ISSN:1420-8008    

DOI:10.1159/000107113

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Senile dementia of Lewy body type is characterized clinically by presenting symptoms such as acute/ subacute fluctuating confusion and in the majority also visual hallucinations, and neuropathologically by the presence of Lewy bodies especially in archicortical areas. Progressive dementia develops in the course of the disease which shares with Alzheimer''s disease a cortical cholinergic deficit, evident at autopsy. In two of four brain areas examined, parietal and temporal cortex, choline acetyltransferase activities were significantly lower in patients with, compared to those without, hallucinations (20% and 50% of the normal, respectively). These new findings suggest cholinergic mechanisms are involved in hallucinatory experiences and that this clinical feature may be diagnostic of severely deranged cholinergic activity in dementia.

ISSN:1420-8008    

DOI:10.1159/000107114

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Pathologic evaluation of the amygdala in Alzheimer''s disease (AD) revealed, as compared to controls, a 43.7% decrease in total amygdaloid area, with areal reductions in lateral and basolateral nuclei of 52.9 and 54.3%, respectively. Thioflavin-S stained sections of the amygdala demonstrated a topographic distribution of neuritic plaques, with classic plaques located primarily in accessory basal, medial basal and cortical nuclei, whereas diffuse plaques predominated in the lateral nucleus. Neurofibrillary tangles were also topographically distributed and were up to 10 times more numerous than neuritic plaques. Tangle-bearing neurons predominated in cortical, medial, accessory basal and medial basal nuclei, whereas extracellular tangles characterized lateral and basolateral nuclei. These results are interpreted in light of known anatomical connections and suggest a predictive pattern of pathology in AD.

ISSN:1420-8008    

DOI:10.1159/000107115

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The study demonstrates the presence of neuropeptide Y (NPY)-, C-terminal flanking peptide of NPY (C-PON)-, and galanin (GA)-immunoreactive (-i) neurons and axons in the locus coeruleus in normal adult human brain and in brains of patients with senile dementia of the Alzheimer type (SDAT) and Parkinson''s disease (PD) as well as evidence for the coexistence of peptides with catecholamines in individual locus coeruleus neurons. The morphology of C-PON-i neurons is analysed in detail with a computer-assisted program. They are either multipolar neurons with round or multiangular somata, or ''bipolar'' neurons with major dendrites issuing from the two poles of fusiform cell bodies, and represent small- to medium-sized locus coeruleus neurons. In the controls, C-PON-i and NPY-i neuron numbers are highest rostrally, lower in the middle and lowest in the caudal locus coeruleus. GA-i neurons are more frequent caudally. C-PON-i neuron numbers are decreased in old normal adult brains compared to young brains. NPY-i and GA-i neuron numbers are very low in all age groups. The axonal networks are densest rostrally. C-PON-i and NPY-i axons possess larger varicosities and thicker intervaricose segments than GA-i axons. Both the peptidergic neuronal systems and the innervation pattern are detrimentally altered in SDAT and PD, more so in the latter than in the former cases. In SDAT, some C-PON-i locus coeruleus neurons display morphological alterations resembling those encountered in tyrosine hydroxylase (TH)-i neurons in the same cases, with blurred somatic outlines, misshapen cell bodies and foreshortened dendrites. However, the alterations are generally less severe than those of the TH-i neurons and many C-PON-i neurons appear to be entirely normal. Relative to the number of TH-i neurons, the numbers of peptide-i neurons are higher in SDAT than in controls, and often more neurons are located caudally. Peptide-i axonal networks are less dense, and the remaining C-PON-i and NPY-i axons are tortuous and have larger varicosities than normal. In PD, the changes of C-PON-i neuronal morphology are as severe as in the TH-i neuron population, with rounded cell bodies and loss of dendritic arbors; the peptide-i innervation is reduced. The alterations in the peptide-i systems of the locus coeruleus, especially the increase in the numbers of neurons in SDAT, may be interpreted in terms of a plasticity of the aged brain.

ISSN:1420-8008    

DOI:10.1159/000107116

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The prevalence of abnormal neurologic symptoms and signs in mildly to moderately demented patients with Alzheimer''s disease (AD) was determined by comparison with healthy control subjects, and abnormal findings in AD were examined in relation to progression of dementia, as reflected in the annual rate of change in scores on a dementia scale. Abnormalities on mental status testing were more prevalent in AD than abnormalities on symptom scales or findings on the remainder of the neurologic examination. Recent memory impairment was the most prevalent abnormality, whereas impaired object naming was most strongly associated with progression of dementia. Prominent impairment of naming and other language abilities early in the course of dementia may identify a subtype of AD characterized by more rapid progression.

