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Akhtar A, Singh S, Kaushik R, Awasthi R, Behl T. Types of memory, dementia, Alzheimer's disease, and their various pathological cascades as targets for potential pharmacological drugs. Ageing Res Rev 2024; 96:102289. [PMID: 38582379 DOI: 10.1016/j.arr.2024.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 03/30/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024]
Abstract
Alzheimer's disease (AD) is the most common type of dementia accounting for 90% of cases; however, frontotemporal dementia, vascular dementia, etc. prevails only in a minority of populations. The term dementia is defined as loss of memory which further takes several other categories of memories like working memory, spatial memory, fear memory, and long-term, and short-term memory into consideration. In this review, these memories have critically been elaborated based on context, duration, events, appearance, intensity, etc. The most important part and purpose of the review is the various pathological cascades as well as molecular levels of targets of AD, which have extracellular amyloid plaques and intracellular hyperphosphorylated tau protein as major disease hallmarks. There is another phenomenon that either leads to or arises from the above-mentioned hallmarks, such as oxidative stress, mitochondrial dysfunction, neuroinflammation, cholinergic dysfunction, and insulin resistance. Several potential drugs like antioxidants, anti-inflammatory drugs, acetylcholinesterase inhibitors, insulin mimetics or sensitizers, etc. studied in various previous preclinical or clinical reports were put as having the capacity to act on these pathological targets. Additionally, agents directly or indirectly targeting amyloid and tau were also discussed. This could be further investigated in future research.
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Affiliation(s)
- Ansab Akhtar
- Louisiana State University Health Sciences Center, Neuroscience Center of Excellence, School of Medicine, New Orleans, LA 70112, USA.
| | - Siddharth Singh
- School of Health Sciences & Technology, UPES University, Bidholi, Dehradun, Uttarakhand 248007, India
| | - Ravinder Kaushik
- School of Health Sciences & Technology, UPES University, Bidholi, Dehradun, Uttarakhand 248007, India
| | - Rajendra Awasthi
- School of Health Sciences & Technology, UPES University, Bidholi, Dehradun, Uttarakhand 248007, India
| | - Tapan Behl
- Amity School of Pharmaceutical Sciences, Amity University, Mohali, Punjab 140306, India
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Jakhmola Mani R, Dogra N, Katare DP. The Connection between Chronic Liver Damage and Sporadic Alzheimer's Disease: Evidence and Insights from a Rat Model. Brain Sci 2023; 13:1391. [PMID: 37891760 PMCID: PMC10605053 DOI: 10.3390/brainsci13101391] [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: 08/01/2023] [Revised: 09/17/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Junk foods are typically low in essential nutrients, such as vitamins, minerals, and antioxidants. They are also loaded with trans fats and saturated fats, which can increase the level of triglycerides in the blood. High triglyceride levels can contribute to the development of non-alcoholic fatty liver disease (NAFLD), a condition where excess fat accumulates in the liver. A high intake of junk foods can lead to insulin resistance, a condition where the body's cells become less responsive to insulin. A diet lacking in nutrients and loaded with unwanted toxins can impair the liver's ability to detoxify harmful substances and damage its overall function. It is known that the regular consumption of junk food can be linked to memory impairment and cognitive decline. Several studies have shown that diets high in unhealthy fats, sugars, and processed foods can negatively impact brain health, including memory function. In this study, Wistar rats were used to model Late-Onset Alzheimer's Disease (LOAD), which was inspired by knowledge of the liver-brain axis's role in causing dementia. The model mimicked junk-food-induced liver-brain damage, and was developed by using the toxins d-galactosamine, ethanol and d-galactose. To begin with, the model rats demonstrated insulin resistance, a characteristic of LOAD patients. Glucose levels in both the brain and liver tissues were significantly elevated in the model, paralleling clinical findings in LOAD patients. High glucose levels in the brain lead to the increased production of advanced glycation end-products (AGEs), which, along with amyloid beta, harm neighbouring neurons. Histopathological analysis revealed deformed glial nodules, apoptotic neurons, and amyloid plaques in the brain section in the later stages of the disease. Simultaneously, the liver section displayed features of cirrhosis, including an effaced lobular architecture and the extravasation of red blood cells. Liver enzymes ALT, AST and ALP were consistently elevated with disease progression. Furthermore, immunohistochemistry confirmed the presence of amyloid precursor protein (APP) in the diseased brain. The positive expression of Hypoxia-Inducible Factor 3-Alpha (HIF3A) in the brain indicated hypoxic conditions, which is consistent with other LOAD studies. This model also exhibited damaged intestinal villi and excessive bowel and urinary incontinence, indicating malnutrition and a disturbed gut microbiome, which is also consistent with LOAD patients. Bioinformatics analysis on serum protein suggests a few affected molecular pathways, like the amyloid secretase pathway, androgen/oestrogen/progesterone biosynthesis, the apoptosis signalling pathway, the insulin/IGF pathway-protein kinase B signalling cascade, the Metabotropic glutamate receptor group I pathway, the Wnt signalling pathway, etc. Behavioural analysis confirmed memory decline and the loss of muscle strength with disease progression. Overall, this rat model of LOAD sheds valuable light on LOAD pathology and highlights the potential link between liver dysfunction, particularly induced by the excessive consumption of junk food, and LOAD. This study contributes to a deeper understanding of the complex molecular mechanisms involved in LOAD, paving the way for new possibilities in therapeutic interventions.
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Affiliation(s)
| | | | - Deepshikha Pande Katare
- Proteomics and Translational Research Lab, Centre for Medical Biotechnology, Amity Institute of Biotechnology, Amity University, Noida 201301, India; (R.J.M.); (N.D.)
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Sathyan S, Ayers E, Blumen H, Weiss EF, Adhikari D, Stimmel M, Abdulsalam K, Noone M, George RK, Ceide M, Ambrose AF, Wang C, Narayanan P, Sureshbabu S, Shaji KS, Sigamani A, Mathuranath PS, Pradeep VG, Verghese J. Epidemiology of Motoric Cognitive Risk Syndrome in the Kerala Einstein Study: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2023; 12:e49933. [PMID: 37590054 PMCID: PMC10472178 DOI: 10.2196/49933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The southern India state of Kerala has among the highest proportion of older adults in its population in the country. An increase in chronic age-related diseases such as dementia is expected in the older Kerala population. Identifying older individuals early in the course of cognitive decline offers the best hope of introducing preventive measures early and planning management. However, the epidemiology and pathogenesis of predementia syndromes at the early stages of cognitive decline in older adults are not well established in India. OBJECTIVE The Kerala Einstein Study (KES) is a community-based cohort study that was established in 2008 and is based in the Kozhikode district in Kerala state. KES aims to establish risk factors and brain substrates of motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by the presence of slow gait and subjective cognitive concerns in individuals without dementia or disability. This protocol describes the study design and procedures for this KES project. METHODS KES is proposing to enroll a sample of 1000 adults ≥60 years old from urban and rural areas in the Kozhikode district of Kerala state: 200 recruited in the previous phase of KES and 800 new participants to be recruited in this project. MCR is the cognitive phenotype of primary interest. The associations between previously established risk factors for dementia as well as novel risk factors (apathy and traumatic brain injury) and MCR will be examined in KES. Risk factor profiles for MCR will be compared between urban and rural residents as well as with individuals who meet the criteria for mild cognitive impairment (MCI). Cognitive and physical function, medical history and medications, sociodemographic characteristics, lifestyle patterns, and activities of daily living will be evaluated. Participants will also undergo magnetic resonance imaging and electrocardiogram investigations. Longitudinal follow-up is planned in a subset of participants as a prelude to future longitudinal studies. RESULTS KES (2R01AG039330-07) was funded by the US National Institutes of Health in September 2019 and received approval from the Indian Medical Council of Research to start the study in June 2021. We had recruited 433 new participants from urban and rural sites in Kozhikode as of May 2023: 41.1% (178/433) women, 67.7% (293/433) rural residents, and 13.4% (58/433) MCR cases. Enrollment is actively ongoing at all the KES recruitment sites. CONCLUSIONS KES will provide new insights into risk factors and brain substrates associated with MCR in India and will help guide future development of regionally specific preventive interventions for dementia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49933.
