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Janigro D, Bailey DM, Lehmann S, Badaut J, O'Flynn R, Hirtz C, Marchi N. Peripheral Blood and Salivary Biomarkers of Blood-Brain Barrier Permeability and Neuronal Damage: Clinical and Applied Concepts. Front Neurol 2021; 11:577312. [PMID: 33613412 PMCID: PMC7890078 DOI: 10.3389/fneur.2020.577312] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022] Open
Abstract
Within the neurovascular unit (NVU), the blood–brain barrier (BBB) operates as a key cerebrovascular interface, dynamically insulating the brain parenchyma from peripheral blood and compartments. Increased BBB permeability is clinically relevant for at least two reasons: it actively participates to the etiology of central nervous system (CNS) diseases, and it enables the diagnosis of neurological disorders based on the detection of CNS molecules in peripheral body fluids. In pathological conditions, a suite of glial, neuronal, and pericyte biomarkers can exit the brain reaching the peripheral blood and, after a process of filtration, may also appear in saliva or urine according to varying temporal trajectories. Here, we specifically examine the evidence in favor of or against the use of protein biomarkers of NVU damage and BBB permeability in traumatic head injury, including sport (sub)concussive impacts, seizure disorders, and neurodegenerative processes such as Alzheimer's disease. We further extend this analysis by focusing on the correlates of human extreme physiology applied to the NVU and its biomarkers. To this end, we report NVU changes after prolonged exercise, freediving, and gravitational stress, focusing on the presence of peripheral biomarkers in these conditions. The development of a biomarker toolkit will enable minimally invasive routines for the assessment of brain health in a broad spectrum of clinical, emergency, and sport settings.
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Affiliation(s)
- Damir Janigro
- Department of Physiology Case Western Reserve University, Cleveland, OH, United States.,FloTBI Inc., Cleveland, OH, United States
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, United Kingdom
| | - Sylvain Lehmann
- IRMB, INM, UFR Odontology, University Montpellier, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Jerome Badaut
- Brain Molecular Imaging Lab, CNRS UMR 5287, INCIA, University of Bordeaux, Bordeaux, France
| | - Robin O'Flynn
- IRMB, INM, UFR Odontology, University Montpellier, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Christophe Hirtz
- IRMB, INM, UFR Odontology, University Montpellier, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Nicola Marchi
- Cerebrovascular and Glia Research, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U 1191 INSERM, University of Montpellier), Montpellier, France
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Calverley TA, Ogoh S, Marley CJ, Steggall M, Marchi N, Brassard P, Lucas SJE, Cotter JD, Roig M, Ainslie PN, Wisløff U, Bailey DM. HIITing the brain with exercise: mechanisms, consequences and practical recommendations. J Physiol 2020; 598:2513-2530. [PMID: 32347544 DOI: 10.1113/jp275021] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/15/2020] [Indexed: 01/30/2023] Open
Abstract
The increasing number of older adults has seen a corresponding growth in those affected by neurovascular diseases, including stroke and dementia. Since cures are currently unavailable, major efforts in improving brain health need to focus on prevention, with emphasis on modifiable risk factors such as promoting physical activity. Moderate-intensity continuous training (MICT) paradigms have been shown to confer vascular benefits translating into improved musculoskeletal, cardiopulmonary and cerebrovascular function. However, the time commitment associated with MICT is a potential barrier to participation, and high-intensity interval training (HIIT) has since emerged as a more time-efficient mode of exercise that can promote similar if not indeed superior improvements in cardiorespiratory fitness for a given training volume and further promote vascular adaptation. However, randomised controlled trials (RCTs) investigating the impact of HIIT on the brain are surprisingly limited. The present review outlines how the HIIT paradigm has evolved from a historical perspective and describes the established physiological changes including its mechanistic bases. Given the dearth of RCTs, the vascular benefits of MICT are discussed with a focus on the translational neuroprotective benefits including their mechanistic bases that could be further potentiated through HIIT. Safety implications are highlighted and components of an optimal HIIT intervention are discussed including practical recommendations. Finally, statistical effect sizes have been calculated to allow prospective research to be appropriately powered and optimise the potential for detecting treatment effects. Future RCTs that focus on the potential clinical benefits of HIIT are encouraged given the prevalence of cognitive decline in an ever-ageing population.
