Advanced MRI scans may help treat essential tremors and Parkinson's disease

Researchers at UT Southwestern Medical Center have recently developed MRI techniques used to more precisely target a small area in the brain linked to Parkinson's disease and essential tremor. This may lead to better outcomes without surgery and with less risk of negative effects of treatment of tremors and Parkinson's disease.

The study have been published in the journal Brain.

The research describes recently refined MRI methods designed to allow neuroradiologists to zero in on a pea-sized region in the brain's thalamus involved in movement. Using the images, doctors then can use high-intensity focused ultrasound (HIFU) to ablate, or burn away, problem tissue, says Bhavya R. Shah, M.D., first author of the study and an assistant professor of radiology and neurological surgery at UT Southwestern's Peter O'Donnell Jr. Brain Institute.

"The benefit for patients is that we will be better able to target the brain structures that we want," Shah says. "And because we're not hitting the wrong target, we'll have fewer adverse effects." The procedures are already Food and Drug Administration-approved for use in patients, and UTSW plans to begin employing them to treat patients when its Neuro High Intensity Focused Ultrasound Program opens this fall.

Adverse effects from imprecise targeting include problems walking or slurring words. While such effects are usually temporary, they can be permanent in 15 to 20 percent of cases, says Dr. Shah.

According to the National Institutes of Health, essential tremor affects up to 10 million Americans and Parkinson's disease impacts more than 1 million. Both are neurologic diseases thought to have genetic links. The first line of treatment for the involuntary trembling or shaking seen with these diseases is medication. However, approximately 30 percent of patients do not respond well to drugs, according to the study.

In the late 1990s, neurosurgeons began using a procedure called deep brain stimulation, opening the skull to permanently implant metal electrodes that could then be stimulated via a battery pack.

About a decade ago, a new MRI-guided procedure emerged that uses high-intensity ultrasound waves to heat and eliminate a small section of the thalamus linked to the disorders. MRI-guided HIFU is currently approved for treatment of essential tremor and tremors seen in Parkinson's disease patients. The outpatient procedure does not require opening the skull, and the patient is awake while it is performed, says Dr. Shah. "No cuts. No anesthesia. No implanted devices."

A challenge in both procedures has been locating the precise area inside the brain's thalamus to treat - the pea-sized ventral intermediate nucleus, says Dr. Shah.

Traditionally, doctors have relied on either landmarks or maps of the brain drawn from cadavers to help them pinpoint the correct location. However, every brain is different, Dr. Shah says, and tiny errors can lead to damage in surrounding tissue, or to missing portions of the correct target.

Three newly refined MRI techniques are better at delineating the target tissue, according to the study.

The most widely studied and perhaps most promising imaging method is called diffusion tractography, says Dr. Shah. It creates precise brain images by taking into account the natural water movement within tissues.

The other methods described are quantitative susceptibility mapping - which creates contrast in the image by detecting distortions in the magnetic field caused by substances such as iron or blood - and fast gray matter acquisition TI inversion recovery - which operates much like a photo negative, turning the brain's white matter dark and its gray matter white in order to provide greater detail in the gray matter.

Dr. Shah and his team plan to participate in a multicenter clinical trial with collaborators at the Mayo Clinic in Rochester, Minnesota, testing the diffusion tractography method in patients.

 

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UV Protection is Important for Your Eyes

Most of us are aware of the dangerous effects ultraviolet (UV) rays have on our skin, but not many realize the danger imposed on our eyes. However, while it may seem obvious to put on sun block, how should we care for our eyes? Be it from natural sunlight or artificial UV rays, UV radiation can cause significant damage to the eye's surface tissues as well as the cornea and lens. The rays may also burn the front surface of the eye, much like a sunburn on the skin. 

 What is UV radiation?

UV radiation consists of invisible rays from the sun. There are three types of UV radiation: UVA, UVB, and UVC. While UVC rays do not pose any threat (these rays are absorbed by the ozone layer) exposure to UVA and UVB can have adverse effects on your eyes and vision. 

Significant damage can be caused when exposed to these dangerous rays, both short- and long-term. It is also important to note that UV radiation can also be given off by artificial sources, like welding machines, tanning beds and lasers.

What are the short-term effects?

If exposed to UV rays while unprotected, you are likely to experience an effect called photokeratitis - an inflammation of the cornea caused by brief exposure to UV radiation. This usually occurs when combined with cold wind and snow. It is similar to a 'sunburn of the eye' and may be painful. Symptoms may include red eyes, a foreign body sensation or a gritty feeling in the eyes. You may also feel extreme sensitivity to light and experience excessive tearing. This is usually temporary and rarely causes permanent damage to the eyes.

What are the long-term effects?

Long term exposure to UV rays can be more serious. Scientific studies and research  have shown that exposure to small amounts of UV radiation over a period of years may increase the chance of developing a cataract which may damage the retina - the lining of the eye that is used for seeing. This damage is not reversible and  may contribute to chronic eye diseases as well as increase the risk of developing skin cancer around the eyelids. Long-term exposure may also increase the risk of developing pterygium - a growth that invades the corner of the eyes and the pinguecula - a yellowish, slightly raised lesion that forms on the surface tissue of the white part of your eye.

