Journal of Clinical Medicine

Research

17 pages, 1627 KiB

Open AccessArticle

Task-Oriented Circuit Training as an Alternative to Ergometer-Type Aerobic Exercise Training after Stroke

by Liam P. Kelly, Augustine J. Devasahayam, Arthur R. Chaves, Marie E. Curtis, Edward W. Randell, Jason McCarthy, Fabien A. Basset and Michelle Ploughman

J. Clin. Med. 2021, 10(11), 2423; https://doi.org/10.3390/jcm10112423 - 30 May 2021

Cited by 1 | Viewed by 5171

Abstract

Moderate-intensity aerobic exercise training is an important treatment strategy to enhance functional recovery and decrease cardiometabolic risk factors after stroke. However, stroke related impairments limit access to ergometer-type exercise. The aims of the current study were (1) to evaluate whether our task-oriented circuit [...] Read more.

Moderate-intensity aerobic exercise training is an important treatment strategy to enhance functional recovery and decrease cardiometabolic risk factors after stroke. However, stroke related impairments limit access to ergometer-type exercise. The aims of the current study were (1) to evaluate whether our task-oriented circuit training protocol (intermittent functional training; IFT) could be used to sustain moderate-intensity aerobic workloads over a 10-week intervention period, and (2) to investigate its preliminary effects on cardiorespiratory fitness and metabolic profiles compared to constant-load ergometer-type exercise (CET). Forty chronic hemiparetic stroke survivors were randomized to receive 30 sessions of IFT or CET over ten weeks. Similar proportions of participants were randomized to IFT (7/19) and CET (9/18) sustained workloads associated with moderate-intensity aerobic exercise over the study period (p = 0.515). However, CET was associated with more substantial changes in maximal oxygen uptake (MD = 2.79 mL min⁻¹ kg⁻¹ CI: 0.84 to 4.74) compared to IFT (MD = 0.62 mL min⁻¹ kg⁻¹ CI: −0.38 to 1.62). Pre to post changes in C-reactive protein (−0.9 mg/L; p =0.017), short-term glycemia (+14.7 mol/L; p = 0.026), and resting whole-body carbohydrate oxidation (+24.2 mg min⁻¹; p = 0.046) were observed when considering both groups together. Accordingly, IFT can replicate the aerobic intensities sustained during traditional ergometer-type exercise training. More work is needed to evaluate the dose–response effects of such task-oriented circuit training protocols on secondary prevention targets across the continuum of stroke recovery. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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17 pages, 1083 KiB

Open AccessArticle

A Novel Nutraceutical Formulation Can Improve Motor Activity and Decrease the Stress Level in a Murine Model of Middle-Age Animals

by Dimitris Tsoukalas, Ovidiu Zlatian, Mihaela Mitroi, Elisavet Renieri, Aristidis Tsatsakis, Boris Nikolaevich Izotov, Florin Burada, Simona Sosoi, Emilia Burada, Ana Maria Buga, Ion Rogoveanu, Anca Oana Docea and Daniela Calina

J. Clin. Med. 2021, 10(4), 624; https://doi.org/10.3390/jcm10040624 - 6 Feb 2021

Cited by 32 | Viewed by 3623

Abstract

Ageing is a genetically programmed physiological process that is modulated by numerous environmental factors, associated with decreasing physiological function, decreasing reproductive rate and increasing age-related mortality rate. Maintaining mobility performance and physical function in the elderly is the main objective of the successful [...] Read more.

