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P2‐017: EFFECTS OF TECHNOLOGY‐ENABLED PHYSICAL ACTIVITY COUNSELLING ON INTRA‐INDIVIDUAL VARIABILITY AND OTHER MEASURES OF COGNITIVE PERFORMANCE AMONG ADULTS WITH KNEE OSTEOARTHRITIS
Author(s) -
Best John R.,
Falck Ryan S.,
Li Linda C.,
Feehan Lynne M.,
Liu-Ambrose Teresa
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.701
Subject(s) - cognition , physical therapy , medicine , randomized controlled trial , osteoarthritis , stroop effect , physical medicine and rehabilitation , contrast (vision) , cognitive decline , audiology , dementia , psychology , psychiatry , alternative medicine , disease , pathology , artificial intelligence , computer science
Background: Resveratrol with red wine polyphenols (R/P) was shown to unexpectedly and rapidly improve Parkinson’s with "Alzheimer’s Changes" motor and non-motor symptoms shown through improved Unified Parkinson’s Disease Rating Scale (UPDRS) scores, likely by disaggregating a-synuclein (SNCA) sparing dopamine and inducing autophagy and neuroprotection via SIRT1/ AMPK activation with bioavailability likely enhanced by the polyphenol quercetin. Resveratrol alone has improved Alzheimer’s symptoms and reduces b-amyloid aggregates in mice. Inhibition and disaggregation of SNCA oligomers was shown by several phenolic compounds including resveratrol, quercetin, myricetin providing evidence for superior treatment efficacy as a combined extract, rather than individual components. These findings argue for a clinical trial protocol to test the R/P as an herbal extract rather than R alone. Methods:The UPDRS and tremor scales were sufficient to measure improvements in advanced PD patient function, already showing dyskinesia, using a rigorously analyzed R/P herbal extract. Because R is known to reduce inflammation and protect dopamine neurons, Cerebrospinal Fluid (CSF) tests to measure inflammation through microglia activation and/or clearance of SNCA aggregates such as those against TNFa and IL-1b proteins or preferably peripheral blood assessment of increased C-reactive protein, inversely associated with elderly functional measures could be considered. The rapid improvements using R/P seen after the initial dose would necessitate close monitoring for the first 2448 hours to potentially adjust carbidopa/levodopa dosages. Trial details will be illustrated. Results: An R/P herbal extract improved symptoms in a patient with advanced PD with AD changes better than resveratrol alone and the mixture should thus be tested on a larger patient cohort with the above suggested tests, preferably against placebo for a phase II small three-arm efficacy trial in advanced patients showing dyskinesias. Conclusions: The efficacy of the combined R/P herbal extract in PD with "AD changes" over five years suggests performing a brief, larger trial against R alone and against placebo as purifying the components would likely reduce the effects and be cost-prohibitive. The low toxicity and side effects of Resveratrol with red wine polyphenols makes it an attractive preventive and adjunct to PD and AD therapy which a small inexpensive trial would help accomplish.