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Gillies NA, Milan AM, Cameron-Smith D, Mumme KD, Conlon CA, von Hurst PR, Haskell-Ramsay CF, Jones B, Roy NC, Coad J, Wall CR, Beck KL. Vitamin B and One-Carbon Metabolite Profiles Show Divergent Associations with Cardiometabolic Risk Markers but not Cognitive Function in Older New Zealand Adults: A Secondary Analysis of the REACH Study. J Nutr 2023; 153:3529-3542. [PMID: 37863266 DOI: 10.1016/j.tjnut.2023.10.012] [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: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Vitamin B inadequacies and elevated homocysteine status have been associated with impaired cognitive and cardiometabolic health with aging. There is, however, a scarcity of research investigating integrated profiles of one-carbon (1C) metabolites in this context, including metabolites of interconnected folate, methionine, choline oxidation, and transsulfuration pathways. OBJECTIVES The study aimed to examine associations between vitamins B and 1C metabolites with cardiometabolic health and cognitive function in healthy older adults, including the interactive effects of Apolipoprotein E-ε4 status. METHODS Three hundred and thirteen healthy participants (65-74 y, 65% female) were analyzed. Vitamins B were estimated according to dietary intake (4-d food records) and biochemical status (serum folate and vitamin B12). Fasting plasma 1C metabolites were quantified by liquid chromatography with tandem mass spectrometry. Measures of cardiometabolic health included biochemical (lipid panel, blood glucose) and anthropometric markers. Cognitive function was assessed by the Computerized Mental Performance Assessment System (COMPASS) and Montreal Cognitive Assessment (MoCA). Associations were analyzed using multivariate linear (COMPASS, cardiometabolic health) and Poisson (MoCA) regression modeling. RESULTS Over 90% of participants met dietary recommendations for riboflavin and vitamins B6 and B12, but only 78% of males and 67% of females achieved adequate folate intakes. Higher serum folate and plasma betaine and glycine concentrations were associated with favorable cardiometabolic markers, whereas higher plasma choline and homocysteine concentrations were associated with greater cardiometabolic risk based on body mass index and serum lipids concentration values (P< 0.05). Vitamins B and homocysteine were not associated with cognitive performance in this cohort, though higher glycine concentrations were associated with better global cognitive performance (P = 0.017), episodic memory (P = 0.016), and spatial memory (P = 0.027) scores. Apolipoprotein E-ε4 status did not modify the relationship between vitamins B or 1C metabolites with cognitive function in linear regression analyses. CONCLUSIONS Vitamin B and 1C metabolite profiles showed divergent associations with cardiometabolic risk markers and limited associations with cognitive performance in this cohort of healthy older adults.
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Affiliation(s)
- Nicola A Gillies
- The Liggins Institute, The University of Auckland, New Zealand; The Riddet Institute, New Zealand
| | - Amber M Milan
- The Liggins Institute, The University of Auckland, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand; AgResearch Ltd, Grasslands Research Centre, New Zealand
| | - David Cameron-Smith
- The Liggins Institute, The University of Auckland, New Zealand; The Riddet Institute, New Zealand; School of Agriculture, Food and Ecosystem Sciences, The University of Melbourne, Australia
| | - Karen D Mumme
- School of Sport Exercise and Nutrition, Massey University, New Zealand
| | - Cathryn A Conlon
- School of Sport Exercise and Nutrition, Massey University, New Zealand
| | | | | | - Beatrix Jones
- Department of Statistics, University of Auckland, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand
| | - Nicole C Roy
- The Riddet Institute, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand; Department of Human Nutrition, University of Otago, New Zealand
| | - Jane Coad
- College of Sciences, Massey University, New Zealand
| | - Clare R Wall
- Discipline of Nutrition and Dietetics, University of Auckland, Auckland, New Zealand
| | - Kathryn L Beck
- School of Sport Exercise and Nutrition, Massey University, New Zealand.
