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Rajendran P, Al-Saeedi FJ, Ammar RB, Abdallah BM, Ali EM, Al Abdulsalam NK, Tejavat S, Althumairy D, Veeraraghavan VP, Alamer SA, Bekhet GM, Ahmed EA. Geraniol attenuates oxidative stress and neuroinflammation-mediated cognitive impairment in D galactose-induced mouse aging model. Aging (Albany NY) 2024; 16:5000-5026. [PMID: 38517361 PMCID: PMC11006477 DOI: 10.18632/aging.205677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024]
Abstract
D-galactose (D-gal) administration was proven to induce cognitive impairment and aging in rodents' models. Geraniol (GNL) belongs to the acyclic isoprenoid monoterpenes. GNL reduces inflammation by changing important signaling pathways and cytokines, and thus it is plausible to be used as a medicine for treating disorders linked to inflammation. Herein, we examined the therapeutic effects of GNL on D-gal-induced oxidative stress and neuroinflammation-mediated memory loss in mice. The study was conducted using six groups of mice (6 mice per group). The first group received normal saline, then D-gal (150 mg/wt) dissolved in normal saline solution (0.9%, w/v) was given orally for 9 weeks to the second group. In the III group, from the second week until the 10th week, mice were treated orally (without anesthesia) with D-gal (150 mg/kg body wt) and GNL weekly twice (40 mg/kg body wt) four hours later. Mice in Group IV were treated with GNL from the second week up until the end of the experiment. For comparison of young versus elderly mice, 4 month old (Group V) and 16-month-old (Group VI) control mice were used. We evaluated the changes in antioxidant levels, PI3K/Akt levels, and Nrf2 levels. We also examined how D-gal and GNL treated pathological aging changes. Administration of GNL induced a significant increase in spatial learning and memory with spontaneously altered behavior. Enhancing anti-oxidant and anti-inflammatory effects and activating PI3K/Akt were the mechanisms that mediated this effect. Further, GNL treatment upregulated Nrf2 and HO-1 to reduce oxidative stress and apoptosis. This was confirmed using 99mTc-HMPAO brain flow gamma bioassays. Thus, our data suggested GNL as a promising agent for treating neuroinflammation-induced cognitive impairment.
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Affiliation(s)
- Peramaiyan Rajendran
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Fatma J. Al-Saeedi
- Department of Nuclear Medicine, College of Medicine, Kuwait University, Safat 13110, Kuwait
| | - Rebai Ben Ammar
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Laboratory of Aromatic and Medicinal Plants, Center of Biotechnology of Borj-Cedria, Technopole of Borj-Cedria PBOX 901, Hammam-Lif 2050, Tunisia
| | - Basem M. Abdallah
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Enas M. Ali
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Najla Khaled Al Abdulsalam
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Sujatha Tejavat
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Duaa Althumairy
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Vishnu Priya Veeraraghavan
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Sarah Abdulaziz Alamer
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Gamal M. Bekhet
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Zoology, Faculty of Science, Alexandria University Egypt, Alexandria 21544, Egypt
| | - Emad A. Ahmed
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Laboratory of Molecular Physiology, Zoology Department, Faculty of Science, Assiut University, Assiut 71515, Egypt
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Wu S, Mao Y, Chen S, Pan P, Zhang H, Chen S, Liu J, Mi D. Safety and Efficacy of Tight Versus Loose Glycemic Control in Acute Stroke Patients: A Meta-Analysis of Randomized Controlled Trials. Int J Stroke 2024:17474930241241994. [PMID: 38472157 DOI: 10.1177/17474930241241994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Hyperglycemia is associated with worse stroke outcomes but it is uncertain whether tight glycaemic control during the acute stroke period is associated with a better outcome. We conducted a meta-analysis to compare the effect of tight glycemic control versus loose glycemic control in the acute phase of stroke patients. METHODS A literature search was performed to identify randomized controlled trials (RCTs) comparing the safety and efficacy of tight glycemic control with a relatively loose control of blood glucose of acute stroke (ischemic or hemorrhagic) patients within 24 hours after stroke onset. We required that the blood glucose level of the patients should not be lower than 6.11mmol/L at the time of enrollment, and for the intensive blood glucose control range, we defined the blood glucose level as lower than that of the control group.Tight glycaemic control was defined as blood glucose ≥ 6.11 mmol/L. The primary efficacy outcome measure was deaths from any cause at 90 days. Secondary efficacy outcomes comprised the number of participants with modified Rankin score (mRS), We define mRS scores 0-2 as favorable scores, recurrent stroke, and the National Institute of Health stroke scale (NIHSS) or the European Stroke Scale (ESS) scores. We defined the number of participants with hypoglycemia as our primary safety outcome. Subgroup analysis was performed according to age, the variety of interventions, maintained glucose level, and status of hypoglycemia on NIHSS scores or ESS scores. RESULTS Fifteen RCTs with 2957 participants meeting the including criteria were identified and included in this meta-analysis, although not all included data on every outcome measure. Data on the primary efficacy endpoint, mortality at 90 days, was available in 11 RCTs a total of 2575 participants. There was no significant difference between the intervention and control groups (OR: 1.00; 95%CI: 0.81 to 1.23; P=0.99). For secondary endpoints, there was no difference between intervention and control groups for a mRS < from 0-2 (OR: 0.96; 95%CI: 0.80 to 1.15; P=0.69; data from 9 RCTs available), or recurrent stroke (OR: 1.34; 95%CI: 0.92 to 1.96; P=0.13; data from 3 RCTs available). For NIHSS scores or ESS scores, there was a small difference in favor of intensive controls (SMD: -0.29; 95%CI: -0.54 to -0.04; P=0.02) There was a marked increase in hypoglycemia with tight control: (OR of 9.46 (95%CI: 4.59 to 19.50; P<0.00001; data from 9 RCTs available). CONCLUSIONS There was no difference between tight and loose glycemic control on mortality, independence, or recurrent stroke outcome in acute stroke, but an increase in hypoglycaemia. There was a small effect improvement on neurological scales but the relevance of this needs confirming in future adequately powered studies.
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Affiliation(s)
- Shuangzhe Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Yuke Mao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Sijia Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Peiyan Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Huiying Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Siqi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Donghua Mi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
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Ferchaud C, Lartaud A, Vettes A. [The multi-professional alliance in the diagnostic process]. Soins Gerontol 2024; 29:42-45. [PMID: 38418071 DOI: 10.1016/j.sger.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Professional support for elderly people suffering from cognitive impairment needs to be comprehensive, and requires the active involvement of a wide range of professionals. Two clinical cases show how the combined support of a therapeutic day-care center and medical specialists can improve the quality of life of patients and their families, by helping to refine diagnoses or adjust treatment.
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Affiliation(s)
- Catherine Ferchaud
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France
| | - Amélie Lartaud
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France.
| | - Audrey Vettes
- Accueil de jour "Les Balkans", 1 allée Alquier-Debrousse, 75020 Paris, France
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Kivioja T, Posti JP, Sipilä J, Rauhala M, Frantzén J, Gardberg M, Rahi M, Rautajoki K, Nykter M, Vuorinen V, Nordfors K, Haapasalo H, Haapasalo J. Motor dysfunction as a primary symptom predicts poor outcome: multicenter study of glioma symptoms. Front Oncol 2024; 13:1305725. [PMID: 38239655 PMCID: PMC10794640 DOI: 10.3389/fonc.2023.1305725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024] Open
Abstract
Background and objectives The objectives of this study were to investigate the prognostic value of primary symptoms and leading symptoms in adult patients with diffuse infiltrating glioma and to provide a clinical perspective for evaluating survival. Methods This study included a retrospective cohort from two tertiary university hospitals (n = 604, 2006-2013, Tampere University Hospital and Turku University Hospital) and a prospective cohort (n = 156, 2014-2018, Tampere University Hospital). Preoperative symptoms were divided into primary and leading symptoms. Results were validated with the newer WHO 2021 classification criteria. Results The most common primary symptoms were epileptic seizure (30.8% retrospective, 28.2% prospective), cognitive disorder (13.2% retrospective, 16.0% prospective), headache (8.6% retrospective, 12.8% prospective), and motor paresis (7.0% retrospective, 7.1% prospective). Symptoms that predicted better survival were epileptic seizure and visual or other sense-affecting symptom in the retrospective cohort and epileptic seizure and headache in the prospective cohort. Predictors of poor survival were cognitive disorder, motor dysfunction, sensory symptom, tumor hemorrhage, speech disorder and dizziness in the retrospective cohort and cognitive disorder, motor dysfunction, sensory symptom, and dizziness in the prospective cohort. Motor dysfunction served as an independent predictor of survival in a multivariate model (OR = 1.636). Conclusion Primary and leading symptoms in diffuse gliomas are associated with prognoses in retrospective and prospective settings. Motor paresis was an independent prognostic factor for poor survival in multivariate analysis for grade 2-4 diffuse gliomas, especially in glioblastomas.
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Affiliation(s)
- Tomi Kivioja
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Jussi P. Posti
- Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Jussi Sipilä
- Department of Neurology, Siun Sote, North Karelia Central Hospital, Joensuu, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
| | - Minna Rauhala
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Janek Frantzén
- Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Maria Gardberg
- Turku University Hospital, Tyks Laboratories, Pathology and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Melissa Rahi
- Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Kirsi Rautajoki
- Prostate Cancer Research Center, Faculty of Medicine and Health Technology, Tampere University and Tays Cancer Center, Tampere, Finland
| | - Matti Nykter
- Faculty of Medicine and Health Technology, Tampere University and Tays Cancer Center, Tampere, Finland
| | - Ville Vuorinen
- Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Hannu Haapasalo
- Fimlab Laboratories Ltd., Tampere University Hospital, Tampere, Finland
| | - Joonas Haapasalo
- Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, Finland
- Fimlab Laboratories Ltd., Tampere University Hospital, Tampere, Finland
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van de Schraaf SAJ. Vascular cognitive impairment: When memory loss is not the biggest challenge. Dementia (London) 2024; 23:152-171. [PMID: 37997896 PMCID: PMC10798009 DOI: 10.1177/14713012231214299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Vascular cognitive impairment is the second most common type of cognitive impairment. Care needs of community-dwelling people with vascular cognitive impairment and their caregivers have not been thoroughly studied. Therefore, we aimed to explore care needs of people with vascular cognitive impairment and their family caregivers. DESIGN A qualitative interview study. SETTING AND PARTICIPANTS Participants were purposefully sampled community-dwelling people with vascular cognitive impairment and their family caregivers. METHODS Interviews were audiotaped and transcribed verbatim. Analysis and data collection followed an iterative process, until data saturation was achieved. We conducted 18 interviews (nine people with vascular cognitive impairment and nine caregivers), concerning 13 unique people with vascular cognitive impairment. We analyzed the data using inductive thematic analysis following the Braun & Clark method. The study was reported in accordance with the COREQ criteria. FINDINGS Five themes were identified in the care needs reported by people with vascular cognitive impairment and family caregivers: (1) Specific information need with subtheme (1A) No memory problem, no dementia? (2) Being respected as a person, (3) Differing concerns about the future, (4) The roles of the caregiver and (5) Decisiveness from professional healthcare. CONCLUSIONS AND IMPLICATIONS The care needs of people with vascular cognitive impairment and their caregivers were affected by (a lack of knowledge about) the characteristic symptoms of this condition. Participants equated cognitive impairment or dementia to memory loss ("Alzheimerization"), although memory loss was not their biggest challenge. People with vascular cognitive impairment and caregivers preferred resolute and decisive healthcare professionals. These professionals activate the person with vascular cognitive impairment who lacks initiative and diminishe role conflict of the caregiver. Care for people with vascular cognitive impairment and their caregivers could be improved by providing tailored information, promoting awareness of neuropsychiatric symptoms, particularly apathy, and by healthcare professionals providing more guidance in decision-making.
