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Cadoni MPL, Coradduzza D, Congiargiu A, Sedda S, Zinellu A, Medici S, Nivoli AM, Carru C. Platelet Dynamics in Neurodegenerative Disorders: Investigating the Role of Platelets in Neurological Pathology. J Clin Med 2024; 13:2102. [PMID: 38610867 PMCID: PMC11012481 DOI: 10.3390/jcm13072102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Neurological disorders, particularly those associated with aging, pose significant challenges in early diagnosis and treatment. The identification of specific biomarkers, such as platelets (PLTs), has emerged as a promising strategy for early detection and intervention in neurological health. This systematic review aims to explore the intricate relationship between PLT dynamics and neurological health, focusing on their potential role in cognitive functions and the pathogenesis of cognitive disorders. Methods: Adhering to PRISMA guidelines, a comprehensive search strategy was employed in the PubMed and Scholar databases to identify studies on the role of PLTs in neurological disorders published from 2013 to 2023. The search criteria included studies focusing on PLTs as biomarkers in neurological disorders, their dynamics, and their potential in monitoring disease progression and therapy effectiveness. Results: The systematic review included 104 studies, revealing PLTs as crucial biomarkers in neurocognitive disorders, acting as inflammatory mediators. The findings suggest that PLTs share common features with altered neurons, which could be utilised for monitoring disease progression and evaluating the effectiveness of treatments. PLTs are identified as significant biomarkers for detecting neurological disorders in their early stages and understanding the pathological events leading to neuronal death. Conclusions: The systematic review underscores the critical role of PLTs in neurological disorders, highlighting their potential as biomarkers for the early detection and monitoring of disease progression. However, it also emphasises the need for further research to solidify the use of PLTs in neurological disorders, aiming to enhance early diagnosis and intervention strategies.
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Affiliation(s)
| | | | | | - Stefania Sedda
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Serenella Medici
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, 07100 Sassari, Italy
| | - Alessandra Matilde Nivoli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- Psychiatric Unit Clinic of the University Hospital, 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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2
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Raimo S, Cropano M, Gaita M, Maggi G, Cavallo ND, Roldan-Tapia MD, Santangelo G. The Efficacy of Cognitive Training on Neuropsychological Outcomes in Mild Cognitive Impairment: A Meta-Analysis. Brain Sci 2023; 13:1510. [PMID: 38002471 PMCID: PMC10669748 DOI: 10.3390/brainsci13111510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Mild cognitive impairment (MCI) or mild neurocognitive disorder is an intermediate stage of cognitive impairment between normal cognitive aging and dementia. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how cognitive training (CT) could benefit MCI. This meta-analysis aims to update and assess the efficacy of CT on specific neuropsychological test performance (global cognitive functioning, short-term verbal memory, long-term verbal memory, generativity, working memory, and visuospatial abilities) in individuals diagnosed with MCI, as compared to MCI control groups. After searching electronic databases for randomized controlled trials, 31 studies were found including 2496 participants. Results showed that CT significantly improved global cognitive functioning, short-term and long-term verbal memory, generativity, working memory, and visuospatial abilities. However, no significant effects were observed for shifting, abstraction ability/concept formation, processing speed, and language. The mode of CT had a moderating effect on abstraction ability/concept formation. The findings provide specific insights into the cognitive functions influenced by CT and guide the development of tailored interventions for MCI. While CT holds promise, further research is needed to address certain cognitive deficits and assess long-term effects on dementia progression.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Maria Cropano
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Mariachiara Gaita
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Gianpaolo Maggi
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Nicola Davide Cavallo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | | | - Gabriella Santangelo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
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3
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Gómez-Soria I, Cuenca-Zaldívar JN, Rodriguez-Roca B, Subirón-Valera AB, Salavera C, Marcén-Román Y, Andrade-Gómez E, Calatayud E. Cognitive Effects of a Cognitive Stimulation Programme on Trained Domains in Older Adults with Subjective Memory Complaints: Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3636. [PMID: 36834329 PMCID: PMC9967658 DOI: 10.3390/ijerph20043636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.
