Is It Possible to Treat Vascular Dementia?

Zekry, Dina

doi:10.1159/000197888

Cited by 6 publications

(7 citation statements)

References 43 publications

(34 reference statements)

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“…According to DSM-IV-TR criteria, the presence of stroke per se in a demented individual excludes a diagnosis of AD. However, our results, as well as those from other recent studies, show that VaD patients usually have "mixed" pathology 24,25. In this context, our findings suggests that poststroke CIND can be regarded as subclinical AD if there is MTA or memory dysfunction, and that cholinesterase inhibitors or memantine can be beneficial for these individuals.…”

Section: Discussionsupporting

confidence: 79%

Medial Temporal Atrophy and Memory Dysfunction in Poststroke Cognitive Impairment-No Dementia

Kim

Jang

et al. 2012

J Clin Neurol

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Background and PurposeIt was recently reported that the prevalence of poststroke memory dysfunction might be higher than previously thought. Stroke may exist concomitantly with underlying Alzheimer's disease (AD), and so we determined whether post-stroke memory dysfunction indicates manifestation of underlying subclinical AD.MethodsOf 1201 patients in a prospective cognitive assessment database, we enrolled subjects with poststroke amnestic vascular cognitive impairment-no dementia (aVCIND; n=48), poststroke nonamnestic vascular cognitive impairment-no dementia (naVCIND; n=50), and nonstroke amnestic mild cognitive impairment (aMCI; n=65). All subjects had cognitive deficits, but did not meet the criteria for dementia. A standardized neuropsychological test battery and magnetic resonance imaging were performed at least 90 days after the index stroke (mean, 473 days). Visual assessment of medial temporal atrophy (MTA) was used as a measure of underlying AD pathology.ResultsThe MTA score was significantly lower in the naVCIND group (0.64±0.85, mean±SD) than in the aVCIND (1.10±1.08) and aMCI (1.45±1.13; p<0.01) groups. Multivariable ordinal logistic regression analysis revealed that compared with naVCIND, aVCIND [odds ratio (OR)=2.69; 95% confidence interval (CI)=1.21-5.99] and aMCI (OR=5.20; 95% CI=2.41-11.23) were significantly associated with increasing severity of MTA.ConclusionsOur findings show that compared with poststroke naVCIND, the odds of having more-severe MTA were increased for poststroke aVCIND and nonstroke aMCI.

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Section: Discussionsupporting

confidence: 79%

Medial Temporal Atrophy and Memory Dysfunction in Poststroke Cognitive Impairment-No Dementia

Kim

Jang

et al. 2012

J Clin Neurol

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“…However, the increase in risk of developing dementia with a vascular component for the combined ApoEe4/CCR5-Δ32 genotype is such that this notion might have to be reconsidered. Presently, vascular dementia is not curable but preventable [45]. Can the ApoEe4/CCR5-Δ32 constellation be used to predict conversion to dementia with a vascular component?…”

Section: Discussionmentioning

confidence: 99%

CCR5 deficiency: decreased neuronal resilience to oxidative stress and increased risk of vascular dementia

Tournier

Sorce

Marteyn

et al. 2023

Preprint

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Introduction. As the chemokine receptor5 (CCR5) may play a role in ischemia, we studied the links between CCR5 deficiency, the sensitivity of neurons to oxidative stress, and the development of dementia. Methods. Logistic regression models with CCR5 and ApoE polymorphisms were applied to 205 cognitively normal and 189 dementia patients included in Geneva. The impact of oxidative stress on Ccr5 expression and cell death was assessed in mice neurons. Results. CCR5-Δ32 allele synergized with ApoEε4 as risk factor for dementia and specifically for dementia with a vascular component. We confirmed these results in an independent cohort from Italy (157 cognitively normal and 620 dementia). Carriers of the ApoEε4/CCR5-Δ32 genotype aged ≥80 years have an eleven-fold greater risk of vascular and mixed dementia. Oxidative stress induced cell death in Ccr5-/- mice neurons. Discussion. We propose the vulnerability of CCR5-deficient neurons in response to oxidative stress as possible mechanisms contributing to dementia.

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“…Medications currently used in the treatment of VaD, including cholinesterase inhibitors such as donepezil and non-cholinergics such as memantine ( 26 , 27 ), have been proven to be efficient to a certain extent. Owing to the limitations of these drugs ( 28 ), however, an increasing number of patients and clinician have resorted to using herbal medications to treat VaD.…”

Section: Discussionmentioning

confidence: 99%

Yifei Xuanfei Jiangzhuo formula, a Chinese herbal decoction, improves memory impairment through inhibiting apoptosis and enhancing PKA/CREB signal transduction in rats with cerebral ischemia/reperfusion

Zhao

et al. 2015

Molecular Medicine Reports

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Apoptosis and the dysfunction of the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/cAMP-responsive element binding protein (CREB) signaling pathway have a key role in memory impairment in vascular dementia (VaD), a challenging clinical problem. Yifei Xuanfei Jiangzhuo formula (YXJF), a Chinese herbal decoction, has been used to treat VaD in clinical practice and has produced positive outcomes; however, convincing evidence is currently lacking. The present study aimed to investigate the effects of YXJF on memory impairment in rats with cerebral ischemia/reperfusion and to explore the underlying mechanism. YXJF ameliorated memory impairment in rats with cerebral ischemia/reperfusion, inhibited hippocampal apoptosis in a dose-dependent manner and attenuated increases in the protein expression of B-cell lymphoma 2 (Bcl-2)-associated X protein as well as c-Jun and a reduction in Bcl-2 protein expression in the hippocampal tissue of the rats. Furthermore, administration of YXJF significantly increased the protein expression of PKA C-α and CREB, and promoted CREB phosphorylation. The results indicated that YXJF improves memory impairment through inhibiting apoptosis and enhancing PKA/CREB signal transduction in rats with cerebral ischemia/reperfusion.

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Is It Possible to Treat Vascular Dementia?

Cited by 6 publications

References 43 publications

Medial Temporal Atrophy and Memory Dysfunction in Poststroke Cognitive Impairment-No Dementia

Medial Temporal Atrophy and Memory Dysfunction in Poststroke Cognitive Impairment-No Dementia

CCR5 deficiency: decreased neuronal resilience to oxidative stress and increased risk of vascular dementia

Yifei Xuanfei Jiangzhuo formula, a Chinese herbal decoction, improves memory impairment through inhibiting apoptosis and enhancing PKA/CREB signal transduction in rats with cerebral ischemia/reperfusion

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