• 동의신경정신과학회지
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• 제26권3호
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• pp.319-336
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• 2015

Objectives: The object of this study was to evaluate the cognition and motor function recovery effects of Sungshim-san (SSS), a traditional Korean cardio-protective polyherbal formula in the severe rat stroke, permanent middle cerebral artery occlusion (pMCAO) model. Methods: The experimental animals were divided into 6 groups. SSS aqueous extracts (yield=16.82%; 400, 200 and 100 mg/kg) were administered orally by using Sonde, once daily, for 28 continuous days from 24 hrs post-pMCAO. Donepezil 10 mg/kg, a representative drug for dementia, was used as a reference drug. The body weight changes, infarct/defect sizes, sensorimotor function and cognitive motor behavior were serially monitored. Limb placing and body-swing test for sensorimotor functions were conducted at 1 day before operation (base line), and 1, 3, 7, 14, 21 and 28 days post-pMCAO; and water maze test for the cognitive motor behavior was conducted at 14 and 28 days post-pMCAO, respectively. Results: Focal cerebral cortex infarct and defects due to pMCAO resulted in marked decreases of body weight, disorders of sensorimotor functions and cognitive motor behaviors. However, the pMCAO-related ischemic damages were markedly and dose-dependently inhibited by treatment with SSS 400 and 200 mg/kg, respectively. Donepezil markedly decreased the body weight and gains, as compared with pMCAO control rats; however, SSS 400 and 200 mg/kg favorably ameliorated the pMCAO-induced decreases in body weight and gains. SSS 100 mg/kg treated rats did not show any favorable effects on the pMCAO-related ischemic damages, as compared with pMCAO control rats. Conclusions: The results of the study indicated that oral administration of SSS 400 and 200 mg/kg accelerated cognition and motor function recovery in the rat pMCAO model. The treatment effect was potentially mediated by neuroprotection via the known augmentation of cerebral antioxidant defense system of SSS itself or its individual herbal components. Especially, the overall effects of SSS 200 mg/kg were similar to those of donepezil 10 mg/kg, but less toxic.

• 한국임상약학회지
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• 제29권1호
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• pp.1-8
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• 2019

Background: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. Purpose: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. Method: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. Results: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. Conclusions: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.

• Journal of Ginseng Research
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• 제45권2호
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• pp.264-272
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• 2021

Background: Gintonin is a ginseng-derived exogenous G-protein-coupled lysophosphatidic acid (LPA) receptor ligand, which exhibits in vitro and in vivo functions against Alzheimer disease (AD) through lysophosphatidic acid 1/3 receptors. A recent study demonstrated that systemic treatment with gintonin enhances paracellular permeability of the blood-brain barrier (BBB) through the LPA1/3 receptor. However, little is known about whether gintonin can enhance brain delivery of donepezil (DPZ) (Aricept), which is a representative cognition-improving drug used in AD clinics. In the present study, we examined whether systemic administration of gintonin can stimulate brain delivery of DPZ. Methods: We administered gintonin and DPZ alone or coadministered gintonin with DPZ intravenously or orally to rats. Then we collected the cerebral spinal fluid (CSF) and serum and determined the DPZ concentration through liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results: Intravenous, but not oral, coadministration of gintonin with DPZ increased the CSF concentration of DPZ in a concentration- and time-dependent manner. Gintonin-mediated enhancement of brain delivery of DPZ was blocked by Ki16425, a LPA1/3 receptor antagonist. Coadministration of vascular endothelial growth factor (VEGF) + gintonin with DPZ similarly increased CSF DPZ concentration. However, gintonin-mediated enhancement of brain delivery of DPZ was blocked by axitinip, a VEGF receptor antagonist. Mannitol, a BBB disrupting agent that increases the BBB permeability, enhanced gintonin-mediated enhancement of brain delivery of DPZ. Conclusions: We found that intravenous, but not oral, coadministration of gintonin facilitates brain delivery of DPZ from plasma via LPA1/3 and VEGF receptors. Gintonin is a potential candidate as a ginseng-derived novel agent for the brain delivery of DPZ for treatment of patients with AD.

