Intradialytic hypotension and relationship with cognitive function and brain morphometry

Abstract Background The haemodynamic stress brought about by dialysis could justify the loss of structural and functional integrity of the central nervous system (CNS). The main objective of this study was to analyse the relationship between intradialytic hypotension (IDH) and cognitive function and brain morphometry. Methods The cross-sectional KIDBRAIN study (Cohort Study of Morphological Changes of the Brain by MRI in Chronic Kidney Disease Patients) included 68 prevalent patients with no history of neurological disorders (cerebrovascular disease and cognitive impairment) undergoing haemodialysis (HD). We analysed 18 non-consecutive dialysis sessions (first three of each month over a 6-month period) and various definitions of IDH were recorded. Global cognitive function (GCF) was assessed using the Mini-Mental State Examination (MMSE) and parameters of structural integrity of the CNS were obtained using volume morphometry magnetic resonance imaging analysis [grey matter (GM), white matter (WM) and hippocampus). Results A greater number of sessions with IDH were associated with less volume of WM (r = −0.359,P = 0.003) and hippocampus (r = −0.395, P = 0.001) independent of cardiovascular risk factors according to multivariable linear regression models (β = −0.198, P = 0.046 for WM; β = −0.253, P = 0.017 for hippocampus). The GCF by the MMSE was 27.3 ± 7.3.1 and was associated with WM volume (β = 0.403, P = 0.001) independent of GM and hippocampus volume. Symptomatic IDH was associated with GCF (r = −0.420, P < 0.001) in adjusted analysis (β = −0.339, P = 0.008). Conclusions Even when asymptomatic, IDH is associated with a lower WM and hippocampus volume and reduced GCF in patients undergoing HD, thus suggesting greater vulnerability of the brain to the haemodynamic stress that may be generated by a dialysis session.

Download Full-text

The relationship between plasma free fatty acids, cognitive function and structural integrity of the brain in middle-aged healthy humans

Aging ◽

10.18632/aging.203573 ◽

2021 ◽

Vol 13 (18) ◽

pp. 22078-22091

Author(s):

Markus Herrmann ◽

Sebastian Simstich ◽

Günter Fauler ◽

Edith Hofer ◽

Eva Fritz-Petrin ◽

...

Keyword(s):

Fatty Acids ◽

Cognitive Function ◽

Free Fatty Acids ◽

Structural Integrity ◽

Middle Aged ◽

Plasma Free Fatty Acids ◽

Healthy Humans ◽

The Relationship ◽

The Brain

Download Full-text

Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000265 ◽

2014 ◽

Vol 42 (1) ◽

pp. 7-18 ◽

Cited By ~ 56

Author(s):

Jochen Seitz ◽

Katharina Bühren ◽

Georg G. von Polier ◽

Nicole Heussen ◽

Beate Herpertz-Dahlmann ◽

...

Keyword(s):

Anorexia Nervosa ◽

Cognitive Deficits ◽

Time Course ◽

Morphological Changes ◽

Meta Analysis ◽

Short Term ◽

Clinical Prognosis ◽

Qualitative Review ◽

Brain Changes ◽

The Brain

Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2–5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2–8 years of remission GM and WM were nearly normalized, and differences to HC (GM: –1.0%, WM: –0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.

Download Full-text

Interaction of clozapine with metformin in a schizophrenia rat model

Scientific Reports ◽

10.1038/s41598-021-96478-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

G. Horvath ◽

G. Kis ◽

G. Kekesi ◽

A. Büki ◽

L. G. Adlan ◽

...

Keyword(s):

Gene Expression ◽

Cognitive Function ◽

Negative Symptoms ◽

Antipsychotic Drugs ◽

D1 Receptor ◽

Antidiabetic Drug ◽

Beneficial Effects ◽

Adjuvant Therapies ◽

Behavioral Parameters ◽

The Brain

AbstractThe low efficacy of antipsychotic drugs (e.g., clozapine) for negative symptoms and cognitive impairment has led to the introduction of adjuvant therapies. Because previous data suggest the procognitive potential of the antidiabetic drug metformin, this study aimed to assess the effects of chronic clozapine and metformin oral administration (alone and in combination) on locomotor and exploratory activities and cognitive function in a reward-based test in control and a schizophrenia-like animal model (Wisket rats). As impaired dopamine D1 receptor (D1R) function might play a role in the cognitive dysfunctions observed in patients with schizophrenia, the second goal of this study was to determine the brain-region-specific D1R-mediated signaling, ligand binding, and mRNA expression. None of the treatments affected the behavior of the control animals significantly; however, the combination treatment enhanced D1R binding and activation in the cerebral cortex. The Wisket rats exhibited impaired motivation, attention, and cognitive function, as well as a lower level of cortical D1R binding, signaling, and gene expression. Clozapine caused further deterioration of the behavioral parameters, without a significant effect on the D1R system. Metformin blunted the clozapine-induced impairments, and, similarly to that observed in the control animals, increased the functional activity of D1R. This study highlights the beneficial effects of metformin (at the behavioral and cellular levels) in blunting clozapine-induced adverse effects.

