pulmicort and Cognition-Disorders

The long-term effects on neurodevelopment of the use of inhaled glucocorticoids in extremely preterm infants for the prevention or treatment of bronchopulmonary dysplasia are uncertain.. We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to receive early (within 24 hours after birth) inhaled budesonide or placebo. The prespecified secondary long-term outcome was neurodevelopmental disability among survivors, defined as a composite of cerebral palsy, cognitive delay (a Mental Development Index score of <85 [1 SD below the mean of 100] on the Bayley Scales of Infant Development, Second Edition, with higher scores on the scale indicating better performance), deafness, or blindness at a corrected age of 18 to 22 months.. Adequate data on the prespecified composite long-term outcome were available for 629 infants. Of these infants, 148 (48.1%) of 308 infants assigned to budesonide had neurodevelopmental disability, as compared with 165 (51.4%) of 321 infants assigned to placebo (relative risk, adjusted for gestational age, 0.93; 95% confidence interval [CI], 0.80 to 1.09; P=0.40). There was no significant difference in any of the individual components of the prespecified outcome. There were more deaths in the budesonide group than in the placebo group (82 [19.9%] of 413 infants vs. 58 [14.5%] of 400 infants for whom vital status was available; relative risk, 1.37; 95% CI, 1.01 to 1.86; P=0.04).. Among surviving extremely preterm infants, the rate of neurodevelopmental disability at 2 years did not differ significantly between infants who received early inhaled budesonide for the prevention of bronchopulmonary dysplasia and those who received placebo, but the mortality rate was higher among those who received budesonide. (Funded by the European Union and Chiesi Farmaceutici; ClinicalTrials.gov number, NCT01035190 .).

Topics: Administration, Inhalation; Blindness; Bronchopulmonary Dysplasia; Budesonide; Cerebral Palsy; Cognition Disorders; Developmental Disabilities; Female; Follow-Up Studies; Gestational Age; Glucocorticoids; Hearing Loss; Humans; Infant, Extremely Premature; Infant, Newborn; Infant, Premature, Diseases; Male

Asthma is the most common chronic childhood illness today. However, little attention is paid for the impacts of chronic asthma-induced hypoxia on cognitive function in children. The present study used immature mice to establish ovalbumin-induced chronic asthma model, and found that chronic asthma impaired learning and memory ability in Morris Water Maze test. Further study revealed that chronic asthma destroyed synaptic structure, impaired long-term potentiation (LTP) maintaining in the CA1 region of mouse hippocampal slices. We found that intermittent hypoxia during chronic asthma resulted in down-regulation of c-fos, Arc and neurogenesis, which was responsible for the impairment of learning and memory in immature mice. Moreover, our results showed that budesonide treatment alone was inadequate for attenuating chronic asthma-induced cognitive impairment. Therefore, our findings indicate that chronic asthma might result in cognitive dysfunction in children, and more attention should be paid for chronic asthma-induced brain damage in the clinical therapy.

Topics: Animals; Animals, Newborn; Asthma; Bronchodilator Agents; Budesonide; Chronic Disease; Cognition Disorders; Cytoskeletal Proteins; Developmental Disabilities; Disease Models, Animal; Female; Gene Expression Regulation, Developmental; Hippocampus; In Vitro Techniques; Ki-67 Antigen; Lung; Maze Learning; Mice; Mice, Inbred BALB C; Nerve Tissue Proteins; Ovalbumin; Pneumonia; Time Factors; Vascular Endothelial Growth Factor A

The severity of asthma in older people is frequently underestimated because of underdiagnosis and undertreatment. There are a number of reasons for this. In elderly patients, chronic diseases can be related to declining cognitive function. This situation could influence diagnosis and treatment. The objective of this study was to evaluate the influence of appropriate asthma therapy on cognitive function.. A total of 359 participants diagnosed with bronchial asthma, 219 women and 140 men with a mean age of 69 ± 4.03 years, were included in this study. Cognitive function was assessed with the Mini-Mental State Examination (MMSE) at the beginning of this study and after 1 year. Patients were divided into three subgroups based on their initial MMSE scores dementia, mild cognitive impairment (MCI), and good cognition.. At the beginning of this study, 31.2% of patients presented uncontrolled asthma, 46.2% exhibited partly controlled asthma, and 25.1% had well-controlled asthma. A significant improvement in control over the patients' asthma was observed over the course of this study. After 1 year of treatment, the mean MMSE score significantly increased in initially demented patients, from 18.2 ± 3.1 (mean ± SD) to 21.9 ± 2.1 (p < .01); in subjects with MCI, from 25.4 ± 0.9 to 27.2 ± 1.2; and in patients with good cognition, from 27.4 ± 0.7 to 29.7 ± 0.4 (chi-square test, p < .01).. Proper control of asthma in patients with cognitive impairments can improve some cognitive functions.

Topics: Aged; Aged, 80 and over; Albuterol; Anti-Asthmatic Agents; Asthma; Budesonide; Cognition Disorders; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Salmeterol Xinafoate; Spirometry