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Xu J, Cao N, Qu Y, Shang S, Liu X, Wang X, Hu F, Bai X, Qu Q, Zhang M, Cao H. Protocol for a Phase 2 randomized controlled patient-assessor blinded study: efficacy and safety of combined cortical and cerebellar dual-target transcranial magnetic stimulation for the treatment of essential tremor. Front Neurol 2025; 15:1505154. [PMID: 39845937 PMCID: PMC11750658 DOI: 10.3389/fneur.2024.1505154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 12/13/2024] [Indexed: 01/24/2025] Open
Abstract
Background Essential tremor (ET) is the most common neurological movement disorder with few treatments and limited therapeutic efficacy, research into noninvasive and effective treatments is critical. Abnormal cerebello-thalamo-cortical (CTC) loop function are thought to be significant pathogenic causes of ET, with the cerebellum and cortex are common targets for ET treatment. In recent years, transcranial magnetic stimulation (TMS) has been recognized as a promising brain research technique owing to its noninvasive nature and safety. In this study, we will use left M1 cortex continuous theta-burst stimulation (cTBS) combined with right cerebellar hemisphere 1 Hz repetitive transcranial magnetic stimulation (rTMS) dual-target stimulation to explore the Safety, feasibility and efficiency of this dual-target stimulation mode, and the mechanism of its therapeutic effect. Methods Twenty-four patients with ET will be randomly assigned to three groups: dual-target stimulation, single-target stimulation, or sham stimulation. The single-target stimulation group will receive stimulation of the right cerebellar hemisphere for 10 days, whereas the dual-target stimulation group will be given stimulation of both the left M1 cortex and the right cerebellar hemisphere. The sham stimulation group will be given sham stimulation for 10 days. Tremor will be assessed using both the subjective The Essential Tremor Rating Assessment Scale (TETRAS) and objective accelerometer-based tremor analysis. at baseline (before stimulation), after the first, fifth, tenth days of treatment (D1, 5, 10), 24 h after 10 days of treatment (D10-24 h), and 1, 2, 3, and 4 weeks after stimulation (W1, 2, 3, 4). Discussion This is a Phase 2 randomized, controlled, patient-assessor blinded clinical trial. The goal of this study is to investigate the Safety, feasibility and efficiency of TMS for the treatment of ET.
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Affiliation(s)
- Jing Xu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Na Cao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Yan Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Suhang Shang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Xincheng Liu
- College of Mechanical Engineering, Xi'an Jiaotong University, Xi’an, China
| | - Xuexin Wang
- College of Mechanical Engineering, Xi'an Jiaotong University, Xi’an, China
| | - Fangfang Hu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Xuerong Bai
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Meng Zhang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Hongmei Cao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
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Raza ML. Coffee and brain health: An introductory overview. PROGRESS IN BRAIN RESEARCH 2024; 288:1-22. [PMID: 39168553 DOI: 10.1016/bs.pbr.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Introduction to the "Impact of Coffee on Brain Health" explores the multifaceted relationship between coffee consumption and brain function. The chapter begins by highlighting coffee's global popularity and cultural significance, setting the stage for an in-depth exploration of its effects on brain health. It describes the intricate components of coffee, including caffeine, antioxidants, and polyphenols, elucidating their physiological and medicinal roles in promoting cognitive function and neuroprotection. While moderate coffee consumption offers potential benefits such as enhanced cognitive performance and mood regulation, excessive intake can pose risks such as insomnia and medication interactions. Research studies provide robust evidence supporting coffee's neuroprotective effects, while practical implications offer recommendations for optimizing consumption and minimizing risks. By embracing a personalized approach to coffee consumption and staying informed about its potential impacts, individuals can harness its benefits for brain health and overall well-being.
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Affiliation(s)
- Muhammad Liaquat Raza
- Department of Infection Prevention & Control, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
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Zhang L, Yin J, Li J, Sun H, Liu Y, Yang J. Association between dietary caffeine intake and severe headache or migraine in US adults. Sci Rep 2023; 13:10220. [PMID: 37353507 PMCID: PMC10290098 DOI: 10.1038/s41598-023-36325-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
The relationship between current dietary caffeine intake and severe headache or migraine is controversial. Therefore, we investigated the association between dietary caffeine intake and severe headaches or migraines among American adults. This cross-sectional study included 8993 adults (aged ≥ 20 years) with a dietary caffeine intake from the National Health and Nutrition Examination Surveys of America from 1999 to 2004. Covariates, including age, race/ethnicity, body mass index, poverty-income ratio, educational level, marital status, hypertension, cancer, energy intake, protein intake, calcium intake, magnesium intake, iron intake, sodium intake, alcohol status, smoking status, and triglycerides, were adjusted in multivariate logistic regression models. In US adults, after adjusting for potential confounders, a 100 mg/day increase in dietary caffeine intake was associated with a 5% increase in the prevalence of severe headache or migraine (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.07). Further, the prevalence of severe headache or migraine was 42% higher with caffeine intake of ≥ 400 mg/day than with caffeine intake of ≥ 0 to < 40 mg/day (OR 1.42, 95% CI 1.16-1.75). Conclusively, dietary caffeine intake is positively associated with severe headaches or migraines in US adults.
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Affiliation(s)
- Lu Zhang
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jinling Li
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haiyang Sun
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuanxiang Liu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China.
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Cintineo HP, Bello ML, Chandler AJ, Cardaci TD, McFadden BA, Arent SM. Effects of caffeine, methylliberine, and theacrine on vigilance, marksmanship, and hemodynamic responses in tactical personnel: a double-blind, randomized, placebo-controlled trial. J Int Soc Sports Nutr 2022; 19:543-564. [PMID: 36016763 PMCID: PMC9397462 DOI: 10.1080/15502783.2022.2113339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Tactical athletes require fast reaction times (RT) along with high levels of vigilance and marksmanship performance. Caffeine has been shown to improve these measures but also results in increased blood pressure and jitteriness. Research on other purine alkaloids, such as methylliberine and theacrine, has suggested they do not increase blood pressure or jitteriness to the same extent, but their impact on tactical performance is unknown. Methods A between-subjects, randomized, placebo-controlled design was used to test the effects of placebo (PLA), 300 mg caffeine (CAF), and a combination of 150 mg caffeine, 100 mg methylliberine, and 50 mg theacrine (CMT) on RT and marksmanship along with hemodynamic and arousal measures following a sustained vigilance task in tactical personnel (n = 48). Following consumption of the supplement, participants underwent a 150-min protocol consisting of two rounds. Each round began with leisurely reading followed by a 30-min vigilance task before beginning two trials of movement and marksmanship tasks. Hemodynamics and felt arousal were assessed throughout the protocol. Composite Z-scores were calculated for overall performance measures at each timepoint, and mixed-effects models were used to assess differences in RT, accuracy, and composite Z-scores along with hemodynamics and felt arousal. An α-level of 0.05 was used to determine statistical significance, and Cohen’s d was used to quantify effect sizes. Results A Group-by-Time interaction for vigilance RT (P = 0.038) indicated improvements for both CAF and CMT from round 1 to round 2 (P < 0.01) while PLA did not change (P = 0.27). No Group main effects or Group-by-Time interactions were found for movement or marksmanship performance (P > 0.20). Group main effects for systolic (SBP; P = 0.001) and diastolic blood pressure (DBP; P = 0.028) indicated higher SBP in CAF (P = 0.003, d= 0.84) and CMT (P = 0.007, d= 0.79) compared to PLA but only higher DBP in CAF (P = 0.025, d= 0.74). No Group-by-Time interaction or Group main effect was found for felt arousal (P > 0.16). Conclusions These findings suggest similar benefits on RT during a vigilance task between CAF, containing 300 mg caffeine, and CMT above PLA, though CAF resulted in slightly less favorable hemodynamic changes. This study is the first to provide data showing similar efficacy of combined caffeine, methylliberine, and theacrine compared to double the caffeine dose consumed alone on vigilance RT but without a significant rise in DBP above PLA in tactical personnel.
