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Pan GP, Liu YH, Qi MX, Guo YQ, Shao ZL, Liu HT, Qian YW, Guo S, Yin YL, Li P. Alizarin attenuates oxidative stress-induced mitochondrial damage in vascular dementia rats by promoting TRPM2 ubiquitination and proteasomal degradation via Smurf2. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 135:156119. [PMID: 39418971 DOI: 10.1016/j.phymed.2024.156119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/27/2024] [Accepted: 07/13/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Alizarin (AZ) is a natural anthraquinone with anti-inflammatory and moderate antioxidant properties. PURPOSE In this study, we characterized the role of AZ in a rat model of vascular dementia (VaD) and explored its underlying mechanisms. METHODS VaD was induced by bilateral common carotid artery occlusion. RESULTS We found that AZ attenuated oxidative stress and improved mitochondrial structure and function in VaD rats, which led to the improvement of their learning and memory function. Mechanistically, AZ reduced transient receptor potential melastatin 2 (TRPM2) expression and activation of the Janus-kinase and signal transducer activator of transcription (JAK-STAT) pathway in VaD rats. In particular, the reduction in the expression of TRPM2 channels was the key to the attenuation of the oxidative stress-induced mitochondrial damage, which may be achieved by increasing the expression of the E3 ubiquitin ligase, Smad-ubiquitination regulatory factor 2 (Smurf2); thereby increasing the ubiquitination and degradation levels of TRPM2. CONCLUSION Our results suggest that AZ is an effective candidate drug for ameliorating VaD and provide new insights into the current clinical treatment of VaD.
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Affiliation(s)
- Guo-Pin Pan
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China
| | - Yan-Hua Liu
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China; Pharmacy Department, the First Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China
| | - Ming-Xu Qi
- College of Pharmacy, Changchun University of Chinese Medicine, Changchun 130000, China
| | - Ya-Qi Guo
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China
| | - Zhen-Lei Shao
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China; Pharmacy Department, the First Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China
| | - Hui-Ting Liu
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China
| | - Yi-Wen Qian
- Department of Pharmacy, College of Basic Medicine and Forensic Medicien, Henan University of Science and Technology, Luoyang 471000, China
| | - Shuang Guo
- Hubei Key Laboratory of Diabetes and Angiopathy, Hubei University of Science and Technology, Xianning 437100, China
| | - Ya-Ling Yin
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
| | - Peng Li
- Henan international joint laboratory of cardiovascular remodeling and drug intervention, Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and Neurobiology, School of Basic Medical Sciences, College of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China.
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He JB, Zhang H, Zheng HX, Jia JX, Zhang YC, Yan XS, Li XX, Wei KW, Mao J, Chen H, Li J, Wang H, Zhang M, Zhao ZY. Effects of schisandrin B on hypoxia-related cognitive function and protein expression in vascular dementia rats. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2024; 87:421-427. [PMID: 38551405 DOI: 10.1080/15287394.2024.2334247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Vascular dementia (VD) a heterogenous group of brain disorders in which cognitive impairment is attributable to vascular risk factors and cerebrovascular disease. A common phenomenon in VD is a dysfunctional cerebral regulatory mechanism associated with insufficient cerebral blood flow, ischemia and hypoxia. Under hypoxic conditions oxygen supply to the brain results in neuronal death leading to neurodegenerative diseases including Alzheimer's (AD) and VD. In conditions of hypoxia and low oxygen perfusion, expression of hypoxia-inducible factor 1 alpha (HIF-1α) increases under conditions of low oxygen and low perfusion associated with upregulation of expression of hypoxia-upregulated mitochondrial movement regulator (HUMMR), which promotes anterograde mitochondrial transport by binding with trafficking protein kinesin 2 (TRAK2). Schisandrin B (Sch B) an active component derived from Chinese herb Wuweizi prevented β-amyloid protein induced morphological alterations and cell death using a SH-SY5Y neuronal cells considered an AD model. It was thus of interest to determine whether Sch B might also alleviate VD using a rat bilateral common carotid artery occlusion (BCAO) dementia model. The aim of this study was to examine the effects of Sch B in BCAO on cognitive functions such as Morris water maze test and underlying mechanisms involving expression of HIF-1α, TRAK2, and HUMMR levels. The results showed that Sch B improved learning and memory function of rats with VD and exerted a protective effect on the hippocampus by inhibition of protein expression of HIF-1α, TRAK2, and HUMMR factors. Evidence indicates that Sch B may be considered as an alternative in VD treatment.
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Affiliation(s)
- Jing-Bo He
- Department of Pharmacy, Baotou Medical College, Inner Mongolia, China
| | - He Zhang
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Hong-Xia Zheng
- Faculty of Foreign Languages, Baotou Teachers' College, Inner Mongolia, China
| | - Jian-Xin Jia
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Yi-Chi Zhang
- Class15, Senior two, Baotou No.9 High School, Inner Mongolia, China
| | - Xu-Sheng Yan
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Xiao-Xu Li
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Kai-Wen Wei
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Jun Mao
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Hong Chen
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Jing Li
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
- Department of Anesthesia, The Fourth Hospital of Inner Mongolia Autonomous Region, Inner Mongolia, China
| | - He Wang
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Ming Zhang
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
| | - Zhi-Ying Zhao
- Institute of Neuroscience, Department of Anatomy, Baotou Medical College, Inner Mongolia, China
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Gainey M, Niles A, Imeh-Nathaniel S, Goodwin RL, Roley LT, Win O, Nathaniel TI, Imeh-Nathaniel A. Comorbidities in patients with vascular dementia and Alzheimer's disease with Neuropsychiatric symptoms. Geriatr Nurs 2024; 57:217-223. [PMID: 38696879 DOI: 10.1016/j.gerinurse.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 05/04/2024]
Abstract
INTRODUCTION This study aimed to examine baseline risk factors in Alzheimer's Disease (AD) and Vascular dementia (VaD) patients with neuropsychiatry symptoms (NPS), and determine whether specific risk factors differ by subtypes of dementia for AD and VaD patients with NPS. METHODS A retrospective data analysis was conducted to evaluate similarities and differences in the risk factors for AD and VaD with NPS. The analysis included 2949 patients with VaD and 6341 patients with clinical confirmation of AD and VaD with or without NPS collected between February 2016 and August 2021. The multivariate logistic regression analysis was used to determine the risk factors associated with AD and VaD with NPS, by predicting the increasing odds (odds ratios (ORs) of an association of a specific baseline risk factor with AD or VaD with NPS. The validity of the regression models was tested using a Hosmer-Lemeshow test, while the Receiver Operating Curve (ROC) was used to test the sensitivity of the models. RESULTS In the adjusted analysis TSH (OR = 1.781, 95 % CI, p = 0.0025) and CHF (OR = 1.620, 95 %, p = 0.016) were associated with VaD with NPS, while a history of emergency department(ED) admission (OR = 0.277, 95 % CI, p = 0.003) likely to be associated with VaD patients without NPS. For AD patients, a history of CVA (OR = 1.395, 95 % CI, p = 0.032) and cancer (OR = 1.485, 95 % CI, p = 0.013) were associated with AD patients with NPS. DISCUSSION The findings of this study indicate that an abnormal thyroid gland and CHF were linked to VaD patients with behavioral disturbances, while CVA and cancer were linked to AD patients with behavioral disturbances. These findings suggest the need to develop management strategies for the care of patients with AD and VaD with NPS.
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Affiliation(s)
- Mallory Gainey
- University of South Carolina, School of Medicine-Greenville, 701 Grove Rd, Greenville, SC, 29605, USA
| | - Addison Niles
- PRISMA Health UP-State South Carolina, 701 Grove Rd, Greenville, SC, 29605, USA
| | | | | | | | - Ohmar Win
- PRISMA Health UP-State South Carolina, 701 Grove Rd, Greenville, SC, 29605, USA
| | - Thomas I Nathaniel
- University of South Carolina, School of Medicine-Greenville, 701 Grove Rd, Greenville, SC, 29605, USA.
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Zhang L, Chen Y, Fan Y, Shi L. Treadmill exercise pretreatment ameliorated structural synaptic plasticity impairments of medial prefrontal cortex in vascular dementia rat and improved recognition memory. Sci Rep 2024; 14:7116. [PMID: 38531892 PMCID: PMC10965903 DOI: 10.1038/s41598-024-57080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
This study aimed to investigate structural synaptic plasticity in the medial prefrontal cortex of rats under treadmill exercise pretreatment or naive conditions in a vascular dementia model, followed by recognition memory performance in a novel object recognition task. In this study, 24 Sprague-Dawley rats were obtained and randomly assigned into 4 groups as follows: control group (Con group, n = 6), vascular dementia (VD group, n = 6), exercise and vascular dementia group (Exe + VD group, n = 6), and exercise group (Exe group, n = 6). Initially, 4 weeks of treadmill exercise intervention was administered to the rats in the Exe + VD and Exe groups. Then, to establish the vascular dementia model, the rats both in the VD and Exe + VD groups were subjected to bilateral common carotids arteries surgery. One week later, open-field task and novel recognition memory task were adopted to evaluate anxiety-like behavior and recognition memory in each group. Then, immunofluorescence and Golgi staining were used to evaluate neuronal number and spine density in the rat medial prefrontal cortex. Transmission electron microscopy was used to observe the synaptic ultrastructure. Finally, microdialysis coupled with high-performance liquid chromatography was used to assess the levels of 5-HT and dopamine in the medial prefrontal cortex. The behavior results showed that 4 weeks of treadmill exercise pretreatment significantly alleviated recognition memory impairment and anxiety-like behavior in VD rats (P < 0.01), while the rats in VD group exhibited impaired recognition memory and anxiety-like behavior when compared with the Con group (P < 0.001). Additionally, NeuN immunostaining results revealed a significant decrease of NeuN-marked neuron in the VD group compared to Con group (P < 0.01), but a significantly increase in this molecular marker was found in the Exe + VD group compared to the Con group (P < 0.01). Golgi staining results showed that the medial prefrontal cortex neurons in the VD group displayed fewer dendritic spines than those in the Con group (P < 0.01), and there were more spines on the dendrites of medial prefrontal cortex cells in Exe + VD rats than in VD rats (P < 0.01). Transmission electron microscopy further revealed that there was a significant reduction of synapses intensity in the medial prefrontal cortex of rats in the VD group when compared with the Con group(P < 0.01), but physical exercise was found to significantly increased synapses intensity in the VD model (P < 0.01). Lastly, the levels of dopamine and 5-HT in the medial prefrontal cortex of rats in the VD group was significantly lower compared to the Con group (P < 0.01), and treadmill exercise was shown to significantly increased the levels of dopamine and 5-HT in the VD rats (P < 0.05). Treadmill exercise pretreatment ameliorated structural synaptic plasticity impairments of medial prefrontal cortex in VD rat and improved recognition memory.
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Affiliation(s)
- Linlin Zhang
- Department of Physical Education, Henan Normal University, Xinxiang, 453007, China
| | - Yuanyuan Chen
- Department of Psychology and Education, Shantou Polytechnic, Shantou, 515071, China
| | - Yongzhao Fan
- Department of Physical Education, Henan Normal University, Xinxiang, 453007, China
| | - Lin Shi
- Department of Physical Education and Sport, Shanghai Ocean University, Shanghai, 201306, China.
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Chua XY, Torta F, Chong JR, Venketasubramanian N, Hilal S, Wenk MR, Chen CP, Arumugam TV, Herr DR, Lai MKP. Lipidomics profiling reveals distinct patterns of plasma sphingolipid alterations in Alzheimer's disease and vascular dementia. Alzheimers Res Ther 2023; 15:214. [PMID: 38087395 PMCID: PMC10714620 DOI: 10.1186/s13195-023-01359-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and vascular dementia (VaD) are two of the commonest causes of dementia in the elderly. Of the myriad biomolecules implicated in dementia pathogenesis, sphingolipids have attracted relatively scant research attention despite their known involvement in multiple pathophysiological processes. The potential utility of peripheral sphingolipids as biomarkers in dementia cohorts with high concomitance of cerebrovascular diseases is also unclear. METHODS Using a lipidomics platform, we performed a case-control study of plasma sphingolipids in a prospectively assessed cohort of 526 participants (non-cognitively impaired, NCI = 93, cognitively impaired = 217, AD = 166, VaD = 50) using a lipidomics platform. RESULTS Distinct patterns of sphingolipid alterations were found in AD and VaD, namely an upregulation of d18:1 species in AD compared to downregulation of d16:1 species in VaD. In particular, GM3 d18:1/16:0 and GM3 d18:1/24:1 showed the strongest positive associations with AD. Furthermore, evaluation of sphingolipids panels showed specific combinations with higher sensitivity and specificity for classification of AD (Cer d16:1/24:0. Cer d18:1/16:0, GM3 d16:1/22:0, GM3 d18:1/16:0, SM d16:1/22:0, HexCer d18:1/18:0) and VAD (Cer d16:1/24:0, Cer d18:1/16:0, Hex2Cer d16:1/16:0, HexCer d18:1/18:0, SM d16:1/16:0, SM d16:1/20:0, SM d18:2/22:0) compared to NCI. CONCLUSIONS AD and VaD are associated with distinct changes of plasma sphingolipids, warranting further studies into underlying pathophysiological mechanisms and assessments of their potential utility as dementia biomarkers and therapeutic targets.
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Affiliation(s)
- Xin Ying Chua
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Federico Torta
- Singapore Lipidomics Incubator (SLING), Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joyce R Chong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | | | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Markus R Wenk
- Singapore Lipidomics Incubator (SLING), Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Thiruma V Arumugam
- Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Deron R Herr
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Center for Genetic Disorders and Aging Research, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.
- Memory, Aging and Cognition Centre, National University Health System, Singapore, Singapore.
