Smoking cannabis linked to higher stroke risk in young adults

Cannabis use may double the stroke risk in young adults, according to a recent study by researchers in the Centre for Brain Research at The University of Auckland.

The study showed that ischemic stroke and transient ischemic attack (TIA) patients were 2.3 times more likely to have cannabis detected in urine tests as other age and sex matched patients.

“This is the first case-controlled study to show a possible link to the increased risk of stroke from cannabis,” said Professor Alan Barber, lead investigator for the study and Neurological Foundation professor of clinical neurology at the University. “Cannabis has been thought by the public to be a relatively safe, although illegal substance. This study shows this might not be the case; it may lead to stroke.”

Professor Barber this week presented the study findings to the American Stroke Association’s International Stroke Conference 2013 in Honolulu. The study included 160 ischemic stroke/TIA patients aged 18-55 years who had urine screens upon admission to the hospital.

Among the patients, 150 had ischemic stroke and 10 had TIAs. Sixteen percent of patients tested positive for cannabis, and were mostly male who also smoked tobacco, while only 8.1 percent of controls tested positive for cannabis in urine samples. Researchers found no differences in age, stroke mechanism or most vascular risk factors between cannabis users and non-users.

In previous case reports, ischemic stroke and TIAs developed hours after cannabis use, says Professor Barber. “These patients usually had no other vascular risk factors apart from tobacco, alcohol and other drug usage. It’s challenging to perform prospective studies involving illegal substances such as cannabis because “questioning stroke and control patients about cannabis use is likely to obtain unreliable responses,” he says.

The study provides the strongest evidence to date of an association between cannabis and stroke, says Professor Barber. But the association is confounded because all but one of the stroke patients who were cannabis users also used tobacco regularly.

“We believe it is the cannabis use and not tobacco,” says Professor Barber, who hopes to conduct another study to determine whether there’s an association between cannabis and stroke independent of tobacco use.

“This may prove difficult given the risks of bias and ethical strictures of studying the use of an illegal substance,” he says. “However, the high prevalence of cannabis use in this cohort of younger stroke patients makes this research imperative.”

Physicians should test young people who come in with stroke for cannabis use, says Professor Barber. “People need to think twice about using cannabis, because it can affect brain development and result in emphysema, heart attack and now stroke.”

The study was funded by the Auckland District Health Board’s A+ Trust. Co-authors were: Dr Neil E. Anderson (ADHB), Dr Heidi Pridmore, Dr Venkatesh Krishnamurthy, Dr Sally Roberts, Dr David A. Spriggs, and Dr Kristie Carter.

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Predicting Recovery After Stroke

A team of scientists from the Centre for Brain Research have just had their research into predictors for stroke recovery published in the prestigious journal ‘Brain’, one of the world’s top clinical neurology periodicals.

Cathy Stinear, Alan Barber, Matt Petoe and Winston Byblow collaborated to develop and test an algorithm for predicting the potential for recovery of function in the arms of stroke patients, by combining tests of physical function three days post-stroke with measures of nerve function and MRI scans of patients.  The resulting algorithm shows excellent predictive capability, and has the potential to transform stroke recovery practice, allowing for tailored rehabilitation planning, more efficient use of healthcare resources, and improved outcomes for patients.

Read the full media release here: http://www.fmhs.auckland.ac.nz/faculty/newsandevents/news_details.aspx?Id=948

The abstract for this article may be viewed online here: http://brain.oxfordjournals.org/content/135/8/2527.abstract

CeleBRation Choir to perform at your place!

The CeleBRation Choir, a social singing group for people with communication difficulties as a result of neurological conditions, is an initiative of the Centre for Brain Research, and meets to practice weekly at the University, led by Music Therapists, with support from Speech and Language Therapists.

The choir has performed for various audiences since its inception three years ago, and now you can hear a selection of their work, in your very own home – a professionally produced video is available to view online at the Centre for Brain Research’s website.

Go to: http://www.fmhs.auckland.ac.nz/faculty/cbr/events/choir.aspx to view, and remember that anyone with a neurological condition is welcome to come along and join us in making music – it’s not called CeleBRation for nothing!

