Testing the Effects of Dietary Lecithin on Memory in the Elderly: An Example of Social Work/ Medical Research Collaboration

A sample of 61 healthy volunteers (mean age = 65 years) participated in a study of the effect of lecithin on memory conducted by a gerontological social worker in collaboration with a physician specializing in neurological research. Forty-one subjects ingested 2 tablespoons of lecithin for 5 weeks whereas a control group of 20 subjects ingested a placebo for the same length of time. Memory function was established through a brief memory test and from a diary of memory lapses kept by the subject for 7 days prior to the experimental period and repeated during the 5th week. Analysis of the data found a significant improvement on memory test scores for the experimental group, which exceeded those obtained by the placebo group subjects. Participants receiving lecithin reported fewer memory lapses posttreatment than did the placebo subjects. Replication of the research with larger samples as well as an investigation of long-term effects, are recommended

Potential Neuroregenerative and Neuroprotective Effects of Uridine/Choline-Enriched Multinutrient Dietary Intervention for Mild Cognitive Impairment: A Narrative Review

In mild cognitive impairment (MCI) due to Alzheimer disease (AD), also known as prodromal AD, there is evidence for a pathologic shortage of uridine, choline, and docosahexaenoic acid [DHA]), which are key nutrients needed by the brain. Preclinical and clinical evidence shows the importance of nutrient bioavailability to support the development and maintenance of brain structure and function in MCI and AD. Availability of key nutrients is limited in MCI, creating a distinct nutritional need for uridine, choline, and DHA. Evidence suggests that metabolic derangements associated with ageing and disease-related pathology can affect the body’s ability to generate and utilize nutrients. This is reflected in lower levels of nutrients measured in the plasma and brains of individuals with MCI and AD dementia, and progressive loss of cognitive performance. The uridine shortage cannot be corrected by normal diet, making uridine a conditionally essential nutrient in affected individuals. It is also challenging to correct the choline shortfall through diet alone, because brain uptake from the plasma significantly decreases with ageing. There is no strong evidence to support the use of single-agent supplements in the management of MCI due to AD. As uridine and choline work synergistically with DHA to increase phosphatidylcholine formation, there is a compelling rationale to combine these nutrients. A multinutrient enriched with uridine, choline, and DHA developed to support brain function has been evaluated in randomized controlled trials covering a spectrum of dementia from MCI to moderate AD. A randomized controlled trial in subjects with prodromal AD showed that multinutrient intervention slowed brain atrophy and improved some measures of cognition. Based on the available clinical evidence, nutritional intervention should be considered as a part of the approach to the management of individuals with MCI due to AD, including adherence to a healthy, balanced diet, and consideration of evidence-based multinutrient supplements

Oxiracetam in the treatment of multi-infarct dementia

1.1. Initial clinical trials in approximately 200 patients with dementias of diverse etiology suggested that oxiracetam, a structural analogue of the nootropic piracetam, was of some benefit in the treatment of cognitive dysfunction.2.2. Because previous studies had not specifically examined the effects of oxiracetam upon dementias of vascular origin, the present study evaluated the therapeutic efficacy and safety of oxiracetam in the treatment of symptoms of multi-infarct dementia (MID) of Bild to moderate severity.3.3. Incremental doses of up to 1200 mg oxiracetam daily were tested in a dose-range finding design in a group of patients with clinically and neuropsychologically confirmed MID.4.4. Based on improvement in global evaluations of clinical change, our analysis suggests that the drug may be of some benefit in MID

A Comparison of Naproxen Sodium to Propranolol Hydrochloride and a Placebo Control for the Prophylaxis of Migraine Headache

SYNOPSIS A 17 week, double‐blind, randomized, parallel, multicenter study compared naproxen sodium 550 mg bid, propranolol hydrochloride 40 mg tid, and placebo in 129 patients with classical or common migraine. Daily efficacy data were collected during the 12 week full treatment phase. Characteristics measured included headache days, headache severity, nausea, vomiting and visual disturbances. Patients and investigators, separately, rated the overall response and tolerance to the medication at the end of the trial. Patients' daily records revealed a trend toward superiority in the reduction of headache frequency, headache severity, nausea and visual disturbances for naproxen sodium and propranolol hydrochloride when compared to the placebo. In the overall evaluation of therapeutic response, both patients and investigators favored naproxen sodium in comparison with placebo. In a similar paired comparison the patients, but not the investigators, judged the overall response to propranolol better than placebo. In the overall evaluation of tolerance, both the patients and investigators favored propranolol hydrochloride. The majority of patients reported a high incidence and severity of gastrointestinal complaints associated with naproxen sodium treatment than propranolol hydrochloride treatment. The incidence and severity of nongastrointestinal complaints related to naproxen and propranolol hydrochloride treatment were comparable. Headache activity occurring before and after the onset of menses was analyzed for a subset of 30 patients. Those treated with naproxen sodium experienced lesser headache frequency and severity during the week prior to menses, compared with the week after onset of menses. The difference in severity in the naproxen sodium treated patients was statistically significant when compared to the placebo treated patients and approached significance when compared to the propranolol hydrochloride treated patients. In this study naproxen sodium was shown to be an effective prophylactic medication for migraine. A long‐term study, to confirm these findings, seems warranted

Visualization of Focal Thinning of the Ganglion Cell-Inner Plexiform Layer in Patients with Mild Cognitive Impairment and Alzheimer's Disease

A detailed analysis of the tomographic thickness of intraretinal layers may provide more information on neurodegeneration in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). The goal was to analyze tomographic thickness patterns of intraretinal layers in patients with AD andMCI. Forty-nine patients (25 AD and 24 MCI) and 21 cognitively normal (CN) controls were imaged using ultra-high-resolution optical coherence tomography to obtain volumetric data centered on the fovea. The segmented intraretinal layers were retinal nerve fiber layer (RNFL), ganglion cell- inner plexiform layer (GCIPL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL), and retinal photoreceptor (PR), in addition to the total retinal thickness(TRT). The thickness differences were negative (thinning) mainly in TRT, RNFL, and GCIPL in both AD and MCI groups in comparison to CN, while the thickness differences were positive (thickening) mainly in ONL and PR in AD. GCIPL of AD and MCI was thinner in superior, nasal superior, and temporal superior quadrants, compared to CN (p < 0.05). GCIPL of the inner superior, inner nasal superior, inner temporal superior, and outer nasal superior sectors was significantly thinner in AD than CN (p < 0.05). GCIPL of the outer superior, inner temporal superior, outer nasal, and temporal superior sectors was significantly thinner in MCI than CN (p < 0.05). Focal thinning of the GCIPL was visualized and quantified by detailed partitions in AD and MCI, which provides specific information about neurodegeneration in MCI and AD