The evidence for a beneficial effect of a Mediterranean style diet (MedDiet) on brain health grows on a regular basis.For those interested in a good summary of the effects of the MedDiet on cognition, I recommend reading the free full text review recently published in Frontiers in Neuroscience.In this review, Roy Hardman and colleagues searched for research studies on cognition and the Mediterranean diet published between 2000 and 2015.A figure in the review proposed several mechanisms where com........ Read more »
Hardman RJ, Kennedy G, Macpherson H, Scholey AB, & Pipingas A. (2016) Adherence to a Mediterranean-Style Diet and Effects on Cognition in Adults: A Qualitative Evaluation and Systematic Review of Longitudinal and Prospective Trials. Frontiers in nutrition, 22. PMID: 27500135
Entorhinal Cortex Highlighted in BluePrevious posts in this blog have highlighted some the research related to links between brain health and elements of the Mediterranean diet.I want to inform readers of a new important research study from the Mayo Clinic.In this study, researchers completed brain cortical thickness analyses on 672 cognitively normal adults. It is generally accepted that greater cortical thickness relates to improved cognitive performance.The participants completed an extensive........ Read more »
Staubo SC, Aakre JA, Vemuri P, Syrjanen JA, Mielke MM, Geda YE, Kremers WK, Machulda MM, Knopman DS, Petersen RC.... (2016) Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness. Alzheimer's . PMID: 27461490
This is a very interesting trial that may surprise the many outspoken amiodarone advocates, but it should not surprise anyone who pays attention to research.
ALPS showed that we should stop giving amiodarone for unwitnessed shockable cardiac arrest. The lead researcher is still trying to spin amiodarone for witnessed shockable cardiac arrest, even though the results do not show improvement in the one outcome that matters – leaving the hospital with a brain that still works.,,... Read more »
Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW.... (2016) Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. The New England journal of medicine, 374(18), 1711-22. PMID: 27043165
Ortiz M, Martín A, Arribas F, Coll-Vinent B, Del Arco C, Peinado R, Almendral J, & PROCAMIO Study Investigators. (2016) Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study. European heart journal. PMID: 27354046
Marill KA, deSouza IS, Nishijima DK, Senecal EL, Setnik GS, Stair TO, Ruskin JN, & Ellinor PT. (2010) Amiodarone or procainamide for the termination of sustained stable ventricular tachycardia: an historical multicenter comparison. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 17(3), 297-306. PMID: 20370763
Marill KA, deSouza IS, Nishijima DK, Stair TO, Setnik GS, & Ruskin JN. (2006) Amiodarone is poorly effective for the acute termination of ventricular tachycardia. Annals of emergency medicine, 47(3), 217-24. PMID: 16492484
Tomlinson DR, Cherian P, Betts TR, & Bashir Y. (2008) Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?. Emergency medicine journal : EMJ, 25(1), 15-8. PMID: 18156531
Kułakowski P, Karczmarewicz S, Karpiński G, Soszyńska M, & Ceremuzyński L. (2000) Effects of intravenous amiodarone on ventricular refractoriness, intraventricular conduction, and ventricular tachycardia induction. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2(3), 207-15. PMID: 11227590
Bonny A, De Sisti A, Márquez MF, Megbemado R, Hidden-Lucet F, & Fontaine G. (2012) Low doses of intravenous epinephrine for refractory sustained monomorphic ventricular tachycardia. World journal of cardiology, 4(10), 296-301. PMID: 23110246
Kowey PR. (1988) The calamity of cardioversion of conscious patients. The American journal of cardiology, 61(13), 1106-7. PMID: 3364364
Should we have people providing "fake" acupuncture in the Emergency Department?
If so, how should we do this?
