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Ramirez-Camba CD, Levesque CL. The Linear-Logistic Model: A Novel Paradigm for Estimating Dietary Amino Acid Requirements. Animals (Basel) 2023; 13:ani13101708. [PMID: 37238138 DOI: 10.3390/ani13101708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to determine whether current methods for estimating AA requirements for animal health and welfare are sufficient. An exploratory data analysis (EDA) was conducted, which involved a review of assumptions underlying AA requirements research, a data mining approach to identify animal responses to dietary AA levels exceeding those for maximum protein retention, and a literature review to assess the physiological relevance of the linear-logistic model developed through the data mining approach. The results showed that AA dietary levels above those for maximum growth resulted in improvements in key physiological responses, and the linear-logistic model depicted the AA level at which growth and protein retention rates were maximized, along with key metabolic functions related to milk yield, litter size, immune response, intestinal permeability, and plasma AA concentrations. The results suggest that current methods based solely on growth and protein retention measurements are insufficient for optimizing key physiological responses associated with health, survival, and reproduction. The linear-logistic model could be used to estimate AA doses that optimize these responses and, potentially, survival rates.
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Affiliation(s)
- Christian D Ramirez-Camba
- Department of Animal Science, University of Minnesota, St. Paul, MN 55108, USA
- Department of Animal Science, South Dakota State University, Brookings, SD 57007, USA
| | - Crystal L Levesque
- Department of Animal Science, South Dakota State University, Brookings, SD 57007, USA
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Comai S, Melloni E, Lorenzi C, Bollettini I, Vai B, Zanardi R, Colombo C, Valtorta F, Benedetti F, Poletti S. Selective association of cytokine levels and kynurenine/tryptophan ratio with alterations in white matter microstructure in bipolar but not in unipolar depression. Eur Neuropsychopharmacol 2022; 55:96-109. [PMID: 34847455 DOI: 10.1016/j.euroneuro.2021.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
Bipolar (BD) and major depression (MDD) disorders are severe mental illnesses characterised by altered levels of immune/inflammatory markers and disrupted white matter (WM) microstructure. A pro-inflammatory state was suggested to activate indoleamine 2,3-dioxygenase which, in turn, increases the amount of tryptophan (Trp) converted into kynurenine (Kyn). We investigated whether plasma levels of Trp, Kyn and Kyn/Trp ratio are associated with peripheral levels of immune/inflammatory markers and whether they are related to WM integrity in 100 MDD and 66 BD patients. Patients also underwent MRI, and fractional anisotropy (FA) was estimated as a measure of WM microstructure. BD patients showed higher Kyn levels and Kyn/Trp ratio than MDD patients, and lower FA in several WM tracts, including the corpus callosum and the inferior fronto-occipital fasciculus (IFO). Lower Trp levels associated with a more severe depressive symptomatology irrespective of diagnosis and with lower FA in the corpus callosum (CC) and external capsule (EC). We found an association of immune/inflammatory markers with Kyn/Trp ratio selectively in BD patients: IL-1β and TNF-α showed a positive relationship and IL-2 and IL-9 a negative relationship; in addition, higher IL-4 correlated with lower Kyn levels; higher Kyn/Trp ratio and IL-1β correlated with lower FA in the CC and IFO. Notably, the detrimental effect of IL-1β on the IFO was moderated by the Kyn/Trp ratio. These data suggest that in BD, cytokines and the conversion of Trp into Kyn may affect WM microstructure and support the idea that distinct mechanisms underlie the pathophysiology of BD and MDD.
