• Title/Summary/Keyword: Vascular dementia

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The Clinical Effect of Oxiracetam in Patients with Organic Brain Syndrome-Double Blind, Placebo-Controlled Study (기질성 뇌증후군에서 Oxiracetam의 임상적 효과에 대한 이중맹검 대조연구)

  • 이병철;권기한;권기한;송홍기;김성민;유경호;이현미;강경수;윤여훈
    • YAKHAK HOEJI
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    • v.37 no.5
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    • pp.442-452
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    • 1993
  • Previous experimental and clinical investigations suggest a possible role of new nootropic drug, oxiracetam, in improving cognitive performances in patients affected by organic brain syndrome. In this study, the cognitive and behavioral effects of oxiracetam treatment in patients with clinical symptoms of organic brain syndrome were evaluated. Sixty-six patients were enrolled and assigned to either oxiracetam or placebo, according to a randomized, double-blind design between two patient-groups. Either oxiracetam or placebo was orally given bid for 8 weeks ; daily dose of oxiracetam was 1600mg. All the patients, enrolled in this study, were diagnosed as having mild to moderate cognitive dysfunction as defined by a baseline Mini Mental State ExaminationKorean version (MMSE-K) score between 14 and 25. The patients under-went, at baseline, 4 weeks and 8 weeks after, routine laboratory study (CBC, SMA12, U/A, EKG) and the following neuropsychological tests ; MMSE-K, modified Korean Wechsler Intelligence Scale(MKWIS), Nurses' Observation Scale for Geriatric patients(NOSGER). Fifteen patients of whom were dropped out or excluded from the analysis because of poor compliance or violation of the protocol. Fiftyone patients (aged 54~78 years, male 25, female 26) were analyzed (vascular dementia, 30 ; senile dementia of Alzheimer type, 9 ; mixed type, 5 ; other cause, 7). Statistical analysis of the data demonstrated that the two groups were comparable at baseline. At the end of each study period the oxiracetam group scored significantly better on the majority of the tests evaluating cognitive function, psychometricity and the improvement rating scale of subjective symptoms than placebo group, in which worsening trends or no changes were seen on the whole. No side effects were noted during oxiracetam treatment. The present study, showing positive clinical findings after oxiracetam therapy, confirmed that this drug can be useful pharmacological treatment in organic brain syndrome.

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Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong;Choi, Jung-Kyu;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.2
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    • pp.92-102
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    • 2018
  • Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

Whole body hypoxic preconditioning-mediated multiorgan protection in db/db mice via nitric oxide-BDNF-GSK-3β-Nrf2 signaling pathway

  • Li, Yuefang;Huang, Yan;Cheng, Xi;He, Youjun;Hu, Xin
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.4
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    • pp.281-296
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    • 2021
  • The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetes-induced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholine-induced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O2 for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (L-NAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IR-induced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

The Relationship between Dementia and Oral Health in Some Elderly in Daejeon (대전 일부 노인의 치매와 구강건강의 관계)

  • Go, Hye-Bin;Kim, Min-Gyeong;Kim, Jin-Young;Kim, Hyun-Soo;Park, Young-Seo;Seo, Seung-Hyeon;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.481-487
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    • 2016
  • The elderly population with dementia is rapidly growing in South Korea. The aim of this study was to investigate the relationship between dementia and oral health in 197 subjects aged ${\geq}65$ years. The questionnaire included questions on subjective health status, subjective health concern, subjective oral health status and behavior, mastication ability, Oral Health Impact Profile-14 (OHIP-14), and Korean Dementia Screening Questionnaires (KDSQ). Oral examination was conducted by a single dentist to evaluate upper or lower denture use, and determine the numbers of remaining and functioning teeth, including implant and fixed prosthesis. The subjects who required a dementia test (KDSQ-C [cognition] of ${\geq}6$) had significant differences in systemic disease prevalence rate, subjective health status, subjective health concern, KDSQ-V (vascular disease) score, KDSQ-D (depression) score, subjective oral treatment need, key food mastication ability and OHIP-14 score compared to the healthy subjects. The proportion of denture wearers, total remaining teeth, total functioning teeth, toothbrushing frequency, oral pain severity, symptoms of periodontal disease, subjective oral health status, and subjective oral health concern showed no significant differences between the two groups. KDSQ-C and OHIP-14 scores showed a strong positive relationship, while KDSQ-C score and total remaining teeth or key food mastication ability showed a weak negative relationship. In the multiple regression analysis, the KDSQ-D, KDSQ-V, and OHIP-14 scores influenced the KDSQ-C scores. We suggest a relationship between oral health and cognitive impairment.

