Neuron-associated macrophage proliferation in the sensory ganglia is associated with peripheral nerve injury-induced neuropathic pain involving CX3CR1 signaling.

Resident macrophages are distributed across all tissues and are highly heterogeneous due to adaptation to different tissue-specific environments. The resident macrophages of the sensory ganglia (sensory neuron-associated macrophages, sNAMs) are in close contact with the cell body of primary sensory neurons and might play physiological and pathophysiological roles. After peripheral nerve injury, there is an increase in the population of macrophages in the sensory ganglia, which have been implicated in different conditions, including neuropathic pain development. However, it is still under debate whether macrophage accumulation in the sensory ganglia after peripheral nerve injury is due to the local proliferation of resident macrophages or a result of blood monocyte infiltration. Here, we confirmed that the number of macrophages increased in the sensory ganglia after the spared nerve injury (SNI) model in mice. Using different approaches, we found that the increase in the number of macrophages in the sensory ganglia after SNI is a consequence of the proliferation of resident CX3CR1+ macrophages, which participate in the development of neuropathic pain, but not due to infiltration of peripheral blood monocytes. These proliferating macrophages are the source of pro-inflammatory cytokines such as TNF and IL-1b. In addition, we found that CX3CR1 signaling is involved in the sNAMs proliferation and neuropathic pain development after peripheral nerve injury. In summary, these results indicated that peripheral nerve injury leads to sNAMs proliferation in the sensory ganglia in a CX3CR1-dependent manner accounting for neuropathic pain development. In conclusion, sNAMs proliferation could be modulated to change pathophysiological conditions such as chronic neuropathic pain.

Correlation between changes in Timed Up and Go performance and cognition in older people with mild cognitive impairment: A longitudinal study.

BACKGROUND: Compare changes in performance on subtasks of the Timed Up and Go test over 32 months in older adults with and without mild cognitive impairment; analyze the correlation between frontal cognitive functions at baseline and changes in Timed Up and Go subtasks over time. METHODS: A longitudinal study was conducted involving 31 older adults (15 with and 16 without cognitive impairment). Functional mobility was assessed at both evaluations using an adapted version of the Timed Up and Go test and the Qualisys motion system. The test was divided into five subtasks: sit-to-stand, walking forward, turn-to-walk, walking back and turn-to-sit. Cognition was assessed at baseline using the Frontal Assessment Battery and the Clock Drawing Test. FINDINGS: Significant differences in changes in the sit-to-stand subtask over time were found between groups. The difference in the time required to conclude this subtask was greater in the older adults with cognitive impairment. However, the difference in kinematic variables (peak trunk speed and range of motion) was greater in the group without cognitive impairment. Strong and moderate correlations were found between frontal cognitive functions and changes in Timed Up and Go subtasks, especially those involving transitions (sit-to-stand, turn-to-walk and turn-to-sit) in both groups. INTERPRETATION: Motor intervention protocols should incorporate the sit-to-stand subtask in older adults with mild cognitive impairment. Moreover, changes in more complex subtasks seem to be related to frontal cognitive performance at baseline. Therefore, treatments that combine motor and cognitive functions should be administered to older adults regardless of cognitive impairment.

Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease.

BACKGROUND: Studies with functional and applicable methods and new cognitive demands involving executive function are needed to improve screening, prevention and rehabilitation of cognitive impairment and falls. OBJECTIVE: to identify differences in gait, dual task performances, and history of falls between elderly people with preserved cognition, mild cognitive impairment and mild Alzheimer's disease. METHOD: A cross-sectional study was conducted. The sample consisted of 40 community-dwelling older adults with preserved cognition, 40 older adults with mild cognitive impairment, and 38 older adults with mild Alzheimer's disease. The assessment consisted of anamneses, gait (measured by the 10-meter walk test), dual task (measured by the Timed Up and Go Test associated with the motor-cognitive task of calling a phone number), and history of falls in the past year. RESULTS: There were no differences among all groups for all variables. However, the Alzheimer's disease Group performed significantly worse in the dual task than the other groups. No item of dual task could distinguish people with preserved cognition from those with mild cognitive impairment. The groups with cognitive impairment included more fallers, and specific characteristics in history of falls between groups were identified. CONCLUSION: Dual task could distinguish Alzheimer's disease patients specifically from other cognitive profiles.

The relationship between dual-task and cognitive performance among elderly participants who exercise regularly.

