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He Y, He T, Li H, Chen W, Zhong B, Wu Y, Chen R, Hu Y, Ma H, Wu B, Hu W, Han Z. Deciphering mitochondrial dysfunction: Pathophysiological mechanisms in vascular cognitive impairment. Biomed Pharmacother 2024; 174:116428. [PMID: 38599056 DOI: 10.1016/j.biopha.2024.116428] [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: 12/20/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024] Open
Abstract
Vascular cognitive impairment (VCI) encompasses a range of cognitive deficits arising from vascular pathology. The pathophysiological mechanisms underlying VCI remain incompletely understood; however, chronic cerebral hypoperfusion (CCH) is widely acknowledged as a principal pathological contributor. Mitochondria, crucial for cellular energy production and intracellular signaling, can lead to numerous neurological impairments when dysfunctional. Recent evidence indicates that mitochondrial dysfunction-marked by oxidative stress, disturbed calcium homeostasis, compromised mitophagy, and anomalies in mitochondrial dynamics-plays a pivotal role in VCI pathogenesis. This review offers a detailed examination of the latest insights into mitochondrial dysfunction within the VCI context, focusing on both the origins and consequences of compromised mitochondrial health. It aims to lay a robust scientific groundwork for guiding the development and refinement of mitochondrial-targeted interventions for VCI.
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Affiliation(s)
- Yuyao He
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Tiantian He
- Sichuan Academy of Chinese Medicine Sciences, China
| | - Hongpei Li
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Wei Chen
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Biying Zhong
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Yue Wu
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Runming Chen
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Yuli Hu
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Huaping Ma
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Bin Wu
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Wenyue Hu
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China.
| | - Zhenyun Han
- Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China.
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Gonzalez-Fernandez E, Liu Y, Auchus AP, Fan F, Roman RJ. Vascular contributions to cognitive impairment and dementia: the emerging role of 20-HETE. Clin Sci (Lond) 2021; 135:1929-1944. [PMID: 34374423 PMCID: PMC8783562 DOI: 10.1042/cs20201033] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 05/07/2021] [Revised: 07/09/2021] [Accepted: 07/26/2021] [Indexed: 12/13/2022]
Abstract
The accumulation of extracellular amyloid-β (Aβ) and intracellular hyperphosphorylated τ proteins in the brain are the hallmarks of Alzheimer's disease (AD). Much of the research into the pathogenesis of AD has focused on the amyloid or τ hypothesis. These hypotheses propose that Aβ or τ aggregation is the inciting event in AD that leads to downstream neurodegeneration, inflammation, brain atrophy and cognitive impairment. Multiple drugs have been developed and are effective in preventing the accumulation and/or clearing of Aβ or τ proteins. However, clinical trials examining these therapeutic agents have failed to show efficacy in preventing or slowing the progression of the disease. Thus, there is a need for fresh perspectives and the evaluation of alternative therapeutic targets in this field. Epidemiology studies have revealed significant overlap between cardiovascular and cerebrovascular risk factors such as hypertension, diabetes, atherosclerosis and stroke to the development of cognitive impairment. This strong correlation has given birth to a renewed focus on vascular contributions to AD and related dementias. However, few genes and mechanisms have been identified. 20-Hydroxyeicosatetraenoic acid (20-HETE) is a potent vasoconstrictor that plays a complex role in hypertension, autoregulation of cerebral blood flow and blood-brain barrier (BBB) integrity. Multiple human genome-wide association studies have linked mutations in the cytochrome P450 (CYP) 4A (CYP4A) genes that produce 20-HETE to hypertension and stroke. Most recently, genetic variants in the enzymes that produce 20-HETE have also been linked to AD in human population studies. This review examines the emerging role of 20-HETE in AD and related dementias.
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Affiliation(s)
- Ezekiel Gonzalez-Fernandez
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | - Yedan Liu
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | - Alexander P. Auchus
- Department of Neurology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | - Fan Fan
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | - Richard J. Roman
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
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Yeverino-Castro SG, Mejía-Arango S, Mimenza-Alvarado AJ, Cantú-Brito C, Avila-Funes JA, Aguilar-Navarro SG. Prevalence and incidence of possible vascular dementia among Mexican older adults: Analysis of the Mexican Health and Aging Study. PLoS One 2021; 16:e0253856. [PMID: 34237081 PMCID: PMC8266048 DOI: 10.1371/journal.pone.0253856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Vascular dementia is the second most common cause of dementia. Physical disability and cognitive impairment due to stroke are conditions that considerably affect quality of life. We estimated the prevalence and incidence of possible vascular dementia (PVD) in older adults using data from the Mexican Health and Aging Study (MHAS 2012 and 2015 waves). Methods The MHAS is a representative longitudinal cohort study of Mexican adults aged ≥50 years. Data from 14, 893 participants from the 2012 cohort and 14,154 from the 2015 cohort were analyzed to estimate the prevalence and incidence of PVD. Self-respondents with history of stroke were classified as PVD if scores in two or more cognitive domains in the Cross-Cultural Cognitive Examination were ≥ 1.5 standard deviations below the mean on reference norms and if limitations in ≥ 1 instrumental activities of daily living were present. For proxy respondents with history of stroke, we used a score ≥3.4 on the Informant Questionnaire on Cognitive Decline in the Elderly. Crude and standardized rates of prevalent and incident PVD were estimated. Results Prevalence of PVD was 0.6% (95% CI, 0.5–0.8) (0.5 with age and sex- standardization). Rates increased with age reaching 2.0% among those aged 80 and older and decreased with educational attainment. After 3.0 years of follow-up, 87 new cases of PVD represented an overall incident rate of 2.2 (95% CI, 1.7–2.6) per 1,000 person-years (2.0 with age and sex- standardization). Incidence also increased with advancing age reaching an overall rate of 9.4 (95% CI, 6.3–13.6) per 1,000 person-years for participants aged >80 years. Hypertension and depressive symptoms were strong predictors of incident PVD. Conclusion These data provide new estimates of PVD prevalence and incidence in the Mexican population. We found that PVD incidence increased with age. Males aged 80 years or older showed a greater incidence rate when compared to females, which is comparable to previous estimates from other studies.
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Affiliation(s)
- Sara G. Yeverino-Castro
- Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
| | - Silvia Mejía-Arango
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México
| | - Alberto J. Mimenza-Alvarado
- Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos Cantú-Brito
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José A. Avila-Funes
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Inserm, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, Bordeaux, France
| | - Sara G. Aguilar-Navarro
- Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- * E-mail:
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Babiloni C, Arakaki X, Bonanni L, Bujan A, Carrillo MC, Del Percio C, Edelmayer RM, Egan G, Elahh FM, Evans A, Ferri R, Frisoni GB, Güntekin B, Hainsworth A, Hampel H, Jelic V, Jeong J, Kim DK, Kramberger M, Kumar S, Lizio R, Nobili F, Noce G, Puce A, Ritter P, Smit DJA, Soricelli A, Teipel S, Tucci F, Sachdev P, Valdes-Sosa M, Valdes-Sosa P, Vergallo A, Yener G. EEG measures for clinical research in major vascular cognitive impairment: recommendations by an expert panel. Neurobiol Aging 2021; 103:78-97. [PMID: 33845399 DOI: 10.1016/j.neurobiolaging.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/15/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 11/22/2022]
Abstract
Vascular contribution to cognitive impairment (VCI) and dementia is related to etiologies that may affect the neurophysiological mechanisms regulating brain arousal and generating electroencephalographic (EEG) activity. A multidisciplinary expert panel reviewed the clinical literature and reached consensus about the EEG measures consistently found as abnormal in VCI patients with dementia. As compared to cognitively unimpaired individuals, those VCI patients showed (1) smaller amplitude of resting state alpha (8-12 Hz) rhythms dominant in posterior regions; (2) widespread increases in amplitude of delta (< 4 Hz) and theta (4-8 Hz) rhythms; and (3) delayed N200/P300 peak latencies in averaged event-related potentials, especially during the detection of auditory rare target stimuli requiring participants' responses in "oddball" paradigms. The expert panel formulated the following recommendations: (1) the above EEG measures are not specific for VCI and should not be used for its diagnosis; (2) they may be considered as "neural synchronization" biomarkers to enlighten the relationships between features of the VCI-related cerebrovascular lesions and abnormalities in neurophysiological brain mechanisms; and (3) they may be tested in future clinical trials as prognostic biomarkers and endpoints of interventions aimed at normalizing background brain excitability and vigilance in wakefulness.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy; San Raffaele Cassino, Cassino, FR, Italy.
| | | | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ana Bujan
- Psychological Neuroscience Lab, School of Psychology, University of Minho, Portugal
| | | | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Gary Egan
- Foundation Director of the Monash Biomedical Imaging (MBI) research facilities, Monash University, Clayton, Australia
| | - Fanny M Elahh
- Memory and Aging Center, University of California, San Francisco
| | - Alan Evans
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | | | - Giovanni B Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland; Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey; REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey
| | - Atticus Hainsworth
- University of London St George's Molecular and Clinical Sciences Research Institute, London, UK
| | - Harald Hampel
- Sorbonne University, GRC No. 21, Alzheimer Precision Medicine, Pitié-Salpêtrière Hospital, Paris, France
| | - Vesna Jelic
- Division of Clinical Geriatrics, NVS Department, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jaeseung Jeong
- Department of Bio and Brain Engineering/Program of Brain and Cognitive Engineering Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Doh Kwan Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Milica Kramberger
- Center for cognitive and movement disorders, Department of neurology, University Medical Center Ljubljana, Slovenia
| | - Sanjeev Kumar
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Flavio Nobili
- Clinica neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI)
| | | | - Aina Puce
- Department of Psychological and Brain Sciences at Indiana University in Bloomington, Indiana, USA
| | - Petra Ritter
- Brain Simulation Section, Department of Neurology, Charité Universitätsmedizin and Berlin Institute of Health, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Dirk J A Smit
- Department of Psychiatry Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, the Netherlands
| | - Andrea Soricelli
- IRCCS SDN, Naples, Italy; Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Stefan Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald, Rostock, Germany
| | - Federico Tucci
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
| | | | - Pedro Valdes-Sosa
- Cuban Neuroscience Center, Havana, Cuba; Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Andrea Vergallo
- Sorbonne University, GRC No. 21, Alzheimer Precision Medicine, Pitié-Salpêtrière Hospital, Paris, France
| | - Görsev Yener
- Izmir Biomedicine and Genome Center. Dokuz Eylul University Health Campus, Izmir, Turkey
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Shaw K, Bell L, Boyd K, Grijseels DM, Clarke D, Bonnar O, Crombag HS, Hall CN. Neurovascular coupling and oxygenation are decreased in hippocampus compared to neocortex because of microvascular differences. Nat Commun 2021; 12:3190. [PMID: 34045465 PMCID: PMC8160329 DOI: 10.1038/s41467-021-23508-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/26/2021] [Indexed: 02/04/2023] Open
Abstract
The hippocampus is essential for spatial and episodic memory but is damaged early in Alzheimer's disease and is very sensitive to hypoxia. Understanding how it regulates its oxygen supply is therefore key for designing interventions to preserve its function. However, studies of neurovascular function in the hippocampus in vivo have been limited by its relative inaccessibility. Here we compared hippocampal and visual cortical neurovascular function in awake mice, using two photon imaging of individual neurons and vessels and measures of regional blood flow and haemoglobin oxygenation. We show that blood flow, blood oxygenation and neurovascular coupling were decreased in the hippocampus compared to neocortex, because of differences in both the vascular network and pericyte and endothelial cell function. Modelling oxygen diffusion indicates that these features of the hippocampal vasculature may restrict oxygen availability and could explain its sensitivity to damage during neurological conditions, including Alzheimer's disease, where the brain's energy supply is decreased.
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Affiliation(s)
- K Shaw
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - L Bell
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - K Boyd
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - D M Grijseels
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - D Clarke
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - O Bonnar
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - H S Crombag
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom
| | - C N Hall
- School of Psychology and Sussex Neuroscience, University of Sussex, Falmer, Brighton, United Kingdom.
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Zhu HY, Hong FF, Yang SL. The Roles of Nitric Oxide Synthase/Nitric Oxide Pathway in the Pathology of Vascular Dementia and Related Therapeutic Approaches. Int J Mol Sci 2021; 22:ijms22094540. [PMID: 33926146 PMCID: PMC8123648 DOI: 10.3390/ijms22094540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022] Open
Abstract
Vascular dementia (VaD) is the second most common form of dementia worldwide. It is caused by cerebrovascular disease, and patients often show severe impairments of advanced cognitive abilities. Nitric oxide synthase (NOS) and nitric oxide (NO) play vital roles in the pathogenesis of VaD. The functions of NO are determined by its concentration and bioavailability, which are regulated by NOS activity. The activities of different NOS subtypes in the brain are partitioned. Pathologically, endothelial NOS is inactivated, which causes insufficient NO production and aggravates oxidative stress before inducing cerebrovascular endothelial dysfunction, while neuronal NOS is overactive and can produce excessive NO to cause neurotoxicity. Meanwhile, inflammation stimulates the massive expression of inducible NOS, which also produces excessive NO and then induces neuroinflammation. The vicious circle of these kinds of damage having impacts on each other finally leads to VaD. This review summarizes the roles of the NOS/NO pathway in the pathology of VaD and also proposes some potential therapeutic methods that target this pathway in the hope of inspiring novel ideas for VaD therapeutic approaches.
