New and Noteworthy Information—January 2015
Brains affected by autism share a pattern of increased immune responses, according to a data analysis published December 10 in Nature Communications. The researchers examined gene expression in samples from two tissue banks, comparing gene expression in people with autism with that in controls without the condition. Data from 104 brain samples from 72 individuals were analyzed. The investigators focused their analysis on microglial cells. In the brains with autism, the microglial cells appeared to be perpetually activated, and their genes for inflammation responses were activated. The results highlight “the lack of current understanding about how innate immunity controls neural circuits,” stated the study authors. Given the known genetic contributors to autism, inflammation is unlikely to be its root cause, they added.
Compared with placebo, progesterone did not improve outcomes when administered to patients with acute traumatic brain injury (TBI), according to a study published online ahead of print December 10 in the New England Journal of Medicine. Patients were randomly assigned to IV progesterone or placebo, and study treatment was initiated within four hours after injury and administered for 96 hours. The trial was stopped for futility. The researchers found no significant difference between the progesterone group and the placebo group in the proportion of patients with a favorable outcome. Favorable outcomes occurred in 51% of patients who received progesterone and in 56% of those who received placebo. Mortality after six months was 18.8% for participants receiving progesterone and 15.7% for those receiving placebo. Phlebitis was more common in the progesterone group.
Learning-related brain activity in patients with Parkinson’s disease improves as much in response to placebo as to medication, according to a study published in the December issue of Nature Neuroscience. For the study, researchers used functional MRI to scan the brains of 18 patients with Parkinson’s disease as they played a computer game that measures reward learning. In the game, participants discover through trial and error which of two symbols is more likely to lead to a better outcome. Participants played the game when they were not taking medication, when they took medication, and when they took placebo. The researchers found that the dopamine-rich areas of the brain associated with reward learning became equally active when patients took either the real medication or the placebo.
Oral fingolimod may improve outcomes for patients with acute and anterior cerebral circulation occlusion stroke, according to a study published online ahead of print December 8 in Proceedings of the National Academy of Sciences. The researchers conducted an open-label, evaluator-blinded, parallel-group clinical pilot trial of 22 patients with anterior cerebral circulation occlusion, among whom stroke onset had occurred more than 4.5 hours previously. Participants received standard management alone or standard management plus 0.5 mg of oral fingolimod per day for three consecutive days. Patients receiving fingolimod had lower circulating lymphocyte counts, milder neurologic deficits, and better recovery of neurologic functions. Neurologic rehabilitation was faster among participants who received fingolimod. In addition, enlargement of lesion size was less pronounced between baseline and day seven among patients who received fingolimod.
Migraine headache may double the risk of Bell’s palsy, according to a study published online ahead of print December 17 in Neurology. Two groups of 136,704 people age 18 and older, one group with migraine and one without, were followed for an average of three years. During that time, 671 people in the migraine group and 365 people in the control group were diagnosed with Bell’s palsy. Participants with migraine were twice as likely to develop Bell’s palsy, even after researchers accounted for other factors that could increase the risk of the condition, such as sex, high blood pressure, and diabetes. “Infection, inflammation, or heart and vascular problems could be shared causes for these diseases,” stated the researchers.
Struggling to balance on one leg for 20 seconds or longer is linked to an increased risk for small blood vessel damage in the brain and reduced cognitive function in healthy people with no clinical symptoms, according to a study published online ahead of print December 18 in Stroke. Investigators examined 841 women and 546 men with an average age of 67. To measure one-leg standing time, participants stood with their eyes open and raised one leg. In all, 34.5% of participants with more than two lacunar infarction lesions had trouble balancing, 16% of people with one lacunar infarction lesion had trouble balancing, 30% of participants with more than two microbleed lesions had trouble balancing, and 15.3% of people with one microbleed lesion had trouble balancing.
