Nonsteroidal anti-inflammatory drugs may significantly delay some forms of Alzheimer's disease pathology, according to a report in the August 1 Journal of Neuroscience. The authors fed Tg2576 mouse models chow containing 375 ppm ibuprofen at 10 months of age—when amyloid plaques first appear—and the authors continued to do so for six months. This diet was associated with a reduction in the number and size of ß-amyloid deposits and central nervous system inflammation, said the authors.

Opinions differ widely among family practitioners and headache specialists on the use of triptans, according to the authors of a report in the July/August Headache. The study showed that there is no consensus about when to avoid using a triptan due to excessive cardiac risk factors, when to obtain an electrocardiogram prior to using a triptan, and when to give the first dose of a triptan in the office. The 65 headache specialists and 67 family practitioners saw an average 36.3 and 7.2 patients with headache per week, respectively. Based on the results of the study, the authors suggest "the need to develop evidence upon which rational guidelines could be based."

Behavioral interventions and drug therapies may be combined to treat violent behavior in some individuals, according to the authors of a study in the July 28 Science. In many subjects with violent behavior, brain activity was disrupted: while orbital and anterior activity was reduced, activity in the amygdala was normal or increased. A group of subjects also had a genetic deficit that causes a disruption in the brain's serotonin levels. "Given what we know about brain plasticity and the fact that the brain really can change in response to experience, we have good reason to expect that these treatments may, in fact, have beneficial consequences," said author Richard Davidson, a psychologist at the University of Wisconsin at Madison.

Operative stroke during or immediately after carotid endarterectomy is associated with transcranial Doppler-detected microemboli during dissection and wound closure, an at least 90% middle cerebral artery velocity decrease at cross-clamping, and an at least 100% pulsatility index increase at clamp release, indicated data from two hospitals in the United States and the Netherlands. The study indicates that transcranial Doppler intraoperative monitoring may decrease the risk of stroke during or immediately after carotid endarterectomy, said the authors in the August Stroke.

Neurologic symptoms of cluster headache may be initial symptoms rather than a reaction to pain, according to a case report in the August 7 Neurology. The 22-year-old subject of the report said that he experienced nasal stuffiness, a droopy eyelid, and contraction of the left pupil but not pain. The attacks lasted one or two hours at a time and occurred one to three times a day for six weeks before disappearing for six years. When the symptoms recurred, they were accompanied by pain and lasted for about 90 minutes. Treatment with sumatriptan alleviated the pain, and the cluster headaches disappeared within six weeks.

Not all ginkgo biloba extracts are the same, according to a panel at the 41st Annual Meeting of the American Society of Pharmacognosy. "Their uniformity and effectiveness depend on the quality of the raw plant material, the manufacturing processes used, and particular blend of the extract," said Ezio Bombardelli, BS, President of the scientific board of Indena SpA. Extracts include flavone glycosides and several terpene molecules unique to ginkgo. Terpenes are believed to improve circulation in the brain and peripheral tissue.

Neuritic plaques were observed in living, transgenic mouse models of Alzheimer's disease by researchers at the Mayo Clinic in Rochester, Minnesota. According to the study in the August Nature Biotechnology, radiolabeled amyloid-ß peptide crossed the blood-brain barrier and bound to amyloid-ß plaques. The authors also found that the permeability of the amyloid-ß peptide and its affinity to disease plaques increased twofold with covalent modification by the polyamine putrescine.

A gene on the subtelomeric region of chromosome 3p contributes to general intelligence, according to a study in the August 8 Neurology. The study, led by J. J. Higgins, MD, of the New York State Department of Health, included 32 individuals from a single pedigree. The authors identified 10 of these individuals as having nonsyndromic mental retardation. Although "it does not seem likely" that the mental retardation was nonsyndromal, the study represents a "substantial advance" toward the mapping and molecular characterization of many autosomal recessive disorders, said John M. Opitz, MD, of the University of Utah, Salt Lake City, in an accompanying editorial.

A questionnaire may be useful in the diagnosis and the monitoring of therapies for frontotemporal dementia and Alzheimer's disease, report the authors of a study in the August Journal of Neurology, Neurosurgery and Psychiatry. The Cambridge, UK, researchers found that the questionnaire identified stereotypic behavior, changes in eating preference, disinhibition, and features of social awareness. These differences "reliably differentiated patients with frontotemporal dementia from patients with Alzheimer's disease," they said. The researchers also found that both groups of patients were behaviorally similar and that dysexecutive symptoms and poor self-care were affected by the severity of the disease.

Severe disability is common among extremely preterm infants, according to a study in the August 10 New England Journal of Medicine. Of the 308 surviving children who were born at less than 26 completed weeks of gestation in the United Kingdom and Ireland between March and December 1995, 283 children were evaluated when they reached a median age 30 months (corrected for gestational age). Overall, 49% of the children had disability. Nineteen percent had severely delayed development, 28% had severe neuromotor disability, 2% were blind or perceived light only, and 3% had hearing loss that was uncorrectable or that required hearing aids. The authors noted that the study only evaluated severe disability; such children are also at risk for later behavioral, fine-motor, and educational impairment.

Use of methylenedioxymethamphetamine (MDMA or "ecstasy") is associated with 50% to 80% depletion of brain serotonin levels, reported Stephen J. Kish, PhD, of the Centre for Addiction and Mental Health in Toronto, in the July 25 Neurology. "This is the first study to show that this drug can deplete the level of serotonin in humans," he said. Dr. Kish and colleagues compared autopsied brain tissue of a 26-year-old ecstasy user to that of 11 neurologically normal subjects. The researchers suggested that some behavioral problems that occur during ecstasy withdrawal could be addressed by therapeutic efforts to normalize serotonin levels.

Individuals with autism spectrum disorder may perform better than nonautistic individuals on the false-memory test, according to a study in the July 18 Proceedings of the National Academy of Science. During the study, eight adults with autistic spectrum disorder and 16 nonautistic adults listened to 24 lists of 12 semantically related words. Nonautistic subjects were more likely to have thought they had heard a word that was related to the index word but that was not actually included in the lists. The authors suggested that the superior memory of people with autism spectrum disorder should be considered for "optimal vocational rehabilitation."

Short-term function outcomes and the possibility of community reintegration are higher for stroke patients receiving fee-for-service care than for stroke patients receiving Medicare health maintenance organization care, indicated data from a study of 429 randomly selected stroke patients who were treated between 1993 and 1995. These findings are consistent with the more intensive rehabilitation (in rehabilitation hospitals or units) and more specialty care, said the authors in the July Journal of the American Geriatrics Society.

—Kathryn Blair

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