Ageing is a genetically programmed physiological process that is modulated by numerous environmental factors, associated with decreasing physiological function, decreasing reproductive rate and increasing age-related mortality rate. Maintaining mobility performance and physical function in the elderly is the main objective of the successful ageing concept. In this study, we aimed to evaluate the beneficial effect of a novel nutraceutical formulation containing Centella asiatica L. extract, vitamin C, zinc and vitamin D3 (as cholecalciferol) on motor activity and anxiety with the use of a murine model of old animals, as a means of providing proof for clinical use in the elderly, for enhancing physical strength and improving life quality. Eighteen Sprague Dawley 18 months old male rats were divided into three groups and received corn oil (the control group) or 1 capsule/kg bw Reverse supplement (treatment group 1) or 2 capsules/kg bw Reverse supplement (treatment group 2), for a period of 3 months. The Reverse supplement (Natural Doctor S.A, Athens, Greece) contains 9 mg Centella asiatica L. extract, vitamin C (200 mg as magnesium ascorbate), zinc (5 mg as zinc citrate), vitamin D3 (50 µg as cholecalciferol) per capsule. Before and after the treatment, the motor function and behavioral changes for anxiety and depression were evaluated using the open-field test, elevated plus-maze test and rotarod test. The supplementation with Reverse (Natural Doctor S.A) supplement can improve the locomotor activity in old rats in a dose-dependent manner, as demonstrated by an increase in the latency to leave from the middle square, in the number of rearings in the open field test, in the time spent in the open arms and time spent in the center in the elevated plus-maze test and the latency to all in all three consecutive trials in the rotarod test. Stress also decreased significantly in a dose-dependent manner, following the treatment with Reverse supplement, as was demonstrated by the decrease in the number of groomings at the open field test and time spent in the dark and the number of groomings at the elevated plus-maze test. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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9 pages, 278 KiB

Open AccessArticle

ADORA2A rs5760423 and CYP1A2 rs762551 Polymorphisms as Risk Factors for Parkinson’s Disease

by Vasileios Siokas, Athina-Maria Aloizou, Zisis Tsouris, Ioannis Liampas, Panagiotis Liakos, Daniela Calina, Anca Oana Docea, Aristidis Tsatsakis, Dimitrios P. Bogdanos, Georgios M. Hadjigeorgiou and Efthimios Dardiotis

J. Clin. Med. 2021, 10(3), 381; https://doi.org/10.3390/jcm10030381 - 20 Jan 2021

Cited by 27 | Viewed by 2935

Abstract

Background: Parkinson’s disease (PD) is the second commonest neurodegenerative disease. The genetic basis of PD is indisputable. Both ADORA2A rs5760423 and CYP1A2 rs762551 have been linked to PD, to some extent, but the exact role of those polymorphisms in PD remains controversial. Objective: [...] Read more.

Background: Parkinson’s disease (PD) is the second commonest neurodegenerative disease. The genetic basis of PD is indisputable. Both ADORA2A rs5760423 and CYP1A2 rs762551 have been linked to PD, to some extent, but the exact role of those polymorphisms in PD remains controversial. Objective: We assessed the role of ADORA2A rs5760423 and CYP1A2 rs762551 on PD risk. Methods: We genotyped 358 patients with PD and 358 healthy controls for ADORA2A rs5760423 and CYP1A2 rs762551. We also merged and meta-analyzed our data with data from previous studies, regarding these two polymorphisms and PD. Results: No significant association with PD was revealed (p > 0.05), for either ADORA2A rs5760423 or CYP1A2 rs762551, in any of the examined genetic model of inheritance. In addition, results from meta-analyses yield negative results. Conclusions: Based on our analyses, it appears rather unlikely that ADORA2A rs5760423 or CYP1A2 rs762551 is among the major risk factors for PD, at least in Greek patients with PD. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

14 pages, 1507 KiB

Open AccessArticle

Estimating Minimal Clinically Important Differences for Knee Range of Motion after Stroke

by Agnieszka Guzik, Mariusz Drużbicki, Andżelina Wolan-Nieroda, Andrea Turolla and Pawel Kiper

J. Clin. Med. 2020, 9(10), 3305; https://doi.org/10.3390/jcm9103305 - 15 Oct 2020

Cited by 29 | Viewed by 4081

Abstract

The importance of knee sagittal kinematic parameters, as a predictor of walking performance in post-stroke gait has been emphasised by numerous researchers. However, no studies so far were designed to determine the minimal clinically important differences (MCID), i.e., the smallest difference in the [...] Read more.