Promising young brain researcher returns to NZ

Hawkes Bay-born Dr Erin Cawston has been named the 2011 Neurological Foundation Repatriation Fellow. Erin will return from her position as Research Fellow at the Mayo Clinic Arizona next month, in order to further her research into Huntington’s disease at the Centre for Brain Research.

 The Repatriation Fellowship ensures outstanding young researchers who have completed postdoctoral studies overseas can return home and continue to develop their research careers in their specialist area. Dr Cawston says “I am incredibly grateful to the Neurological Foundation for this Repatriation Fellowship allowing me to come home to New Zealand. I look forward to working with Associate Professor Michelle Glass and Professor Mike Dragunow on such an exciting project as well as being back amongst the New Zealand scientific community.” Dr Cawston begins her Fellowship at The University of Auckland in February.

 Alongside this exciting research, the Neurological Foundation has also funded a number of exciting new research projects at the CBR.

 Optimising a novel induced neural precursor-like cell line Associate Professor Bronwen Connor, Department of Pharmacology and Clinical Pharmacology, Centre for Brain Research University of Auckland, $136,862 

 The generation of ‘embryonic-like’ stem cells from adult human skin was first demonstrated in 2007. This project will advance this capability by directly generating immature brain cells (neural precursor cells) from adult human skin. Of major significance is that this will avoid the need to generate an intermediate embryonic-like stem cell phase, providing neural precursor cells for therapeutic applications without risk of tumour formation from stem cells. This project provides a unique opportunity to establish a novel technology which is likely to have wide-reaching applications for future research in the areas of neurological disease modeling, drug development, and potentially cell replacement therapy.

 A genetic mechanism underlying late-onset Alzheimer’s disease Professor Russell Snell, School of Biological Sciences University of Auckland, $86,875

 Alzheimer’s disease is a debilitating disorder affecting up to 50 per cent of those aged over 80 years old. Despite decades of research and innumerable clinical trials, there are no treatments that prevent or reverse the progression of the disease. There is currently some evidence that patients have a small proportion of brain cells with three copies of chromosome 21 instead of the normal two, leading to an increased production of the toxic protein amyloid-beta peptide. This study aims to confirm this observation, determine the pathological consequences of these cells and look for markers that make these cells different, which may lead to new therapies.

 Immodulation of stroke with risperidone Associate Professor Bronwen Connor, Department of Pharmacology and Clinical Pharmacology, Centre for Brain Research, University of Auckland, $11,999

 Stroke is a leading cause of disability in New Zealand and the burden associated with this neurological disorder is increasing. Treatment of stroke represents a large, unmet medical need. Neuroinflammation is an important pathophysiological mechanism involved in stroke and impacts profoundly on the extent of cell loss, as well as injury progression. Neuroinflammation therefore offers an exciting therapeutic target for the treatment of stroke. It has been recently demonstrated that the anti-psychotic drug, risperidone, is effective at reducing neuroinflammation and disease progression in a model of multiple sclerosis. This project will now explore whether the anti-inflammatory properties of risperidone can reduce the progression and severity of stroke. 

 Do BMP antagonists play a role in directing the fate of adult neural progenitor cells following neural cell loss?
Shwetha George, Department of Pharmacology and Clinical Pharmacology, Centre for Brain Research, University of Auckland, $4,000

 The ability for adult neural stem cells to migrate to areas of brain damage and generate replacement brain cells may provide a unique mechanism by which to develop novel therapeutic strategies for the treatment of brain injury or neurological disease. However, the local environment appears to be critical for directing the final fate of adult stem cells in the damaged brain. This study will investigate whether brain injury alters the expression of a group of compounds known as bone morphogenic protein antagonists to promote adult neural stem cells to form glial rather than neuronal cells. The results of this study will enhance our knowledge as to how stem cells respond to brain cell loss and may assist in the development of novel therapeutic strategies for the treatment of brain injury or disease.

Singing for health

Auckland City Mayor Len Brown sang with members of the CeleBRation Choir this week. The community music therapy group offers singing therapy to people with communication problems through brain disease.

