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Undetected spinal fractures can cause damage of the spinal cord and lead to adverse neurological outcomes. A recent study on a pediatric cohort has shown that noncontiguous spinal injuries are often missed on primary radiographic examination, highlighting the need for combined radiographic, clinical and neurophysiological examinations to detect these lesions.
Predicting the molecular pathology that underlies neurodegeneration in patients with frontotemporal lobar degeneration (FTLD) is crucial to determine how to treat each individual. Whitwell and Josephs show how patterns of atrophy assessed on MRI can be used to identify signatures of pathology for each specific diagnosis within this broad spectrum of diseases. The authors discuss how these patterns of atrophy could be used as biomarkers of FTLD.
The geometry of carotid arteries, both normal and narrowed, produces flow characteristics that predict the location of atherosclerosis and the site of plaque rupture. A recent study has shown that the upstream carotid plaque undergoes profound biochemical and apoptotic changes that are closely linked to the development of stroke symptoms.
Understanding the genetic mutations that cause hereditary sensory and autonomic neuropathies (HSANs) is crucial to identify new therapeutic targets for patients with these neurodegenerative diseases. Rotthier et al. review the currently known genetics of the HSANs, discussing the new findings that provide insights into the mechanisms of disease and highlighting how these discoveries could improve treatment for patients with these diseases.
Vaccination represents a mainstay in preventing infection but, in patients with multiple sclerosis (MS), this therapeutic approach can carry the risk of triggering a relapse. Hartung and colleagues review the safety of vaccines against various infections in patients with MS, and discuss the issue of vaccine efficacy in the context of disease-modifying MS drugs.
Positive muscle phenomena arise from spontaneous activity originating in motor neurons or in the muscle itself. Gea Drost and colleagues discuss the pathophysiology and the electromyographic and clinical features of this group of disorders. They also provide an algorithm to aid the differential diagnosis of these muscle phenomena.
The genetic ion channelopathies comprise a new and expanding field of neurological diseases. This Review focuses on the voltage-gated P/Q-type calcium channel, and specifically on inherited mutations in the gene encoding the α1 subunit. The authors consider various conditions arising from channel dysfunction, including episodic ataxia type 2, familial hemiplegic migraine-1 and spinocerebellar ataxia type 6.
Multiple sclerosis research in 2011 produced a combination of new therapeutic developments and innovative findings. Teriflunomide showed beneficial effects in a phase III trial, quantification methods for MRI lesions that should improve monitoring of disease progression were devised, and a link between high cholesterol and low vitamin D emerged.
Research published in 2011 identified important factors related to serious adverse effects of antiepileptic drugs and sudden unexpected death in epilepsy, along with a potential new treatment and a promising marker of epileptogenesis. Further advances in these areas are urgently needed to improve the lives of people with epilepsy.
Several pivotal clinical trials that could have a major impact on the care of patients with stroke were published in 2011. The studies cover a wide range of stroke-care aspects, including stroke prevention, imaging to select patients for thrombolysis, therapies for stroke recovery, and stroke registries to improve care quality.
In 2011, researchers used imaging techniques to investigate brain microbleeds in patients with dementia and highlighted how lobar microbleeds could be used as a marker for amyloid pathology and for predicting mortality. New guidelines on the inclusion and exclusion of participants with microbleeds in anti-amyloid clinical trials were also published.
Subarachnoid hemorrhage is a rare but potentially fatal cause of headache. According to results from a recent study, CT scans enable clinicians to identify patients with subarachnoid hemorrhage, with a high sensitivity. Does CT imaging rule out the need for lumbar puncture in patients who present with headache?
