Researchers have found that 50% of study participants with epilepsy were seizure-free 30 years after temporal lobectomy. According to details of a report in the June 14 Neurology, all participants or their family members were asked whether they had experienced seizures at one, five, 10, and 30 years following surgery. After a mean follow-up of 29.9 years, 24 of 48 patients were seizure-free; 10 had been taking antiepileptic drugs while the remaining 14 had not. The researchers added that patients who had an IEEG and those with a presurgical psychiatric diagnosis were less likely to be seizure-free at the most recent follow-up. Ten patients had died by follow-up—three in the context of a seizure. Age, preoperative duration of epilepsy, resection side or size, pathologic diagnosis, and ipsilateral pneumoencephalogram atrophy did not affect outcome.

A diet high in milk might reduce the risk of heart disease and stroke, according to a study in the June Journal of Epidemiology and Community Health. A total of 764 men ages 45 to 59 were asked to weigh and record all food and drink items they consumed for seven consecutive days. The investigators noted that at the start of the study (1979 to 1983) almost all the participants consumed whole milk; however, a random sample of the participants in 2000 showed that almost all had switched to skim or semi-skim milk within the preceding eight years. During the 20-year study period, 54 men had had a stroke, while 139 developed symptomatic ischemic heart disease; 225 had died. Men who drank the most milk had a lower risk of ischemic heart disease or stroke than did those who drank the least; cholesterol levels and blood pressure were similar in high- and low-quantity milk consumers. “The present perception of milk as harmful in increasing cardiovascular risk should be challenged, and every effort should be made to restore it to its rightful place in a healthy diet,” the investigators concluded.

Novartis Pharmaceuticals Corporation announced that the FDA has approved Focalin XR^™ (dexmethylphenidate) capsules for the treatment of adults, adolescents, and children with ADHD. The approval of dexmethylphenidate was based on data from clinical trials involving approximately 320 patients with ADHD. Trials involving adults with ADHD demonstrated that dexmethylphenidate was well tolerated and superior to placebo in the treatment of ADHD symptoms. Similar results were found in a trial including patients ages 6 to 17 and another trial involving patients ages 6 to 12. The most common adverse effects in both adults and children included decreased appetite, headache, dyspepsia, anxiety, insomnia, feeling jittery, and anorexia. There were no significant changes in patients’ weight or vital signs, such as sitting pulse or sitting blood pressure.

Rats exhibiting signs of depression have increased levels of the omega-6 fatty acid arachidonic acid in their brains, according to a report in the June Journal of Lipid Research. Investigators compared the brains of depressed rats with those of nondepressed rats in an attempt to examine the link between omega-3 fatty acids and depression. They found that omega-6 fatty acid levels differed between the two types of rats—but not omega-3 fatty acid levels. Specifically, depressed rats exhibited higher levels of arachidonic acid. Although this was unexpected, the investigators said that “the finding lends itself nicely to the theory that increased omega-3 fatty acid intake may shift the balance between the two fatty acid families in the brain, since it has been demonstrated in animal studies that increased omega-3 fatty acid intake may result in decreased brain arachidonic acid.” The investigators suggested that in the future, increasing omega-3 fatty acid intake and decreasing omega-6 fatty acid intake might help control depression.

Umbilical cord–blood transplants can save the lives of newborns with Krabbe’s disease, suggested a study in the May 19 New England Journal of Medicine. Twenty-five infants diagnosed with Krabbe’s disease—11 asymptomatic newborns and 14 symptomatic older infants who had undergone chemotherapy—underwent umbilical cord–blood transplantation. According to researchers, all 11 newborns had survived for a median of 36 months, while six of the 14 infants with symptoms had survived for a median of 41 months. The survival rate was better among newborns than among untreated control patients and symptomatic infants. The investigators noted that the newborns maintained normal vision, hearing, and cognitive development, except in areas influenced by gross motor development. In contrast, infants treated after symptom onset showed some stabilization of neurologic disease but remained severely impaired.

Using a rat model, researchers demonstrated a link between atypical febrile seizures and mesial temporal lobe epilepsy, according to a report in the June 6 online Annals of Neurology. They found that almost all rat pups presenting with atyptical febrile seizures had developed temporal lobe epilepsy in adulthood. These rat pups also showed impaired performance on the Morris water maze compared with control rats, suggesting mild deficits in learning and in memory. “Our results stress the importance of a careful evaluation of children with atypical febrile seizures. Early identification of children at risk of epilepsy could lead to neuroprotective treatments that could prevent the development of later epilepsy,” the researchers said.

