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Lin M, Liu W, Ma C, Gao J, Huang L, Zhu J, Liang S, He Y, Liu J, Tao J, Liu Z, Huang J, Wang Z, Chen L. Tai Chi-Induced Exosomal LRP1 is Associated With Memory Function and Hippocampus Plasticity in aMCI Patients. Am J Geriatr Psychiatry 2024; 32:1215-1230. [PMID: 38824049 DOI: 10.1016/j.jagp.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES The study was designed to identify the potential peripheral processes of circulating exosome in response to Tai Chi (TC) exercise and the possibility of its loaded cargos in mediating the effects of TC training on cognitive function among older adults with amnestic mild cognitive impairment (aMCI). DESIGN, SETTING, AND PARTICIPANTS This was a multicenter randomized controlled trial. One hundred community-dwelling old adults with aMCI were randomly assigned (1:1) to experimental (n = 50) and control groups (n = 50). INTERVENTION The experimental group participated in TC exercise 5 times/week, with each session lasting 60 minutes for 12 weeks. Both experimental and control groups received health education every 4 weeks. MEASUREMENTS The primary outcome was global cognitive function. Neurocognitive assessments, MRI examination, and large-scale proteomics analysis of peripheric exosome were conducted at baseline and after 12-week training. Outcome assessors and statisticians were blinded to group allocation. RESULTS A total of 96 participants (96%) completed all outcome measurements. TC training improved global cognitive function (adjusted mean difference [MD] = 1.9, 95%CI 0.93-2.87, p <0.001) and memory (adjusted MD = 6.42, 95%CI 2.09-10.74, p = 0.004), increased right hippocampus volume (adjusted MD = 88.52, 95%CI 13.63-163.4, p = 0.021), and enhanced rest state functional connectivity (rsFC) between hippocampus and cuneus, which mediated the group effect on global cognitive function (bootstrapping CIs: [0.0208, 1.2826], [0.0689, 1.2211]) and verbal delay recall (bootstrapping CI: [0.0002, 0.6277]). Simultaneously, 24 differentially expressed exosomal proteins were detected in tandem mass tag-labelling proteomic analysis. Of which, the candidate protein low-density lipoprotein receptor-related protein 1 (LRP1) was further confirmed by parallel reaction monitoring and ELISA. Moreover, the up-regulated LRP1 was both positively associated with verbal delay recall and rsFC (left hippocampus-right cuneus). CONCLUSION TC promotes LRP1 release via exosome, which was associated with enhanced memory function and hippocampus plasticity in aMCI patients. Our findings provided an insight into potential therapeutic neurobiological targets focusing on peripheric exosome in respond to TC exercise.
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Affiliation(s)
- Miaoran Lin
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Weilin Liu
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Chuyi Ma
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jiahui Gao
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Li Huang
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jingfang Zhu
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Shengxiang Liang
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Youze He
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jiao Liu
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jing Tao
- TCM Rehabilitation Research Center of SATCM (JT, JH), Fuzhou 350122, China
| | - Zhizhen Liu
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jia Huang
- TCM Rehabilitation Research Center of SATCM (JT, JH), Fuzhou 350122, China
| | - Zhifu Wang
- The Affiliated Rehabilitation Hospital (ZW), Fujian University of Traditional Chinese Medicine, Fuzhou 350003, China
| | - Lidian Chen
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Fujian University of Traditional Chinese Medicine (LC), Shangjie University Town, Fuzhou, China.
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Spencer FSE, Elsworthy RJ, Breen L, Bishop J, Morrissey S, Aldred S. The Relationship Between Physical Activity and Non-Modifiable Risk Factors on Alzheimer's Disease and Brain Health Markers: A UK Biobank Study. J Alzheimers Dis 2024:JAD240269. [PMID: 39269836 DOI: 10.3233/jad-240269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Background Modifiable (physical activity) and non-modifiable (sex and genotype) risk factors interact to affect Alzheimer's disease (AD) risk. Further investigation is necessary to understand if these factors influence brain volume and cognition. Objective The study aimed to assess the effect of physical activity, APOE genotype, and sex on AD risk, brain volume, and cognition. Methods UK Biobank data from 2006 to 2023 was accessed. Physical activity was measured by accelerometers, and International Physical Activity Questionnaire. Outcomes were AD incidence; brain volume (ventricular cerebrospinal fluid and total brain); and cognition (executive function, memory, visuospatial ability, processing speed, and reaction time). Logistic and linear regression models were conducted. Results 69,060 participants met inclusion criteria (mean age: 62.28 years, SD: 7.84; 54.64% female). Higher self-reported (OR = 0.63, 95% CI [0.40, 1.00], p = 0.047) and accelerometer-assessed (OR = 0.96 [0.93, 0.98], p = 0.002) physical activity was associated with lower disease incidence. Smaller ventricular cerebrospinal fluid volume (β= - 65.43 [- 109.68, - 17.40], p = 0.007), and larger total brain volume (β= 4398.46 [165.11, 8631.82], p < 0.001) was associated with increased accelerometer-assessed and self-reported physical activity respectively. Both brain volume analyses were moderated by sex. Increased accelerometer-assessed physical activity levels were associated with faster reaction time (β= - 0.43 [- 0.68, - 0.18], p = 0.001); though poorer visuospatial ability (β= - 0.06 [- 0.09, - 0.03], p < 0.001), and executive function (β= 0.49 [0.31, 0.66], p < 0.001; β= 0.27 [0.10, 0.45], p = 0.002) was related to self-reported physical activity levels. Conclusions Higher levels of physical activity reduce AD risk independently of non-modifiable risk factors. Moderation of sex on brain volume highlighted the importance of incorporating non-modifiable risk factors in analysis.
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Affiliation(s)
- Felicity S E Spencer
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Richard J Elsworthy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Jonathan Bishop
- Birmingham Clinical Trials Unit, Institute of Applied Health Research, Public Health Building, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sol Morrissey
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Chang YK, Etnier JL, Li RH, Ren FF, Ai JY, Chu CH. Acute Exercise Effect on Neurocognitive Function Among Cognitively Normal Late-Middle-Aged Adults With/Without Genetic Risk of AD: The Moderating Role of Exercise Volume and APOE Genotype. J Gerontol A Biol Sci Med Sci 2024; 79:glad179. [PMID: 37526237 DOI: 10.1093/gerona/glad179] [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: 02/27/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Acute exercise is a behavior that benefits cognitive function; however, its effect on populations with different risks for Alzheimer's disease (AD) and the role of exercise variance and Apolipoprotein E (APOE) genotype on this effect remains unknown. This study explores the acute exercise effect on behavioral and neurocognitive function, and its potential moderation by exercise intensity and duration and APOE genetic risk. METHODS Fifty-one cognitively normal adults (~36% APOE ε4 carriers) performed the Stroop task under a rest condition and 3 exercise conditions while electroencephalographic activity was assessed. RESULTS Acute exercise improved cognitive performance assessed through both behavioral and neuroelectrical indices. These benefits were observed regardless of adjustments of intensity and duration at a predetermined exercise volume as well as being evident irrespective of APOE ɛ4 carrier status. CONCLUSIONS Acute exercise could be proposed as a lifestyle intervention to benefit neurocognitive function in populations with and without genetic risk of AD. Future exploration should further the precise exercise prescription and also the mechanisms underlying the beneficial effects of acute exercise for neurocognitive function. CLINICAL TRIALS REGISTRATION NUMBER NCT05591313.
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Affiliation(s)
- Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
- Social Emotional Education and Development Center, National Taiwan Normal University, Taipei, Taiwan
| | - Jennifer L Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Ruei-Hong Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Jing-Yi Ai
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Heng Chu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
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Yiallourou SR, Cribb L, Cavuoto MG, Rowsthorn E, Nicolazzo J, Gibson M, Baril AA, Pase MP. Association of the Sleep Regularity Index With Incident Dementia and Brain Volume. Neurology 2024; 102:e208029. [PMID: 38165323 DOI: 10.1212/wnl.0000000000208029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Irregular sleep may increase the risk of cardiometabolic conditions, but its association with incident dementia is unclear. The aim of this study was to assess the association between sleep regularity, that is, the day-to-day consistency in sleep-wake patterns and the risk of incident dementia and related brain MRI endophenotypes. METHODS We used Cox proportional hazard models to investigate the relationships between sleep regularity and incident dementia in 88,094 UK Biobank participants. The sleep regularity index (SRI) was calculated as the probability of being in the same state (asleep/awake) at any 2 time points 24 hours apart, averaged over 7 days of accelerometry. RESULTS The mean age of the sample was 62 years (SD = 8), 56% were women, and the median SRI was 60 (SD = 10). There were 480 cases of incident dementia over a median 7.2 years of follow-up. Following adjustments for demographic, clinical, and genetic confounders (APOE ε4), there was a nonlinear association between the SRI and dementia hazard (p [global test of spline term] < 0.001) with hazard ratios (HRs) following a U-shape pattern. HRs, relative to the median SRI, were 1.53 (95% CI 1.24-1.89) for participants with SRI at the 5th percentile (SRI = 41) and 1.16 (95% CI 0.89-1.50) for those with SRI at the 95th percentile (SRI = 71). In a subset with brain MRI (n = 15,263), gray matter and hippocampal volume tended to be lowest at the extremes of the SRI. DISCUSSION Sleep regularity displayed a U-shaped association with risk of incident dementia. Irregular sleep may represent a novel dementia risk factor.
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Affiliation(s)
- Stephanie R Yiallourou
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Lachlan Cribb
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Marina G Cavuoto
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Ella Rowsthorn
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Jessica Nicolazzo
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Madeline Gibson
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Andrée-Ann Baril
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Matthew P Pase
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
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Konwar S, Manca R, De Marco M, Soininen H, Venneri A. The effect of physical activity on white matter integrity in aging and prodromal to mild Alzheimer's disease with vascular comorbidity. Front Aging Neurosci 2023; 15:1096798. [PMID: 37520122 PMCID: PMC10382177 DOI: 10.3389/fnagi.2023.1096798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/02/2023] [Indexed: 08/01/2023] Open
Abstract
Background Physical activity is a modifiable lifestyle factor that has been previously associated with reduced vascular burden and reduced risk of dementia. Objectives This study tested whether physical activity (i.e., being inactive vs. active) contributed to preservation of white matter microstructure in healthy aging controls and patients in prodromal to mild Alzheimer's disease with low/high vascular burden. Materials A total of 213 participants were recruited from memory clinics. They were classified as being either physically active (n = 113) or inactive (n = 100) based on the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) questionnaire. Diffusion-weighted images were acquired for all participants and pre-processed based on a standard protocol. Methods A factorial design using voxel-wise tract-based spatial statistics (TBSS) was adopted, with 5,000 permutations and threshold-free cluster enhancement (TFCE), to identify significant clusters for fractional anisotropy (FA), axial diffusivity (AxD), mean diffusivity (MD), and radial diffusivity (RD). Results Clusters of higher FA and lower AxD, MD, and RD values were found for physically active compared with inactive participants that were widespread covering mainly association and projection tracts but also some commissural tracts. A three-way Group × Physical Activity × Vascular Burden interaction effect was found for FA mostly in a variety of projection tracts with a right predominance, and some commissural and association tracts. Post hoc analyses revealed higher FA in patients with high vascular burden who were physically active compared with those patients with high vascular burden who were inactive mainly in projection and association/limbic tracts with a right predominance. Additionally, higher FA was observed in physically active patients with high vascular burden as compared with physically inactive controls with high vascular burden, mainly in bilateral projection fibers and cerebellar regions. Conclusion Voxel-wise TBSS analysis revealed better preservation of white matter microstructure that was prominent in the high-risk group such as the patients with high vascular burden, specifically those who were physically active. The beneficial effects of physical activity on white matter microstructure were not observed in the controls.
