ABSTRACT
Along with antioxidant properties, carnitine is an important regulator of lipid metabolism in humans. While beneficial effects of carnitine have been demonstrated in animal models of Huntington's disease (HD), metabolism of carnitine has not been studied in humans with this illness. In this retrospective database review from 23 patients admitted to a HD-specialized nursing home unit, we found a relatively high prevalence of hypocarnitinemia (6 cases, 26%). Our review suggests that catabolism and chronic valproate use predisposed our patients to develop hypocarnitinemia. The patients with low serum carnitine levels who received levocarnitine supplementation, during a mean period of 7.3 months, showed improvement in motor, cognitive and behavioral measures. We hypothesize that observed improvement related to the resolution of reversible metabolic encephalopathy and myopathy associated with secondary carnitine deficiency. In conclusion, notwithstanding its limitations, this is the first study to report measurements of carnitine levels in HD patients, revealing relatively high prevalence of hypocarnitinemia in our population. Our findings suggest that HD patients with hypocarnitinemia may benefit from low-dose levocarnitine supplementation. Further studies of carnitine metabolism and supplementation in HD patients are warranted.
Subject(s)
Carnitine/blood , Carnitine/therapeutic use , Huntington Disease/blood , Huntington Disease/drug therapy , Adult , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Carnitine/deficiency , Databases, Factual , Diet , Dietary Supplements , Female , Hospitalization , Humans , Male , Middle Aged , Neuropsychological Tests , Nutritional Status , Retrospective Studies , Valproic Acid/adverse effects , Valproic Acid/therapeutic useSubject(s)
Brain Injuries/rehabilitation , Cognition Disorders/rehabilitation , Cognitive Behavioral Therapy/methods , Communication Disorders/rehabilitation , Language Disorders/rehabilitation , Speech Disorders/rehabilitation , Attention , Brain Injuries/complications , Brain Injuries/psychology , Cognition Disorders/etiology , Communication Disorders/diagnosis , Communication Disorders/psychology , Evidence-Based Medicine , Executive Function , Humans , Injury Severity Score , Interdisciplinary Communication , Language Disorders/etiology , Male , Memory , Military Personnel , Neuropsychological Tests , Practice Guidelines as Topic , Speech Disorders/etiology , Treatment Outcome , United States , VeteransABSTRACT
The objective of this study was to evaluate the "CALM" (Counseling on Access to Lethal Means) training, in which community-based mental health care providers were trained to work with at-risk clients and their families to assess and reduce access to lethal means of suicide, including firearms. In 2006, CALM trainers conducted workshops in 7 community-based mental health care centers in New Hampshire towns. Participants completed a post-test immediately after the workshop and a follow-up questionnaire approximately 6 weeks later. At follow-up, 65% reported that they had counseled clients' parents about access to lethal means (n = 111). Findings also indicate that the workshop influenced participants' attitudes, beliefs, and skills regarding conducting lethal means counseling.
Subject(s)
Behavior Therapy/education , Education, Medical, Continuing/methods , Firearms , Health Knowledge, Attitudes, Practice , Mental Health Services/organization & administration , Suicide Prevention , Wounds and Injuries/prevention & control , Adolescent , Attitude of Health Personnel , Attitude to Health , Child , Community-Institutional Relations , Female , Follow-Up Studies , Humans , Male , Mental Disorders , New Hampshire , Program Evaluation , Risk Management/organization & administrationABSTRACT
Polysomnographic sleep patterns in Huntington's disease (HD) have been studied sporadically in small groups of patients, providing variable results. In this study, by comparing the polysomnographic sleep patterns of HD patients and their unaffected relatives, identifying sleep traits more specifically related to the HD gene was attempted. The results corroborated previously reported findings of prolonged sleep latency and the virtual absence of nocturnal respiratory disturbances in early HD. Sleep latency in the HD patients positively correlated with the results of a screening test for frontal lobe dysfunction. Larger, more standardized studies will be needed to correlate genetic markers and sleep patterns in HD.
