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Cao HL, Meng YJ, Zhang YM, Deng W, Guo WJ, Li ML, Li T. The volume of gray matter mediates the relationship between glucolipid metabolism and neurocognition in first-episode, drug-naïve patients with schizophrenia. J Psychiatr Res 2024; 172:402-410. [PMID: 38458112 DOI: 10.1016/j.jpsychires.2024.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/17/2024] [Accepted: 02/24/2024] [Indexed: 03/10/2024]
Abstract
We aimed to examine the hypotheses that glucolipid metabolism is linked to neurocognition and gray matter volume (GMV) and that GMV mediates the association of glucolipid metabolism with neurocognition in first-episode, drug-naïve (FEDN) patients with schizophrenia. Parameters of glucolipid metabolism, neurocognition, and magnetic resonance imaging were assessed in 63 patients and 31 controls. Compared to controls, patients exhibited higher levels of fasting glucose, triglyceride, and insulin resistance index, lower levels of cholesterol and high-density lipoprotein cholesterol, poorer neurocognitive functions, and decreased GMV in the bilateral insula, left middle occipital gyrus, and left postcentral gyrus. In the patient group, triglyceride levels and the insulin resistance index exhibited a negative correlation with Rapid Visual Information Processing (RVP) mean latency, a measure of attention within the Cambridge Neurocognitive Test Automated Battery (CANTAB), while showing a positive association with GMV in the right insula. The mediation model revealed that triglyceride and insulin resistance index had a significant positive indirect (mediated) influence on RVP mean latency through GMV in the right insula. Glucolipid metabolism was linked to both neurocognitive functions and GMV in FEDN patients with schizophrenia, with the effect pattern differing from that observed in chronic schizophrenia or schizophrenia comorbid with metabolic syndrome. Moreover, glucolipid metabolism might indirectly contribute to neurocognitive deficits through the mediating role of GMV in these patients.
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Affiliation(s)
- Hai-Ling Cao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ya-Jing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ya-Min Zhang
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Deng
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wan-Jun Guo
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming-Li Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, 311121, China; NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, 310058, China.
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Chen Y, Zhang J, Yuan L, Hu H, Li T, Zhao Y, Wu Y, Wang M, Huo W, Gao Y, Ke Y, Wang L, Zhang W, Fu X, Li X, Hu F, Zhang M, Sun L, Hu D. Obesity and risk of depressive disorder in children and adolescents: A meta-analysis of observational studies. Child Care Health Dev 2024; 50:e13237. [PMID: 38410046 DOI: 10.1111/cch.13237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE This meta-analysis evaluated the relationship between overweight/obesity and depressive disorders in children and adolescents. METHODS We examined the databases of PubMed, Embase and Web of Science for pertinent observational studies released up until 20 February 2022. The pooled relative risks (RRs) and 95% confidence intervals (CIs) of obesity and overweight with depressive disorder were calculated by means of random-effects models. The Newcastle-Ottawa Quality Assessment Scale and Agency for Healthcare Research and Quality scale were adopted to evaluate the study quality. RESULTS Finally, for this meta-analysis, we evaluated 22 observational publications covering 175 135 participants (5 cohort study articles, 1 case-control study article and 16 cross-sectional study articles). A significant positive association was found between obesity and the risk of depression (RR 1.32, 95% CI 1.09-1.60, I2 = 79.90%, Pheterogeneity < 0.001) and in the association between obesity and depressive symptoms (RR 1.16, 95% CI: 1.00-1.35, I2 = 25.0%, Pheterogeneity = 0.247). On sensitivity analysis, the pooled RRs remained robust. Subgroup analysis indicated that obese children and teenagers in western countries were more prone to depression. CONCLUSION Evidence from this meta-analysis, based on observational studies, supported the idea that obese children and adolescents are more likely to experience depression and depressive symptoms.
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Affiliation(s)
- Yaobing Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jinli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Mengmeng Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Weifeng Huo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yajuan Gao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yamin Ke
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Longkang Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Wenkai Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xueru Fu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Liang Sun
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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Ijaz N, Jamil Y, Brown CH, Krishnaswami A, Orkaby A, Stimmel MB, Gerstenblith G, Nanna MG, Damluji AA. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. J Am Heart Assoc 2024; 13:e033594. [PMID: 38353229 PMCID: PMC11010094 DOI: 10.1161/jaha.123.033594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024]
Abstract
As the older adult population expands, an increasing number of patients affected by geriatric syndromes are seen by cardiovascular clinicians. One such syndrome that has been associated with poor outcomes is cognitive frailty: the simultaneous presence of cognitive impairment, without evidence of dementia, and physical frailty, which results in decreased cognitive reserve. Driven by common pathophysiologic underpinnings (eg, inflammation and neurohormonal dysregulation), cardiovascular disease, cognitive impairment, and frailty also share the following risk factors: hypertension, diabetes, obesity, sedentary behavior, and tobacco use. Cardiovascular disease has been associated with the onset and progression of cognitive frailty, which may be reversible in early stages, making it essential for clinicians to diagnose the condition in a timely manner and prescribe appropriate interventions. Additional research is required to elucidate the mechanisms underlying the development of cognitive frailty, establish preventive and therapeutic strategies to address the needs of older patients with cardiovascular disease at risk for cognitive frailty, and ultimately facilitate targeted intervention studies.
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Affiliation(s)
- Naila Ijaz
- Thomas Jefferson University HospitalPhiladelphiaPAUSA
| | - Yasser Jamil
- Yale University School of MedicineNew HavenCTUSA
| | | | | | - Ariela Orkaby
- New England GRECC, VA Boston Healthcare SystemBostonMAUSA
- Division of AgingBrigham & Women’s Hospital, Harvard Medical SchoolBostonMAUSA
| | | | | | | | - Abdulla A. Damluji
- Johns Hopkins University School of MedicineBaltimoreMDUSA
- The Inova Center of Outcomes ResearchInova Heart and Vascular InstituteFalls ChurchVAUSA
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Petrović A, Madić V, Stojanović G, Zlatanović I, Zlatković B, Vasiljević P, Đorđević L. Antidiabetic effects of polyherbal mixture made of Centaurium erythraea, Cichorium intybus and Potentilla erecta. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117032. [PMID: 37582477 DOI: 10.1016/j.jep.2023.117032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/29/2023] [Accepted: 08/11/2023] [Indexed: 08/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The polyherbal mixture made of Centaurium erythraea aerial parts and Cichorium intybus roots and Potentilla erecta rhizomes has been used for centuries to treat both the primary and secondary complications of diabetes. AIM OF THE STUDY As a continuation of our search for the most effective herbal mixture used as an ethnopharmacological remedy for diabetes, this study aimed to compare the in vitro biological activities of this polyherbal mixture and its individual ingredients, and, most importantly, to validate the ethnopharmacological value of the herbal mixture through evaluation of its phytochemical composition, its potential in vivo toxicity and its effect on diabetes complications. MATERIALS AND METHODS Phytochemical analysis was performed using HPLC-UV. Antioxidant activity was estimated via the DPPH test. Potential cytotoxicity/anticytotoxicity was assessed using an in vitro RBCs antihemolytic assay and an in vivo sub-chronic oral toxicity method. Antidiabetic activity was evaluated using an in vitro α-amylase inhibition assay and in vivo using a chemically induced diabetic rat model. RESULTS The HPLC-UV analysis revealed the presence of p-hydroxybenzoic acid, p-hydroxybenzoic acid derivative, catechin, five catechin derivatives, epicatechin, isoquercetin, hyperoside, rutin, four quercetin derivatives, caffeic acid, and four caffeic acid derivatives in the polyherbal mixture decoction. Treatment with the decoction has shown no toxic effects. The antioxidant and cytoprotective activities of the polyherbal mixture were higher than the reference's ones. Its antidiabetic activity was high in both in vitro and in vivo studies. Fourteen days of treatment with the decoction (15 g/kg) completely normalized blood glucose levels of diabetic animals, while treatments with insulin and glimepiride only slightly lowered glycemic values. In addition, lipid status of treated animals as well as levels of serum AST, ALT, ALP, creatinine, urea and MDA were completely normalized. In addition, the polyherbal mixture completely restored the histopathological changes of the liver, kidneys and all four Cornu ammonis regions of the hippocampus. CONCLUSIONS The polyherbal mixture was effective in the prevention of both primary and secondary diabetic complications such as hyperlipidemia, increased lipid peroxidation, non-alcoholic fatty liver disease, nephropathy and neurodegeneration.
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Affiliation(s)
- Aleksandra Petrović
- Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia.
| | - Višnja Madić
- Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
| | - Gordana Stojanović
- Department of Chemistry, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
| | - Ivana Zlatanović
- Department of Chemistry, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
| | - Bojan Zlatković
- Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
| | - Perica Vasiljević
- Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
| | - Ljubiša Đorđević
- Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia
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Smith K, Fan J, Marriner GA, Gerdes J, Kessler R, Zinn KR. Distribution of insulin in primate brain following nose-to-brain transport. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12459. [PMID: 38469552 PMCID: PMC10925727 DOI: 10.1002/trc2.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/24/2024] [Accepted: 02/02/2024] [Indexed: 03/13/2024]
Abstract
Introduction Nose-to-brain (N2B) insulin delivery has potential for Alzheimer's disease (AD) therapy. However, clinical implementation has been challenging without methods to follow N2B delivery non-invasively. Positron emission tomography (PET) was applied to measure F-18-labeled insulin ([18F]FB-insulin) from intranasal dosing to brain uptake in non-human primates following N2B delivery. Methods [18F]FB-insulin was prepared by reacting A1,B29-di(tert-butyloxycarbonyl)insulin with [18F]-N-succinimidyl-4-fluorobenzoate. Three methods of N2B delivery for [18F]FB-insulin were compared - delivery as aerosol via tubing (rhesus macaque, n = 2), as aerosol via preplaced catheter (rhesus macaque, n = 3), and as solution via preplaced catheter (cynomolgus macaque, n = 3). Following dosing, dynamic PET imaging (120 min) quantified delivery efficiency to the nasal cavity and whole brain. Area under the time-activity curve was calculated for 46 regions of the cynomolgus macaque brain to determine regional [18F]FB-insulin levels. Results Liquid instillation of [18F]FB-insulin by catheter outperformed aerosol methods for delivery to the subject (39.89% injected dose vs 10.03% for aerosol via tubing, 0.17% for aerosol by catheter) and subsequently to brain (0.34% injected dose vs 0.00020% for aerosol via tubing, 0.05% for aerosol by catheter). [18F]FB-insulin was rapidly transferred across the cribriform plate to limbic and frontotemporal areas responsible for emotional and memory processing. [18F]FB-insulin half-life was longer in olfactory nerve projection sites with high insulin receptor density compared to the whole brain. Discussion The catheter-based liquid delivery approach combined with PET imaging successfully tracked the fate of N2B [18F]FB-insulin and is thought to be broadly applicable for assessments of other therapeutic agents. This method can be rapidly applied in humans to advance clinical evaluation of N2B insulin as an AD therapeutic. Highlights for [18F]FB-insulin passage across the cribriform plate was detected by PET.Intranasal [18F]FB-insulin reached the brain within 13 min.[18F]FB-insulin activity was highest in emotional and memory processing regions.Aerosol delivery was less efficient than liquid instillation by preplaced catheter.Insulin delivery to the cribriform plate was critical for arrival in the brain.
