ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Medical and Scientific Advisory Committee, Alzheimer's Disease International

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary A questionnaire, collecting information on methods used at neuropathology core facilities for handling of brain autopsies on dementia and control subjects, was sent to 29 CERAD (Consortium to Establish a Registry for Alzheimer's Disease) and/or Alzheimer's Disease Center (ADC) sites. Neuropathologists shared their successes and concerns in response to questions regarding administrative, technical, and neuropathological procedures for brain autopsies and tissue banking. Adequacy of fiscal support and staff, scarcity of control cases, and logistical aspects of autopsy coordination emerged as common problems. Successful strategies included the designation of dedicated autopsy coordinators, enhanced relationships with community hospital pathologists and funeral homes, and increased multilevel educational efforts on the importance of the autopsy.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary The National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disorders Association criteria for probable Alzheimer disease (AD) require exclusion of non-AD dementia-producing conditions but do not specify how the non-AD conditions are to be identified. We addressed this issue for the case of cerebrovascular disease (CVD) by defining exclusion rules based on commonly described clinical features: (a) history of strokelike episodes; (b) history of stepwise cognitive decline; (c) focal deficits on neurological examination; and (d) evidence of significant CVD on neuroimaging. We applied these rules retrospectively to clinical records for 92 cognitively impaired patients who otherwise met criteria for probable AD and whose brains were subsequently available for postmortem examination. We used Fisher's exact test to assess the effectiveness of the exclusion rules in predicting the presence of CVD on autopsy. Prediction was better than chance when all four clinical features were used together (p = 0.0008) and when the stepwise decline or neuroimaging criteria were used alone (p = 0.03 and p = 0.05, respectively). Overall, the CVD exclusion rules were deficient because of low accuracy (50.0%) and low sensitivity (52.6%). These results support provisional use of the CVD criteria chosen for this study but suggest that modifications are needed for acceptable diagnostic accuracy and sensitivity to be achieved.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary Phosphoinositide-specific phospholipase C (PLC) is a key enzyme in signal transduction. We have previously demonstrated that a PLC isozyme is abnormally accumulated in the brain tissue in Alzheimer's disease (AD). AD has been suggested to be a systemic disease in which the expression of abnormalities is most prominent in neuronal tissues. In a recent study, we have revealed the increase of the cytosolic protein kinase C (PKC) concentration in platelets of AD patients, suggesting the change of PLC, which is upstream to PKC in phosphoinositide metabolism. In this study, we examined phosphatidylinositol-specific PLC activity in platelets from patients with AD and age-matched controls by measuring the formation of radioactive inositol phosphate. The PLC activity was significantly lower in the AD platelets than in the controls. These findings suggest that aberrant phosphoinositide metabolism is present in nonneuronal tissues as well as the brain in AD.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary The relationship between Alzheimer disease (AD) and dementia with Lewy bodies (senile dementia Lewy body type, or SDLT) and dementia in Parkinson's disease is unclear. AD pathology is characterised by both amyloid deposition and abnormal phosphorylation of tau in paired helical filaments (PHF-$tU). In AD, abnormally phosphorylated PHF-$tU is present in neurofibrillary tangles, in neuritic processes of senile plaques, and also in neuropil threads dispersed throughout the cerebral cortex. Cortical homogenates from 12 cases each of AD and SDLT, 13 cases of Parkinson's disease, and 11 normal controls were examined by Western blot analysis with antibodies that detect PHF-$tU. No PHF-$tU was found in Parkinson's disease or control cortex. No PHF-$tU was found in SDLT cases without histological evidence of tangles. PHF-$tU was detectable in SDLT cases with a low density of tangles, and large amounts of PHF-$tU were present in AD cases. This study demonstrates that abnormally phosphorylated PHF-$tU is only present where tangles are found and not in SDLT cases without tangles or with only occasional tangles. It is concluded that Lewy body dementias are distinct at a molecular level from AD.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary Physostigmine, a reversible and nonselective cholinesterase inhibitor, administered by steady-state, continuous intravenous infusion to carefully selected subjects with mild-moderate Alzheimer disease, produced significant but modest improvement in memory in five of nine subjects. Drug dosing was limited by the occurrence of adverse effects. Apparent tolerance to adverse effects was observed in two subjects when the dose of physostigmine was escalated slowly over at least 2 weeks. Steady-state cholinesterase inhibition by physostigmine appears to produce sustained cognitive improvement in some subjects with Alzheimer disease without substantially altering its therapeutic index.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Summary Although several reports suggest that intermediate to high doses of propranolol (80–160 and 200–600 mg/day) can effectively treat aggressive behavior in dementia, significant side effects can occur at these doses. To minimize these side effects, we treated and followed-up a series of 12 demented patients, whose caregivers sought medical help for their disruptive, aggressive behavior, with low-dose propranolol monotherapy (10–80 mg/day). Assessment measures obtained at baseline and during treatment by caregiver interview included ordinal ratings of aggression severity, the Cohen-Mansfield Agitation Inventory (CMAI), and the California Behavior Questionnaire (CBQ). The aggression ratings showed that low-dose propranolol effectively reduced aggression in eight of 12 patients (67%) within 2 weeks of treatment and remained effective for the duration of follow-up (1 to 14 months). Subscales of the CMAI showed responders to have significant reductions in physical and verbal aggression/agitation and in pacing/wandering. These results suggest that low-dose propranolol should be further studied for treating aggression or agitation in demented patients.

ISSN:0893-0341    

出版商:OVID    

年代:1995

数据来源: OVID