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Vos SJB, Delvenne A, Jack CR, Thal DR, Visser PJ. The clinical importance of suspected non-Alzheimer disease pathophysiology. Nat Rev Neurol 2024; 20:337-346. [PMID: 38724589 DOI: 10.1038/s41582-024-00962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 06/06/2024]
Abstract
The development of biomarkers for Alzheimer disease (AD) has led to the origin of suspected non-AD pathophysiology (SNAP) - a heterogeneous biomarker-based concept that describes individuals with normal amyloid and abnormal tau and/or neurodegeneration biomarker status. In this Review, we describe the origins of the SNAP construct, along with its prevalence, diagnostic and prognostic implications, and underlying neuropathology. As we discuss, SNAP can be operationalized using different biomarker modalities, which could affect prevalence estimates and reported characteristics of SNAP in ways that are not yet fully understood. Moreover, the underlying aetiologies that lead to a SNAP biomarker profile, and whether SNAP is the same in people with and without cognitive impairment, remains unclear. Improved insight into the clinical characteristics and pathophysiology of SNAP is of major importance for research and clinical practice, as well as for trial design to optimize care and treatment of individuals with SNAP.
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Affiliation(s)
- Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Aurore Delvenne
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Dietmar R Thal
- Laboratory for Neuropathology, Department of Imaging and Pathology and Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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Wu A, Sharrett AR, Folsom AR, Alonso A, Walker KA, Gottesman RF, Gross AL, Rawlings AM, Schneider ALC, Coresh J. Midlife Hemostasis Measures, 20-Year Cognitive Decline, and Incident Dementia. Neurology 2023; 101:e1697-e1707. [PMID: 37652701 PMCID: PMC10624500 DOI: 10.1212/wnl.0000000000207771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Blood concentrations of hemostatic factors affect thrombosis and bleeding diathesis and may contribute to cognitive impairment through modifiable vascular pathologies. Whether hemostasis, assessed in middle age, is associated with late-life cognitive impairment remains largely unknown in a community-dwelling population. METHODS Using data from 14,128 participants with cognitive function measurements in 1990-1992 from the Atherosclerosis Risk in Communities study, we assessed the associations of hemostasis measures with 20-year changes in cognitive performance and incident dementia. Activated partial thromboplastin time (aPTT) and level of fibrinogen, von Willebrand factor (VWF), factor VIII, factor VII, factor XI, d-dimer, and soluble thrombomodulin were measured in 1987-1989 or 1993-1995. Hemostasis measures were categorized into quintiles, with the lowest quintile indicating low coagulability. Cognitive performance was characterized using a combined z-score from 3 tests (that is, delayed word recall test [DWRT], digit symbol substitution [DSST], and word fluency test [WFT]), assessed in 1990-1992, 1996-1998, and 2011-2013. Dementia was determined either from in-person evaluations or using dementia surveillance through 2017. Mixed-effects models and Cox proportional hazards models were used to assess cognitive trajectories and risk of dementia, respectively. RESULTS Among 12,765 participants with hemostasis measures in 1987-1989, who were aged 47-70 years at the first cognitive assessment, we observed significant trends of shorter aPTT (p for trend <0.001; difference in 20-year cognitive decline for fifth vs first quintile [Q5 vs Q1]: -0.104 [95% CI -0.160 to -0.048]) and higher levels of factor VII (p < 0.002; Q5 vs Q1: -0.085 [-0.142, -0.028]) and factor VIII (p = 0.033; Q4 vs Q1: -0.055 [-0.111, -0.000]) with greater 20-year cognitive declines. The associations with the decline in DSST were stronger than those with the decline in WFT or DWRT. Consistently, shorter aPTT and higher factor VIII levels were associated with higher dementia risk with HRs for Q5 vs Q1 of 1.23 (95% CI 1.07 to 1.42) and 1.17 (1.01-1.36), respectively, and p for trend of 0.008 and 0.024, respectively. DISCUSSION Overall, our study found consistent trend associations of aPTT and factor VIII measured in midlife with cognitive decline and incident dementia over 20 years, likely driven by vascular pathologies.
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Affiliation(s)
- Aozhou Wu
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - A Richey Sharrett
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Aaron R Folsom
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alvaro Alonso
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Keenan A Walker
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rebecca F Gottesman
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alden L Gross
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Andreea M Rawlings
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Andrea Lauren Christman Schneider
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Josef Coresh
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Zhou YT, An DD, Xu YX, Zhou Y, Li QQ, Dai HB, Zhang XN, Wang Y, Lou M, Chen Z, Hu WW. Activation of glutamatergic neurons in the somatosensory cortex promotes remyelination in ischemic vascular dementia. FUNDAMENTAL RESEARCH 2022. [DOI: 10.1016/j.fmre.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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4
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Ahmed HA, Ismael S, Salman M, Devlin P, McDonald MP, Liao FF, Ishrat T. Direct AT2R Stimulation Slows Post-stroke Cognitive Decline in the 5XFAD Alzheimer's Disease Mice. Mol Neurobiol 2022; 59:4124-4140. [PMID: 35486224 PMCID: PMC10947502 DOI: 10.1007/s12035-022-02839-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
Abstract
Alzheimer's disease (AD), currently the single leading cause of death still on the rise, almost always coexists alongside vascular cognitive impairment (VCI). In fact, the ischemic disease affects up to 90% of AD patients, with strokes and major infarctions representing over a third of vascular lesions. Studies also confirmed that amyloid plaques, typical of AD, are much more likely to cause dementia if strokes or cerebrovascular damage also exist, leading to the term "mixed pathology" cognitive impairment. Although its incidence is expected to grow, there are no satisfactory treatments. There is hence an urgent need for safe and effective therapies that preserve cognition, maintain function, and prevent the clinical deterioration that results from the progression of this irreversible, neurodegenerative disease. To our knowledge, this is the first study to investigate the effects of long-term treatment with C21, a novel angiotensin II type 2 receptor (AT2R) agonist, on the development of "mixed pathology" cognitive impairment. This was accomplished using a unique model that employs the fundamental elements of both AD and VCI. Treatment with C21/vehicle was started 1 h post-stroke and continued for 5 weeks in mice with concurrent AD pathology. Efficacy was established through a series of functional tests assessing various aspects of cognition, including spatial learning, short-term/working memory, long-term/reference memory, and cognitive flexibility, in addition to the molecular markers characteristic of AD. Our findings demonstrate that C21 treatment preserves cognitive function, maintains cerebral blood flow, and reduces Aβ accumulation and toxic tau phosphorylation in AD animals post-stroke.
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Affiliation(s)
- Heba A Ahmed
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA
| | - Saifudeen Ismael
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA
| | - Mohd Salman
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA
| | - Patrick Devlin
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA
| | - Michael P McDonald
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA
- Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
- Neuroscience Institute, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Francesca-Fang Liao
- Neuroscience Institute, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
- Department of Pharmacology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Tauheed Ishrat
- Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA.
- Neuroscience Institute, University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
- Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
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5
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Wan YS, You Y, Ding QY, Xu YX, Chen H, Wang RR, Huang YW, Chen Z, Hu WW, Jiang L. Triptolide protects against white matter injury induced by chronic cerebral hypoperfusion in mice. Acta Pharmacol Sin 2022; 43:15-25. [PMID: 33824460 PMCID: PMC8724323 DOI: 10.1038/s41401-021-00637-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/03/2021] [Indexed: 02/01/2023] Open
Abstract
White matter injury is the major pathological alteration of subcortical ischemic vascular dementia (SIVD) caused by chronic cerebral hypoperfusion. It is characterized by progressive demyelination, apoptosis of oligodendrocytes and microglial activation, which leads to impairment of cognitive function. Triptolide exhibits a variety of pharmacological activities including anti-inflammation, immunosuppression and antitumor, etc. In this study, we investigated the effects of triptolide on white matter injury and cognitive impairments in mice with chronic cerebral hypoperfusion induced by the right unilateral common carotid artery occlusion (rUCCAO). We showed that triptolide administration alleviated the demyelination, axonal injury, and oligodendrocyte loss in the mice. Triptolide also improved cognitive function in novel object recognition test and Morris water maze test. In primary oligodendrocytes following oxygen-glucose deprivation (OGD), application of triptolide (0.001-0.1 nM) exerted concentration-dependent protection. We revealed that the protective effect of triptolide resulted from its inhibition of oligodendrocyte apoptosis via increasing the phosphorylation of the Src/Akt/GSK3β pathway. Moreover, triptolide suppressed microglial activation and proinflammatory cytokines expression after chronic cerebral hypoperfusion in mice and in BV2 microglial cells following OGD, which also contributing to its alleviation of white matter injury. Importantly, mice received triptolide at the dose of 20 μg·kg-1·d-1 did not show hepatotoxicity and nephrotoxicity even after chronic treatment. Thus, our results highlight that triptolide alleviates whiter matter injury induced by chronic cerebral hypoperfusion through direct protection against oligodendrocyte apoptosis and indirect protection by inhibition of microglial inflammation. Triptolide may have novel indication in clinic such as the treatment of chronic cerebral hypoperfusion-induced SIVD.
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Affiliation(s)
- Yu-shan Wan
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Yi You
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Qian-yun Ding
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China ,grid.268505.c0000 0000 8744 8924College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053 China
| | - Yi-xin Xu
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Han Chen
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Rong-rong Wang
- grid.13402.340000 0004 1759 700XDepartment of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China
| | - Yu-wen Huang
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Zhong Chen
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China ,grid.268505.c0000 0000 8744 8924College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053 China
| | - Wei-wei Hu
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Lei Jiang
- grid.13402.340000 0004 1759 700XDepartment of Pharmacology and Department of Pharmacy of the Second Affiliated Hospital, NHC and CAMS Key Laboratory of Medical Neurobiology, Department of Anatomy, School of Basic Medical Science, Zhejiang University School of Medicine, Hangzhou, 310058 China
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6
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Lai MMY, Sharman MJ, Ames DJ, Ellis KA, Cox KL, Hepworth G, Desmond P, Cyarto EV, Martins RN, Masters CL, Lautenschlager NT. Relationship of Established Cardiovascular Risk Factors and Peripheral Biomarkers on Cognitive Function in Adults at Risk of Cognitive Deterioration. J Alzheimers Dis 2021; 74:163-171. [PMID: 32007955 DOI: 10.3233/jad-190953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND There is a paucity of information on the role of microvascular and inflammatory biomarkers in cognitive dysfunction. OBJECTIVE This study sought to evaluate the relationships between established and a number of peripheral biomarkers on cognitive patterns in 108 older adults with memory complaints. METHODS Participants in the AIBL Active study aged 60 years and older with at least one vascular risk factor and memory complaints completed a neuropsychological test battery and provided cross-sectional health data. Linear regression models adjusted for covariates examined associations between cognitive performance and a panel of vascular risk factors (Framingham cardiovascular scores, hs-CRP, homocysteine, fasting glucose, LDL-cholesterol) and peripheral biomarkers (TNF-α, BDNF, VCAM-1, ICAM-1, PAI-1, CD40L). RESULTS Higher fasting glucose and homocysteine levels were independent factors associated with poorer performance in Trail Making Test (TMT) B (adjusted β= 0.40±0.10 and 0.43±0.09, respectively). Increasing homocysteine levels were weakly associated with poorer global cognition and delayed recall (adjusted β= 0.23±0.10 and -0.20±0.10 respectively). Increasing Framingham cardiovascular scores were related to poorer performance in TMT B (β = 0.42±0.19). There was early evidence of associations between increasing plasma TNF-α and poorer TMT B (adjusted β = 0.21±0.10) and between increasing BDNF and better global cognition (β= -0.20±0.09). CONCLUSION This study provides evidence to support the associations between vascular risk factors (Framingham scores, fasting glucose, and homocysteine) and poorer cognitive functions. Additionally, we measured several peripheral biomarkers to further investigate their associations with cognition. The relationship between TNF-α, BDNF, and cognitive performance in various domains may offer new insights into potential mechanisms in vascular cognitive impairment.
