
Brain Sodium Linked to Cognitive Deficits in MS - Mz
http://www.medscape.com/viewarticle/873803
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fencepost
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
> 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).

~~~
fencepost
Argh, I completely blew past noting that what they weren't saying was that
sodium was the problem, that it was quite possible that the sodium buildup was
the result of other problems that were the problem. Thanks for clarifying.

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hprotagonist
A better link -- abstract to the actual study.

[http://www.neurology.org/content/early/2016/12/14/WNL.000000...](http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short)

I am thrilled whenever anyone includes ROC analysis in their studies.

~~~
mhneu
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
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.

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gubby
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
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?

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Nomentatus
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)

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

~~~
dvh
Click on the "web" link, that will get you to google, click on second article
and you can read it without password.

~~~
0xcde4c3db
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
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
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.000000...](http://www.neurology.org/content/early/2016/12/14/WNL.0000000000003511.short)

