December 15, 2022
A review of 364 studies, published between 1990 and 2022, examining aspects of climate change and neuroinfectious diseases found that increased or extreme temperature increases and stroke, migraine, seizure, and other neurological found to be associated with an increased risk of academic problems.
As global temperatures continue to rise, what impact will climate change have on neurological diseases and their incidence, prevalence, morbidity and mortality?
This is a key question in the scoping review and neurologyset out to answer.
Andrew Dhawan, MD, DPhil, a neuro-oncology fellow at the Cleveland Clinic, and co-authors examined 364 studies published between 1990 and 2022. Studies that focused on childhood diseases or had no English translation available were excluded from the analysis.
They found that elevated and extreme temperatures are associated with an increased risk of stroke, migraine, seizures in people with epilepsy, hospitalization in people with dementia, and exacerbation of multiple sclerosis (MS) symptoms. I found
Exposure to airborne pollutants, particularly nitrates and particulate matter (PM 2.5), was also associated with increased stroke incidence and mortality. Increased risk of intracerebral hemorrhage, Parkinson’s disease, and dementia. Emergency migraine treatment is more frequent. More severe MS symptoms, according to reviews.
For emerging neuroinfectious diseases such as tick-borne encephalitis, West Nile virus, and meningococcal meningitis, the literature suggests that rising temperatures and climate change will spread these diseases to new geographic areas. It is now possible.
“Taken together, these findings suggest that physiological changes caused by temperature extremes, high temperature fluctuations, and certain airborne contaminants have wide-ranging effects on the body. [central] the nervous system via several potential mechanisms, including accelerated aging,” write Dr. Dhawan and colleagues.
Neurology Today We spoke with Dr. Dhawan about the motivation for this review, key takeaways, and how neurologists will continue to ask and address these important questions in the future.
What prompted the review and how was it put together?
This review was my passion project. I have always been interested in understanding climate change and its effects on health. “What is known about climate change in relation to our neurological patients and their care?” I asked. And I found a variety of studies, each addressing an important but small part of climate change.
It became clear that as neurologists we needed to better examine the conditions we treat and understand how they might change in a warming world. connected to the design.
We reached out to co-residents, interested medical students and faculty. I asked them to be authors and help me with the review, and those who were interested could help put the research together. It was an enormous amount of work that was alleviated by the team’s efforts, as there was quite a bit of literature to sift through.
What were your main discoveries?
The biggest thing for me is the fact that there are indeed epidemiological studies examining the effects of temperature and its variability on cerebrovascular disease. Although these may have methodological limitations, there is a relevance between these results.
The second is the strong association identified in studies linking airborne pollutants to cognitive health and dementia. Given the high number of young people exposed to airborne pollutants, these were both surprising and sobering.
Finally, among the most obvious impacts of climate change is the migration of vectors of zoonotic diseases such as tick-borne encephalitis. While human land-use patterns influence the incidence of these diseases, it is their migration to more northern regions where their migration has been documented. Across Europe and North America, it’s important not to ignore.
What do you do if something surprises you about the theme you’ve identified?
The most surprising aspects of the three themes we identified (neuroinfections, the effects of temperature and its variability on neurological diseases, and the effects of airborne contaminants on the nervous system) took place in these areas. It was the amount of research, but also much more needed to be done to clarify the findings. For example, large studies (involving hundreds of thousands of patients) investigate airborne contaminants and temperatures and their variability to neurological disease, whereas individual participants’ contaminants and temperatures Measuring the exposure of is a major methodological limitation that has not been addressed.
There is also a lack of prospective research, and perhaps not surprisingly, there is a significant lack of research on the impacts of climate change and pollution on the most affected countries in the Southern Hemisphere.
What are the biggest challenges you have identified?
Each of these studies had methodological limitations that prevented a meta-analysis of the results. It also lacked mechanisms to support causality. Further research is needed in this area to better understand why these changes occur.
Are there any action points for neurologists to take based on this review?
A neurologist’s primary action point is to advocate for patients and their health. As medical professionals, we have a duty to keep our patients healthy and, most importantly, to support large-scale political action to mitigate climate change and pollution.
Designing health systems that are more robust in the face of climate disasters and studying the impacts of climate change and pollution to further empower change are also critical.
What key questions remain?
The big problem that remains is [underlying] Mechanisms for how temperature changes and their variability affect neurological diseases, especially cerebrovascular diseases. The mechanisms of how airborne pollutants affect cognitive health are also unclear, and perhaps it is related to increased white matter burden in patients exposed to higher levels of pollutants. The underlying pathophysiology remains unclear.
Dr. Dhawan had no relevant disclosures to report..