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Affiliation(s)
- Han-Yan Zhu
- Department of Physiology, College of Medicine, Nanchang University, 461 Bayi Avenue, Nanchang 330006, China;
- Queen Marry College, College of Medicine, Nanchang University, 461 Bayi Avenue, Nanchang 330006, China
| | - Fen-Fang Hong
- Teaching Center, Department of Experimental, Nanchang University, 461 Bayi Avenue, Nanchang 330006, China
- Correspondence: (F.-F.H.); (S.-L.Y.)
| | - Shu-Long Yang
- Department of Physiology, College of Medicine, Nanchang University, 461 Bayi Avenue, Nanchang 330006, China;
- Correspondence: (F.-F.H.); (S.-L.Y.)
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Zheng G, Wang L, Li X, Niu X, Xu G, Lv P. Rapamycin alleviates cognitive impairment in murine vascular dementia: The enhancement of mitophagy by PI3K/AKT/mTOR axis. Tissue Cell 2021; 69:101481. [PMID: 33383488 DOI: 10.1016/j.tice.2020.101481] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 08/20/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022]
Abstract
There are no approved symptomatic treatments for vascular dementia (VaD). Rapamycin (RAPA) improves cognitive deficits in Alzheimer's disease rats. To explore whether RAPA improves cognitive impairment after VaD and its possible molecular mechanisms. Thirty Sprague Dawley rats were randomly divided into three groups: sham (received sham-operation), VaD model (received permanent ligation of bilateral carotid arteries) and RAPA (7.5 mg/kg) treatment. Cognitive function was evaluated by Morris water maze test. Neuronal apoptosis was evaluated by TUNEL staining. Mitophagy was assessed by mitochondrial DNA (mtDNA), ATP level, transmission electron microscope and mitophagy-associated proteins. Proteins were quantified by Western blot and immunofluorescence. BV2 cells were exposed to RAPA or/and MHY1485 (mTOR activator) to verify in vivo results. Compared to VaD rats, the escape latency of RAPA-treated rats was significantly decreased, and time spent in target quadrant was longer. Pathologic changes, mitochondrial dysfunction, increase of neuronal apoptosis and related proteins in VaD rats were remarkably alleviated by RAPA. After RAPA treatment, an increase in number of autophagosomes was observed, along with up-regulation of mitophagy-related proteins. Overexpression of PI3K, AKT and mTOR were suppressed by RAPA treatment. In vitro experiments confirmed effects of RAPA, and demonstrated that MHY1485 addition reversed the RAPA-caused apoptosis inhibition and mitophagy enhancement. Overall, RAPA improved the cognitive impairment of VaD rats, alleviated neuronal injury and mitochondrial dysfunction. We proposed a potential mechanism that RAPA may play improving role by inhibiting neuronal apoptosis and enhancing mitophagy through PI3K/AKT/mTOR pathway. Findings provided an exciting possibility for novel treatment strategy of VaD.
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Affiliation(s)
- Guimin Zheng
- Department of Neurology, Hebei Medical University, China; Department of Rheumatology and Immunology, HeBei General Hospital, China.
| | - Lei Wang
- Department of Medical Imaging, HeBei General Hospital, China.
| | - Xiuqin Li
- Department of Geriatric Medicine, HeBei General Hospital, China.
| | - Xiaoli Niu
- Department of Neurology, HeBei General Hospital, China.
| | - Guodong Xu
- Department of Neurointerventional Surgery, HeBei General Hospital, China.
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, China; Department of Neurology, HeBei General Hospital, China.
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Bhatia P, Kaur G, Singh N. Ozagrel a thromboxane A2 synthase inhibitor extenuates endothelial dysfunction, oxidative stress and neuroinflammation in rat model of bilateral common carotid artery occlusion induced vascular dementia. Vascul Pharmacol 2021; 137:106827. [PMID: 33346090 DOI: 10.1016/j.vph.2020.106827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/11/2020] [Revised: 08/14/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022]
Abstract
The present study investigates the potential of ozagrel, a thromboxane A2 (TXA2) synthase inhibitor, in bilateral common carotid artery occlusion (BCCAo) induced vascular dementia (VaD). Wistar rats were subjected to BCCAo procedure under anesthesia to induce VaD. Morris water maze (MWM) test was employed on 7th day post-surgery to determine learning and memory. Endothelial dysfunction was assessed in isolated aorta by observing endothelial dependent vasorelaxation and levels of serum nitrite. A battery of biochemical and histopathological estimations was performed. Expression analysis of inflammatory cytokines TNF-α and IL-6 was carried out by RT-PCR. BCCAo produced significant impairment in endothelium dependent vasorelaxation and decrease in serum nitrite levels indicating endothelial dysfunction along with poor performance on MWM represents impairment of learning and memory. There was a significant rise in brain oxidative stress level (indicated by increase in brain thiobarbituric acid reactive species and decrease in reduced glutathione levels); increase in brain acetylcholinesterase activity; brain myeloperoxidase activity; brain TNF-α & IL-6 levels, brain TNF-α & IL-6 mRNA expression and brain neutrophil infiltration (as marker of inflammation) were also observed. Treatment of ozagrel (10 & 20 mg/kg, p. o.)/donepezil (0. 5 mg/kg, i.p., serving as standard) ameliorated BCCAo induced endothelial dysfunction; memory deficits; biochemical and histopathological changes in a significant manner. It may be concluded that ozagrel markedly improved endothelial dysfunction; learning and memory; biochemical and histopathological alteration associated with BCCAo induced VaD and that TXA2 can be considered as an important therapeutic target for the treatment of VaD.
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MESH Headings
- Animals
- Behavior, Animal/drug effects
- Brain/drug effects
- Brain/enzymology
- Brain/physiopathology
- Carotid Artery, Common/surgery
- Carotid Stenosis/complications
- Dementia, Vascular/drug therapy
- Dementia, Vascular/enzymology
- Dementia, Vascular/etiology
- Dementia, Vascular/physiopathology
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/enzymology
- Endothelium, Vascular/physiopathology
- Enzyme Inhibitors/pharmacology
- Female
- Inflammation Mediators/metabolism
- Ligation
- Male
- Methacrylates/pharmacology
- Morris Water Maze Test/drug effects
- Oxidative Stress/drug effects
- Rats, Wistar
- Thromboxane-A Synthase/antagonists & inhibitors
- Thromboxane-A Synthase/metabolism
- Rats
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Affiliation(s)
- Pankaj Bhatia
- CNS Research lab., Pharmacology division, Department of Pharmaceutical Sciences and Drug Research, Faculty of Medicine, Punjabi University, Patiala 147002, Punjab, India
| | - Gagandeep Kaur
- CNS Research lab., Pharmacology division, Department of Pharmaceutical Sciences and Drug Research, Faculty of Medicine, Punjabi University, Patiala 147002, Punjab, India
| | - Nirmal Singh
- Pharmacology division, Department of Pharmaceutical Sciences and Drug Research, Faculty of Medicine, Punjabi University, Patiala 147002, Punjab, India.
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Yang K, Zeng L, Ge A, Yi Y, Wang S, Ge J. Exploring the Oxidative Stress Mechanism of Buyang Huanwu Decoction in Intervention of Vascular Dementia Based on Systems Biology Strategy. Oxid Med Cell Longev 2021; 2021:8879060. [PMID: 33747352 PMCID: PMC7953864 DOI: 10.1155/2021/8879060] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore the oxidative stress mechanism of modified Buyang Huanwu decoction (MBHD) in intervention of vascular dementia (VD) based on systems biology strategy. METHODS In this study, through the reverse virtual target prediction technology and transcriptomics integration strategy, the active ingredients and potential targets of MBHD treatment of VD were analyzed, and the drug-disease protein-protein interaction (PPI) network was constructed. Then, bioinformatics analysis methods are used for Gene Ontology (GO) enrichment analysis and pathway enrichment analysis, and finally find the core biological process. After that, in animal models, low-throughput technology is used to detect gene expression and protein expression of key molecular targets in oxidative stress-mediated inflammation and apoptosis signaling pathways to verify the mechanism of MBHD treatment of VD rats. Finally, the potential interaction relationship between MBHD and VD-related molecules is further explored through molecular docking technology. RESULTS There are a total of 54 MBHD components, 252 potential targets, and 360 VD genes. The results of GO enrichment analysis and pathway enrichment analysis showed that MBHD may regulate neuronal apoptosis, nitric oxide synthesis and metabolism, platelet activation, NF-κB signaling pathway-mediated inflammation, oxidative stress, angiogenesis, etc. Among them, SIRT1, NF-κB, BAX, BCL-2, CASP3, and APP may be important targets for MBHD to treat VD. Low-throughput technology (qRT-PCR/WB/immunohistochemical technology) detects oxidative stress-mediated inflammation and apoptosis-related signaling pathway molecules. The molecular docking results showed that 64474-51-7, cycloartenol, ferulic acid, formononetin, kaempferol, liquiritigenin, senkyunone, wallichilide, xanthinin, and other molecules can directly interact with NF-κB p65, BAX, BCL-2, and CASP3. CONCLUSION The active compounds of MBHD interact with multiple targets and multiple pathways in a synergistic manner, and have important therapeutic effects on VD mainly by balancing oxidative stress/anti-inflammatory and antiapoptotic, enhancing metabolism, and enhancing the immune system.
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Affiliation(s)
- Kailin Yang
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
- Key Lab of Hunan Province for Prevention and Treatment of Cardio-Cerebral Diseases with Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, China
| | - Liuting Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Anqi Ge
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Yaqiao Yi
- Key Lab of Hunan Province for Prevention and Treatment of Cardio-Cerebral Diseases with Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, China
| | - Shanshan Wang
- Key Lab of Hunan Province for Prevention and Treatment of Cardio-Cerebral Diseases with Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, China
| | - Jinwen Ge
- Key Lab of Hunan Province for Prevention and Treatment of Cardio-Cerebral Diseases with Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, China
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10
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Fontaine JT, Rosehart AC, Joutel A, Dabertrand F. HB-EGF depolarizes hippocampal arterioles to restore myogenic tone in a genetic model of small vessel disease. Mech Ageing Dev 2020; 192:111389. [PMID: 33127441 PMCID: PMC7683376 DOI: 10.1016/j.mad.2020.111389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/28/2020] [Revised: 10/16/2020] [Accepted: 10/22/2020] [Indexed: 12/26/2022]
Abstract
Vascular cognitive impairment, the second most common cause of dementia, profoundly affects hippocampal-dependent functions. However, while the growing literature covers complex neuronal interactions, little is known about the sustaining hippocampal microcirculation. Here we examined vasoconstriction to physiological pressures of hippocampal arterioles, a fundamental feature of small arteries, in a genetic mouse model of CADASIL, an archetypal cerebral small vessel disease. Using diameter and membrane potential recordings on isolated arterioles, we observed both blunted pressure-induced vasoconstriction and smooth muscle cell depolarization in CADASIL. This impairment was abolished in the presence of voltage-gated potassium (KV1) channel blocker 4-aminopyridine, or by application of heparin-binding EGF-like growth factor (HB-EGF), which promotes KV1 channel down-regulations. Interestingly, we observed that HB-EGF induced a depolarization of the myocyte plasma membrane within the arteriolar wall in CADASIL, but not wild-type, arterioles. Collectively, our results indicate that hippocampal arterioles in CADASIL mice display a blunted contractile response to luminal pressure, similar to the defect we previously reported in cortical arterioles and pial arteries, that is rescued by HB-EGF. Hippocampal vascular dysfunction in CADASIL could then contribute to the decreased vascular reserve associated with decreased cognitive performance, and its correction may provide a therapeutic option for treating vascular cognitive impairment.
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Affiliation(s)
- Jackson T Fontaine
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Amanda C Rosehart
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne Joutel
- Department of Pharmacology, Larner College of Medicine University of Vermont, Burlington, VT, USA; Institute of Psychiatry and Neurosciences of Paris, INSERM UMR1266, University of Paris, GHU Paris Psychiatrie et Neurosciences, France
| | - Fabrice Dabertrand
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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11
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Schager B, Brown CE. Susceptibility to capillary plugging can predict brain region specific vessel loss with aging. J Cereb Blood Flow Metab 2020; 40:2475-2490. [PMID: 31903837 PMCID: PMC7820682 DOI: 10.1177/0271678x19895245] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/28/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Abstract
Vessel loss in the aging brain is commonly reported, yet important questions remain concerning whether there are regional vulnerabilities and what mechanisms could account for these regional differences, if they exist. Here we imaged and quantified vessel length, tortuosity and width in 15 brain regions in young adult and aged mice. Our data indicate that vessel loss was most pronounced in white matter followed by cortical, then subcortical grey matter regions, while some regions (visual cortex, amygdala, thalamus) showed no decline with aging. Regions supplied by the anterior cerebral artery were more vulnerable to loss than those supplied by middle or posterior cerebral arteries. Vessel width and tortuosity generally increased with age but neither reliably predicted regional vessel loss. Since capillaries are naturally prone to plugging and prolonged obstructions often lead to vessel pruning, we hypothesized that regional susceptibilities to plugging could help predict vessel loss. By mapping the distribution of microsphere-induced capillary obstructions, we discovered that regions with a higher density of persistent obstructions were more likely to show vessel loss with aging and vice versa. These findings indicate that age-related vessel loss is region specific and can be explained, at least partially, by regional susceptibilities to capillary plugging.