Singing for health

Mayor Len Brown sang with members of the CeleBRation Choir, who have communication problems through brain disease

Mayor Brown’s love of singing is well known, and he was very keen to visit the 30-strong CeleBRation Choir, run by the Centre

 

for Brain Research at The University of Auckland. Members include people who live with the effects of stroke, Parkinson’s or Alzheimer’s disease, along with other neurological conditions. People with these conditions may have problems speaking but find they can still sing.

Mayor Brown was treated to a list of well-known songs, solos and rounds before he discussed his love of singing and its role in his own recovery from a heart attack. He then led a rendition of the Christmas carol “Oh Come All Ye Faithful” and gave a solo performance of a new waiata “Ko Tamaki Matou” celebrating the history and future of Auckland.

His visit provided a snapshot into some of the University’s latest research around brain disease and recovery, led by scientists in the Centre for Brain Research’s Brain Recovery Clinic. He took part in a demonstration of Transcranial Magnetic Stimulation by Dr Jim Stinear, an exercise rehabilitation expert. This electromagnetic stimulation technology is described by Jim as “a simple but effective concept” providing new rehabilitation hope for people with movement problems through stroke.

The CeleBRation Choir choral group began as a social gathering for people affected by brain disease in September 2009. Now, two years on, it is not only a successful meeting of camaraderie, good cheer and melodies but also the subject of a number of academic studies into the unique benefits of singing therapy for the brain.

A team at the Centre for Brain Research is studying the CeleBRation Choir as a potential therapy for people with communication disorders through brain disease. Called SPICCATO (Stroke and Parkinson’s: Investigating Community Choir Engagement and Therapeutic Outcomes), the research is funded by the Health Research Council.  The team is led by Speech Science Head Professor Suzanne Purdy, and will look at therapeutic benefits from taking part in group singing – including people who have aphasia through stroke, and people with Parkinson’s disease who can develop voice or speech problems.

The Choir meets weekly on Mondays at the University’s Tāmaki Innovation Campus. New members are always welcome. For information on dates look at our website: http://www.fmhs.auckland.ac.nz/faculty/cbr/events/choir.aspx

New hope for neurological patients with Health Research Council Funding

Groundbreaking research developing new treatments for neurological disorders has been given the go-ahead with funding from the Health Research Council of New Zealand (HRC). Over $7 million of grant funding has been awarded to scientists working in the Centre for Brain Research.

The new programmes include $4.46M over five years to Professor Mike Dragunow and his team running the Biobank and Human Brain Bank. Over 100,000 New Zealanders are currently living with neurodegenerative conditions. The rate of Alzheimer’s disease is increasing in New Zealand, and CBR researchers are contributing to the global effort to find more effective treatments to combat this, and other devastating neurological disorders.

Professor Dragunow will work with Professor Richard Faull and other scientists to study the underlying causes and treatments for Alzheimer’s, epilepsy, Parkinson’s, and Huntington’s disease. The world-class team of neuroscientists and chemists has well-developed linkages with neurosurgeons, gerontologists, other clinical groups in the District Health Boards involved in clinical trials, and with NZ Biotech industries. Their goal is to translate lab-based research into therapies for patients suffering from neurodegenerative diseases.

Other projects funded include a study to determine personalized treatment pathways for stroke patients. Dr Cathy Stinear and her team at the Brain Recovery Clinic will use MRI and other techniques to define the rehabilitation strategy which will work best for each patient. In another project, Professor Laura Bennet’s team will examine whether stem cells can help brain-injured preterm babies. Meanwhile Professor Suzanne Purdy’s speech therapy team will look at therapeutic outcomes from being part of the CeleBRation Choir.

