New and Noteworthy Information—August 2015
Incident stroke is associated with an acute decline in cognitive function and accelerated and persistent cognitive decline over six years, according to a study published July 7 in JAMA. Researchers used data from 23,572 cognitively healthy participants age 45 or older from the Reasons for Geographic and Racial Differences in Stroke study. Participants resided in the United States, were enrolled in the study from 2003 through 2007, and were followed up through March 31, 2013. In all, 515 participants survived expert-adjudicated incident stroke, and 23,057 remained stroke-free. Stroke was associated with acute decline in global cognition, new learning, and verbal memory. Participants with stroke, compared with those without stroke, had faster declines in global cognition and executive function, but not in new learning and verbal memory, compared with prestroke changes.
Childhood adversities are associated with migraine, and greater numbers of adversities are associated with increasing odds of migraine, according to a study published online ahead of print June 23 in Headache. Researchers used a representative sample of 10,358 men and 12,638 women and performed gender-specific logistic regression analyses to determine the association between number and type of self-reported childhood adversities and migraine, while controlling for sociodemographics, comorbid adversities, health behaviors, depression, and anxiety. Overall, 6.5% of men and 14.2% of women reported migraines. Physical abuse, witnessing parental domestic violence, and sexual abuse were significantly associated with migraine for both genders, even after controlling for variables. Men reporting all three adversities had more than three times the odds of migraine, compared with those without childhood adversities.
Full truncal vagotomy is associated with a decreased risk for subsequent Parkinson’s disease, suggesting that the vagal nerve may be involved in the pathogenesis of Parkinson’s disease, according to a study published online ahead of print May 29 in Annals of Neurology. Researchers constructed cohorts of all patients in Denmark who underwent vagotomy from 1977 through 1995, and a matched general population cohort. Investigators used Cox regression analysis to compute hazard ratios for Parkinson’s disease, adjusting for potential confounders. Risk of Parkinson’s disease was decreased in patients who underwent truncal vagotomy, compared with superselective vagotomy. Risk of Parkinson’s disease also was decreased following truncal vagotomy when compared with the general population cohort. In patients who underwent superselective vagotomy, risk of Parkinson’s disease was similar to that of the general population.
In women with acute ischemic stroke treated with alteplase, uric acid reduced infarct growth in selected patients and was better than placebo for reaching excellent outcome, according to a study published online ahead of print July 9 in Stroke. Researchers reanalyzed 2014 data from the randomized, double-blind URICO-ICTUS trial of patients admitted to Spanish stroke centers. Participants included 206 women and 205 men. All participants received therapies to remove the clots, while half in each gender group also received either 1,000 mg of uric acid IV or placebo. Uric acid doubled the effect of placebo to achieve excellent outcome in women, but not in men. The interactions between treatment and serum uric acid levels or allantoin–uric acid ratio on infarct growth were significant only in women.
Women with epilepsy are at a heightened risk for adverse outcomes during their delivery hospitalizations, according to a study published online ahead of print July 6 in JAMA Neurology. Researchers examined a retrospective cohort study of pregnant women identified through delivery hospitalization records from the 2007 through 2011 Nationwide Inpatient Sample. Investigators obtained a weighted sample of delivery hospitalizations from 69,385 women with epilepsy and 20,449,532 women without epilepsy. Women with epilepsy had a risk of death during delivery hospitalization of 80 deaths per 100,000 pregnancies, compared with six deaths per 100,000 pregnancies among controls. Women with epilepsy also were at increased risk for pre-eclampsia, preterm labor, and stillbirth. They also had increased health care utilization, including an increased risk of cesarean delivery and prolonged hospital stay.
Eight-hour sleep duration may help consolidate newly learned procedural and declarative memories and ensure full access to them during periods of subjective stress, according to a study published online ahead of print June 22 in Sleep. For this study, 15 healthy young men learned object locations and a finger tapping sequence in the evening. Participants either had the opportunity to sleep for eight hours or could sleep between the hours of 3:00 am and 7:00 am. Retrieval of both memory tasks was tested in the morning after each sleep condition, both before and after stress exposure. Post-sleep memory changes did not differ between sleep conditions. Men who received less sleep, however, had reduced recall ability after exposure to stress, while post-stress recall was not affected in those who received a full night of sleep.