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Affiliation(s)
- Kylie Smith
- Department of Biomedical EngineeringMichigan State UniversityEast LansingMichiganUSA
- Institute for Quantitative Health Science and Engineering, Michigan State UniversityEast LansingMichiganUSA
| | - Jinda Fan
- Institute for Quantitative Health Science and Engineering, Michigan State UniversityEast LansingMichiganUSA
- Department of ChemistryMichigan State UniversityEast LansingMichiganUSA
- Department of RadiologyMichigan State UniversityEast LansingMichiganUSA
| | | | - John Gerdes
- Department of Biomedical and Pharmaceutical SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Robert Kessler
- Department of RadiologyMichigan State UniversityEast LansingMichiganUSA
| | - Kurt R. Zinn
- Department of Biomedical EngineeringMichigan State UniversityEast LansingMichiganUSA
- Institute for Quantitative Health Science and Engineering, Michigan State UniversityEast LansingMichiganUSA
- Department of RadiologyMichigan State UniversityEast LansingMichiganUSA
- Department of Small Animal Clinical SciencesMichigan State UniversityEast LansingMichiganUSA
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Wei B, Dong Q, Ma J, Zhang A. The association between triglyceride-glucose index and cognitive function in nondiabetic elderly: NHANES 2011-2014. Lipids Health Dis 2023; 22:188. [PMID: 37932783 PMCID: PMC10629120 DOI: 10.1186/s12944-023-01959-0] [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: 09/07/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The relationship between Insulin resistance (IR) evaluated through homeostasis model assessment insulin resistance (HOMA-IR) and cognitive function is controversial among nondiabetic individuals. No study so far has reported the association between the IR evaluated through triglyceride glucose (TyG) index and cognitive function among nondiabetics. This study aims to assess this association among US nondiabetic older elderly. METHODS Data were obtained from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Low cognitive function was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease Battery for immediate word list learning (CERAD-WL) and delayed recall (CERAD-DR) test, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Logistic regression analyses were conducted to compute the odds ratio (OR) and 95% confidential interval (CI) to examine the association between the TyG index (continuous and quartiles) and low cognitive function. RESULTS A total of 661 nondiabetic older adults were included with a mean age of 68.62 ± 6.49 years. Compared to the 1st quartile of the TyG index, participants in the TyG index 4th quartile were associated with low cognitive function evaluated through the CERAD test (CERAD-WL and CERAD-DR) [OR: 2.62; 95% CI (1.31, 5.23); P < 0.05]. Subgroup analyses showed that females (ORQ4 VS Q1: 3.07; 95% CI (1.04, 9.05); P < 0.05) and smokers (OR Q4 VS Q1: 2.70; 95% CI (1.01, 7.26); P < 0.05) categories were related with a higher risk of low cognitive function. CONCLUSIONS A high TyG index was strongly correlated with low cognitive function evaluated through the CERAD test (CERAD-WL and CERAD-DR) among US nondiabetic older women. The management of IR in women might be beneficial to primarily prevent low cognitive function among nondiabetic older elderly.
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Affiliation(s)
- Baojian Wei
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Daiyue District, Taian, 271000, China
| | - Qianni Dong
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Daiyue District, Taian, 271000, China
| | - Jinlong Ma
- School of Nursing, Yanbian University, Yanji, China
| | - Aihua Zhang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Daiyue District, Taian, 271000, China.
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Watson K, Akil H, Rasgon N. Toward a Precision Treatment Approach for Metabolic Depression: Integrating Epidemiology, Neuroscience, and Psychiatry. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:623-631. [PMID: 37881556 PMCID: PMC10593951 DOI: 10.1016/j.bpsgos.2023.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 10/27/2023] Open
Abstract
Background Individuals with comorbid major depressive disorder and type 2 diabetes represent an important subgroup of patients for whom conventional treatment may be insufficient. A precision treatment approach that addresses insulin resistance with an outcome of a positive response to antidepressants may prove beneficial. Methods This study utilized an emulated target trial on a large dataset from the Optum Clinformatics Data Mart Database. We evaluated the effect of adjuvant pioglitazone, an insulin-sensitizing drug, on antidepressant response among 4696 people with type 2 diabetes, comparing it with DPP4 (dipeptidyl peptidase-4) inhibitors (non-insulin-sensitizing). An additional analysis involving 6518 participants was conducted to assess the efficacy of pioglitazone versus sulfonylureas. Results The instrumental variable analysis indicated that the initiation of an antidepressant with pioglitazone was superior to DPP4 inhibitors in terms of antidepressant response, with fewer treatment shifts and/or additions of new antidepressant or antipsychotic over a 1-year period. This result was consistent when pioglitazone was compared with sulfonylureas in a supplemental analysis. Conclusions Our findings suggest that pioglitazone may be more effective than DPP4 inhibitors or sulfonylureas in enhancing antidepressant response among people with comorbid major depressive disorder and type 2 diabetes. This provides a strong case for the use of pioglitazone in patients with these conditions, emphasizing the potential of precision medicine strategies. The results should be interpreted with caution due to inherent limitations associated with observational data.
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Affiliation(s)
- Kathleen Watson
- Center for Neuroscience in Women’s Health, Stanford University, Palo Alto, California
| | - Huda Akil
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan
| | - Natalie Rasgon
- Center for Neuroscience in Women’s Health, Stanford University, Palo Alto, California
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Nowell J, Blunt E, Gupta D, Edison P. Antidiabetic agents as a novel treatment for Alzheimer's and Parkinson's disease. Ageing Res Rev 2023; 89:101979. [PMID: 37328112 DOI: 10.1016/j.arr.2023.101979] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023]
Abstract
Therapeutic strategies for neurodegenerative disorders have commonly targeted individual aspects of the disease pathogenesis to little success. Neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD), are characterized by several pathological features. In AD and PD, there is an abnormal accumulation of toxic proteins, increased inflammation, decreased synaptic function, neuronal loss, increased astrocyte activation, and perhaps a state of insulin resistance. Epidemiological evidence has revealed a link between AD/PD and type 2 diabetes mellitus, with these disorders sharing some pathological commonalities. Such a link has opened up a promising avenue for repurposing antidiabetic agents in the treatment of neurodegenerative disorders. A successful therapeutic strategy for AD/PD would likely require a single or several agents which target the separate pathological processes in the disease. Targeting cerebral insulin signalling produces numerous neuroprotective effects in preclinical AD/PD brain models. Clinical trials have shown the promise of approved diabetic compounds in improving motor symptoms of PD and preventing neurodegenerative decline, with numerous further phase II trials and phase III trials underway in AD and PD populations. Alongside insulin signalling, targeting incretin receptors in the brain represents one of the most promising strategies for repurposing currently available agents for the treatment of AD/PD. Most notably, glucagon-like-peptide-1 (GLP-1) receptor agonists have displayed impressive clinical potential in preclinical and early clinical studies. In AD the GLP-1 receptor agonist, liraglutide, has been demonstrated to improve cerebral glucose metabolism and functional connectivity in small-scale pilot trials. Whilst in PD, the GLP-1 receptor agonist exenatide is effective in restoring motor function and cognition. Targeting brain incretin receptors reduces inflammation, inhibits apoptosis, prevents toxic protein aggregation, enhances long-term potentiation and autophagy as well as restores dysfunctional insulin signalling. Support is also increasing for the use of additional approved diabetic treatments, including intranasal insulin, metformin hydrochloride, peroxisome proliferator-activated nuclear receptor γ agonists, amylin analogs, and protein tyrosine phosphatase 1B inhibitors which are in the investigation for deployment in PD and AD treatment. As such, we provide a comprehensive review of several promising anti-diabetic agents for the treatment of AD and PD.
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Affiliation(s)
- Joseph Nowell
- Department of Brain Sciences, Imperial College London, London, UK
| | - Eleanor Blunt
- Department of Brain Sciences, Imperial College London, London, UK
| | - Dhruv Gupta
- Department of Brain Sciences, Imperial College London, London, UK
| | - Paul Edison
- Department of Brain Sciences, Imperial College London, London, UK; School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
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Li C, Guo J, Zhao Y, Sun K, Abdelrahman Z, Cao X, Zhang J, Zheng Z, Yuan C, Huang H, Chen Y, Liu Z, Chen Z. Visit-to-visit HbA1c variability, dementia, and hippocampal atrophy among adults without diabetes. Exp Gerontol 2023; 178:112225. [PMID: 37263368 DOI: 10.1016/j.exger.2023.112225] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Adults without diabetes are not completely healthy; they are probably heterogeneous with several potential health problems. The management of hemoglobin A1c (HbA1c) is crucial among patients with diabetes; but whether similar management strategy is needed for adults without diabetes is unclear. Thus, this study aimed to investigate the associations of visit-to-visit HbA1c variability with incident dementia and hippocampal volume among middle-aged and older adults without diabetes, providing potential insights into this question. METHODS We conducted a prospective analysis for incident dementia in 10,792 participants (mean age 58.9 years, 47.8 % men) from the UK Biobank. A subgroup of 3793 participants (mean age 57.8 years, 48.6 % men) was included in the analysis for hippocampal volume. We defined HbA1c variability as the difference in HbA1c divided by the mean HbA1c over the 2 sequential visits ([latter - former]/mean). Dementia was identified using hospital inpatient records with ICD-9 codes. T1-structural brain magnetic resonance imaging was conducted to derive hippocampal volume (normalized for head size). The nonlinear and linear associations were examined using restricted cubic spline (RCS) models, Cox regression models, and multiple linear regression models. RESULTS During a mean follow-up (since the second round) of 8.4 years, 90 (0.8 %) participants developed dementia. The RCS models suggested no significant nonlinear associations of HbA1c variability with incident dementia and hippocampal volume, respectively (All P > 0.05). Above an optimal cutoff of HbA1c variability at 0.08, high HbA1c variability (increment in HbA1c) was associated with an increased risk of dementia (Hazard Ratio, 1.88; 95 % Confidence Interval, 1.13 to 3.14, P = 0.015), and lower hippocampal volume (coefficient, -96.84 mm3, P = 0.037), respectively, in models with adjustment of covariates including age, sex, etc. Similar results were found for a different cut-off of 0. A series of sensitivity analyses verified the robustness of the findings. CONCLUSIONS Among middle-aged and older adults without diabetes, increasing visit-to-visit HbA1c variability was associated with an increased dementia risk and lower hippocampal volume. The findings highlight the importance of monitoring and controlling HbA1c fluctuation in apparently healthy adults without diabetes.
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Affiliation(s)
- Chenxi Li
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Junyan Guo
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Yining Zhao
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Kaili Sun
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Zeinab Abdelrahman
- Department of Neurobiology, Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China; NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China; Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang, China
| | - Xingqi Cao
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jingyun Zhang
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Zhoutao Zheng
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Changzheng Yuan
- Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Huiqian Huang
- Clinical Research Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Zuyun Liu
- School of Public Health, The Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China.
| | - Zuobing Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang, China.
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10
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Kim AB, Arvanitakis Z. Insulin resistance, cognition, and Alzheimer disease. Obesity (Silver Spring) 2023; 31:1486-1498. [PMID: 37203336 PMCID: PMC10421533 DOI: 10.1002/oby.23761] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 05/20/2023]
Abstract
Chronic diseases of aging are increasingly common. Dementia, often due to multiple etiologies including Alzheimer disease (AD), is at the forefront. Previous studies have reported higher rates of dementia among persons with diabetes, yet less is known about how insulin resistance relates to cognition. This article reviews recently published data on the relationship of insulin resistance to cognition and AD, and remaining knowledge gaps in the field are discussed. A structured review of studies was conducted over a 5-year period, investigating insulin and cognitive function in adults with a baseline mean age of ≥65 years. This search yielded 146 articles, of which 26 met the predetermined inclusion and exclusion criteria. Among the nine studies that specifically examined insulin resistance and cognitive dysfunction and/or decline, eight studies suggest an association, but some only in subanalyses. Results are mixed in studies relating insulin to structural and functional changes on brain imaging, and data on intranasal insulin for cognition remain unclear. Future avenues are proposed to elucidate the impact of insulin resistance on brain structure and function, including cognition, in persons with and without AD.
