Roundup: Migraines, Congenital Heart Defect Linked to Strokes in Younger Adults; and More News

Rising Stroke Risk in Younger Adults Linked to Nontraditional Causes, Including Migraines, Heart Defects

Strokes in adults under the age of 50 are increasing, with a significant number classified as cryptogenic — meaning they occur without a clearly identifiable cause such as high blood pressure or diabetes.

A new study, published in the American Heart Association journal Stroke, sheds light on potential hidden contributors to these unexplained strokes, pointing to nontraditional risk factors such as migraines and a relatively common heart condition known as a patent foramen ovale (PFO).

A PFO is a small hole between the upper chambers of the heart that usually closes shortly after birth. However, it remains open in about one in four adults. Though often benign, a PFO can increase the risk of stroke, particularly when combined with other nontraditional health conditions.

The study found that stroke survivors with a PFO were significantly more likely to have nontraditional risk factors, compared to those without the heart condition. Notably, migraine with aura emerged as the most prominent nontraditional risk factor linked to cryptogenic stroke — particularly among women and individuals with a PFO.

The international study, conducted as part of the SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young) research project, analyzed health data from 523 adults aged 18 to 49 who had experienced a cryptogenic ischemic stroke. These individuals were compared with 523 age-matched people who had not had a stroke. Data were collected from 19 medical centers across 13 European countries between 2013 and 2022.

Researchers examined both traditional stroke risk factors — such as high blood pressure, obesity, smoking, and high cholesterol — and 10 nontraditional factors, including chronic kidney disease, cancer, blood clots in the veins, and migraine with aura. Five risk factors specific to women, such as preeclampsia and gestational diabetes, were also considered.

“We were surprised by the role of nontraditional risk factors, especially migraine headaches, which seems to be one of the leading risk factors in the development of strokes in younger adults,” said lead researcher Jukka Putaala, M.D., head of the stroke unit at the Neurocenter at Helsinki University Hospital in Finland, in a news release.

While traditional risk factors remain very important, Putaala emphasized the need for a more personalized approach. “We should be especially asking young women if they have a history of migraine headaches and about other nontraditional risk factors.”

The data also highlighted that women who had experienced a stroke were more likely to have faced pregnancy-related complications, regardless of whether they had a PFO. This suggests that sex-specific health factors play a critical role in stroke risk for younger women.

Statistical analysis showed that for participants with a PFO, each additional nontraditional risk factor more than doubled the likelihood of having a stroke. Even for those without a PFO, the odds increased by 70 percent with each added nontraditional factor.

Despite these findings, researchers caution that the “findings do not show cause and effect because of the observational nature of the study,” according to a news release from the American Heart Association. Moreover, 95 percent of the study participants were white Europeans and the results may not apply to more diverse populations.

Explore Stroke Services at Baptist Health South Florida.

Bacterial Toxin Linked to Concerning Rise of Early-Onset Colorectal Cancer Cases

A specific bacterial toxin, colibactin, may play a significant role in the increasing incidence of colorectal cancer among young adults, according to a newly published study in Nature. The international research team, led by scientists at the University of California San Diego, identified a distinctive mutational fingerprint in the DNA of colon cells that points to early-life exposure to colibactin as a potential trigger for early-onset colorectal cancer.

Colibactin is produced by certain strains of Escherichia coli (E. coli) that reside in the human colon and rectum. This toxin is known to damage DNA, and the new findings suggest that its impact may begin in childhood.

According to the research, colibactin exposure can imprint a specific pattern of mutations—referred to as a "mutational signature"—on the DNA of colon cells. This signature appears to be much more prevalent in colorectal cancer cases diagnosed before the age of 50, especially those diagnosed before age 40.

“These mutation patterns are a kind of historical record in the genome, and they point to early-life exposure to colibactin as a driving force behind early-onset disease,” said Professor Ludmil Alexandrov, senior author of the study and faculty member at UC San Diego’s Shu Chien-Gene Lay Department of Bioengineering and the Department of Cellular and Molecular Medicine, in a news release. Mr. Alexandrov is also affiliated with the UC San Diego Moores Cancer Center and Sanford Stem Cell Fitness and Space Medicine Center.

The study analyzed the genomes of 981 individuals with colorectal cancer across 11 countries. Researchers found that colibactin-related mutations were 3.3 times more common in early-onset cases --compared to those diagnosed after age 70. These mutations were also more prevalent in countries that report higher rates of early-onset colorectal cancer, suggesting a potential global pattern linked to environmental or microbial exposure.

