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Foda AM, Ibrahim SS, Ibrahim SM, Elbaz EM. Pterostilbene Ameliorates Cognitive Impairment in Polycystic Ovary Syndrome Rat Model through Improving Insulin Resistance via the IRS-1/PI3K/Akt/GSK-3β Pathway: A Comparative Study with Metformin. ACS Chem Neurosci 2024; 15:3064-3077. [PMID: 39119909 DOI: 10.1021/acschemneuro.4c00352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is an intricate endocrine disorder that targets millions of women globally. Recent research has drawn attention to its association with cognitive impairment and Alzheimer's disease (AD) risk, yet the exact mechanism remains elusive. This study aimed to explore the potential role of PCOS-associated insulin resistance (IR) and inflammation in linking PCOS to AD pathogenesis. It additionally investigated the therapeutic merits of pterostilbene (PTS) in ameliorating PCOS and associated cognitive deficits in comparison to metformin (MET). Rats were divided into five groups; vehicle group, PTS group [30 mg/kg, per os (p.o.) for 13 days], and the remaining three groups received letrozole (1 mg/kg, p.o. for 21 days) to represent the PCOS, PCOS + MET (300 mg/kg, p.o. for 13 days), and PCOS + PTS groups, respectively. Behavioral tests were conducted, along with a histopathological investigation of brains and ovaries. Assessment of serum hormonal profile and hippocampal IRS-1/PI3K/AKT/GSK-3β insulin signaling pathway components were performed. PTS rats exhibited improved insulin sensitivity and hormonal profile, besides enhanced neurobehavioral tests performance and histopathological findings. These effects may be attributed to modulation of the IRS-1/PI3K/AKT/GSK-3β pathway, reducing GSK-3β activity, and mitigating Tau hyperphosphorylation and Aβ accumulation in the brain. Likewise, PTS attenuated nuclear factor kappa B-mediated inflammation and reversed AChE elevation, suggesting multifaceted neuroprotective effects. Comparatively, PTS showed outcomes similar to those of MET in most parameters. The obtained findings validated that dysregulated insulin signaling in PCOS rats detrimentally affects cognitive function, which is halted by PTS, unveiling the potential of PTS as a novel therapy for PCOS and related cognitive deficits.
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Affiliation(s)
- Aliaa M Foda
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Safinaz S Ibrahim
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Sherehan M Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Modern University for Technology and Information, Cairo 11571, Egypt
| | - Eman M Elbaz
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
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Sobczuk J, Paczkowska K, Andrusiów S, Bolanowski M, Daroszewski J. Are Women with Polycystic Ovary Syndrome at Increased Risk of Alzheimer Disease? Lessons from Insulin Resistance, Tryptophan and Gonadotropin Disturbances and Their Link with Amyloid-Beta Aggregation. Biomolecules 2024; 14:918. [PMID: 39199306 PMCID: PMC11352735 DOI: 10.3390/biom14080918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
Alzheimer disease, the leading cause of dementia, and polycystic ovary syndrome, one of the most prevalent female endocrine disorders, appear to be unrelated conditions. However, studies show that both disease entities have common risk factors, and the amount of certain protein marker of neurodegeneration is increased in PCOS. Reports on the pathomechanism of both diseases point to the possibility of common denominators linking them. Dysregulation of the kynurenine pathway, insulin resistance, and impairment of the hypothalamic-pituitary-gonadal axis, which are correlated with amyloid-beta aggregation are these common areas. This article discusses the relationship between Alzheimer disease and polycystic ovary syndrome, with a particular focus on the role of disorders of tryptophan metabolism in both conditions. Based on a review of the available literature, we concluded that systemic changes occurring in PCOS influence the increased risk of neurodegeneration.
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Affiliation(s)
- Joachim Sobczuk
- Department of Endocrinology, Diabetes and Isotope Therapy, University Clinical Hospital, 50-367 Wroclaw, Poland
| | | | - Szymon Andrusiów
- Department of Neurology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Marek Bolanowski
- Department of Endocrinology, Diabetes and Isotope Therapy, University Clinical Hospital, 50-367 Wroclaw, Poland
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Jacek Daroszewski
- Department of Endocrinology, Diabetes and Isotope Therapy, University Clinical Hospital, 50-367 Wroclaw, Poland
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Del Moro L, Pirovano E, Rota E. Mind the Metabolic Gap: Bridging Migraine and Alzheimer's disease through Brain Insulin Resistance. Aging Dis 2024:AD.2024.0351. [PMID: 38913047 DOI: 10.14336/ad.2024.0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/11/2024] [Indexed: 06/25/2024] Open
Abstract
Brain insulin resistance has recently been described as a metabolic abnormality of brain glucose homeostasis that has been proven to downregulate insulin receptors, both in astrocytes and neurons, triggering a reduction in glucose uptake and glycogen synthesis. This condition may generate a mismatch between brain's energy reserve and expenditure, mainly during high metabolic demand, which could be involved in the chronification of migraine and, in the long run, at least in certain subsets of patients, in the prodromic phase of Alzheimer's disease, along a putative metabolic physiopathological continuum. Indeed, the persistent disruption of glucose homeostasis and energy supply to neurons may eventually impair protein folding, an energy-requiring process, promoting pathological changes in Alzheimer's disease, such as amyloid-β deposition and tau hyperphosphorylation. Hopefully, the "neuroenergetic hypothesis" presented herein will provide further insight on there being a conceivable metabolic bridge between chronic migraine and Alzheimer's disease, elucidating novel potential targets for the prophylactic treatment of both diseases.
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Affiliation(s)
- Lorenzo Del Moro
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Elenamaria Pirovano
- Center for Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Eugenia Rota
- Neurology Unit, San Giacomo Hospital, Novi Ligure, ASL AL, Italy
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Huddleston HG, Jaswa EG, Casaletto KB, Neuhaus J, Kim C, Wellons M, Launer LJ, Yaffe K. Associations of Polycystic Ovary Syndrome With Indicators of Brain Health at Midlife in the CARDIA Cohort. Neurology 2024; 102:e208104. [PMID: 38295344 PMCID: PMC11383880 DOI: 10.1212/wnl.0000000000208104] [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: 08/31/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Polycystic ovary syndrome (PCOS) is a common reproductive disorder associated with an adverse cardiometabolic profile early in life. Increasing evidence links cardiovascular risk factors, such as diabetes and hypertension, to accelerated cognitive aging. However, less is known about PCOS and its relationship to brain health, particularly at midlife. Our goal was to investigate possible associations between PCOS and midlife cognitive function and brain MRI findings in an ongoing prospective study. METHODS We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a geographically diverse prospective cohort study of individuals who were 18-30 years at baseline (1985-1986) and followed for 30 years. We identified women with PCOS from an ancillary study (CARDIA Women's study (CWS); n = 1,163) as those with elevated androgen levels and/or hirsutism in conjunction with symptoms of oligomenorrhea. At year 30, participants completed cognitive testing, including the Montreal Cognitive Assessment, Rey Auditory Verbal Learning Test (RAVLT) (verbal learning and memory), Digit Symbol Substitution Test (processing speed and executive function), Stroop test (attention and cognitive control), and category and letter fluency tests (semantics and attention). A subset completed brain MRI to assess brain structure and white matter integrity. Multivariable linear regression models estimated the association between PCOS and outcomes, adjusting for age, race, education, and study center. RESULTS Of the 1163 women in CWS, 907 completed cognitive testing, and of these, 66 (7.1%) met criteria for PCOS (age 54.7 years). Women with and without PCOS were similar for age, BMI, smoking/drinking status, and income. At year 30, participants with PCOS performed lower (mean z score; 95% CI) on Stroop (-0.323 (-0.69 to -7.37); p = 0.008), RAVLT (-0.254 (-0.473 to -0.034); p = 0.002), and category fluency (-0.267 (-0.480 to -0.040); p = 0.02) tests. Of the 291 participants with MRI, 25 (8.5%) met PCOS criteria and demonstrated lower total white matter fractional anisotropy, a measure of white matter integrity (coefficient (95% CI) -0.013 (-0.021 to -0.005); p = 0.002), though not abnormal white matter. DISCUSSION Our results suggest that women with PCOS have lower cognitive performance and lower white matter integrity at midlife. Additional research is needed to confirm these findings and to determine potential mechanistic pathways including potential modifiable factors.
