scholarly journals 83 The acute effects of feeding a grain-free diet with or without methionine, taurine or methyl donor/acceptor supplementation on plasma and whole blood amino acid concentrations in dogs

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 62-62
Author(s):  
Sydney Banton ◽  
Julia G Pezzali ◽  
Renan Antunes Donadelli ◽  
Marica Bakovic ◽  
Katharine M Wood ◽  
...  
Keyword(s):  
Whole Blood ◽  
Repeated Measures ◽  
Latin Square ◽  
Acute Effects ◽  
Treatment Groups ◽  
Time Points ◽  
Postprandial Response ◽  
Donor Acceptor ◽  
Amino Acid Concentrations ◽  
Time Point

Abstract Grain-free pet foods have been sold for over a decade and comprise more than 40% of dog and cat diets sold today. Grain-free diets replace grain ingredients with pulse ingredients, which are high in lysine but low in methionine and cysteine, the precursor amino acids to taurine synthesis in the dog. The objective of this study was to evaluate the postprandial response of plasma methionine and taurine and whole blood taurine concentrations of dogs fed a grain-free diet without supplementation (CON) or with methionine (MET), taurine (TAU) or creatine, carnitine and choline (CCC) supplementation. Eight Beagles were pair housed and fed one of the four experimental diets for seven days in a 4x4 Latin Square Design. On the morning of d 7, cephalic catheters were placed and one fasted sample (0 min) and nine post-meal blood samples (15, 30, 60, 90, 120, 180, 240, 300 and 360 min) were collected. Data were analyzed as repeated measures using the PROC GLIMMIX function in SAS (Version 9.4). Dogs supplemented with MET had significantly higher plasma methionine concentrations from 30 to 360 minutes post-meal compared to dogs on CON, TAU and CCC treatments (P < 0.05). However, no differences were observed in plasma methionine concentrations between CON, TAU and CCC treatments at any time point (P > 0.05). Plasma taurine concentrations were significantly higher across time points in all treatment groups compared to CON (P < 0.05). Whole blood taurine concentrations tended to be higher across time points in MET and TAU treatment groups compared to CCC (P = 0.0513). Overall, MET, TAU and CCC supplementation increased plasma taurine concentrations compared to CON, but only MET supplementation increased plasma methionine concentrations from 30 to 360 minutes post-meal.

scholarly journals Cytotoxicity assessment of different doses of ozonated water on dental pulp cells

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ferdiye Küçük ◽  
Sibel Yıldırım ◽  
Serap Çetiner
Keyword(s):  
Cell Viability ◽  
Repeated Measures ◽  
Dental Pulp ◽  
Control Group ◽  
Dental Pulp Cells ◽  
Time Points ◽  
Significant Difference ◽  
Pulp Cells ◽  
Time Point ◽  
Ozonated Water

Abstract Background The purpose of this study was to assess the cytotoxicity of various concentrations of ozonated water (OW) on human primary dental pulp cells. Methods Human primary dental pulp cells were isolated from exfoliated primary canine teeth of an 11-year-old patient with good systemic and oral health. Afterwards, cells were divided into 6 experimental groups; four groups of OW in concentrations of 2 mg/L, 4 mg/L, 8 mg/L, and 16 mg/L, untreated control group, and cell culture without cells. Cytotoxicity was evaluated after exposure for 5-min exposure using Mosmann’s Tetrazolium Toxicity (MTT) assay at 0 h and 48 h time points. Data were analyzed using a repeated measures analysis of variance and Post-hoc tests were performed using Bonferroni correction for multiple comparisons. Results All experimental groups showed proliferation at 0 h time point. However, all groups also experienced a decrease in overtime at 48 h time point (p < 0.05). At both time points 2 mg/L OW showed the highest cell viability as well as proliferation. At 0 h time point, the increase in cell viability for all experimental groups was found statistically significant when compared to positive control group (p < 0.05). At 48 h time point, although 8 mg/L and 16 mg/L OW showed statistically significant reduction in compare to 0 h time point, 2 mg/L and 4 mg/L OW groups didn’t experience any statistically significant difference (p < 0.05). Conclusion Considering our findings, due to ozonated water's induced a higher proliferation rate of dental pulp cells, indicating their biocompatibility and a possible adjuvant on irrigating agent in regenerative endodontic procedures.

