La ingesta de frutos secos en el primer trimestre de embarazo se relaciona con un mejor desarrollo neuropsicológico

Maternal nut intake in pregnancy and child neuropsychological development up to 8 years old: a population-based cohort study in Spain

Abstract

There is scientific evidence on the protective effects of nut intake against cognitive decline in the elderly; however, this effect has been less explored in child neurodevelopment and no studies have explored the potential longitudinal association with nut intake during pregnancy. We aimed to analyze the association of maternal nut intake during pregnancy with child neuropsychological outcomes. We included 2208 mother–child pairs from a population-based birth cohort in four regions of Spain. The follow up settings were during pregnancy (first and third trimesters), birth, 1.5, 5 and 8 years. Neuropsychological examinations were based on Bayley Scales of Infant Development (1.5 years), McCarthy scales of Children’s Abilities (5 year), Attention Network Test (ANT, 8 year) and N-Back test (8 year). Nut intake in pregnancy was reported through a validated food frequency questionnaire during the first and the third trimester. Multivariable regressions analyzed associations after controlling for priori selected confounders notably maternal education, social class, body mass index, energy intake, fish intake, omega-3 supplements, alcohol consumption and smoking habits during pregnancy. Children within the highest tertile of maternal nut consumption during first pregnancy trimester (> 32 g/week) had a decrease of 13.82 ms [95% confidence interval (CI) − 23.40, − 4.23] in the ANT—hit reaction time standard error, compared to the first tertile (median 0 g/w). A similar protective association pattern was observed with the other cognitive scores at the different child ages. After correcting for multiple testing using Bonferroni familywise error rate (FWER), Hochberg FWER and Simes false discovery rate, ANT—hit reaction time standard error remained significant. Final model estimates by inverse probability weighting did not change results. Third pregnancy trimester nut intake showed weaker associations. These data indicate that nut intake during early pregnancy is associated with long-term child neuropsychological development. Future cohort studies and randomized clinical trials are needed to confirm this association pattern in order to further extend nutrition guidelines among pregnant women.

Keywords

Nut Maternal diet Children Neurodevelopment Population-based cohort

Eficacia de la realidad virtual sobre el equilibrio y la marcha en pacientes con esclerosis múltiple

Efficacy of virtual reality on balance and gait in multiple sclerosis. Systematic review of randomized controlled trials

INTRODUCTION. 

Multiple sclerosis (MS) is a neurodegenerative disease that causes gait abnormalities and a deficit in balance control in the vast majority of people affected by it. Virtual reality has been proposed as a complementary approach to conventional physiotherapeutic treatment as a way of improving these variables.

AIM. 

To assess the real efficacy of this approach compared to other neurorehabilitation therapies, or no intervention, in MS.

PATIENTS AND METHODS. 

A systematic review of randomized controlled trials was conducted. Studies of the last five years that compare virtual reality with conventional treatment or no intervention, on balance and/or gait, in adults with MS, were included. PEDro scale was used to assess methodological quality and the Oxford scale to determine the level of evidence and grades of recommendations.

RESULTS. 

Eight studies met the eligibility criteria. For balance, the efficacy of virtual reality is, at least, comparable as conventional training. For gait, virtual reality seems not to be superior in improving the speed, compared with the other types of interventions assessed. Methodological quality of studies was low-moderate.

CONCLUSIONS. 

Virtual reality is as effective as conventional training for improving balance in people with MS. No data suggests that virtual reality is superior to other interventions in improving gait speed. For other gait parameters, virtual reality’s efficacy remains unknown.

KeywordsBalanceGaitMultiple sclerosisNeurorehabilitationVirtual reality

Compuestos de la yerba mate podrían atenuar el daño cerebral en ciertos tumores

Effects of bioavailable phenolic compounds from Ilex paraguariensis on the brain of mice with lung adenocarcinoma

Abstract

Lung carcinoma is one of the most common cancers and has a high mortality. Recently, we showed that it produces neurological paraneoplastic syndrome, with Ilex paraguariensis (IP) extract exerting palliative effects due to its content of phenolic compounds. It is possible, therefore, that these diet agents can arrive at the brain and exert neuroprotection, after the oral intake of IP. Here, the aim was to investigate the protective role of bioavailable IP compounds on the telencephalon and diencephalon in lung adenocarcinoma‐bearing BALB/cJ males. Mice aged 2 months were treated for 3 weeks with 0–100 IP mg·kg−1·day−1. HPLC‐UV revealed the presence of chlorogenic acid and quercetin in brain regions, liver, and tumour, in an IP dose‐dependent manner. Brain was also evaluated histologically, and interleukin‐6 was measured by ELISA. Chlorogenic acid was the major compound found in brain, whereas quercetin was observed at the diencephalon to a lesser extent. Both compounds were involved in IP dose‐dependent diencephalic interleukin‐6 reduction. Histology suggested cellular protection with less apoptosis in chlorogenic‐exposed areas. Taken together, chlorogenic acid and quercetin from dietary IP were bioavailable and bioactive in brain, thereby attenuating lung cancer‐related neuroinflammation and damage. These findings support plant‐based strategies to improve prognosis.

