Volume 11 Issue 7, July 2015

A recent study has identified a variant of the SLC9A9 gene that is associated with the clinical response to IFN-β treatment. IFN-β induces SLC9A9 expression, resulting in inhibition of proinflammatory T lymphocytes. The findings suggest a key role for this gene in determining the response to IFN-β in patients with multiple sclerosis.

Class I evidence supports the efficacy of surgical treatment in patients with temporal lobe epilepsy that is refractory to antiseizure medications. One major concern, however, is the risk of memory decline, particularly after temporal lobe resection in the language-dominant hemisphere. A new study evaluates a noninvasive technique to predict these memory deficits.

Treatment of older patients with glioblastoma must take into account reduced treatment benefits and increased treatment-related toxicity, as this group of frail patients has a particularly poor prognosis. A new systematic review provides guidance for treating elderly patients, but decision-making in clinical practice faces many challenges.

The list of vascular, lifestyle-related and other risk factors and biomarkers associated with dementia development has constantly grown over the past few years. A recent study emphasizes the importance of risk prediction models for identification of individuals with increased risk of future cognitive impairment who could benefit from preventive interventions.

A surprisingly high rate of nonconvulsive seizures and status epilepticus is found during continuous EEG monitoring in critically ill patients. A recent analysis of data regarding hospitalization and mortality in patients with status epilepticus emphasizes the relevance not only of how status epilepticus is defined, but also of how it is detected.

A subset of patients with multiple sclerosis (MS) demonstrate rapid accumulation of disability, and symptoms that are refractory to standard disease-modifying therapies. Rush and colleagues present criteria for identifying patients with so-called aggressive MS, and outline the efficacy of various therapies in this group of patients. The authors emphasize the need to act quickly with these patients, and propose a treatment algorithm to aid clinical decision-making.

Current rehabilitative strategies for children with unilateral cerebral palsy (UCP) focus on activity-based tasks, but a greater understanding of the condition and the way in which the brain responds to therapy could enable the development of more-effective approaches. In this Review, the authors first discuss current rehabilitative strategies and the factors that are crucial to their success. They then consider in detail how neuroimaging is informing us about the neurobiology of UCP and the neuroplasticity in the brains of children with the condition, and how this knowledge could transform therapy.

Loss of hypocretin neurons is a hallmark finding in narcolepsy; recent findings have implicated also increased number of histamine neurons in this disorder. This Review provides an overview of coregulation of sleep and wakefulness by hypocretin and histamine. The authors also review the changes in hypocretin and histamine systems in narcolepsy and neurodegenerative diseases (such as Alzheimer disease, Parkinson disease and Huntington disease) and discuss novel therapeutic approaches for manipulation of the histamine system in these diseases.

Dopa-responsive dystonia is a highly treatable movement disorder that usually presents in childhood, but the heterogeneity of its aetiology and presentation can lead to delayed diagnosis. In this Review, Wijemanne and Jankovic summarize the diversity of conditions that present with dopa-responsive dystonia, consider the differential diagnosis for the symptoms, and outline the tests that can be used to ensure an early and accurate diagnosis that enables appropriate treatment to be started as early as possible.