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Affiliation(s)
- Ben Schager
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Craig E Brown
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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12
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Zhou L, Yang R, Wu F. Efficacy and safety of butylphthalide as adjunctive therapy for vascular dementia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23236. [PMID: 33181711 PMCID: PMC7668513 DOI: 10.1097/md.0000000000023236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Butylphthalide is widely used for the adjunctive treatment of vascular dementia; however, the clinical evidences are not well synthesized yet. METHODS We proposed a systematic review and meta-analysis to evaluate the efficacy and safety of butylphthalide as adjunctive therapy for vascular dementia. Seven electronic databases (China National Knowledge Infrastructure, Wanfang database, Chongqing VIP database, China Biomedical Literature Database, Pubmed, EMBASE and Cochrane library) will be searched for eligible randomized controlled trials (RCTs). Required data of included studies will be collected. Quality of studies will be evaluated using Cochrane risk of bias assessment tool. Data synthesis will be performed using Review Manager software. Subgroup analysis and sensitivity analysis will also be carried. RESULTS Synthesis results of current available RCTs regarding the efficacy and safety of butylphthalide for the treatment vascular dementia will be provided by this systematic review and meta-analysis. CONCLUSION This systematic review and meta-analysis will provide high level evidence of butylphthalide clinical application. REGISTRATION PROSPERO CRD42020168947.
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13
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Chua XY, Ho LTY, Xiang P, Chew WS, Lam BWS, Chen CP, Ong WY, Lai MKP, Herr DR. Preclinical and Clinical Evidence for the Involvement of Sphingosine 1-Phosphate Signaling in the Pathophysiology of Vascular Cognitive Impairment. Neuromolecular Med 2020; 23:47-67. [PMID: 33180310 DOI: 10.1007/s12017-020-08632-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/26/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Abstract
Sphingosine 1-phosphates (S1Ps) are bioactive lipids that mediate a diverse range of effects through the activation of cognate receptors, S1P1-S1P5. Scrutiny of S1P-regulated pathways over the past three decades has identified important and occasionally counteracting functions in the brain and cerebrovascular system. For example, while S1P1 and S1P3 mediate proinflammatory effects on glial cells and directly promote endothelial cell barrier integrity, S1P2 is anti-inflammatory but disrupts barrier integrity. Cumulatively, there is significant preclinical evidence implicating critical roles for this pathway in regulating processes that drive cerebrovascular disease and vascular dementia, both being part of the continuum of vascular cognitive impairment (VCI). This is supported by clinical studies that have identified correlations between alterations of S1P and cognitive deficits. We review studies which proposed and evaluated potential mechanisms by which such alterations contribute to pathological S1P signaling that leads to VCI-associated chronic neuroinflammation and neurodegeneration. Notably, S1P receptors have divergent but overlapping expression patterns and demonstrate complex interactions. Therefore, the net effect produced by S1P represents the cumulative contributions of S1P receptors acting additively, synergistically, or antagonistically on the neural, vascular, and immune cells of the brain. Ultimately, an optimized therapeutic strategy that targets S1P signaling will have to consider these complex interactions.
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Affiliation(s)
- Xin Ying Chua
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Leona T Y Ho
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119260, Singapore
| | - Ping Xiang
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wee Siong Chew
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Brenda Wan Shing Lam
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Kent Ridge, Singapore
| | - Wei-Yi Ong
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119260, Singapore
- Neurobiology Programme, Life Sciences Institute, National University of Singapore, Singapore, 119260, Singapore
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Memory Aging and Cognition Centre, National University Health System, Kent Ridge, Singapore.
| | - Deron R Herr
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Biology, San Diego State University, San Diego, CA, USA.
- American University of Health Sciences, Long Beach, CA, USA.
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14
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Miceli V, Russelli G, Iannolo G, Gallo A, Lo Re V, Agnese V, Sparacia G, Conaldi PG, Bulati M. Role of non-coding RNAs in age-related vascular cognitive impairment: An overview on diagnostic/prognostic value in Vascular Dementia and Vascular Parkinsonism. Mech Ageing Dev 2020; 191:111332. [PMID: 32805261 DOI: 10.1016/j.mad.2020.111332] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023]
Abstract
Age is the pivotal risk factor for different common medical conditions such as cardiovascular diseases, cancer and dementia. Among age-related disorders, cardiovascular and cerebrovascular diseases, represent the leading causes of premature mortality strictly related to vascular ageing, a pathological condition characterized by endothelial dysfunction, atherosclerosis, hypertension, heart disease and stroke. These features negatively impact on the brain, owing to altered cerebral blood flow, neurovascular coupling and impaired endothelial permeability leading to cerebrovascular diseases (CVDs) as Vascular Dementia (VD) and Parkinsonism (VP). It is an increasing opinion that neurodegenerative disorders and cerebrovascular diseases are associated from a pathogenetic point of view, and in this review, we discuss how cerebrovascular dysfunctions, due to epigenetic alterations, are linked with neuronal degeneration/dysfunction that lead to cognitive impairment. The relation between neurodegenerative and cerebrovascular diseases are reviewed with a focus on role of ncRNAs in age-related vascular diseases impairing the endothelium in the blood-brain barrier with consequent dysfunction of cerebral blood flow. In this review we dissert about different regulatory mechanisms of gene expression implemented by ncRNAs in the pathogenesis of age-related neurovascular impairment, aiming to highlight the potential use of ncRNAs as biomarkers for diagnostic/prognostic purposes as well as novel therapeutic targets.
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Affiliation(s)
- V Miceli
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - G Russelli
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - G Iannolo
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - A Gallo
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - V Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - V Agnese
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - G Sparacia
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - P G Conaldi
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy
| | - M Bulati
- Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy.
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15
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Zongfang Z, Wenjing L, Zhaomin C, Lei Z. Therapeutic effect of piracetam with nimodipine on vascular dementia after cerebral infarction. Pak J Pharm Sci 2020; 33:2405-2411. [PMID: 33832882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article investigated the clinical effects of piracetam with nimodipine in the treatment of vascular dementia (VD) after cerebral infarction. 98 patients with vascular dementia after cerebral infarction were selected and divided into the control group and the study group according to the treatment method. The control group was treated with nimodipine alone. The study group was treated with piracetam on the basis of this observation, and we test the ADL (life ability score), MoCA(montreal cognitive assessment scale), ADAS-Cog(alzheimer's scale-cognition), MMSE(mental status examination) scores and quality of life scores before and after treatment in the two groups. Before treatment, there were no significant differences in ADL, MoCA, and ADAS-Cog scores between the two groups (P>0.05). After treatment, the ADL, MoCA, and ADAS-Cog scores of the study group were superior to the control group. The difference was statistically significant (P<0.05). There was no significant difference in MMSE scores between the two groups before treatment and 1 month after treatment (P>0.05). The MMSE scores of the study group were better than the control group after 3 months of treatment and half a year after treatment. The difference was statistically significant (P <0.05). Before treatment, there was no significant difference in the quality of life scores between the two groups (P>0.05). After treatment, the quality of life scores was significantly higher than the control group, and the difference was statistically significant (P<0.05). For patients with vascular dementia after cerebral infarction, piracetam combined with nimodipine can improve the cognitive function, improve the quality of life, and have a significant clinical effect.
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Affiliation(s)
- Zhang Zongfang
- Outpatient Department, Tengzhou Central People's Hospital, Tengzhou, China
| | - Liu Wenjing
- Internal Medicine-Neurology, Tengzhou Central People's Hospital, Tengzhou, China
| | - Chai Zhaomin
- Gastrointestinal Surgery Department, Tengzhou Central People's Hospital, Tengzhou, China
| | - Zhang Lei
- Rehabilitation Department, Tengzhou Central People's Hospital, Tengzhou, China
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16
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Lee NK, Kim H, Chang JW, Jang H, Kim H, Yang J, Kim J, Son JP, Na DL. Exploring the Potential of Mesenchymal Stem Cell-Based Therapy in Mouse Models of Vascular Cognitive Impairment. Int J Mol Sci 2020; 21:ijms21155524. [PMID: 32752272 PMCID: PMC7432487 DOI: 10.3390/ijms21155524] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 12/29/2022] Open
Abstract
Closely linked to Alzheimer’s disease (AD), the pathological spectrum of vascular cognitive impairment (VCI) is known to be wide and complex. Considering that multiple instead of a single targeting approach is considered a treatment option for such complicated diseases, the multifaceted aspects of mesenchymal stem cells (MSCs) make them a suitable candidate to tackle the heterogeneity of VCI. MSCs were delivered via the intracerebroventricular (ICV) route in mice that were subjected to VCI by carotid artery stenosis. VCI was induced in C57BL6/J mice wild type (C57VCI) mice by applying a combination of ameroid constrictors and microcoils, while ameroid constrictors alone were bilaterally applied to 5xFAD (transgenic AD mouse model) mice (5xVCI). Compared to the controls (minimal essential medium (MEM)-injected C57VCI mice), changes in spatial working memory were not noted in the MSC-injected C57VCI mice, and unexpectedly, the mortality rate was higher. In contrast, compared to the MEM-injected 5xVCI mice, mortality was not observed, and the spatial working memory was also improved in MSC-injected 5xVCI mice. Disease progression of the VCI-induced mice seems to be affected by the method of carotid artery stenosis and due to this heterogeneity, various factors must be considered to maximize the therapeutic benefits exerted by MSCs. Factors, such as the optimal MSC injection time point, cell concentration, sacrifice time point, and immunogenicity of the transplanted cells, must all be adequately addressed so that MSCs can be appropriately and effectively used as a treatment option for VCI.
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Affiliation(s)
- Na Kyung Lee
- School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea;
- Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.W.C.); (H.J.)
- Samsung Alzheimer Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Hyeongseop Kim
- Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.W.C.); (H.J.)
- Stem Cell Institute, ENCell Co. Ltd., Seoul 06072, Korea
| | - Jong Wook Chang
- Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.W.C.); (H.J.)
- Stem Cell Institute, ENCell Co. Ltd., Seoul 06072, Korea
| | - Hyemin Jang
- Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.W.C.); (H.J.)
- Samsung Alzheimer Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Hunnyun Kim
- Laboratory Animal Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.Y.); (J.K.)
| | - Jehoon Yang
- Laboratory Animal Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.Y.); (J.K.)
| | - Jeyun Kim
- Laboratory Animal Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.Y.); (J.K.)
| | - Jeong Pyo Son
- Laboratory Animal Center, Osong Medical Innovation Foundation, Cheongju 28160, Korea;
| | - Duk L. Na
- School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea;
- Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (H.K.); (J.W.C.); (H.J.)
- Samsung Alzheimer Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-2-3410-3591; Fax: +82-2-3412-3423
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17
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Oo EM, Ruamyod K, Khowawisetsut L, Turbpaiboon C, Chaisuksunt V, Uawithya P, Pholphana N, Rangkadilok N, Chompoopong S. Germinated Brown Rice Attenuates Cell Death in Vascular Cognitive Impaired Mice and Glutamate-Induced Toxicity In HT22 Cells. J Agric Food Chem 2020; 68:5093-5106. [PMID: 32275827 DOI: 10.1021/acs.jafc.9b07957] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Germinated brown rice (GBR) with unpolishing, soaking, and germinating processes can improve the texture, flavor, and nutritional value, including GABA and phenolic contents. The effect of GBR was first investigated in vascular cognitive impaired mice and glutamate-induced toxicity in HT22 cells with respect to standard pure GABA. Feeding mice with GBR for 5 weeks showed neuroprotection. In this study, the modified bilateral common carotid artery occlusion mice model was mild but a significant difference in cognitive impairment was still shown. Like pure GABA, GBR decreased cognitive deficits in memory behavioral tests and significantly attenuated hippocampal neuronal cell death at P < 0.001. Similarly to 0.125 μM of GABA, 100 μg/mL of GBR increased HT22 cell viability after glutamate toxicity. GBR affected less apoptotic cell death and less blocking by the GABAA antangonist bicuculline in comparison to GABA. When the results are taken together, the underlying mechanism of GBR protection may mediate though the GABAA receptor and its phenolic contents.
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Affiliation(s)
- Eve Mon Oo
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Katesirin Ruamyod
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Ladawan Khowawisetsut
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Chairat Turbpaiboon
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Vipavadee Chaisuksunt
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Panapat Uawithya
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nanthanit Pholphana
- Laboratory of Pharmacology, Chulabhorn Research Institute (CRI), Kamphaeng Phet 6, Laksi, Bangkok 10210, Thailand
| | - Nuchanart Rangkadilok
- Laboratory of Pharmacology, Chulabhorn Research Institute (CRI), Kamphaeng Phet 6, Laksi, Bangkok 10210, Thailand
| | - Supin Chompoopong
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Shigihara Y, Hoshi H, Shinada K, Okada T, Kamada H. Non-pharmacological treatment changes brain activity in patients with dementia. Sci Rep 2020; 10:6744. [PMID: 32317774 PMCID: PMC7174400 DOI: 10.1038/s41598-020-63881-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 04/07/2020] [Indexed: 12/05/2022] Open
Abstract
Non-pharmacological treatment (NPT) improves cognitive functions and behavioural disturbances in patients with dementia, but the underlying neural mechanisms are unclear. In this observational study, 21 patients with dementia received NPTs for several months. Patients were scanned using magnetoencephalography twice during the NPT period to evaluate NPT effects on resting-state brain activity. Additionally, cognitive functions and behavioural disturbances were measured using the Mini-Mental State Examination (MMSE-J) and a short version of the Dementia Behaviour Disturbance Scale (DBD-13) at the beginning and the end of the NPT period. In contrast to the average DBD-13 score, the average MMSE-J score improved after the NPT period. Magnetoencephalography data revealed a reduced alpha activity in the right temporal lobe and fusiform gyrus, as well as an increased low-gamma activity in the right angular gyrus. DBD-13 score changes were correlated with beta activity in the sensorimotor area. These findings corroborate previous studies confirming NPT effects on brain activity in healthy participants and people at risk of dementia. Our results provide additional evidence that brains of patients with dementia have the capacity for plasticity, which may be responsible for the observed NPT effects. In dementia, NPT might lead to improvements in the quality of life.
