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Ensayo controlado aleatorizado2020Acceso abierto

Brain delivery of supplemental docosahexaenoic acid (DHA): A randomized placebo-controlled clinical trial

Arellanes IC, Choe N, Solomon V, He X, Kavin B, Martinez AE, Kono N, Buennagel DP, Hazra N, Kim G, D'Orazio LM, McCleary C, Sagare A, Zlokovic BV, Hodis HN, Mack WJ, Chui HC, Harrington MG, Braskie MN, Schneider LS, Yassine HN

EBioMedicine · 111 citas

Cómo se estudió

Diseño
Ensayo controlado aleatorizado (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación independiente
Gobierno
National Institute on Aging
Gobierno
National Center for Advancing Translational Sciences
Gobierno
NIA NIH HHS
Gobierno
NCATS NIH HHS
Subvenciones
National Institute on Aging (R01 AG055770); National Institute on Aging (P50 AG005142); National Institute on Aging (P30-AG066530); National Institute on Aging (R01AG067063); National Center for Advancing Translational Sciences (UL1‐TR‐001855); National Institute on Aging (R21 AG056518); National Institute on Aging (R01 AG054434)

Según 4 financiadores declarados y la declaración de financiación del texto completo.

Publicación

Publicado
2020-07-17 · EBioMedicine · vol. 59 · pág. 102883
Editorial
Elsevier BV
Citado
134 citas · más que el 99% de estudios similares · 8.2× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
63 trabajos
Acceso
Acceso abierto (revista) · CC-BY-NC-ND
Áreas de investigación
Fatty Acid Research and Health · Antioxidant Activity and Oxidative Stress · Diet and metabolism studies
Palabras clave
Docosahexaenoic acid, Medicine, Eicosapentaenoic acid, Placebo, Internal medicine, Vitamin D and neurology, Randomized controlled trial, Gastroenterology, Physiology, Endocrinology, Polyunsaturated fatty acid, Fatty acid, Pathology, Biology, Biochemistry
MeSH
brain, humans, alzheimer disease, docosahexaenoic acids, treatment outcome, cognition, genotype, dietary supplements, aged, aged, 80 and over, middle aged, female, male, apolipoprotein e4

21 autores

  • Isabella C. Arellanes🇺🇸Keck Hospital of USC
  • Nicholas Choe🇺🇸Keck Hospital of USC
  • Victoria A. Solomon🇺🇸Keck Hospital of USC
  • Xulei He🇺🇸Keck Hospital of USC
  • Brian Kavin🇺🇸Keck Hospital of USC
  • Ashley E. Martinez🇺🇸Keck Hospital of USC
  • Naoko Kono🇺🇸Keck Hospital of USC
  • David P Buennagel🇺🇸Huntington Medical Research Institutes
  • Nalini Hazra
  • Giselle Kim
  • Lina M. D’Orazio🇺🇸Keck Hospital of USC
  • Carol A. McCleary🇺🇸Keck Hospital of USC
  • Abhay P. Sagare🇺🇸Keck Hospital of USC
  • Berislav V. Zloković🇺🇸Keck Hospital of USC
  • Howard N. Hodis🇺🇸Keck Hospital of USC
  • Wendy Jean Mack🇺🇸Keck Hospital of USC
  • Helena Chang Chui🇺🇸Keck Hospital of USC
  • Michael G. Harrington🇺🇸Huntington Medical Research Institutes; Keck Hospital of USC
  • Meredith N. Braskie
  • Lon S. Schneider🇺🇸Keck Hospital of USC
  • Hussein N. Yassine🇺🇸 · autor de correspondenciaKeck Hospital of USC

Resumen

El texto original del estudio, en el idioma en que se publicó.

Background

Past clinical trials of docosahexaenoic Acid (DHA) supplements for the prevention of Alzheimer's disease (AD) dementia have used lower doses and have been largely negative. We hypothesized that larger doses of DHA are needed for adequate brain bioavailability and that APOE4 is associated with reduced delivery of DHA and eicosapentaenoic acid (EPA) to the brain before the onset of cognitive impairment.

Methods

33 individuals were provided with a vitamin B complex (1 mg vitamin B12, 100 mg of vitamin B6 and 800 mcg of folic acid per day) and randomized to 2,152 mg of DHA per day or placebo over 6 months. 26 individuals completed both lumbar punctures and MRIs, and 29 completed cognitive assessments at baseline and 6 months. The primary outcome was the change in CSF DHA. Secondary outcomes included changes in CSF EPA levels, MRI hippocampal volume and entorhinal thickness; exploratory outcomes were measures of cognition.

Findings

A 28% increase in CSF DHA and 43% increase in CSF EPA were observed in the DHA treatment arm compared to placebo (mean difference for DHA (95% CI): 0.08 µg/mL (0.05, 0.10), p<0.0001; mean difference for EPA: 0.008 µg/mL (0.004, 0.011), p<0.0001). The increase in CSF EPA in non-APOE4 carriers after supplementation was three times greater than APOE4 carriers. The change in brain volumes and cognitive scores did not differ between groups.

Interpretation

Dementia prevention trials using omega-3 supplementation doses equal or lower to 1 g per day may have reduced brain effects, particularly in APOE4 carriers.

Trial registration

NCT02541929.

Funding

HNY was supported by R01AG055770, R01AG054434, R01AG067063 from the National Institute of Aging and NIRG-15-361854 from the Alzheimer's Association, and MGH by the L. K. Whittier Foundation. This work was also supported by P50AG05142 (HCC) from the National Institutes of Health. Funders had no role in study design, data collection, data analysis, interpretation, or writing of the report.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC-ND).

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