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  • Neuro-oncology: A new role for Zika virus in glioblastoma therapy?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Heather Wood

    Neuro-oncology: A new role for Zika virus in glioblastoma therapy? Nature Reviews Neurology, Published online: 22 September 2017; doi:10.1038/nrneurol.2017.138

    更新日期:2017-09-22
  • Neural repair and rehabilitation: Prolonged neural stem cell maturation restores motor function in spinal cord-lesioned rats
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Mitesh Patel

    Neural repair and rehabilitation: Prolonged neural stem cell maturation restores motor function in spinal cord-lesioned ratsNature Reviews Neurology, Published online: 15 September 2017; doi:10.1038/nrneurol.2017.133

    更新日期:2017-09-21
  • Multiple sclerosis: Concussion during adolescence linked to increased risk of MS
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Peter Sidaway

    Multiple sclerosis: Concussion during adolescence linked to increased risk of MSNature Reviews Neurology, Published online: 15 September 2017; doi:10.1038/nrneurol.2017.135

    更新日期:2017-09-21
  • Parkinson disease: CSMD1 gene mutations can lead to familial Parkinson disease
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Mitesh Patel

    Parkinson disease: CSMD1 gene mutations can lead to familial Parkinson diseaseNature Reviews Neurology, Published online: 15 September 2017; doi:10.1038/nrneurol.2017.132

    更新日期:2017-09-21
  • Parkinson disease: Asthma drug could protect against PD
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Charlotte Ridler

    Parkinson disease: Asthma drug could protect against PDNature Reviews Neurology, Published online: 15 September 2017; doi:10.1038/nrneurol.2017.134

    更新日期:2017-09-21
  • CIDP and other inflammatory neuropathies in diabetes — diagnosis and management
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-09-15
    Yusuf A. Rajabally, Mark Stettner, Bernd C. Kieseier, Hans-Peter Hartung, Rayaz A. Malik

    Distal symmetric polyneuropathy (DSPN) is the most common neuropathy to occur in diabetes mellitus. However, patients with diabetes can also develop inflammatory neuropathies, the most common and most treatable of which is chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Whether diabetes is a risk factor for CIDP remains under debate. Early studies suggested that patients with diabetes were at increased risk of CIDP, but epidemiological studies failed to confirm the association, and subsequent data have re-opened the debate. Inadequate interpretation of investigations and differentials between CIDP and other neuropathies that can occur in diabetes, such as DSPN, diabetic radiculoplexus neuropathies and vasculitic multiple mononeuropathy, might mean that CIDP is under-recognized. Despite a response rate of >80% to first-line therapies for CIDP in patients with or without diabetes, those with diabetes often present with greater disability owing to late referral and axonal pathology attributed to DSPN. The increasing worldwide prevalence of diabetes creates an urgent need to improve identification of potentially treatable neuropathies, such as CIDP. In this Review, we consider the features of CIDP in patients with diabetes, and discuss how these features can be used to differentiate the condition from other neuropathies. We also review the management options for CIDP and other inflammatory neuropathies in patients with diabetes.

    更新日期:2017-09-21
  • Multiple sclerosis: Intrathecal inflammation mediates mood in relapsing–remitting multiple sclerosis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 
    Mitesh Patel

    Multiple sclerosis: Intrathecal inflammation mediates mood in relapsing–remitting multiple sclerosisNature Reviews Neurology, Published online: 15 September 2017; doi:10.1038/nrneurol.2017.131

    更新日期:2017-09-21
  • Tuberculous meningitis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-09-08
    Robert J. Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E. Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E. Thwaites

    Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation. Antibiotic regimens for TBM are based on those used to treat pulmonary tuberculosis, which probably results in suboptimal drug levels in the cerebrospinal fluid, owing to poor blood–brain barrier penetrance. The role of adjunctive anti-inflammatory, host-directed therapies — including corticosteroids, aspirin and thalidomide — has not been extensively explored. To address this deficit, two expert meetings were held in 2009 and 2015 to share findings and define research priorities. This Review summarizes historical and current research into TBM and identifies important gaps in our knowledge. We will discuss advances in the understanding of inflammation in TBM and its potential modulation; vascular and hypoxia-mediated tissue injury; the role of intensified antibiotic treatment; and the importance of rapid and accurate diagnostics and supportive care in TBM.

