Brain

medicine

6 Best Fish for Brain Health, According to a Top MD

When I picture myself in my older years, I like to hope that my mind will be just as sharp as Sophia on Golden Girls. Sure, I still want to be able to go for walks around the neighborhood and get in on any shuffleboard games going on, but I definitely want my brain to still be strong, too. As with any health goal, preparing for the future means thinking in the present.

Functional medicine doctor Mark Hyman, MD is passionate about brain health, too. He talks about it a lot in his books, specifically focusing on how food can benefit brain health both in the immediate and long-term. And this week, he revealed his number one favorite brain-boosting food on Instagram. Can you guess what it is? Fish!

“Seafood is one of the best dietary sources of protein around, and it’s chock-full of nutrients like iodine, selenium, vitamin D, and B12,” Dr. Hyman wrote in the caption of his post. “But the biggest health benefits of fish comes from the two omega-3 fatty acids that we get from them and nowhere else.” He adds that these polyunsaturated fats—specifically DHA and EPA—are strongly linked to benefitting both the heart and the brain.  (Love a multitasking food.) “Large studies have found that omega-3 fats also protect you from type 2 diabetes, inflammation, autoimmune disease, and even depression,” Dr. Hyman adds.

Of course, there’s a lot of fish in the, er, sea so the next question becomes what type of fish to buy. Dr. Hyman’s favorites are sardines, anchovies, mackerel, herring, rainbow trout, and wild salmon—all of which have the highest amounts of DHA and EPA. He recommends minimizing the amount of tuna, swordfish, king mackerel, catfish, Chilean sea bass, and tilefish you consume because they tend to be higher in mercury.

It’s also important to consider sustainability when shopping for fish, and there are some helpful labels that can help. The main one to look for is the Marine Stewardship Council, which takes into account codes and guidelines provided by the UN Food and Agriculture Organization (FAO), ISEAL, and the Global Sustainable Seafood Initiative (GSSI). These standards require fisheries to combat overfishing, have a minimal impact on the environment, and other requirements.

Even if you’re not going grocery shopping as often, you can still stock up on brain-healthy fish by buying frozen seafood, which will last longer and also tends to be less expensive. “Fish can be even more nutritious when frozen,” registered dietitian Tracy Lockwood Beckerman, RD previously told Well+Good. This is because it’s typically frozen almost as soon as it’s caught, which preserves nutrients at their peak.

Will taking fish oil supplements give you the same benefits as eating seafood? Watch the video below to find out:



So next time you’re at the grocery store and want to fill your cart with something you know will benefit your brain, you know what to do: go fish.

Oh hi! You look like someone who loves free workouts,

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medicine

Combining Mixed Reality Tech With Brain Signals Could Improve Rehabilitative Medicine

A new headset and software platform allows researchers and developers of mixed reality programs the opportunity to incorporate signals from the brain and body into their technology, something that has wide potential for use in rehabilitative medicine.

Virtual and augmented reality has already been used to treat patients with a range of psychiatric disorders including ADHD, PTSD and anxiety, but this tech could help improve how effective it is.

“You can use virtual reality to put people into those environments and throttle how intense the experience is, but if you could know how intense the reaction is that someone is having, you can decide whether to dial it up a little bit, or dial it down a little bit just to make sure that they’re not overwhelmed by the immersion,” says Conor Russomanno, CEO of OpenBCI, a Brooklyn-based startup that developed the Galea headset.

Another application of the technology, is to give people with spinal injuries or other forms of paralysis more freedom and to allow those who have lost limbs the ability to better control prosthetics.

There are different types of brain-computer interfaces and many involve actually implanting electrodes into the brain or spinal cord to either give people the ability to control a computer, or an artificial limb. However, the OpenBCI technology relies on external, non-invasive electroencephalogram readings to monitor brain activity (taken from sensors on a cap).

“The amount of control and the fidelity you have, obviously increases with the signal quality, and the best signal quality you’re going to get is by putting electrodes down into the brain,” says Russomanno.

