There are many articles of interest to our readers in the present issue of the Swiss Archives of Neurology and Psychiatry.
Mental health in the elderly is a topic of increasing meaning because of the aging of the population. Hatzinger (“Affektive Störungen im Alter”) reviews current scientific knowledge on mood disorders in the elderly. One can take the view that “age-related depression” is not a separate syndrome, but rather, as depression in younger adults, that it is a multi-factorial event. A finding of potential importance is epidemiological data that show that depression per se contributes to an increase in the risk of dementia. The probability of the occurrence of new affective phases also increases in relation to the number of preceding phases. Imaging studies provide evidence of increasing areas of atrophy in the region of the hippocampus in these patients, which corroborates the clinical findings. Neurologists will certainly appreciate the detailed physiopathological and therapeutical discussion, as they are frequently confronted with this group of patients in their own practice.
Gaul et al. (“Neuromodulative Therapieoptionen beim therapierefraktären chronischen Clusterkopfschmerz”) discuss the challenge to treat refractory chronic cluster headache. While ablative procedures have been dismissed, neuromodulatory procedures still need to prove their effectiveness. Fortunately the number of affected individuals is small, however this renders evidence-based recommendations for neuro-modulative therapies very difficult.
Mutter and Landolt (“An observational study of the use of continuous clinical outcome assessment and therapy management in neurosurgery”) should be congratulated on tackling the difficult issue of outcome assessment in neurosurgical patients. They have developed a standardised daily evaluation protocol based on established clinical scales. The reliability of the tool in assessing key outcome domains was investigated in patients undergoing lumbar micro-discectomy. Used on a larger basis, this outcome scale could lead to improvements in efficiency and patient safety.
A case report (Antille: “L’hémorragie cérébrale pour diminuer l’angoisse?”) poses the intriguing question regarding what kind of mechanisms may play a role in modulating anxiety in a young stroke patient.
Two minireviews (Wetzel and Mattle et al.) give an update on acute stroke therapy, discussing recent trials with intra-arterial and intravenous thrombolysis as well as mechanical thrombectomy.
We wish our readers an informative summer reading experience.
