No description available.

No description available.

Yes / To determine whether or not jugular venous reflux (JVR) is associated with structural brain parenchyma changes in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD). 16 AD patients (mean (SD): 81.9 (5.8) years), 33 MCI patients (mean (SD): 81.4 (6.1) years) and 18 healthy elderly controls (mean (SD): 81.5 (3.4) years) underwent duplex ultrasonography and magnetic resonance imaging scans to quantify structural brain parenchyma changes. Normalized whole brain (WB), gray matter (GM) and white matter (WM) volumes were collected, together with CSF volume. JVR was strongly associated with increased normalized WB (p = 0.014) and GM (p = 0.002) volumes across all three subject groups. There was a trend towards increased WB and GM volumes, which was accompanied by decreased CSF volume, in the JVR-positive subjects in both the MCI and AD groups. When the MCI and AD subjects were aggregated together significant increases were observed in both normalized WB (p = 0.009) and GM (p = 0.003) volumes for the JVR-positive group. No corresponding increases were observed for the JVR-positive subjects in the control group. Through receiver operating characteristic analysis of the brain volumetric data it was possible to discriminate between the JVR-positive and negative AD subjects with reasonable accuracy (sensitivity = 71.4%; specificity = 88.9%; p = 0.007). JVR is associated with intracranial structural changes in MCI and AD patients, which result in increased WB and GM volumes. The neuropathology of this unexpected and counterintuitive finding requires further investigation, but may suggest that JVR retrogradely transmits venous hypertension into the brain and leads to brain tissues swelling due to vasogenic edema.

Introduction: Many studies have found an association between Toxoplasma gondii seropositivity and behavioral and cognitive changes in animal models and in humans. In addition, early findings have suggested an association between T. gondii seropositivity and Alzheimer's disease (AD). We sought to determine whether there is an association between T. gondii seropositivity and AD as well as cognitive functioning (including memory, working memory, processing speed, language functioning, executive functioning) in a large, well-characterized sample of subjects with AD and matched controls without dementia. Method: Using ELISA assays, we determined anti-T. gondii IgG antibody titers in 114 control subjects and in 105 subjects diagnosed with AD through an Alzheimer's Disease Research Center. We compared the seroprevalence between the two groups using propensity score matching (PSM). We also compared associations between T. gondii seropositivity and cognitive functioning using both PSM and linear regressions. Results: We found no differences between groups in age, ethnicity, or gender. Education and socioeconomic status was slightly higher in the control group. Using PSM, we did not find a significant difference in having AD due to T. gondii seropositivity between the two groups. Using PSM, we found T. gondii seropositivity was associated with worse performance on the WAIS-R Digit Symbol test. Within the AD group, we found T. gondii seropositivity was associated with worse performance on the WAIS Block Design and Trail Making B tests. Conclusion: In this sample, we found no evidence of an association between T. gondii seropositivity and AD in a larger study than previous studies. We found evidence of a negative association between processing speed and T. gondii seropositivity as well as a negative association between processing speed, executive functioning, and T. gondii seropositivity in those with AD.

No description available.