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Affiliation(s)
- Isabel Gómez-Soria
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
- Physical Therapy Unit, Primary Health Care Center “El Abajón”, Las Rozas de Madrid, 28231 Madrid, Spain
| | | | | | - Carlos Salavera
- Department of Psychology and Sociology, Education Faculty, University of Zaragoza, 50009 Zaragoza, Spain
| | - Yolanda Marcén-Román
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
| | - Elena Andrade-Gómez
- Department of Nursing, University of La Rioja, La Rioja, 26004 Logroño, Spain
| | - Estela Calatayud
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
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4
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Balietti M, Casoli T, Giacconi R, Giuli C. Platelet total PLA2 activity, serum oxidative level and plasma Cu/Zn ratio: a vicious cycle with a potential role to monitor MCI and Alzheimer's disease progression. Rejuvenation Res 2021; 25:16-24. [PMID: 34913745 DOI: 10.1089/rej.2021.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Alzheimer's disease (AD) has no cure, mainly because of late diagnosis. Early diagnostic biomarkers are crucial. Phospholipases A2 (PLA2) are hydrolases with several functions in the brain, nevertheless their deregulation contributes to neurodegeneration. We evaluated platelet total PLA2 activity (ptotPLA2) in healthy elderly subjects (HE, n = 102), patients suffering from Mild Cognitive Impairment (MCI, n = 90) and AD (n = 91). Platelets are considered "circulating neurons" and ptotPLA2 seems to mirror the cerebral activity. ptotPLA2 of the three cohorts was similar, but in MCI the higher ptotPLA2 the worse the global cognitive status (Mini Mental State Examination score, MMSE) and in AD the lower ptotPLA2 the more severe the pathology stage (Clinical Dementia Rating, CDR). Accordingly, MCI with MMSE ≥ 26 overlapped HE, in MCI with MMSE < 26 and in AD with CDR 1 ptotPLA2 increased, in AD with CDR 2 ptotPLA2 decreased. In MCI ptotPLA2 positively correlated with blood oxidation and inflammation, in AD it was the opposite. Finally, Discrimination Index (DI) - calculated multiplying ptotPLA2, oxidative level and Cu/Zn ratio (an inflammation parameter) - differentiated MCI patients who progressed to dementia in the following 24 months and AD patients with the worse pathology development. Summarizing, ptotPLA2 changes during MCI and AD progression, is linked, in opposite way, to oxidative/inflammatory status in MCI and AD and might help, when included in DI, to identify MCI converters to dementia and AD patients with the more severe prognosis. ptotPLA2 may have a diagnostic/prognostic value and be a potential therapeutic target.
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Affiliation(s)
- Marta Balietti
- INRCA, Neurobiology of Aging, Via Birrelli 8, Ancona, Italy, 60121;
| | | | | | - Cinzia Giuli
- INRCA IRCCS Hospital, Unit of Geriatrics, contrada Mossa 2, Fermo, Italy, 63900;
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5
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Abstract
Classification between individuals with mild cognitive impairment (MCI) and healthy controls (HC) based on electroencephalography (EEG) has been considered a challenging task to be addressed for the purpose of its early detection. In this study, we proposed a novel EEG feature, the kernel eigen-relative-power (KERP) feature, for achieving high classification accuracy of MCI versus HC. First, we introduced the relative powers (RPs) between pairs of electrodes across 21 different subbands of 2-Hz width as the features, which have not yet been used in previous MCI-HC classification studies. Next, the Fisher’s class separability criterion was applied to determine the best electrode pairs (five electrodes) as well as the frequency subbands for extracting the most sensitive RP features. The kernel principal component analysis (kernel PCA) algorithm was further performed to extract a few more discriminating nonlinear principal components from the optimal RPs, and these components form a KERP feature vector. Results carried out on 51 participants (24 MCI and 27 HC) show that the newly introduced subband RP feature showed superior classification performance to commonly used spectral power features, including the band power, single-electrode relative power, and also the RP based on the conventional frequency bands. A high leave-one-participant-out cross-validation (LOPO-CV) classification accuracy 86.27% was achieved by the RP feature, using a simple linear discriminant analysis (LDA) classifier. Moreover, with the same classifier, the proposed KERP further improved the accuracy to 88.24%. Finally, cascading the KERP feature to a nonlinear classifier, the support vector machine (SVM), yields a high MCI-HC classification accuracy of 90.20% (sensitivity = 87.50% and specificity = 92.59%). The proposed method demonstrated a high accuracy and a high usability (only five electrodes are required), and therefore, has great potential to further develop an EEG-based computer-aided diagnosis system that can be applied for the early detection of MCI.
