Aspartame and the brain: a systematic review of neurological effects

Artificial sweeteners like Aspartame are popular due to their low caloric value. They are used as a substitute for sugar, especially for individuals with diabetes and obesity. However, its effects on the neurological system have been debated. Studies suggest aspartame metabolism can lead to altered neurotransmitter synthesis. This review aims to gather literature on the neurotoxic effects of aspartame in humans, aiming to curb this problem. The review was conducted using PubMed, Europe PMC, Cochrane, and Google Scholar. The quality and risk of bias of the extracted studies were assessed using the Critical Appraisal Skills Programme (CASP) checklist, specifically designed for Randomized Controlled Trials (RCTs). The systematic review of aspartame consumption was conducted using PRISMA guidelines and included 11 articles. The studies investigated the effects of aspartame consumption on behavior, cognition, and neurological function through RCTs of varying durations and across different age groups. Aspartame was the primary intervention in all studies, with some neuro biomarkers assessed mainly phenylalanine and tyrosine levels. While some studies reported negative impacts on the above-mentioned parameters others found no significant adverse effects. The review of studies on the effects of aspartame consumption on behavior, cognition, and neurological function reveals mixed results. Neurobiomarkers, specifically phenylalanine and tyrosine, were not consistently assessed across all investigations, making it difficult to establish a clear link between aspartame consumption and neurobiological changes. The studies reviewed provide valuable insights into aspartame effects but highlight complexity. Further research is needed to address limitations.

Area postrema syndrome: an atypical presentation of primary Sjogren's

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition characterized by antibodies against serum aquaporin-4 (AQP4), primarily affecting the optic nerves and spinal cord. This case report sheds light on the diagnostic challenges of area postrema syndrome (APS) as the initial manifestation of Sjogren's syndrome, often misidentified due to its diverse symptomatology. APS, seen in 10% of NMOSD cases, manifests as persistent nausea, vomiting, and uncontrollable hiccups. Left untreated, APS can progress to optic neuritis and longitudinally extensive myelitis, emphasizing the need for early intervention with corticosteroid therapy and immunomodulators. NMOSD commonly coexists with other autoimmune diseases like Sjogren's syndrome and systemic lupus erythematosus. Recent evidence also highlights NMOSD's impact on peripheral organs, particularly skeletal muscles, with elevated creatine kinase levels during acute phases. Understanding the relationship between NMOSD and autoimmune diseases is vital for accurate diagnosis and management, especially in cases of seronegative NMOSD and recurrent attacks, emphasizing comprehensive clinical evaluations and a broader diagnostic approach.

Role of Black Salt to Reduce in Hypertension, Reality and Evidence Based Studies

Salt in diet is very important to make our life healthy and energetic. Quantity and quality of salt with appropriate ratio or balance in electrolytes which are responsible for volume of body, blood velocity, for functions of receptors and enzymes, to prevent inflammation, proliferation and to make balance in muscles contraction and nerve conduction through to avoid high stimulation of sympathetic nervous system. Hence, scanning and focus with monitoring and supply of healthy salt in limits may prevent volume overload, renal dysfunction & left ventricular hypertrophy, to prevent cardiac functions, to avoid the weaken gut immunity and also to prevent cerebral oedema, cerebral aneurysm and hypertension cause stroke. Control of salt with intake of low quantity and high quality with more frequency of intervals during 24 hours in required amount of salt in balanced electrolytes may help to avoid high salt sensitivity. Balanced salt intake is also important to avoid volume expansion and obesity with reduction of insulin resistance leads to prevent hypertension and diabetes which are leading risk factors for cardio-renal syndrome, cardiovascular morbidity and mortality. Our data suggested a 2.5-fold higher risk for high blood pressure in sea or white salt users versus black salt or Himalayan rock salt which showed more potassium and magnesium with low sodium ions as compared to sea salt.

Repetitive transcranial magnetic stimulation in chronic tension-type headache: A pilot study

Background & objectives: Tension-type headache (TTH) is the most common type of primary headache disorder. Its chronic form is often the most ignored and challenging to treat. Transcranial magnetic stimulation (TMS) is a novel technique in the treatment of chronic pain. The aim of this pilot study was to explore the effect of low-frequency repetitive TMS (rTMS) on pain status in chronic TTH (CTTH) by subjective and objective pain assessment. Methods: Patients (n=30) diagnosed with CTTH were randomized into rTMS (n=15) and placebo (n=15) groups in this study. Pre-intervention detailed history of patients was taken. Numerical Rating Scale (NRS) for Pain and questionnaires [Headache Impact Test-6 (HIT-6), McGill Pain Questionnaire, Pain Beliefs Questionnaire, Coping Strategies Questionnaire, State-Trait Anxiety Inventory Test, Hamilton Rating Scale for Depression and WHO-Quality of Life Questionnaire-Brief version] were filled, and objective assessments such as nociceptive flexion reflex (NFR) and conditioned pain modulation were done. The tests were repeated after 20 sessions (5 days/week). In the rTMS group, 1200 pulses in eight trains of 150 pulses each were given at 1Hz over the right dorsolateral prefrontal cortex (RDLPFC). In the placebo group, the rTMS coil was placed such that magnetic stimulation did not reach the cortex. Results: The NRS score decreased significantly (P<0.001) and NFR thresholds increased significantly (P=0.011) in the rTMS group when compared to placebo group. Interpretation & conclusions: Subjective improvements in the NRS, HIT-6, McGill Present Pain Intensity, trait of anxiety and psychological pain beliefs were observed. The increase in the thresholds of NFR served as an objective marker for improvement in pain status. Further studies need to be done to confirm our preliminary findings.