Volume 13 Issue 11, November 2017

Preventing the misfolding, aggregation, accumulation and propagation of α-synuclein — pivotal mechanisms that contribute to neurodegeneration in Parkinson disease (PD) and other synucleinopathies — is the ultimate goal of research into neuroprotective therapy. Now, exenatide, a glucagon-like peptide-1 (GLP-1) agonist, has been reported to ameliorate the severity of motor symptoms associated with PD.

In recently published guidelines on the diagnosis and treatment of cerebral venous thrombosis, the European Stroke Organization has applied a rigorous evidence-based methodology, following the GRADE system. However, the guidelines provide many weak recommendations, reflecting the fact that more high-quality evidence from multicentre observational and experimental studies is needed.

Genome engineering tools, including targeted gene editing and gene regulation, are becoming available to correct the mutations that cause neuromuscular disorders such as muscular dystrophy, spinal muscular atrophy and myotonic dystrophy. This Review summarizes the genome engineering strategies that are under preclinical evaluation for the treatment of degenerative neuromuscular disorders, focusing on the tools that show the greatest potential for clinical translation.

Fatigue, defined as extreme and persistent mental and/or physical tiredness, weakness or exhaustion, frequently occurs as a challenging symptom or comorbidity in many neurological diseases. In this Review, Penner and Paul discuss the definitions and manifestations of fatigue, focusing on its pathophysiological background, assessment strategies, and current treatment options.

PET is a versatile imaging technique that is advancing our understanding of cerebrovascular disease and intracerebral pathophysiology. In this Review, Evans and colleagues describe mechanistic insights from PET studies relating to the metabolic pathophysiology of carotid atherosclerosis, salvageable penumbra after stroke, and neuroinflammatory changes associated with small vessel disease and vascular cognitive impairment.

Exercise and physical therapy are important adjunct interventions to improve gait and balance impairments in patients with Parkinson disease (PD), as these features are inadequately treated by current pharmacological and surgical treatments. Here, Mak and colleagues discuss the long-term effects of exercise and physical therapy for PD, possible risks, recommendations for clinical practice, and emerging treatment approaches.