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The past few years have seen the identification of a growing number of risk factors for Alzheimer disease (AD). In this Perspectives article, the authors discuss the evidence for a bidirectional relationship between disrupted sleep patterns and amyloid-β accumulation, and the potential implications for disease progression in AD.
A population-based study of babies who were exposed to antiepileptic drugs (AEDs) in utero revealed impairment of fine motor and social skills as early as 6 months of age. Such neurocognitive changes were independent of breastfeeding status at 18 months, suggesting that breastfeeding can be recommended in women receiving AEDs.
Medulloblastomas can be categorized into four molecular subgroups. A new report shows, for the first time, that these tumours remain in the same subgroup at relapse, and the molecular subgroup influences the pattern of relapse. These findings indicate that this developmentally defined classification is robust, although its relationship to prognosis remains uncertain.
A key challenge to improving the design of clinical trials in Huntington disease (HD) has been the limited data on the natural history of HD. A recent prospective longitudinal study has provided important information in this regard, which could be useful for future translation of disease-modifying therapies for early-stage HD.
According to a new systematic review, placebo treatment in clinical trials of migraine prophylaxis results in responder rates ranging from 0–56%, probably owing to variable combinations of spontaneous improvement and genuine placebo effects. Clinicians who treat patients with migraine should be aware of the potential nonspecific effects of any treatment modality.
In this Review, Paul Matthews and colleagues outline the potential benefits of a stratified approach to health-care delivery in neurology, including reduced risk of adverse events from medicines, and lower treatment costs. They provide examples of neurological diseases in which stratified medicine is already improving treatment, and consider challenges to implementation of these approaches.
Subarachnoid haemorrhage (SAH) has a high case fatality. In addition to neurological injury occurring at the time of haemorrhage, delayed neurological deterioration can occur days later owing to processes such as cerebral vasospasm and microthrombosis, which culminate in delayed cerebral ischaemia. R. Loch Macdonald reviews the pathophysiology of these delayed complications of SAH, and outlines existing treatments and drugs in development for this indication.