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Affiliation(s)
- Heather G Huddleston
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Eleni G Jaswa
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Kaitlin B Casaletto
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - John Neuhaus
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Catherine Kim
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Melissa Wellons
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Lenore J Launer
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Kristine Yaffe
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
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Bucci M, Rebelos E, Oikonen V, Rinne J, Nummenmaa L, Iozzo P, Nuutila P. Kinetic Modeling of Brain [ 18-F]FDG Positron Emission Tomography Time Activity Curves with Input Function Recovery (IR) Method. Metabolites 2024; 14:114. [PMID: 38393006 PMCID: PMC10890269 DOI: 10.3390/metabo14020114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Accurate positron emission tomography (PET) data quantification relies on high-quality input plasma curves, but venous blood sampling may yield poor-quality data, jeopardizing modeling outcomes. In this study, we aimed to recover sub-optimal input functions by using information from the tail (5th-100th min) of curves obtained through the frequent sampling protocol and an input recovery (IR) model trained with reference curves of optimal shape. Initially, we included 170 plasma input curves from eight published studies with clamp [18F]-fluorodeoxyglucose PET exams. Model validation involved 78 brain PET studies for which compartmental model (CM) analysis was feasible (reference (ref) + training sets). Recovered curves were compared with original curves using area under curve (AUC), max peak standardized uptake value (maxSUV). CM parameters (ref + training sets) and fractional uptake rate (FUR) (all sets) were computed. Original and recovered curves from the ref set had comparable AUC (d = 0.02, not significant (NS)), maxSUV (d = 0.05, NS) and comparable brain CM results (NS). Recovered curves from the training set were different from the original according to maxSUV (d = 3) and biologically plausible according to the max theoretical K1 (53//56). Brain CM results were different in the training set (p < 0.05 for all CM parameters and brain regions) but not in the ref set. FUR showed reductions similarly in the recovered curves of the training and test sets compared to the original curves (p < 0.05 for all regions for both sets). The IR method successfully recovered the plasma inputs of poor quality, rescuing cases otherwise excluded from the kinetic modeling results. The validation approach proved useful and can be applied to different tracers and metabolic conditions.
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Affiliation(s)
- Marco Bucci
- Turku PET Centre, Turku University Hospital, 20521 Turku, Finland
- Turku PET Centre, University of Turku, 20521 Turku, Finland
- Turku PET Centre, Åbo Akademi University, 20521 Turku, Finland
- Theme Inflammation and Aging, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska University, SE-141 84 Stockholm, Sweden
| | - Eleni Rebelos
- Turku PET Centre, University of Turku, 20521 Turku, Finland
| | - Vesa Oikonen
- Turku PET Centre, University of Turku, 20521 Turku, Finland
| | - Juha Rinne
- Turku PET Centre, Turku University Hospital, 20521 Turku, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, 20521 Turku, Finland
- Department of Psychology, University of Turku, 20520 Turku, Finland
| | - Patricia Iozzo
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 56124 Pisa, Italy
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, 20521 Turku, Finland
- Department of Endocrinology, Turku University Hospital, 20521 Turku, Finland
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Carr ST, Saito ER, Walton CM, Saito JY, Hanegan CM, Warren CE, Trumbull AM, Bikman BT. Ceramides Mediate Insulin-Induced Impairments in Cerebral Mitochondrial Bioenergetics in ApoE4 Mice. Int J Mol Sci 2023; 24:16635. [PMID: 38068958 PMCID: PMC10706658 DOI: 10.3390/ijms242316635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Alzheimer's disease (AD) is the most common form of neurodegenerative disease worldwide. A large body of work implicates insulin resistance in the development and progression of AD. Moreover, impairment in mitochondrial function, a common symptom of insulin resistance, now represents a fundamental aspect of AD pathobiology. Ceramides are a class of bioactive sphingolipids that have been hypothesized to drive insulin resistance. Here, we describe preliminary work that tests the hypothesis that hyperinsulinemia pathologically alters cerebral mitochondrial function in AD mice via accrual of the ceramides. Homozygous male and female ApoE4 mice, an oft-used model of AD research, were given chronic injections of PBS (control), insulin, myriocin (an inhibitor of ceramide biosynthesis), or insulin and myriocin over four weeks. Cerebral ceramide content was assessed using liquid chromatography-mass spectrometry. Mitochondrial oxygen consumption rates were measured with high-resolution respirometry, and H2O2 emissions were quantified via biochemical assays on brain tissue from the cerebral cortex. Significant increases in brain ceramides and impairments in brain oxygen consumption were observed in the insulin-treated group. These hyperinsulinemia-induced impairments in mitochondrial function were reversed with the administration of myriocin. Altogether, these data demonstrate a causative role for insulin in promoting brain ceramide accrual and subsequent mitochondrial impairments that may be involved in AD expression and progression.
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Affiliation(s)
| | | | | | | | | | | | | | - Benjamin T. Bikman
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA; (S.T.C.); (E.R.S.); (C.M.W.); (A.M.T.)
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Duval A, Huckins W, Berbrier DE, Usselman CW. Is polycystic ovary syndrome associated with elevated muscle sympathetic nerve activity? Exp Physiol 2023; 108:1250-1256. [PMID: 37642329 PMCID: PMC10988453 DOI: 10.1113/ep091216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex disorder characterized by reproductive abnormalities, cardiometabolic disturbances and a heightened risk of cardiovascular disease. A small but compelling body of research demonstrates that females with PCOS present with elevated muscle sympathetic nerve activity (MSNA) at rest. Heightened MSNA is present in lean, overweight and obese females with PCOS, but limited evidence suggests that androgens may be more strongly linked to elevated MSNA in lean females with PCOS than in obese females with PCOS. Although the specific mechanisms underlying elevated MSNA in PCOS remain elusive, sympathetic activation is implicated in the progression of several cardiovascular diseases and may contribute to the cardiovascular pathophysiology of PCOS. Encouragingly, MSNA appears responsive to non-pharmacological intervention, making the sympathetic nervous system a promising therapeutic target to mitigate cardiovascular risk in PCOS. This brief review summarizes the existing evidence regarding elevated MSNA, cardiovascular risk profile and vascular function, as well as the potential for clinical intervention and future research directions in females with PCOS. NEW FINDINGS: What is the topic of this review? The presence of elevated muscle sympathetic nerve activity in females with polycystic ovary syndrome and the implications for cardiovascular health. What advance does it highlight? The sympathetic nervous system likely contributes to elevated cardiovascular disease risk in females with polycystic ovary syndrome. Moreover, it presents as a promising therapeutic target for mitigating cardiovascular disease and merits further investigation.