Protecting your eyes

It is important to wear quality sunglasses that offer good protection and a wide-brimmed hat when outdoors. Your sunglasses should block 99% of both UVA and UVB rays and screen out 75% to 90% of visible light. Sunglasses should also be free of distortion and imperfection and have lenses that are gray for the proper color recognition. Teenagers and children should also wear sunglasses when outdoors. Kids especially are at a greater risk for developing serious vision damage later in life without regular UV eye protection.

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Drugs for eye treatment may harm growing infants

Researchers have found that a few drugs used for treating retinal diseases may mix with breast milk, further causing a safety issue for the growing infants.

Ranibizumab and aflibercept are medications used to treat several retinal diseases. They contain an agent called anti-vascular endothelial growth factor ( anti-VEGF0, which blocks the eye's production of vascular endothelial growth factor (VEGF).

VEGF is a protein that stimulates the development of blood vessels but is associated with retinal diseases in high quantities.

VEGF is present in breast milk and plays an important role in the development of an infant's digestive system. As a result, anti-VEGF drugs in a nursing mother raise concerns about possible adverse events in a developing infant if the drugs were to pass into breast milk and suppress VEGF.

As retina specialists, we often tell our pregnant or nursing patients that there's a risk of a small amount of these drugs making its way into the breast milk, but we can't be sure, said the co-lead author of the study.

We don't want these patients to lose their vision so we make a decision, despite limited information, added the Dr.

Hoping to change this, the authors measured the concentrations of retinal medications in the breast milk of 3 lactating patients following injection of anti-VEGF therapy.

The team found that the drugs were excreted into the breast milk within the 1st couple of days following injection, with a corresponding reduction in VEGF levels.

They also found that the amount of medication detected in the patient who continued to breastfeed was significantly lower than the other 2 patients, suggesting that the medication was constantly excreted and ingested by the infant.

These results definitely show us that the drug reaches the breast milk, said the Dr. We realise that some readers may question the small sample size, but of the drug reaches the breast milk in 3 patients, it will reach in 30 patients because it's the same biological process.

As the 1st study to evaluate the presence of Health Canada approved anti-VEGF therapy in human breast milk, these results provide a resource for ophthalmologists and retina specialists counselling pregnant and nursing patients.

I'm comforted knowing that other pregnant or nursing mothers with retinal diseases will have the information needed to make an educated decision about whether to consider nursing while receiving these medications, said one of the study participants.


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Researchers find a way to make food taste salty with less sodium chloride.

Want a low salt diet but no compromise with the taste? Researchers have found a new way that can make your food taste salty but with less sodium chloride which is linked to poor   health.

It's a stealth approach, not like buying the ' reduced salt' option, which people generally don't like. If we can stair-step people down, then we increase health while still making food that people want to eat said a researcher.

The researchers took into account, salt blends that use less sodium chloride but include other salts like calcium chloride and potassium chloride.

Calcium and potassium chloride do not have those adverse effects on health. Potassium can help reduce blood pressure. Although, they aren't that great in taste. Potassium chloride tastes bitter, hence people really don't like it.

The research had an electronic tongue to check how much of the substitute salts could be added for sodium chloride before people object of the food being not tasty.

Using the e-tongue and panels, they found that a blend using approximately 96.4% sodium chloride with 1.6% potassium chloride and 2 % calcium chloride was the ideal reduction.

They had a higher reduction when they added only calcium chloride, getting acceptable rates with a combination of 78 % sodium chloride and 22 % calcium chloride.

This combination of the 2 salts did not significantly differ compared to 100 % sodium chloride but when we added potassium chloride, consumer acceptance decreased, claimed the researcher.

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Consumption of sugary beverages linked with early death

The study, found that drinking 1-4 sugary drinks per month was linked with one per cent increased risk of death and 2-6 drinks per week linked with six per cent increase risk of death.

In the study, researchers analyzed data from 80,647 women and 37,716 men who answered questionnaires about lifestyle factors and health status every two years.

They found that carbonated and non-carbonated soft drinks, fruit drinks, energy drinks, and sports drinks are the single largest source of added sugar in the U.S. diet.

The more sugar-sweetened beverages (SSBs) a person drank, the more risks of early death from any cause increased, according to the study.

The increased early death risk linked with sugar-sweetened beverages consumption was more pronounced among women than among men, the findings of the research showed.

“Our results provide further support to limit intake of sugar-sweetened beverages and to replace them with other beverages, preferably water, to improve overall health and longevity,” said lead author.

However, drinking one artificially-sweetened beverage per day instead of carbonated and non-carbonated soft drinks, fruit drinks, energy drinks, and sports drinks lowered the risk of premature death.

Those who drank two or more servings per day of SSBs had a 31 percent higher risk of early death from cardiovascular diseases. Each additional serving per day of SSBs was linked with a 10 percent increased higher risk of cardiovascular diseases-related death.

Also, among both men and women, there was a modest link between SSB consumption and early death risk from cancer.

“These findings are consistent with the known adverse effects of high sugar intake on metabolic risk factors and the strong evidence that drinking sugar-sweetened beverages increases the risk of type 2 diabetes, itself a major risk factor for premature death,” said a professor of epidemiology and nutrition.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                    PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/                                                                                                                                                         FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                  https:// kneereplacement-stickclub.blogspot.com/           

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