The Mechanisms of Sevoflurane-Induced Neuroinflammation

Sevoflurane is one of the most commonly used inhaled anesthetics due to its low blood gas coefficient, fast onset, low airway irritation, and aromatic smell. However, recent studies have reported that sevoflurane exposure may have deleterious effects on cognitive function. Although neuroinflammation was most widely mentioned among the established mechanisms of sevoflurane-induced cognitive dysfunction, its upstream mechanisms have yet to be illustrated. Thus, we reviewed the relevant literature and discussed the most mentioned mechanisms, including the modulation of the microglial function, blood–brain barrier (BBB) breakdown, changes in gut microbiota, and ease of cholinergic neurotransmission to help us understand the properties of sevoflurane, providing us new perspectives for the prevention of sevoflurane-induced cognitive impairment.

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Study of cognitive functions in major idiopathic interstitial pneumonias

Egyptian Journal of Bronchology ◽

10.1186/s43168-020-00046-7 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Mohamed W. Zakaria ◽

Reem I. El-Korashy ◽

Mostafa O. Shaheen ◽

Samah Selim ◽

Kwashi J. Amum

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Mini Mental State Examination ◽

Mmse Score ◽

Control Group ◽

Healthy Individuals ◽

Co Morbidity ◽

Impaired Lung Function ◽

State Examination

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.

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Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20140144 ◽

2015 ◽

Vol 73 (2) ◽

pp. 90-95 ◽

Cited By ~ 3

Author(s):

Emine Bilgi ◽

Hasan Hüseyin Özdemir ◽

Ayhan Bingol ◽

Serpil Bulut

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Group Psychotherapy ◽

Cognitive Dysfunction ◽

Beck Depression Inventory ◽

Neuropsychological Tests ◽

Depression Severity ◽

Group Members ◽

Repeatable Battery

Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

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Severe Hypoglycemia Contributing to Cognitive Dysfunction in Diabetic Mice is Associated with Pericyte and Blood–Brain Barrier Dysfunction

10.21203/rs.3.rs-903076/v1 ◽

2021 ◽

Author(s):

Lu Lin ◽

Lishan Huang ◽

Lijing Wang ◽

Yubin Wu ◽

Zhou Chen ◽

...

Keyword(s):

Cognitive Function ◽

Cognitive Dysfunction ◽

Blood Brain Barrier ◽

Severe Hypoglycemia ◽

Brain Barrier ◽

Blue Staining ◽

Diabetic Patients ◽

Inflammatory Factor ◽

Diabetic Mice ◽

Blood Brain

Abstract Background: Severe hypoglycemia can cause cognitive impairment in diabetic patients, but the underlying molecular mechanism remains unclear.Objective: To assess the effect of severe hypoglycemia on cognitive function in diabetic mice to clarify the relationship between the mechanism and dysfunction of pericytes and the blood–brain barrier (BBB).Method: We established type 1 diabetes mellitus in 80 male C57BL/6J mice by intraperitoneal injection of streptozotocin (180 mg/kg). Further abdominal injection of short-acting insulin induced severe hypoglycemia. The mice were divided into normal, diabetes, and diabetic + severe hypoglycemia groups, and their blood glucose and general weight index were examined. Pericyte and BBB morphology and function were detected by histological and western blot analyses, BBB permeability was detected by Evans blue staining, and cognitive function was detected with the Morris water maze.Results: Severe hypoglycemia aggravated the histological damage, BBB damage, brain edema, and pericyte loss in the diabetic mice. It also reduced the expression of the BBB tight junction proteins occludin and claudin-5, the expression of the pericyte-specific markers PDGFR-β (platelet-derived growth factor receptor-β) and α-SMA, and increased the expression of the inflammatory factor MMP9. At the same time, diabetic mice with severe hypoglycemia had significantly reduced cognitive function.Conclusion: Severe hypoglycemia leads to cognitive dysfunction in diabetic mice, and its possible mechanism is related to pericyte dysfunction and BBB destruction.

