1
|
Kim CY, Kim J, Yoon S, Yi IJ, Lee H, Seo S, Kim DW, Ko S, Kim SA, Kwon C, Yi SS. Advancing the early detection of canine cognitive dysfunction syndrome with machine learning-enhanced blood-based biomarkers. Front Vet Sci 2024; 11:1390296. [PMID: 39170638 PMCID: PMC11335684 DOI: 10.3389/fvets.2024.1390296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024] Open
Abstract
Up to half of the senior dogs suffer from canine cognitive dysfunction syndrome (CCDS), the diagnosis method relies on subjective questionnaires such as canine cognitive dysfunction rating (CCDR) scores. Therefore, the necessity of objective diagnosis is emerging. Here, we developed blood-based biomarkers for CCDS early detection. Blood samples from dogs with CCDR scores above 25 were analyzed, and the biomarkers retinol-binding protein 4 (RBP4), C-X-C-motif chemokine ligand 10 (CXCL10), and NADPH oxidase 4 (NOX4) were validated against neurodegenerative models. Lower biomarker levels were correlated with higher CCDR scores, indicating cognitive decline. Machine-learning analysis revealed the highest predictive accuracy when analyzing the combination of RBP4 and NOX4 using the support vector machine algorithm and confirmed potential diagnostic biomarkers. These results suggest that blood-based biomarkers can notably improve CCDS early detection and treatment, with implications for neurodegenerative disease management in both animals and humans.
Collapse
Affiliation(s)
- Chae Young Kim
- BK21 Four program, Department of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Jinhye Kim
- iCONNECTOME, Co., Ltd., Cheonan, Republic of Korea
| | - Sunmi Yoon
- iCONNECTOME, Co., Ltd., Cheonan, Republic of Korea
| | - Isaac Jinwon Yi
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, United States
| | - Hyuna Lee
- iamdt, Co., Ltd., Seoul, Republic of Korea
| | - Sanghyuk Seo
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Dae Won Kim
- Department of Biochemistry and Molecular Biology, Research Institute of Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea
| | - Soohyun Ko
- GenesisEgo, Co., Ltd., Seoul, Republic of Korea
| | - Sun-A Kim
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | | | - Sun Shin Yi
- BK21 Four program, Department of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
- iCONNECTOME, Co., Ltd., Cheonan, Republic of Korea
- Department of Biomedical Laboratory Science, Soonchunhyang University, Asan, Republic of Korea
| |
Collapse
|
2
|
Haake J, Meller S, Meyerhoff N, Twele F, Charalambous M, Talbot SR, Volk HA. Comparing standard screening questionnaires of canine behavior for assessment of cognitive dysfunction. Front Vet Sci 2024; 11:1374511. [PMID: 38835892 PMCID: PMC11149356 DOI: 10.3389/fvets.2024.1374511] [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: 01/22/2024] [Accepted: 04/29/2024] [Indexed: 06/06/2024] Open
Abstract
Background Canine cognitive dysfunction (CCD) is a common, yet underdiagnosed neurodegenerative disease affecting older dogs. Treatment is most effective when started early, so identifying mild cognitive decline in the earlier stages of the disease is considered important. Hypothesis/objective To compare the results of three different standard screening questionnaires [Canine Dementia Scale (CADES), Canine Cognitive Assessment Scale (CCAS), and Canine Cognitive Dysfunction Rating Scale (CCDR)] for CCD diagnosis. Trainability, pain sensitivity, and fear were additionally assessed with the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) in order to evaluate associations between the three dementia scales and behavior. Methods An online survey containing all the mentioned questionnaires was designed for and distributed among owners of elderly dogs. Results Data from 597 dogs were analyzed. Overall, the scores of the three CCD questionnaires correlated well with each other, especially those of the CADES and CCAS. The CADES was more sensitive in identifying dogs with already mild to moderate cognitive impairment, while the others classified them as still undergoing normal aging. CCD scores increased for all questionnaires with age with spatial orientation being a key feature in CCD development. Trainability assessed with the C-BARQ decreased significantly with severity of CCD signs, while pain sensitivity increased. Fear and anxiety was pronounced in animals with mild but not with severe CCD. These associations based on the C-BARQ were more clearly observable in relation to CADES and CCDR than CCAS. Conclusion/clinical relevance The choice of screening questionnaire impacts the evaluation of cognitive status and severity of CCD. Thresholds for severity classification differ significantly and may have an impact on reliable assessment. Further longitudinal studies are required to determine which of the questionnaires investigated in this study is best suited for early detection of CCD.
Collapse
Affiliation(s)
- Julia Haake
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sebastian Meller
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Nina Meyerhoff
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Friederike Twele
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Marios Charalambous
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Steven R Talbot
- Institute for Laboratory Animal Science and Central Animal Laboratory, Hannover Medical School, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
- Center for Systems Neuroscience Hannover, Hannover, Germany
| |
Collapse
|
3
|
Turcsán B, Kubinyi E. Differential behavioral aging trajectories according to body size, expected lifespan, and head shape in dogs. GeroScience 2024; 46:1731-1754. [PMID: 37740140 PMCID: PMC10828231 DOI: 10.1007/s11357-023-00945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023] Open
Abstract
The twofold life expectancy difference between dog breeds predicts differential behavioral and cognitive aging patterns between short- and long-lived dogs. To investigate this prediction, we conducted a cross-sectional analysis using survey data from over 15,000 dogs. We examined the effect of expected lifespan and three related factors (body size, head shape, and purebred status) on the age trajectory of various behavioral characteristics and the prevalence of canine cognitive dysfunction (CCD). Our findings reveal that, although age-related decline in most behavioral characteristics began around 10.5 years of age, the proportion of dogs considered "old" by their owners began to increase uniformly around 6 years of age. From the investigated factors, only body size had a systematic, although not gradual, impact on the aging trajectories of all behavioral characteristics. Dogs weighing over 30 kg exhibited an earlier onset of decline by 2-3 years and a slower rate of decline compared to smaller dogs, probably as a byproduct of their faster age-related physical decline. Larger sized dogs also showed a lower prevalence of CCD risk in their oldest age group, whereas smaller-sized dogs, dolichocephalic breeds, and purebreds had a higher CCD risk prevalence. The identification of differential behavioral and cognitive aging trajectories across dog groups, and the observed associations between body size and the onset, rate, and degree of cognitive decline in dogs have significant translational implications for human aging research, providing valuable insights into the interplay between morphology, physiological ageing, and cognitive decline, and unravelling the trade-off between longevity and relative healthspan.
Collapse
Affiliation(s)
- Borbála Turcsán
- MTA-ELTE Lendület "Momentum" Companion Animal Research Group, Department of Ethology, Eötvös Loránd University, Budapest, Hungary.
- Senior Family Dog Project, Department of Ethology, Eötvös Loránd University, Budapest, Hungary.
| | - Enikő Kubinyi
- MTA-ELTE Lendület "Momentum" Companion Animal Research Group, Department of Ethology, Eötvös Loránd University, Budapest, Hungary
- Senior Family Dog Project, Department of Ethology, Eötvös Loránd University, Budapest, Hungary
- ELTE NAP Canine Brain Research Group, Budapest, Hungary
| |
Collapse
|
4
|
Taylor TL, Smith BP, Hazel SJ. Guardians' perceptions of caring for a dog with canine cognitive dysfunction. Vet Rec 2024; 194:e3266. [PMID: 37503693 DOI: 10.1002/vetr.3266] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/04/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Canine cognitive dysfunction (CCD) is a neurodegenerative disease that is difficult to diagnose, as its clinical signs are similar to those of other age-related conditions. The experience of caring for a senior dog with or without CCD is not well described. METHODS Data were collected via an online survey. Using a mixed methods design, the level of CCD and burden of care were measured using validated tools, and open-ended questions gathered qualitative data. A general linear model showed the factors associated with guardian burden of care. RESULTS Sixteen percent of guardians experienced a clinically significant burden of care. Factors associated with burden of care included severity of CCD, sleep location, guardian employment, household size, dog age, guardian age and the dog taking medication. Few dogs with CCD were prescribed CCD medications to ameliorate clinical signs. Euthanasia, strong attachment mitigating burden and the complexities of caregiving were themes presented by guardians. LIMITATIONS Measures are based on self-reports and as such the usual limitations apply. CONCLUSIONS The burden of caring for an older dog is greater if they have CCD. More attention to the treatment of senior dogs, including medications to reduce clinical signs of CCD, could improve the welfare of older dogs and decrease the clinical burden experienced by guardians.
Collapse
Affiliation(s)
- Tracey L Taylor
- Faculty of Sciences, Engineering and Technology, School of Animal and Veterinary Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Bradley P Smith
- College of Psychology, School of Human Health and Social Sciences, Central Queensland University Australia, Wayville, South Australia, Australia
| | - Susan J Hazel
- Faculty of Sciences, Engineering and Technology, School of Animal and Veterinary Sciences, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
5
|
Provoost L. Cognitive Changes Associated with Aging and Physical Disease in Dogs and Cats. Vet Clin North Am Small Anim Pract 2024; 54:101-119. [PMID: 37722947 DOI: 10.1016/j.cvsm.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Behavior changes may indicate primary physical disease or primary behavioral disorders in veterinary patients. It is imperative to recognize that secondary behavioral problems can develop due to medical causes. The incidence of systemic disease increases with age and behavior manifestations can be similar to those expected with cognitive dysfunction syndrome. In this article, we review basic concepts of cognition, aging, and cognitive dysfunction syndrome. Additionally, we provide information regarding factors that influence cognition, and the role medical conditions have on the behavior of aging pets.