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Affiliation(s)
- Michelle M Y Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,South Metropolitan Health Service, Perth, Australia.,Curtin Medical School, Curtin University, Perth, Australia
| | - Matthew J Sharman
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - David J Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,The Florey Institute, The University of Melbourne, Melbourne, Australia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Australia
| | - Graham Hepworth
- Statistical Consulting Centre, The University of Melbourne, Melbourne, Australia
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital The University of Melbourne, Australia
| | - Elizabeth V Cyarto
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Bolton Clarke Research Institute, Melbourne, Australia
| | - Ralph N Martins
- School of Medical Sciences, Edith Cowan University, Perth, Australia.,Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - Colin L Masters
- The Florey Institute, The University of Melbourne, Melbourne, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,WA Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Australia.,North Western Mental Health, Melbourne Health, Melbourne, Australia
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7
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Widespread severe cerebral elevations of haptoglobin and haemopexin in sporadic Alzheimer's disease: Evidence for a pervasive microvasculopathy. Biochem Biophys Res Commun 2021; 555:89-94. [PMID: 33813281 DOI: 10.1016/j.bbrc.2021.02.107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/22/2021] [Indexed: 12/29/2022]
Abstract
Sporadic Alzheimer's disease (sAD) is the commonest cause of age-related neurodegeneration but there are no available treatments with demonstrated disease-modifying actions. It is therefore relevant to study hitherto-unknown aspects of brain structure and function to seek new disease-related mechanisms that might be targeted by novel disease-modifying interventions. During hypothesis-generating proteomic investigations in a case-control study of sAD, we observed widespread elevations of haptoglobin and haemopexin in all six brain-regions studied, which together represent much of the brain. Measured perturbations were significant, with the posterior probability of upregulation generally >95% and haptoglobin doubling in expression levels on average across deep brain structures (hippocampus, entorhinal cortex and cingulate gyrus) as well as sensory and motor cortices, and cerebellum. Haptoglobin and haemopexin are often regarded as circulating proteins whose main functions are to bind, respectively, the strongly pro-inflammatory extracellular haemoglobin and haeme molecules that form following haemolysis, thereby promoting their clearance and suppressing damage they might otherwise cause, for example, acute kidney injury. To our knowledge, elevations in neither cerebral haptoglobin nor haemopexin have previously been linked to the pathogenesis of sAD. Post-mortem examination of these cases showed no signs of macroscopic cerebral haemorrhage. These findings demonstrate pervasive cerebral elevation of haptoglobin and haemopexin, consistent with low-level intracerebral leakage of haemoglobin and consequent haeme formation throughout sAD brain. They point to a widespread underlying microvasculopathy that facilitates erythrocyte leakage, thereby triggering elevated tissue-free haemoglobin and driving the measured elevations in haptoglobin and haemopexin.
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8
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El-Sheik WM, El-Emam AI, El-Rahman AAEGA, Salim GM. Predictors of dementia after first ischemic stroke. Dement Neuropsychol 2021; 15:216-222. [PMID: 34345363 PMCID: PMC8283871 DOI: 10.1590/1980-57642021dn15-020009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/19/2021] [Indexed: 01/13/2023] Open
Abstract
Various mechanisms contribute to dementia after first ischemic stroke as lesions on strategic areas of cognition and stroke premorbidity. Objectives Assessing clinical and neuroimaging predictors of dementia after first ischemic stroke and its relation to stroke location, subtypes and severity. Methods Eighty first ischemic stroke patients were included. Forty patients with dementia after first stroke and forty patients without dementia according to DSM-IV diagnostic criteria of vascular dementia. All patients were subjected to general and neurological assessment, National Institute Health Stroke Scale (NIHSS) for stroke severity, Montreal Cognitive Assessment (MoCA) scale for cognition assessment, MRI brain and Trial of Org 10172 in acute stroke treatment (TOAST) classification for stroke subtypes. Results Left hemispheric ischemic stroke, strategic infarctions, diabetes mellitus and stroke of anterior circulation were found to be independent risk factors for dementia after first ischemic stroke (OR=3.09, 95%CI 1.67-10.3, OR=2.33, 95%CI 1.87-8.77, OR=1.88, 95%CI 1.44-4.55, OR=1.86, 95%CI 1.45-6.54, respectively). Hypertension, dyslipidemia, smoking, ischemic heart disease, high NIHSS score and large vessel infarction were significantly higher among post stroke dementia patients. However, on binary logistic regression, they did not reach to be independent risk factors. Conclusion Stroke location (left stroke, strategic infarction, anterior circulation stroke) and diabetes mellitus could be predictors of dementia after first ischemic stroke, but stroke severity, stroke subtypes, hypertension, dyslipidemia, smoking and ischemic heart could not.
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9
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Youssef MI, Zhou Y, Eissa IH, Wang Y, Zhang J, Jiang L, Hu W, Qi J, Chen Z. Tetradecyl 2,3-dihydroxybenzoate alleviates oligodendrocyte damage following chronic cerebral hypoperfusion through IGF-1 receptor. Neurochem Int 2020; 138:104749. [PMID: 32387468 DOI: 10.1016/j.neuint.2020.104749] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 12/21/2022]
Abstract
Currently, there is no effective therapy for chronic cerebral hypoperfusion-induced subcortical ischemic vascular dementia (SIVD), which displays cognitive deficits and progressive white matter damage. Tetradecyl 2,3-dihydroxybenzoate (ABG-001) is a lead compound derived from gentisides with neuritogenic activity. In this report, we intended to investigate the effect of ABG-001 on the SIVD experimental model through right unilateral common carotid arteries occlusion (rUCCAO) in mice. We found that ABG-001 remarkably alleviated white matter damage and cognitive deficits after cerebral hypoperfusion induced by rUCCAO. The protection of ABG-001 on the white matter was related to an amelioration of the oligodendrocyte apoptosis and demyelination rather than promoting remyelination. Molecular docking study showed that ABG-001 possesses a high affinity for insulin-like growth factor-1 receptor (IGF-1R), but not for tropomyosin receptor kinase A (TrkA). The protection of ABG-001 against oligodendrocyte damage was abrogated by IGF-1R antagonist or knockdown of IGF-1R through shRNA, but not TrkA antagonist. Moreover, ABG-001 did not induce hematological, renal or hepatic toxicity after chronic treatment. The present study indicates that ABG-001 protects oligodendrocytes through IGF-1R to relieve demyelination following chronic cerebral hypoperfusion, which could be represented as an encouraging treatment for SIVD.
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Affiliation(s)
- Mahmoud I Youssef
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China
| | - Yiting Zhou
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China; Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, East Qingchun Road 3, Hangzhou, Zhejiang, 310016, PR China
| | - Ibrahim H Eissa
- Pharmaceutical Medicinal Chemistry & Drug Design Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Yanhui Wang
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China
| | - Jing Zhang
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, East Qingchun Road 3, Hangzhou, Zhejiang, 310016, PR China
| | - Lei Jiang
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China
| | - Weiwei Hu
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China.
| | - Jianhua Qi
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China
| | - Zhong Chen
- Institute of Pharmacology & Toxicology, NHC and CAMS Key Laboratory of Medical Neurobiology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, PR China.
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10
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Fang YC, Chan L, Liou JP, Tu YK, Lai MJ, Chen CI, Vidyanti AN, Lee HY, Hu CJ. HDAC inhibitor protects chronic cerebral hypoperfusion and oxygen-glucose deprivation injuries via H3K14 and H4K5 acetylation-mediated BDNF expression. J Cell Mol Med 2020; 24:6966-6977. [PMID: 32374084 PMCID: PMC7299713 DOI: 10.1111/jcmm.15358] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022] Open
Abstract
Vascular dementia (VaD) is the second most common cause of dementia, but the treatment is still lacking. Although many studies have reported that histone deacetylase inhibitors (HDACis) confer protective effects against ischemic and hypoxic injuries, their role in VaD is still uncertain. Previous studies shown, one HDACi protected against cognitive decline in animals with chronic cerebral hypoperfusion (CCH). However, the underlying mechanisms remain elusive. In this study, we tested several 10,11‐dihydro‐5H‐dibenzo[b,f]azepine hydroxamates, which act as HDACis in the CCH model (in vivo), and SH‐SY5Y (neuroblastoma cells) with oxygen‐glucose deprivation (OGD, in vitro). We identified a compound 13, which exhibited the best cell viability under OGD. The compound 13 could increase, in part, the protein levels of brain‐derived neurotrophic factor (BDNF). It increased acetylation status on lysine 14 residue of histone 3 (H3K14) and lysine 5 of histone 4 (H4K5). We further clarified which promoters (I, II, III, IV or IX) could be affected by histone acetylation altered by compound 13. The results of chromatin immunoprecipitation and Q‐PCR analysis indicate that an increase in H3K14 acetylation leads to an increase in the expression of BDNF promoter II, while an increase in H4K5 acetylation results in an increase in the activity of BDNF promoter II and III. Afterwards, these cause an increase in the expression of BDNF exon II, III and coding exon IX. In summary, the HDACi compound 13 may increase BDNF specific isoforms expression to rescue the ischemic and hypoxic injuries through changes of acetylation on histones.
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Affiliation(s)
- Yao-Ching Fang
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Lung Chan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jing-Ping Liou
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,TMU Biomedical Commercialization Center, Taipei Medical University, Taipei, Taiwan
| | - Yong-Kwang Tu
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Mei-Jung Lai
- TMU Biomedical Commercialization Center, Taipei Medical University, Taipei, Taiwan
| | - Chin-I Chen
- Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Amelia Nur Vidyanti
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,International Master/PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsueh-Yun Lee
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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11
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Ahmad SS, Khan S, Kamal MA, Wasi U. The Structure and Function of α, β and γ-Secretase as Therapeutic Target Enzymes in the Development of Alzheimer’s Disease: A Review. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2020; 18:657-667. [DOI: 10.2174/1871527318666191011145941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 12/22/2022]
Abstract
:Alzheimer's disease is a progressive neurodegenerative disorder that affects the central nervous system. There are several factors that cause AD, like, intracellular hyperphosphorylated Tau tangles, collection of extracellular Amyloid-β42 and generation of reactive oxygen species due to mitochondrial dysfunction. This review analyses the most active target of AD and both types of AD-like early-onset AD and late-onset AD. BACE1 is a β-secretase involved in the cleavage of amyloid precursor protein and the pathogenesis of Alzheimer's disease. The presenilin proteins play a critical role in the pathogenesis of Alzheimer malady by intervening the intramembranous cleavage of amyloid precursor protein and the generation of amyloid β. The two homologous proteins PS1 and PS2 speak to the reactant subunits of particular γ-secretase edifices that intercede an assortment of cellular processes. Natural products are common molecular platforms in drug development in AD. Many natural products are being tested in various animal model systems for their role as a potential therapeutic target in AD. Presently, there are a few theories clarifying the early mechanisms of AD pathogenesis. Recently, research advancements in the field of nanotechnology, which utilize macromolecular strategies to make drugs in nanoscale measurements, offer nanotechnology-based diagnostic tools and drug carriers which are highly sensitive for effective drug targeting in the treatment of Alzheimer’s disease.