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Affiliation(s)
- Sanish Sathyan
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Helena Blumen
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Erica F Weiss
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Dristi Adhikari
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Marnina Stimmel
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Mohan Noone
- Institute of Neurosciences, Baby Memorial Hospital, Kozhikode, India
| | - Roy K George
- Institute of Neurosciences, Baby Memorial Hospital, Kozhikode, India
| | - Mirnova Ceide
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Anne Felicia Ambrose
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Cuiling Wang
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | | | | | | | | | - Pavagada S Mathuranath
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
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Hao Y, Dong M, Sun Y, Duan X, Niu W. Effectiveness and safety of monoclonal antibodies against amyloid-beta vis-à-vis placebo in mild or moderate Alzheimer's disease. Front Neurol 2023; 14:1147757. [PMID: 37006475 PMCID: PMC10050585 DOI: 10.3389/fneur.2023.1147757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/16/2023] [Indexed: 03/17/2023] Open
Abstract
Backgrounds and objectivesCurrently, no consensus has been reached on the therapeutic implications of monoclonal antibodies against amyloid-beta (Aβ) in Alzheimer's disease (AD). This study aimed to examine the effectiveness and safety of monoclonal antibodies against Aβ as a whole and also to determine the superiority of individual antibodies vis-à-vis placebo in mild or moderate AD.MethodsLiterature retrieval, article selection, and data abstraction were performed independently and in duplicate. Cognition and function were appraised by the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Disability Assessment for Dementia (DAD), and Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB). Effect sizes are expressed as standardized mean difference (SMD) with a 95% confidence interval (CI).ResultsTwenty-nine articles involving 108 drug-specific trials and 21,383 participants were eligible for synthesis. Of the four assessment scales, only CDR-SB was significantly reduced after using monoclonal antibodies against Aβ relative to placebo (SMD: −0.12; 95% CI: −0.2 to −0.03; p = 0.008). Egger's tests indicated a low likelihood of publication bias. At individual levels, bapineuzumab was associated with a significant increase in MMSE (SMD: 0.588; 95% CI: 0.226–0.95) and DAD (SMD: 0.919; 95% CI: 0.105–1.943), and a significant decrease in CDR-SB (SMD: −0.15; 95% CI: −0.282–0.018). Bapineuzumab can increase the significant risk of serious adverse events (OR: 1.281; 95% CI: 1.075–1.525).ConclusionOur findings indicate that monoclonal antibodies against Aβ can effectively improve instrumental activities of daily life in mild or moderate AD. In particular, bapineuzumab can improve cognition and function, as well as activities of daily life, and meanwhile, it triggers serious adverse events.
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Affiliation(s)
- Ying Hao
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Mingrui Dong
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yingtong Sun
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Xiaohui Duan
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Xiaohui Duan
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Wenquan Niu
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Chandrasekaran N, Thulasingam M, Sahu SK, Sood V, Menon V. Effects of web-based training for carers in old age homes using WHO-iSupport for dementia, as a training tool - A mixed-method study. Asian J Psychiatr 2022; 78:103308. [PMID: 36368147 DOI: 10.1016/j.ajp.2022.103308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/04/2022] [Accepted: 10/21/2022] [Indexed: 11/28/2022]
Abstract
WHO recognized Dementia as public health priority and developed iSupport, a knowledge and skills training program for carers of people living with Dementia. This Mixed-Method study assessed the effectiveness of web-based training sessions among carers at old age homes in and around Puducherry, India, using WHO-iSupport for dementia hardcopy manual as a training tool. We registered the clinical trial protocol with Clinical Trial Registry-India (CTRI), CTRI/2020/11/029154. We determined the change in 35 carer's knowledge and attitude following the training sessions using pre and post-test questionnaires quantitatively. Further, we explored their learning experience by conducting eight descriptive one-to-one telephonic interviews. Due to the COVID-19 pandemic, we conducted this study online. i.e., obtained virtual consents, pre and post-test using Google forms, and training sessions through a webbased platform. We divided carers into groups where each carer attended two training sessions, and each session lasted for 2 h. Training sessions improved the carer's knowledge from a pre-test score of Median (IQR) 12 (9, 15) to a post-test score of 17 (16, 20) and attitude score from 30 (27.3, 34.8) to 33.5 (30.3, 39) in post-test. They perceived that the training sessions were helpful as they gained knowledge on dementia care, and their attitude has changed optimistically towards people living with Dementia. These findings suggest that web-based training has an effect and indicates the need for training among carers in various old age homes for betterment in providing care.
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Affiliation(s)
- Nithya Chandrasekaran
- JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Mahalakshmy Thulasingam
- Department of Preventive and Social Medicine, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Swaroop Kumar Sahu
- Department of Preventive and Social Medicine, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Vibhusha Sood
- JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
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Singh J, Agrawal A, Kumari S, Tomar S, Karn A, Singh A. Knowledge of Alzheimer's disease among the healthcare staff in a medical college hospital of India. J Family Med Prim Care 2022; 11:5599-5603. [PMID: 36505520 PMCID: PMC9731040 DOI: 10.4103/jfmpc.jfmpc_571_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/15/2022] Open
Abstract
Background With increasing numbers of people crossing the age threshold of 65 years, there is a strong likelihood that the cases of Alzheimer's disease (AD) cases will increase manifold in the upcoming decades. It is essential for the healthcare professionals to have a reasonable background knowledge about this neurodegenerative condition. This study was done to assess the level of knowledge of AD among the healthcare staff appointed at a tertiary care hospital. Methodology A cross-sectional survey study was done in a tertiary care hospital with healthcare workers. The knowledge level of AD was investigated using Alzheimer's Disease Knowledge Scale (ADKS) while a self-assessment scale was used by the participants to rate their own knowledge about the disease. The extent of background knowledge was then statistically evaluated on the basis of multiple subject-oriented factors. The impact of any prior dementia-specific training was also assessed. Data were analyzed by using SPSS-23 where P value < 0.05 was considered significant. Results Out of a total of 124 participants recruited during the study period, the average score on the ADKS scale was 19.2 ± 3.1. Self-rated Alzheimer's scale depicted a mean value of 4.89 ± 1.7. The participants having a positive family history and personal/professional caring experience for AD did not obtain any remarkably better score. The doctors were more likely to score better than nurses and other healthcare staff (p < 0.001). Moreover, dementia-related training had a significantly better outcome in terms of promoting the knowledge base of AD (p < 0.001). Conclusion There is a below-par knowledge of Alzheimer's dementia among the healthcare staff of the hospital. The staff of the hospital realizes this shortcoming, and there is a need for dementia-specific training to overcome this knowledge gap.
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Affiliation(s)
- Jassimran Singh
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Aditi Agrawal
- Department of Psychiatry, Institution: St. Elizabeth Medical Centre, Boston, MA, USA
| | - Sarita Kumari
- Department of Anaesthesia, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shubham Tomar
- Department of Medical Oncology, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Anukul Karn
- Clinical Document Specialist Coordinator Trainee, Health Information Management, PrimEra, Hyderabad (Prime Healthcare, Ontario, CA), USA
| | - Anup Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India,Address for correspondence: Prof. Anup Singh, Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. E-mail:
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Kaur K, Narang RK, Singh S. AlCl 3 induced learning and memory deficit in zebrafish. Neurotoxicology 2022; 92:67-76. [PMID: 35843305 DOI: 10.1016/j.neuro.2022.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/26/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
Aluminium is a metal known to cause neurotoxicity in the brain, by promoting neurodegeneration and affecting memory and cognitive ability. AlCl3 has been reported to enhance reactive oxygen species (ROS) and inflammatory markers which are further responsible for the degeneration of neurons. AlCl3 exposure to zebrafish causes behavioral, biochemical, and neurochemical changes in the brain. In our study, Zebrafish were exposed to AlCl3 at three different doses (50 µg/L, 100 µg/L, and 200 µg/L) for four consecutive days. On days 1st and 4th, a novel diving test was performed to check anxiety in zebrafish. T - maze and novel object recognition test were used to check the memory on days 3rd and 4th with the help of ANY-maze software. On the last day (4th day), zebrafishes were sacrificed and whole brains were used to perform the biochemical, neurotransmitters, histopathological, and immunohistochemistry analysis. Our study revealed that AlCl3 exposure significantly decreased the total distance traveled, and the number of entries in the top zone and increased the time spent in the bottom zone, checked through the novel diving test. In the T maze test, AlCl3 treated zebrafish showed significantly increased transfer latency to the favorable zone and time spent, and the number of entries to the unfavorable zone. The exploration time with the novel object was reduced significantly after AlCl3 treatment. Moreover, reduced glutathione (GSH) and superoxide dismutase (SOD) levels were significantly reduced in AlCl3 treated zebrafish whereas malondialdehyde (MDA) level was found to be increased, indicating high oxidative stress. The neurotransmitters level was also disturbed indicated by the significantly decreased GABA, dopamine, noradrenaline, and Serotonin levels and increased glutamate level in the brain of zebrafish treated with AlCl3. Moreover, histopathological and immunohistochemistry study shows a markedly increased number of pyknotic neurons and reduced the expression of Nrf2 in the zebrafish brain after AlCl3 exposure. These findings suggest that AlCl3 significantly causes behavioral, biochemical, neurotransmitters, morphological, and molecular changes in zebrafish, ultimately causing AD.
