As usually, we report in this survey the main advances in neurology and neurosciences, as reported in the articles published in Neurological Sciences in the 2017 volume and related to all the main topics of neurology.

Cerebrovascular diseases remain among the dominant topics for neurological research and practice. A growing interest is addressed to pathophysiology of stroke [1], and especially toward genetic causes [2,3,4]. Early rehabilitation is linked to a better recovery and more positive outcomes [5, 6]. Infections, aneurysms, dissections, venous thrombosis, and autoimmune diseases are rarer cause of stroke which may be underconsidered in the final diagnosis [7,8,9,10,11]. It has been established that standardization of stroke assessment and organization of stroke networks could be able to reduce mortality and dependency in stroke patients [12]. Intravenous thrombolysis remains the standard treatment for acute ischemic stroke within 4.5 h of symptom onset. Extra-ischemic brain hemorrhages after thrombolysis for ischemic stroke occur in less than 3% of treated patients, but they worsen prognosis [13] and the administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke is still controversial [14].

Multiple sclerosis (MS) is another very common topic. Since it usually occurs in young adults with a female prevalence and obvious difficulty management during pregnancy and puerperium, the collaboration between neurologists, gynecologists, and psychologists for an interdisciplinary approach has been reported [15]. Conventional magnetic resonance imaging (MRI) remains a fundamental tool to diagnose and monitor MS and advanced MRI techniques are improving the understanding of the mechanisms underlying tissue injury, repair, and functional adaptation in MS [16].

Pharmacological development for MS is growing up in the last years. Rescue therapy with alemtuzumab in multiple sclerosis post-natalizumab puerperium reactivation has shown high efficacy [17]. Safety and tolerability of fingolimod has been better understood [18, 19]. Therapeutic potential of curcumin is a matter of debate [20]. Tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray has shown to be effective in improving overactive bladder symptoms in MS patients demonstrating a favorable impact on detrusor overactivity [21], and treatment with botulinum toxin type A (BoNT-A) for MS-related spasticity has beneficial effects but also high level of discontinuation [22]. Myeloablative autologous hematopoietic stem cell transplant (AHSCT) has proven to be safe and efficacious to control the aggressive forms of MS with better outcome in RR-MS [23].

Alzheimer’s disease (AD) is the main cause of dementia, but rarer alternative diagnosis such as Creutzfeldt-Jakob disease and Whipple disease has to be considered [24, 25]. Also, dementia with Lewy body (LBD) is often misdiagnosed as AD [26, 27]. Association of arterial stiffness with cognition impairment in patients with Lewy body disorder has been evaluated and compared with AD findings [28].

Benzodiazepines (BZD) and cognitive impairment represent an interesting aspect of research, since patients with high-dose BZD intake show profound changes in cognitive function [29]. Several articles reported neuropsychological assessments to distinguish AD from normal aging and from other dementias (vascular dementia, frontotemporal dementia, LBD) [30,31,32,33,34,35]. Recently, eye-tracking has been proposed as an integrative tool for cognitive assessment [36]. Cognitive training, active music therapy, and neuroeducation are emerging issues in mild-moderate AD [37, 38].

Parkinson’s disease (PD) is the most important field of research into movement disorders. The research of diagnostic and prognostic biomarkers is a field of high interest in PD [39,40,41,42,43,44,45,46]. Non-motor symptoms are now better recognized and treated [47,48,49]. Rasagiline has proved to be effective for dysexecutive syndrome [50]. Weight gain after subthalamic nucleus deep brain stimulation is a common side effect, probably influenced by diskinesias’ reduction [51]. Transcranial direct current stimulation (tDCS) has proven to be an efficacious and safe treatment on fatigue reduction in Parkinson’s disease [52]. Cognitive decline and psychiatric disorders can be present also in early stage of the disease [53,54,55,56,57]. Magnetic resonance measurements of brainstem structures have been reported to be useful in differentiating PD patients with not only progressive supranuclear palsy (PSP) but also from vascular parkinsonism [58]. Typical 3-Hz postural tremor seems to be predominant in MSA-C and can be useful in the differential diagnosis between MSA-P and MSA-C [59]. Combined visual and semi-quantitative assessments of 123I-FP-CIT single-photon emission computed tomography (SPECT) show high sensitivity for the diagnosis of dopaminergic neurodegenerative diseases [60]. Quantitative tremor analysis can distinguish Parkinson’s disease from dopamine receptor blocking agent-induced parkinsonism [61].

