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Study: Deep brain stimulation may slow Parkinson’s disease

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Data from a five-year clinical trial is adding to growing evidence that deep brain stimulation, or DBS, can slow the ravages of Parkinson’s disease.

Researchers at Vanderbilt University Medical Center in Nashville, Tenn., said that the therapy appears to curb any worsening of tremor and other symptoms, as well as lessening a patient’s need for medications.

“Parkinson’s is relentless,” senior study author Dr. David Charles, Vanderbilt professor and vice-chair of neurology, said in a medical center news release. “There’s nothing that slows down its progression.”

However, “with this pilot study, we’ve shown that if DBS is implanted early it’s likely to decrease the risk of progression, and if this is borne out in our larger study it would be a landmark achievement in the field of Parkinson’s disease,” he said.

The new study was small — just 30 patients. Between 2006 and 2009, the participants were randomly selected to receive either the optimal Parkinson’s disease drug therapy, or optimal drug therapy plus DBS.

In DBS, doctors surgically implant a pair of ultra-thin electrodes deep into the brain. The electrodes target electric pulses to the subthalamic nucleus, a small cluster of neurons. Similar to a heart pacemaker, the device is powered by a small battery implanted under the skin near the patient’s collarbone.

After five years, patients who’d received only the drug therapy had a five times higher risk of progression of “rest tremor” — a key Parkinson’s symptom — compared to those patients who’d gotten the electrode implants as well as drug therapy, the researchers reported.

What’s more, patients who got DBS needed far fewer meds going forward.

“Patients who were randomized to receive early optimal drug therapy [only] had 15-fold greater odds of needing multiple types of Parkinson’s disease medications,” study project leader Mallory Hacker, an assistant professor of neurology at the medical center, said in the news release.

The evidence of reductions in another key Parkinson’s symptom — worsening motor symptoms — did not reach statistical significance, the researchers said, although there was a trend suggesting a benefit from DBS.

Still, this study was small and the results should be considered preliminary, Charles said.

“While this is an incredibly exciting finding, patients and physicians should not change clinical practice at this time,” Charles said. “What this pilot study is most clearly telling us is that the new FDA-approved Phase III study must be done to definitively determine whether DBS slows the progress of Parkinson’s disease when implanted in the very earliest stages.”

Dr. David Weintraub directs functional neurosurgery at North Shore University Hospital in Manhasset, N.Y. Reading over the study he said that it “provides evidence that the use of DBS surgery early in the course of Parkinson’s disease can have meaningful benefits for patients compared to medication alone.”

Weintraub agreed that the findings remain preliminary. However, he said that positive results from a “larger scale, multicenter trial could potentially lead to the adoption of DBS surgery even earlier in the course of Parkinson’s disease treatment, which would be a very significant advance in the field.”

The study was published in the July issue of Neurology. It received funding from the U.S. National Institutes of Health, the Michael J. Fox Foundation for Parkinson’s Research, and Medtronic, Inc., the manufacturer of the DBS system used in the trial.

More information

Visit the Parkinson’s Foundation for more on Parkinson’s disease.

Copyright 2020 HealthDay. All rights reserved.



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Almost 14 million U.S. adults vape, with use rising fastest in young

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The number of Americans using electronic cigarettes is soaring, especially among youth, a new study finds.

Nearly 14 million U.S. adults vaped in 2018, up from just over 11 million adults in 2016. The increase was seen in all socioeconomic groups, the researchers found.

“An increasing number of individuals are using e-cigarettes, especially in the younger age groups, which suggests that more individuals are becoming addicted to e-cigarettes rather than just experimenting with them, making the increased uptake among tobacco-naive individuals even more concerning,” said lead researcher Dr. Olufunmilayo Obisesan. She’s a postdoctoral fellow at Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, in Baltimore.

“The increase in e-cigarette use among individuals with other health-risk behaviors is also concerning, particularly in light of the outbreak of e-cigarette or vaping use-associated lung injuries that has been linked to the vaping of tetrahydrocannabinoids [THC],” she said. THC is the main mind-altering ingredient found in marijuana.

Between 2016 and 2018, young adults aged 18 to 24 years old were the fastest-growing population to start using e-cigarettes. E-cigarette use in that age group increased from 9% in 2016 to 15% in 2018, and use among students increased from 6% in 2016 to 12% in 2018.

E-cigarette use even increased among people who had never smoked traditional cigarettes — from more than 1.4% in 2016 to 2.3% in 2018, the findings showed.

Also, people who were into other risky behaviors — such as drinking alcohol and smoking marijuana — were more likely to use e-cigarettes, the study authors said.

For the study, the researchers collected data on more than one million Americans who took part in the Behavioral Risk Factor Surveillance System for 2016 to 2018.

“Increase in e-cigarette use among adults in the U.S., particularly daily use, is reflective of the addictive potential of e-cigarettes,” Obisesan said. “This is very important to note, particularly for the youth and for individuals who currently use or are considering using them as a means of experimentation.”

The report was published online Sept. 8 in JAMA Internal Medicine.

