Poor Sleep Associated With Cannabis and Alcohol Use, Dietary Approaches in MS, Noninvasive Brain Stimulation Effective in Alzheimer

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Welcome to this special edition of Neurology News Network. I’m Matt Hoffman.

In a recent longitudinal latent class analysis study of 2995 late-growing adolescents, consistent poor sleep health was associated with higher levels of alcohol and cannabis use, as well as higher health consequences from substance use. This study was the first to use a latent class approach to identify the association of alcohol and cannabis use and adolescents. Across four sleep classes, those considered poor sleepers had the highest levels of alcohol use which was highly significant in comparison with the good sleeper class and the untroubled sleeper class.1 Notably, the troubled, moderately good sleeper class showed a higher alcohol use frequency than the untroubled poor sleeper class. As for cannabis use, the unhealthy sleepers group had greater consequences in comparison with the good sleepers group and the untroubled poor sleepers group.

Data from a meta-analysis of trials evaluating dietary approaches in multiple sclerosis (MS) showed that there are several effective approaches, with paleolithic and Mediterranean diets the most consistent in reducing fatigue and improving physical and mental quality of life (QoL). Investigators noted that because the NutriGRADE credibility of evidence was very low for all direct comparisons, the results should be interpreted with caution. The meta-analysis pulled data from 12 randomized trials that included patient-reported outcomes for fatigue and/or QoL on dietary interventions of at least 4 weeks. In total, the analysis included 608 adults with definite MS based on McDonald criteria and assessed 8 different interventions, including low-fat, Mediterranean, ketogenic, anti-inflammatory, Paleolithic, fasting, calorie restriction, and usual diet (control).

Findings from a 24-week phase 2 study showed that treatment with a precision-delivered noninvasive brain stimulation (PC-rTMS) targeted to patients’ precuneus has the potential to slow the progression of cognitive decline and functional decline in patients with mild-to-moderate dementia due to Alzheimer disease (AD).In the 50-patient, double-blind, sham-controlled trial, those who received the active therapy had cognitive decline slowed by 82% at 6 months in comparison to those on sham, represented by a treatment difference of 1.3 points on Clinical Dementia Rating-Sum of Boxes (CDR-SB) score. Considered one of the largest such trials of brain stimulation in AD, the results showed that PC-rTMS is safe and well tolerated by patients with AD, as adverse events (AE) were uncommon and mild. Patients included in the study were between 50 and 85 years old, had CDR score of 0.5-1, Mini-Mental State Examination score of 18-26 at screening, and had cerebrospinal fluid biomarker evidence of AD amyloid and tau pathology.

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