Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. CNS and Nutrition
3.2. Dysphagia
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- Safe behavioral interventions, such as adjusting food and fluid consistency, upright positioning for improving deglutition, and preventing aspiration;
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- Dietary modifications, such as high-calorie feeding to contrast loss of weight;
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- Nasal tube then/or percutaneous endoscopic gastrostomy (PEG) tube placement to elude an oral feeding deficit (Figure 2a,b).
Eastern Study | CJD Patients | Average Disease Duration Months | Nasal Tube | Median Period Akinetic State–Death | Gastrostomy |
---|---|---|---|---|---|
Iwasaki et al. [14] | 2 gCJD 10 sCJD | 27 | Yes | 22 | |
Iwasaki et al. [15] | 51 sCJD | 9 | 3 | ||
Nagoshi et al. [11] | 1128 sCJD and gCJD | 17.4 | |||
Hayashi et al. [7] | 1 gCJD | 64 | Yes | 50 | |
Kunieda et al. [17] | 1 gCJD | 72 | 42 | Yes | |
Iwasaki et al. [18] | 1 gCJD | 73 | Yes | 11 |
3.3. Tools of Nutrition Management
3.4. Neuroprotection by Nutrition in CJD
4. Discussion
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- ALS patients: regular assessment of BMI (body mass index), weight loss over time, lipid status, and a body composition analysis using DEXA (Dual-Energy X-ray Absorptiometry) or BIA (Bioelectrical Impedance Analysis) at diagnosis and every 3 months during follow-up in order to screen malnutrition and plan for nutritional supplementation and enteral feeding/gastrostomy.
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- PD patients: routine monitoring of dysphagia during the ON-phase in the advanced phases along with supplementation of vitamin D, vitamin B12, and folic acid throughout the disease course.
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- MS patients: early screening for swallowing disfunction, especially in those with cerebellar involvement, and the initiation of enteral nutrition as needed.
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- Stroke patients: during the acute phase, there is a high risk of malnutrition, aspiration pneumonia, and dehydration, so that the enteral feeding is often necessary, even if the condition is not irreversible.
5. Conclusions
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- A rigorous monitoring of swallowing function and weight loss to prevent malnutrition;
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- Long-term tube feeding when patients deteriorate to an akinetic mutism state or exhibit myoclonus along with elevated 14-3-3 protein levels in the CSF;
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- A nutritional intake of 500–1000 kcal/day, comprising 45% carbohydrates, 30% proteins, and 25% fats with 6 mg of vitamin B12 and 400 mg of folic acid;
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- Evaluation of gastrostomy, with comprehensive informed consent from the patient’s family, particularly when prolonged nasal tube feeding leads to complications such as nasal wing erosion and aspiration pneumonia;
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- Supplementation with ACNs, novel flavonoids, and curcumin.
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
Abbreviations
References
- Watson, N.; Brandel, J.P.; Green, A.; Hermann, P.; Ladogana, A.; Lindsay, T.; Mackenzie, J.; Pocchiari, M.; Smith, C.; Zerr, I.; et al. The importance of ongoing international surveillance for Creutzfeldt-Jakob disease. Nat. Rev. Neurol. 2021, 17, 362–379. [Google Scholar] [CrossRef] [PubMed]
- Zerr, I.; Parchi, P. Sporadic Creutzfeldt-Jakob disease. Handb. Clin. Neurol. 2018, 153, 155–174. [Google Scholar] [CrossRef] [PubMed]
- Pocchiari, M.; Puopolo, M.; Croes, E.A.; Budka, H.; Gelpi, E.; Collins, S.; Lewis, V.; Sutcliffe, T.; Guilivi, A.; Delasnerie-Laupretre, N.; et al. Predictors of survival in sporadic Creutzfeldt-Jakob disease and other human transmissible spongiform encephalopathies. Brain 2004, 127 Pt 10, 2348–2359. [Google Scholar] [CrossRef] [PubMed]