“But, a lot of the magic happens in the classification and the machine learning on a case on a person by person basis. And so, this is where I think that BCI technology is going to be used for personalizing control.”

There are of course big attractions to the non-invasive nature of this technology. If the artificial intelligence and machine learning side of the software can make up for the reduced signal then it has great potential to help people in need of this technology.

Russomanno set up OpenBCI with one of his professors after leaving grad school 6 years ago. The company is unusual in that it has been developing inexpensive, non-invasive, open source brain-computer interface technology for the last 6 years.

It’s unusual as most tech companies keep the technology behind their products under high levels of secrecy. “I think it’s super important that that innovation takes place in the public domain, in a way where people have a variety of backgrounds and disciplines can contribute,” emphasizes Russomanno.

“It doesn’t take place behind closed doors where the incentives of what’s being put into the world, and what’s being used by the users, can be misaligned with the best interest of the users themselves.”

Since the company started, many tech companies and researchers have used the OpenBCI tech to develop

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medicine

Scientists identify brain cells that help drive bodily reaction to fear, anxiety — ScienceDaily

Strong emotions such as fear and anxiety tend to be accompanied and reinforced by measurable bodily changes including increased blood pressure, heart rate and respiration, and dilation of the eyes’ pupils. These so-called “physiological arousal responses” are often abnormally high or low in psychiatric illnesses such as anxiety disorders and depression. Now scientists at the UNC School of Medicine have identified a population of brain cells whose activity appears to drive such arousal responses.

The scientists, whose study is published in Cell Reports, found that artificially forcing the activity of these brain cells in mice produced an arousal response in the form of dilated pupils and faster heart rate, and worsened anxiety-like behaviors.

The finding helps illuminate the neural roots of emotions, and point to the possibility that the human-brain counterpart of the newly identified population of arousal-related neurons might be a target of future treatments for anxiety disorders and other illnesses involving abnormal arousal responses.

“Focusing on arousal responses might offer a new way to intervene in psychiatric disorders,” said first author Jose Rodríguez-Romaguera, PhD, assistant professor in the UNC Department of Psychiatry and member of the UNC Neuroscience Center, and co-director of the Carolina Stress Initiative at the UNC School of Medicine.

Rodríguez-Romaguera and co-first author Randall Ung, PhD, an MD-PhD student and adjunct assistant professor in the Department of Psychiatry, led this study when they were members of the UNC laboratory of Garret Stuber, PhD, who is now at the University of Washington.

“This work not only identifies a new population of neurons implicated in arousal and anxiety, but also opens the door for future experiments to systematically examine how molecularly defined cell types contribute to complex emotional and physiological states,” Stuber said. “This will be critical going forward for developing new treatments for neuropsychiatric disorders.”

Anxiety disorders, depression, and other disorders featuring abnormally high or low arousal responses affect a large fraction of the human population, including tens of millions of adults in the United States alone. Treatments may alleviate symptoms, but many have adverse side effects, and the root causes of these disorders generally remain obscure.

Untangling these roots amid the complexity of the brain has been an enormous challenge, one that laboratory technology has only recently begun to surmount.

Rodríguez-Romaguera, Ung, Stuber and colleagues examined a brain region within the amygdala called the BNST (bed nucleus of the stria terminalis), which has been linked in prior research to fear and anxiety-like behaviors in mice.

Increasingly, scientists view this region as a promising target for future psychiatric drugs. In this case, the researchers zeroed in on a set of BNST neurons that express a neurotransmitter gene, Pnoc, known to be linked to pain sensitivity and more recently to motivation.