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Affiliation(s)
- Sara AJ van de Schraaf
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam, Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, Netherlands; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Internal Medicine, Geriatric Medicine Section, Amsterdam, Netherlands
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Vestin E, Boström G, Olsson J, Elgh F, Lind L, Kilander L, Lövheim H, Weidung B. Herpes Simplex Viral Infection Doubles the Risk of Dementia in a Contemporary Cohort of Older Adults: A Prospective Study. J Alzheimers Dis 2024; 97:1841-1850. [PMID: 38306033 PMCID: PMC10894565 DOI: 10.3233/jad-230718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 02/03/2024]
Abstract
Background Evidence indicates that herpes simplex virus (HSV) participates in the pathogenesis of Alzheimer's disease (AD). Objective We investigated AD and dementia risks according to the presence of herpesvirus antibodies in relation to anti-herpesvirus treatment and potential APOE ɛ4 carriership interaction. Methods This study was conducted with 1002 dementia-free 70-year-olds living in Sweden in 2001-2005 who were followed for 15 years. Serum samples were analyzed to detect anti-HSV and anti-HSV-1 immunoglobulin (Ig) G, anti-cytomegalovirus (CMV) IgG, anti-HSV IgM, and anti-HSV and anti-CMV IgG levels. Diagnoses and drug prescriptions were collected from medical records. Cox proportional-hazards regression models were applied. Results Cumulative AD and all-cause dementia incidences were 4% and 7%, respectively. Eighty-two percent of participants were anti-HSV IgG carriers, of whom 6% received anti-herpesvirus treatment. Anti-HSV IgG was associated with a more than doubled dementia risk (fully adjusted hazard ratio = 2.26, p = 0.031). No significant association was found with AD, but the hazard ratio was of the same magnitude as for dementia. Anti-HSV IgM and anti-CMV IgG prevalence, anti-herpesvirus treatment, and anti-HSV and -CMV IgG levels were not associated with AD or dementia, nor were interactions between anti-HSV IgG and APOE ɛ4 or anti-CMV IgG. Similar results were obtained for HSV-1. Conclusions HSV (but not CMV) infection may be indicative of doubled dementia risk. The low AD incidence in this cohort may have impaired the statistical power to detect associations with AD.
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Affiliation(s)
- Erika Vestin
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Gustaf Boström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Västmanland and County Hospital, Uppsala University, Västerås, Sweden
| | - Jan Olsson
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Fredrik Elgh
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Lars Lind
- Department of Medical Sciences, Acute and Internal Medicine, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Bodil Weidung
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
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Wang X, Fu X, Luo X, Lai Y, Cai C, Liao Y, Dai Z, Fang S, Fang J. Network Proximity Analysis Deciphers the Pharmacological Mechanism of Osthole against D-Galactose Induced Cognitive Disorder in Rats. Molecules 2023; 29:21. [PMID: 38202603 PMCID: PMC10779601 DOI: 10.3390/molecules29010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
Osthole, a natural coumarin found in various medicinal plants, has been previously reported to have neuroprotective effects. However, the specific mechanism by which Osthole alleviates dysmnesia associated with Alzheimer's disease (AD) remains unclear. This study aimed to investigate the neuroprotective properties of Osthole against cognitive impairment in rats induced by D-galactose and elucidate its pharmacological mechanism. The rat model was established by subcutaneously injecting D-galactose at a dose of 150 mg/kg/day for 56 days. The effect of Osthole on cognitive impairment was evaluated by behavior and biochemical analysis. Subsequently, a combination of in silico prediction and experimental validation was performed to verify the network-based predictions, using western blot, Nissl staining, and immunofluorescence. The results demonstrate that Osthole could improve memory dysfunction induced by D-galactose in Sprague Dawley male rats. A network proximity-based approach and integrated pathways analysis highlight two key AD-related pathological processes that may be regulated by Osthole, including neuronal apoptosis, i.e., neuroinflammation. Among them, the pro-apoptotic markers (Bax), anti-apoptotic protein (Bcl-2), the microgliosis (Iba-1), Astro-cytosis (GFAP), and inflammatory cytokines (TNF-R1) were evaluated in both hippocampus and cortex. The results indicated that Osthole significantly ameliorated neuronal apoptosis and neuroinflammation in D-galactose-induced cognitive impairment rats. In conclusion, this study sheds light on the pharmacological mechanism of Osthole in mitigating D-galactose-induced memory impairment and identifies Osthole as a potential drug candidate for AD treatment, targeting multiple signaling pathways through network proximity and integrated pathways analysis.
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Affiliation(s)
- Xue Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Xiaomei Fu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Xiurong Luo
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Yiyi Lai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Chuipu Cai
- Division of Data Intelligence, Department of Computer Science, Key Laboratory of Intelligent Manufacturing Technology of Ministry of Education, College of Engineering, Shantou University, Shantou 515063, China;
| | - Yanfang Liao
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Zhao Dai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Shuhuan Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
| | - Jiansong Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; (X.W.); (X.F.); (X.L.); (Y.L.); (Y.L.); (Z.D.)
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Zhou X, Cao S, Hou J, Gui T, Zhu F, Xue Q. Association between myasthenia gravis and cognitive disorders: a PRISMA-compliant meta-analysis. Int J Neurosci 2023; 133:987-998. [PMID: 35285401 DOI: 10.1080/00207454.2022.2031183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/28/2021] [Accepted: 01/06/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This meta-analysis assessed the association between myasthenia gravis (MG) and cognitive disorders. METHODS The PubMed, Web of Science, OVID, EMBASE, CNKI and Wanfang electronic databases were comprehensively searched from inception to October 2020 for relevant studies. The primary outcomes were scores of the cognitive function battery. A random effects model was used to evaluate the cognitive function of patients with MG. RESULTS Eight cross-sectional studies containing 381 patients and 220 healthy controls were included in this meta-analysis. In relation to global cognitive function, patients with MG performed significantly worse than healthy individuals (SMD = -0.4, 95% CI = -0.63 to -0.16, p < 0.001, I2 = 10%). Specifically, the impaired cognitive domains included language, visuospatial function, information processing, verbal immediate and delayed recall memory, visual immediate recall memory, and response fluency, while attention, executive function, and visual delayed recall memory were unimpaired. The patients with early-onset (SMD= -0.527, 95% CI = -0.855 to -0.199, p = 0.002) and generalized MG (SMD= -0.577, 95% CI = -1.047 to -0.107, p = 0.016) had poorer global cognitive performance than the healthy population. CONCLUSIONS Patients with MG may have cognitive disorders, including those associated with the domains of language, visuospatial function, information processing, verbal immediate and delayed recall memory, visual immediate recall memory and response fluency. Furthermore, the age of onset and disease severity may be associated with cognitive disorders in patients with MG.
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Affiliation(s)
- Xiaoling Zhou
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shugang Cao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Jinyi Hou
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Acupuncture and Moxibustion, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, China
| | - Tiantian Gui
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Feng Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qun Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Zhang S, Liu C, Sun J, Li Y, Lu J, Xiong X, Hu L, Zhao H, Zhou H. Bridging the Gap: Investigating the Link between Inflammasomes and Postoperative Cognitive Dysfunction. Aging Dis 2023; 14:1981-2002. [PMID: 37450925 PMCID: PMC10676784 DOI: 10.14336/ad.2023.0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/01/2023] [Indexed: 07/18/2023] Open
Abstract
Postoperative cognitive dysfunction (POCD) is a cluster of cognitive problems that may arise after surgery. POCD symptoms include memory loss, focus inattention, and communication difficulties. Inflammasomes, intracellular multiprotein complexes that control inflammation, may have a significant role in the development of POCD. It has been postulated that the NLRP3 inflammasome promotes cognitive impairment by triggering the inflammatory response in the brain. Nevertheless, there are many gaps in the current literature to understand the underlying pathophysiological mechanisms and develop future therapy. This review article underlines the limits of our current knowledge about the NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) inflammasome and POCD. We first discuss inflammasomes and their types, structures, and functions, then summarize recent evidence of the NLRP3 inflammasome's involvement in POCD. Next, we propose a hypothesis that suggests the involvement of inflammasomes in multiple organs, including local surgical sites, blood circulation, and other peripheral organs, leading to systemic inflammation and subsequent neuronal dysfunction in the brain, resulting in POCD. Research directions are then discussed, including analyses of inflammasomes in more clinical POCD animal models and clinical trials, studies of inflammasome types that are involved in POCD, and investigations into whether inflammasomes occur at the surgical site, in circulating blood, and in peripheral organs. Finally, we discuss the potential benefits of using new technologies and approaches to study inflammasomes in POCD. A thorough investigation of inflammasomes in POCD might substantially affect clinical practice.
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Affiliation(s)
- Siyu Zhang
- Anesthesiology Department, Zhejiang Chinese Medical University, Hangzhou, China.
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
| | - Cuiying Liu
- School of Nursing, Capital Medical University, Beijing, China.
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Joint Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
| | - Jintao Sun
- Anesthesiology Department, Zhejiang Chinese Medical University, Hangzhou, China.
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
| | - Yang Li
- Anesthesiology Department, Zhejiang Chinese Medical University, Hangzhou, China.
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
| | - Jian Lu
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
| | - Xiaoxing Xiong
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Hu
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
| | - Heng Zhao
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Joint Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
| | - Hongmei Zhou
- Anesthesiology Department, Zhejiang Chinese Medical University, Hangzhou, China.
- Anesthesiology Department, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing, China.
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Geng G, Hu W, Meng Y, Zhang H, Zhang H, Chen C, Zhang Y, Gao Z, Liu Y, Shi J. Vagus nerve stimulation for treating developmental and epileptic encephalopathy in young children. Front Neurol 2023; 14:1191831. [PMID: 37928141 PMCID: PMC10624125 DOI: 10.3389/fneur.2023.1191831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
Objective To investigate the clinical variables that might predict the outcome of developmental and epileptic encephalopathy (DEE) after vagus nerve stimulation (VNS) therapy and identify the risk factors for poor long-term outcome. Patients and methods We retrospectively studied 32 consecutive children with drug-resistant DEE who had undergone VNS surgery from April 2019 to July 2021, which were not suitable for corpus callosotomy. In spite of combining valproic acid, levetiracetam, lamotrigine, topiramate, etc. (standard anti-seizure medicine available in China) it has not been possible to effectively reduce seizures in the population we investigate (Cannabidiol and brivaracetam were not available in China). A responder was defined as a frequency reduction decrease > 50%. Seizure freedom was defined as freedom from seizures for at least 6 months. Sex, electroencephalograph (EEG) group, neurodevelopment, time lag, gene mutation, magnetic resonance imaging (MRI), and epilepsy syndrome were analyzed with Fisher's exact test, The age at onset and age at VNS therapy were analyzed with Kruskal-Wallis test, statistical significance was defined as p < 0.05. And used the effect size to correction. Results Among the 32 patients, the median age at VNS implantation was 4.7 years (range: 1-12 years). At the most recent follow-up, five children (15.6%) were seizure-free and 22 (68.8%) were responders. Univariate analysis demonstrated that the responders were significantly associated with mild development delay/intellectual disability (p = 0.044; phi coefficient = 0.357) and a multifocal EEG pattern (p = 0.022; phi coefficient = -0.405). Kaplan-Meier survival analyses demonstrated that a multifocal EEG pattern (p = 0.049) and DEE without epileptic spasm (ES) (p = 0.012) were statistically significant (p = 0.030). Multivariate analysis demonstrated that DEE with ES had significant predictive value for poor long-term outcome (p = 0.014, hazard ratio = 5.433, confidence interval = 1.402-21.058). Conclusions Our study suggested that VNS was a generally effective adjunct treatment for DEE. Although the predictive factors for VNS efficacy remain unclear, it should be emphasized that patients with ES are not suitable candidates for epilepsy surgery. Further investigations are needed to validate the present results.
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Affiliation(s)
- Guifu Geng
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
- Department of Functional Neurosurgery, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Wandong Hu
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Yao Meng
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
- Department of Functional Neurosurgery, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Huan Zhang
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Hongwei Zhang
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Chuanmei Chen
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Yanqing Zhang
- Pediatric Health Care Institute, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Zaifen Gao
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Yong Liu
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Jianguo Shi
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
- Department of Functional Neurosurgery, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
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Yu K, Hao L, Bu F, Guo Y, Duan Y, Hu R, Lu J, Li P. Knowledge structure and emerging trends of cognitive impairment induced by sleep deprivation: A bibliometric analysis based on CiteSpace and VOSviewer from 2000 to 2022. Medicine (Baltimore) 2023; 102:e34776. [PMID: 37800755 PMCID: PMC10552981 DOI: 10.1097/md.0000000000034776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/26/2023] [Indexed: 10/07/2023] Open
Abstract
This paper implements a bibliometric approach to investigate the research hotspots and future research directions in the relevant field literature. It also offers research ideas and methods for preventing and treating cognitive impairment induced by sleep deprivation in the clinical setting. The evolution of various clusters in the field is summarized through Citespace's projection function for keywords in the literature. CiteSpace and Vosviewer are utilized to analyze and visualize the attributes of the articles, including number of publications, citation frequency, country/region, institution, journal, authors, keywords, and references, from the 2280 publications obtained. A total of 2280 publications were collected, with the number of papers and citations in the field continuously increasing year by year. The most influential country in this field is the United States, and the University of Washington is the most influential institution. The most authoritative journal in the field is identified as SLEEP. Sleep deprivation, prefrontal cortex, and performance are the current topics of interest. The article with the strongest citation burst, lasting from 2015 to 2018, is "Sleep Drives Metabolite Clearance from the Adult Brain." The most influential article and co-cited reference, "Neurocognitive Consequences of Sleep Deprivation," highlights that sleep deprivation from various causes may lead to cognitive impairment. Future research should investigate all forms of cognitive impairment resulting from sleep deprivation. The findings of this study will assist researchers in improving their knowledge structure, identifying research hotspots, and revealing future directions in the field.
