Showing posts with label Brain Stimulation. Show all posts
Showing posts with label Brain Stimulation. Show all posts

Monday 11 December 2023

The Excessive TV-Watching will cause Dementia, Depression and Parkinson’s Disease

https://drive.google.com/uc?export=view&id=11ceGYb9jQ4z3pY4zLAsQLY4FSKqmq4Qq
In a digital age where screens often dominate our daily lives, a recent study published in the International Journal of Behavioral Nutrition and Physical Activity offers a thought-provoking insight into the health implications of our viewing habits. This comprehensive analysis, led by Dr. Hanzhang Wu of Tianjin University of Traditional Medicine, China, reveals a concerning correlation between excessive television-watching and an increased risk of dementia, Parkinson's Disease (PD), and depression.

The Study: A Deep Dive into Digital Habits and Health
The research tapped into the UK Biobank, analyzing data from 473,184 individuals aged 39-72 years, followed from 2006 to either a diagnosis of dementia, PD, depression, death, or the study's end. Participants reported their non-work related activities, including exercise, TV-watching, and computer use, alongside undergoing MRI scans to measure brain volume.

The Findings: TV Time and Its Toll
The study's results paint a stark picture: those who indulged in over four hours of TV daily faced a 28% higher risk of dementia, a 35% higher risk of depression, and a 16% greater risk of PD compared to those who watched less than an hour. These figures stand as a cautionary tale against the sedentary lifestyle often associated with excessive TV consumption.

A Silver Lining: Moderate Computer Use
Contrastingly, the study found that moderate computer use (30-60 minutes per day) appeared somewhat protective, lowering the risks for dementia, PD, and depression. This finding challenges the blanket notion that all screen time is detrimental, suggesting that the content and context of digital consumption are key factors.

Exercise: A Vital Substitute
Perhaps most strikingly, replacing just 30 minutes of computer time with structured exercise significantly reduced the risks for dementia and PD. This highlights the immense value of physical activity as a cornerstone of neurological health.

Understanding the Underlying Mechanism
The researchers speculate that the negative impact of prolonged TV-watching might stem from its sedentary nature, which is linked to low-grade inflammation. This inflammation could contribute to neuroinflammation and neurodegeneration, accelerating the onset of diseases like dementia and PD.

Limitations and Considerations
While the study offers valuable insights, it's crucial to note its reliance on self-reported data, which can be subject to recall bias. Additionally, there may be other confounding variables not accounted for in the research.

The Takeaway: Rethinking Our Screen Habits
This study serves as a wake-up call to reassess our daily routines. It suggests that while moderate, purposeful screen use (like computer work) can be part of a healthy lifestyle, excessive, passive screen time (like prolonged TV-watching) might have dire health implications.

 In Practice: Balancing Screen Time with Active Living

For individuals and healthcare professionals alike, the message is clear: balance is key. Integrating regular physical activity into our routines and being mindful of our screen habits could be crucial steps in safeguarding our neurological health.

As we navigate a world increasingly oriented around digital screens, this study underscores the importance of staying active and engaged in a variety of activities. It's not just about cutting screen time; it's about enhancing our overall lifestyle to nurture our physical and mental well-being.

Monday 12 June 2023

The Role of Multivitamins in Memory Boost and Slowing Cognitive Aging

https://drive.google.com/uc?export=view&id=1QfMqcMIcf9rdiZyw9aCryySwOo3RkQNi

We've all heard the adage, "An apple a day keeps the doctor away," but recent research suggests that a multivitamin might be a worthwhile addition to our daily routine. A study co-authored by Dr. JoAnn Manson, a professor of medicine at Harvard Medical School and Brigham and Women's Hospital, has offered some enlightening insights into the benefits of daily multivitamin supplementation, particularly for older adults.

The research is part of the second Cocoa Supplement and Multivitamins Outcome Study (COSMOS), a collaborative effort between Brigham and Columbia University. The findings, which have been published in the American Journal of Clinical Nutrition, suggest that regular multivitamin intake can not only enhance memory but also slow cognitive aging.

Nutrition and Cognitive Health

The human brain requires an array of nutrients to function optimally. Deficiencies in certain micronutrients, such as vitamin B12, thiamin, other B vitamins, lutein, magnesium, and zinc, can accelerate cognitive decline, hence emphasizing the importance of a nutritionally balanced diet for maintaining brain health.

In the trial, 3500 participants aged 60 or older took part in a web-based memory test. Those in the multivitamin group outperformed the placebo group in memory tests and word recall, an outcome that's roughly equivalent to slowing age-related memory loss by about three years. The benefits were noticeable from the first year and lasted throughout the three-year trial duration.

Multivitamins and Cardiovascular Health

An intriguing pattern that emerged from the COSMOS trial, as well as the earlier COSMOS-Mind study, was that participants with a history of cardiovascular disease showed the most significant improvement from multivitamin supplementation. This improvement could potentially be due to their lower initial nutrient status, but this area needs further exploration.

A Balanced Perspective

Despite the promising findings, Dr. Manson stressed that multivitamins are not a magic bullet. They should complement a healthy diet and lifestyle, not replace them. It's also crucial to remember that the trials tested recommended dietary allowances, not megadoses of micronutrients. High doses might not only lack the same cognitive benefits, but they might also lead to toxicity or interfere with the absorption of other nutrients.

Safety and Quality

The multivitamins used in the trial, including Centrum Silver, were found to be safe, without any clear risks or safety concerns. Importantly, Dr. Manson clarified that these benefits are not brand-specific; other high-quality multivitamins should also confer similar advantages. As a rule of thumb, consumers should always check for quality-control documentation, such as seals from the US Pharmacopeia, National Science Foundation, ConsumerLab.com, or other auditors.