Download Full-text

OCT angiography metrics predict intradialytic hypotension episodes in chronic hemodialysis patients: a pilot, prospective study

Scientific Reports ◽

10.1038/s41598-021-86609-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Giuseppe Coppolino ◽

Adriano Carnevali ◽

Valentina Gatti ◽

Caterina Battaglia ◽

Giorgio Randazzo ◽

...

Keyword(s):

Chronic Hemodialysis ◽

Dialysis Session ◽

Intradialytic Hypotension ◽

Inverse Association ◽

Non Invasive ◽

Kaplan Meier ◽

Optimal Thresholds ◽

Scanning Area ◽

Before And After ◽

Capillary Plexus

AbstractIn chronic hemodialysis (HD) patients, intradialytic hypotension (IDH) is a complication that increases mortality risk. We run a pilot study to analyzing possible relationships between optical coherence tomography angiography (OCT-A) metrics and IDH with the aim of evaluating if OCT-A could represent a useful tool to stratify the hypotensive risk in dialysis patients. A total of 35 eyes (35 patients) were analyzed. OCT-A was performed before and after a single dialysis session. We performed OCT-A 3 × 3 mm and 6 × 6 mm scanning area focused on the fovea centralis. Patients were then followed up to 30 days (10 HD sessions) and a total of 73 IDHs were recorded, with 12 patients (60%) experiencing at least one IDH. Different OCT-A parameters were reduced after dialysis: central choroid thickness (CCT), 6 × 6 mm foveal whole vessel density (VD) of superficial capillary plexus (SPC) and 6 × 6 mm foveal VD of deep capillary plexus (DCP). At logistic regression analysis, IDH was positively associated with baseline foveal VD of SCP and DCP, while an inverse association was found with the choroid. In Kaplan–Meier analyses of patients categorized according to the ROC-derived optimal thresholds, CCT, the 3 × 3 foveal VD of SCP, the 3 × 3 mm and 6 × 6 mm foveal VD of DCP and the 6 × 6 mm foveal VD of SCP were strongly associated with a higher risk of IDH over the 30-days follow-up. In HD patients, a single OCT-A measurement may represent a non-invasive, rapid tool to evaluate the compliance of vascular bed to HD stress and to stratify the risk of IDH in the short term.

Download Full-text

Combined Supplementation of Choline and Docosahexaenoic Acid during Pregnancy Enhances Neurodevelopment of Fetal Hippocampus

Neurology Research International ◽

10.1155/2017/8748706 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Huban Thomas Rajarethnem ◽

Kumar Megur Ramakrishna Bhat ◽

Malsawmzuali Jc ◽

Siva Kumar Gopalkrishnan ◽

Ramesh Babu Mugundhu Gopalram ◽

...

Keyword(s):

Docosahexaenoic Acid ◽

Structural Integrity ◽

Fetal Brain ◽

Normal Pregnancy ◽

Saline Control ◽

Fetal Brain Development ◽

Essential Nutrient ◽

Combined Supplementation ◽

And Function ◽

The Brain

Choline is an essential nutrient for humans which plays an important role in structural integrity and signaling functions. Docosahexaenoic acid (DHA) is a polyunsaturated fatty acid, highly enriched in cell membranes of the brain. Dietary intake of choline or DHA alone by pregnant mothers directly affects fetal brain development and function. But no studies show the efficacy of combined supplementation of choline and DHA on fetal neurodevelopment. The aim of the present study was to analyze fetal neurodevelopment on combined supplementation of pregnant dams with choline and DHA. Pregnant dams were divided into five groups: normal control [NC], saline control [SC], choline [C], DHA, and C + DHA. Saline, choline, and DHA were given as supplements to appropriate groups of dams. NC dams were undisturbed during entire gestation. On postnatal day (PND) 40, brains were processed for Cresyl staining. Pups from choline or DHA supplemented group showed significant (p<0.05) increase in number of neurons in hippocampus when compared to the same in NC and SC groups. Moreover, pups from C + DHA supplemented group showed significantly higher number of neurons (p<0.001) in hippocampus when compared to the same in NC and SC groups. Thus combined supplementation of choline and DHA during normal pregnancy enhances fetal hippocampal neurodevelopment better than supplementation of choline or DHA alone.

