Best of 2025: 5 major changes that redefined neurology
Industry Buzz
I anticipate we’ll see an uptick in usage of AI to support physicians while they care for patients, streamline workflows, and improve diagnostics and treatments. We’re also likely to see expanded use of robotics and AI in complex surgeries, particularly for brain and spine procedures.
—E. Antonio Chiocca, MD, PhD
The past year has been unusually dynamic for neurology—marked by disruptive breakthroughs, sharpened diagnostic tools, and fast-evolving models of care. What might have seemed like incremental advances even a few years ago are now accelerating into changes with real, immediate clinical impact.
For neurologists keeping a finger on the pulse, some changes aren’t just headlines—they’re game‑changers. Here, we highlight five major shifts that have the potential to redefine how neurologists diagnose, treat, and manage patients in the months and years ahead.
1. Expanded role of AI and multiomics in neurology
At the American Neurological Association (ANA) 2025 meeting, one of the plenary themes was how “genetics, AI, and data-driven approaches” are changing neurology. []
A recent paper proposed a framework for integrating large language models and generative AI to improve diagnosis and care in Alzheimer’s disease and related disorders. []
“I anticipate we’ll see an uptick in usage of artificial intelligence (AI) to support physicians while they care for patients, streamline workflows and improve diagnostics and treatments in 2025,” said E. Antonio Chiocca, MD, PhD, executive director of the Center for Tumors of the Nervous System at Mass General Brigham. [] “We’re also likely to see expanded use of robotics and AI in complex surgeries, particularly for brain and spine procedures," he added.
Related: How this doc is embracing AI in oncology—and why you should, too2. Revised diagnostic criteria for multiple sclerosis
The 2024 revision of the McDonald criteria—now widely referenced in 2025 literature—permits diagnosis of multiple sclerosis in some asymptomatic individuals with characteristic MRI findings. []
This includes cases with radiologically isolated syndrome, where MRI shows typical multifocal lesions and cerebrospinal fluid reveals oligoclonal bands, now accepted as an alternative to demonstrating dissemination in time.
Lesions in the optic nerve are newly counted toward dissemination in space. At the same time, central vein sign (CVS) and paramagnetic rim lesions (PRLs) as diagnostic imaging biomarkers can support diagnostic confidence in atypical or older cases.
This shift means earlier intervention is possible. “Approximately 20% of people diagnosed with MS might actually have an incorrect diagnosis … Fortunately, the 2024 McDonald criteria revisions introduce some powerful tools to address these challenges,” said Daniel Ontaneda, MD, PhD, coauthor of the revised criteria. []
“We no longer talk about people needing to have symptoms to reach a diagnosis,” Dr. Ontaneda told MedCentral. []
3. Regenerative/ultra-early therapy in movement and neuromuscular disease came of age
Two very different 2025 signals pointed in the same direction: treat earlier and, in some cases, replace cells.
In Parkinson’s disease, two phase I/early II trials (hES-derived dopaminergic neurons in 12 patients; iPSC-derived dopaminergic cells in 7 patients) showed that bilateral putaminal transplantation was feasible and well-tolerated, with several patients improving motor scores over 18 months of follow-up, with no serious adverse events over 24 months of follow-up. [] Long-term data are needed, but this is the cleanest clinical proof-of-concept yet.
In pediatric neuromuscular neurology, presymptomatic spinal muscular atrophy (SMA) treated with daily oral risdiplam (started up to 6 weeks of age) led to 12-month motor milestones (sit, stand, and walk) and 24-month survival without the need for ventilation or feeding support in 26 presymptomatic infants with SMA. These outcomes are better than those expected from the natural history of SMA in infants.
4. Growth in therapeutics for neuroinflammation and neurodegeneration
At the AAN review, neuroinflammatory mechanisms and neurodegenerative biomarkers again featured strongly. []
For example, recent research increasingly identifies that neurofilament light chain, along with glial fibrillary acidic protein and p-tau181, are elevated across multiple neurodegenerative diseases, including Alzheimer’s, mild cognitive impairment, Parkinson’s, and frontotemporal dementia spectrum disorders. []
While no new blockbuster drug has yet changed the standard of care globally, momentum suggests that neurologists need to prepare for new disease-modifying therapies beyond the classic movement disorder and MS domains.
5. Dementia prevention moved from theory to trial-level signals
Two 2025 data points nudged neurology toward vascular and infectious approaches to preventing cognitive decline.
First, a cluster-randomized trial in rural China showed that pushing BP to < 130/80 mmHg reduced all-cause dementia at 48 months (4.6% vs 5.4%). [] While small in absolute terms, the trial provides RCT-level evidence that aggressive BP control can affect cognition.
Second, national program data from Wales and Australia showed that people who were eligible for and received the herpes zoster vaccine had a slightly lower rate of new dementia diagnoses (about 1%–2% lower than those who were unvaccinated) over 7 years of follow-up, adding to the “infection → neuroinflammation → cognitive decline” story.
Neurologists can now quote trial-grade data, not just epidemiology, when they tell patients and primary care physicians to treat hypertension and stay up to date on the zoster vaccine.
Together, these advances redefine neurological care—from managing decline to preventing and repairing it—and push clinicians to adopt earlier diagnosis, integrate molecular screening, and prepare for regenerative therapies entering clinical practice.
Related: A new clue in Alzheimer’s could rewrite what we know about the disease