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Affiliation(s)
- Alicia Duval
- Department of PsychologyMcGill UniversityMontrealCanada
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical EducationMcGill UniversityMontrealCanada
| | - Will Huckins
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical EducationMcGill UniversityMontrealCanada
| | - Danielle E. Berbrier
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical EducationMcGill UniversityMontrealCanada
| | - Charlotte W. Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical EducationMcGill UniversityMontrealCanada
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Naz MSG, Rahnemaei FA, Tehrani FR, Sayehmiri F, Ghasemi V, Banaei M, Ozgoli G. Possible cognition changes in women with polycystic ovary syndrome: a narrative review. Obstet Gynecol Sci 2023; 66:347-363. [PMID: 37376796 PMCID: PMC10514592 DOI: 10.5468/ogs.22165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/15/2022] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Nowadays, polycystic ovary syndrome (PCOS) and cognitive dysfunction are major health problems among female. This narrative review aimed to investigate cognitive dysfunction in female with PCOS. English and Persian articles published in PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, Scientific Information Database, and Cochrane Database of Systematic Reviews until May 2022 were searched. Sixteen studies involving 850 female with PCOS and 974 controls were assessed. In these studies, the association between biochemical factors and symptoms of PCOS and memory, attention, executive functioning, information processing speed, and visuospatial skills was evaluated. The literature review revealed the possible cognitive changes in female with PCOS. This study summarized the different aspects of cognitive function in female with PCOS due to medication, psychological problems (mood disorders caused by disease symptoms and complications), and biochemical markers, such as metabolic and sex hormone abnormalities. Considering the existing scientific gap regarding the possibility of cognitive complications in female with PCOS, further biological studies should be conducted to evaluate the potential mechanisms involved.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Alsadat Rahnemaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht,
Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Sayehmiri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Vida Ghasemi
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad,
Iran
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas,
Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
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9
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Review of the effects of polycystic ovary syndrome on Cognition: Looking beyond the androgen hypothesis. Front Neuroendocrinol 2022; 67:101038. [PMID: 36154816 DOI: 10.1016/j.yfrne.2022.101038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/21/2022]
Abstract
Polycystic-ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age, and many features associated with PCOS - such as elevated androgens, insulin resistance and inflammation - are known to affect cognition. However, effects of PCOS on cognition are not well-understood. Here we review the current literature on PCOS and cognition, note the extent of PCOS symptomatology studied in relation to cognitive outcomes, and identify key research gaps and common methodological concerns. Findings indicate a pattern of worse performance across cognitive domains and brain measures in women with PCOS relative to non-PCOS controls, as well as a lack of evidence for the common assumption that women with PCOS will have higher performance on tasks with a demonstrated male-advantage due to high testosterone levels. We suggest strategies for moving beyond the focus on elevated androgens, in favor of research practices that account for the nuances and heterogeneity of PCOS symptoms.
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10
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Huddleston HG, Casaletto KB, Jaswa EG, Rasgon NL, Maki PP, Cedars MI, Pasch L. Endophenotypic correlates of cognitive function in reproductive-age individuals with polycystic ovary syndrome. F S Rep 2022; 3:372-379. [PMID: 36568925 PMCID: PMC9783146 DOI: 10.1016/j.xfre.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To characterize cognitive performance in relation to hormonal and metabolic factors in women with polycystic ovary syndrome (PCOS). Design Cross-sectional study. Setting Tertiary university center. Patients A total of 48 individuals, aged 21-46 years, with PCOS according to the Rotterdam criteria. Interventions Complete history and physical examinations, endovaginal ultrasounds, dermatologic assessments, neuropsychological assessments, and metabolic and hormonal serum tests. Main Outcome Measures Sample-based z-scores on a comprehensive cognitive test battery. Results Subjects were defined as having an androgenic (n = 31) or a nonandrogenic (n = 17) PCOS phenotype. Compared with their nonandrogenized counterparts, subjects with hyperandrogenism demonstrated lower relative performance on the tests of executive function (β-coefficient for the executive function composite z-score, -0.44; 95% confidence interval, -0.79 to -0.09), despite similar performance on the tests of memory, verbal reasoning, and perceptual reasoning. These differences were independent of age, years of education, and obesity. In an exploratory analysis in which subjects were stratified by the presence of insulin resistance (IR), subjects with PCOS with both IR and hyperandrogenism showed the lowest performance on a composite score of executive function, followed by those with hyperandrogenism alone. Conclusions In this small study, subjects with hyperandrogenic PCOS demonstrated lower performance on the tests of executive function than subjects with nonandrogenic PCOS. Additional research is needed to confirm these findings in larger cohorts and investigate the role of modifiable factors, including IR, on cognitive outcomes.
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Affiliation(s)
- Heather G. Huddleston
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California,Reprint requests: Heather G. Huddleston, M.D., Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 2356 Sutter Street, 7th Floor, San Francisco, California 94115-0916.
| | - Kaitlin B. Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Eleni G. Jaswa
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Natalie L. Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Pauline P. Maki
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Marcelle I. Cedars
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Lauri Pasch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California,Department of Psychology, University of Illinois Chicago, Chicago, Illinois,Department of Psychiatry, University of California San Francisco, San Francisco, California
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11
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Del Moro L, Rota E, Pirovano E, Rainero I. Migraine, Brain Glucose Metabolism and the "Neuroenergetic" Hypothesis: A Scoping Review. THE JOURNAL OF PAIN 2022; 23:1294-1317. [PMID: 35296423 DOI: 10.1016/j.jpain.2022.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 02/06/2023]
Abstract
Increasing evidence suggests that migraine may be the result of an impaired brain glucose metabolism. Several studies have reported brain mitochondrial dysfunction, impaired brain glucose metabolism and gray matter volume reduction in specific brain areas of migraineurs. Furthermore, peripheral insulin resistance, a condition demonstrated in several studies, may extend to the brain, leading to brain insulin resistance. This condition has been proven to downregulate insulin receptors, both in astrocytes and neurons, triggering a reduction in glucose uptake and glycogen synthesis, mainly during high metabolic demand. This scoping review examines the clinical, epidemiologic and pathophysiologic data supporting the hypothesis that abnormalities in brain glucose metabolism may generate a mismatch between the brain's energy reserve and metabolic expenditure, triggering migraine attacks. Moreover, alteration in glucose homeostasis could generate a chronic brain energy deficit promoting migraine chronification. Lastly, insulin resistance may link migraine with its comorbidities, like obesity, depression, cognitive impairment and cerebrovascular diseases. PERSPECTIVE: Although additional experimental studies are needed to support this novel "neuroenergetic" hypothesis, brain insulin resistance in migraineurs may unravel the pathophysiological mechanisms of the disease, explaining the migraine chronification and connecting migraine with comorbidities. Therefore, this hypothesis could elucidate novel potential approaches for migraine treatment.
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Affiliation(s)
- Lorenzo Del Moro
- Foundation Allineare Sanità and Salute, Scientific Committee, Milan, Italy; LUMEN APS, European Salus Network, Scientific Committee, San Pietro in Cerro (PC), Italy.
