Tag: neurodegenerative diseases

Categories : Neurodegenerative DiseasesTags :

Green Light for New Device for MS Treatment

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The American Food & Drug Administration has approved a new device for treating gait deficits in multiple sclerosis (MS) patients.

The Portable Neuromodulation Stimulator (PoNS), generates electrical pulses on the tongue to stimulate trigeminal and facial nerves to treat motor deficits. The FDA said that for it to be available by prescription, must be part of a supervised therapeutic exercise program in MS patients 22 and older. The device was authorised through the FDA’s ‘de novo’ premarket review pathway for new devices which pose do not pose significant risks of adverse effects.

In a statement, Christopher Loftus, MD, acting director of the Office of Neurological and Physical Medicine Devices in the FDA’s Center for Devices and Radiological Health, said: “MS is one of the most common neurological diseases in young adults. Today’s authorisation offers a valuable new aid in physical therapy and increases the value of additional therapies for those who live with MS on a daily basis.”

Onset of MS symptoms, which can include difficulties with walking and balance, typically occurs between 20 and 40, with greater frequency in women.

The PoNS device electrical stimulates the dorsal surface of the patient’s tongue. A control unit is worn around the neck which sends signals to a mouthpiece which the patient keeps in place with lips and teeth. Later, usage data can be viewed by a therapist to spot “potential areas of missed or shortened sessions,” the FDA noted.

The FDA gave their approval based on two clinical studies. One involved 20 MS patients with gait deficits (half with PoNS; half with a sham device). Th FDA said that the PoNS group showed “statistically significant and clinically significant” improvement in Dynamic Gait Index (DGI) scores at 14 weeks not seen in the sham device group.

The other study, with 14 patients, showed improvements from baseline in sensory organisation task scores (but not in DGI scores) at 14 weeks. There were no serious safety or adverse effects reported.

Among the FDA’s cautions, the FDA stated that the PoNS device should not be used by patients with penetrating brain injuries, neurodegenerative diseases, oral health problems, chronic infectious diseases, unmanaged hypertension or diabetes, pacemakers, or a history of seizures.

Source: MedPage Today

Categories : Lab Tests and ImagingTags :

Retinal Images Could Provide Stroke and Dementia Warning

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In the future, images of the retina could warn of a person’s increased risk of stroke and dementia, making it possible to take preventive measures.

These findings come from preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2021.

Retinopathy is damage to the retina from injury or disease, commonly associated with diabetes. People with severe retinopathy are more likely to have a diseased-looking brain on magnetic resonance imaging (MRI). Retinal tissue has the highest consumption of oxygen in the body, and is the most vulnerable to oxidative stress. Most causes of retinopathy involve damage to the retinal and choroidal circulatory systems.

Study Lead Author Michelle P  Lin, MD., MPH, Neurologist at Mayo Clinic explained:”The retina is a window to the brain. A retinal photo that shows a magnified look at the back of the eye, including the retina and optic nerve, is cheaper and faster to perform than an MRI, so we’re wondering if it might be a good screening tool to see who could benefit from a referral to a neurologist for a brain MRI.”

In addition to the ophthalmologist’s office, retinal photos could be taken by a smartphone camera or via a smartphone adapter, Lin said.

Researchers explored the association of retinopathy with stroke, dementia, and the risk of death in 5543 adults who had participated in the annual US National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2008. Interviews were conducted with the participants on a number of aspects of their medical history and health behaviours. Additionally, they received a retinal scan photo to look for signs of retinopathy.

Compared with participants not diagnosed with retinopathy, those with retinopathy were more than twice as likely to have had a stroke. They were also  nearly 70% more likely to have dementia; and more likely to die within the next 10 years, with increasing severity of retinopathy conferring a higher risk of death. The odds were calculated after adjusting for risk factors such as age, hypertension, diabetes and smoking.

“If you have retinopathy, work closely with your primary care doctor to alter your vascular risk factors and ask to be screened for cognitive impairment. You may be referred to a neurologist for evaluation and possibly a brain MRI,” said Dr Lin, who is also an assistant professor of neurology at the Mayo Clinic College of Medicine.

Source: News-Medical.Net

Categories : Lab Tests and Imaging Neurodegenerative DiseasesTags :

A Non-invasive Parkinson’s Test Inspired by Scent

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A  skin swab test has been developed for Parkinson’s disease, based on biomarker analysis of sebum, the oils that protect the skin – and it has a surprising inspiration. 

