Volume 13 Issue 6, June 2017

Genome-wide association studies have provided important insights into the genetic underpinnings of Alzheimer disease (AD), but the relevance of the identified variants to AD pathogenesis is often unclear. A new study uses a powerful quantitative trait approach to identify genetic variants that are associated with biologically meaningful parameters in AD.

The first large trial of a multimodal lifestyle intervention combined with a nutritional supplement for dementia prevention was unsuccessful and adds to conflicting evidence from similar studies. Whether lifestyle interventions are biologically ineffective or whether the lack of efficacy is due to methodological limitations remains to be determined.

The International League Against Epilepsy has published a new classification of seizure types and epilepsies that attempts to reflect recent scientific advances in the epilepsy field. This classification potentially offers a number of advantages, but it leaves some ambiguities and needs to be rigorously tested before entering routine clinical practice.

Determining how the incidence and prevalence of dementia changes over time requires population-based studies that use consistent methods over time. In this Review, the authors discuss the results of 14 worldwide studies that have attempted this approach. The findings consistently indicate that the incidence and prevalence of dementia, at least in Western countries, is stable or declining.

In the past few years, paradigms for the treatment of low-grade glioma have shifted, owing to new diagnostic criteria and new clinical trial evidence. Here, Jan Buckner and colleagues discuss how molecular markers are challenging previous assumptions about low-grade glioma, and examine how new data will affect diagnostic testing, surgery, chemotherapy and radiation therapy for individuals with these tumours.

Central vestibular disorders, including vestibular migraine, account for around 25% of cases of vertigo and dizziness. In this Review, the authors present the key signs and symptoms of central vestibular disorders, and they also consider higher vestibular dysfunctions, which involve more than one sensory modality as well as cognitive domains.

This Review presents an overview of vaccine-based immunotherapies for human glioma. Although efficacy remains unproven for the vaccines in clinical development, Weller and colleagues highlight promising strategies for antagonizing glioma-associated immunosuppression and boosting immune responses in vaccinated patients. Ultimately, such approaches might help to control the growth of human gliomas.

Comorbidity is common in multiple sclerosis (MS). In this Opinion article, Ruth Ann Marrie discusses how comorbidity affects diagnosis, progression, mortality, and health-related quality of life in patients with MS, and how clinicians should incorporate the prevention and management of comorbidities when treating MS.