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White D, John CS, Kucera A, Truver B, Lepping RJ, Kueck PJ, Lee P, Martin L, Billinger SA, Burns JM, Morris JK, Vidoni ED. A methodology for an acute exercise clinical trial called dementia risk and dynamic response to exercise. Sci Rep 2021; 11:12776. [PMID: 34140586 PMCID: PMC8211849 DOI: 10.1038/s41598-021-92177-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/04/2021] [Indexed: 01/21/2023] Open
Abstract
Exercise likely has numerous benefits for brain and cognition. However, those benefits and their causes remain imprecisely defined. If the brain does benefit from exercise it does so primarily through cumulative brief, "acute" exposures over a lifetime. The Dementia Risk and Dynamic Response to Exercise (DYNAMIC) clinical trial seeks to characterize the acute exercise response in cerebral perfusion, and circulating neurotrophic factors in older adults with and without the apolipoprotein e4 genotype (APOE4), the strongest genetic predictor of sporadic, late onset Alzheimer's disease. DYNAMIC will enroll 60 older adults into a single moderate intensity bout of exercise intervention, measuring pre- and post-exercise cerebral blood flow (CBF) using arterial spin labeling, and neurotrophic factors. We expect that APOE4 carriers will have poor CBF regulation, i.e. slower return to baseline perfusion after exercise, and will demonstrate blunted neurotrophic response to exercise, with concentrations of neurotrophic factors positively correlating with CBF regulation. Preliminary findings on 7 older adults and 9 younger adults demonstrate that the experimental method can capture CBF and neurotrophic response over a time course. This methodology will provide important insight into acute exercise response and potential directions for clinical trial outcomes.ClinicalTrials.gov NCT04009629, Registered 05/07/2019.
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Affiliation(s)
- Dreu White
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Casey S John
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Ashley Kucera
- American Academy of Family Physicians, Leawood, KS, USA
| | - Bryce Truver
- University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Paul J Kueck
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Phil Lee
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Laura Martin
- University of Kansas Medical Center, Kansas City, KS, USA
| | | | | | - Jill K Morris
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D Vidoni
- University of Kansas Medical Center, Kansas City, KS, USA.
- University of Kansas Alzheimer's Disease Center, 4350 Shawnee Mission Parkway, Fairway, KS, 60205, MS6002, USA.
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Kohn JN, Troyer E, Guay-Ross RN, Wilson K, Walker A, Spoon C, Pruitt C, Lyasch G, Pung MA, Milic M, Redwine LS, Hong S. Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation. Int Psychogeriatr 2020; 32:815-825. [PMID: 31647051 PMCID: PMC8011648 DOI: 10.1017/s1041610219001492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance. DESIGN This is a cross-sectional study. SETTING Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study. PARTICIPANTS One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments. MEASUREMENTS CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors. RESULTS The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26-4.87, 99% CI: 1.08-7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = -0.26, 95% CI: -0.51 to -0.06, 99% CI: -0.61 to -0.02), with lesser effects on visuospatial performance (β = -0.20, 95% CI: -0.35 to -0.02, 99% CI: -0.39 to 0.03), and memory (β = -0.29, 95% CI: -0.66 to -0.01, 99% CI: -0.76 to 0.08). CONCLUSIONS Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.
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Affiliation(s)
- Jordan N Kohn
- Department of Psychiatry, University of California, San Diego, USA
| | - Emily Troyer
- Department of Psychiatry, University of California, San Diego, USA
| | | | - Kathleen Wilson
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Amanda Walker
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Chad Spoon
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Christopher Pruitt
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Gary Lyasch
- Department of Psychiatry, University of California, San Diego, USA
| | - Meredith A Pung
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Milos Milic
- Department of Medicine, University of California, San Diego, USA
| | - Laura S Redwine
- College of Nursing, University of South Florida, Florida, USA
| | - Suzi Hong
- Department of Psychiatry, University of California, San Diego, USA
- Department of Family Medicine and Public Health, University of California, San Diego, USA
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Vestergaard MB, Jensen MLF, Arngrim N, Lindberg U, Larsson HBW. Higher physiological vulnerability to hypoxic exposure with advancing age in the human brain. J Cereb Blood Flow Metab 2020; 40:341-353. [PMID: 30540217 PMCID: PMC6985989 DOI: 10.1177/0271678x18818291] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/26/2018] [Accepted: 11/10/2018] [Indexed: 12/14/2022]
Abstract
The aging brain is associated with atrophy along with functional and metabolic changes. In this study, we examined age-related changes in resting brain functions and the vulnerability of brain physiology to hypoxic exposure in humans in vivo. Brain functions were examined in 81 healthy humans (aged 18-62 years) by acquisitions of gray and white matter volumes, cerebral blood flow, cerebral oxygen consumption, and concentrations of lactate, N-acetylaspartate, and glutamate+glutamine using magnetic resonance imaging and spectroscopy. We observed impaired cerebral blood flow reactivity in response to inhalation of hypoxic air (p = 0.029) with advancing age along with decreased cerebral oxygen consumption (p = 0.036), and increased lactate concentration (p = 0.009), indicating tissue hypoxia and impaired metabolism. Diminished resilience to hypoxia and consequently increased vulnerability to metabolic stress could be a key part of declining brain health with age. Furthermore, we observed increased resting cerebral lactate concentration with advancing age (p = 0.007), which might reflect inhibited brain clearance of waste products.