| | - Eugenia Rota
- Neurology Unit, ASL AL, San Giacomo Hospital, Novi Ligure, Italy
| | - Elenamaria Pirovano
- Foundation Allineare Sanità and Salute, Scientific Committee, Milan, Italy; LUMEN APS, European Salus Network, Scientific Committee, San Pietro in Cerro (PC), Italy
| | - Innocenzo Rainero
- Headache Center, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Italy
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12
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Avgerinos KI, Mullins RJ, Egan JM, Kapogiannis D. Ketone Ester Effects on Biomarkers of Brain Metabolism and Cognitive Performance in Cognitively Intact Adults ≥ 55 Years Old. A Study Protocol for a Double-Blinded Randomized Controlled Clinical Trial. J Prev Alzheimers Dis 2022; 9:54-66. [PMID: 35098974 PMCID: PMC9359666 DOI: 10.14283/jpad.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Ketone bodies have been proposed as an "energy rescue" for the Alzheimer's disease (AD) brain, which underutilizes glucose. Prior research has shown that oral ketone monoester (KME) safely induces robust ketosis in humans and has demonstrated cognitive-enhancing and pathology-reducing properties in animal models of AD. However, human evidence that KME may enhance brain ketone metabolism, improve cognitive performance and engage AD pathogenic cascades is scarce. OBJECTIVES To investigate the effects of ketone monoester (KME) on brain metabolism, cognitive performance and AD pathogenic cascades in cognitively normal older adults with metabolic syndrome and therefore at higher risk for AD. DESIGN Double-blinded randomized placebo-controlled clinical trial. SETTING Clinical Unit of the National Institute on Aging, Baltimore, US. PARTICIPANTS Fifty cognitively intact adults ≥ 55 years old, with metabolic syndrome. INTERVENTION Drinks containing 25 g of KME or isocaloric placebo consumed three times daily for 28 days. OUTCOMES Primary: concentration of beta-hydroxybutyrate (BHB) in precuneus measured with Magnetic Resonance Spectroscopy (MRS). Exploratory: plasma and urine BHB, multiple brain and muscle metabolites detected with MRS, cognition assessed with the PACC and NIH toolbox, biomarkers of AD and metabolic mediators in plasma extracellular vesicles, and stool microbiome. DISCUSSION This is the first study to investigate the AD-biomarker and cognitive effects of KME in humans. Ketone monoester is safe, tolerable, induces robust ketosis, and animal studies indicate that it can modify AD pathology. By conducting a study of KME in a population at risk for AD, we hope to bridge the existing gap between pre-clinical evidence and the potential for brain-metabolic, pro-cognitive, and anti-Alzheimer's effects in humans.
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Affiliation(s)
- K I Avgerinos
- Dimitrios Kapogiannis, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, 8C228, Baltimore, MD 21224, USA; Email address: ; Telephone: +1 410 350 3953
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13
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Gurvich C, Le J, Thomas N, Thomas EHX, Kulkarni J. Sex hormones and cognition in aging. VITAMINS AND HORMONES 2021; 115:511-533. [PMID: 33706960 DOI: 10.1016/bs.vh.2020.12.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hormones of the hypothalamic-pituitary-gonadal axis that regulate reproductive function are also potent neurosteriods that have multiple effects on the development, maintenance and function of the brain. There is a growing body of evidence linking sex hormones to cognitive functioning across the lifespan. Both subjective and objective cognitive changes can occur with aging. For women, cognitive complains are commonly associated with the menopause transition-a time of significant hormone flux. Sex differences in neurodegenerative conditions associated with cognitive dysfunction, such as Alzheimer's disease and Parkinson's disease, suggest a potential link between sex hormones and cognitive decline. Evidence for the effects of hormone therapy on cognition is growing, but remains inconclusive. This chapter provides an overview of sex hormones and cognition in association with healthy aging, including a focus on the menopause transition, as well as reviewing findings linking sex hormones to cognitive decline associated with Alzheimer's disease and Parkinson's disease. An overview of hormone therapy and cognition is also provided.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia.
| | - Jessica Le
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Natalie Thomas
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Elizabeth H X Thomas
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
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14
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Ozgen Saydam B, Yildiz BO. Polycystic Ovary Syndrome and Brain: An Update on Structural and Functional Studies. J Clin Endocrinol Metab 2021; 106:e430-e441. [PMID: 33205212 DOI: 10.1210/clinem/dgaa843] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Indexed: 12/25/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women in reproductive age and is associated with reproductive, endocrine, metabolic, cardiovascular, and psychological outcomes. All these disorders are thought to be affected by central mechanisms which could be a major contributor in pathogenesis of PCOS. EVIDENCE ACQUISITION This mini-review discusses the relevance of central nervous system imaging modalities in understanding the neuroendocrine origins of PCOS as well as their relevance to understanding its comorbidities. EVIDENCE SYNTHESIS Current data suggest that central nervous system plays a key role in development of PCOS. Decreased global and regional brain volumes and altered white matter microstructure in women with PCOS is shown by structural imaging modalities. Functional studies show diminished reward response in corticolimbic areas, brain glucose hypometabolism, and greater opioid receptor availability in reward-related regions in insulin-resistant patients with PCOS. These structural and functional disturbances are associated with nonhomeostatic eating, diminished appetitive responses, as well as cognitive dysfunction and mood disorders in women with PCOS. CONCLUSION Structural and functional brain imaging is an emerging modality in understanding pathophysiology of metabolic disorders such as diabetes and obesity as well as PCOS. Neuroimaging can help researchers and clinicians for better understanding the pathophysiology of PCOS and related comorbidities as well as better phenotyping PCOS.
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Affiliation(s)
- Basak Ozgen Saydam
- Division of Endocrinology and Metabolism, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Bulent Okan Yildiz
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
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15
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Fortier M, Castellano CA, St-Pierre V, Myette-Côté É, Langlois F, Roy M, Morin MC, Bocti C, Fulop T, Godin JP, Delannoy C, Cuenoud B, Cunnane SC. A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT. Alzheimers Dement 2020; 17:543-552. [PMID: 33103819 PMCID: PMC8048678 DOI: 10.1002/alz.12206] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022]
Abstract
Introduction Counteracting impaired brain glucose metabolism with ketones may improve cognition in mild cognitive impairment (MCI). Methods Cognition, plasma ketone response, and metabolic profile were assessed before and 6 months after supplementation with a ketogenic drink containing medium chain triglyceride (ketogenic medium chain triglyceride [kMCT]; 15 g twice/day; n = 39) or placebo (n = 44). Results Free and cued recall (Trial 1; P = .047), verbal fluency (categories; P = .024), Boston Naming Test (total correct answers; P = .033), and the Trail‐Making Test (total errors; P = .017) improved significantly in the kMCT group compared to placebo (analysis of covariance; pre‐intervention score, sex, age, education, and apolipoprotein E4 as covariates). Some cognitive outcomes also correlated positively with plasma ketones. Plasma metabolic profile and ketone response were unchanged. Conclusions This kMCT drink improved cognitive outcomes in MCI, at least in part by increasing blood ketone level. These data support further assessment of MCI progression to Alzheimer's disease.
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Affiliation(s)
- Mélanie Fortier
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
| | | | - Valérie St-Pierre
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
| | - Étienne Myette-Côté
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Maggie Roy
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Christian Bocti
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Tamas Fulop
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Philippe Godin
- Institute of Food Safety and Analytical Sciences, Nestlé Research, Lausanne, Switzerland
| | | | | | - Stephen C Cunnane
- Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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16
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Cunnane SC, Trushina E, Morland C, Prigione A, Casadesus G, Andrews ZB, Beal MF, Bergersen LH, Brinton RD, de la Monte S, Eckert A, Harvey J, Jeggo R, Jhamandas JH, Kann O, la Cour CM, Martin WF, Mithieux G, Moreira PI, Murphy MP, Nave KA, Nuriel T, Oliet SHR, Saudou F, Mattson MP, Swerdlow RH, Millan MJ. Brain energy rescue: an emerging therapeutic concept for neurodegenerative disorders of ageing. Nat Rev Drug Discov 2020; 19:609-633. [PMID: 32709961 PMCID: PMC7948516 DOI: 10.1038/s41573-020-0072-x] [Citation(s) in RCA: 443] [Impact Index Per Article: 110.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 12/11/2022]
Abstract
The brain requires a continuous supply of energy in the form of ATP, most of which is produced from glucose by oxidative phosphorylation in mitochondria, complemented by aerobic glycolysis in the cytoplasm. When glucose levels are limited, ketone bodies generated in the liver and lactate derived from exercising skeletal muscle can also become important energy substrates for the brain. In neurodegenerative disorders of ageing, brain glucose metabolism deteriorates in a progressive, region-specific and disease-specific manner - a problem that is best characterized in Alzheimer disease, where it begins presymptomatically. This Review discusses the status and prospects of therapeutic strategies for countering neurodegenerative disorders of ageing by improving, preserving or rescuing brain energetics. The approaches described include restoring oxidative phosphorylation and glycolysis, increasing insulin sensitivity, correcting mitochondrial dysfunction, ketone-based interventions, acting via hormones that modulate cerebral energetics, RNA therapeutics and complementary multimodal lifestyle changes.