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Affiliation(s)
- Stefano Comai
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; Department of Biomedical Sciences, University of Padua, Padua, Italy; Department of Psychiatry, McGill University, Montreal, Canada.
| | - Elisa Melloni
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Lorenzi
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Irene Bollettini
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Benedetta Vai
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Raffaella Zanardi
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Colombo
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Flavia Valtorta
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Poletti
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
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Poletti S, Melloni E, Aggio V, Colombo C, Valtorta F, Benedetti F, Comai S. Grey and white matter structure associates with the activation of the tryptophan to kynurenine pathway in bipolar disorder. J Affect Disord 2019; 259:404-412. [PMID: 31610997 DOI: 10.1016/j.jad.2019.08.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/21/2019] [Accepted: 08/17/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental illness characterised by reduced grey matter (GM) volumes and cortical thickness, and disrupted white matter (WM) microstructure. Activation of indoleamine 2,3-dioxygenase following a pro-inflammatory state could increase the amount of tryptophan (Trp) converted to kynurenine (Kyn) possibly leading to the production of detrimental catabolites of the Kyn pathway with neurotoxic effects. We investigated if peripheral levels of Trp-and Kyn and the breakdown of Trp-into Kyn (Kyn/Trp-ratio) are related to WM and GM integrity in BD. METHODS Peripheral levels of Trp-and Kyn were analysed in 72 patients with BD and 33 controls. Patients also underwent MRI in a Philips 3T scanner. RESULTS Patients showed higher Kyn levels and Kyn/Trp-ratio compared to controls. MRI analyses performed in patients with BD showed a negative association between the Kyn/Trp-ratio and the integrity of corpus callosum microstructure, the volume of the amygdala and cortical thickness in fronto-parietal regions. LIMITATION The lack of information on the levels of downstream metabolites of Kyn prevent us to confirm the possible unbalance between quinolinic and kynurenic acids as well as their possible relationship with changes in GM and WM markers. The activation of the Kyn pathway as suggested by the increased Kyn/Trp-ratio may lead to an imbalance of the neurotoxic vs the neuroprotective arm of the biochemical pathway, resulting in significant changes in GM and WM regions of brain areas strongly implicated in the pathophysiology of BD, such as amygdala and corpus callosum.
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Affiliation(s)
- Sara Poletti
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy.
| | - Elisa Melloni
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Veronica Aggio
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Cristina Colombo
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Flavia Valtorta
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Stefano Comai
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
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Chiappelli J, Postolache TT, Kochunov P, Rowland LM, Wijtenburg SA, Shukla DK, Tagamets M, Du X, Savransky A, Lowry CA, Can A, Fuchs D, Hong LE. Tryptophan Metabolism and White Matter Integrity in Schizophrenia. Neuropsychopharmacology 2016; 41:2587-95. [PMID: 27143602 PMCID: PMC4987857 DOI: 10.1038/npp.2016.66] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/24/2016] [Accepted: 04/22/2016] [Indexed: 02/06/2023]
Abstract
Schizophrenia is associated with abnormalities in the structure and functioning of white matter, but the underlying neuropathology is unclear. We hypothesized that increased tryptophan degradation in the kynurenine pathway could be associated with white matter microstructure and biochemistry, potentially contributing to white matter abnormalities in schizophrenia. To test this, fasting plasma samples were obtained from 37 schizophrenia patients and 38 healthy controls and levels of total tryptophan and its metabolite kynurenine were assessed. The ratio of kynurenine to tryptophan was used as an index of tryptophan catabolic activity in this pathway. White matter structure and function were assessed by diffusion tensor imaging (DTI) and (1)H magnetic resonance spectroscopy (MRS). Tryptophan levels were significantly lower (p<0.001), and kynurenine/tryptophan ratios were correspondingly higher (p=0.018) in patients compared with controls. In patients, lower plasma tryptophan levels corresponded to lower structural integrity (DTI fractional anisotropy) (r=0.347, p=0.038). In both patients and controls, the kynurenine/tryptophan ratio was inversely correlated with frontal white matter glutamate level (r=-0.391 and -0.350 respectively, p=0.024 and 0.036). These results provide initial evidence implicating abnormal tryptophan/kynurenine pathway activity in changes to white matter integrity and white matter glutamate in schizophrenia.