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Affiliation(s)
- Anne B Kim
- Rush Medical College, Chicago, Illinois, USA
| | - Zoe Arvanitakis
- Rush Medical College, Chicago, Illinois, USA
- Rush Alzheimer's Disease Center, Rush University, Chicago, Illinois, USA
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11
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Borovcanin MM, Vesic K, Petrovic I, Jovanovic IP, Mijailović NR. Diabetes mellitus type 2 as an underlying, comorbid or consequent state of mental disorders. World J Diabetes 2023; 14:481-493. [PMID: 37273248 PMCID: PMC10236997 DOI: 10.4239/wjd.v14.i5.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/21/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Somatic disturbances that occur in parallel with psychiatric diseases are a major challenge in clinical practice. Various factors contribute to the development of mental and somatic disorders. Type 2 diabetes mellitus (T2DM) is a significant health burden worldwide, and the prevalence of diabetes in adults is increasing. The comorbidity of diabetes and mental disorders is very common. By sharing a bidirectional link, both T2DM and mental disorders influence each other in various manners, but the exact mechanisms underlying this link are not yet elucidated. The potential mechanisms of both mental disorders and T2DM are related to immune and inflammatory system dysfunction, oxidative stress, endothelial dysfunction, and metabolic disturbances. Moreover, diabetes is also a risk factor for cognitive dysfunction that can range from subtle diabetes-associated cognitive decline to pre-dementia and dementia. A complex re-lationship between the gut and the brain also represents a new therapeutic approach since gut-brain signalling pathways regulate food intake and hepatic glucose production. The aim of this minireview is to summarize and present the latest data on mutual pathogenic pathways in these disorders, emphasizing their complexity and interweaving. We also focused on the cognitive performances and changes in neurodegenerative disorders. The importance of implementing integrated approaches in treating both of these states is highlighted, along with the need for individual therapeutic strategies.
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Affiliation(s)
- Milica M Borovcanin
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Katarina Vesic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Ivica Petrovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Ivan P Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Nataša R Mijailović
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
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12
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Al-Hakeim HK, Al-Rubaye HT, Jubran AS, Almulla AF, Moustafa SR, Maes M. Increased insulin resistance due to Long COVID is associated with depressive symptoms and partly predicted by the inflammatory response during acute infection. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:205-215. [PMID: 36917827 PMCID: PMC10288478 DOI: 10.47626/1516-4446-2022-3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE Some months after the remission of acute COVID-19, some individuals show depressive symptoms, which are predicted by increased peak body temperature (PBT) and decreased blood oxygen saturation (SpO2). The present study aimed to examine data on whether long COVID is associated with increased insulin resistance (IR) in association with neuroimmune and oxidative (NIO) processes during the acute infectious and long COVID phases. METHODS This case-control, retrospective cohort study used the Homeostasis Model Assessment 2 (HOMA2) calculator© to compute ß-cell function (HOMA2%B) and insulin sensitivity (HOMA2%S) and resistance (HOMA2-IR) and administered the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) to 86 patients with long COVID and 39 controls. RESULTS Long COVID (3-4 months after the acute infection) is accompanied by increased HOMA2-IR, fasting blood glucose (FBG), and insulin levels; 33.7% of the patients vs. 0% of the controls had HOMA2-IR values > 1.8, suggesting IR. Increased IR was predicted by PBT during acute infection and associated with depressive symptoms above and beyond the effects of NIO pathways (nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing protein 3 [NLRP3] inflammasome, myeloperoxidase [MPO], protein oxidation). There were no significant associations between increased IR and the activated NIO pathways during long COVID. CONCLUSION Long COVID is associated with new-onset IR, which may contribute to onset of depressive symptoms due to long COVID by enhancing overall neurotoxicity.
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Affiliation(s)
| | | | | | - Abbas F. Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Shatha Rouf Moustafa
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
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13
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Al-Hakeim HK, Al-Naqeeb TH, Almulla AF, Maes M. The physio-affective phenome of major depression is strongly associated with biomarkers of astroglial and neuronal projection toxicity which in turn are associated with peripheral inflammation, insulin resistance and lowered calcium. J Affect Disord 2023; 331:300-312. [PMID: 36996718 DOI: 10.1016/j.jad.2023.03.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/28/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by elevated activity of peripheral neuro-immune and neuro-oxidative pathways, which may cause neuro-affective toxicity by disrupting neuronal circuits in the brain. No study has explored peripheral indicators of neuroaxis damage in MDD in relation to serum inflammatory and insulin resistance (IR) biomarkers, calcium, and the physio-affective phenome consisting of depressive, anxious, chronic fatigue, and physiosomatic symptoms. METHODS Serum levels of phosphorylated tau protein 217 (P-tau217), platelet-derived growth factor receptor beta (PDGFR), neurofilament light chain (NF-L), glial fibrillary acidic protein (GFAP), C-reactive protein (CRP), calcium and the HOMA2-insulin resistance (IR) index were measured in 94 MDD patients and 47 controls. RESULTS 61.1 % of the variance in the physio-affective phenome (conceptualized as a factor extracted from depression, anxiety, fatigue and physiosomatic symptoms) is explained by the regression on GFAP, NF-L, P-tau2017, PDGFRβ and HOMA2-IR (all positively associated), and decreased calcium. In addition, CRP and HOMA2-IR predicted 28.9 % of the variance in the neuroaxis index. We observed significant indirect effects of CRP and calcium on the physio-affective phenome which were partly mediated by the four neuroaxis biomarkers. Annotation and enrichment analysis revealed that the enlarged GFAP, P-tau217, PDGFR, and NF-L network was enriched in glial cell and neuronal projections, the cytoskeleton and axonal transport, including a mitochondrion. CONCLUSIONS Peripheral inflammation and IR may damage the astroglial and neuronal projections thereby interfering with mitochondrial transport. This neurotoxicity, combined with inflammation, IR and lowered calcium, may, at least in part, induce the phenome of MDD.
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Affiliation(s)
| | | | - Abbas F Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; School of Medicine, IMPACT Strategic Research Centre, Deakin University, Geelong, Australia; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.
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14
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Mazza E, Calesella F, Paolini M, di Pasquasio C, Poletti S, Lorenzi C, Falini A, Zanardi R, Colombo C, Benedetti F. Insulin resistance disrupts white matter microstructure and amplitude of functional spontaneous activity in bipolar disorder. Bipolar Disord 2023; 25:32-42. [PMID: 36377438 DOI: 10.1111/bdi.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is linked to several structural and functional brain alterations. In addition, BD patients have a three-fold increased risk of developing insulin resistance, which is associated with neural changes and poorer BD outcomes. Therefore, we investigated the effects of insulin and two derived measures (insulin resistance and sensitivity) on white matter (WM) microstructure, resting-state (rs) functional connectivity (FC), and fractional amplitude of low-frequency fluctuation (fALFF). METHODS BD patients (n = 92) underwent DTI acquisition, and a subsample (n = 22) underwent rs-fMRI. Blood samples were collected to determine insulin and glucose levels. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were computed. DTI data were analyzed via tract-based spatial statistics and threshold-free cluster enhancement. From rs-fMRI data, both ROI-to-ROI FC matrices and fALFF maps were extracted. RESULTS Insulin showed a widespread negative association with fractional anisotropy (FA) and a positive effect on radial diffusivity (RD) and mean diffusivity (MD). HOMA-IR exerted a significant effect on RD in the right superior longitudinal fasciculus, whereas QUICKI was positively associated with FA and negatively with RD and MD in the left superior longitudinal fasciculus, left anterior corona radiata, and forceps minor. fALFF was negatively modulated by insulin and HOMA-IR and positively associated with QUICKI in the precuneus. No significant results were found in the ROI-to-ROI analysis. CONCLUSION Our findings suggest that WM microstructure and functional alterations might underlie the effect of IR on BD pathophysiology, even if the causal mechanisms need to be further investigated.
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Affiliation(s)
- Elena Mazza
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Calesella
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Paolini
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Sara Poletti
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Zanardi
- Vita-Salute San Raffaele University, Milan, Italy.,Mood Disorders Unit, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Vita-Salute San Raffaele University, Milan, Italy.,Mood Disorders Unit, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
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15
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Cui Y, Tang TY, Lu CQ, Ju S. Insulin Resistance and Cognitive Impairment: Evidence From Neuroimaging. J Magn Reson Imaging 2022; 56:1621-1649. [PMID: 35852470 DOI: 10.1002/jmri.28358] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/04/2023] Open
Abstract
Insulin is a peptide well known for its role in regulating glucose metabolism in peripheral tissues. Emerging evidence from human and animal studies indicate the multifactorial role of insulin in the brain, such as neuronal and glial metabolism, glucose regulation, and cognitive processes. Insulin resistance (IR), defined as reduced sensitivity to the action of insulin, has been consistently proposed as an important risk factor for developing neurodegeneration and cognitive impairment. Although the exact mechanism of IR-related cognitive impairment still awaits further elucidation, neuroimaging offers a versatile set of novel contrasts to reveal the subtle cerebral abnormalities in IR. These imaging contrasts, including but not limited to brain volume, white matter (WM) microstructure, neural function and brain metabolism, are expected to unravel the nature of the link between IR, cognitive decline, and brain abnormalities, and their changes over time. This review summarizes the current neuroimaging studies with multiparametric techniques, focusing on the cerebral abnormalities related to IR and therapeutic effects of IR-targeting treatments. According to the results, brain regions associated with IR pathophysiology include the medial temporal lobe, hippocampus, prefrontal lobe, cingulate cortex, precuneus, occipital lobe, and the WM tracts across the globe. Of these, alterations in the temporal lobe are highly reproducible across different imaging modalities. These structures have been known to be vulnerable to Alzheimer's disease (AD) pathology and are critical in cognitive processes such as memory and executive functioning. Comparing to asymptomatic subjects, results are more mixed in patients with metabolic disorders such as type 2 diabetes and obesity, which might be attributed to a multifactorial mechanism. Taken together, neuroimaging, especially MRI, is beneficial to reveal early abnormalities in cerebral structure and function in insulin-resistant brain, providing important evidence to unravel the underlying neuronal substrate that reflects the cognitive decline in IR. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ying Cui
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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16
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Gentreau M, Reynes C, Sabatier R, Maller JJ, Meslin C, Deverdun J, Le Bars E, Raymond M, Berticat C, Artero S. Glucometabolic Changes Are Associated with Structural Gray Matter Alterations in Prodromal Dementia. J Alzheimers Dis 2022; 89:1293-1302. [PMID: 36031896 DOI: 10.3233/jad-220490] [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: 11/15/2022]
Abstract
BACKGROUND Glucometabolic changes, such as high glycemic load (GL) diet and insulin resistance (IR), are potential risk factor of Alzheimer's disease (AD). Yet, the effect of these factors on brain alterations that contribute to AD pathology has not been clearly demonstrated. OBJECTIVE We aimed to assess the relationship of GL and IR with gray matter volumes involved in prodromal dementia. METHODS GL and Triglyceride-Glucose (TyG) index, an IR surrogate marker, were calculated in 497 participants who underwent magnetic resonance imaging (MRI). The gray matter volumes most related to prodromal dementia/mild cognitive impairment (diagnosed in 18/158 participants during the 7-year follow-up) were identified using a data-driven machine learning algorithm. RESULTS Higher GL diet was associated with reduced amygdala volume. The TyG index was negatively associated with the hippocampus, amygdala, and putamen volumes. CONCLUSION These results suggest that GL and IR are associated with lower gray matter volumes in brain regions involved in AD pathology.