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Affiliation(s)
- Stephen C Cunnane
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Research Center on Aging, Sherbrooke, QC, Canada.
| | | | - Cecilie Morland
- Department of Pharmaceutical Biosciences, Institute of Pharmacy, University of Oslo, Oslo, Norway
| | - Alessandro Prigione
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University of Dusseldorf, Dusseldorf, Germany
| | - Gemma Casadesus
- Department of Biological Sciences, Kent State University, Kent, OH, USA
| | - Zane B Andrews
- Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
- Department of Physiology, Monash University, Clayton, VIC, Australia
| | - M Flint Beal
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Linda H Bergersen
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | | | | | - Jenni Harvey
- Ninewells Hospital, University of Dundee, Dundee, UK
- Medical School, University of Dundee, Dundee, UK
| | - Ross Jeggo
- Centre for Therapeutic Innovation in Neuropsychiatry, Institut de Recherche Servier, Croissy sur Seine, France
| | - Jack H Jhamandas
- Department of Medicine, University of Albeta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Albeta, Edmonton, AB, Canada
| | - Oliver Kann
- Institute of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany
| | - Clothide Mannoury la Cour
- Centre for Therapeutic Innovation in Neuropsychiatry, Institut de Recherche Servier, Croissy sur Seine, France
| | - William F Martin
- Institute of Molecular Evolution, University of Dusseldorf, Dusseldorf, Germany
| | | | - Paula I Moreira
- CNC Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Michael P Murphy
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Klaus-Armin Nave
- Department of Biosciences, University of Heidelberg, Heidelberg, Germany
| | - Tal Nuriel
- Columbia University Medical Center, New York, NY, USA
| | - Stéphane H R Oliet
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
| | - Frédéric Saudou
- University of Grenoble Alpes, Grenoble, France
- INSERM U1216, CHU Grenoble Alpes, Grenoble Institute Neurosciences, Grenoble, France
| | - Mark P Mattson
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Mark J Millan
- Centre for Therapeutic Innovation in Neuropsychiatry, Institut de Recherche Servier, Croissy sur Seine, France.
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17
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Li G, Hu J, Zhang S, Fan W, Wen L, Wang G, Zhang D. Changes in Resting-State Cerebral Activity in Women With Polycystic Ovary Syndrome: A Functional MR Imaging Study. Front Endocrinol (Lausanne) 2020; 11:603279. [PMID: 33362718 PMCID: PMC7758505 DOI: 10.3389/fendo.2020.603279] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/13/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Previous studies have found that women with polycystic ovary syndrome (PCOS) have some degree of brain function change as well as cognitive function and emotions, such as poor executive functioning and memory, anxiety and depressive symptoms. However, the neurobiological mechanisms underlying these alterations have not yet been clarified. METHOD Fasting serum hormone testing, neuropsychological testing and resting-state magnetic resonance imaging (rs-fMRI) were performed in 41 women with newly diagnosed PCOS and 41 healthy controls matched by age and education during their 2-5 days of menstrual period. Analysis of the amplitude of low-frequency fluctuation (ALFF) was used to calculate the seed points. Then, the functional connectivity (FC) values between these abnormal seed points and other voxels in the whole brain were calculated. Finally, the correlations among clinical indexes, neuropsychological evaluation scores, and neuroimaging data were analyzed. RESULTS Compared with the control group, the PCOS group showed higher luteinizing hormone (LH) and serum insulin levels, worse sleep quality, increased depressive and anxiety state scores, and memory and executive function impairments. Pearson's correlation analysis showed that the decreased ALFF value in the left middle frontal gyrus (MFG.L), which is related to poor executive performance and depressive disorders, was negatively correlated with the plasma insulin level in subjects with insulin resistance. Furthermore, the increased FC strength between the MFG.L and left inferior frontal gyrus (IFG.L) was positively correlated with the serum testosterone level. The enhanced FC strength between the left posterior cingulate gyrus (PCG.L) and triangular part of the left inferior frontal gyrus (IFGtriang.L) was negatively correlated with the plasma LH level. When use the right middle occipital gyrus (MOG.R) as the seed point, the FC strength with the right inferior occipital gyrus (IOG.R), which is associated with impaired memory, was decreased. CONCLUSION The ALFF and FC results elucidated brain functional abnormalities at the regional and network levels in women with PCOS, while correlation analyses simultaneously demonstrated that these alterations were associated with serum hormones and cognitive function. These results may provide useful information regarding the potential mechanisms of cognitive impairment and emotional changes in this population.
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18
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Franik G, Krysta K, Witkowska A, Dudek A, Krzystanek M, Madej P. The impact of sex hormones and metabolic markers on depressive symptoms and cognitive functioning in PCOS patients. Gynecol Endocrinol 2019; 35:965-969. [PMID: 31106608 DOI: 10.1080/09513590.2019.1613359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The aim of the study was to analyze associations between cognitive deficits and such factors like hormone levels and metabolic risk factors in PCOS women. Fifty-five PCOS patients aged 17-30 underwent analyses for FSH, LH, 17-beta-estradiol, DHEAS, androstenedione, SHBG, lipid profile during the follicular phase. Fasting glucose and insulin concentrations were also measured, as well as their levels after oral-glucose administration. All participants underwent an assessment with: Trail Making Test A and B, Stroop Test, Verbal and Categorical Fluency Test. The intensity of depressive symptoms was measured by the Beck Depression Inventory (BDI). We observed a positive correlation of the depression scores with the OGTT 120' and triglycerides, and a negative correlation of the depression scores with serum HDL. The higher were the insulin levels at 120 min; the more pronounced were the deficits of the verbal psychomotor speed. Higher free testosterone correlated with better verbal psychomotor speed. Androstenedione level was associated with worse scores in executive functions assessment. 17-OH-P levels positively correlated with phonology verbal fluency scores and higher plasma cortisol level at 10 p.m. correlated with worse verbal processing speed. Endocrine and metabolic parameters seem to be important factors mediating cognitive deficits in PCOS.
