Contrary to previous findings, Australian researchers have found no evidence for an association between ischemic stroke and the use of the oral contraceptive pill in low doses in young women. The Melbourne Risk Factor Study Group included 234 women between the ages of 15 and 55 with a first-time ischemic stroke and 234 controls. Current use of the oral contraceptive pill, in doses of less than 50-mg estrogen, was not associated with an increased risk of stroke. The study, published in the July Stroke, found that the factors associated with an increased risk of ischemic stroke are largely modifiable, including hypertension, diabetes mellitus, and smoking.

Brain scans of children with dyslexia show activation patterns that match those of normal readers after only three weeks of reading instruction, reported a study in the July 22 Neurology. Researchers used functional MRI (fMRI) to examine a group of children with dyslexia prior to and after the children received a three-week training program based on principles outlined by the National Reading Panel; a group of children without dyslexia also underwent fMRI. After the three-week reading program, the levels of brain activation were essentially the same in the two groups. The investigators explained that the instruction doesn’t “rewire” the brain of a child with dyslexia but rather strengthens the circuits that are already in use. They also believe that appropriate in-school training has great potential for improving the reading ability of dyslexic children.

Abnormal insulin metabolism may contribute to the symptoms and the development of Alzheimer’s disease, investigators reported in the June 24 Neurology. Sixteen healthy older adults (mean age, 68.7) each underwent a saline infusion and an infusion of insulin plus dextrose. After 120 minutes of infusion, researchers recorded blood, cerebrospinal fluid, and cognitive measures. They found that the relationship of increased cerebrospinal fluid Aß42 with increased cerebrospinal fluid insulin concentration significantly strengthened with age; previous research has observed that insulin administration was associated with increased memory performance. However, the participants with higher Aß42 levels following insulin infusion showed lengthy memory facilitation. Therefore, the investigators concluded that prolonged elevations of insulin interfered with memory performance.

The quality of life for children with headaches is comparable to that of children with conditions such as cancer and rheumatic diseases, according to a study in the July Pediatrics. Researchers surveyed 572 children and adolescents receiving care at the Cincinnati Children’s Headache Center and found that 99% were diagnosed with migraines and 40% experienced chronic daily headaches. The investigators discovered that quality of life, when compared with healthy children, is negatively affected in all areas of functioning, including school functioning, emotional functioning, and physical health. Additionally, children with migraines reported more impairment in school functioning and emotional functioning than children with other chronic illnesses.

A toxic by-product of nicotine may help prevent the plaques linked to Alzheimer’s disease from forming, reported a study in the July 8 Proceedings of the National Academy of Sciences. Researchers found that nornicotine, a major nicotine metabolyte in the central nervous system, and glucose together with amyloid b proteins appeared to prevent the formation of plaques. While the investigators found nicotine and nornicotine to be “intriguing and potentially valuable treatments for Alzheimer’s disease,” they believe that more research is needed to develop chemical compounds that mimic the action of nornicotine. They also emphasize that people should not smoke in order to protect themselves against Alzheimer’s disease.

Medical Guidelines for Airline Travel, recently revised by the Aerospace Medical Association, now provides appropriate guidance for air travel for people with epilepsy. For the first time, the guidelines explicitly acknowledge that “in general, most patients with epilepsy can fly safely.” However, they warn, “patients with uncontrolled, frequent seizures should be cautioned about air travel, including the attendant risk of limited medical care capability inflight.” The Aerospace Medical Association also recommends that those with frequent seizures should consider traveling with a companion.

Boys are 28% more likely than girls to have a stroke, and African-American children are more than twice as likely to have a stroke as those from other ethnic groups, researchers reported in the July 22 Neurology. After examining 2,278 cases of childhood stroke, the investigators determined that 51% were ischemic. Boys were almost twice as likely to have trauma than were girls, though after excluding cases with trauma, boys still had an increased risk of ischemic stroke. In addition, the researchers noted that more than 38% of African-American children with ischemic stroke also had sickle cell disease. However, after excluding cases with sickle cell disease, African-American children still had a 61% increased risk of stroke. The investigators believe that more population-based studies are necessary to determine the risk factors of stroke in children.

