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Objective: Lower serum low-density lipoprotein cholesterol (LDL-C) levels are associated with increased intracerebral hemorrhage (ICH) risk. However, reverse causality and residual confounding has not attracted public attention. Therefore, we assessed whether people with LDL-C have increased risk of mortality adjusting for potential confounders using two large Taiwan cohorts.Methods: The Mei-Jhao (MJ) cohort has 414,372 adults participating in a medical screening program with 378 ICH deaths within 15 years of follow-up (1994–2008). Cox proportional hazards regressions estimated hazard death ratios according to LDL-C levels. We identified 4,606 ICH patients from the Taiwan Stroke Registry (TSR) and analyzed the impact of LDL-C on 3-month mortality.Results: Low cholesterol (LDL-C

Migraine is one of the most common neurological disorders. In addition to severe headaches, non-headache symptoms associated with migraine attacks as well as co-morbid disorders frequently aggravate the disabling of migraine patients. Some of these symptoms are related to poor outcomes. In this review, we update the advances of studies on certain non-headache symptoms, including visual disturbance, gastrointestinal symptoms, allodynia, vestibular symptoms, and symptoms of co-morbid restless legs syndrome and psychiatric disorders.

The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with 200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC 15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41-2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11-1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI)

The γ-aminobutyric acid (GABA) tea is popular by consumers in Asia in recent years. This study investigated the effects of GABA tea on apoptosis and autophagy in the cerebral cortex of streptozotocin (STZ)-induced diabetic rats. Thirty-four male Wistar rats at 8 weeks of age were randomly divided into control group, STZ-induced (60 mg/kg, i.p.) diabetes (DM), and DM rats with water GABA tea extracts of containing GABA either 3.01 or 30.1 μg/rat per day for 6 weeks. Treatment with GABA tea dose-dependently lowered blood glucose level in the diabetic rats compared with vehicle. GABA tea reduced the diabetic-induced Fas-dependent and mitochondrial-dependent apoptotic pathway in the diabetic cerebral cortex compared with vehicle, the evidence for which is based on decreases in Fas, activated caspase-8, pro-apoptotic t-Bid, Bax, cytosolic cytochrome c, activated caspase-9 and activated caspase-3. GABA tea also reduced the diabetic-induced autophagy. The results suggest that GABA tea obviously inhibits diabetic-induced apoptosis in the cerebral cortex through the suppression of Fas and mitochondrial pathways. These findings provide the possible diabetes-related apoptotic and autophagy pathways in the cerebral cortex and suggest that GABA tea treatment has the potential to prevent diabetic brain abnormality.

BACKGROUND AND PURPOSE:Previous studies on the clinical and pathological manifestations of Parkinson's disease dementia (PDD) have reported findings more similar to dementia with Lewy bodies (DLB) than to Alzheimer's disease (AD). The aim of this study was to investigate the neuropsychiatric symptoms of PDD compared to DLB and AD. METHODS:We conducted a retrospective case-control study on 125 newly diagnosed consecutive PDD patients and age- and dementia stage-matched controls with either DLB (N = 250) or AD (N = 500) who visited the same hospital over the same period. For each case and control, neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory (NPI). RESULTS:Overall, 513 (58.6%) patients were female and 362 (41.4%) were male. Comparisons of clinical data revealed that the PDD group, similar to the AD group, had a lower NPI total score, NPI caregiver burden score, and rate of antipsychotic use (all p < 0.001) than the DLB group. One or more psychiatric symptoms were reported in 95.2% of the PDD, 99.2% of the DLB, and 96.8% of the AD patients. The PDD group had lower subscores in the items of delusions, hallucinations, agitation, anxiety, irritation, aberrant motor behavior compared to the DLB group. Severe neuropsychiatric symptoms among all dementia patients were associated with younger age, more advanced stage, and a diagnosis of DLB. CONCLUSION:Neuropsychiatric symptoms in PDD were more like those in AD than in DLB. Severe neuropsychiatric symptoms in degenerative dementia were associated with younger age, more advanced stage of dementia, and a diagnosis of DLB.

A stroke often results in post-stroke dementia, a rapid decline in memory and intelligence causing dysfunctions in daily life. The Chinese medicine doctor uses 4 examinations of inspection, listening, smelling, and feeling to determine the Chinese medicine pattern (CMP). Therefore, the purpose of the present study was to investigate the CMP in patients with post-stroke dementia. A total of 101 stroke patients were examined, consistent with the DSM IV diagnostic criteria of the American Psychiatric Association, as well as the National Institute of Neurological Disorders and Stroke-Association International pour Ia Recherche et I’Enseignement en Neurosciences vascular dementia diagnostic criteria of post-stroke dementia. Results: 100 patients (99.0%) were KEDP (kidney essence deficiency pattern, shèn jīng kuī xū zhèng, 腎精虧虛證), 83 patients were AHLYP (ascendant hyperactivity of liver yang pattern, gān yáng shàng kàng zhèng, 肝陽上亢證), 83 patients were QBDP (qi-blood deficiency pattern, qì xuè kuī xū zhèng, 氣血虧虛證), 81 patients were SBOCP (static blood obstructing the collaterals pattern, yū xuè zǔ luò zhèng, 瘀血阻絡證), 72 patients were BSTRP (bowels stagnation turbidity retention pattern, fǔ zhì zhuó liú zhèng, 腑滯濁留證), 50 patients were FHIEP (fire heat interior excess pattern, huǒ rè nèi sheng zhèng, 火熱內盛證), and 39 participants (38.6%) were PTOOP (phlegm turbidity obstructing the orifices pattern, tán zhuó zǔ qiào zhèng, 痰濁阻竅證); one to 31 patients have at least 2 CMPs simultaneously. In conclusion, the most CMP is KEDP CMP in the post-stroke dementia patients, and one patient may have one or at least 2 CMPs simultaneously.