- Watson, N.; Hermann, P.; Ladogana, A.; Denouel, A.; Baiardi, S.; Colaizzo, E.; Giaccone, G.; Glatzel, M.; Green, A.J.E.; Haïk, S.; et al. Validation of Revised International Creutzfeldt-Jakob Disease Surveillance Network Diagnostic Criteria for Sporadic Creutzfeldt-Jakob Disease. JAMA Netw. Open. 2022, 5, e2146319. [Google Scholar] [CrossRef] [PubMed]
- Leung, C.W.; Insolera, N.E.; Wolfson, J.A.; McEvoy, C.T.; Ryan, L.H.; Friedman, E.M.; Langa, K.M.; Heeringa, S.G.; Hao, W. Food insecurity and dementia risk in US older adults: Evidence from the 2013–2021 Panel Study of Income Dynamics. J. Gerontol. B Psychol. Sci. Soc. Sci. 2024, 7, gbae153. [Google Scholar] [CrossRef]
- Du Preez, A.; Lefèvre-Arbogast, S.; González-Domínguez, R.; Houghton, V.; de Lucia, C.; Lee, H.; Low, D.Y.; Helmer, C.; Féart, C.; Delcourt, C.; et al. Association of dietary and nutritional factors with cognitive decline, dementia, and depressive symptomatology in older individuals according to a neurogenesis-centred biological susceptibility to brain ageing. Age Ageing 2024, 53 (Suppl. S2), ii47–ii59. [Google Scholar] [CrossRef]
- Hayashi, Y.; Kunieda, K.; Kudo, T.; Kimura, A.; Fujishima, I.; Shimohata, T. Long-term preservation of pharyngeal swallowing function in MM2-cortical-type sporadic Creutzfeldt-Jakob disease. Prion 2021, 15, 82–86. [Google Scholar] [CrossRef]
- Darbord, J.C. Importance of cleaning for reprocessing endoscopes and thermolabile sterile medical devices: French use and regulations. J. Hosp. Infect. 2004, 56 (Suppl. S2), S40–S43. [Google Scholar] [CrossRef]
- Niu, C.; Zhang, J.; Orakzai, A.; Boppana, L.K.T.; Elkhapery, A.; Verghese, B.; Okolo, P.I. Predictors and inpatient outcomes of aspiration pneumonia in patients with percutaneous endoscopic gastrostomy tube: An analysis of national inpatient sample. Clin. Res. Hepatol. Gastroenterol. 2024, 48, 102463. [Google Scholar] [CrossRef]
- Gauderer, M.W. Percutaneous endoscopic gastrostomy and the evolution of contemporary long-term enteral access. Clin. Nutr. 2002, 21, 103–110. [Google Scholar] [CrossRef]
- Nagoshi, K.; Sadakane; Sadakane, A.; Nakamura, Y.; Yamada, M.; Mizusawa, H. Duration of prion disease is longer in Japan than in other countries. J. Epidemiol. 2011, 21, 255–262. [Google Scholar] [CrossRef] [PubMed]
- Parchi, P.; Giese, A. Classification of sporadic Creutzfeldt-Jakob disease based on molecular and phenotypic analysis of 300 subjects. Ann. Neurol. 1999, 46, 224–233. [Google Scholar] [CrossRef] [PubMed]
- Collins, S.J.; Sanchez-Juan, P. Determinants of diagnostic investigation sensitivities across the clinical spectrum of sporadic Creutzfeldt-Jakob disease. Brain 2006, 129 Pt 9, 2278–2287. [Google Scholar] [CrossRef] [PubMed]
- Iwasaki, Y.; Mori, K.; Ito, M. Investigation of the clinical course and treatment of prion disease patients in the akinetic mutism state in Japan. Rinsho Shinkeigaku 2012, 52, 314–319. [Google Scholar] [CrossRef]
- Iwasaki, Y.; Akagi, A.; Mimuro, M.; Kitamoto, T.; Yoshida, M. Factors influencing the survival period in Japanese patients with sporadic Creutzfeldt-Jakob disease. J. Neurol. Sci. 2015, 357, 63–68. [Google Scholar] [CrossRef]
- Hsieh, P.C.; Li, H.T.; Chang, C.-W.; Wu, Y.-R.; Kuo, H.-C. Predictive factors for early initiation of artificial feeding in patients with sporadic Creutzfeldt-Jakob Disease. Front. Neurol. 2018, 9, 496. [Google Scholar] [CrossRef]
- Kunieda, K.; Hayashi, Y.; Yamada, M.; Waza, M.; Yaguchi, T.; Fujishima, I.; Shimohata, T. Serial evaluation of swallowing function in a long-term survivor of V180I genetic Creutzfeldt-Jakob disease. Prion 2020, 14, 180–184. [Google Scholar] [CrossRef]
- Iwasaki, Y.; Mori, K.; Ito, M.; Nokura, K.; Tatsumi, S.; Mimuro, M.; Kitamoto, T.; Yoshida, M. Gerstmann-Straeussler-Scheinker disease with P102L prion protein gene mutation presenting with rapidly progressive clinical course. Clin. Neuropathol. 2014, 33, 344–353. [Google Scholar] [CrossRef] [PubMed]
- Savica, R.; Petersen, R.C. Prevention of dementia. Psychiatr. Clin. N. Am. 2011, 34, 127–145. [Google Scholar] [CrossRef]
