[In Context] The first report of Alzheimer's disease
Alois Alzheimer (1864-1915), a German psychiatrist and neuropathologist, was the first to describe the clinical and pathological features of a then unrecognised brain disease. In 1895, Alzheimer described “arteriosclerotic brain atrophy”.1 This notion was important for differentiating arterosclerotic dementia from general paralysis since, in those days, syphilis was considered to be the most common form of presenile dementia. (Source: Lancet Neurology)
Source: Lancet Neurology - August 9, 2017 Category: Neurology Authors: Emmanuel Drouin, Guillaume Drouin Tags: In Context Source Type: research
[Corrections] Corrections
Saft C. Identifying modifiers of Huntington's disease progression. Lancet Neurol 2017; 16: 679 –80—In reference 6 of this linked comment, the first author was incorrect. This correction has been made in the online version as of Aug 8, 2017 and is correct in the print version. (Source: Lancet Neurology)
Source: Lancet Neurology - August 9, 2017 Category: Neurology Tags: Corrections Source Type: research
[Comment] Low risk of ischaemic stroke in hyperhomocysteinaemia
Whether elevated serum homocysteine concentrations (ie, hyperhomocysteinaemia) are a risk factor for ischaemic stroke and if normalising hyperhomocysteinaemia might reduce stroke risk are controversial issues. Hyperhomocysteinaemia can be primary (ie, hereditary) or secondary (ie, due to vitamin B12 deficiency, diabetes, etc). The effect of both primary and secondary hyperhomocysteinaemia on putative stroke risk is debated. One study1 has shown that hyperhomocysteinaemia is an independent risk factor for ischaemic stroke, whereas other studies have reached different conclusions. (Source: Lancet Neurology)
Source: Lancet Neurology - August 9, 2017 Category: Neurology Authors: Josef Finsterer Tags: Comment Source Type: research
[Editorial] Pointing the way to primary prevention of dementia
The launch of the World Wide FINGERS network —a research initiative to prevent or delay the onset of cognitive decline—on July 19, 2017, at the Alzheimer's Association International Conference (AAIC) was promising news. The risk of Alzheimer's disease (AD), the most common form of dementia, is in a large part modulated by genetics, but pre valence is decreasing in many high-income countries; hence, modifiable risk factors are also at work. Identifying and tackling these factors is an urgent research priority, for which the network is a step in the right direction. (Source: Lancet Neurology)
Source: Lancet Neurology - August 9, 2017 Category: Neurology Authors: The Lancet Neurology Tags: Editorial Source Type: research
[Comment] NOR-TEST-ing tenecteplase in acute ischaemic stroke
Despite the transformational impact of endovascular treatment on patients with acute ischaemic stroke from proximal cerebral artery occlusion, thrombolysis with intravenous alteplase remains the mainstay of reperfusion therapy because it is widely available and the standard of care upon which the evidence for endovascular treatment has been based.1 However, because alteplase has well recognised limitations, including reduced efficacy in large clots, risk of major intracranial haemorrhage, and requirement for a continuous infusion, there is an imperative to continue efforts to find more efficient, more effective, and safer ...
Source: Lancet Neurology - August 8, 2017 Category: Neurology Authors: Craig S Anderson Tags: Comment Source Type: research
[Articles] Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial
Tenecteplase was not superior to alteplase and showed a similar safety profile. Most patients enrolled in this study had mild stroke. Further trials are needed to establish the safety and efficacy in patients with severe stroke and whether tenecteplase is non-inferior to alteplase. (Source: Lancet Neurology)
Source: Lancet Neurology - August 2, 2017 Category: Neurology Authors: Nicola Logallo, Vojtech Novotny, J örg Assmus, Christopher E Kvistad, Lars Alteheld, Ole Morten Rønning, Bente Thommessen, Karl-Friedrich Amthor, Hege Ihle-Hansen, Martin Kurz, Håkon Tobro, Kamaljit Kaur, Magdalena Stankiewicz, Maria Carlsson, Åse Mor Tags: Articles Source Type: research
[In Context] Moving in the right direction?
“We should consider every day lost on which we have not danced at least once”, Friedrich Nietzsche wrote in his philosophical novel Thus Spoke Zarathustra. Sean Cross, Clinical Director of King's Health Partners Mind and Body Programme, South London and Maudsley National Health Service (NHS) Fou ndation Trusts (SLaM, London, UK), has this quote on his Facebook profile. Cross was one of the speakers at the Moving Bodies, Moving Minds event organised by Performing Medicine in London, UK. Under the banner The Art of Healthcare, Performing Medicine is an award-winning programme created by theat re company Clod Ensemble. (S...
Source: Lancet Neurology - July 19, 2017 Category: Neurology Authors: Jules Morgan Tags: In Context Source Type: research
[Review] Detection, risk factors, and functional consequences of cerebral microinfarcts
Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that is independent of Alzheimer's disease pathology or larger infarcts (ie, lacunar infarcts, and large cortical and non-lacunar subcortical infarcts). Substantial progress has been made with regard to understanding risk factors and functional consequences of cerebral microinfarcts, partly driven by new in-vivo detection methods an...
