Monday, November 20, 2017

Action Video Games to Boost Brain Power : NOPE

  Researchers in Montreal found that habitual players of action video games have less gray matter in their hippocampus (a part of the brain that regulates emotions and is associated with long-term memory and spatial navigation).
  The greater the hippocampal atrophy the greater the risk of Alzheimer's disease as well as depression, schizophrenia and post-traumatic stress disorder.
 Interestingly, researchers found that 90 hours of playing action video games (Call of Duty, Killzone, and Borderlands 2) led to hippocampal atrophy (shrinkage) while 90 hours of playing 3D-platform video games led to an INCREASE in gray matter within the hippocampus.
Mol Psychiatry. 2017 Aug 8

Tumeric to Improve Memory

  From researchers at UCLA, daily oral curcumin (tumeric) may improve memory, mood and attention in cognitively normal middle-age and older adults
  Previous studies suggested that curcumin's anti-oxidant, anti-inflammatory, anti-amyloid and possible anti-tau properties may offer neuro-protective benefits. Prior human trials regarding the effects of circumin have been heretofore inconclusive.
  Doses tested of curcumin were 90 mg twice daily.
  GI side effects are possible such as abdominal pain and gastritis.
2017 Alzheimer's association International Conference

Saturday, September 2, 2017

Alzheimer's Prevention: The Latest Recommendations

  From the recent report of the National Academy of Sciences, Engineering and Medicine come general recommendations.
  Cognitive Training: there is currently no evidence to support a conclusion that cognitive training can prevent or delay mild cognitive impairment or Alzheimer's.
  Hypertension: manage blood pressure in those with hypertension (particularly in mid-life i.e.. 35-65) to prevent, delay or slow the progression of Alzheimer's.
  Physical activity: studies fail to demonstrate increasing physical activity prevents, delays or slows mild cognitive impairment or Alzheimer's. However, the report noted the other health benefits of increased physical activity such as lowering the risk of hypertension, stroke and obesity as well as symptoms of depression.
  Contrastly,to improve your life overall: consider the FINGER study out of Finland which found that targeting diet, exercise, vascular risk factors and brain training slowed cognitive decline in older adults.
Downloadable report:

Reduce Parkinson's Disease Risk: Truncal Vagotomy ?

  Researchers out of Sweden reviewed patients that underwent truncal vagotomy (a surgical procedure that functionally disconnects multiple abdominal organs by cutting the vagus nerve supply to them) and found a decreased risk of developing Parkinson's disease compared to controls. In fact there was a greater decreased risk in those that underwent selective vagotomy (which disconnects only the stomach).
  These findings offer further support for the Braak hypothesis that Parkinson's disease starts in the gut and spreads to the brain.
Neurology 2017Apr 26

Brain Structure Changes When Learning with Music

  Researchers at the University of Edinburgh found that people that practiced a movement task with the left hand to music showed a significant increase in structural connectivity in the white matter tracks that link auditory and motor regions on the right side of the brain.
  Future studies will look to apply this finding to motor rehabilitation programs such as after a stroke.
Brain Cogn. 2017;116:40-46

Friday, September 1, 2017

Is Parkinson's Disease an Autoimmune Disease?

  Following up an earlier study, researchers at Columbia and La Jolla have discovered a population of T cells in the blood of patients with Parkinson's disease that recognize alpha-synuclein peptides providing evidence that PD may be,in part,an autoimmune disease, and autoimmune targeted treatment could potentially slow or stop the disease process.
Nature 2017;Epub 2017 Jun21
Nat Commun 2014;5:3633

Hardening of Arteries in Brain Increases Risk of MCI and Dementia

  Vascular risk factors are known to be associated with dementia. This study suggests atherosclerosis (hardening of the arteries) intracranially (in brain) is associated with mild cognitive impairment (MCI:Pre-dementia?) and dementia.
  Treating vascular risk factors may again decrease the development of atherosclerosis and decrease the prevalence of MCI and dementia.
Neurology 2017 Apr18;88:1556

Stand Less at Work to Decrease Heart Disease

  Sitting at work for prolonged periods has been a known risk factor for increased heart disease. A recent study out of Ontario suggests that occupations associated with prolonged standing increased heart disease two-fold compared to occupations involving primarily seated positions.
  Occupations that combined sitting and standing and walking showed lower risks in in men BUT elevated risks in women.
Am Jrnl of Epidemiology,kwx298

