Elevated Levels of Hemoglobin A1c Are Associated With Cerebral White Matter Disease in Patients With Stroke

Różański, Michał; Richter, Tobias; Grittner, Ulrike; Endres, Matthias; Fiebach, Jochen B.; Jungehülsing, Gerhard Jan

doi:10.1161/strokeaha.114.004740

Cited by 15 publications

(10 citation statements)

References 41 publications

(66 reference statements)

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“…Diabetes is a known risk factor for cognitive impairment, including both vascular and Alzheimer’s dementias [ 30 ], with cognitive changes likely to occur in older individuals [ 30 ]. Like others, we found associations between diabetic risk and WMH burden [ 31, 32 ] implicating cerebrovascular disease as a significant contributor to cognitive impairment in diabetic elderly. It has been shown, however, that the risk for AD in diabetics remains strong even after controlling for CVD risk factors, supporting shared molecular pathways between AD and diabetes, including greater neuronal insulin resistance, amyloid- β (A β ) aggregation, tau hyperphosphorylation, and reduced A β clearance [ 30, 33 ], all of which might be possible contributors to early cortical changes.…”

Section: Discussionsupporting

confidence: 85%

Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly

Silbert

Lahna

Promjunyakul

et al. 2018

JAD

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Background:Cortical gray matter (GM) and white matter (WM) deterioration are signals of neurodegeneration and increased dementia risk; however, their specific etiologies in dementia-free aging is unclear.Objective:The objective of this study was to examine potentially modifiable risk factors of GM and WM degeneration in a well-characterized cohort of dementia-free elderly.Methods:96 Okinawan elderly participants (age 83.6) from the Keys to Optimal Cognitive Aging Project (KOCOA) underwent MRI and cognitive evaluation. Serum markers of inflammation (interleukin-6 (IL-6), high sensitivity C-reactive protein), cerebrovascular disease (systolic blood pressure (SBP) 140+, hemoglobin A1C (HgbA1C), total cholesterol), and essential minerals (copper (Cu), magnesium, and calcium) were examined in relation to mean cortical thickness (MCT) and white matter hyperintensities (WMH), adjusting for age and gender. Voxel-based morphometry (VBM) analyses identified relationships between regional GM density and the above markers.Results:Decreased MCT was associated with SBP 140 + (p = 0.029) and increased serum IL-6 (p = 0.036), HgbA1C (p = 0.002), and Cu (p = 0.025). In VBM analyses, increased IL-6, HgbA1C, and Cu were associated with decreased GM density in temporal lobe regions. HgbA1C (p = 0.004) was associated with greater WMH volume.Conclusions:Peripheral markers of Cu, CVD risk, and inflammation are associated with MRI-markers of decreased brain health in dementia-free Okinawan elderly, with regional cortical thinning in areas involved in early accumulation of Alzheimer’s disease pathology. Results identify potentially modifiable biomarkers as targets in the prevention of dementia in older individuals.

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Section: Discussionsupporting

confidence: 85%

Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly

Silbert

Lahna

Promjunyakul

et al. 2018

JAD

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“…This is based on their different absorption spectra of near infrared light and with respect to a resting baseline condition. Evidence of an association between haemoglobin levels and white matter [ 51 ] suggests that the developmental brain changes discussed earlier may also be evident in changes in haemodynamic concentration as measured by fNIRS. More specifically, fNIRS has been used to show that increases in prefrontal activation are associated with increases in development [ 24 , 52 ] such associations have also been found using fMRI [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Prefrontal Cortex Activation and Young Driver Behaviour: A fNIRS Study

2016

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Road traffic accidents consistently show a significant over-representation for young, novice and particularly male drivers. This research examines the prefrontal cortex activation of young drivers and the changes in activation associated with manipulations of mental workload and inhibitory control. It also considers the explanation that a lack of prefrontal cortex maturation is a contributing factor to the higher accident risk in this young driver population. The prefrontal cortex is associated with a number of factors including mental workload and inhibitory control, both of which are also related to road traffic accidents. This experiment used functional near infrared spectroscopy to measure prefrontal cortex activity during five simulated driving tasks: one following task and four overtaking tasks at varying traffic densities which aimed to dissociate workload and inhibitory control. Age, experience and gender were controlled for throughout the experiment. The results showed that younger drivers had reduced prefrontal cortex activity compared to older drivers. When both mental workload and inhibitory control increased prefrontal cortex activity also increased, however when inhibitory control alone increased there were no changes in activity. Along with an increase in activity during overtaking manoeuvres, these results suggest that prefrontal cortex activation is more indicative of workload in the current task. There were no differences in the number of overtakes completed by younger and older drivers but males overtook significantly more than females. We conclude that prefrontal cortex activity is associated with the mental workload required for overtaking. We additionally suggest that the reduced activation in younger drivers may be related to a lack of prefrontal maturation which could contribute to the increased crash risk seen in this population.

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“…Thus, this aggravates ischemic injury. This phenomenon is known as cerebral ischemia/ reperfusion injury (CIRI) (3). The pathogenesis of CIRI is more complex than that of pure hypoxic-ischemic brain damage and is associated with nerve cell apoptosis, the breakdown of high energy phosphate compounds, lipid peroxidation, inflammatory reactions, the toxic effects of excitatory amino acids, calcium overload, the functions of nitric oxide (NO) and endothelial cell dysfunction (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

SIRT1 exerts neuroprotective effects by attenuating cerebral ischemia/reperfusion-induced injury via targeting p53/microRNA-22

Wang

2016

International Journal of Molecular Medicine

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Abstract. The aim of this study was to investigate whether the SIRT1 exerts neuroprotective effects by attenuating cerebral ischemia/reperfusion-induced injury (CIRI) via targeting p53/microRNA-22. We found that the overexpression of sirtuin 1 (SIRT1) decreased the infarct volume, suppressed p53 protein expression and activated microRNA-22 expression following CIRI. An injection of lipopolysaccharide (LPS, 1 mg/ml; Sigma, St. Louis, MO USA) into the corpus callosum was used to induce CIRI in rats. The infarct volume and neurological deficit score were used to examine the effects of SIRT1 on CIRI. Furthermore, the overexpression of SIRT1 was found to suppress caspase-3 activity, inhibit the activation of the Bax signaling pathway, reduce tumor necrosis factor-α (TNF-α) and interleukin (IL)-6) activity, decrease cyclooxygenase (COX)-2 and inducible nitric oxide synthase (iNOS) protein expression, and increase IL-10 activity following CIRI. Following the downregulation of SIRT1, p53 protein expression was significantly increased, microRNA-22 expression was inhibited, caspase-3 activity was increased and the Bax signaling pathway was activated. In addition, the activity of TNF-α and IL-6 was was enhanced, COX-2 and iNOS protein expression was increased, and IL-10 activity was reduced following CIRI. Thus, the data from our study suggest that SIRT1 attenuates CIRI by targeting the p53/microRNA-22 axix, while suppressing apoptosis, inflammation, COX-2 and iNOS expression.

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Elevated Levels of Hemoglobin A1c Are Associated With Cerebral White Matter Disease in Patients With Stroke

Cited by 15 publications

References 41 publications

Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly

Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly

Prefrontal Cortex Activation and Young Driver Behaviour: A fNIRS Study

SIRT1 exerts neuroprotective effects by attenuating cerebral ischemia/reperfusion-induced injury via targeting p53/microRNA-22

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