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      Efficacy and Safety of Lactobacillus Plantarum C29-Fermented Soybean (DW2009) in Individuals with Mild Cognitive Impairment: A 12-Week, Multi-Center, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

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          Abstract

          Early intervention using dietary supplements may be effective in alleviating cognitive impairment among individuals with mild cognitive impairment (MCI). This study investigated the efficacy and safety of Lactobacillus plantarum C29-fermented soybean (DW2009) as a nutritional supplement for cognitive enhancement. One hundred individuals with MCI were randomly assigned to take DW2009 (800 mg/day, n = 50) or placebo (800 mg/day, n = 50) for 12 weeks. The primary outcome measure was change in the composite score of cognitive functions related to memory and attention, measured by computerized neurocognitive function tests. Associations between changes in serum brain-derived neurotrophic factor (BDNF) levels and cognitive performance for each treatment group were evaluated. Compared to the placebo group, the DW2009 group showed greater improvements in the combined cognitive functions ( z = 2.36, p for interaction = 0.02), especially in the attention domain ( z = 2.34, p for interaction = 0.02). Cognitive improvement was associated with increased serum BDNF levels after consumption of DW2009 ( t = 2.83, p = 0.007). The results of this clinical trial suggest that DW2009 can be safely administered to enhance cognitive function in individuals with MCI. Increased serum BDNF levels after administering DW2009 may provide preliminary insight into the underlying effects of cognitive improvement, which suggests the importance of the gut-brain axis in ameliorating cognitive deficits in MCI.

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          Most cited references26

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          The BDNF val66met Polymorphism Affects Activity-Dependent Secretion of BDNF and Human Memory and Hippocampal Function

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            BDNF and 5-HT: a dynamic duo in age-related neuronal plasticity and neurodegenerative disorders.

            Brain-derived neurotrophic factor (BDNF) and serotonin (5-hydroxytryptamine, 5-HT) are known to regulate synaptic plasticity, neurogenesis and neuronal survival in the adult brain. These two signals co-regulate one another such that 5-HT stimulates the expression of BDNF, and BDNF enhances the growth and survival of 5-HT neurons. Impaired 5-HT and BDNF signaling is central to depression and anxiety disorders, but could also play important roles in the pathogenesis of several age-related disorders, including insulin resistance syndrome, Alzheimer's disease and Huntington's disease. Enhancement of BDNF signaling may be a key mechanism whereby cognitive stimulation, exercise, dietary restriction and antidepressant drugs preserve brain function during aging. Behavioral and pharmacological manipulations that enhance 5-HT and BDNF signaling could help promote healthy brain aging.
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              Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment: the Cocoa, Cognition, and Aging (CoCoA) study.

              Flavanol consumption is favorably associated with cognitive function. We tested the hypothesis that dietary flavanols might improve cognitive function in subjects with mild cognitive impairment. We conducted a double-blind, parallel arm study in 90 elderly individuals with mild cognitive impairment randomized to consume once daily for 8 weeks a drink containing ≈990 mg (high flavanols), ≈520 mg (intermediate flavanols), or ≈45 mg (low flavanols) of cocoa flavanols per day. Cognitive function was assessed by Mini Mental State Examination, Trail Making Test A and B, and verbal fluency test. At the end of the follow-up period, Mini Mental State Examination was similar in the 3 treatment groups (P=0.13). The time required to complete Trail Making Test A and Trail Making Test B was significantly (P<0.05) lower in subjects assigned to high flavanols (38.10±10.94 and 104.10±28.73 seconds, respectively) and intermediate flavanols (40.20±11.35 and 115.97±28.35 seconds, respectively) in comparison with those assigned to low flavanols (52.60±17.97 and 139.23±43.02 seconds, respectively). Similarly, verbal fluency test score was significantly (P<0.05) better in subjects assigned to high flavanols in comparison with those assigned to low flavanols (27.50±6.75 versus 22.30±8.09 words per 60 seconds). Insulin resistance, blood pressure, and lipid peroxidation also decreased among subjects in the high-flavanol and intermediate-flavanol groups. Changes of insulin resistance explained ≈40% of composite z score variability through the study period (partial r(2)=0.4013; P<0.0001). To the best of our knowledge, this is the first dietary intervention study demonstrating that the regular consumption of cocoa flavanols might be effective in improving cognitive function in elderly subjects with mild cognitive impairment. This effect appears mediated in part by an improvement in insulin sensitivity.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                01 February 2019
                February 2019
                : 11
                : 2
                : 305
                Affiliations
                [1 ]DONGWHA Pharm Research Institute, 35-71, Topsil-ro, Giheung-gu, Yongin-si 17084, Korea; yunha.hwang@ 123456dong-wha.co.kr (Y.-H.H.); docgyun.jeong@ 123456dong-wha.co.kr (D.-G.J.); kyuheum.na@ 123456dong-wha.co.kr (K.-H.N.)
                [2 ]Ewha Brain Institute and Department of Brain & Cognitive Sciences, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; shinwon.s.park@ 123456gmail.com (S.P.); eunji.i.ha@ 123456gmail.com (E.H.); myeongju.j.kim@ 123456gmail.com (M.K.); gahae.h.hong@ 123456ewha.ac.kr (G.H.)
                [3 ]Department of Psychiatry, College of Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; paikjw@ 123456khu.ac.kr (J.-W.P.); maumdoctor@ 123456gmail.com (S.-M.L.)
                [4 ]Clinical Trial Center for Functional Foods, Chonbuk National University Hospital, 20, Geonjiro Deokjin-gu, Jeonju-si 54907, Korea; swchae@ 123456jbctc.org (S.-W.C.); shpark@ 123456jbctc.org (S.-H.P.); sjjeong@ 123456jbctc.org (S.-J.J.)
                [5 ]Department of Life and Nanopharmaceutical Sciences, College of Pharmacy, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; dhkim@ 123456khu.ac.kr
                [6 ]Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, 20, Geonjiro Deokjin-gu, Jeonju-si 54907, Korea
                Author notes
                [* ]Correspondence: jungyoon.kimm@ 123456ewha.ac.kr (J.K.); chungyc@ 123456jbnu.ac.kr (Y.-C.C.); Tel.: +82-2-3277-2478 (J.K.); +82-63-250-2185 (Y.-C.C.)
                [†]

                These authors contributed equally to this work as first authors.

                Author information
                https://orcid.org/0000-0003-0543-3019
                https://orcid.org/0000-0002-7419-5221
                Article
                nutrients-11-00305
                10.3390/nu11020305
                6412773
                30717153
                0996df2f-28fa-40e5-a100-ae8b6cee3d5d
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 November 2018
                : 29 January 2019
                Categories
                Article

                Nutrition & Dietetics
                mild cognitive impairment,lactobacillus plantarum c29-fermented soybean (dw2009),cognitive impairment,brain-derived neurotrophic factor

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