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Crnich E, Sanchez E, Havens MA, Kissel DS. Sulfur-bridging the gap: investigating the electrochemistry of novel copper chelating agents for Alzheimer's disease applications. J Biol Inorg Chem 2023; 28:643-653. [PMID: 37594567 DOI: 10.1007/s00775-023-02013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/15/2023] [Indexed: 08/19/2023]
Abstract
There is currently an unmet demand for multi-functional precision treatments for Alzheimer's disease (AD) after several failed attempts at designing drugs based on the amyloid hypothesis. The focus of this work is to investigate sulfur-bridged quinoline ligands that could potentially be used in chelation therapies for a subpopulation of AD patients presenting with an overload of labile copper ions, which are known to catalyze the production of reactive oxygen species (ROS) and exacerbate other markers of AD progression. The ligands 1-(2'-thiopyridyl)isoquinoline (1TPIQ) and 2-(2'-thiopyridyl)quinoline (2TPQ) were synthesized and characterized before being electrochemically investigated in the presence of different oxidizing and reducing agents in solution with a physiological pH relevant to the brain. The electrochemical response of each compound with copper was studied by employing both hydrogen peroxide (H2O2) as an oxidizing agent and ascorbic acid (AA) as an antioxidant during analysis using cyclic voltammetry (CV). The cyclic voltammograms of each quinoline were compared with similar ligands that contained aromatic N-donor groups but no sulfur groups to provide relative electrochemical properties of each complex in solution. In a dose-dependent manner, it was observed that AA exerted dual-efficacy when combined with these chelating ligands: promoting synergistic metal binding while also scavenging harmful ROS, suggesting AA is an effective adjuvant therapeutic agent. Overall, this study shows how coordination by sulfur-bridged quinoline ligands can alter copper electrochemistry in the presence of AA to limit ROS production in solution.
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Affiliation(s)
- Emma Crnich
- Department of Biology, Lewis University, One University Pkwy, Romeoville, IL, 60446, USA
| | - Erik Sanchez
- Department of Chemistry, Lewis University, One University Pkwy, Romeoville, IL, 60446, USA
| | - Mallory A Havens
- Department of Biology, Lewis University, One University Pkwy, Romeoville, IL, 60446, USA
| | - Daniel S Kissel
- Department of Chemistry, Lewis University, One University Pkwy, Romeoville, IL, 60446, USA.
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Yoo MJ, Kang M, Tsoukra P, Chen Z, Farrand S, Kelso W, Evans A, Eratne D, Walterfang M, Velakoulis D, Loi SM. Comparing survival and mortality in patients with late-onset and young-onset vascular dementia. Int Psychogeriatr 2023; 35:519-527. [PMID: 37052303 DOI: 10.1017/s1041610223000248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES Vascular dementia (VD) is one of the more common types of dementia. Much is known about VD in older adults in terms of survival and associated risk factors, but comparatively less is known about VD in a younger population. This study aimed to investigate survival in people with young-onset VD (YO-VD) compared to those with late-onset VD (LO-VD) and to investigate predictors of mortality. DESIGN Retrospective file review from 1992 to 2014. SETTING The inpatient unit of a tertiary neuropsychiatry service in Victoria, Australia. PARTICIPANTS Inpatients with a diagnosis of VD. MEASUREMENTS AND METHODS Mortality information was obtained from the Australian Institute of Health and Welfare. Clinical variables included age of onset, sex, vascular risk factors, structural neuroimaging, and Hachinksi scores. Statistical analyses used were Kaplan-Meier curves for median survival and Cox regression for predictors of mortality. RESULTS Eighty-four participants were included with few clinical differences between the LO-VD and YO-VD groups. Sixty-eight (81%) had died. Median survival was 9.9 years (95% confidence interval 7.9, 11.7), with those with LO-VD having significantly shorter survival compared to those with YO-VD (6.1 years and 12.8 years, respectively) and proportionally more with LO-VD had died (94.6%) compared to those with YO-VD (67.5%), χ2(1) = 9.16, p = 0.002. The only significant predictor of mortality was increasing age (p = 0.001). CONCLUSION While there were few clinical differences, and older age was the only factor associated with survival, further research into the effects of managing cardiovascular risk factors and their impact on survival are recommended.
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Affiliation(s)
- M J Yoo
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Matthew Kang
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Alfred Mental and Addiction Health, Alfred Health, Melbourne, VIC, Australia
| | | | - Zhibin Chen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Sarah Farrand
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wendy Kelso
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Andrew Evans
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Mark Walterfang
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Samantha M Loi
- Neuropsychiatry, NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
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Kim Y, Park C, Yoon B, You J(SH. Bolstering Cognitive and Locomotor Function in Post-Stroke Dementia Using Human-Robotic Interactive Gait Training. J Clin Med 2023; 12:5661. [PMID: 37685727 PMCID: PMC10488393 DOI: 10.3390/jcm12175661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Studies have reported inconclusive results regarding the effectiveness and clinical indications of the exclusive use of human-robotic interactive gait training (HIT) in patients with post-stroke dementia (PSD). This study aimed to compare the effects of human-robotic interactive gait training (HIT) and conventional physiotherapy (CPT) on cognitive and sensorimotor functions, trunk balance and coordination, dynamic and static balance, and activities related to daily living performance in patients with PSD. Forty-eight patients with PSD who received 60-minute therapy sessions three times per week for 6 weeks were assigned to either the CPT (n = 25) or HIT (n = 23) group. The clinical outcomes included the scores of the mini-mental state examination (MMSE), Fugl-Meyer assessment (FMA), trunk impairment scale (TIS), Berg balance scale (BBS), and modified Barthel index (MBI). Friedman tests were conducted at p < 0.05. The Friedman tests showed that HIT had superior effects to CPT in relation to MMSE, FMA, and TIS (p < 0.05), but not in relation to BBS and MBI (p > 0.05). Our results provide promising clinical evidence that HIT significantly improves cognitive and sensorimotor recovery functions, as well as trunk balance and coordination, in patients with PSD who cannot concurrently perform dual cognitive-locomotor tasks.
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Affiliation(s)
| | | | | | - Joshua (Sung) H. You
- Sports Movement Artificial Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju 26943, Republic of Korea; (Y.K.); (C.P.); (B.Y.)
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Yang X, Chen C, Wang A, Li C, Cheng G. Imaging, Genetic, and Pathological Features of Vascular Dementia. Eur Neurol 2023; 86:277-284. [PMID: 37271126 DOI: 10.1159/000531088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Over the past decades, marked progress has been made in detecting vascular dementia (VD) both through maturation of diagnostic concepts and advances in brain imaging, especially MRI. We summarized the imaging, genetic, and pathological features of VD in this review. SUMMARY It is a challenge for the diagnosis and treatment of VD, particularly in patients where there is no evident temporal relation between cerebrovascular events and cognitive dysfunction. In patients with cognitive dysfunction with poststroke onset, the etiological classification is still complicated. KEY MESSAGES In this review, we summarized the clinical, imaging, and genetic as well as pathological features of VD. We hope to offer a framework to translate diagnostic criteria to daily practice, address treatment, and highlight some future perspectives.
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Affiliation(s)
- Xiaoni Yang
- Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Chao Chen
- Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Aishuai Wang
- Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Changsheng Li
- Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Guangqing Cheng
- Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
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Bukreeva I, Junemann O, Cedola A, Brun F, Longo E, Tromba G, Wilde F, Chukalina MV, Krivonosov YS, Dyachkova IG, Buzmakov AV, Zolotov DA, Palermo F, Gigli G, Otlyga DA, Saveliev SV, Fratini M, Asadchikov VE. Micromorphology of pineal gland calcification in age-related neurodegenerative diseases. Med Phys 2023; 50:1601-1613. [PMID: 36309985 DOI: 10.1002/mp.16080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 09/21/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The formation of concrements in human pineal gland (PG) is a physiological process and, according to many researchers, is associated with the involution of PG structures. The majority of scientific publications concern progressive calcification of PG, leaving out studies on the destruction of already formed calcified concrements. Our study fills the gap in knowledge about calcified zones destruction in PG in normal aging and neuropathological conditions, which has not been addressed until now. PURPOSE Our objective is to gain insight into human PG tissue impairment in both normal aging and neurodegenerative conditions. X-ray phase-contrast tomography (XPCT) allowed us to study PG tissue degeneration at high spatial resolution and, for the first time, to examine the damaged PG concrements in detail. Our research finding could potentially enhance the understanding of the PG involvement in the process of aging as well as in Alzheimer's disease (AD) and vascular dementia (VD). METHODS The research was carried out on human PG autopsy material in normal aging, VD, and AD conditions. Laboratory-based micro-computed tomography (micro-CT) was used to collect and evaluate samples of native, uncut, and unstained PG with different degrees of pineal calcification. The detailed high-resolution 3D images of the selected PGs were produced using synchrotron-based XPCT. Histology and immunohistochemistry of soft PG tissue confirmed XPCT results. RESULTS We performed via micro-CT the evaluation of the morphometric parameters of PG such as total sample volume, calcified concrements volume, and percentage of concrements in the total volume of the sample. XPCT imaging revealed high-resolution details of age-related PG alteration. In particular, we noted signs of moderate degradation of concrements in some PGs from elderly donors. In addition, our analysis revealed noticeable degenerative change in both concrements and soft tissue of PGs with neuropathology. In particular, we observed a hollow core and separated layers as well as deep ragged cracks in PG concrements of AD and VD samples. In parenchyma of some samples, we detected wide pinealocyte-free fluid-filled areas adjacent to the calcified zones. CONCLUSION The present work provides the basis for future scientific research focused on the dynamic nature of PG calcium deposits and PG soft tissue in normal aging and neurodegenerative diseases.
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Affiliation(s)
- Inna Bukreeva
- Institute of Nanotechnology - CNR, Rome unit, Rome, Italy
| | - Olga Junemann
- Institute of Nanotechnology - CNR, Rome unit, Rome, Italy
- Research Institute of Human Morphology, Moscow, Russian Federation
| | - Alessia Cedola
- Institute of Nanotechnology - CNR, Rome unit, Rome, Italy
| | - Francesco Brun
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Elena Longo
- Elettra-Sincrotrone Trieste S.C.p.A., Basovizza, Trieste, Italy
| | - Giuliana Tromba
- Elettra-Sincrotrone Trieste S.C.p.A., Basovizza, Trieste, Italy
| | - Fabian Wilde
- Institute of Materials Physics, Helmholtz-Zentrum Hereon, Geesthacht, Germany
| | - Marina V Chukalina
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
- Smart Engines Service LLC, Moscow, Russian Federation
| | - Yuri S Krivonosov
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
| | - Irina G Dyachkova
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
| | - Alexey V Buzmakov
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
| | - Denis A Zolotov
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
| | | | - Giuseppe Gigli
- Institute of Nanotechnology - CNR, c/o Campus Ecotekne - Università del Salento via Monteroni, Lecce, Italy
| | - Dmitry A Otlyga
- Research Institute of Human Morphology, Moscow, Russian Federation
| | | | - Michela Fratini
- Institute of Nanotechnology - CNR, Rome unit, Rome, Italy
- Laboratory of Neurophysics and Neuroimaging (NaN), IRCCS Santa Lucia Foundation, Rome, Italy
| | - Victor E Asadchikov
- Federal Scientific Research Center "Crystallography and Photonics" RAS, Moscow, Russian Federation
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de Liyis BG, Sutedja JC, Kesuma PMI, Liyis S, Widyadharma IPE. A review of literature on Compound 21-loaded gelatin nanoparticle: a promising nose-to-brain therapy for multi-infarct dementia. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00621-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AbstractMulti-infarct dementia (MID) is described as a chronic progressive decline in cortical cognitive function due to the occurrence of multiple infarcts in the cerebral vascularization throughout the gray and white matter. Current therapies of MID mostly focus only on slowing down MID progression and symptomatic medications. A novel therapy which is able to provide both preventive and curative properties for MID is of high interest. The purpose of this review is to identify the potential of Compound 21 (C21) gelatin nanoparticle through the nose-to-brain route as therapy for MID. C21, an angiotensin II type 2 receptor (AT2R) agonist, has shown to reduce the size of cerebral infarct in rodent models, resulting in the preservation and improvement of overall cognitive function and prevention of secondary neurodegenerative effects. It is also shown that C21 decreases neuronal apoptosis, improves damaged axons, and encourage synapse development. The challenge remains in preventing systemic AT2R activation and increasing its low oral bioavailability which can be overcome through nose-to-brain administration of C21. Nose-to-brain drug delivery of C21 significantly increases drug efficiency and limits C21 exposure in order to specifically target the multiple infarcts located in the cerebral cortex. Adhering C21 onto gelatin nanoparticles may enable longer contact time with the olfactory and the trigeminal nerve endings, increasing the potency of C21. In summary, treatment of C21 gelatin nanoparticle through nose-to-brain delivery shows high potential as therapy for vascular dementia. However, clinical trials must be further studied in order to test the safety and efficacy of C21.
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Yuan FY, Ju C, Zang CX, Liu H, Shang MY, Ning JW, Yang Y, Ma JW, Li G, Yu Y, Yao XS, Bao XQ, Zhang D. Gardenia jasminoides Extract GJ-4 Alleviates Memory Deficiency of Vascular Dementia in Rats through PERK-Mediated Endoplasmic Reticulum Stress Pathway. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 51:53-72. [PMID: 36458485 DOI: 10.1142/s0192415x23500040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Endoplasmic reticulum stress (ERS) is involved in the pathological process of vascular dementia (VD). GJ-4 is extracted from Gardenia jasminoides J. Ellis and has been reported to have protective roles in ischemia-related brain damage. However, the role of GJ-4 in ERS has not been elucidated. We established a VD rat model through bilateral common carotid arteries occlusion (2-VO). The rats were intragastrically administrated with GJ-4 (10, 25, and 50[Formula: see text]mg/kg) and nimodipine (10[Formula: see text]mg/kg). Data from a Morris water maze test showed that GJ-4 could significantly alleviate learning and memory deficits in VD rats. Nissl and cleaved caspase-3 staining revealed that GJ-4 can inhibit apoptosis and thus exert a protective role in the brain of 2-VO rats. Western blot results suggested that GJ-4 significantly reduced ERS-related protein expression and inhibited apoptosis through suppression of the PERK/eIF2[Formula: see text]/ATF4/CHOP signaling pathway. For in vitro studies, the oxygen-glucose deprivation (OGD) SH-SY5Y model was employed. Western blot and Hoechst 33342/PI double staining were utilized to explore the effects of crocetin, the main active metabolite of GJ-4. Like GJ-4 in vivo, crocetin in vitro also decreased ERS-related protein expression and inhibited the activation of the PERK/eIF2[Formula: see text]/ATF4/CHOP signaling pathway. Thus, crocetin exerted similar protective roles on OGD challenged SH-SY5Y cells in vitro. In summary, GJ-4 and crocetin reduce the ERS in the brain of VD rats and SY5Y cells subjected to OGD and inhibit neuronal apoptosis through suppression of the PERK/eIF2[Formula: see text]/ATF4/CHOP pathway, suggesting that GJ-4 may be useful for the treatment of VD.