Collapse
Affiliation(s)
- Lena Provoost
- Clinical Sciences & Advanced Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
6
|
Haake J, Meyerhoff N, Meller S, Twele F, Charalambous M, Wilke V, Volk H. Investigating Owner Use of Dietary Supplements in Dogs with Canine Cognitive Dysfunction. Animals (Basel) 2023; 13:3056. [PMID: 37835662 PMCID: PMC10571926 DOI: 10.3390/ani13193056] [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: 08/07/2023] [Revised: 09/10/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Canine cognitive dysfunction (CCD) is becoming increasingly recognized in veterinary medicine, as dogs live longer and with CCD being highly prevalent among the elderly dog population. Various studies have shown that diet and dietary supplementation can positively influence the clinical signs of CCD, especially if given at an early stage. The aim of this study was to investigate owner use of dietary supplements (DSs) in dogs with age-related behavioral changes. An observational study based on an online questionnaire for owners of dogs with age-related behavioral changes was performed. Out of a total of 394 owners who completed the survey, after noticing age-related behavioral changes, over half of the dogs received DSs (54%), whereas only 8% reported changing their dog's base diet. The most used DS was fish oil (48%). The use of DSs should be discussed with and monitored by veterinary surgeons since many geriatric patients have multi-morbidities, may have specific nutritional requirements and receive multi-faceted medications.
Collapse
Affiliation(s)
- Julia Haake
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Nina Meyerhoff
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Friederike Twele
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Marios Charalambous
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Volker Wilke
- Institute for Animal Nutrition, University of Veterinary Medicine, Foundation, 30173 Hannover, Germany;
| | - Holger Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| |
Collapse
|
7
|
Wrightson R, Albertini M, Pirrone F, McPeake K, Piotti P. The Relationship between Signs of Medical Conditions and Cognitive Decline in Senior Dogs. Animals (Basel) 2023; 13:2203. [PMID: 37443999 DOI: 10.3390/ani13132203] [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: 05/15/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Canine cognitive dysfunction syndrome (CCDS) is a progressive age-related neurodegenerative disorder in dogs. Minimal research has been performed to investigate how clinical signs may be impacted by other medical conditions. A cross-sectional study was performed using the Canine Cognitive Assessment Scale (CCAS) to evaluate cognitive impairment as reported by owners. Owner-reported health-related measures included behaviour changes, the body condition score, and veterinary diagnoses of disease. The responses from 804 dogs in the last 25% of their expected lifespan were analysed. Factors were identified in the owner-reported behavioural signs of disease representing pathologies in four body systems: musculoskeletal-neurological, digestive, metabolic, and dermatological, with the items comprising these factors also compiled into a cumulative measure of health. The results showed a strong correlation between the CCAS score and both the musculoskeletal-neurological factor and the overall cumulative measure of health. Moderate correlations between the CCAS score and the digestive factor and metabolic factor were also observed. The correlation between the dermatological factor and the CCAS score was weak. This study highlights the need to screen dogs for concurrent diseases when using scales to assess cognitive impairment and to monitor dogs who have health conditions, particularly those that are painful, for the onset of cognitive impairment.
Collapse
Affiliation(s)
- Rosalind Wrightson
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Mariangela Albertini
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Federica Pirrone
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Kevin McPeake
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Patrizia Piotti
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| |
Collapse
|
8
|
de Sousa AA, Rigby Dames BA, Graff EC, Mohamedelhassan R, Vassilopoulos T, Charvet CJ. Going beyond established model systems of Alzheimer's disease: companion animals provide novel insights into the neurobiology of aging. Commun Biol 2023; 6:655. [PMID: 37344566 DOI: 10.1038/s42003-023-05034-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by brain plaques, tangles, and cognitive impairment. AD is one of the most common age-related dementias in humans. Progress in characterizing AD and other age-related disorders is hindered by a perceived dearth of animal models that naturally reproduce diseases observed in humans. Mice and nonhuman primates are model systems used to understand human diseases. Still, these model systems lack many of the biological characteristics of Alzheimer-like diseases (e.g., plaques, tangles) as they grow older. In contrast, companion animal models (cats and dogs) age in ways that resemble humans. Both companion animal models and humans show evidence of brain atrophy, plaques, and tangles, as well as cognitive decline with age. We embrace a One Health perspective, which recognizes that the health of humans is connected to those of animals, and we illustrate how such a perspective can work synergistically to enhance human and animal health. A comparative biology perspective is ideally suited to integrate insights across veterinary and human medical disciplines and solve long-standing problems in aging.
Collapse
Affiliation(s)
- Alexandra A de Sousa
- Centre for Health and Cognition, Bath Spa University, Bath, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Brier A Rigby Dames
- Department of Psychology, University of Bath, Bath, UK
- Department of Computer Science, University of Bath, Bath, UK
- Department of Biology and Biochemistry, Milner Centre for Evolution, University of Bath, Bath, UK
| | - Emily C Graff
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Rania Mohamedelhassan
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Tatianna Vassilopoulos
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Christine J Charvet
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
| |
Collapse
|
9
|
Evaluation of Two Practical Tools to Assess Cognitive Impairment in Aged Dogs. Animals (Basel) 2022; 12:ani12243538. [PMID: 36552458 PMCID: PMC9774186 DOI: 10.3390/ani12243538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Cognitive dysfunction syndrome is the most common cause of cognitive decline in aged dogs. Early diagnosis is crucial because the sooner treatment is implemented, the greater the chance of slowing the progression of the disease. Assessment tools to assess cognitive decline may differ depending on the environment in which the dogs live. The aims of this study were threefold, first, to describe two feasible methods to evaluate cognitive impairment in aged dogs living in different environments: (i) a Canine Cognitive Assessment Scale (CCAS) for dogs living in a home environment and (ii) a practical cognitive test (PCT) potentially useful for dogs not living in a home environment (NHE); second, to assess the effect of age on the outcome of both tools and, finally, to compare the results of the CCAS with those of the PCT. Both methods were found to be practical to perform. Age was found to significantly predict the score obtained by the CCAS (p = 0.0011) and the outcome of the PCT (p = 0.009). However, the reversal phase from the PCT did not significantly predict the outcomes of the CCAS (p = 0.97). Taken together, these findings suggest that the CCAS is a practical method to evaluate age related cognitive changes in owned dogs. The fact that the PCT has not been proven to be related with the CCAS calls into question the use of the PCT as a sensitive tool to assess cognitive impairment. Further studies in this field are suggested.
Collapse
|
10
|
Mondino A, Gutiérrez M, González C, Mateos D, Torterolo P, Olby N, Delucchi L. Electroencephalographic signatures of dogs with presumptive diagnosis of canine cognitive dysfunction. Res Vet Sci 2022; 150:36-43. [DOI: 10.1016/j.rvsc.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
|
11
|
Brown K, Blake RS, Dennany L. Electrochemiluminescence within Veterinary Science: A Review. Bioelectrochemistry 2022; 146:108156. [DOI: 10.1016/j.bioelechem.2022.108156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
|
12
|
Nutrients, Cognitive Function, and Brain Aging: What We Have Learned from Dogs. Med Sci (Basel) 2021; 9:medsci9040072. [PMID: 34842769 PMCID: PMC8628994 DOI: 10.3390/medsci9040072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/29/2021] [Accepted: 11/13/2021] [Indexed: 12/29/2022] Open
Abstract
Due to a difference in genetics, environmental factors, and nutrition, just like in people, dogs age at different rates. Brain aging in people and dogs share similar morphological changes including irreversible cortical atrophy, cerebral amyloid angiopathy, and ventricular enlargement. Due to severe and irreversible brain atrophy, some aging dogs develop cognitive dysfunction syndrome (CDS), which is equivalent to dementia or Alzheimer’s disease (AD) in people. The risk factors and causes of CDS in dogs have not been fully investigated, but age, gender, oxidative stress, and deficiency of sex hormones appears to be associated with increased risk of accelerated brain aging and CDS in dogs. Both AD and CDS are incurable diseases at this moment, therefore more efforts should be focused on preventing or reducing brain atrophy and minimizing the risk of AD in people and CDS in dogs. Since brain atrophy leads to irreversible cognitive decline and dementia, an optimal nutritional solution should be able to not only enhance cognitive function during aging but also reduce irreversible brain atrophy. Up to now, only one nutritional intervention has demonstrated both cognition-enhancing benefits and atrophy-reducing benefits.
Collapse
|
13
|
O'Brian ML, Herron ME, Smith AM, Aarnes TK. Effects of a four-week group class created for dogs at least eight years of age on the development and progression of signs of cognitive dysfunction syndrome. J Am Vet Med Assoc 2021; 259:637-643. [PMID: 34448609 DOI: 10.2460/javma.259.6.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effects of a 4-week group class specifically created for dogs ≥ 8 years old (senior dogs) on the development and progression of signs consistent with cognitive dysfunction syndrome (CDS). ANIMALS 86 dogs with or without signs of CDS at the time of study enrollment. PROCEDURES Dog owners completed a proprietary CDS survey at baseline and then 3, 6, and 12 months after completion of the baseline survey. Twenty owners with their dogs attended 4 weekly 50-minute classes that were specifically developed for senior dogs, addressed common behavior problems for these dogs, and included training and enrichment activities. Survey results were compared between class and nonclass groups and within groups at 3, 6, and 12 months. RESULTS The association between age and CDS score was significant, such that older dogs had signs consistent with a higher degree of impairment. Cognitive dysfunction syndrome scores for dogs that attended the class did not significantly differ at 12 months, compared with scores at 3 months, whereas the CDS scores for dogs that did not attend the class were significantly increased at 12 months, compared with scores at 3 months. CONCLUSIONS AND CLINICAL RELEVANCE Signs of CDS developed or worsened as dogs aged. Participation in the senior dog class mitigated the progression of signs of CDS and may improve a senior dog's quality of life.