HRC New Programmes:

Professor Michael Dragunow, The University of Auckland, phone (09) 923 6403
Neurodegeneration in the Human Brain – Mechanisms and Therapeutic Targets
60 months, $4,467,504

HRC Projects:

Professor Laura Bennet, The University of Auckland, phone (09) 373 7599 ext 84890
Can Pluripotent Amnion Epithelial Cells help the Injured Preterm Brain?
36 months, $1,154,402

Professor Valery Feigin, AUT University, phone (09) 921 9166
Extension to the Traumatic Brain Injury Burden in New Zealand Study 
14 months, $345,465

Dr Cathy Stinear, The University of Auckland, phone (09) 923 3779 ext 83779
TRIO: Targeted Rehabilitation, Improved Outcomes
36 months, $1,126,268

HRC Feasibility Study Grants:

Professor Suzanne Purdy, The University of Auckland, phone (09) 373 7599 ext 82073
SPICCATO: Stroke and Parkinson’s Community Choir Engagement and Therapeutic Outcomes
12 months, $149,986

Young at heart is a state of mind

By Laura Fogg

“Awwwoooah. I feel good. I knew that I would now.” So go the song lyrics, sung in the inimitable deadpan style of the ‘Young @ Heart Chorus’. This American singing group for the over 70s visits New Zealand shores on the 6th December, with hugely anticipated concerts in Auckland and other cities. And in case you miss them live, the critically acclaimed film of the same name will be screened on Sunday 5th December on TV3.

The thirty-strong choir takes modern day pop songs, and puts their own twist on the words with all the gravitas and perspective that comes from the twilight years of the life spectrum. Songs include Coldplay’s ‘Fix you’, Talking Heads ‘Road to Nowhere’ and James Brown’s ‘I got you (I feel good)’. Yet why all the fuss for a group of past-it pensioners with average singing voices?

Well watch this choir and you’ll find there’s something highly infectious about the guts, stamina and joie de vivre of their performances. Not only are the concerts inspiring for us all as we grow older, but the energy they convey gives many people hope that old age can still be fun and sociable. For me, it’s a message to enjoy life whatever your age.

But is there anything more scientific going on in our brains as we watch the performances and perhaps sing along? Well research from across the globe seems to be indicating there is. Music making is pretty special neurologically, as it engages so many brain circuits, functions and perceptions. Singing itself is unique, as we humans have an innate ability to produce song as a form of expression, spanning every culture in the world. Sing a song to a toddler, and chances are they will sing along with you. Despite many people claiming they can’t sing, biologically, singing is as natural to us as speaking.

However, research is showing that different areas of the brain control singing compared with speaking. MRI imaging studies by Dr Reiker in Germany show that singing involves the right motor cortex, right anterior insula, and left cerebellum whereas speaking produces the opposite response pattern. This leads many scientists to think that singing could be a therapeutic option for people with speech problems.

The author Oliver Sachs in his popular book ‘Musicophilia’ has documented that people with aphasia, a language disorder frequently caused by stroke, often can’t speak a word and yet can still sing. The potentially miraculous qualities of song are even being investigated by leading neurologists and researchers at Harvard University in the US. Melodic Intonation Therapy, where music therapists sing sentences with the patient, is indeed showing some results for speech improvement.  

Back in Auckland it’s a big theme for the CeleBRation Choir as well. This community choir features patients with stroke, Parkinson’s disease and other brain disorders, who all have problems with their speech. Helped by volunteers like myself from the Centre for Brain Research, and led by music therapist Alison Talmage, the group uses singing as a form of expression and vocal exercise.

Yet more than that, singing is about have a stomping great time with other people. It’s about feeling connected with the group, hearing your own voice harmonising and in unison with others. Most people who sing in a choir report coming away with a feeling of wellbeing, and it’s backed up by research. Dr Stephen Clift at Canterbury Christ Church University in the UK examined 1124 choral singers in Australia, England and Germany, and found a significant correlation to psychological wellbeing.

Belonging to a choir gives a sense of collaboration, meaning and purpose to members who may be experiencing problems in other aspects of their lives. Being part of a wider group requires full cooperation from individuals, meaning they leave behind their own problems as they contribute to the whole. So I for one will be singing along at full volume while the ‘Young @ Heart’ singers belt out ‘I feel good’.

 

The CeleBRation Choir will be performing in concert on December 11th at 3pm, at Saint Luke’s Church Remuera.