RESUMEN
Cerebral small vessel disease (CSVD) - is a clinical and radiological phenomenon characteristic of older adults. Currently, the extent of white matter lesions (WML) in patients with moderate cognitive disorders remains uncertain. Also, the relationship of cognitive impairment with the volume of WML has not been sufficiently studied. The aim of the study was to analyze the WML volumes in patients with subcortical vascular mild cognitive impairment (svMCI) and in the control group according to magnetic resonance imaging (MRI). The study included 50 people: 25 patients with svMCI (average age 75,88±4,04 years) and 25 conditionally healthy volunteers (average age 69,96±3,07 years). Significant differences in the volume of WML between the study groups were obtained. The fraction of hypointense WML was 0,74±0,41 in patients with svMCI and 0,15±0,07 in the control group. In the correlation analysis in the svMCI group, only the function of mental control showed a negative relationship with the fraction of WML. The data obtained suggest that the assessment of the volume of WML is important in patients with svMCI, but does not fully explain the decline in cognitive functions.
Asunto(s)
Enfermedades de los Pequeños Vasos Cerebrales , Trastornos del Conocimiento , Disfunción Cognitiva , Humanos , Anciano , Disfunción Cognitiva/diagnóstico por imagen , Disfunción Cognitiva/etiología , Neuroimagen , Cognición , Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico , Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico por imagen , Imagen por Resonancia Magnética/métodosRESUMEN
A decrease in cognitive functions up to the development of dementia in the elderly is associated with a decrease in the blood level of polyunsaturated fatty acids, especially Omega-3, which occurs against the background of oxidative stress. The paper presents a comparative analysis of the spectrum of polyunsaturated fatty acids and the activity of individual components of the enzymatic antioxidant system in the blood of elderly people with impaired cognitive performance to the level of «mild cognitive decline¼ (MCI AD, prodromal Alzheimer's disease) or vascular etiology (MCI VaD, prodromal vascular dementia) compared with older people without signs of cognitive impairment. A decrease in the concentration of Omega-3 polyunsaturated fatty acids in the blood of both groups of the examined patients was revealed compared with the control group. In patients with AD MCI, a sharp decrease in the concentration of arachidonic acid (Omega-6) was detected compared with patients with MCI VaD and the control group. The decrease in the activity of the antioxidant enzymatic system and the decrease in polyunsaturated fatty acids due to their peroxidation revealed in this study indicate an intensification of the OS processes in patients with impaired cognitive functions. The question of the pathogenetic role of arachidonic acid in patients predisposed in the future to the development of AD is discussed.
Asunto(s)
Enfermedad de Alzheimer , Demencia Vascular , Ácidos Grasos Insaturados/metabolismo , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/metabolismo , Disfunción Cognitiva/metabolismo , Demencia Vascular/metabolismo , HumanosRESUMEN
Immune response may play a pivotal role in the pathogenesis of the common synucleinopathy as Parkinson's disease (PD) and could be mediated with the accumulation of neurotoxic alpha-synuclein. There is limited evidence for immune response in another synucleinopathy as dementia with Lewy bodies (DLB). Recent data suggest that immune response may contribute to cognitive impairment. We aimed to estimate plasma cytokine profile in patients with synucleinopathies with dementia (PD dementia (PDD), DLB). Plasma cytokine levels (interferon-gamma (IFN-gamma), interleukin (IL)-4 (IL-4), IL-6, IL-10, tumor necrosis factor alpha (TNF-alpha), monocyte chemoattractant protein-1 (MCP-1)). were estimated in 16 patients with DLB, 19 patients with PDD, 28 patients with PD without dementia (PD) and 19 individuals without neurological disorders (controls) using Luminex array system. Cognitive status was assessed with the Mini-Mental State Examination (MMSE). TNF-alpha and IL-6 plasma levels were elevated in patients with synucleinopathies with dementia (DLB, PDD) compared to controls and IL-10 plasma level was increased in PDD compared to controls (p < 0.05). IFN-gamma levels were decreased in PD and PDD patients compared to controls (p < 0.001, p = 0.026, respectively) and in PD patients than in DLB patients (p = 0.032). Patients with PD, PDD, and DLB were characterized by increased plasma levels of MCP-1 compared to controls (p < 0.001). At the same time, no differences in TNF-alpha, IL-10, IL-6 plasma levels in PD patients compared to controls were found. Our study demonstrated more pronounced immune response in synucleinopathies associated with dementia compared to PD without demetia.
Asunto(s)
Citocinas/sangre , Demencia/etiología , Sinucleinopatías/inmunología , Anciano , Anciano de 80 o más Años , Quimiocina CCL2/sangre , Demencia/sangre , Demencia/inmunología , Femenino , Humanos , Interferón gamma/sangre , Interleucina-10/sangre , Interleucina-6/sangre , Enfermedad por Cuerpos de Lewy/sangre , Enfermedad por Cuerpos de Lewy/inmunología , Pruebas de Estado Mental y Demencia , Persona de Mediana Edad , Enfermedad de Parkinson/sangre , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/inmunología , Sinucleinopatías/sangre , Sinucleinopatías/complicaciones , Factor de Necrosis Tumoral alfa/sangreRESUMEN
Using the Addenbrooke's Cognitive Examination (ACE-III), the Stroop Test (ST), the Wechsler Memory Scale (WMS), and the Frontal Assessment Battery (FAB), we examined 44 respondents of an almost healthy «age norm¼ from 52 to 95 years old. Depending on age, the sample was divided into 2 groups, the first group included people under the age of 65 years (64 years old inclusive), the second group consisted of subjects over 65 years old. Statistically significant differences in the results of the survey of respondents of the two groups by the ACE-III were found in Memory and Total score indicators, while the level of cognitive functioning measured by the ACE-III decreased with age. The results of comparing the survey data using the Stroop Test indicate a decrease in the pace of work under load conditions and a weakening in the flexibility of organization of mental activity and concentration of attention, as well as increased interference in individuals of a more age group examined by us. Correlation analysis of the Stroop test data and the age of the examined showed cognitive control over information processing decreases, interfering influences increase, accuracy and pace of activity decrease, and the activity itself becomes more rigidas age increases. The results of the correlation analysis of the indicators of the WMS and age demonstrated a decrease in the level of mental control over activity, a deterioration of memory in the visual modality, and a progressive working memory reduction as age increases. With the growth of age, a decrease in frontal (executive) functions of healthy subjects, evaluated by the FAB, was found.