Reproduction and Development Toxicity of Anti-Alzheimer′s Drug Dehydroevodiamine-HCl (치매 치료제 염산 디히드로에보다이아민의 생식 및 발생 독성)

  • 성이숙;정성윤;서영득;진미령;최봉웅;장병모;김대경
    • YAKHAK HOEJI
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    • v.46 no.6
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    • pp.452-458
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    • 2002
  • Dehydroevodiamine-HCl (DHED), which is a component separated from Evodia rutaecarpa Bentham, has novel anticholinesterase and antiamnesic activities in a scopolamine-induced amnesia model. Several studies suggest that DHED might be an effective drug for Alzheimer's disease and a vascular type of dementia. DHED was at dose levels of 0, 50, 100 and 200 mg/kg/day administered intraperitoneally to Sprague-Dawley male rats for 60 days before mating and to females from 14 days before mating to 7 days after mating. Effects of the DHED on general symptom and reproductive performance of parent animals and embryonic development were examined. In male parents, whereas no death was observed, reduction in the increase rate of body weight was found at 200 mg/kg. In female parents, both of the mating performance and the fertility of parent animals were decreased at 200 mg/kg, but not significantly. In 200 mg/kg treated group, the fetal death rate was increased but total fetuses showed no changes compared to the control group. There were no malformed F1 fetuses in all groups.

The effect of Woohwangchungsimwon on the learning and memory in NOS inhibitor treated rats in Morris water maze. (우황청심원(牛黃淸心元)이 NOS inhibitor에 의한 흰쥐의 학습(學習) 및 기억장애(記憶障碍)에 미치는 영향(影響))

  • Baek Ji-Seong;Kim Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.10 no.2
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    • pp.115-126
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    • 1999
  • This study was conducted to find out the effects of Woohwangchungsimwon on learning and memory in the NOS inhibitor treated rats. The Morris water maze was used in evaluating them. The result of the study was summarized as follows. 1. In the learning test, three groups have showed a gradual improvement of learning ability by repeating the trials in Morris water maze. WHCS group have showed statistical improvement than control group at 4,5,6 trial(p<0.05, p<0.01, p<0.01). 2. In the memory test, the first latency of WHCH group was statistically shortened than that of control group(p<0.05). 3. In the memory test, there was no statistical difference in the entry number between WHCH group and control. 4. In the memory test, there was no statistical difference in the memory score between WHCH group and control. The result of this experimental study presents that Woohwangchungsimwon has the improving effect on impaired learning and memory in NOS inhibitor treated rats, and implies that Woohwangchungsimwon may be one of the useful prescription for the treatment of vascular dementia after cerebral ischemia.

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Study on Mutagenicity of DehydroevodiamineㆍHCl(DHED) (치료제 DehydroevodiamineㆍHCl(DHED)의 변이원성 연구)

  • 성이숙;정성윤;정주연;채규영;진미령;최봉웅;장병모;김대경
    • YAKHAK HOEJI
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    • v.46 no.3
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    • pp.208-212
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    • 2002
  • Dehydroevodiamine HCl (DHED), which is a component separated from Evodia rutaecarpa Bentham, has novel anticholinesterase and antiamnesic activities in the scopolamine-induced amnesia model. Several studies suggest that DHED might be an effective drug for the Alzheimer's disease and the vascular type of dementia. In order to evaluate the mutagenic potential of DHED, Salmonella typhimurium reversion assay, chromosomal aberration test on Chinese hamster lung cells, in vivo micronucleus assay using mouse bone marrow cells, and comet assay were performed. DHED did not increase the number of revertant in the reverse mutation test using Salmonella typhimurium TA1535, TA1537, TA98, TA100. DHED HCl, at concentration of 5 and 10 $\mu\textrm{g}$/mι, increased the number of chromosome aberrated Chinese hamster lung cells with 5 and 10%, respectively. In mouse micronucleus test, no significant increase in the occurrence of micronucleated polychromatic erythrocyte was observed in ICR mice orally administered with DHED. DHED was tested for ability to induce genotoxic effect in L5178Y cells (mouse lymphoma cells) using the single cell gel electrophoresis assay (comet assay). In comet assay, tail moment did not increase in L5178Y cells treated with 10, 100, 300 $\mu$M DHED.