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Affiliation(s)
- Syed S. Ahmad
- Department of Bioengineering, Faculty of Engineering, Integral University, Lucknow, India
| | - Shahzad Khan
- Wuhan University, School of Medicine, Wuhan, Hubei, China
| | - Mohammad A. Kamal
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
| | - Umam Wasi
- Department of Biosciences, Faculty of Science, Integral University, Lucknow, India
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12
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Bandaru N, Ramu A, Vidhyadhara S. Neuroprotective and antioxidant activities of fraction isolated from methanolic extract of Sapindus laurifolia on scopolamine induced dementia. Pharmacognosy Res 2020. [DOI: 10.4103/pr.pr_50_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Neuroprotective potential of GDF11 in experimental intracerebral hemorrhage in elderly rats. J Clin Neurosci 2019; 63:182-188. [PMID: 30827882 DOI: 10.1016/j.jocn.2019.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/30/2018] [Accepted: 02/20/2019] [Indexed: 02/05/2023]
Abstract
The occurrence of intracerebral hemorrhage (ICH) costs long-standing neurologic deficits in ICH survivors, elderly ones in particular. Recent researches have proved rejuvenating effect of Growth Differentiation Factor 11 (GDF11) in improving multiple systemic diseases on old individuals. Thus, we designed this study to explore the neuroprotective effect and mechanisms of GDF11 in elderly ICH. 45 aged male Sprague-Dawley (SD) rats were randomly divided into sham + vehicle, ICH + vehicle and ICH + rGDF11 groups. ICH models were induced via injection of autologous whole blood into right basal ganglia of rats. ICH rats were given a daily injection of either recombinant (r) GDF11 at 0.1 mg/kg or vehicle for 28 days prior to operation and continued till the experiment completed. Neurological deficits, brain edema, cell apoptosis, microglial activation and heme oxygenase-1 (HO-1) positive cells were compared among each group. In addition, cytochrome c release, mitochondrial calcium buffering capacity and ATP level were monitored to explore the level of mitochondrial injury. Seen in the result, behavior disorders, severe perihematomal edema, inflammation, apoptosis, oxidative stress and mitochondria damage indicated a significant increase in ICH + vehicle group. While in ICH + rGDF11 group, administration of rGDF11 successfully reduced neurological deficits and alleviated ICH-induced edema, inflammation, apoptosis, oxidative stress, and mitochondria damage in perihematomal tissues. Collectively, our study showed that GDF11 ameliorated ICH-induced neurological deficits in elderly individuals via reducing perihematomal edema, apoptosis, inflammatory reaction, oxidative stress and improving mitochondrial dysfunction, indicating neuroprotective effect of GDF11 in elderly ICH.
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14
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Salihović D, Smajlović D, Mijajlović M, Zoletić E, Ibrahimagić OĆ. Cognitive syndromes after the first stroke. Neurol Sci 2018; 39:1445-1451. [PMID: 29779138 DOI: 10.1007/s10072-018-3447-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study is to determine impairments of certain cognitive functions in certain vascular cognitive syndromes and to identify predictors of dementia. PATIENTS AND METHODS One-year prospective study included 275 patients, who were hospitalized at the Department of Neurology Tuzla and therefore fulfilled certain criteria. Patients were divided into following subgroups of vascular cognitive impairment (VCI): dementia of strategic infarct (DSI), cortical dementia (CD), sub cortical dementia (SCD), hemorrhagic dementia (HD), and patients without dementia. Each of the patients underwent the clinical examination and scoring with appropriate measurement scales. RESULTS Some of the types of VCI were verified in 190 (69%) patients, and the most common was SCD (58%). There was statistically significant connection between the level of intelligence and occurrence of VCI in patients after stroke (p < 0.001). We found significant connection between occurrence of dementia and impairment in narrative memory, numerical memory, visual perceptive, and visual constructive functions in patients with dementia compared with non-demented (p = 0.0001). The executive functions were statistically impaired in patients with CD (p = 0.004) and SCD (p < 0.001). Patients without dementia have significantly better quality of life than the demented ones (p < 0.0001). The algorithm "tree of decision" can help us in the prediction of dementia based on the impairment of certain cognitive functions. CONCLUSION Vascular cognitive syndromes are common after stroke. Some of the cognitive functions are significantly impaired in patients with dementia. Impairment of the certain cognitive functions can help in predicting the onset of dementia. Patients without dementia have better quality of life.
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Affiliation(s)
- Denisa Salihović
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina.
| | - Dževdet Smajlović
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
| | - Milija Mijajlović
- Neurology Clinic, Clinical Center of Serbia and School of Medicine, University of Belgrade, Dr Subotića 6, 11000, Belgrade, Serbia
| | - Emina Zoletić
- Department of Psychology, University Clinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
| | - Omer Ć Ibrahimagić
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
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15
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Vinters HV, Zarow C, Borys E, Whitman JD, Tung S, Ellis WG, Zheng L, Chui HC. Review: Vascular dementia: clinicopathologic and genetic considerations. Neuropathol Appl Neurobiol 2018; 44:247-266. [DOI: 10.1111/nan.12472] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/13/2018] [Indexed: 12/21/2022]
Affiliation(s)
- H. V. Vinters
- Departments of Pathology & Laboratory Medicine (Neuropathology) and Neurology; David Geffen School of Medicine at UCLA; Los Angeles CA USA
| | - C. Zarow
- Department of Neurology; Keck School of Medicine at University of Southern California; Los Angeles CA USA
| | - E. Borys
- Department of Pathology; University of California Davis School of Medicine; Sacramento CA USA
- Department of Pathology; Loyola University Medical Center; Maywood IL USA
| | - J. D. Whitman
- Departments of Pathology & Laboratory Medicine (Neuropathology) and Neurology; David Geffen School of Medicine at UCLA; Los Angeles CA USA
- Departments of Pathology & Laboratory Medicine; UC San Francisco Medical Center; San Francisco CA USA
| | - S. Tung
- Departments of Pathology & Laboratory Medicine (Neuropathology) and Neurology; David Geffen School of Medicine at UCLA; Los Angeles CA USA
| | - W. G. Ellis
- Department of Pathology; University of California Davis School of Medicine; Sacramento CA USA
| | - L. Zheng
- Department of Neurology; Keck School of Medicine at University of Southern California; Los Angeles CA USA
| | - H. C. Chui
- Department of Neurology; Keck School of Medicine at University of Southern California; Los Angeles CA USA
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16
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Adiele RC, Adiele CA. Mitochondrial Regulatory Pathways in the Pathogenesis of Alzheimer's Disease. J Alzheimers Dis 2018; 53:1257-70. [PMID: 27392851 DOI: 10.3233/jad-150967] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease (AD) is an age-associated neurodegenerative brain disorder with progressive cognitive decline that leads to terminal dementia and death. For decades, amyloid-beta (Aβ) and neurofibrillary tangle (NFT) aggregation hypotheses have dominated studies on the pathogenesis and identification of potential therapeutic targets in AD. Little attention has been paid to the mitochondrial molecular/biochemical pathways leading to AD. Mitochondria play a critical role in cell viability and death including neurons and neuroglia, not only because they regulate energy and oxygen metabolism but also because they regulate cell death pathways. Mitochondrial impairment and oxidative stress are implicated in the pathogenesis of AD. Interestingly, current therapeutics provide symptomatic benefits to AD patients resulting in the use of preventive trials on presymptomatic subjects. This review article elucidates the pathophysiology of AD and emphasizes the need to explore the mitochondrial pathways to provide solutions to unanswered questions in the prevention and treatment of AD.
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Affiliation(s)
- Reginald C Adiele
- Department of Physiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Chiedukam A Adiele
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
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17
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Vijayan M, Reddy PH. Stroke, Vascular Dementia, and Alzheimer's Disease: Molecular Links. J Alzheimers Dis 2018; 54:427-43. [PMID: 27567871 DOI: 10.3233/jad-160527] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Stroke is a brain disease that occurs when blood flow stops, resulting in reduced oxygen supply to neurons. Stroke occurs at any time and at any age, but increases after the age of 55. It is the second leading cause of death and the third leading cause of disability-adjusted, life-years. The pathophysiology of ischemic stroke is complex and recent molecular, cellular, and animal models and postmortem brain studies have revealed that multiple cellular changes have been implicated, including oxidative stress/mitochondrial dysfunction, inflammatory responses, micro RNA alterations, and marked changes in brain proteins. These cellular changes provide new information for developing therapeutic strategies for ischemic stroke treatment. Research also revealed that stroke increases with a number of modifiable factors and most strokes can be prevented and/or controlled through pharmacological or surgical interventions and lifestyle changes. Ischemic stroke is the major risk factor for vascular dementia and Alzheimer's disease. This review summarizes the latest research findings on stroke, including causal factors and molecular links between stroke and vascular disease/Alzheimer's disease.
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Affiliation(s)
- Murali Vijayan
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Neuroscience and Pharmacology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Department of Speech, Language and Hearing Sciences Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Garrison Institute on Aging, South West Campus, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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18
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Hsu YH, Huang CF, Lo CP, Wang TL, Yang CC, Tu MC. Frontal Assessment Battery as a Useful Tool to Differentiate Mild Cognitive Impairment due to Subcortical Ischemic Vascular Disease from Alzheimer Disease. Dement Geriatr Cogn Disord 2018; 42:331-341. [PMID: 27866203 DOI: 10.1159/000452762] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Prominent executive dysfunction can differentiate vascular dementia from Alzheimer disease (AD). However, it is unclear whether the Frontal Assessment Battery (FAB) screening tool can differentiate subcortical ischemic vascular disease (SIVD) from AD at the pre-dementia stage. In addition, the neural correlates of FAB performance have yet to be clarified. METHODS Patients with mild cognitive impairment (MCI) due to SIVD (MCI-V), MCI due to AD (MCI-A), and demographically matched controls completed the Mini-Mental State Examination, Taiwanese FAB (TFAB), Category Fluency, and Chinese Version of the Verbal Learning Test, and underwent magnetic resonance imaging. White matter hyperintensities were rated according to the Scheltens scale. RESULTS TFAB total scale and its Orthographical Fluency subtest were the only measures that could differentiate MCI-V from MCI-A. Discriminative analysis showed that Orthographical Fluency scores successfully identified 73.2% of the cases with MCI-V, with 85.0% sensitivity. Orthographical Fluency scores were specifically associated with lesion load within frontal periventricular, frontal deep white matter, and basal ganglia regions. CONCLUSION The TFAB, and especially its 1-min Orthographical Fluency subtest, is a useful screening procedure to differentiate MCI due to SIVD from MCI due to AD. The discriminative ability is probably due to frontosubcortical white matter pathologies disproportionately involved in the two disease entities.
