1
|
Morrison L, Dyer AH, Dolphin H, Killane I, Bourke NM, Widdowson M, Woods CP, Gibney J, Reilly RB, Kennelly SP. Discrete Relationships between Spatiotemporal Gait Characteristics and Domain-Specific Neuropsychological Performance in Midlife. SENSORS (BASEL, SWITZERLAND) 2024; 24:3903. [PMID: 38931687 PMCID: PMC11207228 DOI: 10.3390/s24123903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Midlife risk factors such as type 2 diabetes mellitus (T2DM) confer a significantly increased risk of cognitive impairment in later life with executive function, memory, and attention domains often affected first. Spatiotemporal gait characteristics are emerging as important integrative biomarkers of neurocognitive function and of later dementia risk. We examined 24 spatiotemporal gait parameters across five domains of gait previously linked to cognitive function on usual-pace, maximal-pace, and cognitive dual-task gait conditions in 102 middle-aged adults with (57.5 ± 8.0 years; 40% female) and without (57.0 ± 8.3 years; 62.1% female) T2DM. Neurocognitive function was measured using a neuropsychological assessment battery. T2DM was associated with significant changes in gait phases and rhythm domains at usual pace, and greater gait variability observed during maximal pace and dual tasks. In the overall cohort, both the gait pace and rhythm domains were associated with memory and executive function during usual pace. At maximal pace, gait pace parameters were associated with reaction time and delayed memory. During the cognitive dual task, associations between gait variability and both delayed memory/executive function were observed. Associations persisted following covariate adjustment and did not differ by T2DM status. Principal components analysis identified a consistent association of slower gait pace (step/stride length) and increased gait variability during maximal-pace walking with poorer memory and executive function performance. These data support the use of spatiotemporal gait as an integrative biomarker of neurocognitive function in otherwise healthy middle-aged individuals and reveal discrete associations between both differing gait tasks and gait domains with domain-specific neuropsychological performance. Employing both maximal-pace and dual-task paradigms may be important in cognitively unimpaired populations with risk factors for later cognitive decline-with the aim of identifying individuals who may benefit from potential preventative interventions.
Collapse
Affiliation(s)
- Laura Morrison
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Adam H. Dyer
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Helena Dolphin
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Isabelle Killane
- Department of Engineering, Technological University Dublin, D07 EWV4 Dublin, Ireland
| | - Nollaig M. Bourke
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Matthew Widdowson
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Conor P. Woods
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - James Gibney
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Richard B. Reilly
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Sean P. Kennelly
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| |
Collapse
|
2
|
The Association between the Binding Processes of Working Memory and Vascular Risk Profile in Adults. Brain Sci 2021; 11:brainsci11091140. [PMID: 34573162 PMCID: PMC8467480 DOI: 10.3390/brainsci11091140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/17/2022] Open
Abstract
Episodic buffer (EB), a key component of working memory, seems to have a rather complicated function as part of binding processes. Recent papers on the field claim that binding processes of working memory (WM) are assisted by attention and executive functions. On the same page, vascular pathology is gaining more ground as the main underlying cause for many brain pathologies. Hypercholesterolemia, hypertension, obesity, diabetes, lack of exercise and smoking are the most common risk factors that people of all ages suffer from and constitute the main vascular risk factors responsible for a possible decline in executive functions and attention. Thus, this research is an attempt to examine the relation between the binding functions of WM and the existence of vascular risk factors via a computerized test focusing on feature binding. The study comprised adults (n = 229) with and without vascular risk factors. The main tools used were a biomarker questionnaire and a feature binding test (FBT). The results showed that participants who report suffering from one or more vascular risk factors had significantly lower performance on specific subtasks of the FBT in comparison to the participants who were healthy. This allows us to assume that there might be a positive association between feature binding and a vascular risk profile in adults, and such a test could be a useful diagnostic tool for early cognitive impairment due to incipient vascular pathology.
