This issue of ACNR sees us entering our third year of existence and continuing to link neuroscience to neurology and vice versa. The two review articles look at very different aspects of the CNS and disease, the first by Desmond Kidd reviews the neurological complications of Behcet’s disease and the second by Mike Cheetham and Paul Chapple explores neurodegenerative processes through the study of retinitis pigmentosa.

Desmond Kidd has set about trying to explore this often thought of but rare disorder, through the recruitment of patients with the help of the British neurological surveillance unit, and through his work at tertiary referral centres. He then brings this personal experience into a survey of the literature to highlight what is known and not known about this condition. So, for example, he highlights that the evidence for a vasculitis in Behcet’s is lacking and that drug trials in this condition are needed if we are to develop any rational approach to treating what often becomes a chronic, debilitating disorder.

Mike Cheetham and Paul Chapple have concentrated on looking at the molecular mechanisms underlying the photoreceptor degeneration that characterises retinitis pigmentosa (RP).Whilst this may be seen as a relatively specialised area with little clinical significance to most neurologists, the study of the processes underlying it may have wide-ranging implications for a whole host of common neurological disorders. These researchers have set about trying to unravel the intracellular processes causing RP, particularly concentrating on the interaction of mutant proteins with chaperones and chaperonins, whose normal role is to ensure the correct processing of proteins within the cell and by so doing protect it from damage. These proteins are also associated with the proteosome, which acts to remove misfolded or abnormally processed protein from within the cell. Disorders in these pathways have recently been thought to be important in the pathogenesis of a range of common neurodegenerative disorders such as Huntington’s (see journal reviews) and Parkinson’s disease. Thus by studying one system in one condition, inferences can be made that have wide-ranging implications for a host of other disorders, and this in turn may lead to common therapeutic strategies.

The rehabilitation article this month is written by John Shneerson and provides a marvellous overview of the use of ventilatory support in diseases of the nervous system. Alex Leff provides an interesting account on the rather obscure physician of the mid- to late 1800s, Thomas Laycock. Laycock was the first proponent of cerebral reflexes - actions which patients cannot restrain or modify and was also the first person to argue that the anatomical divisions of the CNS in humans is similar to that seen in other animals and forms part of a continuum. Alex Leff gives a beautifully clear account of his life and his contribution to neuroscience, as well as highlighting that he may have been a greater influence of neuroscience than people recognise, through his teaching of Hughlings-Jackson.

We also have our usual collection of regular articles.Wojtek Rakowicz and Mike Hanna conclude the superb series on muscle disease with a beautiful summary of a complex area, this time channelopathies. It is a shame that this is the last in the series, as they have been a real highlight of recent issues – we move on to movement disorders next with David Burn opening the bowling on the approach to such a patient.

Brian McNamara takes on the common peroneal nerve (CPN) and foot drop – a condition which often presents diagnostic problems. Whilst we all confidently tell medical students how to distinguish foot drop in a CPN palsy from a radiculopathy, we often find ourselves in clinic struggling to distinguish between the two (or perhaps it is just me!). Brian takes his usual no-nonsense approach to this issue through his neurophysiological eyes and provides a useful summary, including many sentences telling us very appropriately what steps we need to take to unravel the cause of this common problem. Malcolm Steiger and Hiliary Tyne continue the series on apomorphine, this time outlining the role of the neurologist and the need to educate patients and public alike about this drug and its efficacy, and Tipu Aziz and Dipander Nandi present their results for the neurosurgical treatment of patients with intractable pain. We have our usual journal and book reviews, as well as conference reports.

So another packed issue, hopefully of the kind of articles that you want to read, but if not let us know!

Roger Barker
AdvancesinCNR@aol.com