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Showing posts from June, 2020

Light drinking may protect brain function

Light to moderate weekly alcohol consumption during middle age could help preserve brain function as we get older. Compared to non-drinkers, those who had a drink or two a day tended to have better performance on cognitive tests over time. from Neuroscience News https://ift.tt/38ddgdq
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Introducing a Supportive Care Team for Advance Directive Education in a Neurological and Neurosurgical Patient Population

Congratulations to Charlotte Henke MSc, Emily Mroz MS, PhDc, Ngoc Anh Le MPHc, Hannah M Gregory DOc, Ashley Ghiaseddin MD, Nikolaus R McFarland MD, PhD, and Jacqueline Baron-Lee PhD, on the publication of “Introducing a Supportive Care Team for Advance Directive Education in a Neurological and Neurosurgical Patient Population,” in the Journal of Patient Experience June issue. Abstract Background: Patient-centered care includes delineation of patient treatment values (ie, advance care planning [ACP]). Advance care planning often includes advance directive (AD) completion and is underutilized, particularly among neurology and neurosurgery patients. Implementation of a supportive care team (SCT) in outpatient clinic settings may offer opportunities for AD education and completion. Objective: This study assesses the effectiveness of an integrative SCT composed of hospice volunteers and undergraduate quality improvement interns in their efforts to provide ACP education in neu...
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Novel quantitative approach for crossed cerebellar diaschisis detection in acute ischemic stroke using CT perfusion

Crossed cerebellar diaschisis (CCD) is a common finding in hyper-acute ischemic stroke, related to supratentorial dysfunction of the contralateral hemisphere. Several studies investigated a possible relationship between CCD and clinical outcomes but still no evidence emerged. We used a novel quantitative whole cerebellum analysis using CT perfusion (CTP) imaging to investigate the relationship between CCD and stroke severity, hypoperfused volume and outcome measures. from Journal of the Neurological Sciences https://ift.tt/38gFjsy
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Apathy and its impact on carer burden and psychological wellbeing in primary progressive aphasia

While patients with primary progressive aphasia (PPA) typically present with predominant language impairment, behavioural symptoms, such as apathy, are often under-recognised. We aimed to systematically characterise apathy across the three recognised subtypes of PPA, plus atypical right-lateralised presentations of semantic dementia, and to evaluate the impact of apathy on carer burden and psychological wellbeing. from Journal of the Neurological Sciences https://ift.tt/38joA7N
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The discerning eye of computer vision: Can it measure Parkinson's finger tap bradykinesia?

The worldwide prevalence of Parkinson's disease is increasing. There is urgent need for new tools to objectively measure the condition. Existing methods to record the cardinal motor feature of the condition, bradykinesia, using wearable sensors or smartphone apps have not reached large-scale, routine use. We evaluate new computer vision (artificial intelligence) technology, DeepLabCut, as a contactless method to quantify measures related to Parkinson's bradykinesia from smartphone videos of finger tapping. from Journal of the Neurological Sciences https://ift.tt/2BfsKBI
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Counterpoint: Conventional Fluoroscopy-Guided Selective Cervical Nerve Root Block—A Safe, Effective, and Efficient Modality in the Hands of an Experienced Proceduralist

Fellows’ Journal Club Two-hundred fifty-four conventional fluoroscopy-guided selective cervical nerve root blocks were performed via an anterolateral approach with an average fluoroscopy time of 24.3 seconds for all cases. There were no aborted procedures and no major or permanent complications. There were 14 minor complications; 12 of these were periprocedural and resolved by the 2-week follow-up visit. One-hundred eighty-five patients (75.2%) reported pain improvement of >50% from baseline at 15 minutes postinjection. The authors conclude that this study confirms that conventional fluoroscopy is as safe and effective as CT for the guidance of selective cervical nerve root block when using a meticulous technique and a nonparticulate steroid and performed by an experienced proceduralist. Abstract A , Patient positioned obliquely on a 45° wedge for right-sided injection. B , The patient positioned supine for right-sided injection with the proceduralist using fluoroscopy to p...
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Resting-State Brain Activity for Early Prediction Outcome in Postanoxic Patients in a Coma with Indeterminate Clinical Prognosis

Editor’s Choice The authors used resting-state fMRI in a prospective study to compare whole-brain functional connectivity between patients with good and poor outcomes, implementing support vector machine learning. They automatically predicted coma outcome using resting-state fMRI and also compared the prediction based on resting-state fMRI with the outcome prediction based on DWI. Of 17 eligible patients who completed the study procedure (among 351 patients screened), 9 regained consciousness and 8 remained comatose. They found higher functional connectivity in patients recovering consciousness, with greater changes occurring within and between the occipitoparietal and temporofrontal regions. Coma outcome prognostication based on resting-state fMRI machine learning was very accurate, notably for identifying patients with good outcome. They conclude that resting-state fMRI might bridge the gap left in early prognostication of postanoxic patients in a coma by identifying those with bot...
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NF1 in Adults and Genetic Predisposition to Neoplasms

