New Biomarker Links Brain Waste Clearance to Vascular Dementia

 Your competent? doctor needs to measure this and provide EXACT PROTOCOLS to solve the problem!

New Biomarker Links Brain Waste Clearance to Vascular Dementia

New Biomarker Links Brain Waste Clearance to Vascular Dementia

·January 7, 2025

Summary: A new study has identified a biomarker, DTI-ALPS, which connects glymphatic system dysfunction to vascular dementia. By analyzing over 3,750 participants, researchers found that lower DTI-ALPS scores correlated with worse executive function, highlighting the glymphatic system’s role in clearing brain waste.

The study also uncovered a potential pathway linking impaired waste clearance to cognitive decline, mediated by free water accumulation in white matter. These findings provide a robust tool for clinical trials and potential interventions, including lifestyle changes and medications, to enhance glymphatic function and treat vascular dementia.

3 Key Facts:

• DTI-ALPS Role: DTI-ALPS scores measure glymphatic system health, with lower scores linked to cognitive impairment.
• Pathway Identified: Impaired glymphatic function may lead to free water accumulation, white matter damage, and cognitive decline.
• Diverse Validation: The biomarker was independently validated across four cohorts with diverse demographics.

Source: USC

A new study from the Keck School of Medicine of USC has tested a biomarker linked to vascular dementia across four separate groups and proposed an explanation for how cognitive impairment arises.

The findings were just published in Alzheimer’s & Dementia®: The Journal of the Alzheimer’s Association.

Vascular dementia is the second most common form of dementia following Alzheimer’s disease. It has similar symptoms, including problems with memory, decision-making and language, and represents a significant public health problem as the global population continues to age.

>

The researchers found that lower DTI-ALPS scores, which indicated damage to the glymphatic system, were associated with worse executive function. Credit: Neuroscience News

The condition is usually caused by cerebral small vessel disease (cSVD), which damages the brain’s small blood vessels—but researchers don’t yet know the exact mechanism linking cSVD to dementia.

One theory involves problems with the glymphatic system, which helps clear waste from the brain.

A team of researchers from the Mark and Mary Stevens Neuroimaging and Informatics Institute (Stevens INI), part of the Keck School of Medicine, as well as researchers from the Biomarkers for Vascular Contributions to Cognitive Impairment and Dementia (MarkVCID) consortium, have found new evidence in support of that theory.

With funding from the National Institutes of Health, the group analyzed brain scans and cognitive tests from a total of 3750 people.

The researchers then used technique known Diffusion Tensor Image Analysis along the Perivascular Space – or DTI-ALPS – to determine how well the glymphatic system was functioning in each person based on their brain scans.

The researchers compared the DTI-ALPS results with the cognitive test results and found that people with lower DTI-ALPS scores also performed lower on cognitive tests.

The study confirmed that a low DTI-ALPS score is a biomarker for cSVD and suggests that glymphatic damage may be driving cognitive decline.

“The most significant finding is that we found a clear link between DTI-ALPS and cognitive function in all four cohorts, with ages ranging from middle-age through older adulthood,” said Danny J. J. Wang, PhD, the study’s senior author and a professor of neurology and radiology and director of imaging technology innovation at the Keck School of Medicine’s Stevens INI.

Wang and his team also analyzed the progression of symptoms across study participants, finding a possible pathway to explain how glymphatic problems lead to cognitive impairment.

Their results provide a target for clinical researchers seeking to develop treatments for vascular dementia, Wang said, and may also prove useful for treating symptoms of Alzheimer’s disease.

Validating the biomarker

The DTI-ALPS biomarker relies on magnetic resonance imaging (MRI) to measure water movement along perivascular spaces, fluid-filled regions around the brain’s blood vessels that are a key part of the glymphatic system.

If researchers detect changes in DTI-ALPS score, that can indicate damage and suggest that the waste clearance system is not functioning as it should.

In the present study, Wang and his team analyzed MRI scans to collect a measure of DTI-ALPS for each participant. They compared those measurements to each person’s level of executive function, a composite score of cognition that includes memory, attention, planning, emotion regulation and other abilities that tend to suffer as dementia progresses.  

The researchers found that lower DTI-ALPS scores, which indicated damage to the glymphatic system, were associated with worse executive function.

That link was verified independently in four separate participant groups—from the MarkVCID consortium; the University of California, Davis; the University of California, San Francisco; and the Framingham Heart Study—with a total of 3750 participants.

Independently validating the DTI-ALPS biomarker in each of the four cohorts provides strong evidence for the glymphatic system’s role in cSVD and vascular dementia, Wang said.

The racial and ethnic diversity of the participant groups, as well as the range of ages included (averaging between 56 and 76 years of age across cohorts) also suggests that the findings are robust and can be generalized to a broader patient population.

Treatments for vascular dementia

Once the team linked problems with glymphatic function to declines in executive function, they moved on to the next question — why?

To find out more, the researchers conducted a mediation analysis, which studies the process or mechanism connecting two or more variables. In this case, they found that another biomarker—”free water” or excess water in the brain’s white matter—helped explain the link between glymphatic problems and cognitive decline.