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6
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Giuli C, Paoloni C, Santillo E, Balietti M, Fabbietti P, Postacchini D, Piacenza F. Study of the effects of adapted Tango and multidimensional intervention in pREvention of dementia in agiNG: developing healTHy lifestyle programs (STRENGTH Project)-the experimental protocol of a prospective randomised controlled trial. Aging Clin Exp Res 2020; 32:2529-2537. [PMID: 32124422 PMCID: PMC7680307 DOI: 10.1007/s40520-020-01504-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/05/2020] [Indexed: 11/04/2022]
Abstract
Background Dementia represents a key health issue for older adults, with negative consequences on psycho-social and functional status. Treatments that counteract cognitive deficits in mild cognitive impairment (MCI) are needed to prevent or delay it. Aim To describe the experimental protocol of the STRENGTH Project. This study investigates a multimodal intervention in older adults with MCI to improve cognitive, functional, biochemical and psycho-social aspects. Methods The prospective randomised controlled trial will enrol 300 subjects with MCI (age ≥ 60 years). Participants will be randomly assigned to: (a) the experimental group, which will undergo sessions of adapted tango, music therapy, engagement in social activities, cognitive intervention and psycho-education for 6 months or (b) the control group, which will receive psycho-education and advice on healthy lifestyle for 6 months. All outcomes will be analysed before intervention (baseline), immediately after termination (follow-up 1), after 6 months (follow-up 2) and after 2 years (follow-up 3). Discussion We expect that the findings of this multidisciplinary study will be useful to optimize clinical and psycho-social interventions for improving cognitive and functional status of subjects with MCI. Conclusions This project could have a meaningful impact on National Health Systems by providing clues on multidisciplinary management of older adults affected by cognitive decline to prevent dementia.
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7
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Casoli T, Giuli C, Balietti M, Fabbietti P, Conti F. Effect of a Cognitive Training Program on the Platelet APP Ratio in Patients with Alzheimer's Disease. Int J Mol Sci 2020; 21:ijms21145110. [PMID: 32698329 PMCID: PMC7403991 DOI: 10.3390/ijms21145110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022] Open
Abstract
In patients with Alzheimer’s disease (AD), synaptic plasticity seems to be involved in cognitive improvement induced by cognitive training. The platelet amyloid precursor protein (APP) ratio (APPr), i.e., the ratio between two APP isoforms, may be a useful peripheral biomarker to investigate synaptic plasticity pathways. This study evaluates the changes in neuropsychological/cognitive performance and APPr induced by cognitive training in AD patients participating in the “My Mind Project”. Neuropsychological/cognitive variables and APPr were evaluated in the trained group (n = 28) before a two-month experimental protocol, immediately after its termination at follow-up 1 (FU1), after 6 months at follow-up 2 (FU2), and after 24 months at follow-up 3 (FU3). The control group (n = 31) received general psychoeducational training for two months. Some memory and attention parameters were significantly improved in trained vs. control patients at FU1 and FU2 compared to baseline (Δ values). At FU3, APPr and Mini Mental State Examination (MMSE) scores decreased in trained patients. Δ APPr correlated significantly with the Δ scores of (i) MMSE at FU1, (ii) the prose memory test at FU2, and (iii) Instrumental Activities of Daily Living (IADL), the semantic word fluency test, Clinical Dementia Rating (CDR), and the attentive matrices test at FU3. Our data demonstrate that the platelet APPr correlates with key clinical variables, thereby proving that it may be a reliable biomarker of brain function in AD patients.
