Medical Bulletin 14/ April/ 2025 - Video

A new study from researchers at Boston University Chobanian & Avedisian School of Medicine has found that in cases of low back pain without worrisome signs, use of an X-ray is often sufficient to diagnose the problem. These findings appear online in the American Journal of Physical Medicine & Rehabilitation.

Researchers selected 100 patients from an outpatient pain clinic who had undergone lumbar X-rays within one year prior to undertaking a lumbar MRI. X-ray and MRI reports were analyzed by two readers. They found X-rays predicted MRI results in approximately 75% of the cases for common low back pain problems suggesting they may be a preferred initial imaging study for this condition.

“Imaging, used in the management of low back is not always needed, but when employed there can be an overuse of MRI which adds to patient wait times, costs and the potential for more false positives,” says corresponding author Michael D. Perloff, MD, assistant professor of neurology.

According to the researchers, MRI use does not necessarily change low back pain outcomes and may increase surgical rates. “Patients should be reassured that X-rays can be very helpful for management of low back problems and an MRI is only needed in certain cases. Furthermore, with less need for low back MRIs, the procedure would be more available for other disorders, reducing wait times and systems burden,” said Perloff, a neurologist and director of Pain Medicine at Boston Medical Center.

Reference: McCormick, Robert J. MD; Perloff, Michael D. MD, PhD∗. Xray prediction of MRI in low back pain. American Journal of Physical Medicine & Rehabilitation ():10.1097/PHM.0000000000002741, March 26, 2025. | DOI: 10.1097/PHM.0000000000002741

People who consume eight or more alcoholic drinks per week may face a higher risk of developing brain lesions known as hyaline arteriolosclerosis—markers of brain damage linked to issues with memory and thinking—according to a study published in Neurology®. The study does not prove that heavy drinking causes brain injury; it only shows an association.

The study included 1,781 people who had an average age of 75 at death. All had brain autopsies. Researchers examined brain tissue to look for signs of brain injury including tau tangles and hyaline arteriolosclerosis. They also measured brain weight and the height of each participant.

Family members answered questions about participants' alcohol consumption. Researchers then divided the participants into four groups: 965 people who never drank, 319 moderate drinkers who had seven or fewer drinks per week; 129 heavy drinkers who had eight or more drinks per week; and 368 former heavy drinkers. Researchers defined one drink as having 14 grams of alcohol, which is about 350 milliliters (ml) of beer, 150 ml of wine or 45 ml of distilled spirits.

Of those who never drank, 40% had vascular brain lesions. Of the moderate drinkers, 45% had vascular brain lesions. Of the heavy drinkers, 44% had vascular brain lesions. Of the former heavy drinkers, 50% had vascular brain lesions.

After adjusting for factors that could affect brain health such as age at death, smoking and physical activity, heavy drinkers had 133% higher odds of having vascular brain lesions compared to those who never drank, former heavy drinkers had 89% higher odds and moderate drinkers, 60%.

Researchers also found heavy and former heavy drinkers had higher odds of developing tau tangles, a biomarker associated with Alzheimer's disease, with 41% and 31% higher odds, respectively.

Former heavy drinking was associated with a lower brain mass ratio, a smaller proportion of brain mass compared to body mass, and worse cognitive abilities. No link was found between moderate or heavy drinking and brain mass ratio or cognitive abilities.

Reference: https://www.aan.com/PressRoom/Home/PressRelease/5251

A new study has found that higher muscle strength was associated with over 40% lower risk of T2D, regardless of genetic susceptibility to T2D. The study highlights the importance of maintaining or improving muscle strength as a key strategy for preventing T2D. The findings were published in BMC Medicine.

The research utilised data of 141,848 white British individuals without baseline T2D from the UK Biobank, an ongoing prospective cohort of over 500,000 UK adults which includes extensive genotype and phenotype information. Muscle strength was assessed in the form of grip strength. Genetic risk of T2D was estimated based on 138 known genetic variants for T2D.

The participants were followed up for more than seven years. During the follow-up period, 4,743 new T2D cases were identified. The findings indicated that, compared with low muscle strength, individuals with high muscle strength was associated with a 44% lower relative risk of developing T2D, even after taking into account T2D genetic risk as well as other risk factors. Moreover, the research team observed evidence of an interaction between muscle strength and genetic susceptibility to T2D, suggesting that muscle strength may play a role in modifying the impact of genetic risk to T2D onset. The findings further revealed that individuals at high genetic risk of T2D but with high muscle strength could have a lower absolute risk of T2D, compared with those at low or medium genetic risk but with low muscle strength.

'The findings emphasise the crucial role of maintaining or enhancing muscle strength as a key strategy for preventing T2D in middle-aged and older adults, regardless of their genetic risk levels and including those at high genetic risk. We believe that these results offer novel insights into the significant impact of higher muscle strength on metabolic health,' said Dr Wang Mengyao, from the School of Public Health at HKUMed, the first author of this study.

Reference: https://www.hku.hk/press/press-releases/detail/28229.html