Headache is a widespread disorder and therefore it has a strong impact on quality of life [62, 63], also among children [64,65,66,67]. Migraine pathophysiology is not clearly understood, but it is commonly accepted that female hormones play a negative role [68, 69]. Calcitonin gene-related peptide (CGRP) may play an important role in cluster headache pathophysiology and could represent a potential therapeutic target [70, 71]. Migraine chronicization is a daunting complication and is probably also linked to structural, functional, and metabolic changes in the brain, especially involving the brainstem [72]. Infusion of methylprednisolone and diazepam should determine a consistent reduction in headache frequency and drug assumption during the detoxification for medication overuse headache [73]. Triptans remain highly effective for the treatment of acute migraine attacks [74], and intravenous mannitol for a high number of unresponsive migraine status [75]. Hypertension has been identified as one of the most important factors of chronic transformation of episodic migraine and increases the cerebrovascular and cardiovascular risk of migraine patients [76]. Telmisartan, a long-acting angiotensin II receptor blocker, has preventative benefits in non-responsive migraineurs [77]. OnabotulinumtoxinA, an effective treatment of chronic migraine, presents an increase of therapy efficacy and a progressive trend of “first-time response” [78]. Recent clinical experiences have demonstrated the safety, tolerability, and efficacy of non-invasive vagus nerve stimulation for the acute and prophylactic treatment of migraine also in adolescents [79,80,81,82]. Greater occipital nerve block may represent a therapeutic alternative in chronic migraine [83], while transcutaneous supraorbital neurostimulation is a promising technique [84]. Mindfulness or behavioral therapy is emerging as a helpful treatment for pain, also for chronic migraine [85, 86], while the role of nutraceuticals in migraine prophylaxis is debated [87]. Ketogenic diet is a promising therapy to counteract neuroinflammation in migraine [88]. Cognitive performances in migraine patients show an impairment of executive functions, probably linked to the white matter lesions and the long history of drug abuse [89,90,91].

Epilepsy remains a field of high interest for neurologists, hard to treat in a not low percentage of cases, especially for secondary epilepsy [92,93,94]. Ketogenic diet may be effective but nutritional risks and potential impacts on biochemical nutritional status are possible [95]. Vigabatrin is associated with ocular disorders and evaluation of inner retinal layers with optic coherence tomography can have role in future monitoring of patients [96]. The role of phenytoin toward peripheral nerves is debated [97]. An early involvement of striatum/pallidus on MRI in super refractory status epilepticus has been recently associated with severe prognosis [98].

Research of pathogenic mechanism of amyotrophic lateral sclerosis (ALS) remains a point of principal interest, above all for the potential therapeutic target [99,100,101]. The association of multiple metals is probably involved in ALS degeneration [102]. Cognitive assessment for ALS patients is easily investigated with the Edinburgh Cognitive and Behavioural ALS Screen [103].

Atypical clinical Myasthenia Gravis (MG) patients may have been described [104]. Circulating follicullar helper T (cTfh) cells are significantly higher in MG and may play a role in the immunopathogenesis and the production of anti-AChR Ab [105]. Tacrolimus is a valid option for the management of MG [106]. Coexistence of ALS and MG has been described and is associated with a bulbar onset and a worse prognosis [107]. Thymectomy represents an effective treatment for patients with non-thymomatous ocular myasthenia gravis [108].

Familial amyloidotic polyneuropathy is now easily diagnosed with genetic test and salivary gland biopsy [109–110]. High-dose intravenous immunoglobulin is a confirmed efficacious therapy for multifocal motor neuropathy [111]. Diagnosis of dysimmune peripheral neuropathies remains hard in some cases [112,113,114,115].

Primary brain tumors present a growing prevalence, especially among elderly people [116]. Expression of specific microRNA is related to pathological grading and prognosis of glioma [117, 118] and an evidence linking mobile phone use and risk of brain tumors has been found, especially in long-term users [119]. Extent of perilesional edema in brain metastasis from non-small cell lung cancer could be a predictive factor of response and brain progression after radiosurgery [120].

Many reports are dedicated to rare neurologic diseases, genetic disorders describing new developments on the molecular diagnosis [121–122], the clinical heterogeneity of the clinical spectrum [123,124,125,126,127,128,129,130,131,132,133,134], and the therapeutic opportunities [135,136,137].

In conclusion, during this year, Neurological Sciences has been full of interesting papers in many fields of neurological research, confirming the good quality and actuality of the journal.