[pt] A Doença de Alzheimer (DA) é a maior causa de demência, com cerca de 50 milhões de pacientes em todo mundo em 2020, e este número é projetado para triplicar até 2050, com o custo estimado de 1 trilhão de dólares anualmente. Biometais como cobre e zinco em sua forma iônica são capazes de interagir com o peptídeo beta-amiloide (Abeta), relacionado à doença, deixando-o mais suscetível a agregação, além de contribuírem para o aumento do estresse oxidativo no organismo.A perturbação na homeostase metálica no cérebro, especialmente de cobre e zinco, aumenta o estresse oxidativo no cérebro, gerando espécies reativas de oxigênio (ERO) e nitrogênio (ERN) principalmente através de reações de Fenton e Haber-Weiss. Adicionalmente, cobre e zinco aceleram a agregação de A(beta) ao se ligarem em certos resíduos deste peptídeo.Neste contexto, ligantes conhecidos como metalóforos vêm sido desenvolvidos com objetivo de sequestrar os íons metálicos ligados ao peptídeo ou proteína na finalidade de reduzir os oligômeros de A(beta) e/ou estresse oxidativo induzido por metais. Invés de ligar e sistematicamente remover quaisquer metais dos tecidos, os metalóforos agem a fim de restaurar a homeostase metálica fisiológica através da ligação específica com cobre e/ou zinco, atenuando suas interações anormais com o peptídeo, assim prevenindo a oligomerização.Neste sentido, dois ligantes N-acil-hidrazônicos, com fração eletroativa contendo ferroceno, denominados Feizona e Ferfurona, foram sintetizados e caracterizados com técnicas como FTIR, (1)H NMR, TGA, UV-Vis e XRD. A complexação desses ligantes com Cu(2+) e Zn(2+), bem como sua desprotonação amídica, foram estudadas por voltametria cíclica. Estes ligantes apresentaram capacidade satisfatória em coordenar íons de Cu(2+) em solução em temperatura ambiente, porém necessitam de um meio fortemente básico para coordenarem espécies de Zn(2+). Esta característica indica uma seletividade para íons de Cu(2+)em meio fisiológico.Estudos de estabilidade hidrolítica foram avaliados por espectroscopia eletrônica, mostrando excelente estabilidade configurada pela conjugação eletrônica na estrutura dos compostos. Adicionalmente, a estabilidade fotolítica também foi avaliada por diferentes técnicas, mostrando-se dependente do solvente.O estudo de complexação por voltametria cíclica destes ligantes comprova a dependência de um meio básico para coordenação efetiva de zinco, apresentando perfis sigmoidais duplos para ambos os metais, apontando para diferentes possibilidades na estequiometria de formação destes complexos.Parâmetros farmacológicos calculados foram avaliados utilizando ferramentas disponíveis, apresentando bons resultados teóricos para atravessar barreiras biológicas. As propriedades de potencial eliminação de radicais foram estudadas com radicais superóxidos gerados eletroquimicamente, mostrando eliminação destes radicais com diferenças estatisticamente significativas nas ondas anódicas das espécies de superóxido estudadas.A interação destes ligantes com o peptídeo A(beta)(1-40) foi estimado através de experimentos por voltametria de onda quadrada, mostrando mudanças na corrente do voltamograma, sugerindo uma interação com este peptídeo. O comportamento assintótico da variação de corrente ao longo da adição do peptídeo A(beta)(1-40) indica a saturação na interação dos ligantes com o peptídeo. Como as placas de A(beta) constitui um dos mais importantes marcadores da DA, os sinais eletroquímicos gerados a partir da interação dos ligantes com este marcador demostra o potencial destes compostos como sondas eletroquímicas no contexto dessa doença. / [en] Alzheimer s Disease (AD) is the leading cause of dementia, with around 50 million patients worldwide in 2020, and this number is projected to triple by 2050, with an estimated cost of 1 trillion dollars annually. Biometals such as copper and zinc in their ionic forms can interact with the disease-related beta-amyloid peptide (Abeta), making it more susceptible to aggregation, in addition to contributing to increased oxidative stress in the body. In this context, ligands known as metallophores have been developed to sequester metal ions bound to the peptide in order to reduce A(beta) oligomerization and/or metal-induced oxidative stress. Instead of binding and systematically removing any metals from tissues, metallophores aim to act by restoring physiological metal homeostasis through specific binding with copper and/or zinc, attenuating their abnormal interactions with the peptide. In this scenario, two N-acylhydrazone ligands, with an electroactive fraction containing ferrocene, named Feizone and Ferfurone, were synthesized and characterized using techniques such as FTIR, (1)H NMR, TGA, UV-Vis, and XRD. The complexation of these ligands towards Cu(2+) and Zn(2+), as well as their amide deprotonation, were studied by cyclic voltammetry. The hydrolytic and photolytic stabilities were also assessed through electronic spectroscopy. Their radical scavenging potential was studied towards electrochemically generated superoxide ions and their suitability as electrochemical probes was estimated through interaction with the A(beta)(1-40) peptide by square-wave voltammetry. Both ligands demonstrated satisfactory stability compared to other molecules of the same class, also showing radical scavenging potential with statistically significant differences in the anodic waves of superoxide species. Additionally, experiments involving the full-length A(beta)(1-40) showed current changes in the voltammogram, suggesting their interaction with this peptide. Since plaques formed by A(beta) are one of the main hallmarks of AD, these ligands show potential as electrochemical probes in the context of the disease.

Yes / Objectives: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia. Design and methods: Parallel group multi-centre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer’s, vascular or mixed dementia and mild-to-moderate cognitive impairment (MMSE score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received ten weekly sessions over three months and four maintenance sessions over six months. Participants were followed up three and nine months post-randomisation by blinded researchers. The primary outcome was self-reported goal attainment at three months. Secondary outcomes at three and nine months included informant-reported goal attainment, quality of life, mood, self-efficacy, and cognition, and study partner stress and quality of life. Results: We randomised (1:1) 475 people with dementia; 445 (CR=281) were included in the intention to treat analysis at three months, and 426 (CR=208) at nine months. At three months there were statistically-significant large positive effects for participant-rated goal attainment (d=0.97, 95% CI 0.75 to 1.19), corroborated by informant ratings (d=1.11, 0.89 to 1.34). These effects were maintained at nine months for both participant (d=0.94, 0.71 to 1.17) and informant ratings (d=0.96, 0.73 to 1.2). The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes. Conclusions: Cognitive rehabilitation enables people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy. / National Institute for Health, Health Technology Assessment Programme, Grant/Award Number: 11/15/04