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Affiliation(s)
- Srijan Konwar
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Riccardo Manca
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
| | - Annalena Venneri
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Abdolalizadeh A, Moradi K, Dabbagh Ohadi MA, Mirfazeli FS, Rajimehr R. Larger left hippocampal presubiculum is associated with lower risk of antisocial behavior in healthy adults with childhood conduct history. Sci Rep 2023; 13:6148. [PMID: 37061611 PMCID: PMC10105780 DOI: 10.1038/s41598-023-33198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/08/2023] [Indexed: 04/17/2023] Open
Abstract
Conduct Disorder (CD) is defined as aggressive, antisocial, and rule-breaking behavior during childhood. It is a major risk factor for developing antisocial personality disorder (ASPD) in adulthood. However, nearly half the CDs do not develop ASPD. Identification of reversion factors seems crucial for proper interventions. We identified 40 subjects with childhood history of CD (CC) and 1166 control subjects (HC) from Human Connectome Project. Their psychiatric, emotional, impulsivity, and personality traits were extracted. An emotion recognition task-fMRI analysis was done. We also did subregion analysis of hippocampus and amygdala in 35 CC and 69 demographically matched HCs. CC subjects scored significantly higher in antisocial-related evaluations. No differences in task-fMRI activation of amygdala and hippocampus were observed. CCs had larger subfields of the left hippocampus: presubiculum, CA3, CA4, and dentate gyrus. Further, an interaction model revealed a significant presubiculum volume × group association with antisocial, aggression, and agreeableness scores. Our study shows that healthy young adults with a prior history of CD still exhibit some forms of antisocial-like behavior with larger left hippocampal subfields, including presubiculum that also explains the variability in antisocial behavior. These larger left hippocampal subfield volumes may play a protective role against CD to ASPD conversion.
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Affiliation(s)
- AmirHussein Abdolalizadeh
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl Von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Interdisciplinary Neuroscience Research Program, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Moradi
- Interdisciplinary Neuroscience Research Program, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Dabbagh Ohadi
- Interdisciplinary Neuroscience Research Program, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Mirfazeli
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Reza Rajimehr
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Bhatti JS, Khullar N, Mishra J, Kaur S, Sehrawat A, Sharma E, Bhatti GK, Selman A, Reddy PH. Stem cells in the treatment of Alzheimer's disease - Promises and pitfalls. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166712. [PMID: 37030521 DOI: 10.1016/j.bbadis.2023.166712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
Alzheimer's disease (AD) is the most widespread form of neurodegenerative disorder that causes memory loss and multiple cognitive issues. The underlying mechanisms of AD include the build-up of amyloid-β and phosphorylated tau, synaptic damage, elevated levels of microglia and astrocytes, abnormal microRNAs, mitochondrial dysfunction, hormonal imbalance, and age-related neuronal loss. However, the etiology of AD is complex and involves a multitude of environmental and genetic factors. Currently, available AD medications only alleviate symptoms and do not provide a permanent cure. Therefore, there is a need for therapies that can prevent or reverse cognitive decline, brain tissue loss, and neural instability. Stem cell therapy is a promising treatment for AD because stem cells possess the unique ability to differentiate into any type of cell and maintain their self-renewal. This article provides an overview of the pathophysiology of AD and existing pharmacological treatments. This review article focuses on the role of various types of stem cells in neuroregeneration, the potential challenges, and the future of stem cell-based therapies for AD, including nano delivery and gaps in stem cell technology.
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Affiliation(s)
- Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, India.
| | - Naina Khullar
- Department of Zoology, Mata Gujri College, Fatehgarh Sahib, Punjab, India
| | - Jayapriya Mishra
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, India
| | - Satinder Kaur
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, India
| | - Abhishek Sehrawat
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, India
| | - Eva Sharma
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, India
| | - Gurjit Kaur Bhatti
- Department of Medical Lab Technology, University Institute of Applied Health Sciences, Chandigarh University, Mohali, India
| | - Ashley Selman
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA.
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Frederiksen KS, Jensen CS, Høgh P, Gergelyffy R, Waldemar G, Andersen BB, Gottrup H, Vestergaard K, Wermuth L, Søndergaard HB, Sellebjerg F, Hasselbalch SG, Simonsen AH. Aerobic exercise does not affect serum neurofilament light in patients with mild Alzheimer's disease. Front Neurosci 2023; 17:1108191. [PMID: 36761410 PMCID: PMC9902368 DOI: 10.3389/fnins.2023.1108191] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Aerobic exercise has been shown to modify Alzheimer pathology in animal models, and in patients with multiple sclerosis to reduce neurofilament light (NfL), a biomarker of neurodegeneration. Objective To investigate whether a 16-week aerobic exercise program was able to reduce serum NfL in patients with mild Alzheimer's disease (AD). Methods This is a secondary analysis of data from the multi-center Preserving Cognition, Quality of Life, Physical Health, and Functional Ability in Alzheimer's disease: The Effect of Physical Exercise (ADEX) study. Participants were randomized to 16 weeks of moderate intensity aerobic exercise or usual care. Clinical assessment and measurement of serum NfL was done at baseline and after the intervention. Results A total of 136 participants were included in the analysis. Groups were comparable at baseline except for APOEε4 carriership which was higher in the usual care group (75.3 versus 60.2%; p = 0.04). There was no effect of the intervention on serum NfL [intervention: baseline NfL (pg/mL) 25.76, change from baseline 0.87; usual care: baseline 27.09, change from baseline -1.16, p = 0.09]. Conclusion The findings do not support an effect of the exercise intervention on a single measure of neurodegeneration in AD. Further studies are needed using other types and durations of exercise and other measures of neurodegeneration. Clinical trial registration clinicaltrials.gov, identifier NCT01681602.
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Affiliation(s)
- Kristian Steen Frederiksen
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark,*Correspondence: Kristian Steen Frederiksen,
| | - Camilla Steen Jensen
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Peter Høgh
- Department of Neurology, Regional Dementia Research Centre, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Regional Dementia Research Centre, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Gunhild Waldemar
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Bo Andersen
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Hanne Gottrup
- Dementia Clinic, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lene Wermuth
- Department of Neurology, Dementia Clinic, Slagelse Hospital, Slagelse, Denmark,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Helle Bach Søndergaard
- Danish Multiple Sclerosis Center, Copenhagen University Hospital–Rigshospitalet, Glostrup, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Copenhagen University Hospital–Rigshospitalet, Glostrup, Denmark
| | - Steen Gregers Hasselbalch
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Hviid Simonsen
- Department of Neurology, Danish Dementia Research Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
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Chwa WJ, Raji CA, Toups K, Hathaway A, Gordon D, Chung H, Boyd A, Hill BD, Hausman-Cohen S, Attarha M, Jarrett M, Bredesen DE. Longitudinal White and Gray Matter Response to Precision Medicine-Guided Intervention for Alzheimer's Disease. J Alzheimers Dis 2023; 96:1051-1058. [PMID: 38007669 DOI: 10.3233/jad-230481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a debilitating condition that is widely known to adversely affect gray matter (GM) and white matter (WM) tracts within the brain. Recently, precision medicine has shown promise in alleviating the clinical and gross morphological trajectories of patients with AD. However, regional morphological changes have not yet been adequately characterized. OBJECTIVE Investigate regional morphological responses to a precision medicine-guided intervention with regards to white and gray matter in AD and mild cognitive impairment (MCI). METHODS Clinical and neuroimaging data were compiled over a 9-month period from 25 individuals who were diagnosed with AD or MCI receiving individualized treatment plans. Structural T1-weighted MRI scans underwent segmentation and volumetric quantifications via Neuroreader. Longitudinal changes were calculated via annualized percent change of WM or GM ratios. RESULTS Montreal Cognitive Assessment scores (p < 0.001) and various domains of the Computerized Neurocognitive Screening Vital Signs significantly improved from baseline to 9-month follow-up. There was regional variability in WM and GM atrophy or hypertrophy, but none of these observed changes were statistically significant after correction for multiple comparisons.
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Affiliation(s)
- Won Jong Chwa
- Saint Louis University School of Medicine, Saint Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Cyrus A Raji
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Kat Toups
- Bay Area Wellness, Walnut Creek, CA, USA
| | | | | | | | - Alan Boyd
- CNS Vital Signs, Morrisville, NC, USA
| | - Benjamin D Hill
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | | | | | | | - Dale E Bredesen
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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10
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Ramer JD, Santiago-Rodríguez ME, Vukits AJ, Bustamante EE. The convergent effects of primary school physical activity, sleep, and recreational screen time on cognition and academic performance in grade 9. Front Hum Neurosci 2022; 16:1017598. [DOI: 10.3389/fnhum.2022.1017598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022] Open
Abstract
Lab-based experiments and randomized controlled trials consistently demonstrate improvements in youth cognition following physical activity (PA), while cross-sectional studies suggest that sedentary behavior (especially recreational screen time [RST]) and poor sleep are inversely related to cognition. However, little is known about how these 24-h movement behaviors—sleep, PA, and sedentary behavior—converge to affect youth cognition. Therefore, the purpose of this study is to test the associations between childhood 24-h movement behaviors and adolescent cognition using a longitudinal design and examine moderating effects of each behavior. This study utilized structural equation modeling with data from the NICHD Study of Early Child Care and Youth Development (N = 1,364, 52% female, 80% White). Independent variables—sleep, RST, and PA—were collected in grade 5. Dependent variables of cognitive and academic performance were collected at grade 9, including the Stroop task, Woodcock-Johnson, and Tower of London. Grade 5 PA was inversely associated with grade 9 cognition, but this relationship was no longer significant once grade 5 cognition was controlled for in analyses. Grade 5 sleep was positively related to grade 9 cognition, whether baseline cognition was controlled for or not. Finally, grade 5 RST was inversely related to cognition and academic performance, regardless of whether baseline values were controlled. Moderation analyses showed the relationship between grade 5 RST and grade 9 cognition was moderated by grade 5 PA, while the relationship between grade 5 PA and grade 9 cognition was moderated by grade 5 sleep. In each case, more PA and sleep blunted the negative relationships. These findings extend evidence that greater sleep promotes cognition and greater RST impairs cognition, by affirming these relationships over a longer period. They extend the evidence by demonstrating that the longitudinal relationship between individual 24-h movement behavior and cognition is moderated by other behaviors.