No Sweat:Tatoos and Exercise

  Tattooed skin generated les sweat and higher sodium concentration than nontattooed skin when stimulated by pilocarpine iontophoresis .
  Translated : heavily tattooed athletes sweat less not allowing for heat dissipation with vigorous physical exertion which may pose health risks such as heat exhaustion and fatigue and increase risk of injury.
Med Sci-fi Sports Exec.2017 Jul;49(7):1432-1436

Friday, August 4, 2017

Icelandic Genetic Mutation Found to be Protective Against Alzheimer's

  Researchers studied 1,795 Icelanders and found a coding mutation (A673T) in the APP gene that protects against Alzheimer's disease and decline in memory.
  This finding provides proof of principle for the hypothesis that reducing Beta-cleavage of APP may protect against the disease.
Nature 488, 96-99 Aug 2

Friday, June 16, 2017

Vascular Risk Factors : Narrowing Arteries in the Head = Alzheimer's Risk Increase

  Researchers from the Atherosclerosis Risk in Communities (ARIC) Neurocognitive study demonstrated that hardening of the arteries in the head is associated with mild cognitive impairment and dementia.
  In MCI and dementia patients with posterior (back of the brain) cerebral watery plaque had 44% higher prevalence of MCI than without it. Dementia risk was increased threefold in those with anterior cerebral (front of the brain) artery plaque and twofold in those with narrowing > 70% or involvement of > vascular territories.
  Again, as per my last review, decreasing vascular risk factors (obesity, diabetes, hypertension and high cholesterol) decreases hardening if arteries inside the head and decreases cognitive impairment.
Neurology 2017 Apr 18;88:1156

Take Care in Mid-Life to Reduce the Risk of Alzheimer's

  Vascular risk factors are known to be associated with Alzheimer's i.e., obesity (BMI > 30), smoking, hypertension, diabetes and high cholesterol. In this study, researchers found that those with vascular risk factors in middle age (especially those that are APOE4 allele positive) had a greater amyloid (the protein found in excess in Alzheimer's brains) burden in their brains later in life. 
  However, late-life vascular risk factors were NOT associated with an increased risk later in life.
  Therefore, treatment of vascular risk factors in MIDLIFE while likely to be asymptomatic, may be critical in reducing the development of an underlying AD process.
JAMA 2017 April 11;317:1443

Sleep Deprivation Induces Genetic Change

  Identical twin studies reveal that habitual short sleep (chronic sleep deprivation) was associated with unique patterns of gene expression and pathway enrichment that affect immunity.
  Monozygotic (identical) twin studies allow assessment of environmental influences in these individuals that share genetics and a common environment when growing up.
  This study shows the effects of sleep deprivation on immune dysregulation indicating a potential link between it and adverse metabolic, cardiovascular and inflammatory outcomes.
Sleep 2017 Jan 1;40(1)

Monday, June 12, 2017

Virtual Reality Immersion Significantly Reduces Pain

  According to a study from Cedars-Sinai, virtual reality (VR) significantly reduced hospitalized patient's pain scores after just one 15 minute experience.
  Researchers state VR "hijacks" the a good way. They further attribute the benefit to "immersive distraction" in that the mind is deeply engaged in the immersive experience making it difficult to perceive other stimuli, including pain of varying etiologies.
JMIR Meant Health.2017;4:e9

Sunday, June 11, 2017

The Effect of Sleep Position on Glymphatic System Function

  Researchers at Stony Brook School of Medicine studied the effect of body posture on the glymphatic system transport in experimental animals. They found that amyloid clearance (good) and glymphatic transport were most efficient in the side-sleeping and back-sleeping position while the stomach-sleeping position (i.e., the most upright position mimicking awake posture) resulted in slower clearance.
  According to the authors, the right-sided sleep position was associated with efflux and influx...out through and in through the glymphatic system.
J Neurosci. 2015;35(31):11034-11044

Restorative Function of Sleep: Yep, the Glymphatic System Implicated

  An important factor affecting glymphatic flow is interstitial space volume which increases 40-60% during sleep.Certain anesthetics that induce Stage 2 sleep and natural sleep significantly increase interstitial space volume.
  Awakening sleeping mice (never a good idea, they're real grouches) dramatically reduces glymphatic flow.
  The authors conclusion: the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system by the glymphatic system.
Science 2013;342(6156):373-377

Impaired Glymphatic System After Brain Injury ?

