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The primary aim of the current research project is to answer the question, whether plasma trimethylamine N-oxide (TMAO) level may be used as a marker of ischemic changes in the brain. TMAO is associated with endothelial dysfunction, inflammation and oxidative stress.
The hypothesis is that circulating TMAO level may predict leukoaraiosis (LA) and/or stroke.
Secondary, the investigators would like to examine whether plasma TMAO concentration is related to cognitive impairment and determine whether choline consumption is associated with an incidence of LA severity and dementia.
In the study, subjects will be recruited in the hospital among the patients with brain MRI performed within past 4 weeks. All MRI scans will be reviewed by the neurologist to evaluate ischemic changes. Upon detection of LA, patients (n=150) will be informed about the study aims. In the same time, aged- and sex-matched control group (n=150) with no detected ischemic changes will be recruited.
In each group, the blood samples will be collected, to determine the concentration of plasma TMAO, oxidative stress markers, as well as serum endothelial dysfunction markers and biochemical parameters. To determine the cognitive performance psychological test will be carried out. The diet of all recruited participants, with special consideration on the choline-rich products and supplements, will be analyzed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ischemic changes | Patients with ischemic changes in the brain diagnosed by MRI |
| |
| No ischemic changes | Patients without ischemic changes in the brain diagnosed by MRI |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magnetic Resonance Imaging (MRI) | Diagnostic Test | Magnetic Resonance Imaging (MRI) to diagnose ischemic changes in the brain. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Brain Magnetic Resonance Imaging (MRI) | Leukoaraiosis severity will be evaluated in MRI scans according to the Fazekas' scale. Will be grading scale for periventricular hyperintensities (PVH) and scale of deep white matter hyperintensities. | before qualifying for the study, during the recruitment period |
| Trimethylamine-N-oxide (TMAO) blood concentration | TMAO concentration determined by the ultra-performance liquid-chromatography tandem mass spectrometry (UPLC-MS/MS), marked in µmol/l. | up to 4 weeks after brain MRI |
| Measure | Description | Time Frame |
|---|---|---|
| Brain-derived neurotrophic factor (BDNF) | BDNF concentration determined in serum by ELISA method, marked in pg/mg. | up to 4 weeks after brain MRI |
| Mini Mental State Examination (MMSE) | MMSE is a screening tool for cognitive functions impairment. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients from 7th Navy Hospital in Gdansk, which had a brain MRI performed within the past 4 weeks.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Robert A Olek, PhD | Contact | 58 5547392 | +48 | robol@awf.gda.pl |
| Name | Affiliation | Role |
|---|---|---|
| Robert A Olek, PhD | Gdansk University of Physical Education and Sport | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Physical Education and Sport | Gdansk | Pomeranian Voivodeship | 80-336 | Poland |
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| Blood samples collection | Diagnostic Test | Trimethylamine N-oxide (TMAO) concentration, oxidative stress markers and endothelial dysfunction markers will be determined in blood samples. |
|
| Neuropsychological tests | Diagnostic Test | Cognitive functions assessment |
|
| up to 4 weeks after brain MRI |
| Trail Making Test (TMT) | TMT test to determine the executive functions. | up to 4 weeks after brain MRI |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D049292 | Leukoaraiosis |
| D002545 | Brain Ischemia |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D008279 | Magnetic Resonance Imaging |
| ID | Term |
|---|---|
| D014054 | Tomography |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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