Matthew Gavidia

® since 2019 after receiving his Bachelor's degree at Rutgers University–New Brunswick in journalism and economics.

Deep brain stimulation (DBS) of the subthalmic nucleus (STN) and globus pallidus (GPi) provided significant short-term and long-term improvement in motor function for people with 

 (PD), with DBS of the STN shown to be slightly more effective, according to an 

 presented at the American Academy of Neurology’s 73rd Annual Meeting being held virtually April 17-22, 2021.


In prior research, DBS has been associated with a myriad of benefits for patients with PD, ranging from 

 in social, occupational, and psychosocial function to 

 of disease progression. However, it has been cited to 

 of DBS studied in PD, surgery within the STN and GPi, the researchers of the present study sought to examine the long-term outcomes of both approaches for patients with the condition.

“There are no published studies from prospective randomized trials examining outcomes beyond 3 years comparing STN to GPi DBS,” said the study authors.

CSP468 VA/NINDS multicenter randomized controlled trial

, which included a subset of patients originally randomized to GPi or STN DBS. Participants were followed up to 10 years, with completed visits conducted at 2 years (GPi, n = 85; STN, n = 70), 7 years (GPi, n = 68; STN, n = 49), and 10 years (GPi, n = 49; STN, n = 28).


Baseline characteristics were cited as comparable, with participants of the STN-DBS and GPi-DBS groups assessed for the primary outcome of change in Unified Parkinson’s Disease Rating Scale (UPDRS) motor subscale in the 

Compared with baseline, at which the score was 43.2, motor function was significantly improved and maintained at each completed visit for both the GPi-DBS group (2 years, 25.8; 

= .10) and STN-DBS group (2 years, 27.7, 

Furthermore, the authors noted that improvements were generally similar between both groups over time, but with a trend favoring STN-DBS (

Based on subscales of motor symptoms, tremor showed the greatest reduction over time followed by rigidity, with bradykinesia subscores also showing greater improvement at 7 and 10 years with STN-DBS (

UPDRS I,  II, and IV scores and quality of time based on motor diaries exhibited significant long-term improvement regardless of group.

 total score no longer showed improvement at 7 or 10 years for either group. Both groups had significant medication reduction with no target difference over time (

Speaking on the study findings, the researchers called it “remarkable” considering the progressive nature of PD. “This is the longest follow up describing DBS outcomes comparing the 2 targets in a randomized cohort,” they concluded.

Ostrem J, Weaver F, Follett K, et al. 10 year clinical outcomes of subthalamic nucleus versus pallidal deep brain stimulation for Parkinson’s disease: VA/NINDS CSP #468F. Presented at: The American Academy of Neurology’s 73rd Annual Meeting; April 17-22, 2020.

Articles

In comparing the efficacy of deep brain stimulation of the subthalmic nucleus and globus pallidus, both approaches were similarly effective in improving motor function in people with Parkinson disease, with benefits maintained after 10 years.

Deep Brain Stimulation Effective Long-term in Improving Motor Function in Parkinson Disease

 quality in older adults may be significantly improved through music therapy, particularly through slow-tempo, soft-volume, and smooth melodic music, according to study findings published today in 

Journal of the American Geriatrics Society

Affecting 40% to 70% of older adults, the researchers say that sleep issues increase with age due to changes in sleep architecture and circadian regulation. Moreover, the impact of impaired sleep could prove significant, with prior studies associating sleep issues with poor quality of life and an 

 of randomized controlled trials confirmed that listening to music is a potentially successful nonpharmacological intervention for improving sleep quality in adults.

As the researchers explain, there are 2 classifications of music: (1) sedative, which is characterized by a slow tempo of 60 to 80 beats per minute, soft volume, and smooth melody, and (2) rhythmic, which is characterized by fast tempos, loud volume, and rhythmic patterns.

“Based on psychophysiological theory, listening to sedative music can improve sleep by modulating sympathetic nervous system activity and the release of neuroendocrine levels of cortisol, thereby lowering levels of anxiety and stress responses,” added the study authors.

With the impact of music on improving sleep quality among 

—at least 60 years old and living independently—remaining unclear, the researchers conducted their own systematic review and meta-analysis to examine the association.

They selected 5 randomized controlled trials that met inclusion criteria, totaling 142 participants in the music therapy groups and 146 participants in the control groups. Each participant was a community-dwelling adult whose listening duration ranged from 30 minutes to 1 hour over a period ranging from 2 days to 3 months.