Download Full-text

Zingiber officinaleMitigates Brain Damage and Improves Memory Impairment in Focal Cerebral Ischemic Rat

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2011/429505 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 35

Author(s):

Jintanaporn Wattanathorn ◽

Jinatta Jittiwat ◽

Terdthai Tongun ◽

Supaporn Muchimapura ◽

Kornkanok Ingkaninan

Keyword(s):

Cognitive Function ◽

Cerebral Ischemia ◽

Brain Damage ◽

Focal Cerebral Ischemia ◽

Infarct Volume ◽

Neuroprotective Effect ◽

Morris Water Maze Test ◽

Brain Infarct ◽

Ginger Rhizome ◽

The Brain

Cerebral ischemia is known to produce brain damage and related behavioral deficits including memory. Recently, accumulating lines of evidence showed that dietary enrichment with nutritional antioxidants could reduce brain damage and improve cognitive function. In this study, possible protective effect ofZingiber officinale, a medicinal plant reputed for neuroprotective effect against oxidative stress-related brain damage, on brain damage and memory deficit induced by focal cerebral ischemia was elucidated. Male adult Wistar rats were administrated an alcoholic extract of ginger rhizome orally 14 days before and 21 days after the permanent occlusion of right middle cerebral artery (MCAO). Cognitive function assessment was performed at 7, 14, and 21 days after MCAO using the Morris water maze test. The brain infarct volume and density of neurons in hippocampus were also determined. Furthermore, the level of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) in cerebral cortex, striatum, and hippocampus was also quantified at the end of experiment. The results showed that cognitive function and neurons density in hippocampus of rats receiving ginger rhizome extract were improved while the brain infarct volume was decreased. The cognitive enhancing effect and neuroprotective effect occurred partly via the antioxidant activity of the extract. In conclusion, our study demonstrated the beneficial effect of ginger rhizome to protect against focal cerebral ischemia.

Download Full-text

The impact of dietary macronutrient intake on cognitive function and the brain

Clinical Nutrition ◽

10.1016/j.clnu.2021.04.043 ◽

2021 ◽

Author(s):

Anne-Katrin Muth ◽

Soyoung Q. Park

Keyword(s):

Cognitive Function ◽

Macronutrient Intake ◽

The Impact ◽

The Brain

Download Full-text

Rugby players lose cognitive function and blood flow to the brain over one season, study shows

BMJ ◽

10.1136/bmj.n2161 ◽

2021 ◽

pp. n2161

Author(s):

Luke Taylor

Keyword(s):

Blood Flow ◽

Cognitive Function ◽

Rugby Players ◽

The Brain

Download Full-text

Defective actin dynamics in dendritic spines: cause or consequence of age-induced cognitive decline?

Biological Chemistry ◽

10.1515/hsz-2015-0185 ◽

2016 ◽

Vol 397 (3) ◽

pp. 223-229 ◽

Cited By ~ 3

Author(s):

Till Georg Alexander Mack ◽

Patricia Kreis ◽

Britta Johanna Eickholt

Keyword(s):

Dendritic Spines ◽

Neuronal Excitability ◽

Replicative Senescence ◽

Morphological Changes ◽

Actin Dynamics ◽

Cellular Processes ◽

Filament Dynamics ◽

Neuronal Soma ◽

Deteriorating Process ◽

The Brain

Abstract Ageing is a complex deteriorating process that coincides with changes in metabolism, replicative senescence, increased resistance to apoptosis, as well as progressive mitochondria dysfunction that lead to an increase production and accumulation of reactive oxygen species (ROS). Although controversy on the paradigm of the oxidative damage theory of ageing exists, persuasive studies in Caenorhabditis elegans and yeast have demonstrated that manipulation of ROS can modify the process of ageing and influences the damage of proteins, lipids and DNA. In neurons, ageing impacts on the intrinsic neuronal excitability, it decreases the size of neuronal soma and induces the loss of dendrites and dendritic spines. The actin cytoskeleton is an abundant and broadly expressed system that plays critical functions in many cellular processes ranging from cell motility to controlling cell shape and polarity. It is thus hardly surprising that the expression and the function of actin in neurons is crucial for the morphological changes that occur in the brain throughout life. We propose that alterations in actin filament dynamics in dendritic spines may be one of the key events contributing to the initial phases of ageing in the brain.

Download Full-text