Preventive Neurology

Are you addicted to coffee? Do you need a reason to justify your addiction? Read on!  Photo by Jakob Owens on Unsplash I justify my coffee addiction (6-8 espresso shots per day) by claiming that I am preventing myself from developing Parkinson’s disease in the future. This is #PreventiveNeurology in practice. Sadly coffee consumption doesn’t protect you from getting Alzheimer’s disease or all-cause dementia. However, I was thrilled to note that it seems to protect you from developing chronic liver disease and dying from liver disease. The molecular mechanisms underlying this are plausible. Caffeine is a non-selective blocker of the A2aA receptor, activation of which stimulates collagen production by hepatic stellate cells, which are the primary mediators of fibrosis. But as decaffeinated coffee is also protective it may be the other ingredients in coffee such as chlorogenic acid, kahweol and cafestol, which protect against liver fibrosis. Whatever the mechanism underlying coffee’s pr

Photo by S L on Unsplash Human biology is systems biology; perturb one aspect of human biology and it will have downstream effects, which can be noted throughout the body. As you know sleep is critical for brain health; if you have poor sleep hygiene you are putting yourself at greater risk of developing dementia when you get older. Why?  In this study of cognitively normal older Chinese adults, spinal fluid soluble TREM2 (sTREM2) was associated with self-reported poor sleep hygiene using the Pittsburgh Sleep Quality Index. sTREM2 is shed from activated microglia or macrophages and is thought to be a marker of microglial activation. The implications are that this association may be causal, i.e. poor sleep is pro-inflammatory, both in the periphery and central nervous system and the latter contributes to driving neurodegeneration. Could improved sleep hygiene be anti-inflammatory? Or is the microglial activation simply a response to poorer clearance of CNS debris, which occurs when we

Congratulations to  Al Sandrock , from Biogen, for never giving up on science and for being a  risk-taker extraordinaire .   Photo by Markus Winkler on Unsplash The FDA’s controversial approval of aducanumab for the treatment of Alzheimer’s disease on Monday has caused a shitstorm. The main reason is that in November the FDA’s independent advisory committee voted against recommending approval; they said the data failed to demonstrate persuasively that aducanumab slowed cognitive decline. In a NY Times article Dr Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California and one of the aducanumab site investigators said “This should not be approved, because substantial evidence of effectiveness hasn’t been shown and there’s very little potential that this will address the needs of patients.” What the FDA has done is use the so-called Accelerated Approval Pathway , which allows them to approve a drug for a serious or life-threatening