The Lancet Neurology in conversation with

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.

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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.

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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