Looking to the Future

This research offers an exciting glimpse into the potential benefits of multivitamin supplementation as a safe, accessible, and affordable approach to protecting cognitive health in older adults. Yet, there's more work to be done. Future research needs to pinpoint who is most likely to benefit and delve deeper into the biological mechanisms involved. It's also up to expert committees to evaluate the research and determine whether changes in nutritional guidelines are warranted.

In summary, a daily multivitamin could be a small addition to our routines with potentially significant benefits for our cognitive health. Yet, it should serve as a complementary strategy to a balanced diet and healthy lifestyle, not a substitute. As always, remember to discuss any new supplements with a healthcare provider to ensure they're right for your personal health situation.

Wednesday 22 March 2023

Parkinson Disease

Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed, but not halted, by treatment. The 2 major neuropathologic findings in Parkinson disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites.


Signs and symptoms
https://drive.google.com/uc?export=view&id=1kEMxO4RssoNR94qTF5velJErtk-kw_S5



Initial clinical symptoms of Parkinson disease include the following:

  • Tremor
  • Subtle decrease in dexterity
  • Decreased arm swing on the first-involved side
  • Soft voice
  • Decreased facial expression
  • Sleep disturbances
  • Rapid eye movement (REM) behavior disorder (RBD; a loss of normal atonia during REM sleep)
  • Decreased sense of smell
  • Symptoms of autonomic dysfunction (eg, constipation, sweating abnormalities, sexual dysfunction, seborrheic dermatitis)
  • A general feeling of weakness, malaise, or lassitude
  • Depression or anhedonia
  • Slowness in thinkin

Onset of motor signs include the following:

  • Typically asymmetric
  • The most common initial finding is a resting tremor in an upper extremity
  • Over time, patients experience progressive bradykinesia, rigidity, and gait difficulty
  • Axial posture becomes progressively flexed and strides become shorter
  • Postural instability (balance impairment) is a late phenomenon

Nonmotor symptoms

Nonmotor symptoms are common in early Parkinson disease. Recognition of the combination of nonmotor and motor symptoms can promote early diagnosis and thus early intervention, which often results in a better quality of life.

Diagnosis

Parkinson disease is a clinical diagnosis. No laboratory biomarkers exist for the condition, and findings on routine magnetic resonance imaging and computed tomography scans are unremarkable.

Clinical diagnosis requires the presence of 2 of 3 cardinal signs:

  • Resting tremor
  • Rigidity
  • Bradykinesia

Management

The goal of medical management of Parkinson disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects.

Symptomatic drug therapy

  • Usually provides good control of motor signs of Parkinson disease for 4-6 years
  • Levodopa/carbidopa: The gold standard of symptomatic treatment
  • Monoamine oxidase (MAO)–B inhibitors: Can be considered for initial treatment of early disease
  • Other dopamine agonists (eg, ropinirole, pramipexole): Monotherapy in early disease and adjunctive therapy in moderate to advanced disease
  • Anticholinergic agents (eg, trihexyphenidyl, benztropine): Second-line drugs for tremor only

Treatment for nonmotor symptoms

  • Sildenafil citrate (Viagra): For erectile dysfunction
  • Polyethylene glycol: For constipation
  • Modafinil: For excessive daytime somnolence
  • Methylphenidate: For fatigue (potential for abuse and addiction)

Deep brain stimulation

  • Surgical procedure of choice for Parkinson disease
  • Does not involve destruction of brain tissue
  • Reversible
  • Can be adjusted as the disease progresses or adverse events occur
  • Bilateral procedures can be performed without a significant increase in adverse events

Prognosis

Before the introduction of levodopa, Parkinson disease caused severe disability or death in 25% of patients within 5 years of onset, 65% within 10 years, and 89% within 15 years. The mortality rate from Parkinson disease was 3 times that of the general population matched for age, sex, and racial origin. With the introduction of levodopa, the mortality rate dropped approximately 50%, and longevity was extended by many years. This is thought to be due to the symptomatic effects of levodopa, as no clear evidence suggests that levodopa stems the progressive nature of the disease.

The American Academy of Neurology notes that the following clinical features may help predict the rate of progression of Parkinson disease :
Older age at onset and initial rigidity/hypokinesia can be used to predict (1) a more rapid rate of motor progression in those with newly diagnosed Parkinson disease and (2) earlier development of cognitive decline and dementia; however, initially presenting with tremor may predict a more benign disease course and longer therapeutic benefit from levodopa
A faster rate of motor progression may also be predicted if the patient is male, has associated comorbidities, and has postural instability/gait difficulty (PIGD)
Older age at onset, dementia, and decreased responsiveness to dopaminergic therapy may predict earlier nursing home placement and decreased survival
Patient Education

Patients with Parkinson disease should be encouraged to participate in decision making regarding their condition. In addition, individuals and their caregivers should be provided with information that is appropriate for their disease state and expected or ongoing challenges. Psychosocial support and concerns should be addressed and/or referred to a social worker or psychologist as needed.

Prevention of falls should be discussed. The UK National Institute for Health and Clinical Excellence has several guidance documents including those for patients and caregivers.

Other issues that commonly need to be addressed at appropriate times in the disease course include cognitive decline, personality changes, depression, dysphagia, sleepiness and fatigue, and impulse control disorders. Additional information is also often needed for financial planning, insurance issues, disability application, and placement (assisted living facility, nursing home).