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Environmental and social factors could increase the likelihood of heart disease and stroke development

Recent research of significant importance published in the Journal of the American Heart Association, an accessible, peer-reviewed journal, suggests that individuals residing in areas plagued by social and environmental challenges could face a twofold increase in the risk of heart disease and stroke. The study, a beacon of knowledge, highlights a broad range of ecological adversities such as air and water pollution, potentially harmful or toxic locations, scarcity of recreational parks, and proximity to busy roads, railways, or airports. Social vulnerabilities were identified based on factors including racial and ethnic minority status, socio-economic aspects like income, education, employment levels, housing situations, and the availability of internet and healthcare.

Sarju Ganatra, M.D., the study’s senior author, emphasised the research’s novelty in considering both social and environmental factors simultaneously, aiming to understand their intricate relationship. Dr Ganatra, who serves as a cardiologist and vice-chair in the department of medicine for research and is the director of the Cardio-Oncology Program and South Asian Cardio-Metabolic Program at Lahey Hospital and Medical Center in Burlington, Massachusetts, detailed the comprehensive nature of this analysis.

The study assessed environmental disadvantages across U.S. census tracts using the Environmental Justice Index, which incorporates data from the U.S. Census Bureau, the Environmental Protection Agency, the Mine Safety and Health Administration, and the Centers for Disease Control and Prevention. The findings were revealing: individuals in the most environmentally vulnerable areas experienced a 1.6-fold increase in the occurrence of blocked arteries and more than double the rate of strokes compared to those in less vulnerable areas. Further, these areas also reported significantly higher rates of cardiovascular risk factors, including Type 2 diabetes, chronic kidney disease, high blood pressure, and obesity.

The study also shed light on the demographic distribution of environmental burdens, noting that a significant portion of the U.S. population, particularly among younger adults and Black and Hispanic communities, resides in areas with high ecological risks. Dr. Ganatra expressed surprise at the strong correlation between social and environmental factors and their combined impact on health outcomes, even after adjusting for socio-economic variables.

Addressing the urgent consequences of social and environmental disadvantages, the researchers strongly advocate for a comprehensive strategy involving pollution reduction, poverty alleviation, urban renewal, education improvement, job creation, affordable housing, and ensuring universal healthcare access. The goal is to enable healthcare providers to better educate patients about the environmental risks they face, thereby empowering individuals to minimise their exposure to health hazards.

In line with these findings, the American Heart Association’s policy statement in March 2024 calls for integrated public policies to adapt cities for heart-healthy, sustainable living. It emphasises the importance of urban provisioning systems, including energy, mobility, housing, green infrastructure, water, and waste management, in improving the cardiovascular and metabolic health of urban populations.

The study employed the 2022 Environmental Justice Index, a socio-environmental justice index, and an environmental burden module to evaluate the cumulative impact of ecological injustice across over 71,000 U.S. census tracts. By comparing age-adjusted rate ratios of blocked arteries, strokes, and various health measures from the Prevention Population-Level Analysis and Community Estimates data, the research provides a detailed analysis of the pervasive influence of socio-environmental factors on health.

More information: Sumanth Khadke et al, Association of Environmental Injustice and Cardiovascular Diseases and Risk Factors in the United States, Journal of the American Heart Association. DOI: 10.1161/JAHA.123.033428

Journal information: Journal of the American Heart Association Provided by American Heart Association

Using generative AI to convert inpatient discharge summaries into a language and format that is friendly for patients

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This study, which analysed 50 discharge summaries, indicates that large language models (LLMs) can potentially render these summaries into formats that are much more accessible and understandable for patients than their original form in electronic health records. Despite this promise, hurdles need to be addressed, such as enhancing the accuracy, completeness, and safety of the translated summaries. Concerns over safety underscore the need for physician oversight in the early stages of implementation.

The core inquiry of this research was whether LLMs could effectively reformat discharge summaries to make them easier for patients to read and understand. The study’s findings revealed a notable improvement in the readability and comprehensibility of patient-friendly discharge summaries. The summaries were deemed completely comprehensive in 56 out of 100 evaluations, yet 18 reviews raised alarms about potential safety risks due to omissions and inaccuracies.

These outcomes are significant because they demonstrate that LLMs can indeed serve as tools for converting discharge summaries into patient-friendly language and structures. However, this potential comes with the caveat that before such a model can be implemented widely, it is imperative to address the concerns related to accuracy, completeness, and safety. The initial phase of introducing this innovative approach will necessitate a review by medical professionals to mitigate safety risks.