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Affiliation(s)
- Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA,Maryland Psychiatric Research Center, PO Box 21247, Baltimore, MD 21228, USA, Tel: +1 410 402 6827, Fax: +1 410 402 6077, E-mail:
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA,MIRECC, VISN 5, Baltimore, MD, USA,Rocky Mountain MIRECC for Suicide Prevention, Denver, CO, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dinesh K Shukla
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Malle Tagamets
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anya Savransky
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Adem Can
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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Komatsu K, Mikami T, Noshiro S, Miyata K, Wanibuchi M, Mikuni N. Reversibility of White Matter Hyperintensity by Revascularization Surgery in Moyamoya Disease. J Stroke Cerebrovasc Dis 2016; 25:1495-502. [PMID: 27038979 DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 02/09/2016] [Accepted: 02/25/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND White matter lesions (WMLs) indicate progressive cerebral small vessel disease and are frequently observed in aging people and stroke patients. The purpose of this study was to evaluate WMLs and the influence of revascularization surgery for WMLs in patients with moyamoya disease. METHODS A total of 42 hemispheres in 21 patients with moyamoya disease were included in this analysis. WMLs were detected on fluid-attenuated inversion recovery (FLAIR) imaging in 24 hemispheres. The distribution pattern of WMLs was categorized. WMLs were measured by manually creating a region of interest, and the total WML volume in the hemisphere was estimated and compared with the control group. Clinical features of patients with WMLs and postoperative changes were analyzed. RESULTS The total WML volume in moyamoya disease was significantly higher than that of controls (P = .014). WMLs were observed in the internal watershed zone, especially in the watershed zone between the anterior cerebral artery and the middle cerebral artery. Patients with WMLs had significantly higher magnetic resonance angiography scores compared with controls (P = .015). A given patient's total WML volume per hemisphere was significantly decreased after surgery (P = .001). CONCLUSIONS WMLs on FLAIR imaging increase in patients with moyamoya disease and are reversible by revascularization surgery. Improvement of cerebral blood flow is partly related to the decrease in WMLs. The present results provide insight into the potential role of revascularization surgery.
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Affiliation(s)
- Katsuya Komatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Shouhei Noshiro
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Kei Miyata
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | | | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
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Kuriyama N, Mizuno T, Kita M, Yamada K, Ozaki E, Matsumoto S, Takada A, Watanabe A, Kasai T, Nagakane Y, Mitani S, Matsui D, Watanabe I, Takeda K, Nakagawa M, Watanabe Y. TGF-beta1 is associated with the progression of intracranial deep white matter lesions: a pilot study with 5 years of magnetic resonance imaging follow-up. Neurol Res 2013; 36:47-52. [PMID: 24083683 DOI: 10.1179/1743132813y.0000000256] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Elevated expression of transforming growth factor (TGF)-beta1 has been reported in hereditary cerebral small-vessel (HCSV) disease. The aim of this study was to clarify whether TGF-beta1 is a risk factor for intracranial deep white matter lesions (DWLs) and their progression in a general elderly population. METHODS The subjects included 81 participants (Groups DWL, DWLP, and C) who had voluntarily undergone a health examination and brain magnetic resonance imaging (MRI) in 2003 and 2008 and 43 age-matched patients with previous symptomatic brain infarctions. Deep white matter lesions were graded from Grade 0 to 3 according to the Fazekas classification. Group DWL (23 subjects) was defined as DWLs with no progression in the grade level, and Group DWLP (progression of DWL) (12 subjects) was defined as DWLs with an increase in one or more grade number and an apparent worsening of Grade 3. Forty-six age-matched control subjects with consistent normal brain MRI were included in Group C. The associations between DWLs and various vascular risk factors, including peripheral blood TGF-beta1 levels, were examined. RESULTS In addition to the classical risk factors, the highest TGF-beta1 levels were found in Group DWLP. The TGF-beta1 levels were significantly higher in Group DWLP than in Group DWL, and DWLP was significantly correlated with elevated TGF-beta1 levels (odds ratio [OR] = 1·72). CONCLUSIONS The present data suggest that TGF-beta1 may be important in the pathogenesis and progression of DWLs, and it is expected to be useful as a clinical indicator reflecting the presence of intracranial white matter lesions.
