By Beth Gilbert HealthDay Reporter
The annual meeting of the American Academy of Neurology was held this year from April 5 to 9 in San Diego. Participants included clinicians, academicians, allied health professionals, and others interested in neurology. The conference highlighted recent advances in neurological disorders, with presentations focusing on the diagnosis, management, and treatment of disorders impacting the brain and nervous system.
In one study, Sarju Ganatra, M.D., of Lahey Hospital and Medical Center in Burlington, Massachusetts, and colleagues identified a significant association between elevated marine microplastic exposure and a higher prevalence of multiple disabilities at the population level.
In a cross-sectional, population-level study, the authors examined data from 218 U.S. coastal counties and found that counties with the highest levels of marine microplastics had a significantly greater prevalence of disabilities related to cognition, mobility, self-care, and independent living. The analysis adjusted for socioeconomic and environmental vulnerability factors to isolate the potential effect of microplastic exposure.
“This finding highlights an urgent need for more research into the mechanisms by which microplastics may impact neurological and physical function,” Ganatra said. “While the findings do not yet change individual clinical care pathways, they point to a growing area of concern for public health. As clinicians, staying informed about environmental exposures, like microplastics, is crucial. These factors may be contributing to neurocognitive and functional impairments, especially in vulnerable communities.”
In another study, Anisa Kelley, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues found that prophylactic zonisamide is effective in significantly reducing median headache days per month for pediatric patients with migraine.
Using a retrospective chart review at a single institution, the authors identified pediatric and adolescent patients with migraine disease who were treated with zonisamide prophylaxis. Change in headache days per month from initial visit to first follow-up were recorded for 256 patients with intractable (having failed two more prophylactic medications in the past) and nonintractable migraine.
The results suggested a median decrease from 18 to six headache days per month at first follow-up after zonisamide initiation. When analyzed separately, both intractable and nonintractable patient groups showed a significant median decrease of six headache days per month at first follow-up.
“The data support the potential novel clinical impact of using zonisamide for migraine prophylaxis in pediatric and adolescent migraine patients. This is especially important on our intractable migraine population, as we have limited treatment options for these patients currently,” Kelley said. “This is a novel use of a well-tolerated prophylaxis. It should be noted that our study was not controlled, so future trials comparing zonisamide to the current gold standard of topiramate would be beneficial to continue to support zonisamide’s use as prophylaxis.”
Kimford J. Meador, M.D., Ph.D., of Stanford University in Palo Alto, California, and colleagues recommend women of childbearing potential take folic acid to improve pregnancy outcomes.
The authors evaluated 345 6-year-old children, including 262 children of women with epilepsy and 83 children of women without epilepsy, and found that higher doses of folic acid taken by women during their first trimester of pregnancy were safe and associated with improved verbal and behavioral skills among their children at the age of 6 years. The researchers did not observe adverse high-dose effects of folic acid in offspring when taken by women with epilepsy or by healthy women. Meanwhile, the most effective dose of folic acid remains unknown.
“Folic acid improves neurodevelopmental outcomes (e.g., IQ, language, and behavioral problems like autism) of offspring in both healthy women and also women with epilepsy,” Meador said. “Females should take at least 0.4 mg/day, but more is likely needed if taking medicines like some antiseizure medications that interfere with folate metabolism.”
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