Collapse
|
3
|
Exploring brain insulin resistance in adults with bipolar depression using extracellular vesicles of neuronal origin. J Psychiatr Res 2021; 133:82-92. [PMID: 33316649 PMCID: PMC7855678 DOI: 10.1016/j.jpsychires.2020.12.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that disrupted insulin signaling is involved in bipolar disorder (BD) pathogenesis. Herein, we aimed to directly explore the potential role of neuronal insulin signaling using an innovative technique based on biomarkers derived from plasma extracellular vesicles enriched for neuronal origin (NEVs). We leveraged plasma samples from a randomized, double-blind, placebo-controlled, 12-week clinical trial evaluating infliximab as a treatment of bipolar depression. We isolated NEVs using immunoprecipitation against neuronal marker L1CAM from samples collected at baseline and weeks 2, 6 and 12 (endpoint) and measured NEV biomarkers using immunoassays. We assessed neuronal insulin signaling at its first node (IRS-1) and along the canonical (Akt, GSK-3β, p70S6K) and alternative (ERK1/2, JNK and p38-MAPK) pathways. A subset of participants (n = 27) also underwent whole-brain magnetic resonance imaging (MRI) at baseline and endpoint. Pre-treatment, NEV biomarkers of insulin signaling were independently associated with cognitive function and MRI measures (i.e. hippocampal and ventromedial prefrontal cortex [vmPFC] volumes). In fact, the association between IRS-1 phosphorylation at serine site 312 (pS312-IRS-1), an indicator of insulin resistance, and cognitive dysfunction was mediated by vmPFC volume. In the longitudinal analysis, patients treated with infliximab, a tumor necrosis factor-alpha antagonist with known insulin sensitizing properties, compared to those treated with placebo, had augmented phosphorylation of proteins from the alternative pathway. Infliximab responders had significant increases in phosphorylated JNK levels, relative to infliximab non-responders and placebo responders. In addition, treatment with infliximab resulted in increase in MRI measures of brain volume; treatment-related changes in the dorsolateral prefrontal cortex volume were mediated by changes in biomarkers from the insulin alternative pathway. In conclusion, our findings support the idea that brain insulin signaling is a target for further mechanistic and therapeutic investigations.
Collapse
|
4
|
Colín-Castelán D, Zaina S. Associations between atherosclerosis and neurological diseases, beyond ischemia-induced cerebral damage. Rev Endocr Metab Disord 2019; 20:15-25. [PMID: 30891682 DOI: 10.1007/s11154-019-09486-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Neurodegeneration is traditionally viewed as a consequence of peptide accumulation in the brain, stroke and/or cerebral ischemia. Nonetheless, a number of scattered observations suggest that neurological disease and atherosclerosis may be linked by more complex mechanisms. Understanding the intricate link between atherosclerosis and neurological conditions may have a significant impact on the quality of life of the growing ageing population and of high cardiovascular risk groups in general. Epidemiological data support the notion that neurological dysfunction and atherosclerosis coexist long before any evident clinical complications of cardiovascular disease appear and may be causally linked. Baffling, often overlooked, molecular data suggest that nervous tissue-specific gene expression is relaxed specifically in the atheromatous vascular wall, and/or that a systemic dysregulation of genes involved in nervous system biology dictates a concomitant progression of neurological disease and atherosclerosis. Further epidemiological and experimental work is needed to clarify the details and clinical relevance of those complex links.
Collapse
Affiliation(s)
- Dannia Colín-Castelán
- Department of Medical Sciences, Division of Health Sciences, Campus León, University of Guanajuato, León, Guanajuato, Mexico.
| | - Silvio Zaina
- Department of Medical Sciences, Division of Health Sciences, Campus León, University of Guanajuato, León, Guanajuato, Mexico
| |
Collapse
|
5
|
Abstract
Objectives: Type 2 diabetes mellitus has been linked with cognitive decrement and an increased risk of dementia in older people. Less is known about whether diabetes affects cognition at younger ages. The objective of this meta-analysis was to examine possible differences (effect sizes) in cognitive performance between middle-aged type 2 diabetic patients and healthy controls. Secondary aim was to examine whether age is related to the magnitude of effect sizes. Methods: Electronic databases and lists of references of selected articles were used to search for studies examining type 2 diabetes and cognition in patients under age 65 compared to healthy controls. Twelve studies met the inclusion criteria. Standardized mean differences (Hedges's g) were calculated for main cognitive domains and their subdomains. Association between age and effect sizes was evaluated with meta-regression analyses. Publication bias and methodological quality of the studies were assessed. Results: Patients performed worse than controls in several cognitive functions. The largest differences were found in information processing speed (g = -0.68), attention/concentration (g = -0.55), executive functions (g = -0.51), and working memory (g = -0.51). There was no significance difference in visual memory (g = -0.15). Age was significantly related to the effect size in information processing speed, language, verbal memory and visual memory. However, the direction of association varied across these cognitive domains. Conclusions: The results suggest that cognitive decrement in diabetes is not restricted to older people, but may begin to appear in middle age. More attention should be paid to early recognition and treatment of diabetes-related cognitive decrement in healthcare systems. (JINS, 2019, 25, 215-229).
