by Isabella Colonna and Raphael Wurm
Each month the eanNews editorial team reviews the scientific press for recently published papers of outstanding interest to neurologists. Below we present our selection for March 2026.
For our Paper of the Month, go here: Research Paper of the Month: Coffee and Tea Intake, Dementia Risk, and Cognitive Function
Comparative Effectiveness of Brivaracetam, Cenobamate, Lacosamide, and Perampanel in Focal Epilepsy
Focal epilepsy is the most prevalent form of epilepsy in adults. Treatment decisions for drug-resistant focal epilepsy remain largely empirical, as direct comparative evidence among newer antiseizure medications is limited. The aim of this study was to evaluate the comparative effectiveness and safety of brivaracetam, cenobamate, lacosamide, and perampanel as adjunctive therapies in adults with drug-resistant focal epilepsy, using a multicentre pooled analysis of four previously conducted retrospective real-world medical record review studies.
After adjustment for confounding factors, cenobamate was associated with higher responder rates at both six and twelve months, as well as a greater likelihood of seizure freedom at twelve months, compared with the other studied drugs. In addition, cenobamate showed significantly higher retention rates compared with brivaracetam and perampanel. In terms of tolerability, cenobamate was associated with the highest incidence of adverse events, most commonly somnolence, dizziness, and other central nervous system–related symptoms. Overall, these findings suggest that cenobamate may be more effective than brivaracetam, lacosamide, and perampanel in adults with drug-resistant focal epilepsy, based on data from a large real-world population.
Read the paper here: Comparative Effectiveness of Brivaracetam, Cenobamate, Lacosamide, and Perampanel in Focal Epilepsy | Epilepsy and Seizures | JAMA Neurology | JAMA Network
Dietary Patterns and Indicators of Cognitive Function
Although healthier diets are believed to support cognitive health, the current evidence remains limited and inconsistent. This study aimed to examine the associations between adherence to six healthy dietary patterns and both subjective cognitive decline (SCD) and objectively measured cognitive function. A total of 159,347 individuals from three US-based cohort studies were included. The six dietary patterns analysed were: the AHEI-2010, the Dietary Approaches to Stop Hypertension (DASH) diet score, the Healthful Plant-Based Diet Index (hPDI), the Planetary Health Diet Index (PHDI), and the reversed empirical dietary indices for hyperinsulinemia (rEDIH) and inflammation (rEDIP).
Greater adherence to all dietary patterns, particularly the DASH diet, was associated with a lower risk of SCD and, with the exception of hPDI and PHDI, with improved objective cognitive function in a dose-response manner. The DASH diet was associated with lower SCD risk, even when measured up to 26 years before the SCD assessments, and showed robust protective effects across different ages, particularly during midlife (45–54 years). Higher consumption of vegetables, fish, and moderate amounts of wine contributed to the observed beneficial associations, whereas greater intake of red and processed meats, fried potatoes, and sugary beverages was linked to poorer cognitive function.
These findings underscore the potential of a healthy diet to maintain long-term cognitive health and highlight the need for implementation research to translate these insights into scalable interventions.
Read the paper here: Dietary Patterns and Indicators of Cognitive Function | Lifestyle Behaviors | JAMA Neurology | JAMA Network
Anti-amyloid antibody Crenezumab does not delay decline in preclinical familial AD
This double-blind, placebo-controlled trial investigated the efficacy of crenezumab, an anti-amyloid monoclonal antibody, in cognitively unimpaired carriers of the PSEN1Glu280Ala mutation. These individuals are at nearly 100% risk of developing early-onset Alzheimer’s disease at approximately the same age as their relatives. A total of 252 participants (85 crenezumab-carriers, 84 placebo-carriers, and 83 placebo-non-carriers) were randomized to receive either the study drug or a placebo for 5 to 8 years to assess whether early intervention could prevent or delay the onset of clinical symptoms. Primary endpoints were the API ADAD, a score that assesses overall cognitive function, and the FCSRT-CI, which measures episodic memory.
The study did not meet its dual primary endpoints: the annualized rate of change in the API ADAD composite score was –1.10 (SE 0.29) for the crenezumab group versus –1.43 (0.29) for the placebo group (between-group difference off0.33 (95% CI –0.48 to 1.13; p = 0.43). Similarly, the FCSRT–CI showed no significant difference, with a between-group difference of 0.01 (95% CI 0.00 to 0.02; p = 0.16). Safety profiles were comparable, with serious adverse events occurring in 27% of the crenezumab group and 25% of the placebo group. Secondary endpoints showed that crenezumab did not significantly engage its target, as plaque burden measured by PET and downstream AD biomarkers were similar between the groups. These results suggest that a robust reduction in fibrillar amyloid may be a prerequisite for clinical efficacy in Alzheimer’s disease prevention.