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Affiliation(s)
- Mélissa Gentreau
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | | | - Robert Sabatier
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Jerome J Maller
- Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia.,General Electric Healthcare, Richmond, Melbourne, Australia
| | - Chantal Meslin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Jeremy Deverdun
- I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Emmanuelle Le Bars
- I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Michel Raymond
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Claire Berticat
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Sylvaine Artero
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
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17
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Woodfield A, Porter T, Gilani I, Noordin S, Li QX, Collins S, Martins RN, Maruff P, Masters CL, Rowe CC, Villemagne VL, Dore V, Newsholme P, Laws SM, Verdile G. Insulin resistance, cognition and Alzheimer's disease biomarkers: Evidence that CSF Aβ42 moderates the association between insulin resistance and increased CSF tau levels. Neurobiol Aging 2022; 114:38-48. [DOI: 10.1016/j.neurobiolaging.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/09/2022] [Accepted: 03/07/2022] [Indexed: 12/16/2022]
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18
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Frangou S, Abbasi F, Watson K, Haas SS, Antoniades M, Modabbernia A, Myoraku A, Robakis T, Rasgon N. Hippocampal volume reduction is associated with direct measure of insulin resistance in adults. Neurosci Res 2022; 174:19-24. [PMID: 34352294 PMCID: PMC9164143 DOI: 10.1016/j.neures.2021.07.006] [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: 03/30/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 01/03/2023]
Abstract
Hippocampal integrity is highly susceptible to metabolic dysfunction, yet its mechanisms are not well defined. We studied 126 healthy individuals aged 23-61 years. Insulin resistance (IR) was quantified by measuring steady-state plasma glucose (SSPG) concentration during the insulin suppression test. Body mass index (BMI), adiposity, fasting insulin, glucose, leptin as well as structural neuroimaing with automatic hippocampal subfield segmentation were performed. Data analysis using unsupervised machine learning (k-means clustering) identified two subgroups reflecting a pattern of more pronounced hippocampal volume reduction being concurrently associated with greater adiposity and insulin resistance; the hippocampal volume reductions were uniform across subfields. Individuals in the most deviant subgroup were predominantly women (79 versus 42 %) with higher BMI [27.9 (2.5) versus 30.5 (4.6) kg/m2], IR (SSPG concentration, [156 (61) versus 123 (70) mg/dL] and leptinemia [21.7 (17.0) versus 44.5 (30.4) μg/L]. The use of person-based modeling in healthy individuals suggests that adiposity, insulin resistance and compromised structural hippocampal integrity behave as a composite phenotype; female sex emerged as risk factor for this phenotype.
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Affiliation(s)
- Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Psychiatry, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada,Corresponding author at: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA., (S. Frangou), (N. Rasgon)
| | - Fahim Abbasi
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Katie Watson
- Department of Psychiatry, Stanford University School of Medicine, USA
| | - Shalaila S. Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mathilde Antoniades
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Alison Myoraku
- Department of Psychiatry, Stanford University School of Medicine, USA
| | - Thalia Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natalie Rasgon
- Department of Psychiatry, Stanford University School of Medicine, USA,Corresponding author at: 401 Quarry Road, MC 5723, Palo Alto, CA 94304, USA
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19
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Myoraku A, Lang A, Taylor CT, Scott Mackin R, Meyerhoff DJ, Mueller S, Strigo IA, Tosun D. Age-dependent brain morphometry in Major Depressive disorder. Neuroimage Clin 2021; 33:102924. [PMID: 34959051 PMCID: PMC8718744 DOI: 10.1016/j.nicl.2021.102924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a complex disorder that affects nearly 264 million people worldwide. Structural brain abnormalities in multiple neuroanatomical networks have been implicated in the etiology of MDD, but the degree to which MDD affects brain structure during early to late adulthood is unclear. METHODS We examined morphometry of brain regions commonly implicated in MDD, including the amygdala, hippocampus, anterior cingulate gyrus, lateral orbitofrontal gyrus, subgenual cortex, and insular cortex subregions, from early to late adulthood. Harmonized measures for gray matter (GM) volume and cortical thickness of each region were estimated cross-sectionally for 305 healthy controls (CTLs) and 247 individuals with MDD (MDDs), collated from four research cohorts. We modeled the nonlinear associations of age with GM volume and cortical thickness using generalized additive modeling and tested for age-dependent group differences. RESULTS Overall, all investigated regions exhibited smaller GM volume and thinner cortical measures with increasing age. Compared to age matched CTLs, MDDs had thicker cortices and greater GM volume from early adulthood until early middle age (average 35 years), but thinner cortices and smaller GM volume during and after middle age in the lateral orbital gyrus and all insular subregions. Deviations of the MDD and CTL models for both GM volume and cortical thickness in these regions started as early as age 18. CONCLUSIONS The analyses revealed that brain morphometry differences between MDDs and CTLs are dependent on age and brain region. The significant age-by-group interactions in the lateral orbital frontal gyrus and insular subregions make these regions potential targets for future longitudinal studies of MDD.
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Affiliation(s)
- Alison Myoraku
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States.
| | - Adam Lang
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States
| | - Charles T Taylor
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA 92093, United States
| | - R Scott Mackin
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Dieter J Meyerhoff
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Susanne Mueller
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Irina A Strigo
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143, United States; Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, San Francisco, CA 94121, United States
| | - Duygu Tosun
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
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20
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Ha J, Choi DW, Kim KJ, Cho SY, Kim H, Kim KY, Koh Y, Nam CM, Kim E. Association of metformin use with Alzheimer's disease in patients with newly diagnosed type 2 diabetes: a population-based nested case-control study. Sci Rep 2021; 11:24069. [PMID: 34912022 PMCID: PMC8674300 DOI: 10.1038/s41598-021-03406-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/22/2021] [Indexed: 01/08/2023] Open
Abstract
Metformin reduces insulin resistance, which constitutes a pathophysiological connection of diabetes with Alzheimer’s disease (AD), but the evidence of metformin on AD development was still insufficient and conflicting. We investigated AD risk in patients with newly diagnosed type 2 DM treated with metformin. This retrospective, observational, nested case–control study included patients with newly diagnosed type 2 DM obtained from the Korean National Health Insurance Service DM cohort (2002–2017). Among 70,499 dementia-free DM patients, 1675 AD cases were matched to 8375 controls for age, sex, and DM onset and duration. The association between AD and metformin was analyzed by multivariable regression analyses, adjusted for comorbidities and cardiometabolic risk profile. Metformin use was associated with an increased odds of AD (adjusted odds ratio [AOR] 1.50; 95% CI 1.23–1.83). The risk of AD was higher in patients with a longer DM duration. Furthermore, AD risk was significantly high in DM patients with depression (AOR 2.05; 95% CI 1.02–4.12). Given the large number of patients with DM who are taking metformin worldwide, a double-blinded, prospective study is required to determine the long-term cognitive safety of metformin.
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Affiliation(s)
- Junghee Ha
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Dong-Woo Choi
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Yeon Cho
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Brain Korea 21 FOUR Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyunjeong Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Keun You Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Youngseung Koh
- Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eosu Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Brain Korea 21 FOUR Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
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21
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Reagan L, Cowan H, Woodruff J, Piroli G, Erichsen J, Evans A, Burzynski H, Maxwell N, Loyo-Rosado F, Macht V, Grillo C. Hippocampal-specific insulin resistance elicits behavioral despair and hippocampal dendritic atrophy. Neurobiol Stress 2021; 15:100354. [PMID: 34258333 PMCID: PMC8252121 DOI: 10.1016/j.ynstr.2021.100354] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 01/02/2023] Open
Abstract
Insulin resistance is a major contributor to the neuroplasticity deficits observed in patients with metabolic disorders. However, the relative contribution of peripheral versus central insulin resistance in the development of neuroplasticity deficits remains equivocal. To distinguish between peripheral and central insulin resistance, we developed a lentiviral vector containing an antisense sequence selective for the insulin receptor (LV-IRAS). We previously demonstrated that intra-hippocampal injection of this vector impairs synaptic transmission and hippocampal-dependent learning and memory in the absence of peripheral insulin resistance. In view of the increased risk for the development of neuropsychiatric disorders in patients with insulin resistance, the current study examined depressive and anxiety-like behaviors, as well as hippocampal structural plasticity in rats with hippocampal-specific insulin resistance. Following hippocampal administration of either the LV-control virus or the LV-IRAS, anhedonia was evaluated by the sucrose preference test, despair behavior was assessed in the forced swim test, and anxiety-like behaviors were determined in the elevated plus maze. Hippocampal neuron morphology was studied by Golgi-Cox staining. Rats with hippocampal insulin resistance exhibited anxiety-like behaviors and behavioral despair without differences in anhedonia, suggesting that some but not all components of depressive-like behaviors were affected. Morphologically, hippocampal-specific insulin resistance elicited atrophy of the basal dendrites of CA3 pyramidal neurons and dentate gyrus granule neurons, and also reduced the expression of immature dentate gyrus granule neurons. In conclusion, hippocampal-specific insulin resistance elicits structural deficits that are accompanied by behavioral despair and anxiety-like behaviors, identifying hippocampal insulin resistance as a key factor in depressive illness.
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Affiliation(s)
- L.P. Reagan
- Columbia VA Health Care System, Columbia, SC, 29209, USA
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - H.B. Cowan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - J.L. Woodruff
- Columbia VA Health Care System, Columbia, SC, 29209, USA
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - G.G. Piroli
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - J.M. Erichsen
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - A.N. Evans
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - H.E. Burzynski
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - N.D. Maxwell
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - F.Z. Loyo-Rosado
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - V.A. Macht
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
| | - C.A. Grillo
- Columbia VA Health Care System, Columbia, SC, 29209, USA
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29209, USA
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22
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Nasca C, Dobbin J, Bigio B, Watson K, de Angelis P, Kautz M, Cochran A, Mathé AA, Kocsis JH, Lee FS, Murrough JW, McEwen BS, Rasgon N. Insulin receptor substrate in brain-enriched exosomes in subjects with major depression: on the path of creation of biosignatures of central insulin resistance. Mol Psychiatry 2021; 26:5140-5149. [PMID: 32536688 PMCID: PMC7787430 DOI: 10.1038/s41380-020-0804-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/17/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023]
Abstract
Insulin signaling is critical for neuroplasticity, cerebral metabolism as well as for systemic energy metabolism. In rodent studies, impaired brain insulin signaling with resultant insulin resistance (IR) modulates synaptic plasticity and the corresponding behavioral functions. Despite discoveries of central actions of insulin, in vivo molecular mechanisms of brain IR until recently have proven difficult to study in the human brain. In the current study, we leveraged recent technological advances in molecular biology and herein report an increased number of exosomes enriched for L1CAM, a marker predominantly expressed in the brain, in subjects with major depressive disorder (MDD) as compared with age- and sex-matched healthy controls (HC). We also report increased concentration of the insulin receptor substrate-1 (IRS-1) in L1CAM+ exosomes in subjects with MDD as compared with age- and sex-matched HC. We found a relationship between expression of IRS-1 in L1CAM+ exosomes and systemic IR as assessed by homeostatic model assessment of IR in HC, but not in subjects with MDD. The increased IRS-1 levels in L1CAM+ exosomes were greater in subjects with MDD and were associated with suicidality and anhedonia. Finally, our data suggested sex differences in serine-312 phosphorylation of IRS-1 in L1CAM+ exosomes in subjects with MDD. These findings provide a starting point for creating mechanistic framework of brain IR in further development of personalized medicine strategies to effectively treat MDD.
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Affiliation(s)
- Carla Nasca
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA.
| | - Josh Dobbin
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, USA
| | - Benedetta Bigio
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, USA
| | - Kathleen Watson
- Center for Neuroscience in Women’s Health, Stanford University, Palo Alto, CA 91304, USA
| | - Paolo de Angelis
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, USA
| | - Marin Kautz
- Mood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Ashly Cochran
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Aleksander A Mathé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - James H Kocsis
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Francis S Lee
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA.,Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, NY, USA
| | - James W Murrough
- Mood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Bruce S McEwen
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, USA
| | - Natalie Rasgon
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA. .,Center for Neuroscience in Women's Health, Stanford University, Palo Alto, CA, 91304, USA.