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Affiliation(s)
- Harry P. Cintineo
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Marissa L. Bello
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Alexa J. Chandler
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Thomas D. Cardaci
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Bridget A. McFadden
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Shawn M. Arent
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Zhang RC, Madan CR. How does caffeine influence memory? Drug, experimental, and demographic factors. Neurosci Biobehav Rev 2021; 131:525-538. [PMID: 34563564 DOI: 10.1016/j.neubiorev.2021.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
Caffeine is a widely used nootropic drug, but its effects on memory in healthy participants have not been sufficiently evaluated. Here we review evidence of the effects of caffeine on different types of memory, and the associated drug, experimental, and demographical factors. There is limited evidence that caffeine affects performance in memory tasks beyond improved reaction times. For drug factors, a dose-response relationship may exist but findings are inconsistent. Moreover, there is evidence that the source of caffeine can modulate its effects on memory. For experimental factors, past studies often lacked a baseline control for diet and sleep and none discussed the possible reversal of withdrawal effect due to pre-experimental fasting. For demographic factors, caffeine may interact with sex and age, and the direction of the effect may depend on the dose, individual tolerance, and metabolism at baseline. Future studies should incorporate these considerations, as well as providing continued evidence on the effect of caffeine in visuospatial, prospective, and implicit memory measures.
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Affiliation(s)
- Ruo-Chong Zhang
- School of Psychology, University of Nottingham, Nottingham, UK.
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Coffee break has no impact on laparoscopic skills: a randomized double-blinded placebo-controlled parallel-group trial. Surg Endosc 2021; 36:3533-3541. [PMID: 34459976 PMCID: PMC9001621 DOI: 10.1007/s00464-021-08675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/07/2021] [Indexed: 12/03/2022]
Abstract
Background Coffee is a widely consumed beverage. Surgeons often drink coffee before performing surgery. Caffeine intake leads to tremor which might have a negative effect on surgeons’ fine motor skills. Methods A double-blinded parallel-group trial was conducted in order to investigate if caffeinated coffee intake has a negative effect on laparoscopic skills and increases tremor, regardless of previous coffee consumption. 118 participants were selected during a congress of the German Society of Surgery. Exclusion criteria were immaturity and no given consent. Participants and investigators were blinded. Participants were randomized with a 1:1 allocation into interventional group receiving caffeinated coffee or placebo group receiving decaffeinated coffee. The motor skills were tested with two validated laparoscopic exercises at a laparoscopy simulator (LapSim®) before and 30 min after coffee intake. Data on influencing factors were recorded in a standardized questionnaire and tested for equal distribution in both groups. In both exercises four parameters were recorded: left and right hand path length and angular path. Their differences and the resulting effect scores were calculated for both groups as primary outcome to test which group showed greater improvement on the second round of exercises. Registration number DRKS00023608, registered retrospectively. Results Fifty nine subjects were assigned to each the interventional (54 analyzed) and placebo group (53 analyzed) with 11 drop outs. There was no significant difference between the placebo and interventional group in the two exercises in effect score 30 min after coffee intake [mean (SD); 38.58 (10.66) vs. 41.73 (7.40) and 113.09 (28.94) vs. 116.59 (25.63)]. A significant improvement from first to second measurement in the first exercise could be observed for both groups, demonstrating the training effect. Conclusion In our study, we verified that additional caffeinated coffee intake, e.g., during a coffee break, does not lead to deterioration of laparoscopic fine motor skills. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-021-08675-9.
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Piccioni A, Covino M, Zanza C, Longhitano Y, Tullo G, Bonadia N, Rinninella E, Ojetti V, Gasbarrini A, Franceschi F. Energy drinks: a narrative review of their physiological and pathological effects. Intern Med J 2021; 51:636-646. [PMID: 32369250 DOI: 10.1111/imj.14881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/18/2020] [Accepted: 03/29/2020] [Indexed: 12/19/2022]
Abstract
The consumption of energy drinks (Edks) has increased significantly in past years, with a growing market that is estimated to reach $61 billion by 2021 worldwide. Several studies demonstrated the physiological and pathological effects of these substances contained in Edks. The most common ingredient contained in Edks is caffeine, which is commonly mixed with taurine, and B-group vitamins. Scientific evidence of potentially serious adverse health effects are known, but it would be better to acquire more information regarding these beverages. We systematically checked Medical literature on MEDLINE-Pubmed from inception to January 2020 to find studies and reports on Edks and adverse events. Edks consumption is specially related to cardiovascular effects as malignant arrhythmias. We found a significant focus on arrhythmogenic risk in patients affected by long QT syndrome or other predisposing conditions for QT elongation. Other pathological effects are known as gastrointestinal, vascular and neurological disorders. Edks, as well as all caffeinated beverages, should be taken with caution or avoided in select populations, such as patients suffering from cardiovascular or neurological illnesses; their use can unmask a sleepy life-threatening disease.
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Affiliation(s)
- Andrea Piccioni
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marcello Covino
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Christian Zanza
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Anesthesia and Critical Care, Keck Medical School of University Southern California, California, Los Angeles, USA
| | - Yaroslava Longhitano
- Department of Anesthesia and Critical Care, Keck Medical School of University Southern California, California, Los Angeles, USA
| | - Gianluca Tullo
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Bonadia
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Rinninella
- UOC Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Veronica Ojetti
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- UOC Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Franceschi
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Enomoto H, Terauchi M, Odai T, Kato K, Iizuka M, Akiyoshi M, Miyasaka N. Independent association of palpitation with vasomotor symptoms and anxiety in middle-aged women. Menopause 2021; 28:741-747. [PMID: 34033601 DOI: 10.1097/gme.0000000000001776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women. METHODS Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants. RESULTS Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]). CONCLUSIONS Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.
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Affiliation(s)
- Haruka Enomoto
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masakazu Terauchi
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tamami Odai
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyoko Kato
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Iizuka
- Saitama Medical Center, Dokkyo Medical University, Saitama, Japan
| | - Mihoko Akiyoshi
- Faculty of Health and Nutrition, Bunkyo University, Kanagawa, Japan
| | - Naoyuki Miyasaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
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Effects of Coffee and Its Components on the Gastrointestinal Tract and the Brain-Gut Axis. Nutrients 2020; 13:nu13010088. [PMID: 33383958 PMCID: PMC7824117 DOI: 10.3390/nu13010088] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 02/06/2023] Open
Abstract
Coffee is one of the most popular beverages consumed worldwide. Roasted coffee is a complex mixture of thousands of bioactive compounds, and some of them have numerous potential health-promoting properties that have been extensively studied in the cardiovascular and central nervous systems, with relatively much less attention given to other body systems, such as the gastrointestinal tract and its particular connection with the brain, known as the brain–gut axis. This narrative review provides an overview of the effect of coffee brew; its by-products; and its components on the gastrointestinal mucosa (mainly involved in permeability, secretion, and proliferation), the neural and non-neural components of the gut wall responsible for its motor function, and the brain–gut axis. Despite in vitro, in vivo, and epidemiological studies having shown that coffee may exert multiple effects on the digestive tract, including antioxidant, anti-inflammatory, and antiproliferative effects on the mucosa, and pro-motility effects on the external muscle layers, much is still surprisingly unknown. Further studies are needed to understand the mechanisms of action of certain health-promoting properties of coffee on the gastrointestinal tract and to transfer this knowledge to the industry to develop functional foods to improve the gastrointestinal and brain–gut axis health.
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Unobtrusive detection of Parkinson's disease from multi-modal and in-the-wild sensor data using deep learning techniques. Sci Rep 2020; 10:21370. [PMID: 33288807 PMCID: PMC7721908 DOI: 10.1038/s41598-020-78418-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
Parkinson’s Disease (PD) is the second most common neurodegenerative disorder, affecting more than 1% of the population above 60 years old with both motor and non-motor symptoms of escalating severity as it progresses. Since it cannot be cured, treatment options focus on the improvement of PD symptoms. In fact, evidence suggests that early PD intervention has the potential to slow down symptom progression and improve the general quality of life in the long term. However, the initial motor symptoms are usually very subtle and, as a result, patients seek medical assistance only when their condition has substantially deteriorated; thus, missing the opportunity for an improved clinical outcome. This situation highlights the need for accessible tools that can screen for early motor PD symptoms and alert individuals to act accordingly. Here we show that PD and its motor symptoms can unobtrusively be detected from the combination of accelerometer and touchscreen typing data that are passively captured during natural user-smartphone interaction. To this end, we introduce a deep learning framework that analyses such data to simultaneously predict tremor, fine-motor impairment and PD. In a validation dataset from 22 clinically-assessed subjects (8 Healthy Controls (HC)/14 PD patients with a total data contribution of 18.305 accelerometer and 2.922 typing sessions), the proposed approach achieved 0.86/0.93 sensitivity/specificity for the binary classification task of HC versus PD. Additional validation on data from 157 subjects (131 HC/26 PD with a total contribution of 76.528 accelerometer and 18.069 typing sessions) with self-reported health status (HC or PD), resulted in area under curve of 0.87, with sensitivity/specificity of 0.92/0.69 and 0.60/0.92 at the operating points of highest sensitivity or specificity, respectively. Our findings suggest that the proposed method can be used as a stepping stone towards the development of an accessible PD screening tool that will passively monitor the subject-smartphone interaction for signs of PD and which could be used to reduce the critical gap between disease onset and start of treatment.