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Affiliation(s)
- Kai Yu
- The First Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
- Urology Department, The First Hospital of Jilin University Changchun, Changchun, China
| | - Lei Hao
- Department of Pathophysiology, Inner Mongolia Medical University, Inner Mongolia, China
| | - Fan Bu
- The First Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Yuanzhi Guo
- The First Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Yaqi Duan
- The First Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Rui Hu
- Urology Department, The First Hospital of Jilin University Changchun, Changchun, China
| | - Ji Lu
- Urology Department, The First Hospital of Jilin University Changchun, Changchun, China
| | - Peng Li
- The First Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
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Lee W, Kang S, Kim S, Lee S, Myung W, Jheon K, Yoon C, Suh J, Youn T, Chae I. Impact of dementia and drug compliance on patients with acute myocardial infarction. Clin Cardiol 2023; 46:1253-1259. [PMID: 37488767 PMCID: PMC10577568 DOI: 10.1002/clc.24091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND In South Korea, the number of people with dementia is rising at a worrisome rate, and many of them also have acute myocardial infarction (AMI), a disease with a high mortality rate. HYPOTHESIS We speculated that dementia and drug compliance have significant impact on the mortality of patients with AMI. METHODS The study derived data from the National Health Insurance Service-Senior for a retrospective cohort study. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16 835, among whom 2021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence. RESULTS AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (hazard ratio [HR]: 2.49; 95% confidence interval [CI]: 2.34-2.66; p < .001) and lower MPR (aspirin: 21.9% vs. 42.8%; p < .001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence, followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53-1.75; p < .001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49-1.71; p < .001) had a significant association with all-cause mortality in AMI patients. CONCLUSIONS AMI patients with dementia have a higher mortality rate. Their prognosis is negatively affected by their poorer medication adherence than patients without dementia.
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Affiliation(s)
- Wonjae Lee
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Si‐Hyuck Kang
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Sun‐Hwa Kim
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Seung‐Yeon Lee
- International Healthcare CenterSeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Woojae Myung
- Department of PsychiatrySeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Ki‐Hyun Jheon
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Chang‐Hwan Yoon
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Jung‐Won Suh
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Tae‐Jin Youn
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - In‐Ho Chae
- Department of Internal Medicine, Division of CardiologyCardiovascular Center, Seoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
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Simon P, Agli O. [All on stage: Exploratory study of the use of improvisational theatre in nursing home]. Geriatr Psychol Neuropsychiatr Vieil 2023; 21:376-383. [PMID: 38093574 DOI: 10.1684/pnv.2023.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Supporting an elderly person with a neuro-evolutionary disease is a complex task, especially if the person has cognitive problems and lives in a nursing home. Non-drug approaches offer good alternatives to traditional treatment and care. More and more therapies based on theatrical improvisation are being developed to act on psychological health. The aim of this research is to study the effect of participation in theatrical improvisation workshops over a period of 8 weeks on quality of life, self-esteem, depressive symptoms and personal satisfaction in 10 elderly people (Mean = 87.70 years; SD = 2.87 years) with mild cognitive impairment. At the end of the theatre sessions, the participants reported better psychological health. This study provides insights into the development of non-drug mediations for elderly people with neuro-evolutionary diseases.
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Affiliation(s)
- Pauline Simon
- étudiante en psychologie dans le master de gérontologie, Université Toulouse Jean-Jaurès, Toulouse, France
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14
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Shi S, Zhang S, Kong L. Effects of Treatment with Probiotics on Cognitive Function and Regulatory Role of Cortisol and IL-1β in Adolescent Patients with Major Depressive Disorder. Life (Basel) 2023; 13:1829. [PMID: 37763233 PMCID: PMC10532456 DOI: 10.3390/life13091829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/14/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this study was to investigate the effects of probiotics on cognitive function and the regulation of cortisol and IL-1β in adolescents with depression. All 180 participants were randomly assigned to a study group (treated with probiotics combined with sertraline hydrochloride) and a control group (treated with sertraline hydrochloride). The repetitive Neuropsychological State Test (RBANS) and Hamilton Depression Scale (HAMD) were administered to MDD patients. The levels of serum cortisol and IL-1β were detected using an ELISA kit. Except for speech function, factors including immediate memory, visual span, attention function, delayed memory, and the RBANS in the study group were significantly higher than those in the control group. The levels of cortisol and interleukin-1β in the study group were significantly downregulated compared to those in the control group. Except for speech function, the cortisol level was negatively correlated with the RBANS total score and other factors in the study group. Interleukin-1β was also negatively correlated with the RBANS total score and each factor score. Cortisol and interleukin-1β were predictors of the RBANS total score, which explained 46.80% of the variance. Cortisol had significant predictive effects on attention function and delayed memory, and interleukin-1β had significant predictive effects on visual span and speech function. It could be concluded that probiotics could improve cognitive function in adolescents with depression by regulating cortisol and IL-1β levels.
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Affiliation(s)
- Shaoli Shi
- Psychiatry Department, The 5th People’s Hospital of Luoyang, Luoyang 471027, China;
| | - Shuyou Zhang
- Intervention Center of Mental Crisis, No.904 Hospital, Changzhou 213003, China;
| | - Lingming Kong
- Intervention Center of Mental Crisis, No.904 Hospital, Changzhou 213003, China;
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15
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Destrebecq V, Naeije G. Cognitive impairment in essential tremor assessed by the cerebellar cognitive affective syndrome scale. Front Neurol 2023; 14:1224478. [PMID: 37662041 PMCID: PMC10473101 DOI: 10.3389/fneur.2023.1224478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Essential tremor (ET) is a movement disorder characterized by cerebellar neurodegenerative changes. ET is also associated with non-motor symptoms including cognitive impairment. The neuropsychologic profile of a patient with ET could relate to cerebellar cognitive affective syndrome (CCAS). Objective This study aimed to assess the prevalence of cognitive impairment in patients with ET and identify whether the cognitive impairment in ET corresponds to a CCAS. Methods Cognitive functions were evaluated with the CCAS-Scale (CCAS-S) in 20 patients with ET and 20 controls matched for age, sex, and level of education. The results of the CCAS-S were compared between patients and controls. The underlying determinant of CCAS inpatients with ET was identified through the correlation between the results of the CCAS-S and age at onset of symptoms, disease duration, and the Essential Tremor Rating Assessment Scale (TETRAS). Results On a group level, ET patients performed significantly worse than matched controls. In total, 13 individuals with ET had a definite CCAS (CCAS-S failed items ≥ 3). ASO and TETRAS scores significantly correlated with CCAS-S performances in ET patients. Conclusion CCAS is highly prevalent in patients with ET which supports the cerebellar pathophysiology of associated cognitive impairment and supports a more systematic use of the CCAS-S to cognitively assessed patients with ET.
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Affiliation(s)
- Virginie Destrebecq
- Clinique Universitaire de Bruxelles (CUB) Hôpital Erasme, Department of Neurology, Université Libre de Bruxelles, Brussels, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie translationnelles, UNI-ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Gilles Naeije
- Clinique Universitaire de Bruxelles (CUB) Hôpital Erasme, Department of Neurology, Université Libre de Bruxelles, Brussels, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie translationnelles, UNI-ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
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Erokhina OA, Voloshina IG, Koroleva KY, Nadutkina IE, Svishcheva IK. [The analysis of problems of supporting long-term nursing of individuals who lost their ability to self-care in Russia]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:587-593. [PMID: 37642101 DOI: 10.32687/0869-866x-2023-31-4-587-593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/13/2023] [Indexed: 08/31/2023]
Abstract
The article presents results of research study intended for identifying degree of cognitive impairment in elderly citizen residing in conditions of institution of stationary social support. The study was conducted in a multidisciplinary rehabilitation institution of social services. The obtained results confirmed necessity to organize primary preventive work and permitted to test program of correctional classes with elderly people having cognitive impairments. The comparative analysis of results of primary and control diagnostics testifies that efficiency of corrective impact depends on degree of cognitive impairment and beginning time of correctional work. The early correction of cognitive abnormality of light and moderate degree is the most successful. It actualizes issues of timely diagnosis of cognitive abnormalities in elderly people and necessity to develop activities of primary prevention of dementia.
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Affiliation(s)
- O A Erokhina
- The Federal State Autonomous Educational Institution of Higher Education "The Belgorod State National Research University", 308015, Belgorod, Russia
| | - I G Voloshina
- The Federal State Autonomous Educational Institution of Higher Education "The Belgorod State National Research University", 308015, Belgorod, Russia
| | - K Yu Koroleva
- The Federal State Autonomous Educational Institution of Higher Education "The Belgorod State National Research University", 308015, Belgorod, Russia,
| | - I E Nadutkina
- The Federal State Autonomous Educational Institution of Higher Education "The Belgorod State National Research University", 308015, Belgorod, Russia
| | - I K Svishcheva
- The Federal State Autonomous Educational Institution of Higher Education "The Belgorod State National Research University", 308015, Belgorod, Russia
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Amendola-Pires MM, Fakoury MK, Salazar H, De Oliveira SB, Brandão-Mello CE, Schmidt SL. Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease. J Clin Med 2023; 12:3910. [PMID: 37373605 DOI: 10.3390/jcm12123910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/12/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hepatitis C virus (HCV) infection is a leading cause of liver cirrhosis, hepatocellular carcinoma, and liver-related deaths. It is estimated that 40-74% of patients with hepatitis C will experience at least one extrahepatic manifestation within their lifetime. The finding of HCV-RNA sequences in post-mortem brain tissue raises the possibility that HCV infection may affect the central nervous system and be the source of subtle neuropsychological symptoms, even in non-cirrhotic. Our investigation aimed to evaluate whether asymptomatic, HCV-infected subjects showed cognitive dysfunctions. Twenty-eight untreated asymptomatic HCV subjects and 18 healthy controls were tested using three neuropsychological instruments in a random sequence: Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association Test (COWAT), and Continuous Visual Attention Test (CVAT). We performed depression screening, liver fibrosis assessment, blood tests, genotyping, and HCV-RNA viral load. A MANCOVA and univariate ANCOVAS were performed to examine group differences (HCV vs. healthy controls) in four scores of the CVAT (omission errors, commission errors, reaction time-RT, and variability of RT-VRT), and the scores derived from the SDMT, and the COWAT. A discriminant analysis was performed to identify which test variables effectively discriminate HCV-infected subjects from healthy controls. There were no group differences in the scores of the COWAT, SDMT, and in two variables of the CVAT (omission and commission errors). In contrast, the performance of the HCV group was poorer than the controls in RT (p = 0.047) and VRT (p = 0.046). The discriminant analysis further indicated that the RT was the most reliable variable to discriminate the two groups with an accuracy of 71.7%. The higher RT exhibited by the HCV group may reflect deficits in the intrinsic-alertness attention subdomain. As the RT variable was found to be the best discriminator between HCV patients and controls, we suggest that intrinsic-alertness deficits in HCV patients may affect the stability of response times increasing VRT and leading to significant lapses in attention. In conclusion, HCV subjects with mild disease showed deficits in RT and intraindividual VRT as compared to healthy controls.
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Affiliation(s)
- Marcia Maria Amendola-Pires
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
- Gastroenterology & Liver Unit, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
| | - Max K Fakoury
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
- Gastroenterology & Liver Unit, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
- Internal Medicine Department, Gaffrée e Güinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
| | - Hellen Salazar
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
| | - Silvia B De Oliveira
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
| | - Carlos Eduardo Brandão-Mello
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
- Gastroenterology & Liver Unit, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
- Internal Medicine Department, Gaffrée e Güinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
| | - Sergio L Schmidt
- Postgraduate Program in Neurology, Neurobehavioral Laboratory, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-901, Brazil
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Kim KS, Ahn S, Han JW, Cho SH, Lee JT, Lee HJ, Kim KW. Oral health and risk of cognitive disorders in older adults: A biannual longitudinal follow-up cohort. J Oral Rehabil 2023. [PMID: 37159220 DOI: 10.1111/joor.13486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/06/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Oral health may be associated with cognitive disorders such as mild cognitive impairment or dementia. OBJECTIVE This study elucidates the effects of oral health conditions on the progression of cognitive disorders. METHODS Data were collected from 153 participants of the Korean Longitudinal Study on Cognitive Aging and Dementia cohort who completed the longitudinal dental examinations and cognitive function assessments using the three-wave biannual survey. We analyzed the relationship between dental factors and the conversion of cognitive function. RESULTS The ratio of maxillary removable partial denture use (p = 0.03) was high in the converter and mild cognitive impairment/dementia groups. The low-grade ratio of posterior masticatory performance increased in the converter and mild cognitive impairment/dementia groups (modified Eichner index 2, p = 0.04). The mild cognitive impairment/dementia group had a higher rate of complete mandibular denture use (p < 0.001). The converter and mild cognitive impairment/dementia groups had fewer remaining teeth (p < 0.05) or removable prostheses (p < 0.01) than the normal group. CONCLUSIONS Masticatory performance is associated with the conversion of cognitive disorders. Our findings suggest that oral health management can help delay the progression of cognitive disorders.
