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1.
J Biol Regul Homeost Agents ; 34(1): 111-121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32148012

RESUMO

During the menopause women may experience increased oxidative stress and decreased antioxidant capacity and, together with the decline of neurosteroids, this represents a risk factor for Alzheimer's disease. The aim of the present study was to test a functional food (FPP-ORI, Osato Research Institute, Gifu, Japan) on redox and mitochondrial efficiency in post-menopausal women. The study population consisting of 69 untreated post-menopausal women were given supplements as follows: Group A was given a multivitamin (MV) 1c 2 times a day, and group B was given FPP 4.5 g 2 times a day. Group C consisted of 23 fertile premenopausal women as the control group. The tests carried out on entry, and at 3 and 6 months were erythrocyte redox parameters, plasma oxidated proteins, brain-derived neurotrophic factor (BDNF) and peripheral blood mononuclear cell (PBMC) mitochondria cytochrome c oxidase Vmax activity. Menopausal women showed an increased malondialdehyde (MDA) (p<0.05 vs control) which was normalized by both treatments (p<0.05), but MV failed to do so in the BMI ≥26 subgroup (p<0.05). All other redox enzymes and BDNF were significantly lower in menopausal women and they responded only to FPP (p<0.05). Carbonyl protein level was higher in "BMI ≥ 26" subgroup (p<0.05) and reduced only by FPP (p<0.05). The PBMC cyclooxygenase to citrate synthase activity was reduced (<40%) in the menopausal group (p<0.01) and only FPP caused a significant restoration (p<0.05). Although preliminary, these data confirm the redox and mitochondrial dysfunction occurring in post-menopause and responsive to FPP but very poorly to high dosage antioxidants. This may lead to potential preventive opportunities in menopause-associated neurodegenerative disease.


Assuntos
Alimento Funcional , Mitocôndrias/patologia , Doenças Neurodegenerativas/epidemiologia , Pós-Menopausa , Antioxidantes/fisiologia , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Feminino , Humanos , Japão , Leucócitos Mononucleares , Malondialdeído/metabolismo , Oxirredução , Estresse Oxidativo , Projetos Piloto , Fatores de Risco
2.
J Orthop Surg Res ; 14(1): 252, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395104

RESUMO

BACKGROUND: Conventional posterior open lumbar surgery is associated with considerable trauma to the paraspinal muscles. Severe damage to the paraspinal muscles could cause low back pain (LBP), resulting in poor functional outcomes. Thus, several studies have proposed numerous surgical techniques that can minimize damage to the paraspinal muscles, particularly unilateral laminotomy for bilateral decompression. The purpose of this study is to compare the degree of postoperative LBP, functional outcome, and quality of life of patients between bilateral decompression via unilateral laminotomy (BDUL; group U) and conventional laminectomy (CL; group C). METHODS: Of 87 patients who underwent diagnostic and decompression surgery, 50 patients who met the inclusion and exclusion criteria and were followed up for > 2 years were enrolled. The patients were asked to record their visual analog scale pain score after 6, 12, and 24 months postoperatively. BDUL was used for group U, whereas CL was used for group C. The patients were randomly divided based on one of the two techniques, and they were followed up for over 2 years. Functional outcomes were assessed by the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and SF-36. RESULTS: Operation time was significantly shorter in group U than in group C (p = 0.003). At 6, 12, and 24 months, there was no significant difference between the two groups in terms of spine-related pain (all p > 0.05). Functional outcomes using ODI and RMDQ and quality of life using SF-36 were not significantly different between the groups (all p > 0.05). CONCLUSIONS: Regarding single-level decompression for degenerative lumbar spinal stenosis, group U had the advantages of shorter operation time than group C, but not in terms of back pain, functional outcome, and quality of life.


Assuntos
Descompressão Cirúrgica/métodos , Laminectomia/métodos , Dor Lombar/cirurgia , Doenças Neurodegenerativas/cirurgia , Qualidade de Vida , Estenose Espinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Descompressão Cirúrgica/normas , Feminino , Humanos , Laminectomia/normas , Dor Lombar/diagnóstico por imagem , Dor Lombar/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/epidemiologia , Estudos Prospectivos , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/epidemiologia , Resultado do Tratamento
3.
Acta Neurol Scand ; 140(6): 399-404, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31411727