In essence, while the study underscores LLMs’ capacity to make discharge summaries more accessible to patients, it also highlights the importance of refining these tools to ensure they meet the highest standards of medical communication. The dual focus on innovation and safety reflects a cautious yet optimistic approach to leveraging AI in healthcare to enhance patient understanding and engagement in their care processes.

More information: Jonah Zaretsky et al, Generative Artificial Intelligence to Transform Inpatient Discharge Summaries to Patient-Friendly Language and Format, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2024.0357

Journal information: JAMA Network Open Provided by JAMA Network

A smartphone self-assessment for memory can detect initial indicators of Alzheimer’s disease

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The development of smartphone-based memory assessments, which have shown promise in identifying “mild cognitive impairment” (MCI), a precursor to Alzheimer’s disease, is a testament to the collaborative effort between researchers at the German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, University of Wisconsin-Madison, and the Magdeburg-based company neotiv. This significant advancement, published in the journal npj Digital Medicine, results from a study involving 199 older adults and underscores the potential of mobile applications in Alzheimer’s research, clinical trials, and regular healthcare. The app, a product of this collective effort, is now available to healthcare professionals to assist in the early identification of memory issues.

Memory impairment is a hallmark symptom of Alzheimer’s disease, crucial for both diagnosis and research. Traditionally, memory tests are conducted in a clinical setting under the supervision of a healthcare professional, involving tasks like recalling words, listing items on a topic, or drawing shapes as per instructions. Due to their need for professional oversight, these tests must be administered at home.

Prof. Emrah Düzel, a leading figure in neurosciences at DZNE and the University of Magdeburg and an entrepreneur in medical technology, proposes a novel approach. He suggests that the ability to conduct these tests independently, akin to how one might use a long-term ECG, could facilitate earlier detection of memory impairments and closer monitoring of disease progression. That is especially pertinent given recent advances in treatments for Alzheimer’s, highlighting the importance of early diagnosis.

The collaboration between DZNE and the startup neotiv has yielded an app that empowers individuals to take control of their memory health. It allows them to perform memory tests independently using smartphones or tablets without professional oversight. The app, scientifically validated and now offered as a digital tool for doctors, aims to support the detection of MCI. Although MCI affects daily living minimally, it significantly increases the risk of developing Alzheimer’s dementia.

Dr David Berron, a research group leader at DZNE and co-founder of Neotiv, explains that the validation process compared this novel, unsupervised method with traditional, in-clinic neuropsychological tests. The findings revealed that the app’s technique is as effective as the in-clinic approach in detecting MCI with high precision, offering clinicians invaluable insights that might not be possible to obtain during a regular clinic visit. These results have been published in the respected journal “npj Digital Medicine”.

The study included participants from Germany and the USA, reflecting a range of cognitive states from healthy to those with MCI or subjective memory concerns. Participants engaged with the neotiv app over at least six weeks, conducting tests at their convenience. The app involves interactive memory tasks targeting various brain areas affected at different stages of Alzheimer’s. The German-US research team compared app-based results with traditional assessment outcomes, demonstrating the app’s efficacy in meaningful memory impairment assessment. Positive app findings could lead to further clinical examinations, while average results reassure individuals for the time being.

This approach is not only proving valuable in Alzheimer’s research but also inspiring a new era of cognitive assessments in clinical studies across several countries. Ongoing and future studies aim to validate this method in larger cohorts and investigate its utility in tracking Alzheimer’s progression. The challenge remains to integrate real-world self-assessment data with clinical profiles, a task that, according to current studies, is progressing well within the field.

More information: David Berron et al, A remote digital memory composite to detect cognitive impairment in memory clinic samples in unsupervised settings using mobile devices, npj Digital Medicine. DOI: 10.1038/s41746-024-00999-9

Journal information: npj Digital Medicine Provided by DZNE – German Center for Neurodegenerative Diseases

Research indicates that vaccinated elderly individuals seldom experienced breakthrough COVID infections

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A publication in the Journal of American Medical Directors Association (JAMDA) has revealed that nursing home residents who have been fully vaccinated against COVID-19 face a low risk of severe illness from the virus. The research highlighted that individuals aged 85 and older, particularly those with pre-existing conditions such as heart and kidney diseases, were at increased risk of vulnerability. Nonetheless, breakthrough COVID-19 infections among fully vaccinated residents were discovered to be under 10%.

The study analysed the data of 23,172 fully vaccinated nursing home residents across 984 facilities from March to November 2021. It was found that a mere 5% of these individuals developed a breakthrough infection (B.T.I.) of COVID-19, regardless of the variant, within the observed period.

