Advanced scanning techniques can find hidden inflammation in the brains of multiple sclerosis (MS) patients, a new study shows. This “smoldering” inflammation detected by positron emission tomography (PET) brain scans could help explain why patients continue to decline even though imaging shows no brain changes, researchers reported recently in the journal Clinical Nuclear Medicine. “One of the perplexing challenges for clinicians treating patients with MS is after a certain amount of time, patients continue to get worse while their MRIs don’t change,” explained lead researcher Dr. Tarun Singhal, an associate professor of neurology and director of the PET Imaging Program at Brigham and Women’s Hospital in Boston.  Singhal and colleagues started the study after noticing patients being treated with the most effective MS therapies available had symptoms that continued to worsen. The team has been working for eight years on newfangled brain scans involving microglia, immune cells in the brain that are thought to have a role in MS but cannot be seen by routine MRIs. The new technique involves a tracer dye that binds to the microglia cells. PET scans track the movement of such tracers, allowing doctors to observe the way tissues and organs in the body interact. A similar PET tracer scan has been FDA-approved to track amyloid beta protein in the brains of Alzheimer’s disease patients, the researchers noted. “This is…  read on >  read on >

Prescription opioids taken during pregnancy are not associated with a substantial increase in risk of developmental disorders like ADHD in children, a new study has found. “A slightly increased risk of neuropsychiatric disorders was found, but this should not be considered clinically meaningful” because it was limited to mothers taking more than one opioid, prescribed high doses and using the drugs over longer periods of time, concluded the research team led by Dong Keon Yon, a professor of pediatrics with Kyung Hee University College of Medicine in Seoul, South Korea. About 7% of women in the United States are prescribed opioids during pregnancy, according to the U.S. Centers for Disease Control and Prevention. Previous studies have had mixed findings regarding opioid use during pregnancy and various health outcomes in children, mainly due to small sample sizes and short follow-up periods. To produce a high-powered examination of the potential problem, researchers analyzed health data for more than 3.1 million infants born in South Korea between 2010 and 2017 to nearly 2.3 million mothers. Moms were grouped according to the dose, duration and frequency of opioid prescriptions during their pregnancy, and babies were followed an average of six years after birth. About 7% of infants were exposed to opioids during pregnancy, researchers found. The team found a small, but clinically insignificant, increased risk for developmental disorders among…  read on >  read on >

People taking heartburn meds have a higher risk of migraines and other types of severe headaches, a new study warns. All classes of acid-reducing drugs — proton pump inhibitors, H2 blockers, and even antacids — appear to promote an increased risk of migraine and headache, results show. “Given the wide usage of acid-reducing drugs and these potential implications with migraine, these results warrant further investigation,” said researcher Margaret Slavin, an associate professor of nutrition and food science with the University of Maryland in College Park. “These drugs are often considered to be overprescribed, and new research has shown other risks tied to long-term use of proton pump inhibitors, such as an increased risk of dementia,” Slavin added. Acid reflux occurs when stomach acid backs up into the esophagus, researchers said. It usually occurs after a meal or when lying down, and it can cause heartburn and ulcers. In extreme cases, it can lead to cancer of the esophagus. For the study, researchers looked at data on nearly 12,000 people using acid-reducing drugs, to see whether they’d had migraines or severe headaches within the past three months. Proton pump inhibitors block acid production and help the esophagus heal. Brand names include Prevacid, Prilosec and Nexium. H-2 blockers reduce acid production. Brand names include Tagamet, Pepcid and Axid. And then there are simple antacids containing calcium carbonate…  read on >  read on >

It’s long been known that exposure to agricultural pesticides can greatly raise a person’s odds for Parkinson’s disease. New genetics research now reveals those who might be most vulnerable. A team at the University of California, Los Angeles (UCLA), pored over genetic data from 800 Parkinson’s patients living and working in that state’s agricultural heartland, the Central Valley. Many of these people “had long-term exposure to 10 pesticides used on cotton crops for at least a decade prior to developing the disease, with some patients having been exposed as far back as 1974,” the researchers noted in a UCLA news release. They honed in on certain gene variants connected to lysosomes, parts of cells that break down cellular waste. Impairment in lysosomal function has long been linked to the genesis of Parkinson’s, explained a team led by Dr. Brent Fogel, a professor of neurology and human genetics at UCLA. The variants associated with lysosomal processes were “enriched” in patients who’d had prolonged exposures to pesticides, the study showed. The findings were published April 25 in the journal NPJ Parkinson’s Disease. These gene variants also appeared to interfere with proper protein function. According to the researchers, this suggests that aberrant waste-disposal in the cell could be an underlying cause of Parkinson’s, occurring alongside chronic exposure to pesticides. As toxic compounds — including a protein called alpha…  read on >  read on >

A budget-busting 3.6 million Medicare recipients could now be eligible for coverage of the weight-loss drug Wegovy, a new KFF analysis says. That’s because the U.S. Food and Drug Administration has approved the use of Wegovy (semaglutide) to reduce the risk of heart attacks and stroke in certain patients, the study says. The FDA’s ruling potentially allows Wegovy prescription coverage for more than a quarter of 13.7 million Medicare patients who’ve been diagnosed with obesity or excess weight, KFF says. Those 3.6 million people — about 7% of all beneficiaries — have established heart disease as well as excess weight, and thus could be eligible for coverage of Wegovy. However, KFF notes that among this group 1.9 million also have diabetes and therefore are already eligible for coverage of weight-loss drugs like Wegovy or Zepbound. “Although Wegovy already had FDA approval as an anti-obesity medication, Medicare is prohibited by law from covering drugs when prescribed for obesity,” KFF said in a news release. How the FDA’s change affects Medicare spending will depend in part on how many Part D plans add coverage for Wegovy, and the extent to which plans will restrict coverage, researchers said. Assuming just 10% of eligible Medicare patients use Wegovy in a given year, and assuming a 50% rebate on the list price, the program would still incur nearly $3 billion…  read on >  read on >