MINNEAPOLIS – A new study has found that while the prevalence of neurologic conditions like dementia, stroke, Parkinson’s disease and multiple sclerosis (MS) is consistent across the U.S., the distribution of neurologists is not, and people in more rural areas may be less likely to receive specialty care for certain neurologic conditions. The study, funded by the American Academy of Neurology, is published in the December 23, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Neurologists in the United States are not evenly spread out, which affects whether patients can see a neurologist for certain conditions like dementia and stroke,” said study author Brian C. Callaghan, MD, MS, of the University of Michigan in Ann Arbor and a Fellow of the American Academy of Neurology. “Our research found that some areas of the country have up to four times as many neurologists as the lowest served areas, and these differences mean that some people do not have access to neurologists who are specially trained in treating brain diseases.”
Christine Baugh, PhD, MPH, assistant professor of medicine at the University of Colorado School of Medicine and member of the CU Center for Bioethics and Humanities, is the corresponding author of the article, “Accuracy of US College Football Players’ Estimates of Their Risk of Concussion or Injury.”
Baugh and co-authors report on survey results of 296 college football players from four teams in the Power 5 Conferences of the National Collegiate Athletic Association. Athletes were surveyed in 2017. The researchers found that between 43 percent and 91 percent of respondents underestimated their risk of injury and between 42 percent and 63 percent underestimated their risk of concussion.
To measure the accuracy of football players’ risk estimations, the researchers modeled individual athletes’ probabilities of sustaining a concussion or injury and compared model estimates to athlete perceptions. While recognizing that many people underestimate health risks, the authors point out that the risks college football athletes face may be more severe or debilitating than those faced by many in the general population. Given this elevated risk profile, they say it is concerning that athletes tend to underestimate the likelihood of these risks. These results raise questions about informed consent and how much risk should be acceptable in the context of a game, Baugh and her co-authors write.
WINSTON-SALEM, N.C. – Dec. 14, 2020 – Migraine is a neurological disease that can be severely debilitating and is the second leading cause of disability worldwide. Unfortunately, many patients with migraine discontinue medications due to ineffectiveness or side effects. Many patients still use opioids despite recommendations against them for headache treatment. However, in a recent clinical trial from Wake Forest Baptist Health, researchers showed that mindfulness-based stress reduction (MBSR) may provide benefit to people with migraine.
“Mindfulness-based stress reduction is a mind-body treatment that teaches moment-by-moment awareness through mindfulness meditation and yoga,” said Rebecca Erwin Wells, M.D., M.P.H., associate professor of neurology at Wake Forest School of Medicine, part of Wake Forest Baptist Health. “Mindfulness can also teach new ways to respond to stress, a commonly reported migraine trigger.”
According to an article published by JAMA Internal Medicine, researchers studied whether MBSR improved migraine outcomes, pain perception and measures of emotional well-being compared to headache education.
MINNEAPOLIS – Just like with drug costs, the amount of money people pay out-of-pocket for diagnostic tests and office visits for neurologic conditions has risen over 15 years, according to a new study published in the December 23, 2020, online issue of issue of Neurology®, the medical journal of the American Academy of Neurology. The study, funded by the American Academy of Neurology, found that people enrolled in high-deductible health plans were more likely to have high out-of-pocket costs than people in other types of plans.
“This trend of increased out-of-pocket costs could be harmful, as people may forgo diagnostic evaluation due to costs, or those who complete diagnostic testing may be put in a position of financial hardship before they can even start to treat their condition,” said study author Chloe E. Hill, MD, MS, of the University of Michigan in Ann Arbor and a member of the American Academy of Neurology. “What’s more, right now neurologists and patients may not have individualized information available regarding what the out-of-pocket costs might be to make informed decisions about use of care.”
Scientists at Sanford Burnham Prebys Medical Discovery Institute, Fondazione Santa Lucia IRCCS, and Università Cattolica del Sacro Cuore in Rome have shown that pharmacological (drug) correction of the content of extracellular vesicles released within dystrophic muscles can restore their ability to regenerate muscle and prevent muscle scarring (fibrosis). The study, published in EMBO Reports, reveals a promising new therapeutic approach for Duchenne muscular dystrophy (DMD), an incurable muscle-wasting condition, and has far-reaching implications for the field of regenerative medicine.
“Our study shows that extracellular vesicles are bioactive mediators that can transfer the benefits of medicine–in this case, HDAC inhibitors (HDACi)–to treat DMD,” says Pier Lorenzo Puri, M.D., professor in the Development, Aging and Regeneration Program at Sanford Burnham Prebys and co-corresponding author of the study. “We discovered the promise of this treatment almost 20 years ago and did all of the preclinical work, which led to a current clinical trial for boys with DMD. However, the therapeutic potential of HDACi has been so far limited by its systemic adverse effects.”
