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- The role of iron in brain ageing and neurodegenerative disorders. [REVIEW]
- Lancet Neurol 2014 Oct; 13(10):1045-1060.
In the CNS, iron in several proteins is involved in many important processes such as oxygen transportation, oxidative phosphorylation, myelin production, and the synthesis and metabolism of neurotransmitters. Abnormal iron homoeostasis can induce cellular damage through hydroxyl radical production, which can cause the oxidation and modification of lipids, proteins, carbohydrates, and DNA. During ageing, different iron complexes accumulate in brain regions associated with motor and cognitive impairment. In various neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease, changes in iron homoeostasis result in altered cellular iron distribution and accumulation. MRI can often identify these changes, thus providing a potential diagnostic biomarker of neurodegenerative diseases. An important avenue to reduce iron accumulation is the use of iron chelators that are able to cross the blood-brain barrier, penetrate cells, and reduce excessive iron accumulation, thereby affording neuroprotection.
- Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa. [REVIEW]
- Lancet Neurol 2014 Oct; 13(10):1029-1044.
Epilepsy is a common neurological disease in tropical countries, particularly in sub-Saharan Africa. Previous work on epilepsy in sub-Saharan Africa has shown that many cases are severe, partly a result of some specific causes, that it carries a stigma, and that it is not adequately treated in many cases. Many studies on the epidemiology, aetiology, and management of epilepsy in sub-Saharan Africa have been reported in the past 10 years. The prevalence estimated from door-to-door studies is almost double that in Asia, Europe, and North America. The most commonly implicated risk factors are birth trauma, CNS infections, and traumatic brain injury. About 60% of patients with epilepsy receive no antiepileptic treatment, largely for economic and social reasons. Further epidemiological studies should be a priority to improve understanding of possible risk factors and thereby the prevention of epilepsy in Africa, and action should be taken to improve access to treatment.
- Connections between sleep and cognition in older adults. [REVIEW]
- Lancet Neurol 2014 Oct; 13(10):1017-1028.
Sleep disturbances and cognitive impairment are common in older adults. Mounting evidence points to a potential connection between sleep and cognitive function. Findings from observational studies support a role for sleep disturbances (particularly for sleep duration, sleep fragmentation, and sleep-disordered breathing) in the development of cognitive impairment. Less consistent evidence exists for associations of insomnia and circadian rhythm dysfunction with cognition. These findings suggest that the sleep-wake cycle plays a crucial part in brain ageing, pointing to a potential avenue for improvement of cognitive outcomes in people at risk of cognitive decline and dementia. Several biological mechanisms might underlie the association between sleep and cognition, but these pathways are not completely understood. Future studies that aim to clarify the association between sleep and cognition might help to identify people at risk of cognitive disorders and to facilitate the development of novel therapies to treat and potentially prevent both sleep disturbances and cognitive impairment.
- The neuro-ophthalmology of head trauma. [REVIEW]
- Lancet Neurol 2014 Oct; 13(10):1006-1016.
Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Concussion, a form of mild TBI, might be associated with long-term neurological symptoms. The effects of TBI and concussion are not restricted to cognition and balance. TBI can also affect multiple aspects of vision; mild TBI frequently leads to disruptions in visual functioning, while moderate or severe TBI often causes structural lesions. In patients with mild TBI, there might be abnormalities in saccades, pursuit, convergence, accommodation, and vestibulo-ocular reflex. Moderate and severe TBI might additionally lead to ocular motor palsies, optic neuropathies, and orbital pathologies. Vision-based testing is vital in the management of all forms of TBI and provides a sensitive approach for sideline or post-injury concussion screening. One sideline test, the King-Devick test, uses rapid number naming and has been tested in multiple athlete cohorts.
- King of the field. [Journal Article]
- Lancet Neurol 2014 Oct; 13(10):974.
- Clifford Jack: biomarker curves and all that jazz. [Journal Article]
- Lancet Neurol 2014 Oct; 13(10):973.
- Welcome to the future of integrated neuroscience. [Journal Article]
- Lancet Neurol 2014 Oct; 13(10):971-2.
- Sports-related head trauma and neurodegenerative disease. [Letter]
- Lancet Neurol 2014 Oct; 13(10):969-70.
- Sepsis-associated encephalopathy versus sepsis-induced encephalopathy-Authors' reply. [Letter]
- Lancet Neurol 2014 Oct; 13(10):968-9.
- Embolic strokes of undetermined source: support for a new clinical construct. [Letter]
- Lancet Neurol 2014 Oct; 13(10):967.