6 ms·

Brain Sodium Linked to Cognitive Deficits in MS

45 points by Mz 10y ago

coldcode 10y ago
You can't read this without a username & pw.
- dvh 10y ago
  Click on the "web" link, that will get you to google, click on second article and you can read it without password.
  - 0xcde4c3db 10y ago
    Which outlet are you talking about? The second match for this on the "web" link for me is this HN story; the third and fourth are pages on newsblock.io and bioportfolio.com that don't have the full story, and after that there are just partial matches.
    - lstamour 10y ago
      I clicked the actual story, www.medscape.com/viewarticle/873803 from Google and it loaded for me, where before it showed just a login prompt.
      - Nomentatus 10y ago
        PMID: 27974643 https://www.ncbi.nlm.nih.gov/pubmed/27974643 https://www.ncbi.nlm.nih.gov/pubmed/27974643 or http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short http://www.neurology.org/content/early/2016/12/14/WNL.000000...
hprotagonist 10y ago
A better link -- abstract to the actual study. http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short http://www.neurology.org/content/early/2016/12/14/WNL.000000... I am thrilled whenever anyone includes ROC analysis in their studies.
- mhneu 10y ago
  Thanks for the link. ROC analysis is mostly useful for actual signal detection paradigms, like radar for which it was invented. It's generally not terribly useful as a statistical test, as tests like Kolmogorov-Smirnoff have much more power while remaining non parametric. And other descriptive statistics are usually more interpretable than ROC.
  - hprotagonist 10y ago
    Interesting. Thanks for pointing me to K-S -- non-parametric tests have their uses and I like to have as many dirty tricks as I can get. I have a signals and controls background, not really a stats one -- so ROC makes some intuitive sense to me. It's gained currency in the biomedical world, probably because so many of us come from EE backgrounds.
gubby 10y ago
For those Googling this to find out whether it's "too much" or "too little", here's a couple of quotes from the article: "A buildup of sodium in the brain detected by magnetic resonance imaging (MRI) may be a biomarker for the degeneration of nerve cells that occurs in patients with multiple sclerosis (MS)" and "In the early-stage RRMS patients, sodium MRI revealed abnormally high concentrations of sodium in specific brain regions (...). In the advanced-stage RRMS patients, abnormally high sodium accumulation was widespread throughout the whole brain, including normal appearing brain tissue." (RR = Relapsing Remitting)
- raverbashing 10y ago
  What would be interesting to note is how is this accumulating (that is, in which form) Is there some process that's causing the formation of an insoluble salt or other insoluble substance containing sodium? Or does this has to do with some misregulation of some process? Did they try dietary sodium restriction to see if it had an impact?
fencepost 10y ago
Based on the abstract, right now all they're saying is that there's a correlation in a study of less than 60 patients. That's going to lead to some significant additional studies, but anything definitive out of those is going to take time since part of what's being studied is slowly-increasing cognitive deficit. Size-wise, it's probably comparable to the significance of the studies a few years back showing that intestinal parasites (whipworms/helminths) are strongly correlated with reduced MS symptoms and relapses - last I heard there are ongoing studies in that area as well, but I don't know that I'd advocate going and getting wormy. Among the studies likely already in the starting phases: * Are similar accumulations and cognitive issues seen in non-MS study participants? Is this indicative of a wider-spread issue but happened to be noticed first in a population that's more actively studied? Does a college diet of ramen, canned goods and frozen pizza make you stupid? * Does a low-sodium diet impact the accumulation of sodium in brain tissues in patients with MS? Test participants generally? I'd expect preliminary work on this to happen by recruiting people already on medically-mandated low sodium diets, but a better-controlled study would take years. * Are there practices or treatments that are effective at lowering the sodium load in brain tissue, or is what's there basically "locked in" in a format that's semi-permanent? Using another reactive metal as an example, is this the equivalent of calcium chloride that washes away or is this blobs of cement mucking things up? * (half joking) Are intestinal parasites correlated with lowered sodium in the brain? That's not to say it's a bad idea to reduce sodium intake, because reducing sodium is almost certainly great for your health not just because of lower sodium but because that reduction is probably accomplished in part by switching from highly-processed foods preserved with salt to fresher foods.
- kevinalexbrown 10y ago
  > right now all they're saying is that there's a correlation in a study of less than 60 patients Sort-of. Many recent studies had already suggested a role of sodium accumulation in brain tissue loss in MS. Previous work had also shown significant sodium accumulation in regions where there was no apparent cell death, suggesting that cell-death does not drive measured sodium concentrations. What's cool about this result is 1) that sodium measurements from the brain are better indicators of cognitive defects than actual death of brain cells. 2) Abnormal sodium accumulation occurred in neocortex, which is the first place you'd suspect cognitive impairment to originate. That's a correlation across patients, and brain areas, suggesting at the least that NaMRI is a good tool for early MS detection. I doubt it's dietary sodium. Likely, sodium accumulation occurs when normal processes are disrupted. I wouldn't expect increased sodium in your diet to lead directly to increased sodium in selective areas of the brain (could be wrong here).
Nomentatus 10y ago
Note that POTS/dysautonomia due to poor brain perfusion (not enough blood flow in the brain) is extremely frequent in Ehlers-Danlos Syndrome and is treated and self-treated by very high salt intake (sodium) - and that those with Ehlers-Danlos Syndrome appear to have ten times the rate of MS than the general population. This leads to the obvious suggestion that excess sodium in the brain may be a proxy for poor brain perfusion, which of course profoundly affects cognition! If you want to increase brain perfusion, for whatever reason, mixing concentrace (sea salt with the sodium removed) and potassium chloride are better choices or should also be taken along with sodium chloride. "Ehlers-Danlos syndrome and multiple sclerosis: a possible association." https://www.ncbi.nlm.nih.gov/pubmed/18208891 https://www.ncbi.nlm.nih.gov/pubmed/18208891