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Xia EH, Tong W, Wu Q, Wei S, Zhao J, Zhang ZZ, Wei CL, Wan XC. Tea plant genomics: achievements, challenges and perspectives. HORTICULTURE RESEARCH 2020; 7:7. [PMID: 31908810 PMCID: PMC6938499 DOI: 10.1038/s41438-019-0225-4] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/17/2019] [Accepted: 11/03/2019] [Indexed: 05/18/2023]
Abstract
Tea is among the world's most widely consumed non-alcoholic beverages and possesses enormous economic, health, and cultural values. It is produced from the cured leaves of tea plants, which are important evergreen crops globally cultivated in over 50 countries. Along with recent innovations and advances in biotechnologies, great progress in tea plant genomics and genetics has been achieved, which has facilitated our understanding of the molecular mechanisms of tea quality and the evolution of the tea plant genome. In this review, we briefly summarize the achievements of the past two decades, which primarily include diverse genome and transcriptome sequencing projects, gene discovery and regulation studies, investigation of the epigenetics and noncoding RNAs, origin and domestication, phylogenetics and germplasm utilization of tea plant as well as newly developed tools/platforms. We also present perspectives and possible challenges for future functional genomic studies that will contribute to the acceleration of breeding programs in tea plants.
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Affiliation(s)
- En-Hua Xia
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Wei Tong
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Qiong Wu
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Shu Wei
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Jian Zhao
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Zheng-Zhu Zhang
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Chao-Ling Wei
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
| | - Xiao-Chun Wan
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, 230036 China
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Olfati N, Shoeibi A, Abdollahian E, Ahmadi H, Hoseini A, Akhlaghi S, Vakili V, Foroughipour M, Rezaeitalab F, Farzadfard MT, Layegh P, Naseri S. Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial. Brain Stimul 2019; 13:190-196. [PMID: 31624048 DOI: 10.1016/j.brs.2019.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/28/2019] [Accepted: 10/03/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is controversial evidence about the effect of cerebellar low-frequency stimulation in patients with essential tremor (ET). OBJECTIVES In this study we assessed safety and effectiveness of 1 Hz (low-frequency) cerebellar repetitive transcranial magnetic stimulation (rTMS) on tremor severity in patients with essential tremor in a sham-controlled crossover trial. METHODS A total of 23 patients assigned into two groups to receive either sham (n = 10) or rTMS (n = 13) treatment, with crossing over after a two-month washout period. Intervention consisted of 900 pulses of 1 Hz rTMS at 90% resting motor threshold or the same protocol of sham stimulation over each cerebellar hemisphere for 5 consecutive days. Tremor severity was assessed by Fahn-Tolosa-Marin (FTM) scale at baseline and at days 5, 12 and 30 after intervention. The FTM consists of 3 subscales including tremor severity rating, performance of motor tasks, and functional disability. Carry-over and treatment effects were analyzed using independent samples t-test. RESULTS There was no significant improvement in the total FTM scores in rTMS compared to the sham stimulation on day 5 (p = 0.132), day 12 (p = 0.574), or day 30 (p = 0.382). Similarly, FTM subscales, including tremor severity rating, motor tasks, and functional disability did not improve significantly after rTMS treatment. Mild headache and local pain were the most frequent adverse events. CONCLUSION Although cerebellar rTMS seems to have acceptable safety when used in ET patients, this study could not prove any efficacy for it in reduction of tremor in these patients. Larger studies are needed to evaluate efficacy of this therapeutic intervention and to provide evidence about the optimal stimulation parameters.
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Affiliation(s)
- Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Ali Shoeibi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Ebrahim Abdollahian
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Psychiatry and Behavioral Sciences Research Center, Ibn-Sina Medical Center, Mashhad, Iran.
| | - Hamideh Ahmadi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Alireza Hoseini
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeed Akhlaghi
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Psychiatry and Behavioral Sciences Research Center, Ibn-Sina Medical Center, Mashhad, Iran.
| | - Vida Vakili
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Foroughipour
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Fariborz Rezaeitalab
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Mohammad-Taghi Farzadfard
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Parvaneh Layegh
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran.
| | - Shahrokh Naseri
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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Wong LR, Flynn-Evans E, Ruskin KJ. Fatigue Risk Management: The Impact of Anesthesiology Residents' Work Schedules on Job Performance and a Review of Potential Countermeasures. Anesth Analg 2019; 126:1340-1348. [PMID: 29049076 DOI: 10.1213/ane.0000000000002548] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being. We then propose countermeasures that have been implemented to mitigate the effects of fatigue and describe how training programs or practice groups who must work overnight can adapt these strategies for use in a hospital setting. Countermeasures include the use of scheduling interventions, strategic naps, microbreaks, caffeine use during overnight and extended shifts, and the use of bright lights in the clinical setting when possible or personal blue light devices when the room lights must be turned off. Although this review focuses primarily on anesthesiology residents in training, many of the mitigation strategies described here can be used effectively by physicians in practice.
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Affiliation(s)
- Lily R Wong
- From the San Jose State University Research Foundation, San Jose, California.,Human Factors Research Division, NASA Ames Research Center, Moffett Field, California
| | - Erin Flynn-Evans
- Human Factors Research Division, NASA Ames Research Center, Moffett Field, California
| | - Keith J Ruskin
- Department of Anesthesia and Critical Care, University of Chicago School of Medicine, Chicago, Illinois
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Louis ED, Meyers JH, Cristal AD, Factor-Litvak P. Caffeine Consumption in First-Degree Relatives of Essential Tremor Cases: Evidence of Dietary Modification Before Disease Onset. Neuroepidemiology 2018; 51:64-70. [PMID: 29953981 DOI: 10.1159/000489960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Caffeine can exacerbate tremor. Reducing caffeine intake or switching to decaffeinated beverages can lessen tremor. Unaffected relatives of essential tremor (ET) cases often have mild, subclinical tremor. One question is whether the coffee and tea consumption pattern in these individuals differs from that of controls (Co). METHODS We ascertained the patterns of coffee and tea intake using a structured questionnaire, and compared the use in unaffected first-degree relatives of ET cases (FD-ET) to the use in age-matched Co. Three measures of relative caffeinated coffee + tea to decaffeinated coffee + tea were constructed. Caffeine index 1 = (cups of caffeinated coffee + tea) - (cups of decaffeinated coffee + tea) consumed on the day of evaluation. Caffeine index 2 = (cups of caffeinated coffee + tea) - (cups of decaffeinated coffee + tea) consumed in a typical month. The percentage of coffee and tea that was caffeinated in a typical month was also calculated. RESULTS There were 263 individuals (190 FD-ET, 73 Co). Caffeine index 1 in FD-ET was less than 1-half that of Co (p = 0.001). Caffeine index 2 was similarly lower in FD-ET than Co (p = 0.027). The percentage of coffee and tea that was caffeinated in a typical month was also significantly lower in FD-ET than Co (p = 0.018). CONCLUSION The balance of caffeinated to decaffeinated beverages is different in FD-ET than Co. These data raise several intriguing questions. Among these is whether relatives of ET cases modify their caffeine consumption before disease onset.
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Affiliation(s)
- Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - James H Meyers
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Ashley D Cristal
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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15
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Methodological Issues in Nutritional Epidemiology Research—Sorting Through the Confusion. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0567-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Wassef B, Kohansieh M, Makaryus AN. Effects of energy drinks on the cardiovascular system. World J Cardiol 2017; 9:796-806. [PMID: 29225735 PMCID: PMC5714807 DOI: 10.4330/wjc.v9.i11.796] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/04/2017] [Accepted: 08/15/2017] [Indexed: 02/06/2023] Open
Abstract
Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.
