JNS.jpgThe January issue of the Journal of the Neurological Sciences Vol 422 is now available online.

 

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Issue highlights

Exploring new avenues for modifying course of progression of Alzheimer's disease: The rise of natural medicine

With a constantly growing elderly population worldwide, a focus on developing efficient prevention and therapy for Alzheimer's disease (AD) seems timely and topical. Emphasis on natural medicine is increasingly popular in the search for drug candidates that are capable of preventing and treating AD related pathology, particularly where suppression of amyloid accumulation, neurofibrillary tangle formation, neuroinflammation and oxidative stress are equally significant. A number of phytochemical compounds have been shown to collectively reduce these AD hallmarks with the progression of natural drug candidates into human clinical trials.

This review focuses on current research surrounding the therapies emerging within natural medicines and their related therapeutic potential for AD treatment.

  • Emergent natural medicine and related therapeutic potential for Alzheimer's Disease.
  • Phytochemical compounds decrease neuroinflammation and oxidative stress.
  • Phytochemical compounds can reduce neurodegeneration.

Long-term outcomes of endovascular simple coiling versus neurosurgical clipping of unruptured intracranial aneurysms: A systematic review and meta-analysis

Previous studies on ruptured intracranial aneurysms have shown favourable long-term outcomes of patients undergoing endovascular coiling compared to neurosurgical clipping. We aimed to evaluate if these results also apply to patients with unruptured intracranial aneurysms (UIAs).

  • Simple coiling has lower short-term mortality than surgical clipping in unruptured intracranial aneurysms (UIAs).
  • Simple coiling and surgical clipping have similar long-term mortality in UIAs.
  • Coiled patients have higher retreatment rates than clipped patients in UIAs.
  • Future studies should account for differences in coiling techniques and confounding factors such as size and location of UIAs.

Management decisions on unruptured intracranial aneurysms before and after implementation of the PHASES score

In management decisions on saccular unruptured intracranial aneurysms (UIAs) the risk of rupture is an important factor. The PHASES score, introduced in 2014, provides absolute 5-year risks of rupture based on six easily retrievable patient and aneurysm characteristics. We assessed whether management decisions on UIAs changed after implementation of the PHASES score.

  • Clinical decision making in unruptured intracranial aneurysms is a complex process.
  • PHASES predicts 5-year aneurysm rupture risks using 6 easy clinical characteristics.
  • After PHASES score implementation the proportion of treated aneurysms decreased.
  • The implementation effect varied across centers and depended on age subgroups.

Single-dose L-dopa increases upper brainstem GABA in Parkinson's disease: A preliminary study

Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder, characterized by the dysfunction between dopaminergic and GABAergic neuronal activities. Dopamine (DA) replacement by its precursor L-dopa remains the primary treatment for PD.

In this preliminary study, we test the hypotheses that GABA+ levels would be lower in PD patients than controls, and normalized by L-dopa.

  • Patients with Parkinson's disease show decreased GABA+ levels in the upper brainstem, measured with edited MRS.
  • Edited MRS reveals increased GABA+ levels in the upper brainstem in patients with PD by single-dose of L-dopa.
  • GABAergic neurotransmission may play a role in the therapeutic mechanism of L-dopa.