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Arch Neurol. 1998;55:1049.

Sphingolipid Therapy
Brady (SEE ARTICLE) has been the leader for years in defining the biochemical genetics of the sphingolipidoses. In this neurological review, he turns his attention to therapy that he has pioneered and brings us up to date.

Adenovirus Gene Therapy
Smith (SEE ARTICLE) presents salient basic science mechanisms of adenovirus vectors for gene therapy of serious neurologic diseases. It is a timely review for the clinician gauging the future prospects of this inevitable form of neurologic therapy in the 21st century.

APOE 4 and Thinking
Jonker et al (SEE ARTICLE) examined a community-based sample for cognitive decline relative to the presence of the apolipoprotein E 4 allele (APOE 4). Their observations are put into proper perspective in a comprehensive and elegant editorial by Growdon (SEE ARTICLE) . These 2 contributions are essential reading for the clinician wanting a clear explanation of the interrelationships of APOE 4 and cognitive function.

Immune Causes of Parkinson Disease
Chen et al (SEE ARTICLE) present provocative and important new information about the potential immune mechanisms involved in neuronal injury that underlie Parkinson disease. Their findings open new avenues of thinking for us.

Cortical Promotion of Recovery
Motor recovery after cortical infarction in the middle cerebral artery territory appears to rely on activation of premotor cortical areas. These observations by Seitz and colleagues (SEE ARTICLE) describe neurophysiological mechanisms of a specific nature that are invoked to induce recovery after stroke. Neuroplasticity takes on a new dimension.

Treating Parkinson Disease With Tolcapone
Adler and colleagues (SEE ARTICLE) demonstrate that tolcapone, a new catechol-O-methyltransferase inhibitor, is effective in treating Parkinson disease.

Trying to Treat PSP
Progressive supranuclear palsy (PSP) is a difficult clinical syndrome, especially so because it is often refractory to therapy. Kompoliti et al (SEE ARTICLE) agree that antiparkinsonian medications and other neurotransmitter replacement therapies were largely ineffective in treating patients with autopsy-confirmed PSP. Their sobering report points out how much more we need to know about this troubling clinical entity.

Predicting Alzheimer Disease
Claus et al (SEE ARTICLE) describe specific electroencephalographic quantitative spectral findings to predict the natural history of Alzheimer disease. Their findings are interesting and have specific clinical relevance.

Reorganizing Language and Motor Abilities
Müller et al (SEE ARTICLE) describe a greater potential for homotopic interhemispheric reorganization in the language rather than the motor domain. Thus, there are differential reorganizational patterns following an early left hemispheric lesion. The adaptability of the brain to acute early lesions is real and modality specific.

The Genetics of PSP
Oliva et al (SEE ARTICLE) examined the tau gene A0/A0 genotype in patients with progressive supranuclear palsy (PSP). They found a significant overrepresentation of the A0/A0 genotype and a decrease in the A0/A3 genotype in Spanish patients with PSP. There may be both genetic risk and protective factors in the expression of PSP.

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