Mutations in a recently discovered gene can cause Parkinson’s disease in patients with no family history of the disorder, according to a study in the June 30 online edition of the Annals of Neurology. Researchers discovered the mutations in the DJ-1 gene in a patient who had been diagnosed with the disease at age 24. Researchers admit that they do not know what the protein product of the DJ-1 gene does in the body, much less how the mutations could lead to Parkinson’s disease, but they believe they can use their findings as a starting point to determine how these proteins associate and interact with each other.

Obstructive sleep apnea is frequently seen in patients with epilepsy, stated a report in the June Epilepsia. Researchers screened 283 adult patients with epilepsy for obstructive sleep apnea using structured interviews regarding sleep quality, daytime sleepiness, and predictive symptoms of apnea. Patients suspected of having obstructive sleep apnea were monitored for a full night. The investigators found that 10.2% of the patients with epilepsy also had obstructive sleep apnea. Of these patients, apnea was mild in 66.6%, moderate in 22.2%, and severe in 11.1%. Researchers reported that the patients with epilepsy and obstructive sleep apnea were older, heavier, and sleepier than patients with epilepsy only.

Stroke related to over-the-counter sympathomimetics is associated with hypertension and vasospasm, most due to the use of phenylpropanolamine (PPA), noted researchers in the July Stroke. They added that stroke occurred with the use of pseudoephedrine as well. Investigators identified 22 patients who had a stroke associated with over-the-counter cough and cold medications. Sixteen of the strokes were associated with PPA, four with pseudoephedrine, and the remaining two with sympathomimetics that were administered nasally. Stroke occurred when doses that were higher than recommended were used but also when the drugs were taken properly. The researchers proposed that stroke could have been caused by hypertensive crisis (found in 31% of the cases) or “as a consequence of a direct vasoconstrictive action of the drugs,” seen in 55% of the patients.

Drivers who wait three months after a seizure to begin driving again have no more seizure-related accidents than those who wait one year, according to researchers from the Mayo Clinic, Scottsdale, Arizona. A time trend study was performed to analyze motor vehicle crash reports in Arizona in the three years before and the three years after the seizure-free interval was decreased from 12 months to three months. The researchers found that seizure-related crashes increased from 125 to 136 for the respective time periods, but the total rate of seizure-related crashes did not increase compared to all other crashes. However, the researchers noted, little other data exist in this area, and the results, which were published in the July Mayo Clinic Proceedings, should prompt further studies.

Participants in a prospective study who consumed fish once or more per week had a 60% less risk of Alzheimer’s disease, compared with those who rarely or never ate fish, according to research published in the July Archives of Neurology. The findings were based on dietary questionnaire analysis at four-year follow-up for 815 participants (ages 65 to 94) who were initially unaffected by Alzheimer’s disease. The researchers also found that total intake of n-3 polyunsaturated fatty acids was associated with reduced risk of disease, as was intake of docosahexaenoic acid, while eicosapentaenoic acid was not associated with Alzheimer’s disease. Intake of alpha-linolenic acid was protective only in persons with the APOE epsilon4 allele, and total n-3 fatty acid intake was protective only in women, the researchers noted. The associations remained unchanged after adjustment for confounding variables.

Injections of a stimulant into the brains of rats expanded blood vessels and improved blood flow; researchers believe this may lead to a new, noninvasive way to prevent stroke. Rats treated with granulocyte macrophage-colony stimulating factor had almost twice the arteriogenesis after one week compared with rats given saline solution. The increase was associated with improved circulation and accumulation of cells that are thought to play a key role in artery development. After obstructing arteries and reducing blood flow to the rats’ brains, the researchers induced arteriogenesis by transforming preexisting arteries that were located away from the blockage into functioning blood-carrying vessels capable of taking over for the blocked vessels. The article was published in the June 30 rapid access issue of Circulation.

NR

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