Tuesday, September 6, 2011

What are the five hottest topics in neuropathology today?

What are the most promising or exciting topics in neuropathology today? Put up your list in the comments. Off the top of my head, in surgical neuropathology, the discussion regarding the utility of MGMT testing on high-grade gliomas (and whether PCR or IHC means of analysis) appears to be a timely topic. In non-surgical neuropathology, Chronic Traumatic Encephalopathy has been in the news lately. And what about TDP-43 protein in FTLD and MND? Come up with your own list and place in the comments. If we, as a virtual community, can come up with five of the most provocative topics in the field, I'll put them up on my next post.

9 comments:

Mint said...

How about IDH1 in gliomas ?

Brian E. Moore, MD said...

I agree, Mint, IDH1 should be among the "hot five". Thank you!

shipcolldoc said...

Brain tumor stem cells: their existence; how to identify them; their prognostic and predictive importance; their role as potential targets of therapy

henry brown said...

I get queries about MGMT every few months, so I would be very interested in others' comments. I tend to discourage it since everyone still seems to get treated with temodar regardless. I was asked about it today in reference to a low grade astrocytoma! So, either I am not following this area as closely as I should be (highly possible), or there is a lot of misunderstanding out there.

Forensic Pathology Blog said...

Great post, Brian. Reading this kind of stuff makes me so happy I'm a neuropathologist! However, it also fills me with a bit of sadness because I see so few tumors in forensics! I read the old MGMT post and am wondering if you found any ref's for a correlation between EGFR and MGMT?

jd said...

1--Molecular testing in brain tumors (e.g. MGMT, 1p/19q, EGFR, IDH1, etc.) 2--Traumatic encephalopathy. 3--Teleneuropathology, doing frozens by remote TV link. 4--Biomarkers in Alzheimer's disease, though that straddles the clinical line. 5--Explosion of molecular and genetic details in inherited neuromuscular and pediatric developmental diseases in this century

Brian E. Moore, MD said...

Thanks for all of the excellent responses! Keep 'em rolling in!

A prominent neuropathologist emailed me this list:

1. Role of microvascular disease in expression & pathogenesis of AD
2. Autophagic dysfunction in both neurodegeneration and neoplasia
3. Role of tumor stem cells in glioma recurrence
4. Molecular subtyping of GBMs & medulloblastoma

Brian E. Moore, MD said...

To Forensic Pathology: I don't immediately know of any references to EGFR and MGMT correlation, but perhaps someone in our virtual community can help you. Anybody?

Dani said...

Hi. Regarding the MGMT post above, I agree that Temodar and the MGMT test are hot topics. As the wife of a GBM patient, I have specifically requested the MGMT test. If the $600 MGMT test can show that the $10,000 Temodar Rx is ineffective, then why use it? P.S. There is an ezine article on this, which might explain why patients are asking more about it. Hope that helps!