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de Liyis BG, Sutedja JC, Kesuma PMI, Liyis S, Widyadharma IPE. A review of literature on Compound 21-loaded gelatin nanoparticle: a promising nose-to-brain therapy for multi-infarct dementia. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00621-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AbstractMulti-infarct dementia (MID) is described as a chronic progressive decline in cortical cognitive function due to the occurrence of multiple infarcts in the cerebral vascularization throughout the gray and white matter. Current therapies of MID mostly focus only on slowing down MID progression and symptomatic medications. A novel therapy which is able to provide both preventive and curative properties for MID is of high interest. The purpose of this review is to identify the potential of Compound 21 (C21) gelatin nanoparticle through the nose-to-brain route as therapy for MID. C21, an angiotensin II type 2 receptor (AT2R) agonist, has shown to reduce the size of cerebral infarct in rodent models, resulting in the preservation and improvement of overall cognitive function and prevention of secondary neurodegenerative effects. It is also shown that C21 decreases neuronal apoptosis, improves damaged axons, and encourage synapse development. The challenge remains in preventing systemic AT2R activation and increasing its low oral bioavailability which can be overcome through nose-to-brain administration of C21. Nose-to-brain drug delivery of C21 significantly increases drug efficiency and limits C21 exposure in order to specifically target the multiple infarcts located in the cerebral cortex. Adhering C21 onto gelatin nanoparticles may enable longer contact time with the olfactory and the trigeminal nerve endings, increasing the potency of C21. In summary, treatment of C21 gelatin nanoparticle through nose-to-brain delivery shows high potential as therapy for vascular dementia. However, clinical trials must be further studied in order to test the safety and efficacy of C21.
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Kaur M, Sharma S. Molecular mechanisms of cognitive impairment associated with stroke. Metab Brain Dis 2022; 37:279-287. [PMID: 35029798 DOI: 10.1007/s11011-022-00901-0] [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: 06/09/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
Stroke is the second leading cause of death after coronary heart disease in developed countries and is the greatest cause of disability and cognitive impairment. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, hypertension, arterial fibrillation, diabetes, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke, depressive illness duration of a stroke, location, volume, intensity, and degree of neuronal degeneration, location and size of infarction after stroke, time interval after stroke other cerebral dysfunctions. The pathophysiology of stroke associated cognitive impairment is complex and recent molecular, cellular, and animal models studies have revealed that multiple cellular changes have been implicated, including altered redox state, mitochondrial dysfunction, disruption of the blood-brain barrier, perivascular spacing, glymphatic system impairment, microglia activation and amyloid-β deposition in the parenchyma of the brain. These studies have also evidenced the involvement of various transcription factors, intracellular adhesion molecules, and endogenous growth factors in the pathogenesis of cognitive impairment associated with stroke and providing scope for developing therapeutic strategies for treatment. This review summarizes the latest research findings on molecular mechanisms involved in cognitive impairment associated with stroke.
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Affiliation(s)
- Mandeep Kaur
- Department of Pharmacology, School of Pharmaceutical Sciences, CT University, Ludhiana, Punjab, India
| | - Saurabh Sharma
- School of Pharmaceutical Sciences, CT University, Ludhiana, Punjab, India.