  Glymphatic system function was reduced by 60% following traumatic brain injury in experimentally modified mice for at least one month. 
  In mice genetically modified to lack aquaporin channels (crucial in facilitating spinal fluid transport from the periarterial space to the interstitial space to drive waste removal via the glymphatic system) that sustained brain injury, the glymphatic system dysfunction was further exacerbated causing neurodegeneration and neurofibrillary pathology like that seen in the brains of humans with chronic traumatic encephalopathy.
  These findings have potential to enhance our understanding of the changes that take place in brain injury with further efforts needed to lessen the impact of such.
J Neurosci.2014;34(49):16180-16193

Game Changing, Earth Shattering : THE GLYMPHATIC SYSTEM

  The glymphatic system, named from the glial cells and the lymphatic system that it mimics, may explain how one of the most metabolically active organs, the brain, clears waste products and excess fluids without a lymphatic system.
  It is most active during sleep and may be implicated in headache and neurodegenerative diseases such as Alzheimer's and Parkinson's disease in which abnormal proteins accumulate in the brain and in excess are neurotoxic and cause cell death. 
  The glymphatic system concept was first described in 2012 in mice by researchers at U of Rochester New York.
  Researchers in Norway published a case report supporting the existence of a glymphatic system in humans in 2015.
  Better understanding of the glymphatic system may facilitate drug delivery into the...tough to get into...central nervous system to treat tumors and infection. Or to enhance its function to clear toxic accumulations of misfolded proteins seen in neurodegenerative disease.
Sci Transl Med. 2012;4(147):147ra111
Acta Radiol Open. 2015;4(11):2058460115609635

Computer-Brain Interface in Locked-In Syndrome

  In a recent study, 4 patients with completely locked-in syndrome responded to yes or no questions by thinking their answers allowing them to communicate.
  Researchers used a non-invasive brain-computer interface to assess changes in frontocentral cortical oxygenation which was measured using functional near-infrared spectroscopy to determine a patients' answers.
PLOS Biology January 31 2017

Listen to Music or Meditate to Improve Memory and Cognition

  In a recent study, participants that reported memory decline were asked to meditate (Kirtan Kriya program) or listen to music 12 minutes every day for 3 months then as often as they wanted for the next 3 months.
  Both groups showed marked and significant improvement in cognitive performance and memory at 6 months.
Journal of Alzheimer's Disease Feb 3 2017

The IKEA Foundation and UNHCR Create the "Better Shelter"

  FACT: In 2014, there were 24 persons displaced every second with an average of 10 years in exile. Enter a unique collaboration between the IKEA Foundation and the UNHCR that has resulted in a new, safer and more durable shelter for refugee families around the world. 
  The Better Shelter is a temporary, lightweight 17.5 square meter modular emergency shelter that ships flat and can be assembled on site without special tools in hours by a group of four.
  Better Shelter has a solar panel on its roof that provides 4 hours of interior light as electricity is scarce in refugee camps.
  The roof and wall panels are modular replaceable and are recyclable.
  The 4 windows and lockable door can be placed in a number of configurations providing for space for a family of 5.
  The units can be expanded to provide space for a temporary hospital or school.

Paralyzed ALS Patient Speaks !

  From researchers in the Netherlands, a patient with ALS ( Lou Gehrig's disease ) operated a speech generating computer by moving her fingers in her mind ! Her thoughts changed a brain signal from small electrodes placed through her skull and into brain that were then sent to a transmitter implanted under the collarbone that amplified and transmitted the signals. The signal change was converted to a mouse click over an alphabet on a screen. Letter by letter the patient was able to compose words that were spoken by the computer.
  In ALS, a progressive degenerative motor neuron disease, patient's motor nerves die over time causing loss of motor function impairing not only movement but speech, swallowing and breathing. All while being fully aware.
  This technology, although in its infancy, has obvious application to others with stroke and speech arrest but also to the paralyzed as per my last report.
NEJM. 2016 Nov 12

Mind Control : The Future Is Now

  From my dad's alma mater Case Western Reserve (it was just Case in dad's time) scientists allowed a man paralyzed from the neck down to scratch his nose (!), grasp a mug to drink and to eat mashed potatoes using his thoughts alone ! Reaching and grasping were accomplished by combining functional electrical stimulation with an intra-cortical brain-computer interface to create a connection between the man's brain and his paralyzed muscles.
Lancet 2017;Epub 2017 Mar 28
Video demo:

Cardiac Arrest at Home? Chill Out !