45 points by Mz 10y ago

coldcode 10y ago

You can't read this without a username & pw.

dvh 10y ago
Click on the "web" link, that will get you to google, click on second article and you can read it without password.
- 0xcde4c3db 10y ago
  Which outlet are you talking about? The second match for this on the "web" link for me is this HN story; the third and fourth are pages on newsblock.io and bioportfolio.com that don't have the full story, and after that there are just partial matches.
  - lstamour 10y ago
    I clicked the actual story, www.medscape.com/viewarticle/873803 from Google and it loaded for me, where before it showed just a login prompt.
    - Nomentatus 10y ago
      PMID: 27974643 https://www.ncbi.nlm.nih.gov/pubmed/27974643 https://www.ncbi.nlm.nih.gov/pubmed/27974643 or http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short http://www.neurology.org/content/early/2016/12/14/WNL.000000...

hprotagonist 10y ago

A better link -- abstract to the actual study. http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short http://www.neurology.org/content/early/2016/12/14/WNL.000000... I am thrilled whenever anyone includes ROC analysis in their studies.

mhneu 10y ago
Thanks for the link. ROC analysis is mostly useful for actual signal detection paradigms, like radar for which it was invented. It's generally not terribly useful as a statistical test, as tests like Kolmogorov-Smirnoff have much more power while remaining non parametric. And other descriptive statistics are usually more interpretable than ROC.
- hprotagonist 10y ago
  Interesting. Thanks for pointing me to K-S -- non-parametric tests have their uses and I like to have as many dirty tricks as I can get. I have a signals and controls background, not really a stats one -- so ROC makes some intuitive sense to me. It's gained currency in the biomedical world, probably because so many of us come from EE backgrounds.