Moreover, it was noted that fewer than 10% of those vaccinated residents who did experience a breakthrough infection necessitated hospitalisation or succumbed to the disease within 30 days, recording a percentage of 8.6%. It was mainly the residents aged 85 and above, with severe infections and specific comorbidities like heart and kidney diseases, who were identified as more likely to experience these outcomes.

Sarah D. Berry, M.D., M.P.H., the study’s co-author and Associate Director at the Musculoskeletal Research Center, as well as an Associate Scientist at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, stated that the study aimed to assess the frequency of breakthrough infections and severe illnesses among nursing home residents vaccinated against COVID-19.

Dr. Berry elaborated that despite the evolution of the COVID-19 virus, the likelihood of encountering a severe infection in vaccinated elderly individuals within nursing homes remains minimal. That is particularly relevant as the pandemic persists and testing policies become less stringent, offering crucial prognostic data for nursing facilities dealing with ongoing outbreaks.

The significance of the study’s findings, according to Dr Berry, lies in the indication that while the rates of B.T.I. and severe illness may fluctuate with different virus variants, the risk factors for serious illnesses appear consistent. This consistency could aid healthcare providers in predicting who might become seriously ill during future outbreaks.

This retrospective cohort study was a collaborative effort involving Brown University, N.Y.U., and the University of Michigan.

Ana Montoya, MD, M.P.H., C.M.D., serving as the Clinical Assistant Professor of Geriatric and Palliative Medicine, Medical Director at Sub-Acute Service, and Medical Director at Glacier Hills Care and Rehabilitation Center at the University of Michigan School of Medicine, took the lead as the first author of the study. Among the contributing authors were Vincent Mor, PhD, Professor of Health Services, Policy & Practice and the Florence Pirce Grant University Professor at Brown University School of Public Health; Elizabeth (Betsy) White, APRN, PhD, Assistant Professor of Health Services, Policy, and Practice at Brown University School of Public Health; and Jasmine L. Travers, AGPCNP-BC, CCRN, PhD. R.N., Assistant Professor of Nursing at N.Y.U. Rory Meyers College of Nursing.

More information: Ana Montoya et al, Resident Factors Associated With Breakthrough SARS-CoV-2 Infections, Journal of American Medical Directors. DOI: 10.1016/j.jamda.2023.02.102

Journal information: Journal of American Medical Directors Provided by Hebrew SeniorLife and Hinda and Arthur Marcus Institute For Aging Research

Why we all hate waiting

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In 1981, Tom Petty famously sang about the challenges of waiting, describing it as the hardest part. This sentiment finds resonance in contemporary research from The University of Texas, which delves into the underlying reasons for our struggle with patience.

Annabelle Roberts, an assistant marketing professor at Texas McCombs, has published two significant studies shedding light on the psychological tug-of-war that ensues when people find themselves in situations requiring patience, such as enduring long lines or anticipating crucial news.

Her research shows how the quest for closure is pivotal in impatience. The first study explores the influence of closure on decision-making processes, such as the preference for completing a task sooner rather than later. The second study investigates how individuals’ emotional states fluctuate during the waiting period, especially as the conclusion of the wait approaches.

With a PhD in behavioural science, Roberts is keenly interested in examining how impatience impacts decision-making, influencing choices between immediate gratification and future gains.

Roberts also provides insights into strategies marketers might employ to mitigate the irritation of waiting. She comments on the universal frustration experienced during waiting periods, highlighting the importance of understanding this phenomenon.

The need for closure is a critical factor that Roberts and her colleagues, Alex Imas and Ayelet Fishbach from the University of Chicago, identified as a cause of impatience. They demonstrate that a desire for closure significantly affects how individuals value immediate versus future outcomes.

Through a series of online and laboratory studies, the research illustrates that participants will expend more effort or money to achieve closure sooner. That could involve paying extra to settle a bill promptly or opting to work more for the same pay if it means completing tasks ahead of schedule. These findings suggest that the impetus behind impatience extends beyond a mere eagerness for rewards to include a desire to conclude pending goals.

These insights are precious for managers seeking to motivate their teams and marketers designing promotions. The aversion to the lingering stress of unresolved obligations may explain why specific marketing strategies, like those “buy now, pay later” offers, might not always be appealing.

In another study focusing on the emotional aspects of waiting, Roberts finds that the distress associated with waiting intensifies as the endpoint nears. That was observed in real-life contexts, such as the anticipation for the COVID-19 vaccine or public transportation arrivals, where frustration grew as the conclusion of the wait became imminent.

