The latest epilepsy research from prestigious universities and journals throughout the world.
Epilepsy is relatively common - it is a group of disorders that involve recurrent seizures. Epilepsy can start at any age, but it mostly begins during childhood. Treatment involves using epilepsy drugs to control seizures. In rare cases, surgery may be used to either remove a specific area of the brain that is affected, or install an electrical device to assist in controlling seizures

Links between autism and epilepsy deepen

Over recent years, medical research has uncovered a number of links between autism and epilepsy. The latest study investigating this relationship demonstrates that having a relative with epilepsy is a risk factor for autism.

Epilepsy and autism are known to be linked, but why this is the case is open for debate.

Autism is a mental condition characterized by difficulty in communicating, forming relationships, and an altered way of perceiving the world.
Epilepsy is characterized by bursts of intense electrical activity in the brain and seizures.
At face value, the two conditions do not necessarily look like they are related. However, the relationship between them is now well documented.
Around 20-30 percent of children with autism develop epilepsy by the time they reach adulthood, and autism is present in an estimated 15-50 percent of individuals with epilepsy.
Why the link exists is not known, but the latest research, conducted at University Hospital in Linköping, Sweden, solidifies them further.

Family links between autism and epilepsy

The new study, published this week in Neurology, investigates whether having a relative with epilepsy might increase the risk of an autism diagnosis.

"Other studies have linked the two conditions, however, our study looks specifically at the brothers and sisters and sons and daughters of people with epilepsy to determine a possible autism risk in these relatives."

Lead author Dr. Heléne E.K. Sundelin

The researchers delved into the data registry and identified 85,201 people with epilepsy, along with their siblings (80,511 individuals) and offspring (98,534 individuals).
Each person with epilepsy was compared with five other people of the same sex, similar age, and from the same country. The siblings of the people with epilepsy were compared with siblings and offspring of people without an epilepsy diagnosis.
Over the course of the 6-year follow-up, 1,381 of the participants with epilepsy and 700 of the people without epilepsy were diagnosed with autism.
The results show that people with epilepsy have an increased risk of being diagnosed with autism - 1.6 percent compared with 0.2 percent. The highest increased risk was seen in those diagnosed with epilepsy while in childhood (5.2 percent).
When the relatives of individuals with epilepsy were studied, they found a 63 percent increased risk of developing autism for siblings and offspring. The effect was most marked in the offspring of mothers with epilepsy, who had a 91 percent increased risk; offspring of fathers with epilepsy had a 38 percent increased risk.

Why the link between autism and epilepsy?

The findings mark another step toward understanding the relationship between the two disorders. By uncovering the similarities and links between them, researchers hope to gain a stronger understanding of the mechanisms at play in both conditions and, eventually, how they can best be treated.
As Dr. Sundelin says: "The goal is to find out more about how these two diseases may be linked so that treatments may be developed that will target both conditions."
Why autism and epilepsy share common ground is not yet understood. Some scientists theorize that they might have a shared genetic basis. For instance, there has been some interest in the roles of GABA receptor genes and sodium channel genes in both epilepsy and autism. Other mutations in synapse-forming genes, including neuroligins, neurexins, and SHANK-3, have also been investigated as possibilities.
Alternatively, some researchers think that there might be a causal relationship; perhaps the seizures, in some way, produce the autistic features by damaging particular parts of the brain. This opens up the possibility that by treating epilepsy more effectively, autism diagnoses might be reduced. However, the results of the current study show that if there is a causal relationship, it is not the whole story.
Whether epilepsy drugs might reduce autism or vice versa is another question awaiting an answer. The relationship, as well-documented as it is, still holds a raft of mysteries.

How stress increases seizures for patients with epilepsy

It is well known that stress can increase the frequency and severity of seizures for patients with epilepsy. Now, researchers have shed light on why this is, and they may have even found a way to stop it.

Researchers have shed light on why stress increases seizure frequency for patients with epilepsy.