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Affiliation(s)
- Keun-Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
| | - Sang Hyun Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
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Song L, Liu X, Yang W, Chen Q, Lv H, Yang Z, Liu W, Wang H, Wang Z. Altered Resting-State Functional Networks in Nondialysis Patients with Stage 5 Chronic Kidney Disease: A Graph-Theoretical Analysis. Brain Sci 2023; 13:brainsci13040628. [PMID: 37190593 DOI: 10.3390/brainsci13040628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
This study aimed to investigate the topological characteristics of the resting-state functional network and the underlying pathological mechanism in nondialysis patients with stage 5 chronic kidney disease (CKD5 ND). Eighty-five subjects (21 patients with CKD5 ND, 32 patients with CKD on maintenance hemodialysis (HD), and 32 healthy controls (HCs)) underwent laboratory examinations, neuropsychological tests, and brain magnetic resonance imaging. The topological characteristics of networks were compared with a graph-theoretical approach, and correlations between neuropsychological scores and network properties were analyzed. All participants exhibited networks with small-world attributes, and global topological attributes were impaired in both groups of patients with CKD 5 (ND and HD) compared with HCs (p < 0.05); these impairments were more severe in the CKD5 ND group than in the HD group (p < 0.05). Compared with the HC group, the degree centrality of the CKD5 ND group decreased mainly in the basal ganglia and increased in the bilateral orbitofrontal gyrus, bilateral precuneus, and right cuneus. Correlation analysis showed that the degree of small-worldness, normalized clustering coefficients, and Montreal Cognitive Assessment (MoCA) scores were positively correlated and that characteristic path length was negatively correlated with these variables in patients with CKD5 ND. The nodal efficiency of the bilateral putamen (r = 0.53, p < 0.001 and r = 0.47, p < 0.001), left thalamus (r = 0.37, p < 0.001), and right caudate nucleus (r = 0.28, p = 0.01) was positively correlated with MoCA scores. In conclusion, all CKD5 ND patients exhibited changes in functional network topological properties and were closely associated with mild cognitive impairment. More interestingly, the topological property changes in CKD5 ND patients were dominated by basal ganglia areas, which may be more helpful to understand and possibly reveal the underlying pathological mechanisms of cognitive impairment in CKD5 ND.
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Affiliation(s)
- Lijun Song
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Xu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Wenbo Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
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20
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Beichler H, Grabovac I, Dorner TE. Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS. Int J Environ Res Public Health 2023; 20:3374. [PMID: 36834069 PMCID: PMC9965658 DOI: 10.3390/ijerph20043374] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disciplines. HIV/AIDS poses challenges to both patients and health care professionals within the framework of care due to frequent visits to physicians, avoidable hospitalizations, comorbidities, complications, and the resulting polypharmacy. The concepts of integrated care (IC) represent sustainable approaches to solving the complex care situation of PLWH. AIMS This study aimed to describe the national and international models of integrated care and their benefits regarding PLWH as complex, chronically ill patients in the health care system. METHODS We conducted a narrative review of the current national and international innovative models and approaches to integrated care for people with HIV/AIDS. The literature search covered the period between March and November 2022 and was conducted in the databases Cinahl, Cochrane, and Pubmed. Quantitative and qualitative studies, meta-analyses, and reviews were included. RESULTS The main findings are the benefits of integrated care (IC) as an interconnected, guideline- and pathway-based multiprofessional, multidisciplinary, patient-centered treatment for PLWH with complex chronic HIV/AIDS. This includes the evidence-based continuity of care with decreased hospitalization, reductions in costly and burdensome duplicate testing, and the saving of overall health care costs. Furthermore, it includes motivation for adherence, the prevention of HIV transmission through unrestricted access to ART, the reduction and timely treatment of comorbidities, the reduction of multimorbidity and polypharmacy, palliative care, and the treatment of chronic pain. IC is initiated, implemented, and financed by health policy in the form of integrated health care, managed care, case and care management, primary care, and general practitioner-centered concepts for the care of PLWH. Integrated care was originally founded in the United States of America. The complexity of HIV/AIDS intensifies as the disease progresses. CONCLUSIONS Integrated care focuses on the holistic view of PLWH, considering medical, nursing, psychosocial, and psychiatric needs, as well as the various interactions among them. A comprehensive expansion of integrated care in primary health care settings will not only relieve the burden on hospitals but also significantly improve the patient situation and the outcome of treatment.
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Affiliation(s)
- Helmut Beichler
- Nursing School, Vienna General Hospital, Medical University of Vienna, 1090 Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Academy for Ageing Research, Haus der Barmherzigkeit, 1090 Vienna, Austria
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21
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Taïb S, Yrondi A, Lemesle B, Péran P, Pariente J. What are the neural correlates of dissociative amnesia? A systematic review of the functional neuroimaging literature. Front Psychiatry 2023; 14:1092826. [PMID: 36778638 PMCID: PMC9909275 DOI: 10.3389/fpsyt.2023.1092826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
AIM Dissociative amnesia is an emblematic psychiatric condition in which patients experience massive memory loss ranging from focal to global amnesia. This condition remains poorly understood and this review aims to investigate the neuroanatomical feature of this disease. METHODS We conducted a systematic review of the scientific literature available on PubMed, up to December 1, 2022, using a combination of keywords referring to dissociative amnesia. We included every scientific report involving patients undergoing a functional imaging procedure. RESULTS Twenty-two studies met our inclusion criteria (gathering 49 patients). Only one was a controlled study with a large sample. The other 21 were case reports and case series. In resting state, neuroimaging studies mostly showed a hypo-activated right inferolateral prefrontal cortex, associated with limbic hypoactivity and lesser activation of the hippocampal and para-hippocampal structures. The patients also presented abnormal patterns of cerebral activation when performing memory tasks. When testing recognition of memories from the amnestic period, patients showed increased activation across temporal areas (hippocampal and para-hippocampal gyri) and the limbic network. When trying to recollect memories from an amnestic period compared to a non-amnestic period, patients failed to activate these structures efficiently. Most of these patterns tended to return to normal when symptoms resolved. CONCLUSION This review identified a paucity of controlled studies in the field of dissociative amnesia neuroimaging, which restricts the extrapolation of results. Patients with dissociative amnesia present a broad prefronto-temporo-limbic network dysfunction. Some of the brain areas implicated in this network might represent potential targets for innovative treatments.
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Affiliation(s)
- Simon Taïb
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Service de Psychiatrie, Psychothérapie et Art-Thérapie, Centre Expert du Stress Traumatique, CHU de Toulouse, Toulouse, France
| | - Antoine Yrondi
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Service Universitaire de Psychiatrie et Psychologie Médicale, CHU de Toulouse, Toulouse, France
| | | | - Patrice Péran
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France
| | - Jérémie Pariente
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Pôle Neurosciences, CHU de Toulouse, Toulouse, France
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22
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Tacchino A, Podda J, Bergamaschi V, Pedullà L, Brichetto G. Cognitive rehabilitation in multiple sclerosis: Three digital ingredients to address current and future priorities. Front Hum Neurosci 2023; 17:1130231. [PMID: 36908712 PMCID: PMC9995764 DOI: 10.3389/fnhum.2023.1130231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
Multiple sclerosis (MS) is a neurological chronic disease with autoimmune demyelinating lesions and one of the most common disability causes in young adults. People with MS (PwMS) experience cognitive impairments (CIs) and clinical evidence shows their presence during all MS stages even in the absence of other symptoms. Cognitive rehabilitation (CR) aims at reducing CI and improving PwMS' awareness of cognitive difficulties faced in their daily living. More defined cognitive profiles, easier treatment access and the need to transfer intervention effects into everyday life activities are aims of utmost relevance for CR in MS. Currently, advanced technologies may pave the way to rethink CR in MS to address the priority of more personalized and effective, accessible and ecological interventions. For this purpose, digital twins, tele-cognitive-rehabilitation and metaverse are the main candidate digital ingredients. Based on scientific evidences, we propose digital twin technology to enhance MS cognitive phenotyping; tele-cognitive-rehabilitation to make feasible the cognitive intervention access to a larger number of PwMS; and metaverse to represent the best choice to train real-world dual- and multi-tasking deficits in virtual daily life environments. Moreover, multi-domain high-frequency big-data collected through tele-cognitive-assessment, tele-cognitive-rehabilitation, and metaverse may be merged to refine artificial intelligence algorithms and obtain increasingly detailed patient's cognitive profile in order to enhance intervention personalization. Here, we present how these digital ingredients and their integration could be crucial to address the current and future needs of CR facilitating the early detection of subtle CI and the delivery of increasingly effective treatments.
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Affiliation(s)
- Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Valeria Bergamaschi
- AISM Rehabilitation Center Liguria, Italian Multiple Sclerosis Society (AISM), Genoa, Italy
| | - Ludovico Pedullà
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.,AISM Rehabilitation Center Liguria, Italian Multiple Sclerosis Society (AISM), Genoa, Italy
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23
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Saita K, Amano S, Kaneko F, Okamura H. A scoping review of cognitive assessment tools and domains for chemotherapy-induced cognitive impairments in cancer survivors. Front Hum Neurosci 2023; 17:1063674. [PMID: 36891148 PMCID: PMC9987518 DOI: 10.3389/fnhum.2023.1063674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Backgrounds Cancer survivors suffer from specific symptoms known as chemotherapy-induced cognitive impairments (CICIs). CICIs are difficult to capture with existing assessments such as the brief screening test for dementia. Although recommended neuropsychological tests (NPTs) exist, international consensus and shared cognitive domains of assessment tools are unknown. The aim of this scoping review was as follows: (1) to identify studies that assess CICIs in cancer survivors; (2) to identify shared cognitive assessment tools and domains by mapping the domains reported in studies using the International Classification of Functioning, Disability and Health (ICF) framework. Methods The study followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched the following three databases through October 2021: PubMed, CINAHL, and Web of Science. Prospective longitudinal or cross-sectional studies were selected to determine CICI-specific assessment tools for adult cancer survivors. Results Sixty-four prospective studies (36 longitudinal studies and 28 cross-sectional studies) were included after checking for eligibility. The NPTs were divided into seven main cognitive domains. The specific mental functions were often used in the order of memory, attention, higher-level cognitive functions, and psychomotor functions. Perceptual functions were used less frequently. In some ICF domains, shared NPTs were not clearly identified. In some different domains, the same NPTs were used, such as the trail making test and the verbal fluency test. When the association between the publishing year and the amount of NPT use was examined, it was found that the amount of tool use tended to decline over the publication years. The Functional Assessment of Cancer Therapy-Cognitive function (FACT-Cog) was a shared consensus tool among the patient-reported outcomes (PROs). Conclusion Chemotherapy-induced cognitive impairments are currently gaining interest. Shared ICF domains such as memory and attention were identified for NPTs. There was a gap between the publicly recommended tools and the tools actually used in the studies. For PROs, a clearly shared tool, FACT-Cog, was identified. Mapping the domains reported in studies using the ICF can help in the process of reviewing consensus on which NPTs may be used to target cognitive domains. Systematic review registration https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053710, identifier UMIN000047104.