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Affiliation(s)
- Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Mette LF Jensen
- Danish Centre for Sleep Medicine, Department of Clinical Neurophysiology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Nanna Arngrim
- Danish Headache Centre, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Henrik BW Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
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6
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Vestergaard MB, Larsson HB. Cerebral metabolism and vascular reactivity during breath-hold and hypoxic challenge in freedivers and healthy controls. J Cereb Blood Flow Metab 2019; 39:834-848. [PMID: 29099292 PMCID: PMC6498754 DOI: 10.1177/0271678x17737909] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The goal of the present study was to examine the cerebral metabolism and vascular reactivity during extended breath-holds (ranging from 2 min 32 s to 7 min 0 s) and during a hypoxic challenge in freedivers and non-diver controls. Magnetic resonance imaging was used to measure the global cerebral blood flow (CBF) and metabolic rate of oxygen (CMRO2), and magnetic resonance spectroscopy was used to measure the cerebral lactate, glutamate+glutamine, N-acetylaspartate and phosphocreatine+creatine concentrations in the occipital lobe. Fifteen freedivers and seventeen non-diver controls participated. The freedivers showed remarkable increases in CBF (107%) during the breath-holds, compensating for arterial desaturation, and sustained cerebral oxygen delivery (CDO2). CMRO2 was unaffected throughout the breath-holds. During the hypoxic challenge, the freedivers had larger increases in blood flow in the sagittal sinus than the non-divers, and could sustain normal CDO2. No differences were found in lactate production, global CBF or CMRO2. We conclude that the mechanism for sustaining brain function during breath-holding in freedivers involves an extraordinary increase in perfusion, and that freedivers present evidence for higher cerebrovascular reactivity, but not for higher lactate-producing glycolysis during a hypoxic challenge compared to controls.
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Affiliation(s)
- Mark B Vestergaard
- 1 Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging Unit, Copenhagen University Hospital, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Henrik Bw Larsson
- 1 Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging Unit, Copenhagen University Hospital, Rigshospitalet Glostrup, Glostrup, Denmark.,2 Institute of Clinical Medicine, The Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Tyndall AV, Argourd L, Sajobi TT, Davenport MH, Forbes SC, Gill SJ, Parboosingh JS, Anderson TJ, Wilson BJ, Smith EE, Hogan DB, Hill MD, Poulin MJ. Cardiometabolic risk factors predict cerebrovascular health in older adults: results from the Brain in Motion study. Physiol Rep 2016; 4:e12733. [PMID: 27117804 PMCID: PMC4848715 DOI: 10.14814/phy2.12733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 02/15/2016] [Accepted: 02/16/2016] [Indexed: 12/20/2022] Open
Abstract
Aging and physical inactivity are associated with an increased risk of developing metabolic syndrome (MetS). With the rising prevalence of MetS, it is important to determine the extent to which it affects cerebrovascular health. The primary purpose of this report is to examine the impact of MetS on cerebrovascular health (resting cerebral blood flow (CBF) peak velocity (V¯P), cerebrovascular conductance (CVC), and CBF responses to hypercapnia) in healthy older adults with normal cognition. A secondary goal was to examine the influence of apolipoprotein E (APOE) ε4 expression on these indices. In a sample of 258 healthy men and women older than 53 years, 29.1% met criteria for MetS. MetS, sex, and age were found to be significant predictors of CVC, and V¯P, MetS, and APOE status were significant predictors of V¯P-reactivity, and CVC-reactivity was best predicted by MetS status. After controlling for these factors, participants with MetS demonstrated lower cerebrovascular measures (CVC, V¯P, CVC-reactivity, and V¯P-reactivity) compared to participants without MetS. APOE ε4 carriers had higher V¯P-reactivity than noncarriers. These results provide evidence that cardiometabolic and vascular risk factors clustered together as the MetS predict measures of cerebrovascular health indices in older adults. Higher V¯P-reactivity in APOE ε4 carriers suggests vascular compensation for deleterious effects of this known risk allele for Alzheimer's disease and stroke.
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Affiliation(s)
- Amanda V Tyndall
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Laurie Argourd
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Tolulope T Sajobi
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Margie H Davenport
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Scott C Forbes
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Stephanie J Gill
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Jillian S Parboosingh
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Alberta, T3B 6A8, Canada
| | - Todd J Anderson
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Ben J Wilson
- Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Eric E Smith
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - David B Hogan
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Michael D Hill
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Marc J Poulin
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada Department of Medicine, Cumming School of Medicine University of Calgary, Calgary, Alberta, T2N 4N1, Canada Faculty of Kinesiology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
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