BACKGROUND: The dual-task performance is associated with the functionality of the elderly and it becomes more complex with age. OBJECTIVE: To investigate the relationship between the Timed Up and Go dual task (TUG-DT) and cognitive tests among elderly participants who exercise regularly. METHOD: This study examined 98 non-institutionalized people over 60 years old who exercised regularly. Participants were assessed using the TUG-DT (i.e. doing the TUG while listing the days of the week in reverse order), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Mini Mental State Examination (MMSE). The motor (i.e. time and number of steps) and cognitive (i.e. number of correct words) data were collected from TUG-DT. We used a significance level of α=0.05 and SPSS 17.0 for all data analyses. RESULTS: This current elderly sample featured a predominance of women (69.4%) who were highly educated (median=10 years of education) compared to Brazilian population and mostly non-fallers (86.7%). The volunteers showed a good performance on the TUG-DT and the other cognitive tests, except the MoCA, with scores below the cutoff of 26 points. Significant and weak correlations were observed between the TUG-DT (time) and the visuo-spatial/executive domain of the MoCA and the MMSE. The cognitive component of the TUG-DT showed strong correlations between the total MoCA performance score and its visuo-spatial/executive domain. CONCLUSIONS: The use of the TUG-DT to assess cognition is promising; however, the use of more challenging cognitive tasks should be considered when the study population has a high level of education.

The relationship between dual-task and cognitive performance among elderly participants who exercise regularly

BACKGROUND: The dual-task performance is associated with the functionality of the elderly and it becomes more complex with age. OBJECTIVE: To investigate the relationship between the Timed Up and Go dual task (TUG-DT) and cognitive tests among elderly participants who exercise regularly. METHOD: This study examined 98 non-institutionalized people over 60 years old who exercised regularly. Participants were assessed using the TUG-DT (i.e. doing the TUG while listing the days of the week in reverse order), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Mini Mental State Examination (MMSE). The motor (i.e. time and number of steps) and cognitive (i.e. number of correct words) data were collected from TUG-DT . We used a significance level of α=0.05 and SPSS 17.0 for all data analyses. RESULTS: This current elderly sample featured a predominance of women (69.4%) who were highly educated (median=10 years of education) compared to Brazilian population and mostly non-fallers (86.7%). The volunteers showed a good performance on the TUG-DT and the other cognitive tests, except the MoCA, with scores below the cutoff of 26 points. Significant and weak correlations were observed between the TUG-DT (time) and the visuo-spatial/executive domain of the MoCA and the MMSE. The cognitive component of the TUG-DT showed strong correlations between the total MoCA performance score and its visuo-spatial/executive domain. CONCLUSIONS: The use of the TUG-DT to assess cognition is promising; however, the use of more challenging cognitive tasks should be considered when the study population has a high level of education. .

Benefits of multimodal exercise intervention for postural control and frontal cognitive functions in individuals with Alzheimer's disease: a controlled trial.

OBJECTIVE: To verify the effects of a systematized multimodal exercise intervention program on frontal cognitive function, postural control, and functional capacity components of individuals with Alzheimer's disease (AD). DESIGN: Nonrandomized controlled trial with pre- and posttraining tests in a training group and a control group. SETTING: Kinesiotherapy program for seniors with AD, São Paulo State University. PARTICIPANTS: Convenience sample of older adults with AD (n = 30) were assigned to a training (n = 14; aged 78.6 ± 7.1) and a control (n = 16; aged 77.0 ± 6.3) group. INTERVENTION: The intervention program was structured with the aim of simultaneously promoting better balance and frontal cognitive capacity. The participants attended a 1-hour session three times a week for 16 weeks, whereas the control group did not participate in any activity during the same period. MEASUREMENTS: Frontal cognitive function was evaluated using the Montreal Cognitive Assessment, the Clock Drawing Test, the Frontal Assessment Battery, and the Symbol Search Subtest. Postural control (center of pressure area) was analyzed under four dual-task conditions. Functional capacity components were analyzed using the Timed Up and Go Test, the 30-second sit-to-stand test, the sit-and-reach test, and the Berg Functional Balance Scale. RESULTS: Intervention group participants showed a significant increase in frontal cognitive function (P < .001, partial η(2) = 0.838), with less body sway (P = .04, partial η(2) = 0.04) during the dual tasks, and greater functional capacity (P = .001, partial η(2) = 0.676) after the 16-week period. CONCLUSION: Intervention participants performed better on dual-task activities and had better postural balance and greater functional capacity than controls.

