News Roundup

News Roundup: New and Noteworthy Information


 

Premature birth may increase the risk of epilepsy as an adult, according to a study published in the October 4 Neurology. Investigators observed rates of hospitalization for epilepsy and prescription of antiepileptic drugs during a four-year period in 630,090 adults (including 27,953 who were born preterm). “We found a strong association between preterm birth and epilepsy that increased by earlier gestational age,” the researchers stated. After adjusting for fetal growth and potential confounders, the investigators found that individuals who were born at 23 to 31 weeks were almost five times more likely to be hospitalized for epilepsy than those who were born full-term. The odds ratios for those born at 32 to 34 weeks and 35 to 36 weeks were 1.98 and 1.76, respectively. “These associations persisted after excluding individuals with cerebral palsy, inflammatory diseases of the CNS, cerebrovascular disease, and brain tumors,” the investigators noted.

The use of attention-deficit/hyperactivity disorder (ADHD) medications is not associated with an increased risk of serious cardiovascular events, as some adverse-event reports have suggested, according to a report published online November 1 in the New England Journal of Medicine. A group of researchers estimated the risk of serious cardiovascular events (sudden cardiac death, acute myocardial infarction, and stroke) among more than 1 million children and young adults (age range, 2 to 24). There were 81 cardiovascular events among the cohort members and seven serious cardiovascular events in current users. “Current users of ADHD drugs were not at increased risk for serious cardiovascular events (hazard ratio, 0.75),” the investigators reported. “Risk was not increased for any of the individual end points, or for current users as compared with former users (hazard ratio, 0.70).”

Researchers have identified several genetic variants that contribute to early stent thrombosis, as reported in the October 26 JAMA. Twenty-three genetic variants were examined in 15 different genes in a population of patients undergoing percutaneous coronary intervention. “Among the 23 genetic variants investigated in 15 different genes, the significant determinants of early stent thrombosis were CYP2C19 metabolic status (odds ratio, 1.99), ABCB1 3435 TT genotype (odds ratio, 2.16), and ITGB3 PLA2 carriage (odds ratio, 0.52),” the investigators reported. The researchers also found that certain nongenetic factors (including use of proton pump inhibitors and higher clopidogrel loading doses) were associated with early stent thrombosis. “Future studies are needed to validate the prognostic accuracy of these risk factors in prospective cohorts,” the investigators concluded.

Changes in the blurring of the cortical gray and white matter border were associated with lower verbal expression abilities, according to a study that was published in the October 26 issue of the Journal of Neuroscience. Healthy participants underwent MRI to determine their gray and white matter contrast (GWC), and they also completed measures of verbal expression and verbal working memory. The investigators found that blurring in the participants’ left hemisphere inferior frontal cortex and temporal pole was associated with reduced verbal expression abilities, and that reduced verbal working memory was associated with blurring in widespread left frontal and temporal cortices. “Such lateralized and focal results provide support for GWC as a measure of regional functional integrity and highlight its potential role in probing the neuroanatomic substrates of cognition in healthy and diseased populations,” the researchers concluded.

The FDA has approved ONFI (clobazam) for use as an adjunctive therapy for seizures that are associated with Lennox-Gastaut syndrome in patients who are two years and older. ONFI (Lundbeck, Inc; Deerfield, Illinois) is an oral antiepileptic drug and is a derivative of benzodiazepine. The drug will be available in 5-, 10-, and 20-mg tablets. The exact mechanism of action of clobazam is not fully understood, but it is thought to involve potentiation of GABA-ergic neurotransmission resulting from binding at the benzodiazepine site of the GABA A receptor. The FDA’s approval was based on the results of two multicenter controlled studies, including a phase 3 trial involving 238 patients with Lennox-Gastaut syndrome who experienced a significant reduction in the weekly frequency of drop seizures. The most common side effects of clobazam include sleepiness, fever, drooling, aggressive behavior, irritability, and lack of coordination.

People who rate their health as poor or fair may be significantly more likely to develop Alzheimer’s disease or vascular dementia, compared with those who rate their health as good, according to a study that was published in the October 11 issue of Neurology. Study participants rated their health status at baseline (as “good,” “fair,” or “poor”) and were followed for a median of 6.7 years for the incidence of dementia. During the follow-up period, 618 participants developed dementia, and risk of dementia was increased among participants with poor (hazard ratio, 1.70) or fair (hazard ratio, 1.34) self-rated health, compared with participants with good self-rated health. “Self-rated health could help raise awareness of medical doctors about a patient’s risk of dementia, especially in those without conditions indicative of potential cognitive impairment,” the investigators concluded.

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