Attacks of Migraine : More Than Just A Headache

  The postdrome phase of migraine  ie. the time between headache resolution and feeling completely back to normal, consisting mostly of fatigue and cognitive disability is an underappreciated contributor to migraine symptomatology.
  Disability from migraine is substantial. It is estimated to be the sixth most disabling condition worldwide (Lancet 2015;386:743).
  According to a recent study, even after the headache passes, sufferers are not able to perform optimally at work or in school for at least several hours.
Neurology 2016 Jul 19;87:309

Experimental Trials for Alzheimer's

   Experimental trials worth mentioning include but are not exclusively : 
1. Infusion therapies to recruit the immune system : solanezumab, aducanumab.
2. To prevent destruction of brain connections : saracatinib which  turns off Fyn, a brain protein which when over-activated triggers destruction of connections between brain cells ( ie. synapses). 
3. Beta-amyloid production blockers such as beta- and gamma- secretase inhibitors. 
4. Tau aggregation inhibitors and tau vaccines to prevent tau from forming the tangles seen in Alzheimer's. 
5. Reduce chronic, low-level inflammation eg. pioglitazone (Actos). 
6. Insulin nasal spray to alter insulin changes in Alzheimer brains. 
7. Modulating known risk factors eg. hypertension, diabetes, stroke, high cholesterol and heart disease. 
8. Estrogen-based hormone therapy to protect women with a higher risk of Alzheimer's.

Best Treatment for Critical Lumbar Spinal Stenosis

  Most patients who underwent spinal fusion after laminectomy decompression scored no better than those who underwent decompression procedures alone in scales that measured difficulty in walking, pain, and impact on quality of life.
NEJM 2016;374:1413-1422
NEJM 2016;374:1424-1434

Lyrica Associated with Major Birth Defects

  From Researchers in Lausanne Switzerland, women that took Lyrica (pregabalin) for a variety of conditions (pain related) during their first trimester of pregnancy had infants with a much higher rate of major birth defects than matched control subjects not taking Lyrica.
Neurology Today
19 May 2016 Vol. 16 - Issue 10:pp1,12-15

Accelerated Brain Atrophy with Atrial Fibrillation

  According to data presented at the 2015 European Society of Cardiology Congress, atrial fibrillation in the elderly general population were found to independently have accelerated loss of brain volume and cognitive function.
  The mechanism is unknown but may be multifactorial including altered autonomic regulation of cerebral blood flow, micro emboli to the brain and atrial fibrillation- induced  diminished cerebral blood flow.
STROKE.2013;44(4):1020-1025

Risk of Stroke Increases With IncreasedJob Stress

In a meta-analytic study out of China, people with high stress jobs had a 22% higher risk of stroke than those with low-stress jobs. Women with high-stress jobs had a 33% higher risk of stroke than women with low-stress jobs.Those with high-stress jobs were 58% more likely to have an ischemic stroke than those with low-stress jobs. People with passive (janitors,miners, other manual laborers) and active (doctors,teachers,engineers)did NOT have an increased risk of stroke.
  High stress jobs were found in the service industry (waitresses,nurses aides).
Neurology.2015 Oct 14

IBS, Migraine and Tension Headaches Linked ?

   Irritable bowel syndrome, (the most common GI disorder internationally with 45 million sufferers in the US alone) , tension headaches and migraine may share common genetic mutations.
  Researchers from Istanbul University in Turkey when looking at the serotonin transporter gene and serotonin receptor gene 2A found that IBS, migraine and tension headache groups had at least one gene that differed from healthy participants.
AAN ANNUAL MEETING 2016 Vancouver