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Affiliation(s)
- Grzegorz Franik
- Department of Endocrinological Gynecology, Medical University of Silesia , Katowice , Poland
| | - Krzysztof Krysta
- Department of Rehabilitation Psychiatry, Medical University of Silesia , Katowice , Poland
| | - Agnieszka Witkowska
- Department of Endocrinological Gynecology, Students' Scientific Society, Medical University of Silesia , Katowice , Poland
| | - Arkadiusz Dudek
- Department of Rehabilitation Psychiatry, Students' Scientific Society, Medical University of Silesia , Katowice , Poland
| | - Marek Krzystanek
- Department of Rehabilitation Psychiatry, Medical University of Silesia , Katowice , Poland
| | - Paweł Madej
- Department of Endocrinological Gynecology, Medical University of Silesia , Katowice , Poland
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19
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Jarrett BY, Vantman N, Mergler RJ, Brooks ED, Pierson RA, Chizen DR, Lujan ME. Dysglycemia, Not Altered Sex Steroid Hormones, Affects Cognitive Function in Polycystic Ovary Syndrome. J Endocr Soc 2019; 3:1858-1868. [PMID: 31583367 PMCID: PMC6767628 DOI: 10.1210/js.2019-00112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023] Open
Abstract
Context Polycystic ovary syndrome (PCOS) is a complex endocrine condition characterized by multiple reproductive and metabolic abnormalities. Because individual reproductive and metabolic abnormalities modulate working memory in the general population, there is growing interest in whether cognitive function is dually and negatively affected in PCOS. Objective To examine the association of reproductive and metabolic features with cognitive function in women with and without PCOS. Design An observational, cross-sectional study was conducted at an academic clinical research center in North America between 2006 and 2009. Common tests of working memory (i.e., manual dexterity, perceptual speed, and visuospatial ability) were performed by women with PCOS (n = 40) and control subjects (n = 40). Markers of sex steroid hormones, ovulatory function, and cardiometabolic health were also assessed. Results Reduced visuospatial ability was observed in women with PCOS compared with control subjects (P < 0.01). Reduced visuospatial ability was linked to higher levels of hemoglobin A1c in the entire study cohort, independent of body mass index or PCOS status. No associations were observed between visuospatial ability and reproductive features, after controlling for confounding variables. Conclusion Our findings support a role for glycemic control, and not PCOS per se, in cognitive dysfunction in women of reproductive age. Additional studies are needed to understand the short- and long-term effects of dysglycemia on brain health in women with PCOS, given their increased propensity for metabolic comorbidities, compared with control subjects.
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Affiliation(s)
| | - Natalie Vantman
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Reid J Mergler
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Eric D Brooks
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Roger A Pierson
- Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna R Chizen
- Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marla E Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
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20
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Castellano CA, Hudon C, Croteau E, Fortier M, St-Pierre V, Vandenberghe C, Nugent S, Tremblay S, Paquet N, Lepage M, Fülöp T, Turcotte ÉE, Dionne IJ, Potvin O, Duchesne S, Cunnane SC. Links Between Metabolic and Structural Changes in the Brain of Cognitively Normal Older Adults: A 4-Year Longitudinal Follow-Up. Front Aging Neurosci 2019; 11:15. [PMID: 30828297 PMCID: PMC6384269 DOI: 10.3389/fnagi.2019.00015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/16/2019] [Indexed: 12/22/2022] Open
Abstract
We aimed to longitudinally assess the relationship between changing brain energy metabolism (glucose and acetoacetate) and cognition during healthy aging. Participants aged 71 ± 5 year underwent cognitive evaluation and quantitative positron emission tomography (PET) and magnetic resonance imaging (MRI) scans at baseline (N = 25) and two (N = 25) and four (N = 16) years later. During the follow-up, the rate constant for brain extraction of glucose (Kglc) declined by 6%–12% mainly in the temporo-parietal lobes and cingulate gyri (p ≤ 0.05), whereas brain acetoacetate extraction (Kacac) and utilization remained unchanged in all brain regions (p ≥ 0.06). Over the 4 years, cognitive results remained within the normal age range but an age-related decline was observed in processing speed. Kglc in the caudate was directly related to performance on several cognitive tests (r = +0.41 to +0.43, allp ≤ 0.04). Peripheral insulin resistance assessed by the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly inversely related to Kglc in the thalamus (r = −0.44, p = 0.04) and in the caudate (r = −0.43, p = 0.05), and also inversely related to executive function, attention and processing speed (r = −0.45 to −0.53, all p ≤ 0.03). We confirm in a longitudinal setting that the age-related decline in Kglc is directly associated with declining performance on some tests of cognition but does not significantly affect Kacac.
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Affiliation(s)
- Christian-Alexandre Castellano
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Carol Hudon
- Centre de Recherche sur le Vieillissement (CERVO) Brain Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale-Nationale, Québec, QC, Canada.,School of Psychology, Université Laval, Québec, QC, Canada
| | - Etienne Croteau
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada.,Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Fortier
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Valérie St-Pierre
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Camille Vandenberghe
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Scott Nugent
- Centre de Recherche sur le Vieillissement (CERVO) Brain Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale-Nationale, Québec, QC, Canada
| | - Sébastien Tremblay
- Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nancy Paquet
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, QC, Canada.,Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada.,CR-Centre hospitalier Universitaire de Sherbrooke (CHUS), Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de l'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Tamàs Fülöp
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Éric E Turcotte
- Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, QC, Canada.,Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada.,CR-Centre hospitalier Universitaire de Sherbrooke (CHUS), Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de l'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Isabelle J Dionne
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Olivier Potvin
- Centre de Recherche sur le Vieillissement (CERVO) Brain Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale-Nationale, Québec, QC, Canada
| | - Simon Duchesne
- Centre de Recherche sur le Vieillissement (CERVO) Brain Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale-Nationale, Québec, QC, Canada.,Department of Radiology, Université Laval, Québec, QC, Canada
| | - Stephen C Cunnane
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie (CIUSSS) de L'Estrie-Centre hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada.,Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada.,Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
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21
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Morris G, Berk M, Maes M, Puri BK. Could Alzheimer's Disease Originate in the Periphery and If So How So? Mol Neurobiol 2019; 56:406-434. [PMID: 29705945 PMCID: PMC6372984 DOI: 10.1007/s12035-018-1092-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 04/17/2018] [Indexed: 12/11/2022]
Abstract
The classical amyloid cascade model for Alzheimer's disease (AD) has been challenged by several findings. Here, an alternative molecular neurobiological model is proposed. It is shown that the presence of the APOE ε4 allele, altered miRNA expression and epigenetic dysregulation in the promoter region and exon 1 of TREM2, as well as ANK1 hypermethylation and altered levels of histone post-translational methylation leading to increased transcription of TNFA, could variously explain increased levels of peripheral and central inflammation found in AD. In particular, as a result of increased activity of triggering receptor expressed on myeloid cells 2 (TREM-2), the presence of the apolipoprotein E4 (ApoE4) isoform, and changes in ANK1 expression, with subsequent changes in miR-486 leading to altered levels of protein kinase B (Akt), mechanistic (previously mammalian) target of rapamycin (mTOR) and signal transducer and activator of transcription 3 (STAT3), all of which play major roles in microglial activation, proliferation and survival, there is activation of microglia, leading to the subsequent (further) production of cytokines, chemokines, nitric oxide, prostaglandins, reactive oxygen species, inducible nitric oxide synthase and cyclooxygenase-2, and other mediators of inflammation and neurotoxicity. These changes are associated with the development of amyloid and tau pathology, mitochondrial dysfunction (including impaired activity of the electron transport chain, depleted basal mitochondrial potential and oxidative damage to key tricarboxylic acid enzymes), synaptic dysfunction, altered glycogen synthase kinase-3 (GSK-3) activity, mTOR activation, impairment of autophagy, compromised ubiquitin-proteasome system, iron dyshomeostasis, changes in APP translation, amyloid plaque formation, tau hyperphosphorylation and neurofibrillary tangle formation.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, P.O. Box 291, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, University of Melbourne, 30 Royal Parade, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - Basant K Puri
- Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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22
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Velusami D, Sivasubramanian S. Sympathovagal imbalance and neurophysiologic cognitive assessment using evoked potentials in polycystic ovary syndrome in young adolescents - a cross-sectional study. J Basic Clin Physiol Pharmacol 2018; 30:233-237. [PMID: 30332394 DOI: 10.1515/jbcpp-2018-0081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/10/2018] [Indexed: 05/27/2023]
Abstract
Background Altered lifestyle and urbanization have potentially increased the prevalence of polycystic ovary syndrome (PCOS) among the women in India. The aim of the present study was to evaluate the autonomic function and subclinical cognition impairment using evoked potentials in PCOS-affected young adolescents. Methods This was a cross-sectional study, approved by Indian Medical of Council Research as a short-term student project. The study was performed with adolescent girls (age group, 10-18 years) diagnosed as having PCOS, attending the Department of Obstetrics and Gynecology at Sri Manakula Vinayagar Medical College and Hospital, Puducherry. Autonomic function was evaluated using heart rate variability and cognition employing auditory evoked potentials (P300 latency and amplitude) among the control group (n=30) and the PCOS group (n=30). Results Our study reports indicated that autonomic functions were significantly affected among the PCOS group compared to the control group (p=0.03), with sympathetic dominance and decreased vagal tone. P300 latency was prolonged and amplitude was decreased among the PCOS group, but the results were not statistically significant when compared to the control group. Body mass index showed significant correlation with sympathovagal imbalance. Conclusion The study indicates that autonomic functions are significantly altered in the PCOS group. Subclinical cognition impairment is seen among the PCOS group but is not pronounced enough to be proven statistically. This study informs adolescent girls to make early lifestyle changes as soon as possible before any significant clinical impairment occurs.
