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Ohlrogge AH, Camen S, Nagel L, Brederecke J, Jensen M, Stenmans E, Engler D, Schulte C, Albrecht J, Csengeri D, Kirchhof P, Cheng B, Petersen M, Mayer C, Börschel CS, Wenzel JP, Blankenberg S, Kühn S, Thomalla G, Schnabel RB. Subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with reduced cognitive function: results from the Hamburg City Health Study. Clin Res Cardiol 2024:10.1007/s00392-024-02581-5. [PMID: 39601872 DOI: 10.1007/s00392-024-02581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 11/18/2024] [Indexed: 11/29/2024]
Abstract
BACKGROUND Atrial fibrillation is associated with cognitive dysfunction. Atrial cardiomyopathy has been correlated with both entities. We aimed to characterize the association of echocardiographic parameters of atrial cardiomyopathy with cognitive function and cerebral changes. METHODS Participants of the population-based Hamburg City Health Study underwent in-depth transthoracic echocardiography and cognitive function testing, the Animal Naming Test (ANT), the Trail Making Test A (TMT-A) and B (TMT-B), 10-word learning test and cerebral magnetic resonance imaging. RESULTS After excluding individuals with stroke or depression, data from 7852 individuals were available. In multi-variable-adjusted regression analyses, the E/e'-ratio was associated with the level of impairment in the ANT (- 0.19 per one standard deviation [SD] increase, 95% confidence interval [CI] - 0.36-[- 0.01]) and the TMT-A (0.01 per one SD increase, 95% CI 0.003-0.020). Left atrial global peak strain was associated with positive performance in the TMT-A and B (-0.01 per one SD increase [95% CI - 0.02-(- 0.002)] and - 0.02 per one SD increase [95% CI - 0.03-(- 0.01)], respectively) and the immediate recall of the 10-word learning test (0.11 per one SD increase, 95% CI 0.02-0.20). The E/e'-ratio was positively associated with the total and periventricular white matter hyperintensity load in age- and sex-adjusted regression analyses though statistical significance was lost after multi-variable adjustment. CONCLUSIONS Subclinical echocardiographic signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with impaired performance in cognitive tests in the population. Our data provide evidence of the clinically important cardio-cerebral axis, relating cardiac dysfunction with cognitive performance.
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Affiliation(s)
- Amelie H Ohlrogge
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Stephan Camen
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Lina Nagel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Auguste-Viktoria-Hospital, Berlin, Germany
| | - Jan Brederecke
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Märit Jensen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ewgenia Stenmans
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Engler
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Christian Schulte
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Jan Albrecht
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Dora Csengeri
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, Medical School, University of Birmingham, Edgbaston, Birmingham, UK
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christin S Börschel
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Jan-Per Wenzel
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Rhythmology, University Heart Center Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Renate B Schnabel
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany.
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Bucci T, Choi SE, Tsang CTW, Yiu KH, Buckley BJR, Pignatelli P, Scheitz JF, Lip GYH, Abdul-Rahim AH. Incident dementia in ischaemic stroke patients with early cardiac complications: A propensity-score matched cohort study. Eur Stroke J 2024:23969873241293573. [PMID: 39487764 PMCID: PMC11558657 DOI: 10.1177/23969873241293573] [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: 07/21/2024] [Accepted: 10/07/2024] [Indexed: 11/04/2024] Open
Abstract
INTRODUCTION The risk of dementia in patients with stroke-heart syndrome (SHS) remains unexplored. PATIENTS AND METHODS Retrospective analysis using the TriNetX network, including patients with ischaemic stroke from 2010 to 2020. These patients were categorised into two groups: those with SHS (heart failure, myocardial infarction, ventricular fibrillation, or Takotsubo cardiomyopathy within 30 days post-stroke) and those without SHS. The primary outcome was the 1-year risk of dementia (vascular dementia, dementia in other disease, unspecified dementia, or Alzheimer's disease). The secondary outcome was the 1-year risk of all-cause death. Cox regression analysis after 1:1 propensity score matching (PSM) was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the outcomes. RESULTS We included 52,971 patients with SHS (66.6 ± 14.6 years, 42.2% females) and 854,232 patients without SHS (64.7 ± 15.4 years, 48.2% females). Following PSM, 52,970 well-balanced patients were considered in each group. Patients with SHS had a higher risk of incident dementia compared to those without SHS (HR 1.28, 95%CI 1.20-1.36). The risk was the highest during the first 31 days of follow-up (HR 1.51, 95%CI 1.31-1.74) and was mainly driven by vascular and mixed forms. The increased risk of dementia in patients with SHS, was independent of oral anticoagulant use, sex and age but it was the highest in those aged <75 years compared to ⩾75 years. DISCUSSION AND CONCLUSION SHS is associated with increased risk of dementia. Future studies are needed to develop innovative strategies for preventing complications associated with stroke-heart syndrome and improving the long-term prognosis of these patients.
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Affiliation(s)
- Tommaso Bucci
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Sylvia E Choi
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Christopher TW Tsang
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kai-Hang Yiu
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Benjamin JR Buckley
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Cardiovascular Health Sciences, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Jan F Scheitz
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Gregory YH Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Azmil H Abdul-Rahim
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Stroke Division, Department Medicine for Older People, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK
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Salis Torres A, Lee JE, Caporali A, Semple RK, Horrocks MH, MacRae VE. Mitochondrial Dysfunction as a Potential Mechanism Mediating Cardiac Comorbidities in Parkinson's Disease. Int J Mol Sci 2024; 25:10973. [PMID: 39456761 PMCID: PMC11507255 DOI: 10.3390/ijms252010973] [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: 09/11/2024] [Revised: 10/02/2024] [Accepted: 10/08/2024] [Indexed: 10/28/2024] Open
Abstract
Individuals diagnosed with Parkinson's disease (PD) often exhibit heightened susceptibility to cardiac dysfunction, reflecting a complex interaction between these conditions. The involvement of mitochondrial dysfunction in the development and progression of cardiac dysfunction and PD suggests a plausible commonality in some aspects of their molecular pathogenesis, potentially contributing to the prevalence of cardiac issues in PD. Mitochondria, crucial organelles responsible for energy production and cellular regulation, play important roles in tissues with high energetic demands, such as neurons and cardiac cells. Mitochondrial dysfunction can occur in different and non-mutually exclusive ways; however, some mechanisms include alterations in mitochondrial dynamics, compromised bioenergetics, biogenesis deficits, oxidative stress, impaired mitophagy, and disrupted calcium balance. It is plausible that these factors contribute to the increased prevalence of cardiac dysfunction in PD, suggesting mitochondrial health as a potential target for therapeutic intervention. This review provides an overview of the physiological mechanisms underlying mitochondrial quality control systems. It summarises the diverse roles of mitochondria in brain and heart function, highlighting shared pathways potentially exhibiting dysfunction and driving cardiac comorbidities in PD. By highlighting strategies to mitigate dysfunction associated with mitochondrial impairment in cardiac and neural tissues, our review aims to provide new perspectives on therapeutic approaches.
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Affiliation(s)
- Agustina Salis Torres
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush, Midlothian EH25 9RH, UK; (A.S.T.); (J.-E.L.)
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh EH9 3FJ, UK;
| | - Ji-Eun Lee
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush, Midlothian EH25 9RH, UK; (A.S.T.); (J.-E.L.)
- IRR Chemistry Hub, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh EH16 4UU, UK
| | - Andrea Caporali
- Centre for Cardiovascular Science, Queen’s Medical Research Institute (QMRI), The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; (A.C.); (R.K.S.)
| | - Robert K. Semple
- Centre for Cardiovascular Science, Queen’s Medical Research Institute (QMRI), The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; (A.C.); (R.K.S.)
| | - Mathew H. Horrocks
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh EH9 3FJ, UK;
- MRC Human Genetics Unit, Institute for Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Vicky E. MacRae
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush, Midlothian EH25 9RH, UK; (A.S.T.); (J.-E.L.)
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Gutiérrez-García B, Cáceres CM, Núñez-Marín F, Molero J, Prats L, Mestre N, Martínez S, Teixidor P, Comas S, Balañà C, Villà S. Early region-specific impact of adjuvant radiation therapy on cognition and quality of life in adult patients with primary brain tumors. Clin Transl Oncol 2024:10.1007/s12094-024-03740-w. [PMID: 39367900 DOI: 10.1007/s12094-024-03740-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 09/16/2024] [Indexed: 10/07/2024]
Abstract
PURPOSE While treatments for primary brain tumors increase survival, they have cognitive sequelae. Neurocognition's anatomical distribution makes it susceptible to brain damage. This study aims to evaluate the contribution of radiotherapy on short-term cognitive impairment. METHODS/PATIENTS Using a prospective database of cognitive rehabilitation in adults operated on for primary brain tumors, a retrospective sub-analysis of the contribution of radiotherapy was performed. Thirty-four subdivisions of 12 neurocognitive regions were delineated in 48 irradiated patients and 30 non-irradiated patients. In the first group, the correlation between radiation dose and deterioration was evaluated. In all patients, the impact of tumor and surgical changes on dysfunction was calculated and compared with dose-dependent response. RESULTS The correlation between cognitive status and radiation dose is especially strong and significant in the left hemisphere and in specific subdivisions such as the posterior hippocampus or the dorsolateral prefrontal cortex, with the left prevailing over posterior dominance. Memory is the most affected domain 1 month after radiotherapy, as attention is three months later. The hippocampus is involved in various cognitive domains in addition to memory. The prefrontal subregions and the genu of the corpus callosum are more affected by the relationship with disease and surgical changes than by radiation exposure. Patients ongoing a course of radiotherapy do not benefit from concurrent cognitive rehabilitation. CONCLUSIONS There is a correlation between the dose of radiation received by several encephalic regions and degree of short-term domain-specific cognition decline, considering other factors of risk and cognitive rehabilitation.
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Affiliation(s)
- Beatriz Gutiérrez-García
- Radiation Oncology, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
| | - Cynthia M Cáceres
- Neuropsychology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Jaume Molero
- Radiophysics and Radiological Protection, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Lluis Prats
- Radiophysics and Radiological Protection, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Neus Mestre
- Biostatistics, Centro de Regulación Genómica, Barcelona, Spain
| | - Silvia Martínez
- Neuropsychology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Pilar Teixidor
- Neurosurgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Silvia Comas
- Radiation Oncology, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Carme Balañà
- Medical Oncology, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Salvador Villà
- Radiation Oncology, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Alla N, Palatheeya S, Challa SR, Kakarla R. Morin attenuated the global cerebral ischemia via antioxidant, anti-inflammatory, and antiapoptotic mechanisms in rats. Metab Brain Dis 2024; 39:1323-1334. [PMID: 39136806 DOI: 10.1007/s11011-024-01410-y] [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: 06/05/2023] [Accepted: 08/07/2024] [Indexed: 10/29/2024]
Abstract
Global cerebral ischemia is one of the major causes of memory and cognitive impairment. Hyperactivation of acetylcholine esterase (AChE), oxidative stress, and inflammation are reported to cause memory and cognitive impairment in global cerebral ischemia. Morin, a flavonoid, is reported to have neuroprotective properties through its antioxidant and anti-inflammatory in multiple neurological diseases. However, its neuroprotective effects and memory and cognition enhancement have not yet been investigated. In the present study, we have determined the memory and cognition, and neuroprotective activity of Morin in bilateral common carotid artery occlusion and reperfusion (BCCAO/R) in Wistar rats. We found that Morin treatment significantly improved motor performance like grip strength and rotarod. Further, Morin improved memory and cognition in BCCAO rats by decreasing the AchE enzyme activity and enhancing the acetylcholine (Ach) levels. Additionally, Morin exhibited neuroprotection by ameliorating oxidative stress, neuroinflammation, and apoptosis in BCCAO rats. These findings confirm that Morin could enhance memory and cognition by ameliorating AchE activity, oxidative stress, neuroinflammation, and apoptosis in global cerebral ischemia. Therefore, Morin could be a promising neuroprotective and memory enhancer against global cerebral ischemic injury.
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Affiliation(s)
- Narayanarao Alla
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh, India.