In this potential pathway, “first waste clearance is impaired, which causes accumulation of free water in the brain’s white matter. That leads to tissue damage and eventually to cognitive impairment,” said the paper’s first author, Xiaodan Liu, MD, PhD, a former postdoctoral researcher at the USC Stevens INI, now an assistant researcher in radiology at the University of California, San Francisco.

More research, including longitudinal work, is needed to confirm whether each step in that pathway is causal. But the team’s findings indicate that the DTI-ALPS score biomarker for vascular dementia is robust and ready to be used in clinical trials, Wang said.

Those studies could explore enhancing glymphatic function as a way to treat vascular dementia. Lifestyle changes such as exercising more and improving sleep quality are one way to do that, Wang said, and future studies may also reveal medications that can help.

The findings could also provide clues for how to treat Alzheimer’s disease, which has been linked to low DTI-ALPS scores in other studies.

About this research

In addition to Wang, the study’s other authors are Xiaodan Liu, Xingfeng Shao and Kay Jann from the Laboratory of fMRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California; Steven Cen and John M. Ringman from the Department of Neurology, Keck School of Medicine of USC, University of Southern California; Pauline Maillard and Charles S. DeCarli from the University of California, Davis; Giuseppe Barisano from Stanford University; Arvind Caprihan from the Mind Research Network, Albuquerque, New Mexico; Hanzhang Lu from Johns Hopkins University School of Medicine; Konstantinos Arfanakis from the Illinois Institute of Technology and Rush University Medical Center, Chicago, Illinois; Brian T. Gold from the University of Kentucky; Sudha Seshadri^, Claudia L. Satizabal and Mohamad Habes from the University of Texas Health Science Center at San Antonio, San Antonio, Texas; Alexa S. Beiser from Boston University; Joel H. Kramer and Lara Stables from the University of California, San Francisco; Herpreet Singh, Kristin Schwab and Steven M. Greenberg from Massachusetts General Hospital, Boston, Massachusetts; and Karl G. Helmer from Harvard Medical School, Massachusetts General Hospital and the Massachusetts Institute of Technology.

Funding: This work was supported by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging, part of the National Institutes of Health [U24NS100591, UH3NS100599, UH3NS100605, UH3NS100588, UH3NS100608, UH3NS100606, UH3NS100598 and UH3NS100614]

About this neurology research news

Author: Laura LeBlanc
Source: USC
Contact: Laura LeBlanc – USC
Image: The image is credited to Neuroscience News

Original Research: Open access.
“MRI free water mediates the association between diffusion tensor image analysis along the perivascular space and executive function in four independent middle to aged cohorts” by Danny J. J. Wang et al. Alzheimer’s & Dementia

---

Vascular dementia: A look at dementia caused by strokes

 

With your chances of getting dementia post stroke, your competent? doctor needs to be monitoring this and provide dementia prevention solutions. Over a decade to accomplish that! Was it done? NO? So, you DON'T have a functioning stroke doctor, do you? YOUR DOCTOR IS RESPONSIBLE FOR PREVENTING THIS!

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

The latest here:

Vascular dementia: A look at dementia caused by strokes

Dementia is a condition that affects memory, thinking, and reasoning, leading to impaired day-to-day function. Vascular dementia (dementia due to strokes), alone or in combination with a degenerative disease such as Alzheimer's, is one of the most common forms of dementia. While vascular dementia can't be cured, certain treatments may help slow its progression.

What is vascular dementia?

The brain needs a constant supply of oxygen-rich blood to function properly. Vascular dementia occurs when blood flow to the brain is reduced or blocked, either suddenly or gradually, resulting in damage to brain cells. This damage can lead to issues with thinking, memory, and other cognitive functions, which are key signs of dementia.

Causes of vascular dementia

The cause of vascular dementia is strokes. Large clotting strokes occur when a blood clot blocks a blood vessel in the brain, cutting off its blood supply. Risk factors for large strokes include heart disease including an irregular heartbeat (atrial fibrillation), and cholesterol plaques in the large arteries of the neck (such as the carotids). These large strokes are typically noticed immediately by the individual or their family.

Strokes can also be caused by the obstruction of tiny blood vessels, and thus are often called small vessel disease. Over time, the small blood vessels in the brain can be damaged by high blood pressure, diabetes, and high cholesterol — the same conditions that can lead to heart disease. When small vessels in the brain are occluded, blood flow to those parts of the brain is cut off.

Strokes can also occur due to a brain bleed or hemorrhage.

Who is at risk for vascular dementia?

Things that increase your risk for stroke also raise the likelihood of developing vascular dementia. Some common risk factors for stroke and vascular dementia are:

• Age: The risk of vascular dementia increases with age, especially after age 65.

• High blood pressure: Long-term high blood pressure can damage blood vessels in the brain, due to the high-pressure pounding of the blood, leading small vessels to become occluded.
• Diabetes: High blood sugar damages blood vessel walls, leading small vessels to become occluded.
• Smoking: Smoking harms blood vessels and can increase your risk of both large and small strokes.
• High cholesterol: High cholesterol levels can cause the buildup of plaque in arteries, leading to an increase in risk of both large and small strokes.
• Heart disease: Conditions that affect the heart and blood vessels, such as coronary artery disease or atrial fibrillation, can increase the risk of large strokes.
• Other lifestyle factors: Heavy alcohol intake, lower physical activity levels, and obesity are also known risk factors for strokes and vascular dementia.