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Affiliation(s)
- Kazuya Saita
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoru Amano
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Fumiko Kaneko
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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24
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Chen X, Zhang W, Lin Z, Zheng C, Chen S, Zhou H, Liu Z. Preliminary evidence for developing safe and efficient fecal microbiota transplantation as potential treatment for aged related cognitive impairments. Front Cell Infect Microbiol 2023; 13:1103189. [PMID: 37113132 PMCID: PMC10127103 DOI: 10.3389/fcimb.2023.1103189] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/17/2023] [Indexed: 04/29/2023] Open
Abstract
Background Recent studies have reported that gut microbiota is closely associated with cognitive fuction. Fecal microbiota transplantation (FMT) may be a potential treatment for cognitive impairment, but its efficacy in patients with cognitive impairment is unknown. Objectives This study aimed to investigate the safety and efficacy of FMT for cognitive impairment treatment. Methods Five patients aged 54-80 years (three women) were enrolled in this single-arm clinical trial from July 2021 to May 2022. The Montreal Cognitive Assessment-B (MoCA-B), Activities of Daily Living (ADL), and the cognitive section of the Alzheimer's Disease Assessment Scale (ADAS-Cog) were assessed at days 0, 30, 60, 90, and 180. Additionally, stool and serum samples were obtained twice before FMT was administered and six months after the treatment. The structure of fecal microbiota was analyzed by 16S RNA gene sequencing. Serum samples were analyzed for metabolomics and lipopolysaccharide (LPS)-binding proteins by liquid chromatography-mass spectrometry and enzyme-linked immunosorbent assay, respectively. Safety was assessed based on adverse events, vital signs, and laboratory parameters during FMT and the follow-up period. Results The MoCA, ADL, and ADAS-Cog scores of patients with mild cognitive impairment (patients C and E) after FMT were improved or maintained compared with those before transplantation. However, patients with severe cognitive impairment (patients A, B, and D) had no worsening of cognitive scores. Fecal microbiota analysis showed that FMT changed the structure of gut microbiota. The results of serum metabolomics analysis suggested that there were significant changes in the serum metabolomics of patients after FMT, with 7 up-regulated and 28 down-regulated metabolites. 3b,12a-dihydroxy-5a-cholanoic acid, 25-acetylvulgaroside, deoxycholic acid, 2(R)-hydroxydocosanoic acid, and P-anisic acid increased, while bilirubin and other metabolites decreased. KEFF pathway analysis indicated that the main metabolic pathways were bile secretion and choline metabolism in cancer. No adverse effects were reported throughout the study. Conclusions In this pilot study, FMT could maintain and improve cognitive function in mild cognitive impairment by changing gut microbiota structure and affecting serum metabolomics. Fecal bacteria capsules were safe. However, further studies are needed to evaluate the safety and efficacy of fecal microbiota transplantation. ClinicalTrials.gov Identifier: CHiCTR2100043548.
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Affiliation(s)
| | | | | | | | | | | | - Zhou Liu
- *Correspondence: Haihong Zhou, ; Zhou Liu,
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25
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Quan W, Lin Y, Zou H, Li M, Luo J, He Z, Chen J, Liu Z. Can habitual tea drinking be an effective approach against age-related neurodegenerative cognitive disorders: A systematic review and meta-analysis of epidemiological evidence. Crit Rev Food Sci Nutr 2022:1-17. [PMID: 36579429 DOI: 10.1080/10408398.2022.2158780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Our present knowledge about the efficacy of tea consumption in improving age-related cognitive disorders is incomplete since previous epidemiological studies provide inconsistent evidence. This unified systematic review and meta-analysis based on updated epidemiological cohort studies and randomized controlled trials (RCTs) evidence aimed to overcome the limitations of previous reviews by examining the efficacy of distinct types of tea consumption. PubMed, Embase, and MEDLINE were searched up to May 20, 2022, and 23 cohorts and 12 cross-sectional studies were included. Random-effects meta-analyses were conducted to obtain pooled RRs or mean differences with 95% CIs. The pooled RRs of the highest versus lowest tea consumption categories were 0.81 (95% CIs: 0.75-0.88) and 0.69 (95% CIs: 0.61-0.77), respectively. The pooled mean difference of four included RCTs revealed a beneficial effect of tea on cognitive dysfunction (MMSE ES: 1.03; 95% CI, 0.14-1.92). Subgroup analyses further demonstrated that green and black tea intake was associated with a lower risk of cognitive disorders in eastern countries, especially in women. The evidence quality was generally low to moderate. The present review provides insight into whether habitual tea consumption can be an effective approach against age-related neurodegenerative cognitive disorders and summarizes potential mechanisms based on currently published literature.
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Affiliation(s)
- Wei Quan
- College of Food Science and Technology, Hunan Agricultural University, Changsha, Hunan, China
- National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Yong Lin
- National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Huiyu Zou
- College of Food Science and Technology, Hunan Agricultural University, Changsha, Hunan, China
| | - Maiquan Li
- College of Food Science and Technology, Hunan Agricultural University, Changsha, Hunan, China
- National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
| | - Jie Luo
- College of Food Science and Technology, Hunan Agricultural University, Changsha, Hunan, China
| | - Zhiyong He
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Jie Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
- International Joint Laboratory on Food Safety, Jiangnan University, Wuxi, Jiangsu, China
| | - Zhonghua Liu
- National Research Center of Engineering Technology for Utilization of Functional Ingredients from Botanicals, Hunan Agricultural University, Changsha, Hunan, China
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26
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Secades JJ, Gareri P. Citicoline: pharmacological and clinical review, 2022 update. Rev Neurol 2022; 75:S1-S89. [PMID: 36544369 PMCID: PMC10548481 DOI: 10.33588/rn.75s05.2022311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Indexed: 12/24/2022]
Abstract
This review is based on the previous one published in 2016 (Secades JJ. Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol 2016; 63 (Supl 3): S1-S73), incorporating 176 new references, having all the information available in the same document to facilitate the access to the information in one document. This review is focused on the main indications of the drug, as acute stroke and its sequelae, including the cognitive impairment, and traumatic brain injury and its sequelae. There are retrieved the most important experimental and clinical data in both indications.
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Affiliation(s)
- Julio J. Secades
- Medical Department. Grupo Ferrer, S.A.
Barcelona, SpainMedical DepartmentGrupo Ferrer, S.A.BarcelonaSpain
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia -
Catanzaro Lido. ASP Catanzaro. Catanzaro, ItalyCenter for Cognitive Disorders and Dementia -
Catanzaro LidoCenter for Cognitive Disorders and Dementia -
Catanzaro LidoCatanzaroItaly
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27
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Abstract
Previous studies have revealed that Berberine (BBR) had therapeutic effects on Alzheimer's disease (AD). However, the underlying mechanism of BBR in the treatment of AD is unclear. The study was to investigate whether berberine ameliorates cognitive disorder in AD by regulating on GSK3β/PGC-1α signaling pathway. APP/PS1 mice were treated with BBR (50 mg/kg and 100 mg/kg) for 4 mo, and the cognitive function of mice was tested by Morris water maze. The levels of inflammatory cytokines IL-1β, TNF-α, and IL-6 in hippocampus of mice were detected by ELISA kits. The damage of neuronal in hippocampal CA1 was detected by Nissl staining. The tau and GSK3β protein were detected by western blot. The results showed that BBR treatment obviously improved spatial cognitive function of APP/PS1 mice. Meanwhile, the pro-inflammatory cytokines were decreased in hippocampus by the administration of BBR. Additionally, BBR significantly alleviated neuronal damage and reduced the levels of hyperphosphorylated tau at sites of Thr205 and Thr231 in hippocampus. Importantly, BBR inhibited the activity of GSK3β and increased the expression of PGC-1α. Consequently, our results demonstrates that BBR could improve the cognitive function by inhibiting the tau hyperphosphorylation and neuroinflammation. These beneficial effects of BBR may be attributed to the regulation of GSK3β/PGC-1α signaling pathway in APP/PS1 mice. These findings reveal a vital role for GSK3β/PGC-1α signaling pathway in retarding cognitive disorder, indicating that PGC-1α might be a potential target for the treatment of AD.
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Affiliation(s)
- Meng Yang
- College of Pharmaceutical Engineering, Jiangsu Food & Pharmaceutical Science College
| | - Jing Wang
- College of Pharmaceutical Engineering, Jiangsu Food & Pharmaceutical Science College
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28
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Liu P, Zhou X, Zhang H, Wang R, Wu X, Jian W, Li W, Yuan D, Wang Q, Zhao W. Danggui-Shaoyao-San Attenuates Cognitive Impairment via the Microbiota-Gut-Brain Axis With Regulation of Lipid Metabolism in Scopolamine-Induced Amnesia. Front Immunol 2022; 13:796542. [PMID: 35664001 PMCID: PMC9162091 DOI: 10.3389/fimmu.2022.796542] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/28/2022] [Indexed: 01/09/2023] Open
Abstract
Danggui-Shaoyao-San (DSS) has a long history of being used as a traditional medicine (TCM) and has been reported to show therapeutic effects in alleviating the symptoms of cognitive impairment. The purpose of this study was to investigate whether DSS treatment attenuates cognitive impairment via the microbiota–gut–brain axis in scopolamine-induced amnesia. In this work, we first performed the Morris water maze (MWM) test and novel object recognition (NOR) test to evaluate the memory function of treated C57BL/6N mice. Then we evaluated 16S rRNA for gut microbiota analysis, as well as assessment of blood–brain barrier function and intestinal barrier function and lipid metabolism analysis on tissues from different groups. We hypothesised that DSS may affect brain function and behavior through the gut–brain axis in a bidirectional interplay with both top-down and bottom-up regulation. Furthermore, in order to confirm whether intestinal flora plays a crucial role in scopolamine-induced amnesia, C57BL/6N mice were treated with fecal microbial transplantation (FMT), and then behavioral tests were performed. The mice’s feces were simultaneously evaluated by 16S rRNA analysis. The result supported that the FMT-induced improvement in cognitive function highlights the role of the gut microbiota–brain axis to mediate cognitive function and behavior. Besides theses works, more findings indicated that DSS altered lipid metabolism by activating LXR-PPAR-γ and repaired mucosal barrier dysfunction assessed with a broad range of techniques, which attenuated cognitive impairment via the microbiota–gut–brain axis.
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Affiliation(s)
- Piaoxue Liu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xun Zhou
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoran Zhang
- Gastrointestinal Surgery Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaolang Wu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenxuan Jian
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weirong Li
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongsheng Yuan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Zhao
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
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29
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Li W, Wen Q, Xie YH, Hu AL, Wu Q, Wang YX. Improvement of poststroke cognitive impairment by intermittent theta bursts: A double-blind randomized controlled trial. Brain Behav 2022; 12:e2569. [PMID: 35484991 PMCID: PMC9226849 DOI: 10.1002/brb3.2569] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS) is known to improve cognitive impairment caused by Alzheimer's disease and Parkinson's disease, but studies are lacking with respect to the efficacy of iTBS on poststroke cognitive impairment (PSCI). OBJECTIVE This study was conducted to investigate the effect of left dorsolateral prefrontal cortex (DLPFC) iTBS on improving cognitive function in stroke patients. METHODS Fifty-eight patients with PSCI are randomly divided into iTBS (n = 28) and sham stimulation groups (n = 30). Both groups receive routine cognitive-related rehabilitation. The iTBS group is treated with iTBS intervention of the left DLPFC, and the sham stimulation group is treated with the same parameters at the same site for 2 weeks. Outcome measures are assessed at baseline (T0) and immediately after the last intervention (T1) by mini-mental state examination (MMSE), Oxford cognitive screen, and event-related potential P300. RESULTS There are no differences in baseline clinical characteristics between the two groups. After intervention, the MMSE scores and P300 amplitude increase significantly for both groups, and the P300 incubation period reduces significantly. The change value of the iTBS group is significantly higher than that of sham stimulation group (p < .05). Compared with the sham stimulation group, the iTBS group has more significant changes in semantic comprehension and executive function (p < .05). CONCLUSION iTBS can effectively and safely improve overall cognitive impairment in stroke patients, including semantic understanding and executive function, and it also has a positive impact on memory function. Future randomized controlled studies with large samples and long-term follow-up should be conducted to further validate the results of the present study.
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Affiliation(s)
- Wen Li
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Qian Wen
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | | | - An-Li Hu
- Hubei University Of Economics, WuHan, China
| | - Qing Wu
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Yin-Xu Wang
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Sichuan, China
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30
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Abstract
Aquaporin-4 (AQP4) is the most abundantly expressed aquaporin in the central nervous system (CNS) and is an integral part of the glymphatic system that cannot be ignored. The CNS has the glymphatic system instead of the conventional lymphatic system. The glymphatic system plays an essential role in the pathophysiological processes of many cognitive disorders. AQP4 shows noteworthy changes in various cognitive disorders and is part of the pathogenesis of these diseases. For this reason, AQP4 has attracted attention as a potential and promising target for regulating and even reversing cognitive dysfunction. This review will summarize the role of AQP4 in the pathophysiological processes of several cognitive disorders as reported in recent studies.
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Affiliation(s)
- Yifan Wang
- 1Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chuyi Huang
- 2Health Management Center, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai China
| | - Qihao Guo
- 1Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Heling Chu
- 1Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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31
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Abstract
Delirium is a cognitive disorder with complex etiology, which brings a great burden to social health care. Articles with high citation frequency can provide important information about the current research situation in a certain field. Web of Science was used to search the 100 most-cited articles and we extracted key information, such as the authors, countries/regions, institutions, journals, and study types of these articles. CiteSpace was used to visually analyze the keywords. Our bibliometric analysis shows that the attention in this field continues to rise. Authors from the United States published the most articles and Inouye SK is the most influential author in the field. The journals that published these articles have high impact factors. Cohort studies are the main cited articles in this field, and there are a large number of systematic reviews or meta-analyses of cohort studies. Risk factors for delirium, psychometric evaluation, hospital care, and various clinical study design are still the focus of research. In short, we summarized the 100 most-cited articles in the field of delirium to identify the current status and global trends. These results enable researchers to understand the quality and trend of research in the field of delirium and make better use of the classical literature.
