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journal neurology
A simple eye test may offer a fast and easy way to monitor patients with multiple sclerosis (MS), medical experts say in the journal Neurology.
Optical Coherence Tomography (OCT) is a scan that measures the thickness of the lining at the back of the eye – the retina.
It takes a few minutes per eye and can be performed in a doctor’s surgery.
In a trial involving 164 people with MS, those with thinning of their retina had earlier and more active MS.
The team of researchers from the Johns Hopkins University School of Medicine say larger trials with a long follow up are needed to judge how useful the test might be in everyday practice.
The latest study tracked the patients’ disease progression over a two-year period.
Multiple sclerosis is an illness that affects the nerves in the brain and spinal cord causing problems with muscle movement, balance and vision. In MS, the protective sheath or layer around nerves, called myelin, comes under attack which, in turn, leaves the nerves open to damaged.
Optical Coherence Tomography test may offer a fast and easy way to monitor patients with multiple sclerosis
There are different types of MS – most people with the condition have the relapsing remitting type where the symptoms come and go over days, weeks or months.
Usually after a decade or so, half of patients with this type of MS will develop secondary progressive disease where the symptoms get gradually worse and there are no or very few periods of remission.
Another type of MS is primary progressive disease where symptoms get worse from the outset.
There is no cure but treatments can help slow disease progression.
It can be difficult for doctors to monitor MS because it has a varied course and can be unpredictable.
Brain scans can reveal inflammation and scarring, but it is not clear how early these changes might occur in the disease and whether they accurately reflect ongoing damage.
Scientists have been looking for additional ways to track MS, and believe OCT may be a contender.
OCT measures the thickness of nerve fibres housed in the retina at the back of the eye.
Unlike nerve cells in the rest of the brain which are covered with protective myelin, the nerve cells in the retina are bare with no myelin coat.
Experts suspect that this means the nerves here will show the earliest signs of MS damage.
The study at Johns Hopkins found that people with MS relapses had much faster thinning of their retina than people with MS who had no relapses. So too did those whose level of disability worsened.
Similarly, people with MS who had inflammatory lesions that were visible on brain scans also had faster retinal thinning than those without visible brain lesions.
Study author Dr. Peter Calabresi said OCT may show how fast MS is progressing.
“As more therapies are developed to slow the progression of MS, testing retinal thinning in the eyes may be helpful in evaluating how effective those therapies are,” he added.
In an accompanying editorial in the same medical journal that the research is published in, MS experts Drs Robert Bermel and Matilde Inglese say OCT “holds promise” as an MS test.
Experts from Edinburgh University found that exercising in your 70’s may stop your brain from shrinking and showing the signs of ageing linked to dementia.
Brain scans of 638 people past the age of retirement showed those who were most physically active had less brain shrinkage over a three-year period.
Exercise did not have to be strenuous – going for a walk several times a week sufficed, the journal Neurology says.
But giving the mind a workout by doing a tricky crossword had little impact.
The study found no real brain-size benefit from mentally challenging activities, such as reading a book, or other pastimes such as socializing with friends and family.
When the researchers examined the brain’s white matter – the wiring that transmits messages round the brain – they found that the people over the age of 70 who were more physically active had fewer damaged areas than those who did little exercise.
And they had more grey matter – the parts of the brain where the messages originate.
Experts already know that our brains tend to shrink as we age and that this shrinkage is linked to poorer memory and thinking.
And previous studies have shown that exercise helps reduce the risk of dementia and can slow down its onset.
But scientists are still baffled about why this is.
Exercise increases blood flow to the brain, delivering oxygen and nutrients to brain cells, which may be important.
Or it may be that as people’s brains shrink, they become less inclined to exercise.
Regardless of why, experts say the findings are good news because exercise is an easy thing to do to boost health.
Prof. James Goodwin, head of research at Age UK, the charity that provided the funding for the research, said: “This research re-emphasizes that it really is never too late to benefit from exercise, so whether it’s a brisk walk to the shops, gardening or competing in a fun run it is crucial that, those of us who can, get active as we grow older.”
Finnish researchers have found that a diet rich in tomatoes may reduce the risk of having a stroke.
They were investigating the impact of lycopene – a bright red chemical found in tomatoes, peppers and water-melons.
A study of 1,031 men, published in the journal Neurology, showed those with the most lycopene in their bloodstream were the least likely to have a stroke.
The Stroke Association called for more research into why lycopene seemed to have this effect.
The levels of lycopene in the blood were assessed at the beginning of the study, which then followed the men for the next 12 years.
They were split into four groups based on the amount of lycopene in their blood. There were 25 strokes in the 258 men in the low lycopene group and 11 strokes out of the 259 men in the high lycopene group.
The study said the risk of stroke was cut by 55% by having a diet rich in lycopene.
Dr. Jouni Karppi, from the University of Eastern Finland in Kuopio, said: “This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke.
“The results support the recommendation that people get more than five servings of fruits and vegetables a day, which would likely lead to a major reduction in the number of strokes worldwide, according to previous research.”
He said lycopene acted as an antioxidant, reduced inflammation and prevented blood clotting.
US researchers have found that the examination of the back of the eye may offer an insight into the health of someone’s brain.
A small study, published in the journal Neurology, linked damage to the retina with declining brain function.
Researchers believe issues with the blood supply may be damaging both the eye and the brain.
The eye condition the researchers were looking at was retinopathy, which is common in patients with Type 2 diabetes or high blood pressure. Damage to the retina can eventually lead to blindness.
Scientists followed 511 women, who were 65 or older, for a decade. Some 39 were diagnosed with retinopathy.
Those with the eye condition tended to have lower scores in tests of brain function, including memory and abstract reasoning exams.
The eye condition the researchers were looking at was retinopathy, which is common in patients with Type 2 diabetes or high blood pressure
Brain scans also showed up more areas of damaged brain tissue, ischemic lesions, in those with retinopathy.
Dr. Mary Haan, from the University of California, San Francisco, said: “Problems with the tiny blood vessels in the eye may be a sign that there are also problems with the blood vessels in the brain that can lead to cognitive problems.
“This could be very useful if simple eye screening could give us an early indication that people might be at risk of problems with their brain health and functioning.”
There was only a small number of patients with retinopathy in the study. Much larger studies would be needed to see if the findings could be used as a clinical test for declining brain function.
While there was no suggestion of dementia in the patients, brain decline can be an early sign of the disease.
Dr. Simon Ridley, head of research at Alzheimer’s Research UK, who was not involved in the research, said: “Accurate early detection of the cognitive decline that can be associated with dementia could unlock our ability to treat it.
“This small study offers clues for another possible route doctors could consider when monitoring for the signs of cognitive decline.
“The study adds to mounting evidence linking vascular health to cognitive decline, and underlines the importance of looking after our hearts. It will be useful to see whether the people in this study went on to develop dementia.”
