Parkinson's Disease-Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge

Mild cognitive impairment (MCI) is a common feature in Parkinson's Disease (PD), even at the time of diagnosis. Some levels of heterogeneity in nature and severity of cognitive impairment and risk of conversion to Parkinson's Disease Dementia (PDD) exist. This brief overview summarized the current understanding of MCI in PD, by considering the following major points: historical development of the clinical entity, evaluation, epidemiology, predictors and outcomes, neuroimaging findings, pathophysiology, treatment, and pharmacological and non-pharmacological intervention. MCI in PD represents a concept in evolution and plays a pivotal role in advancing our understanding of the disease mechanisms, with the ultimate goal of building effective strategies to prevent conversion into PDD. Challenges for future research are also discussed

A similar 24‐h blood pressure control is obtained by zofenopril and candesartan in primary hypertensive patients

Objective. To compare the antihypertensive effect of treatment with zofenopril vs candesartan by office and ambulatory blood pressure (BP). Design and methods. Following a 2‐week wash‐out from previous treatment, 236 grade I–II primary hypertensive patients were randomized double‐blind to 12 weeks treatment with zofenopril 30 mg or candesartan 8 mg od. After 4 weeks, treatment was doubled in responder non‐normalized (office systolic BP⩾140 mmHg and office diastolic BP reduction ⩾10 mmHg) or non‐responder patients (office systolic BP⩾140 mmHg and office diastolic BP reduction <10 mmHg). Following a further 4 weeks, non‐responder or non‐normalized patients were withdrawn. Results. In the intention‐to‐treat population, office systolic BP and diastolic BP reductions after 12 weeks of treatment were similar between the two groups (zofenopril: 21±11/15±8 mmHg, n = 114 vs C: 20±11/15±7 mmHg, n = 122; p = NS). In the 163 patients of the per‐protocol population, office BP dropped by 22±11/15±8 mmHg (zofenopril) an..

Oxidative Stress and Cognitive Decline: The Neuroprotective Role of Natural Antioxidants

Free- radicals (Oxygen and Nitrogen species) are formed in mitochondria during the oxidative phosphorylation. Their high reactivity, due to not-engaged electrons, leads to an increase of the oxidative stress. This condition affects above all the brain, that usually needs a large oxygen amount and in which there is the major possibility to accumulate “Reacting Species.” Antioxidant molecules are fundamental in limiting freeradical damage, in particular in the central nervous system: the oxidative stress, in fact, seems to worsen the course of neurodegenerative diseases. The aim of this review is to sum up natural antioxidant molecules with the greatest neuroprotective properties against free radical genesis, understanding their relationship with the Central Nervous System

Can Mediterranean Diet Counteract Metabolic Syndrome Diffusion?

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Effects of Mediterranean diet and weight loss on blood-lipid profile in overweight adults with hypercholesterolemia

Blood cholesterol has been positively associated with increased cardiovascular risk as a modifiable risk factors together with the lifestyle and diet. Furthermore, an improvement of the blood-lipid profile seems to be able to produce a decrease in cardiovascular events. Cholesterol plasma levels are related to the body mass index (BMI) and are affected by diet. The aim of this study was to evaluate the effectiveness of a Mediterranean diet (MD) weight-loss programme to improve blood cholesterol profiles in overweight adults subjected to real-world outpatient diet. Forty-nine hypercholesteraemic, overweight adults of both sexes were subjected to a dietary weight-loss intervention. Patients were prescribed a slightly hypocaloric MD for 16 weeks, followed by an 8-week follow-up period with a normocaloric diet. Data showed significant weight loss and cholesterol blood profile improvement both under the hypocaloric diet and during the follow-up period. In particular, the decrease in both Total and LDL-cholesterol was greater than their critical differences indicating the clinical relevance of blood lipid improvement induced by MD

Energy cost and psychological impact of robotic assisted gait training in people with spinal cord injury: effect of two different types of devices

Background: In the last years, there has been an intense technological development of robotic devices for gait rehabilitation in spinal cord injury (SCI) patients. The aim of the present study was to evaluate energy cost and psychological impact during a rehabilitation program with two different types of robotic rehabilitation systems (stationary system on a treadmill, Lokomat, and overground walking system, Ekso GT). Methods: Fifteen SCI patients with different injury levels underwent robot-assisted gait training sessions, divided into 2 phases: in the first phase, all subjects completed 3 sessions both Lokomat and Ekso GT. Afterwards, participants were randomly assigned to Lokomat or the Ekso for 17 sessions. A questionnaire, investigating the subjective psychological impact (SPI) during gait training, was administered. The functional outcome measures were oxygen consumption (VO2), carbon dioxide production (VCO2), metabolic equivalent of task (MET), walking economy, and heart rate (HR). Results: The metabolic responses (7.73 ± 1.02 mL/kg/min) and MET values (3.20 ± 1.01) during robotic overground walking resulted to be higher than those during robotic treadmill walking (3.91 ± 0.93 mL/kg/min and 1.58 ± 0.44; p &lt; 0.01).Both devices showed high scores in emotion and satisfaction. Overground walking resulted in higher scores of fatigue, mental effort, and discomfort while walking with Lokomat showed a higher score in muscle relaxation. All patients showed improvements in walking economy due to a decrease in energy cost with increased speed and workload. Conclusions: Overground robotic-assisted gait training in rehabilitation program needs higher cognitive and cardiovascular efforts than robot-assisted gait training on a treadmill