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Affiliation(s)
- Tiziana Casoli
- Center for Neurobiology of Aging, IRCCS INRCA, 60121 Ancona, Italy; (M.B.); (F.C.)
- Correspondence: ; Tel.: +39-071-800-4203
| | - Cinzia Giuli
- Geriatrics Operative Unit, IRCCS INRCA, 63023 Fermo, Italy;
| | - Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, 60121 Ancona, Italy; (M.B.); (F.C.)
| | - Paolo Fabbietti
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 87100 Cosenza, Italy;
| | - Fiorenzo Conti
- Center for Neurobiology of Aging, IRCCS INRCA, 60121 Ancona, Italy; (M.B.); (F.C.)
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, Università Politecnica delle Marche, 60126 Ancona, Italy
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8
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Sherman DS, Durbin KA, Ross DM. Meta-Analysis of Memory-Focused Training and Multidomain Interventions in Mild Cognitive Impairment. J Alzheimers Dis 2020; 76:399-421. [PMID: 32508325 DOI: 10.3233/jad-200261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention. OBJECTIVE A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions. METHODS A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions. RESULTS We found significant, large effects for memory-focused training (Hedges' g observed = 0.947; 95% CI [-1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges' g observed = 0.420; 95% CI [-0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain. CONCLUSION Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
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Affiliation(s)
- Dale S Sherman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Rossier School of Education, University of Southern California, Los Angeles, CA, USA
| | - Kelly A Durbin
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - David M Ross
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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9
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Sales TA, Marcussi S, Ramalho TC. Current Anti-Inflammatory Therapies and the Potential of Secretory Phospholipase A2 Inhibitors in the Design of New Anti-Inflammatory Drugs: A Review of 2012 - 2018. Curr Med Chem 2020; 27:477-497. [PMID: 30706775 DOI: 10.2174/0929867326666190201120646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 11/12/2018] [Accepted: 12/11/2018] [Indexed: 01/30/2023]
Abstract
The inflammatory process is a natural self-defense response of the organism to damage agents and its action mechanism involves a series of complex reactions. However, in some cases, this process can become chronic, causing much harm to the body. Therefore, over the years, many anti-inflammatory drugs have been developed aiming to decrease the concentrations of inflammatory mediators in the organism, which is a way of controlling these abnormal chain reactions. The main target of conventional anti-inflammatory drugs is the cyclooxygenase (COX) enzyme, but its use implies several side effects. Thus, based on these limitations, many studies have been performed, aiming to create new drugs, with new action mechanisms. In this sense, the phospholipase A2 (PLA2) enzymes stand out. Among all the existing isoforms, secretory PLA2 is the major target for inhibitor development, since many studies have proven that this enzyme participates in various inflammatory conditions, such as cancer, Alzheimer and arthritis. Finally, for the purpose of developing anti-inflammatory drugs that are sPLA2 inhibitors, many molecules have been designed. Accordingly, this work presents an overview of inflammatory processes and mediators, the current available anti-inflammatory drugs, and it briefly covers the PLA2 enzymes, as well as the diverse structural array of the newest sPLA2 inhibitors as a possible target for the production of new anti-inflammatory drugs.