The research also touched on the heightened impatience surrounding the 2020 presidential election results, illustrating how the desire for closure can magnify the experience of waiting.

Roberts advises that managing customer expectations around waiting times can alleviate impatience. She suggests that companies might benefit from preparing customers for longer waits to avoid escalating impatience as deadlines approach.

Looking ahead, Roberts is exploring interventions to help individuals manage their waiting experiences more effectively. She aims to equip people with strategies to enhance their patience and make prudent decisions, such as saving for future needs. This work underscores a broader aim to understand and improve how we cope with the inevitable waits that punctuate our lives, offering practical and theoretical insights into the mechanics of patience and decision-making.

More information: Roberts, A. R., Imas, A., & Fishbach, A. Can’t wait to pay: The desire for goal closure increases impatience for costs, Journal of Personality and Social Psychology. DOI: 10.1037/pspa0000367

Journal information: Journal of Personality and Social Psychology Provided by The University of Texas at Austin

Study by UNCG shows connection between selenium and COVID-19 death rates

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Chemists at the University of North Carolina at Greensboro have published a paper in the journal Antioxidants, unveiling a novel understanding of how dietary selenium impacts the severity of COVID-19. Their research expands upon earlier findings, pinpointing six proteins within the host that might be targeted by SARS-CoV-2 by confirming that three selenoproteins, known for their roles in antioxidant defence and antiviral activities, were indeed cleaved at predicted sites. They further discovered that the virus’s protease attacks and possibly deactivates glutamate-cysteine ligase catalytic subunit (GCLC), a crucial enzyme in glutathione synthesis. This action undermines the body’s antioxidant defence by impairing a vital selenoprotein’s function and reducing glutathione levels observed in patients with COVID-19, thereby compromising the immune response and facilitating more efficient viral replication.

Ethan W. Taylor, a professor of biomedical chemistry at UNCG and co-author of the study, highlighted the significance of this discovery. He stated that it is the inaugural demonstration of a virus actively targeting human selenium-dependent proteins. He suggested that selenium’s role in biochemistry might be pivotal for enhancing immune defences against COVID.

The study’s authors, including Ignacio A. Gallardo, Daniel A. Todd, Stella T. Lima, Jonathan R. Checkan, Norman H. Chu, and Taylor, leveraged prior research that correlated dietary selenium intake with the outcomes of viral infections. Their current work experimentally verified that the main protease of SARS-CoV-2 could cleave targets in four out of six identified host proteins, including selenoproteins such as thioredoxin reductase 1 (TXNRD1), selenoprotein F, and selenoprotein P, in addition to GCLC. They observed that the cleavage of the full-length TXNRD1 protein by the viral protease led to a loss of its antioxidant functionality by severing its C-terminal redox centre.

Taylor elaborated on the mechanism, noting that the proteins targeted for cleavage by the virus play significant roles in antioxidation and antiviral defence. Reducing disulfide bonds can deactivate viral proteins, which could amplify viral infectivity by undermining the function of several essential proteins.

The research also posits that the virus’s strategy may extend to impeding DNA synthesis to conserve ribonucleotide pools, thereby enhancing RNA synthesis and viral replication. This revelation points to the necessity for further exploration into the clinical benefits of selenium supplementation and various dietary sulfur compounds that serve as glutathione precursors. Such compounds include N-acetyl cysteine (NAC), the combination of NAC and glycine, or gamma-glutamylcysteine (GGC), as well as potential substitutes like alpha lipoic acid (ALA) that mimic glutathione’s effects. This direction could yield new adjunctive treatments for COVID-19, offering symptomatic relief to patients.

More information: Ignacio A. Gallardo, Daniel A. Todd, Stella T. Lima, Jonathan R. Chekan, Norman H. Chiu and Ethan Will Taylor. SARS-CoV-2 Main Protease Targets Host Selenoproteins and Glutathione Biosynthesis for Knockdown via Proteolysis, Potentially Disrupting the Thioredoxin and Glutaredoxin Redox Cycles, Antioxidants. DOI: 10.3390/antiox12030559

Journal information: Antioxidants Provided by University of North Carolina Greensboro

Over a billion individuals worldwide are grappling with obesity

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Since 1990, obesity has emerged as the predominant form of malnutrition in numerous countries, experiencing a surge across all demographics, including men, women, children, and adolescents. Specifically, the incidence of obesity in adult males has almost tripled, while the prevalence among women has doubled during the same period. Alarmingly, the obesity rates among children and adolescents have seen a fourfold increase. By 2022, the global count of obese individuals will reach approximately 880 million adults and 160 million children.