The importance of knee sagittal kinematic parameters, as a predictor of walking performance in post-stroke gait has been emphasised by numerous researchers. However, no studies so far were designed to determine the minimal clinically important differences (MCID), i.e., the smallest difference in the relevant score for the kinematic gait parameters, which are perceived as beneficial for patients with stroke. Studies focusing on clinically important difference are useful because they can identify the clinical relevance of changes in the scores. The purpose of the study was to estimate the MCID for knee range of motion (ROM) in the sagittal plane for the affected and unaffected side at a chronic stage post-stroke. Fifty individuals were identified in a database of a rehabilitation clinic. We estimated MCID values using: an anchor-based method, distribution-based method, linear regression analysis and specification of the receiver operating characteristic (ROC) curve. In the anchor-based study, the mean change in knee flexion/extension ROM for the affected/unaffected side in the MCID group amounted to 8.48°/6.81° (the first MCID estimate). In the distribution-based study, the standard error of measurement for the no-change group was 1.86°/5.63° (the second MCID estimate). Method 3 analyses showed 7.71°/4.66° change in the ROM corresponding to 1.85-point change in the Barthel Index. The best cut-off point, determined with ROC curve, was the value corresponding to 3.9°/3.8° of change in the knee sagittal ROM for the affected/unaffected side (the fourth MCID estimate). We have determined that, in chronic stroke, MCID estimates of knee sagittal ROM for the affected side amount to 8.48° and for the unaffected side to 6.81°. These findings will assist clinicians and researchers in interpreting the significance of changes observed in kinematic sagittal plane parameters of the knee. The data are part of the following clinical trial: Australian New Zealand Clinical Trials Registry: ACTRN12617000436370 Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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14 pages, 280 KiB

Open AccessArticle

Knowledge on Signs and Risk Factors in Stroke Patients

by Raúl Soto-Cámara, Jerónimo J. González-Bernal, Josefa González-Santos, José M. Aguilar-Parra, Rubén Trigueros and Remedios López-Liria

J. Clin. Med. 2020, 9(8), 2557; https://doi.org/10.3390/jcm9082557 - 7 Aug 2020

Cited by 37 | Viewed by 8903

Abstract

Background: There is a pressing need to contribute evidence to the improvement in the early identification of signs and symptoms associated with strokes, and address the treatment-seeking delays. The objective of this study is to describe the knowledge regarding the warning signs and [...] Read more.

Background: There is a pressing need to contribute evidence to the improvement in the early identification of signs and symptoms associated with strokes, and address the treatment-seeking delays. The objective of this study is to describe the knowledge regarding the warning signs and risk factors (RFs) among stroke patients, as well as of their attitudes toward a suspected event, and the analysis of its possible relationship with the socio-demographic and clinical characteristics of these patients. Method: A cross-sectional study was designed, in which all stroke patients admitted consecutively to the Burgos University Hospital (Spain) were included. The principal outcomes were the patient’s ability to identify two RFs and two warning signs and the patient’s hypothetical response to a possible stroke event. The possible factors associated with the knowledge of warning signs, RFs, and the correct response to a new event were studied using univariate and multivariate regression analysis. Results: A total of 529 patients were included. Having a higher education level or a history of prior stroke were associated with a greater degree of knowledge of warning signs (odds ratio (OR) 3.19, 95% confidence interval (CI) 1.70–5.74, p = 0.003; OR 3.54, 95%CI 2.09–5.99, p ≤ 0.001, respectively), RFs (OR 3.15, 95%CI 1.75–5.67, p = 0.008; OR 4.08, 95%CI 2.41–6.91, p = 0.002, respectively), and the correct response to a possible stroke (OR 1.82, 95%CI 1.16–2.86; p = 0.030; OR 2.11, 95%CI 1.29–3.46, p = 0.022, respectively). Conclusion: Knowledge of warning signs or stroke RFs is low in the hospitalized patients. A previous stroke or secondary/higher education levels are the predictor factors that increase the probability of knowledge of warning signs, RFs, or reaction to possible event. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

12 pages, 737 KiB

Open AccessArticle

Age-Related Risk Factors at the First Stroke Event

by Raúl Soto-Cámara, Jerónimo J. González-Bernal, Josefa González-Santos, José M. Aguilar-Parra, Rubén Trigueros and Remedios López-Liria

J. Clin. Med. 2020, 9(7), 2233; https://doi.org/10.3390/jcm9072233 - 14 Jul 2020

Cited by 19 | Viewed by 4592

Abstract

(1) Background: Stroke is a multifactorial disease, which can affect individuals at any age. Risk factors (RFs) associated with the first stroke event have been well identified; however, the influence of these RFs on the patient’s age needs to be studied. (2) Objective: [...] Read more.

