FISH OIL SUPPLEMENTS MAY IMPROVE MEMORY FUNCTION

Rhode Island Hospital researchers have completed a study that found regular use of fish oil supplements (FOS) was associated with a significant reduction in cognitive decline and brain atrophy in older adults. The study examined the relationship between FOS use during the Alzheimer's Disease Neuroimaging Initiative (ADNI) and indicators of cognitive decline. The findings are published online in advance of print in the journal Alzheimer's & Dementia

At least one person is diagnosed every minute with Alzheimer's disease (AD) and despite best efforts, we have not yet found a cure for this pervasive and debilitating disease," said principal investigator Lori Daiello, PharmD, of the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital. "The field is currently engaged in numerous studies to find better treatments for people suffering with AD; however, researching ways to prevent AD or slow cognitive decline in normal aging is of utmost importance."

In this retrospective study, older adults involved in the ADNI study were assessed with neuropsychological tests and brain magnetic resonance imaging (MRI) every six months. The group included 229 older adults who were cognitively normal; 397 who were diagnosed with mild cognitive impairment; and 193 with AD.

The study found that fish oil supplement use during the study was associated with significantly lower rates of cognitive decline as measured by the Alzheimer's Disease Assessment Scale (ADAS-cog), and the Mini Mental State Exam (MMSE), but this benefit was observed only for the group of participants without dementia at the time of enrollment.

"Additionally, serial brain imaging conducted during this study showed that the participants with normal cognition who reported taking fish oil supplements demonstrated less brain shrinkage in key neurological areas, compared to those who did not use the supplements," Daiello said. "Also, the positive findings on cognitive testing and brain MRI were only observed in persons who did not carry the best-studied genetic risk factor for AD, APOE-4. More research is needed, but these findings are promising and highlight the need for future studies to expand the current knowledge of the effects of FOS use on cognitive aging and AD."

It is estimated that more than 5 million people in the U.S. have Alzheimer's disease. It is the most common form of dementia and is the sixth leading cause of death in the U.S.

Using Sensors To Improve Neuropathy Balance

Today's post from podiatrytoday.com (see link below) talks about using technology to monitor balance issues for people with neuropathic foot problems. It involves a sort of physiotherapy that involves interactive balance training, using information gleaned from sensors. Unfortunately, the article doesn't go into detail about the sensors themselves, which I'm sure most readers are interested in. However, there's no doubt that more emphasis on training to avoid loss of balance due to numbness and wrong signals would be very helpful to all people living with neuropathy - it's a somewhat neglected area of neuropathy treatment. Don't worry about the title reference to diabetes - it applies to all forms of neuropathy.

Can Sensors And Balance Exercises Improve Balance And Reduce Fall Risk In People With Diabetic Neuropathy?
Thursday, 02/26/15 David G. Armstrong DPM MD PhD
 
Diabetic peripheral neuropathy can be a risk factor for falls due to deficits in sensory and motor skills that can lead to proprioceptive difficulties. In a new study in Gerontology, my coauthors and I investigate the use of interactive balance training to increase postural stability.1

The randomized study performed at our unit focused on 39 patients with diabetic peripheral neuropathy (with an average age of 63.7 years) with one group performing sensor-based interactive exercise twice a week for four weeks and the other group being a control group.1 The exercises included shifting weight and crossing virtual obstacles. Participants wore sensors to acquire kinematic data and provide real-time joint visual feedback during the training.

Patients in the intervention group showed a significantly reduced center of motion sway, ankle sway and hip joint sway during the balance test with open eyes, according to the study.1 Ankle sway in our study was also significantly lower in the intervention group during measurements while the eyes were closed. These promising data certainly provide early evidence to potentially promote the use of wearable technology in exercise training but we need future studies to compare this technology with commercially available systems to evaluate the benefit of interactive visual joint movement feedback.

There are some really extraordinary technologies available to us in the sensor world. Trends are moving to smaller, cheaper and more flexible sensors. Some of the newest flexible sensors we have available are actually more like medical tattoos. These sensors would normally have taken up an entire backpack just a few years ago. The sensors are becoming so inexpensive and so ubiquitous that we are not only going to be able to measure aspects of instability but we are also going to be able to intervene right away by trying to measure and steadily improve people’s postural stability. By doing this, I believe we can reduce the completely unnecessary number of falls and unnecessary morbidity and death that occurs every day in homes and hospitals not only in the United States but around the world.

This problem of falls is getting more and more common not only in people with diabetes but also in the aging population overall. This fall risk is preventing people from being independent, productive members of society, keeping them at home and putting them forever on this cycle of dependence. We think these sort of sensors can really help us measure what we manage as doctors and patients.