Brain Iron Imaging in Aging and Cognitive Disorders: MRI Approaches (노화 및 인지기능장애에서 뇌 철 영상 기법: 자기공명영상을 이용한 접근)

  • Jinhee Jang;Junghwa Kang;Yoonho Nam
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.527-537
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    • 2022
  • Iron has a vital role in the human body, including the central nervous system. Increased deposition of iron in the brain has been reported in aging and important neurodegenerative diseases. Owing to the unique magnetic resonance properties of iron, MRI has great potential for in vivo assessment of iron deposition, distribution, and non-invasive quantification. In this paper, we will review the MRI methods for iron assessment and their changes in aging and neurodegenerative diseases, focusing on Alzheimer's disease. In addition, we will summarize the limitations of current approaches and introduce new areas and MRI methods for iron imaging that are expected in the future.

Age and Gender Differences in the Relationship of Cognitive Impairment, Vascular Risk Factors, and Subclinical Carotid Atherosclerosis from Community-based Elderly (나이와 성별에 따른 지역사회 거주 노인에서 무증상 경동맥 죽상경화증에 대한 혈관위험인자 및 인지장애와의 관련성)

  • Kim, Ji-Hee;Park, Hyun-Young;Kim, Dae-Won;Byun, Seung-Jae;Moon, Hyo-Jeong;Lee, In;Yang, Chung-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.399-407
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    • 2012
  • To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

Paeonia Radix decreases Intracerebral Hemorrhage-induced Neuronal Cell Death via Suppression on Caspase-3 Expressionin Rats

  • Kim Ho-Jun;Kim Sung-Soo;Lee Jong-Soo
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.95-107
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    • 2004
  • Objective : The inappropriate or excessive apoptosis has been known to be associated with neurodegenerative disorders including intracranial hemorrhage(ICH). Paeoniae radix, in traditional Korean medicine, has played its role as blood­nourisher and yin-astringent. In the present study, the effect of Paeoniae radix on the inhibition of neurodegeneration in the brain of rats after artificial ICH and on the resulting apoptosis was investigated. Methods : 30 rats were divided into 6 equal groups ; the sham-operation group, the hemorrhage-induction group, the hemorrhage-induction with 10, 50, 100, and 200 mg/kg Paeoniae radix-treated group, respectively. Stereotactic surgery was performed and collagenase was infused to induce ICH in the region of CA1 of hippocampus of rats. The sham group took only saline infusion. For 7 days after the surgery, 4 testing groups had intraperitoneal injections of Paeoniae radix extract. The step-down inhibitory avoidance task, measurement of neurodegeneration degree in the CA1 region of the hippocampus, and detection of caspase-3 and newly generated cells in the dentate gyrus were done after animal sacrifice. Results : Rats receiving Paeoniae radix extract showed increased latency time in the inhibitory avoidance task. The extension of neuron-deprived areas in the CA1 region was significantly suppressed in the Paeonia treated groups. Also expressions of caspase-3 in the CA1 region and cortex were significantly inhibited in the Paeonia treated groups. The cell proliferation was evaluated by means of BrdU methods and proved to be decreased in the Paeonia treated groups. Conclusion : These results suggest that Paeoniae radix has potential to suppress short-tenn memory loss after devastating neurologic accidents. Also it was proved that Paeoniae radix has a neuroprotective effect and alleviates central nervous complications following intracerebral hemorrhage. Furthermore, it may imply that this medicinal plant can be widely used for vascular dementia and other neurodegenerative disorders.

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