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The association between systemic lupus erythematosus and dementia A meta-analysis

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-020006 ◽

2018 ◽

Vol 12 (2) ◽

pp. 143-151 ◽

Cited By ~ 3

Author(s):

Zhuoxian Zhao ◽

Natalia P. Rocha ◽

Haitham Salem ◽

Breno S. Diniz ◽

Antonio L. Teixeira

Keyword(s):

Systemic Lupus Erythematosus ◽

Cognitive Impairment ◽

Cognitive Dysfunction ◽

Lupus Erythematosus ◽

Meta Analysis ◽

Relevant Literature ◽

Systemic Lupus ◽

Increased Risk ◽

Relationship Of ◽

The Relationship

Abstract A growing body of evidence indicates that systemic lupus erythematosus (SLE) is associated with increased risk of cognitive impairment and dementia. However, to date, no studies have been conducted to quantitatively summarize and evaluate the consistency of data. Objective: To quantitatively evaluate the relationship of SLE and antiphospholipid antibodies (aPL) with cognitive dysfunction and dementia. Methods: All relevant literature was retrieved from Pubmed, Scopus, and PsycINFO databases. The meta-analysis was performed using effect estimates and 95% confidence intervals (CIs) to calculate pooled risk estimates. The heterogeneity among studies was also examined. Results: The meta-analysis included 11 original studies involving a total of 81,668 patients with dementia and 407 patients with cognitive dysfunction. There were significant associations on fixed-effect models between SLE and dementia (3 studies; RR=1.50; 95% CI=1.37-1.64), SLE and cognitive dysfunction (4 studies; OR=2.97; 95% CI=1.72-5.15), and aPL and cognitive dysfunction (5 studies, OR=1.97; 95% CI=1.55-2.52). We also combined cognitive dysfunction and dementia outcomes as they both represented cognitive impairment. There were significant associations between aPL and cognitive impairment (6 studies; OR=2.03; 95% CI=1.62-2.55), and SLE and cognitive impairment (7 studies; OR=1.83; 95% CI=1.42-2.35). Moderate heterogeneity (I2=45.7%) was found in the association between SLE and cognitive impairment, low heterogeneity (I2=21.8%) in the association between SLE and dementia, and near zero heterogeneity for the other three main analyses. Conclusion: Both SLE and aPL are associated with cognitive impairment.

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Blood-brain barrier leakage in systemic lupus erythematosus is associated with gray matter loss and cognitive impairment

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-218004 ◽

2020 ◽

Vol 79 (12) ◽

pp. 1580-1587

Author(s):

Lyna Kamintsky ◽

Steven D Beyea ◽

John D Fisk ◽

Javeria A Hashmi ◽

Antonina Omisade ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cognitive Impairment ◽

Cognitive Function ◽

Blood Brain Barrier ◽

Lupus Erythematosus ◽

Brain Volume ◽

Brain Barrier ◽

Systemic Lupus ◽

Blood Brain ◽

Gray Matter Loss

ObjectivesTo examine the association between blood-brain barrier (BBB) integrity, brain volume and cognitive dysfunction in adult patients with systemic lupus erythematosus (SLE).MethodsA total of 65 ambulatory patients with SLE and 9 healthy controls underwent dynamic contrast-enhanced MRI scanning, for quantitative assessment of BBB permeability. Volumetric data were extracted using the VolBrain pipeline. Global cognitive function was evaluated using a screening battery consisting of tasks falling into five broad cognitive domains, and was compared between patients with normal versus extensive BBB leakage.ResultsPatients with SLE had significantly higher levels of BBB leakage compared with controls (p=0.04). Extensive BBB leakage (affecting over >9% of brain volume) was identified only in patients with SLE (16/65; 24.6%), who also had smaller right and left cerebral grey matter volumes compared with controls (p=0.04). Extensive BBB leakage was associated with lower global cognitive scores (p=0.02), and with the presence of impairment on one or more cognitive tasks (p=0.01).ConclusionOur findings provide evidence for a link between extensive BBB leakage and changes in both brain structure and cognitive function in patients with SLE. Future studies should investigate the mechanisms underlying BBB-mediated cognitive impairment, validate the diagnostic utility of BBB imaging, and determine the potential of targeting the BBB as a therapeutic strategy in patients with SLE.

