Chorea as a clinical sign is most commonly seen in patients with PD on L-dopa therapy, but outside of this, it is normally associated with Huntington’s Disease (HD). However, there are a range of other rare genetic disorders which can have chorea as part of their clinical features along with the presence of acanthocytes. This is the topic for the excellent review by Hans Jung, Adrian Danek and Ruth Walker as they delineate the key features of these conditions.

Nitric oxide (NO) has been a molecule of great interest to the neuroscientific community for many years, and in an excellent review article by Joern R Steinert, Tatyana Chernova and Ian D Forsythe in this issue of ACNR, we get an up-to-date account of how this molecule may be important to CNS function in health and disease. In particular, the capacity of the NO to diffuse across membranes means that it has great potential to influence a large number of neural elements and as such may serve a unique function in controlling the excitability of a swathe of synaptic connections and networks. How this plays out in disease pathogenesis is not clear, but the expert authors of this review, marshall this complex field to give us a clear, succinct account of the possible mechanisms being investigated.

Andrew Larner once more allows us to explore all aspects of his mind as he gives us two short pieces on the utility of board games as a means of exploring neuropsychological deficits in patients, as well as providing an account of illusory visual spread by Margiad Evans. Justin Cross and HK Cheow this time take Nuclear Medicine as their topic in the ongoing series on Neuroradiology. In this latest article, Justin and HK explain the basis for the technique and how it has, and will be sued in neurological practice. As with all articles in this series, it is easy to follow and extremely informative.

In this issue of ACNR, we have the first article in our new Neuropaediatric series edited by Dr Anna Maw. This new series aims “to provide practical guidance and information on common paediatric neurological conditions which will be useful in your daily practice”. In the first in the series, this is fabulously exemplified as we are taken through the approach to the paediatric patient with neurological problems and the challenges that the younger patient throws up.

The challenge of pursuing a clinical academic career has never been an easy one, but in the last ten years this has become more problematic as the training of doctors changes and academic research is relegated to a level of almost non-existence. In the Training series edited by Boyd Ghosh, we have Chris Butler writing about the attempts that have recently been made to try and resurrect this vital area of medicine through the creation of Academic Clinical Fellowships and Lectureships. This excellent account highlights the origins of this scheme and how it has been conceived to work. In contrast, Jane Alty in the ABNT section explains the (r)evolution in thinking that has led to the Less Than Full Time (LTFT) training scheme that now exists and which is attracting much attention from many neurological trainees. Jane explains how the system works and how you can go about finding out more about it.

Heather Angus-Leppan and Charles Warlow in this issue of ACNR also talk about how we can best develop central sets of notes which allows easy access and yet is secure enough to protect patients – a challenge which if conquered would have major advantages to all in clinical practice. Trying to stay up to date in neurology is hard and it is useful to be told by Sara Clarke and David Chadwick about a new development called NHS evidence. This new initiative began some 10 years ago but has now evolved to the level of centralised up-to-date accounts of data summarising best clinical practice. Whilst it is increasingly difficult to master all the data that is out there, this is useful second step in that process, after reading ACNR of course!

In our historical series, J Pearce tells us about the origins of adrenaline taking us from observations made in the 18th century to the Nobel prize winning work of Henry Dale. En route, we have a wonderful account of a hugely significant meeting between an enthusiastic physician from Harrogate and a grumpy Professor of Medicine in London. Finally, we have our usual round up of conference and book reviews, and we would also like to welcome Dr Mike Zandi to the editorial team.

Roger Barker
Roger@acnr.co.uk