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Affiliation(s)
- Bishoy Wassef
- Department of Family Medicine, Eisenhower Medical Center, Rancho Mirage, CA 92270, United States
| | - Michelle Kohansieh
- Stern College for Women, Yeshiva University, New York, NY 10016, United States
| | - Amgad N Makaryus
- Department of Cardiology, Northwell Health/Nassau University Medical Center, East Meadow, NY 11554, United States
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17
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Martin VT, Vij B. Diet and Headache: Part 1. Headache 2016; 56:1543-1552. [PMID: 27699780 DOI: 10.1111/head.12953] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 08/31/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Vincent T. Martin
- Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
| | - Brinder Vij
- Department of Neurology; University of Cincinnati College of Medicine; Cincinnati OH USA
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18
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Development of a Food Safety and Nutrition Education Program for Adolescents by Applying Social Cognitive Theory. Osong Public Health Res Perspect 2016; 7:248-60. [PMID: 27635375 PMCID: PMC5014748 DOI: 10.1016/j.phrp.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/11/2016] [Accepted: 05/30/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives The purpose of this study was to develop an educational model regarding food safety and nutrition. In particular, we aimed to develop educational materials, such as middle- and high-school textbooks, a teacher’s guidebook, and school posters, by applying social cognitive theory. Methods To develop a food safety and nutrition education program, we took into account diverse factors influencing an individual’s behavior, such as personal, behavioral, and environmental factors, based on social cognitive theory. We also conducted a pilot study of the educational materials targeting middle-school students (n = 26), high-school students (n = 24), and dietitians (n = 13) regarding comprehension level, content, design, and quality by employing the 5-point Likert scale in May 2016. Results The food safety and nutrition education program covered six themes: (1) caffeine; (2) food additives; (3) foodborne illness; (4) nutrition and meal planning; (5) obesity and eating disorders; and (6) nutrition labeling. Each class activity was created to improve self-efficacy by setting one’s own goal and to increase self-control by monitoring one’s dietary intake. We also considered environmental factors by creating school posters and leaflets to educate teachers and parents. The overall evaluation score for the textbook was 4.0 points among middle- and high-school students, and 4.5 points among dietitians. Conclusion This study provides a useful program model that could serve as a guide to develop educational materials for nutrition-related subjects in the curriculum. This program model was created to increase awareness of nutrition problems and self-efficacy. This program also helped to improve nutrition management skills and to promote a healthy eating environment in middle- and high-school students.
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19
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Mabunga DFN, Gonzales ELT, Kim HJ, Choung SY. Treatment of GABA from Fermented Rice Germ Ameliorates Caffeine-Induced Sleep Disturbance in Mice. Biomol Ther (Seoul) 2015; 23:268-74. [PMID: 25995826 PMCID: PMC4428720 DOI: 10.4062/biomolther.2015.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/04/2015] [Accepted: 03/10/2015] [Indexed: 01/25/2023] Open
Abstract
γ-Aminobutyric acid (GABA), a major inhibitory neurotransmitter in the mammalian central nervous system, is involved in sleep physiology. Caffeine is widely used psychoactive substance known to induce wakefulness and insomnia to its consumers. This study was performed to examine whether GABA extracts from fermented rice germ ameliorates caffeine-induced sleep disturbance in mice, without affecting spontaneous locomotor activity and motor coordination. Indeed, caffeine (10 mg/kg, i.p.) delayed sleep onset and reduced sleep duration of mice. Conversely, rice germ ferment extracts-GABA treatment (10, 30, or 100 mg/kg, p.o.), especially at 100 mg/kg, normalized the sleep disturbance induced by caffeine. In locomotor tests, rice germ ferment extracts-GABA slightly but not significantly reduced the caffeine-induced increase in locomotor activity without affecting motor coordination. Additionally, rice germ ferment extracts-GABA per se did not affect the spontaneous locomotor activity and motor coordination of mice. In conclusion, rice germ ferment extracts-GABA supplementation can counter the sleep disturbance induced by caffeine, without affecting the general locomotor activities of mice.
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Affiliation(s)
- Darine Froy N Mabunga
- Department of Neuroscience, School of Medicine, and Neuroscience Research Center, SMART-IABS and KU Open Innovation Center, Konkuk University, Seoul 143-701
| | - Edson Luck T Gonzales
- Department of Neuroscience, School of Medicine, and Neuroscience Research Center, SMART-IABS and KU Open Innovation Center, Konkuk University, Seoul 143-701
| | - Hee Jin Kim
- Uimyung Research Institute for Neuroscience, Department of Pharmacy, Sahmyook University, Seoul 139-742
| | - Se Young Choung
- Department of Preventive Pharmacy and Toxicology, College of Pharmacy, Kyung Hee University, Seoul 130-701, Republic of Korea
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20
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Fagernaes CF, Heuch I, Zwart JA, Winsvold BS, Linde M, Hagen K. Blood pressure as a risk factor for headache and migraine: a prospective population-based study. Eur J Neurol 2014; 22:156-62, e10-1. [DOI: 10.1111/ene.12547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/02/2014] [Indexed: 01/15/2023]
Affiliation(s)
- C. F. Fagernaes
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
| | - I. Heuch
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
| | - J.-A. Zwart
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - B. S. Winsvold
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - M. Linde
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
| | - K. Hagen
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
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21
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O'Keefe JH, Bhatti SK, Patil HR, DiNicolantonio JJ, Lucan SC, Lavie CJ. Effects of habitual coffee consumption on cardiometabolic disease, cardiovascular health, and all-cause mortality. J Am Coll Cardiol 2013; 62:1043-1051. [PMID: 23871889 DOI: 10.1016/j.jacc.2013.06.035] [Citation(s) in RCA: 211] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/09/2013] [Accepted: 06/18/2013] [Indexed: 12/30/2022]
Abstract
Coffee, after water, is the most widely consumed beverage in the United States, and is the principal source of caffeine intake among adults. The biological effects of coffee may be substantial and are not limited to the actions of caffeine. Coffee is a complex beverage containing hundreds of biologically active compounds, and the health effects of chronic coffee intake are wide ranging. From a cardiovascular (CV) standpoint, coffee consumption may reduce the risk of type 2 diabetes mellitus and hypertension, as well as other conditions associated with CV risk such as obesity and depression; but it may adversely affect lipid profiles depending on how the beverage is prepared. Regardless, a growing body of data suggests that habitual coffee consumption is neutral to beneficial regarding the risks of a variety of adverse CV outcomes including coronary heart disease, congestive heart failure, arrhythmias, and stroke. Moreover, large epidemiological studies suggest that regular coffee drinkers have reduced risks of mortality, both CV and all-cause. The potential benefits also include protection against neurodegenerative diseases, improved asthma control, and lower risk of select gastrointestinal diseases. A daily intake of ∼2 to 3 cups of coffee appears to be safe and is associated with neutral to beneficial effects for most of the studied health outcomes. However, most of the data on coffee's health effects are based on observational data, with very few randomized, controlled studies, and association does not prove causation. Additionally, the possible advantages of regular coffee consumption have to be weighed against potential risks (which are mostly related to its high caffeine content) including anxiety, insomnia, tremulousness, and palpitations, as well as bone loss and possibly increased risk of fractures.
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Affiliation(s)
- James H O'Keefe
- Mid America Heart Institute at Saint Luke's Hospital of Kansas City and University of Missouri-Kansas City, Kansas City, Missouri.
| | - Salman K Bhatti
- Mid America Heart Institute at Saint Luke's Hospital of Kansas City and University of Missouri-Kansas City, Kansas City, Missouri
| | - Harshal R Patil
- Mid America Heart Institute at Saint Luke's Hospital of Kansas City and University of Missouri-Kansas City, Kansas City, Missouri
| | - James J DiNicolantonio
- Mid America Heart Institute at Saint Luke's Hospital of Kansas City and University of Missouri-Kansas City, Kansas City, Missouri
| | - Sean C Lucan
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
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22
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Martínez-Sellés M, Datino T, Figueiras-Graillet L, Gama JG, Jones C, Franklin R, Fernández-Avilés F. Cardiovascular safety of anagrelide in healthy subjects: effects of caffeine and food intake on pharmacokinetics and adverse reactions. Clin Drug Investig 2013. [PMID: 23184666 PMCID: PMC3586167 DOI: 10.1007/s40261-012-0032-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Essential thrombocythaemia (ET) is a rare clonal myeloproliferative disorder characterized by a sustained elevation in platelet count and megakaryocyte hyperplasia. Anagrelide is used in the treatment of ET, where it has been shown to reduce platelet count. Anagrelide is metabolized by cytochrome P450 (CYP) 1A2, and previous studies of the effect of food on the bioavailability and pharmacokinetics of anagrelide were conducted prior to the identification of the active metabolite, 3-hydroxyanagrelide. Objectives The objectives of this study were to determine the effect of food and caffeine on the pharmacokinetics of anagrelide and its active metabolite, 3-hydroxyanagrelide, to monitor electrocardiogram (ECG) parameters following drug administration, and to document the relationship between palpitations, ECG changes and caffeine intake Methods Thirty-five healthy subjects who received 1 mg of anagrelide following either a 10-h fast or within 30 min of a standardized breakfast, including two cups of coffee, were studied. Results Time to maximum (peak) plasma concentration (Cmax) of anagrelide was 4.0 h in the fed and 1.5 h in the fasted group (p < 0.05); similar results were observed for 3-hydroxyanagrelide. The mean Cmax of anagrelide was 4.45 ± 2.32 ng/mL and 5.08 ± 2.99 ng/mL in the fed/caffeine and fasted groups, respectively; peak concentrations were higher for 3-hydroxyanagrelide in both the fed/caffeine and fasted groups. The most frequent adverse events (AEs) were headache (60 %) and palpitations (40 %). There were no serious AEs and all ECGs were normal, although significant reductions in PR interval, QRS length and QT interval were observed in both groups. Heart rate increased after anagrelide administration in both fed/caffeine and fasted states (p < 0.01); however, increased heart rate was significantly more frequent in the fed/caffeine state than in the fasted state (p < 0.001 for heart rate increase in the first hour after drug administration). There was a trend towards a greater heart rate increase in subjects reporting palpitations than in those without (mean heart rate ± SD at 1 h: 10.1 ± 6.4 vs. 8.0 ± 8.4 beats/min [p = 0.35]; at 4 h: 12.7 ± 7.5 vs. 9.1 ± 8.8 beats/min [p = 0.10], respectively). Conclusion We conclude that food/caffeine delayed absorption of anagrelide. Anagrelide was generally well tolerated and had small effects on ECG parameters and heart rate. Caffeine may be implicated in a higher increase in heart rate and increased frequency of palpitations observed following administration of anagrelide with food/caffeine versus fasting.
