Volume 5 Issue 7, July 2009

On Wednesday 22 April 2009, Rita Levi-Montalcini, Nobel Prize laureate and discoverer of the first neural growth factor, turned 100 years old. Her scientific work drastically changed basic neuroscience and could have important implications for the treatment of neurological disorders.

The issue of whether progressive brain injury occurs in pharmacoresistant epilepsy remains important and controversial. A combined longitudinal and cross-sectional MRI study, in which an automated method was used to measure cortical thickness, has demonstrated accelerated brain atrophy in patients with chronic epilepsy.

In an era of etiology-specific therapies, defining the criteria for behavioral variant frontotemporal dementia is essential. How do we determine whether bad manners, laziness, or unsolicited friendliness represents the earliest presentation of this condition? Diagnostic criteria are being actively evaluated to help establish a foundation for diagnostic decisions regarding this and other neurodegenerative diseases.

Successfully treating chronic pain is challenging, as patients respond heterogeneously to analgesic treatments. Such variation in response can be attributed to differing underlying pain-generating mechanisms. A novel clinical bedside test that identifies distinct pain phenotypes might help deliver more-effective mechanism-based treatment strategies.

The progression of Alzheimer disease might be monitored by measuring the rate of hippocampal volume loss by means of MRI. Research suggests that a reduction in hippocampal volume can be detected over a period as short as 6 months, and that such volume loss is associated with cognitive decline and other indicators of Alzheimer disease neuropathology.

New-onset epilepsy in elderly individuals presents important diagnostic and therapeutic challenges for the clinician. Arain and Abou-Khalil highlight the conditions that should be considered in the differential diagnosis, and discuss the factors that need to be taken into account when devising an appropriate drug regimen, including age-related changes in pharmacokinetic factors, potential drug interactions, and adverse-effect profiles.

Improvements in the survival of critically ill patients over the past few decades have led to an increased incidence of acquired muscular weakness in intensive care units. Zink and colleagues review the clinical and diagnostic features of critical illness polyneuropathy and myopathy and discuss preventive and therapeutic approaches to these severe and costly medical complications.

The developing brain is especially prone to seizure activity, and population studies have shown that seizure incidence peaks during the first month of life. Research into the factors responsible for this enhanced seizure susceptibility could yield potential therapeutic targets to prevent epileptogenesis and provide biomarkers to identify individuals who are at heightened risk of developing epilepsy.

In lumbar spinal stenosis (LSS), narrowing of the spinal canal leads to neural compression and, frequently, pain in the lower back. LSS has become the most common reason for lumbar spine surgery, partly reflecting the elevated demand for mobility and flexibility in the aging population. In this article, Siebert et al. review the underlying pathophysiology of LSS, and discuss how to diagnose and treat the condition.