The NCD Risk Factor Collaboration, an international collective of health researchers dedicated to assessing and disseminating data on key risk factors affecting countries worldwide, detailed this global malnutrition landscape in partnership with the World Health Organization. Dr. Peter Katzmarzyk of the Pennington Biomedical Research Center in Baton Rouge, serving as Associate Executive Director of Population and Public Health Sciences, contributed to this significant report.

The collaborative effort involved scrutinizing body mass index (BMI) data from over 3,600 studies from 1990 to 2022. This extensive review aimed to chart malnutrition trends attributable to obesity or being underweight across various nations and observe the shifts over the years.

Dr. Katzmarzyk expressed concern over the current obesity trends, which have been upward for over thirty years. Highlighting the importance of addressing obesity within a broader health context, he pointed out the direct correlation between obesity and various comorbidities such as hypertension, heart disease, diabetes, cancer, and obstructive sleep apnea. He stressed the necessity of understanding obesity’s underlying causes to devise effective prevention, treatment, and reversal strategies for its adverse impacts.

Among the 190-plus countries included in the study, the United States was notably high on the list for obesity prevalence, ranking 10th for men and 36th for women, with significant increases observed since 1990. The rates among American boys and girls also climbed, with the U.S. ranking 26th and 22nd globally.

The findings underline the escalating issue of obesity at both the national and state levels, exemplified by Louisiana, where 38% of adults were reported to be obese in 2020, according to County Health Rankings and Roadmaps.

Dr. John Kirwan, Executive Director of Pennington Biomedical, underscored the study’s findings’ alignment with the institution’s mission. He reaffirmed Pennington Biomedical’s dedication to advancing metabolic health, combating metabolic diseases, uncovering obesity triggers, and enhancing overall health. Dr. Kirwan also commended Dr. Katzmarzyk’s contribution to this pivotal global analysis.

Conversely, the study period also saw a decline in the rates of underweight individuals among children, adolescents, and adults worldwide, with a notable decrease in underweight men within certain African countries. Interestingly, in two-thirds of the world’s nations, obesity rates now exceed those of being underweight among boys and girls, highlighting the dual burden of malnutrition.

The study titled “International Study of Childhood Obesity, Lifestyle and the Environment,” spearheaded by Pennington Biomedical and involving over 6,000 children from every inhabited continent, is one of many that have informed these findings. It illustrates the comprehensive effort to understand and address the global obesity epidemic.

More information: Peter T. Katzmarzyk et al, Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults, The Lancet. DOI: 10.1016/S0140-6736(23)02750-2

Journal information: The Lancet Provided by Pennington Biomedical Research Center

Selenium supplementation safeguards against obesity and may prolong lifespan

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A study published today in eLife reveals that incorporating selenium into diets shields against obesity and delivers metabolic advantages to mice. This discovery opens the possibility for interventions that mimic the anti-ageing benefits linked to dietary restriction while still allowing individuals to maintain their usual eating habits.

Various diets have been identified to enhance healthspan—the duration of life spent in good health. Limiting dietary methionine, an amino acid, has been confirmed as a method to prolong healthspan in several species, including mammals, not humans. Recent research indicates that the benefits of methionine restriction on healthspan might also apply to humans. While some may find methionine restriction achievable through specific diets, such as veganism, it may not be feasible or appealing to all. In response, researchers from the Orentreich Foundation for the Advancement of Science (OFAS) in Cold Spring, New York, US, set out to develop an alternative that emulates the effects of methionine restriction without necessitating a restricted diet.

A significant hint for this research was that limiting methionine decreases levels of IGF-1, a hormone that regulates energy. If a treatment reduces IGF-1 levels, it also promotes healthspan. Previous studies demonstrated that selenium supplementation lowers IGF-1 levels in rats, making it a promising candidate.

The research team first examined if selenium supplementation could protect against obesity as methionine restriction does. The team provided young male and older female mice with one of three high-fat diets: a standard diet, a methionine-restricted diet, and a standard diet with selenium. The study found that selenium supplementation effectively prevented the weight gain and fat build-up seen in control diet mice, mirroring the effects of methionine restriction.

To investigate the diets’ impact on metabolic changes associated with methionine restriction, the team set up tests that measured four metabolic markers in the mice’s blood. The results were promising, showing significant reductions in IGF-1 and leptin levels, a hormone controlling hunger and energy use, in both male and female mice. These findings suggest that selenium supplementation can replicate most of the benefits of methionine restriction, offering enhancements similar to the healthspan.