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Affiliation(s)
- Manuel Martínez-Sellés
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Calle del Doctor Esquerdo, 46, 28007, Madrid, Spain.
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Abstract
The classification of sleep disorders is necessary to discriminate between disorders and to facilitate an understanding of symptoms, etiology, and pathophysiology that allows for appropriate treatment. The earliest classification systems, largely organized according to major symptoms (insomnia, excessive sleepiness, and abnormal events that occur during sleep), were unable to be based on pathophysiology because the cause of most sleep disorders was unknown. These 3 symptom-based categories are easily understood by physicians and are therefore useful for developing a differential diagnosis. The International Classification of Sleep Disorders, version 2, published in 2005 and currently undergoing revision, combines a symptomatic presentation (e.g., insomnia) with 1 organized in part on pathophysiology (e.g., circadian rhythms) and in part on body systems (e.g., breathing disorders). This organization of sleep disorders is necessary because of the varied nature and because the pathophysiology for many of the disorders is still unknown. The International Classification of Sleep Disorders, version 2 provides relevant diagnostic and epidemiological information on sleep disorders to more easily differentiate between the disorders.
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Affiliation(s)
- Michael J Thorpy
- Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, NY, USA.
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24
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Fitt E, Pell D, Cole D. Assessing caffeine intake in the United Kingdom diet. Food Chem 2012; 140:421-6. [PMID: 23601385 DOI: 10.1016/j.foodchem.2012.07.092] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 07/04/2012] [Accepted: 07/20/2012] [Indexed: 01/22/2023]
Abstract
Caffeine occurs naturally in the leaves and seeds of many plants and is artificially added to some beverages. Consumption of caffeine has been linked to both positive and adverse health outcomes. We incorporated estimates of caffeine content (mg/100g or ml) of foods and drinks, taken from the published literature, to provide a preliminary estimate of caffeine intake for the UK population, based on data collected in the National Diet and Nutrition Survey 2008-10. Among consumers mean total caffeine intakes of adult men 19+ y were significantly greater than intakes by boys 4-10y and 11-18y (p<0.05), with the same age-related differences seen for females. 4.1% of men 19+ y and 3.8% of women 19+ y had caffeine intakes in excess of 300mg/d. The addition of caffeine to UK food composition databases will allow more detailed study of the health effects of caffeine consumption.
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Affiliation(s)
- Emily Fitt
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge CB1 9NL, UK.
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25
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LLORET-LINARES C, LAFUENTE-LAFUENTE C, CHASSANY O, GREEN A, DELCEY V, MOULY S, BERGMANN JF. Does a single cup of coffee at dinner alter the sleep? A controlled cross-over randomised trial in real-life conditions. Nutr Diet 2012. [DOI: 10.1111/j.1747-0080.2012.01601.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Brathwaite JM, Da Costa LA, El-Sohemy A. Catechol-O-Methyltransferase Genotype Is Associated with Self-Reported Increased Heart Rate Following Caffeine Consumption. JOURNAL OF CAFFEINE RESEARCH 2011. [DOI: 10.1089/jcr.2011.0015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Joanne M. Brathwaite
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Laura A. Da Costa
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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27
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Louis ED, Hafeman D, Parvez F, Liu X, Alcalay RN, Islam T, Ahmed A, Siddique AB, Patwary TI, Melkonian S, Argos M, Levy D, Ahsan H. Tremor severity and age: a cross-sectional, population-based study of 2,524 young and midlife normal adults. Mov Disord 2011; 26:1515-20. [PMID: 21442657 DOI: 10.1002/mds.23674] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 11/15/2010] [Accepted: 01/13/2011] [Indexed: 11/09/2022] Open
Abstract
Mild action tremor occurs in most normal people. Yet this tremor mainly has been studied within the context of advanced age rather than among the vast bulk of adults who are not elderly. Whether this tremor worsens during young and middle age is unknown. Using cross-sectional data from a large population-based study of young and midlife normal adults (age range, 18-60 years), we assessed whether increasing age is associated with more severe action tremor. Two thousand five hundred and twenty-four adults in Araihazar, Bangladesh, drew an Archimedes spiral with each hand. Tremor in spirals was rated (0-3) by a blinded neurologist, and a spiral score (range, 0-6) was assigned. Spiral score was correlated with age (r = 0.06, P = .004). With each advancing decade, the spiral score increased (P = .002) so that the spiral score in participants in the highest age group (age 60) was approximately twice that of participants in the youngest age group (age 18-19); P = .003. In the regression model that adjusted for potential confounders (sex, cigarettes, medications, asthma inhalers, and tea and betel nut use), spiral score was associated with age (P = .0045). In this cross-sectional, population-based study of more than 2500 young and midlife normal adults, there was a clear association between age and tremor severity. Although the magnitude of the correlation coefficient was modest, tremor severity was higher with each passing decade. These data suggest that age-dependent increase in tremor amplitude is not restricted to older people but occurs in all adult age groups.
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Affiliation(s)
- Elan D Louis
- GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
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Wöber C, Wöber-Bingöl C. Triggers of migraine and tension-type headache. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:161-172. [PMID: 20816418 DOI: 10.1016/s0072-9752(10)97012-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Identification of trigger factors or precipitants is frequently recommended as a basic strategy in the treatment of migraine and tension-type headache (TTH). Trigger factors increase the probability of headache in the short term. Potential trigger factors have been examined most frequently in migraine and less often in TTH. Many of these factors are related to migraine as well as to TTH, but their prevalence may differ in the two headache types. In this chapter, we will review the findings of retrospective as well as of prospective and controlled studies. Taken together, virtually all aspects of life have been suspected to trigger migraine or TTH, but scientific evidence for many of these triggers is poor. Menstruation has a prominent unfavorable role in migraine and possibly in TTH. There is at least some evidence that environmental factors such as weather, lights, noise and odors, stress and other psychological factors, sleeping problems, fatigue and tiredness may play a role. In addition, intake of alcohol, caffeine withdrawal, skipping meals, and possibly dehydration may trigger migraine and TTH in some patients. Scientific evidence is lacking that any other food or food additive plays a relevant role as a trigger factor of headaches.
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Affiliation(s)
- Christian Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria.
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29
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Sin CWM, Ho JSC, Chung JWY. Systematic review on the effectiveness of caffeine abstinence on the quality of sleep. J Clin Nurs 2009; 18:13-21. [PMID: 19120728 DOI: 10.1111/j.1365-2702.2008.02375.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM The aim of the present study is to review the effects of caffeine abstinence on the quality of sleep. BACKGROUND Insomnia is a common problem and abstinence from caffeine is the most popular component in sleep hygiene advice. However, there have been inconsistent results relating to the effectiveness of caffeine abstinence in improving sleep. DESIGN Systematic review. METHODS We browsed several electronic databases and reference lists of articles about the correlation of caffeine consumption and sleep deprivation. We selected the articles according to predefined inclusion and exclusion criteria. Two reviewers assessed the quality of trials, which were selected according to the Jadad quality assessment scale. We included the trials scoring three or above in the systematic review and extracted their data. We assessed the heterogeneity of the studies before we considered whether or not to combine the studies' results. RESULTS Three randomised control trials fulfilled the selection criteria among which two trials scored > or =3 on the Jadad scale. We included these two trials in our systematic review. The designs and outcome measurements of these two trials were not homogeneous, therefore, we did not combine their results. Instead, we conducted a critical appraisal. In one trial, caffeine abstinence was associated with significant lengthening of sleep duration (p < 0.01) and better sleep quality (p < 0.05). In another trial, subjects had less difficulty falling asleep on days when they drank decaffeinated coffee (p < 0.05). CONCLUSIONS The results showed that caffeine abstinence for a whole day could improve sleep quality. Thus, health practitioners were recommended to include caffeine abstinence in the instructions for sleep hygiene. RELEVANCE TO CLINICAL PRACTICE This study demonstrates the effectiveness of caffeine abstinence in improving sleep quality. It provides evidence for the practice of including caffeine abstinence in sleep hygiene advice.