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Akhter F, Persaud A, Zaokari Y, Zhao Z, Zhu D. Vascular Dementia and Underlying Sex Differences. Front Aging Neurosci 2021; 13:720715. [PMID: 34566624 PMCID: PMC8457333 DOI: 10.3389/fnagi.2021.720715] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022] Open
Abstract
Vascular dementia (VaD) is the second most common form of dementia after Alzheimer's disease (AD); where Alzheimer's accounts for 60-70% of cases of dementia and VaD accounts for 20% of all dementia cases. VaD is defined as a reduced or lack of blood flow to the brain that causes dementia. VaD is also known occasionally as vascular contributions to cognitive impairment and dementia (VCID) or multi-infarct dementia (MID). VCID is the condition arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior, and VaD is the most severe stage while MID is produced by the synergistic effects caused by multiple mini strokes in the brain irrespective of specific location or volume. There are also subtle differences in the presentation of VaD in males and females, but they are often overlooked. Since 1672 when the first case of VaD was reported until now, sex and gender differences have had little to no research done when it comes to the umbrella term of dementia in general. This review summarizes the fundamentals of VaD followed by a focus on the differences between sex and gender when an individual is diagnosed. In addition, we provide critical evidence concerning sex and gender differences with a few of the main risk factors of VaD including pre-existing health conditions and family history, gene variants, aging, hormone fluctuations, and environmental risk factors. Additionally, the pharmaceutical treatments and possible mitigation of risk factors is explored.
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Affiliation(s)
- Firoz Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Alicia Persaud
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Younis Zaokari
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Zhen Zhao
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
- Neuroscience Graduate Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
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Muirhead K, Macaden L, Clarke C, Smyth K, Polson R, O'Malley C. The characteristics of effective technology-enabled dementia education for health and social care practitioners: protocol for a mixed studies systematic review. Syst Rev 2019; 8:316. [PMID: 31810480 PMCID: PMC6896733 DOI: 10.1186/s13643-019-1212-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The global prevalence of people living with dementia is expected to increase exponentially and yet evidence suggests gaps in dementia-specific knowledge amongst practitioners. Evidence-based learning approaches can support educators and learners who are transitioning into new educational paradigms resulting from technological advances. Technology-enabled learning is increasingly being used in health care education and may be a feasible approach to dementia education. METHODS This protocol aims to describe the methodological and analytical approaches for undertaking a systematic review of the current evidence based on technology-enabled approaches to dementia education for health and social care practitioners. The design and methodology were informed by guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. DISCUSSION The evidence generated from a systematic review of the current evidence is intended to inform the design and implementation of technology-enabled dementia education programmes and to advance the current academic literature at a time of unprecedented demographic and technological transition. TRIAL REGISTRATION PROSPERO, CRD42018115378.
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Affiliation(s)
- Kevin Muirhead
- Department of Nursing and Midwifery, School of Health, Social Care & Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK.
| | - Leah Macaden
- Department of Nursing and Midwifery, School of Health, Social Care & Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK
| | - Charlotte Clarke
- School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Keith Smyth
- Learning and Teaching Academy, University of the Highlands and Islands, Ness Walk, Inverness, IV3 5SQ, UK
| | - Rob Polson
- Highland Health Sciences Library, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK
| | - Chris O'Malley
- Highland Health Sciences Library, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK
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Balbi M, Vanni MP, Vega MJ, Silasi G, Sekino Y, Boyd JD, LeDue JM, Murphy TH. Longitudinal monitoring of mesoscopic cortical activity in a mouse model of microinfarcts reveals dissociations with behavioral and motor function. J Cereb Blood Flow Metab 2019; 39:1486-1500. [PMID: 29521138 PMCID: PMC6681536 DOI: 10.1177/0271678x18763428] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/29/2018] [Accepted: 02/01/2018] [Indexed: 12/14/2022]
Abstract
Small vessel disease is characterized by sporadic obstruction of small vessels leading to neuronal cell death. These microinfarcts often escape detection by conventional magnetic resonance imaging and are identified only upon postmortem examination. Our work explores a brain-wide microinfarct model in awake head-fixed mice, where occlusions of small penetrating arterioles are reproduced by endovascular injection of fluorescent microspheres. Mesoscopic functional connectivity was mapped longitudinally in awake GCaMP6 mice using genetically encoded calcium indicators for transcranial wide-field calcium imaging. Microsphere occlusions were quantified and changes in cerebral blood flow were measured with laser speckle imaging. The neurodeficit score in microinfarct mice was significantly higher than in sham, indicating impairment in motor function. The novel object recognition test showed a reduction in the discrimination index in microinfarct mice compared to sham. Graph-theoretic analysis of functional connectivity did not reveal significant differences in functional connectivity between sham and microinfarct mice. While behavioral tasks revealed impairments following microinfarct induction, the absence of measurable functional alterations in cortical activity has a less straightforward interpretation. The behavioral alterations produced by this model are consistent with alterations observed in human patients suffering from microinfarcts and support the validity of microsphere injection as a microinfarct model.