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Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects: the Sefuri brain MRI study. Hypertens Res 2009; 32:586-90. [PMID: 19424282 DOI: 10.1038/hr.2009.65] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Apathy is defined as a syndrome of primary loss of motivation not attributable to emotional distress, intellectual impairment or consciousness disturbance. The aim of our study was to investigate the effects of vascular risk factors and silent ischemic brain lesions on apathetic behavior of community-dwelling elderly subjects. Brain MRI and other medical examinations were performed on 222 non-demented community-dwelling elderly subjects (96 men and 126 women, average age 70.1 years). The apathy group was defined as the most apathetic quintile determined by Starkstein's apathy scale. Silent infarction, deep white matter lesions (DWMLs) and periventricular hyperintensities were detected in 12.2, 39.2 and 22.5%, respectively. Linear regression analysis (Pearson) revealed that the scores on the apathy scale correlated slightly but significantly with logarithmically transformed scores of the Modified Stroop Test (r=0.135, P=0.045), but not with the Mini-Mental State Examination. The apathy group tended to have more high blood pressure (141.6/82.6 vs. 136.1/79.6 mm Hg), less prevalent hyperlipidemia (18 vs. 35%) and lower serum albumin. Multivariate analysis (the forward stepwise method of logistic analysis) revealed an independent correlation between the apathy and grade of DWMLs (odds ratio 1.826, 95% confidence interval (CI) 1.129-2.953 per grade) or diastolic blood pressure (DBP) (odds ratio 1.055, 95% CI 1.014-1.098 per mm Hg) after adjusting for possible confounders. The mean apathy scale score in the DBP>or=90 mm Hg group was significantly lower (more apathetic) than that in the DBP<80 group (P=0.011, analysis of covariance). This study showed that hypertension and DWMLs are independently associated with apathy in healthy elderly subjects.
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TOYODA K. Cerebral White Matter Lesions and Microbleeds: Tiny but Meaningful Indicators of Hypertensive Damage. Hypertens Res 2008; 31:5-6. [DOI: 10.1291/hypres.31.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Matsui T, Nemoto M, Maruyama M, Yuzuriha T, Yao H, Tanji H, Ootsuki M, Tomita N, Matsushita S, Higuchi S, Yoshida YI, Seki T, Iwasaki K, Furukawa K, Arai H. Plasma Homocysteine and Risk of Coexisting Silent Brain Infarction in Alzheimer’s Disease. NEURODEGENER DIS 2006; 2:299-304. [PMID: 16909012 DOI: 10.1159/000092316] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Accepted: 01/23/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cerebrovascular disease is common in Alzheimer's disease (AD). Elevated plasma homocysteine (pHcy) levels are reported to be associated with an increased risk of poor cognition and dementia. OBJECTIVE To determine whether high pHcy levels are associated with an increased risk of coexisting silent brain infarctions (SBIs) in AD. METHODS Study population comprising 143 outpatients with clinical diagnosis of probable AD (73.3 +/- 7.0 years) were classified into 2 groups according to the presence or absence of SBIs on magnetic resonance imaging. RESULTS SBIs were noted in 32.9% (47/143) of the AD patients. The pHcy levels in the AD with SBIs (14.0 +/- 4.5 micromol/l) were significant ly elevated compared with the AD without SBIs (11.7 +/- 4.7 micromol/l, p = 0.007). After adjusting for age and gender, high pHcy (>12.4 micromol/l), but not hypertension, was associated with an increased risk of developing SBIs in AD (OR = 4.61, 95% CI = 1.74-12.2, p = 0.002). However, age at onset, cognitive function, cerebrospinal tau or amyloid beta-peptide(1-42) levels were not significantly correlated with pHcy levels in AD. CONCLUSION SBIs commonly coexist with AD, and may be a unique vascular condition in which homocysteine plays an important role. Homocysteine-lowering therapy rather than antihypertensive medication might be an appropriate strategy to prevent stroke associated with AD.