The team used a relatively new technique called two-photon microscopy to directly image BNST Pnoc neurons in the brains of mice while the mice were presented with noxious or appealing odors — stimuli that reliably induce fear/anxiety and reward behaviors, respectively, along with the appropriate

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medicine

CereHealth’s Novel SPECT-Analysis Approach to Reveal Brain Abnormalities Validated in Exploration of Medicine Special Issue

DENVER, Nov. 10, 2020 /PRNewswire/ — CereHealth Corporation’s unique approach to analyzing single photon emission computed tomography (SPECT) imaging to reveal brain perfusion abnormalities in neurodegenerative diseases like Alzheimer’s was validated in a manuscript “Going Against the Norm: Validation of a Novel Alternative to Brain SPECT Normative Datasets that was recently published in Exploration of Medicine.  Historically, quantification has been dependent on comparisons to groups of healthy individuals, but the manuscript instead explored comparisons to a population template, derived from more than 2,000 clinical patient scans in CereHealth’s database. Validation by three testing methods demonstrated that the population template was noninferior to a group of 90 controls despite inclusion of abnormal scans.

CereHealth’s Senior Medical Imaging Engineer Lindsay Quandt, MS, MBA was the lead author of the published manuscript, which was co-authored by Cyrus Raji, MD, PhD of the Mallinckrodt Institute of Radiology at Washington University in St. Louis. 

The SPECT approach was first developed for CereHealth’s FDA-cleared CereMetrix® software that uses the population template to measure perfusion levels in SPECT scans. This method is unique to CereHealth’s software application and relies on the company’s proprietary, dynamic database. Defense of their methodology was an integral component of their FDA 510(k) filing and subsequent clearance of the software under the agency’s medical device guidelines in 2018.

“Encouraged by our successful discussions with the FDA, our objective in the manuscript was to share CereHealth’s novel methods with the broader scientific and medical communities to demonstrate the capabilities and performance of our CereMetrix® platform,” said John Kelley, CEO of CereHealth Corporation.

The article is available through Exploration of Medicine, a peer-reviewed, open access online journal promoting articles that provide substantial and novel insights into medicine.  Its special issue, guest edited by Dr. Rhoda Au of Boston University, sought papers that featured technological advances that help fill the gaps in fully characterizing Alzheimer’s Disease across the entire life course path. The journal encourages originality, well-designed experiments, and rigorous data in its content and performed an in-depth review during its selection of the paper.

A complete copy of the manuscript may be accessed at  A New Frontier for Medicine

About CereHealth Corporation
CereHealth is a data analytics technology company that provides Medical Analytics as a Service, enabling medical providers, research scientists and others serving the healthcare community to quickly make more-informed decisions regarding patient-specific treatments to improve outcomes and patients’ quality of life.

CereHealth’s browser-based platforms offer enhanced insights not previously available and were developed with future artificial intelligence (AI) capabilities in mind. Drawing on a growing database these insights can enable greater diagnosis and treatment accuracy, thereby improving patient outcomes and reducing healthcare costs.

Let us show you how you can transform your radiological or clinical practice by registering for a live demonstration of our software, tailored to your particular needs, at https://ceremetrix.io/request-a-demo/

For Information Contact:
CereHealth Corporation
John Kelley
CEO
+1-720-259-1875
[email protected] 
www.cerescan.com
https://ceremetrix.io/
 

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Maradona Undergoes Successful Brain Surgery On Blood Clot

Argentine football great Diego Maradona underwent successful brain surgery for a blood clot in a specialist private clinic in Buenos Aires on Tuesday, his doctor said.

“We managed to successfully remove the clot. Diego coped well with the surgery,” Leopoldo Luque said at the icon’s private clinic in the capital Buenos Aires.

“It’s under control, there’s a little drainage (of blood). He’ll remain under observation.”

World Cup winner Maradona had been taken to hospital in La Plata — where he is the coach of top flight side Gimnasia y Esgrima — on Monday for a series of tests after feeling unwell.

Diego Maradona (pictured September 2020) was hospitalized in Argentina, but his doctor ruled out any link to the coronavirus Diego Maradona (pictured September 2020) was hospitalized in Argentina, but his doctor ruled out any link to the coronavirus Photo: Gimnasia y Esgrima La Plata / Eva PARDO

A scan revealed the blood clot, and on Tuesday he was transfered to the specialist clinic in a northern neighborhood of the capital.