Source: Lancet Neurology - July 14, 2017 Category: Neurology Authors: Susanne J van Veluw, Andy Y Shih, Eric E Smith, Christopher Chen, Julie A Schneider, Joanna M Wardlaw, Steven M Greenberg, Geert Jan Biessels Tags: Review Source Type: research
[Corrections] Corrections
Byrne LM, Rodrigues FB, Blennow K, et al. Neurofilament light protein in blood as a potential biomarker of neurodegeneration in Huntington's disease: a retrospective cohort analysis. Lancet Neurol 2017; 16: 601 –09—In figure 5C, the legend for the x-axis should have been “NfL concentration in plasma (pg/mL)” These corrections have been made to the online version as of July 14, 2017. (Source: Lancet Neurology)
Source: Lancet Neurology - July 14, 2017 Category: Neurology Tags: Corrections Source Type: research
[Articles] Intracerebral gene therapy in children with mucopolysaccharidosis type IIIB syndrome: an uncontrolled phase 1/2 clinical trial
Intracerebral rAVV2/5 was well tolerated and induced sustained enzyme production in the brain. The initial specific anti-NAGLU immune response that later subsided suggested acquired immunological tolerance. The best results being obtained in the youngest patient implies a potential window of opportunity. Longer follow-up is needed to further assess safety outcomes and persistence of improved cognitive development. (Source: Lancet Neurology)
Source: Lancet Neurology - July 13, 2017 Category: Neurology Authors: Marc Tardieu, Michel Z érah, Marie-Lise Gougeon, Jérome Ausseil, Stéphanie de Bournonville, Béatrice Husson, Dimitrios Zafeiriou, Giancarlo Parenti, Philippe Bourget, Béatrice Poirier, Valérie Furlan, Cécile Artaud, Thomas Baugnon, Thomas Roujeau, Tags: Articles Source Type: research
[In Context] Marc Tardieu: the interface man
“To be a doctor is also to be an activist”, Marc Tardieu told me. Coming from anyone else this might appear a surprising statement. But not from this mixer and masher of paediatric neurology, neurovirology, neuroimmunology, and patient-association advocacy. “Well, I like to be at the interface of things”, he says. One glance at the paper on mucopolysaccharidosis IIIB he coauthors in this issue of The Lancet Neurology—an innovative gene therapy trial for treatment of a rare disease that induces severe disability in children, and which required a large team working at the intersection between many specialities—sh...
Source: Lancet Neurology - July 13, 2017 Category: Neurology Authors: Adrian Burton Tags: In Context Source Type: research
[Corrections] Corrections
Liu G, Locascio JJ, Corvol J-C, et al. Prediction of cognition in Parkinson's disease with a clinical –genetic score: a longitudinal analysis of nine cohorts. Lancet Neurol 2017; 16: 620–29—In this Article, the author list should have said “for the HBS, CamPaIGN, PICNICS, PROPARK, PSG, DIGPD, and PDBP investigators”. The appendix has also been replaced. These corrections have been made to the online version as of July 13, 2017. (Source: Lancet Neurology)
Source: Lancet Neurology - July 13, 2017 Category: Neurology Tags: Corrections Source Type: research
[Comment] Intracerebral gene therapy for mucopolysaccharidosis type IIIB syndrome
The devastating paediatric-onset lysosomal storage disorder mucopolysaccharidosis type III syndrome (also known as Sanfilippo syndrome), has been viewed as untreatable. Rapidly progressing neurological impairments lead to death, typically in the second decade of life. In The Lancet Neurology, Marc Tardieu and colleagues1 report the outcomes of a phase 1/2 clinical trial of intracerebral gene therapy with a recombinant adenoassociated viral vector serotype 2/5 encoding human α-N-acetylglucosaminidase (NAGLU) in four young children (age 20–53 months) with mucopolysaccharidosis type IIIB syndrome. (Source: Lancet Neurology)
Source: Lancet Neurology - July 13, 2017 Category: Neurology Authors: Kim Hemsley, Adeline Lau Tags: Comment Source Type: research
[Policy View] Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers
The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care. (Source: Lancet Neurology)
Source: Lancet Neurology - July 12, 2017 Category: Neurology Authors: Giovanni B Frisoni, Marina Boccardi, Frederik Barkhof, Kaj Blennow, Stefano Cappa, Konstantinos Chiotis, Jean-Francois D émonet, Valentina Garibotto, Panteleimon Giannakopoulos, Anton Gietl, Oskar Hansson, Karl Herholz, Clifford R Jack, Flavio Nobili, Ag Tags: Policy View Source Type: research
[Series] Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management
Normal haemostasis depends on an intricate balance between mechanisms of bleeding and mechanisms of thrombosis, and this balance can be altered after traumatic brain injury (TBI). Impaired haemostasis could exacerbate the primary insult with risk of initiation or aggravation of bleeding; anticoagulant use at the time of injury can also contribute to bleeding risk after TBI. Many patients with TBI have abnormalities on conventional coagulation tests at admission to the emergency department, and the presence of coagulopathy is associated with increased morbidity and mortality. (Source: Lancet Neurology)
Source: Lancet Neurology - July 12, 2017 Category: Neurology Authors: Marc Maegele, Herbert Sch öchl, Tomas Menovsky, Hugues Maréchal, Niklas Marklund, Andras Buki, Simon Stanworth Tags: Series Source Type: research