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Affiliation(s)
- Deepika Velusami
- Assistant Professor,Department of Physiology, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Puducherry 605107, India
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23
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Vandenberghe C, Castellano CA, Maltais M, Fortier M, St-Pierre V, Dionne IJ, Cunnane SC. A short-term intervention combining aerobic exercise with medium-chain triglycerides (MCT) is more ketogenic than either MCT or aerobic exercise alone: a comparison of normoglycemic and prediabetic older women. Appl Physiol Nutr Metab 2018; 44:66-73. [PMID: 29986150 DOI: 10.1139/apnm-2018-0367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The objectives of this study were to determine (i) whether a 5-day aerobic exercise (AE) program combined with a medium-chain triglyceride (MCT) supplement would increase the plasma ketone response in older women more than either intervention alone and (ii) whether ketonemia after these combined or separate treatments was alike in normoglycemic (NG) and prediabetic (PD) women. Older women (NG, n = 10; PD, n = 9) underwent a 4-h metabolic study after each of 4 different treatments: (i) no treatment (control), (ii) 5 days of MCT alone (30 g·day-1), (iii) 1 session of 30 min of AE alone, and (iv) 5 days of MCT and AE combined (MCT+AE). Blood was sampled every 30 min over 4 h for analysis. In NG, MCT+AE induced the highest area under the curve (AUC) for plasma ketones (835 ± 341 μmol·h·L-1); this value was 69% higher than that observed with MCT alone (P < 0.05). AUCs were not different between MCT alone and MCT+AE in PD, but both treatments induced a significantly higher AUC than the control or AE alone (P < 0.05). Although there was a trend towards a higher ketone AUC in NG versus PD with AE alone (P = 0.091), there was no significant difference between the ketone AUCs in PD and NG. In conclusion, MCT+AE was more ketogenic in older women than MCT or AE alone. MCT+AE had a synergistic effect on ketonemia in NG but not in PD. Whether improving insulin sensitivity with a longer term AE intervention can improve the ketogenic effect of MCT in PD and thereby increase brain ketone uptake in older people merits further investigation.
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Affiliation(s)
- Camille Vandenberghe
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada.,b Department of Pharmacology and Physiology, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | | | - Mathieu Maltais
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada.,c Faculty of Science of Physical Activity, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Mélanie Fortier
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada
| | - Valérie St-Pierre
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada
| | - Isabelle J Dionne
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada.,c Faculty of Science of Physical Activity, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Stephen C Cunnane
- a Research Centre on Aging, 1036 Belvedere St. South, Sherbrooke, QC J1H 4C4, Canada.,b Department of Pharmacology and Physiology, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.,d Department of Medicine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
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24
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Snyder B, Cunningham RL. Sex differences in sleep apnea and comorbid neurodegenerative diseases. Steroids 2018; 133:28-33. [PMID: 29258810 PMCID: PMC5864541 DOI: 10.1016/j.steroids.2017.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/05/2017] [Accepted: 12/10/2017] [Indexed: 12/13/2022]
Abstract
Sleep apnea is a disorder, which increasingly affects people worldwide. Whether the associated hypoxic events during sleep are central or obstructive in origin, the end result is excessive daytime sleepiness and an increased risk for several comorbidities, such as cardiovascular and neurodegenerative disorders. Sleep apnea is diagnosed more frequently in men than women, suggesting a role of sex hormones in the pathology of the disease. Furthermore, there are sex differences in the development and progression of comorbid diseases associated with sleep apnea. Therefore, treatment of sleep apnea may be clinically relevant for prevention of subsequent sex-specific comorbid disorders. While the impact sleep apnea has on cardiovascular events has been the subject of many research studies, the role of sleep apnea in neurodegeneration is less established. Here we review known risk factors for sleep apnea and the implications of the observed sex differences in this disease. We also summarize the evidence and mechanisms for how sleep apnea may contribute to the onset of neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.
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Affiliation(s)
- Brina Snyder
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Rebecca L Cunningham
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, United States.
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25
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Rodriguez RL, Albeck JG, Taha AY, Ori-McKenney KM, Recanzone GH, Stradleigh TW, Hernandez BC, Tang FYV, Chiang EPI, Cruz-Orengo L. Impact of diet-derived signaling molecules on human cognition: exploring the food-brain axis. NPJ Sci Food 2017; 1:2. [PMID: 31304244 PMCID: PMC6548416 DOI: 10.1038/s41538-017-0002-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 08/25/2017] [Accepted: 09/01/2017] [Indexed: 01/02/2023] Open
Abstract
The processes that define mammalian physiology evolved millions of years ago in response to ancient signaling molecules, most of which were acquired by ingestion and digestion. In this way, evolution inextricably linked diet to all major physiological systems including the nervous system. The importance of diet in neurological development is well documented, although the mechanisms by which diet-derived signaling molecules (DSMs) affect cognition are poorly understood. Studies on the positive impact of nutritive and non-nutritive bioactive molecules on brain function are encouraging but lack the statistical power needed to demonstrate strong positive associations. Establishing associations between DSMs and cognitive functions like mood, memory and learning are made even more difficult by the lack of robust phenotypic markers that can be used to accurately and reproducibly measure the effects of DSMs. Lastly, it is now apparent that processes like neurogenesis and neuroplasticity are embedded within layers of interlocked signaling pathways and gene regulatory networks. Within these interdependent pathways and networks, the various transducers of DSMs are used combinatorially to produce those emergent adaptive gene expression responses needed for stimulus-induced neurogenesis and neuroplasticity. Taken together, it appears that cognition is encoded genomically and modified by epigenetics and epitranscriptomics to produce complex transcriptional programs that are exquisitely sensitive to signaling molecules from the environment. Models for how DSMs mediate the interplay between the environment and various neuronal processes are discussed in the context of the food-brain axis.