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Affiliation(s)
- Thomas A Calverley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Shigehiko Ogoh
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK.,Department of Biomedical Engineering, Faculty of Engineering, Toyo University, Saitama, Japan
| | - Christopher J Marley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Martin Steggall
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Nicola Marchi
- Cerebrovascular and Glia Research Laboratory, Department of Neuroscience, Institute of Functional Genomics, Montpellier, France
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Marc Roig
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Philip N Ainslie
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK.,Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia-Okanagan Campus, Kelowna, BC, Canada
| | - Ulrik Wisløff
- The Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
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Sensitivity and Specificity of the ECAS in Parkinson's Disease and Progressive Supranuclear Palsy. PARKINSONS DISEASE 2018; 2018:2426012. [PMID: 29862010 PMCID: PMC5971325 DOI: 10.1155/2018/2426012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/19/2018] [Indexed: 12/11/2022]
Abstract
Disentangling Parkinson's disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP.
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Alladi S, Bak TH, Shailaja M, Gollahalli D, Rajan A, Surampudi B, Hornberger M, Duggirala V, Chaudhuri JR, Kaul S. Bilingualism delays the onset of behavioral but not aphasic forms of frontotemporal dementia. Neuropsychologia 2017; 99:207-212. [PMID: 28322905 DOI: 10.1016/j.neuropsychologia.2017.03.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/04/2017] [Accepted: 03/16/2017] [Indexed: 12/14/2022]
Abstract
Bilingualism has been found to delay onset of dementia and this has been attributed to an advantage in executive control in bilinguals. However, the relationship between bilingualism and cognition is complex, with costs as well as benefits to language functions. To further explore the cognitive consequences of bilingualism, the study used Frontotemporal dementia (FTD) syndromes, to examine whether bilingualism modifies the age at onset of behavioral and language variants of Frontotemporal dementia (FTD) differently. Case records of 193 patients presenting with FTD (121 of them bilingual) were examined and the age at onset of the first symptoms were compared between monolinguals and bilinguals. A significant effect of bilingualism delaying the age at onset of dementia was found in behavioral variant FTD (5.7 years) but not in progressive nonfluent aphasia (0.7 years), semantic dementia (0.5 years), corticobasal syndrome (0.4 years), progressive supranuclear palsy (4.3 years) and FTD-motor neuron disease (3 years). On dividing all patients predominantly behavioral and predominantly aphasic groups, age at onset in the bilingual behavioral group (62.6) was over 6 years higher than in the monolingual patients (56.5, p=0.006), while there was no difference in the aphasic FTD group (60.9 vs. 60.6 years, p=0.851). The bilingual effect on age of bvFTD onset was shown independently of other potential confounding factors such as education, gender, occupation, and urban vs rural dwelling of subjects. To conclude, bilingualism delays the age at onset in the behavioral but not in the aphasic variants of FTD. The results are in line with similar findings based on research in stroke and with the current views of the interaction between bilingualism and cognition, pointing to advantages in executive functions and disadvantages in lexical tasks.
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Affiliation(s)
- Suvarna Alladi
- Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India.
| | - Thomas H Bak
- Department of Psychology, Centre for Cognitive Aging and Cognitive Epidemiology (CCACE) and Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK.
| | - Mekala Shailaja
- Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India.
| | - Divyaraj Gollahalli
- Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India.
| | - Amulya Rajan
- Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India.
| | - Bapiraju Surampudi
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad & Centre for Neural and Cognitive Sciences, University of Hyderabad, Hyderabad, India.
| | | | | | | | - Subhash Kaul
- Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India.
