Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by...Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.展开更多
This review summarizes and describes the use of curcumin in diagnosis,prevention,and treatment of Alzheimer＇s disease.For diagnosis of Alzheimer＇s disease,amyloid-β and highly phosphorylated tau protein are the maj...This review summarizes and describes the use of curcumin in diagnosis,prevention,and treatment of Alzheimer＇s disease.For diagnosis of Alzheimer＇s disease,amyloid-β and highly phosphorylated tau protein are the major biomarkers.Curcumin was developed as an early diagnostic probe based on its natural fluorescence and high binding affinity to amyloid-β.Because of its multi-target effects,curcumin has protective and preventive effects on many chronic diseases such as cerebrovascular disease,hypertension,and hyperlipidemia.For prevention and treatment of Alzheimer＇s disease,curcumin has been shown to effectively maintain the normal structure and function of cerebral vessels,mitochondria,and synapses,reduce risk factors for a variety of chronic diseases,and decrease the risk of Alzheimer＇s disease.The effect of curcumin on Alzheimer＇s disease involves multiple signaling pathways：anti-amyloid and metal iron chelating properties,antioxidation and anti-inflammatory activities.Indeed,there is a scientific basis for the rational application of curcumin in prevention and treatment of Alzheimer＇s disease.展开更多
Neurological conditions,including cognitive impairment and Alzheimer’s disease(AD),impose a huge burden on society,affecting millions of people globally.In addition to genetic factors,recent studies indicate that env...Neurological conditions,including cognitive impairment and Alzheimer’s disease(AD),impose a huge burden on society,affecting millions of people globally.In addition to genetic factors,recent studies indicate that environmental and experiential factors may contribute to the pathogenesis of these diseases.Early life adversity(ELA)has a profound impact on brain function and health later in life.In rodent models,exposure to ELA results in specific cognitive deficits and aggravated AD pathology.Extensive concerns have been raised regarding the higher risk of developing cognitive impairments in people with a history of ELA.In this review,we scrutinize findings from human and animal studies focusing on the connection of ELA with cognitive impairment and AD.These discoveries suggest that ELA,especially at early postnatal stages,increases susceptibility to cognitive impairment and AD later in life.In terms of mechanisms,ELA could lead to dysregulation of the hypothalamus-pituitary-adrenal axis,altered gut microbiome,persistent inflammation,oligodendrocyte dysfunction,hypomyelination,and aberrant adult hippocampal neurogenesis.Crosstalks among these events may synergistically contribute to cognitive impairment later in life.Additionally,we discuss several interventions that may alleviate adverse consequences of ELA.Further investigation into this crucial area will help improve ELA management and reduce the burden of related neurological conditions.展开更多
During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positivel...During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positively the agitation of demented patients aged ≥ 65 years.To gather information on the utilization of pain killers in demented patients a preliminary survey has been conducted in collaboration with the Calabrian Pharmacovigilance Territorial Service of the health district of Catanzaro（Italy）.The study has taken into consideration the prescriptions of acetylcholinesterase inhibitors and memantine during the period ranging from July 2015 to June 2016 and the percentage of patients treated against pain with non steroidal antinflammatory drugs,opioids,and anticonvulsants have been monitored.The latter have been evaluated statistically for difference between the treatment before（pre） and after（post） the settlement of acetylcholinesterase inhibitors（ACh EI） or memantine therapy.The results do support accuracy in painkillers utilization in the course of dementia in the regional population of Calabria（Italy）.展开更多
基金supported by the National Natural Science Foundation of China,No.8187052509(to XGY)the National Key Research and Development Plan of China,No.2017YFC0114005(to ZPL)
文摘Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.
基金supported by a grant from the Department of Education of Guangdong Province of China,No.2016KCXTD005
文摘This review summarizes and describes the use of curcumin in diagnosis,prevention,and treatment of Alzheimer＇s disease.For diagnosis of Alzheimer＇s disease,amyloid-β and highly phosphorylated tau protein are the major biomarkers.Curcumin was developed as an early diagnostic probe based on its natural fluorescence and high binding affinity to amyloid-β.Because of its multi-target effects,curcumin has protective and preventive effects on many chronic diseases such as cerebrovascular disease,hypertension,and hyperlipidemia.For prevention and treatment of Alzheimer＇s disease,curcumin has been shown to effectively maintain the normal structure and function of cerebral vessels,mitochondria,and synapses,reduce risk factors for a variety of chronic diseases,and decrease the risk of Alzheimer＇s disease.The effect of curcumin on Alzheimer＇s disease involves multiple signaling pathways：anti-amyloid and metal iron chelating properties,antioxidation and anti-inflammatory activities.Indeed,there is a scientific basis for the rational application of curcumin in prevention and treatment of Alzheimer＇s disease.
基金supported by the National Institute on Aging of the National Institutes of Health under Award Number RF1AG058603.
文摘Neurological conditions,including cognitive impairment and Alzheimer’s disease(AD),impose a huge burden on society,affecting millions of people globally.In addition to genetic factors,recent studies indicate that environmental and experiential factors may contribute to the pathogenesis of these diseases.Early life adversity(ELA)has a profound impact on brain function and health later in life.In rodent models,exposure to ELA results in specific cognitive deficits and aggravated AD pathology.Extensive concerns have been raised regarding the higher risk of developing cognitive impairments in people with a history of ELA.In this review,we scrutinize findings from human and animal studies focusing on the connection of ELA with cognitive impairment and AD.These discoveries suggest that ELA,especially at early postnatal stages,increases susceptibility to cognitive impairment and AD later in life.In terms of mechanisms,ELA could lead to dysregulation of the hypothalamus-pituitary-adrenal axis,altered gut microbiome,persistent inflammation,oligodendrocyte dysfunction,hypomyelination,and aberrant adult hippocampal neurogenesis.Crosstalks among these events may synergistically contribute to cognitive impairment later in life.Additionally,we discuss several interventions that may alleviate adverse consequences of ELA.Further investigation into this crucial area will help improve ELA management and reduce the burden of related neurological conditions.
文摘During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positively the agitation of demented patients aged ≥ 65 years.To gather information on the utilization of pain killers in demented patients a preliminary survey has been conducted in collaboration with the Calabrian Pharmacovigilance Territorial Service of the health district of Catanzaro（Italy）.The study has taken into consideration the prescriptions of acetylcholinesterase inhibitors and memantine during the period ranging from July 2015 to June 2016 and the percentage of patients treated against pain with non steroidal antinflammatory drugs,opioids,and anticonvulsants have been monitored.The latter have been evaluated statistically for difference between the treatment before（pre） and after（post） the settlement of acetylcholinesterase inhibitors（ACh EI） or memantine therapy.The results do support accuracy in painkillers utilization in the course of dementia in the regional population of Calabria（Italy）.