To understand the broader implications of selenium supplementation, the team explored its effects on yeast, another organism. They assessed yeast healthspan through two metrics: chronological lifespan, the longevity of dormant yeast, and replicative lifespan, the yeast’s ability to produce offspring. Previous research showed methionine restriction increased yeast’s chronological lifespan, leading the team to investigate if selenium would have a comparable effect. Selenium-enriched yeast demonstrated a 62% increase in chronological lifespan (from 13 to 21 days) and a replicative lifespan extended by nine generations compared to controls. That indicates selenium’s capacity to significantly improve health span, as evidenced by various ageing cell tests.

Jay Johnson, Senior Scientist at OFAS and the study’s senior author, highlights the ageing research community’s aim to find simple, effective interventions to boost human healthspan. The study provides evidence that short-term selenium supplementation, whether from organic or inorganic sources, offers numerous health benefits to mice, particularly in preventing diet-induced obesity. Looking ahead, the research team anticipates these selenium compounds will also thwart age-related diseases and increase mice’s overall lifespan, hoping these advantages will extend to humans.

More information: Jason D Plummer, Spike DL Postnikoff, Jessica K Tyler, Jay E Johnson, Selenium supplementation inhibits IGF-1 signaling and confers methionine restriction-like healthspan benefits to mice, eLife. DOI: 10.7554/eLife.62483

Journal information: eLife

Size Matters: Understanding the Neuroanatomy Behind Trigeminal Neuralgia’s Response to Treatment

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The publication in the journal *Cephalalgia*, recognized as the official outlet of the International Headache Society, unveils groundbreaking findings on the neuroanatomical factors affecting treatment outcomes for individuals suffering from trigeminal neuralgia. Led by Dr Tejas Sankar from the University of Alberta, Canada, the research titled “Hippocampal and trigeminal nerve volume predict the outcome of surgical treatment for trigeminal neuralgia” casts a new light on this debilitating condition.

Trigeminal neuralgia (TG), often manifesting as intense facial pain primarily felt in the cheek or jaw, is briefly described in the 3rd Version of the International Classification of Headache Disorders (ICHD-3) as a disorder marked by recurrent, unilateral, electric shock-like pains. These pains are abrupt in onset and cessation, confined to the trigeminal nerve’s distribution, and are provoked by benign stimuli. While it may arise spontaneously, it can also stem from an underlying disorder, with a possibility of accompanying continuous, moderate-intensity pain within the affected nerve’s distribution.

The research delineates two prevalent forms of TN: the classical form, linked with neurovascular compression at the nerve’s root entry zone, and the idiopathic form, which lacks this neurovascular compression. In cases where pharmacological treatments fail, microvascular decompression emerges as a viable surgical alternative.

Dr. Sankar’s hypothesis builds on existing evidence that suggests a consistent reduction in trigeminal nerve volume and cross-sectional area on the afflicted side in TN patients. The research proposes that those failing to respond to surgical interventions may exhibit distinct neuroanatomical characteristics.

The study analyzed 37 patients diagnosed with either classical or idiopathic TN, employing neuroimaging techniques like T2-weighted magnetic resonance imaging (1.5T) performed a year before undergoing microvascular decompression surgery. The focus was on evaluating the trigeminal nerve and other subcortical brain structures, such as the thalamus, hippocampus, and amygdala, due to their roles in the trigeminal sensory relay and as potential factors in the limbic aspects of chronic pain. Comparisons were made between the ipsilateral and contralateral sides relative to the pain location, including total nerve volume and percentage differences.

The findings revealed a 68% success rate among patients post-surgery, which aligns with prior research. Key observations include a larger thalamus volume on the side opposite the pain in all patients; non-responders had a larger intracranial volume, greater trigeminal nerve volume on the side opposite the pain, and a larger contralateral hippocampus volume than responders. Moreover, the contralateral trigeminal nerve and hippocampus volumes indicated treatment outcomes, with larger volumes associated with non-response to treatment. The role of the hippocampus, both ipsilateral and contralateral, was significant in predicting treatment success.

Despite these novel findings, the researchers caution against overly simplistic interpretations of their data. Treatment resistance in chronic pain likely involves complex interactions among multiple brain structures rather than being attributable to a single entity. They advocate for future studies to explore network and connectivity patterns between responders and non-responders, emphasizing the potential of the hippocampus and other limbic structures as integral components of these networks. This approach could offer deeper insights into how chronic pain is modulated, potentially leading to more effective treatment strategies.