• 대한약침학회지
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• 제22권4호
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• pp.231-238
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• 2019

Objectives: Alzheimer's disease (AD), an overwhelming neurodegenerative disease, has deleterious effects on the brain that consequently causes memory loss and language impairment. This study was intended to investigate the neuroprotective activity of the two essential oils (EOs) from Iranian Pistacia khinjuk (PK) leaves and Allium sativum (AS) cloves against β-Amyloid 25-35 (Aβ25-35) induced elevation of cholinesterase enzymes in AD. Methods: The EOs of PK (PKEO) and AS (ASEO) were prepared and analyzed in terms of extraction yield, phenolic content, and cholinergic markers in vitro. Moreover, both were administered orally to adult male Wistar rats at concentrations of 1, 2, and 3%. The inhibitory potential of PKEO and ASEO was compared with Donepezil (0.75 mg/kg) against the high activities of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes. Results: PKEO reached an inhibition rate of 83.6% and 81.4% against AChE and BChE, respectively. ASEO had lower anti-cholinesterase activity (65.4% and 31.5% for the inhibition AChE and BChE). PKEO was found to have more phenolic content than ASEO. A significantly positive correlation was observed between the total phenolics and anti-cholinesterase potential. In rats, both EOs decreased the enzyme activity in a concentration-dependent manner. As compared with Donepezil, the significant difference in the AChE and BChE inhibition occurred as rats were treated with PKEO 3% (p < 0.05). Conclusion: It could be concluded that PKEO and ASEO are potent inhibitors of AChE and BChE in rats that hold promise to be used for the treatment of AD.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2003년도 Annual Meeting of KSAP : International Symposium on Pharmaceutical and Biomedical Sciences on Obesity
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• pp.106-106
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• 2003

Choline serves critical roles in the CNS both as a precursor of neurotransmitter and as an essential component of membrane phospholipids. The long-term maintenance of brain choline concentration is dependent on choline transport across the blood-brain barrier (BBB), And, we examined to elucidate the characteristics of transport of choline across the BBB using conditionally immortalized rat brain capillary endothelial cell line (TR-BBB) in vitro. The ［$^3$H］choline in TR - BBB was increased by time dependently, but independent on Na$\^$＋/, and the transport process is saturable with Michaelis-Menten constrant, Km of about 26 ${\mu}$M. The uptake of ［$^3$H］choline is susceptible for inhibition by various organic cationic compounds including hemicholinium-3, tetraethylammonium chloride (TEA) and $\ell$-carnitine. Also, we investigated the relationship of transport of choline and cationic drugs. The uptake of ［$^3$H］choline is inhibited by antioxidant, a-phenyl-n-tert-butyl nitrone (PBN) with IC$\sub$50/ of 1.2 mM. and by Alzheimer's disease therapeutics, such as acetyl $\ell$-carnitine, tacrine and donepezil. Also, choline uptake presented competitive inhibition with PBN, donepezil and acetyl $\ell$-carnitine in Lineweaver-Burk plot. In conclusion, TR-BBB cells express a saturable transport system for uptake of choline, and several cationic drugs may be transported into the brain by BBB choline transporter.

• Journal of Korean Neurosurgical Society
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• 제43권5호
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• pp.242-245
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• 2008

A 64-year-old man with TBI was admitted to our institute. In following days, he showed unusual behavior of agitation, restlessness, emotional instability and inattention. Post-traumatic delirium was tentatively diagnosed, and donepezil was given for his cognitive dysfunction. Although there was partial relief of agitation, he sustained back pain despite medication. Lumbar magnetic resonance image revealed SDH along the whole lumbar spine, and surgical drainage was followed. Postoperatively, his agitation disappeared and further medication was discontinued. We report a unique case of post-traumatic delirium in a patient with concomitant TBI and spinal subdural hemorrhage (SDH) that resolved with operative drainage of spinal hemorrhage.

• 한국식품영양과학회지
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• 제43권6호
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• pp.799-806
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• 2014

본 연구는 scopolamine으로 유도한 기억력 및 인지기능 감퇴 동물모델에서 비파엽 추출물의 기억력 및 인지기능 개선효과를 평가하기 위해 수행되어졌다. 6주령의 SD-rat(male)을 총 5개 군으로 분리하였으며, 양성대조군으로 donepezil(1 mg/kg b.w.)을 처리하였다. 15일간 24시간 간격으로 EJE를 50, 200 mg/kg b.w. 농도로 전처리(경구투여) 하였으며, 16일째에 농도별로 EJE 및 양성대조군으로서 donepezil을 투여하고 scopolamine을 복강투여(1 mg/kg b.w.) 하였다. Water maze test와 passive avoidance test를 통해 scopolamine으로 유도한 동물모델에서 EJE의 기억력 및 인지능력 개선 효과를 확인한 결과, scopolamine에 의해 감소된 기억력 및 학습능력이 EJE를 투여함으로써 유의적으로 회복 및 증가한 것을 확인할 수 있었다. Scopolamine에 의해 인지능력과 함께 감소된 운동능력의 평가를 위해 수행한 rotarod test 및 vertical pole test에서는 scopolamine의 투여로 감소된 균형감각, 협응력 그리고 grip strength와 같은 운동능력들이 EJE의 투여로 유의적으로 회복된 것을 확인하였다. 또한 scopolamine에 의해 증가한 AchE의 활성과 감소한 Ach의 함량이 EJE의 투여로 각각 개선되었다. 본 연구에서는 이와 같은 결과를 바탕으로 EJE의 scopolamine으로 유도한 동물모델에서 인지능력 개선과 감퇴한 운동능력의 향상 및 cholinergic neurotransmission system의 강화 효과를 확인할 수 있었으며, 이러한 연구 성과들로 비파엽 추출물이 퇴행성뇌질환인 AD 치료와 학습 및 기억력 개선에 있어 효과적인 대안으로서 보다 더 많은 분야에서 연구되기를 바라는 바이다.