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Zhou L, Bai X, Huang J, Tan Y, Yang Q. Vitamin B12 supplementation improves cognitive function in middle aged and elderly patients with cognitive impairment. NUTR HOSP 2023; 40:724-731. [PMID: 37334792 DOI: 10.20960/nh.04394] [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: 06/21/2023] Open
Abstract
Introduction Objectives: to determine the effects of vitamin B12 supplementation on neuropsychological function and disease progression in middle aged and elderly patients with cognitive impairment. Methods: this was a prospective case-control study. From May 2020 to May 2021, 307 participants clinically diagnosed with cognitive impairment in the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University were enrolled. A total of 115 patients were included in this study. Meanwhile, 115 participants with cognitive impairment were randomly assigned in equal proportions to two groups: vitamin B12 treatment group (n = 58, vitamin B12 500 mg/d intramuscularly for seven days, followed by cobamamide 0.25 mg/d and methylcobalamin 0.50 mg/d) and the control group (n = 57). Demographic characteristics and blood biochemical variables were obtained from all participants. Cognitive performance was measured using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Cognitive performance was measured at baseline and after six months. Results: the vitamin B12 supplementation treatment patients who presented with cognitive impairment showed significant improvement, especially in attention, calculation (p < 0.01) and visual-constructional ability (p < 0.05), in their neuropsychological function compared to their matched group. Conclusion: vitamin B12 supplementation may improve frontal function in patients with cognitive decline. Vitamin B12 levels should be investigated in all patients with cognitive impairment.
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Affiliation(s)
- Li Zhou
- Department of Neurology. The First Affiliated Hospital of Chongqing Medical University
| | - Xue Bai
- Department of Neurology. The First People's Hospital of Neijiang
| | - Jiagui Huang
- Department of Neurology. The First Affiliated Hospital of Chongqing Medical University
| | - Yongjun Tan
- Department of Neurology. The First Affiliated Hospital of Chongqing Medical University
| | - Qin Yang
- Department of Neurology. The First Affiliated Hospital of Chongqing Medical University
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Hu Q, Wang Q, Li Y, Xie Z, Lin X, Huang G, Zhan L, Jia X, Zhao X. Intrinsic Brain Activity Alterations in Patients With Mild Cognitive Impairment-to-Normal Reversion: A Resting-State Functional Magnetic Resonance Imaging Study From Voxel to Whole-Brain Level. Front Aging Neurosci 2022; 13:788765. [PMID: 35111039 PMCID: PMC8802752 DOI: 10.3389/fnagi.2021.788765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/08/2021] [Indexed: 12/25/2022] Open
Abstract
Mild cognitive impairment (MCI) reversion refers to patients with MCI who revert from MCI to a normal cognitive state. Exploring the underlying neuromechanism of MCI reverters may contribute to providing new insights into the pathogenesis of Alzheimer's disease and developing therapeutic interventions. Information on patients with MCI and healthy controls (HCs) was collected from the Alzheimer's Disease Neuroimaging Initiative database. We redefined MCI reverters as patients with MCI whose logical memory scores changed from MCI to normal levels using the logical memory criteria. We explored intrinsic brain activity alterations in MCI reverters from voxel, regional, and whole-brain levels by comparing resting-state functional magnetic resonance imaging metrics of the amplitude of low-frequency of fluctuation (ALFF), the fractional amplitude of low-frequency fluctuation (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC) between MCI reverters and HCs. Finally, partial correlation analyses were conducted between cognitive scale scores and resting-state functional magnetic resonance imaging metrics of brain regions, revealing significant group differences. Thirty-two patients with MCI from the Alzheimer's Disease Neuroimaging Initiative database were identified as reverters. Thirty-seven age-, sex-, and education-matched healthy individuals were also enrolled. At the voxel level, compared with the HCs, MCI reverters had increased ALFF, fALFF, and PerAF in the frontal gyrus (including the bilateral orbital inferior frontal gyrus and left middle frontal gyrus), increased PerAF in the left fusiform gyrus, and decreased ALFF and fALFF in the right inferior cerebellum. Regarding regional and whole-brain levels, MCI reverters showed increased ReHo in the left fusiform gyrus and right median cingulate and paracingulate gyri; increased DC in the left inferior temporal gyrus and left medial superior frontal; decreased DC in the right inferior cerebellum and bilateral insular gyrus relative to HCs. Furthermore, significant correlations were found between cognitive performance and neuroimaging changes. These findings suggest that MCI reverters show significant intrinsic brain activity changes compared with HCs, potentially related to the cognitive reversion of patients with MCI. These results enhance our understanding of the underlying neuromechanism of MCI reverters and may contribute to further exploration of Alzheimer's disease.
