RESUMO
BACKGROUND: The aim of this study was to determine the relationship between apolipoprotein E (ApoE)-ε4 genotype and senile dementia (SD) by analyzing the ApoE allelic frequency distributions among the elderly Han Chinese population. METHODS: For this purpose, a total of 316 Chongqing residents aged ≥60 years were classified as SD or control groups following the criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association. Genomic DNA was isolated from the peripheral blood lymphocytes and exon 4 of the ApoE gene with polymorphism sites was amplified by PCR and genotypes determined by restriction fragment length polymorphism (RFLP). RESULTS: We found that the most prevalent genotype was ApoE-ε3/3, followed in order by ApoE-ε3/4 and ApoE-ε2/2. The estimated ApoE allelic frequencies in individuals with SD were 0.095, 0.560, and 0.345 for ε2, ε3, and ε4, respectively. In controls, the corresponding ApoE allelic frequencies were 0.146, 0.699, and 0.155. The percentage of ε4 allele carriers in SD group was significantly higher than that in control group (P<0.01); while those of ε2 and ε3 genotypes were lower in SD group as compared with control group. CONCLUSIONS: We concluded that in the elderly Han Chinese residents of Chongqing aged 60 years and over, ApoE-ε3/3 and ApoE-ε2/2 were the most and least prevalent genotypes, respectively. Further, based on strong linkage, ApoEε4 allele might be a significant risk factor for the development of senile dementia.
Assuntos
Doença de Alzheimer/genética , Apolipoproteínas E/genética , Idoso , Idoso de 80 Anos ou mais , Povo Asiático/genética , Feminino , Predisposição Genética para Doença/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: This report focused on investigating the relationship between alcohol consumption and dementia in elderly people through prospective studies. METHODS: We conducted a 2-year follow-up study of elderly people from six communities in Chongqing, China. Dementia was detected using the Mini-Mental State Examination (MMSE) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The relationship between alcohol consumption and dementia was investigated using multiple logistic regression models, adjusting for the potential confounders age, sex, educational level and cigarette smoking. RESULTS: Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with non-drinking. Excessive drinking was related to a higher risk of dementia. The effect of light-to-moderate drinking seemed most prominent among vascular dementia, 0.63 (0.55-0.72) for Alzheimer's disease, 0.31 (0.19-0.51) for vascular dementia and 0.45 (0.12-1.69) for other dementia. In a model adjusting for confounding variables, a light-to-moderate intake of beer was associated with a significantly higher risk of dementia than a non-drinker of beer. For wine, a significantly lower risk of dementia existed for a light-to-moderate drinker. CONCLUSIONS: Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with a non-drinker.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Demência/epidemiologia , Idoso , China/epidemiologia , Demência/classificação , Demência/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prevalência , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To investigate the role of the thrombin in inducing inflammatory response in brain tissue adjacent to hematoma in the brain. METHODS: Seventy-two male Wistar rats were randomly divided into two groups: sham-operated control group and thrombin injection group. Immunohistochemical technique and myeloperoxidase (MPO) determination were respectively used to evaluate intercellular adhesion molecule-1 (ICAM-1) expression and neutrophil infiltration in adjacent brain tissue of the thrombin injection zone at 6, 12, 24, 48, 72 and 128 hours after thrombin injection. RESULTS: The expression of ICAM-1 in tissues adjacent to thrombin injection started to increase 6 hours after the injection, peaking at 72 hours, and lasting for 120 hours. MPO activity of tissues in the area increased 6 hours, reached a high level at 24 hours, then decreased slightly, and it peaked at 72 hours after thrombin injection, correlating closely with the increase in ICAM-1 expression except the changes at 24 hours. CONCLUSION: The increased expression of ICAM-1 after thrombin injection is correlated with the degree of the neutrophil infiltration in the brain tissue around the thrombin injection zone, indicating thrombin is important to produce secondary brain damage after cerebral hemorrhage.