Although your age can't be changed, most other risk factors can be managed or improved.

Symptoms of vascular dementia

Different parts of the brain control different functions, so the symptoms of vascular dementia can vary depending on the part of the brain that is affected. In some cases, symptoms can appear suddenly, such as after a large stroke, while in other cases they may develop more slowly over time due to the accumulation of small strokes.

People who suffer from vascular dementia often struggle with executive functioning, which includes tasks like planning, organizing, and decision-making. These are the processes that help you manage everyday tasks. When executive function is impaired, it becomes harder to think things through, make choices, and remember important details. Othercommon symptoms of vascular dementia, that are also present in other dementias such as Alzheimer's disease, include:

• memory problems such as difficulty remembering recent events or names
• difficulty concentrating
• slowed thinking
• confusion or feeling disoriented, especially in unfamiliar situations
• mood changes such as depression, anxiety, and mood swings.

Early symptoms may be mild in some cases, but often worsen over time. More advanced symptoms of vascular dementia (and other causes of dementias) may include:

• aphasia: difficulty speaking, understanding words, reading, or writing
• apraxia: trouble performing movements or tasks
• difficulty with balance leading to frequent falls
• loss of bladder control.

How do symptoms of Alzheimer's disease differ from vascular dementia?

Vascular dementia and Alzheimer's disease share some similar symptoms, such as memory loss and confusion. However, there are key differences in how these symptoms appear.

Vascular dementia often has a quicker, more noticeable onset, with physical symptoms like coordination and walking difficulties appearing earlier. This is particularly true when the cause of vascular dementia is large strokes. In contrast, Alzheimer's disease usually begins with memory and cognitive issues, with physical symptoms like balance problems emerging in the later stages.

The progression of these conditions also varies. People with vascular dementia due to large strokes tend to have a stepwise progression, with periods of quick declines followed by stability. Alzheimer's disease progresses more gradually and relentlessly, with cognitive impairment worsening slowly over the years, making changes harder to detect from day to day. However, vascular dementia due to small vessel disease can, like Alzheimer's, progress slowly over years.

How is vascular dementia diagnosed?

Diagnosing vascular dementia requires a thorough assessment from a healthcare provider. This often starts with a detailed medical history. Your doctor will ask about any previous strokes or heart-related conditions, as well as symptoms you've noticed. It can be helpful to bring a loved one to the appointment to share their observations. The doctor will also perform a physical examination and evaluate your neurological function.

Other techniques used in diagnosis include:

• Blood tests: These can help identify underlying health conditions, such as diabetes or high cholesterol, that may be contributing to vascular dementia.
• Cognitive tests: These tests evaluate memory, problem-solving skills, and other aspects of thinking.
• Neuropsychological testing: More advanced testing that can assist in distinguishing vascular dementia from Alzheimer's disease and other forms of dementia.
• Brain imaging: Scans, such as an magnetic resonance imaging (MRI) or computed tomography (CT) scan, are essential for making the diagnosis of vascular dementia, as these images can visualize the strokes. MRI scans are more sensitive and are the preferred test. Other imaging tests, such as flurodeoxyglucose (FDG) or amyloid positron emission tomography (PET) scans, can be used to search for other causes of dementia (such as Alzheimer's disease) that may be present with vascular dementia or may be causing the dementia by itself.

Treatments to slow progression of vascular dementia

The FDA has not approved any medications specifically for treating vascular dementia, but the following interventions can help slow its progression, manage symptoms, and improve quality of life.

Managing risk factors that could cause additional strokes is a key treatment approach. Your doctor may prescribe medications to control your blood pressure, cholesterol, and blood sugar, and to prevent blood clots.

If needed, procedures to open the carotid arteries such as endarterectomy, angioplasty, and stenting may be done to improve blood flow to the brain.

Certain medications can improve memory and cognitive function in people with Alzheimer's disease, and these drugs may be prescribed for some people with vascular dementia. They include cholinesterase inhibitors such as donepezil (Aricept), galantamine, and rivastigmine (Exelon), as well as the NMDA-receptor and dopamine agonist memantine (Namenda). Dextromethorphan, by itself or with quinidine (Neudexta), can help with the emotional changes that often accompany vascular dementia.

Cognitive or occupational therapy may be recommended to help manage physical or emotional symptoms and improve daily functioning. And lifestyle changes like regular aerobic exercise, quitting smoking, and eating a heart-healthy Mediterranean menu of whole foods can help improve overall health and protect the brain.