Collapse
|
6
|
Black S, Kraemer K, Shah A, Simpson G, Scogin F, Smith A. Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation. Curr Diab Rep 2018; 18:118. [PMID: 30267224 DOI: 10.1007/s11892-018-1079-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW The study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management. RECENT FINDINGS Both type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management. Individuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recursive cycle of depression and hyperglycemia. This recursive cycle can ultimately lead to diabetes-related complications.
Collapse
Affiliation(s)
- Sheila Black
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA.
| | - Kyle Kraemer
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA
| | - Avani Shah
- School of Social Work, University of Alabama, Box 870314, Tuscaloosa, AL, 35401, USA
| | - Gaynell Simpson
- School of Social Work, University of Alabama, Box 870314, Tuscaloosa, AL, 35401, USA
| | - Forrest Scogin
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA
| | - Annie Smith
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA
| |
Collapse
|
7
|
Hou D, Ma Y, Wang B, Hou X, Chen J, Hong Y, Xu S, Nie S, Liu X. Selective Impairment of Attentional Networks of Executive Control in Middle-Aged Subjects with Type 2 Diabetes Mellitus. Med Sci Monit 2018; 24:5355-5362. [PMID: 30067608 PMCID: PMC6085979 DOI: 10.12659/msm.909142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The influence of type 2 diabetes mellitus (T2DM) on attention has been elusive. The Attention Network Test (ANT) was developed to evaluate the functioning of 3 individual attentional networks: orienting, alerting, and executive control. The purpose of this study was to use the ANT to assess attentional function and its sub-components in T2DM patients ages 40–60 years. Material/Methods Thirty T2DM patients and 30 healthy controls ages 40–60 years were recruited in this investigation. The ANT was used to statistically compare the efficiency among 3 sub-components of the attention networks between middle-aged T2DM patients (n=30) and gender-, age-, and education-matched healthy controls (n=30). Results The ANT demonstrated a significant difference in executive control network between the T2DM patients and healthy controls (t=3.242, P=0.002), whereas no significant difference was observed regarding the domains of alerting (t=0.515, P=0.609) and orienting control (t=0.078, P=0.938) between the T2DM patient group and the healthy control group. Moreover, the mean reaction time in the ANT in the T2DM patients was significantly longer compared with that in the healthy controls (t=3.561, P=0.001). Conclusions The ANT reveals significant impairment in the executive control of middle-aged patients diagnosed with T2DM, whereas no significant impairment was observed in the domains of alerting and orienting.
