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Alzheimer disease features neurobiological changes long before the first symptoms of cognitive decline. Results from a new study to define the orderly changes of markers of amyloidosis and neurodegeneration over the disease course will assist the development of biomarker-based protocols for early diagnosis, and disease-modifying drugs.
Intracerebral haemorrhage continues to carry a poor prognosis despite several recent therapeutic clinical trials. A study has demonstrated that CT angiography of the brain on admission can predict haematoma expansion and clinical outcome. This CT 'spot sign' could, therefore, help physicians to select patients who are likely to benefit from treatment.
Psychogenic nonepileptic seizures (PNES) resemble epileptic seizures, but are the result of underlying psychological processes. In a recent study characterizing seizure presentations in childhood PNES, a modified semiological categorization of the disorder was proposed. Does seizure semiology matter when determining the underlying psychological factors of PNES or predicting patient outcome?
The American Academy of Neurology has published guidelines for intravenous immunoglobulin (IVIg) treatment of neuromuscular diseases. These guidelines differ from those in Europe owing to different conventions for grading of recommendations. Although IVIg is an effective treatment for inflammatory neuropathies and neuromuscular diseases, it is much more expensive than alternative therapies.
A new study suggests that lesion volume assessed within 72 h of stroke onset is an important independent predictor of 90-day functional outcome and neurological recovery. If used in stroke trials, outcome models including stroke volume, age and NIH Stroke Scale scores could increase power for detecting treatment effect.
Effective targeting of therapeutics to the CNS has been hampered by many biological obstacles, including the tight blood–brain barrier. In this Review, Srikanth and Kessler propose that the use of nanotechnology can overcome such issues. The authors discuss evidence for the efficacy of nanotechnology in CNS disorders, ranging from neurodegeneration to injury and brain tumours, and highlight the potential for the translation of nanotechnology-based therapeutics to the clinic.
Anticoagulant therapy aims to prevent recurrent ischaemic stroke and venous thromboembolism; however, anticoagulant drugs currently in use or in trials have limitations. In this article, Graeme Hankey provides an update of the clinical data on the safety and efficacy of anticoagulant therapies, and discusses the clinical implications and future directions.
Olfactory dysfunction is a common feature of Parkinson disease (PD) and precedes the onset of motor symptoms. Richard Doty provides a comprehensive overview of this phenomenon, including clinical and neurophysiological characteristics. Evidence that exposure to environmental substances could play a part in causing olfactory dysfunction in PD is also discussed.
Medulloblastoma, once thought to represent a single disease entity, is now recognized to comprise distinct subgroups that can be identified using histological, genetic and transcriptomic approaches. Northcott et al. present the evidence for the four recently defined subgroups of medulloblastoma, and highlight how stratification of tumours into these subgroups could have important clinical implications for patient prognosis, treatment and care.