Preventing vascular dementia: Steps you can take to lower your risk

Here are some tangible steps you can take to lower your risk of vascular dementia by protecting healthy blood flow to the brain:

• Manage chronic conditions: Keep your blood pressure, cholesterol, and blood sugar levels in a healthy range through a combination of healthy diet, regular exercise, and medication.
• Stop smoking: Quitting smoking can reduce the risk of blood vessel damage and improve brain and overall health.
• Exercise regularly: Aerobic exercise improves blood flow to the brain and is associated with a lower risk of all causes of dementia. Aim for 150 minutes of moderate-intensity physical activity every week.
• Eat a healthy diet: A whole-food diet rich in fruits, vegetables, and lean proteins can help keep your blood vessels healthy. The DASH (dietary approach to stop hypertension) diet and the Mediterranean diet have both been linked to slowing down memory and thinking problems in older adults.

About the Author

Jennifer Fisher, MMSc, PA-C, Health Writer

Jennifer is a board-certified physician assistant. She earned her bachelor of science in kinesiology at James Madison University, then went on to obtain her master of medical science at Tufts University School of Medicine, where she … See Full Bio

View all posts by Jennifer Fisher, MMSc, PA-C

Glial enriched stem cell progenitors repair functional deficits due to white matter stroke and vascular dementia

Since this is in mice your doctor and hospital will need to ensure human testing. Or you could let them just be incompetent as usual and do nothing, but this impacts you and you might want a solution.

 

Glial enriched stem cell progenitors repair functional deficits due to white matter stroke and vascular dementia 

A one-time injection of an experimental stem cell therapy can repair brain damage and improve memory function in mice with conditions that replicate human strokes and dementia, a new study finds.

Dementia can arise from multiple conditions, and it is characterized by an array of symptoms including problems with memory, attention, communication and physical coordination. The two most common causes of dementia are Alzheimer's disease and white matter strokes -- small strokes that accumulate in the connecting areas of the brain.

"It's a vicious cycle: The two leading causes of dementia are almost always seen together and each one accelerates the other," said the senior author of the study.
An estimated 5 million Americans have dementia. "And with the aging population, that number is going to skyrocket," the author said.

Currently, there are no therapies capable of stopping the progression of white matter strokes or enhancing the brain's limited ability to repair itself after they occur. The new study, published in Science Translational Medicine, identifies a cell therapy that can stop the progressive damage caused by the disease and stimulate the brain's own repair processes.

The cells used in the therapy are a specialized type of glial cells, which are cells that surround and support neurons in the central nervous system. The researchers evaluated the effects of their glial cell therapy by injecting it into the brains of mice with brain damage similar to that seen in humans in the early to middle stages of dementia.

"Upon injection, our cell therapy traveled to damaged areas of the brain and secreted chemicals called growth factors that stimulated the brain's stem cells to launch a repair response," said the paper's first author.

Activating that repair process not only limited the progression of damage, but it also enhanced the formation of new neural connections and increased the production of myelin -- a fatty substance that covers and protects the connections.

The team used a method for quickly producing large numbers of glial cells by treating human induced pluripotent stem cells with a drug called deferoxamine. Induced pluripotent stem cells are derived from skin or blood cells that have been reprogrammed back to an embryonic stem cell-like state from which scientists can create an unlimited supply of any cell type.

In the future, if the therapy is shown to be safe and effective through clinical trials in humans, the researchers envision it becoming an "off-the-shelf" product, meaning that the cells would be mass manufactured, frozen and shipped to hospitals, where they could be used as a one-time therapy for people with early signs of white matter stroke.

That would set the treatment apart from patient-specific cell therapies, which are created using each individual patient's own cells. While patient-specific cell therapies are appealing because they do not require patients to take drugs to prevent their immune systems from rejecting the transplanted cells, they are also expensive and can take weeks or months to produce.

"The damage from white matter strokes is progressive, so you don't have months to spend producing a treatment for each patient," said the senior author. "If you can have a treatment that's already in the freezer ready to go during the window of time when it could be most effective, that's a much better option."

The brain is a particularly good target for off-the-shelf cell therapies because immune activity in the brain is highly controlled. That feature, known as immune privilege, allows donor cells or tissues that would be rejected by other parts of the body to survive for prolonged, even indefinite, periods.

Interestingly, the researchers found that even if they eliminated the injected cells a few months after they had been transplanted, the mice's recovery was unaffected. That's because the therapy primarily serves as a wake-up call to stimulate the brain's own repair processes.

"Because the cell therapy is not directly repairing the brain, you don't need to rely on the transplanted cells to persist in order for the treatment to be successful," the author said.

The team is now conducting the additional studies necessary to apply to the Food and Drug Administration for permission to test the therapy in a clinical trial in humans.

https://stm.sciencemag.org/content/13/590/eaaz6747

 

Catching a stroke quickly can avoid vascular dementia. See how one smart lady, with one smartphone, shot the video that saved her brain.

While this was a wonderful outcome, I still expect our stroke medical professionals to have 100% recovery protocols for every survivor presenting in their hospital. IF THAT IS NOT YOUR HOSPITAL, YOU NEED TO HAVE THE BOARD OF DIRECTORS FIRED. 

Catching a stroke quickly can avoid vascular dementia. See how one smart lady, with one smartphone, shot the video that saved her brain.

Prevent Stroke to Prevent Dementia?