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23
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Hagi K, Nosaka T, Dickinson D, Lindenmayer JP, Lee J, Friedman J, Boyer L, Han M, Abdul-Rashid NA, Correll CU. Association Between Cardiovascular Risk Factors and Cognitive Impairment in People With Schizophrenia: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021; 78:510-518. [PMID: 33656533 PMCID: PMC7931134 DOI: 10.1001/jamapsychiatry.2021.0015] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Schizophrenia is associated with cognitive dysfunction and cardiovascular risk factors, including metabolic syndrome (MetS) and its constituent criteria. Cognitive dysfunction and cardiovascular risk factors can worsen cognition in the general population and may contribute to cognitive impairment in schizophrenia. OBJECTIVE To study the association between cognitive dysfunction and cardiovascular risk factors and cognitive impairment in individuals with schizophrenia. DATA SOURCES A search was conducted of Embase, Scopus, MEDLINE, PubMed, and Cochrane databases from inception to February 25, 2020, using terms that included synonyms of schizophrenia AND metabolic adversities AND cognitive function. Conference proceedings, clinical trial registries, and reference lists of relevant publications were also searched. STUDY SELECTION Studies were included that (1) examined cognitive functioning in patients with schizophrenia or schizoaffective disorder; (2) investigated the association of cardiovascular disease risk factors, including MetS, diabetes, obesity, overweight, obesity or overweight, hypertension, dyslipidemia, and insulin resistance with outcomes; and (3) compared cognitive performance of patients with schizophrenia/schizoaffective disorder between those with vs without cardiovascular disease risk factors. DATA EXTRACTION AND SYNTHESIS Extraction of data was conducted by 2 to 3 independent reviewers per article. Data were meta-analyzed using a random-effects model. MAIN OUTCOMES AND MEASURES The primary outcome was global cognition, defined as a test score using clinically validated measures of overall cognitive functioning. RESULTS Twenty-seven studies involving 10 174 individuals with schizophrenia were included. Significantly greater global cognitive deficits were present in patients with schizophrenia who had MetS (13 studies; n = 2800; effect size [ES] = 0.31; 95% CI, 0.13-0.50; P = .001), diabetes (8 studies; n = 2976; ES = 0.32; 95% CI, 0.23-0.42; P < .001), or hypertension (5 studies; n = 1899; ES = 0.21; 95% CI, 0.11-0.31; P < .001); nonsignificantly greater deficits were present in patients with obesity (8 studies; n = 2779; P = .20), overweight (8 studies; n = 2825; P = .41), and insulin resistance (1 study; n = 193; P = .18). Worse performance in specific cognitive domains was associated with cognitive dysfunction and cardiovascular risk factors regarding 5 domains in patients with diabetes (ES range, 0.23 [95% CI, 0.12-0.33] to 0.40 [95% CI, 0.20-0.61]) and 4 domains with MetS (ES range, 0.15 [95% CI, 0.03-0.28] to 0.40 [95% CI, 0.20-0.61]) and hypertension (ES range, 0.15 [95% CI, 0.04-0.26] to 0.27 [95% CI, 0.15-0.39]). CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, MetS, diabetes, and hypertension were significantly associated with global cognitive impairment in people with schizophrenia.
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Affiliation(s)
- Katsuhiko Hagi
- Medical Affairs, Sumitomo Dainippon Pharma, Tokyo, Japan
| | - Tadashi Nosaka
- Medical Affairs, Sumitomo Dainippon Pharma, Tokyo, Japan
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | | | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore,Department of Psychosis, Institute of Mental Health, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Joseph Friedman
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
| | - Laurent Boyer
- Aix-Marseille University, Public Health, Chronic Diseases and Quality of Life, Research Unit, Marseille, France
| | - Mei Han
- School of Medicine, University of Wollongong, Wollongong, Australia,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | | | - Christoph U. Correll
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York,Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York,Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York,Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
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24
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Reia A, Petruzzo M, Falco F, Costabile T, Conenna M, Carotenuto A, Petracca M, Servillo G, Lanzillo R, Brescia Morra V, Moccia M. A Retrospective Exploratory Analysis on Cardiovascular Risk and Cognitive Dysfunction in Multiple Sclerosis. Brain Sci 2021; 11:502. [PMID: 33923390 PMCID: PMC8071566 DOI: 10.3390/brainsci11040502] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cardiovascular comorbidities have been associated with cognitive decline in the general population. OBJECTIVES To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. METHODS This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham risk score, which provides the 10-year probability of developing macrovascular disease, using age, sex, diabetes, smoking, systolic blood pressure, and cholesterol levels as input variables. Cognitive function was examined with the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). RESULTS Each point increase of the Framingham risk score corresponded to 0.21 lower CVLT-II score. Looking at Framingham risk score components, male sex and higher total cholesterol levels corresponded to lower CVLT scores (Coeff = -8.54; 95%CI = -15.51, -1.57; and Coeff = -0.11; 95%CI = -0.20, -0.02, respectively). No associations were found between cardiovascular risk and SDMT or BVMT-R. CONCLUSIONS In our exploratory analyses, cardiovascular risk was associated with verbal learning dysfunction in MS. Lifestyle and pharmacological interventions on cardiovascular risk factors should be considered carefully in the management of MS, given the possible effects on cognitive function.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Marcello Moccia
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, 80131 Naples, Italy; (A.R.); (M.P.); (F.F.); (T.C.); (M.C.); (A.C.); (M.P.); (G.S.); (R.L.); (V.B.M.)
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25
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Femminella GD, Livingston NR, Raza S, van der Doef T, Frangou E, Love S, Busza G, Calsolaro V, Carver S, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Passmore AP, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Tan T, Holscher C, Harrison J, Brooks DJ, Ballard C, Edison P. Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects? ALZHEIMERS RESEARCH & THERAPY 2021; 13:47. [PMID: 33597002 PMCID: PMC7890851 DOI: 10.1186/s13195-021-00784-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Background Type 2 diabetes is a risk factor for Alzheimer’s disease (AD), and AD brain shows impaired insulin signalling. The role of peripheral insulin resistance on AD aetiopathogenesis in non-diabetic patients is still debated. Here we evaluated the influence of insulin resistance on brain glucose metabolism, grey matter volume and white matter lesions (WMLs) in non-diabetic AD subjects. Methods In total, 130 non-diabetic AD subjects underwent MRI and [18F]FDG PET scans with arterial cannula insertion for radioactivity measurement. T1 Volumetric and FLAIR sequences were acquired on a 3-T MRI scanner. These subjects also had measurement of glucose and insulin levels after a 4-h fast on the same day of the scan. Insulin resistance was calculated by the updated homeostatic model assessment (HOMA2). For [18F]FDG analysis, cerebral glucose metabolic rate (rCMRGlc) parametric images were generated using spectral analysis with arterial plasma input function. Results In this non-diabetic AD population, HOMA2 was negatively associated with hippocampal rCMRGlc, along with total grey matter volumes. No significant correlation was observed between HOMA2, hippocampal volume and WMLs. Conclusions In non-diabetic AD, peripheral insulin resistance is independently associated with reduced hippocampal glucose metabolism and with lower grey matter volume, suggesting that peripheral insulin resistance might influence AD pathology by its action on cerebral glucose metabolism and on neurodegeneration. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00784-w.
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Affiliation(s)
- Grazia Daniela Femminella
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Nicholas R Livingston
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Sanara Raza
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Thalia van der Doef
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | | | | | - Gail Busza
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Valeria Calsolaro
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Stefan Carver
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | | | | | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust, London, UK
| | | | - George Tadros
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - Basil H Ridha
- Brighton and Sussex University Hospital Trust, Brighton, UK
| | | | - Zuzana Walker
- Mental Health Unit, St. Margaret's Hospital, Epping, Essex, UK
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust, Wolverhampton, UK
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
| | - Salman Karim
- Lancashire Care NHS Foundation Trust, Preston, UK
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust, Warrington, UK
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust, Redruth, UK
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust, South Petherton, UK
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Shrewsbury, UK
| | - Tricia Tan
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Christian Holscher
- Research and Experimental Center, Henan University of Chinese Medicine, Zhengzhou, China
| | - John Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Paul Edison
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
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26
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De Vito AN, Bernstein JPK, Weitzner D, Calamia M, Keller JN. The Effects of Cardiovascular Risk Factors on Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Performance in Cognitively Healthy Older Adults. Arch Clin Neuropsychol 2021; 36:165-176. [PMID: 31647516 DOI: 10.1093/arclin/acz039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/30/2019] [Accepted: 06/26/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The current study investigated the differential impact cardiovascular risk factors (CVRFs) on Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) performance in a large, cognitively healthy, older adult sample across 4 years. METHOD Participants were 486 individuals recruited through a longitudinal aging research study in the southeastern United States. Participants were 69.3% female, an average of 69.96 years old (SD = 6.58), 16.32 years of education (SD = 2.27), and Mini-Mental Status Exam score of 29.12 (SD = 1.16). Participants completed the RBANS at baseline and yearly thereafter, as well as the Uniform Data Set demographic and health questionnaires and the Geriatric Depression Scale. RESULTS Multilevel modeling was conducted using standardized RBANS index scores. Overall, across indices, performance generally improved across time consistent with practice effects from repeated testing. Some CVRFs were associated with worse performance over time. For example, individuals with hypertension performed more poorly on immediate memory over time (t = -2.06, p < .05). Other CVRFs (e.g., BMI) were not associated with baseline performance or performance over time. (p > .05). CONCLUSIONS CVRFs differentially affect RBANS performance over time. These results extend previous cross-sectional findings regarding the impact of different cardiovascular health risks to a large, cognitively healthy, longitudinal sample.
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Affiliation(s)
- Alyssa N De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - John P K Bernstein
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Daniel Weitzner
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Jeffrey N Keller
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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27
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Dionysopoulou S, Charmandari E, Bargiota A, Vlahos NF, Mastorakos G, Valsamakis G. The Role of Hypothalamic Inflammation in Diet-Induced Obesity and Its Association with Cognitive and Mood Disorders. Nutrients 2021; 13:498. [PMID: 33546219 PMCID: PMC7913301 DOI: 10.3390/nu13020498] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity is often associated with cognitive and mood disorders. Recent evidence suggests that obesity may cause hypothalamic inflammation. Our aim was to investigate the hypothesis that there is a causal link between obesity-induced hypothalamic inflammation and cognitive and mood disorders. Inflammation may influence hypothalamic inter-connections with regions important for cognition and mood, while it may cause dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and influence monoaminergic systems. Exercise, healthy diet, and glucagon-like peptide receptor agonists, which can reduce hypothalamic inflammation in obese models, could improve the deleterious effects on cognition and mood.
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Affiliation(s)
- Sofia Dionysopoulou
- Division of Endocrinology, Metabolism and Diabetes, Hippocratio General Hospital, 11527 Athens, Greece;
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece;
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, University Hospital of Larisa, Medical School of Larisa, University of Thessaly, 41334 Larisa, Greece;
| | - Nikolaos F Vlahos
- 2nd Department of Obstetrics and Gynecology, Areteion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - George Mastorakos
- Endocrine Unit, Areteion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Georgios Valsamakis
- Department of Endocrinology and Metabolic Diseases, University Hospital of Larisa, Medical School of Larisa, University of Thessaly, 41334 Larisa, Greece;
- Endocrine Unit, Areteion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
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Shao Q, Wu Y, Ji J, Xu T, Yu Q, Ma C, Liao X, Cheng F, Wang X. Interaction Mechanisms Between Major Depressive Disorder and Non-alcoholic Fatty Liver Disease. Front Psychiatry 2021; 12:711835. [PMID: 34966296 PMCID: PMC8710489 DOI: 10.3389/fpsyt.2021.711835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Major depressive disorder (MDD), which is highly associated with non-alcoholic fatty liver disease (NAFLD), has complex pathogenic mechanisms. However, a limited number of studies have evaluated the mutual pathomechanisms involved in MDD and NAFLD development. Chronic stress-mediated elevations in glucocorticoid (GC) levels play an important role in the development of MDD-related NAFLD. Elevated GC levels can induce the release of inflammatory factors and changes in gut permeability. Elevated levels of inflammatory factors activate the hypothalamic-pituitary-adrenal (HPA) axis, which further increases the release of GC. At the same time, changes in gut permeability promote the release of inflammatory factors, which results in a vicious circle among the three, causing disease outbreaks. Even though the specific role of the thyroid hormone (TH) in this pathogenesis has not been fully established, it is highly correlated with MDD and NAFLD. Therefore, changing lifestyles and reducing psychological stress levels are necessary measures for preventing MDD-related NAFLD. Among them, GC inhibitors and receptor antagonists may be key in the alleviation of early and mid-term disease progression. However, combination medications may be important in late-stage diseases, but they are associated with various side effects. Traditional Chinese medicines have been shown to be potential therapeutic alternatives for such complex diseases.
