Forget About It

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Vascular Dementia ◽  
Clinical Course ◽  
White Matter Lesions ◽  
Acetylcholinesterase Inhibitors ◽  
Cognitive Symptoms ◽  
Vascular Events ◽  
Off Label

Cognitive impairment is common following stroke. The clinical course and presentation are variable in vascular dementia, but the diagnosis can often be tied to recent vascular events or to progressive white matter lesions on MRI. Because there is considerable overlap between patients with vascular and Alzheimer’s type dementia, both acetylcholinesterase inhibitors and memantine have been tried off-label to treat the cognitive symptoms of vascular dementia with mixed results.

scholarly journals Acupuncture improves white matter perfusion and white matter integrity in vascular dementia rats: an MRI-based imaging study

2020 ◽  
Author(s):  
Siming Ma ◽  
Lu Wang ◽  
Xin-Tong Su ◽  
Jin Huang ◽  
Lu-Lu Lin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Impairment ◽  
White Matter ◽  
Vascular Dementia ◽  
Acupuncture Treatment ◽  
Diffusion Tensor ◽  
White Matter Lesions ◽  
Microglia Activation ◽  
White Matter Integrity

Abstract Background: White matter lesions induced by chronic cerebral hypoperfusion (CCH) are common pathological changes, and are associated with cognitive impairment in vascular dementia (VaD). It has been reported that acupuncture can improve cognitive deficits of VaD rats through increasing cortical cerebral blood flow and attenuating neuroinflammation. However, the effects of acupuncture on white matter perfusion and white matter structural integrity have been not investigated. Methods: VaD was induced by bilateral common carotid arteries occlusion (BCCAO) in Wistar rats. Morris water maze (MWM) was used to evaluated the spatial learning and memory of rats. Arterial spin labeling imaging (ASL) and diffusion tensor imaging (DTI) were performed to measure the cerebral blood flow and white matter integrity in corpus callosum, external capsule, internal capsule, optic nerve and optic tract. Pathological staining was also applied to detect the myelin loss and neuroinflammation. Results: BCCAO rats with declined cerebral blood flow exhibited significant worse MWM performance, and altered DTI parameters including decreased fractional anisotropy, elevated radial diffusivity and axial diffusivity in white matter regions. After acupuncture treatment at GV20 and ST36, cognitive dysfunction, disruption of white matter perfusion and integrity were reversed. Pathological results supported that acupuncture could attenuate the loss of myelin sheath and microglia activation. Conclusions: Our findings suggest that acupuncture treatment protects cognitive impairment of BCCAO rats through increasing subcortical white matter perfusion and improving white matter lesions. Keywords: Acupuncture; ASL; DTI; cerebral blood flow; white matter; microglia activation

Abstract WMP78: The Efficacy of Angiotensin II Peptide Vaccination Against White Matter Lesions of Vascular Dementia in Rats

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kouji Wakayama ◽  
Munehisa Shimamura ◽  
Hironori Nakagami ◽  
Ryuichi Morishita
Keyword(s):  
Endothelial Cells ◽  
Cognitive Function ◽  
Angiotensin Ii ◽  
White Matter ◽  
Western Blot ◽  
Vascular Dementia ◽  
White Matter Lesions ◽  
Ang Ii ◽  
Peptide Vaccination ◽  
Brdu Assay

Background & Purposes: There had been no attempt to show the efficacy of therapeutic vaccination in vascular dementia. A rat model of vascular dementia was prepared by bilateral common carotid artery ligation (2VO). The purpose of this study is to investigate whether pre-exposure Angiotensin II (Ang II) peptide vaccination exhibits the protective effects against white matter lesions (WML) in 2VO rats. Methods: After subcutaneous injection of Ang II peptide vaccine (10μg/200μl) or saline (200μl) to Wistar rats (male) at the time point of 6, 8 and 10 week-old, 2VO or sham surgery was performed at 12 week-old. Cognitive function was evaluated after 14 days of 2VO using the novel object recognition (NOR) test. Anti-Ang II antibody (Ab) level was quantified using ELISA. Histological examinations of WML and demyelination in the corpus callosum (CC) were evaluated using immunohistochemistry (IHC), 5-bromodeoxyuridine (BrdU) assay and Klüver-Barrera staining. Western blot analyses of VCAM-1, FGF2, phospho-CREB and CREB using proteins extracted from CC were performed to investigate the mechanism of restoration of WML by Ang II vaccination. Results: Histological examinations presented that exacerbation of WML and demyelination observed in saline treated (S) rats was ameliorated in Ang II vaccinated (V) rats. The results of NOR test indicated that cognitive dysfunction observed in S rats was improved in V rats at 14 days after 2VO. Expression of VCAM-1 in CC of S rats was significantly reduced in V rats at 7 days after 2VO. BrdU assay exhibited that vaccination accelerated the differentiation of oligodendrocyte progenitor cells (OPCs) in WML from 14 days to 28 days of 2VO. Western blot presented that both CREB phosphorylation and FGF2 expression in CC were increased in V rats compared with S rats at 14 days after 2VO. Double IHC showed that FGF2 expressing cells were mostly endothelial cells and astrocytes in WML. Conclusions: Ang II vaccination restored WML as well as cognitive function in 2VO rats. Our findings suggested that Ang II vaccination ameliorated cerebrovascular endothelial dysfunction which could accelerate the OPCs differentiation through increased expression of FGF2 in endothelial cells or astrocytes in 2VO rats.

