It is now over 15 years since the first gene linked to familial ALS was described. Since then, much has been done in the lab with the resultant transgenic animals, although sadly little from this research has made an impact in the natural history of this condition in patients. However, recently a number of new genes have been discovered in ALS and with this comes renewed hope that disease modifying therapies may be soon in the clinic. In this issue of ACNR we are extremely fortunate to have this work summarised for us by Jemeen Sreedharan and Chris Shaw, part of a team who have made a substantial contribution to this area of ALS research.

Sarah Creer and colleagues in the Rehabilitation article discuss "voice banking".This is storing your voice early in the course of a neurodegenerative process, so that it can be used later in the course to help fashion and aid communication. The article describes how this process can be done and how it will evolve in the years to come.

The article by the ABNT discusses the results of a new survey of trainees and concludes "Despite some difficulties, most neurology registrar posts continue to offer excellent training opportunities. However, registrars with any concerns about their training programme should certainly raise these with their Programme Director and, failing that, with the ABNT. Only with active trainee involvement will the high standard of neurology training be maintained in the face of the pressures of service delivery."

Mal de Debarquement Syndrome is a rare condition that many will not have heard about. As a consequence it is often hard to diagnose and Jane Houghton describes her own experiences with this condition in our Personal perspectives article. Since the introduction of L-dopa for the treatment of PD in the late 1960s, the use of this drug has always caused debate. In our sponsored article,Murat Emre and colleagues discuss how best to employ this agent in the management of PD, including which formulation. The next article in the series from the UAE,by Khalid Mohamed and SabahatWasti,takes as its theme the topic of spasticity in cerebral palsy. They describe the current management of this condition and how this is changing as the health care system in UAE evolves.

In the neuroliterature series,Andrew Larner explores further the works of Charles Dickens, highlighting the author’s acute powers of observation. Heather Angus-Leppan has written a short viewpoint on the vexed issue of integrating paediatric-adolescent and adult services,in this case in the context of neurological care. This interesting article is thought provoking and does raise issues about how best to integrate young patients with more advanced cases of the same condition.

We have our usual collection of reviews, and in addition we have two meetings to highlight: the annual ENS meeting in Milan in June, and the first of the new style ABN meetings which is taking place in Liverpool, also in June. Professor Alastair Compston offers an invitation to attend the ABN,and you can also see details of the programme on pages 33 and 34

Finally don’t forget our planned ACNR digest event which is advertised in this issue of the ACNR. See page 39 for further information. We look forward to seeing many of you there.

Roger Barker
Roger@acnr.co.uk