Collapse
Affiliation(s)
- Dianlong Hou
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Neurology, The People's Hospital of Huantai County, Huantai, Shandong, China (mainland)
| | - Yingjuan Ma
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Baolan Wang
- Department of Endocrinology, The People's Hospital of Huantai County, Huantai, Shandong, China (mainland)
| | - Xunyao Hou
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Jian Chen
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Yan Hong
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Song Xu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Shanjing Nie
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Xueping Liu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| |
Collapse
|
8
|
Mansur RB, Lee Y, Subramaniapillai M, Brietzke E, McIntyre RS. Cognitive dysfunction and metabolic comorbidities in mood disorders: A repurposing opportunity for glucagon-like peptide 1 receptor agonists? Neuropharmacology 2018; 136:335-342. [PMID: 29481915 DOI: 10.1016/j.neuropharm.2018.01.048] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 12/14/2022]
Abstract
Major depressive disorder and bipolar disorder are highly prevalent and disabling conditions. Cognition is considered a core domain of their psychopathology and a principle mediator of psychosocial impairment, disproportionately accounting for overall illness-associated costs. There are few interventions with replicated evidence of efficacy in treating cognitive deficits in mood disorders. Evidence also indicates that cognitive deficits are associated with obesity and involve significant impairment across multiple domains. Conversely, weight-loss interventions, such as physical exercise and bariatric surgery, have been shown to beneficially affect cognitive function. This convergent phenomenology suggests that currently available agents that target metabolic systems may also be capable of mitigating deficits in cognitive functions, and are, therefore, candidates for repurposing. The incretin glucagon-like peptide-1 (GLP-1) is a hormone secreted by intestinal epithelial cells. GLP-1 receptors (GLP-1R) are widely expressed in the central nervous system. Activation of GLP-1R leads to facilitation of glucose utilization and antiapoptotic effects in various organs. Pre-clinical trials have demonstrated significant neuroprotective effects of GLP-1, including protection from cell death, promotion of neuronal differentiation and proliferation; and facilitation of long-term potentiation. Liraglutide is a GLP-1R agonist that has been approved for the treatment of type 2 diabetes mellitus and obesity. Convergent preclinical and clinical evidence, including a proof-of-concept pilot study from group, has suggested that liraglutide may improve objective measures of cognitive function in adults with mood disorders. The safety and availability of GLP-1R agonists indicate that they are promising candidates for repurposing, and that they may be viable therapeutic options for mood disorders. This article is part of the Special Issue entitled 'Metabolic Impairment as Risk Factors for Neurodegenerative Disorders.'
Collapse
Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; University of Toronto, Toronto, Canada.
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Elisa Brietzke
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; University of Toronto, Toronto, Canada
| |
Collapse
|
9
|
Mansur RB, Zugman A, Ahmed J, Cha DS, Subramaniapillai M, Lee Y, Lovshin J, Lee JG, Lee JH, Drobinin V, Newport J, Brietzke E, Reininghaus EZ, Sim K, Vinberg M, Rasgon N, Hajek T, McIntyre RS. Treatment with a GLP-1R agonist over four weeks promotes weight loss-moderated changes in frontal-striatal brain structures in individuals with mood disorders. Eur Neuropsychopharmacol 2017; 27:1153-1162. [PMID: 28867303 DOI: 10.1016/j.euroneuro.2017.08.433] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 08/09/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Abstract
Cognitive deficits are a core feature across psychiatric disorders. Emerging evidence indicates that metabolic pathways are highly relevant for the substrates and phenomenology of the cognitive domain. Herein, we aimed to determine the effects of liraglutide, a GLP-1R agonist, on brain structural/volumetric parameters in adults with a mood disorder. This is the secondary analysis of a 4-week, pilot, proof-of-concept, open-label study. Participants (N=19) exhibiting impairments in executive function with either major depressive disorder (MDD) or bipolar disorder (BD) were recruited. Liraglutide 1.8mg/day was added as an adjunct to existing pharmacotherapy. Structural magnetic resonance imaging (MRI) scanning was obtained at baseline and endpoint. Results showed that at endpoint there was significant weight loss (mean: 3.15%; p<0.001). Changes in frontal and striatal volumes were significantly correlated with changes in body mass index (BMI), indicating the weight loss was associated with volume increase in most regions (e.g. r=-0.561, p=0.042 in the left superior frontal area). After adjusting for intracranial volume, age, gender, and BMI, we observed significant changes from baseline to endpoint in multiple regions (e.g. RR: 1.011, p=0.049 in the left rostral middle frontal area). Changes in regional volumes were associated with improvement in executive function (e.g. r=0.698, p=0.003 for the right superior frontal area). Adjunctive liraglutide results in clinically significant weight loss, with corresponding improvement in cognitive function; changes in cognitive function were partially moderated by changes in brain morphometry, underscoring the interrelationship between weight and brain structure/function.
