December 29, 2017
Hans-Christoph Diener, MD, PhD, University of Essen (Germany), recently summarized four new neurological studies that increase care professionals’ knowledge related to the development and management of stroke and Parkinson disease (PD) (Medscape Commentary. December 6, 2017).
In the first study, researchers analyzed data from a Swedish national health registry and drug prescription registry, ultimately investigating over 400,000 patients with atrial fibrillation. About half were anticoagulated and the other ones were not anticoagulated. The results showed that between 2006 and 2014, the risk of developing dementia was reduced by almost 30% in patients who were anticoagulated (true for those on warfarin and novel oral anticoagulants) (Eur Heart J. 2017; doi:10.1093/eurheartj/ehx579).
In another study published in Neurology, researchers investigated whether the administration of caffeine twice daily (200 mg) would have an impact on the symptoms of Parkinson disease. One-hundred and twenty patients were randomized to either caffeine twice daily or to placebo. No benefits were seen in the neurologic symptoms of PD. The study could not answer, either way, if caffeine may have preventative effects on the cause of PD (2017; doi:10.1212/WNL.0000000000004568).
In the third study Dr Diener discusses, findings showed that patients who stopped smoking saw a risk reduction for recurrent stroke, myocardial infarction, and vascular death. The study investigated pioglitazone in patients who had had a transient ischemic attack or stroke over a period of 5 years. They also looked at patients who had quit smoking in the next 5 years. There was a 35% risk reduction in those who had stopped smoking. The benefits were clear for stroke or death but not significant for myocardial infarction (Circulation. 2017; doi:10.1161/CIRCULATIONAHA.117.030458).
The fourth study examined whether traumatic brain injury may be associated with PD. Investigators looked at about 89,000 older adults with PD and 118,000 controls. Over a period of 5 years, researchers found a 64% increase in the risk of developing PD if the traumatic brain injury was within those past 5 years. Risk increased if the time interval between the injury and PD was shorter (Ann Neurol. 2017; doi:10.1002/ana.25074).
—Amanda Del Signore
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