scholarly journals Acute Arginine Supplementation Is Associated with Increased Growth Hormone in Younger Healthy Males: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 609-609
Author(s):  
John Apolzan ◽  
Jennifer Rood ◽  
Robbie Beyl ◽  
Shengping Yang ◽  
Frank Greenway ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Sex Hormone Binding Globulin ◽  
Double Blind ◽  
Time Points ◽  
Arginine Supplementation ◽  
Time Point

Abstract Objectives Assess the effects of the amino acid arginine on growth hormone (GH), other metabolites, and mood. Arginine is reported to increase GH, but the mechanism is not known. It was hypothesized prolactin mediated this effect since it is similar in structure to GH and, like GH, is secreted by the pituitary gland. Methods Thirty physically active healthy young males (18–39 y; 18.5–25 kg/m2) were enrolled in a randomized, double-blind, placebo-controlled, crossover trial. Two days prior and 1 day following each treatment a standardized diet was provided that maintained arginine at 3–5 g/d. Arginine or placebo treatments in the form of a beverage were consumed after an overnight fast. Treatment conditions were separated by at least a one week washout period. The beverages contained either 10 g of arginine or 0 g (placebo). Blood was collected at baseline and 1.5, 3.0, and 24 hr post treatment. Plasma GH, prolactin, amino acids, glucose, insulin, triacylglycerols, thyroid hormones, sex hormone binding globulin (SHBG), testosterone, cortisol, and dehydroepiandrosterone (DHEA) were assessed. The Profile of Mood States (POMS) was administered at the same time as blood draws. Repeated measures ANOVAs were used to estimate treatment effects at each time point. Results Arginine increased plasma arginine at 1.5, 3.0, and 24 hr (P ≤ 0.001) and GH at 24 hr (P ˂ 0.05) but not other time points. Arginine increased glucose and insulin at the 1.5 and 3.0 hr (P ˂ 0.05) but not 24 hr. Arginine did not affect any other dependent measure (P &gt; 0.05) including prolactin. When only individuals with detectable levels of GH (responders; n = 16) were analyzed separately, arginine increased GH at the 1.5 (P ˂ 0.05) but not the 3.0 or 24 hr time points. Among the responders, arginine also increased thyroid stimulating hormone (TSH) at the 24 hr time point (P ˂ 0.05) but not the 1.5 and 3.0 hr time points. Conclusions Arginine supplementation modestly increased growth hormone. Despite their similar structures, prolactin secretion was not elevated following arginine supplementation, thus another mechanism is responsible for growth hormone secretion. Funding Sources DoD and NIH P30DK072476. Views expressed are those of the authors and do not reflect official policy of the Army, DoD, or US Government.

Citrate Storage Affects Thrombelastograph®Analysis

2000 ◽  
Vol 92 (5) ◽  
pp. 1242-1249 ◽  
Author(s):  
Vladimir Camenzind ◽  
Thomas Bombeli ◽  
Burkhardt Seifert ◽  
Marina Jamnicki ◽  
Dragoljub Popovic ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Analysis Of Variance ◽  
Whole Blood ◽  
Repeated Measures ◽  
Surgical Patients ◽  
Time Points ◽  
Prothrombin Fragment ◽  
Repeated Measures Analysis ◽  
Thrombin Activation ◽  
And Storage

