New and Noteworthy Information—October 2014
Fish oil may reduce seizure frequency in patients with epilepsy, according to a study published online ahead of print September 8 in the Journal of Neurology, Neurosurgery, and Psychiatry. Twenty-four patients with drug-resistant epilepsy were given three separate treatments for 10 weeks and separated by a six-week period. Participants were given three capsules of fish oil daily, plus three capsules of corn oil (placebo); six capsules of fish oil daily; and three capsules of corn oil twice daily. The average number of seizures among those taking low-dose fish oil was around 12 per month, compared with slightly more than 17 for the high dose, and slightly more than 18 for the placebo. Two people who had the low dose were seizure free during the 10-week trial. No one taking the high-dose fish oil or the placebo was seizure free.
Blood type AB and higher factor VIII (FVIII) are associated with increased incidence of cognitive impairment, according to a study published online ahead of print September 10 in Neurology. Findings are based on a cohort from the REGARDS Study, in which more than 30,000 people were followed for an average of 3.4 years. After adjusting for age, race, region, and sex, the researchers found that people with blood group AB (odds ratio [OR], 1.82) and those with higher FVIII (OR, 1.24) had an increased risk of cognitive impairment. The mean FVIII was higher in people with blood type AB (142 IU/dL), compared with O (104 IU/dL), and FVIII mediated 18% of the association between AB group and incident cognitive impairment, according to the researchers.
Magnesium sulfate administered IV to pregnant women at risk of giving birth before 30 weeks gestation was not associated with neurologic, cognitive, behavioral, growth, or functional outcomes in their children at school age, investigators reported in the September 17 issue of JAMA. Researchers randomly assigned magnesium sulfate or placebo to pregnant women (n = 535 magnesium; n = 527 placebo) for whom birth was planned or expected before 30 weeks gestation; 1,255 fetuses were known to be alive at randomization. Of the 867 survivors available for follow-up, outcomes at school age (6 to 11) were determined for 669 children (77%). The investigators found that receiving antenatal magnesium sulfate was not associated with any long-term benefits or harms, compared with placebo. The study authors also observed a nonsignificant reduction in the risk of death in the magnesium sulfate group.
Older patients with Parkinson’s disease who underwent deep brain stimulation (DBS) had a similar 90-day complication risk, compared with that in younger patients, according to a study published online ahead of print August 25 in JAMA Neurology. Researchers analyzed data from more than 1,750 patients who had DBS from 2000 to 2009. Of those, 7.5% of subjects experienced at least one complication within 90 days of having the device implanted. The investigators determined that increasing age did not significantly affect the overall complication rates. The findings suggest that age alone should not be a primary exclusion factor for determining candidacy for DBS. “Instead, a clear focus on patients with medication-refractory and difficult to control on-off fluctuations with preserved cognition, regardless of age, may allow for an expansion of the traditional therapeutic window,” the researchers concluded.
Confusional arousals are highly prevalent in the general population, according to a study published in the August 26 issue of Neurology. A total of 19,136 people age 18 and older were interviewed about their sleep habits and whether they had experienced symptoms of the disorder. Participants also were asked about any medications they took and about mental illness diagnoses. Results showed that 15% had experienced an episode in the last year, with more than half reporting more than one episode per week. In the majority of cases, 84% of those with confusional arousals (also known as sleep drunkenness) also had a sleep disorder, mental health disorder, or were taking psychotropic drugs. Fewer than 1% of the people with confusional arousals had no known cause or related condition. “These episodes of waking up confused have received considerably less attention than sleepwalking even though the consequences can be just as serious,” stated researchers.
High potassium intake is associated with a lower risk of all stroke and ischemic stroke and all-cause mortality in older women, investigators reported online ahead of print September 4 in Stroke. Researchers studied 90,137 postmenopausal women ages 50 to 79 for an average of 11 years. Women who consumed the most potassium were 10% less likely to die than were those who had consumed the least amount. The women also were 12% less likely to have a stroke and 16% less likely to have an ischemic stroke than were women who consumed the least amount. Those without hypertension who had consumed the most potassium had a 27% lower ischemic stroke risk and 21% reduced risk for all stroke types, compared with women who had the least potassium in their diets. Among women with hypertension, those who consumed the most potassium had a lower risk of mortality.