Collapse
Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Research Group in Molecular and Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Andre Zugman
- Interdiscipinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Juhie Ahmed
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Danielle S Cha
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Julie Lovshin
- Division of Endocrinology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Jung G Lee
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea
| | - Jae-Hon Lee
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Department of Psychiatry, Samsung Seoul Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | | | - Jason Newport
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Elisa Brietzke
- Research Group in Molecular and Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Kang Sim
- Research Division, Institute of Mental Health, Singapore
| | - Maj Vinberg
- Psychiatric Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Natalie Rasgon
- Department of Psychiatry, Stanford University, Palo Alto, CA, United states
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada
| |
Collapse
|
10
|
Chen S, Zuo X, Li Y, Jiang T, Zhang N, Dai F, Chen Q, Zhang Q. Ghrelin is a possible new predictor associated with executive function in patients with type 2 diabetes mellitus. J Diabetes Investig 2016; 8:306-313. [PMID: 27689345 PMCID: PMC5415456 DOI: 10.1111/jdi.12580] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/27/2016] [Accepted: 09/27/2016] [Indexed: 01/21/2023] Open
Abstract
AIMS/INTRODUCTION The aim of the present research was to study the ghrelin level, executive function and their possible association in patients with type 2 diabetes mellitus. MATERIALS AND METHODS A total of 370 people were recruited between March 2015 and March 2016 in this study. Among them, 212 participants were patients with type 2 diabetes mellitus and 158 participants were included as the control group. Their blood sample was analyzed for the level of ghrelin and other clinical indexes. Cognitive function was measured by the Montreal Cognitive Assessment, and executive function was evaluated by the Wisconsin Card Sorting Test. RESULTS In the type 2 diabetes mellitus group, age, years of education, duration of diabetes, fasting blood glucose, glycated hemoglobin, hypertension and waist-to-hip ratio were correlated with total Montreal Cognitive Assessment scores. No association was found between ghrelin level and total Montreal Cognitive Assessment score in patients with type 2 diabetes mellitus. However, ghrelin was found to be a significant predictor for executive function impairment measured by the Wisconsin Card Sorting Test in patients with type 2 diabetes mellitus. CONCLUSIONS The level of serum ghrelin might be a biomarker of executive function and become a strong predictor of executive function impairment in patients with type 2 diabetes mellitus. Ghrelin might have a potential protective effect against cognitive function impairment in type 2 diabetes patients.
Collapse
Affiliation(s)
- Siting Chen
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xuyang Zuo
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yuan Li
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Nan Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Fang Dai
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qiaoer Chen
- College of Stomatology, Anhui Medical University, Hefei, Anhui, China
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| |
Collapse
|
11
|
Executive functions in patients with Alzheimer's disease, type 2 diabetes mellitus patients and cognitively healthy older adults. Exp Gerontol 2016; 83:47-55. [DOI: 10.1016/j.exger.2016.07.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 06/16/2016] [Accepted: 07/20/2016] [Indexed: 01/21/2023]
|
12
|
Satish L, Lakshmi VS. Impact of individualized yoga therapy on perceived quality of life performance on cognitive tasks and depression among Type II diabetic patients. Int J Yoga 2016; 9:130-6. [PMID: 27512320 PMCID: PMC4959323 DOI: 10.4103/0973-6131.183707] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Context: An individualized approach of providing yoga support can address many of the disease-related concerns indicated in the management of diabetes, specifically the impact on other life activities and long-term functional wellbeing. Aim: To analyze the role of regular yoga practice as a self-management approach to achieve glycemic control and psychological wellbeing in Type II diabetic patients. Methods: Ninety-one subjects of both sexes responded to the announcement and consented to participate in the study. This was a single group, before and after yoga evaluation without control comparison. The fasting and postprandial blood sugar, glycosylated hemoglobin (HBA1c), cognitive tasks, depression, cognitive failure, and diabetic-related quality of life (QOL) were measured as pretest. The subjects underwent one-to-one individualized yoga therapy sessions, which included 12 supervised sessions spread over a 3-month period. The posttest data were analyzed using paired t-test and Wilcoxon paired rank test. Results: Showed significant reduction in fasting blood sugar. QOL of the diabetic patients had improved significantly. There was a significant reduction in the frequency (mean difference of 7.58, P > 0.01) of depressive symptoms and intensity of depression (mean difference 1.66, P > 0.05). Concentration and attention span improved significantly and mean discrepancy score reduced (mean difference 3.42, P > 0.01). There were no marked changes in the postprandial blood sugar and HBA1c. Conclusion: Yoga practice enhances the subjective wellbeing, QOL, improves mood and concentration, and facilitates achievement of adequate glycemic control among Type II diabetic patients.