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Affiliation(s)
- Fang-Yu Yuan
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Cheng Ju
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Cai-Xia Zang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Hui Liu
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Mei-Yu Shang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Jing-Wen Ning
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Yang Yang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Jing-Wei Ma
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Gen Li
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Yang Yu
- Institute of TCM and Natural Products, College of Pharmacy, Jinan University, Guangzhou, Guangdong Province 510632, P. R. China
| | - Xin-Sheng Yao
- Institute of TCM and Natural Products, College of Pharmacy, Jinan University, Guangzhou, Guangdong Province 510632, P. R. China
| | - Xiu-Qi Bao
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
| | - Dan Zhang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materica Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, P. R. China
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Murdaca G, Banchero S, Casciaro M, Tonacci A, Billeci L, Nencioni A, Pioggia G, Genovese S, Monacelli F, Gangemi S. Potential Predictors for Cognitive Decline in Vascular Dementia: A Machine Learning Analysis. Processes (Basel) 2022; 10:2088. [DOI: 10.3390/pr10102088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2025] Open
Abstract
Vascular dementia (VD) is a cognitive impairment typical of advanced age with vascular etiology. It results from several vascular micro-accidents involving brain vessels carrying less oxygen and nutrients than it needs. This being a degenerative disease, the diagnosis often arrives too late, when the brain tissue is already damaged. Thus, prevention is the best solution to avoid irreversible cognitive impairment in patients with specific risk factors. Using the machine learning (ML) approach, our group evaluated Mini-Mental State Examination (MMSE) changes in patients affected by Alzheimer’s disease by considering different clinical parameters. We decided to apply a similar ML scheme to VD due to the consistent data obtained from the first work, including the assessment of various ML models (LASSO, RIDGE, Elastic Net, CART, Random Forest) for the outcome prediction (i.e., the MMSE modification throughout time). MMSE at recruitment, folate, MCV, PTH, creatinine, vitamin B12, TSH, and hemoglobinwere the best predictive parameters individuated by the best ML model: Random Forest. ML results can be useful inidentify predictive biomarkers for cognitive worsening in VD early and also for focusing on necessary examinations at the first visits to draw the most predictive features, saving time and money and reducethe burden on the patients themselves. Such results should be integrated with brain imaging, physiological signal measurements, and sensory patterns, particularly forthose senses already demonstrated to have a significant link with neurodegeneration. Adjusting compound deficit by administering nutraceuticals could support treatment effectiveness and lead to a better quality of life for patients, families, and caregivers, with a consistent impact on the national health systems load.
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Affiliation(s)
- Giuseppe Murdaca
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
- IRCCS OspedalePoliclinico San Martino, 16132 Genoa, Italy
| | - Sara Banchero
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
- IRCCS OspedalePoliclinico San Martino, 16132 Genoa, Italy
| | - Marco Casciaro
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Alessandro Tonacci
- Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), 56124 Pisa, Italy
| | - Lucia Billeci
- Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), 56124 Pisa, Italy
| | - Alessio Nencioni
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
- IRCCS OspedalePoliclinico San Martino, 16132 Genoa, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| | - Sara Genovese
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
| | - Fiammetta Monacelli
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
- IRCCS OspedalePoliclinico San Martino, 16132 Genoa, Italy
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
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Adamo D, Canfora F, Calabria E, Coppola N, Leuci S, Pecoraro G, Cuocolo R, Ugga L, D’Aniello L, Aria M, Mignogna MD. White matter hyperintensities in Burning Mouth Syndrome assessed according to the Age-Related White Matter Changes scale. Front Aging Neurosci 2022; 14:923720. [PMID: 36118686 PMCID: PMC9475000 DOI: 10.3389/fnagi.2022.923720] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/01/2022] [Indexed: 12/13/2022] Open
Abstract
Background White matter hyperintensities (WMHs) of the brain are observed in normal aging, in various subtypes of dementia and in chronic pain, playing a crucial role in pain processing. The aim of the study has been to assess the WMHs in Burning Mouth Syndrome (BMS) patients by means of the Age-Related White Matter Changes scale (ARWMCs) and to analyze their predictors. Methods One hundred BMS patients were prospectively recruited and underwent magnetic resonance imaging (MRI) of the brain. Their ARWMCs scores were compared with those of an equal number of healthy subjects matched for age and sex. Intensity and quality of pain, psychological profile, and blood biomarkers of BMS patients were further investigated to find potential predictors of WMHs. Specifically, the Numeric Rating Scale (NRS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hamilton rating scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) were administered. Results The BMS patients presented statistically significant higher scores on the ARWMCs compared to the controls, especially in the right frontal, left frontal, right parietal-occipital, left parietal-occipital, right temporal and left temporal lobes (p-values: <0.001, <0.001, 0.005, 0.002, 0.009, 0.002, and <0.001, respectively). Age, a lower educational level, unemployment, essential hypertension, and hypercholesterolemia were correlated to a higher total score on the ARWMCs (p-values: <0.001, 0.016, 0.014, 0.001, and 0.039, respectively). No correlation was found with the blood biomarkers, NRS, SF-MPQ, HAM-A, HAM-D, PSQI, and ESS. Conclusion Patients with BMS showed a higher frequency of WMHs of the brain as suggested by the higher ARWCs scores compared with the normal aging of the healthy subjects. These findings could have a role in the pathophysiology of the disease and potentially affect and enhance pain perception.
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Affiliation(s)
- Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
- *Correspondence: Elena Calabria,
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Luca D’Aniello
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University of Naples Federico II, Naples, Italy
| | - Michele D. Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Salwierz P, Davenport C, Sumra V, Iulita MF, Ferretti MT, Tartaglia MC. Sex and gender differences in dementia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:179-233. [PMID: 36038204 DOI: 10.1016/bs.irn.2022.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The dementia landscape has undergone a striking paradigm shift. The advances in understanding of neurodegeneration and proteinopathies has changed our approach to patients with cognitive impairment. Firstly, it has recently been shown that the various proteinopathies that are the cause of the dementia begin to build up long before the appearance of any obvious symptoms. This has cemented the idea that there is an urgency in diagnosis as it occurs very late in the pathophysiology of these diseases. Secondly, that accurate diagnosis is required to deliver targeted therapies, that is precision medicine. With this latter point, the realization that various factors of a person need to be considered as they may impact the presentation and progression of disease has risen to the forefront. Two of these factors aside from race and age are biological sex and gender (social construct), as both can have tremendous impact on manifestation of disease. This chapter will cover what is known and remains to be known on the interaction of sex and gender with some of the major causes of dementia.
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Affiliation(s)
- Patrick Salwierz
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Carly Davenport
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Vishaal Sumra
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - M Florencia Iulita
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Women's Brain Project, Guntershausen, Switzerland
| | | | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada; Memory Clinic, Krembil Brain Institute, University Health Network, Toronto, ON, Canada.
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Moretti R, Giuffré M, Crocè LS, Gazzin S, Tiribelli C. Nonalcoholic Fatty Liver Disease and Altered Neuropsychological Functions in Patients with Subcortical Vascular Dementia. J Pers Med 2022; 12:1106. [PMID: 35887603 PMCID: PMC9323787 DOI: 10.3390/jpm12071106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023] Open
Abstract
NAFLD is the most common cause of abnormality in liver function tests. NAFLD is considered a potential cardiovascular risk factor and is linked to cardiovascular risk factors such as obesity, hypertension, type 2 diabetes, and dyslipidemia. Few previous studies have investigated whether NAFLD could be independently associated with cognitive impairment. The current study aims to find a possible role of NAFLD in the development of subcortical vascular dementia (sVaD). We considered NAFLD as a possible independent vascular risk factor or, considering its metabolic role, associated with other commonly accepted sVaD risk factors, i.e., lack of folate, vitamin B12, and vitamin D-OH25, and increased levels of homocysteine. We studied 319 patients diagnosed with sVaD. All patients underwent an abdominal ultrasound examination to classify steatosis into four levels (1-none up to 4-severe). sVaD patients were divided into two groups according to the presence or absence of NAFLD. Our results demonstrated a strong correlation between NAFLD and sVaD. Patients with the two comorbidities had worse neuropsychological outcomes and a worse metabolic profile. We also found a robust relationship between NAFLD and severe vitamin B12, folate, vitamin D hypovitaminosis, and higher hyperhomocysteinemia levels. This way, it is evident that NAFLD contributes to a more severe metabolic pathway. However, the strong relationship with the three parameters (B12, folate and vitamin D, and homocysteinemia) suggests that NAFLD can contribute to a proinflammatory condition.
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Affiliation(s)
- Rita Moretti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, 34149 Trieste, Italy; (R.M.); (L.S.C.)
| | - Mauro Giuffré
- Department of Medical, Surgical, and Health Sciences, University of Trieste, 34149 Trieste, Italy; (R.M.); (L.S.C.)
- Italian Liver Foundation, Centro Studi Fegato, 34149 Trieste, Italy; (S.G.); (C.T.)
| | - Lory Saveria Crocè
- Department of Medical, Surgical, and Health Sciences, University of Trieste, 34149 Trieste, Italy; (R.M.); (L.S.C.)
- Italian Liver Foundation, Centro Studi Fegato, 34149 Trieste, Italy; (S.G.); (C.T.)
| | - Silvia Gazzin
- Italian Liver Foundation, Centro Studi Fegato, 34149 Trieste, Italy; (S.G.); (C.T.)
| | - Claudio Tiribelli
- Italian Liver Foundation, Centro Studi Fegato, 34149 Trieste, Italy; (S.G.); (C.T.)
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Karjee H, Ghosh S, Dhibar T. Association of mid-life cerebral small vessel disease with diabetic retinopathy in type 2 diabetes in an Indian population. J Diabetes Complications 2022; 36:108149. [PMID: 35172935 DOI: 10.1016/j.jdiacomp.2022.108149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/18/2022] [Accepted: 02/06/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Prevalence of cerebral small vessel disease (SVD) in elderly patients with diabetic retinopathy (DR) is higher than in those without DR. We determined the prevalence and severity of SVD in middle-aged patients with DR and compared it with those without DR (NODR) in a subset of the Indian population. We feel this information is critical with evolving trends of an increasing incidence of stroke at younger ages. METHOD Institution-based analytical cross-sectional study with 88 middle-aged type 2 diabetes patients; 44 in each group with <10 years diabetes duration, <8% HbA1C value, and with no history of cardiovascular disease. The presence and severity of SVD were determined by magnetic resonance imaging (MRI). RESULT Prevalence of SVD was 59.1% among study participants; 70.5% in DR and 47.7% in NODR (p = .03). Significantly increased SVD score (p = .008), high SVD score (p = .030), and white matter hyperintensity (WMH) load (p = .017) were observed in DR compared to NODR. There was no difference in the load of lacune and microbleed. SVD score did not differ according to the severity of DR (p = .395). The location-wise study of MRI revealed a significantly higher SVD load at the centrum semiovale in DR than in NODR (p = .014). We observed a 2.6 times greater chance of SVD (Odds ratio: 2.6, 95% CI 1.1-6.3) and a 9.6 times greater chance of high SVD score (Odds ratio: 9.6, 95% CI 1.1-80.0) in DR compared to NODR. CONCLUSION Significantly higher burden of SVD in DR was observed, particularly affecting the centrum semiovale suggesting an association of mid-life SVD with DR in this population.
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Affiliation(s)
- Himadri Karjee
- Department of Ophthalmology, Calcutta National Medical College, 32 Gorachand Road, Kolkata 700014, India
| | - Sambuddha Ghosh
- Department of Ophthalmology, Calcutta National Medical College, 32 Gorachand Road, Kolkata 700014, India.
| | - Tapan Dhibar
- Department of Radiology, Bangur Institue of Neurosciences, 52/1a, Sambhunath Pandit St, Gokhel Road, Bhowanipore, Kolkata 700020, India
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Gil Martínez V, Avedillo Salas A, Santander Ballestín S. Vitamin Supplementation and Dementia: A Systematic Review. Nutrients 2022; 14:1033. [PMID: 35268010 PMCID: PMC8912288 DOI: 10.3390/nu14051033] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Dementia is a syndrome characterized by progressive cognitive impairment that interferes with independent function in daily activities. Symptoms of dementia depend on its cause and vary greatly between individuals. There is extensive evidence supporting a relationship between diet and cognitive functions. This systematic review studies the efficacy of using vitamin supplements in the diet as a solution to nutritional deficiencies and the prevention of dementia and mild cognitive impairment. METHODS An intensive search of different databases (PubMed, Web of Science, and Cochrane CENTRAL) was performed. Articles that were published between 2011 and November 2021 were retrieved using the mentioned search strategy. This systematic review has been conducted according to the PRISMA statement. RESULTS Folic acid supplementation proved to have better outcomes on cognitive tests than their respective control groups. The combined supplementation of folic acid and vitamin B12 showed some discrepancies between studies. Thiamine as supplementation did not only prove to have a positive impact on cognitive performance when given alone but also when given in combination with folic acid. Regarding vitamin D supplementation, the results observed were not so encouraging. A concomitant supplementation of low-dose vitamin E and vitamin C was also not associated with an improvement of cognitive function. CONCLUSIONS The findings of this systematic review suggest that supplementation of B Complex vitamins, especially folic acid, may have a positive effect on delaying and preventing the risk of cognitive decline. Ascorbic acid and a high dose of vitamin E, when given separately, also showed positive effects on cognitive performance, but there is not sufficient evidence to support their use. The results of vitamin D supplementation trials are not conclusive in assessing the potential benefits that vitamin D might have on cognition.