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Affiliation(s)
- Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Obihiro City, Japan.
- Department of Neurosurgery, Hokuto Hospital, Obihiro City, Japan.
| | - Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Obihiro City, Japan
| | - Keita Shinada
- Geriatric Health Services Facility Kakehashi, Hokuto Hospital Group, Obihiro City, Japan
| | - Toyoji Okada
- Department of Clinical Laboratory, Hokuto Hospital, Obihiro City, Japan
| | - Hajime Kamada
- Department of Neurosurgery, Hokuto Hospital, Obihiro City, Japan
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Wang W, Zhang Y, Yu W, Gao W, Shen N, Jin B, Wang X, Fang C, Wang Y. Bushenhuoxue improves cognitive function and activates brain-derived neurotrophic factor-mediated signaling in a rat model of vascular dementia. J TRADIT CHIN MED 2020; 40:49-58. [PMID: 32227765] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the protective mechanisms of the Traditional Chinese Medicine Bushenhuoxue (BSHX) in a rat model of vascular dementia (VD). METHODS A rat model of VD was developed using bilateral common carotid artery occlusion (BCCAO). Rats were administered BSHX (10.14 or 5.07 g/kg), nimodipine (11.06 mg/kg; positive control), or saline (control) by gavage daily for 30 d post-surgery. Learning and memory abilities were assessed using the Morris water maze. Morphological changes in the hippocampus were observed using light microscopy (hematoxylin and eosin staining) and transmission electron microscopy (TEM). The mRNA and protein expression levels of brain-derived neurotrophic factor (BDNF), tyrosine receptor kinase B (TrkB), phosphatidyl inositol 3-kinase (PI3K), serine/threonine kinase (AKT), and cAMP response element binding protein (CREB) were measured by real-time polymerase chain reaction (RT-PCR) and Western blot, respectively. RESULTS Compared with the sham group, rats with BCCAO exhibited impaired learning and memory abilities (Morris water maze) and showed abnormalities in neuronal morphology (light microscopy) and ultrastructure (TEM) in the hippocampus. They also had decreased mRNA and protein expressions of BDNF, TrkB, PI3K, AKT, and CREB in hippocampal tissue (all P < 0.05). In rats with BCCAO, administration of BSHX attenuated deficits in learning and memory, improved the morphology and ultrastructure of hippocampal neurons, and enhanced mRNA and protein expression levels of BDNF, TrkB, PI3K, AKT, and CREB (all P < 0.05). CONCLUSION BSHX may protect hippocampal neurons and improve learning and memory abilities, at least in part via the activation of BDNF/TrkB/PI3K/AKT/CREB signaling.
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Affiliation(s)
- Wei Wang
- General Medical Practice, Shuangyushu Community Health Service Center of Haidian District, Beijing 100086, China
| | - Yixin Zhang
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
| | - Wentao Yu
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
| | - Weijuan Gao
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
| | - Ning Shen
- Acupuncture and Moxibustion Hospital of Chinese Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Bing Jin
- Department of Geriatrics, Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Xiangting Wang
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
| | - Chaoyi Fang
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
| | - Yanjun Wang
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, China
- and Hebei Key Laboratory of Chinese Medicine Research on Cardio-Cerebrovascular Disease, Shijiazhuang 050091, China
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Kim YG, Park DG, Moon SY, Jeon JY, Kim HJ, Kim DJ, Lee KW, Han SJ. Hypoglycemia and Dementia Risk in Older Patients with Type 2 Diabetes Mellitus: A Propensity-Score Matched Analysis of a Population-Based Cohort Study. Diabetes Metab J 2020; 44:125-133. [PMID: 31701690 PMCID: PMC7043983 DOI: 10.4093/dmj.2018.0260] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/19/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with an increased risk for dementia. The effects of hypoglycemia on dementia are controversial. Thus, we evaluated whether hypoglycemia increases the risk for dementia in senior patients with T2DM. METHODS We used the Korean National Health Insurance Service Senior cohort, which includes >10% of the entire senior population of South Korea. In total, 5,966 patients who had ever experienced at least one episode of hypoglycemia were matched with those who had not, using propensity score matching. The risk of dementia was assessed through a survival analysis of matched pairs. RESULTS Patients with underlying hypoglycemic events had an increased risk for all-cause dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) compared with those who had not experienced a hypoglycemic event (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.166 to 1.349; P<0.001 for all-cause dementia; HR, 1.264; 95% CI, 1.162 to 1.375; P<0.001 for AD; HR, 1.286; 95% CI, 1.110 to 1.490; P<0.001 for VaD). According to number of hypoglycemic episodes, the HRs of dementia were 1.170, 1.201, and 1.358 in patients with one hypoglycemic episode, two or three episodes, and more than three episodes, respectively. In the subgroup analysis, hypoglycemia was associated with an increased risk for dementia in both sexes with or without T2DM microvascular or macrovascular complications. CONCLUSION Our findings suggest that patients with a history of hypoglycemia have a higher risk for dementia. This trend was similar for AD and VaD, the two most important subtypes of dementia.
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Affiliation(s)
- Young Gun Kim
- Department of Medical Sciences, Ajou University Graduate School, Suwon, Korea
- Ministry of Health and Welfare, Gyeonggi Provincial Government, Suwon, Korea
| | - Dong Gyu Park
- Department of Neurology, Yeongwolgun Public Health Center, Yeongwol, Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Ja Young Jeon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Kwan Woo Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
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Kang MW, Park S, Lee S, Lee Y, Cho S, Han K, Cho H, Kim Y, Kim YC, Han SS, Lee H, Lee JP, Joo KW, Lim CS, Kim YS, Kim DK. Glomerular hyperfiltration is associated with dementia: A nationwide population-based study. PLoS One 2020; 15:e0228361. [PMID: 31990949 PMCID: PMC6986766 DOI: 10.1371/journal.pone.0228361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/13/2020] [Indexed: 01/06/2023] Open
Abstract
Background Glomerular hyperfiltration may be a clinical phenotype of endothelial dysfunction. Endothelial dysfunction may cause vascular dementia through the deterioration of cerebral blood flow. We aimed to identify the risk of dementia in people with glomerular hyperfiltration. Methods Using the Korean National Health Information Database, we included subjects aged ≥45 years who underwent national health screening examinations between 2012 and 2015 and who had no previous history of end-stage renal disease or dementia (n = 2,244,582). The primary exposure was glomerular hyperfiltration. We divided the subjects into groups by sex and five-year age intervals and categorized each group into 8 intervals according to estimated glomerular filtration (eGFR). The subjects with an eGFR ≥95th percentile in each group were defined as the hyperfiltration group. The outcomes were development of all types of dementia, Alzheimer's dementia and vascular dementia. Multivariable Cox proportional hazards models were used to analyze the hazard ratios (HRs) for outcomes. Results The Hyperfiltration group showed a higher risk for the development of all types of dementia [adjusted HR 1.09 (95% CI, 1.03–1.15)] and vascular dementia [adjusted HR 1.33 (95% CI, 1.14–1.55)] than the reference group. However, the association between hyperfiltration and Alzheimer's dementia was not statistically significant. Conclusions Glomerular hyperfiltration may be associated with dementia. In this respect, subjects with glomerular hyperfiltration should be monitored more closely for signs and symptoms of dementia.
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Affiliation(s)
- Min Woo Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sehoon Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Soojin Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeonhee Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Semin Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yaerim Kim
- Department of Internal Medicine, Keimyung School of Medicine, Seoul, Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Chun Soo Lim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Wang F, Yang J, Yang X, Wang L, Zheng C, Ming D. Effects of Gastrin-releasing Peptide on Hippocampal Neural Networks in Vascular Dementia Rats .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:4400-4403. [PMID: 31946842 DOI: 10.1109/embc.2019.8857771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Gastrin-releasing peptide (GRP) has been confirmed to exhibit a variety of physiological functions in the brain and play a role in many neurological diseases. Our previous research found that GRP could restore the impaired synaptic plasticity and the spatial learning and memory impairments induced by vascular dementia (VD). However, the specific mechanisms of GRP affecting hippocampus, especially the effects on the neuronal oscillations were still poorly understood. In this study, we examined the effects of GRP on the changes of the interactions between theta and gamma oscillations in the hippocampal CA3-CA1 pathway of VD rats and explored the potential electrophysiological mechanism. To this purpose, local field potentials (LFPs) simultaneously collected from hippocampal CA3 and CA1 were measured by the power spectrum, phase synchronization, phase-phase coupling (PPC) and phase-amplitude coupling (PAC). We found that GRP substantially restored the phase synchronization of the theta and gamma oscillations. The GRP also significantly improved the strength of theta-gamma cross-frequency coupling (including theta-gamma PPC and theta-gamma PAC) in the CA3-CA1 network. The results indicated that GRP could alleviate the changes of neural activities in hippocampal CA3-CA1 pathway induced by VD. This might be an electrophysiological mechanism for GRP preventing cognitive impairments induced by VD.
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Cantone M, Lanza G, Fisicaro F, Pennisi M, Bella R, Di Lazzaro V, Di Pino G. Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation. Neural Plast 2020; 2020:8820881. [PMID: 33193753 PMCID: PMC7641667 DOI: 10.1155/2020/8820881] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called "brains at risk" for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.
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Affiliation(s)
- Mariagiovanna Cantone
- 1Department of Neurology, Sant'Elia Hospital, ASP Caltanissetta, Caltanissetta 93100, Italy
| | - Giuseppe Lanza
- 2Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
- 3Department of Neurology IC, Oasi Research Institute–IRCCS, Troina 94108, Italy
| | - Francesco Fisicaro
- 4Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
| | - Manuela Pennisi
- 4Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
| | - Rita Bella
- 5Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania 95123, Italy
| | - Vincenzo Di Lazzaro
- 6Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome 00128, Italy
| | - Giovanni Di Pino
- 7Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction (NeXTlab), Università Campus Bio-Medico di Roma, Rome 00128, Italy
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Nagata S, Yamasaki M, Kitamura K. Polyethylene glycol-conjugated human adrenomedullin as a possible treatment for vascular dementia. Peptides 2019; 121:170133. [PMID: 31449828 DOI: 10.1016/j.peptides.2019.170133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/25/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 12/24/2022]
Abstract
Adrenomedullin (AM) is a multifunctional bioactive peptide. Recent studies have shown that AM has protective effects against ischemic brain damage. We recently prepared a long-acting human AM derivative that was conjugated with a 60 kDa polyethylene glycol (PEG-AM), which had an effect similar to that of native AM. In this study, we examined the effect of PEG-AM on four-vessel occlusion model rats, which exhibit vascular dementia. From day 10 to day 14 after surgery, the learning and memory abilities of the rats were examined using a Morris water maze. The rats were treated with a single subcutaneous injection of 1.0 or 10.0 nmol/kg of PEG-AM. PEG-AM treatment reduced the escape latency in the hidden platform test. Furthermore, the treatment increased the time spent in the platform quadrant in the probe test. The data showed that PEG-AM injection prevented memory loss and learning disorders in dose-dependent manner. On day 14, the immunoreactive AM concentration in plasma was 9.749 ± 2.167 pM in the high-dose group (10.0 nmol/kg) and 0.334 ± 0.073 pM in the low-dose group (1.0 nmol/kg). However, even in the low-dose group, a significant effect was observed in both tests. The present data indicate that PEG-AM is a possible therapeutic agent for the treatment of ischemic brain injury or vascular dementia.
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Affiliation(s)
- Sayaka Nagata
- Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692, Japan.
| | - Motoo Yamasaki
- Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692, Japan
| | - Kazuo Kitamura
- Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692, Japan
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25
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Xiao Y, Shen H, Li R, Zhou X, Xiao H, Yan J. A Novel Octapeptide Derived From G Protein-Coupled Receptor 124 Improves Cognitive Function Via Pro-Angiogenesis In A Rat Model Of Chronic Cerebral Hypoperfusion-Induced Vascular Dementia. Drug Des Devel Ther 2019; 13:3669-3682. [PMID: 31695334 PMCID: PMC6815762 DOI: 10.2147/dddt.s226473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/02/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The lack of effective therapies mandates the development of new treatment strategies for vascular dementia (VaD). G protein-coupled receptor 124 (GPR124) may be a therapeutic target for angiogenesis-related diseases of CNS, including VaD. The GCPF peptide is a truncated and screened fragment of the GPR124 extracellular domain. The potential use of GCPF for VaD treatment, angiogenesis and targeting of integrin αvβ3 are evaluated. METHODS AND RESULTS First, the in vivo results indicated that the GCPF peptide could decrease mean escape latency and increase platform crossing times in BCCAO rats. Second, the in vitro and ex vivo results indicated that the GCPF peptide was an active angiogenic peptide and could promote hCMEC/D3 cell migration and adhesion to ECM molecules. Third, in silico analyses predicted that GCPF could specifically interact with integrin αvβ3; the ∆G of GCPF binding to the binding pocket was -16.402 KJ/mol. The molecular characteristics indicated that highly hydrophilic GCPF with a pI of 11.70 had a short half-life in mammals (~1 hr). Finally, the ELISA experiments indicated that low dissociation constant (Kd= 2.412±0.455 nM) corresponds to the high affinity of GCPF for integrin αvβ3. CONCLUSION The data indicate that adhesion of GCPF immobilized on ECM surface to endothelial cells via integrin αvβ3 modulates cellular functions to promote angiogenesis and improve cognitive function. This is the first report to prove that GCPF, a novel octapeptide, may be an effective strategy for VaD therapy.
