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Volume 3, No 1 - Winter 2006

Volume 3, No 1 - Winter 2006

Table of Contents

Asperger Syndrome Revisited Diagnosis Update
Asperger syndrome (AS) is a disorder on the continuum of autistic spectrum disorders characterized by a lack of social reciprocity and empathy, and severe difficulties in social integration. Controversy remains as to what constitutes AS and whether it should be declared a separate disease or higher-functioning autism. This review discusses the contributions made by Hans Asperger and Leo Kanner in first delineating the condition, and examines the syndrome’s incidence, prevalence, and etiologies. Recent studies using neuroimaging are described, along with current diagnostic and treatment options. [Rev Neurol Dis. 2006;3(1):1-7]
Angioplasty and Stenting to Treat Occlusive Vascular Disease Treatment Update
The advent of effective percutaneous treatment of occlusive vascular lesions by angioplasty and stenting is one of the most important contributions to medical care early in the 21st century. Evaluation of angioplasty and stenting procedures is still in a very early phase. New types of stents and other technologies and devices are being continuously developed and there is a definite learning curve. The experience, training, and number of procedures clearly relate to outcomes, and many different specialists are still learning and so far have not had optimal experience. This review provides an overview of studies that have examined the efficacy of stenting in conjunction with balloon angioplasty for carotid atherosclerosis compared with endarterectomy. Also discussed are angioplasty/stenting of other neck arteries and intracranial arteries and the key issues surrounding percutaneous intervention, including patient selection criteria, clinical assessment of lesions most suitable for treatment, the use of distal protective devices and drug-eluting stents, and recommendations for physician selection. [Rev Neurol Dis. 2006;3(1):8-18]
How Useful is (123I) ß-CIT SPECT in the Diagnosis of Parkinson’s Disease? Diagnosis Update
Because clinical features of parkinsonism can occur in other forms of parkinsonian syndromes in addition to Parkinson’s disease, neuroimaging may have a role in determining true disease status. Iodine-123 (123I) (2-carboxymethoxy-3-[4- iodophenyl] tropane) or (123I) -CIT is a recently developed diagnostic biomarker of Parkinson’s disease that provides in vivo information about nigrostriatal degeneration. In clinical trials, -CIT single photon emission computed tomography (SPECT) has been shown to be a highly sensitive diagnostic tool in differentiating clinically probable Parkinson’s disease from normal subjects and essential tremor patients. As a tool for differentiating Parkinson’s disease from atypical parkinsonian syndromes, (123I) -CIT SPECT may have more limited use because of more extensive postsynaptic pathology in the latter. Differentiating among various parkinsonian syndromes may be improved by methodological refinements, a combined strategy of imaging presynaptic and postsynaptic sites, or by metabolic imaging. [Rev Neurol Dis. 2006;3(1):19-22]
Multiple Sclerosis: Pathologic, Clinical, and Imaging Updates Meeting Review
Highlights of the 21st Congress of the European Committee for Treatment and Research in Multiple Sclerosis September 28 – October 1, 2005 Thessaloniki, Greece