In this issue of Neurology Now, I'm delighted to bring you some news from the 63rd Annual Meeting of the American Academy of Neurology, being held April 9-16 in Honolulu, HI. More than 10,000 neurologists are gathering to learn the most up-to-date information about diagnosing, treating, and managing all types of neurologic disorders. Here are a few highlights from the meeting.
People with problems in thinking and memory may have a higher stroke risk than people without these problems. In a study of nearly 18,000 people, cognitive tests were given to people who had never had a stroke. These people were then contacted twice a year by phone for almost five years to determine whether they had developed a stroke. Overall, those who scored in the bottom 20 percent on cognitive tests were about three and a half times more likely to have a stroke over the follow-up period than those who scored in the top 20 percent. People in their fifties who scored in the bottom 20 percent were nearly 10 times more likely to develop a stroke. This held true when other factors that increase stroke risk were taken into account.
It's unclear whether these kinds of cognitive problems pose a real risk factor for stroke or are the result of sub-clinical damage to the brain, sometimes called “mini-strokes,” that do not in and of themselves cause typical stroke symptoms. Such cognitive impairments may really be a symptom of subclinical vascular disease—in other words, as-yet undetected diseases of the blood vessels.
Another study suggests that subclinical vascular damage to the brain may in fact be the cause of cognitive impairment. Researchers found that people in their fifties at high risk for cardiovascular disease had poorer cognitive function in middle age, with a faster rate of cognitive decline over 10 years. The researchers determined cardiovascular risk by considering these factors: age, gender, HDL cholesterol, total cholesterol, blood pressure, smoking, and diabetes. This suggests that people with cognitive problems should do all they can to decrease all treatable risk factors for stroke—not only to prevent stroke, but also to preserve cognitive function.
Warm weather is known to worsen symptoms in people with multiple sclerosis (MS). A new study looked specifically at its effect on thinking. The research team did cognitive testing on a small number of people with MS and those without the disease. Those with MS scored 70 percent better on cooler days than on warmer days. This difference was not seen in people without MS. More research is needed to confirm this finding, but these results suggest that keeping cool during warm weather could improve cognitive skills in people with MS.
Many researchers are working on ways to prevent Parkinson's disease (PD). One study involving 50,000 men and 80,000 women showed that men and women who regularly eat berries may have a lower risk of developing PD. The risk for developing PD in men was further decreased by eating flavonoid-rich foods such as apples, citrus, tea, chocolate, and red wine.
A different study showed that people who reported using the amphetamines benzedrine and dexedrine were nearly 60 percent more likely to develop PD than those who did not use these drugs. Benzedrine and dexedrine are often prescribed to treat attention deficit disorder, narcolepsy, and traumatic brain injuries—and are also drugs of abuse. More research is needed to confirm this finding and understand how these drugs increase PD risk.
It's reassuring that such good work is being done to better understand neurologic disorders and to find better ways to diagnose and treat people with those disorders. My hope is that this work will translate into better care for all of us in the near future.
Take good care,
Robin L. Brey, M.D.