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Affiliation(s)
- Qili Hu
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Qianqian Wang
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Yunfei Li
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Zhou Xie
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Xiaomei Lin
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Guofeng Huang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - LinLin Zhan
- School of Western Language, Heilongjiang University, Heilongjiang, China
| | - Xize Jia
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Xiaohu Zhao
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
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You YX, Shahar S, Mohamad M, Rajab NF, Che Din N, Lau HJ, Abdul Hamid H. Is There Any Relationship Between Biochemical Indices and Anthropometric Measurements With Dorsolateral Prefrontal Cortex Activation Among Older Adults With Mild Cognitive Impairment? Front Hum Neurosci 2022; 15:765451. [PMID: 35046782 PMCID: PMC8762169 DOI: 10.3389/fnhum.2021.765451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Working memory is developed in one region of the brain called the dorsolateral prefrontal cortex (DLPFC). The dysfunction of this region leads to synaptic neuroplasticity impairment. It has been reported that several biochemical parameters and anthropometric measurements play a vital role in cognition and brain health. This study aimed to investigate the relationships between cognitive function, serum biochemical profile, and anthropometric measurements using DLPFC activation. A cross-sectional study was conducted among 35 older adults (≥60 years) who experienced mild cognitive impairment (MCI). For this purpose, we distributed a comprehensive interview-based questionnaire for collecting sociodemographic information from the participants and conducting cognitive tests. Anthropometric values were measured, and fasting blood specimens were collected. We investigated their brain activation using the task-based functional MRI (fMRI; N-back), specifically in the DLPFC region. Positive relationships were observed between brain-derived neurotrophic factor (BDNF) (β = 0.494, p < 0.01) and Mini-Mental State Examination (MMSE) (β = 0.698, p < 0.01); however, negative relationships were observed between serum triglyceride (β = −0.402, p < 0.05) and serum malondialdehyde (MDA) (β = −0.326, p < 0.05) with right DLPFC activation (R2 = 0.512) while the participants performed 1-back task after adjustments for age, gender, and years of education. In conclusion, higher serum triglycerides, higher oxidative stress, and lower neurotrophic factor were associated with lower right DLPFC activation among older adults with MCI. A further investigation needs to be carried out to understand the causal-effect mechanisms of the significant parameters and the DLPFC activation so that better intervention strategies can be developed for reducing the risk of irreversible neurodegenerative diseases among older adults with MCI.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Suzana Shahar,
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hui Jin Lau
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Piersson AD, Ibrahim B, Suppiah S, Mohamad M, Hassan HA, Omar NF, Ibrahim MI, Yusoff AN, Ibrahim N, Saripan MI, Razali RM. Multiparametric MRI for the improved diagnostic accuracy of Alzheimer's disease and mild cognitive impairment: Research protocol of a case-control study design. PLoS One 2021; 16:e0252883. [PMID: 34547018 PMCID: PMC8454976 DOI: 10.1371/journal.pone.0252883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Alzheimer’s disease (AD) is a major neurocognitive disorder identified by memory loss and a significant cognitive decline based on previous level of performance in one or more cognitive domains that interferes in the independence of everyday activities. The accuracy of imaging helps to identify the neuropathological features that differentiate AD from its common precursor, mild cognitive impairment (MCI). Identification of early signs will aid in risk stratification of disease and ensures proper management is instituted to reduce the morbidity and mortality associated with AD. Magnetic resonance imaging (MRI) using structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (1H-MRS) performed alone is inadequate. Thus, the combination of multiparametric MRI is proposed to increase the accuracy of diagnosing MCI and AD when compared to elderly healthy controls. Methods This protocol describes a non-interventional case control study. The AD and MCI patients and the healthy elderly controls will undergo multi-parametric MRI. The protocol consists of sMRI, fMRI, DTI, and single-voxel proton MRS sequences. An eco-planar imaging (EPI) will be used to perform resting-state fMRI sequence. The structural images will be analysed using Computational Anatomy Toolbox-12, functional images will be analysed using Statistical Parametric Mapping-12, DPABI (Data Processing & Analysis for Brain Imaging), and Conn software, while DTI and 1H-MRS will be analysed using the FSL (FMRIB’s Software Library) and Tarquin respectively. Correlation of the MRI results and the data acquired from the APOE genotyping, neuropsychological evaluations (i.e. Montreal Cognitive Assessment [MoCA], and Mini–Mental State Examination [MMSE] scores) will be performed. The imaging results will also be correlated with the sociodemographic factors. The diagnosis of AD and MCI will be standardized and based on the DSM-5 criteria and the neuropsychological scores. Discussion The combination of sMRI, fMRI, DTI, and MRS sequences can provide information on the anatomical and functional changes in the brain such as regional grey matter volume atrophy, impaired functional connectivity among brain regions, and decreased metabolite levels specifically at the posterior cingulate cortex/precuneus. The combination of multiparametric MRI sequences can be used to stratify the management of MCI and AD patients. Accurate imaging can decide on the frequency of follow-up at memory clinics and select classifiers for machine learning that may aid in the disease identification and prognostication. Reliable and consistent quantification, using standardised protocols, are crucial to establish an optimal diagnostic capability in the early detection of Alzheimer’s disease.