Collapse
Affiliation(s)
- Latha Satish
- Department of Research, Krishnamacharya Yoga Mandiram, Chennai, Tamil Nadu, India
| | - V Subbu Lakshmi
- Department of Research, Krishnamacharya Yoga Mandiram, Chennai, Tamil Nadu, India
| |
Collapse
|
13
|
Palleria C, Leporini C, Maida F, Succurro E, De Sarro G, Arturi F, Russo E. Potential effects of current drug therapies on cognitive impairment in patients with type 2 diabetes. Front Neuroendocrinol 2016; 42:76-92. [PMID: 27521218 DOI: 10.1016/j.yfrne.2016.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/13/2016] [Accepted: 07/22/2016] [Indexed: 02/07/2023]
Abstract
Type 2 diabetes mellitus is a complex metabolic disease that can cause serious damage to various organs. Among the best-known complications, an important role is played by cognitive impairment. Impairment of cognitive functioning has been reported both in type 1 and 2 diabetes mellitus. While this comorbidity has long been known, no major advances have been achieved in clinical research; it is clear that appropriate control of blood glucose levels represents the best current (although unsatisfactory) approach in the prevention of cognitive impairment. We have focused our attention on the possible effect on the brain of antidiabetic drugs, despite their effects on blood glucose levels, giving a brief rationale on the mechanisms (e.g. GLP-1, BDNF, ghrelin) that might be involved. Indeed, GLP-1 agonists are currently clinically studied in other neurodegenerative diseases (i.e. Parkinson's and Alzheimer's disease); furthermore, also other antidiabetic drugs have proven efficacy in preclinical studies. Overall, promising results are already available and finding new intervention strategies represents a current need in this field of research.
Collapse
Affiliation(s)
- Caterina Palleria
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Christian Leporini
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Francesca Maida
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, Internal Medicine Unit of "Mater Domini", University Hospital, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100 Catanzaro, Italy
| | - Giovambattista De Sarro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, Internal Medicine Unit of "Mater Domini", University Hospital, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100 Catanzaro, Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy.
| |
Collapse
|
14
|
Sato N, Morishita R. Brain alterations and clinical symptoms of dementia in diabetes: aβ/tau-dependent and independent mechanisms. Front Endocrinol (Lausanne) 2014; 5:143. [PMID: 25250014 PMCID: PMC4155814 DOI: 10.3389/fendo.2014.00143] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/15/2014] [Indexed: 12/31/2022] Open
Abstract
Emerging evidence suggests that diabetes affects cognitive function and increases the incidence of dementia. However, the mechanisms by which diabetes modifies cognitive function still remains unclear. Morphologically, diabetes is associated with neuronal loss in the frontal and temporal lobes including the hippocampus, and aberrant functional connectivity of the posterior cingulate cortex and medial frontal/temporal gyrus. Clinically, diabetic patients show decreased executive function, information processing, planning, visuospatial construction, and visual memory. Therefore, in comparison with the characteristics of AD brain structure and cognition, diabetes seems to affect cognitive function through not only simple AD pathological feature-dependent mechanisms but also independent mechanisms. As an Aβ/tau-independent mechanism, diabetes compromises cerebrovascular function, increases subcortical infarction, and might alter the blood-brain barrier. Diabetes also affects glucose metabolism, insulin signaling, and mitochondrial function in the brain. Diabetes also modifies metabolism of Aβ and tau and causes Aβ/tau-dependent pathological changes. Moreover, there is evidence that suggests an interaction between Aβ/tau-dependent and independent mechanisms. Therefore, diabetes modifies cognitive function through Aβ/tau-dependent and independent mechanisms. Interaction between these two mechanisms forms a vicious cycle.
Collapse
Affiliation(s)
- Naoyuki Sato
- Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Geriatric Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- *Correspondence: Naoyuki Sato, Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan e-mail:
| | - Ryuichi Morishita
- Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|