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Affiliation(s)
- Ying Xiao
- College of Science, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Hong Shen
- Neuro-Psychiatric Institute, Nanjing Medical University Affiliated Brain Hospital, Nanjing, People’s Republic of China
| | - Rui Li
- School of Pharmacy, Nanjing Medical University, Nanjing, Nanjing, People’s Republic of China
| | - Xia Zhou
- Neuro-Psychiatric Institute, Nanjing Medical University Affiliated Brain Hospital, Nanjing, People’s Republic of China
| | - Hong Xiao
- Neuro-Psychiatric Institute, Nanjing Medical University Affiliated Brain Hospital, Nanjing, People’s Republic of China
| | - Jun Yan
- Department of Geriatric Neurology, Nanjing Medical University Affiliated Brain Hospital, Nanjing, People’s Republic of China
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Abstract
Maintaining normal learning and memory functions requires a high degree of coordination between neural and vascular cells. Basic and clinical studies have shown that brain microvasculature dysfunction activates inflammatory cells in the brain, leading to progressive neuronal loss and eventually dementia. This review focuses on recent studies aimed at identifying the molecular events that link cerebral microvascular dysfunction to neurodegeneration, including oxidative/nitrosative stress, cellular metabolic dysfunction, inflammatory signalling and abnormal synaptic plasticity. A better understanding of the coupling between vasculature and brain neurons and how this coupling is disrupted under pathological conditions is of great significance in identifying new diagnostic and treatment targets for dementia for which no new drugs have been approved since 2003.
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Affiliation(s)
- Feng Han
- Key Laboratory of Cardiovascular and Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
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Perri R, Monaco M, Fadda L, Caltagirone C, Carlesimo GA. Influence of controlled encoding and retrieval facilitation on memory performance of patients with subcortical ischemic vascular dementia and Alzheimer's disease. J Neurol 2019; 266:2447-2456. [PMID: 31214768 DOI: 10.1007/s00415-019-09411-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/23/2019] [Revised: 05/09/2019] [Accepted: 05/30/2019] [Indexed: 11/25/2022]
Abstract
Patients with subcortical ischemic vascular dementia (SIVD) perform better than Alzheimer's disease patients (AD) on the Free and Cued Recall Selective Reminding test (FCSRT). In this test, SIVD are able to overcome their strategic retrieval deficit, whereas AD patients, whose memory impairment is due to a hippocampal storage deficit, are not. However, the FCSRT does not assess the advantage passing from free to assisted learning, which is expected to be different in frontal and hippocampal damage. We compared SIVD, AD and healthy subjects on the free recall of a 15-word list not assisted at encoding and on the free and cued recall of the FCRST. Indexes of Encoding, Cueing and Total (measuring the advantage passing from the 15-word list free recall to the free and cued recall of the FCRST) were computed. The two groups performed comparably poorly on the free recall of the 15-word list, but SIVD outperformed AD patients in the free and cued recall of the FCSRT and took greater advantage than AD patients on both learning and recall when passing from the unassisted to the assisted paradigms. All indexes significantly predicted diagnostic group membership, but the Total Index showed the larger classification accuracy with 80% of AD and 71% of SIVD correctly classified. These results confirm that the FCRST is able to differentiate AD and SIVD patients with a good level of accuracy. However, the evaluation of memory performance variation as a function of support to encoding provides additional data able to increase diagnostic reliability.
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Affiliation(s)
- Roberta Perri
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy.
| | - Marco Monaco
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy
| | - Lucia Fadda
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Carlo Caltagirone
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Giovanni A Carlesimo
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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28
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Park SY, Kim HY, Lee YS, Heo HJ, Shin HK, Lee WS, Hong KW, Kim CD. Augmented improvement of cognition and memory by aripiprazole add-on for cilostazol treatment in the chronic cerebral hypoperfusion mouse model. Behav Brain Res 2019; 365:133-140. [PMID: 30851315 DOI: 10.1016/j.bbr.2019.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/17/2019] [Revised: 02/21/2019] [Accepted: 03/04/2019] [Indexed: 12/27/2022]
Abstract
Cerebrovascular dysfunction is associated with cognitive impairment in vascular dementia patients. This study aimed to explore augmented improvement of cognition and memory by aripiprazole add-on for cilostazol treatment in vascular dementia model. Male C57BL/6 mice were subjected to BCAS, and spatial probe and memory retention were examined using the Morris water maze (MWM) test. In the present study, the escape latency on the first day after 3rd week was 21.4 ± 4.0 s in sham-operated mice, and 76.3 ± 4.2 s in the vehicle-treated BCAS mice. In the spatial probe tests in the 3rd week, aripiprazole (1 mg/kg/day) showed time-dependently amelioration in spatial learning and memory impairments in contrast to 0.5 mg/kg/day. After treatment with 20 mg/kg/day of cilostazol for 3 weeks, the escape latency significantly decreased to 26.6 ± 5.8 s on the first day and further shortened to 21.6 ± 6.8 s on the fourth day. When the BCAS mice were concurrently treated with 0.5 mg/kg/day aripiprazole plus 20 mg/kg/day of cilostazol for 3 weeks, the escape latency was more shortened from 20.4 ± 1.2 s (1st day) to 14.9 ± 1.7 s on the 4th day of the 3-week trials. Furthermore, decreased spatial memory retention in BCAS mice was significantly alleviated by aripiprazole plus cilostazol cotreatment, indicating the benefit of aripiprazole add-on therapy. In line with these, significantly increased mBDNF and P-CREB levels and reduced apoptosis were identified in the BCAS mouse brain dentate gyrus by cotreatment as contrasted to each monotherapy. These results may provide the synergistic therapeutic avenues for augmented improvement of cognition and memory by cotreatment with aripiprazole plus cilostazol in cases of vascular dementia.
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Affiliation(s)
- So Youn Park
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea; Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Hae Young Kim
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea; Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Yi Sle Lee
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea; Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Hye Jin Heo
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea; Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Hwa Kyoung Shin
- Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Won Suk Lee
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Ki Whan Hong
- Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Chi Dae Kim
- Department of Pharmacology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea; Gene & Cell Therapy Research Center for Vessel-Associated Diseases, Pusan National University, Gyeongsangnam-do, Republic of Korea.
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Morel E, Armand S, Assal F, Allali G. Is frontal gait a myth in normal pressure hydrocephalus? J Neurol Sci 2019; 402:175-179. [PMID: 31158556 DOI: 10.1016/j.jns.2019.05.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 01/29/2019] [Revised: 05/06/2019] [Accepted: 05/25/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with idiopathic normal pressure hydrocephalus (iNPH) are considered to present a magnetic, slow, wide-based gait, also called frontal gait. However, this gait profile is not specific for iNPH and encountered in patients with other neurological conditions mimicking iNPH (i.e. iNPH mimics), such as vascular dementia. We aimed to characterize the gait profiles in iNPH and their mimics and to compare the prevalence of clinical gait abnormalities between both groups. METHODS This retrospective study included 140 patients suspected of iNPH (76.3 ± 6.8 yo; 30.7% female). Eighty patients (57.1%) were diagnosed with iNPH according to the NPH consensus guidelines criteria; the remaining sixty patients were classified as mimics (23 neurodegenerative conditions, 12 multifactorial conditions, 9 vascular dementia, 7 mixed dementias, 6 toxic conditions, 2 psychiatric conditions, and 1 stroke). Two independent diagnosis-blinded clinicians (kappa, 0.73) evaluated gait according to four categories: frontal gait, parkinsonian gait, other clinical gait abnormalities, and normal gait. RESULTS iNPH patients and mimics shared similar clinical characteristics. Frontal gait occurred in only 26% of patients (with a similar prevalence for the mimics). Parkinsonian gait was significantly more prevalent among the mimics (32% versus 15%; p-value: 0.032). This association between parkinsonian gait and mimics remained significant after adjusting for age, gender, comorbidities and white matter changes (OR: 2.404; 95% CI: [1.03-5.64]; p value: 0.044). CONCLUSION Frontal gait is not the most prevalent gait abnormality in iNPH and does not discriminate iNPH from its mimics. Parkinsonian gait is more prevalent among the mimics.
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Affiliation(s)
- Eric Morel
- Department of Internal Medicine, Regionalspital Emmental AG, Burgdorf, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Stéphane Armand
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Willy Taillard Laboratory of Kinesiology, University Geneva Hospitals, Geneva, Switzerland
| | - Frédéric Assal
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Clinical Neurosciences, Division of Neurology, University Geneva Hospitals, Geneva, Switzerland
| | - Gilles Allali
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Clinical Neurosciences, Division of Neurology, University Geneva Hospitals, Geneva, Switzerland; Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA
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30
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de Montgolfier O, Pouliot P, Gillis MA, Ferland G, Lesage F, Thorin-Trescases N, Thorin É. Systolic hypertension-induced neurovascular unit disruption magnifies vascular cognitive impairment in middle-age atherosclerotic LDLr -/-:hApoB +/+ mice. GeroScience 2019; 41:511-532. [PMID: 31093829 DOI: 10.1007/s11357-019-00070-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 03/25/2019] [Accepted: 04/16/2019] [Indexed: 12/20/2022] Open
Abstract
Cognitive functions are dependent upon intercommunications between the cellular components of the neurovascular unit (NVU). Vascular risk factors are associated with a more rapid rate of cognitive decline with aging and cerebrovascular diseases magnify both the incidence and the rate of cognitive decline. The causal relationship between vascular risk factors and injury to the NVU is, however, lacking. We hypothesized that vascular risk factors, such as hypertension and dyslipidemia, promote disruption of the NVU leading to early cognitive impairment. We compared brain structure and cerebrovascular functions of 1-year old (middle-aged) male wild-type (WT) and atherosclerotic hypertensive (LDLr-/-:hApoB+/+, ATX) mice. In addition, mice were subjected, or not, to a transverse aortic constriction (TAC) for 6 weeks to assess the acute impact of an increase in systolic blood pressure on the NVU and cognitive functions. Compared with WT mice, ATX mice prematurely developed cognitive decline associated with cerebral micro-hemorrhages, loss of microvessel density and brain atrophy, cerebral endothelial cell senescence and dysfunction, brain inflammation, and oxidative stress associated with blood-brain barrier leakage and brain hypoperfusion. These data suggest functional disturbances in both vascular and parenchymal components of the NVU. Exposure to TAC-induced systolic hypertension promoted cerebrovascular damage and cognitive decline in WT mice, similar to those observed in sham-operated ATX mice; TAC exacerbated the existing cerebrovascular dysfunctions and cognitive failure in ATX mice. Thus, a hemodynamic stress such as systolic hypertension could initiate the cascade involving cerebrovascular injury and NVU deregulation and lead to cognitive decline, a process accelerated in atherosclerotic mice.
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Affiliation(s)
- Olivia de Montgolfier
- Faculty of Medicine, Department of pharmacology and physiology, Université de Montréal, Montreal, QC, Canada
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada
| | - Philippe Pouliot
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada
- Ecole Polytechnique de Montréal, Montreal, QC, Canada
| | - Marc-Antoine Gillis
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada
| | - Guylaine Ferland
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada
- Faculty of Medicine, Department of nutrition, Université de Montréal, Montreal, QC, Canada
| | - Frédéric Lesage
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada
- Ecole Polytechnique de Montréal, Montreal, QC, Canada
| | | | - Éric Thorin
- Faculty of Medicine, Department of pharmacology and physiology, Université de Montréal, Montreal, QC, Canada.
- Research Center, Montreal Heart Institute, 5000 rue Bélanger Est, Montreal, QC, H1T 1C8, Canada.
- Faculty of Medicine, Department of surgery, Université de Montréal, Montreal, QC, Canada.
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31
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Fulop GA, Tarantini S, Yabluchanskiy A, Molnar A, Prodan CI, Kiss T, Csipo T, Lipecz A, Balasubramanian P, Farkas E, Toth P, Sorond F, Csiszar A, Ungvari Z. Role of age-related alterations of the cerebral venous circulation in the pathogenesis of vascular cognitive impairment. Am J Physiol Heart Circ Physiol 2019; 316:H1124-H1140. [PMID: 30848677 PMCID: PMC6580383 DOI: 10.1152/ajpheart.00776.2018] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/31/2019] [Accepted: 02/18/2019] [Indexed: 02/07/2023]
Abstract
There has been an increasing appreciation of the role of vascular contributions to cognitive impairment and dementia (VCID) associated with old age. Strong preclinical and translational evidence links age-related dysfunction and structural alterations of the cerebral arteries, arterioles, and capillaries to the pathogenesis of many types of dementia in the elderly, including Alzheimer's disease. The low-pressure, low-velocity, and large-volume venous circulation of the brain also plays critical roles in the maintenance of homeostasis in the central nervous system. Despite its physiological importance, the role of age-related alterations of the brain venous circulation in the pathogenesis of vascular cognitive impairment and dementia is much less understood. This overview discusses the role of cerebral veins in the pathogenesis of VCID. Pathophysiological consequences of age-related dysregulation of the cerebral venous circulation are explored, including blood-brain barrier disruption, neuroinflammation, exacerbation of neurodegeneration, development of cerebral microhemorrhages of venous origin, altered production of cerebrospinal fluid, impaired function of the glymphatics system, dysregulation of cerebral blood flow, and ischemic neuronal dysfunction and damage. Understanding the age-related functional and phenotypic alterations of the cerebral venous circulation is critical for developing new preventive, diagnostic, and therapeutic approaches to preserve brain health in older individuals.