Reference

1. Grewal GS, Schwenk M, Lee-Eng J, et al. Sensor-based interactive balance training with visual joint movement feedback for improving postural stability in diabetics with peripheral neuropathy: a randomized controlled trial. Gerontology. 2015; epub ahead of print.

http://www.podiatrytoday.com/blogged/can-sensors-and-balance-exercises-improve-balance-and-reduce-fall-risk-people-diabetic

Can Acupuncture Improve Conduction Of Nerve Signals

Today's post from neuropathytreatment.co (see link below) looks again at the possibility of acupuncture being of help to neuropathy patients. It suggests that acupuncture can improve nerve conduction through improving blood and energy flows along the nerve pathways. It doesn't really explain how acupuncture can tackle specific nerve damage and talks in terms of a traditional medical approach which may seem alien to many people. However, acupuncture in its many forms can clearly help many people with medical problems, whether neuropathy is one of them is open to debate. The article suggests that the acupuncture treatment should be long-term (up to a year) and that may explain why so many people have found their acupuncture sessions to be of little benefit. Most insurance companies will not cover acupuncture, which leads to an expensive series of sessions and many people go to unqualified practitioners, whose skills may be questionable. It's certainly an alternative but also an accompaniment to traditional medicine but it may be worthwhile getting advice first. If you have benefited from acupuncture treatment, please let us know.

Acupuncture – Chinese Medicine as Treatment for Peripheral Neuropathy
MAY 18, 2013 BY WESLEY MILNE

With the still limited studies conducted on the nature of peripheral neuropathy—it’s causes, pattern, characteristics—treatments for the said condition are also currently limited. The most common type of treatment offered to patients is relief from the pain they are experiencing.

But the age-old art of acupuncture and Chinese medicine may be the key in treating peripheral neuropathy (PN) and its other types due to its scientifically proven effect on the patients with PN.

According to a research conducted by the Heidelberg School of Chinese Medicine located in Heidelberg, Germany, treatment using acupuncture has improved the nerve conduction in various patients experiencing peripheral neuropathy.

Further, the group found out that therapeutic acupuncture has a positive effect on the PN-afflicted subjects studied over a period of 1 year, according to their research published online in March 2007 in the website of the National Institute for Health (NIH).

Peripheral Neuropathy
The peripheral nervous system, one of the most important parts of the body, consists of the ganglia and the nerves in the exterior of the spinal cord and the brain. It connects the central nervous system to the various organs, limbs and muscles and conveys sensations all through the body as its main function, making it possible to feel.

With peripheral neuropathy, the nerves that help in the transportation of information from the limbs to the brain or vice-versa become impaired due to various factors.

A person might already have an existing condition such as diabetes, Acquired Immunodeficiency Syndrome (AIDS)/Human Immunodeficiency Virus infection (HIV), leprosy, undergoing cancer therapies (caused by poisoning from chemotherapy), alcoholism, or a hereditary disease prior to their condition to develop into peripheral neuropathy or also known as polyneuritis.

The condition of PN might also include causes such as penetrated injuries, carpal tunnel syndrome (due to entrapment or compression), pressures on the superficial nerves on the ulna or radial, which might be from prolonged position (such as using crutches), disjointed bones or fractures, physical injury directly affecting the nerve including trauma, atherosclerosis or radiation, prolonged exposure to cold, tumor or intraneural hemorrhage.

The condition of peripheral neuropathy is characterized by these symptoms: tingling of the distal limbs, the feeling of burning, numbing, aching, and pain and also includes itching or excessive sensitivity to even slightest touch. The symptoms are oftentimes bilateral (two-sided), and aggravated at night, which also affects the lower limbs more than the upper limbs. However, not all people afflicted with PN experience these symptoms upon diagnosis, making it more complicated to assess those needing treatments.

Acupuncture
The similarity of all the diseases above is that they have a severe lack of qi, yin which results to static blood being produced. For lasting effects, the origin of these factors should be addressed first, together with the treatment that will help invigorate the blood, given that the etiology (origin) of the blood stagnation is the lack of yin, blood and qi.

The practice of traditional acupuncture in treating various ailments has been proven not only by centuries of tradition but is supported with scientific facts as well.

In traditional Chinese medicine, it is taught that peripheral neuropathy is caused by the humidity or the dampness going to the limbs, blocking the natural flow of blood and the energy or the Qi flowing in them. There is a two-fold treatment in it: first is to determine the underlying reason that caused the accumulation of dampness and then to directly aid the Blood and Qi circulation in the affected parts. Through the improved circulation, nerve tissues within the affected area will be revived and nourished in order to restore the functions of the nerve and to reduce pain.