- Department of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh, India.
| | - Sujatha Palatheeya
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh, India
- Department of Pharmacy, University College of Pharmaceutical Sciences, Palamuru University, Mahabubnagar, Telngana, India
| | - Siva Reddy Challa
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh, India
- Department of Pharmacology, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh, India
| | - Ramakrishna Kakarla
- Department of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh, India
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Chang X, Xia S, Liu Y, Mao X, Wu X, Chu M, Niu H, Sun L, He Y, Liu Y, Guo D, Shi M, Zhang Y, Zhu Z, Zhao J. Cardiac biomarkers are associated with increased risks of adverse clinical outcomes after ischemic stroke. J Neurol 2024; 271:6313-6324. [PMID: 39105893 DOI: 10.1007/s00415-024-12536-5] [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: 05/11/2024] [Revised: 06/20/2024] [Accepted: 06/23/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Impaired cardiac function was suggested to be implicated in the functional recovery after ischemic stroke, but the prognostic value of cardiac biomarkers among ischemic stroke patients remains unclear. We aimed to prospectively explore the associations of serum lactate dehydrogenase (LDH), plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), and plasma high-sensitivity cardiac troponin T (hs-cTnT) with adverse clinical outcomes after ischemic stroke in a large-scale cohort study. METHODS We measured serum LDH, plasma NT-proBNP, and plasma hs-cTnT levels at baseline among 5056 ischemic stroke patients from the Minhang Stroke Cohort study. All patients were followed up at 3 months after ischemic stroke onset. The primary outcome was composite outcome of death and major disability (modified Rankin Scale [mRS] score ≥ 3) at 3 months after stroke onset, and secondary outcomes included death and ordered 7-level categorical score of the mRS. RESULTS During 3 months of follow-up, 1584 patients developed the primary outcome. Baseline serum LDH, plasma NT-proBNP, and plasma hs-cTnT were positively associated with the risk of adverse outcomes after ischemic stroke. The multivariable-adjusted odds ratios of primary outcome for the highest versus lowest quartile of LDH, NT-proBNP, and hs-cTnT were 1.37 (95% CI 1.13-1.66; Ptrend = 0.001), 2.51 (95% CI, 2.00-3.16; Ptrend < 0.001), and 2.24 (95% CI 1.77-2.83; Ptrend < 0.001), respectively. Each SD increase of log-transformed cardiac biomarker score was associated with a 49% (95% CI 37-62%; P < 0.001) increased risk of primary outcome. Multivariable-adjusted spline regression analyses showed linear relationships between cardiac biomarkers and the risk of primary outcome (all P for linearity < 0.001). Moreover, adding LDH, NT-proBNP, hs-cTnT, or cardiac biomarker score to conventional risk factors significantly improved the risk reclassification of primary outcome after ischemic stroke (all P < 0.05). CONCLUSION High LDH, NT-proBNP, hs-cTnT, and cardiac biomarker score were independently associated with increased risks of adverse clinical outcomes among ischemic stroke patients, suggesting that cardiac biomarkers might be potential prognostic biomarkers for ischemic stroke.
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Affiliation(s)
- Xinyue Chang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Shiliang Xia
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Yang Liu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, China
| | - Xueyu Mao
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Xuechun Wu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Min Chu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Huicong Niu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Lulu Sun
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Yu He
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Yi Liu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Daoxia Guo
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China.
| | - Jing Zhao
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China.
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
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Liao F, Hou Z. Risk factors of atrial fibrillation complicated with cognitive impairment and the relationship between cardiac function parameters and the degree of cognitive impairment. Clinics (Sao Paulo) 2024; 79:100453. [PMID: 39197404 PMCID: PMC11399607 DOI: 10.1016/j.clinsp.2024.100453] [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: 10/30/2023] [Revised: 06/10/2024] [Accepted: 07/11/2024] [Indexed: 09/01/2024] Open
Abstract
OBJECTIVE To explore the risk factors of Atrial Fibrillation (AF) with Cognitive Impairment (CI) and to analyze the relationship between cardiac function parameters and the degree of CI in patients. METHODS 120 AF patients were selected, and Montreal Cognitive Assessment (MoCA) was used to distinguish between AF patients with and without CI. Univariate analysis and multivariate Logistic regression analysis were used to evaluate the impact of sociodemographic data, disease-related data, and clinical data on risk factors for AF with CI. Pearson's method was used to analyze the correlation between cardiac function parameters and cognitive function scores in AF patients. RESULTS There were 89 patients with CI and 31 patients without CI, and the MoCA scores of patients with CI were lower than those in patients without CI. Age, occupational status, educational level, combined smoking history, drinking history, and heart failure, as well as systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, C-reactive protein, free thyroxine, free triiodothyronine, and D-dimer were risk factors for the patient with CI. Left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left atrial maximum volume in patients with CI were higher than those in patients without CI, and left ventricular ejection fraction and peak early diastolic velocity/peak late-diastolic mitral velocity ratio were lower. CONCLUSION The cardiac function parameters of patients are closely related to attention, orientation, memory, visuospatial, and executive ability. Cardiac function parameters were closely related to cognitive functions.
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Affiliation(s)
- FengJiao Liao
- Department of Neurology, The First People's Hospital of Pinghu City, Pinghu City, Zhejiang Province, China.
| | - ZongYi Hou
- Department of Neurology, The First People's Hospital of Pinghu City, Pinghu City, Zhejiang Province, China
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Guttenthaler V, Fidorra J, Wittmann M, Menzenbach J. Predictiveness of preoperative laboratory values for postoperative delirium. Health Sci Rep 2024; 7:e2219. [PMID: 38952405 PMCID: PMC11215531 DOI: 10.1002/hsr2.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/03/2024] Open
Abstract
Background Postoperative delirium (POD) is a common postoperative complication, especially in patients over 60 years, with an incidence ranging from 15% to 50%. In most cases, POD manifests in the first 5 days after surgery. Multiple contributing risk factors for POD have been detected. Besides the predisposing factors such as higher age, cognitive impairment, high blood pressure, atrial fibrillation, and past stroke, pathophysiological mechanisms like neuroinflammation are also considered as contributing factors. Methods In a subanalysis of the "PRe- Operative Prediction of postoperative DElirium by appropriate SCreening" (PROPDESC) study, the preoperative laboratory values of sodium, potassium, total protein, hemoglobin concentration (Hgb), and white blood cells as well as the biomarkers creatinine, HbA1c, NT-pro-BNP, high sensitive Troponin T (hsTnT), and C-reactive protein (CRP) were assessed to investigate a possible relationship to the occurrence of POD. Results After correction for age, physical status classification, surgery risk after Johns Hopkins, and operative discipline (cardiac surgery vs. noncardiac surgery), male patients with a Hgb <13 g/dL had significantly higher odds for POD (p = 0.025). Furthermore, patients with CRP ≥ 10 mg/L, HbA1c value ≥ 8.5% as well as patients with hypernatraemia (>145 mmol/L) presented significantly higher odds to develop POD (p = 0.011, p < 0.001, and p = 0.021, respectively). A raised (>14-52 ng/L) or high (>52 ng/L) hsTnT value was also associated with a significantly higher chance for POD compared to the patient group with hsTnT <14 ng/L (p < 0.001 and p = 0.016, respectively). Conclusions Preoperative Hgb, CRP, HbA1c, sodium, and hsTnT could be used to complement and refine the preoperative screening for patients at risk for POD. Further studies should track these correlations to investigate the potential of targeted POD protection and enabling hospital staff to initiate POD-preventing measures in time.
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Affiliation(s)
- Vera Guttenthaler
- Clinic of Anaesthesia and Intensive Care MedicineUniversity BonnBonnGermany
| | - Jacqueline Fidorra
- Clinic of Anaesthesia and Intensive Care MedicineUniversity BonnBonnGermany
- Asklepios Clinic North HeidbergClinic for Internal Medicine Department IHamburgGermany
| | - Maria Wittmann
- Clinic of Anaesthesia and Intensive Care MedicineUniversity BonnBonnGermany
| | - Jan Menzenbach
- Clinic of Anaesthesia and Intensive Care MedicineUniversity BonnBonnGermany
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9
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Rajeev V, Tabassum NI, Fann DY, Chen CP, Lai MK, Arumugam TV. Intermittent Metabolic Switching and Vascular Cognitive Impairment. J Obes Metab Syndr 2024; 33:92-107. [PMID: 38736362 PMCID: PMC11224924 DOI: 10.7570/jomes24010] [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: 02/23/2024] [Revised: 03/25/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024] Open
Abstract
Intermittent fasting (IF), a dietary pattern alternating between eating and fasting periods within a 24-hour cycle, has garnered recognition for its potential to enhance both healthspan and lifespan in animal models and humans. It also shows promise in alleviating age-related diseases, including neurodegeneration. Vascular cognitive impairment (VCI) spans a severity range from mild cognitive deficits to severe cognitive deficits and loss of function in vascular dementia. Chronic cerebral hypoperfusion has emerged as a significant contributor to VCI, instigating vascular pathologies such as microbleeds, blood-brain barrier dysfunction, neuronal loss, and white matter lesions. Preclinical studies in rodents strongly suggest that IF has the potential to attenuate pathological mechanisms, including excitotoxicity, oxidative stress, inflammation, and cell death pathways in VCI models. Hence, this supports evaluating IF in clinical trials for both existing and at-risk VCI patients. This review compiles existing data supporting IF's potential in treating VCI-related vascular and neuronal pathologies, emphasizing the mechanisms by which IF may mitigate these issues. Hence providing a comprehensive overview of the available data supporting IF's potential in treating VCI by emphasizing the underlying mechanisms that make IF a promising intervention for VCI.
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Affiliation(s)
- Vismitha Rajeev
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nishat I. Tabassum
- Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
| | - David Y. Fann
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christopher P. Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Mitchell K.P. Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Thiruma V. Arumugam
- Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
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10
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Oviedo DC, Tratner AE, Rodríguez-Araña S, Villarreal AE, Rangel G, Carreira MB, Britton GB. Predictors of cognitive change in cognitively healthy older women in Panama: the PARI-HD study. Front Glob Womens Health 2024; 5:1353657. [PMID: 38939750 PMCID: PMC11208464 DOI: 10.3389/fgwh.2024.1353657] [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: 12/11/2023] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
Background Evidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition. Objective Describe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women. Methods The study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up. Results On average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention. Discussion Our study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia.
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Affiliation(s)
- Diana C. Oviedo
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Escuela de Psicología, Universidad Santa María la Antigua (USMA), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Adam E. Tratner
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
- Florida State University, Panama City, Panamá
| | - Sofía Rodríguez-Araña
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
| | - Alcibiades E. Villarreal
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Giselle Rangel
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - María B. Carreira
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Gabrielle B. Britton
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
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11
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Norouzkhani N, Afshari S, Sadatmadani SF, Mollaqasem MM, Mosadeghi S, Ghadri H, Fazlizade S, Alizadeh K, Akbari Javar P, Amiri H, Foroughi E, Ansari A, Mousazadeh K, Davany BA, Akhtari kohnehshahri A, Alizadeh A, Dadkhah PA, Poudineh M. Therapeutic potential of berries in age-related neurological disorders. Front Pharmacol 2024; 15:1348127. [PMID: 38783949 PMCID: PMC11112503 DOI: 10.3389/fphar.2024.1348127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
Aging significantly impacts several age-related neurological problems, such as stroke, brain tumors, oxidative stress, neurodegenerative diseases (Alzheimer's, Parkinson's, and dementia), neuroinflammation, and neurotoxicity. Current treatments for these conditions often come with side effects like hallucinations, dyskinesia, nausea, diarrhea, and gastrointestinal distress. Given the widespread availability and cultural acceptance of natural remedies, research is exploring the potential effectiveness of plants in common medicines. The ancient medical system used many botanical drugs and medicinal plants to treat a wide range of diseases, including age-related neurological problems. According to current clinical investigations, berries improve motor and cognitive functions and protect against age-related neurodegenerative diseases. Additionally, berries may influence signaling pathways critical to neurotransmission, cell survival, inflammation regulation, and neuroplasticity. The abundance of phytochemicals in berries is believed to contribute to these potentially neuroprotective effects. This review aimed to explore the potential benefits of berries as a source of natural neuroprotective agents for age-related neurological disorders.
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Affiliation(s)
- Narges Norouzkhani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Afshari
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | | | - Shakila Mosadeghi
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hani Ghadri
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Safa Fazlizade
- Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Keyvan Alizadeh
- Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Pouyan Akbari Javar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hamidreza Amiri
- Student Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Elaheh Foroughi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Kourosh Mousazadeh
- School of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | | | - Ata Akhtari kohnehshahri
- Student Research Committee, Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Alaleh Alizadeh
- Student Research Committee, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Parisa Alsadat Dadkhah
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohadeseh Poudineh
- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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12
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Morgan AE, Mc Auley MT. Vascular dementia: From pathobiology to emerging perspectives. Ageing Res Rev 2024; 96:102278. [PMID: 38513772 DOI: 10.1016/j.arr.2024.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
Vascular dementia (VaD) is the second most common type of dementia. VaD is synonymous with ageing, and its symptoms place a significant burden on the health and wellbeing of older people. Despite the identification of a substantial number of risk factors for VaD, the pathological mechanisms underpinning this disease remain to be fully elucidated. Consequently, a biogerontological imperative exists to highlight the modifiable lifestyle factors which can mitigate against the risk of developing VaD. This review will critically examine some of the factors which have been revealed to modulate VaD risk. The survey commences by providing an overview of the putative mechanisms which are associated with the pathobiology of VaD. Next, the factors which influence the risk of developing VaD are examined. Finally, emerging treatment avenues including epigenetics, the gut microbiome, and pro-longevity pharmaceuticals are discussed. By drawing this key evidence together, it is our hope that it can be used to inform future experimental investigations in this field.