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Affiliation(s)
- Thais A Sales
- Molecular Modeling Laboratory, Chemistry Department, Federal University of Lavras, 37200-000 Lavras, Brazil
| | - Silvana Marcussi
- Biochemistry Laboratory, Chemistry Department, Federal University of Lavras, 37200-000 Lavras, Brazil
| | - Teodorico C Ramalho
- Molecular Modeling Laboratory, Chemistry Department, Federal University of Lavras, 37200-000 Lavras, Brazil.,Center for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, 62, 50003 Rokitanskeho, Czech Republic
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10
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Four-Week, Home-Based, Robot Cognitive Intervention for Patients with Mild Cognitive Impairment: a Pilot Randomized Controlled Trial. Dement Neurocogn Disord 2020; 19:96-107. [PMID: 32985149 PMCID: PMC7521954 DOI: 10.12779/dnd.2020.19.3.96] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose Previous studies suggest that cognitive intervention can mitigate the development of dementia in patients with mild cognitive impairment (MCI). However, the previous cognitive intervention was mostly provided as a group session, in which MCI patients sometimes had difficulty in regularly attending sessions or were reluctant to participate in group-based classes. Additionally, experienced instructors for traditional cognitive intervention may be unavailable in some chronic-care facilities or community centers. Considering these reasons, we have developed 5 programs for home-based cognitive intervention using a personal robot for MCI patients. In this preliminary study, we aimed to demonstrate the effects of our newly developed home-based cognitive intervention with robots on cognitive function in MCI patients. Methods We conducted a single-blind randomized controlled trial enrolling 46 MCI patients. Participants were randomized into 2 groups: the robot cognitive intervention (robot) (n=24) group and without cognitive intervention (control) (n=22) group. The interventions comprised 60-min sessions per day for 4 weeks. The primary outcome was the change in cognitive function measured using the Cambridge Neuropsychological Test Automated Battery. Results There were no significant baseline demographic or clinical differences between the robot and control groups. After the 4-week cognitive intervention, the robot group showed greater improvement in working memory than did the control group. Conclusions Our home-based cognitive intervention with a personal robot improved the working memory in MCI patients. Further studies with larger samples and longer study periods are required to demonstrate the effects of these programs in other cognitive domains in MCI patients.
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11
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Fattoretti P, Malavolta M, Fabbietti P, Papa R, Giacconi R, Costarelli L, Galeazzi R, Paoloni C, Postacchini D, Lattanzio F, Giuli C. Oxidative Stress in Elderly with Different Cognitive Status: My Mind Project. J Alzheimers Dis 2019; 63:1405-1414. [PMID: 29843238 DOI: 10.3233/jad-171117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Biomarkers of oxidative stress have been associated with cognitive status in humans and have been proposed to guide prognosis/treatment in Alzheimer's disease (AD) and mild cognitive impairment (MCI). OBJECTIVE The aim of this study was to compare oxidative stress status in the plasma of mild-moderate AD, MCI, and healthy elderly with normal cognition (HE) undergoing a non-pharmacological intervention including multi-modal cognitive training ("My Mind Project"). METHODS A prospective randomized trial involving 321 elderly people enrolled in Marche Region, Italy. Each subject was randomly assigned to an experimental (cognitive training) or to a control group. Cognitive performances and biomarkers have been analyzed before intervention (baseline), immediately after termination (follow-up 1), after 6 months (follow-up 2), and after 2 years (follow-up 3). The biological antioxidant potential (BAP) to Diacron reactive oxygen metabolites (d-ROM) ratio has been used as an indicator of oxidative stress status and as outcome variable. RESULTS We have found no differences in the oxidative status among AD, MCI, and HE. Neither did we find a significant effect of the intervention within experimental groups. Gender was the sole factor with a strong significant effect on BAP/d-ROM. CONCLUSIONS Based on these results, the utility of biomarkers of oxidative stress to guide prognosis/treatment in AD or MCI seems to be limited by lack of specificity, large interindividual variability, and gender bias.