Participants were observed for the primary assessment of sleep quality, measured via the 

 (PSQI), with subgroup analyses also conducted to explore whether the effectiveness of music intervention differed by treatment durations, as measured in weeks, as well as whether effectiveness varied by music type (sedative or rhythmic).

In their findings, significantly better sleep quality was reported in participants of the music therapy groups compared with those who did not listen to music (mean difference (MD), −1.96; 95% CI, −2.23 to −1.73; 

 = .003), with sleep quality further improved among people listening to music for longer than 4 weeks (MD, −2.61; 95% CI, −4.72 to −0.50; 

Furthermore, older adults who listened to sedative music exhibited a more effective improvement in sleep quality than those who listened to rhythm-centered music (MD, −2.35; 95% CI, –3.59 to −1.10; 

“Music intervention is an effective strategy and is easy to administer by a caregiver or health care worker,” noted the researchers. “Music therapy might be the first line of therapy to recommend in older adults with sleep disturbances, which would reduce the need for or dependence on sedatives and sleeping medication.”

Chen CT, Fang CJ, Chang YJ, et al. Effect of music therapy on improving sleep quality in older adults: A systematic review and meta-analysis. 

. Published online April 21, 2021. doi:10.1111/jgs.17149

Music therapy among older adults was associated with significant improvements in sleep quality, with sedative music cited as more effective than rhythm-centered music. 

Music Therapy Found to Significantly Improve Sleep Quality in Older Adults

Women experiencing arousal burden may be at significantly greater risk of 

 (CV)-related death and death from any cause, with men also linked but to a lesser degree, according to study findings published today in the 

, the researchers note that unconscious wakefulness, called cortical arousal, occurs spontaneously or is triggered by sleep-disordered breathing and periodic limb movements during sleep, trauma, pain, temperature, light, and traffic noise.


“Arousals, irrespective of the underlying mechanism, impact heart rate, blood pressure, and cardiac hemodynamics acutely, but, when frequent, may also disrupt the circadian rhythm of the CV system, which is associated with unfavorable metabolic profiles, such as higher blood pressure, dysregulated blood lipids, and insulin resistance,” said the study authors.


 burden may be associated with long-term CV and overall mortality, the researchers assessed the prognostic value of a simple index that combined arousal frequency, duration, and total sleep time measured via polysomnograms from 3 studies:

2782 male participants of the Osteoporotic Fractures in Men Study (MrOS) sleep study (mean [SD] age at baseline, 76.66 [5.5] years)

424 female participants in the Study of Osteoporotic Fractures (SOF) (mean age at baseline, 82.9 [3.2] years)

2221 men and 2574 women in the Sleep Heart Health Study (SHHS) (mean age at baseline, 64 years)

During follow-up of the MrOS study (11.2 [2.1] years), 665 men died, and 236 were CV-related deaths. Furthermore, follow-up for the SOF study (6.4 [1.6] years) saw 105 deaths among women, including 47 CV-related deaths, and there were 987 deaths, including 344 CV-related deaths, reported during the follow-up of the SHHS study (10.7 [3.1] years).

Adjusting for common confounders, including body mass index, 

, and smoking, multivariable Cox proportional hazard analysis in female participants experiencing arousal burden that accounted for more than 6.5% of their night's sleep exhibited significant associations with all-cause mortality (SOF: HR, 1.58; 95% CI, 1.01-2.42; 

 = .038; SHHS-women: HR, 1.21; 95% CI, 1.06-1.42;  

 = .012) and CV mortality (SOF: HR, 2.17; 95% CI, 1.04-4.50; 

 = .037; SHHS-women: HR, 1.60; 95% CI, 1.12–2.28; 

 = .009) compared with women with a lower arousal burden.

For men experiencing arousal burden that accounted for more than 8.5% of their night's sleep, significant associations were shown in the SHHS study for all-cause mortality (HR, 1.31; 95% CI, 1.06-1.62; 

 = .011) and in the MrOS study for CV mortality (HR, 1.35; 95% CI, 1.02-1.79; 

 = .034) compared with men with a lower arousal burden.


However, findings for increased risk of death for all-cause mortality in MrOS (HR, 1.11; 95% CI, 0.94-1.32; 

 = .261) and CV-related death in SHHS (HR, 1.24; 95% CI, 0.86-1.79; 

 = .271) were not statistically significant.