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Testosterone and cognitive function: current clinical evidence of a relationship

Acta Endocrinologica ◽

10.1530/eje.1.02306 ◽

2006 ◽

Vol 155 (6) ◽

pp. 773-781 ◽

Cited By ~ 87

Author(s):

Olivier Beauchet

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Ability ◽

Cognitive Dysfunction ◽

Clinical Evidence ◽

Serum Testosterone ◽

Older Men ◽

Testosterone Levels ◽

Testosterone Substitution ◽

Low Testosterone

Background: Testosterone levels decline as men age, as does cognitive function. Whether there is more than a temporal relationship between testosterone and cognitive function is unclear. Chemical castration studies in men with prostate cancer suggest that low serum testosterone may be associated with cognitive dysfunction. Low testosterone levels have also been observed in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This paper reviews the current clinical evidence of the relationship between serum testosterone levels and cognitive function in older men. Methods: A systematic literature search was conducted using PubMed and EMBASE to identify clinical studies and relevant reviews that evaluated cognitive function and endogenous testosterone levels or the effects of testosterone substitution in older men. Results: Low levels of endogenous testosterone in healthy older men may be associated with poor performance on at least some cognitive tests. The results of randomized, placebo-controlled studies have been mixed, but generally indicate that testosterone substitution may have moderate positive effects on selective cognitive domains (e.g. spatial ability) in older men with and without hypogonadism. Similar results have been found in studies in patients with existing AD or MCI. Conclusions: Low endogenous levels of testosterone may be related to reduced cognitive ability, and testosterone substitution may improve some aspects of cognitive ability. Measurement of serum testosterone should be considered in older men with cognitive dysfunction. For men with both cognitive impairment and low testosterone, testosterone substitution may be considered. Large, long-term studies evaluating the effects of testosterone substitution on cognitive function in older men are warranted.

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The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin

Pathophysiology ◽

10.3390/pathophysiology27010003 ◽

2020 ◽

Vol 27 (1) ◽

pp. 14-27

Author(s):

Lorenzo Brognara ◽

Iacopo Volta ◽

Vito Michele Cassano ◽

Emmanuel Navarro-Flores ◽

Omar Cauli

Keyword(s):

Diabetes Mellitus ◽

Cognitive Impairment ◽

Cognitive Function ◽

Glycemic Control ◽

Cognitive Dysfunction ◽

Cognitive Functions ◽

Diabetic Foot ◽

Glycated Hemoglobin ◽

Diabetic Patients ◽

Adherence To Treatment

Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician’s recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p < 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p < 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0–73.3% and specificity 70.6–64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level > 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician’s recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot.

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Altered gut microbiota correlates with cognitive impairment in Chinese children with Down’s syndrome

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01799-2 ◽

2021 ◽

Author(s):

Shimeng Ren ◽

Xinjuan Wang ◽

Jiong Qin ◽

Qing Mu ◽

Shuai Ye ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Gut Microbiota ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Chromosome 21 ◽