Treatment with warfarin may reduce the risk of stroke by more than two thirds in patients with atrial fibrillation, suggested a study in the May 23 Archives of Internal Medicine. Investigators analyzed data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study to assess the occurrence and characteristics of stroke in patients receiving either rate control therapy or sinus rhythm control therapy. They found that 84% of patients receiving rate control therapy and 52% of patients receiving sinus rhythm control therapy received warfarin throughout the study. Use of warfarin was associated with a 69% decrease in the risk of stroke. “These data suggest that the beneficial effect of warfarin therapy exists not only for patients experiencing atrial fibrillation but also for patients who have a history of atrial fibrillation but who are presumably in sinus rhythm,” the investigators said.

According to a report in the June Annals of Neurology, investigators have developed a method for blocking the signals responsible for neuropathic pain. Rats with nerve damage were injected with a herpes simplex virus (HSV) vector. Injection with the viral vector resulted in less pain-related behavior; this effect lasted up to six weeks, or even longer in rats that received additional injections. The study was the first to demonstrate the successful use of gene transfer technology to treat peripheral neuropathic pain in animals. “[W]e’re not trying to correct a genetic defect. Our goal is simply to deliver a gene to sensory nerve cells, so its product can be used to block transmission of pain signals from damaged nerves to the brain,” said the researchers. They explained that the HSV vector works by triggering the expression of the GAD (glutamic acid decarboxylase) enzyme in the nucleus of neurons, thereby triggering nerve terminals in the spinal cord to release GABA (γ-aminobutyric acid), which blocks the transmission of pain signals to the brain.

Inducing moderate hypothermia (32°C to 33°C) after severe traumatic brain injury is a safe therapeutic intervention for children, reported researchers in the April Neurosurgery. Forty-eight children younger than 13 who were admitted within six hours of severe traumatic brain injury were randomized to receive moderate hypothermia treatment or to sustain normal body temperature, both in conjunction with standardized head injury management. An additional 27 patients who were admitted between six and 24 hours of injury—or in whom time of injury was unknown—or who were ages 13 to 18 were included in a parallel trial. Researchers found that in both groups, inducing hypothermia tended to reduce mortality and lower the severity of intracranial hypertension during the cooling phase, and had the potential to improve the functional outcome of young patients.

Repetitive transcranial magnetic stimulation seems to improve motor function in stroke patients, according to a study in the May 24 Neurology. Researchers compared eight people who had had a stroke in the last year and who were relearning how to use their affected hands with six people who had never had a stroke. Stroke patients received three sessions of magnetic stimulation (including sham stimulation) to the side of the brain that had not been affected by the stroke. According to the researchers, compared to controls, stroke patients improved by as much as 50% on various measures, such as reaction time, when magnetic stimulation was applied. There was no improvement in stroke patients who received sham stimulation or in the healthy controls following repeated testing, they noted.

Lafora’s disease might be caused by mutations in a gene that regulates the concentration of the protein laforin, according to a study in the June 14 Proceedings of the National Academy of Sciences. Researchers found that approximately 40% of study participants with Lafora’s disease have mutations in the gene that encodes malin, abolishing the protein’s ability to polyubiquitinate and signal the degradation of laforin. The increase in laforin might lead to Lafora’s disease through aberrant glycogen metabolism, they added. The researchers stated that activity of malin “is necessary to prevent a neurodegenerative disease that involves formation of nonproteinacious inclusion bodies.”

Vaccination with human alpha-synuclein is effective in reducing neuronal accumulation of abnormal human alpha-synuclein, according to a report in the June 16 Neuron. Researchers said that vaccination in mice resulted in the generation of antibodies, which decreased the accumulation of abnormal human alpha-synuclein in neuronal cell bodies and synapses and, in turn, reduced neurodegeneration. The investigators suggested that further development of this approach might have a role in the treatment of Lewy body disease, including Alzheimer’s disease and Parkinson’s disease. They are now working with Elan Pharmaceuticals to develop alternative ways to produce alpha-synuclein antibodies, with the goal of making a vaccine that is safe and effective in humans.

Reduced ubiquitin carboxyl-terminal hydrolase (UCHL1) function may jeopardize the survival of central nervous system neurons, according to a study in the May 31 Proceedings of the National Academy of Sciences. Previous studies have identified deficiencies in UCHL1 in patients with Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. In the current study, researchers examined a brain region in male zebra finches known as the high vocal center (HVC), which controls singing behavior in songbirds. They noted that the HVC has two types of neurons, one of which continues to be produced and replaced in adulthood; in songbirds, a bird’s active singing level increases the survival rate of new neurons. The investigators reported that replaceable HVC neurons showed consistent underexpression of UCHL1. Furthermore, they found that singing behavior significantly increased levels of UCHL1 in replaceable neurons but not in nonreplaceable neurons. “These findings suggest that rising levels of UCHL1 may be associated with a reduced risk of neuronal death,” said the researchers. Further examination of mouse brains revealed low expression of UCHL1 in replaceable neurons of the hippocampus and olfactory bulb.

NR