This research underscores the importance of the hippocampus in integrating the emotional aspects of chronic pain. It echos findings in other pain-related disorders, such as migraine, where structural brain changes and increased hippocampal connectivity have been observed. These insights enrich our understanding of trigeminal neuralgia and hint at broader implications for treating chronic pain conditions, highlighting the complex interplay between brain structure, emotional processing, and pain perception.

More information: Hayden Danyluk, Esther Kyungsu Lee, Tejas Sankar et al, Hippocampal and trigeminal nerve volume predict outcome of surgical treatment for trigeminal neuralgia, Cephalalgia. DOI: 10.1177/0333102419877659

Journal information: Cephalalgia Provided by International Headache Society

Does the Mediterranean diet genuinely reduce your risk of dementia?

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Several studies have proposed that adhering to a healthy diet could lessen the likelihood of developing dementia. However, research published on October 12, 2022, in the online issue of Neurology®, the American Academy of Neurology medical journal, has challenged this notion. This study specifically scrutinized the Mediterranean diet, renowned for its high consumption of vegetables, fruits, legumes, fish, healthy fats like olive oil, and minimal dairy, meats, and saturated fats. Despite its wholesome reputation, the study concluded that neither the Mediterranean diet nor two other diets have a demonstrable link to decreased dementia risk.

Isabelle Glans, MD, from Lund University in Sweden and the study’s lead author, remarked on the inconsistent findings of previous dietary studies on dementia risk. She highlighted that although their research, with its extensive follow-up duration and inclusion of younger participants who were not required to recall their dietary habits from years past, did not entirely dismiss a potential relationship between diet and dementia, it failed to establish a direct correlation within their research framework.

The study meticulously tracked 28,000 Swedish participants over 20 years. These individuals, who had an average age of 58 and showed no signs of dementia at the study’s onset, were monitored through detailed food diaries, food frequency questionnaires, and interviews. By the conclusion of the study, 1,943 participants, or 6.9%, had been diagnosed with forms of dementia, including Alzheimer’s disease and vascular dementia. The investigation assessed how the participants’ diets aligned with traditional and Mediterranean dietary guidelines, adjusting for variables such as age, gender, and educational background. Yet, no evidence was found to suggest that adherence to either diet significantly impacted dementia risk reduction.

Isabelle Glans has called for further research to verify these findings, indicating the complexity of diet’s role in cognitive function and the potential need for multifaceted approaches to dementia risk reduction. Echoing this sentiment, Nils Peters, MD, from the University of Basel in Switzerland, who authored an editorial accompanying the study, suggested that diet might influence cognitive health. He advocated for dietary strategies to be considered alongside other measures to mitigate risk factors for cognitive decline.

One of the study’s limitations was the potential for participants to report their dietary and lifestyle habits inaccurately. A range of Swedish foundations and councils, including the Swedish Research Council, the Knut and Alice Wallenberg Foundation, the Marianne and Marcus Wallenberg Foundation, Lund University, the Swedish Alzheimer Foundation, the Swedish Brain Foundation, and other organizations provided funding for the research. This study underscores the ongoing debate and need for further exploration into the impact of diet on dementia risk, highlighting the importance of a holistic approach to understanding and potentially mitigating this complex condition.

More information: Isabelle Glans et al, Association Between Dietary Habits in Midlife With Dementia Incidence Over a 20-Year Period, Neurology. DOI: 10.1212/WNL.0000000000201336

Journal information: Neurology Provided by American Academy of Neurology

Research pinpoints characteristics of cities conducive to supporting the mental health of young people

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As urban centres worldwide continue to attract young individuals for employment, education, and social interactions, a recent study highlights urban features that could enhance the mental well-being of young city residents. Based on feedback from a globally diverse group, including young adults and professionals across various fields, the research outlines essential elements that urban planners can integrate to foster secure, fair, and welcoming environments.

The research commenced with an initial survey of over 400 participants, comprising young individuals and experts from multiple disciplines. Following two more rounds of surveying, six key urban attributes emerged as critical for the mental health of young urbanites: opportunities for personal development and life skills; youth-friendly spaces that respect and validate young emotions and values; accessible, safe public places for social connections; stable employment opportunities; initiatives targeting social health determinants; and urban planning that reflects the needs and inputs of young people.

This significant study was published on February 21 in Nature, led by Pamela Collins, MD, MPH, of the Johns Hopkins Bloomberg School of Public Health, in collaboration with citiesRISE and an international team. This collaboration emphasizes the critical role of urban settings in shaping health outcomes, spotlighting the disproportionate impact of urban challenges on vulnerable youth populations. With mental disorders being a leading cause of disability among 10- to 24-year-olds globally, the study underscores the urgency of addressing mental health in urban planning.