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Affiliation(s)
| | - Ana Avedillo Salas
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Sonia Santander Ballestín
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
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Fan Y, Zhang L, Kong X, Liu K, Wu H. Different Exercise Time on 5-HT and Anxiety-like Behavior in the Rat With Vascular Dementia. Am J Alzheimers Dis Other Demen 2022; 37:15333175221082743. [PMID: 35344444 PMCID: PMC10581105 DOI: 10.1177/15333175221082743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies have demonstrated that pre-exercise suppresses anxiety-like behavior, but the effects of different exercise times on vascular dementia induced anxiety-like behavior have not been well investigated. OBJECTIVE The present study aims to investigate the underlying neurochemical mechanism of different pre-vascular-dementia exercise times on 5-HT and anxiety-like behavior in rats with vascular dementia. METHODS 32 Sprague-Dawley (SD) rats were randomly divided into 4 groups: sham group (S group, n = 8), vascular dementia group (VD group, n = 8), 1-week physical exercise and vascular dementia group (1WVD group, n = 8), and 4 weeks physical exercise and vascular dementia group (4WVD group, n = 8). 1 week and 4 weeks of voluntary wheel running were used as pre-exercise training. The vascular dementia model was established by bilateral common carotid arteries occlusion (BCCAo) for 1 week. But bilateral common carotid arteries were not ligated in the sham group. The level of hippocampal 5-HT was detected with in vivo microdialysis coupled with high-performance liquid chromatography (MD-HPLC). Elevated plus maze (EPM), open field (OF), and light/dark box test were used to test anxiety-like behavior. RESULTS Compared with the C group, the hippocampal 5-HT was significantly decreased in the VD group after 1 week of ligated operation. The hippocampal 5-HT levels in 1WVD and 4WVD groups were substantially higher than the level in the VD group. The hippocampal 5-HT level has no significant difference among C, 1WVD, and 4WVD. Behavioral data suggested that the rats in the VD group developed obvious anxiety-like behavior after 1 week of ligation surgery. Still, the rats in 1WVD and 4WVD groups did not show significant anxiety-like behavior. CONCLUSION Both 1 week and 4 weeks of voluntary running wheel exercise can inhibit the anxiety-like behavior in rats with vascular dementia by upregulating 5-HT levels in the hippocampus in the VD model.
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Affiliation(s)
- Yongzhao Fan
- Capital University of Physical Education and Sports, Comprehensive Key Laboratory of Sports Ability Evaluation and Research of the General Administration of Sport of China, Beijing Key Laboratory of Sports Function Assessment and Technical Analysis, Beijing, 100191, China
| | - Linlin Zhang
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, China
| | - Xiaoyang Kong
- Capital University of Physical Education and Sports, Comprehensive Key Laboratory of Sports Ability Evaluation and Research of the General Administration of Sport of China, Beijing Key Laboratory of Sports Function Assessment and Technical Analysis, Beijing, 100191, China
| | - Kun Liu
- Capital University of Physical Education and Sports, Comprehensive Key Laboratory of Sports Ability Evaluation and Research of the General Administration of Sport of China, Beijing Key Laboratory of Sports Function Assessment and Technical Analysis, Beijing, 100191, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Brain Peace Science Foundation, New Haven, CT, USA
| | - Hao Wu
- Capital University of Physical Education and Sports, Comprehensive Key Laboratory of Sports Ability Evaluation and Research of the General Administration of Sport of China, Beijing Key Laboratory of Sports Function Assessment and Technical Analysis, Beijing, 100191, China
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20
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Zhu T, Zhu M, Qiu Y, Wu Z, Huang N, Wan G, Xu J, Song P, Wang S, Yin Y, Li P. Puerarin Alleviates Vascular Cognitive Impairment in Vascular Dementia Rats. Front Behav Neurosci 2021; 15:717008. [PMID: 34720898 PMCID: PMC8554240 DOI: 10.3389/fnbeh.2021.717008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Cerebral ischemia triggers vascular dementia (VD), which is characterized by memory loss, cognitive deficits, and vascular injury in the brain. Puerarin (Pur) represents the major isoflavone glycoside of Radix Puerariae, with verified neuroprotective activity and cardiovascular protective effects. However, whether Pur ameliorates cognitive impairment and vascular injury in rats with permanent occlusion of bilateral common carotid arteries (BCCAO) remains unknown. This work aimed to assess Pur's effects on BCCAO-induced VD and to dissect the underlying mechanisms, especially examining the function of transient receptor potential melastatin-related 2 (TRPM2) in alleviating cognitive deficits and vascular injuries. Rats with BCCAO developed VD. Pur (50, 100, and 150 mg/kg) dose-dependently attenuated the pathological changes, increased synaptic structural plasticity in the dorsal CA1 hippocampal region and decreased oxidative stress, which eventually reduced cognitive impairment and vascular injury in BCCAO rats. Notably, Pur-improved neuronal cell loss, synaptic structural plasticity, and endothelial vasorelaxation function might be mediated by the reactive oxygen species (ROS)-dependent TRPM2/NMDAR pathway, evidenced by decreased levels of ROS, malondialdehyde (MDA), Bax, Bax/Bcl2, and TRPM2, and increased levels of superoxide dismutase (SOD), Bcl2, and NR2A. In conclusion, Pur has therapeutic potential for VD, alleviating neuronal cell apoptosis and vascular injury, which may be related to the ROS-dependent TRPM2/NMDAR pathway.
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Affiliation(s)
- Tiantian Zhu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Moli Zhu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Yue Qiu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Zeqing Wu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Ning Huang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Guangrui Wan
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Jian Xu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Ping Song
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Shuangxi Wang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
| | - Yaling Yin
- Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China.,School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, China
| | - Peng Li
- College of Pharmacy, Xinxiang Medical University, Xinxiang, China.,Henan International Joint Laboratory of Cardiovascular Remodeling and Drug Intervention, Xinxiang, China.,Xinxiang Key Laboratory of Vascular Remodeling Intervention and Molecular Targeted Therapy Drug Development, Xinxiang, China
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21
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Yang K, Zeng L, Ge A, Cao C, Zhang H, Bao T, Yi Y, Ge J. Systems Biology and Chemoinformatics-Based Strategies to Explore the Biological Mechanism of Fugui Wenyang Decoction in Treating Vascular Dementia Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6693955. [PMID: 34659639 PMCID: PMC8517630 DOI: 10.1155/2021/6693955] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the biological mechanism of Fugui Wenyang Decoction (FGWYD) in treating vascular dementia (VD) rats based on systems pharmacology, proteomics, and a multidirectional pharmacology integration strategy. METHODS Chemoinformatics was utilized to construct and analyze the FGWYD-VD protein-protein interaction (PPI) network. Then, the total protein in the brain tissue of the infarcted side of the rat was extracted for protein identification, pattern identification, and protein quantitative analysis. The differentially expressed proteins are analyzed by bioinformatics. Finally, the important proteins in the oxidative stress-related biological process proteins and indicators were detected through experimental pharmacology to verify the findings of systems biology and chemoinformatics. RESULTS There were a total of 73 FGWYD components with 245 FGWYD and 145 VD genes. The results of GO enrichment analysis and pathway enrichment analysis showed that MBHD may regulate the inflammation module, oxidative stress, the synaptic plasticity regulation module, and the neuronal apoptosis section module. Compared with the sham operation group, there were 23 upregulated proteins and 17 downregulated proteins in the model group (P < 0.05). Compared with the model group, there were 16 upregulated proteins and 10 downregulated proteins in the FGWYD group (P < 0.05). Bioinformatics analysis shows that those proteins were closely related to processes such as inflammation, oxidative stress, neuronal apoptosis, neuronal growth and differentiation, signaling pathways, and transcriptional regulation. Multidirectional pharmacology further verified the neuroprotective mechanism of the Nrf2/HO-1 pathway in FGWYD treatment of VD. CONCLUSION The mechanism of FGWYD in the treatment of VD may be related to inflammation, oxidative stress, angiogenesis, and neuronal apoptosis.
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Affiliation(s)
- Kailin Yang
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Liuting Zeng
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Anqi Ge
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Chuandong Cao
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Haiyan Zhang
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Tingting Bao
- Beijing University of Chinese Medicine, Beijing, China
| | - Yaqiao Yi
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Jinwen Ge
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
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22
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Akhter F, Persaud A, Zaokari Y, Zhao Z, Zhu D. Vascular Dementia and Underlying Sex Differences. Front Aging Neurosci 2021; 13:720715. [PMID: 34566624 PMCID: PMC8457333 DOI: 10.3389/fnagi.2021.720715] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022] Open
Abstract
Vascular dementia (VaD) is the second most common form of dementia after Alzheimer's disease (AD); where Alzheimer's accounts for 60-70% of cases of dementia and VaD accounts for 20% of all dementia cases. VaD is defined as a reduced or lack of blood flow to the brain that causes dementia. VaD is also known occasionally as vascular contributions to cognitive impairment and dementia (VCID) or multi-infarct dementia (MID). VCID is the condition arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior, and VaD is the most severe stage while MID is produced by the synergistic effects caused by multiple mini strokes in the brain irrespective of specific location or volume. There are also subtle differences in the presentation of VaD in males and females, but they are often overlooked. Since 1672 when the first case of VaD was reported until now, sex and gender differences have had little to no research done when it comes to the umbrella term of dementia in general. This review summarizes the fundamentals of VaD followed by a focus on the differences between sex and gender when an individual is diagnosed. In addition, we provide critical evidence concerning sex and gender differences with a few of the main risk factors of VaD including pre-existing health conditions and family history, gene variants, aging, hormone fluctuations, and environmental risk factors. Additionally, the pharmaceutical treatments and possible mitigation of risk factors is explored.
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Affiliation(s)
- Firoz Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Alicia Persaud
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Younis Zaokari
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Zhen Zhao
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
- Neuroscience Graduate Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
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23
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Blazek PJ, Lin MM. Explainable neural networks that simulate reasoning. NATURE COMPUTATIONAL SCIENCE 2021; 1:607-618. [PMID: 38217134 DOI: 10.1038/s43588-021-00132-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/16/2021] [Indexed: 01/15/2024]
Abstract
The success of deep neural networks suggests that cognition may emerge from indecipherable patterns of distributed neural activity. Yet these networks are pattern-matching black boxes that cannot simulate higher cognitive functions and lack numerous neurobiological features. Accordingly, they are currently insufficient computational models for understanding neural information processing. Here, we show how neural circuits can directly encode cognitive processes via simple neurobiological principles. To illustrate, we implemented this model in a non-gradient-based machine learning algorithm to train deep neural networks called essence neural networks (ENNs). Neural information processing in ENNs is intrinsically explainable, even on benchmark computer vision tasks. ENNs can also simulate higher cognitive functions such as deliberation, symbolic reasoning and out-of-distribution generalization. ENNs display network properties associated with the brain, such as modularity, distributed and localist firing, and adversarial robustness. ENNs establish a broad computational framework to decipher the neural basis of cognition and pursue artificial general intelligence.
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Affiliation(s)
- Paul J Blazek
- Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Biophysics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Milo M Lin
- Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Department of Biophysics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Center for Alzheimer's and Neurodegenerative Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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24
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Matsumoto T, Hoshi H, Hirata Y, Ichikawa S, Fukasawa K, Gonda T, Poza J, Rodríguez-González V, Gómez C, Shigihara Y. The association between carotid blood flow and resting-state brain activity in patients with cerebrovascular diseases. Sci Rep 2021; 11:15225. [PMID: 34315975 PMCID: PMC8316461 DOI: 10.1038/s41598-021-94717-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/15/2021] [Indexed: 11/09/2022] Open
Abstract
Cerebral hypoperfusion impairs brain activity and leads to cognitive impairment. Left and right common carotid arteries (CCA) are the major source of cerebral blood supply. It remains unclear whether blood flow in both CCA contributes equally to brain activity. Here, CCA blood flow was evaluated using ultrasonography in 23 patients with cerebrovascular diseases. Resting-state brain activity and cognitive status were also assessed using magnetoencephalography and a cognitive subscale of the Functional Independence Measure, respectively, to explore the relationships between blood flow, functional brain activity, and cognitive status. Our findings indicated that there was an association between blood flow and resting-state brain activity, and between resting-state brain activity and cognitive status. However, blood flow was not significantly associated with cognitive status directly. Furthermore, blood velocity in the right CCA correlated with resting-state brain activity, but not with the resistance index. In contrast, the resistance index in the left CCA correlated with resting-state brain activity, but not with blood velocity. Our findings suggest that hypoperfusion is important in the right CCA, whereas cerebral microcirculation is important in the left CCA for brain activity. Hence, this asymmetry should be considered when designing appropriate therapeutic strategies.
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Affiliation(s)
- Takahiro Matsumoto
- Department of Neurosurgery, Kumagaya General Hospital, Kumagaya, 360-8567, Japan
| | - Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Kisen-7-5 Inadacho, Obihiro, Hokkaido, 080-0833, Japan
| | - Yoko Hirata
- Department of Neurosurgery, Kumagaya General Hospital, Kumagaya, 360-8567, Japan
| | - Sayuri Ichikawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, 360-8567, Japan
| | - Keisuke Fukasawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, 360-8567, Japan
| | - Tomoyuki Gonda
- Department of Rehabilitation, Kumagaya General Hospital, Kumagaya, 360-8567, Japan
| | - Jesús Poza
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, Castilla y León, 47011, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, (CIBER-BBN), Biomateriales y Nanomedicina, Castilla y León, 47011, Valladolid, Spain.,Instituto de Investigación en Matemáticas (IMUVA), University of Valladolid, Castilla y León, 47011, Valladolid, Spain
| | - Víctor Rodríguez-González
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, Castilla y León, 47011, Valladolid, Spain
| | - Carlos Gómez
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, Castilla y León, 47011, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, (CIBER-BBN), Biomateriales y Nanomedicina, Castilla y León, 47011, Valladolid, Spain
| | - Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Kisen-7-5 Inadacho, Obihiro, Hokkaido, 080-0833, Japan. .,Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, 360-8567, Japan.