You're missing the whole fucking point. WHAT NEEDS TO BE DONE TO PREVENT VASCULAR DEMENTIA POST STROKE?  This shows extreme laziness and NO STROKE LEADERSHIP.  I would have all these stroke 'experts' fired. Once again describing a problem but offering NO useful solution. 

Prevent Stroke to Prevent Dementia?

DUBAI, United Arab Emirates — To reduce the incidence of dementia, societies will need to reduce the incidence of strokes, a multinational panel of experts concluded here at the XXIV World Congress of Neurology.
Because there are modifiable risk factors for stroke, it should be possible to lessen the occurrence and impact of dementia, they say.
Disability-adjusted life years (DALYs) from stroke begin to increase in midlife for both women and men, followed approximately at ages 65 to 69 years by a rising trend in DALYs from Alzheimer's disease and other dementias for both sexes — but more so for men.
Given increasing populations, "the age-standardized rates of dementia have not changed even though… the absolute numbers of people with dementia has increased quite sharply," said William Carroll, MBBS, MD, president of the World Federation of Neurology (WFN) and consultant neurologist at the University of Western Australia in Perth.

Estimates are that the number of people living with dementias in the Americas in 2050 will increase by 248% (9 million recently to 31 million people), in Africa by 300% (3 million to 12 million), in Europe by 90% (11 million to 21 million), and in Southeast Asia by 226% (22 million to 72 million).
"The problem is about how countries and people and nations are going to manage this increased number of people suffering from dementia," he said, given that the human, financial, and societal burdens of dementia are already very large.
Because stroke is a risk factor for dementia, one logical approach to prevent dementia is to address hypertension, a major cause of stroke, as well as smoking, diabetes, and lifestyle. Climate change and air pollution have also become risk factors.
"If we reduce the rate of stroke, the argument goes, we may be able to reduce the face of dementia; if not stop it then at least reduce the severity of the dementia," Carroll predicted.

The Alzheimer's Disease International 2018 report gives a figure of 50 million people worldwide living with dementia in 2018. A new case occurs every 3 seconds. By 2050 the prevalence is expected to triple to 152 million people – two thirds of whom will live in developing countries.
During the news conference, Najeeb Qadi, MD, of King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia, illustrated the link between stroke and dementia. He said the top three types of dementia are Alzheimer's disease (47%), mixed dementia (34%), and vascular dementia (9%).
The prevalence of vascular dementia doubles every 5 to 10 years after age 65, and it surpasses Alzheimer's disease after age 85 years. Qadi said dementia occurs in 20% to 30% of people within about 3 months of a stroke, with an additional 25% developing dementia over the next 3 years.

 

Esteemed Panel of World's Leading Stroke Experts Share Breakthrough Research on Relationship Between Stroke Risk and Vascular Dementia During Press Conference Broadcast via Facebook Live from XXIV World Congress of Neurology, Dubai, UAE, Monday, Oct. 28, 3:15 p.m. GST

You're missing the whole fucking point. WHAT NEEDS TO BE DONE TO PREVENT VASCULAR DEMENTIA POST STROKE?  This shows extreme laziness and NO STROKE LEADERSHIP.  I would have all these stroke 'experts' fired. Once again describing a problem but offering NO useful solution.

Esteemed Panel of World's Leading Stroke Experts Share Breakthrough Research on Relationship Between Stroke Risk and Vascular Dementia During Press Conference Broadcast via Facebook Live from XXIV World Congress of Neurology, Dubai, UAE, Monday, Oct. 28, 3:15 p.m. GST 

News provided by

World Federation of Neurology

Oct 25, 2019, 16:48 ET

Share this article

---

DUBAI, United Arab Emirates, Oct. 25, 2019 /PRNewswire/ -- What if by reducing your risk for stroke, you could also reduce the risk of dementia? Breakthrough research suggests that there is a connection. During the XXIV World Congress of Neurology (WCN 2019), join a panel of the world's leading experts on stroke as they discuss this breakthrough research during a live press conference. The press conference will take place at the World Trade Centre in Dubai and will be live-streamed via the World Federation of Neurology Facebook Page (www.facebook.com/wfneurology) on Monday, Oct. 28, 2019, at 3:15 pm. GST.

WCN 2019: Accelerating the Pace of Change

Global incidence of stroke is increasing at alarming rates, with new risk factors such as climate change and air pollution coming to the forefront. As the global burden of stroke becomes more evident, especially in developing countries, the need for a consistent approach to stroke prevention is more evident than ever.