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Affiliation(s)
- Amy Elizabeth Morgan
- School of Health and Sports Sciences, Hope Park, Liverpool Hope University, Liverpool L16 9JD, United Kingdom.
| | - Mark Tomás Mc Auley
- School of Science, Engineering and Environment, University of Salford Manchester, Salford M5 4NT, United Kingdom
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13
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von Rennenberg R, Nolte CH, Liman TG, Hellwig S, Riegler C, Scheitz JF, Georgakis MK, Fang R, Bode FJ, Petzold GC, Hermann P, Zerr I, Goertler M, Bernkopf K, Wunderlich S, Dichgans M, Endres M. High-Sensitivity Cardiac Troponin T and Cognitive Function Over 12 Months After Stroke-Results of the DEMDAS Study. J Am Heart Assoc 2024; 13:e033439. [PMID: 38456438 PMCID: PMC11010029 DOI: 10.1161/jaha.123.033439] [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: 01/24/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Subclinical myocardial injury in form of hs-cTn (high-sensitivity cardiac troponin) levels has been associated with cognitive impairment and imaging markers of cerebral small vessel disease (SVD) in population-based and cardiovascular cohorts. Whether hs-cTn is associated with domain-specific cognitive decline and SVD burden in patients with stroke remains unknown. METHODS AND RESULTS We analyzed patients with acute stroke without premorbid dementia from the prospective multicenter DEMDAS (DZNE [German Center for Neurodegenerative Disease]-Mechanisms of Dementia after Stroke) study. Patients underwent neuropsychological testing 6 and 12 months after the index event. Test results were classified into 5 cognitive domains (language, memory, executive function, attention, and visuospatial function). SVD markers (lacunes, cerebral microbleeds, white matter hyperintensities, and enlarged perivascular spaces) were assessed on cranial magnetic resonance imaging to constitute a global SVD score. We examined the association between hs-cTnT (hs-cTn T levels) and cognitive domains as well as the global SVD score and individual SVD markers, respectively. Measurement of cognitive and SVD-marker analyses were performed in 385 and 466 patients with available hs-cTnT levels, respectively. In analyses adjusted for demographic characteristics, cardiovascular risk factors, and cognitive status at baseline, higher hs-cTnT was negatively associated with the cognitive domains "attention" up to 12 months of follow-up (beta-coefficient, -0.273 [95% CI, -0.436 to -0.109]) and "executive function" after 12 months. Higher hs-cTnT was associated with the global SVD score (adjusted odds ratio, 1.95 [95% CI, 1.27-3.00]) and the white matter hyperintensities and lacune subscores. CONCLUSIONS In patients with stroke, hs-cTnT is associated with a higher burden of SVD markers and cognitive function in domains linked to vascular cognitive impairment. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01334749.
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Affiliation(s)
- Regina von Rennenberg
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site BerlinBerlinGermany
| | - Christian H. Nolte
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site BerlinBerlinGermany
- German Center for Cardiovascular Research (Deutsches Zentrum für Herz‐Kreislaufforschung), partner site Berlin, Charité‐Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health at Charité –Universitätsmedizin Berlin, BIH Biomedical Innovation AcademyBerlinGermany
| | - Thomas G. Liman
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site BerlinBerlinGermany
- Department of Neurology, School of Medicine and Health SciencesCarl von Ossietzky University of OldenburgOldenburgGermany
| | - Simon Hellwig
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health at Charité –Universitätsmedizin Berlin, BIH Biomedical Innovation AcademyBerlinGermany
| | - Christoph Riegler
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
| | - Jan F. Scheitz
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- German Center for Cardiovascular Research (Deutsches Zentrum für Herz‐Kreislaufforschung), partner site Berlin, Charité‐Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health at Charité –Universitätsmedizin Berlin, BIH Biomedical Innovation AcademyBerlinGermany
| | - Marios K. Georgakis
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU MunichMunichGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site MunichMunichGermany
| | - Rong Fang
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU MunichMunichGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site MunichMunichGermany
| | - Felix J. Bode
- Division of Vascular Neurology, Department of NeurologyUniversity Hospital BonnBonnGermany
| | - Gabor C. Petzold
- Division of Vascular Neurology, Department of NeurologyUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site BonnBonnGermany
| | - Peter Hermann
- German Center for Neurodegenerative Diseases (DZNE) GöttingenGöttingenGermany
- Clinical Dementia Center, Department of NeurologyUniversity Medical CenterGöttingenGermany
| | - Inga Zerr
- German Center for Neurodegenerative Diseases (DZNE) GöttingenGöttingenGermany
- Clinical Dementia Center, Department of NeurologyUniversity Medical CenterGöttingenGermany
| | - Michael Goertler
- Department of NeurologyMagdeburg University Vascular and Stroke CentreMagdeburgGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site MagdeburgMagdeburgGermany
| | - Kathleen Bernkopf
- Department of Neurology, School of MedicineKlinikum rechts der Isar, Technical University of MunichMunichGermany
| | - Silke Wunderlich
- Department of Neurology, School of MedicineKlinikum rechts der Isar, Technical University of MunichMunichGermany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU MunichMunichGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site MunichMunichGermany
| | - Matthias Endres
- Department of Neurology (Klinik und Hochschulambulanz für Neurologie)Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité—Universitätsmedizin BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site BerlinBerlinGermany
- German Center for Cardiovascular Research (Deutsches Zentrum für Herz‐Kreislaufforschung), partner site Berlin, Charité‐Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health at Charité –Universitätsmedizin Berlin, BIH Biomedical Innovation AcademyBerlinGermany
- German Center for Mental Health (DZPG), partner site BerlinBerlinGermany
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14
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Wu LY, Chai YL, Cheah IK, Chia RSL, Hilal S, Arumugam TV, Chen CP, Lai MKP. Blood-based biomarkers of cerebral small vessel disease. Ageing Res Rev 2024; 95:102247. [PMID: 38417710 DOI: 10.1016/j.arr.2024.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 02/12/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Age-associated cerebral small vessel disease (CSVD) represents a clinically heterogenous condition, arising from diverse microvascular mechanisms. These lead to chronic cerebrovascular dysfunction and carry a substantial risk of subsequent stroke and vascular cognitive impairment in aging populations. Owing to advances in neuroimaging, in vivo visualization of cerebral vasculature abnormities and detection of CSVD, including lacunes, microinfarcts, microbleeds and white matter lesions, is now possible, but remains a resource-, skills- and time-intensive approach. As a result, there has been a recent proliferation of blood-based biomarker studies for CSVD aimed at developing accessible screening tools for early detection and risk stratification. However, a good understanding of the pathophysiological processes underpinning CSVD is needed to identify and assess clinically useful biomarkers. Here, we provide an overview of processes associated with CSVD pathogenesis, including endothelial injury and dysfunction, neuroinflammation, oxidative stress, perivascular neuronal damage as well as cardiovascular dysfunction. Then, we review clinical studies of the key biomolecules involved in the aforementioned processes. Lastly, we outline future trends and directions for CSVD biomarker discovery and clinical validation.
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Affiliation(s)
- Liu-Yun Wu
- Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yuek Ling Chai
- Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Irwin K Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Neurobiology Programme, Centre for Life Sciences, National University of Singapore, Singapore
| | - Rachel S L Chia
- Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Kent Ridge, Singapore
| | - Thiruma V Arumugam
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea; Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, Australia
| | - Christopher P Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mitchell K P Lai
- Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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15
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Santillo E, Balietti M, Fabbietti P, Antolini MS, Paoloni C, Piacenza F, Giuli C. Association between low values of mean arterial pressure and impaired cognitive performance in older patients with mild cognitive impairment: cross-sectional preliminary findings from the STRENGTH Project. Aging Clin Exp Res 2024; 36:9. [PMID: 38281243 PMCID: PMC10822812 DOI: 10.1007/s40520-023-02668-5] [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: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Uncontrolled blood pressure (BP) is a risk factor for Mild Cognitive Impairment (MCI) and dementia. AIMS This study examined the relationship between BP and clinical/cognitive/neuropsychological aspects in MCI individuals. METHODS MCI patients underwent clinical, functional, cognitive and metacognitive, as well as psychological assessments. Social network, lifestyle characteristics, and medication prescriptions were also evaluated. Each patient underwent BP measurements. RESULTS Lower values of systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were associated with poorer cognitive performance. Notably, MAP showed greater capability in detecting impairments in attention and visuospatial abilities compared to SBP and DBP. DISCUSSION These findings support the notion that in older individuals with MCI excessively low BP values, particularly MAP, might represent a risk and suggest that cerebral hypoperfusion may play a key role. CONCLUSIONS Routine assessment of MAP could aid clinicians in adjusting antihypertensive treatment and closely monitoring cognitive function in MCI patients.
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Affiliation(s)
| | - Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, Via Birarelli 8, 60121, Ancona, Italy.
| | - Paolo Fabbietti
- Centre for Biostatistic and Applied Geriatric Clinical Epidemiology, IRCCS INRCA, Ancona, Italy
| | | | | | - Francesco Piacenza
- Advanced Technology Center for Aging Research, IRCCS INRCA, Ancona, Italy
| | - Cinzia Giuli
- Geriatric Operative Unit, IRCCS INRCA, Fermo, Italy
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Alla N, Palatheeya S, Challa SR, Kakarla R. Tangeretin confers neuroprotection, cognitive and memory enhancement in global cerebral ischemia in rats. 3 Biotech 2024; 14:9. [PMID: 38074289 PMCID: PMC10709536 DOI: 10.1007/s13205-023-03854-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/12/2023] [Indexed: 01/19/2024] Open
Abstract
Global cerebral ischemia is commonly associated with neurological deficits, including cognitive and memory impairments. The present study aims to investigate the neuroprotective, cognitive, and memory enhancement effects of Tangeretin, a flavonoid against global cerebral ischemia in rats. Bilateral common carotid artery occlusion (BCCAO) and reperfusion injury method was used to induce global cerebral ischemia in rats. Motor, cognitive, and memory functions were evaluated using rotarod, grip strength, Y-maze, and Morris water maze. Further, acetylcholine esterase (AchE) enzyme activity, acetylcholine (Ach), oxidative stress markers (ROS, SOD, MDA, and CAT), inflammation (IL-6 and TNF-α), and apoptotic markers (cytochrome C, caspase 9, and caspase 3) in BCCAO rats were measured following Tangeretin (5,10, and 20 mg/kg, oral) treatment. Our findings show that Tangeretin treatment significantly improved cognition and memory by enhancing Ach levels through the amelioration of AchE enzyme activity in BCCAO rats. Moreover, Tangeretin exhibited neuroprotective effects through the mitigation of oxidative stress, inflammation, and apoptosis in the BCCAO rats. In summary, the current findings suggested that Tangeretin exhibited neuroprotection, cognitive and memory enhancement against global cerebral ischemia.
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Affiliation(s)
- Narayanarao Alla
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh India
- KL College of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh India
| | - Sujatha Palatheeya
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh India
- Department of Pharmacy, University College of Pharmaceutical Sciences, Palamuru University, Mahabubnagar, 509001 India
| | - Siva Reddy Challa
- Department of Pharmacy, Krishna University, Machilipatnam, Andhra Pradesh India
- Department of Pharmacology, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh 520010 India
| | - Ramakrishna Kakarla
- KL College of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh India
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17
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Remmele J, Pringsheim M, Nagdyman N, Oberhoffer-Fritz R, Ewert P. Neuromental health aspects in adults with CHD after cardiopulmonary bypass intervention during childhood. Cardiol Young 2024; 34:145-150. [PMID: 37254574 DOI: 10.1017/s1047951123001373] [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: 06/01/2023]
Abstract
OBJECTIVE It is often assumed, that adult patients with CHD (ACHD) have impairments regarding their cognitive function (CF) and health-related quality of life. In particular, it seems reasonable to assume that cyanosis may have a potential impact on CF as well as surgical or drug treatment into adulthood. This study assesses neuromental health aspects such as CF and health-related quality of life in ACHD patients. METHODS Seventy-eight ACHD patients (female n = 39 (50%); 34.1 ± 12.9 years; cyanotic CHD n = 49 (62.8%) with a cyanosis duration of 159.8 ± 196.2 month) who underwent open heart surgery as first intervention were asked to participate during routinely follow-up in 2018. Wechsler Intelligence Scale IV was used for CF and the Short Form 36 Health Survey to assess health-related quality of life. RESULTS Intelligence quotient measures showed significant differences comparing never cyanotic and with a cyanotic phase in verbal comprehension (p = 0.013). There was no association of CF with cyanosis duration, number of surgery or catheter, CHD severity, and time of first surgery. The group of early surgery showed significantly better results in physical function (p = 0.040) of health-related quality of life, and in comparison with their assigned reference, both groups showed significantly reduced results in all domains except in bodily pain and mental health. Full-Scale intelligence quotient correlates with physical function of health-related quality of life. CONCLUSIONS The results show normal CF in ACHD. Health-related quality of life was weak in comparison with the reference. There is a need to improve the well-being of our ACHD with structured programmes, including physical activity programmes. This growing ACHD population should be focused in order of their needs, medical ones on one hand and on the other hand psychosocial matters.