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25
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Moretti R, Caruso P, Giuffré M, Tiribelli C. COVID-19 Lockdown Effect on Not Institutionalized Patients with Dementia and Caregivers. Healthcare (Basel) 2021; 9:893. [PMID: 34356269 PMCID: PMC8303803 DOI: 10.3390/healthcare9070893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/01/2021] [Accepted: 07/13/2021] [Indexed: 01/19/2023] Open
Abstract
SARS-COV-2 is a severe medical condition. Old patients are very vulnerable, but they have been studied only as institutionalized patients. During the lock-down, little attention is dedicated to old, demented patients who lived at home. This study wants to examine their behavioral reactions by video-phone follow-up. We conducted a longitudinal study in subcortical vascular dementia (sVAD) patients. We enrolled 221 sVAD, not institutionalized patients. We divided sVAD patients into low-medium grade sVAD (A) and severe sVAD (B), based on neuroimaging severity degree and executive alterations. At baseline, at the end of lock-down, and two months later, global behavioral symptoms were recorded for each patient. We found significantly higher scores of general behavioral deterioration, anxiety, delusions, hallucinations and apathy after controlling for sVAD severity. The direct consequence was a drastic increment of psychotropic drugs prescribed and employed during the lock-down. Moreover, caregivers' stress has been evaluated, together with their anxiety and depression levels. During the lock-down, their scores increased and reflected a severe worsening of their behavior. Our data demonstrate that social isolation induces a severe perception of loneliness and abandonment; these fears can exacerbate behavior disturbances in old-aged frail persons. Thus, these can be considered as indirect victims of SARS-COV-2.
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Affiliation(s)
- Rita Moretti
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (P.C.); (M.G.)
| | - Paola Caruso
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (P.C.); (M.G.)
| | - Mauro Giuffré
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (P.C.); (M.G.)
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26
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Bir SC, Khan MW, Javalkar V, Toledo EG, Kelley RE. Emerging Concepts in Vascular Dementia: A Review. J Stroke Cerebrovasc Dis 2021; 30:105864. [PMID: 34062312 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105864] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/29/2021] [Accepted: 04/28/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Vascular dementia (VaD) is the second most common cause of dementia and a major health concern worldwide. A comprehensive review on VaD is warranted for better understanding and guidance for the practitioner. We provide an updated overview of the epidemiology, pathophysiological mechanisms, neuroimaging patterns as well as current diagnostic and therapeutic approaches. MATERIALS AND METHODS A narrative review of current literature in VaD was performed based on publications from the database of PubMed, Scopus and Google Scholar up to January, 2021. RESULTS VaD can be the result of ischemic or hemorrhagic tissue injury in a particular region of the brain which translates into clinically significant cognitive impairment. For example, a cerebral infarct in the speech area of the dominant hemisphere would translate into clinically significant impairment as would involvement of projection pathways such as the arcuate fasciculus. Specific involvement of the angular gyrus of the dominant hemisphere, with resultant Gerstman's syndrome, could have a pronounced effect on functional ability despite being termed a "minor stroke". Small vessel cerebrovascular disease can have a cumulate effect on cognitive function over time. It is unfortunately well recognized that "good" functional recovery in acute ischemic or haemorrhagic stroke, including subarachnoid haemorrhage, does not necessarily translate into good cognitive recovery. The victim may often be left unable to have gainful employment, drive a car safely or handle their affairs independently. CONCLUSIONS This review should serve as a compendium of updated information on VaD and provide guidance in terms of newer diagnostic and potential therapeutic approaches.
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Affiliation(s)
- Shyamal C Bir
- Department of Neurology Ocshner/LSU Health Sciences Center-Sheveport, Shreveport, LA, USA
| | - Muhammad W Khan
- Department of Neurology Ocshner/LSU Health Sciences Center-Sheveport, Shreveport, LA, USA
| | - Vijayakumar Javalkar
- Department of Neurology Ocshner/LSU Health Sciences Center-Sheveport, Shreveport, LA, USA
| | | | - Roger E Kelley
- Department of Neurology Ocshner/LSU Health Sciences Center-Sheveport, Shreveport, LA, USA.
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27
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Lewis JP, Manson SM, Jernigan VB, Noonan C. "Making Sense of a Disease That Makes No Sense": Understanding Alzheimer's Disease and Related Disorders Among Caregivers and Providers Within Alaska Native Communities. THE GERONTOLOGIST 2021; 61:363-373. [PMID: 32789474 PMCID: PMC8023374 DOI: 10.1093/geront/gnaa102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES With the rate of Alzheimer's disease and related dementias (ADRD) increasing among Alaska Indian/Alaska Native (AI/AN) people, the Alaska Native Health system is ill-prepared to meet the challenges associated with the growing population at risk of ADRD. The high cost of care, inadequate training of health care providers, and lack of supportive services for caregivers are especially concerning. RESEARCH DESIGN AND METHODS Interviews were conducted with 22 AN caregivers for ANs with ADRD and 12 ANs and non-Native health care providers in communities across Alaska. Interviews lasted approximately 60 min and were transcribed verbatim. We employed directed content analysis to examine the major agreements and disagreements between the participants' understandings of ADRD in each of the domains of Kleinman's Explanatory Model of Illness. RESULTS Caregivers and health care providers expressed concerns about the lack of understanding, resources, and awareness of ADRD among ANs in rural and urban communities. Both caregivers and providers recognized the need to obtain an early diagnosis, blend Western and traditional medicines, promote lifestyle and dietary changes, and foster training for caregivers. Health care providers acknowledged their limited exposure to AN understanding of ADRD and wish to receive culturally relevant training to better serve AN. DISCUSSION AND IMPLICATIONS As the older AN adult population grows, the need for culturally responsive training and support services will continue to increase. We recommend establishing rural outreach and support groups for caregivers, developing an understanding of how ANs view ADRD to train and educate health care providers, and implement screening early for memory loss during routine medical examinations.
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Affiliation(s)
- Jordan P Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Aurora
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Valarie B Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health, Washington State University, Pullman
- Elson S. Floyd College of Medicine, Washington State University, Pullman
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28
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Zheng G, Wang L, Li X, Niu X, Xu G, Lv P. Rapamycin alleviates cognitive impairment in murine vascular dementia: The enhancement of mitophagy by PI3K/AKT/mTOR axis. Tissue Cell 2021; 69:101481. [PMID: 33383488 DOI: 10.1016/j.tice.2020.101481] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022]
Abstract
There are no approved symptomatic treatments for vascular dementia (VaD). Rapamycin (RAPA) improves cognitive deficits in Alzheimer's disease rats. To explore whether RAPA improves cognitive impairment after VaD and its possible molecular mechanisms. Thirty Sprague Dawley rats were randomly divided into three groups: sham (received sham-operation), VaD model (received permanent ligation of bilateral carotid arteries) and RAPA (7.5 mg/kg) treatment. Cognitive function was evaluated by Morris water maze test. Neuronal apoptosis was evaluated by TUNEL staining. Mitophagy was assessed by mitochondrial DNA (mtDNA), ATP level, transmission electron microscope and mitophagy-associated proteins. Proteins were quantified by Western blot and immunofluorescence. BV2 cells were exposed to RAPA or/and MHY1485 (mTOR activator) to verify in vivo results. Compared to VaD rats, the escape latency of RAPA-treated rats was significantly decreased, and time spent in target quadrant was longer. Pathologic changes, mitochondrial dysfunction, increase of neuronal apoptosis and related proteins in VaD rats were remarkably alleviated by RAPA. After RAPA treatment, an increase in number of autophagosomes was observed, along with up-regulation of mitophagy-related proteins. Overexpression of PI3K, AKT and mTOR were suppressed by RAPA treatment. In vitro experiments confirmed effects of RAPA, and demonstrated that MHY1485 addition reversed the RAPA-caused apoptosis inhibition and mitophagy enhancement. Overall, RAPA improved the cognitive impairment of VaD rats, alleviated neuronal injury and mitochondrial dysfunction. We proposed a potential mechanism that RAPA may play improving role by inhibiting neuronal apoptosis and enhancing mitophagy through PI3K/AKT/mTOR pathway. Findings provided an exciting possibility for novel treatment strategy of VaD.
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Affiliation(s)
- Guimin Zheng
- Department of Neurology, Hebei Medical University, China; Department of Rheumatology and Immunology, HeBei General Hospital, China.
| | - Lei Wang
- Department of Medical Imaging, HeBei General Hospital, China.
| | - Xiuqin Li
- Department of Geriatric Medicine, HeBei General Hospital, China.
| | - Xiaoli Niu
- Department of Neurology, HeBei General Hospital, China.
| | - Guodong Xu
- Department of Neurointerventional Surgery, HeBei General Hospital, China.
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, China; Department of Neurology, HeBei General Hospital, China.
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Tayler H, Miners JS, Güzel Ö, MacLachlan R, Love S. Mediators of cerebral hypoperfusion and blood-brain barrier leakiness in Alzheimer's disease, vascular dementia and mixed dementia. Brain Pathol 2021; 31:e12935. [PMID: 33410232 PMCID: PMC8412075 DOI: 10.1111/bpa.12935] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/18/2020] [Accepted: 12/29/2020] [Indexed: 12/31/2022] Open
Abstract
In vascular dementia (VaD) and Alzheimer’s disease (AD), cerebral hypoperfusion and blood‐brain barrier (BBB) leakiness contribute to brain damage. In this study, we have measured biochemical markers and mediators of cerebral hypoperfusion and BBB in the frontal (BA6) and parietal (BA7) cortex and underlying white matter, to investigate the pathophysiology of vascular dysfunction in AD, VaD and mixed dementia. The ratio of myelin‐associated glycoprotein to proteolipid protein‐1 (MAG:PLP1), a post‐mortem biochemical indicator of the adequacy of ante‐mortem cerebral perfusion; the concentration of fibrinogen adjusted for haemoglobin level, a marker of blood‐brain barrier (BBB) leakiness; the level of vascular endothelial growth factor‐A (VEGF), a marker of tissue hypoxia; and endothelin‐1 (EDN1), a potent vasoconstrictor, were measured by ELISA in the frontal and parietal cortex and underlying white matter in 94 AD, 20 VaD, 33 mixed dementia cases and 58 age‐matched controls. All cases were assessed neuropathologically for small vessel disease (SVD), cerebral amyloid angiopathy (CAA) severity, Aβ and phospho‐tau parenchymal load, and Braak tangle stage. Aβ40 and Aβ42 were measured by ELISA in guanidine‐HCl tissue extracts. We found biochemical evidence of cerebral hypoperfusion in AD, VaD and mixed dementia to be associated with SVD, Aβ level, plaque load, EDN1 level and Braak tangle stage, and to be most widespread in mixed dementia. There was evidence of BBB leakiness in AD—limited to the cerebral cortex and related to EDN1 level. In conclusion, abnormalities of cerebral perfusion and BBB function in common types of dementia can largely be explained by a combination of arteriolosclerosis, and Aβ‐, tau‐ and endothelin‐related vascular dysfunction. The relative contributions of these processes vary considerably both between and within the diseases.
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Affiliation(s)
- Hannah Tayler
- Dementia Research Group, Institute of Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - J Scott Miners
- Dementia Research Group, Institute of Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Özge Güzel
- Dementia Research Group, Institute of Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rob MacLachlan
- Dementia Research Group, Institute of Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Seth Love
- Dementia Research Group, Institute of Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
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Cogo A, Mangin G, Maïer B, Callebert J, Mazighi M, Chabriat H, Launay JM, Huberfeld G, Kubis N. Increased serum QUIN/KYNA is a reliable biomarker of post-stroke cognitive decline. Mol Neurodegener 2021; 16:7. [PMID: 33588894 PMCID: PMC7885563 DOI: 10.1186/s13024-020-00421-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Strokes are becoming less severe due to increased numbers of intensive care units and improved treatments. As patients survive longer, post-stroke cognitive impairment (PSCI) has become a major health public issue. Diabetes has been identified as an independent predictive factor for PSCI. Here, we characterized a clinically relevant mouse model of PSCI, induced by permanent cerebral artery occlusion in diabetic mice, and investigated whether a reliable biomarker of PSCI may emerge from the kynurenine pathway which has been linked to inflammatory processes. METHODS Cortical infarct was induced by permanent middle cerebral artery occlusion in male diabetic mice (streptozotocin IP). Six weeks later, cognitive assessment was performed using the Barnes maze, hippocampi long-term potentiation using microelectrodes array recordings, and neuronal death, white matter rarefaction and microglia/macrophages density assessed in both hemispheres using imunohistochemistry. Brain and serum metabolites of the kynurenin pathway were measured using HPLC and mass fragmentography. At last, these same metabolites were measured in the patient's serum, at the acute phase of stroke, to determine if they could predict PSCI 3 months later. RESULTS We found long-term spatial memory was impaired in diabetic mice 6 weeks after stroke induction. Synaptic plasticity was completely suppressed in both hippocampi along with increased neuronal death, white matter rarefaction in both striatum, and increased microglial/macrophage density in the ipsilateral hemisphere. Brain and serum quinolinic acid concentrations and quinolinic acid over kynurenic acid ratios were significantly increased compared to control, diabetic and non-diabetic ischemic mice, where PSCI was absent. These putative serum biomarkers were strongly correlated with degradation of long-term memory, neuronal death, microglia/macrophage infiltration and white matter rarefaction. Moreover, we identified these same serum biomarkers as potential predictors of PSCI in a pilot study of stroke patients. CONCLUSIONS we have established and characterized a new model of PSCI, functionally and structurally, and we have shown that the QUIN/KYNA ratio could be used as a surrogate biomarker of PSCI, which may now be tested in large prospective studies of stroke patients.
