Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Combination therapy is a rational strategy to optimize therapeutic benefits and minimize risks associated with treatment of patients with multiple sclerosis (MS). A recent study reporting negative results of combination therapy in MS should not discourage investigators from future attempts to identify optimal combinations for the treatment of this disease.
Clazosentan—a drug previously demonstrated to reduce angiographic vasospasm in patients with aneurysmal subarachnoid hemorrhage—had no significant effect on vasospasm-related morbidity and mortality in the CONSCIOUS-2 trial. A multifactorial cause for delayed ischemic neurological deficits might partly account for these negative findings.
A recent clinical trial showed no beneficial effects of statin treatment in patients with Alzheimer disease (AD) and normal cholesterol levels. Other studies show that the effects of statins can vary depending on cholesterol levels and stage of disease, so statins should not be ruled out as an AD therapy.
Rituximab is an immunosuppressive monoclonal antibody therapy that is used in some cases to help prevent relapses of neuromyelitis optica, an inflammatory CNS demyelinating disease. A new study provides evidence supporting efficacy and a strategy for optimizing the timing of repeated courses of treatment for the individual patient.
Tourette syndrome, characterized by motor or vocal tics, is a multifactorial neurodevelopmental disorder that affects up to 1% of children and adults worldwide. In this Review, McNaught and Mink describe the history of Tourette syndrome and its clinical presentation, and provide an overview of its epidemiology and pathophysiology. Current treatment strategies and potential future therapies are also discussed.
Neuropsychological assessment can identify deficits in brain function that assist in the diagnosis of patients with dementing illness. Fields et al. highlight the unique properties of neuropsychological measurements, including their role as biomarkers of dementia, in differentiating diseases with similar topographies, and in predicting the risk of dementia. Prediction of functional decline on the basis of these measurements will assist in planning of the future care requirements for patients at risk of dementia.
Most patients who present with longitudinal extensive transverse myelitis (LETM) are diagnosed with neuromyelitis optica (NMO). Trebst et al. use case studies of patients without NMO who presented with spinal lesions to show the variety of different etiologies that can underlie LETM. The authors highlight the diagnostic indicators and difficulties encountered in making differential diagnoses in these patients.
Neurostimulation therapy is often needed for patients with neuropathic pain that is refractory to medical treatment. In this Review, Nguyenet al. compare and contrast the evidence for efficacy of motor cortex stimulation and deep brain stimulation, highlighting the brain-targeting strategies, mechanisms of action and future therapeutic potentials of both treatments in patients with chronic neuropathic pain.
Training in different countries and societies can provide important insights into the sociocultural factors that influence the perception and management of disease. In this article, Michele Viana compares and contrasts his experiences of training at headache centers in Italy and the USA, highlighting differences in attitudes towards headache and its treatment between these two countries.
