Articles in 2016

Participants in collision sports show a high incidence of concussion and can have deleterious long-term consequences for brain function. Here, Rebekah Mannix and colleagues discuss the benefits and risks associated with the practice of contact sports and examine how this balance affects policies regarding the practice of collision sports.

The archetypal vascular endothelial growth factor, VEGF, arose in evolution as a signal affecting neural cells, and was subsequently co-opted to regulate vascular function. Here, the authors review the roles of the VEGF family as both aetiological factors and therapeutic targets in neurological disease.

Alteplase is widely used for acute stroke at a dose of 0.6 mg/kg in Asian patients, whereas the standard in Europe and the USA is 0.9 mg/kg. The ENCHANTED study did not show that 0.6 mg/kg alteplase is noninferior to 0.9 mg/kg, as previously suggested, raising questions about standard practice in Asia.

Overactivation of the mechanistic target of rapamycin (mTOR) signalling pathway contributes to neurological disorders, including neurodevelopmental disorders, tuberous sclerosis complex, epilepsy, and tumours of the CNS. In this Review, Peter Crino discusses the pathophysiological role of mTOR in neurological diseases and provides an overview of clinical trials that have assessed the efficacy of mTOR inhibitors in these diseases.

Premutation CGG expansions in theFMR1gene can lead to various premutation disorders throughout life and ultimately lead to fragile X-associated tremor/ataxia syndrome (FXTAS) in late life. In this Review, the authors summarize our current understanding of the clinical features and management of FXTAS, and consider how our advancing understanding of the pathogenic mechanisms could lead to new therapies.

The American Academy of Neurology (AAN) has updated its guidelines on the use of botulinum neurotoxins in neurological disorders. The new guidelines provide individual recommendations for the four products that are commercially available in the USA; however, the clinical differences between the products are still not clear.

The Response Assessment in Neuro-Oncology Working Group has analysed the role of clinically established PET methods in the diagnostic assessment of brain tumours. The group emphasizes the clinical value of PET imaging, particularly amino acid PET imaging, over conventional MRI, and recommends its use at every stage of management.

Numerous genetic variants have been associated with late-onset Alzheimer disease (LOAD) but the determination of their effect has proven challenging. Here, Gaiteri and co-workers discuss how the analysis of molecular and brain networks and their combination into multiscale models can provide a more comprehensive and clinically relevant representation of the effects of LOAD-associated genetic variants