Collapse
|
14
|
Treatment of canine cognitive dysfunction with novel butyrylcholinesterase inhibitor. Sci Rep 2021; 11:18098. [PMID: 34518582 PMCID: PMC8438013 DOI: 10.1038/s41598-021-97404-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Canine cognitive dysfunction (CCD) is common in aged dogs and has many similarities with Alzheimer’s disease. Unfortunately, like Alzheimer’s disease, CCD cannot be cured. In the present study, we treated dogs with CCD with our newly developed and characterized butyrylcholinesterase inhibitor (BChEi). Seventeen dogs were randomized into two groups (treated with BChEi and untreated) and followed for 6 months at regular check-ups. The dogs’ cognitive status was determined by a Canine Dementia Scale (CADES) questionnaire and two cognitive tests. In dogs with moderate cognitive impairment, treatment caused significant improvement in the clinical rating of cognitive abilities and the performance-based tests of cognitive functioning when compared to the untreated group (p < 0.001). Dogs treated with BChEi showed markedly improved cognitive function with enhanced quality of life. No side effects were observed in the treated dogs with moderate cognitive impairment. According to the results of this preliminary study, there is an indication that novel BChEi may be a promising drug for the treatment of CCD in dogs and may be an interesting candidate for the treatment of Alzheimer's disease in humans. However, further clinical studies are needed to confirm this.
Collapse
|
15
|
Tanprasertsuk J, Tate DE, Shmalberg J. Roles of plant-based ingredients and phytonutrients in canine nutrition and health. J Anim Physiol Anim Nutr (Berl) 2021; 106:586-613. [PMID: 34495560 PMCID: PMC9291198 DOI: 10.1111/jpn.13626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/13/2021] [Accepted: 08/11/2021] [Indexed: 12/05/2022]
Abstract
Dogs possess the ability to obtain essential nutrients, established by the Association of American Feed Control Officials (AAFCO), from both animal‐ and plant‐based ingredients. There has been a recent increase in the popularity of diets that limit or completely exclude certain plant‐based ingredients. Examples of these diets include ‘ancestral’ or ‘evolutionary’ diets, raw meat‐based diets and grain‐free diets. As compared to animal sources, plant‐derived ingredients (including vegetables, fruits, grains, legumes, nuts and seeds) provide many non‐essential phytonutrients with some data suggesting they confer health benefits. This review aims to assess the strength of current evidence on the relationship between the consumption of plant‐based foods and phytonutrients (such as plant‐derived carotenoids, polyphenols and phytosterols) and biomarkers of health and diseases (such as body weight/condition, gastrointestinal health, immune health, cardiovascular health, visual function and cognitive function) from clinical trials and epidemiological studies. This review highlights the potential nutritional and health benefits of including plant‐based ingredients as a part of balanced canine diets. We also highlight current research gaps in existing studies and provide future research directions to inform the impact of incorporating plant‐based ingredients in commercial or home‐prepared diets.
Collapse
Affiliation(s)
| | | | - Justin Shmalberg
- NomNomNow Inc, Nashville, TN, USA.,Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
16
|
Successful and Unsuccessful Brain Aging in Pets: Pathophysiological Mechanisms behind Clinical Signs and Potential Benefits from Palmitoylethanolamide Nutritional Intervention. Animals (Basel) 2021; 11:ani11092584. [PMID: 34573549 PMCID: PMC8470385 DOI: 10.3390/ani11092584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Cognitive dysfunction syndrome is a common yet underreported neurodegenerative disorder of elderly dogs and cats and a natural model of human Alzheimer’s disease. The increasingly expanding life expectancy means a larger proportion of affected animals in the coming decades. Although far from being curative, available treatments are more effective the sooner they are started. Educating veterinary practitioners and owners in the early recognition of age-related cognitive dysfunction is thus mandatory. By shedding light on the mechanism underlying the disease, novel and more effective approaches might be developed. Emerging evidence shows that successful and unsuccessful brain aging share a common underlying mechanism that is neuroinflammation. This process involves astrocytes, microglia, and mast cells and has a restorative homeostatic intent. However, for reasons not fully elucidated yet, neuroinflammation can also exert detrimental consequences substantially contributing to neurodegeneration. Here we summarize the evidence accumulated so far on the pathogenic role of neuroinflammation in the onset and progression of age-related neurodegenerative disorders, such as Alzheimer’s disease. The potential benefit of palmitoylethanolamide dietary intervention in rebalancing neuroinflammation and exerting neuroprotection is also discussed. Abstract Canine and feline cognitive dysfunction syndrome is a common neurodegenerative disorder of old age and a natural model of human Alzheimer’s disease. With the unavoidable expanding life expectancy, an increasing number of small animals will be affected. Although there is no cure, early detection and intervention are vitally important to delay cognitive decline. Knowledge of cellular and molecular mechanisms underlying disease onset and progression is an equally decisive factor for developing effective approaches. Uncontrolled neuroinflammation, orchestrated in the central nervous system mainly by astrocytes, microglia, and resident mast cells, is currently acknowledged as a hallmark of neurodegeneration. This has prompted scientists to find a way to rebalance the altered crosstalk between these cells. In this context, great emphasis has been given to the role played by the expanded endocannabinoid system, i.e., endocannabinoidome, because of its prominent role in physiological and pathological neuroinflammation. Within the endocannabinoidome, great attention has been paid to palmitoylethanolamide due to its safe and pro-homeostatic effects. The availability of new ultramicronized formulations highly improved the oral bioavailability of palmitoylethanolamide, paving the way to its dietary use. Ultramicronized palmitoylethanolamide has been repeatedly tested in animal models of age-related neurodegeneration with promising results. Data accumulated so far suggest that supplementation with ultramicronized palmitoylethanolamide helps to accomplish successful brain aging.
Collapse
|
17
|
Marx A, Lenkei R, Pérez Fraga P, Wallis L, Kubinyi E, Faragó T. Age-dependent changes in dogs’ (Canis familiaris) separation-related behaviours in a longitudinal study. Appl Anim Behav Sci 2021. [DOI: 10.1016/j.applanim.2021.105422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Lazarowski L, Singletary M, Rogers B, Waggoner P. Development and Training for Working Dogs. Vet Clin North Am Small Anim Pract 2021; 51:921-931. [PMID: 34059264 DOI: 10.1016/j.cvsm.2021.04.009] [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: 10/21/2022]
Abstract
Individual differences in behavior lead to wide variability in working dog suitability, and are the primary reason for rejection or early release. Behavioral suitability of a working dog is shaped by interactions with its environment during early development and specialized training. Understanding how aspects of development and training affect a working dog's performance is critical for practitioners to effectively evaluate and treat behavioral concerns in working dogs. This article provides an overview of critical aspects of puppy development that influence future behavior, and reviews important features of training that influence a dog's ability to learn and perform its designated task.
Collapse
Affiliation(s)
- Lucia Lazarowski
- Canine Performance Sciences, 104 Greene Hall, Auburn, AL 36849, USA.
| | | | - Bart Rogers
- Canine Performance Sciences, 104 Greene Hall, Auburn, AL 36849, USA
| | - Paul Waggoner
- Canine Performance Sciences, 104 Greene Hall, Auburn, AL 36849, USA
| |
Collapse
|
19
|
Tynes VV, Landsberg GM. Nutritional Management of Behavior and Brain Disorders in Dogs and Cats. Vet Clin North Am Small Anim Pract 2021; 51:711-727. [PMID: 33773649 DOI: 10.1016/j.cvsm.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
There are several natural products and functional ingredients that, either alone or in combination with other ingredients, have shown evidence for decreasing signs associated with cognitive dysfunction and anxiety in dogs and cats, and in management of seizures in dogs with epilepsy. The evidence supporting the role that a healthy gastrointestinal tract plays in behavior is also growing as more is learned about the gut-brain axis. Nutritional support may play an important role in therapy for certain brain disorders and behavioral problems, in conjunction with other aspects of management. A multimodal approach provides the greatest likelihood of success.