Background Thrombelastograph analysis (TEG) is used to evaluate blood coagulation. Ideally, whole blood is immediately processed. If impossible, blood may be citrated and assessed after recalcification. No data describe the effect of such treatment and storage on TEG parameters. Methods Three studies were performed in 90 surgical patients. In 30 patients, blood was citrated (1:10, 0. 129 M) and recalcified (20 microl 2 M CaCl2 to 340 microl citrated blood), and TEG was performed with native blood and after recalcification after 0, 15, and 30 min of citrate storage. In another 30 patients, TEG was performed with citrated blood recalcified immediately and after 1-72 h storage. In a third study, thrombin-antithrombin complex, prothrombin fragment 1+2, and beta-thromboglobulin were measured (using enzyme-linked immunoabsorbant assay tests) at corresponding time points. Data were compared using repeated-measures analysis of variance and post hocpaired t tests. Results TEG parameters were different in recalcified citrated blood compared with native blood (P &lt; 0.05) and changed significantly during 30-min (P &lt; 0.025) and 72-h (P &lt; 0.001) citrate storage. TEG parameters measured between 1 and 8 h of citrate storage were stable. Thrombin-antithrombin complex and prothrombin fragment 1+2 values were not elevated in native blood. After 30 min of citrate storage a gradual thrombin activation was observed, as evidenced by increasing thrombin-antithrombin complex and prothrombin fragment 1+2 values (P &lt; 0.05). beta-Thromboglobulin level was increased after 2 and 8 h of citrate storage (P &lt; 0.01). Conclusions Analysis of native blood yields the most reliable TEG results. Should immediate TEG processing not be possible, citrated blood may be used if recalcified after 1-8 h.

Longitudinal assessment of taurine and amino acid concentrations in dogs fed a green lentil diet

2021 ◽  
Author(s):  
Lauren M Reilly ◽  
Fei He ◽  
Lindsay Clark ◽  
Maria R C de Godoy
Keyword(s):  
Amino Acid ◽  
Whole Blood ◽  
Nutritional Requirement ◽  
Longitudinal Assessment ◽  
Time Points ◽  
Α Diversity ◽  
Taurine Deficiency ◽  
Green Lentils ◽  
Dietary Treatments ◽  
Amino Acid Concentrations

Abstract A recent association between the inclusion of pulses in canine diets and taurine deficiency has become a prevalent issue in the pet food industry. Although there is not a nutritional requirement for taurine by dogs, the appearance of taurine deficiencies has been related with more serious health issues, such as dilated cardiomyopathy. The objective of this study was to determine the circulating concentrations of plasma and whole blood taurine, indispensable and dispensable amino acid concentrations in the plasma, and taurine and creatinine concentrations in the urine of adult dogs fed a green lentil diet. Twelve, adult, female beagles were randomly assigned to a diet containing 45% green lentils (GLD) or a poultry byproduct meal diet (CON) for 90 days. Fresh urine samples were collected every 30 d and analyzed for taurine and creatinine concentrations. A blood sample also was collected every 30 d and analyzed for amino acids including taurine. Animal procedures were approved by the University of Illinois Institutional Animal Care and Use Committee. All diets were formulated to meet or exceed the nutrient requirements outlined by AAFCO (2018) and all dogs remained healthy throughout the study. The concentrations of taurine in the plasma and whole blood showed no differences (P &gt; 0.05) between dietary treatments or across time points. Similarly, no differences (P &gt; 0.05) in plasma methionine concentrations were observed between treatments or across time points. A treatment effect (P &lt; 0.05) showed dogs fed GLD had higher total primary fecal bile acid (BA) excretion compared with dogs fed CON. The differential abundance of fecal microbial communities showed Firmicutes as the predominant phyla in dogs fed both GLD and CON, with Bacteroidaceae, Erysipelotrichaceae, and Lactobacillaecae as predominant families in dogs fed GLD. The α-diversity of dogs fed GLD ( P &lt; 0.05) was lower than in dogs fed CON. These data suggest that the inclusion of 45% green lentil in extruded diets does not lower whole blood and plasma taurine concentrations during a 90 d period and is appropriate for use in a complete and balanced formulation for dogs.

scholarly journals P0012SHOULD WE DEFINE A NEW STANDARD PRESCRIPTION OF BICARBONATE (HCO3-) IN HEMODIALYSIS (HD)?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ana Rita Valerio Alves ◽  
Cátia Figueiredo ◽  
HernÂNi Ricardo Martins GonÇAlves ◽  
Karina Lopes ◽  
Flora Sofia ◽  
...  
Keyword(s):  
Renal Disease ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Small Sample ◽  
Categorical Variables ◽  
Blood Levels ◽  
P Value ◽  
Disease Etiology ◽  
Time Points ◽  
Time Point

