Volume 11 Issue 9, September 2015

Cognitive impairment is a major sequela after stroke. A recent study shows that cognitive impairment is prevalent after ischaemic stroke, even in patients with good functional recovery, and that compromise in different cognitive domains predicts future functional disability. Here, we reflect on how poststroke cognitive impairment is measured and conceptualized.

Studies into the relationship between diabetes and amyotrophic lateral sclerosis (ALS) have produced conflicting results. In young patients, diabetes is a consistent risk factor for ALS; in older patients, diabetes protects against ALS in Europe, but increases the risk of ALS in Asia. Environment and genotype might both contribute to this variation.

The detection of an unruptured intracranial aneurysm poses a dilemma for the patient and the physician: an aneurysm rupture is a catastrophic event, but preventive repair is not without risks. The recently updated AHA/ASA guidelines provide some foundation for decision-making by summarizing the available evidence, but several clinically relevant questions remain uncertain.

Following the success of pharmacological dopamine replacement in patients with Parkinson disease (PD), cell-based dopamine replacement strategies seemed the next logical step. In this Review, the authors outline the history of this therapeutic approach to PD, emphasizing the importance of obtaining robust preclinical data before proceeding to clinical trials. In addition, they discuss the challenges of bringing the new generation of stem cell-derived dopamine cells to the clinic.

Glioblastoma is the most common primary brain tumour in adults, and has a notoriously poor prognosis. Recent successes of immunotherapy in other cancer types have made immunotherapy—particularly the use of immune checkpoint modulators—an appealing strategy against glioblastoma. Here, Matthias Preusser and colleagues summarize current knowledge on immune checkpoint modulators, and evaluate their potential role in glioblastoma treatment in light of preclinical studies and emerging clinical data.

Dysregulation of the type I interferon pathway has been implicated in the pathogenesis of a spectrum of neuroinfectious and neuroinflammatory disorders. McGlasson et al. review the range of neurological diseases associated with type I interferon underactivity and overactivity, highlighting advances in our understanding of the molecular and cellular pathogenesis of these conditions. They also discuss the potential utility of type I interferon as a biomarker and therapeutic target in neuroinflammatory disease.

After an ischaemic or haemorrhagic stroke, microglial activation and the release of cell death products initiate a chain of inflammatory events that lead to vascular damage and oedema. Here, Shi and colleagues discuss the similarities between acute stroke and multiple sclerosis, and review past attempts to limit poststroke inflammation via immunotherapy. The authors then highlight gaps in our knowledge about the immune system's reaction to stroke, and discuss how best to move forward with this line of research.

The use of infant formula as a substitute for or supplementation to breast milk has increased dramatically since the middle of the 20^th century. Such formula is typically supplemented with high levels of iron, yet the long-term effects of high exposure to iron during infancy are poorly understood. In this Perspectives article, Hare et al. discuss evidence that iron overload in infancy increases the risk of neurodegenerative disorders, such as Parkinson disease, in old age. They also consider methods for accurate measurement of past iron exposure that could be used to further investigate the risks.