Neurologist

what happens around us is here

Berries May Offer Sweet Protection Against Parkinson’s disease

They're rich in an antioxidant that seems to shield men and women from the illness, study finds.

SUNDAY, Feb. 13 (HealthDay News) — People who eat foods rich in antioxidants called flavonoids, especially berries, may be protecting themselves from developing Parkinson’s disease, a new study suggests.

In addition to berries, flavonoids are found in a variety of foods such as apples, chocolate, and citrus fruits. These compounds have been touted as protective against some diseases because of their antioxidant effects, researchers say.

However, not all flavonoids are created equal. Only those known as anthocyanins, found in berries and other red/purplish fruits and vegetables, protected both men and women, according to the results of this study, which was funded by the U.S. National Institutes of Health.

“Although it’s too early to say that eating berries can reduce Parkinson’s disease risk, benefits of berries have been reported in several previous studies, for example, lowering risk of hypertension,” said lead researcher Dr. Xiang Gao, an instructor in medicine at Harvard Medical School. “So it is good, at least [doing] no harm, if we can have 2-3 cups of berries a week,” he said.

“When we combined all individual flavonoids together, total flavonoid intake was also associated with a significantly lower Parkinson’s disease risk in men — but not in women,” Gao noted. Only anthocyanins seemed protective for both sexes.

The results of the study are scheduled to be presented in April at the American Academy of Neurology’s annual meeting in Honolulu.

For the study, Gao’s team collected data on over 49,000 men who took part in the Health Professionals Follow-up Study and more than 80,000 women from the Nurses’ Health Study.

Participants filled out detailed questionnaires about their diets. Using that information, the researchers calculated the amount of flavonoids people consumed. In addition, they also looked at the consumption of tea, berries, apples, red wine and oranges and orange juice.

Over 22 years of follow-up, 805 people developed Parkinson’s disease. Among men, those who consumed the most flavonoids were 40 percent less likely to develop the neurodegenerative illness compared with men who consumed the least amount of flavonoids, the researchers found.

However, among women, there wasn’t any relationship between total flavonoid intake and the risk of developing Parkinson’s, Gao’s group notes.

However, the subset of flavonoids known as anthocyanins — found in berries — were associated with a lower risk of Parkinson’s in both men and women.

“If our observations are confirmed, it suggests that anthocyanins, or berries, could be a potential neuroprotective agent against Parkinson’s disease risk,” Gao said.

Commenting on the study, Parkinson’s expert Dr. Carlos Singer, a professor of neurology at the University of Miami’s Miller School of Medicine, said that “this probably has to do with an antioxidant effect.”

“A lot of the mechanisms in Parkinson’s boil down to how the nerve cells handle oxidative stress,” he said. “Many of the mechanism that are being looked at in Parkinson’s have to do with how do you make the cell work better in terms of oxidative stress.”

Flavonoids may be bolstering the ability of nerve cells to handle oxidative stress, Singer said.

This study shows an association between flavonoids and a lower risk for Parkinson’s, but not a cause-and-effect relationship, he noted.

While the cause of Parkinson’s disease isn’t known, it appears to have both a genetic and an environmental component, Singer said.

If someone is genetically predisposed to the disease and is also exposed to an environmental trigger, the difference between developing Parkinson’s or not could potentially depend the amount of flavonoids in the diet, he speculated.

More information

For more information on Parkinson’s disease, visit the U.S. National Institute of Neurological Disorders and Stroke.

SOURCES: Xiang Gao, M.D., Ph.D., instructor in medicine, Harvard Medical School, Boston; Carlos Singer, M.D., professor of neurology, University of Miami Miller School of Medicine; presentation, American Academy of Neurology’s 63rd Annual Meeting, Honolulu, April 9 to April 16, 2011.

http://health.msn.com/healthy-living/nutrition/articlepage.aspx?cp-documentid=100269780

 

Advertisements

February 15, 2011 Posted by | Uncategorized | Leave a comment

Epilepsy and Genetics: Can You Inherit Epilepsy?

January 13, 2011

By Daniel Hoch, PhD, MD
Editor, AAN.com for Patients and Caregivers

One of the most common questions I get from people with epilepsy who are raising a family is whether their children may have the disorder.

An article in Neurology Today® discusses progress in understanding the molecular basis of epilepsy. The article describes using techniques called genome-wide association and copy number variation to compare people with epilepsy to thousands of people without epilepsy.

While there are probably many differences in genetics between the two groups, the researchers found two differences associated with the epilepsy patients. It’s not entirely clear how these differences in genes and the proteins they produce contribute to epilepsy, but the authors of the paper suggest the genes may impact the way brain cell connections are made.