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Affiliation(s)
- Xinxing Fei
- Department of Psychiatry Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, China
| | - Qiu Zeng
- Department of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jianxiong Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yaqian Gao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Fangyuan Xu
- Department of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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32
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Wang Q, Liu L, Guan H, Zhou Y, Li Q. Schizandrin A ameliorates cognitive functions via modulating microglial polarisation in Alzheimer's disease mice. Pharm Biol 2021; 59:860-867. [PMID: 34214019 PMCID: PMC8259827 DOI: 10.1080/13880209.2021.1941132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/30/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Schizandrin A (Sch A) is a major phytochemical from Schisandra chinensis (Turcz.) Baill. (Schisandraceae), which exerts a neuroprotective effect in Alzheimer's disease (AD). OBJECTIVE To investigate the mechanism of Sch A in AD. MATERIALS AND METHODS AD group: APP/PS1 transgenic mice served as AD models; AD + SCH group: APP/PS1 received 2 mg/kg Sch A by intragastric administration; WT: C57BL/6 mice were used as control. For in vitro assay, mouse microglial BV2 cells were treated with 0.5 µg/mL lipopolysaccharide or combined with 10 μmol/L Sch A for 24 h. The cognitive function and apoptosis in the mice was estimated. Microglial polarisation in the mice and cells was analysed. RESULTS Sch A treatment effectively improved spatial learning and memory ability and suppressed apoptosis in the brain tissues of APP/PS1 mice. APP/PS1 mice exhibited an increase in the levels of Aβ1-42 (2367.9 ± 431.1 pg/mg) and Aβ1-40 (1753.3 ± 253.4 pg/mg), which was abolished by Sch A treatment. Moreover, Sch A treatment repressed the proportions of iNOS+/Iba-1+ cells and IL-6 expression, while enhanced the proportions of Arg-1+/Iba-1+ cells and IL-10 expression in APP/PS1 mice. In vitro, Sch A treatment reduced the proportions of CD16/32+ cells, iNOS expression and IL-6 levels (25.7 ± 5.3 pg/mL) repressed M1 polarisation, and enhanced the proportions of CD206 cells, Arg-1 expression and IL-10 levels (75.9 ± 12.8 pg/mL) in BV2 cells. CONCLUSIONS This research confirms the neuroprotective effect of Sch A in AD, suggesting that Sch A may become a potential anti-AD agent.
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Affiliation(s)
- Qi Wang
- Teaching and Research Department of Basic Theory of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Li Liu
- Department of Cardiovascular Diseases, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Huibo Guan
- Teaching and Research Department of Basic Theory of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Yanyan Zhou
- Teaching and Research Department of Basic Theory of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Quan Li
- Hospital Office, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
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33
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Dorjee K, Kathirvel S, Jeyashree K, Dorji T, Choeda T, Pelzom D, Gurung MS, Tenzin K, Wangmo S, Penjor T. Prevalence, Pattern, and Factors Associated With Self-reported Disability Among the Bhutanese Population: A Secondary Data Analysis of Population and Housing Census. Asia Pac J Public Health 2021; 34:221-229. [PMID: 34696620 DOI: 10.1177/10105395211049856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We analyzed the Population and Health Census of Bhutan (PHCB) 2017 to assess the prevalence and pattern of self-reported disability among people aged ≥15 years and the associated factors. The PHCB 2017 used the Washington Group Short Set on Functioning questionnaire to assess the disability ("lot of difficulty" or "cannot do at all") in seeing, hearing, mobility, cognition, self-care, and communication. Of the 536 443 persons included in the analysis, 384 101(71.6%) were aged <45 years, 283 453(52.8%) were men, and 206 103(38.4%) were from the rural area. The prevalence of any self-reported disability was 2.8%, among whom 34.2% reported multiple disabilities. The disability prevalence (any) was significantly higher among people aged ≥65 years, illiterate, economically inactive, permanent residents, residing in a rural area, and from central and eastern regions of the country compared with their respective counterparts. Further research on access to rehabilitation and linking with social protection schemes for the disabled is required in this country.
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Affiliation(s)
- Kinley Dorjee
- Sustainable Development, Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Soundappan Kathirvel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, Chandigarh, India
| | | | - Thinley Dorji
- Kidu Medical Unit, His Majesty's People's Project, Thimphu, Bhutan
| | - Tshering Choeda
- Gyesar Gyalpo University of Medical Sciences, Royal Government of Bhutan, Thimphu, Bhutan
| | - Dorji Pelzom
- Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Mongal Singh Gurung
- Health Management Information System and Research Unit, Ministry of Health, Thimphu, Bhutan
| | - Karma Tenzin
- Gyesar Gyalpo University of Medical Sciences, Royal Government of Bhutan, Thimphu, Bhutan
| | | | - Tashi Penjor
- Policy and Planning Division, Ministry of Health, Bhutan
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34
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Vaismoradi M, Behboudi-Gandevani S, Lorenzl S, Weck C, Paal P. Needs Assessment of Safe Medicines Management for Older People With Cognitive Disorders in Home Care: An Integrative Systematic Review. Front Neurol 2021; 12:694572. [PMID: 34539551 PMCID: PMC8446192 DOI: 10.3389/fneur.2021.694572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: The global trend of healthcare is to improve the quality and safety of care for older people with cognitive disorders in their own home. There is a need to identify how medicines management for these older people who are cared by their family caregivers can be safeguarded. This integrative systematic review aimed to perform the needs assessment of medicines management for older people with cognitive disorders who receive care from their family caregivers in their own home. Methods: An integrative systematic review of the international literature was conducted to retrieve all original qualitative and quantitative studies that involved the family caregivers of older people with cognitive disorders in medicines management in their own home. MeSH terms and relevant keywords were used to search four online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science and to retrieve studies published up to March 2021. Data were extracted by two independent researchers, and the review process was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Given that selected studies were heterogeneous in terms of the methodological structure and research outcomes, a meta-analysis could not be performed. Therefore, narrative data analysis and knowledge synthesis were performed to report the review results. Results: The search process led to retrieving 1,241 studies, of which 12 studies were selected for data analysis and knowledge synthesis. They involved 3,890 older people with cognitive disorders and 3,465 family caregivers. Their methodologies varied and included cohort, randomised controlled trial, cross-sectional studies, grounded theory, qualitative framework analysis, and thematic analysis. The pillars that supported safe medicines management with the participation of family caregivers in home care consisted of the interconnection between older people's needs, family caregivers' role, and collaboration of multidisciplinary healthcare professionals. Conclusion: Medicines management for older people with cognitive disorders is complex and multidimensional. This systematic review provides a comprehensive image of the interconnection between factors influencing the safety of medicines management in home care. Considering that home-based medicines management is accompanied with stress and burden in family caregivers, multidisciplinary collaboration between healthcare professionals is essential along with the empowerment of family caregivers through education and support.
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Affiliation(s)
| | | | - Stefan Lorenzl
- Palliative Care, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum Agatharied, Hausham, Germany
| | - Christiane Weck
- Palliative Care, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum Agatharied, Hausham, Germany
| | - Piret Paal
- WHO Collaborating Centre at the Institute for Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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35
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Song JH, Jia HY, Shao TP, Liu ZB, Zhao YP. Hydrogen gas post-conditioning alleviates cognitive dysfunction and anxiety-like behavior in a rat model of subarachnoid hemorrhage. Exp Ther Med 2021; 22:1121. [PMID: 34504575 PMCID: PMC8383778 DOI: 10.3892/etm.2021.10555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/19/2021] [Indexed: 01/14/2023] Open
Abstract
Subarachnoid hemorrhage (SAH) results in high rates of mortality and lasting disability. Hydrogen gas (H2) is an antioxidant with demonstrated neuroprotective efficacy. The present study examined the therapeutic efficacy of H2 inhalation on early brain injury following experimental SAH in rats and the potential underlying molecular mechanisms. The rats were randomly separated into three groups (n=36 per group): Sham, SAH and SAH + H2. Endovascular perforation of the right internal carotid artery was used to establish SAH. After perforation, rats in the SAH + H2 group inhaled 2.9% H2 with regular oxygen for 2 h. Then, 24 h post-SAH, TUNEL staining was used to detect apoptotic neurons, and both immunostaining and western blotting were conducted to examine changes in p38 MAPK activity and the expression levels of apoptotic regulators (Bcl-2, Bax and cleaved caspase-3) in the ventromedial prefrontal cortex. Then, 30 day post-SAH, Nissl staining was performed to detect neuronal injury, brain MRI was conducted to detect gross changes in brain structure and metabolism, the open field test was used to assess anxiety and the novel object recognition test was performed to assess memory. H2 inhalation following experimental SAH stabilized brain metabolites, improved recognition memory and reduced anxiety-like behavior, the neuronal apoptosis rate, phosphorylated p38 MAPK expression, cleaved caspase-3 expression and the Bax/Bcl-2 ratio. Collectively, the present results suggested that H2 inhalation can alleviate SAH-induced cognitive impairment, behavioral abnormalities and neuronal apoptosis in rats, possibly via inhibition of the p38 MAPK signal pathway.
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Affiliation(s)
- Jing-Hua Song
- Department of Radioactive Intervention, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Hong-Yan Jia
- Department of Radioactive Intervention, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Tian-Peng Shao
- Department of Radioactive Intervention, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Zhi-Bao Liu
- Department of Radioactive Intervention, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Yuan-Ping Zhao
- Department of Radioactive Intervention, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
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36
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Couteau X. ['Anti-fugue' plant device, an innovative concept in gerontology]. Soins Gerontol 2021; 26:35-37. [PMID: 34462110 DOI: 10.1016/j.sger.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Plant features represent a modality of outdoor architecture that can be integrated into a project to take into account the particularities of patients and residents, and in particular those with cognitive disorders and risks of running away. The concept of a "plant-based security system" is an innovative and transposable prevention approach that reconciles the constitutional right to freedom of movement and security. A living concept illustrated by the Seilleraye EHPAD in Carquefou.
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Affiliation(s)
- Xavier Couteau
- Établissement d'accueil de personnes âgées dépendantes La Seilleraye, centre hospitalier universitaire de Nantes, pôle de gérontologie clinique, impasse Seilleraye, 44470 Carquefou, France.
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37
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Sharma V, Firdaus Z, Rai H, Nayak PK, Singh TD, Gautam DNS. Consumption of Ashtanga Ghrita (clarified cow butter added with herb extracts) improves cognitive dysfunction induced by scopolamine in rats via regulation of acetylcholinesterase activity and oxidative stress. Drug Metab Pers Ther 2021; 36:337-350. [PMID: 34109771 DOI: 10.1515/dmpt-2021-0108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/26/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Ashtanga Ghrita (AG), an Indian traditional formulation, has been used to promote neuropharmacological activities. AG is made up of clarified cow butter (ghee) and eight different herbs. METHODS To test whether scopolamine (SCP)-induced dementia and brain oxidative stress can be counteracted by AG, rats were separated into five groups (n=6/group): group one control, group two SCP (1 mg/kg b.w., i.p.) treated and group three to five were co-treated with different doses of AG (1.25, 2.5 and 5 g/kg b.w., orally) and SCP. After the treatment regimen, behavioral (Y-maze test) and brain biochemical changes were measured in all groups. RESULTS Microbial load and heavy metals were found within permissible limits. Results from attenuated total reflection Fourier-transform infrared spectroscopy demonstrated the complexation/interaction of herbal phytoconstituents with the functional groups of Ghrita. Preliminary phytochemical analysis of AG exhibited the occurrence of flavonoids, phenolics, glycosides, steroids, triterpenes, tannins, and amino acids. Findings of the experimental study exhibited that AG significantly protected the rats from SCP-induced behavioral dysfunction and brain biochemical alterations. CONCLUSIONS This study demonstrates that AG protects the brain from SCP-induced dementia by promoting brain antioxidant activity and thus could be a promising drug for the treatment of neurodegenerative disease.
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Affiliation(s)
- Vineet Sharma
- Department of Rasa Shastra & Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Zeba Firdaus
- Department of Medicinal Chemistry, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Himanshu Rai
- Department of Science and Technology-CIMS, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Prasanta Kumar Nayak
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Tryambak Deo Singh
- Department of Medicinal Chemistry, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Dev Nath Singh Gautam
- Department of Rasa Shastra & Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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38
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Guillaume C, Roche J. [Video calls to disoriented elderly persons during the COVID-19 health crisis]. Soins Gerontol 2021; 26:20-23. [PMID: 34083010 DOI: 10.1016/j.sger.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Maintaining an exchange between the disoriented elderly patient and his family circle is essential to help reduce patient anxiety. When visits are not possible, the implementation of video calls with highly disoriented individuals shows a benefit of these virtual exchanges. The introduction of new technologies, if accompanied, does not disturb the patient and does not alter the quality of the relationship.