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Affiliation(s)
- Toshifumi Matsui
- Department of Geriatric and Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Garau C, Aparicio S, Rial RV, Nicolau MC, Esteban S. Age related changes in the activity-rest circadian rhythms and c-fos expression of ring doves with aging. Effects of tryptophan intake. Exp Gerontol 2006; 41:430-8. [PMID: 16564149 DOI: 10.1016/j.exger.2006.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 01/31/2006] [Accepted: 02/07/2006] [Indexed: 11/16/2022]
Abstract
Age related changes in the circadian rhythms and sleep quality has been linked with impairment in the function of the suprachiasmatic nucleus (SCN) and melatonin secretion. The precursor of melatonin, serotonin (5-HT) is a neurotransmitter involved in the synchronisation of the circadian clock located in SCN, which shows decreased levels with age. The present work studied the effects of L-tryptophan, the precursor of 5-HT, on the circadian activity-rest rhythm and c-fos expression in the SCN of young and old ring doves, animals diurnal and monocyclic as humans. Two hours before the onset of dark phase, animals housed in cages equipped for activity recording and maintained under 12/12 L/D conditions, received orally L-tryptophan (100 and 240 mg/kg) and, for comparative purposes, melatonin (2.5 and 5 mg/kg). The administration of both L-tryptophan and melatonin reduced the nocturnal activity of all ring doves although only the highest doses were effective in old ones. A reduced amplitude in the activity-rest rhythm was observed in old animals in comparison to youngest, but it was increased after the treatments. Sleep parameters, calculated from the activity data, indicated a worsened sleep quality in old animals but it was improved with the treatments. In addition, the expression of c-fos in the SCN was reduced after both mentioned treatments. The results point to the SCN as a target for the observed nocturnal effects of L-tryptophan and melatonin, and support the supplemental administration of the essential amino acid L-tryptophan to reverse the disturbances of the circadian activity-rest cycle related with ageing.
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Affiliation(s)
- Celia Garau
- Laboratori de Neurofisiologia, Departament de Biologia Fonamental i Ciènces de la Salut, Universitat de les Illes Balears, Ctra. Valldemossa Km 7,5, E-07122 Palma de Mallorca, Spain
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Horikawa E, Matsui T, Arai H, Seki T, Iwasaki K, Sasaki H. Risk of falls in Alzheimer's disease: a prospective study. Intern Med 2005; 44:717-21. [PMID: 16093593 DOI: 10.2169/internalmedicine.44.717] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Falls are common in patients with Alzheimer's disease (AD). Identification of the potential risk factors and developing preventive strategies for falls will have a significant impact in maintaining the quality of life in AD. PATIENTS Clinical follow-up of 124 (74.1+/-6.1 years, range 62-88) mild to moderate AD patients in an outpatient memory clinic. METHODS Postural sway, cognitive function, use of neuroleptics, severity of periventricular and deep white matter lesions, and the presence or absence of silent brain infarctions on magnetic resonance imaging were assessed at baseline. RESULTS A total of 104 patients (84%) completed the study. Fall events were confirmed in 42.3% (44/104). After adjustment for age, gender, and cognitive status, a high grade of periventricular white matter lesions (odds ratio 8.7 [95%CI 1.5 to 51.8], p = 0.017) and neuroleptic drug use (odds ratio 3.5 [95%CI 1.2 to 10.5], p = 0.027) were significantly associated with an increased risk of falls. CONCLUSION Our results suggest that periventricular white matter lesions and the use of neuroleptics may be related to falls in mild to moderate AD. A comprehensive risk management of brain ischemia as well as the use of the smallest efficacious dose of neuroleptics in the treatment of behavioral and psychiatric symptoms of AD should be recommended to help reduce the risk of unexpected falls.