Chinese Patients ◽

Rrna Gene ◽

Microbiota Composition ◽

Gut Microbiota Composition

AbstractDown's syndrome (DS), a common chromosomal disease caused by chromosome 21 trisomy, is the main cause of cognitive impairment in children worldwide. Emerging evidence suggests that the microbiota–gut–brain axis plays a potential role in cognitive impairment. However, data regarding gut microbiota alterations in DS patients remain scarce, especially data from children with DS. This case–control study was conducted to explore the gut microbiota composition in Chinese DS children. Additionally, the potential association between gut microbiota and cognitive function in DS was evaluated. Microbiota communities in the feces of 15 DS subjects and 15 matched controls were investigated using high-throughput Illumina Miseq sequencing targeting the V3–V4 region of 16S rRNA gene. The relationships between gut microbiota composition and DS cognitive function scores were analyzed. The structure and richness of the gut microbiota differed between DS patients and healthy controls. The abundance of Acidaminococcaceae was decreased in DS patients. Moreover, the Kyoto Encyclopedia of Genes and Genomes analysis showed increased modules related to peptidases and pyrimidine metabolism. Overall, we confirmed that gut microbiota alterations occurred in Chinese patients with DS. Additionally, the fecal microbiota was closely related to DS cognitive impairment. Larger cohorts are needed to confirm these findings and to clarify the mechanisms involved. Elucidating these novel findings in the field of microbiota-gut-brain axis will provide a promising strategy for future studies of DS cognitive impairment.

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Neuropsychological Tests in Post-operative Cognitive Dysfunction: Methods and Applications

Frontiers in Psychology ◽

10.3389/fpsyg.2021.684307 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jun Liu ◽

Kequn Huang ◽

Binbin Zhu ◽

Bin Zhou ◽

Ahmad Khaled Ahmad Harb ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Older People ◽

Cognitive Dysfunction ◽

Neuropsychological Tests ◽

Clinical Performance ◽

Neurological Complication ◽

Memory Loss ◽

Consciousness Disorders ◽

Consciousness Disorder

Post-operative cognitive dysfunction (POCD) is a neurological complication that relatively frequently occurs in older people after anesthesia/surgery, with varying durations and significant differences in the severity of cognitive impairment. POCD is mainly characterized by memory loss mostly without consciousness disorders, accompanied by abnormal emotions, behaviors, and language, mostly without consciousness disorder. The clinical performance of POCD lacks specificity but can reflect the severity of cognitive impairment in patients. The diagnosis of POCD cannot be separated from the evaluation of perioperative cognitive function of patients, and the more popular and accepted method is neuropsychological tests (NPTs).

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Right Frontoinsular Cortex: A Potential Imaging Biomarker to Evaluate T2DM-Induced Cognitive Impairment

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.674288 ◽

2021 ◽

Vol 13 ◽

Author(s):

Dongsheng Zhang ◽

Yumeng Lei ◽

Jie Gao ◽

Fei Qi ◽

Xuejiao Yan ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Inferior Frontal Gyrus ◽

Brain Network ◽

Imaging Biomarker ◽

Linear Processes ◽

Significant Difference ◽

Normal Cognitive Function ◽

The Right

Cognitive impairment in type 2 diabetes mellitus (T2DM) is associated with functional and structural abnormalities in the intrinsic brain network. The salience network (SN) is a neurocognitive network that maintains normal cognitive function, but it has received little attention in T2DM. We explored SN changes in patients with T2DM with normal cognitive function (DMCN) and in patients with T2DM with mild cognitive impairment (DMCI). Sixty-five T2DM patients and 31 healthy controls (HCs) underwent a neuropsychological assessment, independent component analysis (ICA), and voxel-based morphometry (VBM) analysis. The ICA extracted the SN for VBM to compare SN functional connectivity (FC) and gray matter (GM) volume (GMV) between groups. A correlation analysis examined the relationship between abnormal FC and GMV and clinical/cognitive variables. Compared with HCs, DMCN patients demonstrated increased FC in the left frontoinsular cortex (FIC), right anterior insula, and putamen, while DMCI patients demonstrated decreased right middle/inferior frontal gyrus FC. Compared with DMCN patients, DMCI patients showed decreased right FIC FC. There was no significant difference in SN GMV in DMCN and DMCI patients compared with HCs. FIC GMV was decreased in the DMCI patients compared with DMCN patients. In addition, right FIC FC and SN GMV positively correlated with Montreal Cognitive Assessment and Mini-Mental State Examination (MMSE) scores. These findings indicate that changes in SN FC, and GMV are complex non-linear processes accompanied by increased cognitive dysfunction in patients with T2DM. The right FIC may be a useful imaging biomarker for supplementary assessment of early cognitive dysfunction in patients with T2DM.

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