Abstract Background and Aims One of the aims of the regular, intermittent HD therapy prescribed for patients with end-stage chronic kidney disease, is correction of metabolic acidosis by addition of HCO3- to dialysate fluid. The KDOQI guidelines therapeutic goal is to maintain pre-dialysis HCO3-≥22mmol/L. The aim of the study was to evaluate an individualized HCO3-hemodialysis prescription as a preventing factor of metabolic changes in a HD facility and define a new standard HCO3-prescription. Method 36-month prospective study of patients on online high-flux hemodiafiltration. Every 3 months (13 time points) HCO3-, Calcium (Ca2+), Phosphorus (P+), intact Parathyroid hormone (iPTH) and protein C reactive (PCR) blood levels were analyzed. HCO3-prescription was changed using the following rules: The data collected comprised demographic information, renal disease etiology, comorbidities, HD treatment information and lab results. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. A p-value&lt;0.05 was considered statistically significant. Statistical analysis was performed using SPSS version 23 for Mac OS X. Results From the 50 patients that were evaluated at Time point 0, only 24 patients completed the follow-up period. Sixteen (66.7%) were males, 54.2% (n=13) diabetic and 58.3% (n=14) hypertensives and the median age was 76 years (IQR 13). At baseline (time point 0), median pH was 7.4 (IQR 0.09) and serum HCO3-26.5 mmol/L (IQR 2.32). At time point 12, pH was 7.35 (IQR 0.12) and serum HCO3-23.25mmol/L (IQR 1.93). A repeated measures ANOVA determined that prescribed HCO3- differed with statistical significance during time (F(2.787,83.308)=39.055, p=0.001), and the post Hoc tests confirmed those assumptions between time point 1 and all the others time points, as an example the mean difference between initial prescribed HCO3-and time point 12 was 5.39mmol/L (p=0.001). Wilcoxon Sign-Rank Tests determined that throughout the analyzed period the serum HCO3- approached the reference serum HCO3- (23mmol/L) that we have defined as ideal (at time point 0, median=26.5mmol/L, Z=4.144, p=0-001; at time point 12, median 23.25mmol/L, Z=1.243, p=0.214). On the other hand, a one sample T-Test determined that the HCO3- prescription differed more in each time point from the 32mmol/L defined as standard (at time point 12, t=-2.798, p=0.01) and approached a new suggested value of 26mmol/L. However, at time point 8, 62.5% (n=15) patients had a HCO3-prescription of 28mmol/L, (t(23)=0.001,p=1) and at that time we had hypothesized that that a prescription of 28 mmol/L should be the new standard. Gender, Diabetes Mellitus, Hypertension, and renal disease etiology did not influence the HCO3- prescription neither serum HCO3-. Conclusion HCO3-prescription and serum HCO3- were not influenced by comorbidities like DM and Hypertension. Our findings suggest that the standard HCO3- prescription of 32mmol/L should be rethought, as an individualized HCO3- prescription could be beneficial for the patient. At this time, we suggest that a prescription of 26 mmol/L should be the new standard. However, the limitations of our findings include the small sample size, so further studies with larger samples should be attempted.

scholarly journals M224. LONGITUDINAL DETERIORATION OF GESTURE PERFORMANCE IN SCHIZOPHRENIA IS UNRELATED TO SYMPTOM TRAJECTORIES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S221-S221
Author(s):  
Anastasia Pavlidou ◽  
Katharina Stegmayer ◽  
Lea Schäppi ◽  
Jeanne Moor ◽  
Sebastian Walther
Keyword(s):  
Social Functioning ◽  
Symptom Severity ◽  
Repeated Measures ◽  
Healthy Controls ◽  
Genetic Liability ◽  
Repeated Measures Anova ◽  
Time Points ◽  
Better Than ◽  
Time Point