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Affiliation(s)
- Matilde Balbi
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Matthieu P Vanni
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Max J Vega
- Department of Psychology, Motivated
Cognition Lab, University of British Columbia, Vancouver, British Columbia,
Canada
| | - Gergely Silasi
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Yuki Sekino
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Jamie D Boyd
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Jeffrey M LeDue
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
- Djavad Mowafaghian Center for Brain
Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy H Murphy
- Department of Psychiatry, Kinsmen
Laboratory of Neurological Research, University of British Columbia, Vancouver,
British Columbia, Canada
- Djavad Mowafaghian Center for Brain
Health, University of British Columbia, Vancouver, British Columbia, Canada
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Rochoy M, Chazard E, Gautier S, Bordet R. Vascular dementia encoding in the French nationwide discharge summary database (PMSI): Variability over the 2007-2017 period. Ann Cardiol Angeiol (Paris) 2019; 68:150-154. [PMID: 30409382 DOI: 10.1016/j.ancard.2018.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Vascular dementia (VaD) is the second leading cause of dementia. Diagnostic criteria have evolved from the concept of multiple infarctions to different subtypes: acute onset VaD, subcortical VaD, mixed cortical and subcortical VaD. Our aim was to analyze the evolution in the coding of these different subtypes of VaD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017. METHOD We included all principal diagnoses of VaD in the PMSI hospital stays from 2007 to 2017. RESULTS Between 2007 and 2017, we show a relative decrease in the number of hospital stays for VaD compared to all hospital stays (0.0437% to 0.0404%). The 11,654 hospital stays for VaD in 2017 represent 13.5% of mental organic disorders. Subtype analysis shows a decrease in hospital stays for multiple infarctions between 2007 and 2017 (-50%), an increase for subcortical or mixed VaD (+20%), acute onset VaD (+184%) and an increase in "other VaD" (+85%). CONCLUSION These data suggest a slight decrease in hospital stays for VaD, possibly related to better control of cardiovascular risk factors. They also suggest that the coding should be consistent with the evolution of diagnostic criteria.
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Affiliation(s)
- M Rochoy
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France; Département de médecine générale, 1 Place de Verdun, 59000 Lille, France.
| | - E Chazard
- University Lille, 59000 Lille, France; EA2694, Public Health Department, 59000 Lille, France
| | - S Gautier
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France
| | - R Bordet
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France
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Lang B, Kindy MS, Kozel FA, Schultz SK, Taheri S. Multi-Parametric Classification of Vascular Cognitive Impairment and Dementia: The Impact of Diverse Cerebrovascular Injury Biomarkers. J Alzheimers Dis 2018; 62:39-60. [DOI: 10.3233/jad-170733] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Brittany Lang
- Clinical Psychology Program, University of South Florida, Tampa, FL, USA
| | - Mark S. Kindy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida Tampa, FL, USA
- James A. Haley VA Medical Center, Tampa, FL, USA
| | - F. Andrew Kozel
- James A. Haley VA Medical Center, Tampa, FL, USA
- Psychiatry and Behavioral Sciences, University of South Florida, Tampa, FL, USA
| | - Susan K. Schultz
- James A. Haley VA Medical Center, Tampa, FL, USA
- Psychiatry and Behavioral Sciences, University of South Florida, Tampa, FL, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida Tampa, FL, USA
- Byrd Alzheimer’s Institute, Tampa, FL, USA
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