| 1. |
- Edvinsson, Lars, et al.
(författare)
-
Neuropeptides in cerebrospinal fluid of patients with Alzheimer's disease and dementia with frontotemporal lobe degeneration
- 1993
-
Ingår i: Dementia (Switzerland). - 1013-7424. ; 4:3-4, s. 71-167
-
Tidskriftsartikel (refereegranskat)abstract
- The two major primary degenerative dementias, dementia of Alzheimer type (DAT) and frontal lobe degeneration of non-Alzheimer type (FLD) have several clinical features in common but also many symptoms that differ. In a clinical material of 80 patients with either of the two forms of dementia (DAT = 39, FLD = 41) we have studied the levels of neuropeptides in the cerebrospinal fluid (CSF) in order to find biochemical markers for CNS affection. The dementia forms were evaluated by careful clinical analysis, psychometric testing and measurement of regional cerebral blood flow. Approximately one third of the subjects died during the completion of the study and neuropathology was performed, confirming the diagnoses. We observed reductions in the CSF levels of antidiuretic hormone and somatostatin in both DAT and FLD. A strong tendency to reduction was noted for neuropeptide Y (NPY). There was a correlation with the duration of disease demonstrating a significant reduction in NPY levels in subjects with DAT. Most notably there was a strong reduction in the levels of delta sleep inducing peptide (DSIP) in DAT cases only. The levels of DSIP in FLD were the same as in controls. The reverse was found for corticotropin releasing factor (CRF) which had a significant reduction in FLD patients but not in those with DAT. The present study indicates a difference in the CSF levels of neuropeptides, observations that these may serve as biochemical markers which differentiate DAT and FLD.
|
|
| 2. |
- Elfgren, C, et al.
(författare)
-
Neuropsychological findings in frontal lobe dementia
- 1993
-
Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 4:3-4, s. 9-214
-
Tidskriftsartikel (refereegranskat)abstract
- Neuropsychological investigations were performed on 18 patients with a clinical diagnosis of frontal lobe dementia supported by regional cerebral blood flow measurements. Nature and degree of cognitive impairment were examined with a comprehensive test battery. The results of the neuropsychological assessment could be described as three levels of cognitive impairment. The increasing levels of cognitive impairment were accompanied by corresponding levels of reduced cerebral blood flow in frontotemporal areas. No apparent relationship emerged between impairment level and illness duration, indicating a considerable individual variation in the clinical course of frontal lobe dementia.
|
|
| 3. |
- Elmståhl, S., et al.
(författare)
-
Increased sweat sodium concentration in patients with Alzheimer's disease
- 1993
-
Ingår i: Dementia (Switzerland). - 1013-7424. ; 4:1, s. 50-53
-
Tidskriftsartikel (refereegranskat)abstract
- Sweat sodium concentration was estimated with pilocarpine iontophoresis in I 15 women with Alzheimer's disease (AD) and 29 healthy control women. The age ranged from 76 to 96 years with a mean age of 85 years in both groups. The mean sodium concentration of 91 ± 41 mmol/l (n = 11) in the Alzheimer patients was significantly higher than in the control group (62 ± 29 mmol/l, n=27, p=0.0011). 27% of AD patients and 7% of the control women did not respond to stimulation. The impaired sweating in AD patients make them more vulnerable to heat stress. Further studies are needed to reveal whether the neurophysiological mechanism involved is located in the hypothalamus, in cortical projections to the hypothalamus or in postganglionic sympathetic fibers.
|
|
| 4. |
- Minthon, Lennart, et al.
(författare)
-
Oral tetrahydroaminoacridine treatment of Alzheimer's disease evaluated clinically and by regional cerebral blood flow and EEG
- 1993
-
Ingår i: Dementia (Switzerland). - 1013-7424. ; 4:1, s. 32-42
-
Tidskriftsartikel (refereegranskat)abstract
- Neurochemical evidence indicates that cognitive impairment in dementia of Alzheimer type (DAT) is related to degeneration of cholinergic neurons in the brain. A pharmacological approach is treatment with a cholinesterase inhibitor such as tetrahydroaminoacridine (THA). THA treatment of 17 patients with DAT was studied with a double-blind crossover design with three types of treatment, THA + lecithin, THA + placebo and placebo + placebo. Each treatment period was 6 weeks with wash out periods of 2 weeks. The treatment was evaluated with clinical ratings, psychometric testing, EEG and regional cerebral blood flow (rCBF) measurements. No significant clinical differences between treatment periods were found in the total sample, but marked individual differences were observed. The patients were subdivided into three outcome groups based on four clinical measures: 6 patients improved (responders), 5 patients were mainly unchanged, and 6 patients showed further deterioration during the trial period of 26 weeks. Pretreatment rCBF in responders differed significantly from that of the deteriorated patients. EEG showed more high frequency activity among responders. Hepatotoxic side effects were observed in several cases. Three subjects showed marked increases of liver enzymes, with normalization following dose reduction. The majority of patients who improved or remained unchanged during the study chose to continue THA treatment in an open trial.
|
|
| 5. |
- Risberg, Jarl, et al.
(författare)
-
Regional cerebral blood flow in frontal lobe dementia of non-Alzheimer type.
- 1993
-
Ingår i: Dementia (Basel, Switzerland). - 1013-7424. ; 4:3-4, s. 186-187
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty-five out of 26 cases of autopsy-verified frontal lobe degeneration of non-Alzheimer type (FLD) were found to have focal frontal or frontotemporal blood flow reductions involving both hemispheres. The deviant case had an asymmetric frontal pathology only apparent on the right side. Focal reduction of blood flow in the frontal lobes is, however, a common and unspecific flow abnormality found in e.g. Pick's disease. Creutzfeldt-Jakob's disease, and in some cases of Alzheimer's disease. Low frontal flow has also been reported in schizophrenia and in toxic encephalopathy. Since a characteristic feature of FLD is a steady progress of the pathology, serial flow measurements extending over several years are especially informative.
|
|
| 6. |
- Warkentin, Siegbert, et al.
(författare)
-
Functional activation of the frontal lobes. Regional cerebral blood flow findings in normals and in patients with frontal lobe dementia performing a word fluency test
- 1993
-
Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 4:3-4, s. 188-191
-
Tidskriftsartikel (refereegranskat)abstract
- The present study examined the utility of the Word Fluency Test (WFT) as a frontal-lobe-activating test in brain imaging. Regional cerebral blood flow (rCBF) was measured during rest and during the WFT in 49 healthy volunteers and in 15 patients with frontal lobe dementia (FLD). The results showed a highly significant frontal lobe activation in 85% of the normal subjects. This finding was not related to age or to the level of performance on the WFT. A significant frontal activation was seen in 13 of the 15 FLD patients. The frontal flow increase did not reach normal levels, and was not related to age, illness duration or severity of clinical symptoms. The results suggest that the WFT is an ideal test to use in conjunction with functional imaging in normals as well as in patients with organic dementia.
|
|
