Coronary Artery Bypass Surgery Provokes Alzheimer's Disease-Like Changes in the Cerebrospinal Fluid

Article type: Research Article

Authors: Palotás, András^{a; *} | Reis, Helton J.^b | Bogáts, Gábor^c | Babik, Barna^{c; d} | Racsmány, Mihály^{e; f} | Engvau, Linda^{f; g} | Kecskeméti, Éva^{f; g} | Juhász, Anna^g | Vieira, Luciene B.^b | Teixeira, Antônio L.^h | Mukhamedyarov, Marat A.ⁱ | Rizvanov, Albert A.^{j; k; l} | Yalvaç, Mehmet E.^l | Guimarães, Melissa M.^{b; m} | Ferreira, Cláudia N.^{m; n} | Zefirov, Andrey L.ⁱ | Kiyasov, Andrey P.^o | Wang, Lan^p | Janka, Zoltán^g | Kálmán, János^g

Affiliations: [a] Asklepios-Med (private practice and research center), Szeged, Hungary | [b] Laboratório de Neurofarmacologia, Departamento de Farmacológia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (ICB-UFMG), Belo Horizonte, Minas Gerais, Brazil | [c] Division of Cardiac Surgery, Center for Cardiology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary | [d] Department of Anesthesiology and Intensive Therapy, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary | [e] Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary | [f] Department of Psychology, University of Szeged, Szeged, Hungary | [g] Department of Psychiatry, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary | [h] Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil | [i] Department of Physiology, Kazan State Medical University, Kazan, Russia | [j] Department of Genetics, Faculty of Biology and Soil Sciences, Kazan State University, Kazan, Russia | [k] Core research laboratory, Kazan State Medical University, Kazan, Russia | [l] Department of Genetics and BioEngineering, College of Engineering and Architecture, Yeditepe University, Istanbul, Turkey | [m] Departamento de Ciências Bésicas, Faculdade de Ciências da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Centro Diamantina, Minas Gerais, Brazil | [n] Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil | [o] Department of Anatomy, Kazan State Medical University, Kazan, Russia | [p] Institute of Biotechnology, Cambridge Centre for Neuropsychiatric Research, University of Cambridge, Cambridge, UK

Correspondence: [*] Correspondence to: András Palotás, MD, PhD, Asklepios-Med, H-6722 Szeged, Kossuth Lajos sgt. 23, Hungary. Tel.: +(36)(30)255 6225; E-mail: palotas@asklepios-med.eu.

Abstract: Several biomarkers are used in confirming the diagnosis of cognitive disorders. This study evaluates whether the level of these markers after heart surgery correlates with the development of cognitive dysfunction, which is a frequent complication of cardiac interventions. Concentrations of amyloid-β peptide, tau, and S100β in the cerebro-spinal fluid were assessed, as well as cognitive functions were evaluated before and after coronary artery bypass grafting, utilizing immuno-assays and psychometric tests, respectively. A drastic rise in the level of S100β was observed one week after the surgery, a mark of a severe generalized cerebral injury. The level of amyloid-β peptide significantly decreased, whereas the concentration of tau markedly increased six months postoperatively. Gradual cognitive decline was also present. These findings clearly demonstrate post-surgical cognitive impairment associated with changes in biomarkers similar to that seen in Alzheimer's disease, suggesting a unifying pathognomic factor between the two disorders. A holistic approach to coronary heart disease and Alzheimer's-type dementia is proposed.

Keywords: Alzheimer's disease, amyloid-β peptide, biomarker, cardiac surgery, cerebrospinal fluid, cognitive function, postoperative cognitive decline, S100β, tau

DOI: 10.3233/JAD-2010-100702

Journal: Journal of Alzheimer's Disease, vol. 21, no. 4, pp. 1153-1164, 2010