    更新日期:2017-09-21
  • Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-09-08
    Karen D. Davis, Herta Flor, Henry T. Greely, Gian Domenico Iannetti, Sean Mackey, Markus Ploner, Amanda Pustilnik, Irene Tracey, Rolf-Detlef Treede, Tor D. Wager

    Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendationsNature Reviews Neurology, Published online: 8 September 2017; doi:10.1038/nrneurol.2017.122Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of such uses of brain imaging.

    更新日期:2017-09-21
  • In the news: EAN highlights European success in neurology
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-14
    Ian Fyfe

    The “gross neurological product” of Europe is high and increasing — that was the conclusion from an analysis of neurological publications that was presented by Giorgio Cruccu at the third Congress of the European Academy of Neurology (EAN) in Amsterdam in June. This

    更新日期:2017-08-31
  • Neuroimmunology: New targets in neuropsychiatric lupus
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-04
    Ian Fyfe

    Inhibition of neuronal regeneration and activation of microglia by circulating factors might be involved in the pathophysiology of neuropsychiatric systemic lupus erythematosus (NPSLE), according to two new studies. The authors of both preclinical studies claim that their work identifies novel potential therapeutic targets for NPSLE.

    更新日期:2017-08-31
  • Alzheimer disease: Tau pathology in atomic detail
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Ian Fyfe

    The atomic structures of tau filaments that form in the human brain in sporadic Alzheimer disease (AD) have been revealed for the first time in Nature. The work will provide the basis for future investigation of tau filaments as therapeutic targets in tauopathies, and

    更新日期:2017-08-31
  • Neuro-oncology: A new approach to ependymoma subtyping
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-04
    Heather Wood

    Trimethylation of lysine 7 on histone H3 (H3K27me3), as detected by immunohistochemistry, can differentiate subgroups of childhood ependymomas with markedly different prognoses, according to new research published in Acta Neuropathologica. This relatively simple test could aid the tailoring of treatment to ensure that children

    更新日期:2017-08-31
  • Neurodevelopmental disorders: Gene therapy for mucopolysaccharidosis shows promise
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-28
    Heather Wood

    A novel intracerebral gene therapy approach has produced encouraging results in a phase I/II trial in children with mucopolysaccharidosis type IIIB syndrome (MPS IIIB), a lysosomal storage disorder characterized by onset of progressive cognitive deterioration after 2–4 years of seemingly normal development. The findings indicate

    更新日期:2017-08-31
  • Dementia: Skin α-synuclein deposits — a new biomarker for DLB?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Heather Wood

    The accurate diagnosis of dementia depends on identification of the underlying pathology, which is difficult to accomplish in living patients owing to the inaccessibility of the affected brain tissue. New research reported in Neurology indicates that the presence of phosphorylated α-synuclein deposits in the

    更新日期:2017-08-31
  • Prion disease: 'Anti-prions' block prion disease onset
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-07
    Charlotte Ridler

    Treatment with an artificial, nontoxic prion protein (PrP) could substantially delay or even prevent the development of prion disease, according to a new study in a hamster model of prion disease. Researchers found that synthetic prions — dubbed 'anti-prions' — competed with pathogenic PrP to

    更新日期:2017-08-31
  • Peripheral neuropathies: Long-term opioid therapy in neuropathy: benefit or harm?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Claudia Sommer

    A retrospective population-based cohort study has shown that outcomes were worse for patients with neuropathic pain who received long-term opioid treatment than for those who received short-term opioid treatment. The finding highlights a need for improved pain education for non-specialists and for more-effective therapies.

    更新日期:2017-08-31
  • Multiple sclerosis: Treatment of cognitive impairment in secondary progressive MS
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-28
    Anthony Feinstein

    Cognitive and neuropsychiatric impairment pose a considerable burden to patients with secondary progressive multiple sclerosis, but no effective therapies have been approved to treat these symptoms. A new trial has shown modest benefits of simvastatin treatment in this context. These results are much welcomed, but require more-rigorous testing.