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Affiliation(s)
- Yen-Hsuan Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan, ROC
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19
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Quantitation of circulating GDF-11 and β2-MG in aged patients with age-related impairment in cognitive function. Clin Sci (Lond) 2017; 131:1895-1904. [PMID: 28611236 PMCID: PMC5869852 DOI: 10.1042/cs20171028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/05/2017] [Accepted: 06/10/2017] [Indexed: 11/17/2022]
Abstract
Growth differentiation factor 11 (GDF-11) has been implicated in reverse effects of ageing on the central nervous system of humans. β2-microglobulin (β2-MG) has been reported to negatively regulate cognition. However, there is a lot of controversy about the role of GDF-11 and β2-MG in ageing and cognitive regulation. To examine the involvement of GDF-11 and β2-MG in the ageing process and cognitive dysfunction, a total of 51 healthy subjects and 41 elderly patients with different degrees of age-related cognitive impairment participated in the study. We measured plasma GDF-11 and β2-MG levels using ELISA and immunoturbidimetry, respectively. The results were statistically analyzed to evaluate the associations between levels of GDF-11 and β2-MG, and ageing and cognitive impairments. Circulating GDF-11 levels did not decline with age or correlate with ageing in healthy Chinese males. We did not detect differences in circulating GDF-11 levels amongst the healthy advanced age and four cognitive impairment groups. β2-MG levels increased with age, but there was no significant difference between healthy elderly males and advanced age males. Increased levels of β2-MG were observed in the dementia group compared with the healthy advanced age group. Our results suggest that circulating GDF-11 may not exert a protective effect during the ageing process or on cognitive function, and β2-MG may play a role in ageing and cognitive impairment. However, it is possible that the relatively small sample size in the present study affected the quality of the statistical analysis, and future studies are needed to further validate our findings.
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20
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de Matos AM, de Macedo MP, Rauter AP. Bridging Type 2 Diabetes and Alzheimer's Disease: Assembling the Puzzle Pieces in the Quest for the Molecules With Therapeutic and Preventive Potential. Med Res Rev 2017; 38:261-324. [PMID: 28422298 DOI: 10.1002/med.21440] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/18/2017] [Accepted: 02/14/2017] [Indexed: 12/19/2022]
Abstract
Type 2 diabetes (T2D) and Alzheimer's disease (AD) are two age-related amyloid diseases that affect millions of people worldwide. Broadly supported by epidemiological data, the higher incidence of AD among type 2 diabetic patients led to the recognition of T2D as a tangible risk factor for the development of AD. Indeed, there is now growing evidence on brain structural and functional abnormalities arising from brain insulin resistance and deficiency, ultimately highlighting the need for new approaches capable of preventing the development of AD in type 2 diabetic patients. This review provides an update on overlapping pathophysiological mechanisms and pathways in T2D and AD, such as amyloidogenic events, oxidative stress, endothelial dysfunction, aberrant enzymatic activity, and even shared genetic background. These events will be presented as puzzle pieces put together, thus establishing potential therapeutic targets for drug discovery and development against T2D and diabetes-induced cognitive decline-a heavyweight contributor to the increasing incidence of dementia in developed countries. Hoping to pave the way in this direction, we will present some of the most promising and well-studied drug leads with potential against both pathologies, including their respective bioactivity reports, mechanisms of action, and structure-activity relationships.
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Affiliation(s)
- Ana Marta de Matos
- Faculdade de Ciências, Universidade de Lisboa, Ed. C8, Campo Grande, 1749-016, Lisbon, Portugal.,CEDOC Chronic Diseases, Nova Medical School, Rua Câmara Pestana n 6, 6-A, Ed. CEDOC II, 1150-082, Lisbon, Portugal
| | - Maria Paula de Macedo
- CEDOC Chronic Diseases, Nova Medical School, Rua Câmara Pestana n 6, 6-A, Ed. CEDOC II, 1150-082, Lisbon, Portugal
| | - Amélia Pilar Rauter
- Faculdade de Ciências, Universidade de Lisboa, Ed. C8, Campo Grande, 1749-016, Lisbon, Portugal
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21
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Zhou Y, Zhang J, Wang L, Chen Y, Wan Y, He Y, Jiang L, Ma J, Liao R, Zhang X, Shi L, Qin Z, Zhou Y, Chen Z, Hu W. Interleukin-1β impedes oligodendrocyte progenitor cell recruitment and white matter repair following chronic cerebral hypoperfusion. Brain Behav Immun 2017; 60:93-105. [PMID: 27663285 DOI: 10.1016/j.bbi.2016.09.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/12/2016] [Accepted: 09/20/2016] [Indexed: 10/24/2022] Open
Abstract
Subcortical ischemic vascular dementia (SIVD) caused by chronic cerebral hypoperfusion exhibits progressive white matter and cognitive impairments. However, its pathogenetic mechanisms are poorly understood. We investigated the role of interleukin-1β (IL-1β) and its receptor IL-1 receptor type 1 (IL-1R1) in an experimental SIVD model generated via right unilateral common carotid arteries occlusion (rUCCAO) in mice. We found that IL-1β expression was elevated in the corpus callosum at the early stages after rUCCAO. IL-1 receptor antagonist (IL-1Ra), when delivered at an early stage, as well as IL-1R1 knockout, rescued the downregulation of myelin basic protein (MBP) and improved remyelination at the later stage after rUCCAO. Our data suggest that the recruitment of OPCs, but not the proliferation or differentiation of OPCs, is the only compromised step of remyelination following chronic cerebral ischemia. IL-1Ra treatment and IL-1R1 knockout had no effect on the oligodendrocyte progenitor cell (OPC) proliferation, but did promote the recruitment of newly generated OPCs to the corpus callosum, which can be reversed by compensatory expression of IL-1R1 in the SVZ of IL-1R1 knockout mice. Further, we found that recruited OPCs contribute to oligodendrocyte regeneration and functional recovery. In transwell assays, IL-1β inhibited OPC migration through IL-1R1. Moreover, KdPT which can enter the brain to block IL-1R1 also showed comparable protection when intraperitoneally delivered. Our results suggest that IL-1β during the early stages following chronic cerebral hypoperfusion impedes OPC recruitment via IL-1R1, which inhibits white matter repair and functional recovery. IL-1R1 inhibitors may have potential uses in the treatment of SIVD.
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Affiliation(s)
- Yiting Zhou
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Jing Zhang
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; Department of Pharmacy, Sir Run Run Shaw Hospital, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, PR China
| | - Lu Wang
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Ying Chen
- Department of Pharmacy, Sir Run Run Shaw Hospital, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, PR China
| | - Yushan Wan
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Yang He
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Lei Jiang
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Jing Ma
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Rujia Liao
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Xiangnan Zhang
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, PR China
| | - Liyun Shi
- Department of Basic Medical Science, Key Laboratory of Immunology and Molecular Medicine, School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang 310036, PR China
| | - Zhenghong Qin
- Department of Pharmacology and Laboratory of Aging and Nervous Diseases, Soochow University School of Pharmaceutical Science, Suzhou 215123, PR China
| | - Yudong Zhou
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China
| | - Zhong Chen
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, PR China.
| | - Weiwei Hu
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, PR China.
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Vijayan M, Kumar S, Bhatti JS, Reddy PH. Molecular Links and Biomarkers of Stroke, Vascular Dementia, and Alzheimer's Disease. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 146:95-126. [PMID: 28253992 DOI: 10.1016/bs.pmbts.2016.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stroke is a very common neurological disease, and it occurs when the blood supply to part of the brain is interrupted and the subsequent shortage of oxygen and nutrients causes damage to the brain tissue. Stroke is the second leading cause of death and the third leading cause of disability-adjusted life years. The occurrence of stroke increases with age, but anyone at any age can suffer a stroke. Stroke can be broadly classified in two major clinical types: ischemic stroke (IS) and hemorrhagic stroke. Research also revealed that stroke, vascular dementia (VaD), and Alzheimer's disease (AD) increase with a number of modifiable factors, and most strokes can be prevented and/or controlled through pharmacological or surgical interventions and lifestyle changes. The pathophysiology of stroke, VaD, and AD is complex, and recent molecular and postmortem brain studies have revealed that multiple cellular changes have been implicated, including inflammatory responses, microRNA alterations, and marked changes in brain proteins. These molecular and cellular changes provide new information for developing therapeutic strategies for stroke and related vascular disorders treatment. IS is the major risk factor for VaD and AD. This chapter summarizes the (1) links among stroke-VaD-AD; (2) updates the latest developments of research in identifying protein biomarkers in peripheral and central nervous system tissues; and (3) critically evaluates miRNA profile and function in human blood samples, animal, and postmortem brains.
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Affiliation(s)
- M Vijayan
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
| | - S Kumar
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - J S Bhatti
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, United States; Department of Biotechnology, Sri Guru Gobind Singh College, Chandigarh, India
| | - P H Reddy
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, United States; Texas Tech University Health Sciences Center, Lubbock, TX, United States
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Bressler J, Knopman DS, Sharrett AR, Gottesman RF, Penman A, Chang PP, Rosamond WD, Boerwinkle E, Mosley TH. Incident Heart Failure and Cognitive Decline: The Atherosclerosis Risk in Communities Study. J Card Fail 2017; 23:47-55. [PMID: 27864030 PMCID: PMC5219935 DOI: 10.1016/j.cardfail.2016.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 10/14/2016] [Accepted: 11/08/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cognitive impairment is found in a significant proportion of patients with heart failure (HF). Although cognitive impairment may be a consequence of HF, early signs of cognitive impairment may also indicate subclinical vascular disease, and thus a risk factor for future cardiovascular events. METHODS AND RESULTS The Atherosclerosis Risk in Communities Study is a prospective cohort study of the development of atherosclerosis. Cox proportional hazards regression was used to examine the association between mean 6-year change in cognitive function and incident HF in 7962 white and 1933 African-American men and women aged 46 to 70 years and free of clinical stroke. Scores were obtained for the Delayed Word Recall Test, the Digit Symbol Substitution Test (DSST), and the Word Fluency Test. There was a significantly increased risk of developing HF during the mean 12.6-year follow-up period after adjustment for age, gender, race, and education for those in the quartile with the greatest decline in DSST scores (hazard ratio [HR] = 1.17, P = .009), and in the quartile with the lowest baseline DSST scores (HR = 1.43, P < .001). CONCLUSIONS The results suggest that relatively low performance on a test of information processing speed may serve as an indicator of HF risk in middle age.
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Affiliation(s)
- Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | | | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alan Penman
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Patricia P Chang
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Wayne D Rosamond
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - Thomas H Mosley
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi.