(1) Background: Stroke is a multifactorial disease, which can affect individuals at any age. Risk factors (RFs) associated with the first stroke event have been well identified; however, the influence of these RFs on the patient’s age needs to be studied. (2) Objective: This study aimed to examine the effect of modifiable RFs on the age at which a stroke occurs. (3) Methods: A cross-sectional study was conducted on patients admitted consecutively with a first-ever acute stroke at the Burgos University Hospital (Spain). Data on sociodemographic and clinical parameters were collected (high blood pressure (HBP), smoking habit, diabetes mellitus (DM), dyslipemia, abdominal obesity, sedentary lifestyle, alcohol consumption, and cardiovascular diseases). The possible associations between RFs and age were studied using univariate and multivariate regression analyses and a decision tree. (4) Results: A total of 436 patients with a mean age of 75.39 years (standard deviation (SD) ± 12.67) were included. HBP and overweight/obesity were the most prevalent stroke RFs. Being an active smoker (OR 21.48; 95% confidence interval (CI) 8.80–52.41), having a sedentary lifestyle (OR 3.24; 95% CI 1.97–5.31), being an excessive alcohol drinker (OR 2.36; 95% CI 1.45–3.84), or being overweight or obese (OR 1.95; 95% CI 1.14–3.34) increased the risk of having an acute cerebrovascular event in individuals aged 75 years or below. However, a personal history of HBP (OR 0.40; 95% CI 0.24–0.67) was significantly associated with a greater likelihood of having an acute stroke in individuals aged more than 75 years. (5) Conclusions: This study showed that the modifiable RFs strongly influence the first stroke event in patients aged below 75 years, which will be useful in guiding different prevention strategies. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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12 pages, 965 KiB

Open AccessArticle

Personal Autonomy as Quality of Life Predictor for Multiple Sclerosis Patients

by Rodica Padureanu, Carmen Valeria Albu, Ionica Pirici, Radu Razvan Mititelu, Mihaela Simona Subtirelu, Razvan Aurelian Turcu-Stiolica, Harri Sintonen, Vlad Padureanu and Adina Turcu-Stiolica

J. Clin. Med. 2020, 9(5), 1349; https://doi.org/10.3390/jcm9051349 - 5 May 2020

Cited by 6 | Viewed by 3151

Abstract

Multiple sclerosis (MS) is a chronic, severe disease, characterized by a progressive alteration in neuronal transmission, which decreases personal independence and quality of life (QoL). This study aimed to investigate the relationship between QoL and personal autonomy in patients with MS, as well [...] Read more.

Multiple sclerosis (MS) is a chronic, severe disease, characterized by a progressive alteration in neuronal transmission, which decreases personal independence and quality of life (QoL). This study aimed to investigate the relationship between QoL and personal autonomy in patients with MS, as well as its correlation with age, educational level, and diseases severity. Twenty-six MS patients were followed-up for six months. All patients completed the 15D questionnaire two times: at T0, when they started a new treatment, and at T1 after six months of treatment. At the end point, all patients completed the Personal Autonomy Questionnaire. The average patient age was 43 years (SD = 10), and 89% of them were female. The mean severity and duration of MS were 3.5 (SD = 1.75) and 9.5 (SD = 5.1), respectively. The average QoL of MS patients at T0 was 0.66 (SD = 0.18), and that at T1 was 0.71 (SD = 0.16). The scores of patients with different types of MS, i.e., relapsing–remitting MS (RRMS) or secondary progressive MS (SPMS), were compared. SPMS patients were older than RRMS patients (mean age 47.5 vs. 39.7 years; p = 0.032), and more RRMS patients were working (0.014). SPMS patients described the same QoL and personal autonomy as RRMS patients. Results from bivariate correlation analyses showed a significant relationship between QoL and age, education, and severity of MS. Also, the analysis showed no significant correlation between QoL and personal autonomy. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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Review

Jump to: Research, Other

19 pages, 1604 KiB

Open AccessReview

Thinking Outside the Ischemia Box: Advancements in the Use of Multiple Sclerosis Drugs in Ischemic Stroke

by Athina-Maria Aloizou, Vasileios Siokas, Georgia Pateraki, Ioannis Liampas, Christos Bakirtzis, Zisis Tsouris, George Lazopoulos, Daniela Calina, Anca Oana Docea, Aristidis Tsatsakis, Dimitrios P. Bogdanos and Efthimios Dardiotis