Collapse
Affiliation(s)
- Valarie V Tynes
- Ceva Animal Health, LLC 8735 Rosehill Road, Suite 300 Lenexa, KS 66215, USA.
| | | |
Collapse
|
20
|
Phochantachinda S, Chantong B, Reamtong O, Chatchaisak D. Change in the plasma proteome associated with canine cognitive dysfunction syndrome (CCDS) in Thailand. BMC Vet Res 2021; 17:60. [PMID: 33514370 PMCID: PMC7845120 DOI: 10.1186/s12917-021-02744-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/01/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Canine cognitive dysfunction syndrome (CCDS) is a progressive neurodegenerative disorder found in senior dogs. Due to the lack of biological markers, CCDS is commonly underdiagnosed. The aim of this study was to identify potential plasma biomarkers using proteomics techniques and to increase our understanding of the pathogenic mechanism of the disease. Plasma amyloid beta 42 (Aβ42) has been seen to be a controversial biomarker for CCDS. Proteomics analysis was performed for protein identification and quantification. RESULTS Within CCDS, ageing, and adult dogs, 87 proteins were identified specific to Canis spp. in the plasma samples. Of 87 proteins, 48 and 41 proteins were changed in the ageing and adult groups, respectively. Several distinctly expressed plasma proteins identified in CCDS were involved in complement and coagulation cascades and the apolipoprotein metabolism pathway. Plasma Aβ42 levels considerably overlapped within the CCDS and ageing groups. In the adult group, the Aβ42 level was low compared with that in the other groups. Nevertheless, plasma Aβ42 did not show a correlation with the Canine Cognitive Dysfunction Rating scale (CCDR) score in the CCDS group (p = 0.131, R2 = 0.261). CONCLUSIONS Our present findings suggest that plasma Aβ42 does not show potential for use as a diagnostic biomarker in CCDS. The nano-LC-MS/MS data revealed that the predictive underlying mechanism of CCDS was the co-occurrence of inflammation-mediated acute phase response proteins and complement and coagulation cascades that partly functioned by apolipoproteins and lipid metabolism. Some of the differentially expressed proteins may serve as potential predictor biomarkers along with Aβ42 in plasma for improved CCDS diagnosis. Further study in larger population-based cohort study is required in validation to define the correlation between protein expression and the pathogenesis of CCDS.
Collapse
Affiliation(s)
- Sataporn Phochantachinda
- Faculty of Veterinary Science, Mahidol University, Salaya, Phutthamonthon, Nakorn Pathom, 73170, Thailand
| | - Boonrat Chantong
- Department of Pre-Clinical and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Salaya, Phutthamonthon, Nakorn Pathom, 73170, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Duangthip Chatchaisak
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Salaya, Phutthamonthon, Nakorn Pathom, 73170, Thailand.
| |
Collapse
|
21
|
Vikartovska Z, Farbakova J, Smolek T, Hanes J, Zilka N, Hornakova L, Humenik F, Maloveska M, Hudakova N, Cizkova D. Novel Diagnostic Tools for Identifying Cognitive Impairment in Dogs: Behavior, Biomarkers, and Pathology. Front Vet Sci 2021; 7:551895. [PMID: 33521072 PMCID: PMC7843503 DOI: 10.3389/fvets.2020.551895] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/07/2020] [Indexed: 12/31/2022] Open
Abstract
Canine cognitive dysfunction syndrome (CCDS) is a progressive neurodegenerative disorder in senior dogs that is mainly associated with decreased ability to learn and respond to stimuli. It is commonly under-diagnosed because behavioral changes are often attributed to the natural process of aging. In the present study, we used for the first time a comprehensive approach enabling early diagnosis of canine patients with mild cognitive disorders (MiCI). We included CAnine DEmentia Scale (CADES) questionnaires, biochemical parameters, and biomarkers in blood serum, and correlated them with post-mortem histopathological changes. The CADES questionnaires enabled us to identify MiCI dogs developing changes mainly in domains corresponding to social interaction and spatial orientation, which seems to be crucial for delineating early cognitive disorders. Biochemical analyses in these dogs showed slightly elevated liver enzyme parameters (AST and ALT) and significantly decreased sodium and chloride levels in blood serum. Furthermore, we describe for the first time a significant increase of neurofilament light chain (NFL) in blood serum of MiCI dogs, compared to normal aging seniors and young controls, but no changes in TAU protein and amyloid-β (Aβ42) peptide levels. In canine brains with cognitive impairment, amyloid plaques of mainly diffuse and dense types were detected. Furthermore, activated microglia with amoeboid body and dystrophic processes occurred, in some cases with spheroidal and bulbous swellings. On the other hand, no TAU pathology or neurofibrillary tangles were detected. These results suggest that a combination of CADES questionnaire mainly with CNS injury biomarker (NFL) and with biochemical parameters (ALT, AST, Na, and Cl) in blood serum may predict CCDS in senior dogs.
Collapse
Affiliation(s)
- Zuzana Vikartovska
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Jana Farbakova
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Tomas Smolek
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia.,Neuroimunology Institute, n.p.o., Bratislava, Slovakia
| | - Jozef Hanes
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Norbert Zilka
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lubica Hornakova
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Filip Humenik
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Marcela Maloveska
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Nikola Hudakova
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Dasa Cizkova
- Center for Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia.,Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| |
Collapse
|
22
|
Murray JK, Kinsman RH, Lord MS, Da Costa REP, Woodward JL, Owczarczak-Garstecka SC, Tasker S, Knowles TG, Casey RA. 'Generation Pup' - protocol for a longitudinal study of dog behaviour and health. BMC Vet Res 2021; 17:1. [PMID: 33397375 PMCID: PMC7781182 DOI: 10.1186/s12917-020-02730-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Despite extensive research, many questions remain unanswered about common problems that impact dog welfare, particularly where there are multiple contributing factors that can occur months or years before the problem becomes apparent. The Generation Pup study is the first longitudinal study of dogs that recruits pure- and mixed-breed puppies, aiming to investigate the relative influence of environmental and genetic factors on a range of health and behaviour outcomes, (including separation related behaviour, aggression to familiar/unfamiliar people or dogs and obesity). This paper describes the study protocol in detail. METHODS Prior to commencing recruitment of puppies, the study infrastructure was developed, and subject specialists were consulted to inform data collection methodology. Questionnaire content and timepoint(s) for data collection for outcomes and potential predictors were chosen with the aim of providing the best opportunity of achieving the aims of the study, subject to time and funding constraints. Recruitment of puppies (< 16 weeks, or < 21 weeks of age if entering the United Kingdom or Republic of Ireland through quarantine) is underway. By 23 January 2020, 3726 puppies had been registered, with registration continuing until 10,000 puppies are recruited. Data collection encompasses owner-completed questionnaires issued at set timepoints throughout the dog's life, covering aspects such as training, diet, exercise, canine behaviour, preventative health care, clinical signs and veterinary intervention. Owners can elect to submit additional data (health cards completed by veterinary professionals, canine biological samples) and/or provide consent for access to veterinary clinical notes. Incidence and breed associations will be calculated for conditions for which there is currently limited information (e.g. separation related behaviour). Multivariable statistical analysis will be conducted on a range of outcomes that occur throughout different life stages, with the aim of identifying modifiable risk factors that can be used to improve canine health and welfare. DISCUSSION The Generation Pup project is designed to identify associations between early-life environment, genotypic make-up and outcomes at different life stages. Modifiable risk factors can be used to improve canine health and welfare. Research collaboration with subject specialists is welcomed and already underway within the fields of orthopaedic research, epilepsy, epigenetics and canine impulsivity.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Séverine Tasker
- Linnaeus Group, Shirley, West Midlands, UK
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | | |
Collapse
|
23
|
Individual and group level personality change across the lifespan in dogs. Sci Rep 2020; 10:17276. [PMID: 33057125 PMCID: PMC7560605 DOI: 10.1038/s41598-020-74310-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/25/2020] [Indexed: 02/08/2023] Open
Abstract
In humans, age-related changes in personality occur in a non-random fashion with respect to their direction, timing, and magnitude. In dogs, there are still gaps in our knowledge about the detailed dynamics of age-related personality changes. We analysed the personality of 217 Border collies aged from 0.5 to 15 years both cross-sectionally and longitudinally using a test battery, to specify age periods when changes most prominently occur, assess the magnitude of changes, and analyse individual differences in personality change. We found that similar to humans, changes in personality occur unevenly during the dogs’ life course, however, their dynamics seems to be specific for each trait. Activity-independence decreased mostly from puppyhood (0.5–1 years) to adolescence (> 1–2 years), then continued to decrease in a slowing rate. Novelty seeking did not change markedly until middle age (> 3–6 years), then showed a steady linear decrease. Problem orientation increased strongly until middle age then showed no marked changes in later age periods. We also revealed individual differences in personality change over time, and showed that a few individuals with potential age-related impairments significantly affected the general age trajectory of some traits. These results raise caution against the over-generalisation of global age trends in dogs.
Collapse
|
24
|
Zbóril S, Schmidt AP, Oses JP, Wiener CD, Portela LV, Souza DO, Auler JOC, Carmona MJC, Fugita MS, Flor PB, Cortopassi SRG. S100B protein and neuron-specific enolase as predictors of postoperative cognitive dysfunction in aged dogs: a case-control study. Vet Anaesth Analg 2020; 47:740-747. [PMID: 32800537 DOI: 10.1016/j.vaa.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Postoperative cognitive dysfunction (POCD) may be related to brain injury. S100B protein and neuron-specific enolase (NSE) have been investigated as potential biochemical markers of neural cell injury in animals and humans. This study aimed to investigate the association between POCD, brain injury and serum concentrations of S100B and NSE after periodontal surgery in aged dogs. STUDY DESIGN Prospective observational animal study. ANIMALS A total of 24 male and female dogs undergoing periodontal surgery. METHODS Dogs were separated into two groups based on age: control group, 10 dogs ≤ 8 years and aged group, 14 dogs > 8 years. Cognitive function was measured preoperatively and on the seventh postoperative day using the Canine Cognitive Dysfunction Rating scale and the Age-Related Cognitive and Affective Disorders scale. S100B protein and NSE serum concentrations were measured before and immediately after the surgery. RESULTS POCD was not observed after surgery in the present study. Serum concentrations of S100B and NSE were increased postoperatively in the control group but not in the aged group (p = 0.04 and 0.03, respectively). Preoperative S100B serum concentrations were significantly higher in the aged group (p = 0.01). CONCLUSIONS There was no association between POCD and high concentrations of S100B and NSE in dogs. However, increased postoperative serum concentrations of S100B and NSE were found in the control group after surgery, an effect that may indicate neural damage. CLINICAL RELEVANCE The results suggest that anesthesia and oral surgery are associated with higher postoperative serum concentrations of S100B and NSE in dogs ≤ 8 years old, which may indicate neural damage. Serum concentrations of S100B were elevated in aged dogs before anesthesia, a finding that might be related to chronic preoperative brain damage.
