Higher intake of whole grains may reduce the risk of ischemic stroke in women, according to the results of a prospective study in the September 27 JAMA. A cohort of 75,521 women between ages 38 and 63 was followed for 12 years to assess the link between whole grain consumption and risk of stroke. The study showed that whole grain consumption was associated with a 40% lower risk of ischemic stroke, but not a lower risk of hemorrhagic stroke. In this study, the median consumption of whole grain was one serving per day; three servings per day are recommended.

Routine neuroimaging is unnecessary for children and adolescents with defined clinical headache syndrome diagnoses and whose neurologic examination are normal, according to a retrospective review of children (ages 6 to 18) with headache. Neuroimaging scans revealed abnormalities in four of the patients with migraine (3.7%) and five of the patients with chronic daily headache (16.7%), however all of these abnormalities were considered "clinically silent," the researchers reported in the September Headache.A review of the literature revealed that among 526 children with headache, only 2.7% had an abnormal scan that warranted surgical intervention, the researchers noted.

An unstable ATTCT pentanucleotide repeat expansion in chromosone 22 may cause spinocerebellar ataxia type 10 (SCA10), according to the results of a study in the October Nature Genetics.This expansion in intron 9 of the SCA10 gene is up to 19 kb larger than the normal allele. In the five Mexican families with spinocerebellar ataxia type 10 that were studied, the ATTCT repeat was unstable; the repeat expanded and contracted over the generations.

Hippocampal neural progenitor cells that were injected into the eyes of rats with genetic retinal neurodegeneration migrated into the retina, where they respected the local laminar organization and differentiated into neurons. The study, in the September Molecular and Cellular Neuroscience,supports the hypothesis that neural progenitor cells are capable of responding to injury cues in the mature central nervous system, said the authors. They also noted that future studies will have to show that the transplantation can restore sight in animals before the technique can be tried in humans with retinal damage.

Two studies of the therapeutic efficacy of an altered peptide ligand of myelin basic protein for patients with relapsing–remitting multiple sclerosis were halted due to adverse effects in some patients. The studies, published in the October Nature Medicine,suggested that myelin basic protein is one target autoantigen and that lower doses of this therapy are more effective than higher doses.

Early-onset Alzheimer's disease may result from mutations in presenilins. Altered presenilins may handle calcium differently in the endoplasmic reticulum of cells, according to a study in the September Neuron.The authors described a calcium pathway that causes an increase in the production of amyloid-ß42, from which amyloid plaques form. The research suggests that this calcium pathway may be a therapeutic target for early-onset, inherited Alzheimer's disease. "While we currently don't know whether this information also might be applied to the late-onset, noninherited type of Alzheimer's disease, we would assume that the pathways that go wrong in early-onset illness also are involved in late-onset disease," the researchers wrote.

A loss of neurons may cause narcolepsy, according to a study in the September Neuron. In the study, the brains of patients with narcolepsy had up to 95% fewer neurons that produce hypocretin, a neurotransmitter involved in sleep and appetite regulation, than did the brains of people without narcolepsy. No decrease in melanin-concentrating hormone neurons was found. The loss of neuronal cells that produce hypocretin may be linked to gliosis, which was also found in the narcoleptic brains. The replacement of hypocretin-producing neuronal cells may reverse the symptoms of narcolepsy, suggested the authors.

Gambling and other compulsive disorders in patients with Parkinson's disease may be a side effect of levodopa, according to Spanish researchers. Of the 12 pathologic gamblers in the study, 10 started gambling after the onset of Parkinson's disease, and nine reported that their gambling increased after treatment with levodopa. Of the two patients who gambled before the onset of Parkinson's disease, one reported that gambling increased after starting levodopa therapy. The causes of pathologic gambling are largely unknown, but altered dopamine function may be involved, concluded the authors in the September Movement Disorders.

Higher-than-normal vesicular monoamine transporter protein expression and monoaminergic synaptic terminal concentration may represent a trait-related abnormality in patients with bipolar I disorder. In a study in the October American Journal of Psychiatry,male and female patients showed different patterns of protein expression and terminal concentration. The nine male patients also showed a higher binding of vesicular monoamine transporter protein in the thalamus than did the seven female patients. No differences were detected in the control group.

"There is no scientific basis on which to estimate a fixed upper limit [of maximum life span]," said J. R. Wilmoth, PhD, lead author of a study in the September 29 Science."Whether 115 or 120 years, it is a legend created by scientists who are quoting each other." He and colleagues reported that the maximum life span in Sweden has increased from 101 years in 1861 to 109 years in 1999. The increase is attributable to a larger population base, public health measures, and improved medical practice, they said.

Maternal choline levels are critical for fetal brain development, indicated a University of North Carolina at Chapel Hill study in a supplement to the October Journal of the American College of Nutrition.Rat pups that received choline supplements in utero exhibited lifelong memory enhancement. This improvement in memory function may reflect improved hippocampal development. Translating the results to humans, the author suggested that eating one or two eggs a day could help pregnant women maintain the appropriate choline levels for fetal development.

