Examining the impact of grape consumption on brain metabolism in patients with mild decline in cognition: A double-blinded placebo controlled expansion study
2020
1540 Objectives: We previously reported that grape consumption by people experiencing decline in cognition leads to the preservation of metabolism in brain regions important to cognitive function over six months in a double-blinded placebo-controlled study (Experimental Gerontology 87, 2017; 121-128). In an ongoing expansion study, we are examining the effect of grape consumption on regional cerebral metabolism with an independent cohort of subjects, measured over one year.
Methods: Thirty-two subjects undergoing neuroimaging evaluation for cognitive decline will be included in this study. Subjects are randomized into two groups, Group 1 and Group A, to consume an active grape formulation (36 grams of reconstituted freeze-dried grape powder) or a placebo formulation free of polyphenols, twice daily for 12 months. Changes in brain metabolism occurring with each therapy regimen were assessed by brain PET scans with the radiotracer [F-18] fluorodeoxyglucose (FDG) during initial evaluation and 12 months later. Cognitive performance was measured through neuropsychological assessments performed at baseline, 6 months after initiation of therapy and 12 months after initiation of therapy. Forty-seven standardized volumes of interest (sVOI) were applied to FDG-PET scans to identify areas of significant change in cerebral metabolism occurring over one year, and regionally quantify the magnitudes of change in those areas in each study arm. Results are being analyzed by paired t-tests to examine longitudinal changes within each arm and by unpaired two-tailed t-tests to examine the significance of differences between arms.
Results: At the time of this interim analysis, 16 subjects have been recruited in this ongoing study and completed all baseline studies, and half of them have completed the year-long trial. Of completing subjects, six are in Group 1 (mean age, 74 ± 6 years; 67% female), and two are in Group A (mean age, 82 ± 1 year; 50% female). The majority of individual subjects in Group 1 demonstrated decreases in metabolic activity in sVOI’s of bilateral medial temporal regions, including the right anterior medial temporal region (rMAT), left posterior medial temporal region (lMPT), and right posterior medial temporal region (rMPT), changing by -5.01%, -3.11%, and -3.29% over one year, respectively (each corresponding to p < 0.10). The metabolic activity in each of these regions for subjects in Group A did not decline and actually increased modestly, though not significantly.
Conclusions: Among all subjects completing a full year of grape consumption versus placebo, most subjects in Group 1 experienced significant decreases in metabolic activity in regions of the brain known to be significantly affected in the early stages of Alzheimer’s disease, while subjects in Group A experienced insignificant modest increases.
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