Frontiers in Molecular Neuroscience (Jul 2023)

Extensive multiregional urea elevations in a case-control study of vascular dementia point toward a novel shared mechanism of disease amongst the age-related dementias

  • Sasha A. Philbert,
  • Jingshu Xu,
  • Melissa Scholefield,
  • Stefano Patassini,
  • Stephanie J. Church,
  • Richard D. Unwin,
  • Federico Roncaroli,
  • Garth J. S. Cooper,
  • Garth J. S. Cooper

DOI
https://doi.org/10.3389/fnmol.2023.1215637
Journal volume & issue
Vol. 16

Abstract

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IntroductionVascular dementia (VaD) is one of the most common causes of dementia among the elderly. Despite this, the molecular basis of VaD remains poorly characterized when compared to other age-related dementias. Pervasive cerebral elevations of urea have recently been reported in several dementias; however, a similar analysis was not yet available for VaD.MethodsHere, we utilized ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) to measure urea levels from seven brain regions in post-mortem tissue from cases of VaD (n = 10) and controls (n = 8/9). Brain-urea measurements from our previous investigations of several dementias were also used to generate comparisons with VaD.ResultsElevated urea levels ranging from 2.2- to 2.4-fold-change in VaD cases were identified in six out of the seven regions analysed, which are similar in magnitude to those observed in uremic encephalopathy. Fold-elevation of urea was highest in the basal ganglia and hippocampus (2.4-fold-change), consistent with the observation that these regions are severely affected in VaD.DiscussionTaken together, these data not only describe a multiregional elevation of brain-urea levels in VaD but also imply the existence of a common urea-mediated disease mechanism that is now known to be present in at least four of the main age-related dementias.

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