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Affiliation(s)
- Etsuo Horikawa
- Division of Physical and Behavioral Support System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga
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Takashima Y, Yao H, Koga H, Endo K, Matsumoto T, Uchino A, Sadanaga-Akiyoshi F, Yuzuriha T, Kuroda Y. Frontal lobe dysfunction caused by multiple lacunar infarction in community-dwelling elderly subjects. J Neurol Sci 2003; 214:37-41. [PMID: 12972386 DOI: 10.1016/s0022-510x(03)00171-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We examined the factors that influence frontal lobe function among 119 community-dwelling elderly subjects, based on magnetic resonance imaging (MRI) and clinical findings. We interviewed the subjects, and conducted a neurological examination, electrocardiogram, blood test, brain MRI examination, and cognitive function tests. The modified Stroop test and a personal computer version of the Wisconsin Card Sorting Test (WCST) were used to evaluate frontal lobe function. The subjects with impaired frontal lobe function defined by the modified Stroop test were significantly older, had more lacunar infarcts, and had lower HDL cholesterol values based on a logistic regression model. Among the aged who appear apparently normal, multiple lacunar infarcts are the cause of latent frontal lobe dysfunction.
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Affiliation(s)
- Yuki Takashima
- Center for Emotional and Behavioral Disorder, Hizen National Hospital, Kanzaki, Saga 842-0192, Japan.
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Yao H, Yuzuriha T, Koga H, Takashima Y, Fukuda K, Endo K, Uchino A, Ibayashi S, Uchimura H, Fujishima M, Iida M. Vascular and non-vascular risk factors for deep white matter lesions in community-dwelling elderly subjects. Geriatr Gerontol Int 2003. [DOI: 10.1046/j.1444-1586.2003.00061.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Koga H, Yuzuriha T, Yao H, Endo K, Hiejima S, Takashima Y, Sadanaga F, Matsumoto T, Uchino A, Ogomori K, Ichimiya A, Uchimura H, Tashiro N. Quantitative MRI findings and cognitive impairment among community dwelling elderly subjects. J Neurol Neurosurg Psychiatry 2002; 72:737-41. [PMID: 12023416 PMCID: PMC1737917 DOI: 10.1136/jnnp.72.6.737] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To study the factors which influence cognitive impairment among elderly subjects living in a local community, based on both MRI and clinical findings, to further elucidate the causes of dementia, and also to help develop strategies for its prevention. METHODS Cranial MRI and other medical examinations were performed on non-demented elderly subjects who resided in one rural community. A total of 254 subjects aged from 60 to 91 years of age, with a mean age of 73.9 (SD 6.8) were examined. The mini mental state examination (MMSE) was used to identify cognitive impairment. White matter lesions and cerebral atrophy on MR images were measured quantitatively. A multivariate analysis was also performed with the existence of cognitive impairment as the dependent variable, and the MRI findings and clinical observations were used as the independent variables. RESULTS Cognitive impairment was present in 46 subjects (18.1%). They were older, had a lower educational level, and more frequent hypertension compared with those without cognitive impairment. The packed cell volume was lower in the impaired group. In addition, their MRI findings showed significantly larger quantities of white matter lesions and cerebral atrophy, as well as more infarcts. A logistic regression analysis demonstrated a significant relation among such factors as white matter lesions (odds ratio (OR) 1.575, 95% confidence interval (95% CI) 1.123-2.208), cerebral atrophy (OR 0.761, 95%CI 0.587-0.987), and lower education (OR 0.682, 95%CI 0.544-0.855) for subjects with a cognitive impairment. CONCLUSIONS White matter lesions and cerebral atrophy are factors which induce a cognitive impairment in community dwelling elderly subjects without dementia. It is important to carefully watch for any abnormalities in these factors, and to perform cohort studies to check for the above risk factors, to both prevent and make an early diagnosis of dementia.