J. Clin. Med. 2021, 10(4), 630; https://doi.org/10.3390/jcm10040630 - 7 Feb 2021

Cited by 23 | Viewed by 3629

Abstract

Ischemic stroke (IS) is a major cause of death and disability, despite early intervention. Thrombo-inflammation, the inflammatory process triggered by ischemia, is a concept that ties IS with multiple sclerosis (MS), under the wider ‘umbrella’ of neuroinflammation, i.e., the inflammation of the nervous [...] Read more.

Ischemic stroke (IS) is a major cause of death and disability, despite early intervention. Thrombo-inflammation, the inflammatory process triggered by ischemia, is a concept that ties IS with multiple sclerosis (MS), under the wider ‘umbrella’ of neuroinflammation, i.e., the inflammation of the nervous tissue. Drawing from this, numerous studies have explored the potential of MS disease-modifying drugs in the setting of IS. In this review, we present the available studies and discuss their potential in ameliorating IS outcomes. Based on our search, the vast majority of the studies have been conducted on animals, yielding mostly positive results. Two clinical trials involving natalizumab showed that it does not confer any benefits, but four human studies regarding fingolimod have showcased its potential in improving recovery prospects. However, concerns on safety and other issues are raised, and basic questions still need to be answered. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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26 pages, 2002 KiB

Open AccessReview

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

by Józef Opara, Jakub Taradaj, Karolina Walewicz, Joanna Rosińczuk and Robert Dymarek

J. Clin. Med. 2021, 10(2), 261; https://doi.org/10.3390/jcm10020261 - 12 Jan 2021

Cited by 20 | Viewed by 4874

Abstract

In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient’s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as [...] Read more.

In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient’s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity. The PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT. A total of 22 studies including 468 post-stroke patients—11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions. In conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects. The mechanism of action of ESWT on muscles affected by spasticity is still unknown. To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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25 pages, 808 KiB

Open AccessReview

Functional Recovery in Parkinson’s Disease: Current State and Future Perspective

by Manuela Violeta Bacanoiu, Radu Razvan Mititelu, Mircea Danoiu, Gabriela Olaru and Ana Maria Buga

J. Clin. Med. 2020, 9(11), 3413; https://doi.org/10.3390/jcm9113413 - 24 Oct 2020

Cited by 4 | Viewed by 4516

Abstract

Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders, affecting not only the motor function but also limiting the autonomy of affected people. In the last decade, the physical exercises of different intensities carried out by kinetic therapeutic activities, by robotic [...] Read more.

Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders, affecting not only the motor function but also limiting the autonomy of affected people. In the last decade, the physical exercises of different intensities carried out by kinetic therapeutic activities, by robotic technologies or with the participation of sensory cues, have become increasingly appreciated in the management of Parkinson’s disease impairments. The aim of this paper was to evaluate the impact of physical exercises with and without physical devices on the motor and cognitive variables of PD patients. In order to achieve our objectives, we performed a systematic review of available original articles based on the impact of kinetic therapeutic activity. Through the search strategy, we selected original papers that were laboriously processed using characteristics related to physical therapy, or the tools used in physiological and psychological rehabilitation strategies for PD patients. In this study, we presented the most current intervention techniques in the rehabilitation programs of patients with Parkinson’s disease, namely the use of assisted devices, virtual imagery or the performing of physical therapies that have the capacity to improve walking deficits, tremor and bradykinesia, to reduce freezing episodes of gait and postural instability, or to improve motor and cognitive functions. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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25 pages, 1258 KiB

Open AccessFeature PaperReview

The Treatment of Cognitive, Behavioural and Motor Impairments from Brain Injury and Neurodegenerative Diseases through Cannabinoid System Modulation—Evidence from In Vivo Studies

by Daniela Calina, Ana Maria Buga, Mihaela Mitroi, Aleksandra Buha, Constantin Caruntu, Cristian Scheau, Abdelhakim Bouyahya, Nasreddine El Omari, Naoual El Menyiy and Anca Oana Docea

J. Clin. Med. 2020, 9(8), 2395; https://doi.org/10.3390/jcm9082395 - 27 Jul 2020

Cited by 54 | Viewed by 10010

Abstract

Neurological disorders such as neurodegenerative diseases or traumatic brain injury are associated with cognitive, motor and behavioural changes that influence the quality of life of the patients. Although different therapeutic strategies have been developed and tried until now to decrease the neurological decline, [...] Read more.

