摘要:

Chronic exposure to aluminium (Al) remains a controversial possible cause of sporadic forms of Alzheimer''s disease (AD). This article reviews the evidence that once Al enters the brain and individual brain cells, it may be involved in three pathological processes: (1) the production of abnormal forms of tau leading to the formation of cellular neurofibrillary tangles and neuropil threads; (2) the processing of the amyloid precursor protein, resulting in the formation of β-amyloid deposits and senile plaques, and (3) that via the mutual histocompatibility system, Al could be involved in the initiation of the immune response observed in AD patients. Despite recent evidence that Al could be involved in these processes, a conclusive case that exposure to Al initiates the primary pathological process in sporadic AD remains to be established

ISSN:1420-8008    

DOI:10.1159/000106845

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The aim of the study was to assess the specificity of temporal amygdala (TA) atrophy with magnetic resonance imaging (MRI) by comparing a group of early impaired patients with Alzheimer''s disease (AD) with ''other types of dementia'' and controls. In this prospective case-control study, 41 patients were selected: 12 with probable AD according to NINCDS-ADRDA and CERAD inclusion and exclusion criteria, 14 with other types of dementia and 15 age-matched control subjects. Two radiologists blindly measured the TA volumes on coronal oblique contiguous slices with a 1.5-tesla MRI Scanner. TA volume measurements obtained by the 2 observers and right-left TA values were not significantly different. A significant TA atrophy was found in the AD group as compared to the other groups, with 39.7% (p < 0.001) difference in TA volumes between AD and other types of dementia groups and 41.4% (p < 0.0005) difference between AD and control groups. There was no significant difference between other types of dementia and control groups. There was an overlap between the three groups for 4 patients. TA atrophy assessed with MRI could be of diagnostic value in AD, especially in the early stage of the disease.

ISSN:1420-8008    

DOI:10.1159/000106846

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Diagnosis of Alzheimer''s disease is made on clinical grounds, and the availability of a simple and sensitive quantitative index of the disease might aid in the routine diagnosis. The aim of this study was to assess whether linear measures of brain atrophy as detected by magnetic resonance imaging can be helpful in the differentiation of mild to moderate Alzheimer''s disease from nondemented elderly. Measures of global (bifrontal index and interuncal distance) and hippocampal (minimum thickness of the medial temporal lobe, hippocampal height, width of the choroid fissure, and width of the temporal horn) atrophy were taken from 26 cases and 21 controls. Measures of hippocampal atrophy were the most sensitive in the differentiation of cases from controls, and among them width of the temporal horn yielded the highest sensitivity, predicting the disease in 73% of cases with 95% specificity. A compound measure comprising width of the temporal horn, width of the choroid fissure, and hippocampal height increased sensitivity to 85%. These results suggest that selected simple indices of hippocampal atrophy might be useful in the diagnosis of Alzheimer''s disease.

ISSN:1420-8008    

DOI:10.1159/000106847

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The association of aphasia, apraxia and agnosia with cortical but not subcortical dementias, is a widely held belief. The purpose of the present study was to determine the frequency of aphasia, apraxia, and agnosia in groups of cortical and subcortical dementia patients, and to assess the diagnostic utility of these symptoms. Subjects were 64 patients with subcortical dementias (Parkinson''s disease and normal pressure hydrocephalus) and 192 patients with cortical dementia (probable Alzheimer''s disease) matched for sex, age, and Mini-Mental State Examination score. Each patient was evaluated for the presence of aphasia, apraxia, and agnosia. Results indicated that only aphasia was reported significantly more often in cortical dementia patients than in subcortical dementia patients. The presence of either of these three symptoms has very low diagnostic sensitivity, specificity, and total predictive value. The severity of the patient''s dementia was predicted whether the patient had aphasia or apraxia; type of dementia had no predictive value. These data led to the conclusion that cortical and subcortical dementias cannot be reliably dissociated on the basis of aphasia, apraxia, or agnosia.