    更新日期:2017-08-31
  • Stroke in women — from evidence to inequalities
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Charlotte Cordonnier, Nikola Sprigg, Else Charlotte Sandset, Aleksandra Pavlovic, Katharina S. Sunnerhagen, Valeria Caso, Hanne Christensen

    Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke — including diabetes mellitus and atrial fibrillation — are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy. However, in an era of evidence-based medicine, women are notably under-represented in clinical trials — despite governmental actions highlighting the need to include both men and women in clinical trials — resulting in a reduced generalizability of study results to women. The aim of this Review is to highlight new insights into specificities of stroke in women, to plan future research priorities, and to influence public health policies to decrease the worldwide burden of stroke in women.

    更新日期:2017-08-31
  • Neuroepidemiology: The increasing burden of mortality from neurological diseases
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-11
    Julia Pakpoor, Michael Goldacre

    A new study based on WHO data reports rates of mortality from neurological diseases in the developed world from 1989–1991 to 2012–2014. The reported increase in neurological disease mortality, which was greatest in the USA, highlights the rise of neurological diseases as an emerging threat to global health.

    更新日期:2017-08-31
  • Autoantibodies in chronic inflammatory neuropathies: diagnostic and therapeutic implications
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-14
    Luis Querol, Jérôme Devaux, Ricard Rojas-Garcia, Isabel Illa

    The chronic inflammatory neuropathies (CINs) are rare, very disabling autoimmune disorders that generally respond well to immune therapies such as intravenous immunoglobulin (IVIg). The most common forms of CIN are chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy, and polyneuropathy associated with monoclonal gammopathy of unknown significance. The field of CIN has undergone a major advance with the identification of IgG4 autoantibodies directed against paranodal proteins in patients with CIDP. Although these autoantibodies are only found in a small subset of patients with CIDP, they can be used to guide therapeutic decision-making, as these patients have a poor response to IVIg. These observations provide proof of concept that identifying the target antigens in tissue-specific antibody-mediated autoimmune diseases is important, not only to understand their underlying pathogenic mechanisms, but also to correctly diagnose and treat affected patients. This state-of-the-art Review focuses on the role of autoantibodies against nodes of Ranvier in CIDP, a clinically relevant emerging field of research. The role of autoantibodies in other immune-mediated neuropathies, including other forms of CIN, primary autoimmune neuropathies, neoplasms, and systemic diseases that resemble CIN, are also discussed.

    更新日期:2017-08-31
  • Insights into the mechanisms of deep brain stimulation
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-28
    Keyoumars Ashkan, Priya Rogers, Hagai Bergman, Ismail Ughratdar

    Despite long-term and widespread use of deep brain stimulation (DBS) in a variety of neurological conditions, the underlying mechanisms of action have been elusive. Growing evidence suggests that DBS acts through multimodal mechanisms that are not limited to inhibition and excitation of basal ganglia circuits. DBS also seems to act over variable time spans — for example, the effects on tremor are immediate, whereas the effects on dystonia emerge over several weeks — suggesting that large networks are targeted. Studies reviewing the use of DBS in pain and obsessive–compulsive disorder have demonstrated direct involvement of axonal fibres rather than grey matter. In this Review, we draw on clinical and experimental data to examine the various hypotheses that have been put forward to explain the effects of DBS. In agreement with several other experts, we suggest that the term 'deep brain stimulation' warrants modification. A potentially more accurate term is 'deep brain neuromodulation', as the mode of action spans an array of therapeutic effects over a variable period of time, and is not just limited to 'stimulation' of the basal ganglia brain centres. Terms such as 'electrical neuro-network modulation' may be useful for applications in which deep brain structures are not the primary target.

    更新日期:2017-08-31
  • Cerebral venous thrombosis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-18
    Suzanne M. Silvis, Diana Aguiar de Sousa, José M. Ferro, Jonathan M Coutinho

    Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is highly variable in this disease, and can range from a patient seen at the clinic with a 1-month history of headache, to a comatose patient admitted to the emergency room. Consequently, the diagnosis of CVT is often delayed or overlooked. A variety of therapies for CVT are available, and each should be used in the appropriate setting, preferably guided by data from randomized trials and well-designed cohort studies. Although deaths from CVT have decreased in the past few decades, mortality remains ~5–10%. In this Review, we provide a comprehensive and contemporary overview of CVT in adults, with emphasis on advancements made in the past decade on the epidemiology and treatment of this multifaceted condition.