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Neupane I, Arora RC, Rudolph JL. Cardiac surgery as a stressor and the response of the vulnerable older adult. Exp Gerontol 2017; 87:168-174. [PMID: 27125757 PMCID: PMC5081280 DOI: 10.1016/j.exger.2016.04.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/30/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022]
Abstract
In an aging population, recovery and restoration of function are critical to maintaining independence. Over the past 50years, there have been dramatic improvements made in cardiac surgery processes and outcomes that allow for procedures to be performed on an increasingly older population with the goal of improving function. Although improved function is possible, major surgical procedures are associated with substantial stress, which can severely impact outcomes. Past literature has identified that frail patients, who are vulnerable to the stress of surgery, are more likely to have postoperative major adverse cardiac and cerebrovascular events (OR 4.9, 95% confidence interval 1.6, 14.6). The objective of this manuscript is to examine preoperative frailty in biological, psychological, and social domains using cardiac surgery to induce stress. We systematically searched PubMed for keywords including "cardiac surgery, frailty, and aged" in addition to the biological, psychological, and social keywords. In the biological domain, we examine the association of physiological and physical vulnerabilities, as well as, the impact of comorbidities and inflammation on negative surgical outcomes. In the psychological domain, the impact of cognitive impairment, depression, and anxiety as vulnerabilities were examined. In the social domain, social structure, coping, disparities, and addiction as vulnerabilities are described. Importantly, there is substantial overlap in the domains of vulnerability. While frailty research has largely focused on discrete physical vulnerability criteria, a broader definition of frailty demonstrates that vulnerabilities in biological, psychological, and social domains can limit recovery after the stress of cardiac surgery. Identification of vulnerability in these domains can allow better understanding of the risks of cardiac surgery and tailoring of interventions to improve outcomes.
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Affiliation(s)
- Iva Neupane
- Center of Innovation in Long Term Services and Support, Providence VA Medical Center, Providence, RI, United States; Warren Alpert School of Medicine at Brown University, Providence, RI, United States
| | - Rakesh C Arora
- University of Manitoba, College of Medicine, Department of Surgery, Winnipeg, Manitoba, Canada
| | - James L Rudolph
- Center of Innovation in Long Term Services and Support, Providence VA Medical Center, Providence, RI, United States; Warren Alpert School of Medicine at Brown University, Providence, RI, United States.
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25
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Hane FT, Robinson M, Lee BY, Bai O, Leonenko Z, Albert MS. Recent Progress in Alzheimer's Disease Research, Part 3: Diagnosis and Treatment. J Alzheimers Dis 2017; 57:645-665. [PMID: 28269772 PMCID: PMC5389048 DOI: 10.3233/jad-160907] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2016] [Indexed: 12/12/2022]
Abstract
The field of Alzheimer's disease (AD) research has grown exponentially over the past few decades, especially since the isolation and identification of amyloid-β from postmortem examination of the brains of AD patients. Recently, the Journal of Alzheimer's Disease (JAD) put forth approximately 300 research reports which were deemed to be the most influential research reports in the field of AD since 2010. JAD readers were asked to vote on these most influential reports. In this 3-part review, we review the results of the 300 most influential AD research reports to provide JAD readers with a readily accessible, yet comprehensive review of the state of contemporary research. Notably, this multi-part review identifies the "hottest" fields of AD research providing guidance for both senior investigators as well as investigators new to the field on what is the most pressing fields within AD research. Part 1 of this review covers pathogenesis, both on a molecular and macro scale. Part 2 review genetics and epidemiology, and part 3 covers diagnosis and treatment. This part of the review, diagnosis and treatment, reviews the latest diagnostic criteria, biomarkers, imaging, and treatments in AD.
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Affiliation(s)
- Francis T. Hane
- Department of Chemistry, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - Morgan Robinson
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - Brenda Y. Lee
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - Owen Bai
- Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
| | - Zoya Leonenko
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
- Department of Physics and Astronomy, University of Waterloo, Waterloo, ON, Canada
| | - Mitchell S. Albert
- Department of Chemistry, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
- Northern Ontario School of Medicine, Thunder Bay, ON, Canada
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26
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Cardona-Gómez GP, Lopera F. Dementia, Preclinical Studies in Neurodegeneration and its Potential for Translational Medicine in South America. Front Aging Neurosci 2016; 8:304. [PMID: 28066230 PMCID: PMC5167748 DOI: 10.3389/fnagi.2016.00304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 11/29/2016] [Indexed: 12/17/2022] Open
Abstract
Latin-American people with dementia will increase to an astounding 368% in 2050, higher than USA and Europe. In addition, to sporadic dementia type like Alzheimer, and vascular dementia (VaD) progression after Cerebrovascular disease is also found. These incidences are increased in Colombia by specific populations affected with pure Neurodegenerative and VaDs like Autosomical Dominant familial Alzheimer’s disease (AD) and Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). In spite of the enormous human effort with and economical effort and investment costs, neither sporadic nor genetic kinds of dementia progression have been prevented or blocked yet. Currently, there exist several animal models that partially solve the understanding of the neurodegenerative etiopathogenesis and its treatment. However, when the potential therapies are translated to humans, those do not work or present a limited action. Main difficulties are the diverse comorbility associated to the cause and/or several affected brain regions, reducing the efficacy of some therapies which are limited to a tissue-specific action or modulating a kind of neurotransmission. Global investigation suggests that a general prevention could be achieved with the improvement in the quality of lifestyle, including healthy diet, physical and mental activity, and avoiding mechanical or chemical pro-inflammatory events in an early stage in the most of non-communicable diseases. In this review article, we present some molecular targets and preclinical studies in animal models to propose strategies that could be useful in a future translation to prevent or block neurodegeneration: one is gene therapy; silencing pathogenic genes in critical brain areas where excitotoxicity arise and spread. Another is to take advantage of the natural source and its wide biodiversity of natural products that are capable of identifying, by the blocking and prevention of neurodegeneration. On the other side, the casuistic of pure dementias in the Latin-American region gives an exceptional opportunity to understand the pathogenesis in these human populations. Further, this is in support of the basic and clinical researchers working on an interaction for a better understanding and medical care of mixed dementias, which have more complex factors than pure ones. However, to promote the translation of any therapeutical alternative is necessary to clarify the normative and the protocols for developing clinical trials with original candidates or work upon strategies proposed from South-American countries.
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Affiliation(s)
- Gloria Patricia Cardona-Gómez
- Cellular and Molecular Neurobiology Area, Neuroscience Group of Antioquia, Faculty of Medicine, Sede de Investigación Universitaria (SIU), University of Antioquia Medellin, Colombia
| | - Francisco Lopera
- Clinical Neuroscience Area, Neuroscience Group of Antioquia, Faculty of Medicine, Sede de Investigación Universitaria (SIU), University of Antioquia Medellin, Colombia
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Lee JM, Park JM, Song MK, Oh YJ, Kim CJ, Kim YJ. The ameliorative effects of exercise on cognitive impairment and white matter injury from blood-brain barrier disruption induced by chronic cerebral hypoperfusion in adolescent rats. Neurosci Lett 2016; 638:83-89. [PMID: 27956237 DOI: 10.1016/j.neulet.2016.12.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/13/2016] [Accepted: 12/08/2016] [Indexed: 01/13/2023]
Abstract
Vascular dementia is the progressive change in blood vessels that leads to neuronal injuries in vulnerable areas induced by chronic cerebral hypoperfusion (CCH). CCH induces disruption of blood-brain barrier (BBB), and this BBB disruption can initiate the cognitive impairment and white matter injury. In the present study, we evaluated the effect of treadmill exercise on the cognitive impairment, white matter injury, and BBB disruption induced by CCH. Vascular dementia was induced by permanent bilateral common carotid arteries occlusion (BCCAO) in rats. The rats in the exercise group were made to run on a treadmill for 30min once a day for 14 weeks, starting 4 weeks after birth. Our results revealed that treadmill exercise group was alleviated the cognitive impairment and myelin degradation induced by CCH. The disruption of BBB after CCH indicates degradation of occludin, zonula occluden-1 (ZO-1), and up-regulation of matrix metalloproteinases (MMPs). Treadmill exercise may provide protective effects on BBB disruption from degradation of occludin, ZO-1, and overexpression of MMP-9 after CCH. These findings suggest that treadmill exercise ameliorates cognitive impairment and white matter injury from BBB disruption induced by CCH in rats. The present study will be valuable for means of prophylactic and therapeutic intervention for patients with CCH.
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Affiliation(s)
- Jae-Min Lee
- Department of Physiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, South Korea
| | - Jong-Min Park
- Department of Physiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, South Korea
| | - Min Kyung Song
- Department of Basic Nursing Science, College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701 South Korea
| | - Yoo Joung Oh
- Department of Basic Nursing Science, College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701 South Korea
| | - Chang-Ju Kim
- Department of Physiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, South Korea
| | - Youn-Jung Kim
- Department of Basic Nursing Science, College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701 South Korea.
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Uddin MS, Mamun AA, Hossain MS, Akter F, Iqbal MA, Asaduzzaman M. Exploring the Effect of Phyllanthus emblica L. on Cognitive Performance, Brain Antioxidant Markers and Acetylcholinesterase Activity in Rats: Promising Natural Gift for the Mitigation of Alzheimer's Disease. Ann Neurosci 2016; 23:218-229. [PMID: 27780989 PMCID: PMC5075744 DOI: 10.1159/000449482] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/28/2016] [Indexed: 10/20/2022] Open
Abstract
Neurodegenerative diseases are incurable and debilitating conditions that result in the progressive degeneration of nerve cells, which affect the cognitive activity. Currently, as a result of multiple studies linking Alzheimer's disease (AD) to oxidative damage, the uses of natural antioxidant to prevent, delay, or enhance the pathological changes underlying the progression of AD has received considerable attention. Therefore, this study was aimed at examining the effect of ethanolic extracts of Phyllanthus emblica (EEPE) ripe (EEPEr) and EEPE unripe (EEPEu) fruits on cognitive functions, brain antioxidant enzymes, and acetylcholinesterase (AChE) activity in rat. The effects of EEPEr and EEPEu fruits (i.e., 100 and 200 mg/kg b.w.) were examined in Swiss albino male rats for 12 days and its effect on cognitive functions, brain antioxidant enzymes, and AChE activity determined. Learning and memory enhancing activity of EEPE fruit was examined by using passive avoidance test and rewarded alternation test. Antioxidant potentiality was evaluated by measuring the activity of antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase, reduced glutathione (GSH), glutathione-S-transferase, and the contents of thiobarbituric acid reactive substances (TBARS) in entire brain tissue homogenates. AChE activity was determined using colorimetric method. Administration of the highest dose (i.e., 200 mg/kg b.w.) of EEPEr fruit significantly (p < 0.01) and both lowest and highest doses (i.e., 100 and 200 mg/kg b.w.) of EEPEu fruit markedly (p < 0.05, p < 0.001) increased step-through latency in rats on 6th, 11th, and 12th day with respect to the control group. For aforementioned doses, the percentage of memory retention (MR) was considerably (p < 0.05, p < 0.01) increased in rats on 10th, 11th, and 12th days with respect to the control group. The extract, particularly highest dose (i.e., 200 mg/kg b.w.) of EEPEr fruit markedly (p < 0.05) and lowest and highest doses (i.e., 100 and 200 mg/kg b.w.) of EEPEu fruit significantly (p < 0.01) increased the correct responses in rats on 6th, and 12th day related to the control group. In case of this test, the percentage of MR was significantly (p < 0.05, p < 0.01) increased in rats treated with aforementioned doses on 12th day with respect to the control group. The highest dose (i.e., 200 mg/kg b.w.) of EEPEr fruit suggestively (p < 0.05) and both lowest and highest doses (i.e., 100 and 200 mg/kg b.w.) of EEPEu fruit suggestively (p < 0.05, p < 0.01, p < 0.001) increased the levels of SOD, CAT, GSH, GSH-Px and expressively (p < 0.01) decreased the TBARS level compared to the control group. Treatment with the highest dose (i.e., 200 mg/kg b.w.) of EEPEr fruit significantly (p < 0.05) and both lowest and highest doses (i.e., 100 and 200 mg/kg b.w.) of EEPEu fruit markedly (p < 0.01, p < 0.001) decreased the level of AChE activity compared to that of the control group. The present study shows that EEPE fruit possesses an excellent source for natural cognitive enhancer which could be developed in the treatment of AD and other neurodegenerative diseases.