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Bak TH. Why patients with dementia need a motor examination. J Neurol Neurosurg Psychiatry 2016; 87:1157. [PMID: 27261501 DOI: 10.1136/jnnp-2016-313466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 05/17/2016] [Indexed: 11/03/2022]
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Melloni M, Sedeño L, Hesse E, García-Cordero I, Mikulan E, Plastino A, Marcotti A, López JD, Bustamante C, Lopera F, Pineda D, García AM, Manes F, Trujillo N, Ibáñez A. Cortical dynamics and subcortical signatures of motor-language coupling in Parkinson's disease. Sci Rep 2015; 5:11899. [PMID: 26152329 PMCID: PMC4495549 DOI: 10.1038/srep11899] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/09/2015] [Indexed: 11/27/2022] Open
Abstract
Impairments of action language have been documented in early stage Parkinson’s disease (EPD). The action-sentence compatibility effect (ACE) paradigm has revealed that EPD involves deficits to integrate action-verb processing and ongoing motor actions. Recent studies suggest that an abolished ACE in EPD reflects a cortico-subcortical disruption, and recent neurocognitive models highlight the role of the basal ganglia (BG) in motor-language coupling. Building on such breakthroughs, we report the first exploration of convergent cortical and subcortical signatures of ACE in EPD patients and matched controls. Specifically, we combined cortical recordings of the motor potential, functional connectivity measures, and structural analysis of the BG through voxel-based morphometry. Relative to controls, EPD patients exhibited an impaired ACE, a reduced motor potential, and aberrant frontotemporal connectivity. Furthermore, motor potential abnormalities during the ACE task were predicted by overall BG volume and atrophy. These results corroborate that motor-language coupling is mainly subserved by a cortico-subcortical network including the BG as a key hub. They also evince that action-verb processing may constitute a neurocognitive marker of EPD. Our findings suggest that research on the relationship between language and motor domains is crucial to develop models of motor cognition as well as diagnostic and intervention strategies.
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Affiliation(s)
- Margherita Melloni
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile
| | - Lucas Sedeño
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile
| | - Eugenia Hesse
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina
| | - Indira García-Cordero
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina
| | - Ezequiel Mikulan
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile
| | - Angelo Plastino
- 1] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [2] National University La Plata, Physics Institute, (IFLP-CCT-CONICET) La Plata, 1900, Argentina [3] Physics Department, Universitat de les Illes Balears, Palma de Mallorca, 07122, Spain
| | - Aida Marcotti
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina
| | - José David López
- SISTEMIC, Engineering Faculty, Universidad de Antioquia (UDEA), Medellín, 1226, Colombia
| | - Catalina Bustamante
- Department of Research, Instituto de Alta Tecnología Médica de Antioquia, Medellín, 1234, Colombia
| | - Francisco Lopera
- Neuroscience Group, Faculty of Medicine, University of Antioquia (UDEA), Medellín, 1226, Colombia
| | - David Pineda
- 1] Group of Neuropsychology and Conduct (GRUNECO), Faculty of Medicine, University of Antioquia (UDEA), Medellín,1226, Colombia [2] Neuroscience Group, Faculty of Medicine, University of Antioquia (UDEA), Medellín, 1226, Colombia
| | - Adolfo M García
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile [4] Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Mendoza, 5502, Argentina
| | - Facundo Manes
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile [4] Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), New South Wales, 2109, Australia
| | - Natalia Trujillo
- 1] Mental Health Group. School of Public Health. Universidad de Antioquia (UDEA), Medellín, 1226, Colombia [2] Group of Neuropsychology and Conduct (GRUNECO), Faculty of Medicine, University of Antioquia (UDEA), Medellín,1226, Colombia [3] Neuroscience Group, Faculty of Medicine, University of Antioquia (UDEA), Medellín, 1226, Colombia
| | - Agustín Ibáñez
- 1] Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, 1854, Argentina [2] National Scientific and Technical Research Council (CONICET), Buenos Aires, 1033 Argentina [3] UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, 8370076, Chile [4] Universidad Autónoma del Caribe, Barranquilla, 1234, Colombia [5] Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), New South Wales, 2109, Australia