    更新日期:2017-08-31
  • The far-reaching scope of neuroinflammation after traumatic brain injury
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-04
    Dennis W. Simon, Mandy J. McGeachy, Hülya Bayır, Robert S. B. Clark, David J. Loane, Patrick M. Kochanek

    Nature Reviews Neurology13, 171–191 (2017)In the initially published version of this article, reference 194 was incorrectly cited as reference 193 in the Conclusions section. This error has been corrected in the HTML and PDF versions of the

    更新日期:2017-08-31
  • The tension between early diagnosis and misdiagnosis of multiple sclerosis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-11
    Andrew J. Solomon, John R. Corboy

    Diagnosis of multiple sclerosis (MS) can be challenging, and misdiagnosis remains a persistent problem with considerable consequences for patients and health-care systems. Common syndromes are frequently mistaken for MS. Misapplication of MS diagnostic criteria in patients with abnormal radiographic findings and clinical presentations that are atypical for MS is a frequent cause of misdiagnosis. Delays in diagnosis of MS and initiation of disease-modifying therapy (DMT) are associated with an increased risk of disability, putting pressure on physicians to make therapeutic decisions for patients whose diagnosis remains uncertain. DMT is associated with unnecessary risks and morbidity in misdiagnosed patients. This tension between the benefits of an early diagnosis and the risk of misdiagnosis is a pressing problem. For patients who present with brain MRI abnormalities and clinical syndromes that are atypical for MS, strict adherence to MS diagnostic criteria and further clinical, laboratory and radiographic evaluation is prudent and likely to clarify a diagnosis.

    更新日期:2017-08-31
  • Cerebral venous thrombosis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-18
    Suzanne M. Silvis, Diana Aguiar de Sousa, José M. Ferro, Jonathan M Coutinho

    Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is highly variable in this disease, and can range from a patient seen at the clinic with a 1-month history of headache, to a comatose patient admitted to the emergency room. Consequently, the diagnosis of CVT is often delayed or overlooked. A variety of therapies for CVT are available, and each should be used in the appropriate setting, preferably guided by data from randomized trials and well-designed cohort studies. Although deaths from CVT have decreased in the past few decades, mortality remains ~5–10%. In this Review, we provide a comprehensive and contemporary overview of CVT in adults, with emphasis on advancements made in the past decade on the epidemiology and treatment of this multifaceted condition.

    更新日期:2017-08-18
  • Neuroepidemiology: The increasing burden of mortality from neurological diseases
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-11
    Julia Pakpoor, Michael Goldacre

    A new study based on WHO data reports rates of mortality from neurological diseases in the developed world from 1989–1991 to 2012–2014. The reported increase in neurological disease mortality, which was greatest in the USA, highlights the rise of neurological diseases as an emerging threat to global health.

    更新日期:2017-08-18
  • Multiple sclerosis: Treatment of cognitive impairment in secondary progressive MS
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-28
    Anthony Feinstein

    Cognitive and neuropsychiatric impairment pose a considerable burden to patients with secondary progressive multiple sclerosis, but no effective therapies have been approved to treat these symptoms. A new trial has shown modest benefits of simvastatin treatment in this context. These results are much welcomed, but require more-rigorous testing.

    更新日期:2017-08-18
  • Peripheral neuropathies: Long-term opioid therapy in neuropathy: benefit or harm?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Claudia Sommer

    A retrospective population-based cohort study has shown that outcomes were worse for patients with neuropathic pain who received long-term opioid treatment than for those who received short-term opioid treatment. The finding highlights a need for improved pain education for non-specialists and for more-effective therapies.