RESUMO

OBJECTIVES: REM (rapid eye movement) sleep without atonia (RSWA) is a polysomnographic finding used in diagnosis of REM sleep behavior disorder (RBD). Clinical significance of idiopathic RSWA (iRSWA) unaccompanied by RBD is not known. We designed a prospective study to investigate whether iRSWA constitutes an increased risk for developing neurodegenerative disorders. MATERIALS AND METHODS: Between January 2010 and December 2014, a total of 4362 patients underwent a full-night video-polysomnography. Upon detailed clinical and polysomnographical examination, patients with iRSWA and idiopathic RBD (iRBD) were enrolled into this study and followed up at every six months for at least 4 years up to 9 years. RESULTS: We had a total of 31 patients with iRBD and 67 patients with iRSWA. Mean age was higher in iRBD group than those in iRSWA group (P = .016). Restless legs syndrome/Willis-Ekbom disease was significantly more common in patients with iRBD than those in patient with iRSWA (P < .001). Eighteen patients with iRSWA (26.8%) developed iRBD after 2.6 + 2.2 years. Six patients with iRSWA (8.9%) developed neurodegenerative disorders following 2.4 + 1.5 years; four were diagnosed as Parkinson's disease (PD) and two developed probable Alzheimer-type dementia. In patients with iRBD, eight patients (25.8%) developed neurodegenerative disorders-all was Parkinson's disease-following 2.6 + 2.2 years. Development of neurodegenerative diseases was positively correlated with age (P < .001) and periodic leg movements in sleep in both groups (P < .010). CONCLUSIONS: These results show that iRSWA may also be accepted as a risk factor in the development of PD or neurodegenerative diseases. Advanced age and periodic leg movements in sleep seem to be correlated with higher risk.


Assuntos
Doenças Neurodegenerativas , Transtorno do Comportamento do Sono REM/complicações , Sono REM/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tono Muscular/fisiologia , Doenças Neurodegenerativas/epidemiologia , Polissonografia , Estudos Prospectivos , Transtorno do Comportamento do Sono REM/diagnóstico
5.
Int J Mol Sci ; 20(14)2019 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-31330872

RESUMO

Sphingolipids (SL) modulate several cellular processes including cell death, proliferation and autophagy. The conversion of sphingomyelin (SM) to ceramide and the balance between ceramide and sphingosine-1-phosphate (S1P), also known as the SL rheostat, have been associated with oxidative stress and neurodegeneration. Research in the last decade has focused on the possibility of targeting the SL metabolism as a therapeutic option; and SL levels in biofluids, including serum, plasma, and cerebrospinal fluid (CSF), have been measured in several neurodegenerative diseases with the aim of finding a diagnostic or prognostic marker. Previous reviews focused on results from diseases such as Alzheimer's Disease (AD), evaluated total SL or species levels in human biofluids, post-mortem tissues and/or animal models. However, a comprehensive review of SL alterations comparing results from several neurodegenerative diseases is lacking. The present work compiles data from circulating sphingolipidomic studies and attempts to elucidate a possible connection between certain SL species and neurodegeneration processes. Furthermore, the effects of ceramide species according to their acyl-chain length in cellular pathways such as apoptosis and proliferation are discussed in order to understand the impact of the level alteration in specific species. Finally, enzymatic regulations and the possible influence of insulin resistance in the level alteration of SL are evaluated.


Assuntos
Líquidos Corporais/metabolismo , Doenças Neurodegenerativas/metabolismo , Esfingolipídeos/metabolismo , Animais , Apoptose , Biomarcadores , Vias Biossintéticas , Ceramidas/metabolismo , Cromatografia Líquida de Alta Pressão , Ácidos Graxos/metabolismo , Humanos , Incidência , Resistência à Insulina , Metabolismo dos Lipídeos , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/etiologia , Fenótipo , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem
6.
Environ Sci Process Impacts ; 21(9): 1426-1445, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31305828

RESUMO

Connecting chemical exposures over a lifetime to complex chronic diseases with multifactorial causes such as neurodegenerative diseases is an immense challenge requiring a long-term, interdisciplinary approach. Rapid developments in analytical and data technologies, such as non-target high resolution mass spectrometry (NT-HR-MS), have opened up new possibilities to accomplish this, inconceivable 20 years ago. While NT-HR-MS is being applied to increasingly complex research questions, there are still many unidentified chemicals and uncertainties in linking exposures to human health outcomes and environmental impacts. In this perspective, we explore the possibilities and challenges involved in using cheminformatics and NT-HR-MS to answer complex questions that cross many scientific disciplines, taking the identification of potential (small molecule) neurotoxicants in environmental or biological matrices as a case study. We explore capturing literature knowledge and patient exposure information in a form amenable to high-throughput data mining, and the related cheminformatic challenges. We then briefly cover which sample matrices are available, which method(s) could potentially be used to detect these chemicals in various matrices and what remains beyond the reach of NT-HR-MS. We touch on the potential for biological validation systems to contribute to mechanistic understanding of observations and explore which sampling and data archiving strategies may be required to form an accurate, sustained picture of small molecule signatures on extensive cohorts of patients with chronic neurodegenerative disorders. Finally, we reflect on how NT-HR-MS can support unravelling the contribution of the environment to complex diseases.


