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