Research roundup: Alarm raised over Alzheimer’s blood tests, child concussion management policies, and more

NR Times explores the latest research developments in the field of neurology.

New study raises alarm over Alzheimer’s blood tests

New research indicates that blood tests for Alzheimer’s disease need to be interpreted with caution – particularly for Black patients.

Concentrations of an Alzheimer’s biomarker are significantly lower in blood than in spinal fluid, where they have been validated as a diagnostic tool in white patients. This difference is particularly large for Black patients, who naturally have lower levels of the biomarker in their spinal fluid. Worse memory function itself also raises blood biomarker levels.

The researchers found a 70 per cent correlation between protein levels in spinal fluid and blood.

The racial disparities were significant. When using a blood p-Tau217 threshold optimized for detecting Alzheimer’s, the test showed 90.3 per cent sensitivity (chance of diagnosing patients with disease) and 81.1 per cent specificity (chance of correctly identifying someone as not having the disease) in white participants but 73.7 per cent sensitivity and 72.5 per cent specificity in Black participants.

The researchers emphasized that anyone with memory concerns should see a neurologist for a comprehensive evaluation rather than relying on blood test results alone. They said roughly half of all Americans with Alzheimer’s are thought to be undiagnosed, particularly those with early-stage cases that can benefit most from treatment.

Schizophrenia is reflected in the brain structure

In a new study, researchers have examined the variability of brain structure in patients with schizophrenia, exploring which brain networks show a high degree of individuality and which a high degree of similarity.

The researchers examined several characteristics, including the thickness and surface area of the cerebral cortex, as well as the folding pattern and volume of deeper brain regions.

While variable brain structures in schizophrenia may reflect differences in symptoms between patients, the uniformity of brain folding in the mid-frontal brain area suggests a developmental trait common to people with schizophrenia.

Because brain folding is largely completed in early childhood, brain development during this period appears to be less flexible in schizophrenia patients, particularly in areas responsible for linking thinking and feeling processes.

Center for BrainHealth expands access to proactive brain health through national partnerships

The Center for BrainHealth at UT Dallas has announced three major new partnerships that will enhance its mission to empower people at all ages and circumstances with science-backed approaches for proactive brain health and fitness.

“Over the past 25 years, Center for BrainHealth has been researching brain health and developing both cognitive training protocols and measurement tools to empower individuals and organisations to address a critical unmet need for proactive, holistic ways to improve brain health and performance across the age span,” said Stephen White, chief operating officer at Center for BrainHealth.

“As an academic research institution, the best way for us to achieve our ambitious mission of turning research into impact is to collaborate with respected partners that have aligned missions, broad reach and established credibility. We are excited to collaborate with three organisations that fit that profile.”

The partnerships are with GoMo Health, 21 Impact Labs and Virginia High Performance.

A change in child concussion management policies led to improvements in recovery time

Until roughly a decade ago, there was a common consensus that rehab should primarily be rest-based and that a return to physical activity should begin about four weeks after injury.

However, many concussion specialists disagreed and argued for moving treatment up significantly. Among them were clinicians at the Montreal Children’s Hospital Concussion Clinic, who changed their policies in 2017. A new study of this protocol change shows the approach benefitted patients and decreased recovery time significantly.

The researchers worked closely with Isabelle Gagnon, a clinical scientist in the Trauma Centre at the Montreal Children’s Hospital. She spearheaded the idea of using physiotherapy to treat concussion patients, with research dating back to 2009 suggesting that physical activity could help speed recovery.

Study lead, Elizabeth Teel, says it is important to note that any physical activity after concussion should be low-impact and non-contact, and it should only be taken up after 24 to 48 hours of rest.

Typically, concussion specialists recommend exercises like swimming, cycling and running, and only as tolerated. Avoiding re-injury and specific exercises or treatment environments that overly trigger concussion symptoms is the priority.

NSHAP advances study of older adults’ cognition in post-Covid era

New measures, methods, and data collected during Round 4 of the National Social Life, Health, and Aging Project (NSHAP) have been presented with a focus on cognition and how researchers adapted to working with participants as a result of the Covid-19 pandemic.

NSHAP is a longitudinal, representative study of health, well-being, and social factors among community-dwelling older adults. Its rounds of data are publicly available through the National Archive of Computerized Data on Aging.

The articles describe the shift from collecting data from respondents in person in their homes to collecting data via remote modes including web, phone, and paper-and-pencil, including a few cases that began in one mode and finished in another.

They also address challenges faced in collecting data remotely on cognition and cognitive decline, including among different racial and ethnic groups, and Spanish-speaking older adults. The articles discuss the effects of different modes of data collection, Covid-19’s impact on cognition due to changes in social connectedness, measuring cognition across race and ethnicity, and the risk factors for cognitive decline.

Use of strong synthetic opioids during surgery linked to poor composite experience of pain

The use of powerful synthetic opioids, such as sufentanil and remifentanil, during surgery is linked to a subsequent poor ‘pain experience’ – a composite of emotional, cognitive, and physical aspects of pain, new research suggests.

The findings highlight the need to reassess intraoperative pain relief strategies to reduce complications after surgery and improve the quality of patient care, say the researchers.

The study found that the use of strong opioids, such as remifentanil or sufentanil, during general anaesthesia was strongly and independently linked to postoperative pain experience, with patients almost 27 times as likely to report a poor one.

Patients given postoperative drugs to treat anxiety and those who reported amnesia were, respectively, eight times and 58 per cent more likely to have a poor pain experience the day after surgery, while higher VAS acute pain, and lower wellbeing, scores on day 1 were also predictive.

Older age was associated with a lower likelihood of poor pain experience as were no preoperative sedative use and orthopaedic surgery – 51 per cent and 71 per cent lower, respectively, and seriously ill patients with an ASA 3 score, as defined by the American Society of Anesthesiologists, were five times more likely to report poor pain experience.