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Affiliation(s)
- Patrizia Fattoretti
- Cellular Bioenergetics Laboratory, Center for Neurobiology of Aging, INRCA-IRCCS, Ancona, Italy
| | - Marco Malavolta
- Advanced Technology Center for Aging Research, INRCA-IRCCS, Ancona, Italy
| | - Paolo Fabbietti
- Unit of Geriatric Pharmacoepidemiology, INRCA-IRCCS, Cosenza, Italy
| | - Roberta Papa
- Centre of Socio-Economic Gerontological Research, INRCA-IRCCS, Ancona, Italy
| | - Robertina Giacconi
- Advanced Technology Center for Aging Research, INRCA-IRCCS, Ancona, Italy
| | - Laura Costarelli
- Clinical Laboratory and Molecular Diagnostics, INRCA-IRCCS, Ancona, Italy
| | - Roberta Galeazzi
- Clinical Laboratory and Molecular Diagnostics, INRCA-IRCCS, Ancona, Italy
| | | | | | | | - Cinzia Giuli
- Geriatrics Operative Unit, INRCA-IRCCS, Fermo, Italy
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12
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Akingbade OES, Gibson C, Kalaria RN, Mukaetova-Ladinska EB. Platelets: Peripheral Biomarkers of Dementia? J Alzheimers Dis 2019; 63:1235-1259. [PMID: 29843245 DOI: 10.3233/jad-180181] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dementia continues to be the most burdening neurocognitive disorder, having a negative impact on the lives of millions. The search for biomarkers to improve the clinical diagnosis of dementia is ongoing, with the focus on effective use of readily accessible peripheral markers. In this review, we concentrate on platelets as biomarkers of dementia and analyze their potential as easily-accessible clinical biomarkers for various subtypes of dementia. Current platelet protein biomarkers that have been investigated for their clinical utility in the diagnosis of dementia, in particular Alzheimer's disease, include amyloid-β protein precursor (AβPP), the AβPP secretases (BACE1 and ADAM10), α-synuclein, tau protein, serotonin, cholesterol, phospholipases, clusterin, IgG, surface receptors, MAO-B, and coated platelets. Few of them, i.e., platelet tau, AβPP (particularly with regards to coated platelets) and secreted ADAM10 and BACE1 show the most promise to be taken forward into clinical setting to diagnose dementia. Aside from protein biomarkers, changes in factors such as mean platelet volume have the potential to play a very specific role in both the dementia diagnosis and prognosis. This review raises a number of research questions for consideration before application of the above biomarkers to routine clinical setting. It is without doubt that there is a need for more clarification on the effects of dementia on platelet morphology and protein content before these changes can be clinically applied as dementia biomarkers and explored further in differentiating distinct dementia subtypes.
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Affiliation(s)
- Oluwatomi E S Akingbade
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,School of Life Sciences, Medical School, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Claire Gibson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Elizabeta B Mukaetova-Ladinska
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,Evington Centre, Leicester General Hospital, Leicester, UK
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Sherman DS, Mauser J, Nuno M, Sherzai D. The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures. Neuropsychol Rev 2017; 27:440-484. [PMID: 29282641 PMCID: PMC5754430 DOI: 10.1007/s11065-017-9363-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022]
Abstract
Cognitive training in MCI may stimulate pre-existing neural reserves or recruit neural circuitry as “compensatory scaffolding” prompting neuroplastic reorganization to meet task demands (Reuter-Lorenz & Park, 2014). However, existing systematic reviews and meta-analytic studies exploring the benefits of cognitive interventions in MCI have been mixed. An updated examination regarding the efficacy of cognitive intervention in MCI is needed given improvements in adherence to MCI diagnostic criteria in subject selection, better defined interventions and strategies applied, increased use of neuropsychological measures pre- and post-intervention, as well as identification of moderator variables which may influence treatment. As such, this meta-analytic review was conducted to examine the efficacy of cognitive intervention in individuals diagnosed with mild cognitive impairment (MCI) versus MCI controls based on performance of neuropsychological outcome measures in randomized controlled trials (RCT). RCT studies published from January 1995 to June 2017 were obtained through source databases of MEDLINE-R, PubMed, Healthstar, Global Health, PSYCH-INFO, and Health and Psychological Instruments using search parameters for MCI diagnostic category (mild cognitive impairment, MCI, pre-Alzheimer’s disease, early cognitive decline, early onset Alzheimer’s disease, and preclinical Alzheimer’s disease) and the intervention or training conducted (intervention, training, stimulation, rehabilitation, or treatment). Other inclusion and exclusion criteria included subject selection based on established MCI criteria, RCT design in an outpatient setting, MCI controls (active or passive), and outcomes based on objective neuropsychological measures. From the 1199 abstracts identified, 26 articles met inclusion criteria for the meta-analyses completed across eleven (11) countries; 92.31% of which have been published within the past 7 