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Arch Neurol. 1998;55:1393.

Go With Ginkgo
Oken and colleagues (SEE ARTICLE) have carefully reviewed at least 50 articles on the role of Ginkgo biloba in the treatment of Alzheimer disease (AD). There is a small but significant positive therapeutic effect in cognitive function in treating patients with AD. This study supports additional studies of the pharmacological basis of response.

Treating Language
An interesting and thorough review of therapies for aphasia is provided by Albert (SEE ARTICLE) . Insights and hope for the future are provided in this positive assessment of a difficult subject.

How to Control a Clinical Trial
Should placebo-controlled or active drug–controlled clinical trials be designed to test future drug therapies for AD? This hotly debated subject is reviewed candidly by 2 groups, Karlawish and Whitehouse (SEE ARTICLE) and also byKnopman and colleagues (SEE ARTICLE) . The arguments for and against placebo-controlled trials to test new drugs for AD are presented by both groups and a balanced analysis is also provided on this issue in a fair-minded editorial by Farlow (SEE ARTICLE) .

Ketogenic Diet Again
Vining and associates (SEE ARTICLE) bring us up to date on the ketogenic diet and the management of epilepsy in children. A role for this therapy is supported by their research and placed into perspective in an editorial by Roach (SEE ARTICLE) .

Computers and Aphasia
Lesion site patterns on computed tomography scans are correlated with potential learning using computer-assisted treatment programs, as presented by Naeser and colleagues (SEE ARTICLE) . There may be a role for computerized assisted learning in selected patients with aphasia. This subject is also discussed realistically in a review by Albert (SEE ARTICLE) .

Folate, Vitamin B₁₂, Homocysteine, and AD
Clarke et al (SEE ARTICLE) present data strongly suggesting that low serum levels of folate and vitamin B₁₂ and elevated homocysteine levels may in part cause AD. Their data argue for causality rather than result of disease, and these points are thoroughly discussed in a pointed editorial by Diaz-Arrastia (SEE ARTICLE) .

Assessing Cognition in Partial Seizures and Pseudoseizures
Bell and colleagues (SEE ARTICLE) provide a method of ictal cognitive assessment, which they report as being practical and highly useful for properly classifying seizures. Ictal cognitive assessment, especially for memory, is useful to distinguish complex partial seizures from pseudoseizures.

APOE 4 and Asymmetry of Parietal Regional Cerebral Blood Flow
Van Dyck et al (SEE ARTICLE) examined a group of patients with probable AD for the role of the apolipoprotein E 4 (APOE 4) allele associated with parietal regional cerebral blood flow (rCBF) abnormalities and asymmetries. Of note is their finding of significantly greater parietal rCBF asymmetry in patients without APOE 4 than in those with APOE 4. The absence of APOE 4 in patients with AD may be associated with other genetic or environmental factors that result in greater neuropathological asymmetry.