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Protecting the brain from disease and injury: Simple and simpler look better and better

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Los Angeles Times Staff Writer

The holy grail in neurology research is to find the agent -- a drug, nutritional ingredient, a habit or lifestyle -- that will reliably protect the brain against a wide range of insults that lie in wait as we age: strokes, traumatic brain injury or neurodegenerative diseases such as multiple sclerosis, Alzheimer’s, Parkinson’s or Lou Gehrig’s disease.

The quest for such “neuro-protection” has left a littered trail of failures. But scientists keep hunting, because they suspect that there must be some common mechanism at work in all these brain conditions. If there is, then perhaps a single therapy could fortify our brains against the initial assault of disease or injury, or prevent the cascade of degeneration that follows.

A pair of recent articles look at two readily accessible candidates for the neuroprotection prize: the long-available antibiotic minocycline and an agent that’s been around even longer -- having a purpose in life.

Both look pretty good.

The latest issue of the Archives of General Psychiatry examines the effect of living a “purpose-oriented life” on an individual’s risk of developing just two brain conditions: Alzheimer’s disease and mild cognitive impairment, which often precedes development of full-blown AD.

Following a group of senior Chicago residents for four years, the Rush Memory and Aging Project (known for its many findings on the benefits of social and intellectual engagement in protecting against Alzheimer’s) found that participants who scored highest on having goals and objectives that give life meaning and direction were 2.4 times less likely to develop mild cognitive impairment or Alzheimer’s than those who scored lowest on that measure of psychological well-being.

“It may be time to ponder over the habit of setting goals and directions in life,” writes Dr. Yonas Geda of the Mayo Clinic’s departments of neurology and psychiatry, in the August issue of the Archives of Neurology, which reviewed the study for its audience. Dr. Geda acknowledges that it’s not yet known whether purposeful people have some brain attribute that makes them more impervious to diseases of memory or whether having a strong sense of purpose protects their brain. But “at an individual level, setting goals and deriving meaning from life’s experiences are not harmful behaviors,” he writes. And it just might help.

In an “Online First” article in the latest issue of the Archives of Neurology, a group of California researchers outlines more than a decade of research on the neuroprotective possibilities of minocycline -- an antibiotic and anti-inflammatory drug that is a relative of tetracycline. Administered to mice and rats, minocycline has had mixed results in halting progression of a wide range of brain diseases and the widening injury that follows stroke.

But early, and generally small, clinical trials in humans have shown some real promise -- in stroke, spinal cord injury, multiple sclerosis, Huntington’s disease and amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s). Early trials have shown no benefit in halting the progression of Parkinson’s. In animal and test-tube studies of Alzheimer’s, minocycline seemed to improve behavioral performance and drove down the die-off of brain cells.

But while minocycline has been around a long time and seems to have a long history of safe use, the prospect of its “neuro-protective” use could mean higher doses and longer use than has been seen before. And at some high doses, it’s been found to be toxic. So scientists agree this is a potential wonder drug for the brain that’s far from ready for prime time.

-- Melissa Healy / Los Angeles Times

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