Background and objectives:Although the international community collectively seeks to reduce global temperature rise to under 1.5ºC before 2100, irreversible environmental changes have already occurred, and as the planet warms these changes will continue to occur. As we witness the effects of a warming planet on human health, it is imperative that neurologists anticipate how the epidemiology and incidence of neurologic disease may change. In this review, we organized our analysis around three key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuro-infectious diseases, and pollutant impacts. Across each of these themes, we appraised and reviewed recent literature relevant to neurological disease and practice.Methods:Studies were identified using search terms relating to climate change, pollutants, and neurologic disease in PubMed, OVID MEDLINE, Embase, PsycInfo, and grey literature. Studies published between 1990 and 2022 were included if they pertained to human incidence or prevalence of disease, were in English, and were relevant to neurologic disease.Results:We identified a total of 364 articles, grouped into the three key themes of our study; extreme weather events and temperature fluctuations (38 studies), emerging neuro-infectious diseases (37 studies), and pollutant impacts (289 studies). The included studies highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity.Discussion:Temperature extremes and variability both associated with stroke incidence and severity, migraine headaches, hospitalization in dementia patients, and multiple sclerosis exacerbations. Exposure to airborne pollutants, especially PM2.5 and nitrates, associated with stroke incidence and severity, headaches, dementia risk, Parkinson’s disease, and MS exacerbation. Climate change has demonstrably expanded favorable conditions for zoonotic diseases beyond traditional borders, and poses the risk of disease in new, susceptible populations. Articles were biased towards resource-rich regions, suggesting a discordance between where research occurs and where changes are most acute. As such, three key priorities emerged for further study; neuro-infectious disease risk mitigation, understanding the pathophysiology of airborne pollutants on the nervous system, and methods to improve delivery of neurologic care in the face of climate-related disruptions.

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Purpose of ReviewMyocarditis is a disease caused by inflammation of the heart that can progress to dilated cardiomyopathy, heart failure, and eventually death in many patients. Several etiologies are implicated in the development of myocarditis including autoimmune, drug-induced, infectious, and others. All causes lead to inflammation which causes damage to the myocardium followed by remodeling and fibrosis. This review aims to summarize recent findings in biomarkers for myocarditis and highlight the most promising candidates. Recent Findings Current methods of diagnosing myocarditis, including imaging and endomyocardial biopsy, are invasive, expensive, and often not done early enough to affect progression. Research is being done to find biomarkers of myocarditis that are cost-effective, accurate, and prognostically informative. These biomarkers would allow for earlier screening for myocarditis, as well as earlier treatment, and a better understanding of the disease course for specific patients. Summary Early diagnosis of myocarditis with biomarkers may allow for prompt treatment to improve outcomes in patients.

ImportanceAlthough the international community collectively seeks to reduce global temperature rise to less than 1.5ºC, there are already irreversible environmental changes that have occurred, and currently available evidence suggests these changes will continue to occur. As we begin to witness the effects of a warming planet on human health, it is imperative that as neurologists we anticipate the ways in which the epidemiology and incidence of neurologic disease may be affected.ObjectiveIn this review, we organize our analysis around three key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuro-infectious diseases, and pollutant impacts. Across each of these key themes, we appraise and review recent literature relevant to neurological disease and the practice of neurology.Evidence ReviewStudies were identified using a set of relevant search terms relating to climate change and neurologic diseases in the PubMed repository for publications between 1990 and 2021. Studies were included if they pertained to human incidence or prevalence of disease, were in the English language, and were relevant to neurologic disease.FindingsWe identified a total of 136 articles, grouped into the three key themes of our study; extreme weather events and temperature fluctuations (23 studies), emerging neuro-infectious diseases (42 studies), and pollutant impacts (71 studies). Broadly, the studies included highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity.Conclusions and RelevanceOur work highlights three key priorities for further work; namely, neuro-infectious disease risk mitigation, an understanding of the pathophysiology of airborne pollutants on the nervous system, and research into how to improve delivery of neurologic care in the face of climate-related disruptions.Key PointsQuestionHow does climate change impact neurological disease?Findings136 articles were identified relating neurologic disease to climate change. Articles were grouped into three key themes, highlighting evidence linking neurologic disease exacerbation to temperature fluctuation, tick-borne infections with climate change, and airborne pollutants to cerebrovascular disease.MeaningA substantial body of literature suggests that neurologic disease incidence, morbidity, and mortality is directly impacted by climate change and its sequelae, but much remains to be uncovered.