The study’s timing is poignant, beginning at the onset of the COVID-19 pandemic in April 2020, which brought additional insights into the exacerbated inequalities faced by marginalized urban communities. The diverse panel of over 400 participants from 53 countries highlighted the pandemic’s role in either revealing or confirming the deep-seated inequities and vulnerabilities that impact youth mental health in cities.

The extensive survey process led to the identification of 37 key characteristics supporting youth mental health, categorized into six domains: intrapersonal, interpersonal, community, organizational, policy, and environmental aspects. These findings offer a comprehensive roadmap for policymakers and urban planners, advocating for a multi-sectoral approach to cultivate cities conducive to young people’s mental health. That includes focusing on social and emotional learning, creating opportunities for social engagement, ensuring job security, and involving young people in urban development processes to address their unique needs and perspectives.

The study highlights the importance of adopting policies and planning strategies that prioritize social and economic equality and prevent the exacerbation of existing inequalities through urban development initiatives. It advocates for a holistic, collaborative approach to urban planning that includes young individuals in the conversation. This approach aims to create cities that not only accommodate but actively support their younger residents’ mental health and well-being. This approach signifies a move towards more inclusive, equitable, and mentally healthy urban environments for future generations.

More information: Pamela Y. Collins et al, Making cities mental health friendly for adolescents and young adults, Nature. DOI: 10.1038/s41586-023-07005-4

Journal information: Nature Provided by Johns Hopkins Bloomberg School of Public Health

Investigating a possible new therapy for endometriosis

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In the United States, approximately 15% of women of childbearing age have endometriosis. This condition is distinguished by symptoms such as pelvic discomfort, menstrual cramps, and infertility issues. Endometriosis occurs when tissue similar to that which lines the interior of the uterus begins to grow outside it. Such aberrant growth can lead to swelling and bleeding, manifesting in significant pain and other related symptoms.

Dr Sang Jun Han, the study’s corresponding author, is an associate professor of molecular and cellular biology at Baylor College of Medicine and a Center for Reproductive Medicine member. He explains that estrogen heavily influences endometriosis. Estrogen is a hormone crucial for a woman’s reproductive processes but also impacts various other organs, including the heart, blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and the brain.

The reliance of endometriosis on estrogen and its inflammatory nature has steered existing treatments towards the elimination of estrogen from the system and the application of anti-inflammatory medications. However, Han points out the limitations of current therapies, noting their low effectiveness, high rate of recurrence, and the adverse impacts they have on other estrogen-sensitive tissues. This challenge has led Han’s research, published in the Journal of Biomedical Science, to seek more effective treatments for endometriosis.

A pivotal aspect of endometriosis is its dependency on estrogen, which acts through estrogen receptors (ERs) ER-alpha and ER-beta on cells, crucial for the condition’s development and advancement. Prior studies, including those conducted by Han’s laboratory, have revealed the significant role of ER-beta in the progression of endometriosis. Dr. Yuri Park, a leading researcher in Han’s team, notes that targeting ER-beta specifically could offer a new therapeutic avenue that avoids the side effects associated with current hormonal treatments focusing on ER-alpha.

In their pursuit of non-hormonal treatments for endometriosis, Han and his team screened natural compounds in a laboratory setting. Their search led to the discovery of oleuropein, a compound found in olive leaves. Oleuropein selectively targets ER-beta without affecting ER-alpha, thereby inhibiting the growth of endometriosis lesions in both mouse and human models.

Remarkably, oleuropein did not exhibit toxicity to the liver, nor did it impede the reproductive capabilities of female mice. In fact, oleuropein administration was found to enhance pregnancy rates in mice affected by endometriosis. These promising results underline the potential of oleuropein as a natural and cost-effective treatment for endometriosis, offering a safer alternative to hormonal therapies. The contributions of Yeon Jean Cho, Nuri Sung, Mi Jin Park, Xiaoming Guan, William E. Gibbons, and Bert W. O’Malley, all affiliated with the Baylor College of Medicine, were also pivotal to this groundbreaking research.

More information: Sang Jun Han et al, Oleuropein suppresses endometriosis progression and improves the fertility of mice with endometriosis, Journal of Biomedical Science. DOI: 10.1186/s12929-022-00883-2

Journal information: Journal of Biomedical Science Provided by Baylor College of Medicine