Amyotrophy in Prion Diseases
Worrall et alArticle review their experience and that of the literature in describing amyotrophy in patients with prion diseases. They find that amyotrophy may be a prominent feature of this type of disease, which underscores the importance of documenting lower motor neuron function in patients with prion diseases and examining the spinal cord at autopsy. They point out that cases of amyotrophic lateral sclerosis and dementia warrant testing for protease-resistant prion protein in the brain and also for mutations in the prion gene.
Carotid Endarterectomy—A Therapeutic Triumph
Barnett and MeldrumArticle review the literature and highlight their own experience documenting the value of carotid endarterectomy in selected patients. Barnett has been an important leader in this field and his personal perspective is invaluable.
Neurology at the Millennium
Sixteen thoughtful responsesArticle by neurologists or neuroscientists are recorded as to their views of what have been the important accomplishments in clinical and basic neuroscience in the 20th century and what they predict will be important developments in our field in the 21st century. Their succinct reviews provide insights and predictions that we hope will help provide a chart and map of the future.
Axons and Multiple Sclerosis
Lee and colleaguesArticle demonstrate an elegant relationship of a graded association between N-acetylaspartate concentrations within normal-appearing white matter of a specific tract and functional impairments and suggest that axonal pathology may be an important determinant of disability in multiple sclerosis. WaxmanArticle, an expert in this field, offers an important perspective in his editorial emphasizing multiple sclerosis as a neuronal disease.
Familial Alzheimer Disease in Specific Ethnic and Racial Groups
Devi and colleaguesArticle describe epidemiologic studies showing familial aggregation of Alzheimer disease in Hispanics, African Americans, and whites in New York City. Specific correlations and risk factors are described. This important study is reviewed and critically assessed in a thoughtful editorial by FarrerArticle.
Weinberger and colleaguesArticle describe their experience in identifying aortic arch plaques with B-mode ultrasonography and the occurrence of ischemic strokes. They demonstrate that this is a useful screening procedure that can identify aortic arch plaques and the level of risk that patients have for thromboembolic stroke.
Education and Alzheimer Disease
Munoz and colleaguesArticle describe educational attainment, occupation, socioeconomic and income levels, and their cumulative effect on Alzheimer disease. Looking at all the variables, they conclude that education does not protect against advanced Alzheimer disease; they also review the literature.
Donepezil and Clinical Practice
Greenberg et alArticle, in a 2-center, randomized, placebo-controlled, double-blinded crossover study, suggest that donepezil hydrochloride mildly improves cognition in clinic patients with Alzheimer disease.
Diagnosing Alzheimer Disease With Cerebrospinal Fluid Amyloid
Mehta and colleaguesArticle describe the diagnostic value of cerebrospinal fluid Aβ42 levels in Alzheimer disease, consistent with previous studies. They also describe unique changes in Aβ40 in plasma when it is elevated in sporadic Alzheimer disease and influenced by apolipoprotein E genotype. These observations are put into useful clinical perspective and their findings are of great interest.
Amyotrophic Lateral Sclerosis Mimicry
Traynor and colleaguesArticle describe their experience with the misdiagnosis of amyotrophic lateral sclerosis because of syndromes that mimic it. These findings need to be emphasized and repeated because of their obvious importance.
Dallas With St Louis Encephalitis
Wasay and colleaguesArticle describe specific and unique magnetic resonance imaging findings of the substantia nigra in patients with St Louis encephalitis who were evaluated in Dallas, Tex.