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The past few years have seen the identification of a growing number of risk factors for Alzheimer disease (AD). In this Perspectives article, the authors discuss the evidence for a bidirectional relationship between disrupted sleep patterns and amyloid-β accumulation, and the potential implications for disease progression in AD.
Prion-like propagation of pathogenic proteins has been suggested to underlie several neurodegenerative diseases. In this Perspectives article, Braak et al. posit that progressive lesions in amyotrophic lateral sclerosis (ALS) spread through cell-to-cell transfer of 43-kDA transactive response DNA-binding protein, mainly through cortical neuronal projections to other brain areas and the spinal cord. This model could have important implications for our understanding of ALS and approach to treatment.
Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is an effective treatment for acute ischaemic stroke, although its use for patients with mild forms of this condition remains controversial. Here, Guerrero and Savitz outline the potential risks and benefits of rtPA in this patient population, and explain why they believe patients with mild ischaemic stroke should receive this treatment.
Despite recent advances in our understanding of the pathophysiology of mitochondrial disease, beneficial treatments for these disorders are lacking. In this Perspectives article, Pfeffer et al. retrospectively review data from clinical trials in mitochondrial disease, and find that many problems arise from publication bias and poor trial design. After discussing these issues, the authors make recommendations for the design of future treatment trials in mitochondrial diseases.
Uhthoff's phenomena are transient disturbances in neurological functioning that can be triggered by an increase in core body temperature in patients with multiple sclerosis (MS). In this article, Frohman et al. discuss the pathophysiological underpinnings of Uhthoff's phenomena, and highlight the importance of differentiating between these events and true MS exacerbations in the clinic.
The aim of palliative care is to improve the quality of life for patients with terminal illness, and also their families. In this Perspectives article, the author discusses the challenges specific to palliative care for patients with neurological disorders, and outlines new approaches to the care of these patients.
In this Perspectives article, Roozenbeek et al. discuss issues with epidemiological studies in traumatic brain injury (TBI) and variability in the definition of such injuries. They describe how changing epidemiological patterns have influenced mortality and outcomes following brain injury, and identify the need for standardized epidemiological monitoring in TBI.