"It is unclear why there is a difference between men and women in the associations, but there are some potential explanations,” said Dominik Linz, PhD, associate professor in the Cardiology Department at Maastricht University Medical Center, the Netherlands, in a 

. “The triggers causing an arousal or the body's response to arousal may differ in women compared to men. This may explain the relatively higher risk of cardiovascular death in women...Women may have a higher arousal threshold and so this may result in a higher trigger burden in women compared to men."

Researchers said that arousal burden may represent a promising marker to identify mortality risk, with further analysis of frequency of wake periods or sleep stage transitions’ impact on risk suggested.

Shahrbabaki SS, Linz D, Hartmann S, Redline S, Baumert M. Sleep arousal burden is associated with long-term all-cause and cardiovascular mortality in 8001 community-dwelling older men and women. 

. Published online April 19, 2021. doi:10.1093/eurheartj/ehab151

Unconscious wakefulness during nighttime sleep, known as cortical arousal, was significantly associated with an increased risk of cardiovascular-related death and death from any cause, with women especially at notable risk.

Sleep Disturbance Associated With Increased Risk of Death, Particularly in Women

Algorithms similar to those used by Netflix, Amazon, and Facebook may lead to better comprehension of the biological language of cancer and neurodegenerative diseases such as Parkinson disease (PD) and Alzheimer disease (AD), according to a research article published in 

Proceedings of the National Academy of Sciences

Researchers highlight that intracellular phase separation of proteins into biomolecular disordered proteins that form liquid-like droplets of proteins, called condensates, has become increasingly recognized as a key factor to categorize and regulate the proteins that may contribute to cancer and neurodegenerative diseases. However, determining the optimal way to examine and subsequently predict how proteins will manifest has garnered several hypotheses.

 is characterized by the abnormal clumping of proteins and loss of dopaminergic cells, understanding how protein condensates form could prove significant in developing targeted therapies that may slow or prevent progression.

Conducting an analysis on the potential applicability of protein sequencing on phase behavior, researchers leveraged an approach similar to that of Netflix when it recommends a series to watch, Facebook when it suggests someone to befriend, or Amazon through voice assistants such as Alexa, in which machine-learning algorithms make highly educated predictions on what people will do next or, for this case, how proteins will react next.

Researchers used the machine learning technology to train a large-scale language model to examine and predict protein abnormality inside the body associated with disease onset.

"We specifically asked the program to learn the language of shapeshifting biomolecular condensates—droplets of proteins found in cells—that scientists really need to understand to crack the language of biological function and malfunction that cause cancer and neurodegenerative diseases like AD,” said study author Kadi Liis Saar, PhD, research fellow at St John’s College, in a 

In their findings, researchers discovered that the technology could distinguish between structured proteins and unstructured proteins prone to disease in humans at a high accuracy.

Speaking further on disordered proteins, lead study author Tuomas Knowles, PhD, professor of the Yusuf Hamied Department of Chemistry at the University of Cambridge, said in a 

 that these protein condensates have garnered substantial attention as they can control key events in the cell such as gene expression and protein synthesis.

"Any defects connected with these protein droplets can lead to diseases such as cancer. This is why bringing natural language processing technology into research into the molecular origins of protein malfunction is vital if we want to be able to correct the grammatical mistakes inside cells that cause disease," said Knowles.

With the ultimate aim of using artificial intelligence to develop targeted drugs, Knowles said that this approach could also be leveraged to expand upon current knowledge of cancers and neurodegenerative diseases, as well as even preventing dementia from happening at all.

"Machine-learning can be free of the limitations of what researchers think are the targets for scientific exploration and it will mean new connections will be found that we have not even conceived of yet. It is really very exciting indeed,” said Saar.

Saar KL, Morgunov AS, Qi R, et al. Learning the molecular grammar of protein condensates from sequence determinants and embeddings. 

. Published online April 13, 2021. doi:10.1073/pnas.2019053118

Algorithms similar to those used by Amazon and Netflix may help to unravel the biological language of cancer, Parkinson disease, and other neurodegenerative diseases.

Matthew Gavidia

Articles

Deep Brain Stimulation Effective Long-term in Improving Motor Function in Parkinson Disease

Music Therapy Found to Significantly Improve Sleep Quality in Older Adults

Sleep Disturbance Associated With Increased Risk of Death, Particularly in Women

Machine Learning Technology May Help Decipher Biological Language of Cancer, Parkinson Disease