Neurology
Apathy often a part of Parkinson’s disease
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Patients with Parkinson’s disease may exhibit apathetic behavior without being depressed, a group of clinicians report. They suggest in the medical journal Neurology that apathy may therefore be a “core” feature of the disease.
“It’s important to screen for both apathy and depression so patients can be treated appropriately,” noted Dr. Lindsey Kirsch-Darrow in an American Academy of Neurology statement.
“It will also be important to educate family members and caregivers about apathy to help them understand that it is a characteristic of Parkinson’s disease,” she continued. “Apathetic behavior is not something the patient can voluntarily control, and it is not laziness or the patient trying to be difficult—it is a symptom of Parkinson’s disease.”
Focus on Multiple Sclerosis
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The authors describe how the Multiple Sclerosis (MS) Centers of Excellence use healthcare information technology to care for veterans with MS. The approach is based on a chronic-disease model that was effective for diabetes, asthma, and depression. In this model, the approach to healthcare delivery focuses on two essential elements: “prepared, proactive, practice teams” who use tools such as evidence-based guidelines, and patients who actively participate in their healthcare. Through use of an organized healthcare information system, this model will capitalize on the advantages of information technology and lead to improved healthcare outcomes.
Veterans Health Administration multiple sclerosis surveillance registry: The problem of case-finding from administrative databases, pg. 17
The authors discuss the development of a Veterans Health Administration (VHA) multiple sclerosis (MS) surveillance registry. Numerous VHA registries target specific patient populations as part of programs for improving the quality and availability of veteran care. These registries are often compiled from administrative data based on diagnostic codes that rarely precisely identify veterans in the target patient population. In this study, the authors compare classification of patients (not MS vs MS/possible MS) by chart review and by application of a statistical database algorithm. Results suggest that the algorithm reliably eliminates non-MS cases from the initial surveillance registry and is a reasonable case-finding method.
Research into Parkinson’s Disease receives a boost
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Research into Parkinson’s Disease at the University of Dundee has received a boost from a fundraising campaign organised by the Falkirk Branch of the Parkinson’s Disease Society.
In 2005 over 100 people participated in a sponsored walk using the local canal network around Falkirk as a route and raised ?5,500 for research into the disease.
Dr Anton Gartner, a Principal Investigator in the School of Life Sciences at the University of Dundee will be presented with the cheque on 29 June 2006 by Dr Richard Lenton, the President of the Falkirk Branch of the Parkinson’s Disease Society and a Consultant Geriatrician at Falkirk Infirmary.
Probable cause for Parkinson’s found
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Parkinson’s, Alzheimer’s, Lou Gehrig’s disease and other brain disorders are among a growing list of maladies attributed to oxidative stress, the cell damage caused during metabolism when the oxygen in the body assumes ever more chemically reactive forms.
But the precise connection between oxidation and neurodegenerative diseases has eluded researchers. Now, a study by the Department of Energy’s Pacific Northwest National Laboratory and UCLA’s David Geffen School of Medicine reveals that damage is linked to a natural byproduct of oxidation called nitration.
“We looked at a healthy brain and found nitration of proteins that are implicated in neurodegenerative disease,” said Colette Sacksteder, PNNL scientist and lead author of the study, published in the July issue of the journal Biochemistry. PNNL scientist Wei-Jun Qian was co-lead author.
Study Reveals How ADHD Drugs Work in Brain
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Although millions depend on medications such as Ritalin to quell symptoms of attention deficit hyperactivity disorder (ADHD), scientists have struggled to pinpoint how the drugs work in the brain.
But new work at the University of Wisconsin-Madison is now starting to clear up some of the mystery. Writing in the journal Biological Psychiatry, UW-Madison researchers report that ADHD drugs primarily target the prefrontal cortex (PFC), a region of the brain that is associated with attention, decision-making and an individual’s expression of personality.
The finding could prove invaluable in the search for new ADHD treatments, and comes amidst deep public concern over the widespread abuse of existing ADHD medicines.
Central nervous system can sometimes send out signals that invite hostile immune system attacks
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It may sound like a case of blame the victim, but researchers at Washington University School of Medicine in St. Louis have shown that cells in the central nervous system can sometimes send out signals that invite hostile immune system attacks.
In mice the researchers studied, this invitation resulted in damage to the protective covering of nerves, causing a disease resembling multiple sclerosis.
“It’s been clear for quite a while that our own lymphocytes (white blood cells) have the ability to enter the central nervous system and react with the cells there,” says John Russell, Ph.D., professor of molecular biology and pharmacology. “Under normal circumstances, the brain and the immune system cooperate to keep out those cells that might harm the brain. But in people with multiple sclerosis, they get in.”
Restricting carbohydrates may prevent Alzheimer’s disease
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A recent study directed by Mount Sinai School of Medicine suggests that experimental dietary regimens might calm or even reverse symptoms of Alzheimer’s Disease (AD).
The study, which appears in the July 2006 issue of the Journal of Biological Chemistry, is the first to show that restricting caloric intake, specifically carbohydrates, may prevent AD by triggering activity in the brain associated with longevity.
“Both clinical and epidemiological evidence suggests that modification of lifestyle factors such as nutrition may prove crucial to Alzheimer’s Disease management,” says Giulio Maria Pasinetti, M.D., Ph.D., Professor of Psychiatry and Neuroscience, Director of the Neuroinflammation Research Center at Mount Sinai School of Medicine and lead author of the study. “This research, however, is the first to show a connection between nutrition and Alzheimer’s Disease neuropathy by defining mechanistic pathways in the brain and scrutinizing biochemical functions. We hope these findings further unlock the mystery of Alzheimer’s and bring hope to the millions of Americans suffering from this disease.”