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Affiliation(s)
- Albert Dayor Piersson
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Buhari Ibrahim
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Medicine and Health Sciences, Neuroscience Laboratory for Cognitive Function and Behavioural Imaging (NeuroCoB), Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Basic Medical Sciences, Department of Physiology, Bauchi State University PMB 65, Gadau, Nigeria
| | - Subapriya Suppiah
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Medicine and Health Sciences, Neuroscience Laboratory for Cognitive Function and Behavioural Imaging (NeuroCoB), Universiti Putra Malaysia, Seri Kembangan, Malaysia
- * E-mail:
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasyma Abu Hassan
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Nur Farhayu Omar
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Mohd Izuan Ibrahim
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Nazlim Yusoff
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normala Ibrahim
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - M. Iqbal Saripan
- Faculty of Engineering, Department of Computer & Communication Systems, University Putra Malaysia, Seri Kembangan, Malaysia
| | - Rizah Mazzuin Razali
- Gerontology Unit, Department of Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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You YX, Shahar S, Mohamad M, Rajab NF, Haron H, Che Din N, Abdul Hamid H. Neuroimaging Functional Magnetic Resonance Imaging Task-Based Dorsolateral Prefrontal Cortex Activation Following 12 Weeks of Cosmos caudatus Supplementation Among Older Adults With Mild Cognitive Impairment. J Magn Reson Imaging 2021; 54:1804-1818. [PMID: 34080265 DOI: 10.1002/jmri.27762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Cosmos caudatus (CC) is traditional Asian vegetable, commonly consumed among the Southeast Asian population. It has been reported to be high in flavonoids and might potentially improve brain activity among older adults with mild cognitive impairment (MCI). The effect of CC in brain activation improvement using neuroimaging is yet to be discovered. PURPOSE To investigate the effects of CC supplement on brain activity using functional magnetic resonance imaging (fMRI) among older adults with MCI. STUDY TYPE Prospective, randomized, double-blind, placebo-controlled trial. POPULATION/SUBJECTS Twenty older adults with mild cognitive impairment (60-75 years old), 14 of them (70%) were female subjects. FIELD STRENGTH/SEQUENCE A 3.0-T, T1-weighted anatomical images, T2*-weighted imaging data, A single shot, gradient echo-echo planar imaging (EPI) sequence. ASSESSMENT All subjects were asked to consume two 500 mg capsules of either CC supplement or placebo (maltodextrin) daily for 12 weeks. Cognitive function was measured using validated neuropsychological tests (i.e. Mini-mental State Examination and Digit Span) and task-based fMRI (N-back and Stroop Color Word Test) at baseline and 12th week. Brodmann's area 9, 46 and anterior cingulate cortex were selected as the regions of interest to define dorsolateral prefrontal cortex (DLPFC) in fMRI analysis. STATISTICAL TESTS Normality test was performed with the Shapiro-Wilk test. Two-way repeated ANOVA determined the intervention effects of the CC supplementation on brain activity after adjustments for covariates. Significance level at P < 0.05 for independent-t test and Chi square test; adjusted P < 0.0042 for two-way repeated ANOVA after Bonferroni correction. RESULTS Findings showed significant improvements in digit span (partial η2 = 0.559), increment in right DLPFC activation while performing 1-back task (partial η2 = 0.586) and left DLPFC activation while performing Stroop Color Word Test (SCWT) (congruent) task (partial η2 = 0.432) at 12th week of CC supplementation. CONCLUSION CC supplementation might have the ability to improve DLPFC activation, potentially leading to improved working memory among older adults with MCI after 12 weeks of administration. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Zwart SR, Mulavara AP, Williams TJ, George K, Smith SM. The role of nutrition in space exploration: Implications for sensorimotor, cognition, behavior and the cerebral changes due to the exposure to radiation, altered gravity, and isolation/confinement hazards of spaceflight. Neurosci Biobehav Rev 2021; 127:307-331. [PMID: 33915203 DOI: 10.1016/j.neubiorev.2021.04.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/16/2021] [Accepted: 04/23/2021] [Indexed: 12/19/2022]