ISSN:1420-8008    

DOI:10.1159/000107117

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Single-photon emission computerized tomography demonstrates temporal-parietal (TP) hypoperfusion in many patients with Alzheimer''s disease (AD). However, the specificity of these changes has not yet been determined. We have found TP hypoperfusion in five groups of patients including 1 patient with normal aging, 6 with sleep apnea, 1 with posthypoxic dementia, 5 with multi-infarct dementia and 2 with ''pseudo'' TP hypoperfusion with frontal seizures. These findings suggest that the TP cortex may be particularly sensitive to hypoxia and/or hypotension and that hypoperfusion to TP Cortex is not specific to AD.

ISSN:1420-8008    

DOI:10.1159/000107118

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

We investigated the long-term administration of galanthamine hydrobromide, a cholinesterase inhibitor, in Alzheimer''s disease. The patient was at an advanced stage of the disease and remained unchanged with respect to the results of psychometrical tests. The clinical global impression, however, improved with dosage, and clinical improvement was associated with a remarkable and selective inhibition of acetylcholinesterase activity. Galanthamine was well tolerated without adverse effects or pathological changes in laboratory values, although high doses were given. Intravenous administration of galanthamine to a healthy volunteer revealed that the time course of acetylcholinesterase inhibition and plasma levels of the drug were closely correlated. The pharmacokinetics of galanthamine behaved linearly over the entire dosage range; plasma levels were equal to the concentrations in erythrocytes, and the elimination half-life was even longer than 4.5 h, as described by Westra and co-workers, in anaesthetized patients.

ISSN:1420-8008    

DOI:10.1159/000107119

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The hypothesis that head injuries and surgical anaesthetics might contribute to the risk of age-related cognitive impairment was tested in a prospective study of 103 patients with dementia of Alzheimer type (DAT), and 26 patients with multi-infarct dementia (MID). 90 age-matched demented community controls were studied in a comparison group. A family history (dementia in a first-degree relative) was found significantly more commonly in DAT (31.6%) than in MID (11.5%) or controls (8.9%). Head injuries were more common in demented patients (11.6%) than in controls (5.5%). The highest incidence (13.6%) was found in the group with DAT though the difference was not significant. No difference was found in the incidence of prior surgical anaesthetics amongst the three groups. The results are briefly discussed.

ISSN:1420-8008    

DOI:10.1159/000107120

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Dementia disorders are syndromes of cognito-emotional impairment which are disabling and longstanding. Subgroups of dementia are idiopathic dementias or primary degenerative dementias, vascular dementias and secondary dementias. Neurochemical investigations of postmortem human brain material have shown multiple changes in the neurotransmitter metabolism in patients with Alzheimer''s disease (AD) and senile dementia of the Alzheimer type (SDAT). The cholinergic system is severely disturbed, but also the serotonin system and the catecholamines are disturbed. Reduced concentrations of neuropeptides have also been reported in AD/SDAT. It is obvious, however, that in brains from Alzheimer-afflicted patients, there are also disturbances in gangliosides and white matter components. At present, it is not possible to single out one of these changes as of special importance for the dementia disorder. The recorded neurochemical changes in brains from patients with AD/SDAT must, at present, be assumed to be secondary phenomena to a more fundamental disturbance, the nature of which we still do not know. Another explanation may be that the group AD/SDAT is a heterogeneous group, including several from an etiopathological point of view different disorders. In vascular dementia, there seem to be subgroups, and the multi-infarct dementia (MID) is only one of these. In a non-MID vascular group, there are general neurochemical disturbances in the form of reduced activity of cholineacetyl transferase and concentrations of 5-hydroxytryptamine and 5-hydroxyindoleacetic acid. Although the neurochemical changes in dementia disorders are looked upon as secondary phenomena, they are of pathogenetic importance. Significant correlations have also been shown between neurotransmitter disturbances and behavioral symptoms. Thus, the neurochemical changes form a basis for formulating treatment strategies.

ISSN:1420-8008    

DOI:10.1159/000107121

出版商:S. Karger AG    

年代:1990

数据来源: Karger