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July 2008 Briefing - Neurology

Here are what the editors at HealthDay consider to be the most important developments in Neurology for July 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Genetic Factor Studied in Susceptibility to Migraine

THURSDAY, July 31 (HealthDay News) -- Carriers of the MTHFR 677C>T genotype who have migraines with aura are at increased risk of cardiovascular disease, according to research published online July 30 in Neurology.

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FDA Approves First Generic Divalproex Sodium

WEDNESDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has approved generic versions of Depakote delayed-release tablets (divalproex sodium) for the first time, according to a press release issued by the FDA this week.

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Androgen-Deprivation Therapy May Harm Cognition

WEDNESDAY, July 30 (HealthDay News) -- In men with prostate cancer, androgen-deprivation therapy may be associated with subtle but significant cognitive declines, according to a study published online July 29 in Cancer.

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Statin Use May Decrease Cognitive Impairment

TUESDAY, July 29 (HealthDay News) -- Statin use is associated with a significant decline in dementia and other cognitive impairment, according to the July 29 issue of Neurology.

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Dementia Linked to Both High and Low Thyrotropin Levels

TUESDAY, July 29 (HealthDay News) -- Abnormal thyrotropin levels in women are associated with the development of Alzheimer's disease, according to the July 28 issue of the Archives of Internal Medicine.

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Dementia Rate May Be Underestimated in Some Areas

MONDAY, July 28 (HealthDay News) -- Usage of the DSM-IV may markedly underestimate the prevalence of dementia in less developed areas of the world, according to research published online July 28 in The Lancet.

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Subtotal Discectomy Decreases Reoperation Rates

FRIDAY, July 25 (HealthDay News) -- Subtotal discectomy decreases reherniation after lumbar discectomy and is more effective than fragment excision alone, according to an article published in the July issue of the Journal of Spinal Disorders & Techniques.

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West Nile Virus Cases Reported in 14 States

FRIDAY, July 25 (HealthDay News) -- There were 43 cases of West Nile virus reported from 14 states this year up to July 22, according to a report published in the July 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Elderly Sleep Fewer Hours Than Younger People

FRIDAY, July 25 (HealthDay News) -- The elderly have a lower tendency to sleep during the day and sleep about 1.5 hours less per day than younger people, which could have implications for age-related insomnia, researchers report in the Aug. 5 issue of Current Biology.

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Vacuum-Assisted Wound Closure Improves Healing

FRIDAY, July 25 (HealthDay News) -- Vacuum-assisted wound closure (VAC) may assist wound healing in spinal procedures complicated by wound infections, according to a report the July issue of the Journal of Spinal Disorders & Techniques.

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Cognitive Function Poorer with Coronary Heart Disease

THURSDAY, July 24 (HealthDay News) -- Coronary heart disease is associated with poor cognitive performance in middle age, with greater declines in cognitive function among men with increased time since first coronary event, according to an article published online July 22 in the European Heart Journal.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Spinal Cord Neural Stem Cells Migrate into Injury

WEDNESDAY, July 23 (HealthDay News) -- A population of neural stem cells lining the central canal of the spinal cord in mice migrate into injured spinal cord and contribute to scar formation, according to the results of a study published in the July issue of PLoS Biology.

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Memory and Central Auditory Function Related

WEDNESDAY, July 23 (HealthDay News) -- A stepwise decline in central auditory function was noted when comparing patients with mild memory impairment and no dementia to Alzheimer's patients with memory loss, according to an article published in the July issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Topiramate Therapy During Pregnancy Raises Concerns

TUESDAY, July 22 (HealthDay News) -- The use of topiramate as monotherapy or as an adjunct to other treatment for epilepsy during pregnancy raises some concerns about the increased risk of congenital malformation, according to a report published in the July 22 issue of Neurology.

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New Technique Decreases Radiation Exposure

MONDAY, July 21 (HealthDay News) -- The use of navigation-assisted fluoroscopy for minimally invasive spine surgery is both possible and safe, according to an article published in the July issue of The Spine Journal.

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Dimebon Improves Cognition in Alzheimer's Patients

FRIDAY, July 18 (HealthDay News) -- Dimebon improved the clinical course of patients with mild-to-moderate Alzheimer's disease and was both safe and well tolerated, according to the results of a study published in the July 19 issue of The Lancet.

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New Technique Identifies Correct Operative Spinal Level

FRIDAY, July 18 (HealthDay News) -- Computer-assisted image guidance may improve identification of the correct vertebral level prior to spinal surgery, according to an article published in the July issue of The Spine Journal.

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Intraoperative Radiographs Essential for Avoiding Errors

FRIDAY, July 18 (HealthDay News) -- Intraoperative radiographs and other precautions are critical for preventing incorrect-site surgery among neurosurgeons, according to three letters to the editor published in the July issue of the Journal of Neurosurgery: Spine, in response to a previous report.