Moreover, peripheral neuropathy is one of the symptoms which showed the various patterns of dissonance existing within the body. The treatment done in the traditional Oriental Medicine sense is to treat and address the patients individually in order to assess their specific needs. The treatment will also have to depend on the reason behind the neuropathy and its manifestation, prognosis, etc.

With this, during the treatment, the acupuncturist may interview the patient and will ask about his or her own observation of the disease: what, where, when they exercised, sleep, drink, perspire, eat, felt pain, among others. The acupuncturist will also observe the tongue and take note of the pulse. The initial diagnosis will help the health team, physician, or the acupuncture practitioner to manage and create a special treatment plan to suit the individual patients.

Aside from acupuncture, there are also other treatments applied including transcutaneous electronic nerve stimulation (TENS), used to block the pain signals, cutaneous acupuncture wherein the physical therapy coupled with the herbal treatment could be combined for quicker results.

Acupuncture can also be partnered along with other treatments undergone by the patient.

http://neuropathytreatment.co/acupuncture-chinese-medicine-as-treatment-for-peripheral-neuropathy/

Opioids Were Never Intended To Improve Function Just Relieve Pain

Today's post from clinicalpainadvisor.com (see link below) is an ever-so-subtle addition to the current media-inspired movement that claims all things 'opioid' are bad. It addresses opioids and neuropathic pain directly and comes to negative conclusions based on the study results that show that opioids produce little improvement in function in people who take them. However, opioids don't address the disease and are not meant to be 'cures'. Don't these people realise that opioids are never meant to improve function - they're meant to reduce pain and in that respect, they are very successful. Of course, reduced pain can enable people to function better but only because their pain is gone, not because the original illness has been addressed. Of course the media realise this full well! Inventing negative effects that were never claimed to be benefits of opioid use in the first place, is a sort of negative publicity that's used in politics all the time. The fact is that if you are taking opioids for neuropathic pain, you have tried everything else and nothing works, leaving you with opioids that generally do the job. Of course they have to be controlled and monitored and the patient has to take some responsibility to make sure that the potential for addiction is minimised but good doctors should be monitoring you to within an inch of your life to make sure you're not entering any sort of spiral. Opioids have been used for pain control since the dawn of time but like everything in this modern world, we always seem to need a sledgehammer to crack a nut!

How Effective Are Opioids in Neuropathic Pain? 
Steve Duffy January 26, 2016

Improved function may not necessarily follow opioid treatment.

A new study suggests that opioid prescriptions for patients with neuropathic pain, may not improve their physical function or disability. In fact, results from the study — conducted by the University of Alberta and published in Pain Medicine — indicate that opioid use could be harmful when it comes to physical recovery for patients with neuropathic pain.

"We studied patients with neuropathic pain from nerve injuries such as diabetic neuropathy and pinched nerves, and the ones who weren't prescribed any opioids had statistically lower disability and higher physical functioning scores," said Geoff Bostick, PhD, lead author of the study.

TRENDING ON CPA: ACA Supports Proposed Guideline for Prescribing Opioids to Patients With Chronic Pain

The study sample included 789 patients with neuropathic pain across Canada. Patients gave self-reported measures of physical function (pain disability index) and a medical outcomes study short form-12 physical function (PCSS-12), at the beginning of the study, then again at 6 months and 12 months after treatment began. Analysis of covariance models was created to examine the association between opioid therapy and both physical functioning outcomes with adjustment for confounding.

Results showed that patients prescribed opioid treatment did not report greater physical functioning or lower disability than patients who were not prescribed opioids — even after the results were adjusted for disease severity. The improvements in disability and physical functioning scores from baseline and 12 months for all groups were "modest and may not be clinically significant," authors reported.

They asserted that while opioids are a powerful painkiller, the results of the study testify that improved function does not necessarily follow opioid treatment.

In addition, they highlighted the association between opioid prescription and a patient's quality of life, considering that the treatment may not be aiding the patient's functionality. They call for further research to analyze this correlation.

For those who have chronic pain but are medically cleared for physical activity, a graded approach to recovery is suggested, according to Dr. Bostick. "I tell patients to walk until they are at 50% of their tolerance — walk and stop before the pain gets too bad. Each week, walking time is gradually increased. Over time, this tolerance will slowly increase and so will physical function."
Reference

Bostick G, Toth C, Carr E et al. Physical Functioning and Opioid use in Patients with Neuropathic Pain. Pain Med. 2015;16(7):1361-1368. doi:10.1111/pme.12702.
This article originally appeared on MPR.

http://www.clinicalpainadvisor.com/neuropathic-pain/how-effective-are-opioids-in-neuropathic-pain/article/467341/

LIFT WEIGHTS IMPROVE YOUR MEMORY

Here's another reason why it's a good idea to hit the gym: it can improve memory. A new Georgia Institute of Technology study shows that an intense workout of as little as 20 minutes can enhance episodic memory, also known as long-term memory for previous events, by about 10 percent in healthy young adults.

