News Roundup

New and Noteworthy Information—October 2013


 

By lowering homocysteine levels, vitamin B supplementation may reduce the risk of stroke significantly for some individuals, according to research published online ahead of print September 18 in Neurology. Investigators analyzed data from 14 randomized controlled trials published before August 2012. The trials included 54,913 participants, and the investigators measured the association between B vitamin supplementation and end point events using a fixed-effects model and χ2 tests. The group observed a reduction in overall stroke events resulting from reduction in homocysteine levels following B vitamin supplementation, but not in subgroups divided according to primary or secondary prevention measures, ischemic versus hemorrhagic stroke, or occurrence of fatal stroke. Vitamin B reduced stroke events in subgroups with three or more years of follow-up and without cereal folate fortification or chronic kidney disease.

The deletion of information from chromosome 22 may be a genetic risk factor for early-onset Parkinson’s disease, researchers reported online ahead of print September 9 in JAMA Neurology. The investigators conducted an observational study of the occurrence of Parkinson’s disease in a cohort of 159 adults with a molecularly confirmed diagnosis of 22q11.2 deletion syndrome. The group examined postmortem brain tissue from patients with 22q11.2 deletion syndrome and a clinical history of Parkinson’s disease for neurodegenerative changes and compared it with tissue from persons with no history of a movement disorder. Adults with 22q11.2 deletion syndrome had a significantly elevated occurrence of Parkinson’s disease, compared with standard population estimates. Individuals with early-onset Parkinson’s disease and classic features of 22q11.2 deletion syndrome should be considered for genetic testing, said the authors.

High levels of lipid-depleted (LD) apolipoproteins are associated with cognitive difficulties but may be mitigated by diet, according to research published in the August issue of JAMA Neurology. Investigators randomized 20 adults with normal cognition (mean age, 69) and 27 adults with amnestic mild cognitive impairment (mean age, 67) to a diet high in saturated fat content and with a high glycemic index or to a diet low in saturated fat content and with a low glycemic index. Baseline levels of LD b-amyloid were greater for adults with mild cognitive impairment, compared with adults with normal cognition. The diet low in saturated fat tended to decrease LD b-amyloid levels, and the diet high in saturated fat increased these fractions.

The parkin protein may trigger the destruction of the bacterium that causes tuberculosis, according to research published online ahead of print September 4 in Nature. Genetic polymorphisms in the PARK2 regulatory region are associated with increased susceptibility to intracellular bacterial pathogens in humans. In mouse and human macrophages infected with Mycobacterium tuberculosis, parkin played a role in fighting the bacteria. Mice genetically engineered to lack parkin died after being infected by M. tuberculosis, while control mice survived the infection. In addition, parkin-deficient mice and flies were more sensitive to intracellular bacterial infections. The study results reveal an unexpected functional link between mitophagy and infectious disease, said the researchers. Strategies under investigation for combating Parkinson’s disease also might help fight tuberculosis, the authors added.

Low cardiovascular fitness early in life may be associated with an increased risk of epilepsy in adulthood, according to research published September 17 in Neurology. Investigators examined a population-based cohort study of approximately 1.2 million Swedish male conscripts born from 1950 to 1987 who were followed for as many as 40 years. Data on cardiovascular fitness were collected during conscription exams, and researchers linked the data with hospital registers to calculate later risk of epilepsy using Cox proportional hazard models. Low and medium cardiovascular fitness (compared with high cardiovascular fitness) at age 18 was associated with increased risk of future epilepsy (hazard ratios 1.79 and 1.36, respectively). The associations changed marginally after adjustment for familial influences and prior severe traumatic brain injury, cerebrovascular disease, or diabetes.

Whole-body MRI may predict cardiac and cerebrovascular events in patients with diabetes, according to a study published online ahead of print September 10 in Radiology. Researchers followed up 65 patients with types 1 and 2 diabetes who underwent a comprehensive, contrast-enhanced whole-body MRI protocol at baseline. Follow-up was performed by phone interview. The primary end point was a major adverse cardiac and cerebrovascular event (MACCE), which was defined as composite cardiac-cerebrovascular death, myocardial infarction, cerebrovascular event, or revascularization. Follow-up was completed in 61 patients. Normal whole-body MRI excluded MACCE during the follow-up period, but detectable ischemic or atherosclerotic changes at whole-body MRI were associated with a cumulative event rate of 20% at three years and 35% at six years. Whole-body MRI summary estimate of disease was strongly predictive for MACCE.

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