Collapse
Affiliation(s)
- Sabrina Zbóril
- Department of Surgery, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - André P Schmidt
- Department of Biochemistry, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Department of Anesthesia and Perioperative Medicine, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil; Department of Anesthesia, Santa Casa de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil; Department of Anesthesia, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil.
| | - Jean P Oses
- Postgraduate Program in Biochemistry and Molecular Biology, Setor de Bioquímica, Instituto de Biociências, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Carolina D Wiener
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Luis V Portela
- Department of Biochemistry, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Diogo O Souza
- Department of Biochemistry, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - José O C Auler
- Disciplina de Anestesiologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade de Sao Paulo (USP), São Paulo, SP, Brazil
| | - Maria J C Carmona
- Disciplina de Anestesiologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade de Sao Paulo (USP), São Paulo, SP, Brazil
| | - Mariana S Fugita
- Department of Surgery, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Patricia B Flor
- Department of Surgery, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Silvia R G Cortopassi
- Department of Surgery, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| |
Collapse
|
25
|
Stylianaki I, Polizopoulou ZS, Theodoridis A, Koutouzidou G, Baka R, Papaioannou NG. Amyloid-beta plasma and cerebrospinal fluid biomarkers in aged dogs with cognitive dysfunction syndrome. J Vet Intern Med 2020; 34:1532-1540. [PMID: 32557873 PMCID: PMC7379053 DOI: 10.1111/jvim.15812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/02/2020] [Accepted: 05/08/2020] [Indexed: 01/03/2023] Open
Abstract
Background Cognitive dysfunction syndrome (CDS) is a common progressive neurodegenerative disease that is poorly defined. Specific multitargeted protocols do not exist for setting the diagnosis and the prognosis of the syndrome. Hypothesis/Objectives To quantify Aβ42 and Aβ40 peptides in blood and cerebrospinal fluid (CSF) and to investigate their contribution to CCDS. Animals A total of 61 dogs from a hospital population. Methods Case‐control study. Six young (YG: 0‐4 years old), 8 middle‐aged (4‐8 years old), 17 cognitively unimpaired and aged (CU: 8‐20 years old), and 30 cognitively impaired and aged (CI: 8‐17 years). From the CI group, 10 dogs exhibited mild impairment (CI‐MCI) and 20 exhibited severe impairment (CI‐SCI). Cognitive status was assessed using a validated owner‐based questionnaire. Direct and indirect Aβ markers were determined in plasma fractions (total‐TP, free‐FP, bound to plasma components‐CP) and CSF using commercial ELISA assays (AΒtest, Araclon Biotech). Results TPAβ42/40 facilitated discrimination between CI‐MCI and CU aged dogs with area under curve ≥ 0.79. CSFAβ42 levels were higher (P = .09) in CU (1.25 ± 0.28 ng/mL) than in MCI (1.04 ± 0.32 ng/mL) dogs. CSF Aβ42 levels were correlated with the CP fragment (CPAβ40: P = .02, CPAβ42: P = .02). CPAβ42 was higher in the CI‐MCI (23.03 ± 11.79 pg/μL) group compared to the other aged dogs (CU: 10.42 ± 7.18 pg/μL, P = .02, SCI: 11.40 ± 12.98 pg/μL, P = .26). Conclusion and Clinical Importance The Aβ should be determined in all of the 3 plasma fractions (TP, FP, CP). In the clinical approach, TPAβ42/40 could be used as an efficient preselection tool for the aged canine population targeting dogs with mild cognitive impairment.
Collapse
Affiliation(s)
- Ioanna Stylianaki
- Department of Pathology, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zoe S Polizopoulou
- Diagnostic Laboratory, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Theodoridis
- Laboratory of Animal Production Economics, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Koutouzidou
- Department of Applied Informatics, University of Macedonia, Thessaloniki, Greece
| | - Rania Baka
- Diagnostic Laboratory, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos G Papaioannou
- Department of Pathology, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
26
|
Story BD, Miller ME, Bradbury AM, Million ED, Duan D, Taghian T, Faissler D, Fernau D, Beecy SJ, Gray-Edwards HL. Canine Models of Inherited Musculoskeletal and Neurodegenerative Diseases. Front Vet Sci 2020; 7:80. [PMID: 32219101 PMCID: PMC7078110 DOI: 10.3389/fvets.2020.00080] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/31/2020] [Indexed: 12/11/2022] Open
Abstract
Mouse models of human disease remain the bread and butter of modern biology and therapeutic discovery. Nonetheless, more often than not mouse models do not reproduce the pathophysiology of the human conditions they are designed to mimic. Naturally occurring large animal models have predominantly been found in companion animals or livestock because of their emotional or economic value to modern society and, unlike mice, often recapitulate the human disease state. In particular, numerous models have been discovered in dogs and have a fundamental role in bridging proof of concept studies in mice to human clinical trials. The present article is a review that highlights current canine models of human diseases, including Alzheimer's disease, degenerative myelopathy, neuronal ceroid lipofuscinosis, globoid cell leukodystrophy, Duchenne muscular dystrophy, mucopolysaccharidosis, and fucosidosis. The goal of the review is to discuss canine and human neurodegenerative pathophysiologic similarities, introduce the animal models, and shed light on the ability of canine models to facilitate current and future treatment trials.
Collapse
Affiliation(s)
- Brett D. Story
- Auburn University College of Veterinary Medicine, Auburn, AL, United States
- University of Florida College of Veterinary Medicine, Gainesville, FL, United States
| | - Matthew E. Miller
- Auburn University College of Veterinary Medicine, Auburn, AL, United States
| | - Allison M. Bradbury
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Emily D. Million
- Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Dongsheng Duan
- Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, United States
- Department of Biomedical, Biological and Chemical Engineering, College of Engineering, University of Missouri, Columbia, MO, United States
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
- Department of Neurology, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Toloo Taghian
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
| | - Dominik Faissler
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States
| | - Deborah Fernau
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sidney J. Beecy
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States
| | - Heather L. Gray-Edwards
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, United States
| |
Collapse
|
27
|
Pero ME, Cortese L, Mastellone V, Tudisco R, Musco N, Scandurra A, D'Aniello B, Vassalotti G, Bartolini F, Lombardi P. Effects of a Nutritional Supplement on Cognitive Function in Aged Dogs and on Synaptic Function of Primary Cultured Neurons. Animals (Basel) 2019; 9:ani9070393. [PMID: 31252640 PMCID: PMC6680659 DOI: 10.3390/ani9070393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/10/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022] Open
Abstract
Simple Summary We tested the effects of a nutraceutical product, DiSeniorTM, by spatial navigation test and by in vitro and in vivo experiments. Results showed that DiSeniorTM was safe and able to ameliorate cognitive functions in aged dogs, as demonstrated by the better performances in the treated with respect the untreated groups. The increase of cFOS, a functional marker of activity in cultured neurons, indicated a positive effect of the substance on neuronal functions. The study suggests that DiSeniorTM can improve the quality of life of elderly dogs and may slow the onset of cognitive dysfunction symptoms associated with aging. Abstract The objective of this research was to investigate the efficacy of DìSeniorTM, a nutraceutical formulated to improve cognitive functions in elderly dogs. To this purpose, some clinical and metabolic investigations and a spatial navigation test were performed in treated and untreated dogs. Moreover, the nutraceutical was also tested on primary hippocampal neuron cultures. Results showed no adverse effects on the dogs’ health and a positive effect on learning. In vitro effects on neuron cultures showed an increase in the level of cFOS in treated neurons compared with the vehicle, suggesting that DiSeniorTM has also a positive effect on neuronal functions. Overall, this study suggests that DiSeniorTM can exert a beneficial effect on aged dogs by preventing the negative effects of aging on cognition. Further studies are needed to assess the mechanisms by which it acts on neurons and the specific effect of the different components alone or combined.
