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Medical Rounds

Neurology: More Fuel for Curbing Inflammation

A Johns Hopkins team has added to evidence that rising and chronic inflammation as measured by a biomarker in the blood in middle and late age are linked to visible structural changes in the brains of people with poor cognition and dementia.

The authors say results of their study, based on data gathered from a federally funded study on more than 1,500 people, suggest that efforts to curb inflammation with drugs or lifestyle changes midlife or earlier may be key to delaying or preventing cognitive decline in old age.

“We found that individuals who had an increase in inflammation during midlife that was maintained from mid- to late life have greater abnormalities in the brain’s white matter structure, as measured with MRI scans. This suggests to us that inflammation may have to be chronic, rather than temporary, to have an adverse effect on important aspects of the brain’s structure necessary for cognitive function,” says lead author Keenan Walker, a postdoctoral fellow in the Department of Neurology.

Researchers have long gathered evidence that chronic inflammation and the biochemicals associated with it may damage the brain. C-reactive protein, an inflammatory factor made in the liver, for example, already has become a marker for chemical damage to heart and blood vessel tissue indicative of heart attack.

So far, however, according to Walker, studies linking inflammation to brain abnormalities have not looked at these factors and features over an extended period of time in the same population.

In their new study, described in Neurobiology of Aging, Walker and his colleagues took data from the prospective Atherosclerosis Risk in Communities Study conducted in four United States
cities, that looked at brain structure and integrity, as well as a marker of inflammation, over a 21-year period spanning middle age to late life.

“Our work is important because currently, there aren’t treatments for neurodegenerative diseases, and inflammation may be a reversible factor to prolong or prevent disease onset,” says neurologist and senior author Rebecca Gottesman. “Now, researchers have to look at how we might reduce inflammation to reduce cognitive decline and neurodegeneration.”