scholarly journals An Assessment of the Relationship between Structural and Functional Imaging of Cerebrovascular Disease and Cognition-Related Fibers

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Xiaoping Tang ◽  
Xinlan Xiao ◽  
Jianhua Yin ◽  
Ting Yang ◽  
Bingliang Zeng
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cerebrovascular Disease ◽  
Cognitive Dysfunction ◽  
Functional Imaging ◽  
Small Vessel Disease ◽  
White Matter Lesions ◽  
Cerebral Small Vessel Disease ◽  
Vessel Disease ◽  
The Relationship

In order to assess the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers, this paper chooses a total of 120 patients who underwent cerebral small vessel disease (CSVD) treatment at a designated hospital by this study from June 2013 to June 2018 and divides them into 3 groups according to the random number table method: vascular dementia (VaD) group, vascular cognitive impairment no dementia (VCIND) group, and noncognition impairment (NCI) group with 40 cases of patients in each group. Cognitive function measurement and imaging examination were performed for these 3 groups of patients, and the observation indicators of cognitive state examination (CSE), mental assessment scale (MAS), clock drawing test (CDT), adult intelligence scale (AIS), frontal assessment battery (FAB), verbal fluency test (VFT), trail making test (TMT), cognitive index (CI), white matter lesions (WML), third ventricle width (TVW), and frontal horn index (FHI) were tested, respectively. The results shows that the average scores of CSE, MAS, AIS, and VFT in the VaD and VCIND group are lower than those of the NCI group and the differences are statistically significant (P<0.05); the average scores of FAB, TMT, and CI in the VaD group are higher than those of the VCIND group and the differences are also statistically significant (P<0.05); the average scores of FHI and TVW in the VaD group are lower than those of the VCIND and NCI group with statistically significant differences (P<0.05); the average scores of WML, CDT, and AIS in the VaD group are higher than those of the VCIND and NCI group with statistically significant differences (P<0.05). Therefore, it is believed that the structural and functional imaging features of cerebrovascular disease are closely related to cognition-related fibers, and the incidence of white matter lesions is closely related to the degree of lesions and cognitive dysfunction of cerebral small vessel disease, in which a major risk factor for cognitive dysfunction in patients with small blood vessels is the severity of white matter lesions; brain imaging and neuropsychiatric function assessment can better understand the relationship between cerebrovascular disease and cognitive impairment. The results of this study provide a reference for the further research studies on the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers.

scholarly journals White Matter Lesions and Cognitive Impairment as Silent Cerebral Disease in Hypertension

2006 ◽  
Vol 6 ◽  
pp. 494-501 ◽  
Author(s):  
Cristina Sierra ◽  
Antonio Coca
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
White Matter ◽  
Indirect Evidence ◽  
White Matter Lesions ◽  
Cerebral White Matter ◽  
Cognitive Changes ◽  
Cerebral Disease ◽  
Functional Changes ◽  
Cerebral White Matter Lesions

Although the pathogenesis and clinical significance of cerebral white matter lesions remain controversial, it is well established that age and hypertension are the most important factors related to the presence of these lesions. Hypertension is known to be the most important factor for developing stroke and vascular dementia. In addition, the presence of cerebral white matter lesions is an important prognostic factor for the development of stroke, and also for cognitive impairment and dementia. The mechanisms underlying hypertension-related cognitive changes are complex and are not yet fully understood. Correlations between cerebral white matter lesions and elevated blood pressure provide indirect evidence that structural and functional changes in the brain over time may lead to lowered cognitive functioning when blood pressure control is poor or lacking.Some authors have suggested that the presence of white matter lesions in hypertensive patients could be considered an early marker of brain damage.

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