Efficacy and safety of N‐acetylcysteine in patients with vascular mild cognitive impairment (vMCI): Memory and antioxidant in vMCI Exercise Intervention Trial (MOVE‐IT)
Bibliographic record
Abstract
BACKGROUND: Oxidative stress (OS) is implicated in the etiology of vascular mild cognitive impairment (vMCI), a form of cognitive decline originating from cerebrovascular pathology. vMCI is characterized by early deficits in executive function and memory, with OS suspected to contribute to its development. Although aerobic exercise has been shown to improve cognitive function and oxidative balance, it can also lead to an increase in OS. We hypothesized that the antioxidant N-acetylcysteine (NAC) may help mitigate this damage by replenishing glutathione levels, particularly in those undergoing exercise interventions. This study evaluated the efficacy and safety of oral NAC for improving cognitive function in vMCI patients participating in a cardiac rehabilitation program. METHOD: In this 24-week randomized clinical trial, patients with vMCI (1SD below the norm in executive function, memory, processing speed or working memory, with significant cardiovascular disease) were randomized to receive either NAC (2400mg/day) or placebo. Participants were recruited from the Toronto Rehab Institute-Cardiac rehabilitation program. Cognitive function was assessed using a 60-minute neuropsychological battery, with executive function as the primary outcome. Phonemic fluency, semantic fluency, and the Trail Making Test B were administered as part of the executive function. Z-scores for each task were computed based on published age-matched norms, and a composite z-score was calculated for overall executive function. Data were analyzed using mixed-effects models adjusting for relevant covariates. Adverse events (AEs) were monitored throughout the study period. RESULT: A total of 59 participants [mean(SD) age = 67.6(7.7), male(%) = 69.5%, mean(SD) MoCA= 22.5(3.2)] were randomized. Executive function improved over time (β=0.36, 95%CI=[0.20, 0.53], p<0.001), with no significant differences between NAC (n=29) and placebo (n=30) (β= -0.04, 95%CI= [-0.28, 0.20], p=0.7) while controlling for sex, years of education, BMI, homocysteine levels, and VO2. NAC was well-tolerated, with no significant differences in the frequency or severity of AEs between groups. Common AEs included dyspepsia, nausea, and headache. Most AEs resolved post-treatment. CONCLUSION: NAC supplementation did not provide additional cognitive benefits beyond that of cardiac rehabilitation in patients with vMCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".