Coagulation and inflammatory markers in Alzheimer's and vascular dementia

Gupta, Avdhesh; Watkins, Alan; Thomas, Philippe; Majer, Réka; Habubi, N.; Morris, Gabriela M.; Pansari, K

doi:10.1111/j.1742-1241.2004.00143.x

Cited by 78 publications

(62 citation statements)

References 61 publications

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“…History of tobacco use also was associated with worse cognitive functional outcome in patients with atherothrombosis, an effect that cannot be clearly explained. However, smoking has been shown to be a risk factor for dementia 38 and to increase the levels of serum markers for coagulation and inflammation, 39 which consequently induces leukoaraiosis 40 ; thus, we assume that a similar mechanism exists for the apparent effect of smoking history on decreased cognitive functional outcome in patients with atherothrombosis.…”

Section: Discussionmentioning

confidence: 99%

Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke

Senda

Ito

Kotake

et al. 2016

Stroke

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4are widely used as classifications of ischemic stroke subtype. Although the pathologies of these subtypes are described by these criteria, no diagnostic methods or standards exist for neuroimaging and other examinations. The current diagnostic standards for ischemic stroke subtype used in clinical trials are from the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classifications.5 According to the TOAST classification system, artery-to-artery embolism (A-to-A) can be distinguished from atherothrombosis, 6 and both can be distinguished from CE. However, these concepts are not well Background and Purpose-We investigated the factors influencing inpatient convalescent rehabilitation outcomes in patients with ischemic stroke, particularly severity of leukoaraiosis on magnetic resonance imaging. Methods-Participants included 520 patients with ischemic stroke (317 men and 203 women; mean age, 72.8±8.4 years) who were transferred from acute care hospitals for inpatient convalescent rehabilitation. Ischemic stroke subtypes included lacunar infarction (n=41), atherothrombosis (n=223), artery-to-artery embolism (n=67), cardiogenic embolism (n=97), undetermined embolism (n=76), and uncategorized ischemic stroke (n=16). Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on magnetic resonance imaging. Functional Independence Measure scores were assessed on admission and at discharge. Results-Multiple regression analysis revealed that rehabilitation outcomes, measured as total Functional IndependenceMeasure scores, were significantly associated with leukoaraiosis estimated by PVH grade. This association was observed after adjustment for factors such as severity, age, and poststroke history. In all patients, PVH grades were associated with Functional Independence Measure motor scores (P<0.001), whereas in patients with artery-to-artery embolism or cardiogenic embolism and deep white matter hyperintensity grades were associated with Functional Independence Measure cognitive scores (P<0.05). Conclusions-Our study revealed that the degree of leukoaraiosis was associated with inpatient convalescent rehabilitation outcome in patients with ischemic stroke. Furthermore, the PVH grade was associated with motor function outcome, whereas the deep white matter hyperintensity grade correlated with cognitive function outcome, likely because the progression patterns and anatomic backgrounds of PVH and deep white matter hyperintensity differ according to ischemic stroke subtype.

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Section: Discussionmentioning

confidence: 99%

Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke

Senda

Ito

Kotake

et al. 2016

Stroke

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“…Despite this traditional classification, there is increasing evidence of the common role of haemostatic factors and inflammatory mechanisms in the pathogenesis of both vascular dementia and AD. In fact, many of the risk factors for cerebrovascular disease and vascular dementia, including serum total cholesterol, hypertension, atherosclerosis and Apolipoprotein E (ApoE) genotype, have also been shown to increase the risk of AD (Panza et al 2005, Gupta et al, 2005. Furthermore, longitudinal studies demonstrated a significant increase in the risk of developing AD in cohorts of hypertensive patients compared to normotensive subjects, suggesting that extensive peripheral atherosclerosis is a risk factor for AD (Vogel et al 2005, Newman et al 2005.…”

Section: Introductionmentioning

confidence: 99%

ApolipoproteinE ε4 allelic variant, cognitive decline and psychosis in Alzheimer disease: a review of the literature and suggestions for upcoming studies