In the current clinical trial, boys with DMD are treated with HDACi at suboptimal doses due to the risk of adverse side effects. The scientists are hopeful that extracellular vesicles might provide a cell-free, non-immunogenic, transplantable tool for local delivery of bioactive particles that transfer HDACi to dystrophic muscles, thereby overcoming the undesirable secondary effects caused by chronic use at high doses.
Traditional stroke treatments like clot-dissolving tPA and surgical removal of big clots in the brain are good choices as well when the stroke results from SARS-CoV-2 infection, investigators report.
Excessive blood clotting and stroke — even in young, previously healthy people — are among the myriad of effects the virus is having on people across the globe. Another effect is keeping people away from hospitals even when they experience signs of stroke, like sudden and particularly one-sided weakness in the face, arm or leg, say stroke specialists at the Medical College of Georgia and Augusta University Health System.
“What we know about COVID-19 and stroke is people need to be treated urgently and they tend to do really well with tPA and mechanical thrombectomy (clot removal) if they come in within a short time window,” says Dr. David Hess, stroke specialist and MCG dean, who encourages those with signs of stroke for any reason to get to the hospital as soon as possible.
MINNEAPOLIS – People with restless legs syndrome may have changes in a portion of the brain that processes sensory information, according to a study published in the April 25, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.
Restless legs syndrome is a disorder that causes uncomfortable sensations in the legs, accompanied by an irresistible urge to move them. It often occurs in the evening and at night, sometimes affecting a person’s ability to sleep. In some cases, exercise may reduce symptoms. Iron supplements may also be prescribed if there is an iron deficiency. For more serious cases, there are also medications, but many have serious side effects if taken too long.
“Our study, which we believe is the first to show changes in the sensory system with restless legs syndrome, found evidence of structural changes in the brain’s somatosensory cortex, the area where sensations are processed,” said study author Byeong-Yeul Lee, PhD, of the University of Minnesota in Minneapolis. “It is likely that symptoms may be related to the pathological changes in this area of the brain.”
(TORONTO, Canada) – With concussions seeming more common than ever before, researchers at Toronto Rehabilitation Institute – University Health Network, set out to answer the question, Are we looking at a true epidemic, or just better recognition?
By embarking on the largest-scale study on concussions ever undertaken in Canada, the researchers discovered that 150,000 of Ontarians (1.2% of province’s population) are diagnosed with a concussion each year. That’s almost twice as high as previously recorded, and may represent a closer estimate of the true picture of concussion in Ontario.
“Past research has looked at the incidence of concussion by examining a particular population; cause of injury; or use a single reporting source, such as records from the Emergency Department. This can under-represent estimates of the real incidence of concussion,” says lead author, Laura Langer.
“Our study revealed concussion rates that are almost double what has been previously reported, and highlights the critical importance of looking at everyone who sought medical attention for their concussion.”
Four in 10 people with advanced multiple sclerosis, or MS, are emotionally abused by someone responsible for caring for them, reports a study led by the University of California, Riverside.
Further, the study finds one quarter are financially exploited, one in six are neglected, one in nine are battered, and one in 12 are sexually assaulted by a caregiver.
“We knew we would find some level of abuse and neglect, but we were surprised by how prevalent it is,” said Dr. Elizabeth Morrison-Banks, a health sciences clinical professor at the UC Riverside School of Medicine, who led the study. “The findings of this study represent a collective cry for help from so many families affected by multiple sclerosis across the United States.”
MS is an autoimmune disease that affects more than 2.3 million people worldwide. This chronic, degenerative neurological condition periodically shutters communication between the brain and other parts of the body, resulting in symptoms that include numbness and tingling in the arms and legs, as well as blindness and paralysis.
Deep brain stimulation has been used to treat Parkinson’s disease symptoms for 25 years, but limitations have led researchers to look for ways to improve the technique. This study describes the first fully implanted DBS system that uses feedback from the brain itself to fine-tune its signaling. The study was supported by the National Institutes of Health’s Brain Research through Advancing Innovative Technologies (BRAIN) Initiative and the National Institute of Neurological Disorders and Stroke (NINDS).
“The novel approach taken in this small-scale feasibility study may be an important first step in developing a more refined or personalized way for doctors to reduce the problems patients with Parkinson’s disease face every day,” said Nick B. Langhals, Ph.D., program director at NINDS and team lead for the BRAIN Initiative.
Deep brain stimulation is a method of managing Parkinson’s disease symptoms by surgically implanting an electrode, a thin wire, into the brain. Traditional deep brain stimulation delivers constant stimulation to a part of the brain called the basal ganglia to help treat the symptoms of Parkinson’s. However, this approach can lead to unwanted side effects, requiring reprogramming by a trained clinician. The new method described in this study is adaptive, so that the stimulation delivered is responsive in real time to signals received from the patient’s brain.