Abstract Background Gesture deficits in patients with schizophrenia are highly pronounced, and often linked to poor social functioning, motor abnormalities, and frontal lobe dysfunction. Although gesture performance has been associated to both negative and positive symptoms, its relationship to the severity of these symptoms is still unclear. Here, we examine how gesture performance varies as symptoms change. Furthermore, we aimed to compare gesture performance at two time points to healthy controls and first-degree relatives of schizophrenia patients. Gesture performance in relatives may indicate whether the deficits are associated with genetic liability to schizophrenia. We hypothesize that gesture performance in controls and relatives would be stable; while we expect improvement in patients when symptom severity declines. Methods The present study included 36 patients with schizophrenia (DSM-5 criteria; mean age 35.5 years), 28 unaffected first-degree relatives of schizophrenia patients (mean age 49.9 years) and 38 healthy controls (mean age 39.9 years). All three groups performed the Test for Upper-Limp Apraxia (TULIA), which includes pantomime (performance on verbal command) and imitative (performance upon demonstration) gestures, at two different time points, baseline and re-test (between 1–4 weeks). TULIA performance is recorded on videos and rated blind to diagnosis and stage. In addition, 22 of the 36 patients performed the TULIA at a follow-up session 6-months after baseline. Symptom severity was assessed with the Positive And Negative Syndrome Scale (PANSS). Analysis between the three groups and within patients across the different time points was done using repeated measures ANOVA in R. Results Symptom severity in patients declined between baseline and week 4 (T = 6.7, p&lt;0.001, PANSS total). A 3x2x2 repeated measures ANOVA revealed significant main effects of Group, Type of Gestures, as well as, a significant interaction between Group and Time Point (all F &gt; 3.8; p&lt;0.5) Post hoc analysis, bonferroni corrected, revealed that patients underperformed in both pantomime and imitative gestures compared to healthy controls (p&lt;0.0001) and relatives of schizophrenia patients, although this effect did not reach significance (p=0.26). Performance of pantomime gestures was poorer compared to imitative gestures. Interestingly, this pattern was also observed during the re-test time point (p&lt;0.0001), though gesture performance for imitative gestures significantly declined compared to baseline in patients (p&lt;0.05). In contrast, healthy controls performed better than both patients (p&lt;0.0001) and relatives (p-0.09) and remained stable during the re-test. Likewise, relatives performed intermediate between patients and healthy controls at both time points with scores reaching significance only at re-test (p&lt;0.001). At baseline, imitation was better than pantomime in relatives, but with re-test imitation scores declined while pantomime scores remained stable. Finally, at the 6-month follow-up patients still exhibited lower gesture performance compared to baseline (F=22.25; p&lt;0.05). Discussion Gesture performance in schizophrenia patients remained significantly impaired across time-points, suggesting an extended effect on poor social functioning despite symptom change. In addition, schizophrenia patients and their relatives showed a significant impairment when performing imitative gestures during the re-test compared to baseline. These results call for interventions specifically targeting gesture and social cognition, which would greatly improve patients’ quality of life. Finally, our findings suggest a trait component to gesture behavior that might be linked to genetic liability to psychosis.

Addition of dietary methionine but not dietary taurine or methyl donors/receivers to a grain-free diet increases postprandial homocysteine concentrations in adult dogs

2021 ◽  
Author(s):  
Sydney Banton ◽  
Júlia G Pezzali ◽  
Adronie Verbrugghe ◽  
Marica Bakovic ◽  
Katie M Wood ◽  
...  
Keyword(s):  
Cardiac Disease ◽  
Whole Blood ◽  
Repeated Measures ◽  
Latin Square ◽  
Plasma Homocysteine ◽  
Future Research ◽  
Beagle Dogs ◽  
Methyl Donors ◽  
Dog Food ◽  
Cysteine Amino Acid