Abstract
Multi-year crewed space exploration missions are now on the horizon; therefore, it is important that we understand and mitigate the physiological effects of spaceflight. The spaceflight hazards-radiation, isolation, confinement, and altered gravity-have the potential to contribute to neuroinflammation and produce long-term cognitive and behavioral effects-while the fifth hazard, distance from earth, limits capabilities to mitigate these risks. Accumulated evidence suggests that nutrition has an important role in optimizing cognition and reducing the risk of neurodegenerative diseases caused by neuroinflammation. Here we review the nutritional perspective of how these spaceflight hazards affect the astronaut's brain, behavior, performance, and sensorimotor function. We also assess potential nutrient/nutritional countermeasures that could prevent or mitigate spaceflight risks and ensure that crewmembers remain healthy and perform well during their missions. Just as history has taught us the importance of nutrition in terrestrial exploration, we must understand the role of nutrition in the development and mitigation of spaceflight risks before humans can successfully explore beyond low-Earth orbit.
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Affiliation(s)
- Sara R Zwart
- Univerity of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
| | | | - Thomas J Williams
- NASA Johnson Space Center, Mail Code SK3, 2101 NASA Parkway, Houston, TX, 77058, USA
| | - Kerry George
- KBR, 2400 E NASA Parkway, Houston, TX, 77058, USA
| | - Scott M Smith
- NASA Johnson Space Center, Mail Code SK3, 2101 NASA Parkway, Houston, TX, 77058, USA
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You YX, Shahar S, Rajab NF, Haron H, Yahya HM, Mohamad M, Din NC, Maskat MY. Effects of 12 Weeks Cosmos caudatus Supplement among Older Adults with Mild Cognitive Impairment: A Randomized, Double-Blind and Placebo-Controlled Trial. Nutrients 2021; 13:nu13020434. [PMID: 33572715 PMCID: PMC7912368 DOI: 10.3390/nu13020434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 01/10/2023] Open
Abstract
Cosmos caudatus (CC) contains high flavonoids and might be beneficial in neuroprotection. It has the potential to prevent neurodegenerative diseases. Therefore, we aimed to investigate the effects of 12 weeks of Cosmos caudatus supplement on cognitive function, mood status, blood biochemical profiles and biomarkers among older adults with mild cognitive impairment (MCI) through a double-blind, placebo-controlled trial. The subjects were randomized into CC supplement (n = 24) and placebo group (n = 24). Each of them consumed one capsule of CC supplement (250 mg of CC/capsule) or placebo (500 mg maltodextrin/capsule) twice daily for 12 weeks. Cognitive function and mood status were assessed at baseline, 6th week, and 12th week using validated neuropsychological tests. Blood biochemical profiles and biomarkers were measured at baseline and 12th week. Two-way mixed analysis of variance (ANOVA) analysis showed significant improvements in mini mental state examination (MMSE) (partial η2 = 0.150, p = 0.049), tension (partial η2 = 0.191, p = 0.018), total mood disturbance (partial η2 = 0.171, p = 0.028) and malondialdehyde (MDA) (partial η2 = 0.097, p = 0.047) following CC supplementation. In conclusion, 12 weeks CC supplementation potentially improved global cognition, tension, total mood disturbance, and oxidative stress among older adults with MCI. Larger sample size and longer period of intervention with incorporation of metabolomic approach should be conducted to further investigate the underlying mechanism of CC supplementation in neuroprotection.