Maradona, who turned 60 on Friday, has suffered ill health before. He has survived two heart attacks, and also contracted hepatitis and undergone gastric bypass surgery.

Groups of fans congregated outside the clinic with banners showing Maradona’s face and the words “Come on, Diego!”

“I came with my wife to support the greatest player of all time,” fan Oscar Medina told AFP.

“Once more his health has played a trick on him but he has antibodies to recover with the help of the people,” added Medina.

Fans of Gimnasia y Esgrima hung flags of Diego Maradona outside the clinic in La Plata, where the club is based and the football star was receiving treatment Fans of Gimnasia y Esgrima hung flags of Diego Maradona outside the clinic in La Plata, where the club is based and the football star was receiving treatment Photo: AFP / JUAN MABROMATA

“I feel very sad and impotent but we’re going to stay by his side until the last day,” said another fan, Matias Di Sciosio.

Earlier on Tuesday, Luque insisted it was “a routine operation” and that Maradona was “lucid” and “calm.”

Argentine media speculated the clot was the result of a blow to the head.

Luque said the clot was “imperceptible” and that those suffering from one rarely remembered receiving a knock to the head.

Diego Maradona's personal doctor Leopoldo Luque said the football great was 'very weak, very tired' Diego Maradona’s personal doctor Leopoldo Luque said the football great was ‘very weak, very tired’ Photo: AFP / JUAN MABROMATA

“The operation consists of a small incision to drain the blood. In 24 or 48 hours the patient can leave the hospital,” neurosurgeon Raul Matera told TyC Sports channel.

Maradona was transferred from the hospital in La Plata, 60 kilometers (37 miles) south of Buenos Aires, to the capital at 6:00 pm (2100 GMT) accompanied by one of his daughters, Giannina.

Dozens of Gimnasia fans outside the La Plata hospital chanted his name as he left.

Profile of Diego Maradona who turned 60 on October 30. Profile of Diego Maradona who turned 60 on October 30. Photo: AFP / Anella RETA

Earlier in the day, Luque claimed Maradona was feeling “much better and eager to leave” hospital but insisted that the Gimnasia Y Esgrima coach was suffering from anemia — a lack of iron in his system — and dehydration.

Luque said it has

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Poverty affects brain development, cognitive performance in children, study finds

Nov. 3 (UPI) — Children living in poor neighborhoods don’t perform as well on cognitive function tests and have lower “brain volume” compared to those who reside in higher-income areas, an analysis published Tuesday by JAMA Network Open found.

Increased household income was associated with improved vocabulary, reading skills and memory, among other skills, the researchers said.

These differences were likely attributable to the fact that children in these settings had more developed prefrontal and hippocampal brain regions, they said.

The prefrontal cortex has been linked with behavior, personality and decision making, among other functions, while the hippocampus is believed to be involved in learning and memory skills, according to the researchers.

“This study found evidence for independent associations of household and neighborhood environment with brain and cognitive outcomes in preadolescent children,” the researchers, from Washington University in St. Louis, wrote.

“The study also provided evidence consistent with a pathway wherein variation in prefrontal and hippocampal volume partially explains the association between neighborhood poverty and scores on cognitive tests,” they said.

Earlier research has linked socioeconomic status with brain development and academic performance, according to the researchers.

However, much of this research has focused on the impact of the socioeconomic status of individual households and families on child development, rather than the effects of living in poorer neighborhoods, they said.

“Typically, studies of socioeconomic status and the brain focus on household characteristics,” researchers Bruce Ramphal told UPI. “This study shows … that neighborhood- and household-level socioeconomic factors are uniquely related to the structure of brain regions.”

Ramphal was not part of the JAMA study published Tuesday but has devoted much of his research work to related subjects.

“These findings … [suggest] that equitable child development may be best supported by intervention both at the household and neighborhood levels,” said Ramphal, a research assistant at Columbia University and the New York State Psychiatric Institute.