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11
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Fernández-Calle R, Konings SC, Frontiñán-Rubio J, García-Revilla J, Camprubí-Ferrer L, Svensson M, Martinson I, Boza-Serrano A, Venero JL, Nielsen HM, Gouras GK, Deierborg T. APOE in the bullseye of neurodegenerative diseases: impact of the APOE genotype in Alzheimer's disease pathology and brain diseases. Mol Neurodegener 2022; 17:62. [PMID: 36153580 PMCID: PMC9509584 DOI: 10.1186/s13024-022-00566-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/29/2022] [Indexed: 02/06/2023] Open
Abstract
ApoE is the major lipid and cholesterol carrier in the CNS. There are three major human polymorphisms, apoE2, apoE3, and apoE4, and the genetic expression of APOE4 is one of the most influential risk factors for the development of late-onset Alzheimer's disease (AD). Neuroinflammation has become the third hallmark of AD, together with Amyloid-β plaques and neurofibrillary tangles of hyperphosphorylated aggregated tau protein. This review aims to broadly and extensively describe the differential aspects concerning apoE. Starting from the evolution of apoE to how APOE's single-nucleotide polymorphisms affect its structure, function, and involvement during health and disease. This review reflects on how APOE's polymorphisms impact critical aspects of AD pathology, such as the neuroinflammatory response, particularly the effect of APOE on astrocytic and microglial function and microglial dynamics, synaptic function, amyloid-β load, tau pathology, autophagy, and cell-cell communication. We discuss influential factors affecting AD pathology combined with the APOE genotype, such as sex, age, diet, physical exercise, current therapies and clinical trials in the AD field. The impact of the APOE genotype in other neurodegenerative diseases characterized by overt inflammation, e.g., alpha- synucleinopathies and Parkinson's disease, traumatic brain injury, stroke, amyotrophic lateral sclerosis, and multiple sclerosis, is also addressed. Therefore, this review gathers the most relevant findings related to the APOE genotype up to date and its implications on AD and CNS pathologies to provide a deeper understanding of the knowledge in the APOE field.
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Affiliation(s)
- Rosalía Fernández-Calle
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Sabine C. Konings
- Department of Experimental Medical Science, Experimental Dementia Research Unit, Lund University, Lund, Sweden
| | - Javier Frontiñán-Rubio
- Oxidative Stress and Neurodegeneration Group, Faculty of Medicine, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Juan García-Revilla
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
- Departamento de Bioquímica Y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, and Instituto de Biomedicina de Sevilla-Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Lluís Camprubí-Ferrer
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Martina Svensson
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Isak Martinson
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Antonio Boza-Serrano
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
- Departamento de Bioquímica Y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, and Instituto de Biomedicina de Sevilla-Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - José Luís Venero
- Departamento de Bioquímica Y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, and Instituto de Biomedicina de Sevilla-Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Henrietta M. Nielsen
- Department of Biochemistry and Biophysics at, Stockholm University, Stockholm, Sweden
| | - Gunnar K. Gouras
- Department of Experimental Medical Science, Experimental Dementia Research Unit, Lund University, Lund, Sweden
| | - Tomas Deierborg
- Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
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12
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Maleki S, Hendrikse J, Chye Y, Caeyenberghs K, Coxon JP, Oldham S, Suo C, Yücel M. Associations of cardiorespiratory fitness and exercise with brain white matter in healthy adults: A systematic review and meta-analysis. Brain Imaging Behav 2022; 16:2402-2425. [PMID: 35773556 PMCID: PMC9581839 DOI: 10.1007/s11682-022-00693-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) studies have revealed positive associations between brain structure and physical activity, cardiorespiratory fitness, and exercise (referred to here as PACE). While a considerable body of research has investigated the effects of PACE on grey matter, much less is known about effects on white matter (WM). Hence, we conducted a systematic review of peer-reviewed literature published prior to 5th July 2021 using online databases (PubMed and Scopus) and PRISMA guidelines to synthesise what is currently known about the relationship between PACE and WM in healthy adults. A total of 60 studies met inclusion criteria and were included in the review. Heterogeneity across studies was calculated using Qochran's q test, and publication bias was assessed for each meta-analysis using Begg and Mazumdar rank correlation test. A meta-regression was also conducted to explore factors contributing to any observed heterogeneity. Overall, we observed evidence of positive associations between PACE and global WM volume (effect size (Hedges's g) = 0.137, p < 0.001), global WM anomalies (effect size = 0.182, p < 0.001), and local microstructure integrity (i.e., corpus callosum: effect size = 0.345, p < 0.001, and anterior limb of internal capsule: effect size = 0.198, p < 0.001). These findings suggest that higher levels of PACE are associated with improved global WM volume and local integrity. We appraise the quality of evidence, and discuss the implications of these findings for the preservation of WM across the lifespan. We conclude by providing recommendations for future research in order to advance our understanding of the specific PACE parameters and neurobiological mechanisms underlying these effects.
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Affiliation(s)
- Suzan Maleki
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Joshua Hendrikse
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - James P Coxon
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Stuart Oldham
- Neural Systems and Behaviour, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
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13
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Brown BM, de Frutos Lucas J, Porter T, Frost N, Vacher M, Peiffer JJ, Laws SM. Non-Modifiable Factors as Moderators of the Relationship Between Physical Activity and Brain Volume: A Cross-Sectional UK Biobank Study. J Alzheimers Dis 2022; 88:1091-1101. [PMID: 35754269 DOI: 10.3233/jad-220114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous research suggests physical activity attenuates grey and white matter loss; however, there appears to be individual variability in this effect. Understanding factors that can influence the relationship between physical activity and brain volume may enable prediction of individual response. OBJECTIVE The current study examined the relationship between objectively-measured physical activity and brain volume; and whether this relationship is moderated by age, sex, or a priori candidate genetic factors, brain-derived neurotrophic factor (BDNF) Val66Met, or apolipoprotein (APOE) ɛ4 allele carriage. METHODS Data from 10,083 men and women (50 years and over) of the UK Biobank were used to examine the study objectives. All participants underwent a magnetic resonance imaging scan to quantify grey and white matter volumes, physical activity monitoring via actigraphy, and genotyping. RESULTS Physical activity was associated with total grey matter volume, total white matter volume, and right hippocampal volume. Only males had an association between higher physical activity levels and greater cortical grey matter volume, total grey matter volume, and right hippocampal volume. Age moderated the relationship between physical activity and white matter volume. CONCLUSION Our results indicate that in males, but not females, an association exists between objectively-measured physical activity and grey matter volume. Age may also play a role in impacting the relationship between physical activity and brain volume. Future research should evaluate longitudinal brain volumetrics to better understand the nature of age and sex-effects on the physical activity and brain volume relationship.
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Affiliation(s)
- Belinda M Brown
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia.,Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia.,Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jaisalmer de Frutos Lucas
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, UPM-UCM, Pozuelo de Alarcón, Spain
| | - Tenielle Porter
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.,Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - Natalie Frost
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Michael Vacher
- Australian e-Health Research Centre, CSIRO, Floreat, Western Australia, Australia
| | - Jeremiah J Peiffer
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Simon M Laws
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.,Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
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14
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Fassier P, Kang JH, Lee IM, Grodstein F, Vercambre MN. Vigorous Physical Activity and Cognitive Trajectory Later in Life: Prospective Association and Interaction by Apolipoprotein E e4 in the Nurses' Health Study. J Gerontol A Biol Sci Med Sci 2022; 77:817-825. [PMID: 34125204 PMCID: PMC8974346 DOI: 10.1093/gerona/glab169] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The apolipoprotein E (APOE) e4 allele is a well-established genetic risk factor of brain aging. Vigorous physical activity may be particularly important in APOE-e4 carriers, but data have been inconsistent, likely due to differences in the timing of the physical activity assessment, definition of cognitive decline, and/or sample size. METHODS We prospectively evaluated the association between vigorous physical activity and cognition assessed at least 9 years later, according to APOE-e4 carrier status. Biennially from 1986, Nurses' Health Study participants reported their leisure-time physical activities. Starting in 1995-2001 and through 2008, participants (aged 70+ years) underwent up to 4 repeated cognitive telephone assessments (6 tasks averaged together using z-scores). RESULTS Among 7252 women, latent process mixed models identified 3 major patterns of cognitive change over 6 years: high-stable, medium-stable, and decline. Taking the high-stable cognitive trajectory as the outcome reference in multinomial logistic regressions, highest tertile of vigorous physical activity (≥5.9 metabolic-equivalent [MET]-hours/wk) compared to lowest tertile (≤0.9 MET-hours/wk) was significantly associated with subsequent lower likelihood of the medium-stable trajectory in the global score (odds ratio [OR] [95% CI] = 0.72 [0.63, 0.82]), verbal memory (OR [95% CI] = 0.78 [0.68-0.89]), and telephone interview of cognitive status score (OR [95% CI] = 0.81 [0.70-0.94]). Vigorous physical activity was also associated with lower likelihood of decline in category fluency (OR [95% CI] = 0.72 [0.56, 0.92]). We observed some evidence (p-interaction = .07 for the global score) that the association was stronger among APOE-e4 carriers than noncarriers (OR [95% CI] = 0.60 [0.39, 0.92] vs 0.82 [0.59, 1.16]). CONCLUSION Midlife vigorous physical activity was associated with better cognitive trajectories in women in their seventies, with suggestions of stronger associations among APOE-e4 carriers.
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Affiliation(s)
| | - Jae Hee Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
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15
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Pearce AM, Marr C, Dewar M, Gow AJ. Apolipoprotein E Genotype Moderation of the Association Between Physical Activity and Brain Health. A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 13:815439. [PMID: 35153725 PMCID: PMC8833849 DOI: 10.3389/fnagi.2021.815439] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Possession of one or two e4 alleles of the apolipoprotein E (APOE) gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity may benefit carriers of the e4 allele differently. Method We conducted a systematic review and meta-analysis of studies which assessed APOE differences in the association between physical activity and: lipid profile, Alzheimer's disease pathology, brain structure and brain function in healthy adults. Searches were carried out in PubMed, SCOPUS, Web of Science and PsycInfo. Results Thirty studies were included from 4,896 papers screened. Carriers of the e4 allele gained the same benefit from physical activity as non-carriers on most outcomes. For brain activation, e4 carriers appeared to gain a greater benefit from physical activity on task-related and resting-state activation and resting-state functional connectivity compared to non-carriers. Post-hoc analysis identified possible compensatory mechanisms allowing e4 carriers to maintain cognitive function. Discussion Though there is evidence suggesting physical activity may benefit e4 carriers differently compared to non-carriers, this may vary by the specific brain health outcome, perhaps limited to brain activation. Further research is required to confirm these findings and elucidate the mechanisms.
