Calabro Rocco Salvatore, Gervasi Giuseppe, Baglieri Annalisa, Furnari Anna, Marino Silvia, Bramanti Placido
IRCCS Centro Neurolesi Bonino-Pulejo S.S.113 via Palermo, Messina, Italy.
Curr Aging Sci. 2013 Jul;6(2):170-7. doi: 10.2174/1874609811306020005.
Leukoraraiosis is worldwide considered as a part of the normal aging process, although it is strongly associated with dementia and other disabilities. The pathogenesis of leukoaraiosis still has not been thoroughly acknowledged, even though chronic ischemia with consequent arteriolosclerosis probably due to endothelial dysfunction has been suggested. Treatment focuses on prevention of lesion formation and progression by aggressive control of risk factors, which should begin at an early age and continue on regular basis. Aim of our protocol is to evaluate the effect of long-term oral administration of high-dose L-arginine (6 g/day at least for 24 months) on white matter lesions and neurological and cognitive functions.
Patients affected by mild to moderate leukoaraiosis will be enrolled in the study. After a complete neurovascular assessment (i.e. accurate blood test examinations, Echocardiography, Doppler ultrasound of the neck and peripheral arteries), they will undergo MRI, specific neuropsychological tests and gait analysis. Patients will be evaluated at baseline, at 6, 12, 18 and 24 month-follow up. Statistical Analysis will be performed using the software R. A significant level of P<0.05 will be set for all the tests. PRELIMINARY DATA: Two of the 4 patients currently enrolled in the study presented a mild improvement in cognitive function.
Because of its high prevalence in over-65-year-old subjects, we hypothesized that treatment with 6 gr of Larginine, as supplementary dietary option, could be helpful in patients affected by leukoaraiosis to improve the cognitive and gait impairment often observed in these subjects (as demonstrated by the LADIS study).
尽管脑白质疏松症与痴呆和其他残疾密切相关，但在全球范围内它被视为正常衰老过程的一部分。脑白质疏松症的发病机制尚未得到充分认识，尽管有人提出可能是由于内皮功能障碍导致慢性缺血并进而引发小动脉硬化。治疗的重点是通过积极控制危险因素来预防病变的形成和进展，这应从早年开始并持续进行。我们方案的目的是评估长期口服高剂量L-精氨酸（至少6克/天，持续24个月）对脑白质病变以及神经和认知功能的影响。
患有轻度至中度脑白质疏松症的患者将被纳入该研究。在进行全面的神经血管评估（即准确的血液检查、超声心动图、颈部和外周动脉的多普勒超声检查）后，他们将接受磁共振成像（MRI）、特定的神经心理学测试和步态分析。患者将在基线、6个月、12个月、18个月和24个月随访时接受评估。将使用R软件进行统计分析。所有测试将设定显著性水平P<0.05。初步数据：目前参与该研究的4名患者中有两名认知功能有轻度改善。
鉴于其在65岁以上人群中的高患病率，我们假设，作为补充饮食选择，每天服用6克L-精氨酸进行治疗，可能有助于改善脑白质疏松症患者经常出现的认知和步态障碍（如LADIS研究所示）。