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Affiliation(s)
- Md. Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | | | - Md. Sarwar Hossain
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
| | - Farjana Akter
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
| | | | - Md. Asaduzzaman
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
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Aerobic Exercises for Cognition Rehabilitation following Stroke: A Systematic Review. J Stroke Cerebrovasc Dis 2016; 25:2780-2789. [PMID: 27554073 DOI: 10.1016/j.jstrokecerebrovasdis.2016.07.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/18/2016] [Accepted: 07/22/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Cognitive impairments are highly prevalent in stroke survivors and can substantially affect their physical rehabilitation and quality of life. The management of these impairments currently remains limited, but increasing studies reported the effect of aerobic exercise on cognitive performance in patients suffering from stroke. The purpose of this review was to assess the effects of aerobic exercise on cognitive function following stroke. METHODS Seven electronic databases (China National Knowledge Infrastructure [CNKI], Chinese Science and Technology Periodical Database [VIP], Wanfang, China Biology Medicine disc [CBM], Science Citation Index [SCI], EMBASE, and PubMed) were searched from their inception to May 31, 2015, for the effects of aerobic exercise on cognitive ability compared to usual physical activity in stroke survivors. RevMan V5.3 (The Nordic Cochrane Centre) was used to analyze the data and to evaluate the methodological quality of the included studies. RESULTS Ten eligible studies including 394 participants were identified. Six studies showed that aerobic exercise significantly improved global cognitive ability in stroke survivors. Four studies reported aerobic exercise to be beneficial in improving memory, but only one showed statistical significance. Two studies investigated the effects of aerobic exercise on attention, and one showed a significant improvement. One study reported a significant benefit of aerobic exercise on visuospatial ability in stroke survivors. No adverse events were reported in the included studies. CONCLUSIONS Aerobic exercise may have a positive effect on improving global cognitive ability and a potential benefit on memory, attention, and the visuospatial domain of cognition in stroke survivors. However, further large, rigorously designed trials are needed to confirm these findings.
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Rossor M, Collinge J, Fox N, Mead S, Mummery C, Rohrer J, Schott J, Warren J. Dementia and Cognitive Impairment. Neurology 2016. [DOI: 10.1002/9781118486160.ch8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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31
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De Guio F, Jouvent E, Biessels GJ, Black SE, Brayne C, Chen C, Cordonnier C, De Leeuw FE, Dichgans M, Doubal F, Duering M, Dufouil C, Duzel E, Fazekas F, Hachinski V, Ikram MA, Linn J, Matthews PM, Mazoyer B, Mok V, Norrving B, O'Brien JT, Pantoni L, Ropele S, Sachdev P, Schmidt R, Seshadri S, Smith EE, Sposato LA, Stephan B, Swartz RH, Tzourio C, van Buchem M, van der Lugt A, van Oostenbrugge R, Vernooij MW, Viswanathan A, Werring D, Wollenweber F, Wardlaw JM, Chabriat H. Reproducibility and variability of quantitative magnetic resonance imaging markers in cerebral small vessel disease. J Cereb Blood Flow Metab 2016; 36:1319-37. [PMID: 27170700 PMCID: PMC4976752 DOI: 10.1177/0271678x16647396] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/20/2016] [Indexed: 12/11/2022]
Abstract
Brain imaging is essential for the diagnosis and characterization of cerebral small vessel disease. Several magnetic resonance imaging markers have therefore emerged, providing new information on the diagnosis, progression, and mechanisms of small vessel disease. Yet, the reproducibility of these small vessel disease markers has received little attention despite being widely used in cross-sectional and longitudinal studies. This review focuses on the main small vessel disease-related markers on magnetic resonance imaging including: white matter hyperintensities, lacunes, dilated perivascular spaces, microbleeds, and brain volume. The aim is to summarize, for each marker, what is currently known about: (1) its reproducibility in studies with a scan-rescan procedure either in single or multicenter settings; (2) the acquisition-related sources of variability; and, (3) the techniques used to minimize this variability. Based on the results, we discuss technical and other challenges that need to be overcome in order for these markers to be reliably used as outcome measures in future clinical trials. We also highlight the key points that need to be considered when designing multicenter magnetic resonance imaging studies of small vessel disease.
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Affiliation(s)
- François De Guio
- University Paris Diderot, Sorbonne Paris Cité, UMRS 1161 INSERM, Paris, France DHU NeuroVasc, Sorbonne Paris Cité, Paris, France
| | - Eric Jouvent
- University Paris Diderot, Sorbonne Paris Cité, UMRS 1161 INSERM, Paris, France DHU NeuroVasc, Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hospital, Paris, France
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sandra E Black
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Frank-Eric De Leeuw
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Fergus Doubal
- Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | | | - Emrah Duzel
- Department of Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada
| | - M Arfan Ikram
- Department of Radiology and Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jennifer Linn
- Department of Neuroradiology, University Hospital Munich, Munich, Germany
| | - Paul M Matthews
- Department of Medicine, Division of Brain Sciences, Imperial College London, London, UK
| | | | - Vincent Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Norrving
- Department of Clinical Sciences, Neurology, Lund University, Lund, Sweden
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Eric E Smith
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Luciano A Sposato
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada
| | - Blossom Stephan
- Institute of Health and Society, Newcastle University Institute of Ageing, Newcastle University, Newcastle, UK
| | - Richard H Swartz
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | | | - Mark van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Aad van der Lugt
- Department of Radiology and Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Meike W Vernooij
- Department of Radiology and Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anand Viswanathan
- Department of Neurology, J. Philip Kistler Stroke Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - David Werring
- Department of Brain Repair and Rehabilitation, Stroke Research Group, UCL, London, UK
| | - Frank Wollenweber
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Joanna M Wardlaw
- Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), University of Edinburgh, Edinburgh, UK
| | - Hugues Chabriat
- University Paris Diderot, Sorbonne Paris Cité, UMRS 1161 INSERM, Paris, France DHU NeuroVasc, Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hospital, Paris, France
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Lutsey PL, Bengtson LGS, Punjabi NM, Shahar E, Mosley TH, Gottesman RF, Wruck LM, MacLehose RF, Alonso A. Obstructive Sleep Apnea and 15-Year Cognitive Decline: The Atherosclerosis Risk in Communities (ARIC) Study. Sleep 2016; 39:309-16. [PMID: 26446113 DOI: 10.5665/sleep.5434] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/28/2015] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Prospective data evaluating abnormal sleep quality and quantity with cognitive decline are limited because most studies used subjective data and/or had short follow-up. We hypothesized that, over 15 y of follow-up, participants with objectively measured obstructive sleep apnea (OSA) and other indices of poor sleep quantity and quality would experience greater decline in cognitive functioning than participants with normal sleep patterns. METHODS ARIC participants (n = 966; mean age 61 y, 55% women) with in-home polysomnography (1996-1998) and repeated cognitive testing were followed for 15 y. Three cognitive tests (Delayed Word Recall, Word Fluency, and Digit Symbol Substitution) were administered at two time points (1996-1998 and 2011-2013). Ten additional cognitive tests were administered at the 2011-2013 neurocognitive examination. OSA was modeled using established clinical OSA severity categories. Multivariable linear regression was used to explore associations of OSA and other sleep indices with change in cognitive tests between the two assessments. RESULTS A median of 14.9 y (max: 17.3) passed between the two cognitive assessments. OSA category and additional indices of sleep (other measures of hypoxemia and disordered breathing, sleep fragmentation, sleep duration) were not associated with change in any cognitive test. Analyses of OSA severity categories and 10 cognitive tests administered only in 2011-2013 also showed little evidence of an association. CONCLUSIONS Overall, abnormal sleep quality and quantity at midlife was not related to cognitive decline and later-life cognition. The effect of adverse sleep quality and quantity on cognitive decline among the elderly remains to be determined.
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Abstract
In this chapter, we review the use of neuropsychologic assessment in epidemiologic studies. First, we provide a brief introduction to the history of clinical neuropsychology and neuropsychologic assessment. We expand on the principal components of a neuropsychologic assessment and cognitive domains most commonly examined. This chapter also seeks to highlight specific domains and tests with validated psychometric properties that are widely accepted in clinical practice, as well as how data from a neuropsychologic test should be interpreted. Additionally, the important roles that neuropsychologic assessments play in tracking normative changes, patient diagnoses, care, and research will be discussed. Factors to consider when deciding on the inclusion of test instruments for a research study will also be reviewed. Lastly, we shed light on the contributions that neuropsychology has played in epidemiologic studies, as well as some challenges frequently faced when participating in this field of research.
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Affiliation(s)
- P Palta
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - M C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Eisenmenger LB, Huo EJ, Hoffman JM, Minoshima S, Matesan MC, Lewis DH, Lopresti BJ, Mathis CA, Okonkwo DO, Mountz JM. Advances in PET Imaging of Degenerative, Cerebrovascular, and Traumatic Causes of Dementia. Semin Nucl Med 2016; 46:57-87. [DOI: 10.1053/j.semnuclmed.2015.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Uddin MS, Mamun AA, Hossain MS, Ashaduzzaman M, Noor MAA, Hossain MS, Uddin MJ, Sarker J, Asaduzzaman M. Neuroprotective Effect of <i>Phyllanthus acidus</i> L. on Learning and Memory Impairment in Scopolamine-Induced Animal Model of Dementia and Oxidative Stress: Natural Wonder for Regulating the Development and Progression of Alzheimer’s Disease. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/aad.2016.52005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ma J, Bo SH, Lu XT, Xu AJ, Zhang J. Protective effects of carnosine on white matter damage induced by chronic cerebral hypoperfusion. Neural Regen Res 2016; 11:1438-1444. [PMID: 27857746 PMCID: PMC5090845 DOI: 10.4103/1673-5374.191217] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Carnosine is a dipeptide that scavenges free radicals, inhibits inflammation in the central nervous system, and protects against ischemic and hypoxic brain damage through its anti-oxidative and anti-apoptotic actions. Therefore, we hypothesized that carnosine would also protect against white matter damage caused by subcortical ischemic injury. White matter damage was induced by right unilateral common carotid artery occlusion in mice. The animals were treated with 200, 500 or 750 mg/kg carnosine by intraperitoneal injection 30 minutes before injury and every other day after injury. Then, 37 days later, Klüver-Barrera staining, toluidine blue staining and immunofluorescence staining were performed. Carnosine (200, 500 mg/kg) substantially reduced damage to the white matter in the corpus callosum, internal capsule and optic tract, and it rescued expression of myelin basic protein, and alleviated the loss of oligodendrocytes. However, carnosine at the higher dose of 750 mg/kg did not have the same effects as the 200 and 500 mg/kg doses. These findings show that carnosine, at a particular dose range, protects against white matter damage caused by chronic cerebral ischemia in mice, likely by reducing oligodendroglial cell loss.