Un nuevo tipo de demencia se confundiría con la enfermedad de Alzheimer

Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report 

Abstract

We describe a recently recognized disease entity, limbic-predominant age-related TDP-43 encephalopathy (LATE). LATE neuropathological change (LATE-NC) is defined by a stereotypical TDP-43 proteinopathy in older adults, with or without coexisting hippocampal sclerosis pathology. LATE-NC is a common TDP-43 proteinopathy, associated with an amnestic dementia syndrome that mimicked Alzheimer’s-type dementia in retrospective autopsy studies. LATE is distinguished from frontotemporal lobar degeneration with TDP-43 pathology based on its epidemiology (LATE generally affects older subjects), and relatively restricted neuroanatomical distribution of TDP-43 proteinopathy. In community-based autopsy cohorts, ∼25% of brains had sufficient burden of LATE-NC to be associated with discernible cognitive impairment. Many subjects with LATE-NC have comorbid brain pathologies, often including amyloid-β plaques and tauopathy. Given that the ‘oldest-old’ are at greatest risk for LATE-NC, and subjects of advanced age constitute a rapidly growing demographic group in many countries, LATE has an expanding but under-recognized impact on public health. For these reasons, a working group was convened to develop diagnostic criteria for LATE, aiming both to stimulate research and to promote awareness of this pathway to dementia. We report consensus-based recommendations including guidelines for diagnosis and staging of LATE-NC. For routine autopsy workup of LATE-NC, an anatomically-based preliminary staging scheme is proposed with TDP-43 immunohistochemistry on tissue from three brain areas, reflecting a hierarchical pattern of brain involvement: amygdala, hippocampus, and middle frontal gyrus. LATE-NC appears to affect the medial temporal lobe structures preferentially, but other areas also are impacted. Neuroimaging studies demonstrated that subjects with LATE-NC also had atrophy in the medial temporal lobes, frontal cortex, and other brain regions. Genetic studies have thus far indicated five genes with risk alleles for LATE-NC: GRN, TMEM106B, ABCC9, KCNMB2, and APOE. The discovery of these genetic risk variants indicate that LATE shares pathogenetic mechanisms with both frontotemporal lobar degeneration and Alzheimer’s disease, but also suggests disease-specific underlying mechanisms. Large gaps remain in our understanding of LATE. For advances in prevention, diagnosis, and treatment, there is an urgent need for research focused on LATE, including in vitro and animal models. An obstacle to clinical progress is lack of diagnostic tools, such as biofluid or neuroimaging biomarkers, for ante-mortem detection of LATE. Development of a disease biomarker would augment observational studies seeking to further define the risk factors, natural history, and clinical features of LATE, as well as eventual subject recruitment for targeted therapies in clinical trials.

PET, MRI, FTLD, epidemiology, SNAP

Marcadores psicobiológicos de la conducta agresiva infantil

Testosterone and cortisol modulate the effects of empathy on aggression in children

Abstract

This study aimed to analyze the potential moderating role of circulating testosterone, cortisol and estradiol levels on the attenuating effect of empathy on aggression in children. Participants were 139 children (80 boys and 59 girls) from the 3rd year of primary school (age 8). Their aggressive behavior was measured by the Direct and Indirect Aggression Scale, an instrument which uses peer rating; empathy was measured using the Empathy Quotient-Child Version. Hormone levels (testosterone, cortisol and estradiol) were analyzed using an enzymoimmunoassay technique in saliva samples. A regression analysis revealed an interaction effect of empathy x testosterone in girls, with higher levels of empathy corresponding to lower levels of aggression at both moderate and low testosterone levels. In boys, an interaction effect of empathy x cortisol was observed, with lower levels of empathy corresponding to higher aggression levels at moderate and high cortisol levels, and higher levels of empathy corresponding to lower aggression levels again at moderate and high cortisol levels. Our results indicate the importance of taking the interaction of psychological and biological factors into account in order to gain greater insight into the complex mechanisms underlying aggressive behavior.

Una dieta poco saludable no predice el nivel de síntomas del TDAH de un niño

Children's Attention-Deficit/Hyperactivity Disorder Symptoms Predict Lower Diet Quality but Not Vice Versa: Results from Bidirectional Analyses in a Population-Based Cohort 

ABSTRACT

Background

As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is.

Objectives

We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association—that is, whether dietary patterns predict ADHD symptoms or vice versa.

Methods

We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling.

Results

Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = −0.08; 95% CI: −0.11, −0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls.