Stanton Glantz, a professor of medicine at the Center for Tobacco Control, Research and Education at the University of California, San Francisco, said the increase in e-cigarette use is troubling because the health risks of e-cigarettes are similar to the risks linked to traditional cigarettes.

“I think there’s some things that are pretty clear now — one is in terms of lung disease. E-cigarettes are about as bad as cigarettes — you’re still breathing in ultrafine particles, heavy metals and flavors that have high pulmonary toxicity,” he said.

Glantz also pointed out that the damage e-cigarettes can cause in the lungs may also make COVID-19 infections more severe.

E-cigarette use has also been tied to an increased risk of heart disease, and in animal experiments, to cancer and DNA damage, he added.

The bottom line for Glantz is that e-cigarettes aren’t safe alternatives to regular cigarettes and often lead to dual use.

The U.S. Food and Drug Administration has the power to regulate e-cigarettes, and they could actually ban them, Glantz said.

“The FDA can simply say, we’re not going to allow these products to be sold,” he said. “In order to sell e-cigarettes in the United States, you need to have what’s called a marketing order. If the FDA doesn’t grant a marketing order, then the product can’t be sold. If the product can’t be legally sold, that will solve the problem.”

More information

For more on e-cigarettes, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Study: NSAID pain relievers don’t increase risk for severe COVID-19

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Sept. 8 (UPI) — People who use non-steroidal anti-inflammatory drugs, or NSAIDs, to treat pain are not at risk for more severe illness from COVID-19, according to a study published Tuesday by the journal PLOS Medicine.

Among users of NSAID pain relievers like ibuprofen and diclofenac infected with the new coronavirus, nearly 25% needed to be hospitalized, 5% required admission to the intensive care unit and 6.3% died, the data showed.

To compare, for those who did not use these drugs but tested positive for COVID-19, 21% were hospitalized, 5% needed ICU care and 6.1% died.

In the early phases of the pandemic, there were concerns that the use of the painkiller ibuprofen may lead to a more severe course of coronavirus disease, the researchers, from the University of Southern Denmark and Aarhus University Hospital in Denmark, said.

“Considering the available evidence, there is no reason to withdraw well-indicated use of NSAIDs during the pandemic,” they wrote.

“However, the well-established adverse effects of NSAIDs, particularly their renal, gastrointestinal and cardiovascular effects, should always be considered, and NSAIDs should be used in the lowest possible dose for the shortest possible duration for all patients,” they said.

Ibuprofen and other NSAIDs are some of the most commonly used medications in the United States, with an estimated 30 million doses consumed and 70 million prescriptions administered annually, according to the American College of Rheumatology.

For this study, the researchers obtained data on all 9,326 Danish residents who tested positive for COVID-19 between Feb. 27 and April 29, including NSAID use, hospitalization, ICU admission and need for mechanical ventilation and acute renal replacement therapy.

Overall, 248 people — or just under 3% — of the patients included in the analysis had filled a prescription for NSAIDs within 30 days of their positive virus test, according to the researchers.

There was no association between disease severity and NSAID use, the researchers said.

Another study published Aug. 12 had similar findings.



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Low-dose electrical stimulation helps adults with dyslexia read, study finds

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Sept. 8 (UPI) — Electrical stimulation of the brain improves reading accuracy in adults with dyslexia, according to a study published Tuesday by PLOS Biology.

Transcranial alternating current stimulation, a non-invasive procedure that delivers low-dose electricity to the brain over a period of 20 minutes, was found to improve phonological processing — or ability to discern how words sound or are pronounced — and reading accuracy in 15 adults with dyslexia, the researchers said.

The beneficial effect on phonological processing was most pronounced in those individuals who had poor reading skills, while a slightly disruptive effect was observed in very good readers, they said.

Dyslexia, known commonly as a reading disorder, affects up to 10% of the population, and is characterized by lifelong difficulties with written material,” according to the researchers, who are from the University of Geneva in Switzerland.

Although several possible causes have been proposed for dyslexia, the predominant one is a phonological deficit, or a difficulty in processing word sounds, the researchers said.

The phonological deficit in dyslexia is associated with changes in rhythmic or repetitive patterns of electrical activity in the brain, specifically “low-gamma” oscillations, measuring at 30 hertz or volts, in the left auditory cortex, they said.

However, studies have yet to prove that these these oscillations affect a person’s ability to process word sounds and cause dyslexia, the researchers said.

For this study, the researchers applied transcranial alternating current stimulation over the left auditory cortex in 15 adults with dyslexia and 15 fluent readers for 20 minutes.

At a dose of 30 hertz or volts, the approach resulted in significant improvement in reading accuracy in those with dyslexia, the researchers said.

However, the same improvements were not seen following application of a higher, 60-hertz dose, they said.

The results demonstrate for the first time that low-gamma oscillatory activity causes deficits in phonemic processing and may pave the way to non-invasive treatments aimed at normalizing oscillatory function in auditory cortex in people with dyslexia, the researchers said.

They plan “to investigate whether normalizing oscillatory function in very young children could have a long-lasting effect on the organization of the reading system [and] explore even less invasive means of correcting oscillatory activity,” study co-author Silvia Marchesotti, a post-doctural researcher at the University of Geneva, said in a press release.



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