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Affiliation(s)
- Cécile Guillaume
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France.
| | - Jean Roche
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France
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Colom J, Segura-García L, Bastons-Compta A, Astals M, Andreu-Fernandez V, Barcons N, Vidal R, Ibar AI, Fumadó V, Gómez N, Russiñol A, Garcia-Algar O. Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among Children Adopted from Eastern European Countries: Russia and Ukraine. Int J Environ Res Public Health 2021; 18:1388. [PMID: 33546212 DOI: 10.3390/ijerph18041388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023]
Abstract
Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children adopted internationally from countries where alcohol consumption during pregnancy is very high are at greater risk for FASD. Lack of expertise in diagnosing FASD and mixed neurodevelopmental and behavioral signs due to abandonment complicate a timely diagnosis. The aim of this study was to determine the prevalence of FASD in adopted children. Children between the ages of 8 and 24 adopted from Russia and Ukraine were evaluated for clinical and historical features of FASD. Of the 162 children evaluated, 81 (50%) met FASD diagnostic criteria. Thirty-three (20.4%) children had fetal alcohol syndrome (FAS), 28 (17.2%) had partial FAS, 2 (1.2%) had alcohol-related birth defects (ARBD) and 18 (11.1%) had alcohol-related neurodevelopmental disorder (ARND). Of the 81 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD if a history of maternal alcohol consumption was confirmed. In a population of children with a high risk of prenatal alcohol exposure (adoptees from Eastern European countries), at least 50% showed manifestations associated with FASD. The reported prevalence in this study is in line with the results obtained in a previous study as well as in orphanages of origin.
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40
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Lin L, Li TS. Multidisciplinary collaborative integrated management of increasingly prominent HIV complications in the post-cART era. HIV Med 2020; 21:683-691. [PMID: 33369030 PMCID: PMC7839721 DOI: 10.1111/hiv.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2020] [Indexed: 11/27/2022]
Abstract
Objectives With the prolonged survival time of AIDS patients, complications of various systems and organs of HIV infection are increasingly prominent. These diseases have become the major factors influencing the quality of life and prognosis of HIV‐infected persons, and multidisciplinary cooperation treatment is urgently needed. Methods The Chinese HIV/AIDS Clinical Trial Network has conducted a series of multicentre clinical cohort studies over the past 16 years, in which studies related to people living with HIV systemic complications. Based on the results of previous studies, this review establishes the complications of Chinese people living with HIV after long‐term cART. Results HIV’s direct damage to human cells, chronic abnormal inflammatory activation after HIV infection, long‐term drug side effects caused by cART and persistent reservoirs cause systemic complications in people living with HIV. We summarised the clinical characteristics of the complications of HIV infection in China from the aspects of the liver, cardiovascular, the nervous system, the kidney, bone metabolism, blood glucose, and lipid metabolism. Conclusions The management of the complications of HIV infection is a major link in improving the survival treatment and prognosis of patients in the future. The joint participation of doctors from different departments of general hospitals in the management of comorbidities is the main theme for future improvement of quality of life and prognosis for people living with HIV.
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Affiliation(s)
- L Lin
- Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - T S Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Center for AIDS Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Clinical Immunology Center, Chinese Academy of Medical Sciences, Beijing, China.,Tsinghua-Peking Center for Life Sciences, School of Medicine, Tsinghua University, Beijing, China
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41
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Song Y, Wang Q, Li L, Chen S, Zhao Y, Gao L. Comprehensive epigenetic analysis of m6A modification in the hippocampal injury of diabetic rats. Epigenomics 2020; 12:1811-1824. [PMID: 33112671 DOI: 10.2217/epi-2020-0125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: To study RNA N6-methyladenosine (m6A) modification in the diabetic hippocampus. Methods: Behavioral tests and staining were performed to evaluate the damage to the diabetic hippocampus in model rats. Western blotting was performed to investigate the expression of methylation-related enzymes, and flow cytometry was used to demonstrate HT22 cell apoptosis. M6A and RNA sequencing analyses were conducted to profile m6A-tagged transcripts in the diabetic hippocampus. Results: The rat models of diabetes mellitus suffered from cognitive disorders and hippocampal neuron damage. High glucose levels altered the expression of methylation-related enzymes. A total of 4890 differentially methylated m6A peaks and 63 differentially expressed genes and differentially methylated m6A sites were identified. Conclusion: The findings suggest that m6A modification is altered in the diabetic hippocampus and provide new insight into diabetic hippocampal injury.
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Affiliation(s)
- Yu Song
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Qunhui Wang
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130000, China
| | - Lei Li
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Songyu Chen
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yuhao Zhao
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130000, China
| | - Liang Gao
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
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Fu X, Qin T, Yu J, Jiao J, Ma Z, Fu Q, Deng X, Ma S. Formononetin Ameliorates Cognitive Disorder via PGC-1α Pathway in Neuroinflammation Conditions in High-Fat Diet-Induced Mice. CNS Neurol Disord Drug Targets 2020; 18:566-577. [PMID: 31389320 DOI: 10.2174/1871527318666190807160137] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/18/2019] [Accepted: 07/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Alzheimer's disease is one of the most common neurodegenerative diseases in many modern societies. The core pathogenesis of Alzheimer's disease includes the aggregation of hyperphosphorylated Tau and abnormal Amyloid-β generation. In addition, previous studies have shown that neuroinflammation is one of the pathogenesis of Alzheimer's disease. Formononetin, an isoflavone compound extracted from Trifolium pratense L., has been found to have various properties including anti-obesity, anti-inflammation, and neuroprotective effects. But there are very few studies on the treatment of Alzheimer's disease with Formononetin. OBJECTIVE The present study focused on the protective activities of Formononetin on a high-fat dietinduced cognitive decline and explored the underlying mechanisms. METHODS Mice were fed with HFD for 10 weeks and intragastric administrated daily with metformin (300 mg/kg) and Formononetin (20 and 40 mg/kg). RESULTS We found that Formononetin (20, 40 mg/kg) significantly attenuated the learning and memory deficits companied by weight improvement and decreased the levels of blood glucose, total cholesterol and triglyceride in high-fat diet-induced mice. Meanwhile, we observed high-fat diet significantly caused the Tau hyperphosphorylation in the hippocampus of mice, whereas Formononetin reversed this effect. Additionally, Formononetin markedly reduced the levels of inflammation cytokines IL-1β and TNF-α in high-fat diet-induced mice. The mechanism study showed that Formononetin suppressed the pro-inflammatory NF-κB signaling and enhanced the anti-inflammatory Nrf-2/HO-1 signaling, which might be related to the regulation of PGC-1α in the hippocampus of high-fat diet -induced mice. CONCLUSION Taken together, our results showed that Formononetin could improve the cognitive function by inhibiting neuroinflammation, which is attributed to the regulation of PGC-1α pathway in HFD-induced mice.
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Affiliation(s)
- Xinxin Fu
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Tingting Qin
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Jiayu Yu
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Jie Jiao
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Zhanqiang Ma
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Qiang Fu
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Xueyang Deng
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China
| | - Shiping Ma
- Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, 639, Longmian Road, Nanjing 21198, China.,Qinba Traditional Chinese Medicine Resources Research and Development Center, AnKang University, AnKang 725000, China
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Hubler GK, Hoffman SW, Andreadis TD, DePalma RG. Pulsed Microwave Energy Transduction of Acoustic Phonon Related Brain Injury. Front Neurol 2020; 11:753. [PMID: 32849213 PMCID: PMC7417645 DOI: 10.3389/fneur.2020.00753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/18/2020] [Indexed: 01/31/2023] Open
Abstract
Pulsed microwaves above specific energy thresholds have been reported to cause brain injury in animal models. The actual physical mechanism causing brain damage is unexplained while the clinical reality of these injuries remains controversial. Here we propose mechanisms by which pulsed microwaves may injure brain tissue by transduction of microwave energy into damaging acoustic phonons in brain water. We have shown that low intensity explosive blast waves likely initiate phonon excitations in brain tissues. Brain injury in this instance occurs at nanoscale subcellular levels as predicted by physical consideration of phonon interactions in brain water content. The phonon mechanism may also explain similarities between primary non-impact blast-induced mild Traumatic Brain Injury (mTBI) and recent clinical and imaging findings of unexplained brain injuries observed in US embassy personnel possibly due to directed radiofrequency radiation. We describe experiments to elucidate mechanisms, RF frequencies and power levels by which pulsed microwaves potentially injure brain tissue. Pathological documentation of nanoscale brain blast injury has been supported experimentally using transmission electron microscopy (TEM) demonstrating nanoscale cellular damage in the absence of gross or light microscopic findings. Similar studies are required to better define pulsed microwave brain injury. Based upon existing findings, clinical diagnosis of both low intensity blast and microwave-induced brain injury likely will require diffusion tensor imaging (DTI), a specialized water based magnetic resonance imaging (MRI) technique.
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Affiliation(s)
- Graham K Hubler
- The School of Medicine, University of Missouri, Columbia, MO, United States
| | - Stuart W Hoffman
- US Department of Veterans Affairs, Rehabilitation Research and Development Service, Office of Research and Development, Veterans Health Administration, Washington, DC, United States
| | - Tim D Andreadis
- U.S. Naval Research Laboratory, Tactical Electronic Warfare Division, Washington, DC, United States
| | - Ralph G DePalma
- US Department of Veterans Affairs, Office of Research and Development, Veterans Health Administration, Washington, DC, United States.,Department of Surgery, Uniformed University of the Health Sciences, Bethesda, MD, United States
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Kruse CS, Fohn J, Umunnakwe G, Patel K, Patel S. Evaluating the Facilitators, Barriers, and Medical Outcomes Commensurate with the Use of Assistive Technology to Support People with Dementia: A Systematic Review Literature. Healthcare (Basel) 2020; 8:E278. [PMID: 32824711 PMCID: PMC7551699 DOI: 10.3390/healthcare8030278] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 12/01/2022] Open
Abstract
Background: Assistive technologies (AT) have been used to improve the daily living conditions of people living with dementia (PWD). Research supports the positive impact of the use of AT such as decreased burden on caregivers and behavioral support for people with dementia. Four reviews in the last six years have analyzed AT and PWD, but none have incorporated the dimension of medical outcomes. Objectives: The purpose of this review is to identify the facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. Method: This review queried The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, Science Direct, and PubMed databases for peer-reviewed publications in the last five years for facilitators, barriers, and medical outcomes commensurate with the use of AT with PWD. The study is reported and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the Kruse Protocol for conducting a systematic review. Results: 48 studies were analyzed. Fourteen types of AT, 17 facilitators, 17 barriers, and 16 medical outcomes were identified in the literature. The two most frequently mentioned ATs were cognitive stimulators (9/48, 19%) and social robots (5/48, 10%). The two most frequently mentioned facilitators were caregivers want AT (8/68, 12%) and enables increased independence (7/68, 10%). The top two barriers were cost (8/75, 11%) and PWD reject AT (8/75, 11%). The top medical outcomes were improved cognitive abilities (6/69, 9%), increased activities of daily living (ADLs), and increased autonomy (each at 5/69, 7%): Zero negative outcomes were reported. Conclusion: The systematic review revealed the positive relations that occur when PWD and their caregivers use AT. Although many reservations surrounding the use of AT exist, a majority of the literature shows a positive effect of its use. Research supports a strong support for AT by caregivers due to many positive medical outcomes, but also a reticence to adopt by PWD. If ATs for PWD are a way to reduce stress on caregivers, barriers of cost and complexity need to be addressed through health policy or grants.
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Affiliation(s)
- Clemens Scott Kruse
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA; (J.F.); (G.U.); (K.P.); (S.P.)
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Wang L, Ren B, Hui Y, Chu C, Zhao Z, Zhang Y, Zhao B, Shi R, Ren J, Dai X, Liu Z, Liu X. Methionine Restriction Regulates Cognitive Function in High-Fat Diet-Fed Mice: Roles of Diurnal Rhythms of SCFAs Producing- and Inflammation-Related Microbes. Mol Nutr Food Res 2020; 64:e2000190. [PMID: 32729963 DOI: 10.1002/mnfr.202000190] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/15/2020] [Indexed: 12/11/2022]
Abstract
SCOPE Methionine restriction (MR) is known to potently alleviate inflammation and improve gut microbiome in obese mice. The gut microbiome exhibits diurnal rhythmicity in composition and function, and this, in turn, drives oscillations in host metabolism. High-fat diet (HFD) strongly altered microbiome diurnal rhythmicity, however, the role of microbiome diurnal rhythmicity in mediating the improvement effects of MR on obesity-related metabolic disorders remains unclear. METHODS AND RESULTS 10-week-old male C57BL/6J mice are fed a low-fat diet or HFD for 4 weeks, followed with a full diet (0.86% methionine, w/w) or a methionine-restricted diet (0.17% methionine, w/w) for 8 weeks. Analyzing microbiome diurnal rhythmicity at six time points, the results show that HFD disrupts the cyclical fluctuations of the gut microbiome in mice. MR partially restores these cyclical fluctuations, which lead to time-specifically enhance the abundance of short-chain fatty acids producing bacteria, increases the acetate and butyric, and dampens the oscillation of inflammation-related Desulfovibrionales and Staphylococcaceae over the course of 1 day. Notably, MR, which protects against systemic inflammation, influences brain function and synaptic plasticity. CONCLUSION MR could serve as a potential nutritional intervention for attenuating obesity-induced cognitive impairments by balancing the circadian rhythm in microbiome-gut-brain homeostasis.