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Colosimo C, Bak TH, Bologna M, Berardelli A. Fifty years of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 2014; 85:938-44. [PMID: 24013274 DOI: 10.1136/jnnp-2013-305740] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Carlo Colosimo
- Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy
| | - Thomas H Bak
- School of Philosophy, Psychology and Language Sciences (PPLS) & Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | | | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy Neuromed Institute IRCCS, Pozzilli (IS), Italy
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Bak TH, Chandran S. What wires together dies together: Verbs, actions and neurodegeneration in motor neuron disease. Cortex 2012; 48:936-44. [DOI: 10.1016/j.cortex.2011.07.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 06/21/2011] [Accepted: 07/19/2011] [Indexed: 12/11/2022]
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Foster PP, Rosenblatt KP, Kuljiš RO. Exercise-induced cognitive plasticity, implications for mild cognitive impairment and Alzheimer's disease. Front Neurol 2011; 2:28. [PMID: 21602910 PMCID: PMC3092070 DOI: 10.3389/fneur.2011.00028] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 04/18/2011] [Indexed: 12/17/2022] Open
Abstract
Lifestyle factors such as intellectual stimulation, cognitive and social engagement, nutrition, and various types of exercise appear to reduce the risk for common age-associated disorders such as Alzheimer’s disease (AD) and vascular dementia. In fact, many studies have suggested that promoting physical activity can have a protective effect against cognitive deterioration later in life. Slowing or a deterioration of walking speed is associated with a poor performance in tests assessing psychomotor speed and verbal fluency in elderly individuals. Fitness training influences a wide range of cognitive processes, and the largest positive impact observed is for executive (a.k.a. frontal lobe) functions. Studies show that exercise improves additional cognitive functions such as tasks mediated by the hippocampus, and result in major changes in plasticity in the hippocampus. Interestingly, this exercise-induced plasticity is also pronounced in APOE ε4 carriers who express a risk factor for late-onset AD that may modulate the effect of treatments. Based on AD staging by Braak and Braak (1991) and Braak et al. (1993) we propose that the effects of exercise occur in two temporo-spatial continua of events. The “inward” continuum from isocortex (neocortex) to entorhinal cortex/hippocampus for amyloidosis and a reciprocal “outward” continuum for neurofibrillary alterations. The exercise-induced hypertrophy of the hippocampus at the core of these continua is evaluated in terms of potential for prevention to stave off neuronal degeneration. Exercise-induced production of growth factors such as the brain-derived neurotrophic factor (BDNF) has been shown to enhance neurogenesis and to play a key role in positive cognitive effects. Insulin-like growth factor (IGF-1) may mediate the exercise-induced response to exercise on BDNF, neurogenesis, and cognitive performance. It is also postulated to regulate brain amyloid β (Aβ) levels by increased clearance via the choroid plexus. Growth factors, specifically fibroblast growth factor and IGF-1 receptors and/or their downstream signaling pathways may interact with the Klotho gene which functions as an aging suppressor gene. Neurons may not be the only cells affected by exercise. Glia (astrocytes and microglia), neurovascular units and the Fourth Element may also be affected in a differential fashion by the AD process. Analyses of these factors, as suggested by the multi-dimensional matrix approach, are needed to improve our understanding of this complex multi-factorial process, which is increasingly relevant to conquering the escalating and intersecting world-wide epidemics of dementia, diabetes, and sarcopenia that threaten the global healthcare system. Physical activity and interventions aimed at enhancing and/or mimicking the effects of exercise are likely to play a significant role in mitigating these epidemics, together with the embryonic efforts to develop cognitive rehabilitation for neurodegenerative disorders.
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Affiliation(s)
- Philip P Foster
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Medical Branch Galveston, TX, USA
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