Full Text (subscription or payment may be required) - Ammerman
Full Text (subscription or payment may be required) - Sahjpaul
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Longer Sleep Linked to Higher Stroke Risk in Older Women

FRIDAY, July 18 (HealthDay News) -- Sleep duration affects the risk of stroke in postmenopausal women, with a sharply higher risk for women who sleep more than seven hours a night, according to research published online July 17 in Stroke.

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Brain Stimulation Benefits Adults with Lazy Eye

FRIDAY, July 18 (HealthDay News) -- Non-invasive stimulation of the visual cortex can temporarily improve contrast sensitivity in the affected eye of adults with lazy eye, according to a report in the July 22 issue of Current Biology.

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Nerve Changes Occur After Organophosphate Poisoning

THURSDAY, July 17 (HealthDay News) -- Intermediate syndrome (IMS), or muscle paralysis or weakness caused by organophosphates found in pesticides and nerve agents, is associated with distinct changes in nerve activity that improve with recovery, according to an article published online July 15 in PLoS Medicine.

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Pseudoaneurysm After Spinal Device Migration Treatable

THURSDAY, July 17 (HealthDay News) -- Pseudoaneurysm of the aorta due to device migration is a rare but treatable complication following placement of an anterior spinal device, according to an article published in the July issue of The Spine Journal.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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Study Points to Interaction of Stress, Glucocorticoid Receptor

THURSDAY, July 17 (HealthDay News) -- Glucocorticoid receptors in the forebrain appear to be necessary for glucocorticoid feedback inhibition of acute psychogenic but not systemic stress responses, according to the results of a study in mice published online July 10 in Endocrinology.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Revised Mental Exam Cut Score May Benefit Well-Educated

TUESDAY, July 15 (HealthDay News) -- A cut score of 27 on the Mini-Mental State Examination (MMSE) may be more useful in identifying dementia in older patients with a college education than the traditional cut score of 24, according to research published in the July issue of the Archives of Neurology.

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Fitness May Reduce Brain Atrophy in Alzheimer's Disease

TUESDAY, July 15 (HealthDay News) -- In patients with early Alzheimer's disease, increased cardiorespiratory fitness is associated with reduced brain atrophy, but the reasons are unclear, according to a study published in the July 15 issue of Neurology.

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Dietary Cocktail Improves Memory in Animal Study

MONDAY, July 14 (HealthDay News) -- A dietary cocktail containing an omega-3 fatty acid significantly improves memory and learning in gerbils, suggesting that a similar cocktail may benefit patients with Alzheimer's disease and other forms of dementia, according to a report published online July 7 in the FASEB Journal: The Journal of the Federation of American Societies of Experimental Biology.

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Muscle Stem Cells Can Treat Mouse Muscular Dystrophy

MONDAY, July 14 (HealthDay News) -- Muscle stem cells can be purified and used to improve muscle function in a mouse model of muscular dystrophy, according to the results of a study published in the July 11 issue of Cell.

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Abnormal Scan Predicts Poor Prognosis in Mild Brain Injury

FRIDAY, July 11 (HealthDay News) -- Children with normal computed tomography (CT) findings perform better in multiple cognitive domains one year after mild traumatic brain injury (MTBI) than children with CT evidence of intracranial pathology, according to an article published in the June issue of the Journal of Neurosurgery: Pediatrics.

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Nutrition Linked to Survival in Traumatic Brain Injury

FRIDAY, July 11 (HealthDay News) -- Beginning nutritional support within five days of severe traumatic brain injury is associated with a decrease in two-week mortality, according to research published in the July issue of the Journal of Neurosurgery.

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Heavy Drinking Linked to Stroke and Heart Disease

FRIDAY, July 11 (HealthDay News) -- Men who drink heavily have a higher risk of death from stroke, while women who drink heavily have a higher risk of death from coronary heart disease, but light-to-moderate drinking lowers the risk of death from cardiovascular disease in both sexes, according to research published online July 10 in Stroke.

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Prevalence of Atherosclerosis in Alaska Eskimos High

FRIDAY, July 11 (HealthDay News) -- Despite their traditional diet high in fish oils that are protective against coronary artery disease, Alaska Eskimos have higher rates of atherosclerosis than the general United States population and similar risk factors for cardiovascular disease, according to a report published online July 10 in Stroke.

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Technology Improves Assessment of Bone Fusion

THURSDAY, July 10 (HealthDay News) -- While assessment of osseous fusion post arthrodesis is difficult, computer-assisted techniques may decrease subjectivity in assessing post-operative fusion, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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Therapy Shows Transient Benefits in Parkinson's Disease

THURSDAY, July 10 (HealthDay News) -- Treatment with extradural motor cortex stimulation in four patients with Parkinson's disease led to some improvements in the first six months that were largely lost by the end of the year, researchers report in the July issue of the Journal of Neurosurgery.

