News Roundup: New and Noteworthy Information
Mild cognitive impairment (MCI) may affect more men than women. A study published in the September 7 Neurology found that MCI was 1.5 times higher in men, compared with women. For the study, part of the Mayo Clinic Study of Aging, 2,050 people between the ages of 70 and 89 in Olmstead County, Minnesota, were interviewed about memory and tested on memory and thinking skills. Nearly 14% of the participants had MCI, about 10% had dementia, and 76% had normal memory and thinking skills. MCI was detected in 19% of men, compared with 14% of women. Study participants who had a low level of education or were never married also had a higher rate of MCI. “The finding that the frequency of MCI is greater in men was unexpected, since the frequency of Alzheimer’s disease is actually greater in women. It warrants further study,” said study author Ronald Petersen, MD, PhD.
Family members and close friends are more sensitive to early signs of Alzheimer’s dementia than traditional screening tests, according to a study published online September 7 in the journal Brain. Data from the two-minute Ascertain Dementia 8 (AD8) questionnaire, which uses an informant to evaluate cognitive changes and difficulties with activities of daily living, were collected for 257 individuals, who were also tested using the Mini Mental State Examination (MMSE). Study subjects were also evaluated for biomarkers using spinal fluid assays and amyloid imaging. Results showed that the AD8’s results corresponded with biomarker results more consistently than did the MMSE’s results. “The AD8 gives us a brief and very low-cost alternative that takes a few minutes of the informant’s time to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer’s disease,” said lead investigator John C. Morris, MD.
Mild memory loss is not a part of normal aging, according to a study in the September 15 Neurology. Investigators reported that even the very early, mild changes in memory that are much more common in old age than dementia are caused by the same brain lesions associated with Alzheimer’s disease and other dementias. As part of Rush University’s Religious Orders Study, more than 350 nuns, priests, and brothers completed up to 13 years of annual cognitive testing. Postmortem brains were examined for neurofibrillary tangles, cerebral infarction, and Lewy bodies. The last four to five years of life showed a very rapid decline; preceding years showed a much more gradual decline that would be described as normal aging. Pathologic lesions were related to the rapid decline. Pathology was very strongly predictive of the mild changes in cognitive function. Higher tangle density adversely affected all forms of cognition at all trajectory points. Both Lewy bodies and stroke approximately doubled the rate of gradual memory decline.
Aerobic fitness may relate to the structure and function of the preadolescent brain, according to findings published in the October 28 Brain Research. Among 49 children ages 9 and 10, those who were more physically fit tended to have a bigger hippocampus and perform better on memory tests than their less-fit peers. Researchers used MRI to investigate whether higher- and lower-fit 9- and 10-year-olds showed differences in hippocampal volume and if the differences were related to performance on an item and relational memory task. Higher-fit children showed greater bilateral hippocampal volumes and superior relational memory task performance compared to lower-fit children. Hippocampal volume was positively associated with performance in the relational but not the item memory task. Bilateral hippocampal volume was found to mediate the relationship between fitness level (VO2 max) and relational memory.
The 2009 pandemic influenza A (H1N1) caused a higher rate of neurologic complications in children than the seasonal flu, according to a report in the September Annals of Neurology. Children younger than 19 who were hospitalized with H1N1 and neurologic complications between April 1 and November 20, 2009, were included in a retrospective study. The comparison group comprised records of children hospitalized with seasonal flu and neurologic complications from July 1, 2004, to June 30, 2008. A total of 303 children with 2009 H1N1 were identified, of whom 18 experienced neurologic complications. About 80% of these patients had an underlying medical condition (66% neurologic). The most common neurologic symptoms were seizures (67%) and encephalopathy (50%). The comparison group included 234 children, 16 of whom experienced neurologic complications. Only 25% of the comparison group had underlying medical conditions.
Results of a multicenter, prospective, randomized, blinded feasibility trial indicate that occipital nerve stimulation shows promise for treating medically refractory chronic migraine. In the Occipital Nerve Stimulation for the Treatment of Intractable Migraine (ONSTIM) study, eligible patients received an occipital nerve block. Responders were then randomized to adjustable stimulation, preset stimulation, or medical management. Seventy-five of 110 subjects were assigned to a treatment group. Complete diary data were available for 66. Response was defined as a 50% or greater reduction in the number of headache days per month or a 3-point or greater drop in average overall pain intensity compared with baseline. Three-month responder rates were 39% for adjustable stimulation, 6% for preset stimulation, and 0% for medical management. Study results were published September 29 in an online ahead of print edition of Cephalalgia.
