Can Biomarkers Predict Cognitive
Deficits in Parkinson’s Disease?
Biomarkers may predict which patients with Parkinson’s disease will
have significant cognitive deficits within the first three years after diagnosis,
according to a study published May 17
in PLOS One. Researchers conducted
an international, prospective study of
423 newly diagnosed and untreated
patients with Parkinson’s disease with
no signs of cognitive impairment at the
time of enrollment in 2010. Investigators conducted brain scans, genetic
tests, and analyses of CSF at baseline
and during follow-up. At three years,
between 15% and 38% of participants
had developed cognitive impairment.
Brain scans identified dopamine deficiency and decreased brain volume as
predictors of cognitive decline. Low
CSF beta-amyloid level and single-nucleotide polymorphisms (SNPs)
in COMT and BDNF also predicted
cognitive decline. These SNPs previously had been associated with
Caspell-Garcia C, Simuni T, Tosun-Turgut D,
et al. Multiple modality biomarker prediction of
cognitive impairment in prospectively followed de
novo Parkinson disease. PLoS One. 2017 May
17; 12( 5):e0175674.
Service Members With Concussive
Blast TBI Have Worsening
Military service members with concus-
sive blast traumatic brain injury (TBI)
have considerable decline in clinical
outcomes over five years, according
to a study published online ahead
of print May 1 in JAMA Neurology.
This prospective longitudinal study
enrolled active-duty US military after
concussive blast injury in the acute to
subacute stage and combat-deployed
control individuals in Afghanistan or
after medical evacuation to Germany
from November 1, 2008, through
July 1, 2013. Physicians in the United
States performed one- and five-year
clinical evaluations. Among the 94
participants, global disability, satisfac-
tion with life, neurobehavioral symp-
tom severity, psychiatric symptom
severity, and sleep impairment were
significantly worse in patients with
concussive blast TBI, compared with
combat-deployed controls, whereas
performance on cognitive measures
was no different between groups at
the five-year evaluation.
Mac Donald CL, Barber J, Jordan M, et al. Early
clinical predictors of 5-year outcome after concussive blast traumatic brain injury. JAMA Neurol.
2017 May 1 [Epub ahead of print].
Biomarker Linked to Increased
Risk of Ischemic Stroke in Women
High levels of β2-microglobulin are associated with an increased risk of ischemic stroke among women, according
to a study published online ahead of
print May 10 in Neurology. Researchers performed a nested case–control
study among women enrolled in the
Nurses’ Health Study who provided
blood samples between 1989 and
1990 and were free of prior stroke and
cancer. Investigators measured β2-
microglobulin levels in 473 ischemic
stroke cases and 473 controls matched
on age, race, and other variables. Median levels of β2-microglobulin were
1.86 mg/L in cases and 1.80 mg/L
in controls. Women in the highest β2-microglobulin quartile had a
multivariable-adjusted increased risk
of ischemic stroke, compared with
women in the lowest quartile (odds
ratio, 1.56). Results were similar when
restricted to those without chronic
Rist PM, Jiménez MC, Rexrode KM. Prospective
association between β2-microglobulin levels and
ischemic stroke risk among women. Neurology.
2017 May 10 [Epub ahead of print].
Female Hormones May Cause
Headache in Girls With Migraine
Age and pubertal development could
moderate the effect of ovarian hormones on days of headache onset in
girls with migraine, according to a
study published online ahead of print
May 8 in Cephalalgia. The study included 34 girls with migraine grouped
into three age strata (ie, prepubertal,
pubertal, and postpubertal). Participants collected daily urine samples
and recorded the occurrence and
severity of headache in a daily diary.
Urine samples were assayed for estrone glucuronide and pregnandiol
glucuronide, and the daily change in
each was calculated. The primary outcome measures were headache onset
days and headache severity. Models
of headache onset days demonstrated
a significant interaction between age
and pregnandiol glucuronide. Change
in pregnandiol glucuronide was associated with headache severity.
Martin VT, Allen JR, Houle TT, et al. Ovarian
hormones, age and pubertal development and
their association with days of headache onset in
girls with migraine: an observational cohort study.
Cephalalgia. 2017 Jan 1 [Epub ahead of print].