Assuntos
Exposição Ambiental/análise , Poluentes Ambientais/análise , Espectrometria de Massas/métodos , Doenças Neurodegenerativas/epidemiologia , Biomarcadores/análise , Humanos
7.
Continuum (Minneap Minn) ; 25(3): 753-772, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31162315

RESUMO

PURPOSE OF REVIEW: This article discusses the prevalence, identification, and management of multiple sclerosis (MS)-related symptoms and associated comorbidities, including complications that can present at all stages of the disease course. RECENT FINDINGS: The impact of comorbidities on the outcome of MS is increasingly recognized. This presents an opportunity to impact the course and outcome of MS by identifying and treating associated comorbidities that may be more amenable to treatment than the underlying inflammatory and neurodegenerative disease. The identification of MS-related symptoms and comorbidities is facilitated by brief screening tools, ideally completed by the patient and automatically entered into the patient record, with therapeutic suggestions for the provider. The development of free, open-source screening tools that can be integrated with electronic health records provides opportunities to identify and treat MS-related symptoms and comorbidities at an early stage. SUMMARY: Identification and management of MS-related symptoms and comorbidities can lead to improved outcomes, improved quality of life, and reduced disease activity. The use of brief patient-reported screening tools at or before the point of care can facilitate identification of symptoms and comorbidities that may be amenable to intervention.


Assuntos
Gerenciamento Clínico , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/tratamento farmacológico , Neuromielite Óptica/diagnóstico por imagem , Neuromielite Óptica/tratamento farmacológico , Anticonvulsivantes/administração & dosagem , Carbamazepina/administração & dosagem , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/epidemiologia , Comorbidade , Depressão/diagnóstico por imagem , Depressão/tratamento farmacológico , Depressão/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/tratamento farmacológico , Doenças Neurodegenerativas/epidemiologia , Neuromielite Óptica/epidemiologia
8.
Z Gerontol Geriatr ; 52(4): 324-329, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31139963

RESUMO

BACKGROUND: The proportion of patients with functional movement disorders (FMD) is particularly high in neurology clinics. Treatment options have not been consistently developed, not well evaluated and not validated. This article presents the preliminary data on the prevalence and treatment response of patients with FMD who were treated within the framework of an early rehabilitative geriatric complex treatment at a university hospital for neurology. METHODS: From July 2017 to November 2018 the prevalence, demographic and clinical parameters, and response to treatment of FMD patients were documented and compared to non-FMD patients treated at the neurogeriatric ward of the University Hospital Schleswig-Holstein, in Kiel. Clinical endpoints were the Short Physical Performance Battery (SPPB) for mobility and the Barthel index for instrumented activity of daily life (iADL). RESULTS: The prevalence of FMD was 11% (19/175) and predominantly observed in women (74%). Of the FMD patients nine also had a diagnosis of either idiopathic Parkinson's disease (N = 7), dementia with Lewy bodies (N = 1) or progressive supranuclear palsy (N = 1). At admission, neither the SPPB nor the iADL differed significantly between FMD and non-FMD patients. The treatment response was comparable between the groups: SPPB change was +0.3±1.8 (mean, standard deviation) in FMD and +0.4±1.9 in non-FMD patients (p = 0.83). The iADL change was +19±15 in FMD and +18±17 in non-FMD (p = 0.83). CONCLUSION: The prevalence of FMD was unexpectedly high in the neurogeriatric ward of a German university hospital. There were comparable impairments and responses to multidisciplinary treatment in mobility and iADL between FMD and non-FMD geriatric patients, suggesting that specific and informed treatment provided by a multidisciplinary geriatric team is effective in geriatric FMD patients. Further studies of this underdiagnosed disorder in older age are warranted.


Assuntos
Avaliação Geriátrica/métodos , Pacientes Internados , Doenças Neurodegenerativas/epidemiologia , Desempenho Físico Funcional , Atividades Cotidianas , Distribuição por Idade , Idoso , Demência/epidemiologia , Feminino , Alemanha/epidemiologia , Hospitais Universitários , Humanos , Doença de Parkinson/epidemiologia
9.
Stroke ; 50(5): 1136-1139, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31009345