Xia Wang, MD, PhD Neurofibromatosis Clinic Moffitt Cancer Center 12902 USF Magnolia Drive Tampa, FL  33612   Presentation will be in lecture format with Q & A following   Tuesday, June 30, 2020 12:00pm-1:00pm Zoom Meeting (see link below) https://ufl.zoom.us/j/97699118699 Meeting ID: 976 9911 8699 One tap mobile 646 558 8656 (New York) 312 626 6799 (Chicago)   Upon completion of this activity, participants will be able to: Define the clinical manifestations of NF1 in adults Describe the challenges in the care for adults with NF1 and formulate the team of providers Interpret the genetic variants pertaining to neoplasms   Speaker Disclosure Dr. Wang has disclosed that they have no relevant financial relationships.  No one else in a position to control the content of this activity has any financial relationships to disclose.   Accreditation The University of Florida College of Medicine is accredited by the Accreditation Cou...
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Will Telemedicine Gains Remain After the Pandemic? Four Neurologists Weigh in.

In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services instituted unprecedented expansions to their policies on telemedicine reimbursement. This has dramatically dropped barriers that had been slowing progress in this arena. The question being batted around now is: When the pandemic ends, we still have this same expanded access to telemedicine? Dr. Jaime M. Hatcher-Martin We called up four neurologists – Dr. Heidi Schwarz, Dr. Kim Hutchison, Dr. Laurence Kinsella, and Dr. Jaime Hatcher-Martin – and posed that question to them. “In a good way we’ve sort of let the cat out of the bag,” says Hatcher-Martin. Here’s what else they had to say, with their answers lightly edited for clarity. Heidi Schwarz, MD “Our institution strongly feels that telemedicine is here to stay. The thought is: studies will show that this is equivalent as far as quality of care. “There are already studies out there showing that patients often prefer this mode of physician ...
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Why Single-Use Electrodes Are Being Singled Out as EEG Labs Begin to Open

Single-use EEG cup electrodes got another boost recently when they were discussed by industry leaders at a town hall held by ASET-The neurodiagnostic Society. ASET convened the meeting to address issues surrounding the resumption of neurodiagnostic services amid a pandemic . Their panel of experts included EEG technologists in leadership positions at medical centers across the country. “We use disposables for everything,” was a phrase used more than once when panelists were asked which EEG electrodes they are using now that labs are reopening. “I personally think we should all be using disposables,” said panelist Cheryl Plummer, manager of the Epilepsy Monitoring Unit at Presbyterian Hospital in Pittsburgh, Pennsylvania. “But I know that might not be possible everywhere.” We recently wrote about how the COVID-19 pandemic has led to a surge in the use of single-use electrodes over reusables. The impetus for the increase largely comes down to infection control, but as the townhall p...
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Repeated head impacts associated with later-life depression and worse cognitive function

People who suffer repetitive head injuries experience increased symptoms of depression and a greater risk of cognitive decline as they age. Those with a history of repetitive head injuries and TBI that resulted in a loss of consciousness reported higher levels of mental health problems, including depressive symptoms. from Neuroscience News https://ift.tt/3i4i6yh
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7 remarkable patients who determined the course of neuroscience

It is no exaggeration to say that most progress in medicine has been achieved one unfortunate patient after another. Either by accident , or by misguided design , our understanding of human physiology and pathology have frequently come at the expense of the misfortune of countless patients, and it continues to do so. Whilst large trials teach us a lot about the characteristics of diseases, it is however the single case study that often reveals the most defining insights . For example, it was the  accidental gunshot injury sustained by Alexis St Martin that led to our understanding that the gastric phase of digestion depends on the acid produced by the stomach. The gory injury resulted in a permanent fistula between St Martin’s stomach and his skin, a veritable window through which the army doctor, William Beaumont , peered to see nature at work. By Jesse Shire Myer – A book, Life and Letters of Dr. William Beaumont …, Public Domain, Link But enough of other organs; ...
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Alternative medicine is widespread among people with multiple sclerosis

Multiple sclerosis patients are nine times more likely to discuss the use of alternative medicines, including cannabis, with their neurologists as treatment options than they were in 2001. 81% of MS patients report the use of dietary supplements to help with disease management, and 39% report participating in mindfulness and other mind-body therapies. 30% of patients reported using marijuana to help treat their symptoms. from Neuroscience News https://ift.tt/383ovVy
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First UK-wide study describes brain complications in some patients with severe COVID-19

A new study highlights the most common neurological and psychological complications that arise as a result of coronavirus infection. The most common brain complication was stroke, reported in 77 of 125 patients studied. Of those, 57 patients had a stroke caused by a blood clot in the brain. Behavioral changes, confusion, and altered mental state were also reported in a significant number of patients. Depression and anxiety were also commonly reported. Ten patients developed psychosis as a result of COVID-19, and six developed a dementia-like syndrome. from Neuroscience News https://ift.tt/38chzpq
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Variability in natural speech is challenging for the dyslexic brain