  Therapeutic hypothermia (TH) by reducing body core temperature to 36 degrees C has been shown to improve outcomes after witnessed out-of-hospital cardiac arrest from ventricular fibrillation.
Cochrane Database Syst Rev2016;2:CD004128
  BUT in a recent study TH was NOT found to be beneficial in comatose patients that suffered a cardiac arrest in the hospital.
JAMA 2016 Oct 4;316:1375

Exercise to Reduce Nerve Pain

  Aerobic exercise may reverse some of the effects neuropathy in patients with type 2 diabetes. Studies have shown an increase in epidermal nerve fiber density in diabetics WITH and WITHOUT neuropathy.
Ann Clin Trans Nurol.2014 Oct;1(10):844-849
Pain Med Vol 16, Issue 8 Aug 2015 pp 1482-1489

Bad Sleep Equals Increased Risk of Stroke

  Sleep-disordered breathing (SDB ex. obstructive sleep apnea) has been found to be an independent risk factor for stroke. SBD and sleep-wake disturbances (SWD) increase the risk of stroke AND may impair neuroplasticity and recovery of function AFTER a stroke.
  Sleep studies should be completed in patients with stroke or warning signs of stroke in the form of TIA's.
Neurology August 3 2016

Get Fat Late in Life to Decrease Amyloid in your Brain IF YOU'RE NOT A APOE4 CARRIER

  From the Harvard aging brain study, greater amyloid deposits in brain were seen in individuals with LOW BMI (thin folks). However, those that were APOE4 carriers (increased risk with each APOE4 mutation you carry), NORMAL BMI (normal weight) was associated with greater amyloid burden in brains.
  Amyloid at high levels is toxic to our brains.
Journal of Alzheimer's Disease June 18 2016

Decrease Risk of Alzheimer's with Frequent Sauna Bathing

  2,000 men from Finland in a 20 year follow-up as a part of the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD) that took a sauna 4-7 times per week were found to have a 66% decreased risk of dementia than those that took a sauna once a week.
Age Aging. 2016 Dec 7

Monday, April 24, 2017

Dr Prusinski Featured in ROAD & TRACK Magazine

  For this article, Dr. Christopher Prusinski was interviewed by Max Prince regarding concussion from the perspective of a Neurologist and race car driver and instructor.
Road&Track May 2017 Vol 68, No. 8 pp. 98-99

Tuesday, February 21, 2017

Autism Able to be Predicted in Infants

  1 in 68 children have been diagnosed with autism in the US. The risk increases to 1 in 5 for those children that have an affected sibling.
  Researchers at UNC Chapel Hill used MRI to evaluate the brains of high risk infants (those with a sibling with ASD). Overall brain volume, surface area and thickness of the cerebral cortex in select areas were measured. They discovered an overgrowth of cortical surface area in infants later diagnosed with autism. Using an algorithm they developed researchers were able to predict with near certainty which infants would later go on to develop autism by age 2. Further, cortical thickness was found to remain unchanged but the surface area of the brain increased at a higher rate than normal between 6 and 12 months of age. This expansion is believed to be due to an increase in neural progenitor cells (immature pre-neurons). Additionally, only the social symptoms of autism were found to be a consequence of these brain changes not the repetitive behaviors.
   The study is important in that the earlier we begin behavioral therapy in autism the greater the chance of limiting its adverse consequences.
Nature 542, 348-351 (16 Feb 2017)

Monday, January 16, 2017

Hypnosis: Brain Activity and Connectivity Changes Identified

  Stanford researchers using functional MRI have discovered changes in those highly hynotizable while undergoing hypnosis. First, a decrease in brain activity was seen in brain's salience network (dorsal anterior cingulate). Second, an increase in brain connections that help the brain process and control activity in our bodies (connections between dorsolateral prefrontal cortex and the insula). Lastly, reduced connections between the dorsolateral prefrontal cortex and the default mode network (medial prefrontal cortex and the posterior cingulate cortex).
  This study offers evidence that hypnosis is more than a swinging pocket watch it is a powerful means of changing the way we use our minds to control our body and our perceptions. One example: pain control.
Cereb Cortex. 2016 Jul 28

Pregnant Moms Take Your Ditamin D to Protect Your Baby Against MS

  According to a Danish registry study higher levels of vitamin D in newborns was associated with less risk of developing multiple sclerosis decades later.
Neurology 2016 Nov 30;[e-pub]
  Comparable findings were reported in a Finnish registry measuring the mother's serum vitamin D level.
NEJM JW Neurol May 2016
JAMA Neurol 2016;73:515