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Affiliation(s)
- Karamjeet Kaur
- Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab 142001, India; Affiliated to IKG, Punjab Technical University, Jalandhar, Punjab 144603, India
| | - R K Narang
- Nanomedicine Research Centre, Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Shamsher Singh
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab 142001, India.
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Shirsat-John P, Saldanha T, Kolhe S, Ziyaurrahman AR. Antiamnesic effect of Mesua ferrea (L.) flowers on scopolamine-induced memory impairment and oxidative stress in rats. ADVANCES IN TRADITIONAL MEDICINE 2022. [DOI: 10.1007/s13596-022-00654-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hendriks S, Peetoom K, Bakker C, Koopmans R, van der Flier W, Papma J, Verhey F, de Vugt M, Köhler S. Global incidence of young-onset dementia: A systematic review and meta-analysis. Alzheimers Dement 2022; 19:831-843. [PMID: 35715891 DOI: 10.1002/alz.12695] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/19/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Reliable data on the incidence rates for young-onset dementia (YOD) are lacking, but are necessary for research on disease etiology and to raise awareness among health care professionals. METHODS We performed a systematic review and meta-analysis on population-based studies on the incidence of YOD, published between January 1, 1990 and February 1, 2022, according to Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Data were analyzed using random-effects meta-analyses. Results were age-standardized, and heterogeneity was assessed by subgroup analyses and meta-regression. RESULTS Sixty-one articles were included. Global age-standardized incidence rates increased from 0.17/100,000 in age 30 to 34 years, to 5.14/100,000 in age 60 to 64 years, giving a global total age-standardized incidence rate of 11 per 100,000 in age 30 to 64. This corresponds to 370,000 new YOD cases annually worldwide. Heterogeneity was high and meta-regression showed geographic location significantly influenced this heterogeneity. DISCUSSION This meta-analysis shows the current best estimate of YOD incidence. New prospective cohort studies are needed.
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Affiliation(s)
- Stevie Hendriks
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Raymond Koopmans
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wiesje van der Flier
- Department of Neurology, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Janne Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Shanmugam JV, Duraisamy B, Simon BC, Bhaskaran P. Alzheimer’s disease classification using pre-trained deep networks. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103217] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kaushik A, Bhatnagar A, Kaur T. Removable prosthodontic considerations for patients having neurologic and neuromuscular disorders. JOURNAL OF THE INTERNATIONAL CLINICAL DENTAL RESEARCH ORGANIZATION 2022. [DOI: 10.4103/jicdro.jicdro_57_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Patel R, Kaur K, Singh S. Protective effect of andrographolide against STZ induced Alzheimer's disease in experimental rats: possible neuromodulation and Aβ (1-42) analysis. Inflammopharmacology 2021; 29:1157-1168. [PMID: 34235591 DOI: 10.1007/s10787-021-00843-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/25/2021] [Indexed: 01/24/2023]
Abstract
STZ is a glucosamine-nitrosourea compound, causes dysfunctioning of insulin receptors in the brain and disrupts glucose metabolism, produces cognitive decline and AD-like symptoms. ICV injection of STZ causes accumulation of Aβ and cognitive dysfunctions. Andrographolide (ANDRO) is a major bioactive constituent of Andrographis paniculata, has various biological activities such as antioxidant, anti-inflammatory, anti-cholinesterase, and neuroprotective properties. The study aimed to evaluate the neuroprotective effect of ANDRO against ICV-STZ induced AD-like symptoms in rats. To conduct the study, the Wistar rat received two injections of STZ (3 mg/kg) through the ICV route. Rats were treated with three different doses of ANDRO (15, 30, and 60 mg/kg, p.o.) and donepezil (5 mg/kg, p.o.) for 14 days. The behavioral impairments were analyzed on weekly basis. Subsequently, rats were sacrificed for the assessment of biochemical (MDA, Nitrite, GSH, SOD, Catalase and AChE), neuroinflammatory markers (IL-1β, IL-16, and TNF-α), neurotransmitters (glutamate and GABA), level of Aβ1-42 and p tau in the hippocampus on day 21st. Our result indicated that ANDRO treatment provided a protective effect against STZ induced behavioral deficits and changes in the biochemical, neuroinflammatory mediators, and neurotransmitters of the hippocampus. Further, ANDRO also reduced the level of Aβ1-42 and p tau in the rat hippocampus. These findings suggested that the antioxidant, anti-inflammatory, anti-cholinesterase potential of ANDRO contributed to its neuroprotective effect as well as promising therapeutic candidate for the treatment of cognitive impairment and AD-like symptoms.
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Affiliation(s)
- Royal Patel
- Department of Pharmacology, ISF College of Pharmacy (Affiliated to IKG-Punjab Technical University, Jalandhar, 144603, Punjab, India), Moga, 142001, Punjab, India
| | - Karamjeet Kaur
- Department of Pharmacology, ISF College of Pharmacy (Affiliated to IKG-Punjab Technical University, Jalandhar, 144603, Punjab, India), Moga, 142001, Punjab, India
| | - Shamsher Singh
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India.
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Murty DV, Manikandan K, Kumar WS, Ramesh RG, Purokayastha S, Nagendra B, Ml A, Balakrishnan A, Javali M, Rao NP, Ray S. Stimulus-induced gamma rhythms are weaker in human elderly with mild cognitive impairment and Alzheimer's disease. eLife 2021; 10:61666. [PMID: 34099103 PMCID: PMC8238507 DOI: 10.7554/elife.61666] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 05/23/2021] [Indexed: 12/16/2022] Open
Abstract
Alzheimer’s disease (AD) in elderly adds substantially to socioeconomic burden necessitating early diagnosis. While recent studies in rodent models of AD have suggested diagnostic and therapeutic value for gamma rhythms in brain, the same has not been rigorously tested in humans. In this case-control study, we recruited a large population (N = 244; 106 females) of elderly (>49 years) subjects from the community, who viewed large gratings that induced strong gamma oscillations in their electroencephalogram (EEG). These subjects were classified as healthy (N = 227), mild cognitively impaired (MCI; N = 12), or AD (N = 5) based on clinical history and Clinical Dementia Rating scores. Surprisingly, stimulus-induced gamma rhythms, but not alpha or steady-state visually evoked responses, were significantly lower in MCI/AD subjects compared to their age- and gender-matched controls. This reduction was not due to differences in eye movements or baseline power. Our results suggest that gamma could be used as a potential screening tool for MCI/AD in humans. Alzheimer’s disease is one of the most common forms of dementia, characterised by declining memory and thinking skills, and behavioural changes that worsen over time. It affects millions of people worldwide, mostly in older age, and yet early indicators of the disease are lacking. Most cases are only diagnosed once a person’s brain function becomes noticeably impaired, even though known biological changes underpin the disease. Detecting Alzheimer’s disease early could aid diagnosis and enable early intervention, while also improving the chances of finding treatments to halt or reverse the disease. Currently, brain function is measured by performing cognitive tests, such as remembering a set of words, imaging the brain with MRIs or CT scans, and blood or spinal fluid tests. Many of these tests can be invasive and expensive, so researchers are exploring whether measuring oscillations in the brain’s electrical activity can be a non-invasive and chepaer way of testing brain function. Gamma oscillations are rhythmic signals, thought to be involved in attention and working memory. Animals used to study Alzheimer’s disease have shown some abnormalities in gamma oscillations, and studies of healthy humans have also observed a decline in the strength and frequency of these oscillations with age. These findings have spurred an interest in understanding the link between gamma oscillations and AD in humans. To investigate this link, Murty et al. measured patterns of brain activity in elderly people chosen from the community using electrodes placed on their scalps (a technique called electroencephalography). These participants watched certain images previously shown to elicit gamma oscillations. Participants who were later diagnosed with early Alzheimer’s disease had weaker gamma oscillations than their cognitively healthy peers in the part of the brain that processes visual images. These results build upon previous findings from animal research suggesting that gamma oscillations may be disrupted in early Alzheimer’s disease. The work by Murty et al. could lead the way to new ways of diagnosing Alzheimer’s disease, where early indicators are urgently needed.