years. A series of meta-analyses were performed to examine the effects of cognitive intervention by cognitive domain, type of training, and intervention content (cognitive domain targeted). We found significant, moderate effects for multicomponent training (Hedges’ g observed = 0.398; CI [0.164, 0.631]; Z = 3.337; p = 0.001; Q = 55.511; df = 15; p = 0.000; I2 = 72.978%; τ2 = 0.146) as well as multidomain-focused strategies (Hedges’ g = 0.230; 95% CI [0.108, 0.352]; Z = 3.692; p < 0.001; Q = 12.713; df = 12; p = 0.390; I2 = 5.612; τ2 = 0.003). The effects for other interventions explored by cognitive domain, training type, or intervention content were indeterminate due to concerns for heterogeneity, bias, and small cell sizes. In addition, subgroup and meta-regression analyses were conducted with the moderators of MCI category, mode of intervention, training type, intervention content, program duration (total hours), type of control group (active or passive), post-intervention follow-up assessment period, and control for repeat administration. We found significant overall effects for intervention content with memory focused interventions appearing to be more effective than multidomain approaches. There was no evidence of an influence on outcomes for the other covariates examined. Overall, these findings suggest individuals with MCI who received multicomponent training or interventions targeting multiple domains (including lifestyle changes) were apt to display an improvement on outcome measures of cognition post-intervention. As such, multicomponent and multidomain forms of intervention may prompt recruitment of alternate neural processes as well as support primary networks to meet task demands simultaneously. In addition, interventions with memory and multidomain forms of content appear to be particularly helpful, with memory-based approaches possibly being more effective than multidomain methods. Other factors, such as program duration, appear to have less of an influence on intervention outcomes. Given this, although the creation of new primary network paths appears strained in MCI, interventions with memory-based or multidomain forms of content may facilitate partial activation of compensatory scaffolding and neuroplastic reorganization. The positive benefit of memory-based strategies may also reflect transfer effects indicative of compensatory network activation and the multiple-pathways involved in memory processes. Limitations of this review are similar to other meta-analysis in MCI, including a modest number studies, small sample sizes, multiple forms of interventions and types of training applied (some overlapping), and, while greatly improved in our view, a large diversity of instruments used to measure outcome. This is apt to have contributed to the presence of heterogeneity and publication bias precluding a more definitive determination of the outcomes observed.
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Affiliation(s)
- Dale S Sherman
- Cedars-Sinai Medical Center, 444 S. San Vicente Blvd, Suite 103, Los Angeles, CA, 90048, USA. .,University of Southern California, Los Angeles, CA, USA.
| | - Justin Mauser
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Miriam Nuno
- University of California, Davis, Davis, CA, USA
| | - Dean Sherzai
- Loma Linda University Health, 11370 Anderson Street B100, Loma Linda, CA, 92354, USA
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Giuli C, Fattoretti P, Gagliardi C, Mocchegiani E, Venarucci D, Balietti M, Casoli T, Costarelli L, Giacconi R, Malavolta M, Papa R, Lattanzio F, Postacchini D. My Mind Project: the effects of cognitive training for elderly-the study protocol of a prospective randomized intervention study. Aging Clin Exp Res 2017; 29:353-360. [PMID: 27106901 PMCID: PMC5445186 DOI: 10.1007/s40520-016-0570-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/06/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cognitive decline and dementia represent a key problem for public health as they heavily impair social functioning and independent living. The development of new strategies to support recommendations for patients and their caregivers may represent an outstanding step forward. AIMS To describe the study protocol and methods of "My Mind Project: the effect of cognitive training for elderly" (Grant No. 154/GR-2009-1584108), which investigates, by the use of a multidisciplinary approach, the effects of a comprehensive cognitive training programme on performances in aged subjects with mild-moderate Alzheimer's disease, mild cognitive impairment and normal cognitive functioning. METHODS The study is a prospective randomized intervention for the assessment of cognitive training effects in three groups of elderly subjects with different cognitive status. A total of 321 elderly people were enrolled in Marche Region, Italy. Each subject was randomly assigned to an experimental group or to a control group. Cognitive performances and biochemical blood markers have also been analysed before cognitive training (baseline), immediately after termination (follow-up 1), after 6 months (follow-up 2) and after 2 years (follow-up 3). DISCUSSION The results will be useful to identify some efficient programmes for the enhancement of cognitive performance in elderly with and without cognitive decline. CONCLUSION The application of a non-pharmacological approach in the treatment of elderly with cognitive disorders could have a profound impact on National Health Service.
