Afferent.
The Tract · monthly neurology brief

Two pages a month. What changed in neurology, how strong the evidence is, and whether it should change what you do on Monday. Free, no sign-up.

Cover of Afferent No. 01, October 2026
Latest · No. 01 · October 2026

Tenecteplase before thrombectomy may help cardioembolic stroke more than atherosclerotic

A conference month: ECTRIMS (held jointly with ACTRIMS as MSToronto) and the World Stroke Congress ran in the same week. Europe tightens the clock on encephalitis, MS moves toward smouldering disease and EBV, and a blood test for Alzheimer's risk drew more headlines than it deserved.

  • 01Tenecteplase before thrombectomy may help cardioembolic stroke more than atheroscleroticStroke · Secondary analysis of an RCTWatch
  • 02The first joint European guideline on infectious encephalitis puts a clock on aciclovirNeuro-infection · GuidelineChange practice
  • 03ECTRIMS in two minutes: five things from MSToronto2026Multiple sclerosis · Conference abstracts · 21–23 Oct5 points
  • 04Plasma p-tau217 predicts who becomes impaired — over years, not monthsDementia · Pooled cohorts · JAMANo change
  • !An accelerated-approval filing for CNM-Au8, built on trials that missed their primary endpointsHype check · ALSHype check

Evidence

Five pips for a phase 3 trial or a strong guideline; fewer for subgroups, cohorts and company data. Conference and press-release data are labelled as such.

Practice

Change practice, Consider, Watch or No change: whether the finding should alter what you do now, not how exciting it is.

Hype check

Each issue takes one loud headline and sets it against the evidence underneath.