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Affiliation(s)
| | | | | | | | | | - Bhargavi Nagendra
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | - Abhishek Ml
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | | | - Mahendra Javali
- MS Ramaiah Medical College & Memorial Hospital, Bengaluru, India
| | | | - Supratim Ray
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
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Menon RN, Varghese F, Paplikar A, Mekala S, Alladi S, Sharma M, Aralikatte Onkarappa S, Gollahalli D, Dutt A, Ghosh A, Dhaliwal RS, Hooda R, Iyer GK, Justus S, Kandukuri R, Kaul S, Banu Khan A, Nandi R, Narayanan J, Nehra A, Vasantha PM, Pauranik A, Mathew R, Ramakrishnan S, Sarath L, Shah U, Tripathi M, Padmavathy Narayana S, Varma RP, Verma M, Vishwanath Y. Validation of Indian Council of Medical Research Neurocognitive Tool Box in Diagnosis of Mild Cognitive Impairment in India: Lessons from a Harmonization Process in a Linguistically Diverse Society. Dement Geriatr Cogn Disord 2021; 49:355-364. [PMID: 33412549 DOI: 10.1159/000512393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/16/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS In a linguistically diverse country such as India, challenges remain with regard to diagnosis of early cognitive decline among the elderly, with no prior attempts made to simultaneously validate a comprehensive battery of tests across domains in multiple languages. This study aimed to determine the utility of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB) in the diagnosis of mild cognitive impairment (MCI) and its vascular subtype (VaMCI) in 5 Indian languages. METHODS Literate subjects from 5 centers across the country were recruited using a uniform process, and all subjects were classified based on clinical evaluations and a gold standard test protocol into normal cognition, MCI, and VaMCI. Following adaptation and harmonization of the ICMR-NCTB across 5 different Indian languages into a composite Z score, its test performance against standards, including sensitivity and specificity of the instrument as well as of its subcomponents in diagnosis of MCI, was evaluated in age and education unmatched and matched groups. RESULTS Variability in sensitivity-specificity estimates was noted between languages when a total of 991 controls and 205 patients with MCI (157 MCI and 48 VaMCI) were compared due to a significant impact of age, education, and language. Data from a total of 506 controls, 144 patients with MCI, and 46 patients with VaMCI who were age- and education-matched were compared. Post hoc analysis after correction for multiple comparisons revealed better performance in controls relative to all-cause MCI. An optimum composite Z-score of -0.541 achieved a sensitivity of 81.1% and a specificity of 88.8% for diagnosis of all-cause MCI, with a high specificity for diagnosis of VaMCI. Using combinations of multiple-domain 2 test subcomponents retained a sensitivity and specificity of >80% for diagnosis of MCI. CONCLUSIONS The ICMR-NCTB is a "first of its kind" approach at harmonizing neuropsychological tests across 5 Indian languages for the diagnosis of MCI due to vascular and other etiologies. Utilizing multiple-domain subcomponents also retains the validity of this instrument, making it a valuable tool in MCI research in multilingual settings.
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Affiliation(s)
- Ramshekhar N Menon
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India,
| | - Feba Varghese
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Avanthi Paplikar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Shailaja Mekala
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India.,Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | | | | | - Divyaraj Gollahalli
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Aparna Dutt
- Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata, India.,Duttanagar Mental Health Centre, Neuropsychology & Clinical Psychology Unit, Duttanagar, Kolkata, India
| | - Amitabha Ghosh
- Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata, India
| | | | - Roopa Hooda
- Departments of Neurology and Neuropsychology, All India Institute of Medical Sciences, Delhi, India
| | - Gowri K Iyer
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India.,Indian Institute of Public Health, Hyderabad, India
| | - Sunitha Justus
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Rajmohan Kandukuri
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Subhash Kaul
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India.,Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad, India
| | - Arfa Banu Khan
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, India
| | - Ranita Nandi
- Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata, India
| | | | - Ashima Nehra
- Departments of Neurology and Neuropsychology, All India Institute of Medical Sciences, Delhi, India
| | - Padma M Vasantha
- Departments of Neurology and Neuropsychology, All India Institute of Medical Sciences, Delhi, India
| | | | - Robert Mathew
- Department of Neurology, Sree Mookambika Institute of Medical Sciences, Tamil Nadu, India
| | - Subasree Ramakrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Lekha Sarath
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | | | - Manjari Tripathi
- Departments of Neurology and Neuropsychology, All India Institute of Medical Sciences, Delhi, India
| | - Sylaja Padmavathy Narayana
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Ravi Prasad Varma
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Mansi Verma
- Departments of Neurology and Neuropsychology, All India Institute of Medical Sciences, Delhi, India
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15
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Shen H, Han C, Yang Y, Guo L, Sheng Y, Wang J, Li W, Zhai L, Wang G, Guan Q. Pyroptosis executive protein GSDMD as a biomarker for diagnosis and identification of Alzheimer's disease. Brain Behav 2021; 11:e02063. [PMID: 33587329 PMCID: PMC8035446 DOI: 10.1002/brb3.2063] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/01/2020] [Accepted: 01/17/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE This study was mainly conducted to explore the expression changes of GSDMD and conventional markers (including T-Tau, Tau181p, and Aβ1-42 ) in the cerebrospinal fluid among patients with Alzheimer's disease (AD) and vascular dementia (VD), followed by determination of role of GSDMD in diagnosing and identifying AD and VD. METHODS In this study, 60 patients with VD, 60 patients with AD, and 50 healthy controls were enrolled. Lumbar puncture was performed to collect cerebrospinal fluid samples. Patients with VD and patients with AD were evaluated using the Mini-Mental State Examination (MMSE) scale, Montreal Cognitive Assessment (MoCA) scale, Clinical Dementia Rating (CDR) scale, Activity of Daily Living (ADL) scale, and Neuropsychiatric Inventory (NPI) questionnaire, aiming to determine the behavioral ability of patients. ELISA kit was purchased to determine the levels of GSDMD, T-Tau, Tau181p, and Aβ1-42 in cerebrospinal fluid, and the expression of inflammatory factors, IL-1β and IL-6, was also detected. RESULTS (1) The levels of GSDMD, T-Tau, and Tau181p in the cerebrospinal fluid were higher in patients with AD than those of patients with VD and healthy controls, while the levels of Aβ1-42 in the cerebrospinal fluid were lower in patients with AD than that in healthy controls and patients with VD. (2) GSDMD had good diagnostic accuracy in AD. Additionally, GSDMD, T-Tau, Tau181p, and Aβ1-42 had good discrimination accuracy in distinguishing AD and VD. (3) The expression levels of inflammatory factors (IL-1β and IL-6) in cerebrospinal fluid were higher in patients with AD than those of healthy controls and patients with VD, which were positively correlated with GSDMD expression. CONCLUSION The expression of GSDMD was increased in patients with AD, which could be used as a biomarker for AD diagnosis and identification from VD.