RESUMO

Background and Purpose- Individual markers of cerebral small vessel disease and cerebral atrophy explain a small proportion of variance in vascular risk factors and cognitive function. Combining these markers into a single measure of neurovascular and neurodegenerative disease may be more powerful. We assessed this using data contained in the Virtual International Stroke Trials Archive - Prevention sub-archive. Methods- We extracted white matter hyperintensities (WMH) and cerebrospinal fluid (CSF) volumes from 317 people with ischemic stroke or transient ischemic attack who had baseline magnetic resonance imaging. We assessed progression of volumes in 208 people who had 2-year follow-up magnetic resonance imaging. WMH and CSF volumes were segmented from fluid attenuated inversion recovery and T1 images. The combined neurovascular and neurodegenerative measure was the sum of WMH and CSF volume normalized by intracranial volume. We assessed (1) the relationship between baseline vascular risk factors and imaging markers; and (2) the relationship between baseline imaging markers and Mini-Mental State Examination score at follow-up using multiple linear regression. We also assessed implications for sample size calculations using n=208 participants with follow-up magnetic resonance imaging. Results- Vascular risk factors accounted for 7%, 11%, and 12% of the variance in WMH, CSF, and combined volume, respectively (all P<0.001). The association between baseline combined volume and 6-month follow-up Mini-Mental State Examination (ß=-0.442; SE, 0.07; P<0.0001) was 32% greater than WMH (ß=-0.302; SE, 0.06; P<0.0001) and 12% greater than CSF (ß=-0.391; SE, 0.07; P<0.0001) alone. The combined volume required between 207 and 3305 (20%) fewer patients per arm than WMH alone to detect reductions of 10% to 40% in volume progression over 2 years. Conclusions- A combined neurovascular and neurodegenerative magnetic resonance imaging measure including WMH and CSF volume was more closely related to vascular risk factors and cognitive function than either WMH or CSF volume alone. The combined volume may be a more sensitive measurement for clinical trials.


Assuntos
Transtornos Cerebrovasculares/diagnóstico por imagem , Imagem por Ressonância Magnética/tendências , Doenças Neurodegenerativas/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Escalas de Graduação Psiquiátrica Breve , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/psicologia , Bases de Dados Factuais/tendências , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/psicologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/psicologia
10.
Neurología (Barc., Ed. impr.) ; 34(3): 159-164, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-180781

RESUMO

Introducción: El trastorno de conducta de sueño REM (TCSR) se caracteriza por conductas violentas (gritos, patadas, sueños vívidos) durante la fase REM del sueño. Tiene una prevalencia del 1-2% de la población general, especialmente en varones y en mayores de 60 años. En la última década se ha asociado como pródromo a una enfermedad neurodegenerativa. Nos proponemos analizar las patologías asociadas a los 33 pacientes con TCSR atendidos en la Unidad Multidisciplinar de Trastornos del Sueño del Hospital Infanta Sofía, y su respuesta al tratamiento farmacológico. Pacientes y métodos: Análisis descriptivo, retrospectivo, observacional, de los pacientes con diagnóstico de TCSR, atendidos en la consulta monográfica de Neurología, desde octubre de 2012 hasta diciembre de 2015. Se valoran la edad, el sexo, las enfermedades asociadas, y los tratamientos empleados. Resultados: De los 365 pacientes valorados en la consulta, 33 presentan TCSR: 13 mujeres (40%) y 20 hombres (60%), con una edad media de 62,72 años. En el 48% se identifica una patología asociada: la más frecuente es el deterioro cognitivo leve (69%). El porcentaje de TCSR con patología asociada en mayores de 60 años se eleva al 68%. El 82% de los casos han requerido tratamiento. El fármaco más utilizado ha sido el clonazepam (76%), seguido de melatonina (9%), gabapentina (6%) y trazodona (3%). Discusión: En nuestra serie el 48% de los pacientes presentan una patología asociada. La mayor edad influye directamente en la posibilidad de encontrar una patología asociada. La gran mayoría han precisado tratamiento farmacológico por la severidad de los síntomas, siendo el clonazepam (76%) el fármaco más utilizado


Introduction: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. Patients and methods: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. Results: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). Discussion: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients’ age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transtornos do Sono-Vigília/complicações , Transtorno do Comportamento do Sono REM/complicações , Estudos Retrospectivos , Transtorno do Comportamento do Sono REM/epidemiologia , Doença de Parkinson/epidemiologia , Demência/epidemiologia , Sintomas Prodrômicos , Clonazepam/uso terapêutico , Melatonina/uso terapêutico , Doenças Neurodegenerativas/epidemiologia , Trazodona/uso terapêutico , Polissonografia
11.
Aust Vet J ; 97(4): 89-92, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30919442

RESUMO

BACKGROUND: Devil facial tumour disease (DFTD) is a contagious cancer causing marked population declines in wild Tasmanian devils. In response to this threat, a captive insurance population has been established. This study investigated causes of death in captive Tasmanian devils. METHODS: Clinical and laboratory records of captive Tasmanian devils held in seven Tasmanian captive facilities were analysed for cause of death or severe morbidity requiring euthanasia. RESULTS: Neoplasia was found to be the most common cause of mortality/severe morbidity, accounting for 27/63 of deaths. Cutaneous lymphoma was the most frequently observed tumour (10/27), at a higher incidence than previously reported. The most common cause of severe morbidity, following neoplasia, was leucoencephalomyelopathy, which caused severe, progressive hindlimb paresis and ataxia. CONCLUSION: Neoplasia, specifically cutaneous lymphoma, and degenerative neurological conditions are the most frequent causes of death in captive Tasmanian devils in Tasmania. Further work to determine the aetiologies of these conditions, as well as effective treatments, would be valuable.