For this study, the Washington University researchers analyzed the cognitive performance and brain development of 11,875 9- and 10-year-old children.

Cognitive performance was assessed using an approach created by the National Institutes of Health to measure verbal ability, attention, executive functioning, working memory, brain processing speed, episodic memory and reading ability, the researchers said.

Brain development was measured using 3T magnetic resonance imaging, a more powerful version of MRI designed to provide highly detailed images, they said.

Household socioeconomic status was measured using both household income and the Parent-Reported Financial Adversity Questionnaire, which is used to determine “whether families generally have enough money to pay for basic life expenses, such as food and healthcare,” according to the researchers.

Using the addresses of study participants, the researchers identified those living in neighborhoods with higher poverty levels.

Children living in lower-income households and in poorer neighborhoods generally performed less well on cognitive function tests than those living in wealthier areas, the researchers said.

MRI scans of the children in the study also revealed less development in the prefontal cortex and hippocampus in the brains of those living in poorer

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Study: AI boosts accuracy of CT angiography in spotting brain aneurysms

Nov. 3 (UPI) — Artificial intelligence systems that use deep learning could help doctors detect cerebral aneurysms on CT angiography, according to a study published Tuesday by the journal Radiology.

The algorithm identified about 98% of cerebral aneurysms — also called brain aneurysms — and found eight new aneurysms that were overlooked on the initial assessment, the researchers said.

“The role of this deep-learning system, which has been trained to recognize aneurysms, is to give suggestions to the human reader to improve their performance and reduce mistakes,” study co-author Xi Long said in a statement.

“The combined work of the human reader and computer system improves the diagnostic accuracy for the patient’s sake,” said Long, a professor of radiology at Tongji Medical College’s Union Hospital in Wuhan, China.

A cerebral aneurysm is a weak or thin spot on an artery in the brain that balloons or bulges out and fills with blood, putting pressure on the nerves or brain tissue, according to the U.S. National Institute of Neurological Disorders and Stroke.

These aneurysms can burst or rupture, leaking blood into the surrounding tissue, causing a life-threatening hemorrhage, the institute said.

Detection of these aneurysms is critical, and CT angiography — or computed tomography angiogram, a test that uses X-rays to provide detailed pictures of the brain and the blood vessels that go to it — is usually the first choice for this process, Long and his colleagues said.

CT angiography is highly accurate, but cerebral aneurysms can be overlooked on the initial assessment due to their small size and the complexity of the blood vessels in the brain, they said.

For this study, the researchers developed a fully automated, highly sensitive algorithm for the detection of cerebral aneurysms on CT angiography images.

In their approach, the deep learning system is trained on existing images and learns to recognize abnormalities that can be difficult for a human observer to see.

The researchers used CT angiograms from more than 500 patients to train the deep learning system, and then they tested it on another 534 CT angiograms that included 649 aneurysms.

The algorithm detected 633 of the 649 cerebral aneurysms for a sensitivity of 97.5%, the data showed.

The results suggest that the deep learning algorithm has potential as a supportive tool for detecting cerebral aneurysms, as well as a potential to be used clinically for a second opinion during interpretation of CT angiography images, according to the researchers.

Still, it can miss very small aneurysms or aneurysms located close to similar density structures like bones. The method also also suffers from false positive results, meaning that it mistakenly identifies structures similar to aneurysms as aneurysms, they said.

“Simply put, the deep-learning system is intended to assist human readers, not to replace them,” Long said.

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Does Hard Work Help Preserve the Brain? | Health News

By Cara Murez, HealthDay Reporter

(HealthDay)

MONDAY, NOV 2, 2020 (HealthDay News) — Physical activity is known to help prevent dementia and disease, but it’s possible that the kind you do makes a difference.

A new study found that hard physical work not only doesn’t lower the risk of dementia, it increases the risk of developing the disease.

Researchers found that people who do hard physical work have a 55 percent higher risk of developing dementia than those doing sedentary work.