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Affiliation(s)
- Adrien Cogo
- Université de Paris, INSERM U1148, Laboratory for Vascular Translational Science, F-75018 Paris, France
- Université de Paris, INSERM U965, CART, F-75010 Paris, France
| | - Gabrielle Mangin
- Université de Paris, INSERM U1148, Laboratory for Vascular Translational Science, F-75018 Paris, France
- Université de Paris, INSERM U965, CART, F-75010 Paris, France
| | - Benjamin Maïer
- Université de Paris, INSERM U965, CART, F-75010 Paris, France
| | - Jacques Callebert
- Université de Paris, Inserm UMR-S 942; Département de Biochimie et de Biologie Moléculaire, APHP, Hôpital Lariboisière, F-75010 Paris, France
| | - Mikael Mazighi
- Université de Paris, INSERM U1148, Laboratory for Vascular Translational Science, F-75018 Paris, France
- Service de Neurologie, APHP, Hôpital Lariboisière, F-75010 Paris, France
| | - Hughes Chabriat
- Service de Neurologie, APHP, Hôpital Lariboisière, F-75010 Paris, France
| | - Jean-Marie Launay
- Université de Paris, Inserm UMR-S 942; Département de Biochimie et de Biologie Moléculaire, APHP, Hôpital Lariboisière, F-75010 Paris, France
| | - Gilles Huberfeld
- Neuroglial Interactions in Cerebral Physiopathology, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR 7241, INSERM U1050, Labex Memolife, PSL Research University, F-75005 Paris, France
- Clinical Neurophysiology department, APHP, Pitie-Salpetriere Hospital, Sorbonne Université, APHP, F-75013 Paris, France
| | - Nathalie Kubis
- Université de Paris, INSERM U1148, Laboratory for Vascular Translational Science, F-75018 Paris, France
- Université de Paris, INSERM U965, CART, F-75010 Paris, France
- Service de Physiologie Clinique-Explorations Fonctionnelles, DMU DREAM, APHP, Hôpital Lariboisière, F-75010 Paris, France
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Wei B, Wang Z, Wu S, Orgah J, Zhu J, Song W. Improving Collateral Circulation: A Potential Adjunctive Strategy to Prevent or Slow the Progression of Vascular Dementia. Neuropsychiatr Dis Treat 2021; 17:3061-3067. [PMID: 34675517 PMCID: PMC8502063 DOI: 10.2147/ndt.s328446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Vascular dementia (VaD), a cognitive disorder caused by cerebrovascular pathologies, is the most common cause of dementia in the elderly, being second only to Alzheimer's disease. Researches have shown that adequate cerebral blood flow (CBF) is the first condition for maintaining the structural integrity and normal function of the brain, and VaD is generally considered to be resulted from neuronal loss due to reduced CBF. Collateral circulation, a compensation mechanism for CBF, provides an alternative vascular pathway for blood to reach ischemic tissues, which has been confirmed to be associated with better clinical outcomes of ischemic diseases. At present, considerable effort has been devoted to enhancing the functional prognosis of acute ischemic stroke by improving collateral circulation. Since ischemic stroke is the primary contributor to VaD, it is necessary to explore whether improving collateral circulation is beneficial to prevent or slow the progression of VaD. This article reviews the compensatory characteristics of different levels of cerebral collateral circulation, addresses the relationship between collateral circulation and VaD, and highlights that improving collateral circulation may be a potential adjunctive strategy in preventing and slowing the progression of VaD.
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Affiliation(s)
- Baoyu Wei
- State Key Laboratory of Component-Based Chinese Medicine, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China
| | - Zhaoqi Wang
- State Key Laboratory of Component-Based Chinese Medicine, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China
| | - Shihao Wu
- State Key Laboratory of Component-Based Chinese Medicine, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China
| | - John Orgah
- State Key Laboratory of Component-Based Chinese Medicine, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China
| | - Jinqiang Zhu
- State Key Laboratory of Component-Based Chinese Medicine, Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China
| | - Wanshan Song
- Department of Acupuncture and Cerebropathy, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300250, People's Republic of China
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Clouston SAP, Richmond LL, Scott SB, Luhmann CC, Natale G, Hanes D, Zhang Y, Smith DM. Pattern Recognition to Objectively Differentiate the Etiology of Cognitive Decline: Analysis of the Impact of Stroke and Alzheimer's Disease. Neuroepidemiology 2020; 54:446-453. [PMID: 33017832 PMCID: PMC7726036 DOI: 10.1159/000510133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/13/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Undetected Alzheimer's disease (AD) and stroke neuropathology is believed to account for a large proportion of decline in cognitive performance that is attributed to normal aging. This study examined the amount of variance in age-related cognitive change that is accounted for by AD and stroke using a novel pattern recognition protocol. METHOD Secondary analyses of data collected for the Health and Retirement Study (N = 17,579) were used to objectively characterize patterns of cognitive decline associated with AD and stroke. The rate of decline in episodic memory and orientation was the outcome of interest, while algorithms indicative of AD and stroke pathology were the predictors of interest. RESULTS The average age of the sample was 67.54 ± 10.45 years at baseline, and they completed, on average, 14.20 ± 3.56 years of follow-up. After adjusting for demographics, AD and stroke accounted for approximately half of age-associated decline in cognition (51.07-55.6% for orientation and episodic memory, respectively) and explained variance attributed to random slopes in longitudinal multilevel models. DISCUSSION The results of this study suggested that approximately half of the cognitive decline usually attributed to normal aging are more characteristic of AD and stroke.
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Affiliation(s)
- Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA,
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Stacey B Scott
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Christian C Luhmann
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
- Institute for Advanced Computational Science, Stony Brook University, Stony Brook, New York, USA
| | - Ginny Natale
- Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Douglas Hanes
- Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Yun Zhang
- Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Dylan M Smith
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
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Chua XY, Chai YL, Chew WS, Chong JR, Ang HL, Xiang P, Camara K, Howell AR, Torta F, Wenk MR, Hilal S, Venketasubramanian N, Chen CP, Herr DR, Lai MKP. Immunomodulatory sphingosine-1-phosphates as plasma biomarkers of Alzheimer's disease and vascular cognitive impairment. Alzheimers Res Ther 2020; 12:122. [PMID: 32998767 PMCID: PMC7528375 DOI: 10.1186/s13195-020-00694-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND There has been ongoing research impetus to uncover novel blood-based diagnostic and prognostic biomarkers for Alzheimer's disease (AD), vascular dementia (VaD), and related cerebrovascular disease (CEVD)-associated conditions within the spectrum of vascular cognitive impairment (VCI). Sphingosine-1-phosphates (S1Ps) are signaling lipids which act on the S1PR family of cognate G-protein-coupled receptors and have been shown to modulate neuroinflammation, a process known to be involved in both neurodegenerative and cerebrovascular diseases. However, the status of peripheral S1P in AD and VCI is at present unclear. METHODS We obtained baseline bloods from individuals recruited into an ongoing longitudinal cohort study who had normal cognition (N = 80); cognitive impairment, no dementia (N = 160); AD (N = 113); or VaD (N = 31), along with neuroimaging assessments of cerebrovascular diseases. Plasma samples were processed for the measurements of major S1P species: d16:1, d17:1, d18:0, and d18:1, along with pro-inflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF). Furthermore, in vitro effects of S1Ps on cytokine expression were also studied in an astrocytoma cell line and in rodent primary astrocytes. RESULTS Of the S1Ps species measured, only d16:1 S1P was significantly reduced in the plasma of VaD, but not AD, patients, while the d18:1 to d16:1 ratios were increased in all cognitive subgroups (CIND, AD, and VaD). Furthermore, d18:1 to d16:1 ratios correlated with levels of IL-6, IL-8, and TNF. In both primary astrocytes and an astroglial cell line, treatment with d16:1 or d18:1 S1P resulted in the upregulation of mRNA transcripts of pro-inflammatory cytokines, with d18:1 showing a stronger effect than d16:1. Interestingly, co-treatment assays showed that the addition of d16:1 reduced the extent of d18:1-mediated gene expression, indicating that d16:1 may function to "fine-tune" the pro-inflammatory effects of d18:1. CONCLUSION Taken together, our data suggest that plasma d16:1 S1P may be useful as a diagnostic marker for VCI, while the d18:1 to d16:1 S1P ratio is an index of dysregulated S1P-mediated immunomodulation leading to chronic inflammation-associated neurodegeneration and cerebrovascular damage.
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Affiliation(s)
- Xin Ying Chua
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
| | - Yuek Ling Chai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health Systems, Kent Ridge, Singapore
| | - Wee Siong Chew
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
| | - Joyce R Chong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health Systems, Kent Ridge, Singapore
| | - Hui Li Ang
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
- Cancer Science Institute, National University of Singapore, Kent Ridge, Singapore
| | - Ping Xiang
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
| | - Kaddy Camara
- Department of Chemistry, University of Connecticut, Storrs, CT, USA
| | - Amy R Howell
- Department of Chemistry, University of Connecticut, Storrs, CT, USA
| | - Federico Torta
- Singapore Lipidomics Incubator (SLING), Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore
| | - Markus R Wenk
- Singapore Lipidomics Incubator (SLING), Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health Systems, Kent Ridge, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Kent Ridge, Singapore
| | | | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore
- Memory, Aging and Cognition Centre, National University Health Systems, Kent Ridge, Singapore
| | - Deron R Herr
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore.
- Department of Biology, San Diego State University, San Diego, CA, USA.
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, 117597, Singapore.
- Memory, Aging and Cognition Centre, National University Health Systems, Kent Ridge, Singapore.
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Wang R, Liu N, Tao YY, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. The Application of rs-fMRI in Vascular Cognitive Impairment. Front Neurol 2020; 11:951. [PMID: 33041965 PMCID: PMC7517303 DOI: 10.3389/fneur.2020.00951] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
The incidence of vascular cognitive impairment (VCI) has been increasing for years and has become a major disabling factor in middle-aged and elderly populations. The pathogenesis of VCI is unclear, and there are no standard diagnostic criteria. Resting-state functional magnetic resonance imaging (rs-fMRI) can be used to detect spontaneous brain functional activity in a resting state, which facilitates in-depth investigation of the pathogenesis of VCI and provides an objective reference for early diagnosis, differential diagnosis, and prognostic evaluation. This article mainly reviews the principle and analysis of rs-fMRI data, as well as the progress of its application for VCI diagnosis.
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Affiliation(s)
| | | | | | | | | | | | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease. GeroScience 2020; 42:445-465. [PMID: 32002785 DOI: 10.1007/s11357-020-00164-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 01/22/2020] [Indexed: 01/07/2023] Open
Abstract
Executive dysfunction is the most important predictor for loss of independence in dementia. As executive function involves the coordination of distributed cerebral functions, executive function requires healthy white matter. However, white matter is highly vulnerable to cerebrovascular insults, with executive dysfunction being a core feature of vascular cognitive impairment (VCI). At the same time, cerebrovascular pathology, white matter disease, and executive dysfunction are all increasingly recognized as features of Alzheimer disease (AD). Recent studies have characterized the crucial role of glial cells in the pathological changes observed in both VCI and AD. In comorbid VCI and AD, the glial cells of the neurovascular unit (NVU) emerge as important therapeutic targets for the preservation of white matter integrity and executive function. Our synthesis from current research identifies dysregulation of the NVU, white matter disease, and executive dysfunction as a fundamental triad that is common to both VCI and AD. Further study of this triad will be critical for advancing the prevention and management of dementia.
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Abstract
BACKGROUND There are differences among the outcomes regarding cognitive impairment in heart failure (HF) because the evidence is fragmented and sample size is small. Therefore we aimed to systematically review and analyze the available evidence about the association between HF and dementia. METHODS In the present study, we searched for articles published until August 2019 in the following databases: PubMed, Web of Science, EMBASE, Medline and Google Scholar. The pooled multivariate odds ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) were obtained by the use of STATA 12.0 software. RESULTS The meta-analysis showed a positive association between HF and risk of all-cause dementia (OR/RR = 1.28, 95% CI 1.15 to 1.43, I = 70.0%, P < 0.001). Additionally, the study showed no significant association between HF and risk of Alzheimer's disease (AD) (OR/RR = 1.38, 95% CI 0.90 to 2.13, I = 74.8%, P = 0.008). CONCLUSION In conclusion, HF was associated with an increased risk of developing dementia. In addition, large scale prospective studies are essential to explore the associations between HF and risk of AD.
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Washida K, Hattori Y, Ihara M. Animal Models of Chronic Cerebral Hypoperfusion: From Mouse to Primate. Int J Mol Sci 2019; 20:ijms20246176. [PMID: 31817864 PMCID: PMC6941004 DOI: 10.3390/ijms20246176] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/17/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022] Open
Abstract
Vascular cognitive impairment (VCI) or vascular dementia occurs as a result of brain ischemia and represents the second most common type of dementia after Alzheimer’s disease. To explore the underlying mechanisms of VCI, several animal models of chronic cerebral hypoperfusion have been developed in rats, mice, and primates. We established a mouse model of chronic cerebral hypoperfusion by narrowing the bilateral common carotid arteries with microcoils, eventually resulting in hippocampal atrophy. In addition, a mouse model of white matter infarct-related damage with cognitive and motor dysfunction has also been established by asymmetric common carotid artery surgery. Although most experiments studying chronic cerebral hypoperfusion have been performed in rodents because of the ease of handling and greater ethical acceptability, non-human primates appear to represent the best model for the study of VCI, due to their similarities in much larger white matter volume and amyloid β depositions like humans. Therefore, we also recently developed a baboon model of VCI through three-vessel occlusion (both the internal carotid arteries and the left vertebral artery). In this review, several animal models of chronic cerebral hypoperfusion, from mouse to primate, are extensively discussed to aid in better understanding of pathophysiology of VCI.
