Volume 16, Number 1
FROM THE JOURNALS
Brainwaves Offers a Sampling of Recent Journal Articles:
Some small studies suggest that artificially raising blood pressure in ischemic stroke patients who have a large salvageable, though under-perfused area of brain may be relatively safe and useful. But those studies weren't randomized. Now, neurologists Argye Hillis, M.D., and Robert Wityk, M.D., report a randomized pilot trial of 15 patients, comparing conventional treatment with medically raised blood pressure. Results are that raised-pressure patients do significantly better early on, giving a larger trial the go-ahead.
Cerebrovasc Dis 2003;16(3):236-246.
Little is known about brain involvement in women with X-linked adrenoleukodystrophy (ALD)-a disease characterized by CNS accumulation of very long chain fatty acids. Neurological exams suggest women heterozygous for the disorder vary widely in disability. Now a retrospective study by a team including Ali Fatemi, M.D., and SakkuBai Naidu, M.D., looks at brain MRIs and, in a smaller group, at MRSI scans. MRI results show brain involvement is rare; MRSI suggests axonal dysfunction in some corticospinal areas.
Neurology 2003;60:1301-1307.
Vertebroplasty and kyphoplasty are now standard, minimally invasive ways to treat the benign spinal fractures of osteoporosis. But a study of 56 patients by neurosurgeon Ziya Gokaslan, M.D., and colleagues shows the procedures dramatically reduce the agonizing pain of cancer- caused vertebral body fractures. All patients had lessened pain; no deaths or complications occurred from the treatment.
J Neurosurg 2003;98:21-30.
A study on a gene tied to a major psychiatric illness that resembles schizophrenia may shed light on the biology of the latter disease. Psychiatrist Akira Sawa, M.D., and colleagues followed both normal and mutant DISC-1 (for disrupted in schizophrenia) genes in mice, the normal form of which helps direct cortical development in utero. In rodent cell systems, mutant human DISC-1 fails to bind with a cytoskeletal protein called NUDEL. It also alters normal neurite extension. Since schizophrenia is likely a disease of cortical development via key cytoskeletal proteins, mutant DISC-1 could be a helpful model.
PNAS 2003;100:289-294.
Neuroradiologists Martin Pomper, M.D., Dima Hammoud, M.D., and colleagues assessed CT and MR imaging of the surgical bed in brains of patients receiving BCNU-laden polymer disks for recurring glioma. The researchers compared treated patients with those given placebo. Aside from describing the appearance of the disk in the images, the study showed that gas in the surgical bed is transient and that imaging can pick up differences in tumor growth rate. The latter was slowed in the treatment group.
Am J Roentgenol 2003;180:1469-1475.