The elite panel of experts will discuss breaking news in stroke and vascular dementia, including the following key insights:

• Groundbreaking research revealing that measures of stroke prevention may also work to reduce the risk of dementia
• Climate change, air pollution and other new risk factors for stroke
• Challenges of managing stroke and dementia in Africa and developing countries
• New designation of stroke by the World Health Organization(This occurred 13 years ago, keep up with the program. Incompetence in full display. )
• All over the world, incidents of dementia are increasing at alarming rates

PRESS CONFERENCE PARTICIPANTS

• Prof. William Carroll, MB, BS, MD, President of World Federation of Neurology
• Prof. Michael Brainin MD PhD Dr (hons) FESO FAHA FEAN FWSO, President, World Stroke Organisation
• Prof. Adesola Ogunniyi, MD
• Prof. Najeeb Qadi, MD
• Prof. Vladimir Hachinski, MD

Media are invited to join the WCN 2019 Live Stream at www.facebook.com/wfneurology, and can attend the World Congress of Neurology in person by obtaining complimentary passes upon arrival at the World Trade Centre Dubai.
About the World Federation of NeurologyThe World Federation of Neurology represents 120 member neurological societies around the globe whose mission is to foster quality neurology and brain health worldwide by promoting neurological education and training with an emphasis on under-resourced areas of the world. The WFN supports the spread of accurate research and clinical information in the pursuit of improvements in the field of neurology. With support from member organizations, the WFN unifies the world to give patients better access to brain health.
For more information, please visit www.wfneurology.org. Review all WCN 2019 News on our Virtual Press Office at http://wfneurology.vporoom.com/about. Like us on Facebook at https://www.facebook.com/wfneurology/, and follow us on Twitter at https://twitter.com/wfneurology or by searching using the tag #WCN2019.
Media Contact
Yakkety Yak Contact:
Ashley Logan
Yakkety Yak LLC
press@yakketyyak.com
SOURCE World Federation of Neurology

Brain study paves way for therapy for common cause of dementia

Now our researchers need to find out whether this is the cause of most stroke related dementia. But since we have NO leadership to go to and NO strategy to update nothing will be done.  Without naming the drug you are totally reliant on your doctor figuring out if this can possibly be treated off label. 

Brain study paves way for therapy for common cause of dementia

July 4, 2018, University of Edinburgh

The authors discovered more proliferating dysfunctional endothelial cells (red arrows) in diseased human brains compared to controls. Credit: R.M. Rajani et al., Science Translational Medicine (2018)

Scientists have uncovered a potential approach to treat one of the commonest causes of dementia and stroke in older people.

Studies with rats found the treatment can reverse changes in blood vessels in the brain associated with the condition, called cerebral small vessel disease.
Treatment also prevents damage to brain cells caused by these blood vessel changes, raising hope that it could offer a therapy for dementia.
Small vessel disease, or SVD, is a major cause of dementia and can also worsen the symptoms of Alzheimer's disease. It is responsible for almost half of all dementia cases in the UK and is a major cause of stroke, accounting for around one in five cases.
Patients with SVD are diagnosed from brain scans, which detect damage to white matter—a key component of the brain's wiring.
Until now, it was not known how changes in small blood vessels in the brain associated with SVD can cause damage to brain cells.
A team led by the University of Edinburgh found that SVD occurs when cells that line the small blood vessels in the brain become dysfunctional. This causes them to secrete a molecule into the brain.
The molecule stops production of the protective layer that surrounds brain cells—called myelin—which leads to brain damage.
Treating rats with drugs that stop blood vessel cells from becoming dysfunctional reversed the symptoms of SVD and prevented brain damage, tests found.
Researchers say that further studies will need to test whether the treatment also works when the disease is firmly established. They will also need to check if the treatment can reverse the symptoms of dementia.
Dementia is one of the biggest problems facing society, as people live longer and the population ages. Estimates indicate there are almost 47 million people living with dementia worldwide and the numbers affected are expected to double every 20 years, rising to more than 115 million by 2050.
The research, published in Science Translational Medicine, was carried out at the Medical Research Council Centre for Regenerative Medicine and the UK Dementia Research Institute at the University of Edinburgh. It was funded by the MRC, Alzheimer's Research UK and Fondation Leducq.
Professor Anna Williams, Group Leader at the University of Edinburgh's MRC Centre for Regenerative Medicine, said: "This important research helps us understand why small vessel disease happens, providing a direct link between small blood vessels and changes in the brain that are linked to dementia. It also shows that these changes may be reversible, which paves the way for potential treatments."
Dr. Sara Imarisio, Head of Research at Alzheimer's Research UK said: "Changes to the blood supply in the brain play an important role in Alzheimer's disease as well as being a direct cause of vascular dementia. This pioneering research highlights a molecular link between changes to small blood vessels in the brain and damage to the insulating 'white matter' that helps nerve cells to send signals around the brain.
"The findings highlight a promising direction for research into treatments that could limit the damaging effects of blood vessel changes and help keep nerve cells functioning for longer. There are currently no drugs that slow down or stop Alzheimer's disease and no treatments to help people living with vascular dementia. Alzheimer's Research UK is very pleased to have helped fund this innovative research, which is only possible thanks to the work of our dedicated supporters."
Dr. Nathan Richardson, the MRC's Head of Molecular and Cellular Medicine, commented: "This study is a great example of how innovative discovery science into regenerative mechanisms can be applied to improve our understanding of how vascular changes contribute to dementia. This research in rats opens up new possibilities for developing therapies for cerebral small vessel disease."