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16
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Domingos C, Picó-Pérez M, Magalhães R, Moreira M, Sousa N, Pêgo JM, Santos NC. Free-Living Physical Activity Measured With a Wearable Device Is Associated With Larger Hippocampus Volume and Greater Functional Connectivity in Healthy Older Adults: An Observational, Cross-Sectional Study in Northern Portugal. Front Aging Neurosci 2021; 13:729060. [PMID: 34916921 PMCID: PMC8670087 DOI: 10.3389/fnagi.2021.729060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
Several studies using neuroimaging techniques have established a positive relationship between physical activity (PA) and brain structure and function in older populations. However, the use of subjective measures of PA and the lack of multimodal neuroimaging approaches have limited the understanding of this association. This study aims to explore the associations between PA and brain structure and function by objectively evaluating PA. Community-dwelling cognitively healthy older adults (without diagnosed cognitive, neurological or degenerative disease) were recruited from local health centers and local gyms. In a cross-sectional design, participants were evaluated regarding cognitive, clinical, anthropometric, physical performance, and lifestyle characteristics. A 3 T magnetic resonance imaging (MRI) was performed for structural and functional brain measures. PA time and level was assessed via a Xiaomi Mi Band 2® worn for 15 consecutive days. Participants (n = 110, after inclusion/exclusion criteria and completion of all evaluations) were 58 females (56%), with an average age of 68.42 years old (SD = 3.12), most were active. Multiple regression analysis revealed that higher time spent in vigorous PA associated with larger left parahippocampal gyrus and right hippocampus volumes. Furthermore, the analysis of the functional connectome indicated a greater functional connectivity (FC) between the frontal gyrus, cingulate gyrus, occipital inferior lobe for light, moderate, and total PA time, and sedentary time associated with lower FC in the same networks. Overall, the structural and functional findings may provide evidence on the relevant association between PA and brain health in aging.
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Affiliation(s)
- Célia Domingos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga (2CA-B), Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center - Braga (2CA-B), Braga, Portugal
| | - Ricardo Magalhães
- NeuroSpin, CEA, CNRS, Paris-Saclay University, Gif-sur-Yvette, France
| | - Mariana Moreira
- ENCONTRAR+SE-Association for the Promotion of Mental Health, Porto, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Associação Centro de Medicina P5 (P5), School of Medicine, University of Minho, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga (2CA-B), Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center - Braga (2CA-B), Braga, Portugal.,Associação Centro de Medicina P5 (P5), School of Medicine, University of Minho, Braga, Portugal
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17
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Donofry SD, Stillman CM, Hanson JL, Sheridan M, Sun S, Loucks EB, Erickson KI. Promoting brain health through physical activity among adults exposed to early life adversity: Potential mechanisms and theoretical framework. Neurosci Biobehav Rev 2021; 131:688-703. [PMID: 34624365 PMCID: PMC8642290 DOI: 10.1016/j.neubiorev.2021.09.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022]
Abstract
Adverse childhood experiences such as abuse, neglect, and poverty, profoundly alter neurobehavioral development in a manner that negatively impacts health across the lifespan. Adults who have been exposed to such adversities exhibit premature and more severe age-related declines in brain health. Unfortunately, it remains unclear whether the negative effects of early life adversity (ELA) on brain health can be remediated through intervention in adulthood. Physical activity may represent a low-cost behavioral approach to address the long-term consequences of ELA on brain health. However, there has been limited research examining the impact of physical activity on brain health among adults with a history of ELA. Accordingly, the purpose of this review is to (1) review the influence of ELA on brain health in adulthood and (2) highlight evidence for the role of neurotrophic factors, hypothalamic-adrenal-pituitary axis regulation, inflammatory processes, and epigenetic modifications in mediating the effects of both ELA and physical activity on brain health outcomes in adulthood. We then propose a theoretical framework to guide future research in this area.
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Affiliation(s)
- Shannon D Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Psychiatric and Behavioral Health Institute, Allegheny Health Network Pittsburgh, PA, United States.
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States; Mindfulness Center, Brown University, Providence, RI, United States
| | - Eric B Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States; Mindfulness Center, Brown University, Providence, RI, United States; Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Murdoch University, College of Science, Health, Engineering, and Education, Perth, Western Australia, Australia; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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18
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Fraser MA, Walsh EI, Shaw ME, Anstey KJ, Cherbuin N. Longitudinal Effects of Physical Activity Change on Hippocampal Volumes over up to 12 Years in Middle and Older Age Community-Dwelling Individuals. Cereb Cortex 2021; 32:2705-2716. [PMID: 34671805 DOI: 10.1093/cercor/bhab375] [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: 06/08/2021] [Revised: 09/11/2021] [Accepted: 09/12/2021] [Indexed: 12/17/2022] Open
Abstract
The objectives of this study were to investigate the long-term associations between changes in physical activity levels and hippocampal volumes over time, while considering the influence of age, sex, and APOE-ε4 genotype. We investigated the effects of change in physical activity on hippocampal volumes in 411 middle age (mean age = 47.2 years) and 375 older age (mean age = 63.1 years) adults followed up to 12 years. An annual volume decrease was observed in the left (middle age: 0.46%; older age: 0.51%) but not in the right hippocampus. Each additional 10 metabolic equivalents (METs, ~2 h of moderate exercise) increase in weekly physical activity was associated with 0.33% larger hippocampal volume in middle age (equivalent to ~1 year of typical aging). In older age, each additional MET was associated with 0.05% larger hippocampal volume; however, the effects declined with time by 0.005% per year. For older age APOE-ε4 carriers, each additional MET was associated with a 0.10% increase in hippocampal volume. No sex effects of physical activity change were found. Increasing physical activity has long-term positive effects on hippocampal volumes and appears especially beneficial for older APOE-ε4 carriers. To optimize healthy brain aging, physical activity programs should focus on creating long-term exercise habits.
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Affiliation(s)
- Mark A Fraser
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Erin I Walsh
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia.,Population Health Exchange, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Marnie E Shaw
- ANU College of Engineering & Computer Science, Australian National University, Canberra, Australian Capital Territory 2600, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia.,Ageing Futures Institute, University of New South Wales, Sydney, New South Wales 2052, Australia.,Neuroscience Research Australia, Sydney, New South Wales 2031, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
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19
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Hüttenrauch M, Lopez-Noguerola JS, Castro-Obregón S. Connecting Mind-Body Therapy-Mediated Effects to Pathological Features of Alzheimer's Disease. J Alzheimers Dis 2021; 82:S65-S90. [PMID: 33044183 DOI: 10.3233/jad-200743] [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] [Indexed: 02/06/2023]
Abstract
Alzheimer's disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.
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Affiliation(s)
- Melanie Hüttenrauch
- División de Neurosciencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Ciudad de México, México
| | - José Sócrates Lopez-Noguerola
- Área Académica de Gerontología, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca de Soto, México
| | - Susana Castro-Obregón
- División de Neurosciencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Ciudad de México, México
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20
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Young S, Chung E, Chen MA. Cardiovascular Complications of Acetylcholinesterase Inhibitors in Patients with Alzheimer's Disease: A Narrative Review. Ann Geriatr Med Res 2021; 25:170-177. [PMID: 34610666 PMCID: PMC8497945 DOI: 10.4235/agmr.21.0079] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 12/06/2022] Open
Abstract
While acetylcholinesterase inhibitors are used to treat a wide range of patients with Alzheimer's disease, acetylcholinesterase inhibitor use has also been associated with a variety of cardiovascular complications, including bradycardia and syncope. Herein, we review the pathophysiology and clinical evidence for cardiovascular complications caused by acetylcholinesterase inhibitors in patients being treated for dementia and discuss options for their management.
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Affiliation(s)
- Sara Young
- Boston University School of Medicine, Boston, MA, USA
| | - Enoch Chung
- Boston University School of Medicine, Boston, MA, USA
| | - Michael A. Chen
- Division of Cardiology, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA
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21
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Kaufman CS, Honea RA, Pleen J, Lepping RJ, Watts A, Morris JK, Billinger SA, Burns JM, Vidoni ED. Aerobic exercise improves hippocampal blood flow for hypertensive Apolipoprotein E4 carriers. J Cereb Blood Flow Metab 2021; 41:2026-2037. [PMID: 33509035 PMCID: PMC8327103 DOI: 10.1177/0271678x21990342] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cerebrovascular dysfunction likely contributes causally to Alzheimer's disease (AD). The strongest genetic risk factor for late-onset AD, Apolipoprotein E4 (APOE4), may act synergistically with vascular risk to cause dementia. Therefore, interventions that improve vascular health, such as exercise, may be particularly beneficial for APOE4 carriers. We assigned cognitively normal adults (65-87 years) to an aerobic exercise intervention or education only. Arterial spin labeling MRI measured hippocampal blood flow (HBF) before and after the 52-week intervention. We selected participants with hypertension at enrollment (n = 44). For APOE4 carriers, change in HBF (ΔHBF) was significantly (p = 0.006) higher for participants in the exercise intervention (4.09 mL/100g/min) than the control group (-2.08 mL/100g/min). There was no difference in ΔHBF between the control (-0.32 mL/100g/min) and exercise (-0.54 mL/100g/min) groups for non-carriers (p = 0.918). Additionally, a multiple regression showed an interaction between change in systolic blood pressure (ΔSBP) and APOE4 carrier status on ΔHBF (p = 0.035), with reductions in SBP increasing HBF for APOE4 carriers only. Aerobic exercise improved HBF for hypertensive APOE4 carriers only. Additionally, only APOE4 carriers exhibited an inverse relationship between ΔSBP and ΔHBF. This suggests exercise interventions, particularly those that lower SBP, may be beneficial for individuals at highest genetic risk of AD.ClinicalTrials.gov Identifier: NCT02000583.
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Affiliation(s)
- Carolyn S Kaufman
- Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robyn A Honea
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
| | - Joseph Pleen
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
| | - Rebecca J Lepping
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Jill K Morris
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
| | - Sandra A Billinger
- Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
- Eric D Vidoni, KU Alzheimer's Disease Center, KU Clinical Research Center, 4350 Shawnee Mission Parkway, MS 6002, Fairway, KS 66205, USA.
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22
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Kaufman CS, Morris JK, Vidoni ED, Burns JM, Billinger SA. Apolipoprotein E4 Moderates the Association Between Vascular Risk Factors and Brain Pathology. Alzheimer Dis Assoc Disord 2021; 35:223-229. [PMID: 33734100 PMCID: PMC8387316 DOI: 10.1097/wad.0000000000000442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/18/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The strongest genetic risk factor for late-onset Alzheimer disease (AD), Apolipoprotein E4 (APOE4), increases cardiovascular disease risk and may also act synergistically with vascular risk factors to contribute to AD pathogenesis. Here, we assess the interaction between APOE4 and vascular risk on cerebrovascular dysfunction and brain pathology. METHODS This is an observational study of cognitively normal older adults, which included positron emission tomography imaging and vascular risk factors. We measured beat-to-beat blood pressure and middle cerebral artery velocity at rest and during moderate-intensity exercise. Cerebrovascular measures included cerebrovascular conductance index and the cerebrovascular response to exercise. RESULTS There was a significant interaction between resting cerebrovascular conductance index and APOE4 carrier status on β-amyloid deposition (P=0.026), with poor conductance in the cerebrovasculature associated with elevated β-amyloid for the APOE4 carriers only. There was a significant interaction between non-high-density lipoprotein cholesterol and APOE4 carrier status (P=0.014), with elevated non-high-density lipoprotein cholesterol predicting a blunted cerebrovascular response to exercise in APOE4 carriers and the opposite relationship in noncarriers. CONCLUSIONS Both cerebral and peripheral vascular risk factors are preferentially associated with brain pathology in APOE4 carriers. These findings provide insight into pathogenic vascular risk mechanisms and target strategies to potentially delay AD onset.
