Obese individuals may have an elevated risk of episodic migraine, compared with healthy persons, according to research published online ahead of print September 11 in Neurology. Investigators analyzed data for 3,862 adult participants (including African Americans and Caucasians) in the National Comorbidity Survey Replication. Diagnostic criteria for episodic migraine were based on the International Classification of Headache Disorders. BMI was classified as underweight (<18.5 kg/m2), normal (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), or obese (≥30 kg/m2). The adjusted odds of episodic migraine were 81% greater in individuals who were obese, compared with those of normal weight. Stratified analyses demonstrated that the odds of episodic migraine were greater in obese, compared with normal-weight individuals, who were younger than 50, Caucasian, or female.
Approximately 15% of all ischemic strokes occur in young adults and adolescents, according to a consensus document developed by an expert panel of the American Academy of Neurology and published September 17 in Neurology. Few public-health and research initiatives have focused on stroke in the young, said the authors. Early diagnosis of ischemic stroke is challenging because of the lack of awareness and the relative infrequency of stroke, compared with stroke mimics. The heterogeneity and relative rarity of the causes of ischemic stroke in the young result in uncertainties about diagnostic evaluation and cause-specific management. For these reasons, it is important to formulate and enact strategies to increase awareness and access to resources for young patients with stroke, their caregivers and families, and health care professionals, said the authors.
Retired National Football League (NFL) players may have an increased prevalence of late-life cognitive impairment indicative of diminished cerebral reserve, according to research published in the September issue of the Journal of the International Neuropsychological Society. After examining informant AD8 inventory data for a sample of 513 retired NFL players, the researchers found that 35.1% of the sample had possible cognitive impairment. When the researchers compared neurocognitive profiles in a subsample of this group to those in a clinical sample of patients with a diagnosis of mild cognitive impairment due to Alzheimer’s disease, they found a highly similar profile of impairments. However, said lead author Christopher Randolph, PhD, “there is essentially no evidence to support the existence of any unique clinical disorder such as CTE.” The findings emphasize the need for larger, controlled studies on this issue, he added.
Treatment with 4 g/day of ascorbic acid may not improve neuropathy in subjects with Charcot-Marie-Tooth disease type 1A, according to research published in the August issue of JAMA Neurology. Researchers randomized 110 patients with Charcot-Marie-Tooth disease type 1A to oral ascorbic acid (87 subjects) or matching placebo (23 individuals). Patients’ mean two-year change in Charcot-Marie-Tooth Neuropathy Score (CMTNS) was −0.21 for the ascorbic acid group and −0.92 for the placebo group. The mean two-year change according to natural history is +1.33. Because the results were well below 50% reduction of CMTNS worsening from natural history, the investigators could not declare the study futile. It is unlikely that the results support undertaking a larger trial of 4 g/day of ascorbic acid, said the researchers.
Pilots with occupational exposure to hypobaria may have significantly greater volume and number of white-matter hyperintensity (WMH) lesions, compared with controls, according to data published August 20 in Neurology. Researchers used a 3-T MRI scanner to collect three-dimensional, T2-weighted, high-resolution imaging data for 102 U-2 pilots and 91 controls matched for age, health, and education levels. The investigators compared whole-brain and regional WMH volume and number between groups using a two-tailed Wilcoxon rank sum test. U-2 pilots had an increase in volume (394%) and number (295%) of WMH. Also, WMH were more uniformly distributed throughout the brain in U-2 pilots, compared with a predominantly frontal distribution in controls. Further studies will be necessary to clarify the pathologic mechanisms responsible for the damage, said the researchers.
Nine independent risk factors that can be traced to adolescence, most of which are modifiable, may account for most cases of young-onset dementia in men, according to a study published online ahead of print August 12 in JAMA Internal Medicine. Investigators analyzed data for 488,484 Swedish men from the Swedish Military Service Conscription Register. Multivariate Cox regression analysis indicated that alcohol intoxication, stroke, antipsychotic use, depression, father’s dementia, intoxication with drugs other than alcohol, low cognitive function at conscription, low height at conscription, and high systolic blood pressure at conscription were significant risk factors for young-onset dementia. The population-attributable risk associated with all nine risk factors was 68%. The study results suggest excellent opportunities for early prevention, according to the researchers.