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Affiliation(s)
- Luanfeng Wang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Bo Ren
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Yan Hui
- BGI Institute of Applied Agriculture, BGI-Shenzhen, Shenzhen, 518120, China.,Department of Food Science, University of Copenhagen, Copenhagen, 1958, Denmark
| | - Chuanqi Chu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Zhenting Zhao
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Yuyu Zhang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Beita Zhao
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Renjie Shi
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Junli Ren
- BGI Institute of Applied Agriculture, BGI-Shenzhen, Shenzhen, 518120, China
| | - Xiaoshuang Dai
- BGI Institute of Applied Agriculture, BGI-Shenzhen, Shenzhen, 518120, China
| | - Zhigang Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Xuebo Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
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Kazumata K, Tokairin K, Ito M, Uchino H, Sugiyama T, Kawabori M, Osanai T, Tha KK, Houkin K. Combined structural and diffusion tensor imaging detection of ischemic injury in moyamoya disease: relation to disease advancement and cerebral hypoperfusion. J Neurosurg 2020; 134:1155-1164. [PMID: 32244209 DOI: 10.3171/2020.1.jns193260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The microstructural integrity of gray and white matter is decreased in adult moyamoya disease, suggesting covert ischemic injury as a mechanism of cognitive dysfunction. Establishing a microstructural brain imaging marker is critical for monitoring cognitive outcomes following surgical interventions. The authors of the present study determined the pathophysiological basis of altered microstructural brain injury in relation to advanced arterial occlusion, cerebral hypoperfusion, and cognitive function. METHODS The authors examined 58 patients without apparent brain lesions and 30 healthy controls by using structural MRI, as well as diffusion tensor imaging (DTI). Arterial occlusion in each hemisphere was classified as early or advanced stage based on MRA and posterior cerebral artery (PCA) involvement. Regional cerebral blood flow (rCBF) was measured with N-isopropyl-p-[123I]-iodoamphetamine SPECT. Furthermore, cognitive performance was examined using the Wechsler Adult Intelligence Scale, Third Edition and the Trail Making Test (TMT). Both voxel- and region of interest-based analyses were performed for groupwise comparisons, as well as correlation analysis, using parameters such as cognitive test scores; gray matter volume; fractional anisotropy (FA) of association fiber tracts, including the inferior frontooccipital fasciculus (IFOF) and superior longitudinal fasciculus (SLF); PCA involvement; and rCBF. RESULTS Compared to the early stages, advanced stages of arterial occlusion in the left hemisphere were associated with a lower Performance IQ (p = 0.031), decreased anterior cingulate volumes (p = 0.0001, uncorrected), and lower FA in the IFOF, cingulum, and forceps major (all p < 0.01, all uncorrected). There was no significant difference in rCBF between the early and the advanced stage. In patients with an advanced stage, PCA involvement was correlated with a significantly lower Full Scale IQ (p = 0.036), cingulate volume (p < 0.01, uncorrected), and FA of the left SLF (p = 0.0002, uncorrected) compared to those with an intact PCA. The rCBF was positively correlated with FA of the SLF, IFOF, and forceps major (r > 0.34, p < 0.05). Global gray matter volumes were moderately correlated with TMT part A (r = 0.40, p = 0.003). FA values in the left SLF were moderately associated with processing speed (r = 0.40, p = 0.002). CONCLUSIONS Although hemodynamic compensation may mask cerebral ischemia in advanced stages of adult moyamoya disease, the disease progression is detrimental to gray and white matter microstructure as well as cognition. In particular, additional PCA involvement in advanced disease stages may impair key neural substrates such as the cingulum and SLF. Thus, combined structural MRI and DTI are potentially useful for tracking the neural integrity of key neural substrates associated with cognitive function and detecting subtle anatomical changes associated with persistent ischemia, as well as disease progression.
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Affiliation(s)
- Ken Kazumata
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Kikutaro Tokairin
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Masaki Ito
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Haruto Uchino
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Taku Sugiyama
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Masahito Kawabori
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Toshiya Osanai
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Khin Khin Tha
- 2Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Kiyohiro Houkin
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
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Kundap UP, Choo BKM, Kumari Y, Ahmed N, Othman IB, Shaikh MF. Embelin Protects Against Acute Pentylenetetrazole-Induced Seizures and Positively Modulates Cognitive Function in Adult Zebrafish. Front Pharmacol 2019; 10:1249. [PMID: 31708779 PMCID: PMC6823247 DOI: 10.3389/fphar.2019.01249] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/27/2019] [Indexed: 01/29/2023] Open
Abstract
Purpose of the research: Epilepsy is a continuous process of neurodegeneration categorized by an enduring tendency to generate uncontrolled electrical firing known as seizures causing involuntary movement all over the body. Cognitive impairment and behavioral disturbances are among the more alarming co-morbidities of epilepsy. Anti-epileptic drugs (AEDs) were found to be successful in controlling epilepsy but are reported to worsen cognitive status in patients. Embelin (EMB) is a benzoquinone derived from the plant Embelia ribes and is reported to have central nervous system (CNS) activity. This study aims to evaluate the effectiveness of EMB against pentylenetetrazole (PTZ) induced acute seizures and its associated cognitive dysfunction. This was done via docking studies as well as evaluating neurotransmitter and gene expression in the zebrafish brain. The principal results: Behavioral observations showed that EMB reduced epileptic seizures and the T-maze study revealed that EMB improved the cognitive function of the fish. The docking study of EMB showed a higher affinity toward gamma-aminobutyric acid (GABAA) receptor as compared to the standard diazepam, raising the possibility of EMB working via the alpha subunit of the GABA receptor. EMB was found to modulate several genes, neurotransmitters, and also neuronal growth, all of which play an important role in improving cognitive status after epileptic seizures. Healthy zebrafish treated with EMB alone were found to have no behavioral and biochemical interference or side effects. The immunohistochemistry data suggested that EMB also promotes neuronal protection and neuronal migration in zebrafish brains. Major Conclusions: It was perceived that EMB suppresses seizure-like behavior via GABAA receptor pathway and has a positive impact on cognitive functions. The observed effect was supported by docking study, T-maze behavior, neurotransmitter and gene expression levels, and immunohistology study. The apparatus such as the T-maze and seizure scoring behavior tank were found to be a straightforward technique to score seizure and test learning ability after acute epileptic seizures. These research findings suggest that EMB could be a promising molecule for epilepsy induced learning and memory dysfunction.
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Affiliation(s)
- Uday Praful Kundap
- Department of Neurosciences, University of Montreal Hospital Centre (CRCHUM), Montreal, Canada.,Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia
| | - Brandon Kar Meng Choo
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia
| | - Yatinesh Kumari
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia
| | - Nafees Ahmed
- School of Pharmacy, Monash University Malaysia, Kuala Lumpur, Malaysia
| | - Iekhsan Bin Othman
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia
| | - Mohd Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia
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Jia J, Xie J, Li H, Wei H, Li X, Hu J, Meng D, Zhang Y, Zhang X. Cerebral blood flow abnormalities in neuropsychiatric systemic lupus erythematosus. Lupus 2019; 28:1128-1133. [PMID: 31315530 DOI: 10.1177/0961203319861677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the clinical characteristics, imaging changes and early diagnostic methods of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS Thirty-five SLE patients, of which 16 had overt neuropsychiatric symptoms, underwent examination for multiple autoantibodies, including anti-double-stranded DNA (anti-dsDNA) antibody, anti-nucleosome antibody, anti-cardiac-phospholipid antibody (aCL)-IgG, aCL-IgM, anti-β2-glycoprotein I antibody and anti-ribosomal P antibody, and the SLEDAI score of every patient was recorded. All patients further received neuropsychological tests, including the Mini-Mental State Examination, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale. Imaging examination using 3D arterial spin labeling was performed on 3.0 T MRI scanners. After processing the 3D arterial spin labeling image, the cerebral blood flow map was obtained and the cerebral blood flow value was calculated. RESULTS The values of anti-dsDNA, anti-nucleosome antibody, aCL-IgG and anti-β2-glycoprotein I antibodies were significantly higher in the NPSLE group than those in the SLE group. The SLEDAI scores of the NPSLE group were significantly higher than those of the SLE group. There were no significant differences between the NPSLE group and the SLE group in the directional ability, memory, attention, numeracy, recall ability or language ability scores on the Mini-Mental State Examination scale. Furthermore, there were no symptoms of anxiety or depression in any of the patients, according to the Self-Rating Anxiety Scale and Self-Rating Depression Scale. In the 35 patients with SLE, decreases in blood perfusion were seen in some areas, and were unilateral and asymmetrically distributed. There was obvious asymmetry between sides in areas including the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The incidence of perfusion decreases in frontal lobe in the NPSLE group was significantly higher than in the SLE group. CONCLUSION Neurological lesions in SLE patients can be detected by arterial spin labeling. Cerebral blood flow abnormalities may be helpful for the early diagnosis of neurological lesions in NPSLE.
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Affiliation(s)
- J Jia
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - J Xie
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - H Li
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - H Wei
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - X Li
- 2 Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - J Hu
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - D Meng
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Y Zhang
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - X Zhang
- 1 Department of Rheumatology, Clinical Medical College, Yangzhou University, Yangzhou, China
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Aubry R. [Ethical challenges surrounding the ageing of HIV-positive patients]. Soins 2019; 64:28-30. [PMID: 31023464 DOI: 10.1016/j.soin.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
More and more HIV-positive people now belong to the 50+ age group. This ageing is accompanied by specific medical and psychosocial problems. In 2018, the French National Consultative Ethics Committee published a paper on the ethical challenges of ageing. Ageing is not easy in a society from which people living with HIV and the elderly feel excluded.
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Affiliation(s)
- Régis Aubry
- CHRU de Besançon, Hôpital Jean-Minjoz, 25030 Besançon cedex, France.
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Nielssen O, Yee NY, Dean K, Large M. Outcome of serious violent offenders with psychotic illness and cognitive disorder dealt with by the New South Wales criminal justice system. Aust N Z J Psychiatry 2019; 53:441-446. [PMID: 29756478 DOI: 10.1177/0004867418771751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The few studies of the recidivism by people with psychotic illness and cognitive disorder who are convicted of serious violent offences and sentenced by the courts. METHOD Re-imprisonment data were obtained for 661 individuals convicted of serious non-lethal violent offences in the District Courts of New South Wales in the years 2006 and 2007. Rates of re-imprisonment of offenders known to psychotic illness or cognitive disorder (intellectual disability or acquired brain injury) was compared to those not known to have those conditions. A survival analysis was performed controlling for the effects of male sex, having a report by a mental health professional at the initial sentencing and receiving a custodial sentence for the initial offence. RESULTS There was no significant difference in the overall likelihood of further imprisonment between those with psychotic disorder (53.7%), those with cognitive disorder (50.7%) or among those with neither condition (45.2%; χ2 = 2.22, p = 0.33). A Kaplan-Meier analysis found that people with a psychotic disorder were returned to custody earlier than those not known to have psychosis ( p = 0.002). People with psychosis spent a non-significantly greater time in custody (mean 477 days) than those with a cognitive disorder (mean 334 days) or among those with neither condition (mean 348 days) (Mann-Whitney Z-score = 1.5, η2 = 0.003, p value = 0.13). For the entire sample of 661 offenders, those who received non-custodial sentences for their initial offences had a lower likelihood of spending any time in custody in the follow-up period. CONCLUSION The likelihood of returning to custody of sentenced violent offenders with psychotic illness or cognitive disorder is higher than that of released forensic patients in New South Wales followed up for a similar period. The results suggest an opportunity to improve the outcome of offenders with psychosis by better treatment and rehabilitation.
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Affiliation(s)
- Olav Nielssen
- 1 Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,2 Department of Psychiatry, St Vincents Hospital, Sydney, NSW, Australia
| | - Natalia Yl Yee
- 3 Justice Health, Matraville, NSW, Australia.,4 Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Kimberlie Dean
- 3 Justice Health, Matraville, NSW, Australia.,4 Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Matthew Large
- 4 Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,5 Department of Psychiatry, Prince of Wales Hospital, Sydney, NSW, Australia
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