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Affiliation(s)
- Qi Shao
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yiping Wu
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Ji
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tian Xu
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Qiaoyu Yu
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chongyang Ma
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xuejing Liao
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Fafeng Cheng
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xueqian Wang
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Zhao Y, Liu J, Li J, Zhao F, Du S, Wang Y, Li J, Yang L, Du J, Tang Y. Changes in hippocampal capillaries in transgenic type 2 diabetic mice: A stereological investigation. Anat Rec (Hoboken) 2020; 304:1071-1083. [PMID: 33015956 DOI: 10.1002/ar.24525] [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: 05/01/2020] [Revised: 06/30/2020] [Accepted: 07/19/2020] [Indexed: 11/07/2022]
Abstract
The cognitive dysfunction associated with type 2 diabetes mellitus (T2DM) has been widely studied, and many structures in the hippocampus, such as neurons and synapses, have been shown to play a crucial role in the cognitive decline. However, the mechanism of these changes remains unknown. To further explore this issue, we investigated the changes in the blood supply of the hippocampus in transgenic T2DM mice. In the current study, histochemistry, immunohistochemistry, and unbiased stereological methods were utilized to research the effects of T2DM on hippocampal capillaries of transgenic db/db mice. Twenty (Leprdb ) mut/mut mice and twenty (Leprdb ) wt/wt mice were used in this study. The learning and memory ability was appraised by Morris water maze test.
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Affiliation(s)
- Yuanyu Zhao
- Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Jin Liu
- Laboratory of Electron Microscopy, North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Jing Li
- Laboratory of Electron Microscopy, North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Feng Zhao
- Laboratory of Electron Microscopy, North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Shijuan Du
- Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Yunzi Wang
- Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Juan Li
- Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Lijun Yang
- Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Jiang Du
- Department of General Surgery, Sichuan Science City Hospital, Mianyang, Sichuan Province, China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China
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Ha J, Moon MK, Kim H, Park M, Cho SY, Lee J, Lee JY, Kim E. Plasma Clusterin as a Potential Link Between Diabetes and Alzheimer Disease. J Clin Endocrinol Metab 2020; 105:5860166. [PMID: 32561922 DOI: 10.1210/clinem/dgaa378] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/13/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Plasma clusterin, a promising biomarker of Alzheimer disease (AD), has been associated with diabetes mellitus (DM). However, clusterin has not been investigated considering a relationship with both DM and AD. In this study, we aimed to investigate the individual and interactive relationships of plasma clusterin levels with both diseases. DESIGN Cross-sectional observation study. METHODS We classified participants by the severity of cognitive (normal cognition, mild cognitive impairment [MCI], and AD) and metabolic (healthy control, prediabetes, and DM) impairments. We evaluated the cognitive and metabolic functions of the participants with neuropsychological assessments, brain magnetic resonance imaging, and various blood tests, to explore potential relationships with clusterin. RESULTS Plasma clusterin levels were higher in participants with AD and metabolic impairment (prediabetes and DM). A two-way ANCOVA revealed no synergistic, but an additive effect of AD and DM on clusterin. Clusterin was negatively correlated with cognitive scores. It was also associated with metabolic status indicated by glycated hemoglobin A1c (HbA1c), the Homeostatic Model Assessment for Insulin Resistance index, and fasting C-peptide. It showed correlations between medial temporal atrophy and periventricular white matter lesions, indicating neurodegeneration and microvascular insufficiency, respectively. Further mediation analysis to understand the triadic relationship between clusterin, AD, and DM revealed that the association between DM and AD was significant when clusterin is considered as a mediator of their relationship. CONCLUSIONS Clusterin is a promising biomarker of DM as well as of AD. Additionally, our data suggest that clusterin may have a role in linking DM with AD as a potential mediator.
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Affiliation(s)
- Junghee Ha
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyunjeong Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minsun Park
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Yeon Cho
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jimin Lee
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry and Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eosu Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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Thota RN, Rosato JI, Dias CB, Burrows TL, Martins RN, Garg ML. Dietary Supplementation with Curcumin Reduce Circulating Levels of Glycogen Synthase Kinase-3β and Islet Amyloid Polypeptide in Adults with High Risk of Type 2 Diabetes and Alzheimer's Disease. Nutrients 2020; 12:nu12041032. [PMID: 32283762 PMCID: PMC7230780 DOI: 10.3390/nu12041032] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
Dietary supplementation with curcumin has been previously reported to have beneficial effects in people with insulin resistance, type 2 diabetes (T2D) and Alzheimer’s disease (AD). This study investigated the effects of dietary supplementation with curcumin on key peptides implicated in insulin resistance in individuals with high risk of developing T2D. Plasma samples from participants recruited for a randomised controlled trial with curcumin (180 mg/day) for 12 weeks were analysed for circulating glycogen synthase kinase-3 β (GSK-3β) and islet amyloid polypeptide (IAPP). Outcome measures were determined using ELISA kits. The homeostasis model for assessment of insulin resistance (HOMA-IR) was measured as parameters of glycaemic control. Curcumin supplementation significantly reduced circulating GSK-3β (−2.4 ± 0.4 ng/mL vs. −0.3 ± 0.6, p = 0.0068) and IAPP (−2.0 ± 0.7 ng/mL vs. 0.4 ± 0.6, p = 0.0163) levels compared with the placebo group. Curcumin supplementation significantly reduced insulin resistance (−0.3 ± 0.1 vs. 0.01 ± 0.05, p = 0.0142) compared with placebo group. Dietary supplementation with curcumin reduced circulating levels of IAPP and GSK-3β, thus suggesting a novel mechanism through which curcumin could potentially be used for alleviating insulin resistance related markers for reducing the risk of T2D and AD.
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Affiliation(s)
- Rohith N Thota
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (R.N.T.); (J.I.R.); (C.B.D.); (T.L.B.)
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
| | - Jessica I Rosato
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (R.N.T.); (J.I.R.); (C.B.D.); (T.L.B.)
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Cintia B Dias
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (R.N.T.); (J.I.R.); (C.B.D.); (T.L.B.)
- School of Biomedical Sciences, Macquarie University, Macquarie, NSW 2109, Australia;
| | - Tracy L Burrows
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (R.N.T.); (J.I.R.); (C.B.D.); (T.L.B.)
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Ralph N Martins
- School of Biomedical Sciences, Macquarie University, Macquarie, NSW 2109, Australia;
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (R.N.T.); (J.I.R.); (C.B.D.); (T.L.B.)
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
- Correspondence: ; Tel.: +61-2-4921-5647; Fax: +61-2-49212028
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Fan X, Zhao Z, Wang D, Xiao J. Glycogen synthase kinase-3 as a key regulator of cognitive function. Acta Biochim Biophys Sin (Shanghai) 2020; 52:219-230. [PMID: 32147679 DOI: 10.1093/abbs/gmz156] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/16/2022] Open
Abstract
Glycogen synthase kinase-3 (GSK-3) is a highly conserved and multifunctional serine/threonine protein kinase widely distributed in eukaryotic cells. GSK-3 is originally thought to be an enzyme that regulates glycogen synthesis. It was subsequently found that GSK-3 influences many critical cellular functions, such as cell structure, neural plasticity, gene expression, and neuronal survival. Recently, GSK-3 has been found to be associated with cognition, and its dysregulation leads to cognitive impairments in many diseases, including Alzheimer's disease, diabetes, depression, Parkinson's disease, and others. In this review, we summarized the current knowledge about the structure of GSK-3, the regulation of GSK-3 activity, and its role in cognitive function and cognitive-related disease.
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Affiliation(s)
- Xuhong Fan
- Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang 421001, China
| | - Zhenyu Zhao
- Department of Anesthesiology, The First Hospital of Hunan University of Chinese Medicine, Changsha 410000, China
| | - Deming Wang
- Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang 421001, China
| | - Ji Xiao
- Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang 421001, China
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
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33
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Ciudin A, Ortiz-Zuñiga AM, Fidilio E, Romero D, Sánchez M, Comas M, Gonzalez O, Vilallonga R, Simó-Servat O, Hernández C, Simó R. Retinal Microperimetry: A Useful Tool for Detecting Insulin Resistance-Related Cognitive Impairment in Morbid Obesity. J Clin Med 2019; 8:jcm8122181. [PMID: 31835729 PMCID: PMC6947364 DOI: 10.3390/jcm8122181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/04/2023] Open
Abstract
Background: There is clear association between type 2 diabetes (T2D) and cognitive decline. Retinal microperimetry is a useful tool for detecting cognitive impairment in T2D. Morbid obesity (MO) has been associated with cognitive impairment. Insulin resistance (IR) seems a major determinant, but the data are unclear. The aim of this study was to evaluate the cognitive impairment in MO as well as the utility of retinal microperimetry in identifying these alterations. Methods: In total, 50 consecutive patients with MO were matched by age and gender with 30 healthy controls. All patients underwent cognitive evaluation (Montreal Cognitive Assessment Test-MoCA) and retinal microperimetry, using MAIA microperimeter 3rd generation. Retinal sensitivity and gaze fixation parameters were used for the evaluation of the analysis. Results: MO patients showed a significantly lower neurocognitive performance than the controls: MoCA score 24.94 ± 2.74 vs. 28.95 ± 1.05, p < 0.001. Cognitive function inversely correlated with the HOMA-IR (r = −0.402, p = 0.007). The AUROC for cognitive impairment using microperimetry was 0.807, CI 95% (0.592–0.947), p = 0.017. Conclusions: (1) Systemic insulin resistance is a major underlying mechanism accounting for the higher prevalence of cognitive impairment detected in young MO subjects. (2) Retinal microperimetry is a useful tool for identifying MO patients with cognitive impairment.
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Affiliation(s)
- Andreea Ciudin
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid 28020, Spain
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
- Correspondence: (A.C.); (R.S.); Tel.: +34-934-894-172 (A.C.); +34-934-894-172 (R.S.)
| | - Angel Michael Ortiz-Zuñiga
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Enzamaria Fidilio
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Diana Romero
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
| | - Marta Sánchez
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Marta Comas
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Oscar Gonzalez
- Department of Surgery. Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (O.G.); (R.V.)
| | - Ramon Vilallonga
- Department of Surgery. Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (O.G.); (R.V.)
| | - Olga Simó-Servat
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid 28020, Spain
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Cristina Hernández
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid 28020, Spain
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
| | - Rafael Simó
- Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), Plaça Cívica, Barcelona 08193, Spain; (A.M.O.-Z.); (E.F.); (D.R.); (O.S.-S.); (C.H.)
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid 28020, Spain
- Department of Endocrinology, Vall d’Hebron University Hospital. Passeig Vall d’Hebron 119-139, Barcelona 08035, Spain; (M.S.); (M.C.)
- Correspondence: (A.C.); (R.S.); Tel.: +34-934-894-172 (A.C.); +34-934-894-172 (R.S.)
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Decreased medial entorhinal cortical thickness in olanzapine exposed female rats is not ameliorated by exercise. Pharmacol Biochem Behav 2019; 188:172834. [PMID: 31785244 DOI: 10.1016/j.pbb.2019.172834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 11/20/2022]
Abstract
Aerobic exercise has been associated with hippocampal plasticity, both in healthy adults and in psychosis patients, but its impact on cortical regions remains unclear. The entorhinal cortex serves as a critical gateway for the hippocampus, and recent studies suggest that this region may also be impacted following an exercise regime. In order to investigate the effects of antipsychotic medications and exercise on the entorhinal cortex, female rats were chronically administered either olanzapine or vehicle and were either sedentary or had access to a running wheel for 9 weeks. Olanzapine-treated rats had decreased medial entorhinal cortical thickness compared to vehicle-treated rats. A statistically significant interaction was observed for layer II of the entorhinal cortex, with exercising rats having significantly greater thickness compared to sedentary rats in the vehicle group, but not the olanzapine group. Greater total entorhinal and lateral entorhinal cortical thickness was associated with greater average activity. In exercising rats, decreasing glucose intolerance was associated with larger total entorhinal and layer II cortical thickness. Lower fasting insulin levels were associated with greater total entorhinal, lateral entorhinal, and layer II cortical thickness. The relationship between increased activity and greater entorhinal cortical thickness was mediated by reduced fasting insulin, indicating that regulation of metabolic risk factors may contribute to impact of aerobic exercise on the entorhinal cortex. Aerobic exercise may be helpful in counteracting metabolic side effects of antipsychotic medications and managing these side effects may be key to promoting entorhinal cortical plasticity in patients treated with second-generation antipsychotic drugs.
