Volume 14 Issue 10, October 2018

Patent foramen ovale (PFO) is prevalent among young patients with cryptogenic stroke, and PFO closure reduces the risk of recurrent stroke in these individuals. A new study confirms that PFO is also frequent in patients with cryptogenic stroke aged >60 years, but the optimal management of such patients remains unresolved.

Multimodal imaging in neurodegenerative disorders can provide insights on structural, functional and neurochemical alterations that might not be possible via clinical testing alone. New findings on multimodal imaging in idiopathic REM sleep behaviour disorder (iRBD) have implications for the relationship between iRBD, the clinical phenotype of Parkinson disease and the underlying substrate of Lewy body disease, particularly for understanding the pathophysiology and designing disease-modifying therapies.

In this Review, Khalil et al. consider how technological advances have enabled the detection of neurofilament proteins in the blood, and discuss how these proteins consequently have the potential to be easily measured biomarkers of neuroaxonal injury in various neurological conditions.

Advances in our understanding of the pathogenic mechanisms of spinocerebellar ataxias (SCAs) have resulted in the development of promising therapeutic strategies for these inherited neurodegenerative disorders. Here, Ashizawa and colleagues review the current progress and future challenges facing clinical trials of new therapies for the SCAs.

Lafora disease is an autosomal recessive, progressive myoclonus epilepsy caused by loss of function of laforin or malin, leading to impaired glycogen metabolism. The authors review the clinical and molecular features of Lafora disease and discuss current and emerging treatment options.

In this Review, the authors consider advances over the past decade that have set the stage for a resurgence in attempts to predict seizures in epilepsy, and they propose new avenues of investigation that combine mechanisms, models, data, devices and algorithms.