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South Asia is thought to be the highest contributor to stroke mortality in the world, probably accounting for more than 40% of global stroke deaths. Wasay et al. review stroke epidemiology and management issues in four South Asian countries: India, Pakistan, Sri Lanka and Bangladesh. The authors highlight the prevalence of traditional and nontraditional stroke risk factors in this region, and consider the barriers to effective implementation of stroke prevention and treatment strategies.
The clinical effects of focal brain damage have been researched extensively, but the consequences of diffuse axonal injuries are less well described. Advanced neuroimaging techniques have produced connectivity maps of the brain, and computational modelling has elucidated the role of these networks in cognitive function. In this article, Sharp and colleagues review the effects of traumatic injury on the brain connectivity, and discuss how axonal damage affects the default mode network and saliency network to produce clinical symptoms.
Considerable phenotypic and genetic heterogeneity exists among the neurodevelopmental disorders described by the term autism spectrum disorder (ASD), which presents a challenge to treatment. Shafali and Geschwind outline the latest advances in genetic methods to identify and detect ASD-associated variants, and consider three themes—single-gene disorders, the gender bias in ASD, and neurological comorbidites—that could enable improved definition of ASD subgroups and understanding of disease aetiology.
Lewy body diseases are characterized by aggregates of misfolded α-synuclein within the neuronal cytoplasm. Here, Lee and colleagues review the growing evidence that aberrant α-synuclein is released by neurons into the extracellular milieu and taken up by neighbouring neurons and microglia. They describe how this novel source of α-synuclein could be involved in the pathogenesis of Lewy body diseases, and outline potential therapeutic stratgies to target extracellular α-synuclein.
Disorders of consciousness (DOC) present clinical challenges of diagnosis and treatment, but also provide unique opportunities for fundamental scientific research into the nature of human consciousness. Giacino et al. review recent advances in the neurobiology, diagnosis and treatment of DOC, including the use of novel neuroimaging and electrophysiological assessments. They also discuss the medicolegal and ethical issues surrounding these advances that will influence the medical care of patients with DOC.
The neurobiology of autism spectrum disorder (ASD) is complex and heterogeneous. Although valuable insights into the neural substrates of ASD have been gained in the past decade, the low specificity of neuroimaging measures has hampered the development of ASD biomarkers that are suitable for efficient patient stratification and application in translational research. Ecker and Murphy review recent progress in developing more-specific neuroimaging markers for ASD, and argue for a multidisciplinary approach to enable integration of the findings into translational research.
