Review Articles in 2010

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.

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.

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a frequent consequence of cancer treatment, and can profoundly affect the quality of life of individuals who survive cancer. In this article, Cavaletti and Marmiroli review the mechanistic and clinical aspects of CIPN, as well as assessing the current status of neuroprotective approaches and other treatment options for this condition.

Traditional stroke risk factors do not seem to fully account for the epidemiology of this disease. Here, Grau and colleagues explore the increasing body of evidence indicating that recent acute infection and various chronic infectious diseases might be risk factors for—or triggers of—stroke. In addition to examining the epidemiological evidence supporting these associations, the authors discuss possible mechanisms that might underlie infection-related stroke, and treatment implications.

Diagnosis of low-grade inflitrating gliomas—a class of brain tumors that includes diffuse astrocytoma, oligoastrocytoma and oligodendroglioma—currently relies largely on histological classification, although molecular discoveries are beginning to generate new paradigms for diagnosis and management. Bourne and Schiff highlight the molecular abnormalities that have been identified in low-grade gliomas, and discuss how factors such as chromosome 1p19q codeletion andMGMTpromoter methylation status are facilitating stratification of patients in clinical trials.

Impaired decision-making is a clinical symptom associated with a number of neurodegenerative diseases. In this article, Gleichgerrcht et al. review the neural basis of decision-making cognition in relation to the neuroanatomical changes associated with neurodegenerative diseases. The authors also suggest a number of recommendations that future studies could adopt to aid our understanding of decision-making cognition.

Botulinum neurotoxin (BoNT) is an effective treatment for a wide range of conditions that are frequently seen in the neurology clinic. In this article, Lim and Seet provide an overview of the mechanisms of action of BoNT and its use in the treatment of conditions such as dystonia, spasticity, essential tremor, hemifacial spasm and headaches. Important practical considerations, such as the reconstitution of BoNT, dosing, and methods of administration, are also reviewed.

Intracerebral hemorrhage (ICH) carries a high risk of morbidity or death, and no effective therapies are available to combat this condition. In this article, Adeoye and Broderick discuss the natural history of such hemorrhages before providing an overview of medical and surgical ICH clinical trials that have been completed or initiated within the past decade.

Multiple sclerosis is an incurable condition that introduces great uncertainty into virtually all aspects of a person's life. In this Review, Simmons considers the ways in which this uncertainty is being addressed by improved diagnostic tools, advances in immunotherapy, multidisciplinary rehabilitation, community programs, and provision of information specifically designed to facilitate shared decision-making and empowerment. He discusses these issues in the context of three philosophical frameworks: the biomedical, biopsychosocial and sociopolitical models.

Surgical intervention can represent an effective treatment for some patients with medically refractory epilepsy. In this Review, Duncan explores the various imaging techniques that can be used in epilepsy surgery to identify the epileptic source and/or to reduce the risk of surgery-related morbidity. In addition to examining established clinical practice, Duncan highlights recent advances in this field.

Neuroimaging is highly recommended in the diagnosis and management of acute stroke, including disease characterization, and monitoring of responses to medical interventions. In this Review, Merino and Warach consider the diagnostic information that clinicians might gain from CT and MRI scanning of patients with suspected stroke, and the relative advantages and drawbacks of these imaging techniques.

Diabetes has been implicated to be a risk factor for Alzheimer disease (AD), but the underlying biological mechanisms that link the development of diabetes and AD are not fully understood. In this article, Sims-Robinson et al. summarize the mechanistic pathways that might link these two age-related diseases and discuss the possible points of intervention that future therapies could exploit to treat AD.

Over the past 300 years, the migraine field has been dominated by two theories—the vascular theory and the central neuronal theory. The vascular theory was bolstered by the finding that vasoconstrictors are effective in acute migraine treatment, but evidence is now emerging that vasodilatation is neither necessary nor sufficient to trigger a migraine attack. Ho et al. consider the evidence pointing towards a neuronal mechanism in migraine development, highlighting the role of calcitonin gene-related peptide and its receptors.

Noninvasive therapies such as cognitive intervention could aid the prevention and treatment of Alzheimer disease (AD). In this article, Buschert et al. provide an overview of the current knowledge relating to the use of cognitive intervention in patients with AD, and discuss recent findings that indicate that this treatment provides substantial benefits for patients with cognitive deficits. The authors also review recent studies that have used neuroimaging techniques to identify biological changes within the brain that are associated with cognitive intervention.

Dendritic cells are specialized antigen-presenting cells that are necessary for inducing immunity and regulating immune tolerance. Understanding how these cells regulate adaptive immune responses has aided the development of a number of novel immunotherapies. In this article, Comabella and colleagues provide an overview of dendritic cell function and evaluate the potential of these therapies to treat multiple sclerosis.

The implementation of secondary stroke preventive measures can reduce the risk of recurrent stroke by ≈90%. Here, Spence reviews recent advances in this field, placing his focus on the prevention of recurrent ischemic stroke. In addition to highlighting the importance of lifestyle modification for effective secondary stroke prevention, Spence examines the use of various pharmacological therapies, and the value of endarterectomy and stenting in this setting.

High-frequency stimulation of the subthalamic nucleus has become a widely accepted treatment for some patients with advanced Parkinson disease. Various behavioral and cognitive adverse effects, however, have been associated with this therapeutic approach. In this Review, Volkmann and colleagues examine these detrimental neuropsychiatric effects, exploring their possible etiologies, and discussing the implications for patient management.

For certain types of epilepsy, the results of genetic testing can be used to guide diagnosis, patient management and/or reproductive choices. In this Review, Pal and colleagues highlight the use of genetic testing and genetic counseling in the context of epilepsy, providing a practical guide to the use of these approaches in five common clinical scenarios.

In this Review, Oksenberg and Baranzini examine the field of multiple sclerosis (MS) genetics, focusing on the abundance of data that has been generated from genome-wide association studies. The authors also highlight the challenges that lie ahead in this field, including the need for functional studies to connect the genetic variation observed in patients with the underlying pathophysiology of this condition.

The occurrence of cortical lesions in multiple sclerosis (MS) is an early phenomenon. Furthermore, immunohistochemical data indicate that demyelination of cortical gray matter is extensive in MS. In this Review, Calabrese and colleagues provide a summary of the main histopathological and MRI findings with regard to cortical lesions in MS, and discuss the evidence indicating that cortical lesion burden positively correlates with the severity of physical and cognitive impairments.