by 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 September 2026.
For our Paper of the Month, go here: Paper of the Month Archives – eanNews
Tavapadon Improves Motor Symptoms and Daily Function in Early Parkinson’s Disease
The phase 3, double-blind, randomised TEMPO-2 trial evaluated the safety, tolerability, and efficacy of flexible-dose tavapadon (5–15 mg once daily), a selective dopamine D1/D5 receptor partial agonist, in 304 adults with early Parkinson’s disease (disease duration <3 years). Participants were randomised 1:1 to tavapadon (n = 151) or placebo (n = 153) for 27 weeks. The primary endpoint was change from baseline to week 26 in the combined MDS-UPDRS Parts II and III score.
There was a significant improvement with tavapadon compared to placebo: least squares mean decrease of 10.3 points [95% CI -12.2 to -8.3] vs 1.2 points [95% CI -2.9 to 0.6]; treatment difference −9.1 points, 95% CI -11.7 to -6.5; p < 0.0001. Patient-reported outcomes also favoured tavapadon, with 46% reporting being “much improved” or “very much improved” on the Patient Global Impression of Change scale versus 19% on placebo (p < 0.0001). Adverse events were more frequent with tavapadon than placebo (76% vs 55%), leading to higher discontinuation rates (24% vs 4%), with nausea (30% vs 3%), headache (17% vs 5%), and dizziness (16% vs 5%) being the most common, while somnolence and impulse control disorders occurred infrequently.
Prenatal Antiseizure Polytherapy and Specific Monotherapies Heighten Fetal Growth Risks
This prospective, observational cohort study from the EURAP international registry evaluated foetal growth outcomes across 15,893 singleton livebirths born to women with epilepsy treated with antiseizure medications (ASMs) during pregnancy (12,911 exposed to monotherapy and 2,982 to polytherapy). Compared to monotherapy, prenatal polytherapy exposure was associated with lower birthweight centiles and approximately 50% increased odds of impaired foetal growth, including small for gestational age (adjusted OR 1.48, 95% CI 1.29–1.70), severe small for gestational age (aOR 1.49, 95% CI 1.22–1.83), and low birthweight (aOR 1.50, 95% CI 1.15–1.95).
Among monotherapies, topiramate showed the largest reduction in birthweight centile compared with lamotrigine (adjusted coefficient −11.93, 95% CI −16.72 to −7.15; p < 0.0001). Significantly lower birthweight centiles relative to lamotrigine were also observed for phenobarbital (adjusted coefficient −8.04, 95% CI −12.18 to −3.90), oxcarbazepine (−5.41, 95% CI −9.16 to −1.66), carbamazepine (−3.89, 95% CI −5.56 to −2.23), valproate (−3.14, 95% CI −5.21 to −1.07), and levetiracetam (−2.67, 95% CI −4.62 to −0.73). These findings indicate that poor foetal growth is an important adverse outcome of ASM exposure that requires individualized risk assessment alongside teratogenicity.
Boston Criteria v2.0 Exhibits Reduced Sensitivity for Cerebral Amyloid Angiopathy in Memory Clinic Cohorts
This retrospective multicentre study assessed the diagnostic accuracy of the updated Boston Criteria v2.0 for sporadic cerebral amyloid angiopathy (CAA) in memory clinic populations using neuroimaging and neuropathological data from the ADNI and NACC databases. While the v2.0 criteria have achieved high diagnostic sensitivity (~75–90%) in patients presenting with haemorrhagic stroke, their performance in memory clinic settings with cognitive presentations proved considerably lower.
In this memory clinic cohort, Boston Criteria v2.0 demonstrated a sensitivity of 43% (95% CI 25%–62%), a specificity of 83% (95% CI 72%–92%), and an area under the curve of 0.63 (95% CI 0.52–0.74). These results highlight the limitations of current MRI-based diagnostic criteria for detecting CAA in predominantly cognitive populations, a critical consideration when screening candidates for amyloid-targeting monoclonal antibodies associated with ARIA.