Since it is not the acupuncture, but the patient's reaction to the "ceremony of the placebo" that appears to be providing the pain relief, how many different ways might we vary the "treatment" to improve the placebo effect?... Read more »
Grissa, M., Baccouche, H., Boubaker, H., Beltaief, K., Bzeouich, N., Fredj, N., Msolli, M., Boukef, R., Bouida, W., & Nouira, S. (2016) Acupuncture vs intravenous morphine in the management of acute pain in the ED. The American Journal of Emergency Medicine. DOI: 10.1016/j.ajem.2016.07.028
Espay, A., Norris, M., Eliassen, J., Dwivedi, A., Smith, M., Banks, C., Allendorfer, J., Lang, A., Fleck, D., Linke, M.... (2015) Placebo effect of medication cost in Parkinson disease: A randomized double-blind study. Neurology, 84(8), 794-802. DOI: 10.1212/WNL.0000000000001282
Waber RL, Shiv B, Carmon Z, Ariely D. (2008) Commercial Features of Placebo and Therapeutic Efficacy. JAMA, 299(9), 1016. DOI: 10.1001/jama.299.9.1016
Cherkin, D., Sherman, K., Avins, A., Erro, J., Ichikawa, L., Barlow, W., Delaney, K., Hawkes, R., Hamilton, L., Pressman, A.... (2009) A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain. Archives of Internal Medicine, 169(9), 858. DOI: 10.1001/archinternmed.2009.65
Goldman, R., Stason, W., Park, S., Kim, R., Schnyer, R., Davis, R., Legedza, A., & Kaptchuk, T. (2008) Acupuncture for Treatment of Persistent Arm Pain Due to Repetitive Use. The Clinical Journal of Pain, 24(3), 211-218. DOI: 10.1097/AJP.0b013e31815ec20f
A recent study by Whitworth et al. (2016) reports five new cases of multiple germline mutations in inherited cancer syndrome genes, three of them involve the combination of mutations in FLCN with NF1, TP53, and MSH2, respectively.... Read more »
Whitworth J, Skytte AB, Sunde L, Lim DH, Arends MJ, Happerfield L, Frayling IM, van Minkelen R, Woodward ER, Tischkowitz MD.... (2016) Multilocus Inherited Neoplasia Alleles Syndrome: A Case Series and Review. JAMA oncology, 2(3), 373-9. PMID: 26659639
In a Brain Post from 2012 I reviewed a study of fatigue in elite athletic performance. This study supported a key role in the brain insula in regulating the perception of exercise-induced fatigue. You can access this post by clicking HERE.An update on this topic was recently published in PloS One by a research team in Australia.This study compared performance on a cognitive task after extreme 20 minute cycling time trial. Professional cyclists were compared to recreational cyclists on the Stroop........ Read more »
Martin K, Staiano W, Menaspà P, Hennessey T, Marcora S, Keegan R, Thompson KG, Martin D, Halson S, & Rattray B. (2016) Superior Inhibitory Control and Resistance to Mental Fatigue in Professional Road Cyclists. PloS one, 11(7). PMID: 27441380
Renal cell carcinoma (RCC) is the most common type of kidney cancer and although the majority of cases are sporadic approximately 3% of cases are caused by genetic conditions such as BHD, VHL, HLRCC and TSC (Randall et al., 2014). These inherited forms of RCC have provided great insights into sporadic cancer genetics. BHD patients can develop multiple kidney tumours. In most cases these tumours are small local RCCs that can be surgically removed. However, these treatments are not without risk,........ Read more »
Randall JM, Millard F, & Kurzrock R. (2014) Molecular aberrations, targeted therapy, and renal cell carcinoma: current state-of-the-art. Cancer metastasis reviews, 33(4), 1109-24. PMID: 25365943
In my last post I summarized a review of the pharmacology of the drug dextromethorphan.This drug is receiving significant attention for disorders in neuroscience medicine. A phase 2 clinical trial of dextromethorphan-quinidine (DM-Q) was published last fall in JAMA.Here are the key design and results from this study:Subjects: 220 subjects with a diagnosis of probable Alzheimer's disease with clinically significant agitation.Randomization Design: This was a five week trial of 3:4 random........ Read more »
Cummings JL, Lyketsos CG, Peskind ER, Porsteinsson AP, Mintzer JE, Scharre DW, De La Gandara JE, Agronin M, Davis CS, Nguyen U.... (2015) Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial. JAMA, 314(12), 1242-54. PMID: 26393847
