Stroke and Dementia: Causes, Treatments, and New Research - Lecture 5/24/23

Explore the intricate connections between stroke and dementia in this comprehensive physician grand rounds presentation. Delve into the complexities of stroke types, including small vessel disease, and examine their relationship to various forms of dementia. Learn about the neurovascular unit and its proposed role in small vessel disease, while gaining insights into clinical definitions and the diverse pathologies causing these conditions. Discover historical perspectives, genetic factors, and the roles of amyloid and tau proteins in dementia. Investigate cutting-edge treatments, including monoclonal antibodies targeting amyloid components. Uncover fascinating new research on stroke and dementia, exploring topics such as age-related differences in stroke recovery, the impact of microbiomes, and potential genetic modifications to address aging. Examine the importance of sleep in glymphatic drainage and its implications for brain health. Finally, consider the role of various RNA types in the neurovascular unit and contemplate the nature of reality in the context of neurological disorders.

Intro
Outline
What is a stroke?
Sloppy VEN diagrams for stroke and small stroke
Case 2
Questions on Case 1 and 2
Meet the neurovascular unit and proposed role in small vessel disease
Clinical Definitions; many pathologies causing the clinical condition
Many causes of dementia and some reversible
The Ugly Pathological Reality
Historical tidbits
Some historical wrinkles
Genes and amyloid and tau
Treatment: Bring on the mABS Monoclonal antibodies to amyloid parts
What is Crazy new in stroke and dementi
Old Mice do not recover from MCA stroke as well as Young Mice. Their microbiomes are also different.
Better Microbiome will reduce stroke damage. SCFA (inulin) helps.
Modify genes to modify aging? Stem Cel
Drug infusion to modify genes.
a. Sleep and the benefit of Glymphatic Drainage
b. Sleep (SWS) promotes Glymphatic Drain but SWS declines with age
3. Block orexin and improve sleep and drainage and memory
RNA wild card with Neurovascular Unit: mRNA, tRNA, rRNA + lots of other RNA par
Variety of RNA
What is Reality