    更新日期:2017-08-18
  • Insights into the mechanisms of deep brain stimulation
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-28
    Keyoumars Ashkan, Priya Rogers, Hagai Bergman, Ismail Ughratdar

    Despite long-term and widespread use of deep brain stimulation (DBS) in a variety of neurological conditions, the underlying mechanisms of action have been elusive. Growing evidence suggests that DBS acts through multimodal mechanisms that are not limited to inhibition and excitation of basal ganglia circuits. DBS also seems to act over variable time spans — for example, the effects on tremor are immediate, whereas the effects on dystonia emerge over several weeks — suggesting that large networks are targeted. Studies reviewing the use of DBS in pain and obsessive–compulsive disorder have demonstrated direct involvement of axonal fibres rather than grey matter. In this Review, we draw on clinical and experimental data to examine the various hypotheses that have been put forward to explain the effects of DBS. In agreement with several other experts, we suggest that the term 'deep brain stimulation' warrants modification. A potentially more accurate term is 'deep brain neuromodulation', as the mode of action spans an array of therapeutic effects over a variable period of time, and is not just limited to 'stimulation' of the basal ganglia brain centres. Terms such as 'electrical neuro-network modulation' may be useful for applications in which deep brain structures are not the primary target.

    更新日期:2017-08-18
  • Autoantibodies in chronic inflammatory neuropathies: diagnostic and therapeutic implications
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-14
    Luis Querol, Jérôme Devaux, Ricard Rojas-Garcia, Isabel Illa

    The chronic inflammatory neuropathies (CINs) are rare, very disabling autoimmune disorders that generally respond well to immune therapies such as intravenous immunoglobulin (IVIg). The most common forms of CIN are chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy, and polyneuropathy associated with monoclonal gammopathy of unknown significance. The field of CIN has undergone a major advance with the identification of IgG4 autoantibodies directed against paranodal proteins in patients with CIDP. Although these autoantibodies are only found in a small subset of patients with CIDP, they can be used to guide therapeutic decision-making, as these patients have a poor response to IVIg. These observations provide proof of concept that identifying the target antigens in tissue-specific antibody-mediated autoimmune diseases is important, not only to understand their underlying pathogenic mechanisms, but also to correctly diagnose and treat affected patients. This state-of-the-art Review focuses on the role of autoantibodies against nodes of Ranvier in CIDP, a clinically relevant emerging field of research. The role of autoantibodies in other immune-mediated neuropathies, including other forms of CIN, primary autoimmune neuropathies, neoplasms, and systemic diseases that resemble CIN, are also discussed.

    更新日期:2017-08-18
  • Stroke in women — from evidence to inequalities
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Charlotte Cordonnier, Nikola Sprigg, Else Charlotte Sandset, Aleksandra Pavlovic, Katharina S. Sunnerhagen, Valeria Caso, Hanne Christensen

    Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke — including diabetes mellitus and atrial fibrillation — are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy. However, in an era of evidence-based medicine, women are notably under-represented in clinical trials — despite governmental actions highlighting the need to include both men and women in clinical trials — resulting in a reduced generalizability of study results to women. The aim of this Review is to highlight new insights into specificities of stroke in women, to plan future research priorities, and to influence public health policies to decrease the worldwide burden of stroke in women.

    更新日期:2017-08-18
  • The tension between early diagnosis and misdiagnosis of multiple sclerosis
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-08-11
    Andrew J. Solomon, John R. Corboy

    Diagnosis of multiple sclerosis (MS) can be challenging, and misdiagnosis remains a persistent problem with considerable consequences for patients and health-care systems. Common syndromes are frequently mistaken for MS. Misapplication of MS diagnostic criteria in patients with abnormal radiographic findings and clinical presentations that are atypical for MS is a frequent cause of misdiagnosis. Delays in diagnosis of MS and initiation of disease-modifying therapy (DMT) are associated with an increased risk of disability, putting pressure on physicians to make therapeutic decisions for patients whose diagnosis remains uncertain. DMT is associated with unnecessary risks and morbidity in misdiagnosed patients. This tension between the benefits of an early diagnosis and the risk of misdiagnosis is a pressing problem. For patients who present with brain MRI abnormalities and clinical syndromes that are atypical for MS, strict adherence to MS diagnostic criteria and further clinical, laboratory and radiographic evaluation is prudent and likely to clarify a diagnosis.

