Neurology in the News: Plaque, Parkinson Prevention, Promising Strategies

“Our in vitro data demonstrate that cambinol inhibits neutral sphingomyelinase 2 (nSMase2) enzyme activity in dose response fashion, and suppresses extracellular vesicle (EV) production while reducing tau seed propagation. Our in vivo testing with cambinol shows that it can reduce the nSMase2 activity in the brain after oral administration.” Biochemical and Biophysical Research Communications • May 2018 • Suppression of tau propagation using an inhibitor that targets the DK-switch of nSMase2

“Plasma levels of trimethylamine n-oxide (TMAO), p-cresyl sulfate, p-cresyl glucuronide, and phenylacetylglutamine were significantly lower among patients with the Protected phenotype [less plaque], and higher in those with the Unexplained phenotype [patients with excess plaque], despite no significant differences in renal function or in dietary intake of nutrient precursors of GDUT… These findings raise the possibility of novel approaches to treatment of atherosclerosis such as fecal transplantation and probiotics.” Atherosclerosis • June 2018 • Metabolic products of the intestinal microbiome and extremes of atherosclerosis

Recognizing that EEG is a relatively easy to use, low-cost tool, researchers used EEGs on infants to see if digital biomarkers could be extracted. “The relatively strong correlation between predicted and actual measured [ADOS] CSS scores suggests that the EEG analysis presented herein may be useful not only as a means of predicting a future diagnosis of ASD [autism spectrum disorder], but also for assessing the severity of future symptoms.” Scientific Reports • May 1, 2018 • EEG Analytics for Early Detection of Autism Spectrum Disorder: A Data-Driven Approach

Researchers looked at the effect of age at first exposure to tackle football on chronic traumatic encephalopathy pathology. “Age of exposure before 12 predicted earlier cognitive (p<0.0001) and behavioral/mood (p<0.0001) symptom onset by 13.39 and 13.28 years, respectively. In participants with dementia, younger age of exposure corresponded to earlier functional impairment onset. Similar effects were observed in the 126 CTE only participants.” Although the researchers failed to find an association between younger age of exposure and CTE pathological severity, they concluded, “Youth exposure to tackle football may reduce resiliency to late life neuropathology.” Annals of Neurology • April 30, 2018 • Age of First Exposure to Tackle Football and Chronic Traumatic Encephalopathy

“Patients with inflammatory bowel disease exposed to antitumor necrosis factor therapy had a 78% reduction in Parkinson disease incidence rates compared with unexposed patients… These findings support a role of systemic inflammation in the pathogenesis of both diseases. Further studies are required to determine whether anti-TNF treatment administered to high-risk individuals may mitigate PD risk.” JAMA Neurology • April 23, 2018 • Anti–Tumor Necrosis Factor Therapy and Incidence of Parkinson Disease Among Patients With Inflammatory Bowel Disease

“MIT neuroscientists have developed a new magnetic resonance imaging (MRI) sensor that allows them to monitor neural activity deep within the brain by tracking calcium ions. Because calcium ions are directly linked to neuronal firing-unlike the changes in blood flow detected by other types of MRI, which provide an indirect signal-this new type of sensing could allow researchers to link specific brain functions to their pattern of neuron activity, and to determine how distant brain regions communicate with each other during particular tasks.” April 30, 2018 • MIT News • Calcium-based MRI sensor enables more sensitive brain imagingimaging

“Our data show that PBMCs [peripheral blood mononuclear cells] from RE [Rasmussen’s encephalitis] patients can directly induce seizures and pathological changes typical of RE when engrafted into NSG mice, therefore inferring that the development of seizures in RE is an intrinsic property of patients’ immune cells and providing convincing evidence of the encephalitogenicity of RE patients’ mononuclear cells.” Journal of Clinical Investigation • April 9, 2018. Humanized mouse model of Rasmussen’s encephalitis supports the immune-mediated hypothesis

“Chronic dizziness can be challenging for both patients and physicians, as a variety of specialists may be consulted and tests ordered before a diagnosis is established…. Dizziness that is both chronic and nonspecific in nature should alert a physician to a possible psychiatric cause.” Journal of the American Osteopathic Association • May 2018 Psychogenic Dizziness: An Important but Overlooked Differential Diagnosis in the Workup of the Dizzy Patient