Best And Worst In Health and Healthcare – March 2016




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The best news from March is that spring has sprung in the northern hemisphere! Spring is a great time to go outside and get active, which, as March showed us yet again, will only do you good.

Health and healthcare research also brought us good news in the form of new diagnostic tools and new therapies. But as always, there are also bad news. Here’s a selection of the best and worst news I came across in March. Comments are welcome!

THE BEST

Aging delayed by exercise

Exercise can greatly benefit our brain’s health by delaying the onset of cognitive decline. In a report published in Neurology in March, it was shown just how powerful exercise can be. The effect of leisure-time physical activity in cognitive performance was determined and it was shown that cognitively decline was significantly less accentuated in physically active subjects. Low levels of physical activity were associated with worse executive function, semantic memory, and processing speed, with a difference that was equal to that of 10 years of aging.

This is a great reminder to stay active.

Exercise increases gray matter volume

Another study assessing the health effects of exercise showed that the beneficial effect of physical activity in the brain may be associated with an increase in gray matter volume.

The article published in the Journal of Alzheimer’s Disease showed that physical activity was associated with larger gray matter volumes in the frontal, temporal, and parietal lobes, as well as in the hippocampus, thalamus, and basal ganglia. High levels of physical activity were also shown to decrease gray matter volume loss associated with neurodegeneration.

tDCS for stroke recovery

Rehabilitation of movement after stroke requires practice and time from brain changes to occur. In a new study found in Science Translational Medicine, it was tested whether transcranial direct current stimulation (tDCS) could improve movement in stroke patients.

The authors found that patients who received tDCS did indeed show a greater improvement in movement. These benefits were maintained for several months after motor training. According to these findings, brain stimulation may be an effective alternative therapy to improve clinical outcomes in stroke patients. Furthermore, it shows yet another application of tDSC.

A simple test to detect concussions

The symptoms of a concussion or traumatic brain injury are not always obvious and can sometimes be identifiable only after a few days. An early detection can allow a more effective treatment and may prevent the development of long-term problems. There are two proteins, GFAP and UCH-L1, whose presence in the blood has been proposed as a possible marker of brain injury.

In a new study published in JAMA Neurology, which aimed at determining the diagnostic accuracy of these proteins over time and their applicability in the clinical practice, it was shown that both GFAP and UCH-L1 were indeed detectible in the blood of trauma patients within 1 hour of injury, allowing the detection of mild to moderate traumatic brain injury and intracranial lesions. This can therefore be a very simple and accurate new diagnostic tool.

Voluntary imitation is preserved in Alzheimer’s patients

Cognitive impairment is the most notorious effect of Alzheimer’s disease. One of its consequences is an altered communication capacity in advanced stages of the disease. However, in mild to moderate stages, communication and social interaction abilities may still be preserved. Automatic imitation, an involuntary predisposition to copy observed actions, is one of the features that seems to be preserved. Voluntary imitation mechanisms requiring attention to another person’s actions, on the other hand, seem to be more easily affected by the disease.

Research published in Frontiers in Aging Neuroscience aimed at determining if this skill was indeed affected in Alzheimer’s patients. It was shown that Alzheimer’s patients in mild and moderate stages of the disease maintained an intact ability to reproduce observed movements, particularly when those were performed by a human agent instead of a computer. These results show that the high-level cognitive processes required for voluntary imitation are preserved in mild and moderate stages of Alzheimer’s disease and that they may be used in interpersonal communication.

THE WORST

Transient amnesia induced by fatigue

Working long hours and being sleep deprived can easily induce fatigue – this is quite common in healthcare professionals who have to go through long working shifts. Slower reaction times, decreased performance, and impaired judgment are among the most common consequences of fatigue.

But a new report published in the journal Cortex adds another consequence: transient amnesia. This report describes a few cases of healthcare professionals who had to attend to attention-demanding episodes of care, with their decisions being recorded in writing at the time, but completely forgotten some hours later. Although this is rare, the fact that these cases occurred shows that prolonged wakefulness associated with intensive and intellectually demanding work can lead to transient memory dysfunctions. This may have serious consequences in many professional settings and should be taken into account when long working hours are needed.

Environmental chemicals and neurological diseases

Environmental factors are often associated with the development of numerous diseases. Chemicals released into the environment, namely pesticides, can be particularly harmful. A study published in Nature Communications aimed at pinpointing possible links between neurological diseases and chemicals commonly found in our environment and food.

To do so, the authors exposed neuronal cell cultures to hundreds of pesticides, fungicides and other chemicals, and evaluated the molecular changes that those chemicals induced in neurons. It was found that rotenone, a pesticide that had already been associated with Parkinson’s disease risk, and the fungicides pyraclostrobin, trifloxystrobin, famoxadone and fenamidone, by stimulating oxidation and by inducing structural changes in neurons, led to pathological alterations that resembled those observed in brain samples from humans with autism, advanced age, Alzheimer’s disease and Huntington’s disease. This study highlights the potential impact of chemicals we can potentially ingest in our brain’s health.

Zika and brain damage

The outbreak of the Zika virus has been all over the news recently, mostly due to its association with a possible increased risk of congenital microcephaly.