Collapse
Affiliation(s)
- Maria Elena Pero
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
- Department of Pathology, Anatomy and Cell Biology, Columbia University, New York, NY 10032, USA
| | - Laura Cortese
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| | - Vincenzo Mastellone
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| | - Raffaella Tudisco
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| | - Nadia Musco
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| | - Anna Scandurra
- Department of Biology, University of Naples Federico II, Via Cinthia 21, 80126 Naples, Italy.
| | - Biagio D'Aniello
- Department of Biology, University of Naples Federico II, Via Cinthia 21, 80126 Naples, Italy
| | - Giuseppe Vassalotti
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| | - Francesca Bartolini
- Department of Pathology, Anatomy and Cell Biology, Columbia University, New York, NY 10032, USA
| | - Pietro Lombardi
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Via Delpino 1, 80137 Naples, Italy
| |
Collapse
|
28
|
Prpar Mihevc S, Majdič G. Canine Cognitive Dysfunction and Alzheimer's Disease - Two Facets of the Same Disease? Front Neurosci 2019; 13:604. [PMID: 31249505 PMCID: PMC6582309 DOI: 10.3389/fnins.2019.00604] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 05/27/2019] [Indexed: 12/13/2022] Open
Abstract
Neurodegenerative diseases present a major and increasing burden in the societies worldwide. With aging populations, the prevalence of neurodegenerative diseases is increasing, yet there are no effective cures and very few treatment options are available. Alzheimer's disease is one of the most prevalent neurodegenerative conditions and although the pathology is well studied, the pathogenesis of this debilitating illness is still poorly understood. This is, among other reasons, also due to the lack of good animal models as laboratory rodents do not develop spontaneous neurodegenerative diseases and human Alzheimer's disease is only partially mimicked by transgenic rodent models. On the other hand, older dogs commonly develop canine cognitive dysfunction, a disease that is similar to Alzheimer's disease in many aspects. Dogs show cognitive deficits that could be paralleled to human symptoms such as disorientation, memory loss, changes in behavior, and in their brains, beta amyloid plaques are commonly detected both in extracellular space as senile plaques and around the blood vessels. Dogs could be therefore potentially a very good model for studying pathological process and novel treatment options for Alzheimer's disease. In the present article, we will review the current knowledge about the pathogenesis of canine cognitive dysfunction, its similarities and dissimilarities with Alzheimer's disease, and developments of novel treatments for these two diseases with a focus on canine cognitive dysfunction.
Collapse
Affiliation(s)
- Sonja Prpar Mihevc
- Veterinary Faculty, Institute for Preclinical Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Majdič
- Veterinary Faculty, Institute for Preclinical Sciences, University of Ljubljana, Ljubljana, Slovenia
- Medical Faculty, Institute for Physiology, University of Maribor, Maribor, Slovenia
| |
Collapse
|
29
|
Pan Y, Landsberg G, Mougeot I, Kelly S, Xu H, Bhatnagar S, Gardner CL, Milgram NW. Efficacy of a Therapeutic Diet on Dogs With Signs of Cognitive Dysfunction Syndrome (CDS): A Prospective Double Blinded Placebo Controlled Clinical Study. Front Nutr 2018; 5:127. [PMID: 30619873 PMCID: PMC6299068 DOI: 10.3389/fnut.2018.00127] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/28/2018] [Indexed: 02/04/2023] Open
Abstract
Cognitive dysfunction syndrome (CDS) is a common condition in senior dogs, which may be analogous to dementia such as Alzheimer's disease (AD) in people. In humans, AD has been associated with many risk factors such as reduced cerebral glucose metabolism, docosahexaenoic acid (DHA) deficiency, chronic oxidative stress, and chronic inflammation. By targeting some of these risk factors, we have developed two nutritional solutions (medium chain triglyceride, MCT and Brain Protection Blend, BPB) to enhance cognitive function and slow aging-induced cognitive decline. These have been positively evaluated in colony housed senior dogs and cats. The objective of this clinical study was to evaluate the effects of diets with MCTs and the BPB on client-owned dogs with CDS. Participating veterinary clinics screened senior dogs for signs of CDS as determined by a Senior Canine Behavior Questionnaire and a Canine Medical Health Questionnaire. Eighty-seven dogs were randomly enrolled into one of three diet groups with 29 dogs per group: Control, 6.5% MCT oil + BPB (6.5% MCT diet), 9% MCT oil + BPB (9% MCT diet). Diets were fed for a period of 90 days, and each dog's CDS signs were re-evaluated at day 30 and day 90. All 6 categories of the CDS signs were significantly improved (p <0.05) in the dogs given the 6.5% MCT diet at the end of the 90-day study. Control only improved in 4 out 6 categories. The 9% MCT diet only improved in dogs that accepted the diet. The results from this dog study confirm the benefits of MCT and BPB in managing clinical signs of CDS in dogs. The results support our hypothesis that targeting known risk factors associated with brain aging and AD is able to improve symptoms of CDS in dogs. These data may facilitate the development of similar nutrient blends to manage MCI and AD.
Collapse
Affiliation(s)
- Yuanlong Pan
- Nestlé Purina Research, St. Louis, MO, United States
| | | | | | | | - Hui Xu
- Nestlé Purina Research, St. Louis, MO, United States
| | | | | | | |
Collapse
|
30
|
Krug F, Tillmann M, Piñeiro M, Mendes C, Capella S, Bruhn F, Nobre M. Avaliação diagnóstica na síndrome disfunção cognitiva canina. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do presente estudo foi avaliar o questionário observacional e os testes de reatividade como forma de triagem e diagnóstico da disfunção cognitiva em cães idosos. Foram estudados 10 cães acima de sete anos, que apresentavam queixas comportamentais. Foi utilizado questionário que abordava questões comportamentais, como desorientação, atividade, interação socioambiental, alterações no padrão do sono e casa-sujidade. As respostas foram convertidas em pontuações, cujo somatório classificou o cão com disfunção cognitiva canina (DCC), ou borderline (BL), ou sem alterações comportamentais (SAC). Logo depois, foram realizados, em todos os cães, os seguintes testes cognitivos: open field, curiosidade, interação com humano e com espelho. Pela avaliação do questionário, foi determinado que dois cães tinham DCC, três eram BL, cinco eram SAC. Os cães classificados com DCC tinham idade superior aos demais e apresentaram alterações em todos os testes de reatividade, enquanto os cães BL apresentaram alterações em dois testes de reatividade e os SAC não apresentaram alterações. Conclui-se que, com o aumento da expectativa de vida canina, o questionário observacional foi um instrumento de triagem para a identificação dos cães classificados com DCC, BL e SAC, e os testes de reatividade como um método inovador para identificar o verdadeiro estado cognitivo dos pacientes idosos.
Collapse
|
31
|
Szabó D, Miklósi Á, Kubinyi E. Owner reported sensory impairments affect behavioural signs associated with cognitive decline in dogs. Behav Processes 2018; 157:354-360. [PMID: 30055284 DOI: 10.1016/j.beproc.2018.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022]
Abstract
To describe the extent of age-related cognitive decline in dogs, information regarding the baseline occurrence of associated behaviours in the general population is necessary. With a seven-item, data driven Age-Related Changes scale, we evaluated the relationship between sensory functions, training, sex, and the occurrence of behavioural signs associated with cognitive decline across the whole adult lifespan. The twofold difference in lifespan between small and large dogs presents challenges for ageing studies, with no widely accepted method to control for body size as it relates to chronological age and longevity, when comparing behavioural signs of cognitive decline. To address this issue, we utilized relative age, calculated using the estimated expected lifespan of the individuals in our questionnaire study. Signs of cognitive decline were already detectable in' Mature' dogs (at 50-75% of the expected lifespan). Visual, auditory and olfactory impairments all resulted in significantly higher scores on the Age-Related Changes scale. Participating in dog training activities was revealed to be protective against behavioural signs of cognitive decline in aged dogs as perceived by the owners. These results revealed possible beneficial effects of training on cognitive ageing and emphasize the importance of routinely screening the sensory capacities of ageing dogs.
Collapse
Affiliation(s)
- Dóra Szabó
- Department of Ethology, Eötvös Loránd University; Budapest, Hungary.
| | - Ádám Miklósi
- Department of Ethology, Eötvös Loránd University; Budapest, Hungary; MTA-ELTE Comparative Ethology Research Group, Budapest, Hungary
| | - Enikő Kubinyi
- Department of Ethology, Eötvös Loránd University; Budapest, Hungary
| |
Collapse
|
32
|
Ansari Mood M, Rafie SM, Masouleh MN, Aldavood SJ. Prevalence and risk factors of “cognitive dysfunction syndrome” in geriatric dogs in Tehran. J Vet Behav 2018. [DOI: 10.1016/j.jveb.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Abstract
Behavioral problems of companion animals are becoming more widely recognized. As a result, there are a growing number of behavioral nutraceuticals and diets on the market. These products may be useful for the treatment of mild conditions, for clients who are hesitant to give their pet a psychopharmacologic agent, or sometimes in conjunction with psychopharmacologic agents. Veterinarians should critically review the research associated with nutraceuticals and diets, and have an understanding of the functional ingredients and their mechanisms of action before prescribing treatment. This article provides an overview of nutraceuticals, their mechanisms of action, and relevant research regarding their use.