Explore further: Vascular dementia trial of Viagra-type drug nears closing stages

More information: R.M. Rajani el al., "Reversal of endothelial dysfunction reduces white matter vulnerability in cerebral small vessel disease in rats," Science Translational Medicine (2018). stm.sciencemag.org/lookup/doi/ … scitranslmed.aam9507

Journal reference: Science Translational Medicine
Provided by: University of Edinburgh

Diagnosing Dementia: Alzheimer's May Really Be Mini-Strokes

Hopefully your cognitive reserve is enough to prevent this from happening.
http://www.alzheimersweekly.com/2013/02/diagnosing-dementia-alzheimers-may.html
Memory problems are too quickly diagnosed as Alzheimer's. (In Alzheimer's, the culprit is amyloid-plaque in the brain.) New research shows a more common memory-culprit may be vascular dementia, caused by stroke, mini-stroke and high blood pressure. Learn the difference and why the right diagnosis effects therapy and treatment.

---

Alzheimer's is connected to sticky plaques made of beta-amyloid that choke brain cells, thereby causing dementia. People may act like they have Alzheimer's when they really have vascular dementia. Vascular dementia is caused by vascular events (related to blood vessels) such as strokes and mini-strokes, so treatment is different. (Mini-strokes occur in the brain when blood vessels clog up or burst. They can accumulate slowly and can go unnoticed for years.)

For example, the damage caused by plaque is typically treated with acetylcholinesterase inhibitors like Aricept^®. These drugs target the nervous system. Vascular problems like mini-strokes are treated with blood-targeting medications and therapies.

Alzheimer's disease and vascular dementia are two types of dementia that are common in the elderly. A person's dementia can even be caused by a combination of the two, called "Mixed Dementia."

With today's technology, both vascular brain injury as well as beta-amyloid plaque can be detected in the brain. They both cause memory and thinking problems, called "cognitive impairment". If the cognitive impairment is strong and interferes with a typical person's day, it is called dementia. If it is mild, it is called MCI (Mild Cognitive Impairment).

Until now, doctors generally assumed that when they saw cognitive impairment, it was probably from plaque building up in the brain. Treatment and therapy were given accordingly. New research is showing that vascular brain injury from strokes or the mini-strokes often caused by high blood pressure may deserve the greater part of their attention.

A study at the Alzheimer’s Disease Research Center at UC Davis has found that vascular brain injury from conditions such as high blood pressure and stroke are greater risk factors for cognitive impairment among non-demented older people than is the deposition of the amyloid plaques in the brain that long have been implicated in conditions such as Alzheimer’s disease.

Bruce Reed

Published online early today in JAMA Neurology (formerly Archives of Neurology), the study found that vascular brain injury had by far the greatest influence across a range of cognitive domains, including higher-level thinking and the forgetfulness of mild cognitive decline.

The researchers also sought to determine whether there was a correlation between vascular brain injury and the deposition of beta amyloid (Αβ) plaques, thought to be an early and important marker of Alzheimer’s disease, said Bruce Reed, associate director of the UC Davis Alzheimer’s Disease Research Center in Martinez, Calif. They also sought to decipher what effect each has on memory and executive functioning.

“We looked at two questions,” said Reed, professor in the Department of Neurology at UC Davis. “The first question was whether those two pathologies correlate to each other, and the simple answer is ‘no.’ Earlier research, conducted in animals, has suggested that having a stroke causes more beta amyloid deposition in the brain. If that were the case, people who had more vascular brain injury should have higher levels of beta amyloid. We found no evidence to support that.”

"The second,” Reed continued, “was whether higher levels of cerebrovascular disease or amyloid plaques have a greater impact on cognitive function in older, non-demented adults. Half of the study participants had abnormal levels of beta amyloid and half vascular brain injury, or infarcts. It was really very clear that the amyloid had very little effect, but the vascular brain injury had distinctly negative effects.”

“The more vascular brain injury the participants had, the worse their memory and the worse their executive function – their ability to organize and problem solve,” Reed said.

The research was conducted in 61 male and female study participants who ranged in age from 65 to 90 years old, with an average age of 78. Thirty of the participants were clinically “normal,” 24 were cognitively impaired and seven were diagnosed with dementia, based on cognitive testing. The participants had been recruited from Northern California between 2007 to 2012.

The study participants underwent magnetic resonance imaging (MRI) ― to measure vascular brain injury ― and positron emission tomography (PET) scans to measure beta amyloid deposition: markers of the two most common pathologies that affect the aging brain. Vascular brain injury appears as brain infarcts and “white matter hyperintensities” in MRI scans, areas of the brain that appear bright white.

The study found that both memory and executive function correlated negatively with brain infarcts, especially infarcts in cortical and sub-cortical gray matter. Although infarcts were common in this group, the infarcts varied greatly in size and location, and many had been clinically silent. The level of amyloid in the brain did not correlate with either changes in memory or executive function, and there was no evidence that amyloid interacted with infarcts to impair thinking.

Reed said the study is important because there’s an enormous amount of interest in detecting Alzheimer’s disease at its earliest point, before an individual exhibits clinical symptoms. It’s possible to conduct a brain scan and detect beta amyloid in the brain, and that is a very new development, he said.

“The use of this diagnostic tool will become reasonably widely available within the next couple of years, so doctors will be able to detect whether an older person has abnormal levels of beta amyloid in the brain. So it’s very important to understand the meaning of a finding of beta amyloid deposition,” Reed said.