Inappropriate uncontrollable laughing or crying is common in many neuroscience medicine disorders including after traumatic brain injury or stroke. It can be socially embarrassing and restrict opportunities for social interaction.This loss of control over emotional responses is known by the term pseudobulbar affect or PBA. Until recently, few therapeutic options were available to treat this condition. Now a relatively new drug Nuedexta uses a combination of dextromethorphan and quinide to treat ........ Read more »
Taylor CP, Traynelis SF, Siffert J, Pope LE, & Matsumoto RR. (2016) Pharmacology of dextromethorphan: Relevance to dextromethorphan/quinidine (Nuedexta®) clinical use. Pharmacology . PMID: 27139517
My photo of Mozart No one denies the importance of public education. Raising graduation rates and academic ability in the general population are highly accepted education system goals. Additionally, identification of learning disorders and the barriers to academic progress are the focus of many.However, the study of the gifted is perhaps no less important but this topic receives less attention and research.Matthew Makel and colleagues at Duke University and Vanderbi........ Read more »
Makel MC, Kell HJ, Lubinski D, Putallaz M, & Benbow CP. (2016) When Lightning Strikes Twice: Profoundly Gifted, Profoundly Accomplished. Psychological science. PMID: 27225220
Kell HJ, Lubinski D, Benbow CP, & Steiger JH. (2013) Creativity and technical innovation: spatial ability's unique role. Psychological science, 24(9), 1831-6. PMID: 23846718
Dong et al., (2016) have recently reported two BHD syndrome patients also affected with papillary thyroid cancer. Lesions were bilateral and multifocal and small lymph node metastases occurred. Due to the small number of patients in the study the authors are unsure whether thyroid cancer in BHD patients is susceptible to exhibiting bilaterally and lymph node metastasis. However, they suggest considering thyroidectomy and prophylactic lymph node dissection for thyroid cancer patients with BHD. Th........ Read more »
Dong L, Gao M, Hao WJ, Zheng XQ, Li YG, Li XL, & Yu Y. (2016) Case Report of Birt-Hogg-Dubé Syndrome: Germline Mutations of FLCN Detected in Patients With Renal Cancer and Thyroid Cancer. Medicine, 95(22). PMID: 27258496
As basic and clinical sciences advance, it becomes increasing important to understand the role of multidisciplinary efforts in scientific progress. In this post, I propose rethinking and renaming the medically-related neuroscience disciplines into a new specialty called neuroscience medicine.Basic neuroscience research has evolved and emerged as a powerful discipline due to the increasing use of multidisciplinary research teams. Basic neuroscience involves collaboration of various scientifi........ Read more »
I spent the majority of my career in medical education and saw significant changes over time.One encouraging sign was the emergence of neuroscience as a respected and beneficial academic discipline.Now, a new perspective on Neuroscience Training for the 21st Center has been written by Huda Akil and colleagues. This perspective is recently published in the journal Neuron with free access to the full-text manuscript.Here are my notes from reading this perspective. Readers can access the free full-........ Read more »
The development of speech and language impairment in dementia presents barriers in many clinical domains.One important clinical domain is assessment and management of pain. Dementia may preclude spontaneous or interview-elicited pain reporting.A report today in MedicalXpress noted reduced reporting of pain in patients with diabetes and cognitive impairment.I was able to locate one free full-text manuscript reviewing the prevalence of pain in various types of dementias. This literature review fou........ Read more »
van Kooten J, Binnekade TT, van der Wouden JC, Stek ML, Scherder EJ, Husebø BS, Smalbrugge M, & Hertogh CM. (2016) A Review of Pain Prevalence in Alzheimer's, Vascular, Frontotemporal and Lewy Body Dementias. Dementia and geriatric cognitive disorders, 41(3-4), 220-32. PMID: 27160163
The topic prevention of brain disorders is commonly neglected. This is despite increasing evidence for evidence-based support for prevention opportunities.This issue is highlighted in a recent study out of Finland that examined prenatal nicotine metabolite levels and offspring diagnosis of schizophrenia.In this study, Solja Niemela and the Finnish research team examined all live births in Finland between 1983 and 1998.What makes this study powerful is the measurement of maternal serum coti........ Read more »
