ScienceDaily (Mar. 9, 2011) — Implanting electrodes into a pea-sized part of the brain can dramatically improve life for people with severe cervical dystonia — a rare but extremely debilitating condition that causes painful, twisting neck muscle spasms — according to the results of a pilot study led by Jill Ostrem, MD and Philip Starr, MD PhD at the University of California, San Francisco.

Today, people with cervical dystonia can be treated with medications or injections of botulinum toxin (e.g., Botox®), which interrupt signals from the brain that cause these spasms. However, those treatments do not provide adequate relief for all patients.

Over the last decade, doctors at UCSF and elsewhere have turned to a technique called deep brain stimulation to help people with debilitating dystonia. also used to treat Parkinson’s disease and the neurological disorder essential tremor, the technique is like putting a pacemaker inside a heart patient’s chest — except that deep brain stimulation requires a neurosurgeon to implant electrodes inside the brain.

Scientists are not sure exactly why deep brain stimulation works. the electrodes deliver electric current to tiny parts of the brain, likely altering abnormal brain circuitry and alleviating symptoms by overriding the signals coming from those parts of the brain.

Traditionally doctors have treated cervical dystonia with deep brain stimulation by targeting a brain nucleus known as the "globus pallidus internus." Reporting in the journal Neurology, the UCSF team described the results of the first detailed clinical study looking at deep brain stimulation targeting a completely different part of the brain: the "subthalamic nucleus."

"This target is very widely used for Parkinson’s disease but not widely used for dystonia," said Starr, a professor of neurological surgery at UCSF and senior author of the paper.

The study, led by Ostrem, an associate professor of neurology at UCSF, involved nine patients followed for one year after surgery. "Patients in this study had failed medical treatments, but with the surgery, they were able to improve their movements and quality of life — as well as overcome some of their disability and pain," said Ostrem.

Video analysis and standard measures of dystonia showed the surgeries lowered pain, reduced spasms and improved the overall quality of life without causing serious side effects.

The team is now planning to enroll more patients into a longer study following outcomes for three years post-surgery.

"Medications and botulinum toxin injections still remain the first line of treatment," Ostrem said, "but for those who are really still suffering, we think DBS using this new stimulation location offers another choice for them."

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the above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California – San Francisco.

Journal Reference:

1. J. L. Ostrem, C. a. Racine, G. a. Glass, J. K. Grace, M. M. Volz, S. L. Heath, P. a. Starr. Subthalamic nucleus deep brain stimulation in primary cervical dystonia. Neurology, 2011; 76 (10): 870 DOI: 10.1212/WNL.0b013e31820f2e4f

Note: if no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Latest Womens Health News

American Heart Association Warns of Heart Attack Risk for Women with some Pregnancy Complications

By Denise MannWebMD Health News

Reviewed by Laura J. Martin, MD

Feb. 15, 2011 — Women who have been diagnosed with preeclampsia, pregnancy-induced hypertension, or diabetes during pregnancy are now considered at risk for heart attack or stroke going forward, according to newly updated guidelines from the American Heart Association (AHA).

The 2011 update to the AHA’s cardiovascular prevention guidelines for women recategorizes a woman’s risk for heart disease. It also serves up some gender-specific prevention advice on diet and daily aspirin therapy in women at high risk of coronary heart disease in order to prevent heart attacks.

The guidelines are being published in the journal Circulation and are based on expert reviews of the medical literature.

Women are now classified in three groups: high risk for heart disease, at risk, or ideal cardiovascular health. The high-risk group changed little from previous years and includes women with established heart disease, chronic kidney disease, or diabetes, among other risk factors.

But “the at-risk group now captures women with pregnancy complications such as preeclampsia, gestational diabetes, or pregnancy-induced hypertension,” says guideline chair Lori Mosca, MD, PhD. Mosca is director of preventive cardiology at new York-Presbyterian Hospital and a professor of medicine at Columbia University Medical Center in new York City.

“These complications are the equivalent of a failed stress test,” she says. Doctors use exercise stress tests to diagnose heart disease.

“If you do develop one of these conditions during pregnancy, it is an unmasking of the risk that tells us your vascular system doesn’t function ideally,” Mosca says.

“These complications are an opportunity to detect early that there is a problem,” she says. you can then follow up with your primary care doctor to evaluate your overall cardiac risk and quickly start appropriate prevention strategies.

“If you developed gestational diabetes, follow up and say, ‘What can I do to prevent heart disease and diabetes?’” she says. Your doctor may recommend weight loss, aggressive lifestyle changes, and possibly medication, she says. “We are unmasking a problem early so that we can prevent full-blown cardiovascular disease.”

Educating Women about Heart Risk

The new information about pregnancy complications and heart risk is “a big deal,” says guideline author Ileana L. Pi?a, MD, a professor of medicine and epidemiology and biostatistics at Case Western Reserve University in Cleveland.

“Your blood pressure may return to normal after pregnancy and your blood sugar may return to normal too, but don’t ignore these symptoms,” she says.

Some of the onus about getting the word out about pregnancy complications and heart risks falls on ob-gyns, says Mary Rosser, MD, PhD, an assistant professor in the department of obstetrics and gynecology and women’s health at Montefiore Medical Center in the Bronx, N.Y.

“We are seeing younger women and providing their primary care [and] we can make an impact,” she says.

“When I see patients with gestational diabetes, I say even though you are thin, you are still at risk for developing diabetes later on in life so you need to stay on top of this,” she says.

Other inflammatory diseases such as rheumatoid arthritis (RA) and lupus also place a woman at risk for heart disease, according to the updated guidelines.

Diseases like RA and lupus are more common in women and sometimes have heart disease manifestations.