While previous research had already detected colibactin-associated mutations in colorectal cancer, this study is the first to show a significant enrichment of these mutations specifically in younger patients. Colibactin-related mutations accounted for about 15 percent of APC driver mutations—key genetic changes that initiate the development of colorectal cancer.

“If someone acquires one of these driver mutations by the time they’re 10 years old,” Mr. Alexandrov explained in a news release, “they could be decades ahead of schedule for developing colorectal cancer, getting it at age 40 instead of 60.”

This insight is particularly troubling in light of broader trends. Once considered a disease that primarily affects older adults, colorectal cancer has become increasingly common among individuals under 50. Its incidence in this age group has nearly doubled every decade over the past 20 years, and if current trends continue, it is projected to become the leading cause of cancer-related deaths in young adults by 2030.

Many early-onset colorectal cancer patients lack typical risk factors such as family history, obesity, or hypertension, leading researchers to investigate alternative explanations. This study adds weight to the theory that early microbial exposures—particularly to colibactin-producing E. coli—may be an overlooked contributor.

Study co-author Dr. Marcos Díaz-Gay noted in a statement that this discovery was unexpected: “When we started this project, we weren’t planning to focus on early-onset colorectal cancer. Our original goal was to examine global patterns of colorectal cancer to understand why some countries have much higher rates than others. But as we dug into the data, one of the most interesting and striking findings was how frequently colibactin-related mutations appeared in the early-onset cases.”

In addition to identifying these mutations, the research team used molecular timing techniques to determine when they occur. Their findings suggest that the damage from colibactin begins in early life—possibly even before age 10—long before any symptoms appear. This raises the possibility that the path to colorectal cancer may begin decades before diagnosis.

While the study does not prove that colibactin causes colorectal cancer on its own, it builds on a growing body of research suggesting that environmental and microbial factors can leave permanent marks on our DNA.

The study’s authors emphasize that more research is needed to establish a direct causal relationship and to explore possible interventions.

‘Smart Insoles’ Tracks Real-Time Gait and May Detect Early Disease, Researchers Say

A newly developed smart insole system from researchers at The Ohio State University has the potential to transform how people monitor their health — one step at a time.

By using 22 pressure sensors embedded in the sole and solar panels mounted on the top of the shoe, the innovative device collects detailed biomechanical data while a person walks, runs, or stands. The system’s creators suggest it could play a key role in detecting early signs of health issues -- ranging from plantar fasciitis to Parkinson’s disease.

At the heart of the technology is the ability to monitor gait—a person’s pattern of movement—often considered as unique as a fingerprint. This data is transmitted via Bluetooth to a smartphone, where it can be analyzed in real time using artificial intelligence.

Commercial availability is anticipated within three to five years, the researcher said.  Potential applications of the smart insole include early diagnosis of diabetic foot ulcers, posture correction, injury prevention, and customized rehabilitation programs. The researchers also envision its use in fitness tracking and personalized exercise plans.

Jinghua Li, assistant professor of materials science and engineering and co-author of the study, emphasizes the significance of this advancement in a news release: “Our bodies carry lots of useful information that we’re not even aware of. These statuses also change over time, so it’s our goal to use electronics to extract and decode those signals to encourage better self health care checks.”

About 7 percent of Americans experience ambulatory difficulties such as trouble walking, running, or climbing stairs. While wearable insoles have emerged as a possible solution in recent years, many earlier designs faced limitations related to battery life and performance stability. The Ohio State team, led by Ms. Li and Ph.D. student Qi Wang, addressed these challenges by developing a highly durable and energy-efficient system.

“Our device is innovative in terms of high resolution, spatial sensing, self-powering capability, and its ability to combine with machine learning algorithms,” said Ms. Li in a statement. “So we feel like this research can go further based on the pioneering successes of this field.”

Published in the journal Science Advances, the study details how the smart insole uses AI to classify eight distinct motion states. These range from static positions like sitting and standing to dynamic actions such as squatting and running. This functionality enables the system to support multiple use cases in healthcare and fitness.

The system's self-powering design uses solar cells to convert light into energy, which is stored in compact lithium batteries. These batteries are integrated safely into the shoe and do not interfere with the user's daily activities. The insole's materials are both flexible and skin-safe, allowing for continuous wear.