This comes about after the remarkable discovery of a woman’s ability to detect a certain smell in people who had the disease. 

Joy Milne, a retired nurse, noticed a “musky” scent on her husband years before he was diagnosed with Parkinson’s disease. A series of tests showed that she could detect the presence of Parkinson’s disease in people with 100% based on smell alone, prompting research which isolated the compounds she was smelling: higher concentrations of hippuric acid, eicosane, and octadecanal.

In order to exploit these biomarkers, researchers developed a mass spectrometry test to pick up their levels in sebum obtained with skin swabs. This has proved to be around 80% accurate.

Prof Perdita Barran said: “We believe that our results are an extremely encouraging step towards tests that could be used to help diagnose and monitor Parkinson’s.

“Not only is the test quick, simple and painless but it should also be extremely cost-effective because it uses existing technology that is already widely available.

“We are now looking to take our findings forwards to refine the test to improve accuracy even further and to take steps towards making this a test that can be used in the NHS and to develop more precise diagnostics and better treatment for this debilitating condition.”

This new test with its high reliability could help the diagnosis of Parkinson’s disease, which can be easily missed, especially in the early stages.
Daxa Kalayci, 56, was misdiagnosed several times over four years before finally finding out she had Parkinson’s in 2019.

“I was misdiagnosed with anxiety, stress-related tremors and told that my problems stemmed from going through the menopause,” she said.

“Despite my diagnosis eventually being confirmed… a quick and simple diagnostic test for Parkinson’s would have given me the chance to start my treatment earlier and enjoy life a lot more.

“But instead, I lost so many years not being able to pursue a career as a paramedic or go back to nursing.

“This test could be a game-changer for people living with Parkinson’s and searching for answers, like I was.”

Source: BBC News

Categories : Exercise Neurodegenerative DiseasesTags :

Golf Shines as Physical Activity for Parkinson’s Patients

On By ModernMedia
Putter and golf balls on golf course. Photo by Robert Ruggiero on Unsplash.

In a study comparing physical activity routine for Parkinson’s patients, golf produced greater improvements than tai chi. 

Previous studies had shown that tai chi practice was beneficial as physical activity for Parkinson’s patients, resulting in balance and mobility gains, and is also safe and popular with patients.

“We know that people with Parkinson’s disease benefit from exercise, but not enough people with the disease get enough exercise as therapy,” said study author Anne-Marie A. Wills, MD, of Massachusetts General Hospital Boston. “Golf is popular—the most popular sport for people over the age of 55—which might encourage people to try it and stick with it. We decided to compare golf to tai chi in our study because tai chi is the gold standard for balance and preventing falls in people with Parkinson’s.”

The study involved 20 people with moderate Parkinson’s disease, who were offered 10 weeks of two one-hour group classes a week, randomly assigned to either golf or tai chi.

Researchers evaluated everyone with tests, including ones for mobility. For the test, a person is timed while getting up from a chair, walking 3m and then returning to the chair and sitting down. Golfers were 0.96 seconds faster on the test at the end of the study.

“While the results for golf might be surprising, it’s important to remember that the number of participants in our study was small, and the period over which we studied them was relatively short,” Dr Wills said. “More research in larger groups of people, over longer periods of time, is needed.”

While overall satisfaction was similar in both groups, 86% of golfers compared to 33% of tai chi participants were “definitely” likely to continue the activity.

“Our finding that golfers were much more likely to continue with their sport is exciting because it doesn’t matter how beneficial an exercise is on paper if you people don’t actually do it,” Dr Wills said. “So if swinging a golf club is more appealing than practicing tai chi, by all means, go to a driving range and hit balls for an hour instead!”

Source: Medical Xpress

Categories : Ageing General Interest Neurodegenerative DiseasesTags :

Legendary Singer Tony Bennett Diagnosed with Alzheimer’s

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Music legend Tony Bennett, 94, revealed in an interview that he was diagnosed with Alzheimer’s disease 4 years ago.

The singer’s career has spanned seven decades, he had continued his initial success in the 1950s across multiple genres, becoming a hit with the MTv generation, and in more recent years collaborating with popular artists like Amy Winehouse and Lady Gaga.

