cocoa improves cerebral blood flow in pw impaired flow

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

cocoa improves cerebral blood flow in pw impaired flow

Postby Cece » Thu Aug 08, 2013 6:44 am

http://www.medpagetoday.com/Geriatrics/ ... id=5517461

Among patients with impaired neurovascular coupling (NVC, a measure of cerebral blood flow), performance on a test of cognitive function improved by 30%, which was associated with more than a two-fold increase in NVC. Patients with intact NVC showed no such improvements between baseline and day 30.

Drinking cocoa increases cerebral blood flow in seniors with impaired cerebral blood flow. Improving cerebral blood flow improves performance on tests of cognitive function.
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby erinc14 » Thu Aug 08, 2013 7:14 am

how much ?
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby Cece » Thu Aug 08, 2013 9:26 am

A two-fold increase in NVC after drinking 2 cups of cocoa a day for a month.

edit: I don't understand NVC well enough to know what a two-fold increase means. Gotta look up what NVC means.
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby CuriousRobot » Thu Aug 08, 2013 11:40 am

Too bad they didn't control it with a glucose drink.
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby cheerleader » Thu Aug 08, 2013 2:18 pm

lots of interesting stuff in this study---I got it in my email this morning.
Here's the study
http://neurology.org/content/early/2013 ... 3182a351aa

Neurovascular coupling was measured from the beat-to-beat blood flow velocity responses in the middle cerebral arteries to the N-Back Task. In a subset of MRI-eligible participants, cerebral white matter structural integrity was also measured.

There is a strong correlation between neurovascular coupling and cognitive function, and both can be improved by regular cocoa consumption in individuals with baseline impairments. Better neurovascular coupling is also associated with greater white matter structural integrity.


Wrote a bit about it on Facebook.
https://www.facebook.com/notes/ccsvi-in ... 0148652211

NVC is measured by transcranial doppler ultrasound, and is a mathmatical formulation which adjusts cerebral bloodflow to metabolic need.
http://www.mate.tue.nl/mate/pdfs/7302.pdf

NVC has been studied in relation to MS in a study looking at Tysabri and cerebral bloodflow.
http://www.ncbi.nlm.nih.gov/pubmed/20664205

NVC may be disrupted in MS, as shown by BOLD and fMRI technology
http://cds.ismrm.org/protected/10MProce ... 0Bizzi.pdf

here's more on the cocoa study from medpage today-

NVC refers to the spatial relationship between neuronal activity and cerebral blood flow, and impaired NVC has a strong association with brain pathology. Studies involving preclinical models have shown that impaired NVC plays a role in several types of human disease.

The relationship between NVC and cognitive function has remained unclear, the authors noted, as has NVC's relationship with structural changes in brain tissue that occur with aging and vascular disease. Sorond and colleagues designed a study to examine the issues in older people with vascular disease.


The study had three principal objectives: to determine whether lower cerebral blood flow (impaired NVC) in response to a task translates into lower cognitive performance, examine the relationship between impaired NVC and cerebral white matter disease, and determine whether flavanol-enriched cocoa had an effect on NVC. The authors noted that flavanols have been shown to improve endothelial function and cognitive performance.

"Previous work has demonstrated the antioxidant benefits of flavonoids in chocolate and other foods," said Gary W. Small, MD, of the University of California Los Angeles, who was not involved in the study. "This well-designed, placebo-controlled trial offers new findings in that it links neurovascular coupling, a measure of brain blood flow and neural activity, to improved cognitive abilities in people consuming a popular flavonoid-rich food, cocoa."


I think they probably used cocoa since it was an easy to administer drink for a study....but they could have also used EGCG (green tea) or quercetin, bromelain, resveratrol. All of these flavonoids affect the endothelium in similar ways, without the glucose and calories.

the link to cerebral blood flow continues,
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby cheerleader » Fri Aug 09, 2013 9:57 am

Here's more info on the study -
http://www.forbes.com/sites/alicegwalto ... in-health/
They found that people who had compromised blood flow to the brain and white matter damage at the beginning of the study did show a difference after drinking the cocoa for a month: Blood flow in their brains improved by about 8%, and the time it took them to complete a working memory test dropped from 167 seconds to 116 seconds.

These results are nothing if not enticing, and they do support earlier evidence that cocoa’s benefits may stem from its capacity to improve blood flow to the brain, which uses a whopping 20% of the body’s energy, while only accounting for 2% of its weight. In other words, the brain is quite a needy organ, energetically speaking, so any improvement in blood flow could be reflected in cognition.

“We’re learning more about blood flow in the brain and its effect on thinking skills,” study author Farzaneh A. Sorond tells me. “As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer’s.”

The problem is that not only do we not know exactly how cocoa does this, but we don’t really even know what compound in it is responsible. “How cocoa results in improved neurovascular coupling, we don’t know,” says Sorond. “We also don’t know what it is in cocoa that is beneficial; is it the flavanols, the caffeine, the theobromine? In our study there was no difference between the flavanol poor and rich compounds in terms of benefit. Does this mean the flavanols are not important or does it mean that just a little bit of flavanol is enough?”


interesting that they're not quite sure which compound accounted for the better bloodflow....on the CCSVI in MS page, Arne posited that it might be magnesium. But the part that's intriguing is that it is possible to get better bloodflow and cognition going, using a dietary supplement, in those who have restricted blood flow to the brain.