Data in the October 10 Neurologyindicates that patients with a severe neurologic deficit after acute ischemic stroke have a poor prognosis. Researchers led by Michael R. Frankel, MD, of Grady Memorial Hospital in Atlanta, Georgia, have developed a practical method based on the National Institutes of Health Stroke Scale (NIHSS) for predicting poor outcomes after acute ischemic stroke; an NIHSS score of greater than 17, plus atrial fibrillation in the two hours following study entry indicated a poor outcome at three months. The positive predictive value was 96%. The best predictor at 24 hours was an NIHSS score greater than 22, with a positive predictive value of 98%. At seven to 10 days, the best predictor of poor outcomes was an NIHSS score of greater than 16, which had a positive predictive value of 92%.

The 2000 Nobel Prize in Physiology or Medicine was awarded to Arvid Carlsson, MD, Professor Emeritus in the Department of Pharmacology, University of Göteborg, Sweden. In the 1950s, Dr. Carlsson discovered that dopamine is a neurotransmitter and is important for the control of motor behavior; he also developed a highly sensitive assay to measure tissue levels of dopamine. As a result of his work, levodopa was developed as a therapy for Parkinson's disease. Co-recipients of the prize are Paul Greengard, PhD, and Eric Kandel, MD, whose discoveries clarified the signal transduction mechanisms in the nervous system.

Diffuse brain injury may inhibit anatomical and cognitive manifestations of experience-dependent developmental plasticity, according to a study in the September Journal of Neurotrauma.Forty-eight 17- to 20-day-old rats, the developmental equivalent of 5- to 7-year-old humans, were randomized to traumatic brain injury and recovery in either standard or enriched housing, or to the control group and confinement in either standard or enriched housing. After 17 days, the enriched environment was associated with a 50% increase in intelligence scores on the Morris Water Maze task—but only in nonconcussed rats. Young children may not show clinical deficits and may meet their normal developmental milestones following concussion, said lead author, David Hovda, PhD. He noted, however, that the reduction of plasticity potential following head trauma may cause long-term cognitive impairment or developmental deficit.

Patients with multiple sclerosis experience both mental and physical fatigue, according to a study in the October 10 Neurology.Patients with multiple sclerosis showed cognitive decline after repeated testing, whereas healthy subjects showed improvement, reported Lauren B. Krupp, MD. The study involved 45 patients with multiple sclerosis and 14 healthy control subjects who underwent tests to measure verbal memory and conceptual planning. These findings on mental fatigue should be of interest to teachers, employers, family members, and others who regularly interact with patients with multiple sclerosis, said Dr. Krupp.

An association between serious head injury in early adulthood and Alzheimer's disease in later life was reported in the October 24 Neurology.Researchers reviewed military medical records of 548 male World War II veterans who were hospitalized with head injury and 1,228 veterans without a history of head injury. The use of records instead of recall, the researchers said, allowed them to avoid the problem of "recall error." After determining which veterans currently have dementia, the researchers calculated that those with severe head injuries had a four-fold greater risk of Alzheimer's disease. The increased risk of dementia, some 50 years after the head injuries had occurred, is one more indication that Alzheimer's disease is a chronic disease that unfolds over many decades, they concluded.

Lead exposure on the job can cause progressive declines in memory and learning years after exposure, according to a report in the October 24 Neurology.The study compared 535 former chemical manufacturing employees with occupational exposure to lead to 118 non-exposed control subjects. "The higher the peak level of lead determined in [the bone of] former lead workers, the greater the decline in brain functions," said Brian S. Schwartz, MD. "Since these declines were seen long after exposure to lead had stopped, it suggests that the effect of lead on the brain is progressive."

Results from the CALM-PD (Comparison of the Agonist Pramipexole versus Levodopa on Motor Complications in Parkinson's Disease) trial found that patients who started treatment with the dopamine agonist pramipexole were less likely to develop wearing off, dyskinesias, or on-off fluctuations than patients who began therapy with levodopa. However, pramipexole was not as effective as levodopa with regard to total scores on the Unified Parkinson Disease Rating Scale; and it was associated with more side effects, particularly sleepiness and hallucinations, according to the results published in the October 18 JAMA.

Gene therapy may help prevent and treat cerebral vasospasm, according to an animal study published in the October 26 Circulation Research.Even after a subarachnoid hemorrhage is successfully treated, vasospasm "can develop a few days to three weeks later in nearly four of every 10 patients treated for the initial rupture," said Donald Heistad, MD. The researchers found that gene transfer of calcitonin gene-related peptide (CGRP) in rabbits prevented the vasospasm without causing a severe decline in blood pressure. The potential clinical use is years away, the researchers said; the next step is to ensure that CGRP-based gene therapy is both safe and effective.

NR