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Affiliation(s)
- C Giuli
- Geriatrics Operative Unit, Italian National Research Centre on Aging (INRCA) IRCCS, Contrada Mossa, 63900, Fermo, Italy.
| | - P Fattoretti
- Center for Neurobiology of Aging, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - C Gagliardi
- Centre of Socio-Economic Gerontological Research, Italian National Research Centre on Aging (INRCA), via S. Margherita, Ancona, Italy
| | - E Mocchegiani
- Nutrition and Aging Centre, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - D Venarucci
- Biochemical Operative Unit, Italian National Research Centre on Aging (INRCA), Contrada Mossa, Fermo, Italy
| | - M Balietti
- Center for Neurobiology of Aging, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - T Casoli
- Center for Neurobiology of Aging, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - L Costarelli
- Nutrition and Aging Centre, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - R Giacconi
- Nutrition and Aging Centre, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - M Malavolta
- Nutrition and Aging Centre, Italian National Research Centre on Aging (INRCA), via Birarelli, Ancona, Italy
| | - R Papa
- Centre of Socio-Economic Gerontological Research, Italian National Research Centre on Aging (INRCA), via S. Margherita, Ancona, Italy
| | - F Lattanzio
- Scientific Direction, Italian National Research Centre on Aging (INRCA), via S. Margherita, Ancona, Italy
| | - D Postacchini
- Geriatrics Operative Unit, Italian National Research Centre on Aging (INRCA) IRCCS, Contrada Mossa, 63900, Fermo, Italy
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Giuli C, Fabbietti P, Paoloni C, Pensieri M, Lattanzio F, Postacchini D. Subjective memory complaints in Italian elderly with mild cognitive impairment: implication of psychological status. Neurol Sci 2016; 37:1153-7. [PMID: 27025607 PMCID: PMC4917565 DOI: 10.1007/s10072-016-2553-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/15/2016] [Indexed: 11/27/2022]
Abstract
Subjective cognitive and memory complaints (SMC) are common in later life and are considered an indicator for progression to cognitive decline. The aim of the present study was to identify the relationship among SMC, neuropsychiatric symptoms and psychological aspects in elderly subjects with mild cognitive impairment (MCI) as well as to analyse the effect on SMC of a comprehensive cognitive training. Data from a sample of 94 patients enrolled in ‘My Mind Project’ (Grant No. 154/GR-2009-1584108) were collected. The study evidenced that depression was a significant predictor of SMC and that after the training, the number of subjects with SMC was significantly reduced in the experimental group in comparison to the control one. These results suggest that the participation in cognitive stimulation protocols may improve the perception of SMC in subjects with MCI.
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Affiliation(s)
- Cinzia Giuli
- Unit of Geriatrics, Italian National Research Center on Aging, INRCA, IRCCS, Contrada Mossa, 63900, Fermo, Italy.
| | - Paolo Fabbietti
- Biostatistical Centre, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Cristina Paoloni
- Unit of Geriatrics, Italian National Research Center on Aging, INRCA, IRCCS, Contrada Mossa, 63900, Fermo, Italy
| | - Mirko Pensieri
- Unit of Geriatrics, Italian National Research Center on Aging, INRCA, IRCCS, Contrada Mossa, 63900, Fermo, Italy
| | - Fabrizia Lattanzio
- Scientific Direction, Italian National Research Center on Aging, INRCA, Ancona, Italy
| | - Demetrio Postacchini
- Unit of Geriatrics, Italian National Research Center on Aging, INRCA, IRCCS, Contrada Mossa, 63900, Fermo, Italy
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