Projects / Programmes
ENDOTHELIAL FUNCTION IN PSYCHIATRIC AND NEUROLOGICAL DISEASES
Code |
Science |
Field |
Subfield |
3.09.00 |
Medical sciences |
Psychiatry |
|
Code |
Science |
Field |
B640 |
Biomedical sciences |
Neurology, neuropsychology, neurophysiology |
Code |
Science |
Field |
3.02 |
Medical and Health Sciences |
Clinical medicine |
Dementia, Lekoariosis, Migraine, Endothelium, transcranial Doppler sonography, flow mediated vasodilatation
Researchers (11)
Organisations (2)
Abstract
The project consists of two subprojects A and B in which we will study endothelial function in patients with dementia and migraine
Dementia is one of the most common medical syndromes and therefore represents a significant financial burden to society. It is often accompanied by psychiatric disorders such as depression. The most common causes of dementia are degenerative process (Alzheimer's disease) and cerebral vascular damage. The conclusion of the interlocking pathology consensus is that dementia is most commonly due to both; degenerative process and vascular impairment. Modern neuroradiological methods such as magnetic resonance imaging (MRI) in patients with degenerative and vascular dementia often show cerebral white matter lesions, commonly known as levkoaraiosis. The exact pathophysiological mechanism that causes levkoaraiosis is unknown. It is possible that endothelial dysfunction may cause vascular damage as well as damage of the blood-brain barrier. However, the endothelial function (or dysfunction) in patients with levkoaraiosis is not known.
Migraine is a common neurological cerebrovascular disorder which may be accompanied by psychiatric disorders such as depression and anxiety. It represents a significant financial burden for society. Pathophysiology of migraine is unclear. There are several theories. According one of them says that migraine may be due to endothelial dysfunction. In addition, the functioning of posterior brain blood circulation in patients with migraine is not known. Some studies suggest that migraine generators located in the posterior brain blood circulation. Past studies supported the concept that endothelial function is impaired in the posterior brain blood circulation of patients with migraine.
The aim of our study is to determine the function of the endothelium in patients with leukoaraiosis who have dementia and migraine interictally by using transcranial Doppler sonography (TCD) with L-arginine and endothelium dependent vasodilatation (FMD). We hypothesize that the patients with dementia who have leukoaraiosis have endothelial dysfunction. The work is original because the in vivo endothelial function in patients with dementia and leukoaraiosis has not been tested so far. We assume that the functioning of endothelium in the posterior cerebral circulation in patients with migraine between migraine attacks is impaired. The work is original because the in vivo endothelial function in patients with migraine has not been tested so far.
T The A subproject will include 20 patients with dementia who have leukoaraiosis and 20 healthy subjects. The subproject B will include 20 healthy subjects and 40 patients with migraine with aura and without aura. Both groups of subjects will not differ according age and sex. We will observe the principles of the Helsinki Declaration while conducting the investigation. We will measure mean arterial velocity in the middle cerebral artery (anterior circulation) and in posterior cerebral artery (posterior circulation) with TCD (Multi-Dop X4, DWL). At the same time we will measure arterial pressure and heart rate continuously (Colin 7000, Komaki-City, Japan). The end tidal CO2 (Et-CO2) will be continuously measured with an infrared capnograph (Capnodig, Draeger: Lübeck, Germany). We will calculate the cerebrovascular reactivity to L-arginine from the mean arterial velocity through the observed artery before and after the infusion of L-arginine. In addition, we will perform the endothelial dependent vasodilatation of the radial artery (FMD) (ALOCA alfa 10) according to common protocol in all subjects. Statistical results will be obtained using the statistical program SPSS.
The study will try to clarify current pathophysiological concepts of dementia, and migraine. The results of research could be used in clinical practice, since the confirmation of these concepts can improve the treatment of patients with
Significance for science
We have found that in patients with migraine without risk factors for cardiovascular disease i endothelial functioning of the brain in the last bloodstream worse than in healthy subjects. Endothelial functioning front and rear cerebral blood circulation is related both in healthy subjects and in patients with migraine without factors the risk of cardiovascular disease. It seems that endothelial functioning in systemic blood circulation in patients with migraine without risk factors for cardiovascular disease is not changed. It also appears that the functioning of the endothelial systemic circulation is not associated with the endothelial function of the front and rear of blood circulation. Based on the above mentioned results, it is possible that patients with migraine disturbed endothelial functioning only in the rear of the brain blood stream.
Significance for the country
The research should bring a new knowledge which could be useful in hospital and in outpatients words.
Most important scientific results
Annual report
2011,
2012,
2013,
final report,
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Most important socioeconomically and culturally relevant results
Annual report
2012,
2013,
final report,
complete report on dLib.si