Abstract Grain based ingredients are replaced in part by pulse ingredients in grain-free pet foods. Pulse ingredients are lower in methionine and cysteine, amino acid (AA) precursors to taurine synthesis in dogs. While recent work has investigated plasma and whole blood taurine concentrations when feeding grain-free diets, supplementation of a grain-free diet with various nutrients involved in the biosynthesis of taurine has not been evaluated. This study aimed to investigate the effects of supplementing a complete grain-free dry dog food with either methionine (MET), taurine (TAU), or methyl donors (choline) and methyl receivers (creatine and carnitine; CCC) on postprandial AA concentrations. Eight healthy Beagle dogs were fed 1 of 3 treatments or the control grain-free diet (CON) for 7 d in a 4 × 4 Latin square design. On d7, cephalic catheters were placed and one fasted sample (0 min) and a series of 9 post-meal blood samples were collected at 15, 30, 60, 90, 120, 180, 240, 300 and 360 min. Data were analyzed as repeated measures using the PROC GLIMMIX function in SAS (Version 9.4). Dogs fed MET had greater plasma and whole blood methionine concentrations from 30 - 360 min after a meal (P &lt; 0.0001) and greater plasma homocysteine concentrations from 60 - 360 min after a meal (P &lt; 0.0001) compared to dogs fed CON, TAU and CCC. Dogs fed TAU had greater plasma taurine concentrations over time compared to dogs fed CON (P = 0.02), but were not different than dogs fed MET and CCC (P &gt; 0.05). In addition, most AA remained significantly elevated at 6 h post-meal compared to fasted samples across all treatments. Supplementation of creatine, carnitine and choline in grain-free diets may play a role in sparing the methionine requirement without increasing homocysteine concentrations. Supplementing these nutrients could also aid in the treatment of disease that causes metabolic or oxidative stress, including cardiac disease in dogs, but future research is required.

scholarly journals Progression of Visual Pathway Degeneration in Primary Open-Angle Glaucoma: A Longitudinal Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Shereif Haykal ◽  
Nomdo M. Jansonius ◽  
Frans W. Cornelissen
Keyword(s):  
Longitudinal Study ◽  
Repeated Measures ◽  
Primary Open Angle Glaucoma ◽  
Time Window ◽  
Open Angle Glaucoma ◽  
Visual Pathways ◽  
Open Angle ◽  
Time Points ◽  
Over Time ◽  
Time Point

Background: Primary open-angle glaucoma (POAG) patients exhibit widespread white matter (WM) degeneration throughout their visual pathways. Whether this degeneration starts at the pre- or post-geniculate pathways remains unclear. In this longitudinal study, we assess the progression of WM degeneration exhibited by the pre-geniculate optic tracts (OTs) and the post-geniculate optic radiations (ORs) of POAG patients over time, aiming to determine the source and pattern of spread of this degeneration.Methods: Diffusion-weighted MRI scans were acquired for 12 POAG patients and 14 controls at two time-points 5.4 ± 2.1 years apart. Fiber density (FD), an estimate of WM axonal density, was computed for the OTs and ORs of all participants in an unbiased longitudinal population template space. First, FD was compared between POAG patients and the controls at time-point 1 (TP1) and time-point 2 (TP2) independently. Secondly, repeated measures analysis was performed for FD change in POAG patients between the two time-points. Finally, we compared the rate of FD change over time between the two groups.Results: Compared to the controls, POAG patients exhibited significantly lower FD in the left OT at TP1 and in both OTs and the left OR at TP2. POAG patients showed a significant loss of FD between the time-points in the right OT and both ORs, while the left OR showed a significantly higher rate of FD loss in POAG patients compared to the controls.Conclusions: We find longitudinal progression of neurodegenerative WM changes in both the pre- and post-geniculate visual pathways of POAG patients. The pattern of changes suggests that glaucomatous WM degeneration starts at the pre-geniculate pathways and then spreads to the post-geniculate pathways. Furthermore, we find evidence that the trans-synaptic spread of glaucomatous degeneration to the post-geniculate pathways is a prolonged process which continues in the absence of detectable pre-geniculate degenerative progression. This suggests the presence of a time window for salvaging intact post-geniculate pathways, which could prove to be a viable therapeutic target in the future.