Neurological disorders such as neurodegenerative diseases or traumatic brain injury are associated with cognitive, motor and behavioural changes that influence the quality of life of the patients. Although different therapeutic strategies have been developed and tried until now to decrease the neurological decline, no treatment has been found to cure these pathologies. In the last decades, the implication of the endocannabinoid system in the neurological function has been extensively studied, and the cannabinoids have been tried as a new promising potential treatment. In this study, we aimed to overview the recent available literature regarding in vivo potential of natural and synthetic cannabinoids with underlying mechanisms of action for protecting against cognitive decline and motor impairments. The results of studies on animal models showed that cannabinoids in traumatic brain injury increase neurobehavioral function, working memory performance, and decrease the neurological deficit and ameliorate motor deficit through down-regulation of pro-inflammatory markers, oedema formation and blood–brain barrier permeability, preventing neuronal cell loss and up-regulating the levels of adherence junction proteins. In neurodegenerative diseases, the cannabinoids showed beneficial effects in decreasing the motor disability and disease progression by a complex mechanism targeting more signalling pathways further than classical receptors of the endocannabinoid system. In light of these results, the use of cannabinoids could be beneficial in traumatic brain injuries and multiple sclerosis treatment, especially in those patients who display resistance to conventional treatment. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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15 pages, 2030 KiB

Open AccessReview

Interactions between Amyloid-Β Proteins and Human Brain Pericytes: Implications for the Pathobiology of Alzheimer’s Disease

by Donald J. Alcendor

J. Clin. Med. 2020, 9(5), 1490; https://doi.org/10.3390/jcm9051490 - 15 May 2020

Cited by 31 | Viewed by 5570

Abstract

Alzheimer’s disease (AD) is a progressive neurodegenerative disease that is the most common cause of dementia, especially among aging populations. Despite advances in AD research, the underlying cause and the discovery of disease-modifying treatments have remained elusive. Two key features of AD pathology [...] Read more.

Alzheimer’s disease (AD) is a progressive neurodegenerative disease that is the most common cause of dementia, especially among aging populations. Despite advances in AD research, the underlying cause and the discovery of disease-modifying treatments have remained elusive. Two key features of AD pathology are the aberrant deposition of amyloid beta (amyloid-β or Aβ) proteins in the brain parenchyma and Aβ toxicity in brain pericytes of the neurovascular unit/blood–brain barrier (NVU/BBB). This toxicity induces oxidative stress in pericytes and leads to capillary constriction. The interaction between pericytes and Aβ proteins results in the release of endothelin-1 in the pericytes. Endothelin-1 interacts with ET_A receptors to cause pericyte contraction. This pericyte-mediated constriction of brain capillaries can cause chronic hypoperfusion of the brain microvasculature, subsequently leading to the neurodegeneration and cognitive decline observed in AD patients. The interaction between Aβ proteins and brain pericytes is largely unknown and requires further investigation. This review provides an updated overview of the interaction between Aβ proteins with pericytes, one the most significant and often forgotten cellular components of the BBB and the inner blood–retinal barrier (IBRB). The IBRB has been shown to be a window into the central nervous system (CNS) that could allow the early diagnosis of AD pathology in the brain and the BBB using modern photonic imaging systems such as optical coherence tomography (OCT) and two-photon microscopy. In this review, I explore the regulation of Aβ proteins in the brain parenchyma, their role in AD pathobiology, and their association with pericyte function. This review discusses Aβ proteins and pericytes in the ocular compartment of AD patients as well as strategies to rescue or protect pericytes from the effects of Aβ proteins, or to replace them with healthy cells. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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19 pages, 1510 KiB

