28 research outputs found
Plasma Inflammatory Cytokines Are Elevated in ALS
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease which
leads to death in a median time of 2–3 years. Inflammation has been claimed important
to the ALS pathogenesis, but its role is still not well-characterized. In the present study, a
panel of five cytokines (IL-2, IL-6, IL-10, IFN-gamma, and TNF-alpha)measured in plasma
has been investigated in ALS. These biomarkers of inflammation were measured in a
population-based cohort of 79 patients with ALS and 79 age- and sex-matched healthy
controls using the Bio-Plex technology (Bio-Rad). All the five cytokines were significantly
increased in plasma samples of patients compared with controls (p < 0.0001), with IL-6
having the highest median concentration (10.11 pg/ml) in the ALS group. Furthermore,
IL-6 was the plasma cytokine with the highest discrimination ability between patients and
controls according to the receiver operating characteristic analysis (area under the curve
= 0.93). At a cut-off point of 5.71 pg/ml, it was able to classify patients and controls with
91% of sensitivity and 87% of specificity. In the ALS group, plasma IL-6 concentration
correlated with demographic (age: rs = 0.25, p = 0.025) and clinical (revised ALS
Functional Rating Scale at evaluation: rs = −0.32, p = 0.007; Manual Muscle Testing: rs
=−0.33, p=0.004; progression: rs=0.29, p=0.0395) parameters. In line with previous
studies, our results confirm that inflammatory cytokines are elevated in ALS, supporting
a possible role of inflammation in disease mechanism and progression. However, the
precise role of inflammation in ALS needs to be further investigated on larger samples
and with more mechanistic studies
Episodic memory and learning rates in amyotrophic lateral sclerosis without dementia
In amyotrophic lateral sclerosis (ALS), memory deficits may be primary or secondary to executive dysfunction. We assessed episodic memory and executive function of nondemented ALS patients, comparing episodic memory profiles and learning rates of ALS patients with those of mild cognitive impairment (MCI) subjects and cognitively healthy controls (HC). In a multidisciplinary tertiary centre for motor neuron disease, 72 nondemented ALS patients, 57 amnestic MCI (aMCI), 89 single non amnestic MCI with compromised executive functions (dysexecutive MCI), and 190 HC were enrolled. They were screened using the Frontal Assessment Battery and Mini Mental State Examination. Episodic memory performances and learning rates were tested using the Rey Auditory Verbal Learning Test (RAVLT). Episodic memory dysfunction (immediate recall) was found in 14 ALS patients (19.4%). The ALS group had lower performance than HC on immediate recall, without differences in learning rate, and better performance than aMCI subjects on all RAVLT measures. Compared to dysexecutive MCI subjects, ALS patients had only better verbal learning abilities. ALS patients with executive dysfunction had a lower score on immediate and delayed recalls, verbal learning, and primacy effect than ALS patients without executive dysfunction. The immediate recall among couples of diagnostic groups differed in a statistically significant way except for the ALS/dysexecutive MCI groups. In ALS patients, episodic memory performances and learning rates appeared to be better than in aMCI subjects and similar to those with dysexecutive MCI, suggesting also a secondary functional damage due to executive impairment
Sarcopenia screening in elderly with Alzheimer's disease: performances of the SARC-F-3 and MSRA-5 questionnaires
Background The 3-item SARC-F (SARC-F-3) and the 5-item Mini Sarcopenia Risk Assessment (MSRA-5) questionnaires have been recently proposed to screen elderly people regarding the risk of sarcopenia. However, no studies have investigated their performances in Alzheimer's disease (AD). Methods We conducted a single-center observational study, including 130 consecutive AD patients (mean age: 70.71 +/- 8.50 y, 54.6% women) who attended a center for neurodegenerative diseases. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People of 2010 (EWGSOP1) and of 2018 (EWGSOP2) criteria. Sensitivity, specificity, positive and negative likelihood ratio, and the area under the receiver operating characteristic curve (AUC) were used to assess the diagnostic performance of SARC-F-3 and MSRA-5. Results SARC-F-3 showed a sensitivity of 9.7%, a specificity of 82.8% and an AUC of 0.41 using EWGSOP1, whereas the sensitivity was of 16.7%, specificity of 84.7% and AUC of 0.58 using EWGSOP2. The MSRA-5 displayed a sensitivity of 3.2%, a specificity of 89.9% and an AUC of 0.41 using EWGSOP1, whereas sensitivity was of 0%, specificity of 91.1% and the AUC of 0.55 using EWGSOP2 criteria. The questionnaires showed a moderate agreement (Cohen's k = 0.53). Conclusions In our sample of AD patients, a sizable number of sarcopenic individuals were misidentified by SARC-F-3 and MSRA-5, making those questionnaires unsuitable for sarcopenia screening. Considering that sarcopenia has a high prevalence in dementia and that its correct and timely identification is paramount for optimal management of patients, the development and validation of an ad-hoc sarcopenia screening tool for AD patients is highly desirable