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Affiliation(s)
- Jing Ma
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shu-Hong Bo
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Tong Lu
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - A-Jing Xu
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Zhang
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yang J, d'Esterre C, Ceruti S, Roversi G, Saletti A, Fainardi E, Lee TY. Temporal changes in blood-brain barrier permeability and cerebral perfusion in lacunar/subcortical ischemic stroke. BMC Neurol 2015; 15:214. [PMID: 26490140 PMCID: PMC4618936 DOI: 10.1186/s12883-015-0468-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/08/2015] [Indexed: 12/21/2022] Open
Abstract
Background Cerebral microvascular abnormality is frequently associated with lacunar and subcortical ischemic lesions. We performed acute and follow-up CT perfusion scans over the first 3 months after ischemic stroke to investigate disturbances of the blood–brain barrier (BBB) and cerebral perfusion in patients with lacunar/subcortical lesions compared to those with cortical lesions alone. Methods Thirty-one patients with lacunar/subcortical infarct (n = 14) or with cortical large vessel infarct (n = 17) were recruited and underwent a CT perfusion study at admission, 24 h, 7 days and 3 months after stroke using a two-phase imaging protocol. Functional maps of BBB permeability surface area product (BBB-PS), cerebral blood flow (CBF) and blood volume (CBV) at follow-up were co-registered with those at admission, and the measurements in non-infarcted ipsilateral basal ganglia and thalamus were compared within each group and between the two groups. Results For the lacunar/subcortical group, BBB-PS within non-infarcted ipsilateral basal ganglia and thalamus peaked at day 7 compared to all other time points, and was significantly higher than the cortical group at day 7 and month 3. The CBF and CBV in the same region were significantly lower at admission and transient hyperemia was seen at day 7 in the lacunar/subcortical group. Conclusion Disturbed BBB-PS and compromised cerebral perfusion over the first 3 months post stroke were shown in the non-infarcted basal ganglia and thalamus of lacunar/subcortical stroke using CT perfusion. Future studies are required to elucidate the relationship of post-stroke BBB disturbances to chronic cognitive impairment.
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Affiliation(s)
- Jun Yang
- Imaging Program, Lawson Health Research Institute, London, ON, Canada. .,Imaging Research Lab, Robarts Research Institute, Western University, 1151 Richmond St. N, London, ON, N6A 5B7, Canada.
| | - Christopher d'Esterre
- Radiology Department and Calgary Stroke Program, University of Calgary, Calgary, AB, Canada.
| | - Stefano Ceruti
- Neuroradiology Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
| | - Gloria Roversi
- Section of Neurology, Department of Medical and Surgical Sciences of the Communication and Behaviour, University of Ferrara, Ferrara, Italy.
| | - Andrea Saletti
- Neuroradiology Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
| | - Enrico Fainardi
- Neuroradiology Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
| | - Ting Yim Lee
- Imaging Program, Lawson Health Research Institute, London, ON, Canada. .,Imaging Research Lab, Robarts Research Institute, Western University, 1151 Richmond St. N, London, ON, N6A 5B7, Canada. .,Radiology Department and Calgary Stroke Program, University of Calgary, Calgary, AB, Canada.
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Abstract
Background: Vascular dementia is extremely common and contributes to stroke-associated morbidity and mortality. The study of vascular dementia may help to plan preventive interventions. Aims: To study the frequency of cognitive impairment after stroke in a series of consecutive patients with acute stroke, along with factors which influence it. Methods: Fifty adults with acute infarct or hemorrhage (as seen on computed tomography of the brain) were included in the study. The National Institute of Health Stroke Scale (NIHSS) and Barthel’s Index scores were done. Cognitive testing was done by PGI Battery of Brain Dysfunction (PGI-BBD) and Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly (SIQCODE). Statistical analysis was by Student’s t-test, Chi-square test, Fisher’s exact test, and Mann-Whitney U test. Results: Mean age of patients was 61.82 years; males and ischemic strokes predominated. Dementia was seen in 30%, cognitive impairment no dementia (CIND) in 42%, and normal cognition in 28% patients. Factors associated with vascular cognitive impairment included old age, male sex, low education, hemorrhages, recurrent or severe stroke, silent infarcts, severe cortical atrophy, and left hemispheric or subcortical involvement. Conclusions: Up to 72% of patients have some form of cognitive impairment after a stroke. Secondary stroke prevention could reduce the incidence of vascular dementia.
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Affiliation(s)
| | - Charu Gauba
- Neurosciences, Indraprastha Apollo Hospitals
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Early treatment of minocycline alleviates white matter and cognitive impairments after chronic cerebral hypoperfusion. Sci Rep 2015; 5:12079. [PMID: 26174710 PMCID: PMC4502604 DOI: 10.1038/srep12079] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/13/2015] [Indexed: 11/16/2022] Open
Abstract
Subcortical ischemic vascular dementia (SIVD) caused by chronic cerebral hypoperfusion develops with progressive white matter and cognitive impairments, yet no effective therapy is available. We investigated the temporal effects of minocycline on an experimental SIVD exerted by right unilateral common carotid arteries occlusion (rUCCAO). Minocycline treated at the early stage (day 0–3), but not the late stage after rUCCAO (day 4–32) alleviated the white matter and cognitive impairments, and promoted remyelination. The actions of minocycline may not involve the inhibition of microglia activation, based on the effects after the application of a microglial activation inhibitor, macrophage migration inhibitory factor, and co-treatment with lipopolysaccharides. Furthermore, minocycline treatment at the early stage promoted the proliferation of oligodendrocyte progenitor cells (OPCs) in subventricular zone, increased OPC number and alleviated apoptosis of mature oligodendrocytes in white matter. In vitro, minocycline promoted OPC proliferation and increased the percentage of OPCs in S and G2/M phases. We provided direct evidence that early treatment is critical for minocycline to alleviate white matter and cognitive impairments after chronic cerebral hypoperfusion, which may be due to its robust effects on OPC proliferation and mature oligodendrocyte loss. So, early therapeutic time window may be crucial for its application in SIVD.
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Characterizing brain iron deposition in subcortical ischemic vascular dementia using susceptibility-weighted imaging: An in vivo MR study. Behav Brain Res 2015; 288:33-8. [PMID: 25862942 DOI: 10.1016/j.bbr.2015.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/31/2015] [Accepted: 04/02/2015] [Indexed: 12/26/2022]
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Morgen K, Schneider M, Frölich L, Tost H, Plichta MM, Kölsch H, Rakebrandt F, Rienhoff O, Jessen F, Peters O, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Hampel H, Teipel SJ, Pantel J, Heuser I, Wiltfang J, Rüther E, Kornhuber J, Maier W, Meyer-Lindenberg A. Apolipoprotein E-dependent load of white matter hyperintensities in Alzheimer's disease: a voxel-based lesion mapping study. ALZHEIMERS RESEARCH & THERAPY 2015; 7:27. [PMID: 25984242 PMCID: PMC4432954 DOI: 10.1186/s13195-015-0111-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 02/23/2015] [Indexed: 11/10/2022]
Abstract
Introduction White matter (WM) magnetic resonance imaging (MRI) hyperintensities are common in Alzheimer’s disease (AD), but their pathophysiological relevance and relationship to genetic factors are unclear. In the present study, we investigated potential apolipoprotein E (APOE)-dependent effects on the extent and cognitive impact of WM hyperintensities in patients with AD. Methods WM hyperintensity volume on fluid-attenuated inversion recovery images of 201 patients with AD (128 carriers and 73 non-carriers of the APOE ε4 risk allele) was determined globally as well as regionally with voxel-based lesion mapping. Clinical, neuropsychological and MRI data were collected from prospective multicenter trials conducted by the German Dementia Competence Network. Results WM hyperintensity volume was significantly greater in non-carriers of the APOE ε4 allele. Lesion distribution was similar among ε4 carriers and non-carriers. Only ε4 non-carriers showed a correlation between lesion volume and cognitive performance. Conclusion The current findings indicate an increased prevalence of WM hyperintensities in non-carriers compared with carriers of the APOE ε4 allele among patients with AD. This is consistent with a possibly more pronounced contribution of heterogeneous vascular risk factors to WM damage and cognitive impairment in patients with AD without APOE ε4-mediated risk. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0111-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katrin Morgen
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany ; AHG-Klinik für Psychosomatik, Kurbrunnenstr. 12, 67098, Bad Dürkheim, Germany
| | - Michael Schneider
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Lutz Frölich
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Michael M Plichta
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Heike Kölsch
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Fabian Rakebrandt
- Department of Medical Informatics, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Holbeinstr. 13-15, 53175, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University of Hamburg, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Luckhaus
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Germany
| | - Michael Hüll
- Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5 79104, Freiburg, Germany
| | - Hermann-Josef Gertz
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Johannes Schröder
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Voßstr. 5, 69115, Heidelberg, Germany
| | - Harald Hampel
- Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Hôpital de la Salpêtrière Paris, Université Pierre et Marie Curie, 47 Blvd. de lHopital, 75013, Paris, France
| | - Stefan J Teipel
- Department of Psychiatry and Psychotherapy, University of Rostock and DZNE Rostock, Gehlsheimerstr. 20, 18147 Rostock, Rostock, Germany
| | - Johannes Pantel
- Institute of General Practice, University of Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Essen, Virchowstr. 174, 45147, Essen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Johannes Kornhuber
- Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Holbeinstr. 13-15, 53175, Bonn, Germany
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
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Filley CM. White matter disease and cognitive impairment in FMR1 premutation carriers. Neurology 2015; 20:158-73. [PMID: 20352350 DOI: 10.1007/s11065-010-9127-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 03/16/2010] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This cross-sectional, observational study examined the role of white matter involvement in the cognitive impairment of individuals with the fragile X mental retardation 1 (FMR1) premutation. METHODS Eight asymptomatic premutation carriers, 5 participants with fragile X tremor/ataxia syndrome (FXTAS), and 7 noncarrier controls were studied. The mean age of the asymptomatic premutation carriers, participants with FXTAS, and noncarrier controls was 60, 71, and 67 years, respectively. Magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) were used to examine the middle cerebellar peduncles (MCP) and the genu and splenium of the corpus callosum in relation to executive function and processing speed. MRS measures were N-acetyl aspartate/creatine (NAA/Cr) and choline/creatine, and fractional anisotropy (FA) was used for DTI. Executive function was assessed with the Behavioral Dyscontrol Scale and the Controlled Oral Word Association Test (COWAT), and processing speed with the Symbol Digit Modalities Test. RESULTS Among all 13 FMR1 premutation carriers, significant correlations were found between N-acetyl aspartate/creatine and choline/creatine in the MCP and COWAT scores, and between FA in the genu and performance on the Behavioral Dyscontrol Scale, COWAT, and Symbol Digit Modalities Test; a correlation was also found between FA in the splenium and COWAT performance. In all regions studied, participants with FXTAS had the lowest mean FA. CONCLUSION Microstructural white matter disease as determined by MRS and DTI correlated with executive dysfunction and slowed processing speed in these FMR1 premutation carriers. Neuroimaging abnormalities in the genu and MCP suggest that disruption of white matter within frontocerebellar networks has an important role in the cognitive impairment associated with the FMR1 premutation.