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Affiliation(s)
- Gabor A Fulop
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Heart and Vascular Center, Semmelweis University , Budapest , Hungary
| | - Stefano Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Andrea Molnar
- Heart and Vascular Center, Semmelweis University , Budapest , Hungary
| | - Calin I Prodan
- Veterans Affairs Medical Center , Oklahoma City, Oklahoma
- Department of Neurology, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Tamas Kiss
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Vascular Cognitive Impairment Program, Department of Medical Physics and Informatics, University of Szeged , Szeged , Hungary
| | - Tamas Csipo
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Agnes Lipecz
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Priya Balasubramanian
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
| | - Eszter Farkas
- Vascular Cognitive Impairment Program, Department of Medical Physics and Informatics, University of Szeged , Szeged , Hungary
| | - Peter Toth
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Cerebrovascular Laboratory, Department of Neurosurgery and Szentagothai Research Center, University of Pecs Medical School , Pecs , Hungary
| | - Farzaneh Sorond
- Department of Neurology, Northwestern University , Chicago, Illinois
| | - Anna Csiszar
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Vascular Cognitive Impairment Program, Department of Medical Physics and Informatics, University of Szeged , Szeged , Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Translational Geroscience Laboratory, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma
- Vascular Cognitive Impairment Program, Department of Medical Physics and Informatics, University of Szeged , Szeged , Hungary
- Semmelweis University, Department of Pulmonology , Budapest , Hungary
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32
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Sohn E, Kim YJ, Lim HS, Kim BY, Jeong SJ. Hwangryunhaedok-Tang Exerts Neuropreventive Effect on Memory Impairment by Reducing Cholinergic System Dysfunction and Inflammatory Response in a Vascular Dementia Rat Model. Molecules 2019; 24:molecules24020343. [PMID: 30669383 PMCID: PMC6358959 DOI: 10.3390/molecules24020343] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 01/02/2023] Open
Abstract
Hwangryunhaedok-tang (HRT) is a traditional oriental herbal formula used in Asian countries for treating inflammatory diseases and controlling fever. Our present study aimed to determine whether HRT has therapeutic effects for patients with vascular dementia (VaD) using a bilateral common carotid artery occlusion (BCCAO) rat model and assessing spatial memory impairment and activation of neuroinflammation. BCCAO was performed in male Sprague Dawley rats to induce VaD, and oral HRT was administered daily for 30 d. Our data showed that HRT ameliorated BCCAO-induced memory and cognitive impairment in behavioral tests. In addition, HRT reversed cholinergic dysfunction and neuronal damage in the hippocampus of BCCAO rats. Furthermore, HRT attenuated microglial activation and reduced the phosphorylation of p38 mitogen-activated protein kinase and c-Jun N-terminal kinase (JNK) induced by BCCAO. Simultaneous high-performance liquid chromatography analysis of HRT using index compounds from the herbal composition revealed that both HRT ethanol extract and commercial HRT granules primarily comprise geniposide, baicalin, and berberine. Our study showed that HRT administration resulted in the prevention of neuronal injury induced by BCCAO through improvement of cholinergic dysfunction and inhibition of neuroinflammatory responses, suggesting that HRT may have potential as a treatment for VaD.
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Affiliation(s)
- Eunjin Sohn
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Yu Jin Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea.
| | - Hye-Sun Lim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Bu-Yeo Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Soo-Jin Jeong
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
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33
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Quintana DD, Ren X, Hu H, Engler-Chiurazzi EB, Rellick SL, Lewis SE, Povroznik JM, Simpkins JW, Alvi M. Gradual common carotid artery occlusion as a novel model for cerebrovascular Hypoperfusion. Metab Brain Dis 2018; 33:2039-2044. [PMID: 30267298 PMCID: PMC6342504 DOI: 10.1007/s11011-018-0312-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022]
Abstract
Chronic cerebrovascular hypoperfusion results in vascular dementia and increases predisposition to lacunar infarcts. However, there are no suitable animal models. In this study, we developed a novel model for chronic irreversible cerebral hypoperfusion in mice. Briefly, an ameroid constrictor was placed on the right carotid artery to gradually occlude the vessel, while a microcoil was placed on the left carotid artery to prevent compensation of the blood flow. This procedure resulted in a gradual hypoperfusion developing over a period of 34 days with no cerebral blood flow recovery. Histological analysis of the brain revealed neuronal and axonal degeneration as well as necrotic lesions. The most severely affected regions were located in the hippocampus and the corpus callosum. Overall, our paradigm is a viable model to study brain pathology resulting from gradual cerebrovascular hypoperfusion.
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Affiliation(s)
- Dominic D Quintana
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
| | - Xuefang Ren
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA.
- Department of Microbiology, Immunology & Cell Biology, West Virginia University, Morgantown, WV, 26506, USA.
- Experimental Stroke Core, Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, 26506, USA.
- One Medical Center Drive, West Virginia University, Morgantown, WV, 26506, USA.
| | - Heng Hu
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
- Experimental Stroke Core, Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, 26506, USA
| | - Elizabeth B Engler-Chiurazzi
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
| | - Stephanie L Rellick
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
| | - Sara E Lewis
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
| | - Jessica M Povroznik
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
| | - James W Simpkins
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, 26506, USA
- Experimental Stroke Core, Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, 26506, USA
| | - Mohammad Alvi
- One Medical Center Drive, West Virginia University, Morgantown, WV, 26506, USA.
- Department of Neurology, Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV, 26506, USA.
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34
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Sun W, Li M, Lin T, Sun Z, Xie Y, Ji S, Lin J, Wang L, Jia C, Zheng L, Wu W, Xu D. Effect of acupuncture at 3-points for intelligence on vascular dementia: Protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e12892. [PMID: 30335014 PMCID: PMC6211871 DOI: 10.1097/md.0000000000012892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Vascular dementia (VD) is a commonly-seen disease in the elderly. What is more, "Acupuncture at 3-points for intelligence" is one of the most important components of "Jin's three-needle therapy" created by Rui Jin, a professor of Guangzhou University of Chinese Medicine, which can be used in the VD patients. In this article, researchers will assess the clinical efficacy and safety of acupuncture at 3-points for intelligence in the treatment of VD. METHODS A systematic literature search for articles up to September 2018 will be conducted using 9 databases: PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, Wanfang database, OASIS, and CiNii. Inclusion criteria are randomized controlled trials (RCTs) of acupuncture at 3-points for intelligence on treating VD. The primary outcome measures will be scores reflecting the neurological function of participants based on common medical scales. Hemorheology indexes, homocysteine (Hcy), acetylcholine (Ach), nitric oxide (NO), and adverse events will also be assessed. Stata V.13.0 software will be used for data synthesis, sensitivity analysis, meta-regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. Egger and Begg tests will be further performed to conduct quantitative evaluation of publication bias and to evaluate the symmetry of funnel plot. We will use the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of evidence. RESULTS The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION Our study will provide the evidence for the clinical efficacy and safety of acupuncture at 3-points for intelligence in the treatment of VD.
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Affiliation(s)
| | - Minying Li
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| | | | | | | | | | - Jietao Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chao Jia
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Liang Zheng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Wei Wu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Danghan Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
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35
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Adamski MG, Sternak M, Mohaissen T, Kaczor D, Wierońska JM, Malinowska M, Czaban I, Byk K, Lyngsø KS, Przyborowski K, Hansen PBL, Wilczyński G, Chlopicki S. Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice. J Am Heart Assoc 2018; 7:e007694. [PMID: 29581224 PMCID: PMC5907583 DOI: 10.1161/jaha.117.007694] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/18/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although advanced heart failure (HF) is a clinically documented risk factor for vascular cognitive impairment, the occurrence and pathomechanisms of vascular cognitive impairment in early stages of HF are equivocal. Here, we characterize vascular cognitive impairment in the early stages of HF development and assess whether cerebral hypoperfusion or prothrombotic conditions are involved. METHODS AND RESULTS Tgαq*44 mice with slowly developing isolated HF triggered by cardiomyocyte-specific overexpression of G-αq*44 protein were studied before the end-stage HF, at the ages of 3, 6, and 10 months: before left ventricle dysfunction; at the stage of early left ventricle diastolic dysfunction (with preserved ejection fraction); and left ventricle diastolic/systolic dysfunction, respectively. In 6- to 10-month-old but not in 3-month-old Tgαq*44 mice, behavioral and cognitive impairment was identified with compromised blood-brain barrier permeability, most significantly in brain cortex, that was associated with myelin sheet loss and changes in astrocytes and microglia. Brain endothelial cells displayed increased E-selectin immunoreactivity, which was accompanied by increased amyloid-β1-42 accumulation in piriform cortex and increased cortical oxidative stress (8-OHdG immunoreactivity). Resting cerebral blood flow measured by magnetic resonance imaging in vivo was preserved, but ex vivo NO-dependent cortical arteriole flow regulation was impaired. Platelet hyperreactivity was present in 3- to 10-month-old Tgαq*44 mice, but it was not associated with increased platelet-dependent thrombogenicity. CONCLUSIONS We report for the first time that vascular cognitive impairment is already present in the early stage of HF development, even before left ventricle systolic dysfunction. The underlying pathomechanism, independent of brain hypoperfusion, involves preceding platelet hyperreactivity and brain endothelium inflammatory activation.
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MESH Headings
- Amyloid beta-Peptides/metabolism
- Animals
- Behavior, Animal
- Blood Platelets/metabolism
- Blood-Brain Barrier/metabolism
- Blood-Brain Barrier/physiopathology
- Brain/blood supply
- Capillary Permeability
- Cerebral Arteries/metabolism
- Cerebral Arteries/physiopathology
- Cerebrovascular Circulation
- Cognition
- Cognition Disorders/etiology
- Cognition Disorders/metabolism
- Cognition Disorders/physiopathology
- Cognition Disorders/psychology
- Dementia, Vascular/etiology
- Dementia, Vascular/metabolism
- Dementia, Vascular/physiopathology
- Dementia, Vascular/psychology
- Disease Models, Animal
- Disease Progression
- Encephalitis/etiology
- Encephalitis/metabolism
- Encephalitis/pathology
- Encephalitis/physiopathology
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Female
- GTP-Binding Protein alpha Subunits, Gq-G11/genetics
- Genetic Predisposition to Disease
- Heart Failure/complications
- Heart Failure/genetics
- Heart Failure/metabolism
- Heart Failure/physiopathology
- Mice, Transgenic
- Myocytes, Cardiac/metabolism
- Peptide Fragments/metabolism
- Phenotype
- Time Factors
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Function, Left
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Affiliation(s)
- Mateusz G Adamski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Magdalena Sternak
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Tasnim Mohaissen
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Dawid Kaczor
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | | | - Monika Malinowska
- Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
| | - Iwona Czaban
- Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
| | - Katarzyna Byk
- Institute of Nuclear Physics, Polish Academy of Sciences, Warsaw, Poland
| | | | - Kamil Przyborowski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Pernille B L Hansen
- University of Southern Denmark, Odense, Denmark
- Cardiovascular and Metabolic Disease, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Grzegorz Wilczyński
- Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
| | - Stefan Chlopicki
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
- Chair of Pharmacology, Jagiellonian University, Medical College, Kraków, Poland
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36
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Higaki A, Mogi M, Iwanami J, Min LJ, Bai HY, Shan BS, Kukida M, Kan-no H, Ikeda S, Higaki J, Horiuchi M. Predicting outcome of Morris water maze test in vascular dementia mouse model with deep learning. PLoS One 2018; 13:e0191708. [PMID: 29415035 PMCID: PMC5802845 DOI: 10.1371/journal.pone.0191708] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/10/2018] [Indexed: 01/12/2023] Open
Abstract
The Morris water maze test (MWM) is one of the most popular and established behavioral tests to evaluate rodents’ spatial learning ability. The conventional training period is around 5 days, but there is no clear evidence or guidelines about the appropriate duration. In many cases, the final outcome of the MWM seems predicable from previous data and their trend. So, we assumed that if we can predict the final result with high accuracy, the experimental period could be shortened and the burden on testers reduced. An artificial neural network (ANN) is a useful modeling method for datasets that enables us to obtain an accurate mathematical model. Therefore, we constructed an ANN system to estimate the final outcome in MWM from the previously obtained 4 days of data in both normal mice and vascular dementia model mice. Ten-week-old male C57B1/6 mice (wild type, WT) were subjected to bilateral common carotid artery stenosis (WT-BCAS) or sham-operation (WT-sham). At 6 weeks after surgery, we evaluated their cognitive function with MWM. Mean escape latency was significantly longer in WT-BCAS than in WT-sham. All data were collected and used as training data and test data for the ANN system. We defined a multiple layer perceptron (MLP) as a prediction model using an open source framework for deep learning, Chainer. After a certain number of updates, we compared the predicted values and actual measured values with test data. A significant correlation coefficient was derived form the updated ANN model in both WT-sham and WT-BCAS. Next, we analyzed the predictive capability of human testers with the same datasets. There was no significant difference in the prediction accuracy between human testers and ANN models in both WT-sham and WT-BCAS. In conclusion, deep learning method with ANN could predict the final outcome in MWM from 4 days of data with high predictive accuracy in a vascular dementia model.
