Volume 8 Issue 8, August 2012

Cerebral malaria is a potential, severe outcome of Plasmodium falciparum infection, but the molecular basis of this complication has been unclear. Three recent studies have identified specific var genes encoding the malaria parasite ligand that binds to human brain endothelial cells, pointing to therapeutic targets for cerebral malaria.

Cognitive difficulty in patients with epilepsy is often thought to result from poor control of the disorder. A recent study, however, supports previous observations that cognitive impairment is common at initial presentation. Should methods for establishment of cognitive impairment be considered as part of routine evaluation in patients with epilepsy?

Subarachnoid haemorrhage (SAH) is a type of stroke that is associated with substantial morbidity, requiring neurosurgical and intensive medical management. Recent guidelines for the management of SAH highlight current knowledge and issues that remain to be resolved, and are essential reading for physicians who treat individuals with this condition.

In April 2012, the American Academy of Neurology and the American Headache Society issued new guidelines on preventive treatment for episodic migraine. Although the guidelines provide valuable information regarding drug efficacy, they do not address the equally important issue of adverse events.

Given the national deficit in available organs for transplantation, substantial motivation exists to enhance procurement in the area of donation after cardiac death. This article reviews a new predictive tool that aims to identify donors dying within the viable time frame while reducing the human and resource implications of unsuccessful attempts.

Over the past decade, numerous studies have identified the causative genes and pathological proteins in most cases of frontotemporal dementia (FTD). Most recently, abnormal repeat expansion in theC9orf72 gene was identified as a major cause of the disorder. Rademakers et al. discuss how these discoveries have improved our understanding of the molecular basis of FTD, and highlight how these findings will translate into improved patient care.

Advanced-stage Parkinson disease (PD) is characterized by motor complications caused by dopaminergic therapy and has long been recognized. With the introduction of deep brain stimulation, however, patients are increasingly progressing to later stages of disease, which feature nonmotor symptoms such as dementia, and treatment-resistant motor symptoms including falls. Coelho and Ferreira discuss disease progression from the advanced stage onwards, and propose a functional definition of late-stage PD.

Minimally invasive spine surgery (MISS) was developed to minimize the morbidity associated with large, open surgical approaches, but questions over its benefits and safety. Smith and Fessler review the evidence to support MISS over open approaches for decompression of lumbar stenosis, and highlight new applications of these minimally invasive techniques. Issues with the adoption of MISS, criteria for acceptance of these procedures, and the need for better training and education on MISS are also discussed.

Variant forms of Alzheimer disease (AD) exist that are associated with amyloid deposition in the brain but have disparate clinical features. In this Review, the authors argue that selective vulnerability of a core functional network could explain the clinical heterogeneity of disease symptoms in atypical AD and other neurodegenerative disorders.

Immunotherapy targeting amyloid-β showed promise for treatment of Alzheimer disease (AD) in preclinical studies, but trials in humans have yielded disappointing results. In their Perspectives article, Liu and colleagues discuss adverse effects of amyloid-targeted therapies, which have limited treatment efficacy, and propose strategies to optimize the design of future therapeutic antibodies for AD.