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Affiliation(s)
- Celia W M Sin
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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Hagen K, Thoresen K, Stovner LJ, Zwart JA. High dietary caffeine consumption is associated with a modest increase in headache prevalence: results from the Head-HUNT Study. J Headache Pain 2009; 10:153-9. [PMID: 19308315 PMCID: PMC3451984 DOI: 10.1007/s10194-009-0114-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 03/03/2009] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to investigate the association between caffeine consumption and headache type and frequency in the general adult population. The results were based on cross-sectional data from 50,483 (55%) out of 92,566 invited inhabitants aged ≥20 years who participated in the Nord-Trøndelag Health Survey. In the multivariate analyses, adjusting for age, gender, smoking, and level of education as confounding factors, a weak but significant association (OR = 1.16, 95% CI 1.09–1.23) was found between high caffeine consumption and prevalence of infrequent headache. In contrast, headache >14 days/month was less likely among individuals with high caffeine consumption compared to those with low caffeine consumption. The results may indicate that high caffeine consumption changes chronic headache into infrequent headache due to the analgesic properties of caffeine. Alternatively, chronic headache sufferers tend to avoid intake of caffeine to not aggravate their headaches, whereas individuals with infrequent headache are less aware that high caffeine use can be a cause.
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Affiliation(s)
- Knut Hagen
- Department of Clinical Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Abstract
Caffeine is the most widely consumed psychostimulant drug in the world. With intermittent exposures, caffeine may act as a mild analgesic for headache or as an adjuvant for the actions of other analgesics. Chronic repetitive exposures to caffeine increase the risks for development of analgesic-overuse headache, chronic daily headache, and physical dependency. Cessation of caffeine use after chronic exposures leads to a withdrawal syndrome with headache as a dominant symptom. At dosages achieved by common dietary intake, caffeine acts as a potent antagonist of central and peripheral nervous system adenosine receptors. The complex effects of caffeine on headache disorders suggest important roles for adenosine in these disorders and in the induction of caffeine dependency.
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Affiliation(s)
- Robert E Shapiro
- Department of Neurology, Given C219B, University of Vermont College of Medicine, 89 Beaumont Avenue, Burlington, VT 05405, USA.
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Urso-Baiarda F, Shurey S, Grobbelaar AO. Effect of caffiene on microsurgical technical performance. Microsurgery 2007; 27:84-7. [PMID: 17290375 DOI: 10.1002/micr.20311] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Microsurgeons may choose to avoid caffeine to prevent potentially deleterious caffeine tremor, although an adverse effect on surgical skill has never been shown. This double-blind placebo-controlled crossover study investigated the effect of moderate caffeine intake on microsurgical ability among microsurgical training course attendees. Subjects were randomized to receive either morning placebo and afternoon caffeine, or the reverse, thereby acting as their own controls. Performance in end-to-end vessel anastomosis was graded by a single observer during both sessions using a global rating scale. Subjects consuming caffeine in the morning demonstrated significantly improved scores from morning to afternoon, whereas subjects consuming caffeine in the afternoon showed no such improvement. These results are consistent with an adverse effect of caffeine on microsurgical skill combined with a learning curve among the study population of novice microsurgeons, and support the view that caffeine has a detrimental effect on microsurgical ability among this study group.
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Affiliation(s)
- Fulvio Urso-Baiarda
- Restoration of Appearance and Function Trust (RAFT), Leopold Muller Building, Mount Vernon Hospital, Northwood, Middlesex, UK.
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Abstract
Based on a review of the literature the authors discuss the role of nutrition in the precipitation of migraine and tension-type headache (TTH). The available information relies largely on the subjective assessment of the patients. Controlled trials suggest that alcohol and caffeine withdrawal are the most important nutritional precipitating factors of migraine and TTH. In addition, there is some evidence that missing meals is also an important factor. Dehydration seems to deserve more attention. A selective sensitivity to red wine has been shown in some patients, the importance of chocolate has been doubted seriously, and scientific evidence for cheese as a precipitating factor is lacking. Despite a series of experimental studies demonstrating that NO donors such as nitroglycerin and parenteral histamine cause headache the role of histamine, nitrates, and nitrites in food remains unclear. Similarly, other biogenic amines and aspartame have not been proven to precipitate headache. Sodium glutamate causes adverse reactions including headache probably at large doses ingested on an empty stomach. Therefore, patients should be advised that food plays a limited role as a precipitating factor of migraine and TTH. Subjective sensitivity to certain foods should be examined critically, and proven precipitating factors should be avoided. General dietary restrictions have not been proven to be useful.
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Affiliation(s)
- J Holzhammer
- Universitäts-Klinik für Neurologie, Medizinische Universität Wien
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Luciano M, Kirk KM, Heath AC, Martin NG. The genetics of tea and coffee drinking and preference for source of caffeine in a large community sample of Australian twins. Addiction 2005; 100:1510-7. [PMID: 16185212 DOI: 10.1111/j.1360-0443.2005.01223.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To investigate the genetic and environmental influences on tea consumption and their commonalities with coffee consumption; and to further examine the genetic and environmental aetiology of preference for tea/coffee. DESIGN A classical twin design was used in which the similarity of identical and non-identical twins is compared, enabling estimates of genetic, common environmental and unique environmental influence on the trait. SETTING AND PARTICIPANTS An Australian population-based sample of 1796 identical (i.e. monozygotic) and 2013 non-identical (i.e. dizygotic) twin pairs aged 16-87 years was studied, roughly three-fifths of whom were female. The sample represented approximately 70% of those approached for study participation. MEASUREMENTS As part of a Health and Lifestyle Questionnaire, respondents were asked how many cups of each tea and coffee they consumed per day. Additional measures of 'total tea and coffee consumption' and 'preference for coffee' were calculated. FINDINGS Age was positively associated with tea consumption but negatively associated with coffee preference; women consumed more beverages than men, but showed a lower preference for coffee. An inverse relation between tea and coffee consumption--larger in females (-0.41) than males (-0.34)--was supported. This association was mediated entirely by the unique environment in males, and by both the unique environment (68.3%) and genes (31.7%) in females. Tea and coffee drinking were shown to have similar heritabilities (0.46) in males, but tea consumption was influenced by common environmental factors whereas coffee consumption was not. Coffee preference was shown to be influenced by genes (0.42) and the unique environment (0.58). CONCLUSIONS As the patterns of genetic and environmental variation were shown to differ for tea and coffee consumption it may be more informative to retain them as separate measures of caffeine intake in future studies of stimulant use and taste perception.
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Affiliation(s)
- Michelle Luciano
- Genetic Epidemiology, Queensland Institute of Medical Research, Herston, Brisbane, QLD 4029, Australia.
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Abstract
Chronic daily headache (CDH) refers to the daily or almost daily occurrence of headache for a prolonged period of time, with lack of a well-defined attack pattern. It constitutes the vast majority of daily headaches. Hemicrania continua, a condition that closely resembles CDH, will be discussed as part of this article because the two are difficult, if not impossible, to distinguish solely on the basis of their presentations.