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Affiliation(s)
- Raymond L. Rodriguez
- Department of Molecular and Cellular Biology, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
| | - John G. Albeck
- Department of Molecular and Cellular Biology, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
| | - Ameer Y. Taha
- Department of Food Science and Technology, College of Agriculture and Environmental Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
| | - Kassandra M. Ori-McKenney
- Department of Molecular and Cellular Biology, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
| | - Gregg H. Recanzone
- Department of Neurobiology, Physiology and Behavior, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
- Center for Neuroscience, College of Biological Sciences, University of California, Davis, Davis, CA 95616 USA
| | - Tyler W. Stradleigh
- Department of Neurobiology, Physiology and Behavior, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
- Center for Neuroscience, College of Biological Sciences, University of California, Davis, Davis, CA 95616 USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA 95616 USA
| | - Bronte C. Hernandez
- Department of Molecular and Cellular Biology, College of Biological Sciences, One Shields Avenue, University of California, Davis, Davis, CA 95616 USA
| | | | - En-Pei Isabel Chiang
- Department of Food Science and Biotechnology, National Chung Hsing University, Taichung, Taiwan
- Agricultural Biotechnology Center, National Chung Hsing University, Taichung, Taiwan
| | - Lillian Cruz-Orengo
- Department of Anatomy, Physiology & Cell Biology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616 USA
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26
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Ozgen Saydam B, Has AC, Bozdag G, Oguz KK, Yildiz BO. Structural imaging of the brain reveals decreased total brain and total gray matter volumes in obese but not in lean women with polycystic ovary syndrome compared to body mass index-matched counterparts. Gynecol Endocrinol 2017; 33:519-523. [PMID: 28277117 DOI: 10.1080/09513590.2017.1295440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To detect differences in global brain volumes and identify relations between brain volume and appetite-related hormones in women with polycystic ovary syndrome (PCOS) compared to body mass index-matched controls. METHODS Forty subjects participated in this study. Cranial magnetic resonance imaging and measurements of fasting ghrelin, leptin and glucagon-like peptide 1 (GLP-1), as well as GLP-1 levels during mixed-meal tolerance test (MTT), were performed. RESULTS Total brain volume and total gray matter volume (GMV) were decreased in obese PCOS compared to obese controls (p < 0.05 for both) whereas lean PCOS and controls did not show a significant difference. Secondary analyses of regional brain volumes showed decreases in GMV of the caudate nucleus, ventral diencephalon and hippocampus in obese PCOS compared to obese controls (p < 0.05 for all), whereas lean patients with PCOS had lower GMV in the amygdala than lean controls (p < 0.05). No significant relations were detected between structural differences and measured hormone levels at baseline or during MTT. CONCLUSION This study, investigating structural brain alterations in PCOS, suggests volumetric reductions in global brain areas in obese women with PCOS. Functional studies with larger sample size are needed to determine physiopathological roles of these changes and potential effects of long-term medical management on brain structure of PCOS.
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Affiliation(s)
- Basak Ozgen Saydam
- a Department of Internal Medicine , Hacettepe University School of Medicine , Ankara , Turkey
| | - Arzu Ceylan Has
- b National Magnetic Resonance Research Center (UMRAM), Bilkent University , Ankara , Turkey
| | - Gurkan Bozdag
- c Department of Obstetrics and Gynecology , Hacettepe University School of Medicine , Ankara , Turkey
| | - Kader Karli Oguz
- b National Magnetic Resonance Research Center (UMRAM), Bilkent University , Ankara , Turkey
- d Department of Radiology , Hacettepe University School of Medicine , Ankara , Turkey and
| | - Bulent Okan Yildiz
- a Department of Internal Medicine , Hacettepe University School of Medicine , Ankara , Turkey
- e Division of Endocrinology and Metabolism , Hacettepe University School of Medicine , Ankara , Turkey
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27
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Cunnane SC, Courchesne-Loyer A, Vandenberghe C, St-Pierre V, Fortier M, Hennebelle M, Croteau E, Bocti C, Fulop T, Castellano CA. Can Ketones Help Rescue Brain Fuel Supply in Later Life? Implications for Cognitive Health during Aging and the Treatment of Alzheimer's Disease. Front Mol Neurosci 2016; 9:53. [PMID: 27458340 PMCID: PMC4937039 DOI: 10.3389/fnmol.2016.00053] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/21/2016] [Indexed: 02/02/2023] Open
Abstract
We propose that brain energy deficit is an important pre-symptomatic feature of Alzheimer's disease (AD) that requires closer attention in the development of AD therapeutics. Our rationale is fourfold: (i) Glucose uptake is lower in the frontal cortex of people >65 years-old despite cognitive scores that are normal for age. (ii) The regional deficit in brain glucose uptake is present in adults <40 years-old who have genetic or lifestyle risk factors for AD but in whom cognitive decline has not yet started. Examples include young adult carriers of presenilin-1 or apolipoprotein E4, and young adults with mild insulin resistance or with a maternal family history of AD. (iii) Regional brain glucose uptake is impaired in AD and mild cognitive impairment (MCI), but brain uptake of ketones (beta-hydroxybutyrate and acetoacetate), remains the same in AD and MCI as in cognitively healthy age-matched controls. These observations point to a brain fuel deficit which appears to be specific to glucose, precedes cognitive decline associated with AD, and becomes more severe as MCI progresses toward AD. Since glucose is the brain's main fuel, we suggest that gradual brain glucose exhaustion is contributing significantly to the onset or progression of AD. (iv) Interventions that raise ketone availability to the brain improve cognitive outcomes in both MCI and AD as well as in acute experimental hypoglycemia. Ketones are the brain's main alternative fuel to glucose and brain ketone uptake is still normal in MCI and in early AD, which would help explain why ketogenic interventions improve some cognitive outcomes in MCI and AD. We suggest that the brain energy deficit needs to be overcome in order to successfully develop more effective therapeutics for AD. At present, oral ketogenic supplements are the most promising means of achieving this goal.
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Affiliation(s)
- Stephen C Cunnane
- Research Center on Aging, SherbrookeQC, Canada; Department of Medicine, Université de Sherbrooke, SherbrookeQC, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, SherbrookeQC, Canada
| | - Alexandre Courchesne-Loyer
- Research Center on Aging, SherbrookeQC, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, SherbrookeQC, Canada
| | - Camille Vandenberghe
- Research Center on Aging, SherbrookeQC, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, SherbrookeQC, Canada
| | - Valérie St-Pierre
- Research Center on Aging, SherbrookeQC, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, SherbrookeQC, Canada
| | | | | | | | - Christian Bocti
- Research Center on Aging, SherbrookeQC, Canada; Department of Medicine, Université de Sherbrooke, SherbrookeQC, Canada
| | - Tamas Fulop
- Research Center on Aging, SherbrookeQC, Canada; Department of Medicine, Université de Sherbrooke, SherbrookeQC, Canada
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28
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Cunnane SC, Courchesne-Loyer A, St-Pierre V, Vandenberghe C, Pierotti T, Fortier M, Croteau E, Castellano CA. Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer's disease. Ann N Y Acad Sci 2016; 1367:12-20. [PMID: 26766547 DOI: 10.1111/nyas.12999] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Brain glucose uptake is impaired in Alzheimer's disease (AD). A key question is whether cognitive decline can be delayed if this brain energy defect is at least partly corrected or bypassed early in the disease. The principal ketones (also called ketone bodies), β-hydroxybutyrate and acetoacetate, are the brain's main physiological alternative fuel to glucose. Three studies in mild-to-moderate AD have shown that, unlike with glucose, brain ketone uptake is not different from that in healthy age-matched controls. Published clinical trials demonstrate that increasing ketone availability to the brain via moderate nutritional ketosis has a modest beneficial effect on cognitive outcomes in mild-to-moderate AD and in mild cognitive impairment. Nutritional ketosis can be safely achieved by a high-fat ketogenic diet, by supplements providing 20-70 g/day of medium-chain triglycerides containing the eight- and ten-carbon fatty acids octanoate and decanoate, or by ketone esters. Given the acute dependence of the brain on its energy supply, it seems reasonable that the development of therapeutic strategies aimed at AD mandates consideration of how the underlying problem of deteriorating brain fuel supply can be corrected or delayed.
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Affiliation(s)
- Stephen C Cunnane
- Research Center on Aging.,Departments of Medicine.,Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Alexandre Courchesne-Loyer
- Research Center on Aging.,Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Valérie St-Pierre
- Research Center on Aging.,Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Camille Vandenberghe
- Research Center on Aging.,Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Tyler Pierotti
- Research Center on Aging.,Department of Biology, Bishop's University, Sherbrooke, Québec, Canada
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