Cognitive Function Clinical Trial
Official title:
Study of the Impact of a Flavanol Containing Food Product and Exercise on Cognitive Function and Brain Structure
This is a randomized controlled trial to test the impact of a flavonol containing food product and aerobic exercise on cognitive function and brain structure.
I. Background and Significance A. The epidemiology of cognitive aging. Encompassing multiple
cognitive domains, higher order thinking includes memory, language, abstract reasoning, and
visuospatial ability. A range of studies have established that memory is a cognitive domain
differentially targeted by the normal aging process. With an increase in lifespan and a
decrease in co-morbid diseases, aging individuals expect to lead cognitively-challenging
lives. Even mild forgetfulness, therefore, is no longer considered 'benign'. Indeed, with the
exponential growth of the aging population, and since memory decline will occur in all of us
as we age, age-related memory decline has emerged as a major societal problem.
B. The anatomy of cognitive aging. A range of studies in humans, non-human primates and
rodents have established that the hippocampal formation, a brain circuit vital for memory, is
targeted by the aging process. Age-related hippocampal dysfunction is therefore a major
contributor to age-related memory decline.
The hippocampal formation is organized as a circuit, made up of separate but interconnected
regions, including the entorhinal cortex, the dentate gyrus, the CA subfields, and the
subiculum. Because of hippocampal circuit properties, dysfunction in one subregion will
affect the function of neighboring subregions and the hippocampal circuit as a whole. Thus,
when confronted with any process that causes the hippocampal circuit to malfunction,
pinpointing the subregion that is most effected becomes an important goal.
In the case of age-related memory decline, a range of studies in humans, non-human primates,
and rodents, have suggested that normal aging causes hippocampal dysfunction by
differentially targeting the dentate gyrus.
C. Imaging cognitive aging. The anatomical organization of the hippocampal circuit and the
differential vulnerability of the dentate gyrus to cognitive aging imposes specific
requirements on brain imaging techniques. Specifically, an imaging technique must be able to
assess the functional integrity of the multiple hippocampal subregions, in particular the
dentate gyrus. With this in mind, our lab has been dedicated to optimizing a functional brain
imaging approach applicable to both the human and rodent hippocampal formation. We have
recently achieved this goal, and have been applying our cross-species imaging capabilities to
investigate a range of process that affect hippocampal function.
D. Flavanols, exercise, and cognitive aging. Previous studies have established that physical
exercise improved hippocampal function. We have recently exploited our cross-species imaging
techniques to show, that within the hippocampal circuit, exercise has a selective effect on
dentate gyrus function, in humans and in mice. Independently, a recent study has shown that
the flavanol epichatechin improves hippocampal function, and importantly, within the
hippocampal circuit, epichatechin was found to differentially target the dentate gyrus.
Moreover, this study showed that epichatechin coupled with exercise had its greatest effect
on dentate gyrus function.
E. Summary. Starting at around 30 years of age, all of us will begin experiencing the
insidious cognitive slide of age-related memory decline. With the expansion of aging,
age-related memory decline is swelling to epidemic proportions, and ameliorating age-related
memory decline has emerged as major societal goal.
This proposal is designed to test the following hypothesis: That flavanols with or without
physical exercise will ameliorate age-related memory decline. This hypothesis is informed by
two sets of interleaving findings: First, a range of studies have pinpointed dysfunction in
the dentate gyrus as a specific brain region contributing to age-related memory decline; and
second, flavanol consumption with or without physical exercise enhances memory performance by
improving dentate gyrus function.
In order to experimentally test this hypothesis an imaging technique is required that can
assess the functional integrity of the dentate gyrus, techniques that are now available.
Importantly, these imaging techniques have been developed so that can they can be applied not
only to humans but also to animal models, generating the same 'imaging readout'.
Cross-species imaging is particularly important for translational studies.
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