While research like this shows we’re coming to understand more about the reasons for epilepsy, except in a few cases, we are still a long way from understanding how, if at all, it is inherited.

My advice to my patients is based on common sense. Clearly, some kinds of epilepsy run in families. Australian clinical researcher and epileptologist, Samuel F. Berkovic, MD, has taken advantage of this fact to describe several rare, inheritable forms of epilepsy.

However, without a clear pattern in your family, it’s unlikely that your epilepsy will be passed on to one of your children. Unlikely, but not impossible. Therefore, I tell many of my patients to consider taking part in genetic studies of epilepsy. The Clinical Trials Registry at the National Institutes of Health is one good place to learn about the opportunities.

You can also learn more about epilepsy genetics at the Epilepsy Foundation of America.

While understanding your own genetic makeup can be very valuable, there are risks to consider. I recommend this Neurology Now® magazine article for a discussion of those risks.
http://www.aan.com/news/?event=read&article_id=9300

February 14, 2011 Posted by | Uncategorized | Leave a comment

Antipsychotic drugs could shrink patients’ brains

Experts say findings should not dramatically change current prescription practices.

Coloured magnetic resonance imaging (MRI) scan of the brain from the side, combined with a coloured neck and skull X-ray.The implications of the finding that antipsychotic drugs may reduce the size of patients’ brains are not clear.SOVEREIGN, ISM / SCIENCE PHOTO LIBRARY

Evidence that prescription drugs shrink patients’ brains would, one might think, suggest only one course of action: stop prescribing them. But the matter turns out to be much more complicated, according to research published today inArchives of General Psychiatry on the effects of antipsychotic drugs in people with schizophrenia1.

In the past 15 years, research has indicated that people with schizophrenia have smaller cerebral volumes than the general population, and that this reduction is particularly large in ‘grey-matter’ structures, which contain the cell bodies of neurons. For instance, one meta-analysis points to 5–7% reductions in the size of the amygdala, hippocampus and parahippocampus2, which are all involved in memory storage and retrieval.

But scientists have debated whether the decrease is caused by the disease alone, or whether powerful antipsychotic drugs also have a role. According to the latest findings, the more antipsychotics patients receive, the more likely they are to have a decreased amount of grey matter.

The research was led by Beng Choon Ho, a psychiatrist and neuroscientist at the University of Iowa in Iowa City. His team used magnetic resonance imaging (MRI) to scan the brains of 211 patients, administering on average 3 scans per patient over a 7.2-year period1. They found that treatment length and the type and dose of antipsychotic drugs taken were both relatively good predictors of total brain volume change. Use of antipsychotics explained 6.6% of the change in total brain volume and 1.7% of the change in total grey-matter volume.

The study developed from a previous work in which Ho’s team analysed the contribution of a genetic variation to grey-matter volume reduction3. In the latest work, the researchers looked again at those results and added data from more patients. This time, they examined the contribution from the dose of antipsychotics prescribed. They found that the greatest reduction came in those who had been recently diagnosed — and so would have just started taking the medications. “We did not expect to see this,” says Ho.

Ho says that the effect is “small but significant”. He adds, “We have been looking at the data for five years. We’ve been very careful to get it right because of the potential implications.”

Missing control

The scale of the study is impressive, says Andreas Meyer-Lindenberg, a neuroscientist at the University of Heidelberg in Mannheim, Germany. “It’s by far the largest sample studied longitudinally. And there was a great follow-up and retention rate,” he says. Stefan Borgwardt, a neuropsychiatrist at the University of Basel, Switzerland, says that the study “will definitely have a great impact, not only on the field of schizophrenia research but also on clinical practice”.

Animal studies support the link. David Lewis, a neuroscientist and psychiatrist at the University of Pittsburgh, Pennsylvania, found that healthy non-human primates, given doses of antipsychotics similar to those given to humans, showed brain volume reductions of around 10%, mostly attributable to loss of the glial cells that support and protect neurons4,5.

But Lewis, who has written an editorial to accompany Ho’s study6, warns that his own, Ho’s and other studies are “convergent but still circumstantial”. It is impossible to distinguish the effect of the disease from that of the drug, he says, because “both are changing over time”.

Ho acknowledges that his study is marred by the lack of a placebo control group — for ethical reasons, patients cannot be deprived of the medications they need — and the lack of ‘within individual’ studies in which the same patient either uses or does not uses the drugs. “It’s not the ideal study design, but as good as we could ever get with something like this,” says Ho.

