Brain stimulation helps in stroke treatment

Stimulating the part of the brain which controls movement may improve recovery after a stroke new research suggests.

Brain stimulation helps in stroke treatmentStudies showed firing beams of light into the brains of mice led to the animals moving further and faster than those without the therapy.

The research, published in Proceedings of the National Academy of Science, could help explain how the brain recovers and lead to new treatments.

The Stroke Association said the findings were interesting.

Strokes can affect memory, movement and the ability to communicate. Brain cells die when their supply of oxygen and sugars is cut off by a blood clot.

Stroke care is focused on rapid treatment to minimise the damage, but some recovery is possible in the following months as the brain rewires itself.

The team at Stanford University School of Medicine investigated whether brain stimulation aided recovery in animal experiments.

They used a technique called optogenetics to stimulate just the neurons in the motor cortex – the part of the brain responsible for voluntary movements – following a stroke. After seven days of stimulation, mice were able to walk further down a rotating rod than mice which had not had brain stimulation. After 10 days they were also moving faster.

The researchers believe the stimulation is affecting how the wiring of the brain changes after a stroke. They detected higher levels of chemicals linked to the formation of new connections between brain cells.

Lead researcher Prof Gary Steinberg said it was a struggle to give people drugs to protect brain cells in time as the “time window is very short”.

However he said that aiding recovery could be easier: “The advantage of treating during the recovery period is it’s longer, potentially it could be years, so it has huge potential. I predict that the kind of study we’re doing will help to push stimulation as a therapy for stroke and you can image how import that would be for the millions of stroke patients with disability.”

Optogenetics uses an optic fibre to send light into the brain, which specifically activates cells that are genetically engineered to respond to the light. It allows precision stimulation of parts of the brain in experiments.

The team at Stanford argue using optogenetics will allow them to uncover exactly what changes in the brain as it recovers from stroke,

Prof Steinberg said: “We’re also looking to see if optogenetically stimulating other brain regions after a stroke might be equally or more effective. The goal is to identify the precise circuits that would be most amenable to interventions in the human brain, post-stroke, so that we can take this approach into clinical trials.”

However, optogenetics cannot be used in people yet.

It would require genetic modification of the target cells, but Prof Steinberg argues “it may not be too far in the future that you’re doing refined and elegant stimulation” with optogenetics.

Dr Shamim Quadir, from the Stroke Association charity, said: “This is a very interesting study using light to stimulate specific brain cells of genetically altered mice in the early days after a stroke. Using this optogenetic technique could be helpful in improving our understanding of the mechanisms driving stroke recovery, however it is too early to tell exactly how this research might be developed for the treatment of human stroke patients.”

Hair loss reversed for alopecia sufferers

Scientists have completely reversed hair loss in three people by giving them a drug normally used to treat bone marrow disorders.

Hair loss reversed for alopecia sufferersThe patients had alopecia areata – a condition that can cause severe, patchy baldness that is difficult to treat and after five months of taking the medication ruxolitinib, all three saw total hair re-growth.

The findings from Columbia University Medical Center are published in the journal Nature Medicine.

Alopecia areata affects around two in every 1,000 people in the UK and is thought to be caused by the immune system attacking hair follicles.

The US scientists had previously identified a set of immune cells involved in the destruction of hair and conducted a number of successful trials in mice.

They then gave three patients with moderate to severe alopecia areata a twice daily dose of ruxolitinib.

This medication is already approved for use in bone marrow conditions in the United States and European Union.

All three patients had lost at least a third of their hair but saw dramatic hair growth within five months of therapy.

Lead researcher Dr Raphael Clynes said: “We’ve only begun testing the drug in patients, but if the drug continues to be successful and safe, it will have a dramatic positive impact on the lives of people with the disease.”

Prof David Bickers, a dermatologist at Columbia University who has treated many patients with the disease, said: “There are few tools in the arsenal for the treatment of alopecia areata that have any demonstrated efficacy. This is a major step forward in improving the standard of care for patients suffering from this devastating disease.”

Researchers say more work is now needed to see if the drug can be offered more widely.

Alopecia areata can occur at any age but is most often seen in teenagers and young adults.

It is not related to the more common male-pattern hair loss that is thought to be driven by hormones.

Scientists say as the mechanisms behind this condition are different, the therapy is less likely to prove effective for this more common problem.

Alcohol tax suggested to fund rehab and health service for addicts

Drink and drug addicts should be treated in rehab treatment centres paid for with a new tax on alcohol.

Alcohol tax suggested to fund rehab and health service for addictsThe Centre for Social Justice (CSJ) said that by 2024, a ring-fenced “treatment tax” would put up the cost of alcohol bought in shops by 2p per unit- it is among a number of measures recommended to tackle addiction.

The Department of Health said councils’ £5.4 billion public health budgets would help them address alcohol harm.

The CSJ, which seeks to tackle poverty and its causes wants the government to fund treatment centres for 58,000 addicts per year by 2024.

Its report says 300,000 people in England are addicted to opiates and/or crack, 1.6 million are dependent on alcohol and one in seven children under the age of one lives with a substance abusing parent.