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NSAIDs Improve Postoperative Neurosurgical Pain Control

WEDNESDAY, July 9 (HealthDay News) -- Supplementing opioid analgesics in lumbar spine surgery with non-steroidal anti-inflammatory drugs (NSAIDs) provides better pain control than opioid analgesics alone, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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MRI Signal Intensity Needs More Study As Outcome Predictor

WEDNESDAY, July 9 (HealthDay News) -- Postoperative MRI signal intensity does not significantly reflect postoperative symptoms or outcomes, according to an article published in the June issue of the Journal of Neurosurgery: Spine.

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Early Intervention with Drugs Offers Migraine Relief

TUESDAY, July 8 (HealthDay News) -- Taking a single-tablet formulation of sumatriptan and naproxen sodium soon after the onset of migraine was effective and well-tolerated for treating traditional and non-traditional symptoms, according to research published in the July 8 issue of Neurology.

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Hypertension Treatment Beneficial in Very Elderly

TUESDAY, July 8 (HealthDay News) -- Treatment of very elderly patients for high blood pressure may slightly lower the risk of dementia but is clearly beneficial in reducing strokes and mortality, according to research published online July 8 in The Lancet Neurology.

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Cortical Subarachnoid Space Important in Hydrocephalus

MONDAY, July 7 (HealthDay News) -- In the management of hydrocephalus, the role of the cortical subarachnoid space has been largely ignored and the use of a shunt with an adjustable valve does not prevent the development of slit-like ventricles, according to two studies published in the July issue of the Journal of Neurosurgery: Pediatrics.

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Serotonin Levels May Play Role in Sudden Infant Death

MONDAY, July 7 (HealthDay News) -- Abnormalities in serotonin balance in mice can lead to drops in heart rate and body temperature, and death within months of birth, and the findings may aid research on sudden infant death syndrome (SIDS), according to the results of a study published in the July 4 issue of Science.

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Neurological Status Affects Morbidity in Cervical Fusion

MONDAY, July 7 (HealthDay News) -- Myelopathy increases complications during cervical fusion, regardless of the surgical approach, researchers report in the July issue of the Journal of Neurosurgery: Spine.

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Research Supports Surgery for Refractory Depression

MONDAY, July 7 (HealthDay News) -- Mounting evidence suggests that depression is a network disorder instead of a condition related to perturbation of a single neurotransmitter or brain region, suggesting that surgical interventions such as deep brain stimulation may benefit selected patients with refractory depression, according to two studies published in the July issue of Neurosurgical Focus.

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Dementia Prevalence Increases in Oldest Women But Not Men

THURSDAY, July 3 (HealthDay News) -- The prevalence of dementia doubles every five years in women aged 90 years and older but remains stable in men, according to a report published online July 2 in Neurology.

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Rosiglitazone Linked to Less Neuropathy in Diabetic Mice

THURSDAY, July 3 (HealthDay News) -- In a mouse model of diabetic neuropathy, rosiglitazone improved a measure of thermal latency and reduced oxidative stress in the sciatic nerve, and novel transcriptional control sequences were found in genes correlated with diabetic neuropathy, according to research published online June 26 in Endocrinology.

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Only Six New Pediatric Neurosurgeons A Year

THURSDAY, July 3 (HealthDay News) -- Although the infrastructure exists to train more than 20 pediatric neurosurgeons a year in the United States, the current system is only producing approximately six surgeons a year with American Board of Pediatric Neurological Surgery certification, raising concerns about the sufficiency of expertise in this area, according to an article published in the June issue of the Journal of Neurosurgery: Pediatrics.

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Modified Mice Less Susceptible to Multiple Sclerosis

WEDNESDAY, July 2 (HealthDay News) -- Mice lacking a certain protein are less susceptible to developing a form of multiple sclerosis due to reduced migration of lymphocytes into the central nervous system, according to the results of a study published in the July 8 issue of the Proceedings of the National Academy of Sciences.

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Questionnaire Evaluates Everyday Cognition in Elderly

WEDNESDAY, July 2 (HealthDay News) -- A caregiver-rated questionnaire to evaluate everyday cognitive function in the elderly is effective and can differentiate between cognitively normal and impaired individuals, according to a report in the July issue of Neuropsychology.

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Cholesterol Level Linked to Poor Memory in Middle Aged

TUESDAY, July 1 (HealthDay News) -- Middle-aged individuals with low high-density lipoprotein cholesterol (HDL-C) levels are at higher risk of poor memory and memory decline than individuals with high levels of HDL-C, according to the results of a study published online June 30 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Physician's Briefing