    更新日期:2017-08-18
  • Infectious disease: Musashi-1 protein could mediate the effects of Zika virus on brain development
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-23
    Heather Wood

    The causal link between maternal Zika virus (ZIKV) infection and neonatal microcephaly is now well established, but the factors that render the immature brain particularly susceptible to ZIKV are still being explored. A new study published in Science has identified the RNA-binding protein Musashi-1

    更新日期:2017-08-18
  • Dementia: Persistent pain might be a harbinger of cognitive decline in older people
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-23
    Heather Wood

    The presence of persistent pain is linked to an increased risk of accelerated memory decline and dementia in older individuals, according to a population-based cohort study with over 10,000 participants. Elizabeth Whitlock and colleagues at the University of California, San Francisco, USA recruited 10,065 individuals

    更新日期:2017-08-18
  • Neurodegenerative disease: Loss of TDP-43 in microglia — friend or foe?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-14
    Charlotte Ridler

    Removal of TDP-43 promotes the clearance of amyloid-β (Aβ) by boosting microglial phagocytosis, according to new research. However, this increased clearance comes at a cost, as it also results in a loss of synapses, which could play a part in neurodegeneration and cognitive decline.Microglia

    更新日期:2017-08-18
  • Parkinson disease: Deep brain stimulation — making the right connections
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-23
    Charlotte Ridler

    A specific pattern of connectivity between the site of deep brain stimulation (DBS) and other brain areas is linked to a positive outcome in patients with Parkinson disease (PD), new research has shown. The study highlights the importance of precise DBS electrode placement.DBS in

    更新日期:2017-08-18
  • Parkinson disease: Plasma α-synuclein — a potential marker of cognitive impairment in Parkinson disease
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-23
    Heather Wood

    Levels of α-synuclein in the plasma correlate with cognitive impairment — but not motor symptom severity — in patients with Parkinson disease (PD), research from Taiwan indicates. Ming-Jang Chiu and co-workers used an ultrasensitive immunoassay to measure plasma levels of α-synuclein in 80 patients with

    更新日期:2017-08-18
  • Alzheimer disease: Sniffing out a marker of early Alzheimer disease
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-09
    Ian Fyfe

    Severe olfactory impairment correlates with imaging markers of brain pathology that are present in preclinical Alzheimer disease (AD), new work has shown. The findings suggest that olfactory impairment could be a clinically useful marker of early AD in cognitively normal elderly people.Olfactory impairment has

    更新日期:2017-08-18
  • Neuroimmunology: Complement is no bystander in CNS degeneration
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-16
    Ian Fyfe

    Fresh insight into the contribution of the complement pathway to degeneration in the brain has come from two new animal studies. The research shows that knockout of complement C3 protects against neurodegeneration in a model of Alzheimer disease (AD), and identifies a novel mechanism of

    更新日期:2017-08-18
  • Parkinson disease: T cells recognize α-synuclein peptides in Parkinson disease
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-30
    Ian Fyfe

    Fragments of α-synuclein elicit immune responses in T cells from patients with Parkinson disease (PD), a new study shows. The findings support the existence of a long-suspected autoimmune component in PD.David Sulzer — first author of the new study — and colleagues previously showed

    更新日期:2017-08-18
  • Neuroimmunology: B cells and variant BAFF in autoimmune disease
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-16
    Manuel Comabella

    A variant in the TNFSF13B gene that encodes B-cell-activating factor has been found to increase the risk of multiple sclerosis and systemic lupus erythematosus in the Sardinian population. The findings underscore, and offer new insight into, the role of B cells in these autoimmune disorders, and have implications for personalized therapy.

    更新日期:2017-08-18
  • Repeat expansion disorders: New evidence for RNA gelation in repeat expansion disorders
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-16
    Heather Wood

    Sol–gel phase transitions in nucleotide repeat-containing RNA could contribute to the pathogenesis of certain neurological disorders, a study published in Nature suggests. Nucleotide repeat expansions have been identified as causative factors in conditions including amyotrophic lateral sclerosis (ALS), muscular dystrophy and Huntington disease, but

    更新日期:2017-08-18
  • A clinicopathological approach to the diagnosis of dementia
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-14
    Fanny M. Elahi, Bruce L. Miller