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Affiliation(s)
- Yee Xing You
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Correspondence: ; Tel.: +60-3-9289-7651
| | - Nor Fadilah Rajab
- Biomedical Science Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hasnah Haron
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Hanis Mastura Yahya
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Programme and Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Normah Che Din
- Health Psychology Programme, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Mohamad Yusof Maskat
- Department of Food Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Malaysia;
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Xing Y, Fu S, Li M, Ma X, Liu M, Liu X, Huang Y, Xu G, Jiao Y, Wu H, Jiang G, Tian J. Regional Neural Activity Changes in Parkinson's Disease-Associated Mild Cognitive Impairment and Cognitively Normal Patients. Neuropsychiatr Dis Treat 2021; 17:2697-2706. [PMID: 34429605 PMCID: PMC8380131 DOI: 10.2147/ndt.s323127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/27/2021] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The aim of this study was to compare regional homogeneity (ReHo) changes in Parkinson's disease mild cognitive impairment (PD-MCI) patients with respect to normal controls (NC) and those with cognitively normal PD (PD-CN). Further, the study investigated the relationship between ReHo changes in PD patients and neuropsychological variation. PATIENTS AND METHODS Thirty PD-MCI, 19 PD-CN, and 21 NC subjects were enrolled. Resting state functional magnetic resonance imaging data of all subjects were collected, and regional brain activity was measured for ReHo. Analysis of covariance for ReHo was determined between the PD-MCI, PD-CN, and NC groups. Spearman rank correlations were assessed using the ReHo maps and data from the neuropsychological tests. RESULTS In comparison with NC, PD-CN patients showed significantly higher ReHo values in the right middle frontal gyrus (MFG) and lower ReHo values in the left supramarginal gyrus, bilateral inferior parietal lobule (IPL), and the right postcentral gyrus (PCG). In comparison with PD-CN patients, PD-MCI patients displayed significantly higher ReHo values in the right PCG, left middle occipital gyrus (MOG) and IPL. No significant correlation between ReHo indices and the neuropsychological scales was observed. CONCLUSION Our finding revealed that decreases in ReHo in the default mode network (DMN) may appear before PD-related cognitive impairment. In order to preserve executive attention capacity, ReHo in the right MFG in PD patients lacking cognition impairment increased for compensation. PD-MCI showed increased ReHo in the left MOG, which might have been caused by visual and visual-spatial dysfunction, and increased ReHo in the left IPL, which might reflect network disturbance and induce cognition deficits.
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Affiliation(s)
- Yilan Xing
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Shishun Fu
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Meng Li
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xiaofen Ma
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Mengchen Liu
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xintong Liu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yan Huang
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guang Xu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yonggang Jiao
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Hong Wu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guihua Jiang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Junzhang Tian
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
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Guo M, Ren Y, Yu H, Yang H, Cao C, Li Y, Fan G. Alterations in Degree Centrality and Functional Connectivity in Parkinson's Disease Patients With Freezing of Gait: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2020; 14:582079. [PMID: 33224024 PMCID: PMC7670067 DOI: 10.3389/fnins.2020.582079] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022] Open
Abstract
Objective Freezing of gait (FOG) is a common disabling motor symptom in Parkinson's disease (PD), but the potential pathogenic mechanisms are still unclear. Methods A total of 22 patients with PD with FOG (PD-FOG), 28 patients with PD without FOG (PD-nFOG), and 33 healthy controls (HCs) were recruited in this study. Degree centrality (DC)-a graph theory-based measurement of global connectivity at the voxel level by measuring the number of instantaneous functional connections between one region and the rest of the brain-can map brain hubs with high sensitivity, specificity, and reproducibility. DC was used to explore alterations in the centrality of PD-FOG correlated with brain node levels. PD-FOG cognitive network dysfunction was further revealed via a seed-based functional connectivity (FC) analysis. In addition, correlation analyses were carried out between clinical symptoms and acquired connectivity measurement. Results Compared to the PD-nFOG group, the PD-FOG group showed remarkably increased DC values in the right middle frontal gyrus (RMFG). There were no significant differences in other gray matter regions. Importantly, the clinical severity of FOG was related to the mean DC values in the RMFG. This brain region served as a seed in secondary seed-based FC analysis, and we further found FC changes in the right precuneus, right inferior frontal gyrus, right superior frontal gyrus (SFG), and cerebellum. Conclusion Increased RMFG activity and FC network alterations in the middle frontal cortex with the precuneus, inferior, and SFG, and the cerebellum may have great potential in brain dysfunction in PD with FOG.
