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  1. A Fo Ben

http://dx.doi.org/10.1136/practneurol-2018-002079

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    Going viral

    A Fo Ben admits to being oblivious to the literature that links Alzheimer’s to pathogenic microbes; apparently Sjögren was one of many proponents who called prion disease the ‘slow virus’ and Crapper McLachlan proposed that Alzheimer’s is a SSPE-type illness. A herculean ‘polyomics’ study of nearly 1000 human postmortem brains showed increased levels of human herpes viruses 6A and 7 in 30% of cases versus almost undetectable levels in controls. They also identified varying patterns of gene expression in those herpes-containing specimens. This leaves an interesting question about viral causality—or is there a general susceptibility to infection?

    Neuron 2018;991:64–82.e7.

    Short sharp shock

    What motivates you to act? Helping patients, paying the mortgage or a deep unquenchable self-loathing? Eighty-one adults signed up to a randomised, double-blind, placebo-controlled, stratified, parallel-group trial of transcranial direct current stimulation (tDCS). A day after receiving dorsolateral prefrontal cortex stimulation or sham, they were asked about the intent to commit aggressive acts. Unbelievably being zapped did not make the cohort more tetchy, but instead the treatment arm were reportedly less likely to commit physical and sexual assault and more likely to judge these acts as morally wrong. If you are tempted to commit a morally dubious act, why not ask for tDCS?

    Neurosci 2018;38:6505–12.

    Stroke in the sauna

    A Fo Ben advocates learning from other cultures when it comes to preventative medicine. A Finnish study proves that ‘being a sweater helps you feel-better’ or that ‘hot sauna coals help you attain life-goals’. A total of 1628 Fins aged 53–74 were studied over 15 years; those who attended saunas most often (4–7 times a week) had less stroke (HR=0.39, 95% CI 0.18 to 0.83). The effect seemed particularly strong for ischaemic stroke and was not unduly modified by corrections for physical activity and socioeconomic status, age, sex or other clinical characteristics.

    Neurology 2018;90:e1937–44.

    S/c APO 4 PD

    A Fo Ben loves a riddle: what is an emetic, an opiate addiction remedy, an aphrodisiac and a plot-element for an Agatha Christie tale? Yes—apomorphine. The Lancet Neurology study of a prospective, randomised, placebo-controlled study of apomorphine infusion follows the initial uncontrolled case-reports of 28 patients that heralded the drug’s first use in Parkinson’s disease. A total of 107 people were randomised to 3–8 mg/hours subcutaneous apomorphine or placebo. Participants receiving the active compound had significant improvements in off-time (2.47 hours vs 0.58 hours) and the drug appeared well-tolerated. The drug was used as an adjunct leaving open questions about apomorphine’s role as monotherapy in Parkinson’s disease.

    Lancet Neurol 2018;pii: S1474-4422(18)30239–4.

    Figure 1
    Figure 1

    It is that time of year when doctors (often surgeons), often overseas (Italy) often tell patients (Devon White) who are often British (Chelmsford) that they are lucky (‘it was almost an intelligent shot’) when they shoot objects (a speargun bolt) into their brains (above). (Independent, 28th July 2018)

    Footnotes

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.

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