gubby 10y ago

For those Googling this to find out whether it's "too much" or "too little", here's a couple of quotes from the article: "A buildup of sodium in the brain detected by magnetic resonance imaging (MRI) may be a biomarker for the degeneration of nerve cells that occurs in patients with multiple sclerosis (MS)" and "In the early-stage RRMS patients, sodium MRI revealed abnormally high concentrations of sodium in specific brain regions (...). In the advanced-stage RRMS patients, abnormally high sodium accumulation was widespread throughout the whole brain, including normal appearing brain tissue." (RR = Relapsing Remitting)

raverbashing 10y ago
What would be interesting to note is how is this accumulating (that is, in which form) Is there some process that's causing the formation of an insoluble salt or other insoluble substance containing sodium? Or does this has to do with some misregulation of some process? Did they try dietary sodium restriction to see if it had an impact?

fencepost 10y ago

Based on the abstract, right now all they're saying is that there's a correlation in a study of less than 60 patients. That's going to lead to some significant additional studies, but anything definitive out of those is going to take time since part of what's being studied is slowly-increasing cognitive deficit. Size-wise, it's probably comparable to the significance of the studies a few years back showing that intestinal parasites (whipworms/helminths) are strongly correlated with reduced MS symptoms and relapses - last I heard there are ongoing studies in that area as well, but I don't know that I'd advocate going and getting wormy. Among the studies likely already in the starting phases: * Are similar accumulations and cognitive issues seen in non-MS study participants? Is this indicative of a wider-spread issue but happened to be noticed first in a population that's more actively studied? Does a college diet of ramen, canned goods and frozen pizza make you stupid? * Does a low-sodium diet impact the accumulation of sodium in brain tissues in patients with MS? Test participants generally? I'd expect preliminary work on this to happen by recruiting people already on medically-mandated low sodium diets, but a better-controlled study would take years. * Are there practices or treatments that are effective at lowering the sodium load in brain tissue, or is what's there basically "locked in" in a format that's semi-permanent? Using another reactive metal as an example, is this the equivalent of calcium chloride that washes away or is this blobs of cement mucking things up? * (half joking) Are intestinal parasites correlated with lowered sodium in the brain? That's not to say it's a bad idea to reduce sodium intake, because reducing sodium is almost certainly great for your health not just because of lower sodium but because that reduction is probably accomplished in part by switching from highly-processed foods preserved with salt to fresher foods.

kevinalexbrown 10y ago
> right now all they're saying is that there's a correlation in a study of less than 60 patients Sort-of. Many recent studies had already suggested a role of sodium accumulation in brain tissue loss in MS. Previous work had also shown significant sodium accumulation in regions where there was no apparent cell death, suggesting that cell-death does not drive measured sodium concentrations. What's cool about this result is 1) that sodium measurements from the brain are better indicators of cognitive defects than actual death of brain cells. 2) Abnormal sodium accumulation occurred in neocortex, which is the first place you'd suspect cognitive impairment to originate. That's a correlation across patients, and brain areas, suggesting at the least that NaMRI is a good tool for early MS detection. I doubt it's dietary sodium. Likely, sodium accumulation occurs when normal processes are disrupted. I wouldn't expect increased sodium in your diet to lead directly to increased sodium in selective areas of the brain (could be wrong here).

Nomentatus 10y ago

Note that POTS/dysautonomia due to poor brain perfusion (not enough blood flow in the brain) is extremely frequent in Ehlers-Danlos Syndrome and is treated and self-treated by very high salt intake (sodium) - and that those with Ehlers-Danlos Syndrome appear to have ten times the rate of MS than the general population. This leads to the obvious suggestion that excess sodium in the brain may be a proxy for poor brain perfusion, which of course profoundly affects cognition! If you want to increase brain perfusion, for whatever reason, mixing concentrace (sea salt with the sodium removed) and potassium chloride are better choices or should also be taken along with sodium chloride. "Ehlers-Danlos syndrome and multiple sclerosis: a possible association." https://www.ncbi.nlm.nih.gov/pubmed/18208891 https://www.ncbi.nlm.nih.gov/pubmed/18208891