“What this study says is that doctors should think about this in a little more complicated way. They should not forget about cerebrovascular disease, which is also very common in this age group and could also cause cognitive problems. Even if a person has amyloid plaques, those plaques may not be the cause of their mild cognitive symptoms.”

---

Other study authors include Natalie Marchant of UC Berkeley and the Buck Institute for Research on Aging; Roxana Dhada and William Jagust of UC Berkeley; Charles DeCarli and Dan Mungas of UC Davis; Stephen Kriger and Micheal Weiner of UC San Francisco and Nerses Sanossian, Wendy Mack and Helena Chui of the University of Southern California.

The research was supported by grants number AG012435, AG00266 and AG10129 from the National Institutes of Health.

The UC Davis Alzheimer's Disease Center is one of only 27 research centers designated by the National Institutes of Health's National Institute on Aging. The center's goal is to translate research advances into improved diagnosis and treatment for patients while focusing on the long-term goal of finding a way to prevent or cure Alzheimer's disease. Also funded by the state of California, the center allows researchers to study the effects of the disease on a uniquely diverse population. For more information, visit alzheimer.ucdavis.edu.

Marijuana & Vascular Dementia

So rather than demonizing marijuana like this our researchers should come up with a solution to this  vascular squeezing ability. I bet the stroke and heart attack risk are from the smoking part rather than marijuana itself and people with these other health problems are using marijuana to self-treat themselves.   I plan on using marijuana short term after my next stroke.

My 13 reasons for marijuana use post-stroke.  

But don't listen to me, I have absolutely no medical training.

http://www.alzheimersweekly.com/2017/04/marijuana-vascular-dementia.html
As marijuana legalization spreads, new research is improving our understanding of side effects. Heart cells have cannabis receptors relevant to vascular squeezing ability. Learn about marijuana's link to vascular dementia.

---

WASHINGTON - Using marijuana raises the vascular risks of stroke and heart failure, major risk factors leading to vascular dementia. Even after accounting for demographic factors, other health conditions and lifestyle risk factors such as smoking and alcohol use, the data is compelling, according to research being presented at the American College of Cardiology’s 66th Annual Scientific Session.

Vascular Health

Coming at a time when marijuana, medically known as cannabis, is on track to become legal for medical or recreational use in more than half of U.S. states, this study sheds new light on how the drug affects vascular health. While previous marijuana research has focused mostly on pulmonary and psychiatric complications, the new study is one of only a handful to investigate cardiovascular outcomes.

“Like all other drugs, whether they’re prescribed or not prescribed, we want to know the effects and side effects of this drug,” said Aditi Kalla, MD, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author. “It’s important for physicians to know these effects so we can better educate patients, such as those who are inquiring about the safety of cannabis or even asking for a prescription for cannabis.”

Nationwide Inpatient Sample

The study drew data from the Nationwide Inpatient Sample, which includes the health records of patients admitted at more than 1,000 hospitals comprising about 20 percent of U.S. medical centers. Researchers extracted records from young and middle-aged patients—age 18-55 years—who were discharged from hospitals in 2009 and 2010, when marijuana use was illegal in most states.

Marijuana use was diagnosed in about 1.5 percent (316,000) of more than 20 million health records included in the analysis. Comparing cardiovascular disease rates in these patients to disease rates in patients not reporting marijuana use, researchers found marijuana use was associated with a significantly increased risk for cardiovascular events such as stroke, heart failure, coronary artery disease and sudden cardiac death.

Marijuana - Independent Association

Marijuana use was also linked with a variety of factors known to increase cardiovascular risk, such as obesity, high blood pressure, smoking and alcohol use. After researchers adjusted the analysis to account for these factors, marijuana use was independently associated with a 26 percent increase in the risk of stroke and a 10 percent increase in the risk of developing heart failure. (Really?)

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” Kalla said. “More research will be needed to understand the pathophysiology behind this effect.”

Heart Cells Have Canabis Receptors

Research in cell cultures shows that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system. It is possible that other compounds could be developed to counteract that mechanism and reduce cardiovascular risk, Kalla said.

Because the study was based on hospital discharge records, the findings may not be reflective of the general population. The study was also limited by the researchers’ inability to account for quantity or frequency of marijuana use, purpose of use (recreational or medical), or delivery mechanism (smoking or ingestion).

Further Insights

Kalla suggested that the growing trend toward legalization of marijuana could mean that patients and doctors will become more comfortable speaking openly about marijuana use, which could allow for better data collection and further insights into the drug’s effects and side effects.

SOURCE:

• The American College of Cardiology
  The American College of Cardiology is a 52,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications.

Vascular Dementia Caused by Plaque Build-Up in Arteries

You can compare this Mayo clinic explanation of atherosclerosis to an earlier one I pointed to.
Vascular dementia and artery plaque by Mayo Clinic
You can see a video of how plaque forms here:
Inflammation In Atherosclerotic Plaque Formation 
You can see from both of these that the real solution is to stop the original inflammation in the first place. Reducing cholesterol is a secondary solution and a poor one at that.