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Affiliation(s)
- Akinori Higaki
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
- * E-mail:
| | - Masaki Mogi
- Department of Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Jun Iwanami
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Li-Juan Min
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Hui-Yu Bai
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Bao-Shuai Shan
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Masayoshi Kukida
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Harumi Kan-no
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Shuntaro Ikeda
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Jitsuo Higaki
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
| | - Masatsugu Horiuchi
- Department of Molecular Cardiovascular Biology and Pharmacology, Ehime University, Graduate School of Medicine, Tohon, Ehime, Japan
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Tasci I, Safer U, Naharci MI, Gezer M, Demir O, Bozoglu E, Doruk H. Undetected Peripheral Arterial Disease Among Older Adults With Alzheimer's Disease and Other Dementias. Am J Alzheimers Dis Other Demen 2018; 33:5-11. [PMID: 28786294 PMCID: PMC10852521 DOI: 10.1177/1533317517724000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 04/03/2024]
Abstract
BACKGROUND Peripheral arterial disease (PAD) was reported to increase the risk of dementia(s) even more than stroke. We assessed the prevalence of PAD in a group with definite diagnosis of dementia. METHODS Patients aged 65 years or older with Alzheimer's disease (AD), vascular dementia (VaD), or AD-VaD were enrolled (n = 162, mean age: 78.87 [6.05] years). An age- and gender-matched control group was also included (n = 190). Peripheral arterial disease was diagnosed by the ankle-brachial index. RESULTS Frequency of PAD among patients with and without dementia was 35.2% and 16.3%, respectively ( P < .001), being similar among different types of dementia. After adjustment for covariates, dementia (odds ratio: 2.41, 95% confidence interval: 1.34-4.32; P = .003) was among the predictors of PAD diagnosis along with older age, female gender, and diabetes. CONCLUSIONS The prevalence of PAD was more than double in patients with dementia, with no difference among AD, VaD, and AD-VaD types.
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Affiliation(s)
- Ilker Tasci
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Umut Safer
- Internal Medicine Clinic, Sultan Abulhamid Teaching and Research Hospital, Turkish Ministry of Health, Istanbul, Turkey
| | - Mehmet Ilkin Naharci
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Mustafa Gezer
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Orhan Demir
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Ergun Bozoglu
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Huseyin Doruk
- Department of Internal Medicine, Gulhane Medical School, Health Sciences University, Ankara, Turkey
- Internal Medicine Clinic, Gulhane Teaching and Research Hospital, Turkish Ministry of Health, Ankara, Turkey
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Ambrose CT. The Role of Capillaries in the Lesser Ailments of Old Age and in Alzheimer's Disease and Vascular Dementia: The Potential of Pro-Therapeutic Angiogenesis. J Alzheimers Dis 2018; 54:31-43. [PMID: 27392865 DOI: 10.3233/jad-160303] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Apart from chronic diseases (arthritis, diabetes, etc.), old age is generally characterized by three lesser ailments: muscle weakness, minor memory lapses, and cold intolerance. This trio of complaints may have a common, underlying cause, namely, the age-associated reduced microcirculation in muscles, brain, skin, and elsewhere in the body. The Angiogenesis Hypothesis proposes that old age is in part a deficiency disease due to the decline in angiogenic (AG) factors, resulting in a reduced capillary density (CD) throughout the body. Over fifty published papers document waning levels of AG factors and/or decreased CD in various organ systems of aged animals and people, including those with Alzheimer's disease. The deficiency of AG factors is analogous to that of certain hormones (e.g., testosterone) whose blood levels also decline with age. In theory, therapeutic angiogenesis employing recombinant AG factors is a tenable treatment for the lesser ailments of old age and may improve the later years of human life. An optimal administration route may be intranasal.
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Choi DH, Lee J. A Mini-Review of the NADPH oxidases in Vascular Dementia: Correlation with NOXs and Risk Factors for VaD. Int J Mol Sci 2017; 18:ijms18112500. [PMID: 29165383 PMCID: PMC5713465 DOI: 10.3390/ijms18112500] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023] Open
Abstract
Oxidative stress (OS) is one of the factors that cause dementia conditions such as Alzheimer’s disease and vascular dementia (VaD). In the pathogenesis of VaD, OS is associated with risk factors that include increased age, hypertension, and stroke. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (NOXs) are a molecular source of reactive oxygen species (ROS). According to recent studies, inhibition of NOX activity can reduce cognitive impairment in animal models of VaD. In this article, we review the evidence linking cognitive impairment with NOX-dependent OS, including the vascular NOX and non-vascular NOX systems, in VaD.
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Affiliation(s)
- Dong-Hee Choi
- Center for Neuroscience Research, Institute of Biomedical Science & Technology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 143701, Korea.
- Department of Medical Science, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul 143701, Korea.
| | - Jongmin Lee
- Department of Medical Science, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul 143701, Korea.
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul 143701, Korea.
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Muñoz-Rivas N, Méndez-Bailón M, de Miguel-Yanes JM, Hernández-Barrera V, de Miguel-Díez J, Jimenez-Garcia R, López-de-Andrés A. Observational study of vascular dementia in the Spanish elderly population according to type 2 diabetes status: trends in incidence, characteristics and outcomes (2004-2013). BMJ Open 2017; 7:e016390. [PMID: 28780555 PMCID: PMC5629725 DOI: 10.1136/bmjopen-2017-016390] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To examine trends overtime in the incidence and in-hospital outcomes of vascular dementia (VaD) hospitalisations in patients aged 70 years or over suffering and not suffering from type 2 diabetes mellitus (T2DM) between 2004 and 2013 in Spain. DESIGN Retrospective study. SETTING Spain. PARTICIPANTS National hospital discharge data were used; patients aged ≥70, discharged from a hospital with VaD as a primary diagnosis, were selected. MAIN OUTCOME MEASURES Overall incidence, therapeutic and diagnostic procedures, comorbidities, infectious complications, duration of hospital stays and in-hospital mortality (IHM). RESULTS In total, 170 607 admissions for VaD (34.3% with T2DM) were identified. We found a significant upward linear trend in the incidence of VaD for men and women with and without diabetes between 2004 and 2013. The adjusted incidence was higher among people with T2DM over the study period. We found a higher incidence in men than women in all years under study. A positive association between T2DM and VaD hospitalisation was found among both men (IRR 2.14, 95% CI 2.11 to 2.16) and women (incidence rate ratio (IRR) 2.22; 95% CI 2.19 to 2.25). Pneumonia was significantly associated with a higher mortality (OR 2.59, 95% CI 2.52 to 2.67). We found that percutaneous endoscopic gastrostomy was associated with lower IHM (OR 0.37, 95% CI 0.31 to 0.45), while parenteral nutrition had the opposite effect (OR 1.29, 95% CI 1.18 to 1.41). There was no association between diabetes and higher IHM (OR 0.99, 95% CI 0.93 to 1.06). The time-trend analyses of the entire sample showed a significant reduction in mortality in patients with VaD (OR 0.98, 95% CI 0.97 to 0.99). CONCLUSIONS Incidence rates for VaD hospitalisations were twice as high in patients with diabetes compared with those without. Men had significantly higher incidence rates than women, regardless of diabetes status. In both groups studied, pneumonia and parenteral nutrition were associated with mortality while percutaneous endoscopic gastrostomy was associated with survival. Having diabetes was not associated with higher IHM after hospitalisation with VaD.
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Affiliation(s)
- Nuria Muñoz-Rivas
- Department of Internal Medicine, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Manuel Méndez-Bailón
- Department of Internal Medicine, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - José M de Miguel-Yanes
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
| | - Javier de Miguel-Díez
- Department of Respiratory Care, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
| | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
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Khan MB, Hafez S, Hoda MN, Baban B, Wagner J, Awad ME, Sangabathula H, Haigh S, Elsalanty M, Waller JL, Hess DC. Chronic Remote Ischemic Conditioning Is Cerebroprotective and Induces Vascular Remodeling in a VCID Model. Transl Stroke Res 2017; 9:51-63. [PMID: 28755277 PMCID: PMC5750336 DOI: 10.1007/s12975-017-0555-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/21/2017] [Accepted: 07/18/2017] [Indexed: 01/23/2023]
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) make up 50% of the cases of dementia. The purpose of this study was to determine the effect of chronic remote ischemic conditioning (C-RIC) on improving long-term (6 months) outcomes and cerebral blood flow (CBF) and collateral formation in a mouse model of VCID. Adult C57BL/6J male mice (10 weeks) were randomly assigned to four different groups: (1) sham-bilateral carotid artery stenosis (BCAS), (2) BCAS + sham RIC, (3) BCAS+C-RIC for 1 month (1MO), and (4) BCAS+C-RIC-4 months (4MO). CBF, cognitive impairment, and functional outcomes were performed up for 6 months after BCAS surgery. The expression of CD31, α-SMA, and myelin basic protein (MBP) was assessed by immunohistochemistry (IHC). Additional set of mice were randomized to sham, BCAS, and BCAS+C-RIC. The cerebrovascular angioarchitecture was studied with micro-CT. RIC therapy for either 1 or 4 months significantly improved CBF, new collateral formation, functional and cognitive outcomes, and prevented white matter damage. There was no difference between C-RIC for 1 or 4 months; IHC studies at 6 months showed an increase in brain CD31 and α-SMA expression indicating increased angiogenesis and MBP indicating preservation of white matter in animals receiving RIC. One month of daily RIC is as effective as 4 months of daily RIC in improving CBF, angiogenesis, and long-term functional outcomes (6 months) in a VCID model. This suggests that 1 month of RIC is sufficient to reduce cognitive impairment and induce beneficial cerebrovascular remodeling.
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Affiliation(s)
- Mohammad Badruzzaman Khan
- Departments of Neurology, Medical College of Georgia, Augusta University, 1120 15th Street, CA1053, Augusta, GA, 30912, USA.
| | - Sherif Hafez
- Departments of Neurology, Medical College of Georgia, Augusta University, 1120 15th Street, CA1053, Augusta, GA, 30912, USA
| | - Md Nasrul Hoda
- Department of Medical Laboratory, Imagine and Radiologic Sciences, Augusta University, Augusta, GA, 30912, USA
| | - Babak Baban
- Department of Oral Biology, Augusta University, Augusta, GA, 30912, USA
| | - Jesse Wagner
- Departments of Neurology, Medical College of Georgia, Augusta University, 1120 15th Street, CA1053, Augusta, GA, 30912, USA
| | - Mohamed E Awad
- Department of Oral Biology, Augusta University, Augusta, GA, 30912, USA
| | - Hasith Sangabathula
- Departments of Neurology, Medical College of Georgia, Augusta University, 1120 15th Street, CA1053, Augusta, GA, 30912, USA
| | - Stephen Haigh
- Vascular Biology Center, Augusta University, Augusta, GA, 30912, USA
| | | | - Jennifer L Waller
- Departments of Biostatistics, Augusta University, Augusta, GA, 30912, USA
| | - David C Hess
- Departments of Neurology, Medical College of Georgia, Augusta University, 1120 15th Street, CA1053, Augusta, GA, 30912, USA.
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42
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Love S, Miners JS. Small vessel disease, neurovascular regulation and cognitive impairment: post-mortem studies reveal a complex relationship, still poorly understood. Clin Sci (Lond) 2017; 131:1579-1589. [PMID: 28667060 DOI: 10.1042/cs20170148] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 02/14/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 11/08/2023]
Abstract
The contribution of vascular disease to cognitive impairment is under-recognized and the pathogenesis is poorly understood. This information gap has multiple causes, including a lack of post-mortem validation of clinical diagnoses of vascular cognitive impairment (VCI) or vascular dementia (VaD), the exclusion of cases with concomitant neurodegenerative disease when diagnosing VCI/VaD, and a lack of standardization of neuropathological assessment protocols for vascular disease. Other contributors include a focus on end-stage destructive lesions to the exclusion of more subtle types of diffuse brain injury, on structural abnormalities of arteries and arterioles to the exclusion of non-structural abnormalities and capillary damage, and the use of post-mortem sampling strategies that are biased towards the identification of neurodegenerative pathologies. Recent studies have demonstrated the value of detailed neuropathology in characterizing vascular contributions to cognitive impairment (e.g. in diabetes), and highlight the importance of diffuse white matter changes, capillary damage and vasoregulatory abnormalities in VCI/VaD. The use of standardized, evidence-based post-mortem assessment protocols and the inclusion of biochemical as well as morphological methods in neuropathological studies should improve the accuracy of determination of the contribution of vascular disease to cognitive impairment and clarify the relative contribution of different pathogenic processes to the tissue damage.
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Affiliation(s)
- Seth Love
- Dementia Research Group, School of Clinical Sciences, University of Bristol, Learning and Research Level 1, Southmead Hospital, Bristol BS10 5NB, U.K.
| | - J Scott Miners
- Dementia Research Group, School of Clinical Sciences, University of Bristol, Learning and Research Level 1, Southmead Hospital, Bristol BS10 5NB, U.K
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43
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Zhai LP, Zhang XL, Guan QB, Yu B, Wang YP, Shen HP, Yu XX, Wang DD, Zhu Y. Influence of glucose metabolism on cognitive function of patients with acute small-artery occlusion. J BIOL REG HOMEOS AG 2017; 31:717-724. [PMID: 28956423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this study was to evaluate the influence of abnormal glucose metabolism on cognitive function of patients with acute small-arterial occlusion (SAO). The present study included 1,211 patients, with small-artery occlusion according to the Trial of Org 10172 in acute stroke treatment (TOAST) classification, admitted between March 2014 and December 2016 to The Second Hospital of Jiaxing. According to cognitive function, the patients were divided into a group of normal cognitive function, a mild cognitive impairment group (MCI group) and a dementia group. The patients were also divided into normal a blood sugar group, an impaired glucose regulation group (IGR group) and a diabetes mellitus (DM) group based on glucose metabolism. Cognitive functions of patients in the different glucose metabolism groups were compared based on Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). General data, medical history, neuropsychological assessment and haematological index of the patients in each group were analyzed. Logistic regression analysis was used to study independent risk factors influencing cognitive impairment. When comparing the group of normal cognitive function with the MCI group, there were no statistical significant differences between the MMSEs scores of patients among the three groups, but the difference in MoCAs scores had statistical significance. Hypertension history, hyperhomocysteinemia (Hhcy) and sedentariness were independent risk factors for SAO patients with MCI. When comparing the group of normal cognitive function with the dementia group, there were statistically significant differences (P<0.05) between the MMSE and MoCA scores of patients among the three groups. Abnormal glucose metabolism, old age, female, high blood pressure, Hhcy, family stroke history and sedentariness were independent risk factors for SAO patients with dementia. In conclusion, abnormal glucose metabolism impairing cognitive function is not an independent risk factor for SAO patients with MCI, but is an independent risk factor for SAO patients with dementia.