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Affiliation(s)
- Carolyn S. Kaufman
- Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jill K. Morris
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
| | - Eric D. Vidoni
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
| | - Jeffrey M. Burns
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
| | - Sandra A. Billinger
- Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
- Department of Physical Therapy & Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
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23
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Aghjayan SL, Lesnovskaya A, Esteban-Cornejo I, Peven JC, Stillman CM, Erickson KI. Aerobic exercise, cardiorespiratory fitness, and the human hippocampus. Hippocampus 2021; 31:817-844. [PMID: 34101305 PMCID: PMC8295234 DOI: 10.1002/hipo.23337] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/27/2023]
Abstract
The hippocampus is particularly susceptible to neurodegeneration. Physical activity, specifically increasing cardiorespiratory fitness via aerobic exercise, shows promise as a potential method for mitigating hippocampal decline in humans. Numerous studies have now investigated associations between the structure and function of the hippocampus and engagement in physical activity. Still, there remains continued debate and confusion about the relationship between physical activity and the human hippocampus. In this review, we describe the current state of the physical activity and exercise literature as it pertains to the structure and function of the human hippocampus, focusing on four magnetic resonance imaging measures: volume, diffusion tensor imaging, resting-state functional connectivity, and perfusion. We conclude that, despite significant heterogeneity in study methods, populations of interest, and scope, there are consistent positive findings, suggesting a promising role for physical activity in promoting hippocampal structure and function throughout the lifespan.
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Affiliation(s)
- Sarah L Aghjayan
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alina Lesnovskaya
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Irene Esteban-Cornejo
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
| | - Jamie C Peven
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
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24
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Poddar MK, Banerjee S, Chakraborty A, Dutta D. Metabolic disorder in Alzheimer's disease. Metab Brain Dis 2021; 36:781-813. [PMID: 33638805 DOI: 10.1007/s11011-021-00673-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/14/2021] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD), a well known aging-induced neurodegenerative disease is related to amyloid proteinopathy. This proteinopathy occurs due to abnormalities in protein folding, structure and thereby its function in cells. The root cause of such kind of proteinopathy and its related neurodegeneration is a disorder in metabolism, rather metabolomics of the major as well as minor nutrients. Metabolomics is the most relevant "omics" platform that offers a great potential for the diagnosis and prognosis of neurodegenerative diseases as an individual's metabolome. In recent years, the research on such kinds of neurodegenerative diseases, especially aging-related disorders is broadened its scope towards metabolic function. Different neurotransmitter metabolisms are also involved with AD and its associated neurodegeneration. The genetic and epigenetic backgrounds are also noteworthy. In this review, the physiological changes of AD in relation to its corresponding biochemical, genetic and epigenetic involvements including its (AD) therapeutic aspects are discussed.
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Affiliation(s)
- Mrinal K Poddar
- Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Road, Kolkata, 700032, India.
| | - Soumyabrata Banerjee
- Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Road, Kolkata, 700032, India
- Departrment of Psychology, Neuroscience Program, Field Neurosciences Institute Research Laboratory for Restorative Neurology, Central Michigan University, Mount Pleasant, MI, 48859, USA
| | - Apala Chakraborty
- Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Road, Kolkata, 700032, India
| | - Debasmita Dutta
- Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Road, Kolkata, 700032, India
- Department of Coatings and Polymeric Materials, North Dakota State University, Fargo, ND, 58102, USA
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25
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Anti-Alzheimer's Molecules Derived from Marine Life: Understanding Molecular Mechanisms and Therapeutic Potential. Mar Drugs 2021; 19:md19050251. [PMID: 33925063 PMCID: PMC8146595 DOI: 10.3390/md19050251] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 02/08/2023] Open
Abstract
Alzheimer’s disease (AD) is a devastating neurodegenerative disease and the most common cause of dementia. It has been confirmed that the pathological processes that intervene in AD development are linked with oxidative damage to neurons, neuroinflammation, tau phosphorylation, amyloid beta (Aβ) aggregation, glutamate excitotoxicity, and cholinergic deficit. Still, there is no available therapy that can cure AD. Available therapies only manage some of the AD symptoms at the early stages of AD. Various studies have revealed that bioactive compounds derived from marine organisms and plants can exert neuroprotective activities with fewer adverse events, as compared with synthetic drugs. Furthermore, marine organisms have been identified as a source of novel compounds with therapeutic potential. Thus, there is a growing interest regarding bioactive compounds derived from marine sources that have anti-AD potentials. Various marine drugs including bryostatin-1, homotaurine, anabaseine and its derivative, rifampicins, anhydroexfoliamycin, undecylprodigioisin, gracilins, 13-desmethyl spirolide-C, and dictyostatin displayed excellent bioavailability and efficacy against AD. Most of these marine drugs were found to be well-tolerated in AD patients, along with no significant drug-associated adverse events. In this review, we focus on the drugs derived from marine life that can be useful in AD treatment and also summarize the therapeutic agents that are currently used to treat AD.
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26
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Fernández-Matarrubia M, Goni L, Rognoni T, Razquin C, Fernández-Lázaro CI, Bes-Rastrollo M, Martínez-González MÁ, Toledo E. An Active Lifestyle Is Associated with Better Cognitive Function Over Time in APOE ɛ4 Non-Carriers. J Alzheimers Dis 2021; 79:1257-1268. [DOI: 10.3233/jad-201090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Available evidence on the association of physical activity (PA) or sedentary behavior with cognitive decline is inconclusive. Objective: To assess the association between an active lifestyle score and leisure-time physical activity (LTPA) and changes in cognitive function in the Seguimiento Universidad de Navarra (SUN) prospective cohort. Methods: Cognitive function was evaluated in a subsample of 806 participants of the SUN cohort study using the validated Telephone Interview for Cognitive Status-modified (STICS-m) questionnaire at baseline and after 6 years. LTPA was evaluated with a previously validated 17-item self-administered questionnaire and with information on sedentary lifestyles. We also calculated a multidimensional 8-item PA score. Multivariable linear regression analysis evaluated the association between PA and changes in cognitive function and its interaction by APOE genotype. Results: Mean age of participants was 66 (SD 5.3) years and 69.7% were male. When stratifying by APOE variants, no significant associations between the active lifestyle score or LTPA and changes in cognitive performance over time were found among APOE ɛ4 carriers. However, we observed that a higher adherence to an active lifestyle (high versus low PA score β= 0.76 95% CI 0.15,1.36; p trend = 0.011) and a high LTPA (Q4 versus Q1 β= 0.63; 95% CI –0.01,1.26; p trend = 0.030) were associated with more favorable changes in cognitive function over time among APOE ɛ4 non-carriers with statistically significant interactions in both cases (p for interaction = 0.042 for PA score, and p = 0.039 for LTPA). Conclusion: The results of the present study suggest that an active lifestyle is associated with a better status of cognitive function over time only among APOE ɛ4 non-carriers.
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Affiliation(s)
- Marta Fernández-Matarrubia
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Leticia Goni
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Rognoni
- Department of Neurology, Clínica Universidad de Navarra, Madrid, Spain
| | - Cristina Razquin
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - César Ignacio Fernández-Lázaro
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Maira Bes-Rastrollo
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Estefanía Toledo
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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27
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Exercise as Potential Therapeutic Target to Modulate Alzheimer's Disease Pathology in APOE ε4 Carriers: A Systematic Review. Cardiol Ther 2021; 10:67-88. [PMID: 33403644 PMCID: PMC8126521 DOI: 10.1007/s40119-020-00209-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease for which no effective treatment exists at present. Previous research has found that exercise reduces the risk of AD. Since the apolipoprotein E (APOE) ε4 allele increases the risk of AD and is associated with faster disease progression than the other isoforms, we aimed to highlight the impact of exercise on AD pathology in APOE ε4 carriers. This review focuses on the effect of exercise on cognitive function, dementia risk, amyloid-β (Aβ) metabolism, lipid metabolism, neuroinflammation, neurotrophic factors and vascularization in APOE ε4 carriers. We searched the literature in the PubMed electronic database using the following search terms: physical activity, exercise, aerobic fitness, training, sport, APOE4, Alzheimer's disease, AD and dementia. By cross-referencing, additional publications were identified. Selected studies required older adults to take part in an exercise intervention or to make use of self-reported physical activity questionnaires. All included studies were written and published in English between 2000 and 2020. From these studies, we conclude that exercise is a non-pharmacological treatment option for high-risk APOE ε4 carriers to ameliorate the AD pathological processes including reducing Aβ load, protecting against hippocampal atrophy, improving cognitive function, stabilizing cholesterol levels and lowering pro-inflammatory signals. Variation in study design related to age, cognitive outcomes and the type of intervention explained the differences in study outcomes. However, exercise seems to be effective in delaying the onset of AD and may improve the quality of life of AD patients.
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28
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Pillai JA, Kou L, Bena J, Penn L, Leverenz JB. Hypertension and Hypercholesterolemia Modify Dementia Risk in Relation to APOEɛ4 Status. J Alzheimers Dis 2021; 81:1493-1504. [PMID: 33967045 PMCID: PMC8239808 DOI: 10.3233/jad-201609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is significant interest in understanding the role of modifiable vascular risk factors contributing to dementia risk across age groups. OBJECTIVE Risk of dementia onset was assessed in relation to vascular risk factors of hypertension and hypercholesterolemia among cognitively normal APOEɛ4 carriers and non-carriers. METHODS In a sample of prospectively characterized longitudinal cohort from the National Alzheimer's Coordinating Center database, 9,349 participants met criteria for normal cognition at baseline, had a CDR-Global (CDR-G) score of zero, and had concomitant data on APOEɛ4 status and medical co-morbidities including histories of hypertension and hypercholesterolemia. Multivariable Cox proportional hazards models adjusted for well-known potential confounders were used to compare dementia onset among APOEɛ4 carriers and non-carriers by young (≤65 years) and old (> 65 year) age groups. RESULTS 519 participants converted to dementia within an average follow up of 5.97 years. Among older APOEɛ4 carriers, hypercholesterolemia was related to lower risk of dementia (HR (95% CI), 0.68 (0.49-0.94), p = 0.02). Among older APOEɛ4 non-carriers, hypertension was related to higher risk of dementia (HR (95% CI), 1.44 (1.13-1.82), p = 0.003). These results were corroborated among a subset with autopsy data characterizing underlying neuropathology. Among younger participants, vascular risk factors did not impact dementia risk, likely from a lower frequency of vascular and Alzheimer's as etiologies of dementia among this cohort. CONCLUSION A history of hypercholesterolemia related to a lower risk of dementia among older APOEɛ4 carriers, while hypertension related to a higher risk of dementia among older APOEɛ4 non-carriers.