Clues Help Identify Psychological Seizures
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Up to 30 percent of those diagnosed with epilepsy don’t actually have the disorder. They have psychological nonepileptic seizures, or psychogenic seizures, that are caused by psychological conditions, not by the abnormal electrical activity in the brain that causes epileptic seizures.
Because these nonepileptic seizures are similar to epileptic seizures, they can be difficult to diagnose. Three new studies published in the June 13, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology, may help make that diagnosis easier.
“The need for an accurate diagnosis early on is crucial,” said neurologist Selim Bendadis, MD, of the University of South Florida in Tampa, who wrote an editorial accompanying the studies. “Right now there is an average of seven to nine years from the time someone first has these seizures and when they are correctly diagnosed with psychological nonepileptic seizures. During that time, they are given drugs for epilepsy that do not treat their problem and they undergo repeated testing - they pay a price physically, socially and financially.”
Movement Problems Not the Only Symptoms of Parkinson’s Disease
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Many people think that tremors and slow, rigid movements are the only symptoms of Parkinson’s disease (PD). However, although these are the most noticeable ones, they’re not always the most distressing. In one survey, 88% of PD patients reported troubling non-movement symptoms. If not recognized as part of PD and treated accordingly, these symptoms can have a severe impact on a person’s life, says Harvard Women’s Health Watch.
The newsletter urges people with PD to talk to their neurologists if they experience any of the following:
Researchers Discover Gene for FOP, Profound Skeletal Disorder
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Researchers at the University of Pennsylvania School of Medicine have located the “skeleton key,” a gene that, when damaged, causes the body’s skeletal muscles and soft connective tissue to undergo a metamorphosis into bone, progressively locking joints in place and rendering movement impossible. Identifying the gene that causes fibrodysplasia ossificans progressiva (FOP), one of the rarest and most disabling genetic conditions known to humans and a condition that imprisons its childhood victims in a “second skeleton,” has been the focus at Penn’s Center for Research in FOP and Related Disorders for the past 15 years. This important discovery is relevant, not only for patients with FOP, but also for those with more common skeletal conditions.
Senior authors Eileen M. Shore, PhD, and Frederick S. Kaplan, MD, both from the Penn Department of Orthopaedic Surgery, and their international consortium of colleagues, report their findings in the April 23 advanced online edition of Nature Genetics. “The discovery of the FOP gene is relevant to every condition that affects the formation of bone and every condition that affects the formation of the skeleton,” says Kaplan.
The discovery of the FOP gene was the result of painstaking work by the Penn scientists and their colleagues in the International FOP Research Consortium over many years. It involved the identification and clinical examination of multigenerational families, often in remote regions of the world; genome-wide linkage analysis; identification of candidate genes; and finally, the DNA sequencing and analysis of those candidate genes. The team found that FOP is caused by a mutation of a gene for a receptor called ACVR1 in the bone morphogenetic protein-signaling pathway.
Seven Cases of Creutzfeldt-Jakob Associated with Transplanted Human Tissue
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Seven cases of Creutzfeldt-Jakob disease (CJD) associated with transplanted human tissue have occurred in the UK over a period of 33 years, reveals a study published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry.
The seven cases of the fatal neurodegenerative disease were reported to the UK CJD surveillance system.
This monitors all cases of CJD arising sporadically, genetically, and as a result of infection from contaminated food products (variant form) or surgery (iatrogenic).
Alzheimer’s up on 2004 list of US death causes
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Americans are living longer, healthier lives and only the mortality rate from Alzheimer’s disease is increasing among the top 10 causes of death, the U.S. federal government reported on Wednesday.
Alzheimer’s disease moved to seventh place from eighth place among the leading causes of death in 2004, passing influenza and pneumonia, the National Center for Health Statistics reported.
“The life expectancy of Americans in 2004—77.9 years—is the highest it has ever been,” the NCHS said in a statement.
Sleep-wake mix-up may lead to near-death sensation
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The brain’s tendency to occasionally blur the line between sleep and wakefulness may help explain the phenomenon of near-death experience, preliminary research suggests.
It’s been an open question as to why some people see bright light, feel detached from their bodies or have other extraordinary sensations when they are close to dying or believe they might die.
Some people view these so-called near-death experiences as evidence of life after death, and many neurologists have considered the phenomenon too complex for scientific study.
Epstein-Barr virus infection linked to multiple sclerosis
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Young adults with high levels of antibodies against the Epstein-Barr virus, the virus that most often causes mononucleosis, may be more likely to develop multiple sclerosis 15 to 20 years later, according to a study in the Archives of Neurology.
Researchers have long suspected that external factors may influence the risk for multiple sclerosis (MS), a chronic autoimmune disease that affects the central nervous system, according to background information in the article. Some studies have suggested that the Epstein-Barr virus, which affects up to 96 percent of Americans by the time they reach age 35 to 40 years, may play a role.
Gerald N. DeLorenze, Ph.D., Kaiser Permanente Division of Research, Oakland, Calif., and colleagues examined the records of patients who joined a health plan between 1965 and 1974, when they were an average of 32.4 years old.
Increase in variant Creutzfeldt Jakob Disease predicted
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According to the latest research far more people may be at risk of contracting variant Creutzfeldt Jakob Disease (vCJD) than previously thought.
vCJD is the human form of Bovine Spongiform Encephalopathy (BSE), also known as Mad Cow Disease.
Scientists at the Institute for Animal Health in Edinburgh say a long incubation period for the disease, coupled with an ability to pass it on through blood transfusions and surgical instruments, has the potential to create a “significant public health issue”.
