Exposure to solvents at work may be linked to later-life cognitive impairment in persons with less than a high school education, according to a study published in the May 29 issue of Neurology. Researchers assessed lifetime exposure to four types of solvents in 4,134 participants who had worked at a French national gas and electric company for most of their careers. At an average age of 59, the participants underwent a test of thinking skills. Results showed that among the 58% of participants with less than a high school education, 32% had cognitive impairment, compared with 16% of those with more education. “People with more education may have a greater cognitive reserve that acts like a buffer, allowing the brain to maintain its ability to function in spite of damage,” stated the investigators.
In persons with a low five-year risk of major vascular events, statin therapy to reduce LDL cholesterol leads to an absolute reduction in major vascular events, according to research published in the online May 17 Lancet. The meta-analysis of 17 randomized trials grouped participant data into five categories of baseline five-year major vascular event risk. The researchers then estimated the risk ratio (RR) per 1.0 mmol/L LDL cholesterol reduction. Regardless of age, sex, baseline LDL cholesterol, previous vascular disease, and vascular and all-cause mortality, the reduction of LDL cholesterol through a statin reduced the risk of major vascular events. “In individuals with five-year risk of major vascular events lower than 10%, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1,000 over five years. This benefit greatly exceeds any known hazards of statin therapy,” the authors wrote.
Two stroke patients with long-standing tetraplegia can perform reach and grasp movements with a robotic arm using neural interface system-based control, according to research published in the online May 16 Nature. A 96-channel microelectrode array was implanted in the motor cortex and used to transmit signals from a small, local population of motor cortex neurons to the robotic arm. Without explicit training, both patients controlled the robotic arm over a broad space, with one study participant using the robotic arm to drink coffee from a bottle, despite having been implanted with the sensor five years ago. The researchers noted that although the robotic movements were not comparable to those of a nonparalyzed person, “our results demonstrate the feasibility for people with tetraplegia, years after injury to the CNS, to recreate useful multidimensional control of complex devices directly from a small sample of neural signs.”
Warfarin and aspirin are equally effective at preventing ischemic stroke, intracerebral hemorrhage, or death from any cause in patients with heart failure who are in sinus rhythm, according to clinical trial results published in the May 17 New England Journal of Medicine. The researchers followed 2,305 patients for up to six years, finding that the combined risk of death, ischemic stroke, and intracerebral hemorrhage was not statistically significant between the warfarin group (7.47 events per 1,000 patients) and aspirin group (7.93 events per 1,000 patients). Although warfarin during the follow-up period was associated with a significant reduction in ischemic stroke rates compared with aspirin, this reduced risk was offset by an increased risk of major hemorrhage with warfarin. “The choice between warfarin and aspirin should be individualized,” the investigators concluded.
Researchers have identified common pathogenic determinants leading to chronic traumatic encephalopathy (CTE) in blast-exposed military veterans and head-injured athletes, according to research published in the May 16 online Science Translational Medicine. The investigators used a blast neurotrauma mouse model in which animals’ heads were unrestrained, mimicking the effects of combat blasts. Two weeks following exposure to a single blast, the mice showed phosphorylated tauopathy, myelinated axonopathy, microvasculopathy, chronic neuroinflammation, and neurodegeneration. Up to a month following the blast, the mice had learning and memory deficits from hippocampal damage. However, restraining the animals’ heads during blasts prevented learning or memory deficits. These results “provide mechanistic evidence linking blast exposure to persistent impairments in neurophysiological function, learning, and memory,” the researchers
stated.
Colonic tissue obtained during a colonoscopy or flexible sigmoidoscopy may potentially help predict the development of Parkinson’s disease, researchers reported in the May 1 online issue of Movement Disorders. The investigators obtained old biopsy samples for three patients with Parkinson’s disease—two subjects showed immunostaining for alpha-synuclein two years prior to the first motor disease symptom, and the third patient showed immunostaining for alpha-synuclein five years before disease onset. In comparison, no similar alpha-synuclein immunostaining was observed among 23 healthy controls. “This is the first demonstration of alpha-synuclein in colon tissue prior to onset of Parkinson’s disease,” stated the authors. “Additional study is required to determine whether colonic mucosal biopsy may be a biomarker of premotor Parkinson’s disease.”
Potiga (ezogabine) tablets CV are available as an adjunctive treatment of partial-onset seizures in patients 18 or older. Ezogabine, a potassium channel opener, was approved in June 2011 by the FDA for adjunctive treatment of partial-onset seizures in adults. However, the FDA approval letter indicated that ezogabine would not be available until the Drug Enforcement Administration (DEA) made a final scheduling decision. In accordance with the FDA’s instructions, the DEA moved forward with its decision and placed the drug into schedule V of the Controlled Substances Act. Thus, ezogabine is now available for physicians to prescribe to appropriate patients.
Patients in the emergency room who are diagnosed with aneurysmal subarachnoid hemorrhage (aSAH) have lower rates of disability and death when they are transferred to high-volume facilities, according to the American Heart Association and American Stroke Association’s updated treatment guidelines, published in the June Stroke. After conducting a formal literature search of MEDLINE and then synthesizing data using evidence tables, researchers developed guidelines that were divided into 12 areas of focus for treating patients presenting with aSAH. The investigators noted that patients with aSAH had significantly greater 30-day death rates in hospitals admitting fewer than 10 patients per year (39%), compared with hospitals treating more than 30 patients per year (27%). “aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care,” concluded the research group.
Changes in sensory experiences alter thalamocortical inputs in older rats and imply that the brain can be rewired even after adolescence, researchers reported in the online May 23 Neuron. The investigators trimmed rats’ whiskers to modify sensory experience in the animals and determine whether their brains would respond by altering thalamocortical axons. Results showed that the total axonal length and synapse number in rats with trimmed whispers was reduced by 25%, though the density of the thalamocortical axons along a fiber was not reduced. “Thus, sensory experience alters the total number of thalamocortical synapses,” the researchers wrote. They added, “These findings indicate that thalamocortical input itself remains plastic in adulthood, raising the possibility that the axons of other subcortical structures might also remain in flux throughout life.”
Hospitalization is associated with cognitive decline in persons older than 65, even after investigators controlled for illness severity and prehospital cognitive decline, according to research published in the March 27 issue of Neurology. The study included 1,870 persons older than 65 who underwent interviews and tests of cognitive function at three-year intervals for up to 12 years. During the study, 1,335 (71.4%) participants were hospitalized at least once, and their global cognitive scores declined a mean of 0.031 U per year before first hospitalization compared with 0.75 U per year after hospitalization. Furthermore, cognitive decline following hospitalization was found on measures of episodic memory (3.3-fold increase) and executive function (1.7-fold increase). “More severe illness, longer hospital stay, and older age were each associated with faster cognitive decline after hospitalization but did not eliminate the effect of hospitalization,” the investigators wrote.