Assuntos
Hemorragia Cerebral/metabolismo , Molécula 1 de Adesão Intercelular/metabolismo , Infiltração de Neutrófilos , Trombina/farmacologia , Animais , Hemorragia Cerebral/patologia , Modelos Animais de Doenças , Masculino , Infiltração de Neutrófilos/efeitos dos fármacos , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
OBJECTIVE: We studied a large hospitalized cohort of patients aged 55 years and over with acute ischemic stroke to identify the frequency and predictors of poststroke dementia. METHODS: A total of 434 consecutive patients with ischemic stroke were enrolled in this study. During admission, the demographic data, vascular risk factors, stroke features, and neurological status information were collected. All subjects were examined by a battery of neuropsychological tests during admission and 3 months after stroke. Logistic regression analysis was used to find the predictors of poststroke dementia. RESULTS: (1) The frequency of poststroke dementia was 27.2%, that of stroke-related dementia was 21.6%, and that of dementia after first-ever stroke was 22.7% 3 months after stroke. (2) Univariate analysis indicated that older age, low educational level (Assuntos
Isquemia Encefálica/epidemiologia
, Demência Vascular/epidemiologia
, Acidente Vascular Cerebral/epidemiologia
, Idoso
, Idoso de 80 Anos ou mais
, Isquemia Encefálica/complicações
, Isquemia Encefálica/patologia
, Distribuição de Qui-Quadrado
, China/epidemiologia
, Estudos de Coortes
, Intervalos de Confiança
, Demência Vascular/etiologia
, Demência Vascular/patologia
, Feminino
, Seguimentos
, Humanos
, Modelos Logísticos
, Masculino
, Pessoa de Meia-Idade
, Razão de Chances
, Valor Preditivo dos Testes
, Fatores Socioeconômicos
, Acidente Vascular Cerebral/complicações
, Acidente Vascular Cerebral/patologia
RESUMO
OBJECTIVE: To investigate the features of glutamate activity in the limbic system and the effects of glutamate on the activation of the hypothalamus-pituitary-adrenal (HPA) axis throughout both acute cerebral ischemia and reperfusion. METHODS: The changes in glutamate content in the nervous cell gap, in corticotrophin releasing hormone (CHR) mRNA expression level in brain tissue, and in adrenocorticotropic hormone in blood plasma at different time-points after middle cerebral artery occlusion (MCAO) in rats were determined respectively with high-performance liquid chomatography (HPLC) and in situ hybridization. RESULTS: Glutamate content in the hippocampus and the hypothalamus increased rapidly at ischemia 15 minutes, and reached peak value (the averages were 21.05 mg/g +/- 2.88 mg/g and 14.20 mg/g +/- 2.58 mg/g, respectively) at 1 hour after middle cerebral artery occlusion. During recirculation, it returned rapidly to the baseline level. At 24 hours after reperfusion, it went up once more, and remained at a relative high level until 48 hours after reperfusion, and then declined gradually. CRH mRNA expression levels in the temporal cortex, hippocampus and hypothalamus were enhanced markedly at 1 hour ischemia and were maintained until 96 hours after reperfusion. At the same time, adrenocorticotropic hormone level in plasma was relatively increased. In the peak stage of reperfusion injury, there was a significantly positive correlation (n = 15, r = 0.566, P < 0.05) of the glutamate contents in the hypothalamus with the number of cells positive for CRH mRNA expression level in the hypothalamus. CONCLUSION: It is probable that the CRH system in the central nervous system is mainly distributed in the limbic system, and glutamate might be one of the trigger factors to induce excessive stress response in the HPA axis.
Assuntos
Ácido Glutâmico/análise , Sistema Hipotálamo-Hipofisário/química , Infarto da Artéria Cerebral Média/fisiopatologia , Sistema Límbico/química , Sistema Hipófise-Suprarrenal/química , Animais , Infarto da Artéria Cerebral Média/metabolismo , Masculino , Ratos , Ratos Wistar , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/fisiopatologiaRESUMO
OBJECTIVE: To evaluate the significance of changes of neuropeptide Y (NPY) activity in plasma and brain tissue during experimental intracerebral hemorrhage (ICH). METHODS: Seventy Wistar rats were randomly divided into two groups: control group and ICH group with each group subdivided into preoperation, 0.5 hours, 6 hours, 12 hours,24 hours, 48 hours and 72 hours postoperation subgroups, respectively (n=5). The ICH was established by infusing collagenase and heparin into rat caudate. The changes of NPY in plasma and perihemotoma at preoperation, 0.5 hours, 6 hours, 12 hours, 24 hours, 48 hours and 72 hours after operation were observed, respectively. NPY was determined by radio-immunoassay. The morphologic change of brain was detected. RESULTS: NPY activity in plasma and perihematoma increased synchronously after cerebral hemorrhage, and peaked at 24 hours, then began to reduce in 48 hours, it was still higher than those of preoperation at 72 hours after hemorrhage (P<0.05 or P<0.01). The correspondent pathological changes were observed in brain tissue under light microscope and electron microscope. CONCLUSION: NPY might be involved in the pathogenesis of cerebral hemorrhage.