The measures set out in its Ambitious for Recovery report include:

  • Scrapping the drug advice site FRANK, which it says does not send “a strong signal to young people about the risks of experimenting with drugs”
  • Involving job centres in identifying and helping addicts, with jobseekers “screened for addiction”
  • Offering benefit claimants with addiction problems support and “abstinence-based” treatment with the threat of sanctions if help is refused
  • Piloting a charge card for long-term unemployed parents with serious addiction problems to restrict how they spend any income support to essential items only
  • Doing more to tackle so-called legal highs and educate young people and parents about their dangers

The treatment tax proposal would see a levy of 1p per unit of alcohol added on drinks purchased outside pubs by the end of the next Parliament, rising to 2p by 2024, the CSJ said.

This could mean about 18p added to the price of a bottle of wine after 2024.

The think tank estimated it would raise £155 million a year from 2015, rising to about £520 million a year from 2024.

A Department of Health spokesman said: “We are not considering a tax on particular drinks.  Instead, we are reducing alcohol harm by giving local authorities a £5.4 billion budget to help them manage public health issues including alcohol and drug services. We have also banned sales of the cheapest cut price alcohol.”

Local authorities had the best understanding of local needs to be able to assess, plan and deliver alcohol and drug services and treatment in their areas, he added.

Sally Marlow, an alcohol addiction specialist, said there were “problems with the proposal”.

But she added: “If we’re going to sell it, if we’re going to legitimise it and say we sanction alcohol then we have a duty also to say to the people who get into trouble with it, ‘we’ll help you with it – we’ll help you get out of the trouble that you’re in’.”

Raised depression risks after Parkinson’s diagnosis

Depression and anxiety are twice as common in people newly diagnosed with Parkinson’s disease compared with the general population new research suggests.

Raised depression risks after Parkinson's diagnosisWriting in the journal Neurology, US researchers say depression increases in frequency in Parkinson’s patients and is often left untreated. Previous research suggests that the disease’s impact on the brain can be a trigger for depression.

Parkinson’s UK said depression could be due to a number of causes.

Researchers from the University of Pennsylvania School of Medicine examined 423 newly-diagnosed Parkinson’s patients and tracked their mental health over two years.

At the outset, 14% of patients with Parkinson’s disease were found to have depression, compared with 6.6% of a group of healthy volunteers.

During the follow-up, there was a small rise in the frequency and severity of depression in the group with Parkinson’s, while in the control group a decrease was noted.

At the start of the study, 16% of patients with Parkinson’s were taking an anti-depressant, and this increased significantly to 25% two years later.

But 65-72% of patients who screened positive for depression were still not being treated with medication, the study said.

Dr Daniel Weintraub, associate professor of psychiatry and neurology at the Perelman School of Medicine at the University of Pennsylvania, said depression in Parkinson’s disease was under-recognised.

“There are psychological reasons why people who have been diagnosed with a neuro-degenerative disease like Parkinson’s can become depressed, but their brain pathways are also affected by the disease and these are closely associated with mood.”

Prof David Burn, from the University of Newcastle, who is funded by Parkinson’s UK, said depression can be a sign of Parkinson’s.

“It is well-recognised that people do get depression and anxiety up to 10 years before they develop Parkinson’s disease. People recognise the tremor and movement problems of Parkinson’s, but the disease actually starts in the brain, affecting certain chemicals. This can cause sleep problems initially and can also lead to minor forms of depression.”

Because of the range of possible causes, Parkinson’s UK says it is important that patients speak to their healthcare professional if they are worried about their symptoms.

After Robin Williams died in an apparent suicide last week, it emerged the actor – who had depression – was in the early stages of Parkinson’s disease.

Robin Williams’ death raises mental health debate

The sad death of Robin Williams has raised a wider debate about depression and how society deals with mental illness.

Robin Williams' death raises mental health debateDiscussions have ranged around the sad circumstances of the Hollywood star’s suicide and the fact that he had suffered with depression for some years – and the news on this week that he may have been in the early stages of Parkinson’s raises even more questions.

But his death has also raised wider questions about whether mental health is given the same priority as physical disorders as most people know very little about mental illness.

The new President of the Royal College of Psychiatrists Sir Simon Wessely has highlighted the fact that society found it “apparently acceptable” that while with illnesses such as high blood pressure or cancer the vast majority of people were getting treatment or were known to medical services, the equivalent for mental disorders was no higher than 40%.

Prof Wessely acknowledged that the issue was complicated and that people who knew they had mental health problems often did not want to come forward for fear that their jobs would be at risk. But he argued that the waiting list for advanced psychological therapies was long and that the mental health situation needed to be higher up the political agenda.

In an unrelated development, Health Service Journal published conclusions they had drawn from Freedom of Information Act requests to 52 mental health trusts in England.

These included an overall reduction in nursing staff of 6% between 2011-12 and 2013-14 as well as a fall in the number of doctors employed and the number of beds. Charities and experts in the field described the analysis as painting a “worrying picture” and providing a “warning signal”.

In response to the HSJ report, a Department of Health spokesperson said: “We have gone further than ever before to put mental health on a par with physical health and have instructed the NHS to make sure every community does the same.”

The department points out that the mandate to NHS England states that every community must develop plans to ensure no one in mental health crisis will be turned away.

Calls for a higher profile for mental health and the need for a wider discussion on priorities and resources for patients suffering with depression are increasingly being heard. The sad case of Robin Williams has given new impetus to the debate.