Volume 14 Issue 3, March 2018

A randomized, double-blind, sham-controlled trial, Brave Dreams, has shown no clinical or radiological benefit of percutaneous transluminal angioplasty (PTA) to correct chronic cerebrospinal venous insufficiency in patients with multiple sclerosis (MS). These results finally settle the scientific debate over whether PTA can improve clinical, radiological and symptomatic outcomes in this patient population.

Results from the PATH study indicate that subcutaneous immunoglobulin is efficacious and well tolerated for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (CIDP). This finding represents an important step in the management of patients with immunoglobulin-responsive CIDP, with considerable implications for the cost of treatment and, most importantly, for these patients' quality of life.

Here, Sweeney and colleagues focus on advanced neuroimaging evidence of blood–brain barrier (BBB) breakdown in several neurodegenerative disorders. The role of the ageing cerebrovascular system in neurodegeneration and dementia and the implications of BBB dysfunction for treatment and drug delivery are also discussed.

The congenital myopathies are a group of early-onset neuromuscular disorders characterized by muscle weakness and distinctive structural abnormalities in skeletal muscle. In this Review, the authors summarize the genetic, clinical and pathological features of the main congenital myopathies and discuss current and future approaches to treatment and management.

Alzheimer disease (AD) and related dementias share numerous mechanistic and epidemiological similarities with type 2 diabetes mellitus (T2DM). However, whether these associations result from synergistic interactions between the disorders is unclear. This Review summarizes our current knowledge regarding insulin signalling and resistance in the brain and discusses current evidence concerning neurological impairment in T2DM and insulin resistance in AD.

In this article, Nonnekes and colleagues offer a new approach to the diagnosis of neurological disorders associated with altered gait, balance and posture. Their method takes the presenting sign or signs as the starting point of a focused differential diagnosis, which triggers a tailored search into the underlying neurological syndrome.