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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby 1eye » Fri Aug 09, 2013 10:46 am

No-one has answered the criticism that they didn't control for hydration (did they? I don't usually get these papers for free...), when that could have been another reason for cognitive improvement. Older people are often dehydrated, and that would be even easier to improve their NVC and cognition (and no dairy or sugar, which might also be a factor). Assuming they all have an adequate water supply...

Another fine application of Doppler ultrasound in human circulation:NVC assessment. They don't seem to have any problem with velocity (AKA blood flow rate) in the brain vessels. I wonder how hard it would be to convert that to a volumetric measurement.

Speaking of measurement, it would be great if someone could come up with a non-invasive localized pressure measurement.

From another thread:

drsclafani wrote:The inherent pressures in veins is pretty low. trying to measure a gradient with conventional instruments is unsatisfactory.


I agree. The tools I have seen mention of in ads, etc. sound like they are only for arterial cathether-based measurement. I'm afraid the narrowing caused by the presence of a catheter, or the hole for insertion, would affect the pressure. It should be possible, though, somehow if the viscosity of blood can be measured:

Poisselle's Law in fluid mechanics has direct analogy with Ohm's Law in electricity, which was formerly considered a fluid. That law says P=FR. That means Pressure=Resistance x Flow Rate. This is not news to anyone familiar with fluid dynamics, nor is Ohms Law unfamiliar to those familiar with electricity.

See http://en.wikipedia.org/wiki/Hagen–Poiseuille_equation%23Electrical_circuits_analogy

Electricity was originally understood to be a kind of fluid. This “Hydrolic Analogy” is still conceptually useful for understanding circuits. This analogy is also used to study the frequency response of fluid mechanical networks using circuit tools, in which case the fluid network is termed a Hydraulic Circuit.

Poiseuille's law corresponds to Ohm’s law for electrical circuits (V = I * R), voltage = current * resistance, where the pressure drop P is analogous to the voltage V and volumetric flow rate F is analogous to the current I. So the analogous equation is (P = F * R). In one case R is resistance to electrical current flow, in the other it is resistance to fluid flow.

The resistance to fluid flow R is defined as

R = (8 * Viscosity * pipe length) / ((PI) * (radius)^4)

For Pressure drop, see http://en.wikipedia.org/wiki/Hagen%E2%80%93Poiseuille_equation for

ΔP = 128 * η * L * Q / ((PI) * d^4)

The viscosity is η, ΔP is the pressure drop, L is the length of the pipe, Q is the volumetric flow rate, and d is the pipe’s diameter.

Viscosity of blood should not be hard to measure from a sample.
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby cheerleader » Sat Aug 10, 2013 10:43 am

Hi 1eye--
All of the seniors got the 2 cups of cocoa....but only the group that had impaired cerebral bloodflow prior to the cocoa protocol showed any improvement in neurovascular coupling. This means that the blood traveled more readily to the area of the brain performing the cognitive function. Hydration was the same for all of the seniors. Something about the cocoa (magnesium, flavonols, whatever) improved the ability of the heart to get blood flow to the brain more readily in the seniors that had impaired flow prior. The seniors without this problem did not benefit. It may have been viscousity...I don't have the full paper, either, just going by the news reports and the abstracts.

My take on it is the improvement to the endothelium. Magnesium and flavonols are known to increase NO production and improve endothelial health, allowing for smoother transit of blood to the brain. Hard to know without full paper.
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Re: cocoa improves cerebral blood flow in pw impaired flow

Postby 1eye » Sat Aug 10, 2013 4:40 pm

cheerleader wrote:Hi 1eye--
All of the seniors got the 2 cups of cocoa....but only the group that had impaired cerebral bloodflow prior to the cocoa protocol showed any improvement in neurovascular coupling. This means that the blood traveled more readily to the area of the brain performing the cognitive function. Hydration was the same for all of the seniors. Something about the cocoa (magnesium, flavonols, whatever) improved the ability of the heart to get blood flow to the brain more readily in the seniors that had impaired flow prior. The seniors without this problem did not benefit. It may have been viscousity...I don't have the full paper, either, just going by the news reports and the abstracts.

My take on it is the improvement to the endothelium. Magnesium and flavonols are known to increase NO production and improve endothelial health, allowing for smoother transit of blood to the brain. Hard to know without full paper.
cheer

That's more like it. Now there might be a run on shares of Nestles or something...

Did you realize that with the information I gave you in the previous post, you can measure and calculate unequivocally a venous stenosis, giving an educated guess as to its degree? Using the most meaningful parameter:a pressure drop.

- length between measuring points -- on either side of stenosis (a ruler and a felt marker)
- diameter (see below, anything from a ruler to an MRV, to an IVUS
- flow rate (Doppler machine)
- viscosity (?)

I'd have thought a blood sample would be useable to measure viscosity.

You might have to fudge that a little without an x-ray or an IVUS -- if there is no stenosis and the vein is flat, one diameter will be shorter. Diameter of an equivalent circular vein, without an IVUS, is dicey, but if the vein is more or less round, or even elliptical, I think the diameter is visible on the surface of the neck. That's all you need, for what looks from the outside like a round vein.

If there is too much of a pressure drop, using those four measurements, there is probably a stenosis.
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