Published in the journal Science Signaling, the researchers reveal how epilepsy alters the way brain reacts to stress to cause seizures.
Epilepsy is a neurological disorder characterized by recurrent seizures, which are sudden surges of electrical activity in the brain.
According to the Epilepsy Foundation, around 1.3-2.8 million people in the United States have epilepsy. Each year, around 48 in every 100,000 Americans develop the condition.
Stress and anxiety are well-established triggers for seizures among people with epilepsy, and studies have shown that reducing stress may lower seizure risk for those with the condition.
While neurologists recommend that patients with epilepsy avoid stressful situations as a way of avoiding stress-induced seizures, it is not always possible to do so, highlighting the need for a therapeutic alternative.
However, because scientists have been unclear about how stress causes seizures, such a treatment has proven difficult to find.
Now, Michael O. Poulter, Ph.D., of the University of Western Ontario in Canada, and colleagues believe they may have moved a step closer to fulfilling this need.

Stress-induced seizures caused by increased activity in piriform cortex

For their study, the researchers focused on analyzing the activity of corticotropin-releasing factor (CRF) in the brains of rats with and without epilepsy.
CRF is a neurotransmitter - a chemical that enables communication between nerve cells - that regulates the behavioral response to stress.
The researchers assessed how CRF affected the piriform cortex of the rodents, which is a region of the brain in which seizures are known to occur among humans with epilepsy.
Among rats without epilepsy, the researchers found that CRF reduced activity in the piriform cortex of the brain. Among rats with epilepsy, however, they found CRF did the opposite, increasing activity in the piriform cortex.
"When we used CRF on the epileptic brain, the polarity of the effect flipped; it went from inhibiting the piriform cortex to exciting it," explains Poulter. "At that point we became excited, and decided to explore exactly why this was happening."
On further investigation, the team found that CRF altered neuronal signaling in the brains of rats with epilepsy.

Preventive Medicine News

The latest preventive medicine research from prestigious universities and journals throughout the world.

Preventive Medicine is practiced by all physicians to keep their patients healthy. It is also a unique medical specialty that focuses on the health of individuals, communities and defined populations. Its goal is to protect, promote, and maintain health and wellbeing and to prevent disease, disability and death
Many people take a low dose of aspirin every day to lower their risk of a further heart attack or stroke, or if they have a high risk of either. While the anticipated benefit is a lower chance of vascular disease, taking daily aspirin is not without danger: for instance it raises the risk of internal bleeding. Hence the important need to discuss beforehand with the doctor, "In my case, doc, should I be taking daily aspirin?"

But this week, the publication of three studies in The Lancet, has added a new benefit to the equation: cancer prevention, and stirred up the pros and cons debate.

In those studies, Professor Peter Rothwell of Oxford University in the UK, a world expert on aspirin, and colleagues, confirm that for people in middle age, a daily dose of aspirin can cut the risk of developing several cancers, with effects starting after only two to three years rather than the ten or so previously thought.

Moreover, they propose that treatment with daily aspirin may also prevent an existing, localized cancer from spreading to other parts of the body, which Rothwell says is just as important to know about, since that's when cancer becomes deadly.

If you follow their reasoning, we appear to have reached a crucial point in the debate: on the one hand we have the benefit that aspirin can reduce cancer, stroke and heart attacks, which are much more likely to lead to disability or death, and on the other, we have the risk of internal bleeding, which is less harmful than those diseases.

Such arguments cause more people, even those presently enjoying good health, to ask the question: "Should I be taking aspirin every day?"

But, although Rothwell and colleagues present compelling evidence, despite some limitations, their papers do not necessarily furnish a clear answer to that question.

Nevertheless, the balance of the pros and cons may alter in the light of their evidence, because not only does low dose aspirin therapy appear to increase the pros, it may also reduce the cons, in that the researchers found the risk of internal bleeding reduced with time.

Plus, the new studies also raise a thorny public health question, similar to that surrounding cholesterol-busters, should health authorities consider recommending routine use of aspirin for cancer prevention?

This was the subject of a commentary published in the same issue of the The Lancet. Here, Andrew T Chan and Nancy R Cook of Brigham and Women's Hospital, Harvard Medical School, Boston, suggest that on balance, we are not ready to recommend aspirin for cancer prevention.

One reason is that the Rothwell studies did not include data from the largest randomized trials in primary prevention, the Women's Health Study (WHS), and the Physicians' Health Study (PHS), where subjects took aspirin every other day.

"Also, despite a convincing case that the vascular and anticancer benefits of aspirin outweigh the harms of major extracranial bleeding, these analyses do not account for less serious adverse effects on quality of life, such as less severe bleeding," they add.