- Jansen, S.; Ball, L.; Desbrow, B.; Morgan, K.; Moyle, W.; Hughes, R. Nutrition and dementia care: Informing dietetic practice. Nutr. Diet. 2015, 72, 36–46. [Google Scholar] [CrossRef]
- Livingston, G.; Sommerlad, A.; Orgeta, V.; Costafreda, S.G.; Huntley, J.; Ames, D.; Ballard, C.; Banerjee, S.; Burns, A.; Cohen-Mansfield, J.; et al. Dementia prevention, intervention, and care. Lancet 2017, 390, 2673–2734. [Google Scholar] [CrossRef] [PubMed]
- Iwasaki, Y.; Mori, K.; Ito, M.; Kawai, Y.; Hoshino, K.-I.; Kawabata, Y.; Mimuro, M.; Yoshida, M. Gastrostomy in patients with prion disease. Prion 2017, 11, 186–194. [Google Scholar] [CrossRef]
- Li, P.; Feng, D.; Yang, D.; Li, X.; Sun, J.; Wang, G.; Tian, L.; Jiang, X.; Bai, W. Protective effects of anthocyanins on neurodegenerative diseases. Trends Food Sci. Technol. 2021, 117, 205–217. [Google Scholar] [CrossRef]
- Christoudia, N.; Bekas, N.; Kanata, E.; Chatziefsthathiou, A.; Pettas, S.; Karagianni, K.; Correia, S.M.D.S.; Schmitz, M.; Zerr, I.; Tsamesidis, I.; et al. Anti-prion effects of anthocyanins. Redox Biol. 2024, 72, 103133. [Google Scholar] [CrossRef]
- Glykofridi, P.; Tziouri, V.E.; Xanthopoulos, K.; Vlachou, M.-E.; Correia, S.; Fischer, A.-L.; Thüne, K.; Hatzidimitriou, A.; Zerr, I.; Schmitz, M.; et al. Synthesis, structural characterization and study of antioxidant and anti-PrPSc properties of flavonoids and their rhenium(I)-tricarbonyl complexes. J. Biol. Inorg. Chem. 2023, 28, 235–247. [Google Scholar] [CrossRef]
- Gagliardi, S.; Morasso, C.; Stivaktakis, P.; Pandini, C.; Tinelli, V.; Tsatsakis, A.; Prosperi, D.; Hickey, M.; Corsi, F.; Cereda, C. Curcumin formulations and trials: What’s new in neurological diseases. Molecules 2020, 25, 5389. [Google Scholar] [CrossRef] [PubMed]
- Nakatani, E.; Kanatani, Y.; Kaneda, H.; Nagai, Y.; Teramukai, S.; Nishimura, T.; Zhou, B.; Kojima, S.; Kono, H.; Fukushima, M.; et al. Specific clinical signs and symptoms are predictive of clinical course in sporadic Creutzfeldt-Jakob disease. Eur. J. Neurol. 2016, 23, 1455–1462. [Google Scholar] [CrossRef]
- Kluger, B.M.; Hudson, P.; Hanson, L.C.; Bužgovà, R.; Creutzfeldt, C.J. Palliative care to support the needs of adults with neurological disease. Lancet Neurol. 2023, 22, 619–631. [Google Scholar] [CrossRef] [PubMed]
- Harrison, K.L.; Garrett, S.B.; Gilissen, J.; Terranova, M.J.; Sideman, A.B.; Ritchie, C.S.; Geschwind, M.D. Developing neuropalliative care for sporadic Creutzfeldt-Jakob Disease. Prion 2022, 16, 23–39. [Google Scholar] [CrossRef]
- Burgos, R.; Bretón, I.; Cereda, E.; Desport, J.C.; Dziewas, R.; Genton, L.; Gomes, F.; Jésus, P.; Leischker, A.; Muscaritoli, M.; et al. ESPEN guideline clinical nutrition in neurology. Clin. Nutr. 2018, 37, 354–396. [Google Scholar] [CrossRef]
- Rahman, M.M.; Mim, S.A.; Islam, R.; Parvez, A.; Islam, F.; Uddin, M.B.; Rahaman, S.; Shuvo, P.A.; Ahmed, M.; Greig, N.H.; et al. Exploring the Recent Trends in Management of Dementia and Frailty: Focus on Diagnosis and Treatment. Curr. Med. Chem. 2022, 29, 5289–5314. [Google Scholar] [CrossRef] [PubMed]
- Hussein, S.; Ismail, M. Ageing and elderly care in the arab region: Policy challenges and opportunities. Ageing Int. 2017, 42, 274–289. [Google Scholar] [CrossRef] [PubMed]
- Nan, Y.; Feng, T.; Hu, Y.; Qi, X. Understanding aging policies in China: A bibliometric analysis of policy documents. Int. J. Environ. Res. Public Health 2020, 17, 5956. [Google Scholar] [CrossRef] [PubMed]
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Perna, A.; Santoro, M.; Colaizzo, E. Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences. Life 2024, 14, 1496. https://doi.org/10.3390/life14111496
Perna A, Santoro M, Colaizzo E. Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences. Life. 2024; 14(11):1496. https://doi.org/10.3390/life14111496
Chicago/Turabian StylePerna, Alessia, Massimo Santoro, and Elisa Colaizzo. 2024. "Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences" Life 14, no. 11: 1496. https://doi.org/10.3390/life14111496
APA StylePerna, A., Santoro, M., & Colaizzo, E. (2024). Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences. Life, 14(11), 1496. https://doi.org/10.3390/life14111496