People with dyslexia experience difficulties when acoustic variation was added to speech sounds. In the absence of the variation, neural speech sound processing was consistent between dyslexic and typical readers. Difficulties in detecting linguistically relevant information during acoustic variation in speech may contribute to a dyslexic person's deficits in forming native language phoneme representations during infancy. from Neuroscience News https://ift.tt/3exTiMK
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Study reveals plant compound beats sugar cravings

A mint product that contained gymnemic acids from the Gymnema sylvestre plant significantly reduced the intake of high-sugar sweet foods compared to a placebo. For those with a sweet tooth, the mint significantly decreased the pleasantness and desire for eating more sugar-rich foods. The product may be useful in helping people reduce sugar consumption. from Neuroscience News https://ift.tt/3g5uPyT
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Couples that sleep together sleep better

Couples who sleep next to one another have increased REM sleep and less disrupted sleep than couples who slept individually. from Neuroscience News https://ift.tt/3eAM9LM
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‘Where are my keys?’ and other memory-based choices probed in the brain

Study identifies a different set of individual neurons in the medial frontal cortex that is responsible for memory-based decision making. The findings have implications for the treatment of Alzheimer's disease, schizophrenia, and other disorders associated with problems in cognitive flexibility. from Neuroscience News https://ift.tt/2YycVyT
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Age-dependent efficacy of subthalamic nucleus deep brain stimulation in young- and late-onset Parkinson's disease based on a 10 year follow-up

Long-term efficacy and safety of subthalamic nucleus deep brain stimulation (STN DBS) in patients with young-onset Parkinson's disease (YOPD) and late-onset PD (LOPD) (i.e. motor symptom initial appearance at ages ≤40 and > 40 years, respectively) was compared to identify relationships between PD onset age and the efficacy of DBS. from Journal of the Neurological Sciences https://ift.tt/3g0wCVA
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Efficacy and safety of sonothrombolysis in patients with acute ischemic stroke: A systematic review and meta-analysis

Accumulating clinical evidence has indicated that sonothrombolysis can aid in the treatment of ischemic stroke; however, these findings remain controversial. The purpose of the present meta-analysis was to assess randomized clinical studies concerning the effects of sonothrombolysis on ischemic stroke to evaluate its safety and efficacy. from Journal of the Neurological Sciences https://ift.tt/3duANHT
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How long can the pre-symptomatic phase of MS last?

Serum neurofilament light chain levels in patients with presymptomatic multiple sclerosis. Bjornevik K, Munger KL, Cortese M, et al. JAMA Neurol 2019 (Epub ahead of print). Abstract BACKGROUND: Unrecognized demyelinating events often precede the clinical onset of multiple sclerosis (MS). Identification of these events at the time of occurrence would have implications for early diagnosis […] via How long can the pre-symptomatic phase of MS last? — Neurochecklists Blog from The Neurology Lounge https://ift.tt/2CGHJF3
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Protein in mitochondria appears to regulate health and longevity

Humanin, a peptide encoded in mitochondria, appears to have a beneficial impact on both health and longevity in both humans and animals. Higher levels of humanin in the body are associated with longer life spans and a reduced risk of neurodegenerative disorders, like Alzheimer's disease. from Neuroscience News https://ift.tt/2Z4ZBB5
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Unexpected mental illnesses found in a spectrum of a rare genetic disorder

Fragile X syndrome patients with prematuration had a much earlier onset of neurological problems, including earlier symptoms of neurodegeneration. They also experienced emotional processing problems. Some of the most common emotional processing disorders reported were mood regulation, anxiety, and psychosis. from Neuroscience News https://ift.tt/3hXpWcT
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Humans navigate with stereo olfaction

Findings suggest humans have a stereo sense of smell that subconsciously guides navigation. from Neuroscience News https://ift.tt/2NujI66
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Genes affecting brains and brawn?

Genetic deletions associated with neurodevelopmental disorders may also be linked to dysfunctional organ development, a new study reports. from Neuroscience News https://ift.tt/2B6s1Tc
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Genetic malfunction of brain astrocytes triggers migraine

Familial hemiplegic migraine type 2 (FHM2) causes a malfunction of astrocytes in the cingulate cortex. Manipulating astrocytes in the cingulate cortex reversed the disfunction, preventing an increase in migraine-like symptoms in mice carrying the FHM2 defect. from Neuroscience News https://ift.tt/37VaJV8
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Statin use is linked to lower death rate in hospitalized COVID-19 patients

Cholesterol-lowering statins show promise for the treatment of severe coronavirus infections. Statins lowered the death rate and decreased the need for mechanical ventilation in patients hospitalized for severe COVID-19. from Neuroscience News https://ift.tt/3er5XkB
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