Articles in 2010

MicroRNAs (miRNAs) seem to confer a novel layer of gene regulation, possibly fine-tuning the expression of ≈50% of genes in humans. Dysfunction of these short regulatory RNAs has been noted in various neurological disorders, including Alzheimer disease and Parkinson disease. Here, Junker and colleagues explore the possible involvement of miRNAs in multiple sclerosis, highlighting the therapeutic implications for this disease.

The largest ever study of cognitive function in progressive supranuclear palsy and multiple system atrophy, investigating almost 700 patients, confirms that cognitive dysfunction in these conditions is common and often severe, and can occur early in the course of the disease. Detection, however, depends on an appropriate choice of tests.

Poststroke depression (PSD) shows an association with long-term disability and quality of life in stroke survivors, two new reports confirm. Effective treatments for PSD exist and should be standards of care. More research is required to investigate a causal relationship between PSD and functional outcomes after stroke.

Ischemic stroke diagnosis and optimal patient management begin with neuroimaging. In an evidence-based guideline, the American Academy of Neurology recently published a systematic review to evaluate the diagnostic and prognostic roles of diffusion-weighted and perfusion-weighted imaging techniques in patients with acute ischemic stroke.

Relatively little is known about the mechanisms and processes that lead to the generation of seizures in patients with epilepsy, and this lack of knowledge hampers the development of treatments and cures. In this article, Vezzani et al. provide an overview of the involvement of inflammatory mediators in epileptic seizures. Gaining insights into the role of inflammation should yield new molecular targets for the design of antiepileptic drugs.

Alzheimer disease (AD) biomarkers reflect specific features of AD pathology. These biomarkers may be used in the diagnosis and staging of AD, or may act as surrogate end points in clinical trials. Thus, a thorough understanding of the diagnostic accuracy of and longitudinal change in cerebrospinal fluid and MRI AD biomarkers is important.

Natural history studies have identified numerous features of disability progression in patients with multiple sclerosis (MS), and have provided valuable insight into the underlying pathology of the disease that could assist the development of new treatment strategies. A new study indicates that disability progression occurs in two stages in patients with MS.

Thromboembolism resulting from complex atheromatous plaque formation at the origin of the internal carotid artery is a common cause of ischemic stroke. In appropriately selected patients, plaque removal by carotid endarterectomy is of substantial net benefit. Endovascular stenting appears less 'invasive' than endarterectomy, but is the former as safe and effective as the latter?

Two new studies suggest that pediatric medulloblastomas and high-grade gliomas are genetically different from the same tumors in adults. Age-dependent gene expression might affect tumor biology; therefore, therapies for adult medulloblastomas or gliomas might not produce the same clinical outcomes in pediatric patients, and vice versa.

Lesion location might turn out to be an important factor in long-term disability prediction in patients with primary progressive multiple sclerosis (MS). Using a lesion probability mapping approach, researchers have identified brain regions where the presence of MS lesions predicts an early need for bilateral walking support.

Antiepileptic drugs (AEDs) are receiving increasing attention for a possible association with suicidal thoughts and behaviors. Several recent studies examining this association, however, have yielded inconsistent findings, particularly in terms of the risk of suicidal behavior conferred by specific AEDs. In patients with epilepsy, heightened suicide risk is also attributable to comorbid psychiatric conditions.

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the brain caused by the JC virus. PML usually only develops in individuals who are immunocompromised, and can be caused by immunomodulatory therapies. In this article, Brew et al. review the literature relating to the diagnosis and management of PML. The authors also suggest practical management guidelines for this condition.

Choi et al. describe the case of a 3 month-old infant who, on the second day of life, had begun to experience painful paroxysmal events starting with tonic contraction of the whole body followed by erythematous harlequin-type color changes. The patient was diagnosed as having paroxysmal extreme pain disorder. The condition was attributed to a mutation in the SCN9A gene, which encodes the voltage-gated sodium channel Na_V1.7.