Sundown syndrome in patients with Alzheimer’s disease dementia

Menegardo, Cristiani Sartorio; Friggi, Fernanda Alencar; Scardini, Julia Baldon; Rossi, Tais Souza; Vieira, Thais Dos Santos; Tieppo, Alessandra; Morelato, Renato Lírio

doi:10.1590/1980-57642018dn13-040015

Cited by 15 publications

(13 citation statements)

References 20 publications

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“…Mild cognitive impairment and AD are frequently associated with low melatonin circulating concentrations in animal models [ 193 ]. With regard to clinical trials involving melatonin administration to humans, recent studies support the efficacy of melatonin in improving cognitive deterioration and reducing the so-called “sundown” effect [ 194 ]. The sundown phenomenon implies the aggravation of specific symptoms such as disorganized thinking, agitation, emotional lability, and attention deficit in the evening.…”

Section: Melatonin Effects In Neuronal Inflammation and Degeneratimentioning

confidence: 99%

Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease

et al. 2020

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There is a growing consensus that the antioxidant and anti-inflammatory properties of melatonin are of great importance in preserving the body functions and homeostasis, with great impact in the peripartum period and adult life. Melatonin promotes adaptation through allostasis and stands out as an endogenous, dietary, and therapeutic molecule with important health benefits. The anti-inflammatory and antioxidant effects of melatonin are intertwined and are exerted throughout pregnancy and later during development and aging. Melatonin supplementation during pregnancy can reduce ischemia-induced oxidative damage in the fetal brain, increase offspring survival in inflammatory states, and reduce blood pressure in the adult offspring. In adulthood, disturbances in melatonin production negatively impact the progression of cardiovascular risk factors and promote cardiovascular and neurodegenerative diseases. The most studied cardiovascular effects of melatonin are linked to hypertension and myocardial ischemia/reperfusion injury, while the most promising ones are linked to regaining control of metabolic syndrome components. In addition, there might be an emerging role for melatonin as an adjuvant in treating coronavirus disease 2019 (COVID 19). The present review summarizes and comments on important data regarding the roles exerted by melatonin in homeostasis and oxidative stress and inflammation related pathologies.

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Section: Melatonin Effects In Neuronal Inflammation and Degeneratimentioning

confidence: 99%

Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease

et al. 2020

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“…The fatigability has been rarely related to cerebellar dysfunction [15,16], but could be caused in this patients by altered connections between cerebellum and prefrontal cortex [17] or bilateral glodi pallidi dysconnection [18]. In patients with myasthenia-like symptoms who tested negatively for myasthenia gravis, neurodegenerative diseases [19] comprising inherited and autoimmune cerebellar ataxia [14,20], and disorders of the hypothalamus [21], a diagnosis of ECD should be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar ataxia and exercise intolerance in Erdheim-Chester disease

et al. 2021

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Background Erdheim-Chester disease (ECD), a rare disorder of monocyte/macrophage lineage, has been related to cerebellar dysfunction. To increase the awareness of this rare, protean disease, an unusual, myasthenia-like onset of ECD is reported. Case presentation A 42-year-old man presented with a 6-year history of mild evening fatigability in his four limbs followed by motor and cognitive symptoms associated with cerebellar atrophy, dentate nuclei and dentato-thalamic pathway degeneration. Magnetic resonance imaging revealed hyperintense signals in T2 and fluid-attenuated inversion recovery sequences within the pons, cerebellar white matter, dentate nuclei and globi pallidi in the absence of any contrast enhancement. Whole-body bone scintigraphy with 99Technetium - methylene diphosphonate and fluorodeoxyglucose-positron emission tomography both revealed symmetric uptake in the lower extremities a finding suggestive of a diagnosis of ECD. Histological examination revealed diffuse infiltration of CD 68+ histiocytes with foamy cytoplasms in the presence of B-type of Rapidly Accelerated Fibrosarcoma protein kinase (BRAF)V600E activating mutation in tumor cells. Conclusion In patients with myasthenia-like symptoms who test negatively for myasthenia gravis, neurodegenerative diseases, and disorders of the hypothalamus, a diagnosis of ECD should be taken into consideration.

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“…Indeed, while pyramidal and extrapyramidal symptoms are frequently reported in patients with ECD (6,9), the occurrence of myasthenia-like symptoms with evening fatigability has never previously been described in this patient population, to the best of our knowledge. In patients with myasthenia-like symptoms who tested negatively for myasthenia gravis, neurodegenerative diseases (10), and disorders of the hypothalamus (11), a diagnosis of ECD should be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Myasthenia-Like Presentation in Erdheim-Chester Disease

Lauricella

d’Amati

Ingravallo

et al. 2020

Preprint

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Background: Erdheim-Chester disease (ECD), a rare disorder of monocyte/macrophage lineage, has been related to cerebellar dysfunction. To increase the awareness of this rare, protean disease, an unusual, myasthenia-like onset of ECD is reported.Case presentation: A 42-year-old man presented with a 6-year history of mild evening fatigability in his four limbs followed by motor and cognitive symptoms associated with cerebellar atrophy, dentate nuclei and dentato-thalamic pathway degeneration. Magnetic resonance imaging revealed hyperintense signals in T2 and fluid-attenuated inversion recovery sequences within the pons, cerebellar white matter, dentate nuclei and globi pallidi in the absence of any contrast enhancement. Whole-body bone scintigraphy with 99Technetium - methylene diphosphonate and fluorodeoxyglucose-positron emission tomography both revealed symmetric uptake in the lower extremities a finding suggestive of a diagnosis of ECD. Histological examination revealed diffuse infiltration of CD 68+ histiocytes with foamy cytoplasms in the presence of B-type of Rapidly Accelerated Fibrosarcoma protein kinase (BRAF)V600E activating mutation in tumor cells.Conclusion: In patients with myasthenia-like symptoms who test negatively for myasthenia gravis, neurodegenerative diseases, and disorders of the hypothalamus, a diagnosis of ECD should be taken into consideration.

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Sundown syndrome in patients with Alzheimer’s disease dementia

Cited by 15 publications

References 20 publications

Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease

Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease

Cerebellar ataxia and exercise intolerance in Erdheim-Chester disease

An Unusual Case of Myasthenia-Like Presentation in Erdheim-Chester Disease

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