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Affiliation(s)
- Jagan A. Pillai
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
- Neurological Institute and Cleveland Clinic, Cleveland, OH, USA
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Lei Kou
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - James Bena
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Penn
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - James B. Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
- Neurological Institute and Cleveland Clinic, Cleveland, OH, USA
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
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29
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Domingos C, Pêgo JM, Santos NC. Effects of physical activity on brain function and structure in older adults: A systematic review. Behav Brain Res 2020; 402:113061. [PMID: 33359570 DOI: 10.1016/j.bbr.2020.113061] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/06/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023]
Abstract
Despite increasing evidence that physical activity (PA) contributes to brain health in older individuals, both at the level of brain structure and function, this relationship is not yet well established. To explore this potential association, a systematic literature search was performed using PubMed, Scopus, and Web of Science, adhering to PRISMA guidelines. A total of 32 studies met the eligibility criteria: 24 cross-sectional and 8 longitudinal. Results from structural Magnetic Resonance Imaging (MRI) showed that PA associated with larger brain volumes (less brain atrophy) specifically in brain regions vulnerable to dementia, comprising the hippocampus, temporal, and frontal regions. Furthermore, functional MRI (fMRI) showed greater task-relevant activity in brain areas recruited in executive function and memory tasks. However, the dose-response relationship is unclear due to the high variability in PA measures. Further research using objective measures is needed to better understand which PA type, intensity, frequency, and duration, has the greatest protective effect on brain health. Findings highlight the importance of PA in both cognitive decline and dementia prevention.
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Affiliation(s)
- C Domingos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal; iCognitus4ALL - IT Solutions, Braga, Portugal; Clinical Academic Center-Braga (2CA-B), Braga, Portugal
| | - J M Pêgo
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal; iCognitus4ALL - IT Solutions, Braga, Portugal; Clinical Academic Center-Braga (2CA-B), Braga, Portugal
| | - N C Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center-Braga (2CA-B), Braga, Portugal; Associação Centro de Medicina Digital P5 (ACMP5), Braga, Portugal.
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30
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Balakrishnan J, Kannan S, Govindasamy A. Structured form of DHA prevents neurodegenerative disorders: A better insight into the pathophysiology and the mechanism of DHA transport to the brain. Nutr Res 2020; 85:119-134. [PMID: 33482601 DOI: 10.1016/j.nutres.2020.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
Docosahexaenoic acid (DHA) is one of the most important fatty acids that plays a critical role in maintaining proper brain function and cognitive development. Deficiency of DHA leads to several neurodegenerative disorders and, therefore, dietary supplementations of these fatty acids are essential to maintain cognitive health. However, the complete picture of how DHA is incorporated into the brain is yet to be explored. In general, the de novo synthesis of DHA is poor, and targeting the brain with specific phospholipid carriers provides novel insights into the process of reduction of disease progression. Recent studies have suggested that compared to triacylglycerol form of DHA, esterified form of DHA (i.e., lysophosphatidylcholine [lysoPC]) is better incorporated into the brain. Free DHA is transported across the outer membrane leaflet of the blood-brain barrier via APOE4 receptors, whereas DHA-lysoPC is transported across the inner membrane leaflet of the blood-brain barrier via a specific protein called Mfsd2a. Dietary supplementation of this lysoPC specific form of DHA is a novel therapy and is used to decrease the risk of various neurodegenerative disorders. Currently, structured glycerides of DHA - novel nutraceutical agents - are being widely used for the prevention and treatment of various neurological diseases. However, it is important to fully understand their metabolic regulation and mechanism of transportation to the brain. This article comprehensively reviews various studies that have evaluated the bioavailability of DHA, mechanisms of DHA transport, and role of DHA in preventing neurodegenerative disorders, which provides better insight into the pathophysiology of these disorders and use of structured DHA in improving neurological health.
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Affiliation(s)
- Jeyakumar Balakrishnan
- Central Research Laboratory, Vinayaka Mission's Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to be University), Karaikal, Puducherry, India.
| | - Suganya Kannan
- Central Research Laboratory, Vinayaka Mission's Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to be University), Karaikal, Puducherry, India
| | - Ambujam Govindasamy
- Department of General Surgery, Vinayaka Mission's Medical College and Hospital, Vinayaka Mission Research Foundation (Deemed to be University), Karaikal. Puducherry, India
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McGurran H, Glenn JM, Madero EN, Bott NT. Prevention and Treatment of Alzheimer's Disease: Biological Mechanisms of Exercise. J Alzheimers Dis 2020; 69:311-338. [PMID: 31104021 DOI: 10.3233/jad-180958] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Alzheimer's disease (AD) is the most common form of dementia. With an aging population and no disease modifying treatments available, AD is quickly becoming a global pandemic. A substantial body of research indicates that lifestyle behaviors contribute to the development of AD, and that it may be worthwhile to approach AD like other chronic diseases such as cardiovascular disease, in which prevention is paramount. Exercise is an important lifestyle behavior that may influence the course and pathology of AD, but the biological mechanisms underpinning these effects remain unclear. This review focuses on how exercise can modify four possible mechanisms which are involved with the pathology of AD: oxidative stress, inflammation, peripheral organ and metabolic health, and direct interaction with AD pathology. Exercise is just one of many lifestyle behaviors that may assist in preventing AD, but understanding the systemic and neurobiological mechanisms by which exercise affects AD could help guide the development of novel pharmaceutical agents and non-pharmacological personalized lifestyle interventions for at-risk populations.
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Affiliation(s)
- Hugo McGurran
- Research Master's Programme Brain and Cognitive Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Nicholas T Bott
- Neurotrack Technologies Inc., Redwood City, CA, USA.,Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.,Department of Psychology, PGSP-Stanford Consortium, Palo Alto University, Palo Alto, CA, USA
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32
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Barha CK, Liu-Ambrose T. Sex differences in exercise efficacy: Is midlife a critical window for promoting healthy cognitive aging? FASEB J 2020; 34:11329-11336. [PMID: 32761860 DOI: 10.1096/fj.202000857r] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 01/17/2023]
Abstract
Dementia is one of the most pressing health care issues of this century. As no curative treatment for dementia exists, research efforts are growing to identify effective lifestyle interventions to prevent or delay onset. One such promising strategy that promotes cognitive and brain health is engaging in physical exercise. However, current exercise recommendations are imprecise. To advance the potential of exercise as a preventative and treatment strategy, important questions regarding moderators (ie, biological sex and age) are being addressed in the literature. Biological sex is recognized as an important variable to consider in exercise efficacy on brain health, with females showing greater cognitive gains. This may be related to sex differences in underlying mechanisms. Here, we argue to better understand the sex differences in exercise efficacy, the timing of exercise intervention should also be considered. Specifically, we present the hypothesis that midlife in females is a critical window for the implementation of exercise as an early intervention to promote brain health and prevent dementia. Further, we speculate that exercise interventions targeting midlife will be of critical importance for the female brain, as females exit this period of the lifespan at greater risk for cognitive impairment. Given the potential sex differences in dementia risk and prevalence, it is imperative to assess potential sex differences in exercise efficacy as an early intervention during midlife.
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Affiliation(s)
- Cindy K Barha
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Aging, Mobility, and Cognitive Neuroscience Lab, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Physical Activity for Precision Health Research Cluster, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Aging, Mobility, and Cognitive Neuroscience Lab, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Physical Activity for Precision Health Research Cluster, University of British Columbia, Vancouver, BC, Canada
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Nauer RK, Dunne MF, Stern CE, Storer TW, Schon K. Improving fitness increases dentate gyrus/CA3 volume in the hippocampal head and enhances memory in young adults. Hippocampus 2019; 30:488-504. [PMID: 31588607 DOI: 10.1002/hipo.23166] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 12/25/2022]
Abstract
Converging evidence suggests a relationship between aerobic exercise and hippocampal neuroplasticity that interactively impacts hippocampally dependent memory. The majority of human studies have focused on the potential for exercise to reduce brain atrophy and attenuate cognitive decline in older adults, whereas animal studies often center on exercise-induced neurogenesis and hippocampal plasticity in the dentate gyrus (DG) of young adult animals. In the present study, initially sedentary young adults (18-35 years) participated in a moderate-intensity randomized controlled exercise intervention trial (ClinicalTrials.gov; NCT02057354) for a duration of 12 weeks. The aims of the study were to investigate the relationship between change in cardiorespiratory fitness (CRF) as determined by estimated V ˙ O 2 MAX , hippocampally dependent mnemonic discrimination, and change in hippocampal subfield volume. Results show that improving CRF after exercise training is associated with an increased volume in the left DG/CA3 subregion in young adults. Consistent with previous studies that found exercise-induced increases in anterior hippocampus in older adults, this result was specific to the hippocampal head, or most anterior portion, of the subregion. Our results also demonstrate a positive relationship between change in CRF and change in corrected accuracy for trials requiring the highest level of discrimination on a putative behavioral pattern separation task. This relationship was observed in individuals who were initially lower-fit, suggesting that individuals who show greater improvement in their CRF may receive greater cognitive benefit. This work extends animal models by providing evidence for exercise-induced neuroplasticity specific to the neurogenic zone of the human hippocampus.
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Affiliation(s)
- Rachel K Nauer
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts.,Center for Memory and Brain, Boston University, Boston, Massachusetts.,Center for Systems Neuroscience, Boston University, Boston, Massachusetts.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Matthew F Dunne
- Center for Systems Neuroscience, Boston University, Boston, Massachusetts.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Chantal E Stern
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts.,Center for Memory and Brain, Boston University, Boston, Massachusetts.,Center for Systems Neuroscience, Boston University, Boston, Massachusetts
| | - Thomas W Storer
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Karin Schon
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts.,Center for Memory and Brain, Boston University, Boston, Massachusetts.,Center for Systems Neuroscience, Boston University, Boston, Massachusetts.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
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Buss SS, Padmanabhan J, Saxena S, Pascual-Leone A, Fried PJ. Atrophy in Distributed Networks Predicts Cognition in Alzheimer's Disease and Type 2 Diabetes. J Alzheimers Dis 2019; 65:1301-1312. [PMID: 30149455 DOI: 10.3233/jad-180570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and type 2 diabetes (T2DM) are common causes of cognitive decline among older adults and share strong epidemiological links. Distinct patterns of cortical atrophy are observed in AD and T2DM, but robust comparisons between structure-function relationships across these two disease states are lacking. OBJECTIVE To compare how atrophy within distributed brain networks is related to cognition across the spectrum of cognitive aging. METHODS The relationship between structural MRI changes and cognition was studied in 22 mild-to-moderate AD, 28 T2DM, and 27 healthy participants. Cortical thickness measurements were obtained from networks of interest (NOIs) matching the limbic, default, and frontoparietal resting-state networks. Composite cognitive scores capturing domains of global cognition, memory, and executive function were created. Associations between cognitive scores and the NOIs were assessed using linear regression, with age as a covariate. Within-network General Linear Model (GLM) analysis was run in Freesurfer 6.0 to visualize differences in patterns of cortical atrophy related to cognitive function in each group. A secondary analysis examined hemispheric differences in each group. RESULTS Across all groups, cortical atrophy within the limbic NOI was significantly correlated with Global Cognition (p = 0.009) and Memory Composite (p = 0.002). Within-network GLM analysis and hemispheric analysis revealed qualitatively different patterns of atrophy contributing to cognitive dysfunction between AD and T2DM. CONCLUSION Brain network atrophy is related to cognitive function across AD, T2DM, and healthy participants. Differences in cortical atrophy patterns were seen between AD and T2DM, highlighting neuropathological differences.