Dietary Recommendations for Women

While the new guidelines cast a wider net to catch women at risk for heart disease, they also call for aggressive steps to control known risk factors such as high blood pressure and obesity.

For example, the guidelines call for less than 1,500 milligrams of salt per day for all women. Sugar is limited to five or fewer servings per week.

“We have a lot more data that the sodium content of food in America is too high and the prevalence of hypertension in this country is also high,” Pi?a says. “We believe that lowering sodium content can markedly lower blood pressure, particularly among African-American women whose hypertension is salt-sensitive.”

As for sugar, “the high content of sugar in foods is more fodder for the current obesity epidemic and obesity is highly correlated with the onset of diabetes and metabolic syndrome,” she says. Metabolic syndrome is a cluster of risk factors linked to development of heart disease. “Cutting down on sugar will aid in weight loss, lower blood sugar, and your cholesterol will also go down,” she says.

“It is a bit radical, especially the sodium intake,” says Suzanne Steinbaum, MD, director of women and heart disease at Lenox Hill Hospital in new York City. Steinbaum reviewed the guidelines for WebMD but did not serve on the writing committee.

“The sugar issue is in response to the obesity epidemic and is a way to get women to pay attention to the effects of sugars on the metabolic syndrome and weight gain,” she says.

The updated guidelines also state that folic acid and antioxidant vitamins such as vitamin E, C, and beta-carotene should not be used to prevent cardiovascular disease in women. What’s more, hormone replacement therapy should not be used to prevent heart attacks or strokes.

“If you eat a healthy diet, you don’t need supplements,” Steinbaum says. “Folic acid may reduce levels of homocysteine, but it does not seem to translate to a lower risk for heart disease.” Homocysteine is an amino acid in blood that had been linked to heart risk.

Aspirin and Women

Daily aspirin therapy prevents a recurrent problem in men and women who already have heart disease, Mosca says. but “there is softening of the guidelines when it comes to aspirin as a way of preventing heart disease in otherwise healthy women.”

“The decision about aspirin should take into consideration if she has controlled blood pressure or any risk of gastrointestinal bleeding because these are aspirin side effects that are very common and we don’t want doctors to just jump on it and tell all women to take an aspirin a day,” she says.

“We now understand that while women have been shown to respond similarly to men for many interventions, they may have different side effect profiles,” she says. Many women are not taking medications as prescribed or recommended because of side effects or fear of side effects.

“There is a real call in the guidelines for scientists and policy makers to have data by gender for positive and negative side effects,” Mosca says.

The bottom line is clear. “You do not need to develop heart disease no matter what your family history is,” Steinbaum says. “You need to live a healthy life and if you watch your risk factors, exercise and eat a healthy diet, heart disease doesn’t need to happen to you.”

Pi?a agrees. “Know your risk. Find out your cholesterol and blood pressure numbers and where they should be, and take control.”

SOURCES: Mosca, L. Circulation, 2011.Lori Mosca, MD, PhD, director, preventive cardiology, new York-Presbyterian Hospital, new York City.Ileana L. Pi?a, MD, professor of medicine and epidemiology and biostatistics, Case Western Reserve University, Cleveland.Suzanne Steinbaum, MD, director, women and heart disease, Lenox Hill Hospital, new York City.Mary Rosser, MD, PhD, assistant professor, department of obstetrics and gynecology and women’s health, Montefiore Medical Center, Bronx, N.Y.©2011 WebMD, LLC. All Rights Reserved.

Flavonoids Found in Berries and Other Fruits May Protect against Parkinson’s Disease

Feb. 14, 2011 — Incorporating berries and other fruits in your diet may pay off by reducing the risk of Parkinson’s disease.

A new study shows men who ate the most foods rich in a group of antioxidants known as flavonoids were 35% less likely to develop Parkinson’s disease than those who ate the least. Major dietary sources of flavonoids include berries, apples, tea, red wine, chocolate, and citrus fruits.

“This is the first study in humans to examine the association between flavonoids and risk of developing Parkinson’s disease,” says researcher Xiang Gao, MD, PhD, of the Harvard School of Public Health in Boston, in a news release. “Our findings suggest that flavonoids, specifically a group called anthocyanins, may have neuroprotective effects. if confirmed, flavonoids may be a natural and healthy way to reduce your risk of developing Parkinson’s disease.”

Parkinson’s disease is a progressive neurological disease that causes symptoms including muscle tremors, shaking, and stiffness. the cause of the disease is unknown, and the risk of developing it increases with age.

Berries Blunt Parkinson’s Disease Risk

The study, to be presented in April at the annual meeting of the American Academy of Neurology in Honolulu, looked at the relationship between flavonoid intake and Parkinson’s disease in 49,281 men who participated in the Health Professional Follow-up Study and 80,336 women who participated in the Nurses’ Health Study.

The participants were followed for 20-22 years and filled out questionnaires about the foods they ate.

Researchers calculated total flavonoid intake based on the participants’ consumption of five flavonoid-rich foods included on the questionnaires: tea, berries, apples, red wine, and oranges/orange juice.

The results showed that men who ate the most foods rich in flavonoids had a 35% lower risk of Parkinson’s disease compared with those who ate the least. No link between overall flavonoid consumption and Parkinson’s disease risk was found in women.

But when researchers looked at specific sub-groups of flavonoids, they found both men and women who ate the most foods rich in anthocyanins, which are found primarily in berries and apples, had a 22% lower risk of Parkinson’s disease compared to those who ate the least.

The study doesn’t prove that berries (or flavonoids in any other food) prevent Parkinson’s disease. this was an observational study and therefore can’t establish cause and effect. Nor is it clear why the results differed for men and women.

This study will be presented at a medical conference. the findings should be considered preliminary as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.