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35
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Wahl D, Solon-Biet SM, Cogger VC, Fontana L, Simpson SJ, Le Couteur DG, Ribeiro RV. Aging, lifestyle and dementia. Neurobiol Dis 2019; 130:104481. [PMID: 31136814 DOI: 10.1016/j.nbd.2019.104481] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 12/21/2022] Open
Abstract
Aging is the greatest risk factor for most diseases including cancer, cardiovascular disorders, and neurodegenerative disease. There is emerging evidence that interventions that improve metabolic health with aging may also be effective for brain health. The most robust interventions are non-pharmacological and include limiting calorie or protein intake, increasing aerobic exercise, or environmental enrichment. In humans, dietary patterns including the Mediterranean, Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) and Okinawan diets are associated with improved age-related health and may reduce neurodegenerative disease including dementia. Rapamycin, metformin and resveratrol act on nutrient sensing pathways that improve cardiometabolic health and decrease the risk for age-associated disease. There is some evidence that they may reduce the risk for dementia in rodents. There is a growing recognition that improving metabolic function may be an effective way to optimize brain health during aging.
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Affiliation(s)
- Devin Wahl
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord 2139, Australia.
| | - Samantha M Solon-Biet
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord 2139, Australia
| | - Victoria C Cogger
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord 2139, Australia
| | - Luigi Fontana
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; School of Life and Environmental Sciences, University of Sydney, Sydney 2006, Australia
| | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord 2139, Australia
| | - Rosilene V Ribeiro
- Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; School of Life and Environmental Sciences, University of Sydney, Sydney 2006, Australia
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36
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Uranga RM, Keller JN. The Complex Interactions Between Obesity, Metabolism and the Brain. Front Neurosci 2019; 13:513. [PMID: 31178685 PMCID: PMC6542999 DOI: 10.3389/fnins.2019.00513] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022] Open
Abstract
Obesity is increasing at unprecedented levels globally, and the overall impact of obesity on the various organ systems of the body is only beginning to be fully appreciated. Because of the myriad of direct and indirect effects of obesity causing dysfunction of multiple tissues and organs, it is likely that there will be heterogeneity in the presentation of obesity effects in any given population. Taken together, these realities make it increasingly difficult to understand the complex interplay between obesity effects on different organs, including the brain. The focus of this review is to provide a comprehensive view of metabolic disturbances present in obesity, their direct and indirect effects on the different organ systems of the body, and to discuss the interaction of these effects in the context of brain aging and the development of neurodegenerative diseases.
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Affiliation(s)
- Romina María Uranga
- Instituto de Investigaciones Bioquímicas de Bahía Blanca, Universidad Nacional del Sur-Consejo Nacional de Investigaciones Científicas y Técnicas, Bahía Blanca, Argentina
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Jeffrey Neil Keller
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
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Grillo CA, Woodruff JL, Macht VA, Reagan LP. Insulin resistance and hippocampal dysfunction: Disentangling peripheral and brain causes from consequences. Exp Neurol 2019; 318:71-77. [PMID: 31028829 DOI: 10.1016/j.expneurol.2019.04.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 02/06/2023]
Abstract
In the periphery insulin plays a critical role in the regulation of metabolic homeostasis by stimulating glucose uptake into peripheral organs. In the central nervous system (CNS), insulin plays a critical role in the formation of neural circuits and synaptic connections from the earliest stages of development and facilitates and promotes neuroplasticity in the adult brain. Beyond these physiological roles of insulin, a shared feature between the periphery and CNS is that decreases in insulin receptor activity and signaling (i.e. insulin resistance) contributes to the pathological consequences of type 2 diabetes (T2DM) and obesity. Indeed, clinical and preclinical studies illustrate that CNS insulin resistance elicits neuroplasticity deficits that lead to decreases in cognitive function and increased risk of neuropsychiatric disorders. The goals of this review are to provide an overview of the literature that have identified the neuroplasticity deficits observed in T2DM and obesity, as well as to discuss the potential causes and consequences of insulin resistance in the CNS, with a particular focus on how insulin resistance impacts hippocampal neuroplasticity. Interestingly, studies that have examined the effects of hippocampal-specific insulin resistance illustrate that brain insulin resistance may impair neuroplasticity independent of peripheral insulin resistance, thereby supporting the concept that restoration of brain insulin activity is an attractive therapeutic strategy to ameliorate or reverse cognitive decline observed in patients with CNS insulin resistance such as T2DM and Alzheimer's Disease.
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Affiliation(s)
- Claudia A Grillo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, & Neuroscience, Columbia, SC, USA; WJB Dorn VA Medical Center, Columbia, SC 29209, USA
| | - Jennifer L Woodruff
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, & Neuroscience, Columbia, SC, USA; WJB Dorn VA Medical Center, Columbia, SC 29209, USA
| | - Victoria A Macht
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, & Neuroscience, Columbia, SC, USA; WJB Dorn VA Medical Center, Columbia, SC 29209, USA
| | - Lawrence P Reagan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, & Neuroscience, Columbia, SC, USA; WJB Dorn VA Medical Center, Columbia, SC 29209, USA.
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Chen ST, Volle D, Jalil J, Wu P, Small GW. Health-Promoting Strategies for the Aging Brain. Am J Geriatr Psychiatry 2019; 27:213-236. [PMID: 30686664 DOI: 10.1016/j.jagp.2018.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 12/31/2022]
Abstract
As the world's population ages and people live longer, the changes in the aging brain present substantial challenges to our health and society. With greater longevity come age-related diseases, many of which have direct and indirect influences on the health of the brain. Although there is some degree of predictable decline in brain functioning with aging, meaningful cognitive decline is not inevitable and is perhaps preventable. In this review, we present the case that the course of aging-related brain disease and dysfunction can be modified. We present the evidence for conditions and risk factors that may contribute to cognitive decline and dementia and for interventions that may mitigate their impact on cognitive functioning later in life, or even prevent them and their cognitive sequelae from developing. Although much work remains to be done to meet the challenges of the aging brain, strategies to promote its health have been demonstrated and offer much promise, which can only be realized if we mount a vigorous public health effort to implement these strategies.
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Affiliation(s)
- Stephen T Chen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles.
| | - Dax Volle
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Jason Jalil
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Pauline Wu
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Gary W Small
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
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Singh MK, Leslie SM, Packer MM, Zaiko YV, Phillips OR, Weisman EF, Wall DM, Jo B, Rasgon N. Brain and behavioral correlates of insulin resistance in youth with depression and obesity. Horm Behav 2019; 108:73-83. [PMID: 29596854 PMCID: PMC6173667 DOI: 10.1016/j.yhbeh.2018.03.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/23/2018] [Accepted: 03/24/2018] [Indexed: 01/10/2023]
Abstract
Depression, together with insulin resistance, is increasingly prevalent among youth. These conditions have traditionally been compartmentalized, but recent evidence suggests that a shared brain motivational network underlies their co-occurrence. We posit that, in the context of depressive symptoms, insulin resistance is associated with aberrant structure and functional connectivity in the Anterior Cingulate Cortex (ACC) and hippocampus. This motivational neural circuit underlies dysfunctional behavioral responses and increased sensitivity to rewarding aspects of ingesting high calorie food that lead to disinhibition of eating even when satiated. To investigate this shared mechanism, we evaluated a sample of forty-two depressed and overweight (BMI > 85th%) youth aged 9 to 17. Using ACC and hippocampus structural and seed-based regions of interest, we investigated associations between insulin resistance, depression, structure (ACC thickness, and ACC and hippocampal area), and resting-state functional connectivity (RSFC). We predicted that aberrant associations among these neural and behavioral characteristics would be stronger in insulin resistant compared to insulin sensitive youth. We found that youth with greater insulin resistance had higher levels of anhedonia and more food seeking behaviors, reduced hippocampal and ACC volumes, and greater levels of ACC and hippocampal dysconnectivity to fronto-limbic reward networks at rest. For youth with high levels of insulin resistance, thinner ACC and smaller hippocampal volumes were associated with more severe depressive symptoms, whereas the opposite was true for youth with low levels of insulin resistance. The ACC-hippocampal motivational network that subserves depression and insulin resistance separately, may represent a critical neural interaction that link these syndromes together.
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Affiliation(s)
- Manpreet K Singh
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States.
| | - Sara M Leslie
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Mary Melissa Packer
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Yevgeniya V Zaiko
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Owen R Phillips
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Elizabeth F Weisman
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Danielle M Wall
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Booil Jo
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Natalie Rasgon
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
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Childhood trauma and insulin resistance in patients suffering from depressive disorders. Exp Neurol 2019; 315:15-20. [PMID: 30639184 DOI: 10.1016/j.expneurol.2019.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/18/2018] [Accepted: 01/09/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Insulin resistance (IR) is a metabolic dysfunction often co-morbid with major depressive disorder (MDD). The paths to development of MDD remain largely unspecified, highlighting a need for identification of risk factors. Here, we tested whether specific subscales of childhood trauma as well as family history of type-2 diabetes (Fam-Hx-Dm2) are risk factors for development of metabolic dysfunction and severity of depressive symptoms. RESEARCH DESIGN AND METHODS We used a sample of 45 adults suffering from MDD that was well-characterized for insulin resistance and sensitivity as assessed by measures of fasting plasma glucose (FPG) plasma insulin (FPI) levels, body mass index (BMI), weight, homeostasis model assessment of insulin sensitivity (HOMA), Matsuda index as well as both glucose and insulin responses to oral glucose challenges. Severity of depressive symptoms was assessed with the Hamilton Depression Rating Scale (HDRS-21). Physical, sexual and emotional abuse as well as physical and emotional neglect were assessed with the Childhood Trauma Questionnaire. First- or second-degree relatives with type-2 diabetes defined fam-Hx-DM2. RESULTS Individuals reporting higher rates of emotional abuse were more likely to have greater IR as showed by elevated FPI levels and HOMA. No association was found with any of the other subscales of childhood trauma (e.g., physical abuse). Similarly, Fam-Hx-DM2 was associated with greater degree of IR as shown by elevated FPI, HOMA, but also FPG, weight and BMI. Moreover, we report a relationship and interaction between Fam-Hx-DM2 and emotional abuse on severity of depressive symptoms. Specifically, emotional abuse and Fam-HX-DM2 predicted severity of depressive symptoms at HDRS-21. Also, severity of depressive symptoms was greater with higher reported rates of emotional abuse but only in patients with negative Fam-Hx-Dm2. Individuals reporting higher emotional abuse and negative Fam-Hx-Dm2 also showed higher FPG levels. Conversely, individuals reporting higher emotional abuse and positive Fam-Hx-Dm2 showed higher FPI levels. This data suggest that Fam-Hx-Dm2 may define two different metabolic endophenotypes. CONCLUSIONS Our findings suggest that Fam-HX-DM2 and emotional abuse represent separate risk factors for developing metabolic dysfunction (i.e.: IR) in patients suffering from MDD, and that the effects of emotional abuse on psychiatric illness may depend upon the personal characteristics, including Fam-Hx-DM2.