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Affiliation(s)
- Stephanie S Buss
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jaya Padmanabhan
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sadhvi Saxena
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Institut Guttman, Universitat Autonoma de Barcelona, Badalona, Barcelona, Spain
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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35
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Chao F, Jiang L, Zhang Y, Zhou C, Zhang L, Tang J, Liang X, Qi Y, Zhu Y, Ma J, Tang Y. Stereological Investigation of the Effects of Treadmill Running Exercise on the Hippocampal Neurons in Middle-Aged APP/PS1 Transgenic Mice. J Alzheimers Dis 2019; 63:689-703. [PMID: 29689723 DOI: 10.3233/jad-171017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The risk of cognitive decline during Alzheimer's disease (AD) can be reduced if physical activity is maintained; however, the specific neural events underlying this beneficial effect are still uncertain. To quantitatively investigate the neural events underlying the effect of running exercise on middle-aged AD subjects, 12-month-old male APP/PS1 mice were randomly assigned to a control group or running group, and age-matched non-transgenic littermates were used as a wild-type group. AD running group mice were subjected to a treadmill running protocol (regular and moderate intensity) for four months. Spatial learning and memory abilities were assessed using the Morris water maze. Hippocampal amyloid plaques were observed using Thioflavin S staining and immunohistochemistry. Hippocampal volume, number of neurons, and number of newborn cells (BrdU+ cells) in the hippocampus were estimated using stereological techniques, and newborn neurons were observed using double-labelling immunofluorescence. Marked neuronal loss in both the CA1 field and dentate gyrus (DG) and deficits in both the neurogenesis and survival of new neurons in the DG of middle-aged APP/PS1 mice were observed. Running exercise could improve the spatial learning and memory abilities, reduce amyloid plaques in the hippocampi, delay neuronal loss, induce neurogenesis, and promote the survival of newborn neurons in the DG of middle-aged APP/PS1 mice. Exercise-induced protection of neurons and adult neurogenesis within the DG might be part of the important structural basis of the improved spatial learning and memory abilities observed in AD mice.
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Affiliation(s)
- Fenglei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Lin Jiang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Yi Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Chunni Zhou
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Jing Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Xin Liang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Yingqiang Qi
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Yanqing Zhu
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Jing Ma
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P. R. China
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Frederiksen KS, Madsen K, Andersen BB, Beyer N, Garde E, Høgh P, Waldemar G, Hasselbalch SG, Law I. Moderate- to high-intensity exercise does not modify cortical β-amyloid in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2019; 5:208-215. [PMID: 31198839 PMCID: PMC6556817 DOI: 10.1016/j.trci.2019.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Animal models of Alzheimer's disease show that exercise may modify β-amyloid (Aβ) deposition. We examined the effect of a 16-week exercise intervention on cortical Aβ in patients with mild-to-moderate Alzheimer's disease. METHODS Thirty-six patients with Alzheimer's disease were randomized to either one hour of aerobic exercise three times weekly for 16 weeks or usual care. Pre and post intervention, 11Carbon-Pittsburgh compound B positron emission tomography was carried out to assess cortical Aβ, and quantified using standardized uptake value rations (SUVRs). RESULTS The intervention showed no effect on follow-up SUVRs in a covariance analysis with group allocation, baseline intervention SUVR, age, sex, and baseline Mini-Mental State Examination as predictors. Change in SUVRs did not correlate with changes in measures of physical or aerobic fitness. DISCUSSION The present findings do not support an effect of exercise on Aβ. However, the relatively short intervention period may account for a lack of efficacy. Further studies should test earlier and longer interventions.
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Affiliation(s)
- Kristian S. Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen, Denmark
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte B. Andersen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nina Beyer
- Musculoskeletal Rehabilitation Research Unit and Institute of Sports Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Garde
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Peter Høgh
- Zealand University Hospital, Department of Neurology, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steen G. Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Agüera Sánchez MÁ, Barbancho Ma MÁ, García-Casares N. [Effect of physical exercise on Alzheimer's disease. A sistematic review]. Aten Primaria 2019; 52:307-318. [PMID: 31153668 PMCID: PMC7231856 DOI: 10.1016/j.aprim.2018.09.010] [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: 07/03/2018] [Revised: 08/13/2018] [Accepted: 09/18/2018] [Indexed: 12/20/2022] Open
Abstract
Objetivo El propósito de este estudio es investigar la evidencia científica sobre el efecto del ejercicio físico respecto al estado cognitivo y conductual como medida preventiva y terapéutica no farmacológica en la enfermedad de Alzheimer (EA). Diseño Revisión sistemática Fuentes de datos: Pubmed, Science Direct, Medline y Scopus, con las palabras clave: Alzheimer, Exercise, Neuroimaging, MRI, PET y Physical Activity. Selección de artículos: Se incluyeron aquellos estudios en los que se evaluaba el efecto del ejercicio físico en la evolución de la EA y que además contenían pruebas de imagen (resonancia magnética nuclear o tomografía por emisión de positrones) con marcador Pittsburg Compound B (PiB) analizando la atrofia cerebral o el aumento del depósito de beta-Amiloide respectivamente. Se excluyeron aquellos estudios en otros tipos de demencia que no fueran la EA, los que no incluían pruebas de neuroimagen, los casos únicos y aquellos de lengua no inglesa. Para la extracción de datos se utilizó la escala de calidad PRISMA para la lectura crítica de los estudios. Los investigadores evaluaron de forma independiente los artículos y las discrepancias se resolvieron por consenso. Resultados Se identificaron 75 artículos, de los cuales 23 fueron finalmente incluidos en la revisión. Concusiones La mayoría de los estudios incluidos no permiten conocer la repercusión del ejercicio físico a nivel cognitivo y sobre los cambios estructurales y funcionales cerebrales en pacientes con riesgo de desarrollar la EA o en pacientes que ya presentan la enfermedad. Sin poder descartase un posible efecto beneficioso, son necesarios más estudios con un mejor diseño y rigor metodológico que permitan un mejor conocimiento de esta asociación.
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Affiliation(s)
| | - Miguel Ángel Barbancho Ma
- Departamento de Fisiología Humana, Histología Humana, Anatomía patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, España; Centro de Investigaciones Médico-Sanitarias (C.I.M.E.S), Universidad de Málaga, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - Natalia García-Casares
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, España; Centro de Investigaciones Médico-Sanitarias (C.I.M.E.S), Universidad de Málaga, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
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Patients with Alzheimer's disease who carry the APOE ε4 allele benefit more from physical exercise. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2019; 5:99-106. [PMID: 31011620 PMCID: PMC6461575 DOI: 10.1016/j.trci.2019.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Introduction Our group has completed an exercise study of 200 patients with mild Alzheimer's disease. We found improvements in cognitive, neuropsychiatric, and physical measures in the participants who adhered to the protocol. Epidemiological studies in healthy elderly suggest that exercise preserves cognitive and physical abilities to a higher extent in APOE ε4 carriers. Methods In this post hoc subgroup analysis study, we investigated whether the beneficial effect of an exercise intervention in patients with mild AD was dependent on the patients' APOE genotype. Results We found that patients who were APOE ε4 carriers benefitted more from the exercise intervention by preservation of cognitive performance and improvement in physical measures. Discussion This exploratory study establishes a possible connection between the beneficial effects of exercise in AD and the patients' APOE genotype. These findings, if validated, could greatly impact the clinical management of patients with AD and those at risk for developing AD.
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Stern Y, MacKay-Brandt A, Lee S, McKinley P, McIntyre K, Razlighi Q, Agarunov E, Bartels M, Sloan RP. Effect of aerobic exercise on cognition in younger adults: A randomized clinical trial. Neurology 2019; 92:e905-e916. [PMID: 30700591 PMCID: PMC6404470 DOI: 10.1212/wnl.0000000000007003] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/08/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine efficacy of aerobic exercise for cognitive function in younger healthy adults. METHODS In a randomized, parallel-group, observer-masked, community-based clinical trial, 132 cognitively normal individuals aged 20-67 with below median aerobic capacity were randomly assigned to one of two 6-month, 4-times-weekly conditions: aerobic exercise and stretching/toning. Efficacy measures included aerobic capacity; cognitive function in several domains (executive function, episodic memory, processing speed, language, and attention), everyday function, body mass index (BMI), and cortical thickness. RESULTS Aerobic capacity increased significantly (β = 2.718; p = 0.003), and BMI decreased significantly (β = -0.596; p = 0.013) in the aerobic exercise but not in the stretching/toning condition. Executive function improved significantly in the aerobic exercise condition; this effect was moderated by age (β = 0.018 SD/y; p = 0.028). At age 40, the executive function measure increased by 0.228 SD (95% confidence interval [CI] 0.007-0.448), and by 0.596 SD (95% CI 0.219-0.973) at age 60. Cortical thickness increased significantly in the aerobic exercise group in a left frontal region and did not interact with age. Controlling for age and baseline performance, individuals with at least one APOE ε4 allele showed less improvement in executive function with aerobic exercise (β = 0.5129, 95% CI 0.0381-0.988; p = 0.0346). CONCLUSIONS This randomized clinical trial demonstrates the efficacy of aerobic exercise for cognition in adults age 20-67. The effect of aerobic exercise on executive function was more pronounced as age increased, suggesting that it may mitigate age-related declines. Increased cortical thickness suggests that aerobic exercise contributes to brain health in individuals as young as age 20. CLINICALTRIALSGOV IDENTIFIER NCT01179958. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for adults age 20-67 with below median aerobic capacity, aerobic exercise significantly improves executive function but not other measures of cognitive function.
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Affiliation(s)
- Yaakov Stern
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY.
| | - Anna MacKay-Brandt
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Seonjoo Lee
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Paula McKinley
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Kathleen McIntyre
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Qolamreza Razlighi
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Emil Agarunov
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Matthew Bartels
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Richard P Sloan
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
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40
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease. RECENT FINDINGS Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
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Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA.
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41
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Qiao J, Lv Y, Cao C, Wang Z, Li A. Multivariate Deep Learning Classification of Alzheimer's Disease Based on Hierarchical Partner Matching Independent Component Analysis. Front Aging Neurosci 2018; 10:417. [PMID: 30618723 PMCID: PMC6304436 DOI: 10.3389/fnagi.2018.00417] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/03/2018] [Indexed: 12/11/2022] Open
Abstract
Machine learning and pattern recognition have been widely investigated in order to look for the biomarkers of Alzheimer’s disease (AD). However, most existing methods extract features by seed-based correlation, which not only requires prior information but also ignores the relationship between resting state functional magnetic resonance imaging (rs-fMRI) voxels. In this study, we proposed a deep learning classification framework with multivariate data-driven based feature extraction for automatic diagnosis of AD. Specifically, a three-level hierarchical partner matching independent components analysis (3LHPM-ICA) approach was proposed first in order to address the issues in spatial individual ICA, including the uncertainty of the numbers of components, the randomness of initial values, and the correspondence of ICs of multiple subjects, resulting in stable and reliable ICs which were applied as the intrinsic brain functional connectivity (FC) features. Second, Granger causality (GC) was utilized to infer directional interaction between the ICs that were identified by the 3LHPM-ICA method and extract the effective connectivity features. Finally, a deep learning classification framework was developed to distinguish AD from controls by fusing the functional and effective connectivities. A resting state fMRI dataset containing 34 AD patients and 34 normal controls (NCs) was applied to the multivariate deep learning platform, leading to a classification accuracy of 95.59%, with a sensitivity of 97.06% and a specificity of 94.12% with leave-one-out cross validation (LOOCV). The experimental results demonstrated that the measures of neural connectivities of ICA and GC followed by deep learning classification represented the most powerful methods of distinguishing AD clinical data from NCs, and these aberrant brain connectivities might serve as robust brain biomarkers for AD. This approach also allows for expansion of the methodology to classify other psychiatric disorders.