Assuntos
Eutanásia/estatística & dados numéricos , Marsupiais , Morbidade , Neoplasias/veterinária , Animais , Feminino , Leucoencefalopatias/epidemiologia , Leucoencefalopatias/mortalidade , Leucoencefalopatias/veterinária , Linfoma/epidemiologia , Linfoma/mortalidade , Linfoma/veterinária , Masculino , Neoplasias/mortalidade , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/mortalidade , Doenças Neurodegenerativas/veterinária , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/veterinária , Tasmânia/epidemiologia
12.
BMC Geriatr ; 19(1): 59, 2019 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819102

RESUMO

BACKGROUND: Visual rating scales are still the most popular tools in assessing atrophy degrees of whole brain and lobes. However, the false negative rate of the previous cutoff score of visual rating scales was relatively high for detecting dementia of Alzheimer's type (DAT). This study aimed to evaluate the diagnostic value of new cutoffs of visual rating scales on magnetic resonance imaging for discriminating DAT in a Chinese population. METHODS: Out of 585 enrolled subjects, 296 participants were included and diagnosed as normal cognition (NC)(n = 87), 138 diagnosed as amnestic mild cognitive impairment (aMCI), and 71 as dementia of Alzheimer's type (DAT). Receiver operating characteristic (ROC) curve analyses were used to calculate the diagnostic value of visual rating sales (including medial temporal atrophy (MTA), posterior atrophy rating scale (PA),global cortical atrophy scale (GCA) and medial temporal-lobe atrophy index (MTAi))for detecting NC from DAT . RESULTS: Scores of MTA correlated to age and Mini-mental state examination score. When used to detect DAT from NC, the MTA showed highest diagnostic value than other scales, and when the cutoff score of 1.5 of MTA scale, it obtained an optimal sensitivity (84.5%) and specificity (79.1%) respectively, with a 15.5% of false negative rate. Cutoff scores and diagnostic values were calculated stratified by age. For the age ranges 50-64, 65-74, 75-84 years, the following cut-offs of MTA should be used, ≥1.0(sensitivity and specificity were 92.3 and 68.4%), ≥1.5(sensitivity and specificity were 90.4 and 85.2%), ≥ 2.0(sensitivity and specificity were 70.8 and 82.3%) respectively. All of the scales showed relatively lower diagnostic values for discriminating aMCI from NC. CONCLUSIONS: The new age-based MTA cutoff showed better diagnostic accuracy for detecting DAT than previous standard, the list of practical cut-offs proposed here might be useful in clinical practice.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/epidemiologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Imagem por Ressonância Magnética/normas , Lobo Temporal/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Atrofia/diagnóstico por imagem , Atrofia/epidemiologia , Atrofia/psicologia , China/epidemiologia , Disfunção Cognitiva/psicologia , Estudos de Coortes , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/psicologia , Estudos Prospectivos
13.
Ital J Pediatr ; 45(1): 38, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885247

RESUMO

BACKGROUND: In order to give a new contribution to the knowledge of the psycho-physical, behavioral and socio-relational development of the individuals who were born at neurological risk, we have carried out a research work through a retrospective and observational analysis in such people, followed in their neuro-evolutionary development from the Department of Pediatrics and Neonatology of the Hospital of Jesi. The purpose of this work is to value the quality of life of the individuals born at neurological risk at a distance of time from the birth. In the literature only recently there are studies on the quality of life of some categories of people, but survey does not seem to be performed in individuals previously born at neurological risk. METHODS: A statistical descriptive and inferential survey has been carried out on 812 individuals who were born at neurological risk, 442 preterm newborns and 370 term newborns, followed from 1977 until to 2007. They were classed in order to their age at the time of our observation. We have submitted the entire sample to a Questionnaire to investigate some areas of their life, ranging from their clinical and psycho-social history to their personal coming of life. Then the same persons, subdivided according to the various age groups, were subjected to other Questionnaires on the quality of life, internationally used. RESULTS: Neurological outcomes were found in 14.7% of the preterm newborns and in 6% of the term newborns, with a significant correlation between neurological outcomes and gestational age, low birth-weight, hypoxic-ischemic encephalopathy and low APGAR-index. Neuro-disabilities were found prevalently belong to the small for gestational age preterm newborns. A low quality of life emerged in those who had neurological outcomes. CONCLUSIONS: Our study on the individuals who were born at neurological risk, analyzed at a distance, shows that a good health is associated with a good quality of life, while a low quality of life occurs to those who had neurological outcome, especially in the physical, cognitive, emotional and socio-relational aspects. As far as the few neurological outcomes which we have found in this survey, we think that they are due, other than to the natural factors, also to the high quality of the obstetric and neonatal care, to the early habilitation physiotherapy and to the important collaboration with the family.