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Affiliation(s)
- Christopher M Filley
- Behavioral Neurology Section, University of Colorado Denver School of Medicine, Denver, CO, USA.
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Rawlings AM, Sharrett AR, Schneider ALC, Coresh J, Albert M, Couper D, Griswold M, Gottesman RF, Wagenknecht LE, Windham BG, Selvin E. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med 2014; 161:785-93. [PMID: 25437406 PMCID: PMC4432464 DOI: 10.7326/m14-0737] [Citation(s) in RCA: 267] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Type 2 diabetes is associated with dementia risk, but evidence is limited for possible associations of diabetes and prediabetes with cognitive decline. OBJECTIVE To determine whether diabetes in midlife is associated with 20-year cognitive decline and to characterize long-term cognitive decline across clinical categories of hemoglobin A1c (HbA1c) levels. DESIGN Prospective cohort study. SETTING The community-based ARIC (Atherosclerosis Risk in Communities) study. PARTICIPANTS 13,351 black and white adults aged 48 to 67 years at baseline (1990 to 1992). MEASUREMENTS Diabetes was defined by self-reported physician diagnosis or medication use or HbA1c level of 6.5% or greater. Undiagnosed diabetes, prediabetes, and glucose control in persons with diagnosed diabetes were defined by clinical categories of HbA1c level. Delayed word recall, digit symbol substitution, and word fluency tests were used to assess cognitive performance and were summarized with a global Z score. RESULTS Diabetes in midlife was associated with a 19% greater cognitive decline over 20 years (adjusted global Z-score difference, -0.15 [;95% CI, -0.22 to -0.08];) compared with no diabetes. Cognitive decline was significantly greater among persons with prediabetes (HbA1c level of 5.7% to 6.4%) than among those with an HbA1c level less than 5.7%. Participants with poorly controlled diabetes (HbA1c level ≥ 7.0%) had greater decline than those whose diabetes was controlled (adjusted global Z-score difference, -0.16; P = 0.071). Longer-duration diabetes was also associated with greater late-life cognitive decline (P for trend < 0.001). Rates of decline did not differ significantly between white and black persons (P for interaction = 0.44). LIMITATION Single HbA1c measurement at baseline, 1 test per cognitive domain, and potential geographic confounding of race comparisons. CONCLUSION Diabetes prevention and glucose control in midlife may protect against late-life cognitive decline. PRIMARY FUNDING SOURCE National Institutes of Health.
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Jellinger KA. Pathogenesis and treatment of vascular cognitive impairment. Neurodegener Dis Manag 2014; 4:471-90. [DOI: 10.2217/nmt.14.37] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
SUMMARY Vascular cognitive impairment (VCI) defines a continuum of disorders ranging from mild cognitive impairment to full-blown dementia, attributable to cerebrovascular causes. Major morphological types – multi-infarct encephalopathy, strategic infarct type, subcortical arteriosclerotic leukoencephalopathy, multilacunar state, postischemic encephalopathy – result from systemic, cardiac and local large or small vessel disease. Cognitive decline is commonly caused by widespread small cerebrovascular lesions (CVLs) affecting regions/networks essential for cognition, memory and behavior. CVLs often coexist with Alzheimer-type and other pathologies, which interact in promoting dementia, but in many nondemented elderly individuals, mixed brain pathologies are also present. Due to the high variability of CVLs, no validated clinical and neuropathological criteria for VCI are available. Cholinesterase inhibitors and memantine produce small cognitive improvement but without essential effect. Antihypertensive treatment, cardiovascular control and lifestyle modifications reducing vascular risk factors are essential. Given its growing health, social and economic burden, prevention and treatment of VCI are a major challenge of neuroscience.
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Abstract
Alzheimer's disease/senile dementia of the Alzheimer type (AD/SDAT) is the most common neuropathologic substrate of dementia. It is characterized by synapse loss (predominantly within neocortex) as well as deposition of certain distinctive lesions (the result of protein misfolding) throughout the brain. The latter include senile plaques, composed mainly of an amyloid (Aβ) core and a neuritic component; neurofibrillary tangles, composed predominantly of hyperphosphorylated tau; and cerebral amyloid angiopathy, a microangiopathy affecting both cerebral cortical capillaries and arterioles and resulting from Aβ deposition within their walls or (in the case of capillaries) immediately adjacent brain parenchyma. In this article, I discuss the hypothesized role these lesions play in causing cerebral dysfunction, as well as CSF and neuroimaging biomarkers (for dementia) that are especially relevant as immunotherapeutic approaches are being developed to remove Aβ from the brain parenchyma. In addition, I address the role of neuropathology in characterizing the sequelae of new AD/SDAT therapies and helping to validate CSF and neuroimaging biomarkers of disease. Comorbidity of AD/SDAT and various types of cerebrovascular disease is a major theme in dementia research, especially as cognitive impairment develops in the oldest old, who are especially vulnerable to ischemic and hemorrhagic brain lesions.
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Affiliation(s)
- Harry V Vinters
- Department of Pathology and Laboratory Medicine (Neuropathology), UCLA Medical Center, Los Angeles, California 90095-1732;
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Streit WJ, Xue QS, Tischer J, Bechmann I. Microglial pathology. Acta Neuropathol Commun 2014; 2:142. [PMID: 25257319 PMCID: PMC4180960 DOI: 10.1186/s40478-014-0142-6] [Citation(s) in RCA: 220] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 02/06/2023] Open
Abstract
This paper summarizes pathological changes that affect microglial cells in the human brain during aging and in aging-related neurodegenerative diseases, primarily Alzheimer’s disease (AD). It also provides examples of microglial changes that have been observed in laboratory animals during aging and in some experimentally induced lesions and disease models. Dissimilarities and similarities between humans and rodents are discussed in an attempt to generate a current understanding of microglial pathology and its significance during aging and in the pathogenesis of Alzheimer dementia (AD). The identification of dystrophic (senescent) microglia has created an ostensible conflict with prior work claiming a role for activated microglia and neuroinflammation during normal aging and in AD, and this has raised a basic question: does the brain’s immune system become hyperactive (inflamed) or does it become weakened (senescent) in elderly and demented people, and what is the impact on neuronal function and cognition? Here we strive to reconcile these seemingly contradictory notions by arguing that both low-grade neuroinflammation and microglial senescence are the result of aging-associated free radical injury. Both processes are damaging for microglia as they synergistically exhaust this essential cell population to the point where the brain’s immune system is effete and unable to support neuronal function.
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Abstract
Emerging evidence indicates that there are factors within the blood of young animals that have the ability to restore youthful characteristics to a number of organ systems in older animals. Growth/differentiation factor 11 (GDF11) is the first of such factors to be identified, and two new studies demonstrate that this "factor of youth" rejuvenates stem cells found in the skeletal muscle and brain of aged mice.
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Affiliation(s)
- Rebecca E Andersen
- 1] Department of Neurological Surgery, San Francisco, San Francisco, CA 94143, USA [2] Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, San Francisco, CA 94143, USA [3] Developmental and Stem Cell Biology Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Daniel A Lim
- 1] Department of Neurological Surgery, San Francisco, San Francisco, CA 94143, USA [2] Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, San Francisco, CA 94143, USA [3] San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
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Early small vessel disease affects frontoparietal and cerebellar hubs in close correlation with clinical symptoms--a resting-state fMRI study. J Cereb Blood Flow Metab 2014; 34:1091-5. [PMID: 24780899 PMCID: PMC4083384 DOI: 10.1038/jcbfm.2014.70] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 01/30/2014] [Accepted: 02/24/2014] [Indexed: 11/08/2022]
Abstract
Cerebral small vessel disease, mainly characterized by white matter lesions and lacunes, has a high clinical impact as it leads to vascular dementia. Recent studies have shown that this disease impairs frontoparietal networks. Here, we apply resting-state magnetic resonance imaging and data-driven whole-brain imaging analysis methods (eigenvector centrality) to investigate changes of the functional connectome in early small vessel disease. We show reduced connectivity in frontoparietal networks, whereas connectivity increases in the cerebellum. These functional changes are closely related to white matter lesions and typical neuropsychological deficits associated with small vessel disease.
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Ai Q, Pu YH, Sy C, Liu LP, Gao PY. Impact of regional white matter lesions on cognitive function in subcortical vascular cognitive impairment. Neurol Res 2014; 36:434-43. [PMID: 24641691 DOI: 10.1179/1743132814y.0000000354] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Exact characterization and localization of white matter lesions (WMLs) as they relate and contribute to vascular cognitive impairment is highly debated. The purpose of this study was to investigate the impact of WML on cognitive function by using a new anatomy-based classification method. METHODS We detected WML accurately by using a three-dimensional fluid-attenuated inversion recovery (3D FLAIR) imaging technique and subsequently segmented WMLs by using an anatomy-based method. Participants included 56 consecutive patients diagnosed with subcortical vascular cognitive impairment (SubVCI). The volume of WMLs in different anatomic regions was measured. The volume of the hippocampus, the corpus callosum (CC), any lacunar infarcts, total gray matter (GM), and total brain volumes were also calculated. RESULTS Hippocampal (P = 0.005) as well as temporal WML volumes (P = 0.039) were both independently associated with mini-mental state examination (MMSE) score. Only the parietal WML volume (P = 0.000) was independently associated with Montreal Cognitive Assessment (MoCA) score. Frontal WMLs were independently correlated with executive function. Occipital WMLs were independently associated with visuospatial and recall function. Language impairment was independently correlated with both parietal GM and parietal WML volume. Functions related to orientation were independently associated with parietal WML volume. DISCUSSION The volume of WMLs in the temporal region as well as in the hippocampus were both independently associated with MMSE score. For the MoCA score, however, only parietal WML volumes were independently correlated. White matter lesions within different anatomic regions were separately correlated with different subdomains of cognitive function.
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Rogne S, Vangberg T, Eldevik P, Wikran G, Mathiesen EB, Schirmer H. Mild cognitive impairment, risk factors and magnetic resonance volumetry: role of probable Alzheimer's disease in the family. Dement Geriatr Cogn Disord 2014; 36:87-98. [PMID: 23797189 DOI: 10.1159/000350408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND/AIMS Late-onset Alzheimer's disease (LOAD) comprises sporadic LOAD and familial LOAD. We wanted to determine whether total plasma homocysteine (Hcy), cardiovascular risk factors and volumetric analyses of cerebral magnetic resonance imaging (MRI) were differently associated with mild cognitive impairment (MCI) in subjects from families with aggregation of LOAD (probable familial LOAD) and MCI in subjects from families without LOAD (probable sporadic LOAD). METHODS A total of 103 subjects with MCI without known stroke or other apparent causative diseases were included as cases together with 58 controls. The cases were stratified into 3 groups according to the number of biological relatives with probable LOAD on one side of the family. Cerebral MRI was obtained from all. The case groups were compared to the control group in sex-specific analyses of covariance. RESULTS Hcy was significantly elevated in all cases compared to controls, except for women with probable familial LOAD. These women also had significantly smaller hippocampal volume and significantly larger lateral ventricles, unlike the women in the other case groups. CONCLUSIONS Our findings suggest that research on Hcy, cardiovascular risk factors and other potential risk factors for LOAD might benefit from distinguishing between sporadic and familial LOAD.
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Affiliation(s)
- Sigbjørn Rogne
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway. Sigbjorn.Rogne @ unn.no
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