Patients with Alzheimer’s disease who had more years of education reported the onset of dementia symptoms at an earlier age than did those with fewer years of education in a study published in the January Archives of Neurology. Among two cohorts of patients with Alzheimer’s disease (21,880 and 1,449 participants), age at reported onset of symptoms was consistently younger in those with 12 or more years of education. Patients with eight or fewer years of education were more likely to have severe dementia, however. The mean number of years between onset and first assessment was similar for all levels of education. “Persons with more education may be more likely to be engaged regularly in cognitive tasks or occupational roles that emphasize subtle changes in cognitive function, leading to earlier detection,” suggested the study authors.

Fruits with high levels of phenolics, such as bananas, oranges, and apples, may reduce the risk for neurodegenerative disorders, according to a study in the March Journal of Food Science. Researchers exposed neuron-like PC12 cells to the extracts of the fruits before H₂O₂ treatment and found they had “significant viability,” indicating that the phenolics prevented oxidative stress–induced neurotoxicity. Additional tests by lactate dehydrogenase and trypan blue exclusion assays showed that the extracts reduced oxidative stress–induced neuronal cell membrane damage. The authors suggested that diets rich in fresh fruits might reduce the risk for Alzheimer’s disease.

Low folate concentrations at baseline predicted incident dementia during 2.4 years of follow-up among 518 elderly study participants, as reported in the February 5 online Journal of Neurology, Neurosurgery, and Psychiatry. “The onset of dementia was significantly associated with an exaggerated decline in folate, a weaker increase in vitamin B₁₂ concentrations, and an exaggerated increase in homocysteine concentrations,” although the associations were reduced following adjustment for weight change within the same period, reported the researchers. They suggested that these serum concentration changes may be linked to somatic manifestations of early dementia.

Nabilone, a synthetic cannabinoid, may be effective in reducing pain and improving quality of life in patients with fibromyalgia, according to a study in the February Journal of Pain. Investigators randomized 40 patients with fibromyalgia to receive nabilone (titrated up from 0.5 mg at bedtime to 1 mg twice a day) or a corresponding placebo for four weeks. The nabilone group showed significant improvements on the visual analog scale for pain, on the Fibromyalgia Impact Questionnaire, and in anxiety symptoms at four weeks, versus no significant improvements in the placebo group. The treatment group experienced more side effects per person at weeks 2 and 4; however, the authors concluded that nabilone was well tolerated and “may be a useful adjunct for pain management in fibromyalgia.”

Patients with gliomatosis cerebri have a more favorable prognosis if they have a codeletion of chromosomes 1p and 19q, as reported in the February 19 Neurology. Of 25 patients with gliomatosis cerebri who were treated with temozolomide, those with the codeletion (n = 9) had a higher response rate (88%) than those without the codeletion (n = 16; 25% response rate); progression-free survival and overall survival were also significantly higher (24.5 and 66.8 months, respectively, vs 13.7 and 15.2 months, respectively). The researchers also examined the effect of methylation of the methylguanine methyltransferase promoter on chemosensitivity. Although methylation was associated with the codeletion, and patients with an unmethylated promotor “tended to have a shorter progression-free survival and a higher rate of progressive disease,” the authors concluded that methylation status on gliomatosis cerebri is still unsettled.

Aspirin-resistant patients have a significantly greater risk of clinically important cardiovascular morbidity than do aspirin-sensitive patients, reported researchers in the January 26 BMJ. The meta-analysis included 20 studies, most of which used aspirin regimens ranging from 75 to 325 mg daily; six also included antiplatelet therapy. Among 2,930 patients with cardiovascular disease, 810 (28%) were aspirin resistant. Risks of a cardiovascular-related event, death, and an acute coronary syndrome were increased in aspirin-resistant patients compared with nonresistant patients (odds ratios, 3.85, 5.99, and 4.06, respectively). The authors noted that the patients who were resistant to aspirin also did not benefit from other antiplatelet treatment.

Renin inhibition decreased atherosclerotic lesion development in mice, offering a clinical approach to lowering blood pressure and directly inhibiting atherosclerosis, according to a study in the March 3 Journal of Clinical Investigation. LDL receptor–deficient mice were given a broad dose range of the renin inhibitor aliskiren, which resulted in “striking reductions of atherosclerotic lesion size in both the aortic arch and the root.” Transplants of renin-deficient bone marrow to irradiated mice also decreased atherosclerotic lesion size. Transplantation of angiotensin II type 1a receptor–deficient bone marrow had no effect on lesion development, however. This finding, according to the researchers, suggests that renin-dependent angiotensin production in macrophages does not act in an autocrine/paracrine manner. The investigators also noted that prior research has shown that coculture with renin-expressing macrophages augmented monocyte adhesion to endothelial cells, which offers more evidence for the importance of renin inhibition.

High levels of monoamine oxidase B (MAO-B) increased the incidence of Parkinson’s disease–like symptoms, reported researchers in the February 20 PLoS ONE. Elevated astrocytic MAO-B in mice mimicked the age-related increase seen in humans, they said, resulting in “specific, selective, and progressive loss of dopaminergic neurons in the substantia nigra.” Other Parkinson’s disease–related alterations observed included selective decreases in mitochondrial complex I activity and increased mitochondrial oxidative stress and global and local microglial activation within the substantia ni-gra, which correlated with decreased locomotor activity. The researchers concluded that MAO-B may be directly involved in multiple aspects of Parkinson’s disease neuropathology. They suggested that the inducible astrocytic MAO-B transgenic mouse model continue to be used to explore pathways involved in the initiation and progression of Parkinson’s disease pathology and therapeutic drug testing.

Marijuana use may impair cognitive function in patients with multiple sclerosis (MS), according to the results of a study in the February 13 online Neurology. Of 140 patients with MS, 7.7% had used cannabis in the previous month; each cannabis user was matched, based on demographics and disease variables, with four patients with MS who were nonusers. A higher proportion of cannabis users met DSM-IV criteria for a psychiatric diagnosis than did nonusers, reported the researchers. As a group, cannabis users also had a slower mean performance time and a different pattern of response on a test of cognition compared with the controls. The investigators recommended that future studies investigate the direction of the relationship between inhaled cannabis use and impaired mentation in persons with MS.

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