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Affiliation(s)
- Julia Remmele
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center of Munich, Munich, Germany
- Institute of Preventive Pediatrics Technical University Munich, Munich, Germany
| | - Milka Pringsheim
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center of Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center of Munich, Munich, Germany
- Institute of Preventive Pediatrics Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center of Munich, Munich, Germany
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18
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Zhang M, Jiao H, Wang C, Qu Y, Lv S, Zhao D, Zhong X. Physical activity, sleep disorders, and type of work in the prevention of cognitive function decline in patients with hypertension. BMC Public Health 2023; 23:2431. [PMID: 38057774 PMCID: PMC10699000 DOI: 10.1186/s12889-023-17343-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Hypertensive patients are likelier to have cognitive function decline (CFD). This study aimed to explore physical activity level, sleep disorders, and type of work that influenced intervention effects on cognitive function decline in hypertensive patients and to establish a decision tree model to analyze their predictive significance on the incidence of CFD in hypertensive patients. METHODS This cross-sectional study recruited patients with essential hypertension from several hospitals in Shandong Province from May 2022 to December 2022. Subject exclusion criteria included individuals diagnosed with congestive heart failure, valvular heart disease, cardiac surgery, hepatic and renal dysfunction, and malignancy. Recruitment is through multiple channels such as hospital medical and surgical outpatient clinics, wards, and health examination centers. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Moreover, we obtained information on the patients' type of work through a questionnaire and their level of physical activity through the International Physical Activity Questionnaire (IPAQ). RESULTS The logistic regression analysis results indicate that sleep disorder is a significant risk factor for CFD in hypertension patients(OR:1.85, 95%CI:[1.16,2.94]), mental workers(OR:0.12, 95%CI: [0.04,0.37]) and those who perform both manual and mental workers(OR: 0.5, 95%CI: [0.29,0.86]) exhibit protective effects against CFD. Compared to low-intensity, moderate physical activity(OR: 0.53, 95%CI: [0.32,0.87]) and high-intensity physical activity(OR: 0.26, 95%CI: [0.12,0.58]) protects against CFD in hypertension patients. The importance of predictors in the decision tree model was ranked as follows: physical activity level (54%), type of work (27%), and sleep disorders (19%). The area under the ROC curves the decision tree model predicted was 0.72 [95% CI: 0.68 to 0.76]. CONCLUSION Moderate and high-intensity physical activity may reduce the risk of developing CFD in hypertensive patients. Sleep disorders is a risk factor for CFD in hypertensive patients. Hypertensive patients who engage in mental work and high-intensity physical activity effectively mitigate the onset of CFD in hypertensive patients.
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Affiliation(s)
- Mengdi Zhang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 42, Wenhua West Road, Lixia District, Jinan, Shandong, China.
| | - Cong Wang
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 42, Wenhua West Road, Lixia District, Jinan, Shandong, China
| | - Ying Qu
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shunxin Lv
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dongsheng Zhao
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xia Zhong
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
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19
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Xiao X, Jiang H, Wei H, Zhou Y, Ji X, Zhou C. Endothelial Senescence in Neurological Diseases. Aging Dis 2023; 14:2153-2166. [PMID: 37199574 PMCID: PMC10676791 DOI: 10.14336/ad.2023.0226-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/26/2023] [Indexed: 05/19/2023] Open
Abstract
Endothelial cells, which are highly dynamic cells essential to the vascular network, play an indispensable role in maintaining the normal function of the body. Several lines of evidence indicate that the phenotype associated with senescent endothelial cells causes or promotes some neurological disorders. In this review, we first discuss the phenotypic changes associated with endothelial cell senescence; subsequently, we provide an overview of the molecular mechanisms of endothelial cell senescence and its relationship with neurological disorders. For refractory neurological diseases such as stroke and atherosclerosis, we intend to provide some valid clues and new directions for clinical treatment options.
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Affiliation(s)
- Xuechun Xiao
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
| | - Huimin Jiang
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
| | - Huimin Wei
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
| | - Yifan Zhou
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
| | - Xunming Ji
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
| | - Chen Zhou
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, China
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20
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Hafiz R, Alajlani L, Ali A, Algarni GA, Aljurfi H, Alammar OAM, Ashqan MY, Alkhashan A. The Latest Advances in the Diagnosis and Treatment of Dementia. Cureus 2023; 15:e50522. [PMID: 38222245 PMCID: PMC10787596 DOI: 10.7759/cureus.50522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
Dementia is a debilitating neurological condition that is characterized by persistent cognitive decline. It is a global health challenge, with a rapidly increasing prevalence due to an increasing aging population. Although definitive diagnosis of various conditions of dementia is only possible by autopsy, clinical diagnosis can be performed by a specialist. The diagnostic process has evolved with recent breakthroughs in diagnostic tools, such as advanced imaging techniques and biomarkers. These tools facilitate early and accurate identification of the condition. Early diagnosis is vital, as it enables timely interventions to improve the quality of life for affected individuals. Treatment strategies for dementia encompass both pharmacological and non-pharmacological approaches. Non-pharmacological treatments include cognitive training and lifestyle modifications. Among pharmacological treatments, acetyl-cholinesterase inhibitors including donepezil, rivastigmine, and galantamine can be used in various doses based on the severity of the disease. Apart from these, N-methyl-D-aspartate receptor antagonists such as memantine can also be used. Furthermore, personalized treatments have also gained significant attention in dementia treatment. Interdisciplinary care, involving healthcare professionals, social workers, and support networks, is crucial for comprehensive and holistic dementia management.
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Affiliation(s)
- Rehab Hafiz
- Family Medicine, Al Takassusi Primary Healthcare Center, Makkah, SAU
| | - Lama Alajlani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Albatool Ali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ghadah A Algarni
- College of Medicine, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Hassan Aljurfi
- Family Medicine, Alfath Care Center, Madinah Health Cluster, Ministry of Health, Madinah, SAU
| | | | - Maria Y Ashqan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Alanoud Alkhashan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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21
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Bhat A, Goel D. Coronary Heart Disease, Heart Failure, and Risk of Alzheimer's Disease: How Strong is the Association? Ann Indian Acad Neurol 2023; 26:852-853. [PMID: 38229647 PMCID: PMC10789407 DOI: 10.4103/aian.aian_649_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Ashwani Bhat
- Department of Neurology, Himalayan Institute of Medical Sciences, Swami Ram Himalayan University, Dehradun, Uttarakhand, India
| | - Deepak Goel
- Department of Neurology, Himalayan Institute of Medical Sciences, Swami Ram Himalayan University, Dehradun, Uttarakhand, India
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Hillier E, Covone J, Fischer K, Chen HY, Hafyane T, Friedrich MG. Microvascular Dysfunction as a Possible Link Between Heart Failure and Cognitive Dysfunction. Circ Heart Fail 2023; 16:e010117. [PMID: 37750336 DOI: 10.1161/circheartfailure.122.010117] [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: 08/23/2022] [Accepted: 08/11/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Microvascular function in the brain and heart may play an important role in the course of patients with heart failure (HF), but its relationship with ventricular and cognitive function is not well understood. We hypothesized that microvascular function in HF is closely related to both, cardiac and cognitive function. METHODS In healthy controls and symptomatic patients with HF (New York Heart Association functional class II or III), we used oxygenation-sensitive magnetic resonance imaging during a standardized breathing maneuver to determine the cerebral oxygenation reserve and the myocardial oxygenation reserve (MORE) as markers for microvascular function. A stepwise multivariable linear regression was performed to determine the variables that best predict changes in cerebral oxygenation reserve and MORE. We also measured cognitive function using the Montreal Cognitive Assessment test. RESULTS Twenty patients with HF (age 64.4±8.3 years; 50% female sex), and 21 healthy controls (age 55.0±5.1 years; 62% female sex) were included in the analysis. In patients with HF, cerebral oxygenation reserve and MORE were lower than in healthy controls (MORE, -0.1±3.3 versus 5.0±4.2, cerebral oxygenation reserve: 0.43±0.47 versus 1.21±0.60, respectively) as were Montreal Cognitive Assessment score results (HF, 23.9±3.7; healthy, 27.8±1.5; P=0.002). The Montreal Cognitive Assessment score in patients was correlated with cardiac output (r=0.55, P=0.011) and MORE (r=0.46, P=0.040). In addition to the presence of HF, significant predictors of cerebral and myocardial oxygenation reserve were cardiac output and end-diastolic volume, respectively. CONCLUSIONS Our results indicate that heart failure is an independent predictor of coronary and cerebral microvascular dysfunction as defined by a reduced response to a vasodilatory breathing maneuver. This impaired response was associated with reduced cognitive function.
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Affiliation(s)
- Elizabeth Hillier
- Faculty of Medicine and Health Sciences, Division of Experimental Medicine (E.H., J.C., H.Y.C., M.G.F.), McGill University, Montreal, QC, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada (E.H.)
| | - Jason Covone
- Faculty of Medicine and Health Sciences, Division of Experimental Medicine (E.H., J.C., H.Y.C., M.G.F.), McGill University, Montreal, QC, Canada
| | - Kady Fischer
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland (K.F.)
| | - Hao Yu Chen
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada (E.H.)
| | - Tarik Hafyane
- Research Centre, Montreal Heart Institute, Universite de Montreal, QC, Canada (T.H.)
| | - Matthias G Friedrich
- Faculty of Medicine and Health Sciences, Division of Experimental Medicine (E.H., J.C., H.Y.C., M.G.F.), McGill University, Montreal, QC, Canada
- Division of Cardiology, Departments of Medicine and Diagnostic Radiology (M.G.F.), McGill University, Montreal, QC, Canada
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23
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O’Donnell CM, Barrett DW, O’Connor P, Gonzalez-Lima F. Prefrontal photobiomodulation produces beneficial mitochondrial and oxygenation effects in older adults with bipolar disorder. Front Neurosci 2023; 17:1268955. [PMID: 38027522 PMCID: PMC10644301 DOI: 10.3389/fnins.2023.1268955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
There is growing evidence of mitochondrial dysfunction and prefrontal cortex (PFC) hypometabolism in bipolar disorder (BD). Older adults with BD exhibit greater decline in PFC-related neurocognitive functions than is expected for age-matched controls, and clinical interventions intended for mood stabilization are not targeted to prevent or ameliorate mitochondrial deficits and neurocognitive decline in this population. Transcranial infrared laser stimulation (TILS) is a non-invasive form of photobiomodulation, in which photons delivered to the PFC photo-oxidize the mitochondrial respiratory enzyme, cytochrome-c-oxidase (CCO), a major intracellular photon acceptor in photobiomodulation. TILS at 1064-nm can significantly upregulate oxidized CCO concentrations to promote differential levels of oxygenated vs. deoxygenated hemoglobin (HbD), an index of cerebral oxygenation. The objective of this controlled study was to use non-invasive broadband near-infrared spectroscopy to assess if TILS to bilateral PFC (Brodmann area 10) produces beneficial effects on mitochondrial oxidative energy metabolism (oxidized CCO) and cerebral oxygenation (HbD) in older (≥50 years old) euthymic adults with BD (N = 15). As compared to sham, TILS to the PFC in adults with BD increased oxidized CCO both during and after TILS, and increased HbD concentrations after TILS. By significantly increasing oxidized CCO and HbD concentrations above sham levels, TILS has the potential ability to stabilize mitochondrial oxidative energy production and prevent oxidative damage in the PFC of adults with BD. In conclusion, TILS was both safe and effective in enhancing metabolic function and subsequent hemodynamic responses in the PFC, which might help alleviate the accelerated neurocognitive decline and dysfunctional mitochondria present in BD.
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Affiliation(s)
- Courtney M. O’Donnell
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Douglas W. Barrett
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Patrick O’Connor
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - F. Gonzalez-Lima
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, United States
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Hirabayashi N, Honda T, Hata J, Furuta Y, Shibata M, Ohara T, Tatewaki Y, Taki Y, Nakaji S, Maeda T, Ono K, Mimura M, Nakashima K, Iga JI, Takebayashi M, Ninomiya T. Association Between Frequency of Social Contact and Brain Atrophy in Community-Dwelling Older People Without Dementia: The JPSC-AD Study. Neurology 2023; 101:e1108-e1117. [PMID: 37438128 DOI: 10.1212/wnl.0000000000207602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/16/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Epidemiologic evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study. METHODS Dementia-free community-dwelling Japanese aged 65 years or older underwent brain MRI scans and a comprehensive health examination. Frequency of contact with noncohabiting relatives and friends was determined by asking a single question with 4 categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV), and white matter lesion volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms. RESULTS We included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared with that in the group with the highest frequency of social contact (67.3% vs 67.8%), with a significant increasing trend across the groups (p value for trend <0.001). The white matter lesion volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency group vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q values of false discovery rate correction <0.05). The relationships seemed to be partly mediated by depressive symptoms, which accounted for 15%-29% of the observed associations. DISCUSSION Lower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.
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Affiliation(s)
- Naoki Hirabayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Takanori Honda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun Hata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yoshihiko Furuta
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Mao Shibata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tomoyuki Ohara
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuko Tatewaki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuyuki Taki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Shigeyuki Nakaji
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tetsuya Maeda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenjiro Ono
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Masaru Mimura
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenji Nakashima
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun-Ichi Iga
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Minoru Takebayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Toshiharu Ninomiya
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan.
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25
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Niu Z, Zhou J, Li Y. Prognostic significance of delirium in patients with heart failure: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1217965. [PMID: 37636295 PMCID: PMC10450942 DOI: 10.3389/fcvm.2023.1217965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023] Open
Abstract
Background Delirium is a common symptom of heart failure (HF) and is associated with increased mortality, prolonged hospital stays, and heightened medical costs. The impact of delirium on the prognosis of HF patients is currently controversial. Therefore, we conducted a meta-analysis to evaluate the prognostic significance of delirium in HF. Methods Relevant articles were systematically searched in PubMed, Cochrane Library, Web of Science, and Embase based on the PRISMA guidelines. Studies that reported mortality and hospitalization-related outcomes in HF patients with or without delirium using raw or adjusted hazard ratio (HR) and odds ratio (OD) were included. Meta-analysis was then performed to evaluate the effect of delirium in HF patients. Outcomes of interest were all-cause mortality and events of the hospitalization. Results Of the 1,501 studies identified, 7 eligible studies involving 12,830,390 HF patients (6,322,846 males and 6,507,544 females) were included in the meta-analysis. There were 91,640 patients with delirium (0.71%) and 12,738,750 patients without delirium (99.28%). HF patients with delirium had higher OR for in-hospital mortality (1.95, 95% CI = 1.30-2.91, P = 0.135), higher pooled HR for 90-day mortality (2.64, 95% CI = 1.06-1.56, P = 0.215), higher pooled HR for 1-year mortality (2.08, 95% CI = 1.34-3.22, P = 0.004), and higher pooled HR for 30-day readmission rate (4.15, 95% CI = 2.85-6.04, P = 0.831) than those without delirium. Conclusion Current evidence suggests that combined delirium increases the risk of HF-related mortality and hospitalization-related outcomes in patients with HF. However, more research is needed to assess the impact of delirium on the prognosis of HF patients.