Collapse
|
34
|
Packer RMA, McGreevy PD, Salvin HE, Valenzuela MJ, Chaplin CM, Volk HA. Cognitive dysfunction in naturally occurring canine idiopathic epilepsy. PLoS One 2018; 13:e0192182. [PMID: 29420639 PMCID: PMC5805257 DOI: 10.1371/journal.pone.0192182] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/17/2018] [Indexed: 12/27/2022] Open
Abstract
Globally, epilepsy is a common serious brain disorder. In addition to seizure activity, epilepsy is associated with cognitive impairments including static cognitive impairments present at onset, progressive seizure-induced impairments and co-morbid dementia. Epilepsy occurs naturally in domestic dogs but its impact on canine cognition has yet to be studied, despite canine cognitive dysfunction (CCD) recognised as a spontaneous model of dementia. Here we use data from a psychometrically validated tool, the canine cognitive dysfunction rating (CCDR) scale, to compare cognitive dysfunction in dogs diagnosed with idiopathic epilepsy (IE) with controls while accounting for age. An online cross-sectional study resulted in a sample of 4051 dogs, of which n = 286 had been diagnosed with IE. Four factors were significantly associated with a diagnosis of CCD (above the diagnostic cut-off of CCDR ≥50): (i) epilepsy diagnosis: dogs with epilepsy were at higher risk; (ii) age: older dogs were at higher risk; (iii) weight: lighter dogs (kg) were at higher risk; (iv) training history: dogs with more exposure to training activities were at lower risk. Impairments in memory were most common in dogs with IE, but progression of impairments was not observed compared to controls. A significant interaction between epilepsy and age was identified, with IE dogs exhibiting a higher risk of CCD at a young age, while control dogs followed the expected pattern of low-risk throughout middle age, with risk increasing exponentially in geriatric years. Within the IE sub-population, dogs with a history of cluster seizures and high seizure frequency had higher CCDR scores. The age of onset, nature and progression of cognitive impairment in the current IE dogs appear divergent from those classically seen in CCD. Longitudinal monitoring of cognitive function from seizure onset is required to further characterise these impairments.
Collapse
Affiliation(s)
- Rowena M. A. Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Paul D. McGreevy
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales, Australia
| | - Hannah E. Salvin
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales, Australia
| | - Michael J. Valenzuela
- Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Chloe M. Chaplin
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Holger A. Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| |
Collapse
|
35
|
Katina S, Farbakova J, Madari A, Novak M, Zilka N. Risk factors for canine cognitive dysfunction syndrome in Slovakia. Acta Vet Scand 2016; 58:17. [PMID: 26927954 PMCID: PMC4772312 DOI: 10.1186/s13028-016-0196-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 02/09/2016] [Indexed: 12/30/2022] Open
Abstract
Background Increasing prevalence of cognitive impairment in an aging canine population poses a serious health problem. Identifying risk factors, which may influence the onset of cognitive decline, is becoming increasingly important. Here we investigated whether age, sex, weight, nutrition, dogs’ housing and reproductive state were associated with increased risk of canine cognitive dysfunction syndrome (CCDS) in Slovakia. Results Age was associated with cognitive decline and nutrition emerged as a significant predictor variable. Dogs fed controlled diets had 2.8 times lower odds of developing CCDS when compared with dogs fed uncontrolled diets. Sex, weight, reproductive state and dogs’ housing were not significantly associated with cognitive decline. Further, the prevalence of CCDS was similar in both small and medium/large sized dogs aged 8–11 years, but differed in dogs at an age of 11–13 years. Conclusion Age was found to be the most prominent risk factors of CCDS. Nutrition may influence the cognitive state of dogs. This finding suggests that nutritional interventions may modify canine cognitive functions.
Collapse
|
36
|
Ozawa M, Chambers JK, Uchida K, Nakayama H. The Relation between canine cognitive dysfunction and age-related brain lesions. J Vet Med Sci 2016; 78:997-1006. [PMID: 26922972 PMCID: PMC4937160 DOI: 10.1292/jvms.15-0624] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Canine cognitive dysfunction (CCD) is a syndrome that manifests itself in abnormal behaviors, such as
disorientation and wandering. β-amyloid deposition in the brain, including the senile plaque (SP) and cerebral
amyloid angiopathy (CAA), has been suggested as a major cause of the syndrome. However, the pathological
significance of β-amyloid deposition in CCD dogs remains unclear. The present study was conducted using 16
dogs aged 10 years or older to clarify the relationship between the age-related histopathological lesions,
such as β-amyloid deposition, in the brain and the clinical symptoms of CCD as evaluated in a questionnaire
previously established in a large survey. In addition, age-related brain lesions were assessed in 37 dogs. The
pathological lesions were evaluated by the severity of β-amyloid deposition (SP and CAA), the amount of
ubiquitin-positive granules (UBQ), GFAP-positive astrocytes, Iba-1-positive microglia and Nissle
stain-positive nerve cells. The results revealed that there was no significant correlation between the
severities of canine SP and CCD. The SP increased until 14 years old, but decreased thereafter, although the
incidence of CCD is high at these ages. The CAA consistently increased with age, but did not correlate greatly
with the CCD score. In contrast, the increases of UBQ, astrocytes and microglia were significantly correlated
with CCD. Thus, the impairment in the synapse and/or myelin suggested by increased UBQ and glial activation
might be involved in CCD pathogenesis, but β-amyloid deposition, especially SP, is not a direct pathogenic
factor of CCD.
Collapse
Affiliation(s)
- Makiko Ozawa
- Department of Veterinary Pathology, the University of Tokyo, Tokyo 113-8657, Japan
| | | | | | | |
Collapse
|
37
|
Szabó D, Gee NR, Miklósi Á. Natural or pathologic? Discrepancies in the study of behavioral and cognitive signs in aging family dogs. J Vet Behav 2016. [DOI: 10.1016/j.jveb.2015.08.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
38
|
Schütt T, Toft N, Berendt M. A comparison of 2 screening questionnaires for clinical assessment of canine cognitive dysfunction. J Vet Behav 2015. [DOI: 10.1016/j.jveb.2015.07.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Schütt T, Toft N, Berendt M. Cognitive Function, Progression of Age-related Behavioral Changes, Biomarkers, and Survival in Dogs More Than 8 Years Old. J Vet Intern Med 2015; 29:1569-77. [PMID: 26463980 PMCID: PMC4895687 DOI: 10.1111/jvim.13633] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/18/2015] [Accepted: 09/01/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Canine cognitive dysfunction (CCD) is an age-dependent neurodegenerative condition dominated by changes in behavioral patterns. Cohort studies investigating cognitive status in dogs are lacking. OBJECTIVES To investigate cognitive function, progression of age-related behavioral changes, survival, and possible biomarkers of CCD in aged dogs. ANIMALS Fifty-one dogs >8 years old; 21 with no cognitive deficits, 17 with mild cognitive impairments (MCI) and 13 with CCD. METHODS Longitudinal study. Recruitment period of 12 months and an observational period of 24 months including a baseline and 3 planned subsequent assessments. Cognitive status was determined using validated questionnaires. Plasma Aβ-peptides were quantified using commercial ELISA assays and cytokines by a validated immunoassay. RESULTS Signs characterizing dogs with CCD were aimless wandering, staring into space, avoid getting patted, difficulty finding dropped food and anxiety. Thirty-three percent of dogs with a normal cognitive status progressed to MCI and 22% classified as MCI progressed to CCD during the study period. For 6 dogs diagnosed with CCD, signs of cognitive dysfunction increased with time. A diagnosis of CCD did not affect survival. The level of plasma Aβ42 was significantly increased (P < .05) in the CCD group (92.8 ± 24.0 pg/mL) compared to the MCI (77.0 ± 12.3 pg/mL) and normal group (74.9 ± 10.0 pg/mL), but no significant differences in concentrations of systemic inflammatory markers were detected. CONCLUSIONS Canine cognitive dysfunction is a progressive disorder with an individual variability in the rate of cognitive decline and clinical signs. Plasma Aβ42 seems to be an interesting plasma biomarker of CCD.