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Affiliation(s)
- MiaoRan Guo
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Ren
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - HongMei Yu
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - HuaGuang Yang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - ChengHao Cao
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - YingMei Li
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - GuoGuang Fan
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Ishihara K, Izawa KP, Kitamura M, Ogawa M, Shimogai T, Kanejima Y, Morisawa T, Shimizu I. Relation of Poor Nutritional Status to Mild Cognitive Impairment in Patients with Coronary Artery Disease. J Nutr Health Aging 2020; 24:1080-1086. [PMID: 33244564 DOI: 10.1007/s12603-020-1428-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Nutritional status affects cerebral circulation and cognitive function. More attention needs to be paid to nutritional status in coronary artery disease (CAD) patients, yet the relation between nutritional status or dietary intake (DI) and cognitive function or mild cognitive impairment (MCI) in CAD patients remain unclear. Thus, we examined the following relations: 1) that between nutritional status and cognitive function, and MCI and 2) that between DI and cognitive function, and MCI. DESIGN, SETTING, AND PARTICIPANTS We conducted a cross-sectional study of 208 patients with CAD but without dementia. MEASUREMENTS MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Nutritional status was assessed by the Geriatric Nutritional Risk Index (GNRI), and DI was assessed by total energy intake per day. We investigated the relation between nutritional status or DI and cognitive function by Pearson correlation analysis, and that between nutritional status or DI and MCI by multivariable logistic regression analysis. RESULTS The GNRI and DI were positively associated with the MoCA-J score (r = 0.23, p < 0.001, and r = 0.24, p < 0.001, respectively), and both were independently associated with MCI in the multivariable logistic regression analysis (odds ratio, 0.96; p = 0.045, and odds ratio, 0.998; p = 0.020, respectively). CONCLUSIONS Poor nutritional status and low DI were found to be significantly associated with cognitive function and MCI in CAD patients. Our findings regarding nutritional status and DI might be useful for clinicians to prevent or intervene in the early cognitive decline of inpatients with CAD.
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Affiliation(s)
- K Ishihara
- Kazuhiro P. Izawa, Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan, Tel: +81-78-796-4566; E-mail:
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12
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Rodrigues KE, de Oliveira FR, Barbosa BRC, Paraense RSO, Bannwart CM, Pinheiro BG, Botelho ADS, Muto NA, do Amarante CB, Hamoy M, Macchi BDM, Maia CDSF, do Prado AF, do Nascimento JLM. Aqueous Coriandrum sativum L. extract promotes neuroprotection against motor changes and oxidative damage in rat progeny after maternal exposure to methylmercury. Food Chem Toxicol 2019; 133:110755. [PMID: 31408720 DOI: 10.1016/j.fct.2019.110755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/03/2019] [Accepted: 08/08/2019] [Indexed: 01/18/2023]
Abstract
This study aimed to investigate the effects of Coriandrum sativum aqueous extract (CSAE) on the rat progeny of mothers exposed to methylmercury (MeHg). The presence of bioactive compounds and CSAE's antioxidant capacity been evaluated, and the offspring were assessed for their total mercury levels, motor behavioral parameters and oxidative stress in the cerebellum. The analysis of the bioactive compounds revealed significant amounts of polyphenols, flavonoids, and anthocyanins, as well as a variety of minerals. A DPPH test showed the CSAE had important antioxidant activity. The MeHg + CSAE group performed significantly better spontaneous locomotor activity, palmar grip strength, balance, and motor coordination in behavioral tests compared the MeHg group, as well as in the parameters of oxidative stress, with similar results to those of the control group. The MeHg + CSAE group also had significantly reduced mercury levels in comparison to the MeHg group. Based on the behavioral tests, which detected large locomotor, balance, and coordination improvements, as well as a reduction in oxidative stress, we conclude that CSAE had positive functional results in the offspring of rats exposed to MeHg.