Abstract W P382: Cognitive Outcome in SAMMPRIS: Medical Therapy vs. Stenting

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Alison P Smock ◽  
Tanya N Turan ◽  
George A Cotsonis ◽  
Michael J Lynn ◽  
Colin P Derdeyn ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Repeated Measures ◽  
Mixed Model ◽  
Cerebral Arteries ◽  
Cognitive Outcome ◽  
Chi Square ◽  
Treatment Groups ◽  
Angioplasty And Stenting ◽  
Time Point

Background: It has been hypothesized that revascularization of stenotic cerebral arteries may improve cognitive outcome by increasing cerebral perfusion. We sought to compare cognitive outcome in patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) vs. AMM alone in the SAMMPRIS Trial. Methods: In SAMMPRIS, 451 patients with recent TIA or stroke attributed to 70%-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone. Patients with stroke as the qualifying event who had a NIHSS indicating aphasia or neglect were excluded from these analyses. Patients with any ischemic stroke, cerebral infarct with temporary signs (CITS), or ICH during follow-up were excluded from subsequent follow-up visit analyses. The Montreal Cognitive Assessment (MoCA) score was used to assess cognition at baseline, 4 months, 12 months, and closeout (mean 3.05 years in AMM group and 3.12 years in PTAS group). Cognitive impairment was defined as MoCA <26. Mean MoCA scores and the percentage of patients with cognitive impairment were compared between treatment groups at each time point using t-tests and Chi-square tests. Differences in MoCA means from baseline to follow-up time points were compared using mixed model repeated measures ANOVA and Tukey-Kramer tests. Results: As shown in the Figure, there were no significant differences between the treatment groups for mean MoCA at any time point. There were significant improvements in mean MoCA from baseline to 4 months, 12 months, and closeout in both groups. The percentage of patients with cognitive impairment in the AMM vs. PTAS groups were not significantly different at baseline (53 vs. 56%), 4 months (38 vs. 44%), 12 months (42 vs. 40%), and closeout (43 vs. 39%). Conclusions: Revascularization did not provide any additional cognitive benefit over AMM alone in SAMMPRIS even after excluding patients who had cerebral infarction or ICH during follow-up.

scholarly journals Is There Benefit from Stenting on Cognitive Function in Intracranial Atherosclerosis?

2016 ◽  
Vol 43 (1-2) ◽  
pp. 31-35 ◽  
Author(s):  
Tanya N. Turan ◽  
Alison Smock ◽  
George Cotsonis ◽  
David Bachman ◽  
Sami Al Kasab ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Repeated Measures ◽  
Mixed Model ◽  
Cerebral Arteries ◽  
Arterial Stenosis ◽  
Cerebrovascular Event ◽  
Treatment Groups ◽  
Cognition Impairment ◽  
Time Point

Background: Revascularization of stenotic cerebral arteries is hypothesized to improve cognition by increasing cerebral perfusion. Aims: We compared cognition impairment among patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) versus AMM alone in the Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) Trial. Methods: In SAMMPRIS, 451 patients with recent transient ischemic attack or stroke attributed to 70-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone. Patients who had stroke as the qualifying event with National Institutes of Health Stroke Scale indicating aphasia or neglect were excluded from these analyses. Patients with a cerebrovascular event (ischemic stroke, cerebral infarct with temporary signs or intracranial hemorrhage) during follow-up were excluded from follow-up visit analyses. The Montreal Cognitive Assessment (MoCA) score was used to assess cognition impairment at baseline, 4 months, 12 months and closeout. Cognitive impairment was defined as MoCA <26. Mean MoCA scores and the percentage of patients with cognitive impairment were compared between treatment groups at each time point using t tests and chi-square tests. Differences in MoCA mean at baseline and follow-up time points were compared using mixed model repeated measures ANOVA and Tukey-Kramer tests. Results: There were no significant differences between the treatment groups for mean MoCA at any time point. Mean MoCA scores improved in both groups. The percentage of patients with cognitive impairment in the AMM versus PTAS groups was not significantly different at any time point. Conclusions: Revascularization with PTAS showed no improvement in cognitive impairment over AMM alone among patients who did not have recurrent cerebrovascular events during follow-up.

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