Frequent drinking in midlife is linked to mild cognitive impairment and dementia in old age, according to a study in the September 4 BMJ. After monitoring 1,018 individuals for 23 years, researchers found that those who drank no alcohol and those who drank alcohol frequently were both twice as likely to have mild cognitive impairment in old age compared with those who drank infrequently. Those who drank heavily had a higher risk of dementia, but only if they carried the apolipoprotein E ε4 allele. Although these results confirm previous claims that light to moderate drinking might have a protective effect on the brain, the researchers advised patients against drinking “more alcohol in the belief that they are protecting themselves against dementia.”

Intravenous immunoglobulin might be a promising treatment for Alzheimer’s disease, according to preliminary research in the October Journal of Neurology, Neurosurgery, and Psychiatry. For six months, five patients with early Alzheimer’s disease received monthly intravenous injections of immunoglobulin containing antibodies against β-amyloid. Researchers noted that “although cognitive function improved only slightly in four patients,” it did not worsen. In addition, after collecting cerebrospinal fluid samples at baseline and at six months, they found that ß-amyloid levels fell by 30.1% by the end of the study.

Two proteins—Shh and Gli-1—may prevent the progressive degeneration of nerve cells in the brain that causes Parkinson’s disease, according to a study in the September Molecular Therapy. Researchers delivered the proteins via a genetically engineered virus into the brains of rats and found that they prevented cell death. They said they are currently “constructing other versions of this virus that could eventually be used in clinical trials in humans that are safe even when the body mounts an immune response … these new viral vectors would effectively resist any attack by the immune system and would have built-in switches that allow the doctor to regulate the delivery of the neuroprotective proteins as needed.”

A diet high in docosahexaenoic acid (DHA) may lower the risk of Alzheimer’s disease and help slow the progression of the disorder in its later stages, according to a study in the September 2 Neuron. While testing environmental risk factors for the disorder in genetically engineered mice, researchers discovered that mice living on a diet of soy and fish, which both contain DHA, developed lesions linked to advanced Alzheimer’s disease but showed minimal memory loss or synaptic brain damage. They said that people can consume more DHA by eating coldwater fish, such as salmon, halibut, mackerel, sardines, and herring, or by taking DHA supplements made from algae.

Loss of one copy of two adjacent genes, ZIC1 and ZIC4, causes Dandy-Walker malformation, according to a study in the September Nature Genetics. These findings may have the potential to improve prenatal diagnosis and to provide clues about autism. After identifying eight patients with deletions of genetic material from chromosome 3, the researchers identified two genes—ZIC1 and ZIC4—likely to play a role in the development of Dandy-Walker. They created a mouse model and found that 15% of the mice that had one normal and one abnormal version of both ZIC1 and ZIC4 had abnormalities in the cerebellum that were similar to those in the brains of patients with Dandy-Walker. Because such a low percentage of mice with the characteristic deletions had severe symptoms, researchers cautioned that other genes might be involved as well.

The FDA has approved Cymbalta (duloxetine HCl) for the management of diabetic peripheral neuropathic pain. Two clinical trials were conducted involving nondepressed adults who had the disorder for at least six months. Results of both studies revealed that duloxetine significantly reduced 24-hour average pain compared with placebo. Furthermore, duloxetine was effective in relieving nighttime pain. Researchers said duloxetine works by increasing levels of serotonin and norepinephrine. Cymbalta is marketed by Eli Lilly and Company.

Caregivers who place their relatives into institutionalized care get no relief from depression and anxiety and often suffer additional emotional trauma, according to the results of a multi-site study published in the August 25 JAMA. “Unlike the sense of closure and relief reported by caregivers after the death of a loved one with dementia, caregivers who have placed their family member in an institution continue to experience distress and depression,” researchers said. Caregivers often feel distressed over the suffering and decline of their loved ones; reduced control and increased responsibility to monitor care can also take their toll, they noted.

Eletriptan is more effective in the treatment of migraine if patients take it in the early stages of a migraine attack rather than when the attack becomes more severe, according to data presented at the Eighth Congress of the European Federation of Neurological Societies. Results of the study, which included 613 migraine patients, indicated that 71% of patients who received 40 mg of eletriptan within a half hour of the beginning of pain were pain-free for a period of two hours, compared with 23% of patients who were given the placebo. Only 39% of patients who waited to take eletriptan until the attack was more severe were pain-free for a period of two hours, compared with 21% of those who were given placebo.

Immunization against hepatitis B is associated with an increased risk of multiple sclerosis (MS), according to a study in the September 14 Neurology. After reviewing the medical records of 163 cases of MS and 1,604 controls, researchers found that “immunization against hepatitis B was associated with a threefold increase in the incidence of MS within the three years following vaccination.” However, researchers emphasized that their “study cannot distinguish whether the vaccine hastens the onset of MS in persons destined to develop the disease years later, or whether it causes new cases of MS in susceptible individuals. It is also important to stress that 93% of the MS cases in our study had not been vaccinated.”

Measles-mumps-rubella (MMR) immunization is not associated with the development of autism or other pervasive developmental disorders (PDDs) in children, according to a study in the September 11 Lancet. Researchers compared the rate of MMR vaccination among children who later developed autism or other PDDs with children who did not develop PDDs. They found that “MMR vaccination was not associated with an increased risk of subsequently being diagnosed with a PDD.”

Parkinson’s disease may be caused by a blockage within dopamine neurons in patients with a mutant α-synuclein gene, according to a report in the August 27 Science. After studying the brains of mice, researchers found that the blockages were formed when the mutant α-synuclein proteins bound to protein disposal sites within dopamine neurons. This blockage eventually results in neuronal death. The researchers are now examining whether a backup at the protein disposal sites also plays a role in the most common idiopathic form of Parkinson’s disease. Investigators said “these patients do not carry a mutant α-synuclein gene, but their α-synuclein proteins bear modifications not seen in healthy people that may cause the protein to act as the mutant does.”

NR