Significance of the in vivo endocannabinoid level to predict effectiveness of lifestyle multidomain intervention: The SUPERBRAIN study

Abstract

AbstractBackgroundIn the South Korean study to prevent cognitive impairment and protect brain health through lifestyle intervention in at‐risk elderly people (SUPERBRAIN), we explored changes of in endocannabinoid after 24‐week intervention and impact of baseline endocannabinoid on cognitive and physical effects of intervention.MethodA total of 152 participants, aged 60‐79 years without dementia but with ? 1 modifiable dementia risk factor, were randomly assigned to the facility‐based multidomain intervention (FMI), and home‐based MI (HMI), or control groups. Among them, 125 participants (43 FMI, 44 HMI, and 38 control) took measurement for their levels of cortisol, anandamide (N‐arachidonoylethanolamine; AEA), and 2‐AG (2‐arachidonoylglycerol). Plasma levels were determined by liquid chromatography‐selected reaction monitoring quantification using a QTrap5500 mass spectrometer (ABSciex, Foster City, CA, USA). We compared changes of compound levels between intervention and control groups. In addition, we analyzed whether the baseline level of the compound was independent predictor for changes in clinical measures after intervention.ResultNeither the ratios, cortisol to AEA + 2‐AG, cortisol to AEA, and cortisol to 2‐AG nor the levels in AEA, 2‐AG, and cortisol showed noteworthy differences before and after the SUPERBRAIN program, between control and intervention groups. Some changes in the physical fitness and cognitive function variables were associated with the baseline AEA and cortisol, especially in the intervention group: Figure‐8‐walks (p<0.05),and ‘pre‐contemplation stage’ score of the readiness to change questionnaire for motivational enhancement (p<0.05) for cortisol; Prospective Retrospective Memory Questionnaire (PRMQ) by caregiver (p<0.05), and total scale index score of Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, p<0.05) for AEA; ‘Confirmed control’ score of the questionnaire for motivational enhancement (p<0.05) for both. Among them, intervention status and baseline AEA seemed to be possible independent variables for changes in two cognitive function items, PRMQ by caregiver and total scale index score of RBANS. However, further analysis showed no interaction between intervention status and baseline AEA level on cognitive function.ConclusionBaseline level of in vivo endocannabinoids may predict the cognitive change after a multidomain dementia prevention intervention program, though its modulation on multidomain dementia prevention intervention for cognitive effects needs to be more revealed.