Conclusion

Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.

attention-deficit/hyperactivity disorder, ADHD symptoms, dietary pattern, children, directionality, causality

Efecto combinado del estrés laboral y trastornos del sueño en personas hipertensas

Combined effect of work stress and impaired sleep on coronary and cardiovascular mortality in hypertensive workers: The MONICA/KORA cohort study

Background

Although work stress and impaired sleep are established risk factors for cardiovascular disease (CVD) among healthy individuals, their impact on hypertensive workers is largely unknown.

Design

Prospective cohort study design.

Methods

Hypertensive workers (N = 1959), derived from the population-based MONICA/KORA study in Southern Germany, who were free of any cardiovascular disease and diabetes were interviewed at baseline for work stress (high demand plus low control) and impaired sleep (difficulties falling asleep and/or maintaining sleep). Hazard ratios and 95% confidence intervals (CIs) were estimated by multivariate Cox proportional hazards models with adjustment for relevant covariates.

Results

During a mean follow-up of 17.8 years covering 34,900 person-years, 134 fatal CVD and 73 coronary heart disease (CHD) events were observed. In comparison to participants with low work stress and non-impaired sleep, participants with work stress (hazard ratio (HR) 1.56, 95% CI 0.81-2.98), or impaired sleep (HR 1.76, 95% CI 0.96-3.22) had an increased risk of CVD, while participants with both work stress and impaired sleep had the highest risk of CVD mortality (HR 2.94, 95% CI 1.18-7.33). Participants with both risk conditions had an absolute CVD mortality risk of 7.13 cases per 1000 person-years in comparison to 3.05 cases per 1000-person years in the reference group. Similar risk patterns were found for CHD mortality.

Conclusions

Our findings add a new piece of evidence that work stress together with impaired sleep increase risk of coronary and cardiovascular mortality in hypertensive workers.

Keywords Work stress, impaired sleep, cardiovascular diseases, hypertension, mortality

Mejorar la microbiota intestinal podría ayudar a aliviar los síntomas de autismo

Long-term benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota

Abstract

Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors. Modifying the gut microbiome is a potential route to improve gastrointestinal (GI) and behavioral symptoms in children with ASD, and fecal microbiota transplant could transform the dysbiotic gut microbiome toward a healthy one by delivering a large number of commensal microbes from a healthy donor. We previously performed an open-label trial of Microbiota Transfer Therapy (MTT) that combined antibiotics, a bowel cleanse, a stomach-acid suppressant, and fecal microbiota transplant, and observed significant improvements in GI symptoms, autism-related symptoms, and gut microbiota. Here, we report on a follow-up with the same 18 participants two years after treatment was completed. Notably, most improvements in GI symptoms were maintained, and autism-related symptoms improved even more after the end of treatment. Important changes in gut microbiota at the end of treatment remained at follow-up, including significant increases in bacterial diversity and relative abundances of Bifidobacteria and Prevotella. Our observations demonstrate the long-term safety and efficacy of MTT as a potential therapy to treat children with ASD who have GI problems, and warrant a double-blind, placebo-controlled trial in the future

Persisten en la vejez «huellas» moleculares cerebrales de niveles altos de escolarización

Characterizing the molecular architecture of cortical regions associated with high educational attainment in older individuals

Abstract

Neuroimaging investigations have revealed inter-individual variations in anatomy, metabolism, activity, and connectivity of specific cortical association areas through which years of education (YoE), as a common proxy of cognitive reserve, may operate in the face of age- or pathology-associated brain changes. However, the associated molecular properties of YoE-related brain regions and the biological pathways involved remain poorly understood. In the present study we first identified brain areas that showed an association between cortical thickness and YoE amongst 122 cognitively healthy older human individuals (87 female). We subsequently characterized molecular properties of these regions by studying brain-wide microarray measurements of regional gene expression. In accordance with previous studies, we observed that YoE were associated with higher cortical thickness in medial prefrontal, anterior cingulate and orbitofrontal areas. Compared to the rest of the cortex, these regions exhibited a distinct gene expression profile characterized by relative up-regulation of gene sets implicated in ionotropic and metabotropic neurotransmission as well as activation of immune response. Our genome-wide expression profile analysis of YoE-related brain regions points to distinct molecular pathways that may underlie a higher capacity for plastic changes in response to lifetime intellectual enrichment and potentially also a higher resilience to age-related pathologic brain changes.

Más problemas de atención en niños de 5 años que pasan mucho tiempo ante una pantalla

Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study

Abstract

Background

Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study.

Methods

CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child’s total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score≥65).

Results

Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms (n = 24). Children with more than 2-hours of screen-time/day had a 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). There was no significant association between screen-time and aggressive behaviors (p>0.05).

Conclusion

Increased screen-time in pre-school is associated with worse inattention problems.

Figures