Collapse
Affiliation(s)
- T Schütt
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - N Toft
- Section for Epidemiology, Technical University of Denmark, Frederiksberg C, Denmark
| | - M Berendt
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| |
Collapse
|
40
|
Madari A, Farbakova J, Katina S, Smolek T, Novak P, Weissova T, Novak M, Zilka N. Assessment of severity and progression of canine cognitive dysfunction syndrome using the CAnine DEmentia Scale (CADES). Appl Anim Behav Sci 2015. [DOI: 10.1016/j.applanim.2015.08.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
41
|
Smolek T, Madari A, Farbakova J, Kandrac O, Jadhav S, Cente M, Brezovakova V, Novak M, Zilka N. Tau hyperphosphorylation in synaptosomes and neuroinflammation are associated with canine cognitive impairment. J Comp Neurol 2015; 524:874-95. [PMID: 26239295 DOI: 10.1002/cne.23877] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 12/24/2022]
Abstract
Canine cognitive impairment syndrome (CDS) represents a group of symptoms related to the aging of the canine brain. These changes ultimately lead to a decline of memory function and learning abilities, alteration of social interaction, impairment of normal housetraining, and changes in sleep-wake cycle and general activity. We have clinically examined 215 dogs, 28 of which underwent autopsy. With canine brains, we performed extensive analysis of pathological abnormalities characteristic of human Alzheimer's disease and frontotemporal lobar degeneration, including β-amyloid senile plaques, tau neurofibrillary tangles, and fused in sarcoma (FUS) and TAR DNA-binding protein 43 (TDP43) inclusions. Most demented dogs displayed senile plaques, mainly in the frontal and temporal cortex. Tau neurofibrillary inclusions were found in only one dog. They were identified with antibodies used to detect tau neurofibrillary lesions in the human brain. The inclusions were also positive for Gallyas silver staining. As in humans, they were distributed mainly in the entorhinal cortex, hippocampus, and temporal cortex. On the other hand, FUS and TDP43 aggregates were not present in any of the examined brain samples. We also found that CDS was characterized by the presence of reactive and senescent microglial cells in the frontal cortex. Our transcriptomic study revealed a significant dysregulation of genes involved in neuroinflammation. Finally, we analyzed tau phosphoproteome in the synaptosomes. Proteomic studies revealed a significant increase of hyperphosphorylated tau in synaptosomes of demented dogs compared with nondemented dogs. This study suggests that cognitive decline in dogs is related to the tau synaptic impairment and neuroinflammation. J. Comp. Neurol. 524:874-895, 2016. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Tomas Smolek
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic
| | - Aladar Madari
- University of Veterinary Medicine and Pharmacy, 040 01, Kosice, Slovak Republic
| | - Jana Farbakova
- University of Veterinary Medicine and Pharmacy, 040 01, Kosice, Slovak Republic
| | - Ondrej Kandrac
- University of Veterinary Medicine and Pharmacy, 040 01, Kosice, Slovak Republic
| | - Santosh Jadhav
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic
| | - Martin Cente
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic.,Axon Neuroscience SE, 811 02, Bratislava, Slovak Republic
| | - Veronika Brezovakova
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic
| | - Michal Novak
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic.,Axon Neuroscience SE, 811 02, Bratislava, Slovak Republic
| | - Norbert Zilka
- Institute of Neuroimmunology, Slovak Academy of Sciences, 845 10, Bratislava, Slovak Republic.,Axon Neuroscience SE, 811 02, Bratislava, Slovak Republic.,Institute of Neuroimmunology, n.o., 811 02, Bratislava, Slovak Republic
| |
Collapse
|
42
|
Mongillo P, Araujo JA, Pitteri E, Carnier P, Adamelli S, Regolin L, Marinelli L. Spatial reversal learning is impaired by age in pet dogs. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2273-82. [PMID: 23529504 PMCID: PMC3824977 DOI: 10.1007/s11357-013-9524-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 03/08/2013] [Indexed: 05/18/2023]
Abstract
Aged dogs spontaneously develop progressive decline in both cognitive and behavioral function, in addition to neuropathological changes, that collectively parallel several aspects of human aging and Alzheimer's disease progression and likely contribute to the development of canine cognitive dysfunction syndrome. In the current study, ethologically relevant spatial learning, retention, and reversal learning tasks were conducted, with the goal of expanding canine neuropsychological testing to pet dogs. Initially, dogs (N = 44, aged 7.8 ± 2.8 years, mean ± SD) had to learn which of two alternative routes successfully led out of a T-maze. Two weeks later, long-term memory retention was assessed, immediately followed by a reversal learning task in which the previously correct route out of the maze was reversed compared with the initial learning and memory retention tasks. No effects of age were evident on the learning or retention tasks. However, older (≥ 8 years) dogs were significantly impaired on the reversal learning task compared with younger ones (< 8 years). Moreover, trial response latency was significantly increased in aged dogs across both the initial and reversal learning tasks but not on the retention task, which suggests that processing speed was impaired by increasing age during the acquisition of novel spatial information but not during performance of previously learned responses. Overall, the current study provides a framework for assessing cognitive function in pet dogs, which should improve understanding of the effects of aging on cognition in the dog population.
Collapse
Affiliation(s)
- Paolo Mongillo
- Dipartimento di Biomedicina Comparata e Alimentazione, Università degli Studi di Padova, Padua, Italy,
| | | | | | | | | | | | | |
Collapse
|
43
|
Identification and management of cognitive decline in companion animals and the comparisons with Alzheimer disease: A review. J Vet Behav 2013. [DOI: 10.1016/j.jveb.2012.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
44
|
Fast R, Schütt T, Toft N, Møller A, Berendt M. An Observational Study with Long-Term Follow-Up of Canine Cognitive Dysfunction: Clinical Characteristics, Survival, and Risk Factors. J Vet Intern Med 2013; 27:822-9. [DOI: 10.1111/jvim.12109] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 03/21/2013] [Accepted: 04/11/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- R. Fast
- Department of Veterinary Clinical and Animal Sciences (DVCAS); Faculty of Health and Medical Sciences; University of Copenhagen (UC); Frederiksberg C Denmark
| | - T. Schütt
- Department of Veterinary Clinical and Animal Sciences (DVCAS); Faculty of Health and Medical Sciences; University of Copenhagen (UC); Frederiksberg C Denmark
| | - N. Toft
- Department of Large Animal Sciences; Faculty of Life Science; University of Copenhagen; Frederiksberg C Denmark
| | - A. Møller
- Centre of Functionally Integrative Neuroscience (CFIN); Aarhus University; Aarhus Denmark
| | - M. Berendt
- Department of Veterinary Clinical and Animal Sciences (DVCAS); Faculty of Health and Medical Sciences; University of Copenhagen (UC); Frederiksberg C Denmark
| |
Collapse
|
45
|
Concentrations of platelet α2-adrenoceptors, lymphocyte muscarinic receptors, and blood monoamines in dogs (Canis familiaris) affected by canine cognitive dysfunction syndrome. J Vet Behav 2013. [DOI: 10.1016/j.jveb.2012.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
46
|
Landsberg GM, Nichol J, Araujo JA. Cognitive Dysfunction Syndrome. Vet Clin North Am Small Anim Pract 2012; 42:749-68, vii. [DOI: 10.1016/j.cvsm.2012.04.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
47
|
Landsberg GM, Deporter T, Araujo JA. Clinical signs and management of anxiety, sleeplessness, and cognitive dysfunction in the senior pet. Vet Clin North Am Small Anim Pract 2012; 41:565-90. [PMID: 21601747 DOI: 10.1016/j.cvsm.2011.03.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Physical signs of old age may be obvious, but mental and cognitive changes require more careful observation. Changes in behavior may represent the earliest indications of medical problems, or disorders of the central nervous system, and these may be bidirectional. Cognitive dysfunction syndrome is underdiagnosed and affects a substantial portion of aged companion animals. This article describes potential treatment regimens to address age-related behavioral problems, as well as a framework for investigating differential diagnoses. Early identification of changes in behavior is essential for the adequate treatment and management of medical and behavioral problems, and for monitoring outcomes.
Collapse
Affiliation(s)
- Gary M Landsberg
- North Toronto Animal Clinic, 99 Henderson Avenue, Thornhill, ON L3T 2K9, Canada.
| | | | | |
Collapse
|
48
|
Landsberg GM, Denenberg S, Araujo JA. Cognitive dysfunction in cats: a syndrome we used to dismiss as 'old age'. J Feline Med Surg 2010; 12:837-48. [PMID: 20974401 PMCID: PMC11220932 DOI: 10.1016/j.jfms.2010.09.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PRACTICAL RELEVANCE Cognitive dysfunction syndrome (CDS) is a widely accepted diagnosis in dogs, with established treatment options. In cats, however, our understanding of cognitive dysfunction is still being shaped by ongoing research in the field, and limited treatment options are available. Recent clinical studies indicate that old age in the cat is accompanied by increased behavioural signs such as wandering, vocalization and night-time activity that are not attributable to identifiable medical problems. It is essential, therefore, that veterinarians include behavioural well-being in the routine care of senior cats. PATIENT GROUP While the exact age of onset is not established, studies suggest that age-related behavioural changes consistent with cognitive dysfunction are prevalent in cats as early as 10 years of age and that prevalence increases significantly in older cats. CLINICAL CHALLENGES The diagnosis of cognitive dysfunction requires the identification of geriatric behavioural changes that are not caused by other medical problems, although the two may not be mutually exclusive. Therefore, the practitioner must rely heavily on owner reports and history to ensure prompt diagnosis and treatment. The absence of any approved dietary or pharmaceutical interventions for cognitive dysfunction adds a further challenge, although several possibilities exist. EVIDENCE BASE This article draws on recent research that has produced neuropathological, cognitive and behavioural evidence for cognitive dysfunction in aging cats. As an impetus to further our understanding of this disease and potential treatment options, the authors propose a behavioural checklist that might aid in the clinical diagnosis of feline CDS and discuss treatment options that have proven successful in the canine counterpart of this disease.
Collapse
Affiliation(s)
- Gary M Landsberg
- North Toronto Animal Clinic, Thornhill, Ontario L3T 2K9, Canada.
| | | | | |
Collapse
|
49
|
The canine cognitive dysfunction rating scale (CCDR): a data-driven and ecologically relevant assessment tool. Vet J 2010; 188:331-6. [PMID: 20542455 DOI: 10.1016/j.tvjl.2010.05.014] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 03/17/2010] [Accepted: 05/10/2010] [Indexed: 11/21/2022]
Abstract
Canine cognitive dysfunction (CCD) is an age-related neurobehavioural syndrome which, although common, is severely under-diagnosed in community-based dogs. Using data from a large cross-sectional survey of older dogs (n=957), this study aimed to develop a clinical scale for assessing CCD. Data-driven analytical techniques were used to distil 27 significant behavioural items (previously identified as relevant to CCD) into an assessment tool with maximal cognito-behavioural breadth whilst maintaining clinical utility. The resulting CCD rating scale (CCDR) comprised 13 behavioural items, of which three were sensitive to the severity of the disease stage. When tested on an independent survey sample, the CCDR had an overall 98.9% diagnostic accuracy with a 77.8% positive predictive value and a 99.3% negative predictive value. Test-re-test reliability of the CCDR over 2months was also high (r=0.73, P<0.0001). In conjunction with veterinary assessment, the CCDR could be a valuable tool in research and clinical settings for both the assessment and longitudinal tracking of cognitive change.
Collapse
|
50
|
Denenberg S, Landsberg G. Therapeutic options for treatment of Cognitive Dysfunction Syndrome in companion animals. J Vet Behav 2010. [DOI: 10.1016/j.jveb.2009.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|