Early treatment of migraine with aura by sTMS resulted in increased freedom from pain at 2 h compared with sham stimulation, and absence of pain was sustained 24 h and 48 h after treatment. sTMS could be a promising acute treatment for some patients with migraine with aura.

Migraine is a prevalent disease that leads to considerable suffering and work loss in the most productive years of life. Acute migraine attacks can be treated with simple or combination analgesics or triptans.1 However, not all attacks respond to acute treatment, some patients with migraine have contraindications to triptans, such as vascular diseases2 or pregnancy,3 and triptans are not effective or approved during the aura phase of a migraine attack.4 Therefore, non-medical treatments of acute migraine attacks are needed.

Treatment with bapineuzumab for 78 weeks reduced cortical 11C-PiB retention compared with both baseline and placebo. 11C-PiB PET seems to be useful in assessing the effects of potential Alzheimer's disease treatments on cortical fibrillar amyloid-β load in vivo.

In this issue of The Lancet Neurology, Rinne and colleagues1 report something of a breakthrough by demonstrating the feasibility of eventually testing the so-called amyloid hypothesis of sporadic Alzheimer's disease in vivo. According to their analysis, a passive immunotherapy protocol with an anti-amyloid-β monoclonal antibody (bapineuzumab) was associated with a decrease in the cerebral PET signal after administration of the amyloid plaque imaging compound carbon-11-labelled Pittsburgh compound B (11C-PiB).

A moratorium on carotid artery stenting (CAS) has been recently proposed.1 Current randomised evidence supports the notion that carotid endarterectomy (CEA) is better than CAS. A meta-analysis of the randomised trials compared the two strategies2 and included data from the recent International Carotid Stenting Study (ICSS).3 This meta-analysis indicated that patients who received CAS had a significant increased risk of 30-day death or stroke compared with patients who received CEA (odds ratio 1·60; 95% CI 1·26–2·02).

Roffi and colleagues criticise the ethics of the recent randomised trials of carotid stenting versus carotid endarterectomy in patients with symptomatic carotid stenosis. This is a bold step, considering that the trials received research ethics approval in about 20 countries. Moreover, the three most recent trials, the Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial,1 the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) trial in symptomatic patients,2 and the International Carotid Stenting Study (ICSS)3 included more than 100 academic vascular centres where surgeons, interventionalists, and neurologists all considered the designs of the individual trials appropriate and ethical.

About three times more patients in the stenting group than in the endarterectomy group had new ischaemic lesions on DWI on post-treatment scans. The difference in clinical stroke risk in ICSS is therefore unlikely to have been caused by ascertainment bias. Protection devices did not seem to be effective in preventing cerebral ischaemia during stenting. DWI might serve as a surrogate outcome measure in future trials of carotid interventions.

In recent years carotid artery stenting has increasingly been used as an alternative treatment to endarterectomy for patients with carotid stenosis, even though randomised trials have failed to demonstrate its advantage compared with surgical treatment.1 The long awaited results of the International Carotid Stenting Study (ICSS) have proved the superiority of carotid endarterectomy compared with stenting with a high level of evidence.2 However, concerns arose that the observed differences might have been caused by discrepancies in the number of non-disabling strokes between these groups and therefore could be attributable to an ascertainment bias during follow-up.

Daclizumab is part of an expanding class of new drugs with monospecific modes of action that are being evaluated for the treatment of patients with multiple sclerosis. Like many of these treatments, daclizumab is the result of rational drug design. Or is it?

Add-on daclizumab treatment reduced the number of new or enlarged gadolinium contrast-enhancing lesions compared with interferon beta alone and might reduce multiple sclerosis disease activity to a greater extent than interferon beta alone.