White matter disease derived from vascular and demyelinating origins

Damage or microstructural alterations of the white matter can cause dysfunction of the intrinsic neural networks in a condition termed as white matter disease(WMD).Frequently detected on brain computed tomography and magnetic resonance imaging scans,WMD is commonly presented in inflammatory demyelinating diseases like multiple sclerosis(MS)and vascular diseases such as cerebral small vessel disease(CSVD).Prevention of MS and CSVD progression requires early treatments with drastically different medications and approaches,as such,early and accurate diagnosis of WMD,derived from vascular or demyelinating etiologies,is of paramount importance.However,the clinical and imaging similarities between MS,especially during the early stage,and CSVD,pose a significant dilemma in differentiating these two conditions.In this review,we attempt to summarize and contrast the distinguishing features of MS and CSVD for aiding accurate diagnosis to ensure timely corresponding management in the early stages of MS and CSVD.

Autoantibody to MOG suggests two distinct clinical subtypes of NMOSD

We characterized a unique group of patients with neuromyelitis optica spectrum disorder （NMOSD） who carded autoantibod- ies of aquaporin-4 （AQP4） and myelin-oligodendrocyte glycoprotein （MOG）. Among the 125 NMOSD patients, 10 （8.0%） were AQP4- and MOG-ab double positive, and 14 （11.2%） were MOG-ab single positive. The double-positive patients had a multiphase disease course with a high annual relapse rate （P=0.0431）, and severe residual disability （P〈0.0001）. Of the dou- ble-positive patients, 70% had MS-like brain lesions, more severe edematous, multifocal regions on spinal magnetic resonance imaging （MRI）, pronounced decreases of retinal nerve fiber layer thickness and atrophy of optic nerves. In contrast, patients with only MOG-ab had a higher ratio of monophasic disease course and mild residual disability. Spinal cord MRI illustrated multifocal cord lesions with mild edema, and brain MRIs showed more lesions around lateral ventricles. NMOSD patients carrying both autoantibodies to AQP4 and MOG existed and exhibited combined features of prototypic NMO and relaps- ing-remitting form of MS, whereas NMOSD with antibodies to MOG only exhibited an ＂intermediate＂ phenotype between NMOSD and MS. Our study suggests that antibodies against MOG might be pathogenic in NMOSD patients and that determi- nation of anti-MOG antibodies maybe instructive for management of NMOSD patients.

Dissemination of brain inflammation in traumatic brain injury

Traumatic brain injury(TBI)is recognized as a global health problem due to its increasing occurrence,challenging treatment,and persistent impacts on brain pathophysiology.Neural cell death in patients with TBI swiftly causes inflammation in the injured brain areas,which is recognized as focal brain inflammation.Focal brain inflammation causes secondary brain injury by exacerbating brain edema and neuronal death,while also exerting divergent beneficial effects,such as sealing the damaged limitans and removing cellular debris.Recent evidence from patients with TBI and studies on animal models suggest that brain inflammation after TBI is not only restricted to the focal lesion but also disseminates to remote areas of the brain.The dissemination of inflammation has been detected within days after the primary injury and persists chronically.This state of inflammation may be related to remote complications of TBI in patients,such as hyperthermia and hypopituitarism,and may lead to progressive neurodegeneration,such as chronic traumatic encephalopathy.Future studies should focus on understanding the mechanisms that govern the initiation and propagation of brain inflammation after TBI and its impacts on post-trauma brain pathology.

Stroke-induced immunosuppression and poststroke infection

Infections occur commonly after stroke and are strongly associated with an unfavourable functional outcome of these patients.Approaches for effective management of poststroke infection remain scarce,presenting an urgent need for preventive anti-infection strategies for patients who have suffered a stroke.Emerging evidence indicates that stroke impairs systemic immune responses and increases the susceptibility to infections,suggesting that the modification of impaired immune defence could be beneficial.In this review,we summarised previous attempts to prevent poststroke infections using prophylactic antibiotics and the current understanding of stroke-induced immunosuppression.Further elucidation of the immune mechanisms of stroke will pave the way to tailored design of new treatment to combat poststroke infection via modifying the immune system.

Visualizing Seizure Propagation in Freely-moving Mice via Miniature Two-photon Microscopy

DearEditor,Due to the tight and precise associations between behaviors and neural activities,the investigation of neuronal activity in freely-movingand behavinganimals isamajor unaccomplished goal in neuroscience.Epileptiform seizures,characterized by hyper-synchronized discharges and hyper-excitation in neuronal networks,are one of the most common neurological disorders.