Assuntos
Deficiências do Desenvolvimento/fisiopatologia , Recém-Nascido Prematuro , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/epidemiologia , Qualidade de Vida , Inquéritos e Questionários , Adulto , Fatores Etários , Índice de Apgar , Criança , Pré-Escolar , Doença Crônica , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/etiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/etiologia , Deficiência Intelectual/fisiopatologia , Masculino , Doenças Neurodegenerativas/terapia , Testes Neuropsicológicos , Gravidez , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais
14.
Continuum (Minneap Minn) ; 25(1): 147-164, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30707191

RESUMO

PURPOSE OF REVIEW: This article provides an overview of vascular cognitive impairment; discusses its epidemiology, subtypes, and associations with other neurodegenerative diseases; and reviews the diagnostic evaluation and management of these disorders. RECENT FINDINGS: Cerebrovascular disease is a common cause of dementia and frequently coexists with neurodegenerative causes. The heterogeneity of mechanisms leading to vascular cognitive impairment makes developing unifying clinical and research criteria difficult. Recognizing the neuroimaging hallmarks of different forms of vascular cognitive impairment can allow for individualized treatment and management. In individuals with mild vascular cognitive impairment, aerobic exercise appears to be a promising treatment but requires further investigation. SUMMARY: Vascular cognitive impairment can be caused by several mechanisms. While treating vascular risk factors is rational to prevent worsening of cognitive impairment, well-designed studies are needed to demonstrate efficacy.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Disfunção Cognitiva/epidemiologia , Demência Vascular/etiologia , Doenças Neurodegenerativas/epidemiologia , Encéfalo/patologia , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Demência Vascular/diagnóstico , Demência Vascular/epidemiologia , Humanos , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/diagnóstico , Neuroimagem/métodos
15.
Ann Neurol ; 85(4): 582-592, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30761606

RESUMO

OBJECTIVE: To determine the familial aggregation of idiopathic rapid eye movement sleep behavior disorder (iRBD), neurodegenerative diseases, and related biomarkers. METHODS: A total of 404 and 387 first-degree relatives of 102 patients with iRBD and of 89 controls were recruited, respectively. Among them, 204 and 208 relatives of patients and controls underwent face-to-face clinical assessment, whereas 97 and 75 relatives underwent further video-polysomnographic assessment, respectively. RESULTS: Compared with relatives of controls, relatives of patients demonstrated higher levels of RBD features, including chin tonic electromyography activity (mean = 1.5 ± 7.5 vs 0.3 ± 1.0, p = 0.04) and behavioral events (n [weighted %] = 12 [11.3] vs 2 [1.9], adjusted hazard ratio [aHR] = 7.69, 95% confidence interval [CI] = 1.54-33.33, p = 0.009) during rapid eye movement sleep, probable diagnosis (n [%] = 57 [14.9] vs 20 [4.9], aHR = 3.45, 95% CI = 1.96-6.25, p < 0.001), and definite diagnosis (n [weighted %] = 10 [8.4] vs 2 [1.4], aHR = 5.56, 95% CI = 1.16-25.00, p = 0.03). They also had higher risks of Parkinson disease (3.1% vs 0.5%, aHR = 5.88, 95% CI = 1.37-25.00, p = 0.02), dementia (6.9% vs 2.6%, aHR = 2.44, 95% CI = 1.15-5.26, p = 0.02), constipation (8.3% vs 2.4%, adjusted odds ratio = 4.21, 95% CI = 1.34-13.17, p = 0.01), and motor dysfunction (Movement Disorders Society Unified Parkinson's Disease Rating Scale part III motor score, mean = 1.9 ± 3.2 vs 0.9 ± 2.3, p = 0.002). The unaffected relatives of patients demonstrated a higher likelihood ratio of prodromal Parkinson disease (median [interquartile range] = 0.27 [1.19] vs 0.22 [0.51], p = 0.03). INTERPRETATION: iRBD is familially aggregated from isolated features to full-blown sleep disorder. Relatives of patients carry a higher risk of alpha-synucleinopathy in terms of neurodegenerative diseases and prodromal markers, suggesting a familial aggregation and staging pathology of alpha-synucleinopathy. Ann Neurol 2019;85:582-592.


