Risk of Stroke by Geographic Region

  The lifetime risk of stroke for men and women over age 25 globally is 25%.
  In an NEJM  study, large geographic variations were found. In 2016, the highest-risk regions were East Asia (38.8%), Central Europe (37.1%), and Eastern Europe (31.6%). The lowest region of stroke risk was sub-Saharan Africa (11.8%).
NEJM 20 Dec 2018; 379:2429-2437

UH OH: A History of Drug Treatment for ADHD dramatically Increase Risk of Parkinson's Disease

  From a report from the Center for Disease Control and Prevention 3/4 of children with ADHD are prescribed amphetamine or methylphenidate. A study from the U of Utah school of Dentistry provides  provocative findings. Individuals with ADHD are 2-3 times more likely to develop Parkinson's disease than those without.
  Further, those with ADHD who were prescribed psychostimulant drugs were 8 to 9 times more likely to develop Parkinson's.
Neuropsychopharmacol 2018;43(11):2548-2555

Bullying Hurts the Brain !

  Investigators at King's College London in their IMAGEN project found that bullying was associated with decreases in the volume of particular brain structures namely the caudate and putamen. These structural changes could increase the likelihood of mental illness such as higher levels of generalized anxiety identified in their study population by age 19.
Synonymous terms in this study: bullying and peer victimization.
Mol Psychiatry. 12 Dec  2018

Improve your Memory: DANCE and Tai Chi !

  In an analysis of from 32 randomized, controlled trials  mind-body exercises, particularly dance and tai chi, was shown to improve learning, verbal fluency, working memory, cognitive flexibility and global cognition in older adults.
  Further only MODERATE exercise intensity of 60-120 minutes per week was necessary to significantly increase global cognitive scores.
J AM Geriatr Soc. 2018 Dec 18

African Folk Remedy's for Seizures Molecular Mechanism discovered

  The leaf extract from the shrub Malotus oppositifolius helps to control seizures. Now researchers at UC Irvine have identified two components from the leaf extract activate KCNQ2/3, a potassium channel essential for controlling electrical activity in the brain.   These two components together are highly effective at activating these potassium ion channels and preventing seizures.
  Isovaleric acid, a component of valerian root is one of these active compounds in this African folk remedy.
  Amazing.
Nat Comun. 2018;9(1):3845

Stiff Aorta Predicts Dementia

  From the Cardiovascular Health Study, researchers found that individuals with high carotid-femoral pulse wave velocities (consistent with increased aortic stiffness) were 60% more likely to develop dementia during the following 15 years.
J Alzheimers Dis. 2018;66(1):297-306

High Cortisol Associated with Impaired Memory

  From the Framingham heart study, researchers found that middle-aged individuals with high levels of cortisol in their blood have impaired memory compared to those with normal cortisol.
  Hmm...stay tuned.
Neurology. 2018 Oct 24

Good Sleep Quality to Improve Sport-related Concussion in the Young

  From researchers out of Texas, young athletes with good sleep quality after a sports-related concussion are more likely to recover within two weeks compared to those with poor quality sleep.
  Guide to parent's to improve their child's sleep: avoid electronics one hour before bedtime, establish a regular sleep schedule and encourage 8-10 hours of sleep each night.
American Academy of Pediatrics 2018 Annual Conference

Migraine Prevention in Pregnancy

  A review of the literature from researchers at UCSF indicate that only amitriptyline and LOW DOSE propanolol (ie, 30-40mg per day) have sufficient data to classify them as compatible during pregnancy. Higher doses of propanolol may cause intra-uterine growth retardation.

Contact Lawmakers to Support Brain Research !

  From researchers in the Netherlands, half of all women and one-third of all men will develop dementia, stroke or Parkinsonism.
  Please support the American Academy of Neurology's (and this neurologist's) advocacy efforts to continue funding of the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) initiative by contacting your representatives in congress and the senate.

Sing to Feel and Move Better with Parkinson's !

  From kinesiology researchers at Iowa State, singing improves motor symptoms, mood and decreases physiologic indicators of stress in patient's with Parkinson's disease. Also improved were swallowing and respiratory control. 
  The mechanism is unkown.
Society for Neuroscience 2018

How Often are Staring Spells in Kids due to Seizures ?

