IntroductionHerpes Simplex Virus 1 (HSV1) is a neuroinvasive virus capable of entering the brain which makes it a candidate pathogen for increasing risk of dementia. Previous studies are inconsistent in their findings regarding the link between HSV1 and dementia, therefore, we investigated how HSV1 relates to cognitive decline and dementia risk using data from a population-based study. MethodsWe measured HSV1 immunoglobulin (IgG) antibodies in serum collected between 2002 and 2005 from participants of the Rotterdam Study. We used linear regression to determine HSV1 in relation to change in cognitive performance during 2 consecutive examination rounds on average 6,5 years apart. Next, we determined the association of HSV1 with risk of dementia (until 2016) using a Cox regression model. We repeated analyses for Alzheimer’s disease. All models were adjusted for age, sex, cardiovascular risk factors, and apolipoprotein E genotype. Results Of 1,915 non-demented participants (mean age 71.3 years, 56.7% women), with an average follow-up time of 9.1 years, 244 participants developed dementia (of whom 203 Alzheimer’s disease). HSV1 seropositivity was associated with decline in global cognition (mean difference per standard deviation -0.16; 95% confidence interval (95%CI), -0.26; -0.07), as well as separate cognitive domains, namely memory, information processing, and executive function, but not motor function. Finally, HSV1 seropositivity was not associated with risk of dementia (adjusted hazard ratio, 1.18, 95%CI, 0.83; 1.68), similar for Alzheimer’s disease. DiscussionHSV1 is associated with cognitive decline but not with incident dementia in the general population. These data suggest HSV1 to be associated only with subtle cognitive disturbances but not with greater cognitive disorders that result in dementia.
Background: A substantial proportion of patients after nondisabling stroke are cognitively impaired compared to age- and education-matched community-dwelling controls. Moreover, poststroke patients who have ‘vascular cognitive impairment no dementia' (VCIND) of moderate severity have a high risk of incident dementia, dependency and death. Further studies are urgently needed to demonstrate effective cognition-enhancing therapies in VCIND given the scarcity of evidence-based treatment options. NeuroAiD is a traditional Chinese medicine that has been shown to induce neuroplasticity, promote cell proliferation and stimulate the development of dense axonal and dendritic networks in animal stroke models. NeuroAiD may improve cerebral blood flow and functional recovery after stroke in patients. Objective: To investigate the effects and tolerability of NeuroAiD II in patients with VCIND. Methods: The NeuroAiD II (MLC901) in Vascular Cognitive Impairment Study (NEURITES) is a 24-week, double-blind, randomized, placebo-controlled phase II study of NeuroAiD II in patients with VCIND. The primary outcome is executive function as measured by the Verbal Fluency test. Secondary outcomes include cognitive assessments such as the ADAS-Cog, MoCA, MMSE and Cognitive Battery: activities of daily living as measured by the Alzhei-mer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) scale for mild cognitive impairment, behavior as measured by the Neuropsychiatric Inventory, and depression as measured by the Geriatric Depression Scale and the Beck Depression Scale. In addition, there will be novel exploratory outcomes: (a) magnetic resonance imaging of lesion location (structural imaging), structural integrity of white matter pathways (diffusion tensor imaging), neuronal function (resting studies) and perfusion (arterial spin labeling and MR angiography), and (b) retinal and optic nerve imaging. Safety and tolerability will be assessed using adverse events, laboratory tests and vital signs. Conclusions: NEURITES has the potential to set new standards for the systematic evaluation of Asian traditional medicine for integration into standard medicine practice and establishing a novel therapeutic approach for improving cognition after stroke.
In this large population-based study, calcification in the vertebrobasilar arteries was prevalent in 21% of the elderly.• Calcification in the vertebrobasilar arteries was weak to moderately correlated with calcification in other arteries.• Traditional cardiovascular risk factors were associated with vertebrobasilar artery calcification.• Our findings suggest a different pathophysiology of arteriosclerosis in the posterior-compared to anterior circulation.
Background--Cardiovascular risk factors can track from mother to child by several pathways: pregnancy complications, genetic inheritance, and shared environmental risk factors after pregnancy. The degree of tracking, and to which extent this is influenced by these pathways, is unknown. We hypothesized that cardiovascular risk factors track from mother to child regardless of pregnancy complications and environmental risk factors. We determined the degree of tracking between maternal and offspring micro-and macrovascular cardiovascular risk factors after pregnancy and the extent to which this is influenced by pregnancy complications and shared environmental risk factors.Methods and Results--We included 5624 mother-offspring pairs from The Generation R Study, an ongoing prospective, population-based birth cohort. Information on pregnancy complications (preeclampsia, small for gestational age, and preterm birth) was obtained through hospital charts. Mother-offspring associations were assessed 6 years after pregnancy (central retinal arteriolar and venular calibers, body mass index, blood pressure, left atrial diameter, aortic root diameter, left ventricular mass, fractional shortening, and pulse wave velocity) and 9 years after pregnancy (body mass index and blood pressure). We observed that worse cardiovascular parameters in mothers were associated with worse cardiovascular parameters in their offspring 6 and 9 years after pregnancy (P<0.001). Results were similar when mother-offspring pairs with a previous pregnancy complication were excluded.Conclusions--Six and 9 years after pregnancy, an adverse cardiovascular profile in mothers is strongly associated with an adverse cardiovascular profile in their offspring. Results were not attenuated by environmental exposures or a previous pregnancy complication. This supports the hypothesis that cardiovascular risk factors (micro-and macrovascular) track from mother to child, regardless of the course of pregnancy.
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