Andreea Veronica Stavăr

Cognitive disorders, from mild cognitive impairment to more serious dementia, are becoming more common and are directly related to the increased longevity and quality of life throughout the world. This demographic dynamic places a tremendous pressure on health care systems and fosters vigorous research in the international medical community, with the aim of identifying disease-modifying treatments able to stop or slow the progression of these neurodegenerative diseases. In total, 28 molecules are presently under development in this therapeutic portfolio at various phases of clinical studies. The main purpose of this research is to conduct a detailed analysis of therapeutic agents in Phase III clinical trials, a key phase for evaluating efficacy and safety. Another section describes monoclonal antibodies, a class of drugs that has already demonstrated impressive results as DMTs by specifically targeting pathogenic processes. Besides DMTs, there are several innovative approaches under research for treating acute exacerbations and symptom relief in neurodegenerative diseases. This review aims to critically synthesize the therapeutic landscape in dementia, pointing to promising directions for future clinical research. Of the 28 candidates evaluated, 7.1% met the primary efficacy endpoints in Phase III, 50.0% showed minimal or no efficacy, and 42.9% await definitive results. While monoclonal antibodies demonstrate a modest slowing of clinical progression in early-stage disease, many candidate compounds have failed, underscoring the ongoing difficulties of late-stage pharmaceutical development.

Background/Objectives: Electrotherapy encompasses diverse therapeutic modalities used in Physical and Rehabilitation Medicine, but pediatric evidence varies substantially across modality–indication pairs. This structured narrative review mapped the available pediatric clinical evidence and provided a clinically structured synthesis of clinical applications, treatment parameters, reported therapeutic outcomes, safety, and evidence gaps in pediatric rehabilitation. Methods: PubMed, Scopus, and Web of Science were searched for publications from 1 January 2000 to 17 July 2026. Evidence was synthesized by electrotherapy modality and clinical indication and classified using Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Formal methodological quality and risk-of-bias appraisal using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and Risk of Bias 2 (RoB 2) was performed for the evidence underpinning OCEBM Level 1 classifications; no formal GRADE certainty-of-evidence assessment was performed. Results: A comparatively more developed pediatric evidence base was identified for radial extracorporeal shock wave therapy (rESWT) in cerebral palsy-related spasticity; transcutaneous electrical nerve stimulation (TENS) and interferential current therapy (IFC) in bladder and bowel dysfunction; and neuromuscular electrical stimulation (NMES)/functional electrical stimulation (FES), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) for selected motor rehabilitation outcomes. Photobiomodulation (PBM)/low-level laser therapy (LLLT), pulsed electromagnetic field therapy (PEMF), and high-intensity laser therapy (HILT) showed promising but indication-specific evidence, whereas Transfer of Energy Capacitive and Resistive (TECAR) had preliminary adjunctive evidence. Therapeutic ultrasound and Deep Oscillation Therapy were supported by insufficient pediatric clinical evidence, while several modalities lacked eligible pediatric clinical studies. Short-term tolerability was generally favorable, but long-term safety data remain limited. Conclusions: Electrotherapy has an adjunctive role in selected pediatric rehabilitation indications, but prescription should be based on specific modality–indication pairs. The available evidence does not support comparative effectiveness conclusions between modalities. Standardized multicenter trials and long-term safety studies are required.

Background/Objectives: Electrotherapy encompasses diverse therapeutic modalities used in Physical and Rehabilitation Medicine, but pediatric evidence varies substantially across modality–indication pairs. This structured narrative review critically synthesized evidence on clinical applications, treatment parameters, efficacy, safety, and evidence gaps in pediatric rehabilitation. Methods: PubMed, Scopus, and Web of Science were searched for publications from 1 January 2000 to 17 July 2026. Evidence was synthesized by electrotherapy modality and clinical indication and classified using Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Results: The strongest evidence was identified for rESWT in cerebral palsy-related spasticity; TENS and IFC in bladder and bowel dysfunction; and NMES/FES, rTMS, and tDCS for selected motor rehabilitation outcomes. PBM/LLLT, PEMF, and HILT showed promising but indication-specific evidence, whereas TECAR had preliminary adjunctive evidence. Therapeutic ultrasound and Deep Oscillation Therapy remain insufficiently supported, and several modalities lack pediatric clinical evidence. Short-term tolerability was generally favorable, but long-term safety data remain limited. Conclusions: Electrotherapy has an adjunctive role in selected pediatric rehabilitation indications, but prescription should be based on specific modality–indication pairs. Standardized multicenter trials and long-term safety studies are required.