Sunday, January 15, 2017

Disrupted Sleep Increases Risk of Atrial Fibrillation

   Researchers at UCSF after examining three sources of data have concluded that disruptions in sleep may increase the risk of developing atrial fibrillation later in life.
  People with frequent nighttime awakening had a 26% increase risk of developing atrial fibrillation. People with insomnia had a 29% increased risk of developing atrial fibrillation. 
  Why disturbed sleep is associated with the development of atrial fibrillation is unknown. It may be hypothesized that disturbed sleep negatively impacts the autonomic nervous system.
  Poor sleep is associated with other risk factors for heart disease including stroke, high blood pressure and obesity.
  Improved sleep hygiene may help prevent atrial fibrillation and its associated risk of stroke.
American Heart Association Meeting Presentation: 733 Session: AR.RFO.52 and 218-AR.AOS.780

High Blood Pressure ? Blame it on Your Childhood

  Children with a history of  childhood mistreatment, poverty or family dysfunction may have poor blood pressure regulation. Blood pressure variability has been linked to numerous problems in adults including increased risk of stroke, poor post-stroke recovery and decreased brain function in the elderly.
AHA Meeting Report  Presentation: 307 Session : EP.AOS.760
  Previous research has found an association between adverse childhood experiences and a more rapid increase of blood pressure in adulthood. Further, early-onset hypertension and prehypertension have been linked to preclinical heart disease such as increased arterial stiffness and left ventricular hypertrophy.

Saturday, January 14, 2017

THROW OUT YOUR "PURPLE PILLS" : Proton Pump Inhibitors Possibly Increase Stroke Risk

  PPI's (omeprazole, pantoprazole, lansoprazole, esomeprazole) have been found to be associated with vascular dysfunction including kidney disease, heart attacks and dementia. A recent American Heart Association presentation indicates that a review of records of 244,679 Danish patients with nearly a six year follow up revealed a 21% overall increased risk of ischemic stroke in those taking PPI's. The greatest risk was found with pantoprazole (94%).
  A similar risk was not found in those that took H2 blockers (famotidine, ranitidine).
AHA Meeting Report Presentation: 391-Session: EP.AOS.765

Hope for Alzheimer's Patients and Their Families ?

  As reported by Researchers Against Alzheimer's (RA2) there are 57 drugs in mid-stage testing (phase II) and 23 drugs in late-stage testing (phase III). These drugs could prevent or delay the symptoms of dementia. Phase II/III treatments include AC-1204, an oral drug for patients with mild to moderate Alzheimer's whose mechanism of action is to improve mitochondrial metabolism through chronic ketosis. Also, a combination of albumin and immunoglobulin administered IV with possible anti-amyloid antibodies and albumin binding capacity is in mid/late stage development to treat mild to moderate Alzheimer's disease.
Cummings J Alzheimers Res Ther. 2016;8;39

Kids Drowsy During the Day ? Don't Allow the Use of a Media Device at Bedtime !

  School-age children between the ages of six and nineteen that used a portable screen-based media device at night were more likely to have inadequate sleep quantity, poor sleep quality and excessive daytime drowsiness.
JAMA Pediatr. 2016;170(12):1202-1208

Short Sleepers Drink More Sugary-Caffeinated Drinks

  People that slept five hours or less have been found to consume 21% more sugar-caffeinated beverages. Long sleepers drank less coffee and water.
Sleep Health Nov 9 2016

Run With Virtual Reality

  Risk of falls in adults 60-90 is decreased in those that use a treadmill in combination with virtual reality than without virtual reality.
Lancet Sept 17 2016

Factors Identified as Increased Risk of ALS at an Earlier Age

  People with a BMI (body mass index) above the highest 1/3 percentile (greater than or equal to 25) have a higher risk of developing ALS at a younger agePeople with an IQ above the highest 1/3 percentile have a significantly higher risk of developing ALS at an age of 56 and older. People with physical fitness above the highest 1/3 percentile have a higher risk of developing ALS before age 45.
European Journal of Neurology October 2016

Treat Hypertension Mid-life to Preserve Late-life Brain Function

  According to a review of the literature by a panel of experts, treatment of hypertension in mid-life preserves late-life cognitive function.
  Hypertension disrupts the function and structure of cerebral blood vessels which leads to ischemic damage (as a result of decreased blood flow to brain cell's) of white matter regions critical for cognitive function and may promote Alzheimer pathology.
Hypertension Oct 10 2016
  As previously reported, treatment of elevated blood pressure in the oldest of the old should be more conservative than treatment of younger patients.