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Affiliation(s)
- L P Zhai
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - X L Zhang
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - Q B Guan
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - B Yu
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - Y P Wang
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - H P Shen
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - X X Yu
- Department of Neurology, The Second Hospital of Jiaxing, Jiaxing, China
| | - D D Wang
- Speciality of Neurology, Bengbu Medical College, Bengbu, China
| | - Y Zhu
- Intensive Care Unit, The Second Hospital of Jiaxing, Jiaxing, China
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44
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Li J, Zhang L, Li JJ, Xian-Qu , Chen L, Li DY, Li CY. Effects of estrogen on learning-memory and expression of calbindin-D28K in hippocampus in vascular dementia rats. Pak J Pharm Sci 2017; 30:1403-1406. [PMID: 29043988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vascular dementia (VD) models were made first by repeating cerebral ischemia-reperfusion and followed by treating with estrogen. Learning-memory ability was measured by Morris water maze. Concentration of Ca2+ in hippocampus was determined by Fura-2/AM fluorescence probe and the expression of Calbindin-D28K (CB) in hippocampal CA1 was tested by immunohistochemistry. Learning-memory ability was improved in E group rats; Concentration of Ca2+ in hippocampus was decreased in E group rats. The expression of CB was less in E group rats. It implies that estrogen could improve learning-memory ability in VD rats, which may be associated with suppressing intracellular Ca2+ overload and increasing the expression of CB in hippocampus.
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MESH Headings
- Animals
- Behavior, Animal/drug effects
- CA1 Region, Hippocampal/drug effects
- CA1 Region, Hippocampal/metabolism
- CA1 Region, Hippocampal/physiopathology
- Calbindin 1/metabolism
- Calcium/metabolism
- Dementia, Vascular/drug therapy
- Dementia, Vascular/metabolism
- Dementia, Vascular/physiopathology
- Dementia, Vascular/psychology
- Disease Models, Animal
- Drug Implants
- Estrogens/administration & dosage
- Male
- Maze Learning/drug effects
- Motor Activity/drug effects
- Rats, Wistar
- Reaction Time/drug effects
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Affiliation(s)
- Jing Li
- Nursing College of Beihua University, Jilin Province, China
| | - Lei Zhang
- Department of physiology, Basic Medical College of Beihua University, Jilin Province, China
| | - Jiao-Jiao Li
- Department of physiology, Basic Medical College of Beihua University, Jilin Province, China
| | - - Xian-Qu
- Department of physiology, Basic Medical College of Beihua University, Jilin Province, China
| | - Lin Chen
- Affiliated Hospital of Beihua University, Jilin Province, China
| | - Dong-Ying Li
- Sixth People's Hospital of Jilin city, Jilin Province, China
| | - Chun-Ying Li
- Department of physiology, Basic Medical College of Beihua University, Jilin Province, China
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Bordet R, Ihl R, Korczyn AD, Lanza G, Jansa J, Hoerr R, Guekht A. Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report. BMC Med 2017; 15:107. [PMID: 28539119 PMCID: PMC5444106 DOI: 10.1186/s12916-017-0869-6] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 05/06/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vascular cognitive impairment (VCI) is a complex spectrum encompassing post-stroke cognitive impairment (PSCI) and small vessel disease-related cognitive impairment. Despite the growing health, social, and economic burden of VCI, to date, no specific treatment is available, prompting the introduction of the concept of a disease modifier. CONSENSUS AND SUGGESTIONS Within this clinical spectrum, VCI and PSCI remain advancing conditions as neurodegenerative diseases with progression of both vascular and degenerative lesions accounting for cognitive decline. Disease-modifying strategies should integrate both pharmacological and non-pharmacological multimodal approaches, with pleiotropic effects targeting (1) endothelial and brain-blood barrier dysfunction; (2) neuronal death and axonal loss; (3) cerebral plasticity and compensatory mechanisms; and (4) degenerative-related protein misfolding. Moreover, pharmacological and non-pharmacological treatment in PSCI or VCI requires valid study designs clearly stating the definition of basic methodological issues, such as the instruments that should be used to measure eventual changes, the biomarker-based stratification of participants to be investigated, and statistical tests, as well as the inclusion and exclusion criteria that should be applied. CONCLUSION A consensus emerged to propose the development of a disease-modifying strategy in VCI and PSCI based on pleiotropic pharmacological and non-pharmacological approaches.
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Affiliation(s)
- Régis Bordet
- University of Lille, Inserm, CHU, U1171 'Degenerative and vascular cognitive disorders', Lille, France.
- Département de Pharmacologie Médicale, Faculté de Médecine, 1 place Verdun, 59045, Lille Cedex, France.
| | - Ralf Ihl
- University of Duesseldorf, Alexian Research Center, Krefeld, Germany
| | - Amos D Korczyn
- Department of Neurology, Tel Aviv University, Ramat Aviv, Israel
| | - Giuseppe Lanza
- Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
| | - Jelka Jansa
- University Medical Centre Ljubljana, Neurologic Hospital, Neurorehabilitation Unit, Ljubljana, Slovenia
| | - Robert Hoerr
- Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Alla Guekht
- Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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46
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Frederiksen KS. [Vascular dementia]. Ugeskr Laeger 2017; 179:V10160701. [PMID: 28330543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Vascular dementia comprises a heterogeneous group of conditions covering a range of clinical and neuropathological presentations of cerebrovascular disease-causing dementia. Vascular dementia is a common occurrence, but many questions regarding the disease remain unanswered. Recently, proposed criteria focus on constructing an overarching disease concept, which captures both pre-dementia stages and the clinical and neuropathological heterogeneity. Future research should focus on identifying subtypes with distinct pathophysiological mechanisms in order to facilitate treatment development.
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47
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Lanza G, Bramanti P, Cantone M, Pennisi M, Pennisi G, Bella R. Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation. Behav Neurol 2017; 2017:1421326. [PMID: 28348458 PMCID: PMC5350538 DOI: 10.1155/2017/1421326] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/30/2017] [Accepted: 02/05/2017] [Indexed: 02/07/2023] Open
Abstract
In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of "brain at risk" for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes.
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Affiliation(s)
- Giuseppe Lanza
- 1Department of Neurology IC, I.R.C.C.S. “Oasi” Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy
- *Giuseppe Lanza:
| | - Placido Bramanti
- 2I.R.C.C.S. Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy
| | - Mariagiovanna Cantone
- 1Department of Neurology IC, I.R.C.C.S. “Oasi” Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy
| | - Manuela Pennisi
- 3Spinal Unit, Emergency Hospital “Cannizzaro”, 829 Via Messina, 95126 Catania, Italy
| | - Giovanni Pennisi
- 4Department of Surgery and Medical-Surgical Specialties, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy
| | - Rita Bella
- 5Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy
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Wardlaw JM, Horsburgh K. Small vessels, dementia and chronic diseases-molecular mechanisms and pathophysiology. Clin Sci (Lond) 2016; 130:1875-9. [PMID: 27660310 DOI: 10.1042/cs20160376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/04/2016] [Indexed: 01/31/2023]
Affiliation(s)
- Joanna M Wardlaw
- Centre for Clinical Brain Sciences, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, U.K.
| | - Karen Horsburgh
- Centre for Neuroregeneration, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, U.K
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Iadecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB, Gulati M, Kamel H, Knopman DS, Launer LJ, Saczynski JS, Seshadri S, Zeki Al Hazzouri A. Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association. Hypertension 2016; 68:e67-e94. [PMID: 27977393 DOI: 10.1161/hyp.0000000000000053] [Citation(s) in RCA: 404] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions. METHODS Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data. RESULTS Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive. CONCLUSIONS After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.
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Greenan C, Murphy L, Yu LM, Kehoe PG, Coulthard E, Bath P, Stewart R, Jones R, Corbett A, Thomas A, Connelly P, Arrojo F, Canning R, Wallach S, Henderson C, McGuinness B, O’Sullivan M, Holmes C, Knapp M, Ballard C, Passmore P. A randomised controlled trial of calcium channel blockade (CCB) with Amlodipine For the treatment oF subcortical ischaEmic vasCular demenTia (AFFECT): study protocol. Trials 2016; 17:324. [PMID: 27430267 PMCID: PMC4950108 DOI: 10.1186/s13063-016-1449-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/17/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Vascular dementia is the second most common cause of dementia affecting over seven million people worldwide, yet there are no licensed treatments. There is an urgent need for a clinical trial in this patient group. Subcortical ischaemic vascular dementia is the most common variant of vascular dementia. This randomised trial will investigate whether use of calcium channel blockade with amlodipine, a commonly used agent, can provide the first evidence-based pharmacological treatment for subcortical ischaemic vascular dementia. METHODS/DESIGN This is a randomised controlled trial of calcium channel blockade with Amlodipine For the treatment oF subcortical ischaEmic vasCular demenTia (AFFECT) to test the hypothesis that treatment with amlodipine can improve outcomes for these patients in a phase IIb, multi-centre, double-blind, placebo-controlled randomised trial. The primary outcome is the change from baseline to 12 months in the Vascular Dementia Assessment Scale cognitive subscale (VADAS-cog). Secondary outcomes include cognitive function, executive function, clinical global impression of change, change in blood pressure, quantitative evaluation of lesion accrual based on magnetic resonance imaging (MRI), health-related quality of life, activities of daily living, non-cognitive dementia symptoms, care-giver burden and care-giver health-related quality of life, cost-effectiveness and institutionalisation. A total of 588 patients will be randomised in a 1:1 ratio to either amlodipine or placebo, recruited from sites across the UK and enrolled in the trial for 104 weeks. DISCUSSION There are no treatments licensed for vascular dementia. The most common subtype is subcortical ischaemic vascular dementia (SIVD). This study is designed to investigate whether amlodipine can produce benefits compared to placebo in established SIVD. It is estimated that the numbers of people with VaD and SIVD will increase globally in the future and the results of this study should inform important treatment decisions. TRIAL REGISTRATION Current Controlled Trials ISRCTN31208535 . Registered on 7 March 2014.
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Affiliation(s)
- Caroline Greenan
- />Northern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA UK
| | - Lynn Murphy
- />Northern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA UK
| | - Ly-Mee Yu
- />Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences (Gibson Building), Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - Patrick G. Kehoe
- />Dementia Research Group, Clinical Neurosciences, University of Bristol, Level 1 Learning and Research Building, Bristol, BS10 5NB UK
| | - Elizabeth Coulthard
- />Dementia Research Group, Clinical Neurosciences, University of Bristol, Level 1 Learning and Research Building, Bristol, BS10 5NB UK
| | - Philip Bath
- />Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB UK
| | - Robert Stewart
- />Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
| | - Rob Jones
- />School of Community Health Sciences, Division of Psychiatry, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Anne Corbett
- />Wolfson CARD, Kings College London, Wolfson Wing, Hodgkin Building, Guy’s Campus, London, SE1 1UL UK
| | - Alan Thomas
- />Biomedical Research Building, Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL UK
| | - Peter Connelly
- />Murray Royal Hospital, Muirhall Road, Perth, PH2 7BH UK
| | - Frank Arrojo
- />Research Network Volunteer, Alzheimer’s Society, 58 St Katharine’s Way, London, E1W 1LB UK
| | - Rachel Canning
- />Research Network Volunteer, Alzheimer’s Society, 58 St Katharine’s Way, London, E1W 1LB UK
| | - Sylvia Wallach
- />Research Network Volunteer, Alzheimer’s Society, 58 St Katharine’s Way, London, E1W 1LB UK
| | - Catherine Henderson
- />Personal Social Services Research Unit (PSSRU), London School of Economics, Houghton Street, London, WC2A 2AE UK
| | - Bernadette McGuinness
- />Centre for Public Health, Institute of Clinical Sciences, Block B, Queen’s University Belfast, The Royal Hospitals, Grosvenor Road, Belfast, BT12 6BA UK
| | - Mike O’Sullivan
- />Academic Neuroscience Centre, Institute of Psychiatry, De Crespigny Park, PO Box 41, London, SE5 8AF UK
| | - Clive Holmes
- />MARC, University of Southampton, Moorgreen Hospital, Botley Road, Southampton, S030 3JB UK
| | - Martin Knapp
- />Personal Social Services Research Unit (PSSRU), London School of Economics, Houghton Street, London, WC2A 2AE UK
| | - Clive Ballard
- />Wolfson Centre for Age-Related Diseases, King’s College London, Guy’s Campus, London, SE1 1UL UK
| | - Peter Passmore
- />Centre for Public Health, Institute of Clinical Sciences, Block B, Queen’s University Belfast, The Royal Hospitals, Grosvenor Road, Belfast, BT12 6BA UK
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