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Affiliation(s)
- Egilius L Spierings
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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Kudielka * BM, Von Känel R, Gander ML, Fischer JE. Effort-reward imbalance, overcommitment and sleep in a working population. WORK AND STRESS 2004. [DOI: 10.1080/02678370410001731785] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
AIM To examine the prevalence of functional dyspepsia in the general population, and to evaluate the natural history/clinical course of patients with functional dyspepsia. METHODS Full-length published manuscripts during 1980-2002 were included if: (i) participants had uninvestigated or functional dyspepsia; (ii) dyspepsia was defined; (iii) for prevalence, population-based samples were evaluated; (iv) for prognosis, the total number of the inception cohort and the total number of individuals available at the end of follow-up were reported. RESULTS Twenty-two studies (1976-2002) that examined the prevalence of dyspepsia fulfilled the inclusion and exclusion criteria; 17 studies examined more than 1000 participants, but only two studies provided information sufficient to calculate the prevalence of functional dyspepsia (11.5-14.7%). The prevalence of uninvestigated dyspepsia was in the range 10-40%. When the definition of dyspepsia was restricted to participants with upper abdominal pain, irrespective of the presence of heartburn or acid regurgitation, the prevalence rate estimate was 5-12%. Thirteen studies examined the clinical course of functional dyspepsia (seven retrospective and six prospective). Sample sizes were small (n = 35-209). A follow-up ascertainment of symptoms amongst individuals in the original cohorts was obtained in 92.5-98.2% of prospective studies and in 67.7-82.2% of retrospective studies. The follow-up duration was in the range 1.5-10 years for prospective studies and 5-27 years for retrospective studies; the median follow-up duration for all studies was approximately 5 years. A variable prognosis was reported. An outcome of symptom improvement or becoming asymptomatic was reported in at least one-half of patients in 10 of the 13 studies, and in at least two-thirds of patients in six of the 13 studies. Prognostic factors were inconsistent and, in general, poorly described. CONCLUSIONS Functional dyspepsia is prevalent world-wide, but the prognosis remains poorly defined. There is a need for population-based studies to examine the prevalence and clinical course of documented functional dyspepsia.
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Affiliation(s)
- H B El-Serag
- Sections of Gastroenterology and Health Services Research, Houston Veterans Affairs Medical Center, and Baylor College of Medicine, Houston, TX, USA.
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Claessens AAMC, Heerdink ER, van Eijk JTHM, Lamers CBHW, Leufkens HGM. Determinants of headache in lansoprazole users in The Netherlands: results from a nested case-control study. Drug Saf 2002; 25:287-95. [PMID: 11994030 DOI: 10.2165/00002018-200225040-00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE During proton pump inhibitor (PPI) use, in clinical trials, headache is one of the most frequently reported adverse events (frequency 1.3 to 8.8%), while results of one observational study indicate that headache is the fifth most frequently reported adverse event (incidence densities 2.5 to 4.6 per 1000 patient-months of exposure). However, there are no observational studies performed regarding the occurrence and features of headache during use of PPIs in daily practice. For this reason this study was set up with the aim to assess the incidence and characteristics of headache and to investigate possible associated co-factors in PPI users in daily practice. DESIGN Data were used from a prospective, observational study in which 10 008 lansoprazole users were followed over time. The study was designed according to the Safety Assessment of Marketed Medicines guidelines. A nested case-control design was used to compare PPI users reporting headache or not. RESULTS The frequency of headache was 2.5% in users of lansoprazole and the incidence density was 7.2 per 1000 patient-months of PPI lansoprazole use. Two-thirds of patients with headache had tension headache and one-third had migraine. The analysis of co-factors revealed that women, patients with previous use of analgesics and patients reporting several adverse events, were at risk to develop headache during PPI use. Patients with headache also, significantly more often, reported diarrhoea, nausea and dizziness. A discontinuation of PPI therapy resulted in a cessation or reduction of the headache in 80.0% (20 of 25). CONCLUSIONS As can be expected, headache was reported less frequently in this study compared with clinical trials with lansoprazole. The incidence density was comparable with other observational data of lansoprazole and omeprazole users. Besides several commonly accepted co-factors such as female gender and a history of analgesic use, we also found the reporting of other adverse events to be associated with the reporting of headache during lansoprazole use. The cessation of headache after a discontinuation of use of the PPI and the observed dose relationship suggested that headache was indeed an adverse effect of lansoprazole use.
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Affiliation(s)
- Angela A M C Claessens
- Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands.
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Al-Deeb S, Al-Moutaery K, Arshaduddin M, Biary N, Tariq M. Effect of acute caffeine on severity of harmaline induced tremor in rats. Neurosci Lett 2002; 325:216-8. [PMID: 12044659 DOI: 10.1016/s0304-3940(02)00042-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Recent studies suggest an association between caffeine consumption and tremor. However, the available literature is scanty and inconclusive. The present study was undertaken to investigate the effect of acute caffeine treatment on harmaline induced tremors in the rat. Four groups of male Sprague-Dawley rats (six animals in each group) weighing 88+/-2 g were administered harmaline (10 mg/kg, intraperitoneally (i.p.)) for inducing experimental tremors. The rats in group 1 served as controls and received normal saline, whereas the animals in groups 2, 3 and 4 were given caffeine (i.p.) at doses of 50, 100 and 150 mg/kg, respectively 60 min after harmaline administration. The latency of onset, intensity and duration of tremor and electromyographic (EMG) responses were recorded. Treatment of rats with caffeine resulted in a significant increase in the intensity and duration of harmaline induced tremors. Caffeine also enhanced the EMG amplitude in harmaline treated animals. In conclusion, the results of this study suggest that acute treatment with caffeine significantly potentiates the severity of harmaline induced tremors in rats.
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Affiliation(s)
- Saleh Al-Deeb
- Neuroscience Research Group, Armed Forces Hospital, P.O. Box 7897 (W-912), Riyadh 11159, Saudi Arabia
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Agréus L, Svärdsudd K, Talley NJ, Jones MP, Tibblin G. Natural history of gastroesophageal reflux disease and functional abdominal disorders: a population-based study. Am J Gastroenterol 2001; 96:2905-14. [PMID: 11693325 DOI: 10.1111/j.1572-0241.2001.04680.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Symptomatic gastroesophageal reflux disease (GERD), dyspepsia, and irritable bowel syndrome (IBS) are generally considered to be chronic conditions, but community-based studies are sparse, and long-term natural history data are unavailable. We aimed to determine the natural history of these conditions. METHODS A representative Swedish sample (20-79 yr) completed a validated questionnaire over the preceding 3 months. The survey was repeated after 1 and 7 yr in the same target group (n = 1290, 1260, and 1065; response rates 90%, 87%, and 82%, respectively; 79% responded to all three mailings). RESULTS The prevalence of GERD symptoms remained stable, whereas the prevalence of IBS increased over time, independent of aging. Dyspepsia decreased with advancing age. Although more than half of those with IBS reported the same symptom profile after 1 and 7 yr, there was a substantial symptom fluctuation and symptom profile flux between those reporting dyspepsia, IBS, or minor symptoms. Only a minority with GERD (<10%) changed to dyspepsia and/or IBS, or vice versa. The symptom-free patients remained symptom-free or reported only minor symptoms in > or = 90% of cases. CONCLUSION There seem to be two distinct populations of symptom reporters, those with dyspepsia or IBS, and those with GERD.
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Affiliation(s)
- L Agréus
- Family Medicine Stockholm, Karolinska Institutet, Stockholm, Sweden
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Abstract
Tremor is classified according to anatomic distribution among body parts, and by frequency and amplitude during rest, postural maintenance, movement, intention, and the performance of specific tasks. Key historical features include age at onset, progression over time, family history, exacerbating and remitting factors and behaviors, response to alcohol and medications, and additional neurological signs and symptoms. Accurate diagnosis is a critical factor in predicting the natural history and response to treatment.
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Affiliation(s)
- T A Zesiewicz
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Department of Pharmacology and Experimental Therapeutics, University of South Florida, Tampa, Florida, USA
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Abstract
The typical migraine patient is exposed to a myriad of migraine triggers on a daily basis. These triggers potentially can act at various sites within the cerebral vasculature and the central nervous system to promote the development of migraine headache. The challenge to the physician is in the identification and avoidance of migraine trigger factors within patients suffering from migraine headache. Only through a rational approach to migraine trigger factors can physicians develop an appropriate treatment strategy for migraine patients.