This thesis deals with the neuropsychological diagnosis of Alzheimer's disease. The aim is to evaluate the psychometric characteristics ofthe new Czech translation of the Montreal Cognitive Assessment (MoCA) by comparison with the Mini-Mental State Examination (MMSE), a method widely used by doctors inscreening diagnostics of Alzheimer's disease. The theoretical part deals with the diagnostics of Alzheimer's disease and mild cognitive impairment. We describe international diagnostic criteria of cognitive disorders and provide an overview of the screening neuropsychological methods most commonly used by Czech specialists. We summarize the current psychometric and psychodiagnostic findings on these methods and focuse on description of MMSE and MoCA. In the empirical part we compare Czech version of MMSE and MoCA-CZ (the new Czech translation of the test). We examined 38 patients with Alzheimer's disease and 70 cognitively healthy seniors. The results show that MoCA-CZ is sufficiently valid and reliable screening method that accurately distinguishbetween healthy subjects and patiens with Alzheimer's disease. We believe that it can enrich screening tools that are available to Czech experts. Key words: Montreal Cognitive Assessment, Mini-Mental State Examination, Alzheimer's disease, psychodiagnostics,...

Un ensemble des données cohérentes de la littérature plaide en faveur d'une relation entre une baisse d'activité de la voie de signalisation de la vitamine A, des altérations de la plasticité synaptique et des déficits mnésiques spécifiques associés au vieillissement. Une diminution de l'activité de cette voie de signalisation est également évoquée dans les processus neurodégénératifs caractéristiques de la maladie d'Alzheimer. Dans ce contexte, les objectifs de ce travail étaient de mieux comprendre les conséquences neuro-anatomiques et fonctionnelles d'une baisse d'activité de la voie de signalisation de la vitamine A. Notre approche expérimentale a mis en œuvre 2 modèles animaux, un modèle de carence vitaminique A qui induit spécifiquement une baisse d'activité de sa voie de signalisation et un modèle d'hypothyroïdie dont il a été montré qu'il induit aussi une hypoactivité de la voie de signalisation de la vitamine A. La démarche expérimentale conduite chez les rats carencés en vitamine A comporte deux volets : (i) un volet mettant en œuvre l’imagerie et la spectroscopie RMN, (ii) un volet moléculaire consacrée à l’étude de l’expression de gènes cibles des rétinoïdes impliqués dans le processus amyloïdogène. Les mesures ont été réalisées, d'une part, chez des animaux soumis à un régime dépourvu en vitamine A pendant 10 semaines et d'autre part, chez des animaux soumis à ce même régime pendant une durée de 13 ou 14 semaines. Une partie des animaux carencés a été traitée par de l'AR. Les résultats montrent que dès 10 semaines de carence, les animaux présentent une altération du métabolisme et de son action cellulaire de la vitamine A qui se traduit par (i) une diminution significative du taux de vitamine A sérique, (ii) une diminution du taux d'ARNm codant pour les récepteurs RAR, dans le cerveau entier, le striatum, l'hippocampe et de manière moins prononcée le cortex des animaux. Après 10 semaines de régime dépourvu en vitamine A, des modifications métaboliques ont été mises en évidence essentiellement dans le cortex. Elles se traduisent par une hausse du (i) NAA/Cr, marqueur de la densité neuronale corrigée par une administration d'AR, et (ii) du GSH/Cr, indicateur du potentiel antioxydant cellulaire dans cette structure. Au plan anatomique, un ralentissement de la croissance cérébrale a été observé dés la 7ème semaine de régime. Une diminution du volume hippocampique et une augmentation des espaces ventriculaires ont été observées à partir de 11 semaines de carence. Au plan moléculaire, aucune modification de l'expression du gène codant pour APP, ou du rapport APP770-751/APP695, considéré comme un indicateur précoce de la MA n'a été observée après 10 semaines de carence. Après 14 semaines de régime dépourvu en vitamine A, de profondes modifications métaboliques sont observées dans les trois structures à savoir le cortex, l’hippocampe et le striatum. Au plan moléculaire, les principaux résultats suggèrent un basculement du processus biochimique de dégradation de la protéine APP en faveur de la voie amyloïdogénique dans le cortex, et par voie de conséquence en faveur de la formation du peptide Aß. Cependant, aucune modification du taux protéique des peptides Aß n'a été mise en évidence dans le cortex et l'hippocampe des rats carencés. Le modèle d'hypothyroïdie que nous avons mis en oeuvre entraine bien une hypoactivité de la voie de signalisation de la T3, observée dans l'hippocampe des animaux et une diminution du taux d'ARNm codant pour RARß observée dans le cortex des rats hypothyroïdiens. Au plan moléculaire, l'augmentation du rapport APP770-751/APP695 a été observée chez les rats rendus hypothyroïdiens par rapport aux rats témoins. Comme chez les rats carencés en vitamine A, les indicateurs de la voie physiologique ne sont que très faiblement affectés chez les rats rendus hypothyroïdiens. / Some data reveal that retinoid hyposignalling, presumably resulting from decreased bioavailability of retinoid ligands naturally, was shown to result in aging-related synaptic plasticity and long term potentiation (LTP) alterations as well as in aging-related decline of cognitive function. Moreover, genetic, metabolic and dietary evidence has been provided for a defective retinoid metabolism in Alzheimer disease (AD). Thus, key steps of the amyloid production process are under the control of proteins whose expression is positively regulated by RA in vitro. In this context, the aims of this work were to better understand neuro-anatomical and functionnal consequences of retinoid signaling brain hypoactivity. Our experimental method uses two animal models: a Vitamin A deficiency model which induce especially an hypoactivity of retinoid pathway, and an hypothyroid model which was also characterized by an hypoactivity of retinoid pathway. In the fisrt model, two main approch were used : (i) an NMR imaging and spectroscopy approach, (ii) a molecular approach to study expression of retinoid target genes implicated in amyloidogenic process. NMR results showed that VAD induces severe anatomic and metabolic disorders in particular a slowing of brain growth, hippocampus atrophy, and a decrease of NAA/Cr, marker of neuronal density which was observed in cortex, hippocampus and striatum. Molecular results reveal a vitamin A deficiency-related dysregulation of the amyloid pathway in the cortex of rats, which is known to be the first brain area altered by AD development. In this area, 14 weeks of deprived diet induces physiological dysregulation in the modulation of RA target genes leading to an increased amount of ADAM10, BACE and PS1, with some modifications in amyloidogenic pathway but without increased amount of Aß peptides. In hypothyroid model, molecular results suggests that adult onset-hypothyroidism may induce the amyloidogenic pathway of APP processing by increasing activity of ß and ?secretases and levels of amyloid peptides mainly in hippocampus. Together these data argue for the idea that hypoactivity of retinoid signalling which occurs naturally with aging could be a factor participating in accelerating aging and that hypothyroidism that become more prevalent with advancing age, could increase, via a hyposignaling of T3 pathway, the vulnerability of amyloidogenic pathway of APP processing as well as of other clinical symptoms of AD.

