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Navolokin N, Adushkina V, Zlatogorskaya D, Telnova V, Evsiukova A, Vodovozova E, Eroshova A, Dosadina E, Diduk S, Semyachkina-Glushkovskaya O. Promising Strategies to Reduce the SARS-CoV-2 Amyloid Deposition in the Brain and Prevent COVID-19-Exacerbated Dementia and Alzheimer's Disease. Pharmaceuticals (Basel) 2024; 17:788. [PMID: 38931455 PMCID: PMC11206883 DOI: 10.3390/ph17060788] [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: 04/29/2024] [Revised: 06/02/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
The COVID-19 pandemic, caused by infection with the SARS-CoV-2 virus, is associated with cognitive impairment and Alzheimer's disease (AD) progression. Once it enters the brain, the SARS-CoV-2 virus stimulates accumulation of amyloids in the brain that are highly toxic to neural cells. These amyloids may trigger neurological symptoms in COVID-19. The meningeal lymphatic vessels (MLVs) play an important role in removal of toxins and mediate viral drainage from the brain. MLVs are considered a promising target to prevent COVID-19-exacerbated dementia. However, there are limited methods for augmentation of MLV function. This review highlights new discoveries in the field of COVID-19-mediated amyloid accumulation in the brain associated with the neurological symptoms and the development of promising strategies to stimulate clearance of amyloids from the brain through lymphatic and other pathways. These strategies are based on innovative methods of treating brain dysfunction induced by COVID-19 infection, including the use of photobiomodulation, plasmalogens, and medicinal herbs, which offer hope for addressing the challenges posed by the SARS-CoV-2 virus.
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Affiliation(s)
- Nikita Navolokin
- Department of Pathological Anatomy, Saratov Medical State University, Bolshaya Kazachaya Str. 112, 410012 Saratov, Russia;
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (V.A.); (D.Z.); (V.T.); (A.E.)
| | - Viktoria Adushkina
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (V.A.); (D.Z.); (V.T.); (A.E.)
| | - Daria Zlatogorskaya
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (V.A.); (D.Z.); (V.T.); (A.E.)
| | - Valeria Telnova
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (V.A.); (D.Z.); (V.T.); (A.E.)
| | - Arina Evsiukova
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (V.A.); (D.Z.); (V.T.); (A.E.)
| | - Elena Vodovozova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Miklukho-Maklaya 16/10, 117997 Moscow, Russia;
| | - Anna Eroshova
- Department of Biotechnology, Leeners LLC, Nagornyi Proezd 3a, 117105 Moscow, Russia; (A.E.); (E.D.); (S.D.)
| | - Elina Dosadina
- Department of Biotechnology, Leeners LLC, Nagornyi Proezd 3a, 117105 Moscow, Russia; (A.E.); (E.D.); (S.D.)
| | - Sergey Diduk
- Department of Biotechnology, Leeners LLC, Nagornyi Proezd 3a, 117105 Moscow, Russia; (A.E.); (E.D.); (S.D.)
- Research Institute of Carcinogenesis of the N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Kashirskoe Shosse 24, 115522 Moscow, Russia
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Hoffmann M, Rossi F, Benes Lima L, King C. Frontotemporal disorders: the expansive panoply of syndromes and spectrum of etiologies. Front Neurol 2024; 14:1305071. [PMID: 38264092 PMCID: PMC10803619 DOI: 10.3389/fneur.2023.1305071] [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: 10/13/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Background Frontotemporal lobe disorders (FTD) are amongst the most common brain neurodegenerative disorders. Their relatively covert, frequently subtle presentations and diverse etiologies, pose major challenges in diagnosis and treatments. Recent studies have yielded insights that the etiology in the majority are due to environmental and sporadic causes, rather than genetic in origin. Aims To retrospectively examine the cognitive and behavioral impairments in the veteran population to garner the range of differing syndrome presentations and etiological subcategories with a specific focus on frontotemporal lobe disorders. Methodology The design is a retrospective, observational registry, case series with the collection of epidemiological, clinical, cognitive, laboratory and radiological data on people with cognitive and behavioral disorders. Inclusion criteria for entry were veterans evaluated exclusively at Orlando VA Healthcare System, neurology section, receiving a diagnosis of FTD by standard criteria, during the observation period dated from July 2016 to March 2021. Frontotemporal disorders (FTD) were delineated into five clinical 5 subtypes. Demographic, cardiovascular risk factors, cognitive, behavioral neurological, neuroimaging data and presumed etiological categories, were collected for those with a diagnosis of frontotemporal disorder. Results Of the 200 patients with FTD, further cognitive, behavioral neurological evaluation with standardized, metric testing was possible in 105 patients. Analysis of the etiological groups revealed significantly different younger age of the traumatic brain injury (TBI) and Gulf War Illness (GWI) veterans who also had higher Montreal Cognitive Assessment (MOCA) scores. The TBI group also had significantly more abnormalities of hypometabolism, noted on the PET brain scans. Behavioral neurological testing was notable for the findings that once a frontotemporal disorder had been diagnosed, the four different etiological groups consistently had abnormal FRSBE scores for the 3 principal frontal presentations of (i) abulia/apathy, (ii) disinhibition, and (iii) executive dysfunction as well as abnormal Frontal Behavioral Inventory (FBI) scores with no significant difference amongst the etiological groups. The most common sub-syndromes associated with frontotemporal syndromes were the Geschwind-Gastaut syndrome (GGS), Klüver-Bucy syndrome (KBS), involuntary emotional expression disorder (IEED), cerebellar cognitive affective syndrome (CCA), traumatic encephalopathy syndrome (TES) and prosopagnosia. Comparisons with the three principal frontal lobe syndrome clusters (abulia, disinhibition, executive dysfunction) revealed a significant association with abnormal disinhibition FRSBE T-scores with the GGS. The regression analysis supported the potential contribution of disinhibition behavior that related to this complex, relatively common behavioral syndrome in this series. The less common subsyndromes in particular, were notable, as they constituted the initial overriding, presenting symptoms and syndromes characterized into 16 separate conditions. Conclusion By deconstructing FTD into the multiple sub-syndromes and differing etiologies, this study may provide foundational insights, enabling a more targeted precision medicine approach for future studies, both in treating the sub-syndromes as well as the underlying etiological process.
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Affiliation(s)
- Michael Hoffmann
- University of Central Florida, Orlando, FL, United States
- Roskamp Institute, Sarasota, FL, United States
- Orlando VA Healthcare System, Orlando, FL, United States
| | - Fabian Rossi
- University of Central Florida, Orlando, FL, United States
- Orlando VA Healthcare System, Orlando, FL, United States
| | - Lourdes Benes Lima
- University of Central Florida, Orlando, FL, United States
- Roskamp Institute, Sarasota, FL, United States
| | - Christian King
- University of Central Florida, Orlando, FL, United States
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Qin Y, Han H, Li Y, Cui J, Jia H, Ge X, Ma Y, Bai W, Zhang R, Chen D, Yi F, Yu H. Estimating Bidirectional Transitions and Identifying Predictors of Mild Cognitive Impairment. Neurology 2023; 100:e297-e307. [PMID: 36220593 PMCID: PMC9869761 DOI: 10.1212/wnl.0000000000201386] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Various resources exist for treating mild cognitive impairment (MCI) or dementia separately as terminal events or for focusing solely on a 1-way path from MCI to dementia without taking into account heterogeneous transitions. Little is known about the trajectory of reversion from MCI to normal cognition (NC) or near-NC and patterns of postreversion, which refers to cognitive trajectories of patients who have reversed from MCI to NC. Our objectives were to (1) quantitatively predict bidirectional transitions of MCI (reversion and progression), (2) explore patterns of future cognitive trajectories for postreversion, and (3) estimate the effects of demographic characteristics, APOE, cognition, daily activity ability, depression, and neuropsychiatric symptoms on transition probabilities. METHODS We constructed a retrospective cohort by reviewing patients with an MCI diagnosis at study entry and at least 2 follow-up visits between June 2005 and February 2021. Defining NC or near-NC and MCI as transient states and dementia as an absorbing state, we used continuous-time multistate Markov models to estimate instantaneous transition intensity between states, transition probabilities from one state to another at any given time during follow-up, and hazard ratios of reversion-related variables. RESULTS Among 24,220 observations from 6,651 participants, there were 2,729 transitions to dementia and 1,785 reversions. As for postreversion, there were 630 and 73 transitions of progression to MCI and dementia, respectively. The transition intensity of progression to MCI for postreversion was 0.317 (2.48-fold greater than that for MCI progression or reversion). For postreversion participants, the probability of progressing to dementia increased by 2% yearly. Participants who progressed to MCI were likely to reverse again (probability of 40% over 15 years). Age, independence level, APOE, cognition, daily activity ability, depression, and neuropsychiatric symptoms were significant predictors of bidirectional transitions. DISCUSSION The nature of bidirectional transitions cannot be ignored in multidimensional MCI research. We found that postreversion participants remained at an increased risk of progression to MCI or dementia over the longer term and experienced recurrent reversions. Our findings may serve as a valuable reference for future research and enable health care professionals to better develop proactive management plans and targeted interventions.
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Affiliation(s)
- Yao Qin
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Hongjuan Han
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Yang Li
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Jing Cui
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Haixia Jia
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Xiaoyan Ge
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Yifei Ma
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Wenlin Bai
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Rong Zhang
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Durong Chen
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Fuliang Yi
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Hongmei Yu
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China.
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