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Affiliation(s)
- Heping Shen
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Chenyang Han
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Yi Yang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Li Guo
- Department of Center Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Yongjia Sheng
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Jin Wang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Wenyan Li
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Liping Zhai
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Genghuan Wang
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Qiaobing Guan
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
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16
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Soman SM, Raghavan S, Rajesh P, Mohanan N, Thomas B, Kesavadas C, Menon RN. Does resting state functional connectivity differ between mild cognitive impairment and early Alzheimer's dementia? J Neurol Sci 2020; 418:117093. [DOI: 10.1016/j.jns.2020.117093] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/27/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
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17
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Sen S, Saxena R, Vibha D, Tripathi M, Sharma P, Phuljhele S, Tandon R, Kumar P. Detection of structural and electrical disturbances in macula and optic nerve in Alzheimer's patients and their correlation with disease severity. Semin Ophthalmol 2020; 35:116-125. [PMID: 32306804 DOI: 10.1080/08820538.2020.1748203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Aim: To evaluate and compare structural and functional changes in macula and optic nerve in Alzheimer disease (AD) patients and healthy subjects.Methods: Both eyes of 20 AD patients and 40 age-matched healthy controls were evaluated. All subjects were evaluated by cognitive testing and comprehensive ophthalmological examination, including visual acuity, visual fields, color vision, contrast sensitivity, anterior, and posterior segment examination, optical coherence tomography, multifocal electroretinography (mfERG), and pattern-reversal visual evoked potential (pVEP).Results: AD patients showed significantly reduced contrast sensitivity, thinner nerve fiber layer, ganglion cell layer andmacular volume. Multifocal ERG wave amplitudes were significantly reduced with delayed implicit times, which correlated significantly with the inner retinal layer thinning and poorer disease severity scores. The correlation with structural changes and disease severity was highest for pVEP, which showed significant derangement in AD patients.Conclusion: Subclinical visual dysfunction may be present in AD patients, which may be detected as inner retinal thinning. A probable photoreceptor abnormality may also form a part of the AD disease process.
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Affiliation(s)
- Sagnik Sen
- Department of Ophthalmology, AIIMS, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, AIIMS, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, AIIMS, New Delhi, India
| | | | | | | | | | - Pawan Kumar
- Department of Ophthalmology, AIIMS, New Delhi, India
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18
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Taliyan R, Chandran SK, Kakoty V. Therapeutic Approaches to Alzheimer's Type of Dementia: A Focus on FGF21 Mediated Neuroprotection. Curr Pharm Des 2020; 25:2555-2568. [PMID: 31333086 DOI: 10.2174/1381612825666190716101411] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022]
Abstract
Neurodegenerative disorders are the most devastating disorder of the nervous system. The pathological basis of neurodegeneration is linked with dysfunctional protein trafficking, mitochondrial stress, environmental factors and aging. With the identification of insulin and insulin receptors in some parts of the brain, it has become evident that certain metabolic conditions associated with insulin dysfunction like Type 2 diabetes mellitus (T2DM), dyslipidemia, obesity etc., are also known to contribute to neurodegeneration mainly Alzheimer's Disease (AD). Recently, a member of the fibroblast growth factor (FGF) superfamily, FGF21 has proved tremendous efficacy in diseases like diabetes mellitus, obesity and insulin resistance (IR). Increased levels of FGF21 have been reported to exert multiple beneficial effects in metabolic syndrome. FGF21 receptors are present in certain areas of the brain involved in learning and memory. However, despite extensive research, its function as a neuroprotectant in AD remains elusive. FGF21 is a circulating endocrine hormone which is mainly secreted by the liver primarily in fasting conditions. FGF21 exerts its effects after binding to FGFR1 and co-receptor, β-klotho (KLB). It is involved in regulating energy via glucose and lipid metabolism. It is believed that aberrant FGF21 signalling might account for various anomalies like neurodegeneration, cancer, metabolic dysfunction etc. Hence, this review will majorly focus on FGF21 role as a neuroprotectant and potential metabolic regulator. Moreover, we will also review its potential as an emerging candidate for combating metabolic stress induced neurodegenerative abnormalities.
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Affiliation(s)
- Rajeev Taliyan
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
| | - Sarathlal K Chandran
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
| | - Violina Kakoty
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
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19
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Raju TR, Mohanakumar KP. Neural functions of the aging brain: Daily living, developmental and geriatric disabilities. J Chem Neuroanat 2020; 95:1-5. [PMID: 30635101 DOI: 10.1016/j.jchemneu.2018.12.004] [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: 10/27/2022]
Abstract
Neuronal, microglial, astrocytic and oligodendrocytic functions of the brain are significantly affected during normal aging, and more so if inflicted with neurological diseases. Aging is a consistent risk factor for many neurodegenerative diseases that are sporadic in nature, whereas developmental neurological disabilities stem from errors in brain development. The neuronal functions are affected in both developmental disabilities and geriatric diseases. This special issue, is based on the two-days meeting at Thiruvanathapuram, India on 'Neural Functions of Aging Brain', which had several original presentations, as well as full reviews by neurobiologists and clinicians from India. Out of these, thirteen peer reviewed contributions are published in the present Special Issue of this Journal. This 'Foreword' is also a brief overview on the current scenario of neurobiology research on developmental disabilities and ageing in India based on the manuscripts included in the special issue, vis-s-vis the global scenario. Apparently, there is a void in geriatric and developmental neuroscience research in India since huge data mining and translation, concerted efforts on clinical neuroscience research, and consistent efforts on pure basic research resulting in 'first in the field' novelty are largely missing. Overall, Indian neuroscience excels in making meaningful relevance of contemporary discoveries in neuroscience and contributing towards advances in their applications.
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Affiliation(s)
- T R Raju
- National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, India 560029
| | - K P Mohanakumar
- Inter University Centre for Biomedical Research & Super Speciality Hospital, Mahatma Gandhi University Campus at Thalappady, Rubber Board P.O., Kottayam, Kerala - 686009, India.
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20
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Purushothaman S, Ragavi A, Basavaraju P, Moorthi P, Anand A. The role of trace elements in Alzheimer's disease. ARCHIVES OF MENTAL HEALTH 2020. [DOI: 10.4103/amh.amh_18_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Pauranik A. Cross-cultural Differences in Dementia: Indian Etiquette of Honorifics. Ann Indian Acad Neurol 2019; 22:129-130. [PMID: 31007421 PMCID: PMC6472237 DOI: 10.4103/aian.aian_404_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Apoorva Pauranik
- Director, Pauranik Academy of Medical Education, Ex-Professor, Medicine and Neurology, M.G.M. Medical College, Indore, Madhya Pradesh, India
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22
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Khan AW, Khan AU, Shah SMM, Ullah A, Faheem M, Saleem M. An Updated List of Neuromedicinal Plants of Pakistan, Their Uses, and Phytochemistry. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:6191505. [PMID: 30941198 PMCID: PMC6420976 DOI: 10.1155/2019/6191505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/14/2019] [Accepted: 02/05/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Almost every region of Pakistan is stacked with a large number of medicinal plants. Due to high cost and unavailability of allopathic medicines for the neurological diseases, especially in rural areas, traditional healers prescribe phytotherapy for various neurological diseases like epilepsy, depression, anxiety, insomnia, Alzheimer, and migraine. Such treatments are considered to be most effective by the native people. METHODS The data was collected from articles published on medicinal plants of various districts of Pakistan, using article search engines like Medline, Pubmed, Web of Science, Science Direct, and Google Scholar. Also, information regarding various neurological uses and mode of applications of medicinal plants was obtained from traditional healers, folk medicine users, and local elderly people having knowledge of medicinal plants. RESULTS A total of 54 families were found to be used in various neurological diseases, of which the highest use was of Solanaceae (22.22%), Asteraceae (12.96%), Lamiaceae, Papaveraceae, and Poaceae, 9% each, and Caprifoliaceae, Cucurbitaceae, Rhamnaceae, and Rosaceae, 5.5% each. According to districts, 15% of plants that were effective in neurological affections were found in Bahawalpur, 11% in Swat, 8% in Muzaffarabad, 7% in Malakand, and 6% in Bahawalnagar, Dir, Gilgat, and Sarghoda each, with 5% in Dera ghazi khan and Jhelum each. According to the plant's habit, out of total of 103 plants, 61.15% were found to be herbs, 22.33% trees, 11.65% shrubs, and 4.85% climbers. According to the part used of plant, whole plant, leaves, fruits, roots, seeds, and flowers were found to be used 32.03%, 24.27%, 20.38%, 16.50%, 13.59%, and 11.65%, respectively. According to disease's types, 45.63% were found to be effective in insomnia, 31.06% in epilepsy 12.62% in depression, 6.80% in anxiety, 7.77% in hysteria, and 5.88% in migraine. CONCLUSION Taking into consideration this useful knowledge on medicinal properties of the plants for curing neurologic diseases, it is believed that research in areas of ethnomedicine and ethnopharmacology can bring auspicious results that have potential of adding value to the very rich natural resources of Pakistan. This study will help all the researchers from diverse backgrounds working on plants based medicine for neurological diseases.