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Affiliation(s)
- Jianping Qiao
- Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Institute of Data Science and Technology, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Yingru Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chongfeng Cao
- Department of Emergency, Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Anning Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
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42
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Chen LJ, Hao JC, Ku PW, Stubbs B. Prospective associations of physical fitness and cognitive performance among inpatients with Schizophrenia. Psychiatry Res 2018; 270:738-743. [PMID: 30551318 DOI: 10.1016/j.psychres.2018.10.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
There is a paucity of longitudinal research investigating fitness and cognitive performance in people with schizophrenia. This study examined the prospective associations of physical fitness and cognitive performance among inpatients with schizophrenia. A prospective cohort study over two years was undertaken in 190 inpatients with schizophrenia. Four domains of physical fitness (body composition, muscle endurance, flexibility, and cardiovascular fitness) were measured at baseline in addition to the cognitive domains of attention, hand dexterity and working memory. At baseline, compared to general population normative data, more than one third of the sample had poor cardiovascular fitness, and over half were overweight/obese, had poor muscular fitness and poor flexibility. In the schizophrenia sample, better cardiovascular fitness at baseline was significantly associated with better attention, dexterity, and memory. However, the relationships dissipated after adjusting for baseline cognitive scores. In the final models, aside from baseline cognitive scores, only illness duration was significantly associated with dexterity, and smoking status and duration of hospitilization were associated with working memory. Our data suggest that in a cohort of people with established schizophrenia who already had evidence of cognitive dysfunction, better physical fitness was not associated with improved cognitive performance over two years.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan; Graduate Institute of Recreational Sport Management, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan.
| | - Julie Christina Hao
- Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan; Department of Occupational Therapy, Tsaotun Psychiatric Center, Ministry of Health and Welfare, 161, Yu-Pin Rd, Caotun Township, Nan-Tou County 542, Taiwan.
| | - Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, 1, Jin-De Road, Changhua 500, Taiwan.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom.
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43
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Abstract
Dietary and supplemental intake of the ω-3 fatty acid docosahexaenoic acid (DHA) reduces risk of Alzheimer’s disease (AD) and ameliorates symptoms. The apolipoprotein E (APOE)4 allele is the strongest risk factor for sporadic AD, exclusive of age. APOE4 carriers respond well to the DHA present in fish but do not respond as well to dietary supplements. The mechanisms behind this varied response remain unknown. I posit that the difference is that fish contain DHA in phospholipid form, whereas fish oil supplements do not. This influences whether DHA is metabolized to nonesterified DHA (free DHA) or a phospholipid form called lysophosphatidylcholine DHA (DHA-lysoPC). Free DHA is transported across the outer membrane leaflet of the blood–brain barrier (BBB) via passive diffusion, and DHA-lysoPC is transported across the inner membrane leaflet of the BBB via the major facilitator superfamily domain-containing protein 2A. I propose that APOE4 carriers have impaired brain transport of free DHA but not of DHA-lysoPC, as a consequence of a breakdown in the outer membrane leaflet of the BBB, putting them at increased risk for AD. Dietary sources of DHA in phospholipid form may provide a means to increase plasma levels of DHA-lysoPC, thereby decreasing the risk of AD.—Patrick, R. P. Role of phosphatidylcholine-DHA in preventing APOE4-associated Alzheimer’s disease.
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Affiliation(s)
- Rhonda P Patrick
- University of California San Francisco Benioff, Children's Hospital Oakland Research Institute, Oakland, California, USA
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44
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Diem AK, Carare RO, Weller RO, Bressloff NW. A control mechanism for intra-mural peri-arterial drainage via astrocytes: How neuronal activity could improve waste clearance from the brain. PLoS One 2018; 13:e0205276. [PMID: 30286191 PMCID: PMC6171921 DOI: 10.1371/journal.pone.0205276] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/22/2018] [Indexed: 11/18/2022] Open
Abstract
The mechanisms behind the clearance of soluble waste from deep within the parenchyma of the brain remain unclear. Experimental evidence reveals that one pathway for clearance of waste, termed intra-mural peri-arterial drainage (IPAD), is the rapid drainage of interstitial fluid along basement membranes (BM) of the smooth muscle cells of cerebral arteries; failure of IPAD is closely associated with the pathology of Alzheimer's disease (AD), but its driving mechanism remains unclear. We have previously shown that arterial pulsations generated by the heart beat are not strong enough to drive IPAD. Here we present computational evidence for a mechanism for clearance of waste from the brain that is driven by functional hyperaemia, that is, the dilatation of cerebral arterioles as a consequence of increased nutrient demand from neurons. This mechanism is based on our model for the flow of fluid through the vascular BM. It accounts for clearance rates observed in mouse experiments, and aligns with pathological observations and recommendations to lower the individual risk of AD, such as mental and physical activity. Thus, our neurovascular hypothesis should act as the new working hypothesis for the driving force behind IPAD.
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Affiliation(s)
- Alexandra K. Diem
- Department of Computational Physiology, Simula Research Laboratory, 1364 Fornebu, Norway
- Computational Engineering and Design, Faculty of Engineering and the Environment, University of Southampton, Southampton Boldrewood Innovation Campus, Southampton, SO16 7QF, United Kingdom
- * E-mail:
| | - Roxana O. Carare
- Clinical Neurosciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom
| | - Roy O. Weller
- Neuropathology, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom
| | - Neil W. Bressloff
- Computational Engineering and Design, Faculty of Engineering and the Environment, University of Southampton, Southampton Boldrewood Innovation Campus, Southampton, SO16 7QF, United Kingdom
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45
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Lee J. The Relationship Between Physical Activity and Dementia: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Gerontol Nurs 2018; 44:22-29. [DOI: 10.3928/00989134-20180814-01] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/28/2018] [Indexed: 12/28/2022]
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46
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de Frutos-Lucas J, López-Sanz D, Zuluaga P, Rodríguez-Rojo IC, Luna R, López ME, Delgado-Losada ML, Marcos A, Barabash A, López-Higes R, Maestú F, Fernández A. Physical activity effects on the individual alpha peak frequency of older adults with and without genetic risk factors for Alzheimer’s Disease: A MEG study. Clin Neurophysiol 2018; 129:1981-1989. [DOI: 10.1016/j.clinph.2018.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/29/2018] [Accepted: 06/25/2018] [Indexed: 11/30/2022]
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47
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Cognitive and structural cerebral changes in amnestic mild cognitive impairment due to Alzheimer's disease after multicomponent training. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:473-480. [PMID: 30258976 PMCID: PMC6153377 DOI: 10.1016/j.trci.2018.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction Information about how physical exercise affects patients with amnestic mild cognitive impairment (aMCI) due to Alzheimer's disease (AD) is still missing. This study evaluated the impact of multicomponent exercise training on cognition and brain structure in aMCI subjects with cerebral spinal fluid positive AD biomarkers. Methods Forty aMCI subjects were divided in training (multicomponent exercise thrice a week for 6 months) and nontraining groups. Assessments included cardiorespiratory fitness, neurocognitive tests, and a structural magnetic resonance imaging using 3.0 T scanner. FreeSurfer software analyzed hippocampal volume and cortical thickness. Results The training group showed increased volume in both hippocampi and better performance in episodic memory test after 6 months. In contrast, the nontraining group declined in functional activities, recognition, and cardiorespiratory fitness for the same period. Discussion Multicomponent exercise seems to improve hippocampal volume and episodic memory, and maintains VO2max in aMCI due to AD.
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48
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Jiang L, Ma J, Zhang Y, Zhou CN, Zhang L, Chao FL, Chen LM, Jiang R, Wu H, Tang Y. Effect of running exercise on the number of the neurons in the hippocampus of young transgenic APP/PS1 mice. Brain Res 2018; 1692:56-65. [DOI: 10.1016/j.brainres.2018.04.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/08/2018] [Accepted: 04/25/2018] [Indexed: 12/31/2022]
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49
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Abstract
Alzheimer’s disease is the most common cause of dementia worldwide, with the prevalence continuing to grow in part because of the aging world population. This neurodegenerative disease process is characterized classically by two hallmark pathologies: β-amyloid plaque deposition and neurofibrillary tangles of hyperphosphorylated tau. Diagnosis is based upon clinical presentation fulfilling several criteria as well as fluid and imaging biomarkers. Treatment is currently targeted toward symptomatic therapy, although trials are underway that aim to reduce the production and overall burden of pathology within the brain. Here, we discuss recent advances in our understanding of the clinical evaluation and treatment of Alzheimer’s disease, with updates regarding clinical trials still in progress.
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Affiliation(s)
- Jason Weller
- Department of Neurology, Boston VA Hospital, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA.,Department of Neurology, Boston University School of Medicine, 72 East Concord Street C-309, Boston, MA, USA
| | - Andrew Budson
- Department of Neurology, Boston VA Hospital, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA.,Department of Neurology, Boston University School of Medicine, 72 East Concord Street C-309, Boston, MA, USA
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50
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Kelly DA, Seidenberg M, Reiter K, Nielson KA, Woodard JL, Smith JC, Durgerian S, Rao SM. Differential 5-year brain atrophy rates in cognitively declining and stable APOE-ε4 elders. Neuropsychology 2018; 32:647-653. [PMID: 29911873 DOI: 10.1037/neu0000444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The apolipoprotein E (APOE) ε4 allele is the most important genetic risk factor for late-onset Alzheimer's disease. Many ε4 carriers, however, never develop Alzheimer's disease. The purpose of this study is to characterize the variability in phenotypic expression of the ε4 allele, as measured by the longitudinal trajectory of cognitive test scores and MRI brain volumes, in cognitively intact elders. METHOD Healthy older adults, ages 65-85, participated in a 5-year longitudinal study that included structural MRI and cognitive testing administered at baseline and at 1.5 and 5 years postenrollment. Participants included 22 ε4 noncarriers, 15 ε4 carriers who experienced a decline in cognition over the 5-year interval, and 11 ε4 carriers who remained cognitively stable. RESULTS No baseline cognitive or volumetric group differences were observed. Compared to noncarriers, declining ε4 carriers had significantly greater rates of atrophy in left (p = .001, Cohen's d = .691) and right (p = .003, d = .622) cortical gray matter, left (p = .003, d = .625) and right (p = .020, d = .492) hippocampi, and greater expansion of the right inferior lateral ventricle (p < .001, d = .751) over 5 years. CONCLUSIONS This study illustrates the variability in phenotypic expression of the ε4 allele related to neurodegeneration. Specifically, only those individuals who exhibited longitudinal declines in cognitive function experienced concomitant changes in brain volume. Future research is needed to better understand the biological and lifestyle factors that may influence the expression of the ε4 allele. (PsycINFO Database Record
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Affiliation(s)
- Dana A Kelly
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | | | | | | | - J Carson Smith
- Department of Kinesiology, School of Public Health, University of Maryland
| | | | - Stephen M Rao
- Schey Center for Cognitive Neuroimaging, Cleveland Clinic
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