Ces dernières années, la prise en compte des difficultés quotidiennes des personnes a largement évolué pour être aujourd’hui au centre des préoccupations des cliniciens et chercheurs. Dans le vieillissement en particulier, les difficultés quotidiennes tiennent une place particulière car elles constituent un critère de diagnostic de la démence mais également un facteur de risque de celle-ci, même en l’absence de trouble cognitif avéré.Leur prise en compte relève donc d’un intérêt majeur mais pose la question de leur mesure, notamment au vu des relations non systématiques qu’elles entretiennent avec les troubles cognitifs évalués par les tests neuropsychologiques traditionnels et les plaintes des sujets. Les approches écologiques, la réalité virtuelle en particulier, dans lesquelles s’inscrivent nos travaux, tentent de proposer une évaluation de la cognition « quotidienne » en espérant par ce bais, fournir des mesures qui soient à la fois précises, spécifiques et reflétant le fonctionnement quotidien de la personne. L’utilisation de deux environnements virtuels, représentant un appartement et un quartier résidentiel nous a permis de dégager des profils cognitifs spécifiques associés au vieillissement normal et à la maladie d’Alzheimer dans le cadre de la mémoire épisodique et de navigation spatiale. Ces profils sont discutés en référence au modèle multifactoriel du vieillissement et au regard de l’objectivation des difficultés quotidiennes des personnes. L’application de ces recherches pour le développement d’aides à l’autonomie des âgés est proposé comme perspective de travail. / These last years, taking account of everyday difficulties has largely improved and is at the core of preoccupations of clinicians and researchers.Particularly, everyday difficulties hold a special place in aging because of their potential value as a diagnostic criterion, but also as a risk factor, for dementia, even in the absence of cognitive impairment. However, despite being taken into consideration and their major interest, their assessment is being questioned, especially regarding their inconsistent relationships with cognitive impairments assessed by traditional neuropsychological tests and subjects’ complaints. The purpose of ecological approaches, particularly those using virtual reality technologies, in which our work is framed, is to assess the “daily” cognition, by which we hope providing measures that are accurate, specific and reflecting the one’s daily functioning. The use of two virtual environments, an apartment and a residential district, has allowed us identifying specific cognitive patterns of episodic memory and spatial navigation associated with normal aging and Alzheimer's disease. These patterns are discussed according to the multifactorial model of aging and the objective assessment of daily difficulties.The application of this research to the development of aids for the autonomy of the elderly is proposed as a work perspective.