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Affiliation(s)
| | - Arif-ullah Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | | | - Aziz Ullah
- Department of Pharmacy, Forman Christian College, Lahore, Pakistan
| | - Muhammad Faheem
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | - Muhammad Saleem
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
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23
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Penke B, Bogár F, Crul T, Sántha M, Tóth ME, Vígh L. Heat Shock Proteins and Autophagy Pathways in Neuroprotection: from Molecular Bases to Pharmacological Interventions. Int J Mol Sci 2018; 19:E325. [PMID: 29361800 PMCID: PMC5796267 DOI: 10.3390/ijms19010325] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/15/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023] Open
Abstract
Neurodegenerative diseases (NDDs) such as Alzheimer's disease, Parkinson's disease and Huntington's disease (HD), amyotrophic lateral sclerosis, and prion diseases are all characterized by the accumulation of protein aggregates (amyloids) into inclusions and/or plaques. The ubiquitous presence of amyloids in NDDs suggests the involvement of disturbed protein homeostasis (proteostasis) in the underlying pathomechanisms. This review summarizes specific mechanisms that maintain proteostasis, including molecular chaperons, the ubiquitin-proteasome system (UPS), endoplasmic reticulum associated degradation (ERAD), and different autophagic pathways (chaperon mediated-, micro-, and macro-autophagy). The role of heat shock proteins (Hsps) in cellular quality control and degradation of pathogenic proteins is reviewed. Finally, putative therapeutic strategies for efficient removal of cytotoxic proteins from neurons and design of new therapeutic targets against the progression of NDDs are discussed.
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Affiliation(s)
- Botond Penke
- Department of Medical Chemistry, University of Szeged, H-6720 Szeged, Dóm Square 8, Hungary.
| | - Ferenc Bogár
- Department of Medical Chemistry, University of Szeged, H-6720 Szeged, Dóm Square 8, Hungary.
- MTA-SZTE Biomimetic Systems Research Group, University of Szeged, H-6720 Szeged, Dóm Square 8, Hungary.
| | - Tim Crul
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, H-6726 Szeged, Temesvári krt. 62, Hungary.
| | - Miklós Sántha
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, H-6726 Szeged, Temesvári krt. 62, Hungary.
| | - Melinda E Tóth
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, H-6726 Szeged, Temesvári krt. 62, Hungary.
| | - László Vígh
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, H-6726 Szeged, Temesvári krt. 62, Hungary.
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24
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Kimchi EY, Hshieh TT, Guo R, Wong B, O'Connor M, Marcantonio ER, Metzger ED, Strauss J, Arnold SE, Inouye SK, Fong TG. Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study. J Am Med Dir Assoc 2017; 18:1010-1018.e1. [PMID: 28927945 PMCID: PMC5701828 DOI: 10.1016/j.jamda.2017.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To survey the current methods used to ascertain dementia and mild cognitive impairment (MCI) in longitudinal cohort studies, to categorize differences in approaches and to identify key components of expert panel methodology in current use. METHODS We searched PubMed for the past 10 years, from March 6, 2007 to March 6, 2017 using a combination of controlled vocabulary and keyword terms to identify expert panel consensus methods used to diagnose MCI or dementia in large cohort studies written in English. From these results, we identified a framework for reporting standards and describe as an exemplar the clinical consensus procedure used in an ongoing study of elective surgery patients (the Successful Aging after Elective Surgery study). RESULTS Thirty-one articles representing unique cohorts were included. Among published methods, membership of experts panel varied significantly. There was more similarity in what types of information was use to ascertain disease status. However, information describing the diagnostic decision process and resolution of disagreements was often lacking. CONCLUSIONS Methods used for expert panel diagnosis of MCI and dementia in large cohort studies are widely variable, and there is a need for more standardized reporting of these approaches. By describing the procedure in which our expert panel achieved consensus diagnoses, we hope to encourage the development and publication of well-founded and reproducible methods for diagnosis of MCI and dementia in longitudinal studies.
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Affiliation(s)
- Eyal Y Kimchi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Tammy T Hshieh
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ray Guo
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA
| | - Bonnie Wong
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Margaret O'Connor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Edward R Marcantonio
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Eran D Metzger
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jason Strauss
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA; Harvard Medical School, Boston, MA
| | - Steven E Arnold
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Sharon K Inouye
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tamara G Fong
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Chakraborty P. Mercury exposure and Alzheimer's disease in India - An imminent threat? THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 589:232-235. [PMID: 28262357 DOI: 10.1016/j.scitotenv.2017.02.168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/20/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
India is an industrial giant with one of the fastest growing major economies in the world. Primary energy consumption in India is third after China and the USA. Greater energy production brings the burden of increasing emissions of mercury (Hg). India ranks second for Hg emissions. Rising atmospheric Hg release, high Hg evasion processes, and increasing monomethylmercury (highly neurotoxin) accumulations in marine food products increase the potential for human and ecosystem Hg exposure. Hg has been identified to increase the risk of getting Alzheimer's disease (AD). There are increasing reports of AD and dementia in different age groups in India. The relationship between increasing Hg exposure and increasing neurodegenerative disorder in India is not known. This commentary points to the need for better understanding of the relationship between Hg release and AD in India, and other countries, and how to protect human health and the environment from the adverse effects of Hg.
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Affiliation(s)
- Parthasarathi Chakraborty
- Geological Oceanography Division, CSIR-National Institute of Oceanography, Dona Paula, Goa 403004, India.
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Banerjee TK, Dutta S, Das S, Ghosal M, Ray BK, Biswas A, Hazra A, Chaudhuri A, Paul N, Das SK. Epidemiology of dementia and its burden in the city of Kolkata, India. Int J Geriatr Psychiatry 2017; 32:605-614. [PMID: 27251089 DOI: 10.1002/gps.4499] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 03/21/2016] [Accepted: 04/14/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Increase in aging population is expected to lead to increasing prevalence of dementia in India. In this study, we aimed to determine prevalence, incidence, and mortality of dementia and its subtypes and assess dementia burden in terms of disability-adjusted life years (DALY). METHODS A community study was conducted over 5 years (2003-2008) in Kolkata, India, on 100,802 (males 53,209) randomly selected subjects to assess prevalence and capture data on incident cases and deaths. Standard case definitions were used. The data were used to estimate years of life lost (YLL) due to premature mortality, years of life lived with disability (YLD), and DALY, based on Global Burden of Disease 2010 approach. RESULTS During 2003-2004, there were 103 (men 55) cases of dementia. The prevalence was 1.53% (age adjusted 1.12%) at age ≥65 years. In those ≥55 years age, average annual incidence rate of dementia was 72.57 per 100,000. All-cause standardized mortality ratio in dementia cases was 4.74 (men 6.19, women 3.03). The burden of dementia in 2007-2008 revealed that overall YLL was 47.13 per 100,000 and YLD ranged from 1.87 to 16.95 per 100,000 depending on the clinical severity of dementia. The overall DALY lost per 100,000 due to dementia for the year 2007-2008 was 74.19. CONCLUSIONS This community study revealed a low prevalence and incidence of dementia with consequent low DALY-derived burden of illness compared with many industrialized nations. YLL formed major component of DALY indicating premature mortality to be an outcome of dementia burden. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Saunak Dutta
- Department of Statistics, University of Calcutta Ballygunj Campus, Kolkata, India
| | - Sujata Das
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, India
| | - Malay Ghosal
- Department of Psychiatry, Medical College Kolkata, Kolkata, India
| | - Biman Kanti Ray
- Department of Neurology, R. G. Kar Medical College, Kolkata, India
| | - Atanu Biswas
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | - Arijit Chaudhuri
- Sampling Unit, Department of Applied Statistics, Indian Statistical Institute, Kolkata, India
| | - Neelanjana Paul
- Department of psychiatry, ICARE Institute of Medical Sciences & Research, Haldia, West Bengal, India
| | - Shyamal Kumar Das
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, India
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Randino R, Grimaldi M, Persico M, De Santis A, Cini E, Cabri W, Riva A, D’Errico G, Fattorusso C, D’Ursi AM, Rodriquez M. Investigating the Neuroprotective Effects of Turmeric Extract: Structural Interactions of β-Amyloid Peptide with Single Curcuminoids. Sci Rep 2016; 6:38846. [PMID: 28004737 PMCID: PMC5177957 DOI: 10.1038/srep38846] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/15/2016] [Indexed: 02/04/2023] Open
Abstract
A broad biophysical analysis was performed to investigate the molecular basis of the neuroprotective action of Curcuma longa extracts in Alzheimer's disease. By combining circular dichroism and electron paramagnetic resonance experiments with molecular modeling calculations, the minor components of Curcuma longa extracts, such as demethoxycurcumin (2, DMC), bisdemethoxycurcumin (3, BDMC) and cyclocurcumin (4, CYC), were analyzed in a membrane environment mimicking the phospholipid bilayer. Our study provides the first evidence on the relative role of single curcuminoids interacting with Aβ-peptide. When the CYC and curcumin metabolite tetrahydrocurcumin (5, THC) were inserted into an anionic lipid solution, a significant modification of the Aβ CD curves was detected. These data were implemented by EPR experiments, demonstrating that CYC reaches the inner part of the bilayer, while the other curcuminoids are localized close to the membrane interface. Computational studies provided a model for the curcuminoid-Aβ interaction, highlighting the importance of a constrained "semi-folded" conformation to interact with Aβ analogously to the pattern observed in α-helical coiled-coil peptide structures. This combined approach led to a better understanding of the intriguing in vitro and in vivo activity of curcuminoids as anti-Alzheimer agents, paving a new path for the rational design of optimized druggable analogues.