Open AccessReview

Impact of Natural Compounds on Neurodegenerative Disorders: From Preclinical to Pharmacotherapeutics

by Mehdi Sharifi-Rad, Chintha Lankatillake, Daniel A. Dias, Anca Oana Docea, Mohamad Fawzi Mahomoodally, Devina Lobine, Paul L. Chazot, Begum Kurt, Tugba Boyunegmez Tumer, Ana Catarina Moreira, Farukh Sharopov, Miquel Martorell, Natália Martins, William C. Cho, Daniela Calina and Javad Sharifi-Rad

J. Clin. Med. 2020, 9(4), 1061; https://doi.org/10.3390/jcm9041061 - 8 Apr 2020

Cited by 172 | Viewed by 11091

Abstract

Among the major neurodegenerative disorders (NDDs), Alzheimer’s disease (AD) and Parkinson’s disease (PD), are a huge socioeconomic burden. Over many centuries, people have sought a cure for NDDs from the natural herbals. Many medicinal plants and their secondary metabolites are reported with the [...] Read more.

Among the major neurodegenerative disorders (NDDs), Alzheimer’s disease (AD) and Parkinson’s disease (PD), are a huge socioeconomic burden. Over many centuries, people have sought a cure for NDDs from the natural herbals. Many medicinal plants and their secondary metabolites are reported with the ability to alleviate the symptoms of NDDs. The major mechanisms identified, through which phytochemicals exert their neuroprotective effects and potential maintenance of neurological health in ageing, include antioxidant, anti-inflammatory, antithrombotic, antiapoptotic, acetylcholinesterase and monoamine oxidase inhibition and neurotrophic activities. This article reviews the mechanisms of action of some of the major herbal products with potential in the treatment of NDDs according to their molecular targets, as well as their regional sources (Asia, America and Africa). A number of studies demonstrated the beneficial properties of plant extracts or their bioactive compounds against NDDs. Herbal products may potentially offer new treatment options for patients with NDDs, which is a cheaper and culturally suitable alternative to conventional therapies for millions of people in the world with age-related NDDs. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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16 pages, 2058 KiB

Open AccessReview

Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

by Ruben D. Hidalgo-Agudo, David Lucena-Anton, Carlos Luque-Moreno, Alberto Marcos Heredia-Rizo and Jose A. Moral-Munoz

J. Clin. Med. 2020, 9(4), 1038; https://doi.org/10.3390/jcm9041038 - 7 Apr 2020

Cited by 18 | Viewed by 8705

Abstract

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to [...] Read more.

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson’s disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson’s disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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32 pages, 990 KiB

Open AccessSystematic Review

New Strategies to Improve the Quality of Life for Normal Aging versus Pathological Aging

by Manuela Violeta Bacanoiu and Mircea Danoiu

J. Clin. Med. 2022, 11(14), 4207; https://doi.org/10.3390/jcm11144207 - 20 Jul 2022

Cited by 9 | Viewed by 3094

Abstract

In the context of the manifestation of the phenomenon of normal aging and functional decline at older adults with neurodegenerative pathology, the development of physical activities and healthy lifestyle has become a priority that involves many decisions and responsibilities. Therefore, the study of [...] Read more.

In the context of the manifestation of the phenomenon of normal aging and functional decline at older adults with neurodegenerative pathology, the development of physical activities and healthy lifestyle has become a priority that involves many decisions and responsibilities. Therefore, the study of the quality of life of the elderly in terms of delaying early aging and improving the lifestyle of patients with neurodegenerative diseases is a scientific challenge representing research of great interest and relevance. By promoting physical activity based on telerehabilitation programs or performed according to coordinated training either in the community or at home for both study groups, significant improvements have been obtained. The aim of this paper was to evaluate the intervention suitable patterns, surveys delivered through variables online platforms and tools to reflect the stagnation of early aging and the evolution of patients with PD and dementia. Our study involved selected original studies, intensively processed, which demonstrated through intervention specific tools, such as quantitative, qualitative, socio-economics, physical, and cognitive indicators, that significant improvements can be achieved in the process of early aging, but also significant progress in patients with neurodegenerative diseases. By searching the last five years of papers, our review, presents the importance of intervention by telerehabilitation or by scheduled physical exercises quantified by specific indicators. Full article

(This article belongs to the Special Issue Therapies in Age-Related Neurodegenerative Diseases and Stroke)

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