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Affiliation(s)
- Kazuo Washida
- Correspondence: ; Tel.: +81-6-6170-1070; Fax: +81-6-6170-1782
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Cui S, Chen N, Yang M, Guo J, Zhou M, Zhu C, He L, Cochrane Dementia and Cognitive Improvement Group. Cerebrolysin for vascular dementia. Cochrane Database Syst Rev 2019; 2019:CD008900. [PMID: 31710397 PMCID: PMC6844361 DOI: 10.1002/14651858.cd008900.pub3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although vascular dementia is the second most common cause of dementia globally, evidence-based treatments are still lacking. Cerebrolysin is a porcine brain-derived preparation that is said to have neurotrophic and neuroprotective activity. In many parts of the world Cerebrolysin, given as a series of daily intravenous infusions, is used as a potential intervention for vascular dementia. A previous Cochrane Review on Cerebrolysin in vascular dementia yielded inconsistent results. We wished to update the review to add new studies from the international literature and employ contemporary methods for appraising the strength of the evidence. This is the first update of a review first published in 2013. OBJECTIVES Primary: to assess the effect of Cerebrolysin on cognitive function, global function, and all-cause mortality in people living with vascular dementia. Secondary: to assess the adverse effects of Cerebrolysin and to assess the effect of Cerebrolysin on quality of life and caregiver burden. SEARCH METHODS We searched ALOIS, MEDLINE, Embase, PsycINFO, CINAHL, ISI Web of Knowledge, LILACS, the Cochrane Library, ClinicalTrials.gov, and the WHO ICTRP on 16 June 2017, 9 May 2018, and 9 May 2019. We expanded the search by adding four Chinese databases, searched from 1 January 2012 to 19 May 2019. We checked bibliographies of relevant papers identified and contacted pharmaceutical companies, trial authors, and experts in the field to identify any additional published or unpublished data. SELECTION CRITERIA We included all randomised controlled trials of Cerebrolysin used in people living with vascular dementia. We applied no language restriction. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion and evaluated their methodological quality. Data were extracted and analysed using mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (95% CI) for continuous outcomes. We reported dichotomous outcomes as risk ratio (RR) with 95% CI. We assessed the strength of the available evidence using the GRADE approach. MAIN RESULTS We identified six randomised controlled trials with a total of 597 participants that were eligible for inclusion in the 2013 review. No new studies were eligible for inclusion in this update. Participants in the included studies, where dementia severity was reported, had mild to moderate severity of vascular dementia (four trials). The included studies tested varying doses and duration of Cerebrolysin treatment. Follow-up ranged from 15 days to three years. Five of included studies were conducted in China (three studies), Russia (one study), and Romania (one study), while relevant information of other study was unclear. Where details of funding were available, all studies were supported by the pharmaceutical industry (three studies). Cognitive function was measured using the Mini-Mental State Examination (MMSE) or Alzheimer's Disease Assessment Scale Cognitive Subpart, extended version (ADAS-cog+). Combining the MMSE and ADAS-cog+ data (three studies, 420 people), there was a beneficial effect of Cerebrolysin (SMD 0.36, 95% CI 0.13 to 0.58; very low-quality evidence). Global function was measured by Clinician's Interview-Based Impression of Change plus Caregiver Input (CIBIC+) or Investigator's Clinical Global Impression (CGI). We assessed response rates on these measures (the proportion of participants with a CIBIC+ score of < 3; or at least moderate improvement of the CGI rating at the last visit). There was a beneficial effect of Cerebrolysin (two studies, 379 participants, RR 2.69, 95% CI 1.82 to 3.98; very low-quality evidence). Only one trial described mortality and reported no deaths. Four studies reported adverse events; data from two studies (379 people) were in a format that permitted meta-analysis, and there was no difference in rates of adverse effects (RR 0.91, 95% CI 0.29 to 2.85; very low-quality evidence). No studies reported on quality of life or caregiver burden. AUTHORS' CONCLUSIONS Courses of intravenous Cerebrolysin improved cognition and general function in people living with vascular dementia, with no suggestion of adverse effects. However, these data are not definitive. Our analyses were limited by heterogeneity, and the included papers had high risk of bias. If there are benefits of Cerebrolysin, the effects may be too small to be clinically meaningful. There have been no new studies of Cerebrolysin in vascular dementia since the last Cochrane Review. Cerebrolysin continues to be used and promoted as a treatment for vascular dementia, but the supporting evidence base is weak. Adequately powered, methodologically robust trials are needed to properly assess the effects of Cerebrolysin in vascular dementia.
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Affiliation(s)
- Shuhui Cui
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
| | - Ning Chen
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
| | - Mi Yang
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
| | - Jian Guo
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
| | - Muke Zhou
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
| | - Cairong Zhu
- School of Public Health, Sichuan UniversityEpidemic Disease & Health Statistics DepartmentChengduChina
| | - Li He
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37 Guo Xue XiangChengduSichuanChina610041
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Clouston SAP, Zhang Y, Smith DM. Pattern Recognition to Identify Stroke in the Cognitive Profile: Secondary Analyses of a Prospective Cohort Study. Cerebrovasc Dis Extra 2019; 9:114-122. [PMID: 31593944 PMCID: PMC6873083 DOI: 10.1159/000503002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/28/2019] [Indexed: 11/26/2022] Open
Abstract
Background Stroke can produce subtle changes in the brain that may produce symptoms that are too small to lead to a diagnosis. Noting that a lack of diagnosis may bias research estimates, the current study sought to examine the utility of pattern recognition relying on serial assessments of cognition to objectively identify stroke-like patterns of cognitive decline (pattern-detected stroke, p-stroke). Methods Secondary data analysis was conducted using participants with no reported history of stroke in the Health and Retirement Study, a large (n = 16,113) epidemiological study of cognitive aging among respondents aged 50 years and older that measured episodic memory consistently biennially between 1996 and 2014. Analyses were limited to participants with at least 4 serial measures of episodic memory. Occurrence and date of p-stroke events were identified utilizing pattern recognition to identify stepwise declines in cognition consistent with stroke. Descriptive statistics included the percentage of the population with p-stroke, the mean change in episodic memory resulting in stroke-positive testing, and the mean time between p-stroke and first major diagnosed stroke. Statistical analyses comparing cases of p-stroke with reported major stroke relied on the area under the receiver-operating curve (AUC). Longitudinal modeling was utilized to examine rates of change in those with/without major stroke after adjusting for demographics. Results The pattern recognition protocol identified 7,499 p-strokes that went unreported. On average, individuals with p-stroke declined in episodic memory by 1.986 (SD = 0.023) words at the inferred time of stroke. The resulting pattern recognition protocol was able to identify self-reported major stroke (AUC = 0.58, 95% CI = 0.57-0.59, p < 0.001). In those with a reported major stroke, p-stroke events were detectable on average 4.963 (4.650–5.275) years (p < 0.001) before diagnosis was first reported. The incidence of p-stroke was 40.23/1,000 (95% CI = 39.40–41.08) person-years. After adjusting for sex, age was associated with the incidence of p-stroke and major stroke at similar rates. Conclusions This is the first study to propose utilizing pattern recognition to identify the incidence and timing of p-stroke. Further work is warranted examining the clinical utility of pattern recognition in identifying p-stroke in longitudinal cognitive profiles.
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Affiliation(s)
- Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA,
| | - Yun Zhang
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Dylan M Smith
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
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Walsh E, Blake Y, Donati A, Stoop R, von Gunten A. Early Secure Attachment as a Protective Factor Against Later Cognitive Decline and Dementia. Front Aging Neurosci 2019; 11:161. [PMID: 31333443 PMCID: PMC6622219 DOI: 10.3389/fnagi.2019.00161] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 06/12/2019] [Indexed: 01/07/2023] Open
Abstract
The etiology of neurodegenerative disorders such as dementia is complex and incompletely understood. Interest in a developmental perspective to these pathologies is gaining momentum. An early supportive social environment seems to have important implications for social, affective and cognitive abilities across the lifespan. Attachment theory may help to explain the link between these early experiences and later outcomes. This theory considers early interactions between an infant and its caregiver to be crucial to shaping social behavior and emotion regulation strategies throughout adult life. Furthermore, research has demonstrated that such early attachment experiences can, potentially through epigenetic mechanisms, have profound neurobiological and cognitive consequences. Here we discuss how early attachment might influence the development of affective, cognitive, and neurobiological resources that could protect against cognitive decline and dementia. We argue that social relations, both early and late in life, are vital to ensuring cognitive and neurobiological health. The concepts of brain and cognitive reserve are crucial to understanding how environmental factors may impact cognitive decline. We examine the role that attachment might play in fostering brain and cognitive reserve in old age. Finally, we put forward the concept of affective reserve, to more directly frame the socio-affective consequences of early attachment as protectors against cognitive decline. We thereby aim to highlight that, in the study of aging, cognitive decline and dementia, it is crucial to consider the role of affective and social factors such as attachment.
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Affiliation(s)
- Emilie Walsh
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Yvonne Blake
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Alessia Donati
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ron Stoop
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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CZ-7, a new derivative of Claulansine F, ameliorates 2VO-induced vascular dementia in rats through a Nrf2-mediated antioxidant responses. Acta Pharmacol Sin 2019; 40:425-440. [PMID: 30382185 DOI: 10.1038/s41401-018-0078-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/20/2018] [Indexed: 11/09/2022]
Abstract
Vascular dementia (VD) results from accumulated damage in the vascular system, which is characterized by progressive impairments in memory and cognition and is second only to Alzheimer's disease (AD) in prevalence among all types of dementia. In contrast to AD, there is no FDA-approved treatment for VD owing to its multiple etiologies. In this study, we investigated whether CZ-7, a new derivative of Claulansine F (Clau F) with verified neuroprotective activity in vitro, could ameliorate the cognitive impairment of rats with permanent occlusion of bilateral common carotid arteries (2VO) and its potential mechanisms of action. The 2VO rats were orally administered CZ-7 (10, 20, 40 mg/kg) from day 27 to day 53 post-surgery. Morris water maze tests conducted at day 48-51 revealed that CZ-7 administration significantly reduced the escape latency in 2VO rats. After the rats were sacrificed on day 53, morphological studies using Nissl and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining showed that administration of CZ-7 markedly attenuated the pathological changes in CA1-CA3 area of the hippocampus, including neuronal cell loss, nuclear shrinkage, and dark staining of neurons, and significantly decreased the chronic cerebral hypoperfusion-induced cell loss. Klüver-Barrera staining study revealed that CZ-7 administration significantly improved the white matter lesions. 8-OHdG and reactive oxygen species (ROS) immunofluorescent analyses showed that CZ-7 administration significantly decreased oxidative stress in CA1-CA3 area of the hippocampus. Finally, we found that the CZ-7-improved oxidative stress might be mediated via the Nrf2 pathway, evidenced by the double immunofluorescent staining of Nrf2 and the elevation of expression levels of oxidative stress proteins HO-1 and NQO1. In conclusion, CZ-7 has therapeutic potential for VD by alleviating oxidative stress injury through Nrf2-mediated antioxidant responses.
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Pantsiou K, Sfakianaki O, Papaliagkas V, Savvoulidou D, Costa V, Papantoniou G, Moraitou D. Inhibitory Control, Task/Rule Switching, and Cognitive Planning in Vascular Dementia: Are There Any Differences From Vascular Aging? Front Aging Neurosci 2018; 10:330. [PMID: 30410439 PMCID: PMC6211074 DOI: 10.3389/fnagi.2018.00330] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 09/28/2018] [Indexed: 01/06/2023] Open
Abstract
Recent studies have shown that patients diagnosed with Vascular Dementia (VaD) exhibit deficits in executive functions. According to “vascular hypothesis of cognitive aging,” community-dwelling older adults having risk factors for vascular disease development (RVD) may suffer from cognitive decline of the same type. The aim of the study was to assess the level of specific executive functions (EF) that have been revealed as most affected by vascular abnormalities, in older adults with incipient VaD and RVD. Subsequently specific ways of EF measuring could be suggested for more accurate diagnosis of early stage VaD. The study compared three adult groups (N = 60): (a) patients diagnosed with incipient VaD, according to DSM-5 criteria (n = 20); (b) community-dwelling older adults presenting cardiovascular risk factors (RVD; n = 20); (c) healthy young adult controls (n = 20). Three types of executive functions were examined: inhibitory control, cognitive flexibility as rule/task switching, and planning. The following D-KEFS subtests were administered for their evaluation: The ‘Color-Word Interference Test,’ the ‘Verbal Fluency Test,’ and the ‘Tower Test.’ Mixed-measures ANOVA, MANOVA, and one-way ANOVA as well as Scheffe post hoc test were applied to the data of the scores in each condition of each test. The results showed that VaD patients had significantly lower performance in test conditions requiring switching and planning, compared to RVD group and young controls. The specific deficits of VaD patients, compared to older adults presenting RVD according to multiple-group path analyses were: more uncorrected errors in inhibition, the use of semantic knowledge primarily instead of switching ability to switch between semantic categories, as well as a lower level of movement precision in planning.
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Affiliation(s)
- Krystallia Pantsiou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ourania Sfakianaki
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Savvoulidou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassiliki Costa
- 1st Neurology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Papantoniou
- Department of Early Childhood Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Despina Moraitou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Abstract
INTRODUCTION Prior studies have reported higher health care utilization (HCU) leading up to diagnosis of the Alzheimer disease and related dementia (ADRD), but none have assessed variation in HCU by ADRD subtype or examined disease-specific HCU. The objectives of this study were to identify ADRD subtypes and: (1) characterize all-cause and (2) disease-specific HCU during the 3 years preceding diagnosis, and (3) determine if HCU varied by ADRD subtype. METHODS We used data from the OptumLabs Data Warehouse 2008 to 2014 to identify ADRD subtypes (total N=36,838) using an algorithm based on temporal sequencing of diagnoses and provider type. Annual counts of all-cause and disease-specific HCU in each of the 3 years preceding ADRD diagnosis were regressed on ADRD subtypes with mild cognitive impairment (MCI) as the reference group, year, and other variables. RESULTS HCU increased over time, was highest in the outpatient setting, and varied by ADRD subtype. Compared with MCI, highest HCU was observed in vascular and nonspecific dementia. Compared with MCI, most subtypes had elevated disease-specific HCU. DISCUSSION Variation in HCU by ADRD subtype points to different pathways to diagnosis and patterns of use.