et al. 2006

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-Apolipoprotein E (ApoE) ε4 allele represents a well known vascular risk factor for developing Alzheimer disease (AD) and differences in ApoE genotypes may explain a part of the variability in AD phenotypes. In fact, ApoE ε4 allele possession seems to be associated with a more precocious age of onset, greater episodic memory impairment, and psychotic symptoms. The first question we discuss regards the role of ApoE ε4 on cognitive progression of AD. In fact, while a general agreement exists about the role played by ApoE ε4 on the precocious onset of AD, cognitive decline has been differently associated with ApoE ε4 allele possession in AD patients in a continuum of faster decline, no effect, and slower decline. An attemptable interpretation is that the biological processes leading to the onset of AD are different from those involved in determining its clinical course. The second question regards the possible relationship between the presence of the degenerative pathological hallmarks of the disease in specific cerebral areas and different cognitive or behavioural symptoms. In fact, there is evidence that degenerative pathology in hippocampal formation and frontal cortex reflects the progression of cognitive deficits in brain aging and AD and that hypometabolism in right frontal lobe and greater frontal neuropsychological deficits occur in AD patients with psychosis in comparison to those without. The third question regards, specifically, the relationship between ApoE ε4 variant and behavioural symptoms. In fact, there is evidence supporting the link between being carriers of ApoE ε4 allele and severity of delusions, mostly at the early stage of the illness. In an interpretative challenge, we suggest that the link between being carriers of ApoE ε4 allele and suffering from delusions in AD may be explained by frontal Eur. J. Psychiat. Vol. 20, N.°2, (74-87) 2006 APOLIPOPROTEINE ε4 ALLELIC VARIANT, COGNETIVE DECLINE AND PSYCHOSIS... 75 lobe dysfunctions. Finally, we hypothesize that the most precocious onset of AD illness, described in carriers of ApoE ε4 allelic variant, may also be related to the precocious onset of psychotic symptoms, which produces caregiver and patient distress and requires immediate assessment and treatment.

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“…Of these various paradigms, the notion that spontaneous emboli, most likely due to systemic hypercoagulability, is of particular interest. AD patients have been documented to have abnormally increased activated Factor VII, von Willebrand factor and prothrombin 1+2 fragment in their circulation [13], the substrate and result of intravascular thrombin generation. Of interest, while patients with AD were noted to have fibrinogen concentrations that on average were not abnormally increased [13], another *Address correspondence to this author at the Department of Anesthesiology, the University of Arizona College of Medicine, P.O.…”

Section: Introductionmentioning

confidence: 99%

“…AD patients have been documented to have abnormally increased activated Factor VII, von Willebrand factor and prothrombin 1+2 fragment in their circulation [13], the substrate and result of intravascular thrombin generation. Of interest, while patients with AD were noted to have fibrinogen concentrations that on average were not abnormally increased [13], another *Address correspondence to this author at the Department of Anesthesiology, the University of Arizona College of Medicine, P.O. Box 245114; 1501 North Campbell Avenue, Tucson, AZ 85724-5114, USA; Tel: (520) 626-7195; Fax: (520) 626-6943; E-mail: vgnielsen@email.arizona.edu work noted that patient with mild cognitive impairment were at greater risk of more rapid advancement to AD if their circulating fibrinogen concentration was >300 mg/dl [14].…”

Section: Introductionmentioning

confidence: 99%

Carbon Monoxide and Iron Modulate Plasmatic Coagulation in Alzheimer’s disease

Nielsen¹,

Pretorius

Bester

et al. 2015

CNR

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Alzheimer's disease (AD) is a significant source of morbidity and mortality for millions of people worldwide, and multiple potential etiologies have been postulated to contribute to AD. Among these, spontaneous cerebral emboli and increased cerebral and circulating heme oxygenase (Hmox) activity in AD patients are of particular interest, as two of the products of Hmox activity, carbon monoxide (CO) and iron enhance plasmatic coagulation and modify the ultrastructure of thrombi. We hypothesized that patients afflicted with AD would have coagulation kinetics modulated by CO and iron. Using viscoelastic assessments of coagulation, it was determined with a small cohort (n=11) of AD patients that all had enhancement of coagulation by CO, iron, or both. In a complementary fashion, it was determined that a separate cohort (n=12) of AD patients had thrombi with ultrastructural features consistent with iron and CO exposure as assessed with scanning electron microscopy. Further, when stratified by normal or abnormally increased serum ferritin concentrations (which can be increased by Hmox), the AD patients with abnormal ferritin concentrations had significantly thinner fibrin fiber diameters, not unlike that noted when normal plasma is mixed with iron or CO. In sum, AD patients were noted to have plasmatic coagulation kinetic and thrombus ultrastructural changes consistent with exposure to CO and iron. Future investigation of CO and iron in the pathogenesis of Alzheimer's disease is warranted.

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Coagulation and inflammatory markers in Alzheimer's and vascular dementia

Cited by 78 publications

References 61 publications

Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke

Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke

ApolipoproteinE ε4 allelic variant, cognitive decline and psychosis in Alzheimer disease: a review of the literature and suggestions for upcoming studies

Carbon Monoxide and Iron Modulate Plasmatic Coagulation in Alzheimer’s disease

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