Meyer-Lindenberg warns against over-interpreting MRI data, which can be affected by confounding factors including lifestyle, smoking and socioeconomic differences. “Although it does address them as far as possible statistically, this study cannot exclude them,” he says. Meyer-Lindberg himself published a study last year showing that antipsychotics cause quickly reversible changes in brain volume that do not reflect permanent loss of neurons (see ‘Antipsychotic deflates the brain’)7.

Bigger and better?

The idea that decreased brain volumes are necessarily bad is also controversial. Borgwardt says that small cerebral volumes are generally thought to lead to worse brain function, and some studies show that the greater the decrease, the worse the illness outcome. Antipsychotics have long been known to have side effects — notably uncontrolled tremors (parkinsonism) and restless leg syndrome (akathisia) — that might be explained by reduction in brain volume.

But decreasing brain volume could also be responsible for the beneficial effects of the drugs. Lewis points out that the reduction is greatest in patients who stay on the drugs the longest — meaning, presumably, that they are getting the best benefit and suffering relatively few side effects.

In the brains of adolescents, volume loss has been shown to reflect maturation through the elimination of superfluous synapses, says Meyer-Lindenberg.

Borgwardt has begun to scan the brains of people at high risk of developing schizophrenia and track the cerebral volume of those who go on to be treated8, a strategy that, on a larger scale, could help to clarify the controversy. An alternative route could be to study people with depression and bipolar disorder, says Lewis. Comparing changes in the brain volume of such patients who use antipsychotics with those that do not would help to tease out the relative contribution of the drugs.

In the meantime, Ho’s study and others should strengthen doctors’ commitments to use antipsychotic drugs sparingly, say all the researchers contacted by Nature. “We stated as clearly as possible that we are not advocating that people stop taking medications. A large body of evidence shows the drugs relieve symptoms and prevent relapse,” says Ho. “But this will reinforce what I have always tried to do with my patients — work with them in finding the lowest effective dose.”

February 9, 2011 Posted by | Uncategorized | Leave a comment

Cairo protesters defy ‘putsch’ warning

Protesters in Cairo

A day after one of the biggest anti-Mubarak rallies so far, a few thousand protesters remain in Cairo’s Tahrir Square. At the same time, the US and EU are pushing for an orderly transition of power.

 

The opposition in Egypt reacted angrily on Wednesday to Vice President Omar Suleiman’s warning that the country could be at risk of a military putsch. The coalition of five main youth groups behind the protests, now into day 16, called for the next mass demonstration to take place on Friday.

“He is threatening to impose martial law, which means everybody in the square will be smashed,” Abdul-Rahman Samir, a spokesperson for the coalition, said. “But what would he do with the rest of the 70 million Egyptians who will follow us afterwards?”

In an interview published in several Egyptian dailies earlier, Suleiman warned of the possible consequences if talks with the opposition were to fail.

“We want to avoid a hasty and irrational putsch,” he said. “Dialogue is the right way to achieve stability and resolve the current crisis peacefully.”

Foreign Minister Guido WesterwelleWesterwelle called for an end to the state of emergency

Camped out

Thousands of demonstrators remained in Cairo’s Tahrir Square on Wednesday, a day after one of the biggest rallies so far to demand the resignation of Egyptian President Hosni Mubarak.

Several hundred thousand protesters attended Tuesday’s rally, and opposition groups hope to attract a similar number for the next major demonstration, planned for Friday.

In the meantime, a smaller number of protesters have been camped out, spending the night in makeshift shelters in the square.

Concessions fail to impress

The protests continue despite pledges of reform from Mubarak’s government. The president has appointed a committee to draft amendments to the country’s constitution, which, among other things, would set term limits on the presidency.

Another committee has been set up to investigate last week’s attacks on anti-Mubarak demonstrators, which left at least 11 people dead and hundreds of others injured.

These concessions clearly don’t go far enough for the protesters, who are pledging to keep up the pressure until Mubarak agrees to step down immediately.

“There can be no negotiation until he leaves. After he leaves we can talk about all sorts of things,” Essam Magdi, a 35-year-old lawyer told the AFP news agency.

The president continues to reject this demand, insisting he will remain in office until his term ends in September.

A shared goal

But the president is also coming under increasing international pressure.

Omar SuleimanSuleiman warned of a possible putschGerman Foreign Minister Guido Westerwelle on Wednesday urged the Egyptian government to repeal a state of emergency, which allows the authorities to detain people without bringing charges against them.

