New and Noteworthy Information—March 2015
Women with Alzheimer’s disease had stable cognition for a year when they received leuprolide acetate, according to a study published in the January 1 issue of Journal of Alzheimer’s Disease. The clinical trial followed 109 women with mild to moderate Alzheimer’s disease who were randomized to low-dose leuprolide acetate, high-dose leuprolide acetate, or placebo. Among patients taking an acetylcholinesterase inhibitor, researchers saw a statistically significant benefit in the high-dose leuprolide acetate group, compared with the other groups, as determined by the Alzheimer’s Disease Assessment Scale-cognitive subscale. Mean decline was 0.18 for the high-dose group, 4.21 for the low-dose group, and 3.30 for the placebo group. “This is the first time any therapy has been shown to stabilize memory loss over a year,” the researchers said.
The rate of favorable seizure outcome or seizure freedom after resective epilepsy surgery is significant and remains stable for more than 15 years, according to a study published online ahead of print January 19 in Epilepsy & Behavior. The findings were based on a telephone survey of 253 patients who underwent resection to treat localization-related epilepsy during an 18-year period. The mean age at the time of surgery was 35.4, with a range from five months to 71. Investigators found that 92% of patients surveyed considered epilepsy surgery worthwhile, 32% were seizure-free, and 75% had favorable results. Favorable and seizure-free outcome rates remained stable after surgery over long-term follow-up. Compared with baseline, patients were more likely to be driving and taking antidepressant medication, but less likely to be employed full-time after surgery.
Nearly one in five adults with epilepsy has symptoms of attention deficit hyperactivity disorder (ADHD), which are associated with increased psychosocial morbidity and lowered quality of life, according to a study published online ahead of print January 15 in Epilepsia. In the study, researchers mailed a survey to a national sample of adult patients with epilepsy, as part of the Epilepsy Comorbidities and Health study. The relationship of ADHD symptoms to quality of life outcomes was examined using statistical analyses, which also looked at sociodemographics, depression, anxiety, seizure frequency, and number of antiepileptic drugs. Nearly one-fifth (18.4%) of 1,361 respondents with active epilepsy were classified as experiencing significant ADHD symptoms. “This study reinforces the fact that we have to broaden our view of what epilepsy entails,” said the investigators.
Triheptanoin corrects the bioenergetic profile in the brain of patients with Huntington’s disease early in the course of the disease, according to a study published online ahead of print January 7 in Neurology. Researchers used MRI brain scans to analyze the energy profile before, during, and after the brain was visually stimulated in nine people in the early stages of Huntington’s disease and 13 people without the disease. In the people without the disease, the brain’s metabolism increased during the stimulation, then returned to the normal level. In people with Huntington’s disease, there was no change in metabolism. For the second part of the study, participants with Huntington’s disease received triheptanoin. When these participants underwent the visual stimulation test again, their brain metabolism was normal.
A common gut microbe may curb the risk of developing multiple sclerosis (MS) in women, according to a study published online ahead of print January 19 in the Journal of Neurology, Neurosurgery & Psychiatry. Researchers tested 550 people with confirmed MS and a comparison group of 299 healthy people, matched for age and sex, for antibodies to H. pylori between 2007 and 2011. The prevalence of the infection was significantly lower in participants with MS than in the comparison group, but only among women, in whom it was 30% lower. Among men, a positive test result was linked to higher rates of disability, but a positive test was associated with lower disability among women. The researchers found no evidence of any link between the presence of the infection and relapse rate.
Among patients with relapsing-remitting multiple sclerosis (MS), nonmyeloablative hematopoietic stem cell transplantation is associated with improvement in neurologic disability and other clinical outcomes, according to a study published January 20 in JAMA. In a case series of patients with relapsing-remitting MS or secondary progressive MS, participants received transplantation and were followed up for five years. In all, 41 patients (50%) had significant improvement in Expanded Disability Status Scale score at two years, and 23 patients (64%) had significant improvement at four years. Receipt of hematopoietic stem cell transplantation was associated with improvement in physical function, cognitive function, and quality of life. In addition, treatment was associated with a reduction in the volume of brain lesions associated with MS seen on MRI.