“The WHO [World Health Organization] guide to preventing dementia and disease on the whole mentions physical activity as an important factor. But our study suggests that it must be a ‘good’ form of physical activity, which hard physical work is not,” said researcher Kirsten Nabe-Nielsen, an associate professor from the Department of Public Health at the University of Copenhagen. “Guides from the health authorities should therefore differentiate between physical activity in your spare time and physical activity at work, as there is reason to believe that the two forms of physical activity have opposite effects.”

Another study from the University of Copenhagen recently showed that a healthy lifestyle can halve the risk of developing dementia.

Researchers from the University of Copenhagen and the National Research Centre for the Working Environment used data from the Copenhagen Male Study, in which 4,721 Danish men reported in the 1970s about the type of work they did for 14 Copenhagen-based companies. Over the years, researchers compiled health data on the respondents.

Now, researchers are collecting more data with the intent to identify healthier ways of doing hard physical work in a way that it has an “exercise effect.”

“A lot of workplaces have already taken steps to improve the health of their staff. The problem is that it is the most well-educated and resourceful part of the population that uses these initiatives. Those with a shorter education often struggle with overweight, pain and poor physical fitness, even though they take more steps during the day and to a larger extent use their body as a tool,” said study co-author Andreas Holtermann, from the National Research Centre for the Working Environment.

“For workmen, it is not enough, for example, to avoid heavy lifts if they wish to remain in the profession until age 70. People with a shorter education doing manual labour also need to take preventive steps by strengthening the body’s capacity via, for example, exercise and strength training,” Holtermann said in a university news release.

The research was published recently in the Scandinavian Journal of Medicine and Science in Sports.

SOURCE: University of Copenhagen, Faculty of Health and Medical Sciences, news release, Oct. 26, 2020

Copyright © 2020 HealthDay. All rights reserved.

Source Article

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American Brain Tumor Association Awards 11 Research Grants to Advance Brain Tumor Research

American Brain Tumor Association Awards 11 Research Grants to Advance Brain Tumor Research

PR Newswire

CHICAGO, Oct. 30, 2020

CHICAGO, Oct. 30, 2020 /PRNewswire/ — As the nation’s first nonprofit organization committed to funding brain tumor research and providing education and information across all tumor types, the American Brain Tumor Association (ABTA) persists in its mission, announcing today the investment of $368,000 towards 11 new research grants to foster innovation in diagnosis and treatment of brain tumors in adults and children.

American Brain Tumor Association
American Brain Tumor Association

The ABTA’s grant program plays an integral role in advancing the understanding and treatment of brain tumors. Dedicated to investing in early-stage investigators who have unique perspectives to drive the future of brain tumor science and treatment, the ABTA provides research grants to medical students, post-doctoral fellows, and early-career faculty. This investment is even more critical with the COVID-19 pandemic shifting research priorities and impacting government funding for brain tumor research.

“We are excited to continue our legacy of supporting innovative research and early-career researchers, especially during this challenging time. With almost $33 million invested to date, the ABTA is committed to funding the research that will one day lead to cures,” said Nicole Willmarth, Ph.D., chief mission officer, ABTA.

With the Southeastern Brain Tumor Foundation (SBTF) investing more than $100,000 to support three research projects, the ongoing partnership between the ABTA and SBTF exemplifies the strengths of the ABTA’s rigorous grant selection process and accelerates the research investments of both organizations.

“The vast potential of the new projects we fund and the incredible efforts by the researchers, renews my optimism that better treatments are on the horizon. Our collaborations with organizations, like SBTF, amplify our ability to achieve our common goal of improving outcomes for brain tumor patients,” said Nicole Willmarth.

This year’s slate of research investigates critical areas in neuro-oncology research including experimental therapeutics, the role of the immune system and immunotherapies, as well as factors that modify gene function in brain tumor cells.

The ABTA congratulates the 2020 grant recipients listed below. To learn more about the grant recipients and their research projects, visit https://www.abta.org/research/research-funding-impact/.