ISSN:1420-8008    

DOI:10.1159/000106848

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Ten patients with a clinical diagnosis of frontal lobe degeneration (FLD) were compared with a group of patients with probable Alzheimer’s disease (AD) and with nondemented controls matched for gender and age. In comparison with AD, the duration of illness was slightly shorter and cognitive performance was better in patients with FLD. The greatest enlargement of cerebro-spinal fluid volumes was found in FLD and this effect was most pronounced in the anterior fissure and lateral ventricles. Estimates of EEG band-power and EEG coherence in FLD were not remarkably different from nondemented controls, whereas delta- and theta-power were significantly increased in AD. These observations may indicate different disease processes with a dissociation of volumetric computed tomography and quantitative EEG changes, which may be of differential diagnostic valu

ISSN:1420-8008    

DOI:10.1159/000106849

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This longitudinal study measured the rate of spontaneous speech decline in patients with Alzheimer''s disease (AD) at a 1-year follow-up and determined the effect of clinical and demographic factors on that rate. In addition the pattern of spontaneous speech impairment was examined. The expected pattern of spontaneous speech impairment with prominent disturbances of communication and semantics, moderate disturbances of automatic speech, but with retained phonematic structures, was found at baseline and at follow-up in the majority of our rather large sample (n = 63). This result is discussed in terms of intrafunctional homogeneity and of selective involvement of neuronal systems in AD. There was a trend for a more rapid language decline in patients with a family history of dementia. No relationship was detected between the rate of spontaneous speech decline and other clinical and demographic factors, with the exception of initial spontaneous speech impairment.

ISSN:1420-8008    

DOI:10.1159/000106850

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Dementia of the Alzheimer type, senile onset (SDAT), and multi-infarct dementia (MID) exhibit differences in cerebrovascular blood flow velocity profiles, which were investigated by means of transcranial Doppler sonography. The pulsatility indices (PI), as angle-independent parameters of peripheral vascular resistance measured in the basal cerebral arteries, were significantly increased in MID patients with respect to SDAT cases. In an analysis of the correlations between several variables and the magnitude of PI, we found strong inverse correlations of the CAMCOG score, and strong direct correlations of the blood pressure and the duration of illness, with the PI of all basal cerebral arteries only in MID patients. In SDAT patients, we found a direct correlation between the Hachinski ischemia score and the PI of all basal cerebral arteries. All 3 ischemia scores (Hachinski, Rosen, Loeb and Gandolfo) were significantly correlated with the PI of the middle cerebral and basilar arteries. By analyzing the correlations of the single items of the 3 different ischemia scores with the PI values obtained, we only found a clearcut correlation with the item focal neurological signs. Thus, our findings stress the relative importance of a concomitant cerebrovascular factor in the development of dementia in old age, even in patients with probable SDAT. A raise of the PI in the basal cerebral arteries allows early suspicion of a cerebrovascular factor even in only slight dementia so that possible risk factors for further aggravation of this type of vascular dementia might be detected and treated early in the course of disease.

ISSN:1420-8008    

DOI:10.1159/000106851

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Eighteen patients with probable Alzheimer’s disease (NINCDS/ADRDA criteria) participated in a placebo-controlled, double-blind study, with a crossover design. The patients had mild or moderate dementia (MMSE = 20.3 ± 4.6, range 12–28). The trial consisted of two 4-week periods with a 2-week washout period in between. Nicotine was given in the form of dermal plasters. Most of the patients tolerated the highest doses of 21 mg nicotine/24 h, but some received 14 mg/24 h. The effect was monitored with tests of short-term memory, verbal fluency, attention and psychomotor speed. Nicotine was also determined in the blood. Short-term memory improved significantly after 4 weeks of treatment, both on nicotine and placebo (p < 0.05/p < 0.01). The results of our study thus do not indicate that nicotine applied in the form of dermal plasters is of any significance in the treatment of memory deficits in patient with Alzheimers dis

ISSN:1420-8008    

DOI:10.1159/000106852

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

To compare subcortical involvement of Parkinson''s disease (PD) with that of Binswanger''s disease (BD), we examined visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs) in 29 patients with PD and 7 patients with BD and 11 control subjects. The patients with PD were divided into two groups: PD without dementia (nD-PD: n = 18) and PD with dementia (D-PD: n = 11). The D-PD patients showed significantly longer P100 latencies in VEPs compared with the nD-PD patients or controls. The P100 latencies were negatively correlated with Mini-Mental State Examination (MMSE) score in the PD patients. The BD patients showed significantly Ionger central conduction time (CCT) in SEPs (interpeak Iatency between N13 and N20 responses) compared with the nD-PD patients or controls. There was no correlation between CCT and MMSE score in the BD patients. These results suggest that PD has a predilection for sensory system involvement distinct from that of BD. In D-PD, the visual system seems more vulnerable than the somatosensory system, but almost the reverse is true of BD.

ISSN:1420-8008    

DOI:10.1159/000106853

出版商:S. Karger AG    

年代:1996

数据来源: Karger