Alzheimer’s disease is an age-related, irreversible neurodegenerative condition. In more than 90% of patients, it begins after age 65, although it can occur as early as in the 30s. It is marked by memory loss and confusion that seem like the normal cognitive decline of older age, but it is more rapid and severe, eventually resulting in death. As people live longer and the risks of developing this disease increase with age, the burden of this disease is expected to increase in the future. In the US, the number of people with Alzheimer’s is expected to nearly triple from 5.5 million to 14 million by 2060.

Mr Bennett has been able to work over the past four years but the toll is perceptible. He still recognises his family members but his short-term and long-term memory have drastically deteriorated. Interviewer John Colapinto noted Mr Bennett gazing at his lavishly illustrated book, “Tony Bennett Onstage and in the Studio” (2018). “He stared into its pages not with the air of warm reminiscence but like a man struggling to recall why these images seemed familiar.” His wife, Susan, added that Mr Bennett is “not always sure where he is or what is happening around him. Mundane objects as familiar as a fork or a set of house keys can be utterly mysterious to him.”

Over the past two years, Mr Bennett recorded a second album of duets with Lady Gaga, a follow-up to the hit album with Gaga in 2014. While he had been known to be a “meticulous and hard-driving perfectionist in the studio,” Mr Bennett was much more subdued. speaking rarely, his words coming haltingly and seeming lost or bewildered. Gaga, who considers Mr Bennett to be “an incredible mentor, and friend, and father figure” is seen breaking down in tears as Tony sings a solo passage of a love song.

The album is due to be released this spring, but Mr Bennett will be unable to do promotional interviews. Mr Bennett, together with his wife and son (who is also his manager) decided to break the news, in the hopes that as many fans as possible know about what will likely be his final record. The neurologist who diagnosed Bennett in 2016,  Gayatri Devi, MD, said: “He is doing so many things, at 94, that many people without dementia cannot do. He really is the symbol of hope for someone with a cognitive disorder.”

Source: MedPage Today

Categories : Neurodegenerative DiseasesTags :

Protein Synthesis Fix may Reverse Cognitive Decline in Alzheimer’s

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Restoring protein synthesis in the brain may reverse the cognitive decline associated with Alzheimer’s, according to a study by researchers from New York University (NYU) and the Federal University of Rio de Janeiro (UFRJ).

Current Alzheimer’s treatment research focuses on reducing the phenomena linked to the disease, such as amyloid plaques, neurofibrillary tangles, and neuroinflammation. The study aimed to determine whether restoring protein synthesis would also be beneficial.

“The synthesis of new proteins in the brain is essential for proper neuronal function and, notably, for memory consolidation. We and others have previously shown that impairments in brain protein synthesis contribute memory deficits in Alzheimer’s disease model mice, and that the brains of Alzheimer’s patients exhibit clear signs of impaired protein synthesis. We thus asked ourselves whether rescuing brain protein synthesis might be an approach to improve memory function in Alzheimer’s disease,” said co-senior author Sergio Ferreira, a professor at UFRJ.

“Given the complex nature of Alzheimer’s disease, identifying and targeting abnormal molecular pathways that effectively improve cognition has been challenging,” added co-senior author Eric Klann, a professor at NYU. “Our findings show that jump-starting protein synthesis in the brain can revive lost cognitive functions. We hope that this work can serve as a step forward in treating this devastating disease.”

Previous research found that a cellular quality control mechanism called the integrated stress response (ISR) was found to slow down protein synthesis to weed out problems like cancerous cells, but can get stuck in the ‘on’ position. In 2013, a drug called ISRIB was developed to reverse this (ISRIB stands for ISR InhiBitor). 

Previous research with ISRIB had shown positive results in restoring memory function in mice, months after traumatic brain injury (TBI), reversing cognitive impairments in Down Syndrome , preventing noise-related hearing loss, treating certain prostate cancers, and even cognitive enhancement in healthy animals.

The researchers determined that in Alzheimer’s patients, critical components of protein synthesis are depleted in the hippocampus. The researchers hypothesised that some cognitive function could be returned if protein synthesis was restored with ISRIB.  

The researchers used mice with Alzheimer’s-like conditions as a model. Testing the mice’s memory (eg with maze runs), they found memory function and hippocampal protein synthesis restored with ISRB. Restoration of hippocampal neural plasticity and memory functions was observed even in simulated advanced Alzheimer’s. 

