038/s41467-024-44917-9/).

Research into glioblastoma (GBM) has revealed critical insights into tumor-infiltrating lymphocytes (TILs) and their role in treatment efficacy. A study found that glioblastoma-infiltrating CD8+ T cells are predominantly a clonally expanded GZMK+ effector population, suggesting that these cells may play a significant role in the tumor microenvironment and response to immunotherapy (ref: Wang doi.org/10.1158/2159-8290.CD-23-0913/). In addition, the identification of sexual-biased necroinflammation as a predictor of bevacizumab benefit in GBM patients indicates that gender-specific factors may influence treatment outcomes (ref: Hiller-Vallina doi.org/10.1093/neuonc/). Another study highlighted the potential of secreted clusterin to inhibit tumorigenesis by modulating interactions between tumor cells and macrophages, providing a new avenue for therapeutic intervention in meningioma, a common primary intracranial tumor (ref: Ke doi.org/10.1093/neuonc/). These findings collectively underscore the complexity of GBM and the need for tailored therapeutic strategies.

The management of large ischemic strokes has been significantly advanced by endovascular thrombectomy (EVT), as demonstrated in the SELECT2 trial, which reported improved long-term outcomes for patients undergoing EVT compared to medical care alone (ref: Sarraj doi.org/10.1016/S0140-6736(24)00050-3/). This phase 3 trial confirmed the efficacy of EVT in a diverse patient population across multiple countries. Additionally, a study assessing the impact of adjunctive low-dose methylprednisolone during EVT found no significant improvement in disability outcomes, suggesting that further research is needed to optimize treatment protocols (ref: doi.org/10.1001/jama.2024.0626/). Another analysis focused on the treatment effects of EVT in transferred versus directly presenting patients, revealing that transfer times and neuroimaging changes are crucial for clinical outcomes (ref: Sarraj doi.org/10.1001/jamaneurol.2024.0206/). These studies highlight the ongoing evolution of stroke management and the importance of refining treatment strategies based on patient characteristics.

Neuroinflammation and neurodegeneration are closely linked, with recent studies uncovering mechanisms that contribute to cognitive impairment and other neurological disorders. One study demonstrated that retrograde endocannabinoid signaling at inhibitory synapses plays a significant role in synaptic plasticity, revealing location-specific signaling dynamics in vivo (ref: Dudok doi.org/10.1126/science.adk3863/). Another investigation highlighted the role of monocytes in driving blood-to-brain transcytosis in diabetes, suggesting that circulatory pro-cathepsin D may be a target for interventions aimed at preventing microvascular complications (ref: Zhao doi.org/10.1161/CIRCRESAHA.123.323622/). Additionally, research on the regulation of stress granule formation in oligodendrocytes indicated that metabolic stress combined with pro-inflammatory cytokines leads to persistent stress granules, which may contribute to multiple sclerosis pathology (ref: Pernin doi.org/10.1038/s41467-024-45746-6/). These findings emphasize the intricate interplay between inflammation and neurodegeneration, highlighting potential therapeutic targets.

The study of neuro-oncology has increasingly focused on the tumor microenvironment and its influence on treatment outcomes. Research has shown that the integration of soft neural probes can facilitate long-term monitoring of neural activities, which is crucial for understanding tumor interactions within the brain (ref: Park doi.org/10.1038/s41467-024-45768-0/). Furthermore, secreted clusterin has been identified as a significant factor in inhibiting tumorigenesis by modulating the interactions between tumor cells and macrophages in meningioma, suggesting a potential therapeutic target (ref: Ke doi.org/10.1093/neuonc/). Additionally, the application of a genetic risk score model has improved the prediction of multiple sclerosis diagnosis in patients presenting with optic neuritis, indicating the importance of genetic profiling in understanding tumor behavior and patient outcomes (ref: Loginovic doi.org/10.1038/s41467-024-44917-9/). These studies collectively highlight the need for a comprehensive approach to neuro-oncology that considers both genetic and microenvironmental factors.

Neurosurgical outcomes are increasingly being evaluated through comparative studies of treatment modalities. A recent study assessed functional outcomes in patients with cerebellar infarcts, revealing that surgical management may lead to better outcomes compared to conservative treatment, particularly when stratified by infarct volume and Glasgow Coma Scale scores (ref: Won doi.org/10.1001/jamaneurol.2023.5773/). Additionally, the use of repeated blood-brain barrier opening with an implantable ultrasound device in combination with carboplatin for recurrent glioblastoma showed promising safety and efficacy results, indicating a novel approach to enhancing drug delivery in brain tumors (ref: Carpentier doi.org/10.1038/s41467-024-45818-7/). Furthermore, the investigation into the molecular interplay in hepatocellular carcinoma has identified potential biomarkers for early detection and prognosis, emphasizing the importance of understanding tumor biology in improving patient management (ref: Cai doi.org/10.1186/s40779-024-00515-w/). These findings underscore the need for ongoing research into optimizing surgical and medical management strategies.

Neuroimaging and biomarker research have made significant strides in enhancing diagnostic accuracy and treatment monitoring in neurological disorders. A study utilizing intracranial electroencephalography revealed effector-independent evidence accumulation dynamics across multiple brain regions, providing insights into the neural basis of decision-making processes (ref: Gherman doi.org/10.1038/s41562-024-01824-9/). Additionally, the sequencing of cerebrospinal fluid cell-free DNA has facilitated early differential diagnosis of intramedullary spinal cord tumors, demonstrating the potential of liquid biopsies in neurosurgical practice (ref: Chai doi.org/10.1038/s41698-024-00541-w/). Furthermore, the application of a genetic risk score model has significantly improved the prediction of multiple sclerosis diagnoses in patients presenting with optic neuritis, highlighting the role of genetic factors in clinical decision-making (ref: Loginovic doi.org/10.1038/s41467-024-44917-9/). These advancements underscore the critical role of neuroimaging and biomarkers in shaping the future of neurology and neurosurgery.

Neurophysiology research has provided valuable insights into brain function and its underlying mechanisms. Recent findings on retrograde endocannabinoid signaling at inhibitory synapses have demonstrated the dynamic nature of synaptic interactions in vivo, revealing how location-specific signaling can influence neuronal activity (ref: Dudok doi.org/10.1126/science.adk3863/). Additionally, the integration of soft neural probes has facilitated long-term monitoring of neural activities, which is essential for understanding brain function in both health and disease (ref: Park doi.org/10.1038/s41467-024-45768-0/). Furthermore, studies on the role of IL-6 from cerebrospinal fluid in mediating widespread pain through astrocytosis have highlighted the complex interplay between neuroinflammation and pain perception, suggesting potential therapeutic targets for managing chronic pain conditions (ref: Yu doi.org/10.1186/s12974-024-03049-z/). These studies collectively emphasize the importance of understanding neurophysiological processes in developing effective interventions for neurological disorders.