The Georgia Tech research isn't the first to find that exercise can improve memory. But the study, which was just published in the journal Acta Psychologica, took a few new approaches. While many existing studies have demonstrated that months of aerobic exercises such as running can improve memory, the current study had participants lift weights just once two days before testing them. The Georgia Tech researchers also had participants study events just before the exercise rather than after workout. They did this because of extensive animal research suggesting that the period after learning (or consolidation) is when the arousal or stress caused by exercise is most likely to benefit memory.

The study began with everyone looking at a series of 90 photos on a computer screen. The images were evenly split between positive (i.e. kids on a waterslide), negative (mutilated bodies) and neutral (clocks) pictures. Participants weren't asked to try and remember the photos. Everyone then sat at a leg extension resistance exercise machine. Half of them extended and contracted each leg at their personal maximum effort 50 times. The control group simply sat in the chair and allowed the machine and the experimenter to move their legs. Throughout the process, each participant's blood pressure and heart rate were monitored. Every person also contributed saliva samples so the team could detect levels of neurotransmitter markers linked to stress.

The participants returned to the lab 48 hours later and saw a series of 180 pictures -- the 90 originals were mixed in with 90 new photos. The control group recalled about 50 percent of the photos from the first session. Those who exercised remembered about 60 percent.

"Our study indicates that people don't have to dedicate large amounts of time to give their brain a boost," said Lisa Weinberg, the Georgia Tech graduate student who led the project.

Although the study used weight exercises, Weinberg notes that resistance activities such as squats or knee bends would likely produce the same results. In other words, exercises that don't require the person to be in good enough to shape to bike, run or participate in prolonged aerobic exercises.

While all participants remembered the positive and negative images better than the neutral images, this pattern was greatest in the exercise participants, who showed the highest physiological responses. The team expected that result, as existing research on memory indicates that people are more likely to remember emotional experiences especially after acute (short-term) stress.

But why does it work? Existing, non-Georgia Tech human research has linked memory enhancements to acute stress responses, usually from psychological stressors such as public speaking. Other studies have also tied specific hormonal and norepinephrine releases in rodent brains to better memory. Interestingly, the current study found that exercise participants had increased saliva measures of alpha amylase, a marker of central norepinephrine.

"Even without doing expensive fMRI scans, our results give us an idea of what areas of the brain might be supporting these exercise-induced memory benefits," said Audrey Duarte, an associate professor in the School of Psychology. "The findings are encouraging because they are consistent with rodent literature that pinpoints exactly the parts of the brain that play a role in stress-induced memory benefits caused by exercise."

The collaborative team of psychology and applied physiology faculty and students plans to expand the study in the future, now that the researchers know resistance exercise can enhance episodic memory in healthy young adults.

"We can now try to determine its applicability to other types of memories and the optimal type and amount of resistance exercise in various populations," said Minoru Shinohara, an associate professor in the School of Applied Physiology. "This includes older adults and individuals with memory impairment."

WANT TO IMPROVE YOUR PUTT TRY LISTENING TO JAZZ

Listening to jazz music while putting can boost your performance on the putting green, according to new university research.

While any kind of music improves performance compared to listening to no music at all, jazz is the most effective musical genre for improving putting, according to a study, which was recently published in the Journal of Athletic Enhancement.

The 22 participants in the research were university Division I golfers, an average of 20 years old with at least eight years of golf experience. Each of them completed a series of six trials, which comprised attempting five putts at four pre-designated locations around a hole. In a randomized order, participants were required to listen to either no music or a musical genre that included classical, country, rock, jazz, and hip hop/rap while putting.

Clarkson University Assistant Professor of Physical Therapy & Physician Assistant Studies Ali Boolani says that music can enhance performance in other sports too. "Other research has shown that country music improves batting, rap music improves jump shots and running is improved by any up-temp music. But the benefit of music in fine motor control situations was relatively unknown. Hopefully, this is the first step in answering this question."

Boolani conducted the study along with Assistant Professor Timothy Baghurst, Assistant Professor Tyler Tapps, and Regents Professor Bert H. Jacobson of Oklahoma State University, and student Richard Gill of Tennessee State University.

The paper indicates that future research will be needed with a larger sample to see if the findings can be replicated.