The results indicate that restoring protein synthesis with drugs such as ISRIB, could work together towards reversing cognitive decline from Alzheimer’s in humans. 

Source: Medical Xpress

Journal information: “Correction of eIF2-dependent defects in brain protein synthesis, synaptic plasticity, and memory in mouse models of Alzheimer’s disease,” stke.sciencemag.org/lookup/doi … 26/scisignal.abc5429

Categories : Ageing Neurodegenerative DiseasesTags :

Obesity Adds to Alzheimer Severity

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In addition to it being a risk factor for many known chronic diseases, obesity is an additional burden on cerebral health and may also be associated with the progression of Alzheimer’s disease, according to a new study from the University of Sheffield and the University of Eastern Finland.  

The study used multimodal neural imaging and showed that obesity may contribute to the vulnerability of neural tissue, while maintaining a healthy weight helped to maintain brain structure in mid dementia Alzheimer’s disease.

Alzheimer’s disease is a neurodegenerative disease which accounts for two thirds of dementia in over 65s, is the sixth leading cause of death in the United States and there is no cure at present.  

Lead author Professor Annalena Venneri from the University of Sheffield’s Neuroscience Institute and NIHR Sheffield Biomedical Research Centre, said: “More than 50 million people are thought to be living with Alzheimer’s disease and despite decades of ground breaking studies and a huge global research effort we still don’t have a cure for this cruel disease.

“Prevention plays such an important role in the fight against the disease. It is important to stress this study does not show that obesity causes Alzheimer’s, but what it does show is that being overweight is an additional burden on brain health and it may exacerbate the disease.”

She added that it was important to educate people early on in their lives as it was too late to wait until the 60s to lose weight as the disease lurks in the backgrounds.

The researchers examined MRI scans of the brains of 47 patients diagnosed with mild Alzheimer’s disease dementia, 68 patients with mild cognitive impairment, and 57 individuals who were cognitively healthy. Using three complementary, computational techniques, they studied the brain’s anatomy, blood flow and also the brain’s fibres.

They compared gray matter volume, white matter integrity, cerebral blood flow and obesity. Grey matter volume decreases in Alzheimer’s. In patients with mild Alzheimer’s, an association was found with obesity and grey matter volume around the right temporoparietal junction, suggesting obesity creates a neural vulnerability in cognitively impaired patients. The study also found that maintaining a healthy weight may help preserve brain structure in structure in the presence of age and disease-related weight loss.

Joint author Dr Matteo De Marco from the University of Sheffield’s Neuroscience Institute, said: “Weight-loss is commonly one of the first symptoms in the early stages of Alzheimer’s disease as people forget to eat or begin to snack on easy-to-grab foods like biscuits or crisps, in place of more nutritional meals.

“We found that maintaining a healthy weight could help preserve brain structure in people who are already experiencing mild Alzheimer’s disease dementia. Unlike other diseases such as cardiovascular disease or diabetes, people don’t often think about the importance of nutrition in relation to neurological conditions, but these findings show it can help to preserve brain structure.”

Source: Medical Xpress

Journal information: Manmohi D. Dake et al, Obesity and Brain Vulnerability in Normal and Abnormal Aging: A Multimodal MRI Study, Journal of Alzheimer’s Disease Reports (2021). DOI: 10.3233/ADR-200267

Categories : Ageing Neurodegenerative DiseasesTags :

Parkinson’s Disease Spotted in Advance with Health Checkup

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A study by the University of Nagoya has shown that general health checkups may be effective at spotting early signs of Parkinson’s disease (PD) in advance.

Specifically, the prodromal stage shows sex differences, with the markers for males being decreased cholesterol and haematocrit (the percentage of red blood cells in blood) levels, while in females it is increased blood pressure. PD is the second most common disease affecting the nervous system after Alzheimer’s disease, is caused by a deficiency in the neurotransmitter dopamine. By the stage where sufferers experience motor symptoms such as tremors, stiffness, bradykinesia (slowness of movement), more than half of all dopaminergic neurons have been lost. Postural instability occurs in the late stage. Several processes have been implicated in PD, such as mitochondrial dysfunction, defective protein clearance mechanisms, and neuroinflammation, but it is not clear how these factors interact.

