Interaction of atherosclerosis and inflammation in elderly subjects with poor cognitive function

Neurology ◽  
2003 ◽  
Vol 61 (12) ◽  
pp. 1695-1701 ◽  
Author(s):  
E. van Exel ◽  
A. J.M. de Craen ◽  
E. J. Remarque ◽  
J. Gussekloo ◽  
P. Houx ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Elderly Subjects ◽  
Poor Cognitive Function

scholarly journals Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ahmed Esmael ◽  
Tamer Belal ◽  
Khaled Eltoukhy
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Function ◽  
Cerebral Artery ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Clinical Biomarkers ◽  
Poor Cognitive Function ◽  
Impaired Cognition

Background and Aim. Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) stays under investigation. This study is aimed at predicting the cognitive impairment by transcranial Doppler (TCD) and detecting the associated clinical biomarkers of impaired cognition after aSAH after 3 months from the onset. Methods. Prospective study included 40 cases with acute aSAH. Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher’s grading scales. TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries. At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition. Results. Patients with impaired cognitive functions showed significantly lower mean GCS ( p = 0.03 ), significantly higher mean Hunt and Hess scale grades ( p = 0.04 ), significantly higher mean diabetes mellitus (DM) ( p = 0.03 ), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) ( p = 0.02 and p = 0.005 , respectively), and significantly higher MFVs measured within the first 10 days. The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus ( p = 0.01 ) and a higher incidence of delayed cerebral ischemia (DCI) ( p < 0.001 ). Logistic regression analysis detected that MFV ≥ 86     cm / s in the middle cerebral artery (MCA), MFV ≥ 68     cm / s in the anterior cerebral artery (ACA), and MFV ≥ 45     cm / s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment. Conclusion. Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%. Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH. Increased MFV is a strong predictor for poor cognitive function in aSAH. This trial is registered with NCT04329208.

Effects of acute tryptophan depletion on cognitive function in Alzheimer's disease and in the healthy elderly

2002 ◽  
Vol 33 (1) ◽  
pp. 41-49 ◽  
Author(s):  
R. J. PORTER ◽  
B. S. LUNN ◽  
J. T. O'BRIEN
Keyword(s):  
Cognitive Function ◽  
Rating Scales ◽  
Senile Dementia ◽  
Specific Effect ◽  
Acute Tryptophan Depletion ◽  
Elderly Subjects ◽  
Tryptophan Depletion ◽  
Emotional Symptoms ◽  
Double Blind ◽  
Healthy Elderly

Background. The cholinergic system is profoundly impaired in senile dementia of Alzheimer type (SDAT) and replacement therapy produces only modest clinical benefits. The serotonergic system is also impaired and may contribute both to cognitive and non-cognitive symptoms in SDAT. To investigate this further we assessed the effects of lowering brain serotonin using the technique of acute tryptophan depletion on cognitive function in patients with SDAT and in age matched control subjects.Method. Sixteen patients with probable SDAT and 17 healthy elderly subjects received two amino acid drinks in a within subject, double-blind, placebo-controlled, counterbalanced, crossover design. One of the drinks was nutritionally balanced and contained tryptophan (placebo), the other was identical but contained no tryptophan. A battery of detailed neuropsychological tests was performed between 4 and 6 h after the drink. Mood rating scales and other ratings of behavioural and emotional symptoms were also performed on both occasions.Results. Acute tryptophan depletion resulted in impairment on tasks of working memory in both groups. There was no group specific effect. Female SDAT subjects performed better on a task of pattern recognition during acute tryptophan depletion compared with placebo. There were no changes in behavioural symptoms during acute tryptophan depletion in either group.Conclusion. Compromised serotonergic function may be an important contributor to cognitive decline in SDAT and in ageing. Strategies targeting specific 5HT receptors may be helpful in SDAT.

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