News Roundup

New and Noteworthy Information—May 2016



Patients who have type 1 diabetes have an increased risk of developing epilepsy, according to a study published online ahead of print March 31 in Diabetologia. This study cohort included 2,568 patients with type 1 diabetes, each of whom was frequency-matched by sex, residence, and index year with 10 patients without type 1 diabetes. Cox proportional hazard regression analysis was conducted to estimate the effects of type 1 diabetes on epilepsy risk. After adjusting for potential confounders, the type 1 diabetes cohort was 2.84 times more likely to develop epilepsy than the control cohort. “Metabolic abnormalities of type 1 diabetes, such as hyperglycemia and hypoglycemia, may have a damaging effect on the central nervous system and be associated with significant long-term neurological sequelae,” said the authors.

Antipsychotics are associated with a significantly increased mortality risk in patients with Parkinson’s disease, after adjusting for measurable confounders, according to a study published online ahead of print March 21 in JAMA Neurology. This retrospective matched-cohort study used data from the fiscal years of 1999 to 2010. The rates of 180-day mortality were compared in 7,877 patients initiating antipsychotic therapy and in 7,877 patients who did not initiate antipsychotic therapy. Antipsychotic use was associated with more than twice the hazard ratio of death, compared with nonuse. The hazard ratio was significantly higher for patients who used typical versus atypical antipsychotics. Among the atypical antipsychotics used, hazard ratios relative to nonuse of antipsychotics were, in descending order, 2.79 for olanzapine, 2.46 for risperidone, and 2.16 for quetiapine fumarate.

White matter tracts related to regulation of sleep and wakefulness, and limbic cognitive and sensorimotor regions, are disrupted in the right brain in patients with primary insomnia, according to a study published online ahead of print April 5 in Radiology. Investigators used tract-based spatial statistics to compare changes in diffusion parameters of white matter tracts from 23 patients with primary insomnia and 30 healthy controls. They evaluated how accurately these changes could distinguish patients with insomnia from healthy controls. Patients with primary insomnia had lower fractional anisotropy values mainly in the right anterior limb of the internal capsule, the right posterior limb of the internal capsule, the right anterior corona radiata, the right superior corona radiata, the right superior longitudinal fasciculus, the body of the corpus callosum, and the right thalamus.

Among Chinese adults, a higher level of fruit consumption is associated with lower blood pressure and blood glucose levels and, largely independent of these and other factors, with significantly lower risks of major cardiovascular diseases, according to a study published April 7 in the New England Journal of Medicine. Between 2004 and 2008, researchers recruited 512,891 adults between ages 30 and 79 from 10 locations in China. In all, 5,173 deaths from cardiovascular disease, 2,551 incident major coronary events, 14,579 ischemic strokes, and 3,523 intracerebral hemorrhages were recorded among the 451,665 participants without a history of cardiovascular disease or antihypertensive treatments at baseline. The adjusted hazard ratios for daily consumption versus nonconsumption were 0.75 for ischemic stroke and 0.64 for hemorrhagic stroke.

A low level of leisure-time physical activity is independently associated with greater decline in cognitive performance over time, according to a study published online ahead of print March 23 in Neurology. Researchers assessed cognition in participants in the Northern Manhattan Study using a standard neuropsychologic examination. The neuropsychologic examination was repeated five years later and subcategorized using standardized z scores over validated domains. No or low levels of leisure-time physical activity were associated with worse executive function, semantic memory, and processing speed scores on the first neuropsychologic examination. The associations were slightly attenuated and not significant after adjusting for vascular risk factors. Cognitively unimpaired participants who reported no to low leisure-time physical activity versus moderate to high levels declined more over time in processing speed and episodic memory.

Participation in the “Sleep for Success” education program is associated with significant improvement in children’s sleep and academic performance, according to a study published in Sleep Medicine. Using a community-based participatory research approach, researchers composed a program of four modules that addressed the children, their family and community, the school staff, and decision-makers within the school setting. In all, 71 students participated in the evaluation of the program. The effectiveness of the program was evaluated using nonrandomized, controlled before-and-after study groups that were assessed at two time points. In the intervention group, true sleep was extended by 18.2 minutes per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 minutes. Report card grades also improved significantly in English and mathematics.

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