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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! In advance of its annual meeting next week, the American Academy of Neurology released some of the studies scheduled for presentation. We share findings from two of them: one showing it might be possible to delay the onset of multiple sclerosis symptoms, and another suggesting that a minimally invasive cardiac procedure might help prevent dementia in patients at risk for it due to a heart rhythm disorder. (To track the meeting on social media, use the hashtag #AANAM.) We also report on a study that suggests teens and young adults who undergo weight loss surgery should pay attention to bone health afterward.

In breaking news, see these stories from our Reuters journalists: One-drug medication abortion with misoprostol grows in U.S.; Biden’s COVID vaccine rule for federal contractors was valid, U.S. court rules; and World Health Organization urges Sudan combatants to open humanitarian corridor for medics.

Shown here are microscopic slides of human brain from the Multiple Sclerosis and Parkinson’s UK Tissue Bank. Researchers are looking for ways to delay the onset of multiple sclerosis in asymptomatic people who have detectable warning signs.  REUTERS/Neil Hall.

When early warning signs of multiple sclerosis (MS) are evident on brain scans, treatment with Sanofi’s Aubagio (teriflunomide) may delay onset of symptoms of the crippling disease, a small trial suggests.

Aubagio is currently approved for treating the relapsing-remitting form of MS. Symptoms of MS may include fatigue, numbness, tingling or difficulty walking.

With magnetic resonance imaging (MRI) of the head being done more often for unrelated reasons, such as headache or head trauma, abnormalities in the brain or spinal cord that are often precursors of MS are increasingly being uncovered before symptoms develop. The presence of these lesions in asymptomatic individuals is called radiologically isolated syndrome.

“Many of these people go on to develop MS,” said Dr. Christine Lebrun Frenay of University Hospital of Nice in France, who led the study to be presented on Tuesday in Boston at the annual meeting of the American Academy of Neurology.

Her team randomly assigned 89 people with radiologically isolated syndrome to receive teriflunomide daily, or a placebo. Over the next two years, MS symptoms developed in eight people who took the drug and in 20 who took the placebo.

After adjusting for participants’ other risk factors, the researchers estimated that the Sanofi drug reduced the risk of symptom onset by 72%.

“Our findings suggest that early intervention with teriflunomide may be beneficial to those diagnosed with radiologically isolated syndrome, the presymptomatic phase of MS,” Lebrun Frenay said in a statement, adding that the results must be confirmed with larger trials.

Biogen and Roche are also testing their MS drugs – Tecfidera (dimethyl fumarate) and Ocrevus (ocrelizumab), respectively – to see if they will delay disease onset in patients with radiologically isolated syndrome.

Tecfidera delayed the time before development of a first neurological symptom significantly more than placebo in an 87-patient trial, Biogen reported in December.

In a study of people with the heart rhythm disorder atrial fibrillation, those who underwent a minimally-invasive procedure to destroy some tissue in the heart had a lower risk of developing dementia than those who only received medication, researchers said on Tuesday.

“Previous studies have found that people with arrhythmias may have long-term thinking and memory problems due to how this condition may affect the blood flow to the brain,” study leader Dr. Bahadar Srichawla of University of Massachusetts Chan Medical School in Worcester said in a statement.

People with atrial fibrillation are also five times more like to suffer a stroke. 

The study, scheduled for presentation in Boston on Monday at the annual meeting of the American Academy of Neurology, involved 887 people over age 65, including 193 who chose to undergo catheter ablation, which uses radiofrequency to destroy heart tissue that may be causing the abnormal heartbeat without damaging the rest of the heart. Everyone in both groups also received medication, such as blood thinners and drugs to control heart rate or rhythm.

Taking into account patients’ other risk factors for dementia, those who underwent catheter ablation were 36% less likely to develop cognitive impairment over the next two years than those who did not undergo the procedure, the researchers found.

While the results are encouraging, Srichawla noted, many factors can affect the success of catheter ablation and need to be considered when discussing its risks and benefits for an individual patient.

Adolescents and young adults who undergo weight loss surgery to treat obesity should monitor their bone health afterward, researchers say.

In a study of 29 young people who underwent weight loss surgery and 30 similar participants with obesity who did not, they found the surgery group had lower bone strength and bone density one year later.

“Most of the change in bone strength was due to the significant weight loss, said Dr. Miriam Bredella of  Massachusetts General Hospital in Boston, who led the study published on Wednesday in the Journal of Bone and Mineral Research.

She explained that obesity puts extra weight on bones, stimulating bone formation, “which is the reason that individuals with obesity typically have stronger bones.”

Even after weight loss surgery, patients’ bone density and strength were still in the normal range. But “because the adolescent years are critical to build up bone and any process that interferes with this might have dire consequences later in life,” longer-term studies are needed to assess the effects of weight loss surgery after two years or more, Bredella said.

If there is too much bone loss, medication to increase bone density might be necessary, she said, adding that the benefits of weight loss surgery in young people with obesity still outweigh risk to bones.

“Obesity is a risk factor for heart disease and diabetes, non-alcoholic fatty liver disease, sleep apnea and many other diseases. Weight loss surgery has been shown to be very effective in treating these diseases, which can cause premature death,” she said.

This newsletter was edited by Bill Berkrot.

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