However, Chan and Cook acknowledge that as we await results of additional trials, and the longer term follow up of the WHS and PHS, the Rothwell studies do move us a "step closer to broadening recommendations for aspirin use".

At the very least, it means future evidence-based guidelines cannot ignore the use of aspirin for prevention of vascular disease in isolation from cancer prevention, they conclude.

Other authorities have also been quick to respond to the new studies. In the UK, the NHS's answer to the question "Should I start taking aspirin?" is:

"Overall, aspirin is a highly effective medical treatment when used appropriately, but it is not yet a drug that should be taken unsupervised on a daily basis, even at low doses."

They, like Chan and Cook, say that while the Rothwell studies "provide compelling evidence, taking aspirin is not yet recommended to prevent cancer and people should not start taking it daily as a precautionary measure."

For healthy people considering taking daily aspirin, they have this message:

"Given that the potential risks could outweigh any benefits, it is not currently advised that healthy people with no risk factors for cardiovascular disease take aspirin to prevent possible cardiovascular events such as heart attack and stroke."

They also say the evidence for taking aspirin purely to prevent cancer or to treat it is "even less substantial than for blood thinning", and urge "we cannot be sure that the potential benefits are not outweighed by the known risks".

The reason aspirin is prescribed in a small daily dose as a means to lower the risk of heart attack or stroke, is because of the effect it has on the clotting action of platelets in the bloodstream.

When we bleed, platelets in the blood build up at the site of the wound, forming a plug that stops further blood loss.

But this clotting can also happen inside blood vessels, such as when a fatty deposit in a narrow artery bursts. At the site of the burst, blood platelets clump into a clot that can block the artery and stop blood flow to the brain or heart, resulting in a stroke or heart attack.

Aspirin reduces the ability of the platelets to clump, thereby lowering the risk of having a heart attack or stroke.

In the UK, for example, aspirin is prescribed as a blood-thinner to reduce the risk of clots. The treatment comprises a small daily dose, often around 75mg (a typical aspirin painkilling tablet has about 300mg of aspirin).

But the downside to this anti-clotting benefit, is that aspirin can also cause serious harm, the best known of these being the small but important increased risk of stomach irritation and bleeding.

And, ironically, while daily aspirin can help prevent a clot-related (ischemic) stroke, it may actually increase the risk of a bleeding (hemorrhagic) stroke.

Although aspirin's risk-reduction benefits are different between men and women (and among women, it also depends on age), the risk of bleeding with daily aspirin is about the same in both sexes.

The risk of bleeding also tends to be higher in older people, those with a history of stomach ulcers, and people already taking medication or who have conditions that increase the risk of bleeding.

Daily aspirin use also increases the risk of developing a stomach ulcer. And, for anyone with a bleeding ulcer, taking aspirin will cause it to bleed more, perhaps to a life-threatening extent, say experts at the Mayo Clinic in the US.

People with asthma can also experience breathing problems with aspirin.

Other side effects of taking aspirin include nausea and indigestion, ringing in the ears (tinnitus) and hearing loss. And some people can have an allergic reaction.

Recent developments on aspirin from MNT news
How can aspirin help to cure cancer?
A recent study, published in the journal Cell, suggests that aspirin could be effective in boosting the immune system in patients suffering from breast, skin and bowel cancer.
Aspirin may double survival for cancer patients
Aspirin may double the chances of survival for patients with gastrointestinal cancers, according to the results of a new study recently presented at the 2015 European Cancer Congress in Vienna, Austria.
Daily aspirin could increase chance of pregnancy
Taking low-dose aspirin daily could help women become pregnant, particularly those who have previously miscarried. This is according to new research presented at the American Society of Reproductive Medicine Annual Meeting in Baltimore, MD.
Aspirin benefits reaffirmed for CVD and colorectal cancer
For some patients, it is worth risking the adverse effects of a regular aspirin dose in order to reduce the chance of cardiovascular disease and colorectal cancer, says research published in the Annals of Internal Medicine.
Aspirin may prolong survival for cancer patients by up to a fifth
It has been hailed a "wonder drug" because of its numerous health benefits, and now, a new study provides further evidence that aspirin may help in the fight against cancer.