Niemelä, S., Sourander, A., Surcel, H., Hinkka-Yli-Salomäki, S., McKeague, I., Cheslack-Postava, K., & Brown, A. (2016) Prenatal Nicotine Exposure and Risk of Schizophrenia Among Offspring in a National Birth Cohort. American Journal of Psychiatry. DOI: 10.1176/appi.ajp.2016.15060800
Talati A, Bao Y, Kaufman J, Shen L, Schaefer CA, & Brown AS. (2013) Maternal smoking during pregnancy and bipolar disorder in offspring. The American journal of psychiatry, 170(10), 1178-85. PMID: 24084820
An investigational app and online program to reduce alcohol intake is now available free to the public.This tool is an application of cognitive bias modification. A link to a study supporting cognitive bias modification is noted in the citation below. Click on the PMID link to get to the abstract.The program uses a 15 minutes per day tool for four days.The program was developed at the London School of Economics by Professor Paul Dolan.Users who sign up to use the tool will be providing data to f........ Read more »
Gladwin TE, Rinck M, Eberl C, Becker ES, Lindenmeyer J, & Wiers RW. (2015) Mediation of cognitive bias modification for alcohol addiction via stimulus-specific alcohol avoidance association. Alcoholism, clinical and experimental research, 39(1), 101-7. PMID: 25623410
In my daily review of neuroscience news I ran across an article flu vaccination and dementia risk in heart failure.This study was reported at the 3rd World Congress on Acute Heart Failure by Dr. Ju-Chi Liu from Taipei Medical University.So how might influenza vaccination be related to dementia risk? We do know acute influenza infection reaches the brain causing headache and increasing brain inflammation, at least temporarily. We also know brain inflammation may be involved in the mechanism........ Read more »
Liu JC, Hsu YP, Kao PF, Hao WR, Liu SH, Lin CF, Sung LC, & Wu SY. (2016) Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients: A Population-Based Cohort Study. Medicine, 95(9). PMID: 26945371
A free full-text commentary in the Lancet summarizes recent evidence of the benefit of aspirin in stroke prevention.This commentary focused on what is called secondary prevention. Secondary prevention is defined as prevention following events related to the disease in question.So secondary prevention in stroke would be reduction in stroke risk in those who have had a stroke or pre-stroke syndromes such as transient ischemic attacks (TIA).The key take-home message from the commentary by Graeme Ha........ Read more »
Hankey, G. (2016) The benefits of aspirin in early secondary stroke prevention. The Lancet. DOI: 10.1016/S0140-6736(16)30511-6
Well-designed large population-based studies of the prevalence and correlates of learning disabilities in preschool children are rare.A research group working out of University College London has address that issues with a large study of language disorder in a group of over 7000 4 and 5 year olds in England.A stratified group of 529 children received a comprehensive assessment of language along with assessment of IQ, social, emotional and behavior function.The study found the following important........ Read more »
Norbury, C., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., Vamvakas, G., & Pickles, A. (2016) The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. Journal of Child Psychology and Psychiatry. DOI: 10.1111/jcpp.12573
The Harvard-based Nurses' Health Study has been a remarkably productive longitudinal health study.My wife has been a subject in this study and frequently completes interval questionnaires regarding her health status.A recent publication looked at the relationship between religious service attendance and mortality in the Nurses's Health Study cohort.This manuscript tried to provide a more valid look at the relationship between religiosity/spirituality and health. Previous studies have found a lin........ Read more »
Li, S., Stampfer, M., Williams, D., & VanderWeele, T. (2016) Association of Religious Service Attendance With Mortality Among Women. JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2016.1615
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