Basic Research Fellowships are two-year, $100,000 grants awarded to post-doctoral fellows who are mentored by established and nationally-recognized experts in the neuro-oncology field.

  • Emily Darrow, Ph.D., St. Jude Children’s Research Hospital

  • Tyler Miller, M.D., Ph.D., Massachusetts General Hospital

Discovery Grants are one-year, $50,000 grants supporting cutting-edge, innovative approaches that have the potential to change current diagnostic or treatment standards of care for either adult or pediatric brain tumors.

  • Munjal Acharya, Ph.D., University of California, Irvine

  • Lan Hoang-Minh, Ph.D., University of Florida

  • Gary Kohanbash, Ph.D., Children’s Hospital of Pittsburgh

Medical Student Summer Fellowships are $3,000 grants awarded to medical students to conduct brain tumor research projects under the guidance of neuro-oncology experts. Through these grants, the ABTA seeks to encourage physician-scientists to enter and remain in the brain tumor field.

  • Hasan Alrefai, B.S., University of Alabama at

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SRS Instead of WBRT for Patients With Multiple Brain Metastases

Stereotactic radiosurgery (SRS) should replace whole-brain radiotherapy (WBRT) as the new standard of care for patients with four or more brain metastases, say researchers who report results from a randomized trial conducted in patients with four to 15 brain metastases

“SRS was associated with reduced risk of neurocognitive deterioration compared to WBRT, as demonstrated by a constellation of neurocognitive tests, individually or by composite scores,” said lead author Jing Li, MD, PhD, associate professor of radiation oncology and codirector of the Brain Metastasis Clinic at the University of Texas MD Anderson Cancer Center, Houston.

He was speaking at the American Society for Radiation Oncology (ASTRO) 2020 Annual Meeting, which was held online this year because of the COVID pandemic.

“The results from this phase 3 randomized trial strongly support the use of SRS in patients with four to 15 brain metastases to better preserve cognitive function and to minimize interruption of systemic therapy, without compromising overall survival,” said Li.

SRS is already the standard of care for patients with one to three brain metastases. Two previous phase 3 randomized trials showed that SRS was better at preserving cognitive function without compromising overall survival in comparison to WBRT.

However, there has been some controversy over the use of SRS for patients with multiple brain metastases, commented study discussant Sue S. Yom, MD, PhD, a professor in the Departments of Radiation Oncology and Otolaryngology–Head and Neck Surgery, University of California, San Francisco.

This study has shown “in a practice-changing manner that giving SRS can improve the quality of life of patients with metastatic disease,” she said.

Up to 30% of cancer patients develop brain metastases. Historically, these have been associated with poor overall survival, in the range of 1 to 4 months.

Reduces Cognitive Decline

The new trial involved 72 patients with four to 15 untreated, nonmelanoma brain metastases (up to 20 lesions were allowed at the time of treatment); the median number of brain metastases was eight. Most (83%) of the trial participants were White, nearly half were aged 60 years or older, and 58% were women.

Patients were randomly assigned to receive either SRS (15–24 Gy per Radiation Therapy Oncology Group protocol 9005) or WBRT (30 Gy in 10 fractions). On the basis of previous research, 62% of patients in the WBRT arm were also given memantine, a dementia drug that can help preserve cognitive function.

All participants completed neurocognitive testing, including testing of learning, memory, attention span, executive function, verbal fluency, processing speed, and motor dexterity, at enrollment and longitudinally.

The primary endpoints were Hopkins Verbal Learning Test – Revised Total Recall (HVLT-R TR) score and local control at 4 months. Secondary endpoints included overall survival, distant brain failure, toxicity, and time to initiation of systemic therapy.

In the primary endpoint analysis, at 4 months, the HVLT-R TR standardized z-score increased by +0.21 (standard error [SE], 0.27) for patients who received SRS, but it declined by –0.74 (SE, 0.36) for WBRT-treated patients (P = .041). On the basis

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