Assuntos
Hemorragia Cerebral/patologia , Neuropeptídeo Y/análise , Animais , Encéfalo/metabolismo , Encéfalo/patologia , Encéfalo/ultraestrutura , Química Encefálica , Hemorragia Cerebral/sangue , Hemorragia Cerebral/metabolismo , Feminino , Imuno-Histoquímica , Masculino , Microscopia Eletrônica , Neuropeptídeo Y/sangue , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
BACKGROUND: Adhesion molecules play important roles in the pathophysiology of ischemic stroke. The aim of the present study was to investigate whether serum levels of soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cellular adhesion molecule 1 (sVCAM-1) and soluble E-selectin were associated with neurological deterioration of ischemic stroke. METHODS: 238 consecutive patients with ischemic stroke examined within 24 h from onset were enrolled into the study. The stroke severity was daily assessed with the NIH Stroke Scale (NIHSS) within the first week after admission. Serum levels of sICAM-1, sVCAM-1 and sE-selectin after admission were measured using enzyme-linked immunosorbent assay. Multivariate logistic regression was used to analyze the association of serum levels of sICAM-1, sVCAM-1 and sE-selectin on admission with the neurological deterioration of ischemic stroke, adjusted for potential confounders. RESULTS: 52 (21.8%) out of 238 stroke patients suffered from neurological deterioration. Serum levels of sICAM-1 on admission of stroke patients were significantly higher than those of healthy controls. Compared with patients without deterioration, patients with neurological deterioration had higher levels of sICAM-1, but not of sVCAM-1 and sE-selectin. On multivariate logistic regression, the serum level of sICAM-1 on admission was associated with neurological deterioration of stroke (OR 2.92, 95% CI 1.41-6.05). Other variables associated with neurological deterioration were fasting serum glucose (OR 1.65, 95% CI 1.24-2.20), baseline fibrinogen (OR 1.31, 95% CI 1.13-1.52) and NIHSS score (OR 1.23, 95% CI 1.15-1.32). CONCLUSIONS: The serum level of sICAM-1 on admission is associated with neurological deterioration of ischemic stroke.
Assuntos
Isquemia Encefálica/sangue , Selectina E/sangue , Molécula 1 de Adesão Intercelular/sangue , Acidente Vascular Cerebral/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/complicações , Isquemia Encefálica/terapia , Estudos de Casos e Controles , China , Estudos de Coortes , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Resultado do TratamentoRESUMO
OBJECTIVE: To observe the changes of noradrenaline (NE) content dynamically in the homogenate of rat brain tissues during experimental intracerebral hemorrhage (ICH), so as to understand the role of NE in secondary brain injury. METHODS: Seventy Wistar rats were randomly assigned into sham operation group and ICH group, each group subdivided into different time phase points as pre-operation, 0.5, 6, 12, 24, 48 and 72 h post-operation groups (n=5). ICH model was established by injection of collagenase and heparin into rat caudate nucleus, and the changes of NE content in the peripheral tissues of the hematoma, hypothalamus and brainstem were observed respectively at following time points as before operation and 0.5, 6, 12, 48 and 72 h after the operation. NE was determined by high-performance liquid chromatography. RESULTS: NE activities in the peripheral tissues of the hematoma, hypothalamus and brainstem increased synchronously 0.5 h after operation, peaked at 24 h, and then began to decline at 48 h. At the same time, the neurobehavioral score varied synchronously together with NE. CONCLUSION: NE is involved in the pathogenesis of secondary damage of the brain during ICH.
RESUMO
BACKGROUND: Frequency of poststroke cognitive impairment is high in western countries, and the risk factors of poststroke cognitive impairment have not been fully understood yet. We sought to examine the frequency and risk factors of cognitive impairment after ischemic stroke in a large stroke cohort of China. METHODS: A total of 434 consecutive patients with ischemic stroke were enrolled. The cognitive status before and 3 months after stroke was evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly and the Mini-Mental State Examination, respectively. Poststroke cognitive impairment was defined as cognitive impairment with concomitant stroke, stroke-related cognitive impairment was defined as cognitive impairment developing after index stroke, and cognitive impairment after first-ever stroke was defined as cognitive impairment developing after first-ever stroke. Logistic regression analysis was used to find the risk factors of cognitive impairment after stroke. RESULTS: (1) Frequency of poststroke cognitive impairment was 37.1%, that of stroke-related cognitive impairment was 32.2%, and that of cognitive impairment after first-ever stroke was 29.6%. (2) The patients with cognitive impairment more often had older age, low educational level, atrial fibrillation, prior stroke, everyday drinking, left carotid territory infarction, multiple lesions, embolism, and dysphasia. (3) The factors associated with poststroke cognitive impairment in logistic regression analysis were age (OR 1.215, 95% CI 1.163-1.268), low educational level (OR 2.023, 95% CI 1.171-3.494), prior stroke (OR 5.130, 95% CI 2.875-9.157), everyday drinking (OR 2.013, 95% CI 1.123-3.607), dysphasia (OR 3.994, 95% CI 1.749-9.120), and left carotid territory infarction (OR 2.685, 95% CI 1.595-4.521). CONCLUSIONS: Cognitive impairment is common 3 months after ischemic stroke in Chinese people. Risk factors for poststroke cognitive impairment include age, low educational level, everyday drinking, prior stroke, dysphasia, and left carotid territory infarction.