In March, The New England Journal of Medicine published a report that further supports this association. It describes a case of a pregnant woman and her fetus who were infected with the Zika virus during the 11th gestational week. In 4 weeks, between the 16th and the 20th week of gestation, the fetal head circumference decreased from the 47th to the 24th percentile, revealing a decrease in the rate of brain growth. Around the 20th week of gestation, substantial brain abnormalities were found, and genetic material from the virus was still present in the mother’s serum. Postmortem analysis of the fetal brain showed thinning of the cerebral cortex and the presence of Zika viral particles and genetic material, supporting its role in inducing severe damage to the fetal brain.

Birth control pills increase the risk of seizures

Birth control pills can have some undesired side-effects including, for example, an increase in blood pressure and in the risk of cardiovascular diseases. Studies have also shown that women with epilepsy who use oral contraceptives report a higher frequency of seizures.

Taking that into account, a new study published in Epilepsy Research investigated the effect of ethinyl estradiol, the primary component of birth control pills, on epileptic seizures in mice. Ethinyl estradiol accelerated the rate of epileptic seizures as well as their severity.  This is an important finding that women should take into account when choosing oral contraceptives as a birth control method.

The long-lasting effects of amphetamine use in adolescence

Amphetamine use can induce a number of behavioral and neurochemical changes by interacting with neurotransmitter release in the brain. New experimental research using rats investigated if amphetamine exposure could induce long-lasting changes in neurochemical transmission in the prefrontal cortex, a brain region which plays a key role in behavioral control.

According to the article published in Neuroscience, the brains of rats exposed to amphetamines, either starting at adolescence or adulthood, showed altered dopamine signaling in the prefrontal cortex associated with functional changes. These changes were more persistent after exposure to amphetamine in the adolescence. This indicates that amphetamine use during adolescence, when the brain is still developing, can have long-lasting detrimental consequences.

References

Allman, C., Amadi, U., Winkler, A., Wilkins, L., Filippini, N., Kischka, U., Stagg, C., & Johansen-Berg, H. (2016). Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke Science Translational Medicine, 8 (330), 330-330 DOI: 10.1126/scitranslmed.aad5651

Bisio, A., Casteran, M., Ballay, Y., Manckoundia, P., Mourey, F., & Pozzo, T. (2016). Voluntary Imitation in Alzheimer’s Disease Patients Frontiers in Aging Neuroscience, 8 DOI: 10.3389/fnagi.2016.00048

Dharia, S., & Zeman, A. (2016). Fatigue amnesia Cortex DOI: 10.1016/j.cortex.2016.03.001

Driggers, R., Ho, C., Korhonen, E., Kuivanen, S., Jääskeläinen, A., Smura, T., Rosenberg, A., Hill, D., DeBiasi, R., Vezina, G., Timofeev, J., Rodriguez, F., Levanov, L., Razak, J., Iyengar, P., Hennenfent, A., Kennedy, R., Lanciotti, R., du Plessis, A., & Vapalahti, O. (2016). Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities New England Journal of Medicine DOI: 10.1056/NEJMoa1601824

Kang, S., Paul, K., Hankosky, E., Cox, C., & Gulley, J. (2016). D1 receptor-mediated inhibition of medial prefrontal cortex neurons is disrupted in adult rats exposed to amphetamine in adolescence Neuroscience, 324, 40-49 DOI: 10.1016/j.neuroscience.2016.02.064

Papa, L., Brophy, G., Welch, R., Lewis, L., Braga, C., Tan, C., Ameli, N., Lopez, M., Haeussler, C., Mendez Giordano, D., Silvestri, S., Giordano, P., Weber, K., Hill-Pryor, C., & Hack, D. (2016). Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury JAMA Neurology DOI: 10.1001/jamaneurol.2016.0039

Pearson, B., Simon, J., McCoy, E., Salazar, G., Fragola, G., & Zylka, M. (2016). Identification of chemicals that mimic transcriptional changes associated with autism, brain aging and neurodegeneration Nature Communications, 7 DOI: 10.1038/ncomms11173

Raji CA, Merrill DA, Eyre H, Mallam S, Torosyan N, Erickson KI, Lopez OL, Becker JT, Carmichael OT, Gach HM, Thompson PM, Longstreth WT, & Kuller LH (2016). Longitudinal Relationships between Caloric Expenditure and Gray Matter in the Cardiovascular Health Study. Journal of Alzheimer’s disease : JAD PMID: 26967227

Willey, J., Gardener, H., Caunca, M., Moon, Y., Dong, C., Cheung, Y., Sacco, R., Elkind, M., & Wright, C. (2016). Leisure-time physical activity associates with cognitive decline: The Northern Manhattan Study Neurology DOI: 10.1212/WNL.0000000000002582

Younus, I., & Reddy, D. (2016). Seizure facilitating activity of the oral contraceptive ethinyl estradiol Epilepsy Research, 121, 29-32 DOI: 10.1016/j.eplepsyres.2016.01.007

Image via skeeze / Pixabay.

Sara Adaes, PhD

Sara Adaes, PhD, has been a researcher in neuroscience for over a decade. She studied biochemistry and did her first research studies in neuropharmacology. She has since been investigating the neurobiological mechanisms of pain at the Faculty of Medicine of the University of Porto, in Portugal. Follow her on Twitter @saradaes
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