Vascular risk factors and the effect of white matter lesions on extrapyramidal signs in Alzheimer's disease.

BACKGROUND: Extrapyramidal signs (EPSs), which are important characteristics of Parkinson's disease (PD), occur frequently in Alzheimer's disease (AD). Although AD and PD share common clinical features such as EPSs, these diseases vary with respect to vascular risk factors. The presence of vascular risk factors increases the risk of AD; however, these factors have been known to be inversely associated with PD. We aimed to assess the effect of vascular risk factors and white matter lesions (WMLs) on EPSs in AD. METHODS: We recruited 1,187 AD patients and 333 controls with neither cognitive impairment nor EPSs. All participants underwent detailed clinical evaluations which included assessments of vascular risk factors, cognitive function, and EPSs, as well as WMLs on brain MRIs. EPS subtypes were classified into tremor-dominant, postural instability gait difficulty, or indeterminate; WMLs subtypes were classified into periventricular WML (pvWML) or deep WML (dWML). RESULTS: EPSs were present in 17.9% of subjects with AD and were significantly associated with vascular risk factors such as age, male gender, diabetes mellitus, and WMLs. Additionally, a multivariate logistic regression analysis showed that EPSs in AD were associated with pvWML (odds ratio (OR), 1.61-2.52), not with dWML. With respect to EPS subtypes, the majority (78.4%) of EPSs in AD were postural instability gait difficulty, which was also associated with WMLs (OR 1.84-2.41), pvWML (OR 2.09-3.14), and dWML (OR 1.83-3.42). CONCLUSIONS: EPSs in AD are associated with selected vascular risk factors as well as WMLs.

Gonadotropin-releasing hormone modulates immune system function via the nuclear factor-kappaB pathway in murine Raw264.7 macrophages.

Gonadotropin-releasing hormone (GnRH), which was originally found to be involved in the reproductive process, has also been implicated in the modulation of immune system function. However, the underlying mechanisms of this involvement remain largely unclear. In this study, we found that GnRH increased the intracellular calcium levels in murine Raw264.7 macrophages. Furthermore, the production of nitric oxide, costimulated with lipopolysaccharide and interferon-gamma, was suppressed by exposure to GnRH. Moreover, the modulatory effects of GnRH on calcium and nitric oxide were observed in freshly isolated primary peritoneal macrophages. In addition, the activity of nuclear factor-kappaB was suppressed by GnRH exposure. On the other hand, the phosphorylation of the Janus kinase-signal transducer and activator of transcription pathway was not affected by cotreatment with GnRH. Taken together, these results demonstrate that GnRH participates in the macrophage function and indicate that the nuclear factor-kappaB signaling pathway may be responsible for GnRH-mediated immune system modulation.

Subjective memory complaints and clinical characteristics in elderly Koreans: a questionnaire survey.

OBJECTIVES: The overall objectives of the Ajou-Bundang Study for the Elderly (AB study) were to describe the current geriatric diseases and health behaviors, and to improve the visiting health service in South Korea. The particular objectives of the current study were to describe the AB study and to investigate the associations between subjective memory complaints (SMCs) and objective cognitive function, to assess the clinical characteristics of SMCs, and to measure possible differences between elderly people with and without cognitive dysfunction. METHODS: A cross-sectional study of a sample of people from the AB study was constructed to study the association between SMCs and demographic variables. SMCs, cognitive function, and demographic characteristics were ascertained. A total of 9,477 subjects aged 65 years or over were recruited from the residents of Bundang, Korea. RESULTS: SMCs were reported by 57.3% of the study participants. SMCs were correlated with advanced age and with being female. Further analyses of cognitive functions revealed that associated factor profiles differed between the participants with and without cognitive dysfunction. CONCLUSIONS: These results show that age is associated with SMCs, irrespective of the level of cognitive function. Longitudinal SMC studies should be undertaken to investigate potentially associated clinical parameters.

Helicobacter pylori infection and the CD14 C(-260)T gene polymorphism in ischemic stroke.

INTRODUCTION: There is increasing evidence that infective pathogens such as Helicobacter pylori is linked to atherosclerosis of cerebral vessels. As an independent contributing factor, the CD14 receptor-lipopolysaccharide complex plays an important role in activating inflammatory reactions. In particular, the C(-260)T polymorphism in the CD14 receptor may be implicated in atherosclerotic disease. In this study, we investigated a possible association between H. pylori infection and the polymorphism of CD14, and ischemic stroke. MATERIALS AND METHODS: A total of 125 patients with ischemic stroke and 125 age- and sex-matched controls were included in the study. The stroke subtype of each of the patients was characterized based on the underlying etiology. H. pylori serologic status and the CD14 genotype were determined in both patients and controls. RESULTS: H. pylori seropositivity was more common in the stroke patients than in the controls (80.0% vs. 60.0%, P=0.001). Moreover, H. pylori seropositivity was more common in the stroke subtype of large artery disease (87.7%, P<0.001). The distribution of CD14 genotypes was as follows: patients, T/T 21.6%, C/T 63.2%, C/C 15.2%; controls, T/T 19.2%, C/T 57.6%, C/C 23.2%. There was no significant difference between these two CD14 genotype distributions. CONCLUSIONS: These results suggest that H. pylori infection is a risk factor for ischemic stroke and that CD14 polymorphism is not.