“The announcements count for little, it’s only actions that really count,” Westerwelle told the Bundestag during a debate on the situation in Egypt. He also called for an end to all forms of intimidation of anti-government demonstrators and journalists. The foreign minister reiterated Germany’s offer of help in establishing democratic structures in Egypt.

Westerwelle’s was speaking just hours after US Vice President Joe Biden spoke to Suleiman, to urge him to work with opposition groups to forge a “road map” for a swift and orderly transition of power. He also called on the Egyptian government to revoke the state of emergency.

The European Union has also stressed the need for reform and an orderly transition of power in Egypt. In a speech to the United Nations Security Council, the EU’s high representative for foreign affairs, Catherine Ashton, called for genuine dialogue and free and fair elections.

She also pledged what she described as “practical support” for this process in both Egypt and Tunisia, where a wave of protests forced President Zine El Abidine Ben Ali to flee the country last month.

However both Biden and Ashton stopped short of calling on the Egyptian president to step down immediately.

#b#

No to German hospital stay

The German government on Wednesday also put an end to speculation that President Mubarak could leave Egypt for treatment at a German hospital.

“Not only has there been no official or unofficial request made to the German government in this regard. There has not been any official or unofficial offer,” said a spokesman in Berlin.

Vice President Suleiman also rejected the idea, saying that “the president doesn’t require any medical treatment. He was responding to speculation that a hospital stay in Germany could be used as a way of ending Mubarak’s term in office early.

The Egyptian president has received medical care in Germany on more than one occasion, most recently in March of last year.

 

February 9, 2011 Posted by | Uncategorized | Leave a comment

EU calls for immediate transition as ‘Day of Departure’ protests grow

Hundreds of thousands of protesters in Egypt have gathered for the ‘Day of Departure’ rallies. European Union leaders meeting in

Mass ‘Day of Departure’ protests are underway across Egypt
Hundreds of thousands of protesters in Egypt have gathered for the ‘Day of Departure’ rallies. European Union leaders meeting in Brussels have called on the regime to start an orderly transition of power immediately.

Hundreds of thosands of people are taking part in mass protests, dubbed the “Day of Departure” demonstrations, to force Egyptian President Hosni Mubarak to quit after he said he would like to step down but fears ensuing chaos.

At least 13 people were reported killed in the past two days of violence. Egypt’s health ministry said on Friday that at least 5,000 others have been injured since the unrest began last week.

Embattled President Mubarak said Thursday that if he stepped down now the country would be plunged into chaos. In an interview with US network ABC, Mubarak said he was “fed up” with ruling Egypt, but feared the consequences of leaving office.
“After 62 year in public service, I have had enough. I want to go,” he said. “I don’t care what people say about me. Right now, I care about my country, I care about Egypt.” “If I resign today, there will be chaos,” he added.

Meanwhile the US is said to be discussing various scenarios with the Egyptian regime for a swift transition of power, including Mubarak’s immediate departure.

“We have discussed with the Egyptians a variety of different ways to move that process forward, but all of those decisions must be made by the Egyptian people,” Tommy Vietor, spokesman for the White House National Security Council, said.

Suleiman became Mubarak’s first-ever deputy
The New York Times reported that one such proposal would see power being handed over to a transitional government backed by the military and headed by Vice President Omar Suleiman.

The Egyptian secretary-general of the Arab League, Amr Moussa, has said he would consider running for the presidency. “I’m at the disposal of my country of course. But we will see the political developments,” he told a French radio network. He added that he didn’t expect Mubarak to step down immediately. “I don’t think he will leave. I think he will stay until the end of August.”

International concern

Germany has called in Egypt’s ambassador to protest against the violent treatment of peaceful demonstrators and foreign journalists. A foreign ministry spokeman said “attacks on German citizens and foreign journalists are not acceptable.”

EU leaders meeting in Brussels issued a joint statement urging the authorities to meet the people’s aspirations with “reform, not repression,” and called for an immediate transfer of power. “All parties should show restraint and avoid further violence and begin an orderly transition to a broad-based government. The European Council underlined that this transition process must start now.”

UN chief Ban Ki-moon has urged an orderly transition of power
UN chief Ban Ki-moon also called for an “orderly and peaceful” transition of power in Egypt. In an interview with the German news agency dpa, he said the UN had warned the Arab world for years about its democratic deficits. The unrest, he said, was the “expression of such frustrations from the lack of freedom.”

Author: Rob Mudge (dpa, AFP, Reuters)
Editor: Andreas Illmer

have called on the regime to start an orderly transition of power immediately. »

February 4, 2011 Posted by | Uncategorized | Leave a comment