A new dawn of preventing dementia by preventing cerebrovascular diseases

Pan, Yuesong; Li, Hao; Wardlaw, Joanna M.; Wang, Yongjun

doi:10.1136/bmj.m3692

Cited by 31 publications

(27 citation statements)

References 24 publications

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“…The AHA/ASA presidential advisory recommended the AHA’s Life’s Simple 7 (non-smoking, physical activity, healthy diet, appropriate body mass index, blood pressure, total cholesterol, and blood glucose) to maintain optimal brain health 2. Pan and colleagues discuss how this may indicate a new dawn of preventing some cognitive impairment and brain dysfunction by preventing vascular risk factors or cerebrovascular diseases 20…”

Section: Opportunities and Challenges Of Future Research On Brain Healthmentioning

confidence: 99%

What is brain health and why is it important?

Wang

Pan

2020

BMJ

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Section: Opportunities and Challenges Of Future Research On Brain Healthmentioning

confidence: 99%

What is brain health and why is it important?

Wang

Pan

2020

BMJ

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“…Cognitive impairment is a leading cause of disability worldwide and imposes a heavy public and economic burden ( 1 ). The prevalence of cognitive impairment ranges from 9.7 to 23.3% among subjects aged 65 years or older in China ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease and Longitudinal Cognitive Changes in Middle-Aged and Elderly Adults

Liu

et al. 2022

Front. Med.

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Background and PurposeNon-alcoholic fatty liver disease (NAFLD) and cognitive impairment are common aging-related disorders. This study aims to explore the changes of cognitive function in middle-aged and elderly population with NAFLD from a Jidong impairment cohort.MethodsA total of 1,651 middle-aged and elderly participants (>40 years) without cognitive impairment were recruited into the current study in 2015 and were followed up until to 2019. Abdominal ultrasonography was used for diagnosis of NAFLD. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as a score <18 for illiterates, a score <21 for primary school graduates, and a score <25 for junior school graduates or above. Multivariable regression analysis was performed to evaluate the association between NAFLD and the four-year cognitive changes.ResultsOut of 1,651 participants, 795 (48.2%) of them had NAFLD in 2015. Cognitive impairment occurred in 241 (14.6%) participants in 2019. Patients with NAFLD had higher 4-year incidence of cognitive impairment than non-NAFLD patients did (17.7 vs. 11.7%, p < 0.001). Multivariable linear regression analysis showed significant association of baseline NAFLD with lower MMSE score in 2019 (β = −0.36, p < 0.05). Multivariable logistic analysis found that the adjusted odds ratio (OR) with 95% confidence interval (CI) of baseline NAFLD was 1.45 (1.00–2.11) for cognitive impairment in 2019 (p = 0.05). We also identified effects of baseline NAFLD on subsequent cognitive impairment as modified by age (interaction p < 0.01) and carotid stenosis (interaction p = 0.05) but not by gender.ConclusionsNAFLD is associated with cognitive decline, especially in middle-aged and with carotid stenosis population.

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“…Cerebrovascular disease refers to conditions that have an effect on blood vessels and blood supply to the brain [2]. Since vascular factors are an important contributor to cerebrovascular disease, including a role in mild cognitive impairment and dementia [3], that is predicted to increase to 152 million by 2050 [4]; therefore, therapeutic measures for the cerebrovascular disease are crucial. Transcranial electrical stimulation (tES), particularly transcranial direct current (tDCS), has been shown to be a promising therapeutic method that can evoke regional CBF [5], which may be able to ameliorate hypoperfusion and the related cognitive impairments.…”

Section: Introductionmentioning

confidence: 99%

Grey-box modeling and hypothesis testing of functional near-infrared spectroscopy-based cerebrovascular reactivity to anodal high-definition tDCS in healthy humans

et al. 2021

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Transcranial direct current stimulation (tDCS) has been shown to evoke hemodynamics response; however, the mechanisms have not been investigated systematically using systems biology approaches. Our study presents a grey-box linear model that was developed from a physiologically detailed multi-compartmental neurovascular unit model consisting of the vascular smooth muscle, perivascular space, synaptic space, and astrocyte glial cell. Then, model linearization was performed on the physiologically detailed nonlinear model to find appropriate complexity (Akaike information criterion) to fit functional near-infrared spectroscopy (fNIRS) based measure of blood volume changes, called cerebrovascular reactivity (CVR), to high-definition (HD) tDCS. The grey-box linear model was applied on the fNIRS-based CVR during the first 150 seconds of anodal HD-tDCS in eleven healthy humans. The grey-box linear models for each of the four nested pathways starting from tDCS scalp current density that perturbed synaptic potassium released from active neurons for Pathway 1, astrocytic transmembrane current for Pathway 2, perivascular potassium concentration for Pathway 3, and voltage-gated ion channel current on the smooth muscle cell for Pathway 4 were fitted to the total hemoglobin concentration (tHb) changes from optodes in the vicinity of 4x1 HD-tDCS electrodes as well as on the contralateral sensorimotor cortex. We found that the tDCS perturbation Pathway 3 presented the least mean square error (MSE, median <2.5%) and the lowest Akaike information criterion (AIC, median -1.726) from the individual grey-box linear model fitting at the targeted-region. Then, minimal realization transfer function with reduced-order approximations of the grey-box model pathways was fitted to the ensemble average tHb time series. Again, Pathway 3 with nine poles and two zeros (all free parameters), provided the best Goodness of Fit of 0.0078 for Chi-Square difference test of nested pathways. Therefore, our study provided a systems biology approach to investigate the initial transient hemodynamic response to tDCS based on fNIRS tHb data. Future studies need to investigate the steady-state responses, including steady-state oscillations found to be driven by calcium dynamics, where transcranial alternating current stimulation may provide frequency-dependent physiological entrainment for system identification. We postulate that such a mechanistic understanding from system identification of the hemodynamics response to transcranial electrical stimulation can facilitate adequate delivery of the current density to the neurovascular tissue under simultaneous portable imaging in various cerebrovascular diseases.

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A new dawn of preventing dementia by preventing cerebrovascular diseases

Abstract: Yuesong Pan and colleagues discuss the relation between cerebrovascular diseases and impairment of cognition, with an emphasis on a chance to prevent dementia by preventing cerebrovascular diseases on 31 October 2020 by guest. Protected by copyright.

Cited by 31 publications

References 24 publications

What is brain health and why is it important?

What is brain health and why is it important?

Non-alcoholic Fatty Liver Disease and Longitudinal Cognitive Changes in Middle-Aged and Elderly Adults

Grey-box modeling and hypothesis testing of functional near-infrared spectroscopy-based cerebrovascular reactivity to anodal high-definition tDCS in healthy humans

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