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Affiliation(s)
- Rosario Randino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084-Fisciano-Italy
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084-Fisciano-Italy
| | - Marco Persico
- Department of Pharmacy, University of Naples “Federico II”, Via D. Montesano, 49, 80131-Naples-Italy
| | - Augusta De Santis
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cinthia, 80126-Naples-Italy
| | - Elena Cini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro, 2, 53100-Siena-Italy
| | - Walter Cabri
- R&D Department, Indena, Viale Ortles, 12, 20139-Milan-Italy
- Innovation & Development Fresenius-Kabi, Piazza Maestri del Lavoro, 7, 20063-Cernusco sul Naviglio Milan-Italy
| | - Antonella Riva
- R&D Department, Indena, Viale Ortles, 12, 20139-Milan-Italy
| | - Gerardino D’Errico
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cinthia, 80126-Naples-Italy
| | - Caterina Fattorusso
- Department of Pharmacy, University of Naples “Federico II”, Via D. Montesano, 49, 80131-Naples-Italy
| | - Anna Maria D’Ursi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084-Fisciano-Italy
| | - Manuela Rodriquez
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084-Fisciano-Italy
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Vasantharekha R, Priyanka HP, Swarnalingam T, Srinivasan AV, ThyagaRajan S. Interrelationship between Mini-Mental State Examination scores and biochemical parameters in patients with mild cognitive impairment and Alzheimer's disease. Geriatr Gerontol Int 2016; 17:1737-1745. [PMID: 27921357 DOI: 10.1111/ggi.12957] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/30/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to provide first-hand information about the prevalence of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in Tamil Nadu, a southern state in India, and examine if there exists a relationship between cognitive functions and biochemical parameters in these patients. METHODS Surveys were collected from adults, older men and women (n = 3126) from different regions of Tamil Nadu, which were followed up after 12 months for 1337 participants. Mini-Mental State Examination (MMSE) scores, lipid profile, and liver function tests were carried out in the elderly, MCI and AD patients. Based on the MMSE scores, the elderly population was classified into old control (28.97 ± 1.49; n = 1868), MCI (19.58 ± 1.17; n = 734) and AD (7.18 ± 1.38; n = 304) groups. Peripheral blood samples were collected after overnight fast from both male and female volunteers (n = 40 per group) who were categorized as young adult control, old control, MCI and AD. RESULTS AD patients showed lower MMSE scores compared with the young adults, old and MCI groups, and MMSE further decreased at follow-up examination a year later. In the serum of AD patients, high-density lipoprotein, alkaline phosphatase activity and bilirubin levels were lower, whereas low-density lipoprotein, total cholesterol and triglycerides levels were higher. MMSE was positively correlated with high-density lipoprotein, and negatively correlated with other lipid parameters in AD. CONCLUSIONS Hypercholesterolemia is a risk factor for AD that might result in neurotoxicity and cognitive impairment. Dysfunction of lipoprotein and heme metabolism might also provide additional targets for AD diagnosis. Geriatr Gerontol Int 2017; 17: 1737-1745.
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Affiliation(s)
- Ramasamy Vasantharekha
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
| | - Hannah P Priyanka
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
| | - Thangavel Swarnalingam
- Department of Anesthesiology, Tagore Medical College Hospital and Research Center, Tamil Nadu, India
| | | | - Srinivasan ThyagaRajan
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
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Mushtaq R, Pinto C, Tarfarosh SFA, Hussain A, Shoib S, Shah T, Shah S, Manzoor M, Bhat M, Arif T. A Comparison of the Behavioral and Psychological Symptoms of Dementia (BPSD) in Early-Onset and Late-Onset Alzheimer's Disease - A Study from South East Asia (Kashmir, India). Cureus 2016; 8:e625. [PMID: 27433404 PMCID: PMC4934927 DOI: 10.7759/cureus.625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/27/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND A gradual increase in the longevity due to advancement of treatment modalities and a subsequent surge in elderly population in India have led to a growing curiosity in the geriatric age group with Alzheimer's disease (AD). Behavioral and psychological symptoms of dementia (BPSD) represent epiphenomena of AD. However, no comprehensive study has been carried out in South East Asia (Kashmir, India), to assess the behavioral and psychological symptoms in subtypes of AD. OBJECTIVES The purpose of this study was to assess BPSD in early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD). MATERIAL AND METHODS The study was conducted in the Memory clinic of the postgraduate department of psychiatry, Government Medical College, Kashmir, India from January 2012 to March 2014. The diagnosis of AD patients was done according to NINCDS-ADRDA criteria. A total of 80 patients of AD were screened (40 with age of onset less than 65, and 40 with age of onset greater than 64). Neuropsychiatric inventory (NPI) was the instrument used for evaluating symptoms of BPSD. The data was analyzed using paired t-test. RESULTS The mean age of presentation of EOAD and LOAD was 63.10 years and 84.28 years, respectively, and the difference between the two was found to be statistically significant. The LOAD group had significantly higher symptom severity for delusions, agitation, anxiety, disinhibition, and nighttime behavioral disturbances (NBD) than the EOAD group (p ≤.0001). CONCLUSION The behavioral and psychological symptoms are significantly severe in late onset subtype compared to the early onset subtype of Alzheimer's disease in the Kashmiri (Indian) population.
