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From the editor…

Posted in Editor's introduction on 2nd Aug 2019

Curing degenerative brain disease has, thankfully, become an ambition of many, but the huge investments (in the billions) and expectations make this an area where rigour of science, peer review and reporting are needed. In this edition Roger Barker (Cambridge) surveys the latest in repair therapies for Parkinson’s disease, focusing on cell grafts, the failure of growth factor trials, and the potential promise of induced pluripotent stem cell therapies. Anti-sense oligonucleotide therapy has been one of the major causes for excitement in neurology in the last few years, particularly the story of nusinersen for spinal muscular atrophy, and in the central nervous system the developing story of IONISHTTRx in Huntington’s Disease, e.g. the recently published Tabrizi et al N Engl J Med 2019 (380:2307-2316 DOI: 10.1056/ NEJMoa1900907). Kirsten Revell (Birmingham) decribes RNA biology and the issues, potential pitfalls, and next steps in this area of neuroscience, focusing on Huntington’s disease therapy.

Not all effective therapies should cost billions. Nick Ward, Kate Kelly and Fran Brander at Queen Square write on the evidence that high dose and high intensity for rehabilitation is more effective than lower intensity and frequency therapies, with the data focusing on upper limb rehabilitation after stroke. In other articles, Daniel Eschle (Altdorf) takes a considered approach in weighing up the argument that some forms of transient global amnesia (TGA) may have an epileptic origin. The broad differential diagnosis which is discussed in this article demonstrates that giving a diagnosis of TGA alone as a final diagnosis without further thought is clinically risky. Anum Bhatti (Keele) and George El-Nimr (Stoke-on-Trent) review the evidence for the use of drug therapies for the neuropsychological sequelae of traumatic brain injury.

In our Neurosurgery series, Dev Bhattacharyya looks at the effect of machine learning and artificial intelligence on the use of robots in neurosurgery.

We hope you enjoy this issue of ACNR, which includes the usual diversions, in addition to further short pieces by Rajith de Silva on his brief meeting with Stanley Prusiner, and Andrew Larner on a fictional clinical trial in Arrowsmith by Sinclair Lewis (1885-1951), plus an account of Larner’s mother’s Alzheimer’s disease and scrabble playing.

We welcome feedback and letters to the editor, and you can find the latest here, on the subject of Botox and migraine.