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Affiliation(s)
- Ziru Niu
- Department of Cardiovascular Medicine, The Second Hospital of HeBei Medical University, Shijiazhuang, China
| | - Jiamin Zhou
- Department of Hematology, The Second Hospital of HeBei Medical University, Shijiazhuang, China
| | - Yongjun Li
- Department of Cardiovascular Medicine, The Second Hospital of HeBei Medical University, Shijiazhuang, China
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26
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Munis ÖB. Association of Type 2 Diabetes Mellitus With Perivascular Spaces and Cerebral Amyloid Angiopathy in Alzheimer's Disease: Insights From MRI Imaging. Dement Neurocogn Disord 2023; 22:87-99. [PMID: 37545864 PMCID: PMC10400344 DOI: 10.12779/dnd.2023.22.3.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 08/08/2023] Open
Abstract
Background and Purpose According to the amyloid cascade hypothesis, fibrillary amyloid-beta load in the brain causes Alzheimer's disease (AD) with toxic effects. Recently, perivascular spaces (PVSs), fluid-filled cavities around small penetrating arterioles and venules in the brain, and the glymphatic system relationship with type 2 diabetes mellitus (DM2) and AD has been an important research topic from a physiopathological point of view. There are two types of PVSs that are associated with sporadic atherosclerosis and cerebral amyloid angiopathy. In this study, we evaluated the relationship between the number and localization of enlarged PVSs in AD. Methods A total of 254 patients with AD and 125 healthy controls were included in this study All the patients were evaluated with neurological and cognitive examinations and magnetic resonance imaging (MRI). PVSs on MRI were graded by recording their number and location. The study was a retrospective study. Results In our study, the number of white matter convexity-central semiovale localized PVSs was higher in patients than in the control group. In addition, the number of PVSs in this localization score was higher in patients with DM2. Cerebral PVS counts were higher in patients with AD than in the control group. Conclusions These results suggest the important role of cerebral amyloid angiopathy, one of the vascular risk factors, and the glymphatic system in the pathogenesis of AD. In addition, the results of our study suggest that the evaluation of PVSs levels, especially at the (centrum semiovale), using imaging studies in AD is a potential diagnostic option.
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27
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Rajeev V, Chai YL, Poh L, Selvaraji S, Fann DY, Jo DG, De Silva TM, Drummond GR, Sobey CG, Arumugam TV, Chen CP, Lai MKP. Chronic cerebral hypoperfusion: a critical feature in unravelling the etiology of vascular cognitive impairment. Acta Neuropathol Commun 2023; 11:93. [PMID: 37309012 PMCID: PMC10259064 DOI: 10.1186/s40478-023-01590-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
Vascular cognitive impairment (VCI) describes a wide spectrum of cognitive deficits related to cerebrovascular diseases. Although the loss of blood flow to cortical regions critically involved in cognitive processes must feature as the main driver of VCI, the underlying mechanisms and interactions with related disease processes remain to be fully elucidated. Recent clinical studies of cerebral blood flow measurements have supported the role of chronic cerebral hypoperfusion (CCH) as a major driver of the vascular pathology and clinical manifestations of VCI. Here we review the pathophysiological mechanisms as well as neuropathological changes of CCH. Potential interventional strategies for VCI are also reviewed. A deeper understanding of how CCH can lead to accumulation of VCI-associated pathology could potentially pave the way for early detection and development of disease-modifying therapies, thus allowing preventive interventions instead of symptomatic treatments.
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Affiliation(s)
- Vismitha Rajeev
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Yuek Ling Chai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Luting Poh
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Sharmelee Selvaraji
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - David Y Fann
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dong-Gyu Jo
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - T Michael De Silva
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Grant R Drummond
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher G Sobey
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Thiruma V Arumugam
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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28
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Prajjwal P, Marsool MDM, Inban P, Sharma B, Asharaf S, Aleti S, Gadam S, Al Sakini AS, Hadi DD. Vascular dementia subtypes, pathophysiology, genetics, neuroimaging, biomarkers, and treatment updates along with its association with Alzheimer's dementia and diabetes mellitus. Dis Mon 2023; 69:101557. [PMID: 37031059 DOI: 10.1016/j.disamonth.2023.101557] [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: 04/10/2023]
Abstract
Dementia is a chronic progressive cognitive decline illness that results in functional impairment. Vascular dementia (VaD), second only to Alzheimer's disease (AD), is one of the most prevalent forms of dementia in the elderly (aged over 65 years), with a varied presentation and unpredictable disease development caused by cerebrovascular or cardiovascular illness. To get a better understanding of the changes occurring in the brain and to drive therapy efforts, new biomarkers for early and precise diagnosis of AD and VaD are required. In this review, Firstly, we describe the subtypes of vascular dementia, their clinical features, pathogenesis, genetics implemented, and their associated neuroimaging and biomarkers, while describing extensively the recent biomarkers discovered in the literature. Secondly, we describe some of the well-documented and other less-defined risk factors and their association and pathophysiology in relation to vascular dementia. Finally, we follow recent updates in the management of vascular dementia along with its association and differentiation from Alzheimer's disease. The aim of this review is to gather the scattered updates and the most recent changes in blood, CSF, and neuroimaging biomarkers related to the multiple subtypes of vascular dementia along with its association with Alzheimer's dementia and diabetes mellitus.
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Affiliation(s)
| | | | - Pugazhendi Inban
- Internal Medicine, Government Medical College, Omandurar, Chennai, India
| | | | - Shahnaz Asharaf
- Internal Medicine, Travancore Medical College, Kollam, Kerala, India
| | - Soumya Aleti
- PGY-2, Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA
| | - Srikanth Gadam
- Internal Medicine, Postdoctoral Research Fellow, Mayo Clinic, USA
| | | | - Dalia Dhia Hadi
- University of Baghdad, Al-Kindy College of Medicine, Baghdad, Iraq
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29
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Li Z, Wang W, Sang F, Zhang Z, Li X. White matter changes underlie hypertension-related cognitive decline in older adults. Neuroimage Clin 2023; 38:103389. [PMID: 37004321 PMCID: PMC10102561 DOI: 10.1016/j.nicl.2023.103389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
Hypertension has been well recognized as a risk factor for cognitive impairment and dementia. Although the underlying mechanisms of hypertension-affected cognitive deterioration are not fully understood, white matter changes (WMCs) seem to play an important role. WMCs include low microstructural integrity and subsequent white matter macrostructural lesions, which are common on brain imaging in hypertensive patients and are critical for multiple cognitive domains. This article provides an overview of the impact of hypertension on white matter microstructural and macrostructural changes and its link to cognitive dysfunction. Hypertension may induce microstructural changes in white matter, especially for the long-range fibers such as anterior thalamic radiation (ATR) and inferior fronto-occipital fasciculus (IFOF), and then macrostructural abnormalities affecting different lobes, especially the periventricular area. Different regions' WMCs would further exert different effects to specific cognitive domains and accelerate brain aging. As a modifiable risk factor, hypertension might provide a new perspective for alleviating and delaying cognitive impairment.
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Affiliation(s)
- Zilin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Wenxiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
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30
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Sanders AM, Richard G, Kolskår K, Ulrichsen KM, Alnaes D, Beck D, Dørum ES, Engvig A, Lund MJ, Nordhøy W, Pedersen ML, Rokicki J, Nordvik JE, Westlye LT. Associations between everyday activities and arterial spin labeling-derived cerebral blood flow: A longitudinal study in community-dwelling elderly volunteers. Hum Brain Mapp 2023; 44:3377-3393. [PMID: 36947581 PMCID: PMC10171542 DOI: 10.1002/hbm.26287] [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: 09/26/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
Cerebral blood flow (CBF) is critical for brain metabolism and function. Age-related changes in CBF are associated with increased risk of neurocognitive disorders and vascular events such as stroke. Identifying correlates and positive modifiers of age-related changes in CBF before the emergence of incipient clinical decline may inform public health advice and clinical practice. Former research has been inconclusive regarding the association between regular physical activity and CBF, and there is a lack of studies on the association between level of everyday activities and CBF, in older adults. To investigate these relationships, 118 healthy community-dwelling adults (65-89 years) underwent pseudo-continuous arterial spin labeling (ASL) MRI, neurocognitive, physical, and activity assessments at baseline. Eighty-six participants completed a follow-up ASL MRI, on average 506 (SD = 113) days after the baseline scan. Cross-sectional analysis revealed credible evidence for positive associations between time spent on low intensity physical activity and CBF in multiple cortical and subcortical regions, time spent on moderate to vigorous intensity physical activity and accumbens CBF, participation in social activity and CBF in multiple cortical regions, and between reading and thalamic CBF, indicating higher regional CBF in more active adults. Longitudinal analysis revealed anecdotal evidence for an interaction between time and baseline level of gardening on occipital and parietal CBF, and baseline reading on pallidum CBF, indicating more change in CBF in adults with lower level of activity. The findings support that malleable lifestyle factors contribute to healthy brain aging, with relevance for public health guidelines.
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Affiliation(s)
- Anne-Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Kristine M Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Dag Alnaes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo New University College, Oslo, Norway
| | - Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erlend S Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Andreas Engvig
- Section for Preventive Cardiology, Department of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Martina Jonette Lund
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wibeke Nordhøy
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Physics and Computational Radiology, Div. of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Mads L Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jaroslav Rokicki
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Jan Egil Nordvik
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian Directorate of Health, Oslo, Norway
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
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Lim S, Shin S, Sung Y, Lee HE, Kim KH, Song JY, Lee GH, Aziz H, Lukianenko N, Kang DM, Boesen N, Jeong H, Abdildinova A, Lee J, Yu BY, Lim SM, Lee JS, Ryu H, Pae AN, Kim YK. Levosimendan inhibits disulfide tau oligomerization and ameliorates tau pathology in Tau P301L-BiFC mice. Exp Mol Med 2023; 55:612-627. [PMID: 36914856 PMCID: PMC10073126 DOI: 10.1038/s12276-023-00959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/26/2022] [Accepted: 01/01/2023] [Indexed: 03/14/2023] Open
Abstract
Tau oligomers play critical roles in tau pathology and are responsible for neuronal cell death and transmitting the disease in the brain. Accordingly, preventing tau oligomerization has become an important therapeutic strategy to treat tauopathies, including Alzheimer's disease. However, progress has been slow because detecting tau oligomers in the cellular context is difficult. Working toward tau-targeted drug discovery, our group has developed a tau-BiFC platform to monitor and quantify tau oligomerization. By using the tau-BiFC platform, we screened libraries with FDA-approved and passed phase I drugs and identified levosimendan as a potent anti-tau agent that inhibits tau oligomerization. 14C-isotope labeling of levosimendan revealed that levosimendan covalently bound to tau cysteines, directly inhibiting disulfide-linked tau oligomerization. In addition, levosimendan disassembles tau oligomers into monomers, rescuing neurons from aggregation states. In comparison, the well-known anti-tau agents methylene blue and LMTM failed to protect neurons from tau-mediated toxicity, generating high-molecular-weight tau oligomers. Levosimendan displayed robust potency against tau oligomerization and rescued cognitive declines induced by tauopathy in the TauP301L-BiFC mouse model. Our data present the potential of levosimendan as a disease-modifying drug for tauopathies.
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Affiliation(s)
- Sungsu Lim
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Seulgi Shin
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Yoonsik Sung
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea
| | - Ha Eun Lee
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Kyu Hyeon Kim
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea
| | - Ji Yeon Song
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Gwan-Ho Lee
- Advanced Analysis Center, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Hira Aziz
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea
| | - Nataliia Lukianenko
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea
| | - Dong Min Kang
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Department of Life Sciences, Korea University, Seoul, 02841, Korea
| | - Nicolette Boesen
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea
| | - Hyeanjeong Jeong
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Aizhan Abdildinova
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Junghee Lee
- Boston University Alzheimer's disease Research Center and VA Boston Health care System, Boston, MA, 02130, USA
| | - Byung-Yong Yu
- Advanced Analysis Center, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Sang Min Lim
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea
| | - Jun-Seok Lee
- Department of Pharmacology, Korea University College of Medicine, Seoul, 02792, Republic of Korea
| | - Hoon Ryu
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.,Boston University Alzheimer's disease Research Center and Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Ae Nim Pae
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea.
| | - Yun Kyung Kim
- Center for Brain Disorders, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, Republic of Korea. .,Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea.