An in vitro comparative study of the antioxidant activity and SIRT1 modulation of natural compounds

Oxidative stress arises from an imbalance between the production of free radicals and antioxidant defences. Several studies have suggested that dietary antioxidants (such as polyphenols and berberine) may counteract oxidative stress through the involvement of the Sirtuin 1/Adenosine Monophosphate-Activated Protein Kinase (SIRT1/AMPK) pathway. The aim of this study was to evaluate the direct and specific antioxidant activity of some natural compounds, as well as their ability to modulate the expression of SIRT1 and the activation of AMPK. Quercetin, tyrosol, ferulic acid, catechin, berberine and curcumin were evaluated for their specific and direct antioxidant activity with TOSC assay. Their ability to modulate SIRT1 and AMPK was assessed by immunoblotting assay, while their cytotoxicity by CellTiter-Blue Cell Viability Assay. No statistically significant decrease (p &gt; 0.05) in the number of viable cells was found upon challenging with the natural compounds. Quercetin exhibited the highest antioxidant activity against peroxyl radical and peroxinitrate derivates, while curcumin showed the best anti-hydroxyl activity with respect to the other compounds and, most importantly, respect to the reference antioxidants. Finally, all the tested compounds significantly increased the SIRT1 expression and the activation of AMPK. Our results clearly disclose the specific antioxidant activity of these natural compounds and their ability to increase SIRT1 expression and AMPK activation

Regular physical exercise prevents nitrosative stress caused by ageing in elderly athletes

Ageing is associated with an increased susceptibility to free radical-induced tissue damage. One of the most important classes of free radicals generated in living systems is represented by reactive nitrogen species (RNS), responsible for the so-called nitrosative stress. It has been shown that physical activity is able to induce up-regulation of antioxidant systems contributing to prevent oxidative stress. The aim of the present study was to assess whether regular physical activity is able to counteract age-induced nitrosative stress. Thirty male endurance athletes (average age 70.8 ± 6.1 years, VO2max 59.07 ± 8.5 ml/kg/min) and thirty age-sex-matched sedentary controls ( average age 71.5 ± 4.3 years, VO2max 25.6 ± 8.2 ml/kg/min) were studied. Plasma free radicals antioxidant capacity against peroxynitrite, one of the most important RNS, was evaluated as Total Oxyradical Scavenging Capacity (TOSC) units. Results. Plasma TOSC values against peroxynitrite were higher in athletes than in sedentary controls (22.94 ± 1.85 vs 15.41 ± 1.24 units/ml, p < 0.001). In the athletes group, TOSC values were related to VO2max (r = 0.44, p < 0.05). In conclusion, these results suggest that regular physical activity is associated with increased antioxidant defences in elderly athletes. In athletes, a direct correlation between the scavenger scavenger of the plasma and the VO2max (r = 0.44, p <0.05) was also observed. These results confirm that regular physical activity practised for many years can determine the best response to nitrosative stress induced by peroxynitrite

What Does the Brain Have to Keep Working at Its Best? Resilience Mechanisms Such as Antioxidants and Brain/Cognitive Reserve for Counteracting Alzheimer's Disease Degeneration

here we performed a narrative review highlighting the effect of brain/cognitive reserve and natural/synthetic antioxidants in exerting a neuroprotective effect against cognitive deterioration during physiological and pathological aging. Particularly, we discussed pathogenesis of Alzheimer’s disease, brain and cognitive reserve as means of resilience towards deterioration, and evidence from the literature about antioxidants’ role in sustaining cognitive functioning in the preclinical phase of dementia. During aging, the effects of disease-related brain changes upon cognition are reduced in individuals with higher cognitive reserve, which might lose its potential with emerging cognitive symptoms in the transitional phase over the continuum normal aging-dementia (i.e., Mild Cognitive Impairment). Starting from this assumption, MCI should represent a potential target of intervention in which antioxidants effects may contribute—in part—to counteract a more severe brain deterioration (alongside to cognitive stimulation) causing a rightward shift in the trajectory of cognitive decline, leading patients to cross the threshold for clinical dementia later

The Circadian Rhythm of Hormones Implications for Exercise Adaptations and Athletic Performance

Life on earth undergoes recurrent changes influenced by the 24-h rotation of our planet around its axis...