• Korean Journal of Acupuncture
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• 제36권4호
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• pp.230-240
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• 2019

Objectives : This research was performed to investigate the effects of Hwangryunhaedok-tang decoction and Hwangryunhaedok-tang Pharmacopuncture at BL10 on cognition and memory impairment in a mouse dementia model induced by scopolamine. Methods : Fifty ICR mice were divided into 6 groups : Normal group (n=5), Control group (n=9), Positive control group for pharmacopuncture group (n=9, Donepezil 0.75 mg/kg), Positive control group for oral administration group (n=9, Donepezil 5 mg/kg), Pharmacopuncture group (n=9, Hwangryunhaedok-tang Pharmacopuncture undiluted solution 10 ml/kg), and Oral administration group (n=9, Hwangryunhaedok-tang 200 mg/kg). For a mouse dementia model, 1 mg/kg scopolamine was intraperitoneally administered to ICR mice. Hwangryunhaedok-tang pharmacopuncture was administered on BL10 for 4 weeks at intervals of 2 days. Hwangryunhaedok-tang decoction was given orally for 4 weeks every day. Morris water maze and passive avoidance test were conducted followed by measurement of acetylcholine concentration, acetylcholinesterase activity, and the amount of BDNF and p-CREB in the brain. Results : 1. In the Morris water maze test, the time spent staying around the platform significantly increased in the pharmacopuncture group and oral administration group than in the control group. 2. In the passive avoidance test, the time spent in the bright room significantly increased in the pharmacopuncture group and oral administration group than in the control group. 3. The level of acetylcholine in brains increased in the pharmacopuncture group and oral administration group than in the control group. Also, the activity of acetylcholinesterase decreased in the pharmacopuncture group and oral administration group than in the control group. 4. The expression of BDNF and p-CREB decreased in the control group, but increased in the pharmacopuncture group and oral administration group. Conclusions : These results suggest that Hwangryunhaedok-tang decoction and Hwangryunhaedok-tang pharmacopuncture at BL10 may have cognition and memory-enhancing effect in scopolamine-induced dementia in ICR mice via controlling the content of acetylcholine and the activity of acetylcholinesterase, and activating BDNF and p-CREB.

• 생물정신의학
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• 제23권2호
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• pp.48-56
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• 2016

Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

• The Korean Journal of Physiology and Pharmacology
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• 제18권3호
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• pp.201-209
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• 2014

The present study was designed to investigate the efficacy of selective $ET_A$ receptor antagonist, ambrisentan on hyperhomocysteinemia-induced experimental vascular dementia. L-methionine was administered for 8 weeks to induce hyperhomocysteinemia and associated vascular dementia in male rats. Ambrisentan was administered to L-methionine-treated effect rats for 4 weeks (starting from $5^{th}$ to $8^{th}$ week of L-methionine treatment). On $52^{nd}$ day onward, the animals were exposed to the Morris water maze (MWM) for testing their learning and memory abilities. Vascular endothelial function, serum nitrite/nitrate levels, brain thiobarbituric acid reactive species (TBARS), brain reduced glutathione (GSH) levels, and brain acetylcholinesterase (AChE) activity were also measured. L-methionine-treated animals showed significant learning and memory impairment, endothelial dysfunction, decrease in/serum nitrite/nitrate and brain GSH levels along with an increase in brain TBARS levels and AChE activity. Ambrisentan significantly improved hyperhomocysteinemia-induced impairment of learning, memory, endothelial dysfunction, and changes in various biochemical parameters. These effects were comparable to that of donepezil serving as positive control. It is concluded that ambrisentan, a selective $ET_A$ receptor antagonist may be considered as a potential pharmacological agent for the management of hyperhomocysteinemia-induced vascular dementia.