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32
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Melgarejo JD, Vernooij MW, Ikram MA, Zhang ZY, Bos D. Intracranial Carotid Arteriosclerosis Mediates the Association Between Blood Pressure and Cerebral Small Vessel Disease. Hypertension 2023; 80:618-628. [PMID: 36458543 PMCID: PMC9944388 DOI: 10.1161/hypertensionaha.122.20434] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND Intracranial arteriosclerosis could explain the association between blood pressure (BP) and cerebral small vessel disease (CSVD). Therefore, we tested whether intracranial carotid artery calcification (ICAC) mediates the association between BP and CSVD and determined pathophysiological mechanisms based on ICAC subtypes. METHODS One thousand four hundred fifty-eight stroke-free participants from the Rotterdam Study (mean age, 68 years; 52% women) underwent nonenhanced computed tomography scans to quantify ICAC volume (mm3) between 2003 and 2015. ICAC was categorized into intimal and internal elastic lamina calcifications. CSVD included white matter hyperintensities volume, the presence of lacunes, and cerebral microbleeds visualized on magnetic resonance imaging. Office BP included systolic BP, diastolic BP, pulse pressure, and mean arterial pressure. Mediation analysis included a 2-way decomposition to determine the direct association between BP and CSVD and the indirect or mediated effect (negative or positive mediations expressed in %) of log-ICAC volume on such association. RESULTS BP and log-ICAC were correlated and were also associated with CSVD. In all participants, total log-ICAC volume mediated the association of diastolic BP (-14.5%) and pulse pressure (16.5%) with log-white matter hyperintensities. Internal elastic lamina log-ICAC volume mediated -19.5% of the association between diastolic BP and log-white matter hyperintensities; intimal log-ICAC volume did not mediate associations. For lacunes, total and internal elastic lamina log-ICAC volume mediated the association of diastolic BP (-40% and -45.8%) and pulse pressure (26.9% and 18.2%). We did not observe mediations for cerebral microbleeds. CONCLUSIONS Intracranial arteriosclerosis mediates the association between BP and CSVD. Internal elastic lamina calcification, considered a proxy of arterial stiffness, is the leading mechanism explaining the link between BP and CSVD.
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Affiliation(s)
- Jesus D Melgarejo
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.).,Laboratory of Neurosciences, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela (J.D.M.)
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V., D.B.)
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.)
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.)
| | - Daniel Bos
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V., D.B.)
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33
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Hsieh PI, Chen YC, Chen TF, Chiou JM, Chen JH. Multimorbid Patterns and Cognitive Performance in the Presence of Informative Dropout Among Community-Dwelling Taiwanese Older Adults. Innov Aging 2023; 7:igad012. [PMID: 37007640 PMCID: PMC10053640 DOI: 10.1093/geroni/igad012] [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: 08/26/2022] [Indexed: 02/10/2023] Open
Abstract
Background and Objectives Longitudinal studies among older adults often feature elevated dropout rates and multiple chronic conditions. How Taiwanese multimorbid patterns relate to different cognitive domains remains unclear. This study aims to identify sex-specific multimorbid patterns and associate them with cognitive performance while modeling the risk for dropout. Research Design and Methods A prospective cohort study (2011-19) in Taiwan recruited 449 Taiwanese older adults without dementia. Global and domain-specific cognition were assessed biennially. We used exploratory factor analysis to identify baseline sex-specific multimorbid patterns of 19 self-reported chronic conditions. We utilized a joint model incorporating longitudinal and time-to-dropout data to examine the association between multimorbid patterns and cognitive performance accounting for the informative dropout via the shared random effect. Results At the end of the study, 324 participants (72.1%) remained in the cohort, with an average annual attrition rate of 5.5%. We found that advanced age, low levels of physical activities, and poor cognition at baseline were associated with increased dropout risks. Besides, 6 multimorbid patterns were identified, labeled Mental, Renal-vascular, and Cancer-urinary patterns in men, and Mental, Cardiometabolic, and Cancer-endocrine patterns in women. For men, as the follow-up time increased, the Mental pattern was associated with poor global cognition and attention; the Renal-vascular pattern was associated with poor executive function. For women, the Mental pattern was associated with poor memory; as follow-up time increased, and Cardiometabolic patterns were related to poor memory. Discussion and Implications Sex-specific multimorbid patterns identified in the Taiwanese older population showed differences (notably Renal-vascular pattern in men) from patterns found in Western countries and were differentially associated with cognitive impairment over time. When informative dropout is suspected, appropriate statistical methods should be applied.
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Affiliation(s)
- Pei-Iun Hsieh
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan
- Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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von Rennenberg R, Liman T, Nolte CH, Nave AH, Scheitz JF, Düzel S, Regitz-Zagrosek V, Gerstorf D, Steinhagen-Thiessen E, Demuth I, Endres M. High-Sensitivity Cardiac Troponin T and Cognitive Decline in Older Adults: Results of the Berlin Aging Study II. Gerontology 2023; 69:140-148. [PMID: 35512662 DOI: 10.1159/000523845] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION There is evidence of an association between markers of cardiac injury and cognition in patients with cardiovascular disease. We hypothesized that levels of high-sensitivity cardiac troponin T (hs-cTnT) are associated with cognitive performance and cognitive decline in a population of predominantly healthy older adults. METHODS We included 1,226 predominantly healthy adults ≥60 years from the Berlin Aging Study II. Participants were recruited from the general population of the Berlin metropolitan area from 2009 to 2014. At baseline, participants underwent measurement of hs-cTnT and cognitive testing using the extended Consortium to Establish a Registry for Alzheimer's Disease (CERAD-Plus) battery. In addition, the Digit Symbol Substitution Test (DSST) was performed at baseline and at follow-up (7.3 ± 1.4 years after the baseline visit). The CERAD test results were summarized into four cognitive domains (processing speed, executive function, visuo-construction, and memory). After summing-up the respective raw scores, we calculated standardized z scores. We performed unadjusted and adjusted linear regression models to assess links between hs-cTnT and cognitive domains. We used linear mixed models to analyze associations between hs-cTnT and cognitive decline according to changes in DSST scores over time. RESULTS The mean age of study participants at baseline was 68.5 (±3.6) years, 49% were female, and median hs-cTnT levels were 6 ng/L (IQR 4-8 ng/L). We detected no significant association between hs-cTnT and different cognitive domains at baseline after adjustment for age, sex, education, and cardiovascular risk factors. Hs-cTnT was associated with cognitive decline, which remained statistically significant after full adjustment (adjusted beta-coefficient -0.82 (-1.28 to -0.36), p = 0.001). After stratification for sex, the association with hs-cTnT remained statistically significant in men but not in women. CONCLUSION Higher hs-cTnT levels in older men are associated with cognitive decline measured with the DSST.
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Affiliation(s)
- Regina von Rennenberg
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, Germany
| | - Thomas Liman
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christian H Nolte
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, Germany.,German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander H Nave
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Jan F Scheitz
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Düzel
- Max Planck Institute for Human Development, Berlin, Germany
| | - Vera Regitz-Zagrosek
- German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany.,Gender in Medicine (Institut für Geschlechterforschung in der Medizin, GiM), Charite-Universitätsmedizin, Berlin, Germany
| | - Denis Gerstorf
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Biology of Aging working group, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ilja Demuth
- Biology of Aging working group, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Matthias Endres
- Department of Neurology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, Germany.,German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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Timmermans EJ, Leeuwis AE, Bots ML, van Alphen JL, Biessels GJ, Brunner-La Rocca HP, Kappelle LJ, van Rossum AC, van Osch MJP, Vaartjes I. Neighbourhood walkability in relation to cognitive functioning in patients with disorders along the heart-brain axis. Health Place 2023; 79:102956. [PMID: 36525834 DOI: 10.1016/j.healthplace.2022.102956] [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: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
This study examined associations of neighbourhood walkability with cognitive functioning (i.e., global cognition, memory, language, attention-psychomotor speed, and executive functioning) in participants without or with either heart failure, carotid occlusive disease, or vascular cognitive impairment. Neighbourhood walkability at baseline was positively associated with global cognition and attention-psychomotor speed. These associations were stronger in patients with vascular cognitive impairment. Individuals who live in residential areas with higher walkability levels were less likely to have impairments in language and executive functioning at two-year follow-up. These findings highlight the importance of the built environment for cognitive functioning in healthy and vulnerable groups.
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Affiliation(s)
- Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Anna E Leeuwis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Juliette L van Alphen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - L Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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36
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Lim JY, Kim W, Ha AW. The effect of curcumin on blood pressure and cognitive impairment in spontaneously hypertensive rats. Nutr Res Pract 2023; 17:192-205. [PMID: 37009141 PMCID: PMC10042717 DOI: 10.4162/nrp.2023.17.2.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND/OBJECTIVES It is known that the renin-angiotensin system (RAS) in the brain could regulate cognitive functions as well as blood pressure. Inhibition of RAS for the improvement of cognitive function may be a new strategy, but studies so far have mostly reported on the effects of RAS inhibition by drugs, and there is no research on cognitive improvement through RAS inhibition of food ingredients. Therefore, this study investigated the effect of curcumin on blood pressure and cognitive function and its related mechanism in spontaneously hypertensive rat/Izm (SHR/Izm). MATERIALS/METHODS Six-week-old SHR/Izm rats were divided into 5 groups: control group (CON), scopolamine group (SCO, drug for inducing cognitive deficits), positive control (SCO and tacrine [TAC]), curcumin 100 group (CUR100, SCO + Cur 100 mg/kg), and curcumin 200 group (CUR200, SCO + Cur 200 mg/kg). Changes in blood pressure, RAS, cholinergic system, and cognitive function were compared before and after cognitive impairment. RESULTS The SCO group showed increased blood pressure and significantly reduced cognitive function based on the y-maze and passive avoidance test. Curcumin treatments significantly improved blood pressure and cognitive function compared with the SCO group. In both the CUR100 and CUR200 groups, the mRNA expressions of angiotensin-converting enzyme (ACE) and angiotensin II receptor type1 (AT1), as well as the concentrations of angiotensin II (Ang II) in brain tissue were significantly decreased. The mRNA expression of the muscarinic acetylcholine receptors (mAChRs) and acetylcholine (ACh) content was significantly increased, compared with the SCO group. CONCLUSIONS The administration of curcumin improved blood pressure and cognitive function in SCO-induced hypertensive mice, indicating that the cholinergic system was improved by suppressing RAS and AT1 receptor expression and increasing the mAChR expression.
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Affiliation(s)
- Ji Young Lim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Wookyoung Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Ae Wha Ha
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
- Department of Food Science and Nutrition, Natural Nutraceuticals Industrialization Research Center, Dankook University, Cheonan 31116, Korea
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Mouches P, Wilms M, Aulakh A, Langner S, Forkert ND. Multimodal brain age prediction fusing morphometric and imaging data and association with cardiovascular risk factors. Front Neurol 2022; 13:979774. [PMID: 36588902 PMCID: PMC9794870 DOI: 10.3389/fneur.2022.979774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction The difference between the chronological and biological brain age, called the brain age gap (BAG), has been identified as a promising biomarker to detect deviation from normal brain aging and to indicate the presence of neurodegenerative diseases. Moreover, the BAG has been shown to encode biological information about general health, which can be measured through cardiovascular risk factors. Current approaches for biological brain age estimation, and therefore BAG estimation, either depend on hand-crafted, morphological measurements extracted from brain magnetic resonance imaging (MRI) or on direct analysis of brain MRI images. The former can be processed with traditional machine learning models while the latter is commonly processed with convolutional neural networks (CNNs). Using a multimodal setting, this study aims to compare both approaches in terms of biological brain age prediction accuracy and biological information captured in the BAG. Methods T1-weighted MRI, containing brain tissue information, and magnetic resonance angiography (MRA), providing information about brain arteries, from 1,658 predominantly healthy adults were used. The volumes, surface areas, and cortical thickness of brain structures were extracted from the T1-weighted MRI data, while artery density and thickness within the major blood flow territories and thickness of the major arteries were extracted from MRA data. Independent multilayer perceptron and CNN models were trained to estimate the brain age from the hand-crafted features and image data, respectively. Next, both approaches were fused to assess the benefits of combining image data and hand-crafted features for brain age prediction. Results The combined model achieved a mean absolute error of 4 years between the chronological and predicted biological brain age. Among the independent models, the lowest mean absolute error was observed for the CNN using T1-weighted MRI data (4.2 years). When evaluating the BAGs obtained using the different approaches and imaging modalities, diverging associations between cardiovascular risk factors were found. For example, BAGs obtained from the CNN models showed an association with systolic blood pressure, while BAGs obtained from hand-crafted measurements showed greater associations with obesity markers. Discussion In conclusion, the use of more diverse sources of data can improve brain age estimation modeling and capture more diverse biological deviations from normal aging.
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Affiliation(s)
- Pauline Mouches
- Biomedical Engineering Program, University of Calgary, Calgary, AB, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,*Correspondence: Pauline Mouches
| | - Matthias Wilms
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Agampreet Aulakh
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Nils D. Forkert
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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38
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Asmuje NF, Mat S, Goh CH, Myint PK, Tan MP. Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function. Am J Hypertens 2022; 35:998-1005. [PMID: 36153737 DOI: 10.1093/ajh/hpac107] [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: 06/07/2022] [Revised: 08/16/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over. METHODS Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment. RESULTS Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments. CONCLUSION Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline.