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Affiliation(s)
- H Koga
- Department of Neuropsychiatry, Faculty of Medicine, Kyushu University Hospital, Maidashi, Fukuoka 812-8582, Japan.
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Matsui T, Arai H, Yuzuriha T, Yao H, Miura M, Hashimoto S, Higuchi S, Matsushita S, Morikawa M, Kato A, Sasaki H. Elevated plasma homocysteine levels and risk of silent brain infarction in elderly people. Stroke 2001; 32:1116-9. [PMID: 11340219 DOI: 10.1161/01.str.32.5.1116] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Silent brain infarction (SBI) on MRI is common in elderly people, and recent studies have demonstrated that SBI increases the risk of progression to clinically apparent stroke and cognitive decline. Therefore, an early and accurate detection of SBI and a search for potential treatable risk factors may have a significant impact on public health. METHODS Community-dwelling elderly people aged >/=66 years who participated in the present study (n=153) underwent brain MRI and standardized physical and neuropsychological examinations as well as blood biochemistry determinations, including total plasma homocysteine (pHcy), renal function, vitamin status, and polymorphisms of the methylenetetrahydrofolate reductase gene. RESULTS SBI was found in 24.8% of the participants. In the univariate analysis, the pHcy levels in subjects with SBI (13.6+/-4.1 micromol/L) were significantly higher (P=0.0004) than those in subjects without SBI (11.0+/-3.3 micromol/L). When pHcy levels were stratified into high (>/=15.1 mmol/L), moderate (11.6 to 15.0 mmol/L), and low (</=11.5 mmol/L) groups, age (P<0.0001), male sex (P<0.0001), the habits of cigarette smoking (P<0.0001) and of alcohol consumption (P=0.0002), and folate levels (P=0.01) were significantly associated with an elevation of pHcy levels. The elevated pHcy levels were significantly associated with SBI after individual adjustment for age, sex, hypertension, renal function, and the habits of smoking and alcohol consumption. CONCLUSIONS pHcy level is associated with age and nutritional and other lifestyle factors, and it contributes to a risk for SBI.
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Affiliation(s)
- T Matsui
- Department of Geriatric Medicine, Tohoku University School of Medicine, Sendai, Japan
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Yao H, Fujishima M. Cerebral blood flow and metabolism in silent brain infarction and related cerebrovascular disorders. Ann Med 2001; 33:98-102. [PMID: 11327121 DOI: 10.3109/07853890109002064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The appropriate management of silent stroke requires better understanding of the haemodynamic status in the brain. However, only a few studies have examined cerebral blood flow and metabolism in subjects with silent stroke. Positron emission tomography demonstrated a slight decrease in cortical blood flow with an increase in oxygen extraction fraction (ie misery perfusion) in subjects with silent brain infarction, whereas both cerebral blood flow and oxygen metabolism decreased in patients with symptomatic brain infarction (matched hypoperfusion). These findings confirm that brain circulation is haemodynamically compromised in subjects with silent stroke. Another important point is that subcortical silent stroke may induce a reduction in cortical blood flow and metabolism by a disconnection mechanism (ie diaschisis) between the cortex and the subcortical structures. Silent infarction is not innocuous in terms of compromised cerebral circulation, which may lead to cognitive decline or subsequent clinical stroke. In the future, further developments in functional imaging will permit a more sophisticated analysis of brain circulation and metabolism in silent stroke.
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Affiliation(s)
- H Yao
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan.
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Yao H, Yuzuriha T, Fukuda K, Matsumoto T, Ibayashi S, Uchimura H, Fujishima M. Cerebral blood flow in nondemented elderly subjects with extensive deep white matter lesions on magnetic resonance imaging. J Stroke Cerebrovasc Dis 2000; 9:172-5. [DOI: 10.1053/jscd.2000.7218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/1999] [Accepted: 12/15/1999] [Indexed: 11/11/2022] Open
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