Assuntos
Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/genética , Transtorno do Comportamento do Sono REM/epidemiologia , Transtorno do Comportamento do Sono REM/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Transtorno do Comportamento do Sono REM/diagnóstico
16.
World Neurosurg ; 126: 638-646, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30654156

RESUMO

BACKGROUND: In the coming years the number of patients with cognitive disorders, such as Alzheimer disease and traumatic brain injury, is expected to dramatically increase, leading to an ever-increasing societal cost. Unfortunately, few medical and pharmacologic treatments have shown tangible benefit in the treatment of these diseases. Deep brain stimulation (DBS) is an established surgical technique to address multiple conditions, including Parkinson disease and essential tremor. Data from patients being treated with DBS, as well as those being monitored for seizures with depth electrodes, have suggested improvement in memory with electrical neuromodulation. METHODS: MEDLINE was searched from inception through March 2018 using the keywords "DBS," "Deep Brain Stimulation," "Memory," "Memory Modulation," and "Cognition." Studies evaluating the effect of DBS on memory and learning were shortlisted and reviewed. RESULTS: Efforts to stimulate various nodes within the memory circuitry suggest that the variable effects may result from different mechanisms, including alteration of neural firing patterns, increased activity across several regions, and amplification of neural plasticity. Some of these targets, such as the entorhinal cortex, hippocampus, and nucleus basalis of Meynert, have shown promising results with regards to modulation of memory. CONCLUSIONS: Given the aging population and increasing numbers of patients with memory impairment from neurodegenerative diseases, interest in neuromodulation for memory enhancement will likely expand. Further work should employ more sophisticated responsive stimulation parameters and precise spatial targeting that may lead to an effective stimulation strategy for memory enhancement.


Assuntos
Transtornos da Memória/terapia , Doenças Neurodegenerativas/terapia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Mapeamento Encefálico , Estimulação Encefálica Profunda/métodos , Previsões , Humanos , Memória/fisiologia , Transtornos da Memória/epidemiologia , Transtornos da Memória/fisiopatologia , Rede Nervosa/fisiologia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/fisiopatologia , Doenças Neurodegenerativas/psicologia , Dinâmica Populacional , Terapias em Estudo
17.
Curr Opin Neurol ; 32(2): 279-291, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30672825

RESUMO

PURPOSE OF REVIEW: The purpose of this review is to provide an update on comorbidities in neurodegenerative conditions. The term comorbidity is used here to distinguish cases with overlapping pathogenic mechanisms, which includes combinations of neurodegenerative proteinopathies from cases with multimorbidity, which is defined as concomitant brain and systemic disorders with different pathogenic mechanisms. RECENT FINDINGS: Comorbid proteinopathies are more frequent in both sporadic and hereditary neurodegenerative diseases than previously assumed. The most frequent additional proteinopathies are related to Alzheimer's disease, Lewy body disorder, and limbic predominant transactive response DNA-binding protein 43 proteinopathy, however, different forms of tau pathologies are also increasingly recognized. In addition to ageing, synergistic interaction of proteins, common disease pathways, and the influence of genetic variations are discussed as possible pathogenic players. SUMMARY: Comorbid proteinopathies might influence the clinical course and have implications for biomarker and therapeutic development. As pure forms of proteinopathies are still observed, the notion of current molecular classification is justified. This corroborates elucidation of various pathogenic pathways leading to neurodegeneration. Assuming that single proteins and associated pathways are targeted in therapy trials, efforts are needed to better stratify patients and to select pure proteinopathy forms lacking unfavorable genetic constellations. Otherwise combined therapeutic strategies might be necessary for comorbid proteinopathies.


Assuntos
Doenças Neurodegenerativas/classificação , Doenças Neurodegenerativas/genética , Animais , Comorbidade , Humanos , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/patologia
18.
Neurology ; 92(7): e700-e709, 2019 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-30651382

RESUMO

OBJECTIVE: We aimed to examine whether impaired olfaction is associated with cognitive decline and indicators of neurodegeneration in the brain of dementia-free older adults. METHODS: Within the Rush Memory and Aging Project, 380 dementia-free participants (mean age = 78 years) were followed for up to 15 years, and underwent MRI scans. Olfactory function was assessed using the Brief Smell Identification Test (B-SIT) at baseline, and categorized as anosmia (B-SIT <6), hyposmia (B-SIT 6-10 in men and 6-10.25 in women), and normal (B-SIT 10.25-12 in men and 10.5-12 in women). Cognitive function was annually assessed with a battery of 21 tests, from which composite scores were derived. Structural total and regional brain volumes were estimated. Data were analyzed using linear regression and mixed-effects models. RESULTS: At study entry, 138 (36.3%) had normal olfactory function, 213 (56.1%) had hyposmia, and 29 (7.6%) had anosmia. In multiadjusted mixed-effects models, hyposmia (ß = -0.03, 95% confidence interval [CI] -0.05 to -0.02) and anosmia (ß = -0.13, 95% CI -0.16 to -0.09) were associated with faster rate of cognitive decline compared to normal olfaction. On MRI, impaired olfaction (hyposmia or anosmia) was related to smaller volumes of the hippocampus (ß = -0.19, 95% CI -0.33 to -0.05), and in the entorhinal (ß = -0.16, 95% CI -0.24 to -0.08), fusiform (ß = -0.45, 95% CI -0.78 to -0.14), and middle temporal (ß = -0.38, 95% CI -0.72 to -0.01) cortices. CONCLUSION: Impaired olfaction predicts faster cognitive decline and might indicate neurodegeneration in the brain among dementia-free older adults.