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Affiliation(s)
- Raheel Mushtaq
- Memory Clinic and Geriatric Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Charles Pinto
- Department of Psychiatry, TN Medical College and BYL Nair Hospital, Mumbai
| | | | - Arshad Hussain
- Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Sheikh Shoib
- Memory Clinic and Geriatric Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Tabindah Shah
- MBBS, Government Medical College, Srinagar, J & K, India
| | - Sahil Shah
- MBBS, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, J & K, India
| | | | - Mudassir Bhat
- Postgraduate Department of Radiology, Government Medical College, Srinagar, J & K, India
| | - Tasleem Arif
- Medical Officer, Government Health Services, Kashmir, J & K, India
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Rizzo JR, Raghavan P, McCrery JR, Oh-Park M, Verghese J. Effects of emotionally charged auditory stimulation on gait performance in the elderly: a preliminary study. Arch Phys Med Rehabil 2015; 96:690-6. [PMID: 25542677 PMCID: PMC4526239 DOI: 10.1016/j.apmr.2014.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/01/2014] [Accepted: 12/03/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the effect of a novel divided attention task-walking under auditory constraints-on gait performance in older adults and to determine whether this effect was moderated by cognitive status. DESIGN Validation cohort. SETTING General community. PARTICIPANTS Ambulatory older adults without dementia (N=104). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES In this pilot study, we evaluated walking under auditory constraints in 104 older adults who completed 3 pairs of walking trials on a gait mat under 1 of 3 randomly assigned conditions: 1 pair without auditory stimulation and 2 pairs with emotionally charged auditory stimulation with happy or sad sounds. RESULTS The mean age of subjects was 80.6±4.9 years, and 63% (n=66) were women. The mean velocity during normal walking was 97.9±20.6cm/s, and the mean cadence was 105.1±9.9 steps/min. The effect of walking under auditory constraints on gait characteristics was analyzed using a 2-factorial analysis of variance with a 1-between factor (cognitively intact and minimal cognitive impairment groups) and a 1-within factor (type of auditory stimuli). In both happy and sad auditory stimulation trials, cognitively intact older adults (n=96) showed an average increase of 2.68cm/s in gait velocity (F1.86,191.71=3.99; P=.02) and an average increase of 2.41 steps/min in cadence (F1.75,180.42=10.12; P<.001) as compared with trials without auditory stimulation. In contrast, older adults with minimal cognitive impairment (Blessed test score, 5-10; n=8) showed an average reduction of 5.45cm/s in gait velocity (F1.87,190.83=5.62; P=.005) and an average reduction of 3.88 steps/min in cadence (F1.79,183.10=8.21; P=.001) under both auditory stimulation conditions. Neither baseline fall history nor performance of activities of daily living accounted for these differences. CONCLUSIONS Our results provide preliminary evidence of the differentiating effect of emotionally charged auditory stimuli on gait performance in older individuals with minimal cognitive impairment compared with those without minimal cognitive impairment. A divided attention task using emotionally charged auditory stimuli might be able to elicit compensatory improvement in gait performance in cognitively intact older individuals, but lead to decompensation in those with minimal cognitive impairment. Further investigation is needed to compare gait performance under this task to gait on other dual-task paradigms and to separately examine the effect of physiological aging versus cognitive impairment on gait during walking under auditory constraints.
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Affiliation(s)
- John-Ross Rizzo
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - J R McCrery
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - Mooyeon Oh-Park
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, Kessler Foundation, West Orange, NJ
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
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Menon R, Lekha V, Justus S, Sarma PS, Mathuranath P. A pilot study on utility of Malayalam version of Addenbrooke's Cognitive Examination in detection of amnestic mild cognitive impairment: A critical insight into utility of learning and recall measures. Ann Indian Acad Neurol 2014; 17:420-5. [PMID: 25506164 PMCID: PMC4251016 DOI: 10.4103/0972-2327.144018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/25/2014] [Accepted: 06/16/2014] [Indexed: 11/04/2022] Open
Abstract
AIMS This pilot study sought to determine whether the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) can effectively identify patients with amnestic mild cognitive impairment (a-MCI) and the impact of measures of learning and free recall. MATERIALS AND METHODS A cohort of 23 patients with a-MCI aged between 55-80 years diagnosed as per current criteria and 23 group matched cognitively normal healthy controls (CNHC) were studied. The measures of acquisition and delayed recall were the Rey Auditory Verbal Learning Test (RAVLT) and Wechsler Memory Scale (WMS)-III (verbal and visual subsets) and Delayed Matching-to-sample Test (DMS)-48. Test scores of M-ACE registration and recall scores were included. To examine the differences in test performances between the groups, we compared the number of subjects with test scores less than 1.5 standard deviation (SD) of the control scores. Comparisons between a-MCI and controls were drawn using Fisher's exact test and Mann-Whitney U tests. RESULTS M-ACE registration component ascertained on a 24-point scale failed to demonstrate any differences between a-MCI and controls (P = 0.665) as opposed to recall judged on a cumulative 10-point scale (P = 0.001). Significant differences were noted in RAVLT list learning (P < 0.001) and list recall (P = 0.003), WMS-III paragraph learning (P <0.001) and recall (P = 0.007), visual learning (P = 0.004) and recall (P = 0.001). CONCLUSIONS M-ACE recall scores are an effective screening tool to identify patients with suspected a-MCI. Both word list and paragraph learning and recall components have been found to be sensitive to concretely identify a-MCI and impairment on at least 2 tests should be considered in the diagnostic criteria of MCI rather than rely on a single screening battery.
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Affiliation(s)
- Ramshekhar Menon
- Department of Neurology, Cognition and Behavioural Neurology Section, Trivandrum, Kerala, India
| | - Vs Lekha
- Department of Neurology, Cognition and Behavioural Neurology Section, Trivandrum, Kerala, India
| | - Sunitha Justus
- Department of Neurology, Cognition and Behavioural Neurology Section, Trivandrum, Kerala, India
| | - P Sankara Sarma
- Department of Biostatistics, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ps Mathuranath
- Department of Neurology, Cognitive and Behavioural Neurology Section, National Institute for Mental Health and Neuro Sciences, Bangalore, Karnataka, India
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Nair V, Ayers E, Noone M, Johnson B, Verghese J. Depressive symptoms and mild cognitive impairment: results from the Kerala-Einstein study. J Am Geriatr Soc 2014; 62:197-9. [PMID: 25180388 DOI: 10.1111/jgs.12628] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cataract may be a non-memory feature of Alzheimer’s disease in older people. Eur J Epidemiol 2014; 29:405-9. [DOI: 10.1007/s10654-014-9903-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/11/2014] [Indexed: 01/05/2023]
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Goyal M, Grover S, Dhanjal JK, Goyal S, Tyagi C, Chacko S, Grover A. Novel natural structure corrector of ApoE4 for checking Alzheimer's disease: benefits from high throughput screening and molecular dynamics simulations. BIOMED RESEARCH INTERNATIONAL 2013; 2013:620793. [PMID: 24324968 PMCID: PMC3845489 DOI: 10.1155/2013/620793] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/01/2013] [Indexed: 01/22/2023]
Abstract
A major genetic suspect for Alzheimer's disease is the pathological conformation assumed by apolipoprotein E4 (ApoE4) through intramolecular interaction. In the present study, a large library of natural compounds was screened against ApoE4 to identify novel therapeutic molecules that can prevent ApoE4 from being converted to its pathological conformation. We report two such natural compounds PHC and IAH that bound to the active site of ApoE4 during the docking process. The binding analysis suggested that they have a strong mechanistic ability to correct the pathological structural orientation of ApoE4 by preventing repulsion between Arg 61 and Arg 112, thus inhibiting the formation of a salt bridge between Arg 61 and Glu 255. However, when the molecular dynamics simulations were carried out, structural changes in the PHC-bound complex forced PHC to move out of the cavity thus destabilizing the complex. However, IAH was structurally stable inside the binding pocket throughout the simulations trajectory. Our simulations results indicate that the initial receptor-ligand interaction observed after docking could be limited due to the receptor rigid docking algorithm and that the conformations and interactions observed after simulation runs are more energetically favored and should be better representations of derivative poses in the receptor.
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Affiliation(s)
- Manisha Goyal
- Apaji Institute of Mathematics & Applied Computer Technology, Banasthali University, Tonk, Rajasthan 304022, India
| | - Sonam Grover
- School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
| | - Jaspreet Kaur Dhanjal
- Department of Biotechnology, Delhi Technological University, New Delhi 110042, India
| | - Sukriti Goyal
- Apaji Institute of Mathematics & Applied Computer Technology, Banasthali University, Tonk, Rajasthan 304022, India
| | - Chetna Tyagi
- Apaji Institute of Mathematics & Applied Computer Technology, Banasthali University, Tonk, Rajasthan 304022, India
| | - Sajeev Chacko
- Thematic Unit of Excellence on Computational Materials Science, S. N. Bose National Centre for Basic Sciences, Sector III, Block JD, Salt Lake, Kolkata 700098, India
| | - Abhinav Grover
- School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
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Molecular modelling studies on flavonoid derivatives as dual site inhibitors of human acetyl cholinesterase using 3D-QSAR, pharmacophore and high throughput screening approaches. Med Chem Res 2013. [DOI: 10.1007/s00044-013-0810-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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