Migraine is a common neurological disorder and can cause severely disabling during attacks. The highest prevalence occurs between the ages of 25 and 55 years, potentially the most productive period of life. Migraine leads to a burden not only to the individual, but also to the family and society. Prior studies have found migraine occurs with some illness at a greater than coincidental rate than is seen in the general population. These occurrences are called “comorbidity”, which means that these disorders are interrelated with migraine. To delineate migraine comorbidity is important because it can help improve treatment strategies and understand the possible pathophysiology of migraine. The comorbid illnesses in patients with migraine include stroke, sub-clinical vascular brain lesions, coronary heart disease, hypertension, patent foramen ovale, psychiatric diseases (depression, anxiety, bipolar disorder, panic disorder, and suicide), restless legs syndrome, epilepsy, and asthma. In this paper, we review the existing epidemiological and hospital based studies and illustrate the connections between these illness and migraine.

BACKGROUND: An association between restless legs syndrome and migraine has been reported recently. The clinical correlates and impact of comorbidity of restless legs syndrome (RLS) are not fully described in patients with migraine. OBJECTIVES: To investigate the frequency of RLS among different primary headache disorders, and its impact and clinical correlates in migraine patients. METHODS: Consecutive patients with migraine, tension-type headache (TTH) and cluster headache (CH) were recruited in a headache clinic. Each patient completed the Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria. RESULTS: A total of 1041 patients (migraine 772, TTH 218, CH 51) completed the study. The frequencies of RLS in patients with migraine (11.4%) was higher than in those with TTH (4.6%) or CH (2.0%) (p=0.002). In migraine patients, comorbidity with RLS was associated with higher frequencies of photophobia, phonophobia, exacerbation due to physical activities, vertigo, dizziness, tinnitus and neck pain, and higher mean scores of MIDAS and HADS. Migraine patients with RLS had a poorer sleep quality (Pittsburgh Sleep Quality Index score 11.1±4.1 vs 8.9±4.0, p<0.001) than those without. CONCLUSION: An association between migraine and RLS among different primary headache disorders is demonstrated. Comorbid RLS in migraine patients worsened sleep quality. A shared underlying mechanism may account for the correlates between migraine features and comorbid RLS. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to report the effects of window views and indoor plants on human psychophysiological response in workplace environments. The effects of window views and indoor plants were recorded by measuring participant's electromyography (EMG), electroencephalography (EEG), blood volume pulse (BVP), and state-anxiety. Photo Impact 5.0 was used to simulate the environment in an office, where six conditions were examined: 1) window with a view of a city, 2) window with a view of a city and indoor plants, 3) window with a view of nature, 4) window with a view of nature and indoor plants, 5) office without a window view, and 6) office without a window view and indoor plants. Participants were less nervous or anxious when watching a view of nature and/or when indoor plants were present. When neither the window view nor the indoor plants were shown, participants suffered the highest degree of tension and anxiety. [ABSTRACT FROM AUTHOR]

Objective Several genetic variants have been found to increase the risk of restless legs syndrome (RLS). The aim of the present study was to determine if these genetic variants were also associated with the comorbidity of RLS and migraine in patients. Methods Thirteen single-nucleotide polymorphisms (SNPs) at six RLS risk loci ( MEIS1, BTBD9, MAP2K5, PTPRD, TOX3, and an intergenic region on chromosome 2p14) were genotyped in 211 migraine patients with RLS and 781 migraine patients without RLS. Association analyses were performed for the overall cohort, as well as for the subgroups of patients who experienced migraines with and without aura and episodic migraines (EMs) vs. chronic migraines (CMs). In order to verify which genetic markers were potentially related to the incidence of RLS in migraine patients, multivariate regression analyses were also performed. Results Among the six tested loci, only MEIS1 was significantly associated with RLS. The most significant SNP of MEIS1, rs2300478, increased the risk of RLS by 1.42-fold in the overall cohort ( p = 0.0047). In the subgroup analyses, MEIS1 augmented the risk of RLS only in the patients who experienced EMs (odds ratio (OR) = 1.99, p = 0.0004) and not those experiencing CMs. Multivariate regression analyses further showed that rs2300478 in MEIS1 (OR = 1.39, p = 0.018), a CM diagnosis (OR = 1.52, p = 0.022), and depression (OR = 1.86, p = 0.005) were independent predictors of RLS in migraine. Conclusions MEIS1 variants were associated with an increased risk of RLS in migraine patients. It is possible that an imbalance in iron homeostasis and the dopaminergic system may represent a link between RLS incidence and migraines. [ABSTRACT FROM AUTHOR]