Longitudinal cognitive screening study in community-dwelling individuals / Estudo longitudinal de rastreio cognitivo em sujeitos da comunidade

Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression. Objectives: To evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study. Methods: 168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon's test for intra-group comparison, and the Spearman's correlation coefficient test for comparing cognitive and functionality scores. Results: After three years, the Wilcoxon's test showed a discreet yet significant cognitive decline (MMSE: -0.7 points; p=0.02; Z= -2.29; and global score on the BCB: +3.6 points; p=0.02; Z= -2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= -3.38). Conclusions: After three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.

Mudanças cognitivas no envelhecimento normal podem se assemelhar às alterações nos períodos iniciais de um processo demencial. Estudos longitudinais possibilitam um entendimento melhor desta progressão. Objetivos: Avaliar, em um estudo longitudinal de três anos, a evolução cognitiva e funcional de sujeitos sem demência da comunidade. Métodos: Após três anos de uma primeira avaliação de 168 sujeitos, em 2006, 73 sujeitos foram reavaliados em 2009 quanto à cognição e funcionalidade, através do Mini-Exame do Estado Mental (Mini-Mental), Bateria Breve de Rastreio Cognitivo (BBRC) e Questionário de Atividades Instrumentais (Pfeffer). A análise estatística constou de medidas descritivas, teste de Wilcoxon para comparação intragrupo e coeficiente de correlação de Spearman para comparação entre escores cognitivos e de funcionalidade. Resultados: Após três anos, o teste de Wilcoxon evidenciou declínio cognitivo discreto, porém significativo (Mini Mental: -0.7 pontos; p=0.02; Z= -2.29; e escore global da BBRC: +3.6 pontos; p=0.02; Z= -2.29), além de declínio funcional (Peffer: +0.7 pontos; p= 0.001; Z= -3,38). Conclusões: Após três anos de seguimento, observou-se discreto, porém significativo, declínio cognitivo e funcional dos sujeitos. A BBRC e o Mini-Mental mostraram-se eficazes para o screening cognitivo. O seguimento cognitivo longitudinal representa uma estratégia importante para a identificação precoce de possível evolução de uma condição de normalidade para um processo demencial.

Longitudinal cognitive screening study in community-dwelling individuals.

Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression. OBJECTIVES: To evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study. METHODS: 168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon's test for intra-group comparison, and the Spearman's correlation coefficient test for comparing cognitive and functionality scores. RESULTS: After three years, the Wilcoxon's test showed a discreet yet significant cognitive decline (MMSE: -0.7 points; p=0.02; Z= -2.29; and global score on the BCB: +3.6 points; p=0.02; Z= -2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= -3.38). CONCLUSIONS: After three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.

Mudanças cognitivas no envelhecimento normal podem se assemelhar às alterações nos períodos iniciais de um processo demencial. Estudos longitudinais possibilitam um entendimento melhor desta progressão. OBJETIVOS: Avaliar, em um estudo longitudinal de três anos, a evolução cognitiva e funcional de sujeitos sem demência da comunidade. MÉTODOS: Após três anos de uma primeira avaliação de 168 sujeitos, em 2006, 73 sujeitos foram reavaliados em 2009 quanto à cognição e funcionalidade, através do Mini-Exame do Estado Mental (Mini-Mental), Bateria Breve de Rastreio Cognitivo (BBRC) e Questionário de Atividades Instrumentais (Pfeffer). A análise estatística constou de medidas descritivas, teste de Wilcoxon para comparação intragrupo e coeficiente de correlação de Spearman para comparação entre escores cognitivos e de funcionalidade. RESULTADOS: Após três anos, o teste de Wilcoxon evidenciou declínio cognitivo discreto, porém significativo (Mini Mental: ­0.7 pontos; p=0.02; Z= ­2.29; e escore global da BBRC: +3.6 pontos; p=0.02; Z= ­2.29), além de declínio funcional (Peffer: +0.7 pontos; p= 0.001; Z= ­3,38). CONCLUSÕES: Após três anos de seguimento, observou-se discreto, porém significativo, declínio cognitivo e funcional dos sujeitos. A BBRC e o Mini-Mental mostraram-se eficazes para o screening cognitivo. O seguimento cognitivo longitudinal representa uma estratégia importante para a identificação precoce de possível evolução de uma condição de normalidade para um processo demencial.