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Affiliation(s)
- Nur Fazidah Asmuje
- Kolej Genius Insan, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia.,Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Physiotherapy Programme and Center of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Choon Hian Goh
- Department of Mechatronics and Biomedical Engineering, Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Phyo Kyaw Myint
- Ageing Clinical and Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Medicine for The Elderly, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Innovations in Medical Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
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39
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Griffanti L, Gillis G, O'Donoghue MC, Blane J, Pretorius PM, Mitchell R, Aikin N, Lindsay K, Campbell J, Semple J, Alfaro-Almagro F, Smith SM, Miller KL, Martos L, Raymont V, Mackay CE. Adapting UK Biobank imaging for use in a routine memory clinic setting: The Oxford Brain Health Clinic. Neuroimage Clin 2022; 36:103273. [PMID: 36451375 PMCID: PMC9723313 DOI: 10.1016/j.nicl.2022.103273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/24/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
The Oxford Brain Health Clinic (BHC) is a joint clinical-research service that provides memory clinic patients and clinicians access to high-quality assessments not routinely available, including brain MRI aligned with the UK Biobank imaging study (UKB). In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for memory clinic patients, 2) modified the imaging analysis pipeline to extract measures that are in line with radiology reports and 3) explored the alignment of measures from BHC patients to the largest brain MRI study in the world (ultimately 100,000 participants). Adaptations of the UKB acquisition protocol for BHC patients include dividing the scan into core and optional sequences (i.e., additional imaging modalities) to improve patients' tolerance for the MRI assessment. We adapted the UKB structural MRI analysis pipeline to take into account the characteristics of a memory clinic population (e.g., high amount of white matter hyperintensities and hippocampal atrophy). We then compared the imaging derived phenotypes (IDPs) extracted from the structural scans to visual ratings from radiology reports, non-imaging factors (age, cognition) and to reference distributions derived from UKB data. Of the first 108 BHC attendees (August 2020-November 2021), 92.5 % completed the clinical scans, 88.0 % consented to use of data for research, and 43.5 % completed the additional research sequences, demonstrating that the protocol is well tolerated. The high rates of consent to research makes this a valuable real-world quality research dataset routinely captured in a clinical service. Modified tissue-type segmentation with lesion masking greatly improved grey matter volume estimation. CSF-masking marginally improved hippocampal segmentation. The IDPs were in line with radiology reports and showed significant associations with age and cognitive performance, in line with the literature. Due to the age difference between memory clinic patients of the BHC (age range 65-101 years, average 78.3 years) and UKB participants (44-82 years, average 64 years), additional scans on elderly healthy controls are needed to improve reference distributions. Current and future work aims to integrate automated quantitative measures in the radiology reports and evaluate their clinical utility.
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Affiliation(s)
- Ludovica Griffanti
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom.
| | - Grace Gillis
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - M Clare O'Donoghue
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Jasmine Blane
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Pieter M Pretorius
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | | | - Nicola Aikin
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Karen Lindsay
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Jon Campbell
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Juliet Semple
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Fidel Alfaro-Almagro
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Stephen M Smith
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Karla L Miller
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Lola Martos
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Vanessa Raymont
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
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40
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Choi JJ, Oldham MA, Pancharovski T, Rubano A, Walsh P, Alexis JD, Gosev I, Lee HB. Cognitive Change After Left Ventricular Assist Device Implantation: A Case Series and Systematic Review. J Acad Consult Liaison Psychiatry 2022; 63:599-606. [PMID: 36116764 PMCID: PMC9809990 DOI: 10.1016/j.jaclp.2022.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/08/2022] [Accepted: 09/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Chronic cerebral hypoperfusion is a potential mechanism that causes cognitive impairment in patients with heart failure. Cognitive impairment in this population is associated with an increased mortality and poorer quality of life. Understanding the etiopathogenesis of cognitive impairment is crucial to developing effective treatment. A left ventricular assist device (LVAD) is a durable mechanical circulatory support device that restores systemic perfusion in patients with heart failure, potentially reversing cerebral hypoperfusion and cognitive impairment. OBJECTIVE This case series and systematic review examines the effect of LVAD implantation on cognition in patients with heart failure. METHODS We report a case series of 4 LVAD recipients at a tertiary academic center who underwent preimplant and postimplant cognitive testing. We also conducted a systematic review of studies with adult recipients of a continuous-flow LVAD whose cognition was measured before and after implantation. We searched Medline, EMBASE, SCOPUS, and the Cochrane library (start of database to July 16, 2021) for longitudinal, peer-reviewed studies written in English. RESULTS Cognitive improvement after LVAD implantation was observed in the case series, with improvement on phonemic fluency and digit symbol coding assessments. Two out of 4 cases in the case series improved on Clinical Dementia Rating: one from moderate dementia to mild cognitive impairment and another from mild cognitive impairment to unimpaired. Seven studies were included in the systematic review and were heterogeneous regarding cognitive tests employed, follow-up period, and measured outcomes. Montreal Cognitive Assessment and Trail-Making Test Part B were used most commonly. Cognitive improvement was reported in all 7 studies with at least 1 study reporting statistically significant improvements in each the following cognitive domains: delayed and immediate recall, executive function, visuospatial function, verbal function, attention, and processing speed. Most studies had small sample sizes and lacked a control group. CONCLUSIONS LVAD implantation appears to be associated with improved cognition. Adequately powered, prospective studies are needed to examine the effect of LVAD on cognitive function in patients with heart failure. Additionally, studies that directly examine cerebral blood flow in conjunction with cognitive assessment are needed to establish the relationship between the reversal of cerebral hypoperfusion and improved cognition.
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Affiliation(s)
- Joy J Choi
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Mark A Oldham
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Amanda Rubano
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Patrick Walsh
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY
| | - Jeffrey D Alexis
- Division of Cardiology, Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Igor Gosev
- Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Hochang B Lee
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; University of Rochester School of Medicine and Dentistry, Rochester, NY
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41
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Feter N, Mielke GI, Cunha L, Leite JS, Dumith SC, Rombaldi AJ. Can physical activity attenuate the impact of cardiovascular risk factors in the incidence of dementia? Findings from a population-based cohort study. Psychiatry Res 2022; 317:114865. [PMID: 36179594 DOI: 10.1016/j.psychres.2022.114865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Natan Feter
- Postgraduate Program of Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Dr Miguel Barcelos, 547, Pelotas, Porto Alegre, Rio Grande do Sul 96015-150, Brazil.
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Larissa Cunha
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Jayne S Leite
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Samuel C Dumith
- Postgraduate Program in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Airton J Rombaldi
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
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42
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Gyanwali B, Tan CS, Petr J, Escobosa LLT, Vrooman H, Chen C, Mutsaerts HJ, Hilal S. Arterial Spin-Labeling Parameters and Their Associations with Risk Factors, Cerebral Small-Vessel Disease, and Etiologic Subtypes of Cognitive Impairment and Dementia. AJNR Am J Neuroradiol 2022; 43:1418-1423. [PMID: 36562454 PMCID: PMC9575536 DOI: 10.3174/ajnr.a7630] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/01/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Cerebral small-vessel disease may alter cerebral blood flow (CBF) leading to brain changes and, hence, cognitive impairment and dementia. CBF and the spatial coefficient of variation can be measured quantitatively by arterial spin-labeling. We aimed to investigate the associations of demographics, vascular risk factors, location, and severity of cerebral small-vessel disease as well as the etiologic subtypes of cognitive impairment and dementia with CBF and the spatial coefficient of variation. MATERIALS AND METHODS Three hundred ninety patients with a diagnosis of no cognitive impairment, cognitive impairment no dementia, vascular cognitive impairment no dementia, Alzheimer disease, and vascular dementia were recruited from the memory clinic. Cerebral microbleeds and lacunes were categorized into strictly lobar, strictly deep, and mixed-location and enlarged perivascular spaces into the centrum semiovale and basal ganglia. Total and region-specific white matter hyperintensity volumes were segmented using FreeSurfer. CBF (n = 333) and the spatial coefficient of variation (n = 390) were analyzed with ExploreASL from 2D-EPI pseudocontinuous arterial spin-labeling images in white matter (WM) and gray matter (GM). To analyze the effect of demographic and vascular risk factors as well as the location and severity of cerebral small-vessel disease markers on arterial spin-labeling parameters, we constructed linear regression models, whereas logistic regression models were used to determine the association between arterial spin-labeling parameters and cognitive impairment no dementia, vascular cognitive impairment no dementia, Alzheimer disease, and vascular dementia. RESULTS Increasing age, male sex, hypertension, hyperlipidemia, history of heart disease, and smoking were associated with lower CBF and a higher spatial coefficient of variation. Higher numbers of lacunes and cerebral microbleeds were associated with lower CBF and a higher spatial coefficient of variation. Location-specific analysis showed mixed-location lacunes and cerebral microbleeds were associated with lower CBF. Higher total, anterior, and posterior white matter hyperintensity volumes were associated with a higher spatial coefficient of variation. No association was observed between enlarged perivascular spaces and arterial spin-labeling parameters. A higher spatial coefficient of variation was associated with the diagnosis of vascular cognitive impairment no dementia, Alzheimer's disease, and vascular dementia. CONCLUSIONS Reduced CBF and an increased spatial coefficient of variation were associated with cerebral small-vessel disease, and more specifically lacunes, whereas cerebral microbleeds and white matter hyperintensities were associated with WM-CBF and GM spatial coefficient of variation. The spatial coefficient of variation was associated with cognitive impairment and dementia, suggesting that hypoperfusion might be the key underlying mechanism for vascular brain damage.
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Affiliation(s)
- B Gyanwali
- From the Memory Aging and Cognition Centre (B.G., C.C., S.H.), National University Health System, Singapore
| | - C S Tan
- Saw Swee Hock School of Public Health (C.S.T., L.L.T.E., S.H.), National University of Singapore, and National University Health System, Singapore
| | - J Petr
- Helmholtz-Zentrum Dresden-Rossendorf (J.P.), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - L L T Escobosa
- Saw Swee Hock School of Public Health (C.S.T., L.L.T.E., S.H.), National University of Singapore, and National University Health System, Singapore
| | - H Vrooman
- Department of Radiology and Nuclear Medicine (H.V.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - C Chen
- From the Memory Aging and Cognition Centre (B.G., C.C., S.H.), National University Health System, Singapore
- Department of Pharmacology (C.C., S.H.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - H J Mutsaerts
- Department of Radiology (H.J.M.), VU University Medical Center, Amsterdam, the Netherlands
- Department of Radiology (H.J.M.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - S Hilal
- From the Memory Aging and Cognition Centre (B.G., C.C., S.H.), National University Health System, Singapore
- Saw Swee Hock School of Public Health (C.S.T., L.L.T.E., S.H.), National University of Singapore, and National University Health System, Singapore
- Department of Pharmacology (C.C., S.H.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Mehkri Y, McDonald B, Sriram S, Reddy R, Kounelis-Wuillaume S, Roberts JA, Lucke-Wold B. Recent Treatment Strategies in Alzheimer's Disease and Chronic Traumatic Encephalopathy. BIOMEDICAL RESEARCH AND CLINICAL REVIEWS 2022; 7:128. [PMID: 36743825 PMCID: PMC9897211 DOI: 10.31579/2692-9406/128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Neurotrauma has been well linked to the progression of neurodegenerative disease. Much work has been done characterizing chronic traumatic encephalopathy, but less has been done regarding the contribution to Alzheimer's Disease. This review focuses on AD and its association with neurotrauma. Emerging clinical trials are discussed as well as novel mechanisms. We then address how some of these mechanisms are shared with CTE and emerging pre-clinical studies. This paper is a user-friendly resource that summarizes the emerging findings and proposes further investigation into key areas of interest. It is intended to serve as a catalyst for both research teams and clinicians in the quest to improve effective treatment and diagnostic options.
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Affiliation(s)
- Yusuf Mehkri
- Department of Neurosurgery, University of Florida, Gainesville
| | | | - Sai Sriram
- Department of Neurosurgery, University of Florida, Gainesville
| | - Ramya Reddy
- Department of Neurosurgery, University of Florida, Gainesville
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Fabiani M, Asnakew BA, Bowie DC, Chism SM, Clements GM, Gardner JC, Islam SS, Rubenstein SL, Gratton G. A healthy mind in a healthy body: Effects of arteriosclerosis and other risk factors on cognitive aging and dementia. THE PSYCHOLOGY OF LEARNING AND MOTIVATION 2022; 77:69-123. [PMID: 37139101 PMCID: PMC10153623 DOI: 10.1016/bs.plm.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this review we start from the assumption that, to fully understand cognitive aging, it is important to embrace a holistic view, integrating changes in bodily, brain, and cognitive functions. This broad view can help explain individual differences in aging trajectories and could ultimately enable prevention and remediation strategies. As the title of this review suggests, we claim that there are not only indirect but also direct effects of various organ systems on the brain, creating cascades of phenomena that strongly contribute to age-related cognitive decline. Here we focus primarily on the cerebrovascular system, because of its direct effects on brain health and close connections with the development and progression of Alzheimer's Disease and other types of dementia. We start by reviewing the main cognitive changes that are often observed in normally aging older adults, as well as the brain systems that support them. Second, we provide a brief overview of the cerebrovascular system and its known effects on brain anatomy and function, with a focus on aging. Third, we review genetic and lifestyle risk factors that may affect the cerebrovascular system and ultimately contribute to cognitive decline. Lastly, we discuss this evidence, review limitations, and point out avenues for additional research and clinical intervention.