   Staring spells are not uncommon in kids. From researchers at Emory, 2,818 patients were reviewed that presented to the new onset pediatric seizure clinic for evaluation of staring spells.
  About half were found to have epilepsy.
Annual Meeting of Child Neurology 2018

Stuttering: Major Breakthrough in Treatment !

  From researchers in Houston, nine patients that had stuttering speech aged 18 to 80 were treated for 10 days using noninvasive magnetic brain stimulation (TRPMS, invented at Weill Cornell in New York). All study participants significantly improved in fluency. In other words, it works.
  Next will be followup studies looking at functional MRI changes in treated individuals and an assessment of best treatment frequency.
ANA Annual Meeting 2018
More info at Seraya Medical Systems

Tremor in PD? Skip the Knife

  From neuropsychologists at the U of Virginia, focused ultrasound thalamotomy (that strategically makes a hole deep in the brain) improves the quality of life in patient's with drug resistant tremor associated with Parkinson's disease.
Neurology 2018. 91(14):e1275-e1284

Concussion or Mild Traumatic Brain Injury Increases Risk of Suicide

  From a review of the literature from 1963 to 2017, researchers in Toronto found that experiencing a concussion or mild traumatic brain injury was associated with a twofold higher risk of suicide as well as suicide attempts and suicidal ideation.
JAMA Neurol. 2018 Nov 12

Appendectomy to Decrease Risk of Parkinson's Disease ? Maybe...Stay Tuned

  The vermiform appendix was once considered to be a vestigial (left over, no longer used) organ. There is now evidence that the appendix plays a major role in the regulation of the immune system especially regulation of gut bacteria.
  From the largest of these epidemiologic related studies that reviewed the health records of 1.6 million Swedes that the incidence of PD was 19.3% lower in those that had their appendix removed.
  This data suggests that the appendix may be a reservoir of alpha-synuclein (the protein that accumulates in excess in the brain's of Parkinson's and related conditions (DLB).
  Since only 1% of the population gets PD it has been postulated that some, as yet unknown, confluence of events (such as an environmental trigger) that alters the gut microbiome decades before the disease is evident that mediates the risk of Parkinson's.
Sci Transl Med. 2018;10(465)

Cause Found for Polio-like Acute Flacid Myelitis in Children

  Sporadic outbreaks of Enterovirus (EV) type A71 cause several syndromes, mostly affecting children less than 5 years of age and occur in spring to fall months in North America.
  Syndromes include : pharyngitis, gastroenteritis, exanthems such as the so-called hand/foot/and mouth disease and the severe neurologic syndromes including meningitis, encephalitis, and AFM with flaccid paralysis.
  EV-A71 was identified in nasopharyngeal or rectal specimens BUT very Rarely from spinal fluid.
MMWR Morb Wkly Rep 2018 Sep 14;67:107

Prevalence of Low Back Pain has Increased 100% in the Last Decade

  Low back pain is a major cause of disability and is a major public health issue.
  Occupational exposure that includes hard work, frequent standing, sitting, bending, twisting and concentration demands are risk factors for low back pain (Occup Environ Med 1997;54:742). 
The prevalence of low back pain has increased 100% in the last decade (F1000Research 2016;5:1530)
  The finding of this study provides significant evidence Lumbosacral Radiculopathy can be considered a work related disease especially those jobs that depend on exposure to bending of the trunk, carrying and lifting.
  Of note, there was NOT an association between professional driving or sitting and LRS.
Neurology 2018 Sep 18;91:558

TAI CHI Most Effective For Fall Prevention

  Researchers in Oregon studied elders at high risk for falls. Tai ji quan (better known as Tai Chi) was found to be superior at decreasing risk of falls in this population compared to previously emphasized mutimodal exercise : (strengthening, aerobic training, balance training and flexibility exercises) and stretching.
JAMA INT MED 2018 Sep 10

Areas in Brain Actually Identified that are Associated with Analgesia In Nerve Pain with CANNABIS. WOW.

  The anterior cingulate gyrus (ACC) and dorsolateral pre-frontal cortex (DLPC) are functionally involved in THC-induced analgesia in chronic neuropathic pain.
 Neurology. 2018;91:e1285-e1294