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Murtishaw AS, Heaney CF, Bolton MM, Belmonte KCD, Langhardt MA, Kinney JW. Intermittent streptozotocin administration induces behavioral and pathological features relevant to Alzheimer's disease and vascular dementia. Neuropharmacology 2018; 137:164-177. [PMID: 29738850 DOI: 10.1016/j.neuropharm.2018.04.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 01/21/2023]
Abstract
RATIONALE Diabetes mellitus (DM) is a major risk factor for Alzheimer's disease and vascular dementia. Few animal models exist that focus on the metabolic contributions to dementia onset and progression. Thus, there is strong scientific rationale to explore the effects of streptozotocin (STZ), a diabetogenic compound, on vascular and inflammatory changes within the brain. OBJECTIVE AND METHODS The present study was designed to evaluate the effect of staggered, low-dose administration of STZ on behavioral and cognitive deficits, neuroinflammation, tau pathology, and histopathological alterations related to dementia. RESULTS Staggered administration (Days 1, 2, 3, 14, 15) of streptozotocin (40 mg/kg/mL) induced a diabetic-like state in mice, resulting in sustained hyperglycemia. STZ-treated animals displayed memory deficits in the novel object recognition task as well as increased tau phosphorylation and increased neuroinflammation. Additionally, STZ led to altered insulin signaling, exhibited by decreased plasma insulin and decreased levels of insulin degrading enzyme and pAKT within the hippocampus. CONCLUSIONS STZ-treated animals exhibit cognitive deficits and histopathological changes seen in dementia. This model of dementia warrants continued investigation to better understand the role that DM plays in dementia-related alterations.
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Affiliation(s)
- Andrew S Murtishaw
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Chelcie F Heaney
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Monica M Bolton
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Krystal Courtney D Belmonte
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Michael A Langhardt
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Jefferson W Kinney
- Neurobiology of Disease and Behavior Laboratory, Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA.
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Ceïde ME, Ayers EI, Lipton R, Verghese J. Walking While Talking and Risk of Incident Dementia. Am J Geriatr Psychiatry 2018; 26:580-588. [PMID: 29395856 PMCID: PMC6639040 DOI: 10.1016/j.jagp.2017.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Walking while talking (WWT) is a performance-based test of divided attention that examines cognitive-motor interactions. The purpose of this study is to examine the predictive validity of WWT for dementia and dementia subtypes. METHODS We prospectively studied the associations of WWT performance at baseline with risk of developing incident dementia in 1,156 older adults (mean age: 78.28 ± 5.27 years, 60.7% female) enrolled in the Einstein Aging Study using Cox proportional hazard models. Associations were reported as hazard ratio (HR) with 95% confidence intervals (CI). RESULTS Over a median follow-up of 1.90 years (interquartile range: 4.70 years), 85 participants developed incident dementia (53 Alzheimer dementia [AD] and 26 vascular dementia [VaD]). Three gait domains were derived using principal component analysis. Only variability, which loaded heavily for swing time standard deviation (SD) and step time SD, was associated with an increased risk of incident dementia per 1 point increase (HR: 1.24, 95% CI: 1.02-1.54) and VaD (HR: 1.50, 95% CI: 1.06-2.12) after adjusting for demographics, disease burden, mental status, and normal walking velocity. Among eight individual gait variables, only swing time variability SD was associated with increased risk for both incident dementia (HR: 1.35, 95% CI: 1.03-1.77) and VaD (HR: 1.78, 95% CI: 1.12-2.83). Variability and swing time SD were not significantly associated with risk of incident AD. CONCLUSIONS Complex walking as assessed by the WWT task is a simple and pragmatic tool for assessing risk of developing dementia, especially VaD, in older adults.
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Affiliation(s)
- Mirnova E. Ceïde
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY,Department of Psychiatry and Behavioral Sciences and Medicine, Montefiore Medical Center, Bronx, NY
| | - Emmeline I. Ayers
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY
| | - Richard Lipton
- Division of Cognitive Aging and Dementia, Albert Einstein College of Medicine, Bronx, NY
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY
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Discrimination of stroke-related mild cognitive impairment and vascular dementia using EEG signal analysis. Med Biol Eng Comput 2017; 56:137-157. [DOI: 10.1007/s11517-017-1734-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022]
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Yang FC, Chen SY, Yin JH, Lin CC, Sung YF, Chou CH, Chung CH, Chien WC, Tsai CK, Tsai CL, Lin GY, Lee JT. The association between vertebrobasilar insufficiency and the risk of dementia: a nationwide register-based retrospective cohort study in Taiwan. BMJ Open 2017; 7:e017001. [PMID: 28838901 PMCID: PMC5724144 DOI: 10.1136/bmjopen-2017-017001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Neurodegenerative disorders are reportedly characterised by decreased regional cerebral blood flow. However, the association between vertebrobasilar insufficiency (VBI) and dementia remains unclear. In this nationwide, population-based, retrospective cohort study, we explored the potential association between VBI and dementia. DESIGN Nationwide population-based cohort study. SETTING Patients with VBI were newly diagnosed between 2000 and 2005 from the Taiwan National Health Insurance Research Database. PARTICIPANTS We included 3642 subjects as the VBI group. The control cohort included 14 568 randomly selected age-matched and sex-matched VBI-free individuals. OUTCOME MEASURES All subjects were followed until the diagnosis of dementia, death or the end of 2010. Patients with VBI, dementia (viz, vascular and non-vascular, including Alzheimer's) subtypes and other confounding factors were identified according to the International Classification of Diseases Clinical Modification Codes. Cox proportional hazards regression analysis was employed to examine adjusted HRs after adjusting for confounding factors. RESULTS Patients with VBI had a 1.807-fold (95% CI 1.643 to 1.988, p<0.001) higher risk to develop all-cause dementia than individuals without VBI. The risk was significantly higher in the VBI group than in the non-VBI group regardless of age (<65 years: HR: 2.997, 95% CI 1.451 to 6.454, p<0.001; ≥65 years: HR: 1.752, 95% CI 1.584 to 1.937, p<0.001). The VBI group had a higher risk of all-cause dementia than the non-VBI group regardless of sex and follow-up time intervals (<1 year, 1-2 years and≥2 years). CONCLUSION Patients with VBI appear to have an increased risk of developing dementia. Further research is needed to investigate the underlying pathophysiology.
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Affiliation(s)
- Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shao-Yuan Chen
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taiwan
- Department of Hyperbaric Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Division of Neurology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Li M, Meng Y, Wang M, Yang S, Wu H, Zhao B, Wang G. Cerebral gray matter volume reduction in subcortical vascular mild cognitive impairment patients and subcortical vascular dementia patients, and its relation with cognitive deficits. Brain Behav 2017; 7:e00745. [PMID: 28828207 PMCID: PMC5561307 DOI: 10.1002/brb3.745] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/19/2017] [Accepted: 04/29/2017] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Subcortical vascular mild cognitive impairment (svMCI) is the predementia stage of subcortical vascular dementia (SVaD). The aim of this research is to explore and compare cerebral gray matter (GM) volume reduction in svMCI patients and SVaD patients, and to investigate the relationship between cerebral GM volume reduction and cognitive deficits. METHODS Thirty one svMCI patients, 29 SVaD patients, and 31 healthy controls were recruited in our research. They conducted neuropsychological tests and brain structural magnetic resonance imaging (MRI) examination. To detect cerebral GM volume reduction in svMCI patients and SVaD patients, we used statistical parametric mapping 8-voxel-based morphometry 8 (SPM8-VBM8) method to analyze MRI data. To detect the relationship between cerebral GM volume reduction and cognitive deficits, multiple linear regression analysis was used. RESULTS Compared with healthy controls, svMCI patients showed cerebral GM volume reduction in hippocampus and parahippocampal gyrus, insula and superior temporal gyrus. Compared with healthy controls, SVaD patients exhibited more atrophy which encompasses all of these areas plus anterior and middle cingulate, inferior temporal gyrus, orbitofrontal cortex, and superior frontal gyrus. In svMCI patients, cerebral GM volume reduction correlated with memory loss, attention dysfunction, and language dysfunction; in SVaD patients, besides those cognitive deficits, cerebral GM volume reduction correlated with more cognitive impairments, including executive dysfunction, neuropsychiatric symptom, and depression. CONCLUSIONS Our findings prove that both svMCI patients and SVaD patients exhibit cerebral GM volume reduction and there may exist a hierarchy between svMCI and SVaD, and cerebral GM volume reduction in both svMCI patients and SVaD patients correlates with cognitive deficits, which can help us understand the mechanism of cognitive impairments in svMCI patients and SVaD patients, and diagnose SVaD at its early stage.
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Affiliation(s)
- Maoyu Li
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina
| | - Yao Meng
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina
| | - Minzhong Wang
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina
| | - Shuang Yang
- Department of Magnetic Resonance ImagingShandong Medical Imaging Research Institute Affiliated to Shandong UniversityJinanShandongChina
| | - Hui Wu
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina
| | - Bin Zhao
- Department of Magnetic Resonance ImagingShandong Medical Imaging Research Institute Affiliated to Shandong UniversityJinanShandongChina
| | - Guangbin Wang
- Department of Magnetic Resonance ImagingShandong Medical Imaging Research Institute Affiliated to Shandong UniversityJinanShandongChina
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Moretti R, Caruso P, Dal Ben M, Conti C, Gazzin S, Tiribelli C. Vitamin D, Homocysteine, and Folate in Subcortical Vascular Dementia and Alzheimer Dementia. Front Aging Neurosci 2017; 9:169. [PMID: 28611659 PMCID: PMC5447683 DOI: 10.3389/fnagi.2017.00169] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/15/2017] [Indexed: 01/09/2023] Open
Abstract
Dementia is a worldwide health problem which affects millions of patients; Alzheimer's disease (AD) and subcortical vascular dementia (sVAD) are the two most frequent forms of its presentation. As no definite therapeutic options have been discovered, different risk factors for cognitive impairment have been searched for potential therapies. This report focuses on the possible evidence that vitamin D deficiency and hyper-homocysteinemia can be considered as two important factors for the development or the progression of neurodegenerative or vascular pathologies. To this end, we assessed: the difference in vascular risk factors and vitamin D-OH25 levels among groups of sVAD, AD, and healthy age-matched controls; the association of folate, B12, homocysteine, and vitamin D with sVAD/AD and whether a deficiency of vitamin D and an increment in homocysteine levels may be related to neurodegenerative or vessel damages. The commonly-considered vascular risk factors were collected in 543 patients and compared with those obtained from a healthy old volunteer population. ANOVA group comparison showed that vitamin D deficiency was present in demented cases, as well as low levels of folate and high levels of homocysteine, more pronounced in sVAD cases. The statistical models we employed, with regression models built, and adjustments for biochemical, demographic and neuropsychiatric scores, confirmed the association between the three measures (folate decrease, hyperhomocysteinemia and vitamin D decrease) and dementia, more pronounced in sVAD than in AD.
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Affiliation(s)
- Rita Moretti
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of TriesteTrieste, Italy
| | - Paola Caruso
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of TriesteTrieste, Italy
| | - Matteo Dal Ben
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of TriesteTrieste, Italy
- Italian Liver Foundation, Centro Studi FegatoTrieste, Italy
| | - Corrado Conti
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of TriesteTrieste, Italy
| | - Silvia Gazzin
- Italian Liver Foundation, Centro Studi FegatoTrieste, Italy
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You YN, Cho MR, Park JH, Park GC, Song MY, Choi JB, Na CS, Han JY, Shin JC, Kim JH. Assessing the quality of reports about randomized controlled trials of scalp acupuncture treatment for vascular dementia. Trials 2017; 18:205. [PMID: 28464917 PMCID: PMC5414371 DOI: 10.1186/s13063-017-1945-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 04/12/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the quality of reports about randomized controlled trials (RCTs) of scalp acupuncture (SA) for the treatment of vascular dementia (VD). METHOD A systematic search of reports published through to December 2015 was performed in eight databases. The quality of RCTs that used SA as an intervention for VD was evaluated based on the 2010 Consolidated Standards for Reporting of Trials (CONSORT) and 2010 Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Thirteen items from the CONSORT guideline were scored to give an overall quality score (OQS, range 0-13), and a combined key methodological index score (MIS) (range 0-5) of five key methodological items was measured. The OQS of 17 items from the STRICTA guideline (range 0-17) was also measured. RESULTS In total, 26 reports were evaluated. The median OQS based on the CONSORT guideline was 8 (minimum 5, maximum 11), and "trial design," "sample size," "ancillary analyses," and "harms" had a positive rate of less than 10%. The median MIS was 2 (minimum 0, maximum 5), with "allocation concealment and implementation," "blinding," and "intent-to-treat analysis" having a positive rate of less than 15%. The median OQS based on the STRICTA guideline was 12 (minimum 8, maximum 14), with "extent to which treatment was varied (1c)," "number of needle insertions per subject per session (2a)," and "setting and context of treatment (4b)" having a positive rate of less than 10%. CONCLUSIONS The overall quality of reports on RCTs of SA treatment for VD was moderate to low. The quality of methodological items was markedly lower than that of other items. The CONSORT and STRICTA guidelines should be used more frequently to standardize the quality of RCT reports of SA treatment for VD.
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Affiliation(s)
- Young-Nim You
- Clinical Research Center, DongShin University Gwangju Oriental Hospital, Gwangju City, Republic of Korea
| | - Myung-Rae Cho
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
| | - Ju-Hyung Park
- Clinical Research Center, DongShin University Gwangju Oriental Hospital, Gwangju City, Republic of Korea
| | - Gwang-Cheon Park
- Clinical Research Center, DongShin University Gwangju Oriental Hospital, Gwangju City, Republic of Korea
| | - Min-Yeong Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
| | - Jin-Bong Choi
- Department of Korean Rehabilitation Medicine, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
| | - Chang-Su Na
- Department of Meridian and Acupoint, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
| | - Jae-Young Han
- Department of Physical & Rehabilitation Medicine, Chonnam National University Medical School & Hospital, Gwangju City, Republic of Korea
| | - Jeong-cheol Shin
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
| | - Jae-Hong Kim
- Clinical Research Center, DongShin University Gwangju Oriental Hospital, Gwangju City, Republic of Korea
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine Dong-Shin University, Naju City, Republic of Korea
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