Volume 7 Issue 8, August 2011

Disease-modifying therapies can positively influence the progression of multiple sclerosis, but how many patients continue to take their medications? A new study shows that the majority of patients with multiple sclerosis stop treatment. Research should focus on ways to improve adherence to disease-modifying therapies.

A recently published case report describes the use of epidural spinal cord stimulation to treat a patient with a complete cervical spinal cord injury. Clear improvements in facilitated standing and stepping were demonstrated, as well as some conscious control of movement.

The negative clinical results seen after retinal cell transplantation in patients with Parkinson disease highlight the importance of understanding the mechanisms by which a graft can improve neurological function. Scientific and safety issues must be thoroughly addressed before any cell transplantation approach can progress as a therapy for neurological diseases.

Cladribine, an oral immunomodulatory drug, has been denied FDA and European Medicines Agency approval for the treatment of relapsing–remitting multiple sclerosis. However, a new post-hoc analysis of CLARITY study data shows that cladribine treatment is associated with a significantly increased likelihood of sustained freedom from disease activity.

Despite probable higher rates of recanalization with endovascular therapies, limited evidence exists to support the clinical benefits in patients with stroke who are unresponsive to standard intravenous reperfusion. A new study supports combined intravenous-intra-arterial treatment in a subset of acute stroke patients, and recognizes the need for definitive randomized trials.

Research in neurodegenerative disease is generating vast neuroimaging data sets, necessitating the development of powerful new e-infrastructures for data collection, storage, access and analysis. In this article, Frisoni et al. provide an overview of the currently available e-infrastructures—LONI, neuGRID and CBRAIN—and consider how computational neuroscience in neurodegenerative disease might evolve in the future.

Malignant brain tumors such as glioma have a poor prognosis. Large-scale efforts to compile and store genome-wide data on gliomas have recently been initiated. Riddick and Fine describe these key initiatives and how these genomic approaches aim to improve tumor classification and elucidate the underlying biology of glioma. Use of these genomic technologies in the development of new diagnostic and therapeutic strategies in personalized medicine will also be discussed.

Monitoring for secondary brain injury is central to neurocritical care. Hemphill and colleagues provide an overview of multimodal monitoring in neurocritical care and discuss how bioinformatics tools for data acquisition, analysis and storage could be used in the clinical management of patients with acute brain injuries.

In this Review, Hoppe and Elger discuss the etiological factors underlying depression as a comorbidity of epilepsy, comprising psychological factors such as learned helplessness and the 'burden of epilepsy', and neurobiological factors directly related to the seizures. The authors highlight the need for more clinical studies of antidepressants and psychotherapy, and emphasize the importance of an integrated approach to treatment that addresses both the psychological and the neurobiological factors.

The field of neuroinformatics was originally conceived as the application of information technology to the compilation, integration and analysis of large data sets in basic neuroscience research. In this special issue, we explore how the principles of neuroinformatics are now being extended to the neurology clinic, highlighting initiatives in three diverse areas: glioma genomics, neurocritical care, and brain imaging in neurodegenerative disease.