Best Post of September 2011: The Five Hottest Topics in Neuropathology Today

The next in our "Best of the Month" series is from September 13, 2011:

By consensus, I present to you the five hottest topics in neuropathology today:

1. Chronic Traumatic Encephalopathy - There is an emerging recognition of CTE among those who have played contact sports. The elucidation of CTE will continue to have major public health policy implications.

2. Molecular Subtyping of Brain Tumors - For example, determination of the presence of O(6)-methylguanine DNA methyltransferase (MGMT) activity as a prognosticator of response to alkylating chemotherapy in gliomas is becoming increasingly important to our clinical neuro-oncology colleagues. Other molecular tests that are gaining popularity include IDH1 and EGFR. Molecular profile panels will become the standard of practice in the coming decades.

3. Brain Tumor Stem Cells - Questions about their existence and potential as targets for therapy have energized neuro-oncologic research.

4. Role of Microvascular Disease in Expression and Pathogenesis of Alzheimer Disease - The concept that Alzheimer disease may have a vascular pathogenesis may radically change the way the disease is prevented and treated.

5. Molecular Developments in Frontotemporal Lobar Degeneration -  As UCSF neurologist Bruce Miller, MD said: "Classification of FTLD is moving from a syndromic approach toward one based upon neuropathology and genetics." In particular, the description of the TDP-43 proteinopathies has had a major impact on our understanding of a previously unrecognized form of dementing disease.

There you have it. Thank you to everyone who contributed to this list. I think that it will help raise our collective eyes to the horizon.

Spinocerebellar ataxia type 6 autopsy photographs

On the left is the brain of an 82-year-old patient with a diagnosis of spincocerebellar ataxia, type 6 (SCA6). On the right is the brain of a 96-year-old "control" patient with Alzheimer disease:

Note comparative diminution of the cerebellum in the SCA6 patient.  Here's a closer look at the cerebellum:

SCA6 is one several autosomal dominant cerebellar ataxias. SCA6 results from a CAG trinucleotide repeat expansion in the CACNA1A gene on chromosome 19p.

Lodging info for the AANP meeting in Chicago

The Palmer House Lobby in Chicago.... Pretty sweet!!!

I'm currently booking lodging now for the The Palmer House in Chicago for the 2012 annual meeting of the American Association of Neuropathologists. For those of you who are planning on bunking up with a buddy, note that the AANP nightly group rate of $219 is only good for a single king-size bed room. If you want two double beds, you're gonna have to pay the standard rate of $259 per night. I love the Chicago location; but I am still pushing for someday having our conference in Little Rock, Arkansas, which in 2008 won our poll for preferred places to hold the meeting!

New SAD Treatment – Shining Light Into The Brain Through The Ears

I'm not sure whether or not this is legit, but this story outlines an interesting theory.

Thanks to the ever-awake Doug Shevlin, MD for alerting me to this article.

An 82-year-old Parkinson's patient who had undergone a right-sided pallidotomy procedure twelve years prior to death

Photomicrographs of the pallidotomy site:

Contralateral globus pallidus appearing to exhibit neuronal loss: