Table of contents


Research Highlights

Alzheimer disease: Do natural antibodies prevent Alzheimer disease? | PDF (63 KB)

p463 | doi:10.1038/nrneurol.2009.125

Neurodegenerative disease: A mechanism for axonal transport defects in HD | PDF (70 KB)

p464 | doi:10.1038/nrneurol.2009.120

In brief

Multiple sclerosis | Epilepsy | Spinal cord injury | Migraine | PDF (47 KB)

p464 | doi:10.1038/nrneurol.2009.128

Headache: Mice shed light on photophobia and migraine | PDF (50 KB)

p465 | doi:10.1038/nrneurol.2009.121

Dementia: Visualizing the progress of dementia | PDF (122 KB)

p465 | doi:10.1038/nrneurol.2009.123

Parkinson disease: Pesticides implicated as an environmental factor in PD | PDF (98 KB)

p466 | doi:10.1038/nrneurol.2009.119

Neuromuscular disease: TDP-43 in inclusion body myositis | PDF (105 KB)

p466 | doi:10.1038/nrneurol.2009.124

Neural grafts survive poorly in HD | PDF (47 KB)

p467 | doi:10.1038/nrneurol.2009.132

Parkinson disease: Visual hallucinations in Parkinson disease are associated with cholinergic dysfunction | PDF (49 KB)

p468 | doi:10.1038/nrneurol.2009.122

Multiple sclerosis: New gene variants that increase MS risk | PDF (54 KB)

p468 | doi:10.1038/nrneurol.2009.126

Top

News and Views

Migraine: Is acupuncture clinically viable for treating acute migraine?

Hans-Christoph Diener

p469 | doi:10.1038/nrneurol.2009.129

Chinese investigators performed a well-designed, randomized trial to investigate the efficacy of true Chinese acupuncture compared with two different sham acupuncture approaches for the treatment of acute migraine attacks. Real acupuncture was superior to sham acupuncture, but the absolute pain relief was minimal.

Stroke: Using the ABCD system to evaluate transient ischemic attack

Matthew F. Giles & Peter M. Rothwell

p470 | doi:10.1038/nrneurol.2009.134

The ABCD system uses clinical features identifiable in primary or emergency care to reliably predict the risk of stroke in the acute phase following a transient ischemic attack. Further study is required to establish both the effectiveness of a refined system that includes carotid and brain imaging, and how such a refined system should be implemented in clinical practice.

Neurodegenerative disease: Cortical atrophy in syndromes of progressive aphasia

Richard J. S. Wise

p471 | doi:10.1038/nrneurol.2009.133

Frontotemporal lobar degeneration often presents with distinct language impairments that are associated with different distributions of cortical atrophy. Two studies have now demonstrated that these clinical syndromes are associated with highly characteristic patterns of cortical thinning. Specific cortical atrophy profiles do not, however, seem to reliably predict histologically distinct frontotemporal lobar degeneration variants.

Stroke: Thrombolysis in childhood arterial ischemic stroke

Lori C. Jordan

p473 | doi:10.1038/nrneurol.2009.130

Thrombolytic therapy is often used to treat arterial ischemic stroke in children, despite lack of FDA approval in this age group. The International Pediatric Stroke Study investigators have assessed the extent and nature of recombinant tissue plasminogen activator use in children in their registry, and have compared their findings with previously published case reports.

Stroke: Is cognitive dysfunction common after ischemic stroke?

Rebecca F. Gottesman

p475 | doi:10.1038/nrneurol.2009.131

Estimates of the incidence of cognitive dysfunction following ischemic stroke vary considerably in the medical literature. New research suggests that cognitive dysfunction might occur more frequently than was previously thought, emphasizing the importance of assessing such dysfunction beyond the standard deficits measured on most stroke severity scales.

Top

Reviews

Reducing prehospital delay in acute stroke

Miriam Bouckaert, Robin Lemmens & Vincent Thijs

p477 | doi:10.1038/nrneurol.2009.116

Thrombolytic therapy is an effective treatment for ischemic stroke, but only when delivered within a short period after the onset of the condition. Delay in patients being admitted to hospital is one of the main reasons why the therapeutic window is often missed. This Review examines the factors that affect prehospital delay, and describes strategies designed to overcome the problem.

Managing bipolar disorders in children and adolescents

Eric Taylor

p484 | doi:10.1038/nrneurol.2009.117

Bipolar disorders are recurrent mood disturbances involving periods of depression and mania. Eric Taylor discusses the management of bipolar disorders in children and adolescents, including potential differential diagnoses and the results of treatment trials in these age groups. He also outlines the distinction between classic bipolar disorders and brief emotional outbursts.

Continuing Medical Education

Sudden unexpected death in epilepsy: risk factors and potential pathomechanisms

Rainer Surges, Roland D. Thijs, Hanno L. Tan & Josemir W. Sander

p492 | doi:10.1038/nrneurol.2009.118

Sudden unexpected death in epilepsy most frequently occurs in people with chronic epilepsy, and seems to be a seizure-related event. In this article, Surges et al. review the incidence of sudden unexpected death in epilepsy and the risk factors associated with this condition, before exploring the pathological mechanisms related to chronic epilepsy that could lead to sudden death.

Thrombolysis, stroke-unit admission and early rehabilitation in elderly patients

Laurent Derex & Norbert Nighoghossian

p506 | doi:10.1038/nrneurol.2009.127

Individuals over the age of 80 years account for 30% of the total number of people with ischemic stroke. Nevertheless, elderly patients are more likely to receive suboptimal care than are younger individuals. In this Review, Derex and Nighoghossian examine the effectiveness of thrombolysis therapy, stroke-unit care, and early rehabilitation in elderly patients with stroke.

Top

Case Study

A case of postpartum cerebral angiopathy with subarachnoid hemorrhage

Yolanda Chik, Robert E. Hoesch, Christos Lazaridis, Carla J. Weisman & Rafael H. Llinas

p512 | doi:10.1038/nrneurol.2009.114

Chik et al. describe the case of a woman who developed a severe 'thunderclap' headache, followed by generalized tonic–clonic seizures, shortly after giving birth. A head CT scan revealed a subarachnoid hemorrhage, and an angiogram showed areas of vasoconstriction in the cerebral arteries that were consistent with a diagnosis of postpartum cerebral angiopathy.

Top

Perspectives

Training Matters: Neurologists can make a difference: the rewards of volunteer work

Sidney H. Rosenberg

p517 | doi:10.1038/nrneurol.2009.115

Volunteer work in developing countries can be extremely rewarding for neurologists, from both a professional and a personal perspective. Sidney Rosenberg has worked extensively as a volunteer neurologist in hospitals in India, Cambodia and Botswana, and in this article he provides a personal account of his experiences.

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