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Affiliation(s)
- Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Bethlehem A. Asnakew
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Daniel C. Bowie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sydney M. Chism
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Grace M. Clements
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jennie C. Gardner
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samia S. Islam
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samantha L. Rubenstein
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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Mason SA, Al Saikhan L, Jones S, James SN, Murray-Smith H, Rapala A, Williams S, Sudre C, Wong B, Richards M, Fox NC, Hardy R, Schott JM, Chaturvedi N, Hughes AD. Association between carotid atherosclerosis and brain activation patterns during the Stroop task in older adults: An fNIRS investigation. Neuroimage 2022; 257:119302. [PMID: 35595200 PMCID: PMC10466022 DOI: 10.1016/j.neuroimage.2022.119302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
There is an increasing body of evidence suggesting that vascular disease could contribute to cognitive decline and overt dementia. Of particular interest is atherosclerosis, as it is not only associated with dementia, but could be a potential mechanism through which cardiovascular disease directly impacts brain health. In this work, we evaluated the differences in functional near infrared spectroscopy (fNIRS)-based measures of brain activation, task performance, and the change in central hemodynamics (mean arterial pressure (MAP) and heart rate (HR)) during a Stroop color-word task in individuals with atherosclerosis, defined as bilateral carotid plaques (n = 33) and healthy age-matched controls (n = 33). In the healthy control group, the left prefrontal cortex (LPFC) was the only region showing evidence of activation when comparing the incongruous with the nominal Stroop test. A smaller extent of brain activation was observed in the Plaque group compared with the healthy controls (1) globally, as measured by oxygenated hemoglobin (p = 0.036) and (2) in the LPFC (p = 0.02) and left sensorimotor cortices (LMC)(p = 0.008) as measured by deoxygenated hemoglobin. There were no significant differences in HR, MAP, or task performance (both in terms of the time required to complete the task and number of errors made) between Plaque and control groups. These results suggest that carotid atherosclerosis is associated with altered functional brain activation patterns despite no evidence of impaired performance of the Stroop task or central hemodynamic changes.
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Affiliation(s)
- Sarah A Mason
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Lamia Al Saikhan
- Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, 2835 King Faisal Street, Damman, Kingdom of Saudi Arabia
| | - Siana Jones
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Centre for Medical Image Computing, Department of Computer Science, University College London, London UK
| | - Alicja Rapala
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Suzanne Williams
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Carole Sudre
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Centre for Medical Image Computing, Department of Computer Science, University College London, London UK; School of Biomedical Engineering, King's College, London UK
| | - Brian Wong
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Nick C Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Centre for Medical Image Computing, Department of Computer Science, University College London, London UK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing at University College London, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
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Maroofi A, Moro T, Agrimi J, Safari F. Cognitive decline in heart failure: Biomolecular mechanisms and benefits of exercise. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166511. [PMID: 35932891 DOI: 10.1016/j.bbadis.2022.166511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
By definition, heart failure (HF) is a human pathological condition affecting the structure and function of all organs in the body, and the brain is not an exception to that. Failure of the heart to pump enough blood centrally and peripherally is at the foundation of HF patients' inability to attend even the most ordinary daily activities and progressive deterioration of their cognitive capacity. What is more, between heart and brain exists a bidirectional relationship that goes well beyond hemodynamics and concerns bioelectric and endocrine signaling. This increasingly consolidated evidence makes the scenario even more complex. Studies have mainly chased how HF impairs cognition without focusing much on preventive measures, notably cardio-cerebral health proxies. Here, we aim to provide a brief account of known and hypothetical factors that may explain how exercise can help obviate cognitive dysfunction associated with HF in its different forms. As we shall see, there is a stringent need for a deeper grasp of such mechanisms. Indeed, gaining this new knowledge will automatically shed new light on the inner workings of HF itself, thus resulting in more effective prevention and treatment of this escalating syndrome.
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Affiliation(s)
- Abdulbaset Maroofi
- Department of Exercise Physiology, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy
| | - Jacopo Agrimi
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy.
| | - Fatemeh Safari
- Department of Physiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Wang J, Zhang W, Zhou Y, Jia J, Li Y, Liu K, Ye Z, Jin L. Altered Prefrontal Blood Flow Related With Mild Cognitive Impairment in Parkinson's Disease: A Longitudinal Study. Front Aging Neurosci 2022; 14:896191. [PMID: 35898326 PMCID: PMC9309429 DOI: 10.3389/fnagi.2022.896191] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment is a common non-motor symptom in Parkinson's disease (PD), with executive dysfunction being an initial manifestation. We aimed to investigate whether and how longitudinal changes in the prefrontal perfusion correlate with mild cognitive impairment (MCI) in patients with PD. We recruited 49 patients with PD with normal cognition and 37 matched healthy control subjects (HCs). Patients with PD completed arterial spin labeling MRI (ASL–MRI) scans and a comprehensive battery of neuropsychological assessments at baseline (V0) and 2-year follow-up (V1). HCs completed similar ASL–MRI scans and neuropsychological assessments at baseline. At V1, 10 patients with PD progressed to MCI (converters) and 39 patients remained cognitively normal (non-converters). We examined differences in the cerebral blood flow (CBF) derived from ASL–MRI and neuropsychological measures (a) between patients with PD and HCs at V0 (effect of the disease), (b) between V1 and V0 in patients with PD (effect of the disease progression), and (c) between converters and non-converters (effect of the MCI progression) using t-tests or ANOVAs with false discovery rate correction. We further analyzed the relationship between longitudinal CBF and neuropsychological changes using multivariate regression models with false discovery rate correction, focusing on executive functions. At V0, no group difference was found in prefrontal CBF between patients with PD and HCs, although patients with PD showed worse performances on executive function. At V1, patients with PD showed significantly reduced CBF in multiple prefrontal regions, including the bilateral lateral orbitofrontal, medial orbitofrontal, middle frontal, inferior frontal, superior frontal, caudal anterior cingulate, and rostral anterior cingulate. More importantly, converters showed a more significant CBF reduction in the left lateral orbitofrontal cortex than non-converters. From V0 to V1, the prolonged completion time of Trail Making Test-B (TMT-B) negatively correlated with longitudinal CBF reduction in the right caudal anterior cingulate cortex. The decreased accuracy of the Stroop Color-Word Test positively correlated with longitudinal CBF reduction in the left medial orbitofrontal cortex. In addition, at V1, the completion time of TMT-B negatively correlated with CBF in the left caudal anterior cingulate cortex. Our findings suggest that longitudinal CBF reduction in the prefrontal cortex might impact cognitive functions (especially executive functions) at the early stages of PD.
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Affiliation(s)
- Jian Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Ying Zhou
- Department of Neurology, XiaMen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Jia Jia
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanfang Li
- Department of Neurology, XiaMen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Kai Liu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zheng Ye
- Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
- *Correspondence: Zheng Ye
| | - Lirong Jin
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
- Lirong Jin
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Gerçek M, Irimie AA, Gerçek M, Fox H, Fortmeier V, Rudolph TK, Rudolph V, Friedrichs KP. Dynamics of Cognitive Function in Patients with Heart Failure Following Transcatheter Mitral Valve Repair. J Clin Med 2022; 11:jcm11143990. [PMID: 35887753 PMCID: PMC9317412 DOI: 10.3390/jcm11143990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 02/05/2023] Open
Abstract
Aims: Interventional transcatheter edge-to-edge mitral valve repair (TMVR) is an established treatment option for patients with severe mitral regurgitation (MR) and high operative risk. Cognitive impairment is one of the most common conditions among often extensive comorbidities in these patients. The specific patterns of cognitive decline and particularly the effect of TMVR are not well described. Thus, this study aimed to investigate into the impact of TMVR on cognitive impairment, exercise capacity, and quality of life. Methods: Cognitive function (executive, naming, memory, attention, language, abstraction, and orientation) was assessed with the standardized Montreal Cognitive Assessment test (MoCA; range between 0 and 30 points) before and 3 months after TMVR in 72 consecutive patients alongside echocardiographic examination and assessment of exercise capacity (six-minute walk test) as well as quality-of-life questionnaires (Minnesota living with heart failure questionnaire, MLHF-Q). Results: Patients’ median age was 81 [76.0; 84.5] years, 39.7% were female with a median EuroScore II of 4.4% [2.9; 7.7]. The assessment of cognitive function showed a significant improvement of the cumulative MoCA-Test result (from 22.0 [19.0; 24.5] to 24 [22.0; 26.0]; p < 0.001) with significant changes in the subcategories executive (p < 0.001), attention (p < 0.001), abstraction (p < 0.001), and memory (p < 0.001). In addition, quality of life (from 47.5 [25.0; 69.3] to 24.0 [12.0; 40.0]; p < 0.001) and exercise capacity (from 220.0 m [160.0; 320.0] to 280.0 m [200.0; 380.0]; p = 0.003) increased significantly 3 months after the TMVR procedure. Conclusions: TMVR leads to a significant improvement of cognitive function, exercise capacity, and quality of life in patients with chronic heart failure in 3 months follow up and again highlights the benefit of the evermore established TMVR procedure for patients with high operative risk.
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Affiliation(s)
- Muhammed Gerçek
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (V.F.); (T.K.R.); (V.R.); (K.P.F.)
- Correspondence: ; Tel.: +49-5731-971258
| | - Anca A. Irimie
- Clinic for Neurology, Klinikum Herford, 32049 Herford, Germany;
| | - Mustafa Gerçek
- Clinic for Cardiovascular Surgery, Herzzentrum Duisburg, 47137 Duisburg, Germany;
| | - Henrik Fox
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany;
- Heart Failure Department, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
| | - Vera Fortmeier
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (V.F.); (T.K.R.); (V.R.); (K.P.F.)
| | - Tanja K. Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (V.F.); (T.K.R.); (V.R.); (K.P.F.)
| | - Volker Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (V.F.); (T.K.R.); (V.R.); (K.P.F.)
- Heart Failure Department, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
| | - Kai P. Friedrichs
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (V.F.); (T.K.R.); (V.R.); (K.P.F.)
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Zhang Y, Lu L, Chen C, Field RW, D'Alton M, Kahe K. Does protracted radon exposure play a role in the development of dementia? ENVIRONMENTAL RESEARCH 2022; 210:112980. [PMID: 35189101 PMCID: PMC9081166 DOI: 10.1016/j.envres.2022.112980] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 06/10/2023]
Abstract
Radon is a ubiquitous radioactive gas that decays into a series of solid radioactive decay products. Radon, and its decay products, enter the human body primarily through inhalation and can be delivered to various tissues including the brain through systemic circulation. It can also reach the brain by neuronal pathways via the olfactory system. While ionizing radiation has been suggested as a risk factor of dementia for decades, studies exploring the possible role of radon exposure in the development of Alzheimer's Diseases (AD) and other dementias are sparse. We systematically reviewed the literature and found several lines of evidence suggesting that radon decay products (RDPs) disproportionally deposit in the brain of AD patients with selective accumulation within the protein fractions. Ecologic study findings also indicate a significant positive correlation between geographic-level radon distribution and AD mortality in the US. Additionally, pathologic studies of radon shed light on the potential pathways of radon decay product induced proinflammation and oxidative stress that may result in the development of dementia. In summary, there are plausible underlying biological mechanisms linking radon exposure to the risk of dementia. Since randomized clinical trials on radon exposure are not feasible, well-designed individual-level epidemiologic studies are urgently needed to elucidate the possible association between radon (i.e., RDPs) exposure and the onset of dementia.
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Affiliation(s)
- Yijia Zhang
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - R William Field
- Department of Occupational and Environmental Health and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Mary D'Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, 10032, USA.
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50
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Li M, Wang N, Dupre ME. Association between the self-reported duration and quality of sleep and cognitive function among middle-aged and older adults in China. J Affect Disord 2022; 304:20-27. [PMID: 35176346 DOI: 10.1016/j.jad.2022.02.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/23/2021] [Accepted: 02/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The World Alzheimer Report showed that 46.8 million people suffered from dementia in 2015. This study examined how the duration and quality of sleep are associated with cognition among older adults in China. METHOD Data were drawn from waves 2011, 2013, and 2015 of the China Health and Retirement Longitudinal Study (CHARLS), including noninstitutionalized adults aged 45 and older (n=10,768). Cognition was measured by interview-based assessments of mental status (TICS-10), episodic memory, and visuospatial abilities. Sleep duration was categorized as long, medium, or short and sleep quality was categorized as good, fair, or poor. RESULTS Sleep duration had an inverted U-shape relationship with cognitive scores (P <.001); and sleep quality had a positive linear relationship with cognitive scores (P <.001). Short and long sleep durations were associated with consistently lower cognition scores with increasing age (both P <.001); and fair and poor quality of sleep were associated with consistently lower levels of cognition (both P <.001). Tests of interactions between sleep duration and sleep quality showed that participants reporting long durations of sleep with poor quality of sleep had the lowest overall cognitive scores. LIMITATIONS Self-reported methods were used to measure sleep quality and duration and thus our findings underscore the need for more evidence-based research to improve prevention efforts and tailor interventions to reduce cognitive decline among Chinese older adults. CONCLUSIONS Suboptimal sleep duration and quality were associated with poor cognition. Cognitive scores were lowest among those who reported long durations of sleep that were of poor quality.
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Affiliation(s)
- Minchao Li
- Center for Disease Control and Prevention of Haining County, Jiaxing, Zhejiang, China
| | - Nan Wang
- Department of Global Health Sciences, School of Medicine, University of California at Davis, CA, United States.
| | - Matthew E Dupre
- Department of Population Health Sciences, Duke University, Durham, NC, United States; Department of Sociology, Duke University, Durham, NC, United States; Duke Clinical Research Institute, Duke University, Durham, NC, United States
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