Assuntos
Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Doenças Neurodegenerativas/epidemiologia , Transtornos do Olfato/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Encéfalo/patologia , Disfunção Cognitiva/diagnóstico por imagem , Córtex Entorrinal/diagnóstico por imagem , Córtex Entorrinal/patologia , Feminino , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Modelos Lineares , Imagem por Ressonância Magnética , Masculino , Doenças Neurodegenerativas/diagnóstico por imagem , Testes Neuropsicológicos , Transtornos do Olfato/diagnóstico por imagem , Tamanho do Órgão , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia
19.
ACS Chem Neurosci ; 10(1): 175-181, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-30485059

RESUMO

Glutamate, a primary excitatory neurotransmitter and an important intermediate in the cellular metabolism of the brain, has a widespread influence in the sleep-wake regulatory system. Glutamate transporters, including vesicular glutamate transporters and excitatory amino acid transporters, serve as the main force controlling the extracellular concentration of glutamate in the brain. These are likely to be critical tools needed for the brain to modulate the sleep-wake cycle and are likely innervated by the circadian rhythm system in a day-night variant pattern. Because in the initial stages, nearly all patients with neurodegenerative diseases have rhythmic sleep disorders that become aggravated with disease development and often exhibit glutamate uptake dysfunction, we examined whether the above glutamate transporters could be used as potential targets to help address circadian rhythm sleep disorders in patients with neurodegenerative diseases. Therefore, in this review, we sought to analyze the principles governing glutamate transmission and discuss whether the circadian rhythm regulatory properties of these processes endow glutamate transporters with unique functions in the sleep-wake shift of the brain. We attempt to provide a theoretical framework in this field for future studies, to help in the exploration of potential therapeutic targets to delay or prevent the development of neurodegenerative diseases.


Assuntos
Sistema X-AG de Transporte de Aminoácidos/metabolismo , Ácido Glutâmico/metabolismo , Doenças Neurodegenerativas/metabolismo , Transtornos do Sono do Ritmo Circadiano/metabolismo , Animais , Encéfalo/metabolismo , Ritmo Circadiano/fisiologia , Proteínas de Transporte de Glutamato da Membrana Plasmática/metabolismo , Humanos , Doenças Neurodegenerativas/epidemiologia , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Proteínas Vesiculares de Transporte de Glutamato/metabolismo
20.
Neurologia ; 34(5): 283-290, 2019 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28325559

RESUMO

BACKGROUND: Cancer and degenerative diseases share some pathogenic mechanisms which act in opposition to one another to produce either uncontrolled cell proliferation or cell death. According to several studies, patients with Alzheimer disease have a lower risk of neoplasia, and vice versa. This study describes the prevalence of tumours (active or successfully treated) in a series of patients with and without a dementing degenerative disease treated at a cognitive neurology unit. PATIENTS AND METHOD: We analysed the frequency and topography of tumours and the presence or absence of a neurodegenerative disease in a group of 1,164 patients. Neurodegenerative diseases were classified in 4 groups: Alzheimer disease, synucleinopathies, Pick complex, and polyglutamine complex. We subsequently compared tumour frequency in patients with and without a degenerative disease, and prevalence of neurodegenerative diseases in patients with and without tumours. RESULTS: Tumours were detected in 12.1% of the patients with a neurodegenerative disease and in 17.3% of the remaining patients. Around 14.8% of the patients with a history of neoplasia and 20.8% of the patients with no history of neoplasia were diagnosed with a neurodegenerative disease. Except for these differences and the differences between subgroups (type of degenerative disease and tumour location) were not statistically significant, except when comparing neurodegenerative diseases to central nervous system tumours, and synucleinopathies to neoplasms. CONCLUSION: Dementing degenerative diseases and neoplastic disorders are not mutually exclusive. Nevertheless, the rate of co-occurrence is lower than would be expected given the prevalence rate for each group.


Assuntos
Demência/epidemiologia , Neoplasias/epidemiologia , Doenças Neurodegenerativas/epidemiologia , Doença de Alzheimer/epidemiologia , Degeneração Lobar Frontotemporal/epidemiologia , Humanos , Peptídeos , Prevalência , Sinucleínas
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