    The most definitive classification systems for dementia are based on the underlying pathology which, in turn, is categorized largely according to the observed accumulation of abnormal protein aggregates in neurons and glia. These aggregates perturb molecular processes, cellular functions and, ultimately, cell survival, with ensuing disruption of large-scale neural networks subserving cognitive, behavioural and sensorimotor functions. The functional domains affected and the evolution of deficits in these domains over time serve as footprints that the clinician can trace back with various levels of certainty to the underlying neuropathology. The process of phenotyping and syndromic classification has substantially improved over decades of careful clinicopathological correlation, and through the discovery of in vivo biomarkers of disease. Here, we present an overview of the salient features of the most common dementia subtypes — Alzheimer disease, vascular dementia, frontotemporal dementia and related syndromes, Lewy body dementias, and prion diseases — with an emphasis on neuropathology, relevant epidemiology, risk factors, and signature signs and symptoms.

    更新日期:2017-08-18
  • Parkinson disease: Defining PD subtypes — a step toward personalized management?
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-07
    Caroline H. Williams-Gray, Roger A. Barker

    A recent article published in Brain proposes a clinical method for subtyping Parkinson disease cases on an individual basis, with implications for better patient stratification for personalized medicine. The authors report biological validity in terms of imaging and cerebrospinal fluid parameters, but long-term predictive validity remains to be established.

    更新日期:2017-08-18
  • ER stress and the unfolded protein response in neurodegeneration
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-07-21
    Claudio Hetz, Smita Saxena

    The clinical manifestation of neurodegenerative diseases is initiated by the selective alteration in the functionality of distinct neuronal populations. The pathology of many neurodegenerative diseases includes accumulation of misfolded proteins in the brain. In physiological conditions, the proteostasis network maintains normal protein folding, trafficking and degradation; alterations in this network — particularly disturbances to the function of endoplasmic reticulum (ER) — are thought to contribute to abnormal protein aggregation. ER stress triggers a signalling reaction known as the unfolded protein response (UPR), which induces adaptive programmes that improve protein folding and promote quality control mechanisms and degradative pathways or can activate apoptosis when damage is irreversible. In this Review, we discuss the latest advances in defining the functional contribution of ER stress to brain diseases, including novel evidence that relates the UPR to synaptic function, which has implications for cognition and memory. A complex concept is emerging wherein the consequences of ER stress can differ drastically depending on the disease context and the UPR signalling pathway that is altered. Strategies to target specific components of the UPR using small molecules and gene therapy are in development, and promise interesting avenues for future interventions to delay or stop neurodegeneration.

    更新日期:2017-08-18
  • Chemotherapy-induced peripheral neurotoxicity: management informed by pharmacogenetics
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-06-30
    Andreas A. Argyriou, Jordi Bruna, Armando A. Genazzani, Guido Cavaletti

    The increasing availability of sophisticated methods to characterize human genetic variation has enabled pharmacogenetic data to be used not only to predict responses to treatment (in the context of so-called personalized medicine), but also to identify patients at high or low risk of specific treatment-related adverse effects. Over the past two decades, extensive attempts have been made to understand the genetic basis of chemotherapy-induced peripheral neurotoxicity (CIPN), one of the most severe non-haematological adverse effects of cancer treatment. Despite substantial efforts, however, the identification of a genetic profile that can detect patients at high risk of CIPN still represents an unmet need, as the information obtained from pharmacogenetic studies published so far is inconsistent at best. Among the reasons for these inconsistencies, methodological flaws and the poor reliability of existing tools for assessing CIPN features and severity are particularly relevant. This Review provides a critical update of the pharmacogenetics of CIPN, focusing on the studies published since 2011. Strategies for improving the reliability of future pharmacogenetic studies of CIPN are also discussed.

    更新日期:2017-08-18
  • Current controversies in brain death determination
    Nat. Rev. Neurol. (IF 20.257) Pub Date : 2017-05-26
    Ariane Lewis, David Greer

    Although the concept of brain death is accepted by the majority of physicians, lawyers, ethicists and society at large, controversies about determination of death by neurological criteria persist, and often reach the public eye. In this article, we examine four prominent controversial brain death cases

    更新日期:2017-08-18
Some contents have been Reproduced with permission of the American Chemical Society.
Some contents have been Reproduced by permission of The Royal Society of Chemistry.
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