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Depression and obesity: evidence of shared biological mechanisms. Mol Psychiatry 2019; 24:18-33. [PMID: 29453413 DOI: 10.1038/s41380-018-0017-5] [Citation(s) in RCA: 494] [Impact Index Per Article: 98.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/13/2017] [Accepted: 12/06/2017] [Indexed: 12/17/2022]
Abstract
Depression and obesity are common conditions with major public health implications that tend to co-occur within individuals. The relationship between these conditions is bidirectional: the presence of one increases the risk for developing the other. It has thus become crucial to gain a better understanding of the mechanisms responsible for the intertwined downward physiological spirals associated with both conditions. The present review focuses specifically on shared biological pathways that may mechanistically explain the depression-obesity link, including genetics, alterations in systems involved in homeostatic adjustments (HPA axis, immuno-inflammatory activation, neuroendocrine regulators of energy metabolism including leptin and insulin, and microbiome) and brain circuitries integrating homeostatic and mood regulatory responses. Furthermore, the review addresses interventional opportunities and questions to be answered by future research that will enable a comprehensive characterization and targeting of the biological links between depression and obesity.
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Carvalho C, Cardoso SM, Correia SC, Moreira PI. Tortuous Paths of Insulin Signaling and Mitochondria in Alzheimer's Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1128:161-183. [PMID: 31062330 DOI: 10.1007/978-981-13-3540-2_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Due to the exponential growth of aging population worldwide, neurodegenerative diseases became a major public health concern. Among them, Alzheimer's disease (AD) prevails as the most common in the elderly, rendering it a research priority. After several decades considering the brain as an insulin-insensitive organ, recent advances proved a central role for this hormone in learning and memory processes and showed that AD shares a high number of features with systemic conditions characterized by insulin resistance. Mitochondrial dysfunction has also been widely demonstrated to play a major role in AD development supporting the idea that this neurodegenerative disease is characterized by a pronounced metabolic dysregulation. This chapter is intended to discuss evidence demonstrating the key role of insulin signaling and mitochondrial anomalies in AD.
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Affiliation(s)
- Cristina Carvalho
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Susana M Cardoso
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Sónia C Correia
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Paula I Moreira
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal. .,Laboratory of Physiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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Molecular Connection Between Diabetes and Dementia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1128:103-131. [DOI: 10.1007/978-981-13-3540-2_6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Mosconi L, Rahman A, Diaz I, Wu X, Scheyer O, Hristov HW, Vallabhajosula S, Isaacson RS, de Leon MJ, Brinton RD. Increased Alzheimer's risk during the menopause transition: A 3-year longitudinal brain imaging study. PLoS One 2018; 13:e0207885. [PMID: 30540774 PMCID: PMC6291073 DOI: 10.1371/journal.pone.0207885] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 11/07/2018] [Indexed: 01/17/2023] Open
Abstract
Two thirds of all persons with late-onset Alzheimer's disease (AD) are women. Identification of sex-based molecular mechanisms underpinning the female-based prevalence of AD would advance development of therapeutic targets during the prodromal AD phase when prevention or delay in progression is most likely to be effective. This 3-year brain imaging study examines the impact of the menopausal transition on Alzheimer's disease (AD) biomarker changes [brain β-amyloid load via 11C-PiB PET, and neurodegeneration via 18F-FDG PET and structural MRI] and cognitive performance in midlife. Fifty-nine 40-60 year-old cognitively normal participants with clinical, neuropsychological, and brain imaging exams at least 2 years apart were examined. These included 41 women [15 premenopausal controls (PRE), 14 perimenopausal (PERI), and 12 postmenopausal women (MENO)] and 18 men. We used targeted minimum loss-based estimation to evaluate AD biomarker and cognitive changes. Older age was associated with baseline Aβ and neurodegeneration markers, but not with rates of change in these biomarkers. APOE4 status influenced change in Aβ load, but not neurodegenerative changes. Longitudinally, MENO and PERI groups showed declines in estrogen-dependent memory tests as compared to men (p < .04). Adjusting for age, APOE4 status, and vascular risk confounds, the MENO and PERI groups exhibited higher rates of CMRglc decline as compared to males (p ≤ .015). The MENO group exhibited the highest rate of hippocampal volume loss (p's ≤ .001), and higher rates of Aβ deposition than males (p < .01). CMRglc decline exceeded Aβ and atrophy changes in all female groups vs. men. These findings indicate emergence and progression of a female-specific hypometabolic AD-endophenotype during the menopausal transition. These findings suggest that the optimal window of opportunity for therapeutic intervention to prevent or delay progression of AD endophenotype in women is early in the endocrine aging process.
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Affiliation(s)
- Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States of America
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America
| | - Aneela Rahman
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States of America
| | - Ivan Diaz
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, United States of America
| | - Xian Wu
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, United States of America
| | - Olivia Scheyer
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States of America
| | - Hollie Webb Hristov
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States of America
| | - Shankar Vallabhajosula
- Department of Radiology, Weill Cornell Medical College, New York NY, United States of America
| | - Richard S. Isaacson
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States of America
| | - Mony J. de Leon
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America
| | - Roberta Diaz Brinton
- Departments of Pharmacology and Neurology, College of Medicine, University of Arizona, Tucson, United States of America
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「高齢者肥満症診療ガイドライン2018」. Nihon Ronen Igakkai Zasshi 2018. [PMID: 30464154 DOI: 10.3143/geriatrics.55.g1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Lee J, Kim J, Shin SA, Park S, Yoon DH, Kim H, Kim YK, Moon MK, Koo BK, Lee JY. Moderating Effect of Insulin Resistance on the Relationship between Gray Matter Volumes and Cognitive Function. J Clin Med 2018; 7:jcm7110413. [PMID: 30400348 PMCID: PMC6262494 DOI: 10.3390/jcm7110413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022] Open
Abstract
Background: It is controversial whether exposure to insulin resistance accelerates cognitive deterioration. The present study aimed to investigate the association between insulin resistance and gray matter volume loss to predict the cognitive decline. Methods: We recruited 160 participants (78 with Alzheimer’s disease and 82 without Alzheimer’s disease). Insulin resistance, regional gray matter volume, and cognitive function were assessed. A hierarchical moderated multiple regression (MMR) model was used to determine any associations among insulin resistance, structural changes in the brain, and cognitive decline. Results: The volumes of 7 regions in the gray matter were negatively related to insulin resistance in Alzheimer’s disease (p =0.032). Hierarchical MMR analysis indicated that insulin resistance did not directly affect the cognitive decline but moderated the cognitive decline through the decrease in gray matter volume in the key brain regions, i.e., inferior orbitofrontal gyrus (left), middle cingulate gyrus (right), hippocampus (right), and precuneus (right) (p < 0.05 in each case). Conclusion: Insulin resistance appears to exacerbate the cognitive decline associated with several gray matter volume loss.
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Affiliation(s)
- Jiyeon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Jihyeon Kim
- College of Medicine, Seoul National University, Seoul 03080, Korea.
| | - Seong A Shin
- Department of Biomedical Sciences, Seoul National University, Seoul 08826, Korea.
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
| | - Soowon Park
- Department of Education, Sejong University, Seoul 05006, Korea.
| | - Dong Hyun Yoon
- Department of Psychiatry and Behavioral Science, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
| | - Hongrae Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
| | - Jun-Young Lee
- Department of Psychiatry and Neuroscience Research Institute, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
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Garber A, Csizmadi I, Friedenreich CM, Sajobi TT, Longman RS, Tyndall AV, Drogos LL, Davenport MH, Poulin MJ. Association between glycemic load and cognitive function in community-dwelling older adults: Results from the Brain in Motion study. Clin Nutr 2018; 37:1690-1699. [DOI: 10.1016/j.clnu.2017.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/07/2017] [Indexed: 12/16/2022]
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Watson KT, Wroolie TE, Tong G, Foland-Ross LC, Frangou S, Singh M, McIntyre RS, Roat-Shumway S, Myoraku A, Reiss AL, Rasgon NL. Neural correlates of liraglutide effects in persons at risk for Alzheimer's disease. Behav Brain Res 2018; 356:271-278. [PMID: 30099030 DOI: 10.1016/j.bbr.2018.08.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/30/2018] [Accepted: 08/08/2018] [Indexed: 12/12/2022]
Abstract
Insulin resistance (IR) is a metabolic state preceding development of type 2 diabetes (DM2), cardiovascular disease, and neurodegenerative disorders, including Alzheimer's Disease (AD). Liraglutide, a glucagon-like peptide-1 (GLP) agonist, is an insulin-sensitizing agent with neuroprotective properties, as shown in animal studies. The purpose of this double-blinded, placebo-controlled study was to examine the neural effects of administration of liraglutide in cognitively normal late middle-aged individuals with subjective cognitive complaints (half of subjects had family history of AD). Seed-based resting state connectivity using functional magnetic resonance imaging (fMRI) was conducted before and after 12 weeks of liraglutide treatment or placebo. Neuropsychological testing was conducted before and after treatment to determine whether there were any potential behavioral correlates to neural changes. RESULTS At baseline (time point 1), higher fasting plasma glucose (FPG) was associated with decreased connectivity between bilateral hippocampal and anterior medial frontal structures. At time point 2, we observed significant improvement in intrinsic connectivity within the default mode network (DMN) in the active group relative to placebo. There were no detectable cognitive differences between study groups after this duration of treatment. To our knowledge, this is the first placebo-controlled study to report neural effects of liraglutide in a middle-aged population with subjective cognitive complaints. Larger and longer duration studies are warranted to determine whether liraglutide has neuroprotective benefits in individuals at risk for AD.
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Affiliation(s)
- Kathleen T Watson
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Tonita E Wroolie
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Gabby Tong
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Lara C Foland-Ross
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manpreet Singh
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Siena Roat-Shumway
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Alison Myoraku
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Allan L Reiss
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Natalie L Rasgon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
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Phillips OR, Onopa AK, Zaiko YV, Singh MK. Insulin resistance is associated with smaller brain volumes in a preliminary study of depressed and obese children. Pediatr Diabetes 2018; 19:892-897. [PMID: 29569318 PMCID: PMC6030449 DOI: 10.1111/pedi.12672] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/19/2018] [Accepted: 03/14/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE During childhood, the brain can consume up to 65% of total calories, and a steady supply of the brain's main fuel glucose needs to be maintained. Although the brain itself is not dependent on insulin for the uptake of glucose, insulin plays an important role in energy homeostasis. Thus, the risk for insulin resistance during brain development may negatively impact the whole brain volume. METHODS We investigated the link between the insulin resistance and the whole brain volume as measured by structural Magnetic resonance imaging (MRI) in 46 unmedicated depressed and overweight youths between the ages of 9 and 17 years. RESULTS Smaller whole brain volumes were associated with insulin resistance independent of age, sex, depression severity, body mass index, socioeconomic status, Tanner Stage, and Intelligence quotient (IQ) (r = 0.395, P = .014) CONCLUSIONS There may be a significant cost for developing insulin resistance on the developing brain. Disentangling the precise relationship between the insulin resistance and the developing brain is critical.
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Affiliation(s)
- Owen R. Phillips
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford Pediatric Mood Disorders Program, Division of Child and Adolescent Psychiatry, 401 Quarry Road, Stanford, CA 94305-5719,Corresponding Author: Owen Phillips, PhD, Postdoctoral Scholar, Stanford Pediatric Mood Disorders Program, Division of Child and Adolescent Psychiatry, 401 Quarry Road, Stanford, CA 94305-5719 (; Phone: (650) 725-5922; Fax: (650) 724-7389). Website: med.stanford.edu/pedmood
| | - Alexander K. Onopa
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford Pediatric Mood Disorders Program, Division of Child and Adolescent Psychiatry, 401 Quarry Road, Stanford, CA 94305-5719
| | - Yevgeniya V. Zaiko
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford Pediatric Mood Disorders Program, Division of Child and Adolescent Psychiatry, 401 Quarry Road, Stanford, CA 94305-5719
| | - Manpreet K. Singh
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford Pediatric Mood Disorders Program, Division of Child and Adolescent Psychiatry, 401 Quarry Road, Stanford, CA 94305-5719
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50
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Duarte A, Santos M, Oliveira C, Moreira P. Brain insulin signalling, glucose metabolism and females' reproductive aging: A dangerous triad in Alzheimer's disease. Neuropharmacology 2018; 136:223-242. [DOI: 10.1016/j.neuropharm.2018.01.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/22/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
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