Exploring reward, weight, and processed foods as mechanisms of binge eating and food addiction.

Over the past decade, the clinical landscape of spinal muscular atrophy (SMA) has undergone a profound transformation. Once considered one of the most common genetic causes of infant mortality, SMA has three disease-modifying therapies (DMTs): Spinraza (nusinersen), Zolgensma (onasemnogene abeparvovec), and Evrysdi (risdiplam). These treatments have significantly altered the natural history of the disease and reshaped patient outcomes, standards of care, and long-term expectations. The concurrent implementation of newborn screening programs has further revolutionized disease management by enabling early diagnosis and timely intervention. As SMA management evolves with the advent of adjuvant therapies such as muscle-targeted treatments like apitegromab there remains a critical need to optimize best practices for clinical care and to standardize the selection and administration of clinical outcome assessments (COAs) that comprehensively describe how a patient feels, functions, or survives, while also capturing treatment-related changes in real-world settings. SMA is a recessive neuromuscular disease (NMD) characterized by progressive muscle weakness and atrophy due to lower motor neuron loss. Approximately 90% of SMA is caused by a deletion or mutation on chromosome 5 of the Survival Motor Neuron (SMN) 1 gene (5q13.2), which has a crucial role in producing SMN protein. The SMN protein is essential for lower motor neuron health and function. In addition to the gene, the gene produces a small amount of stable SMN protein. Therefore, a higher number of gene copies generally corresponds to more SMN protein present and less disease severity. SMA clinically manifests with muscular, bulbar and respiratory weakness. As a result, persons with SMA (pwSMA) experience functional impairments, including gross and fine motor impairments, fatigue, reduced social participation, pain, gastrointestinal issues, sleep disturbances, emotional dysregulation, respiratory impairment, and bulbar dysfunction affecting speech and swallowing. Historically, SMA has been classified based on age of symptom onset and maximum motor milestone achievement in untreated patients. However, this classification does not adequately capture the evolving phenotypic spectrum resulting from therapeutic advances and shifts in standard of care. In 2007, a consensus statement on SMA standard of care was published to improve patient management and establish a framework for future clinical trials. These guidelines were subsequently updated in 2018, producing a two-part set of recommendations in response to the expansion of clinical trials and the availability of novel treatments.