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Affiliation(s)
- Keuri Eleutério Rodrigues
- Neuroscience and Cellular Biology Post Graduation Program, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil; Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Fábio Rodrigues de Oliveira
- Neuroscience and Cellular Biology Post Graduation Program, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil; Bromatology and Quality Control Laboratory, Health and Biological Sciences Department, Federal University of Amapa (UNIFAP), Macapa, Ap, Brazil
| | - Benilson Ramos Cassunde Barbosa
- Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Ricardo S Oliveira Paraense
- Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Cahy Manoel Bannwart
- Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Bruno Gonçalves Pinheiro
- Behavioral and Inflammatory Pharmacology Laboratory, Health Sciences Institute, Pharmacy College, Federal University of Para, Belem, PA, Brazil
| | | | - Nilton Akio Muto
- Amazonian Bioactive Compounds Valorization Center, Federal University of Para, Belem, PA, Brazil
| | | | - Moises Hamoy
- Natural Products' Toxicology and Pharmacology Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Barbarella de Matos Macchi
- Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - Cristiane do Socorro Ferraz Maia
- Behavioral and Inflammatory Pharmacology Laboratory, Health Sciences Institute, Pharmacy College, Federal University of Para, Belem, PA, Brazil
| | - Alejandro Ferraz do Prado
- Structural Biology Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil
| | - José Luiz Martins do Nascimento
- Neuroscience and Cellular Biology Post Graduation Program, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil; Molecular and Cellular Neurochemistry Laboratory, Biological Sciences Institute, Federal University of Para, Belem, PA, Brazil; National Institute of Science and Technology in Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, RJ, Brazil; Pharmaceutical Sciences Post Graduation Program, Health and Biological Sciences Department, Federal University of Amapa (UNIFAP), Macapa, Ap, Brazil.
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You YX, Shahar S, Mohamad M, Yahya HM, Haron H, Abdul Hamid H. Does traditional asian vegetables (ulam) consumption correlate with brain activity using fMRI? A study among aging adults from low-income households. J Magn Reson Imaging 2019; 51:1142-1153. [PMID: 31386268 PMCID: PMC7079031 DOI: 10.1002/jmri.26891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 01/08/2023] Open
Abstract
Background Working memory and cognitive flexibility are supported by the dorsolateral prefrontal cortex (DLPFC). Aging adults from low‐income households are individuals with a high risk of cognitive decline who incorporate ulam in their daily diet. Purpose To examine relationship between ulam consumption and the working memory and cognitive flexibility among aging adults from low‐income households who are more susceptible to cognitive decline. Study Type Cross‐sectional. Population/Subjects Thirty‐two aging adults (45–75 years old). Field Strength/Sequence Task‐based fMRI, 3.0T, T1‐weighted anatomical images, T2*‐weighted imaging data. Assessment The dietary and ulam consumption were assessed using the respective validated Dietary History and semiquantitative Food Frequency questionnaires. Working memory and cognitive flexibility were evaluated by using neuropsychological batteries (ie, mini‐mental state examination [MMSE], Digit Span, and Rey auditory verbal learning test [RAVLT]) and task‐based fMRI (N‐back and Stroop Color Word Test [SCWT]). Brodmann's areas 9 and 46 were the regions of interest (ROIs) of DLPFC activation. Statistical Tests Multiple linear regression used to understand the relationship between ulam consumption and the working memory and cognitive flexibility, while analysis of covariance (ANCOVA) was used to compare the difference of working memory and cognitive flexibility among four percentiles of ulam consumption, after age, gender, and education years adjustments. Significance was decided by two‐sided, P < 0.0042 and P < 0.05. Results The multiple linear regression revealed that ulam consumption was positively associated with the Digit Span (R2 = 0.51, β = 0.702, P < 0.001), right DLPFC activation (1‐back) (R2 = 0.34, β = 0.591, P = 0.001), left DLPFC activation (SCWT‐1) (R2 = 0.33, β = 0.553, P = 0.002), and left DLPFC activation (SCWT‐2) (R2 = 0.34, β = 0.497, P = 0.004). The ulam consumption at the 75th and 100th percentile from the ANCOVA analysis had shown a better working memory and cognitive flexibility as compared with those of the 25th and 50th percentiles (P < 0.05). Data Conclusion This study found that high ulam consumption was related to a high intensity of brain activation in DLPFC; however, the elucidation of the neuroprotective properties of ulam have yet to be established from clinical trial studies. Level of Evidence: 2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2020;51:1142–1153.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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