Articles in 2012

Hypertension is highly prevalent, particularly in individuals over 60 years of age, and constitutes a major risk factor for stroke and dementia. Antihypertensive therapy in elderly individuals has, however, been limited owing to concerns over adverse effects of such therapies. In this Perspectives article, Sörös et al. emphasize that treatment of hypertension can markedly reduce stroke and dementia risk, and argue that antihypertensive therapy should be considered in all patients, irrespective of age.

Prion diseases are a group of fatal neurodegenerative disorders caused by accumulation of misfolded prion protein. The time from infection to onset of disease symptoms can be decades, and the public health risk from infective prions is considerable. In this Review the authors discuss current research into passive and active immunization strategies against prion diseases, and the potential for effective therapy.

Anaplastic oligodendroglial tumours are chemosensitive tumours—a fact that has been known for almost 25 years. The role and optimal timing of chemotherapy, however, has remained a subject of debate. Long-term results of two phase III trials now show that, in patients with 1p19q-codeleted tumours, early chemotherapy increases overall survival.

Differential diagnosis of Creutzfeldt–Jakob disease (CJD) versus other—sometimes treatable—neurological disorders is challenging, owing in part to uncertainty about the utility of recommended diagnostic tools. Two recent studies have addressed the reliability of cerebrospinal fluid biomarkers in identification of patients with sporadic CJD among clinically suspected cases.

Pathological changes underlying Alzheimer disease (AD) begin more than 10 years before clinical presentation, and the need for early therapeutic intervention is becoming increasingly recognized. Reisa Sperling and colleagues consider challenges to such an approach—including the difficulty of defining preclinical AD, and ethical issues associated with disclosing information on AD biomarker status to healthy individuals—and discuss possible ways to overcome these hurdles.