BackgroundAgeing is highly associated with cognitive decline and modifiable risk factors such as diet are believed to protect against this process. Specific dietary components and in particular, (poly)phenol-rich fruits such as berries have been increasingly recognised for their protection against age-related neurodegeneration. However, the impact of cranberries on cognitive function and neural functioning in older adults remains unclear.DesignA 12-week parallel randomised placebo-controlled trial of freeze-dried cranberry powder was conducted in 60 older adults aged between 50 and 80 years. Cognitive assessment, including memory and executive function, neuroimaging and blood sample collection were conducted before and after the intervention to assess the impact of daily cranberry consumption on cognition, brain function and biomarkers of neuronal signalling.ResultsCranberry supplementation for 12 weeks was associated with improvements in visual episodic memory in aged participants when compared to placebo. Mechanisms of action may include increased regional perfusion in the right entorhinal cortex, the accumbens area and the caudate in the cranberry group. Significant decrease in low-density lipoprotein (LDL) cholesterol during the course of the intervention was also observed. No significant differences were, however, detected for BDNF levels between groups.ConclusionsThe results of this study indicate that daily cranberry supplementation (equivalent to 1 small cup of cranberries) over a 12-week period improves episodic memory performance and neural functioning, providing a basis for future investigations to determine efficacy in the context of neurological disease. This trial was registered at clinicaltrials.gov as NCT03679533 and at ISRCTN as ISRCTN76069316.

Background and Objectives: The heart is the organ with the highest metabolic demand in the body, and it relies on high ATP turnover and efficient energy substrate utilisation in order to function normally. The derangement of myocardial energetics may lead to abnormalities in cardiac metabolism, which herald the symptoms of heart failure (HF). In addition, phosphorus magnetic resonance spectroscopy (31P MRS) is the only available non-invasive method that allows clinicians and researchers to evaluate the myocardial metabolic state in vivo. This review summarises the importance of myocardial energetics and provides a systematic review of all the available research studies utilising 31P MRS to evaluate patients with a range of cardiac pathologies. Materials and Methods: We have performed a systematic review of all available studies that used 31P MRS for the investigation of myocardial energetics in cardiovascular disease. Results: A systematic search of the Medline database, the Cochrane library, and Web of Science yielded 1092 results, out of which 62 studies were included in the systematic review. The 31P MRS has been used in numerous studies and has demonstrated that impaired myocardial energetics is often the beginning of pathological processes in several cardiac pathologies. Conclusions: The 31P MRS has become a valuable tool in the understanding of myocardial metabolic changes and their impact on the diagnosis, risk stratification, and prognosis of patients with cardiovascular diseases.

Background: Loss of smell or olfactory dysfunction (OD)s a common yet under- addressed problem with an estimated 5% of the general population having no functioning sense of smell. OD secondary to viral infections (eg: Covid-19) is one of the leading causes. Isolation, depression, anxiety, risk of danger from hazards such as toxic gas and spoiled food, weight loss/ gain secondary to loss of appetite are all prevalent negative impacts associated with OD. Various treatment options have been tried to treat smell loss after viral infection. Smell training has been tried with good results in the immediate post-viral phase. Evidence behind treatment with steroids has not shown to have proven effectiveness. With this, a key problem for patients and their clinicians is the lack of proven an effective therapeutic treatment option. Based on previous studies, there is some evidence supporting the regenerative potential of retinoic acid, the metabolically active form of Vitamin A in regeneration of olfactory receptor neurons. It is based on this concept that we have chosen Vitamin A as our study comparator in this two-arm randomised trial to determine proof of conceptMethods/Design: The study will compare 10,000 IU once daily Vitamin A self-administered intranasal drops versus peanut oil drops (placebo) delivered over 12 weeks in patients with post viral olfactory loss. Eligible patients will be recruited from the Smell & Taste Clinic and randomised to receive vitamin A drops or placebo in a 2:1 ratio. They will then be invited to attend the Brain Imaging Centre at the University of East Anglia on two occasions, 3 months apart, Serial MRI scanning will enable volumetric measurement of the OB and ROS; fMRI will then be conducted using an olfactometer to deliver pulsed odours – phenethylalcohol (rose-like) and hydrogen sulphide (rotten eggs). Participants will also undergo a standard smell test at both visits as well as complete a quality-of-life questionnaire. Change in OB volume on MRI will be the primary outcome measure.Discussion: We expect the outputs of this study to enable a subsequent randomised controlled trial of Vitamin A versus placebo. With PPI input we will make the outputs publicly available using journals, conferences and social media via Fifth Sense. We have already prepared a draft RCT proposal in partnership with the Norwich Clinical Trials Unit and would plan to develop this further considering the findings.Trial registration: ISRCTN registry 39523. Date of registration in primary registry: 23rd February 2021

As part of the CANN trial, we compared blood brain barrier (BBB) integrity in subjective memory impairment (SMI) and mild cognitive impairment (MCI), two early indicators of Alzheimer’s disease. Also, the impact of a combined flavanol and omega-3 fatty acid-based nutritional intervention on BBB leakage was explored for the SMI cohort. Dynamic-contrast-enhanced MRI was performed to obtain fractional plasma volume (vp) and volume transfer constant (KTrans) parameters. The results suggest that BBB leakage is similar in the SMI cohort and the nutritional intervention tends to be associated with improved BBB parameters.

To identify the optimal model-based deconvolution process for DSC-MRI, four models of transit time distribution (TTD) were compared in terms of goodness and stability of fit, consistency of perfusion estimates, computational complexity, and robustness against noise. Although all models gave similar fits, the gamma function converged faster and more consistently to the global minimum, regardless of the initial guess. Moreover, it gave more accurate and precise perfusion estimates in the presence of noise. We conclude that the gamma function is the most suitable TTD model for perfusion analysis, and may prove useful in urgent clinical situations and multi-centre studies.