Prior studies have shown that non-motor symptoms including constipation, rapid eye movement sleep behaviour disorder, impairment of sense of smell, and depression, emerge in patients with PD 10 to 20 years before the onset of motor symptoms – meaning that PD may be detectable in advance with other measures.

“If we can detect biological changes in the patients’ bodies well before the onset of the motor symptoms, we can start medical treatments in an early stage,” said Prof Masahisa Katsuno of the Graduate School of Medicine at Nagoya University.

The team used health checkup data from 22 male and 23 female patients with PD, dating to before they were diagnosed with the disease. They supplemented this with data from 60 male and 60 female healthy individuals who had checkup data for at least four years.The checkup data was compared between healthy individuals and PD patients to establish a baseline, and then were examined for longitudinal changes prior to the onset of PD. They found that in the premotor stage, blood pressure increased in females, while in males total and low-density cholesterol levels and haematocrit decreased.

“In this study, we found that blood pressure, haematocrit, and serum cholesterol levels are potential biomarkers of Parkinson’s disease before the onset of its motor symptoms,” said Prof Katsuno. “This finding indicates that general health checkups can help detect early signs of developing Parkinson’s disease.”  Based on the findings, the team is now working to identify individuals at risk of developing PD in an attempt to forestall the development of their disease.

Source: Medical Xpress

Journal information: Katsunori Yokoi et al. Longitudinal analysis of premotor anthropometric and serological markers of Parkinson’s disease, Scientific Reports (2020). DOI: 10.1038/s41598-020-77415-1

Categories : Ageing Diet and Nutrition Mental HealthTags :

Mediterranean-type Diets Protect Against Parkinson’s Disease

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Researchers at the University of British Columbia have shown that the Mediterranean diet and another diet based on it, have a strong link in protecting against Parkinson’s disease (PD). 

These two diets had previously been shown that they could protect against other neurodegenerative diseases. The Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) diet combines aspects of the Mediterranean diet and the DASH diet which protects against hypertension. The MIND diet emphasises consumption of berries, as research shows that they protect against mental decline, eating leafy greens and poultry. The MIND diet also mostly does away with potato, milk and fruit (excluding berries).

Senior author Dr Silke Appel-Cresswell said, “There is a lack of medications to prevent or delay Parkinson’s disease yet we are optimistic that this new evidence suggests nutrition could potentially delay onset of the disease.”
Following the diets delayed the average onset of PD by 17.4 years in women, and 8.4 years in men.

Since PD already has a notable sex difference, with 60% of sufferers being men, despite their shorter average lifespan, the sex difference in response to the diets opens new avenues of research
“It drives home the connection between the gut and the brain for this disease,” Dr Brett Finlay said. “It also shows it’s not just one disease that healthy eating can affect, but several of these cognitive diseases.”

Source: Medical Xpress

Journal information: Avril Metcalfe‐Roach et al, MIND and Mediterranean Diets Associated with Later Onset of Parkinson’s Disease, Movement Disorders (2021). DOI: 10.1002/mds.28464

Categories : Gastrointestinal Neurodegenerative DiseasesTags :

Gut Immune Cells Protect The Brain in MS Flare-ups

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Scientists from the University of California, San Francisco, have observed gut immune cells moving up out of the gastrointestinal tract to the brain during multiple sclerosis (MS) flareups, where they seem to exert some protective effects.

In MS, other immune cells attack the myelin sheath, resulting in flare-ups, where they experience memory problems, vision loss, pain and other problems. These flare-ups subside after some days, but it is not known why the disease switches back and forth between flare-up and remission.

The new research revealed that the flare-ups were brought under control with the unlikely assistance of gut immune cells, which produce Immunoglobulin-A (IgA) and act as the immune system’s first line of defence in the GI tract. Some of these cells actually leave the gut and migrate to the brain, where it appears they reduce inflammation.

“It was a very new idea,” said lead author, Sergio Baranzini, PhD, neurology professor at the UCSF Weill Institute for Neurosciences, . “Nobody thought to look for this type of immune cell.”

The gut immune cells were found only in cerebrospinal fluid of MS sufferers when they experienced a flare-up, and not in remission. Recent research indicated that an unhealthy GI microbiome was involved in MS, and the researchers determined that these immune cells only attacked potentially damaging bacteria, not the myelin sheath.

It is anticipated that this discovery may bring insights into new therapies to treat the disease. 

Source: Medical Xpress