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Affiliation(s)
- V T Martin
- Department of Medicine, University of Cincinnati, Ohio, USA
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Moayyedi P, Forman D, Braunholtz D, Feltbower R, Crocombe W, Liptrott M, Axon A. The proportion of upper gastrointestinal symptoms in the community associated with Helicobacter pylori, lifestyle factors, and nonsteroidal anti-inflammatory drugs. Leeds HELP Study Group. Am J Gastroenterol 2000; 95:1448-55. [PMID: 10894577 DOI: 10.1111/j.1572-0241.2000.2126_1.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Upper gastrointestinal disorders are common in the community, yet the determinants of these symptoms are poorly characterized. The association between upper gastrointestinal symptoms and Helicobacter pylori (H. pylori), socioeconomic status, nonsteroidal antiinflammatory drug (NSAID) use, smoking, alcohol, and coffee intake was assessed in a cross-sectional survey. METHODS Subjects between the ages of 40-49 yr were randomly selected from the lists of 36 primary care centers. Participants attended their local primary care center and were interviewed by a researcher using a validated dyspepsia questionnaire. H. pylori status was determined by a nonfasting 13C-urea breath test. RESULTS A total of 32,929 subjects were invited, and 8,407 (25%) attended and were eligible. Of these, 2,329 (28%) were H. pylori positive and 3,177 (38%) had dyspepsia. Also, 44% of H. pylori-infected participants reported dyspepsia compared with 36% of uninfected subjects [odds ratio = 1.39; 95% confidence interval (CI) 1.26-1.53]. H. pylori infection remained a significant risk factor for dyspepsia in a multiple logistic regression model (odds ratio = 1.21; 95% CI 1.09-1.34), suggesting that 5% of dyspepsia in the population is attributable to H. pylori. NSAIDs, low educational attainment, renting accommodation, absence of central heating, sharing a bed with siblings, and being married were also significantly associated with dyspepsia in this model. Smoking, but not drinking alcohol or coffee, was marginally associated with dyspepsia, but this finding was not robust. These factors were not associated with any dyspepsia subtype. CONCLUSIONS H. pylori is significantly associated with dyspepsia and may be responsible for 5% of upper gastrointestinal symptoms in the community.
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Affiliation(s)
- P Moayyedi
- Centre for Digestive Diseases, The General Infirmary at Leeds, United Kingdom
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Boekema PJ, Samsom M, van Berge Henegouwen GP, Smout AJ. Coffee and gastrointestinal function: facts and fiction. A review. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. SUPPLEMENT 1999; 230:35-9. [PMID: 10499460 DOI: 10.1080/003655299750025525] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Effects of coffee on the gastrointestinal system have been suggested by patients and the lay press, while doctors tend to discourage its consumption in some diseases. METHODS The literature on the effects of coffee and caffeine on the gastrointestinal system is reviewed with emphasis on gastrointestinal function. RESULTS Although often mentioned as a cause of dyspeptic symptoms, no association between coffee and dyspepsia is found. Heartburn is the most frequently reported symptom after coffee drinking. It is demonstrated that coffee promotes gastro-oesophageal reflux. Coffee stimulates gastrin release and gastric acid secretion, but studies on the effect on lower oesophageal sphincter pressure yield conflicting results. Coffee also prolongs the adaptive relaxation of the proximal stomach, suggesting that it might slow gastric emptying. However, other studies indicate that coffee does not affect gastric emptying or small bowel transit. Coffee induces cholecystokinin release and gallbladder contraction, which may explain why patients with symptomatic gallstones often avoid drinking coffee. Coffee increases rectosigmoid motor activity within 4 min after ingestion in some people. Its effects on the colon are found to be comparable to those of a 1000 kCal meal. Since coffee contains no calories, and its effects on the gastrointestinal tract cannot be ascribed to its volume load, acidity or osmolality, it must have pharmacological effects. Caffeine cannot solely account for these gastrointestinal effects. CONCLUSIONS Coffee promotes gastro-oesophageal reflux, but is not associated with dyspepsia. Coffee stimulates gallbladder contraction and colonic motor activity.
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Affiliation(s)
- P J Boekema
- Dept. of Gastroenterology, University Hospital Utrecht, The Netherlands
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Talley NJ, Silverstein MD, Agréus L, Nyrén O, Sonnenberg A, Holtmann G. AGA technical review: evaluation of dyspepsia. American Gastroenterological Association. Gastroenterology 1998; 114:582-95. [PMID: 9496950 DOI: 10.1016/s0016-5085(98)70542-6] [Citation(s) in RCA: 243] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- N J Talley
- Department of Medicine, University of Sydney, Nepean Hospital, Australia
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Khatter AS, Kurth MC, Brewer MA, Crinnian CT, Drazkowski JF, Flitman SS, Imke S, Spector SA, Wood KL, Lieberman AN. Prevalence of tremor and Parkinson's disease. Parkinsonism Relat Disord 1996; 2:205-8. [PMID: 18591041 DOI: 10.1016/s1353-8020(96)00027-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/1996] [Indexed: 11/17/2022]
Affiliation(s)
- A S Khatter
- Barrow Neurological Institute and St. Joseph's Hospital and Medical Center,Phoenix, Arizona U.S.A
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Løchen ML, Rasmussen K. Palpitations and lifestyle: impact of depression and self-rated health. The Nordland Health Study. SCANDINAVIAN JOURNAL OF SOCIAL MEDICINE 1996; 24:140-4. [PMID: 8816004 DOI: 10.1177/140349489602400209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
On the basis of a questionnaire in a population study in the county of Nordland, Norway, the prevalence of palpitations and its associations to some lifestyle factors, depression and self-rated health were analysed. All the 10,497 residents aged 40 to 42 years were invited to participate, 82% attended, 87% of the attenders returned a questionnaire by mail, and 6436 subjects were included in this report. The prevalence of palpitations was 15% in men and 25% in women. Palpitations were significantly associated with coffee consumption, smoking, alcohol intoxication, physical inactivity, depression and poor self-rated health in the univariate analyses. In a logistic regression analysis, the relations between palpitations and lifestyle were weakened. Significant predictors for palpitations were depression and poor self-rated health in both sexes, in addition to heavy coffee drinking and physical inactivity in men and alcohol intoxication in women. In conclusion, palpitations were more firmly linked to depression and self-evaluated health than to lifestyle.
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Affiliation(s)
- M L Løchen
- Institute of Community Medicine, University of Tromsø, Norway
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Abstract
PURPOSE To determine: (1) the etiologies of palpitations, (2) the usefulness of diagnostic tests in determining the etiologies of palpitations, and (3) the outcomes of patients with palpitations. PATIENTS AND METHODS One hundred and ninety consecutive patients presenting with a complaint of palpitations at a university medical center were enrolled in this prospective cohort study. Patients underwent a structured clinical interview and psychiatric screening. The charts were abstracted for results of the physical exam and tests ordered by the primary physician. Assignment of an etiology of palpitations was based on strict adherence to predetermined criteria and achieved by consensus of the two physician investigators. One-year follow-up was obtained in 96% of the patients. RESULTS An etiology of palpitations was determined in 84% of the patients. The etiology of palpitations was cardiac in 43%, psychiatric in 31%, miscellaneous in 10%, and unknown in 16%. Forty percent of the etiologies could be determined with the history and physical examination, an electrocardiogram, and/or laboratory data. The 1-year mortality rate was 1.6% (95% confidence interval [CI] 0% to 3.4%) and the 1-year stroke rate was 1.1% (95% CI 0% to 2.6%). Within the first year, 75% of the patients experienced recurrent palpitations. At 1-year follow-up, 89% reported that their health was the same or improved compared to that at enrollment, 19% reported that their work performance was impaired, 12% reported that workdays were missed, and 33% reported accomplishing less than usual work at home. CONCLUSIONS The etiology of palpitations can often be diagnosed with a simple initial evaluation. Psychiatric illness accounts for the etiology in nearly one third of all patients. The short-term prognosis of patients with palpitations is excellent with low rates of death and stroke at 1 year, but there is a high rate of recurrence of symptoms and a moderate impact on productivity.
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Affiliation(s)
- B E Weber
- St. Mary's Hospital, Rochester, New York 14611, USA
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Abstract
OBJECTIVES To determine the prevalence of dyspepsia in the adult population of Great Britain and to describe the clinical features, treatment, effect of dyspepsia on daily lives and perceptions of peptic ulcer disease. DESIGN Cross-sectional survey of the adult population using structured questionnaires. SETTING Subjects interviewed at more than 150 sampling points in England, Scotland and Wales in November 1994. SUBJECTS A representative sample of the adult population comprising 2112 subjects, aged 16 years or more. MAIN OUTCOME MEASURES The prevalence of dyspepsia in the adult population and the frequency of various characteristics in dyspeptic subjects. RESULTS The prevalence of dyspepsia was 40%. Upper abdominal pain and heartburn were the most frequently reported symptoms. Solitary symptoms were uncommon and there was frequent overlap between 'ulcer-like' and 'reflux-like' dyspepsia. Forty-six per cent of dyspeptic subjects reported moderate or severe symptoms. More than half of symptomatic subjects took medication and 22% had visited their GP during the previous year. Overall, 2% of the survey sample had been absent from work due to dyspepsia. Awareness of the factors precipitating or aggravating peptic ulcer disease was poor, particularly in relation to anti-inflammatory drugs. CONCLUSIONS The present study emphasizes the magnitude of the problem of dyspepsia in the adult population of Great Britain. The survey also shows that the public in general, and patients in particular, require more information if they are to avoid factors known to damage the upper alimentary tract.
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