Naproxen for presymptomatic Alzheimer disease: Is this the end, or shall we try again?

Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been hypothesized to play a protective role in Alzheimer disease (AD). This hypothesis is supported by a large number of cohort studies; a recent meta-analysis of 16 studies demonstrated that current or former NSAID use was associated with a reduced relative risk (RR) of AD (RR 0.81; 95% confidence interval 0.70–0.94).¹ A role for NSAIDs in AD is consistent with the increasing evidence that inflammatory activity plays a crucial role in AD pathogenesis.^2,3 In AD, protein complexes of β-amyloid and hyperphosporylated tau interact with microglia and astrocytes and result in the secretion of cytokines and chemokines, markers of inflammatory activation. Despite the observational epidemiologic data on the protective effect of NSAIDs and the evidence for a biologically plausible role of anti-inflammatory treatment, a large multiyear randomized placebo-controlled trial with naproxen and celecoxib (Alzheimer's Disease Anti-inflammatory Prevention Trial [ADAPT]) failed to support the hypothesis that either drug could delay the onset of AD in adults with a family history of dementia.⁴ While these initial results were disappointing, there was a suggestion of an effect among 3 of the cognitive subtests in the naproxen arm of this study,⁵ which led the investigators to design a subsequent naproxen trial, using a more sensitive outcome measure.

from Neurology recent issues http://bit.ly/2GSZhxi

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UPI: Kids with psych disorders most likely to take dangerous viral challenges

The “choking game” — and other clearly ill-advised and dangerous internet challenges — leave many parents wondering what drives teens to take the bait and participate. Now, a new study suggests that an underlying psychological disorder may be one reason why some kids jump at online dares such as the “Bird Box” challenge, where people walk around blindfolded, and the Tide Pod challenge, daring people to eat laundry detergent. (January 28, 2019) Read the full article here from Brain Health Daily http://bit.ly/2DIWHbD

The emerging influential role of microglia in neurology

In her most catchily titled book, The Angel and the Assassin , Donna Jackson Nakazawa highlighed nerve cells which have hitherto been very little acknowledged – microglia . Long ignored as bit players in the big league of the nervous system, Nakazawa colourfully illustrated what many neuroscientists are beginning to realise: the small size of microglia belies their huge influence ; m icroglia are, after all, the defence force of the nervous system, protecting the brain from microbial invaders . In keeping with their small size, their role is to surreptitiously present the antigens of invading bugs to T cells , the toffs who actually carry out the final hatchet job . It is therefore not surprising that any dysfunction of microglia will come with significant clinical consequences . By GerryShaw – Own work , CC BY-SA 3.0 , Link The most important clinical fallout of dysfunctional microglia appears to be the emergence of dementia. It is indeed spec...

What are the pitfalls and perils of intracranial pressure?

Crudely speaking, the nervous system is made up of two parts. The peripheral nervous system , composed of nerves and muscles , is rather robust and roams free, exposed to the elements. On the other hand, the central nervous system , consisting of the brain and spinal cord , is delicate and fragile. It is therefore protectively cocooned in a rigid skull and a hardy vertebral skeleton . But even this tough fortress isn’t secure enough for these dainty neurones ; they are, after all, the command and control system for the whole body. Therefore, to further insulate them from the physical and physiological perturbations that continuously threaten them, nature has further sequestered them within a very exquisitely regulated irrigation system, the cerebrospinal fluid (CSF) . Internet Archive book Images on Flickr. https://www.flickr.com/photos/internetarchivebookimages/14769907251/ The CSF is actually a fine filtrate of the blood that flows in the arteries. The sieve is the very for...

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