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Biomedical subjects

L Amaducci

Publications and source records attributed to L Amaducci.

At least 109 records · Page 6Linked to original sources

Changes in pyruvate dehydrogenase complex (PDHc) activity and [3H]QNB-receptor binding in rat brain subsequent to intracerebroventricular injection of bromopyruvate.

Pyruvate dehydrogenase complex (PDHc), a link between carbohydrate and acetylcholine metabolism, is a regulatory enzyme for glucose and neurotransmitter metabolism in the brain and is reduced in Alzheimer-diseased brain. To study functional consequences of an inhibition of PDHc on muscarinic receptor binding, bromopyruvate, a suicide inhibitor od PDHc, was injected intracerebroventricularly (icv) in rats. Bromopyruvate caused a reduction of PDHc activity in the 3 brain regions examined, however, reaching significance only in the cerebral cortex and the hippocampus and not in the striatum, 24 h after injection. 3, 6, and 12 weeks later, there was a normalization or transiently increased activity, respectively, of PDHc in these brain regions. No changes in concentrations of energy-rich phosphates could be demonstrated in the cerebral cortex 12 weeks after brompyruvate injection. The number of muscarinic receptors was significantly reduced in the cerebral cortex 12 weeks after injection. The data indicate that a transient reduction of brain PDHc activity in vivo is associated with a long-lasting reduction in muscarinic cholinergic receptors. Because comparable changes of PDHc and muscarinic receptors are found in dementia of Alzhemier type, the model of bromopyruvate inhibition of PDHc in rats is suggested to be useful for experimental dementia research.

Alzheimer Disease↗

Italian Multicentre Study on Dementia (SMID): a neuropsychological test battery for assessing Alzheimer's disease.

For the Italian Multicentre Study on Dementia, a longitudinal survey on Alzheimer's disease (AD) initiated in 1982, we developed a neuropsychological test battery for screening, staging and monitoring cognitive impairment in AD patients and for delineating their pattern of cognitive decline. The tests measured higher cortical functions primarily involved in AD, such as short- and long-term memory, orientation, language, and praxis, and spanned a large enough range of difficulty to minimize ceiling and floor effects. We administered this battery to 143 clinically diagnosed AD patients and 146 hospital controls whose scores were corrected for age and educational level. Interrater and test-retest reliability were substantial, as were content and concurrent validity. Five of the battery's subtests proved capable of accurately screening early demented from non-demented elderly subjects and of staging mild, moderate, severe and very severe mental impairment. The mean performance of subjects classified into these categories differed significantly on all cognitive functions tested. Follow-up studies are in progress.

Aged↗

Leukoaraiosis, intracerebral hemorrhage, and arterial hypertension.

To investigate whether the observed association of leukoaraiosis with intracerebral hemorrhage is direct or mediated by risk factors, we compared 116 patients with intracerebral hemorrhage confirmed by computed tomography and 155 controls without intracerebral hemorrhage, evaluating the prevalence of leukoaraiosis and vascular risk factors. Leukoaraiosis was observed in 21 (18%) of the 116 patients and in 12 (8%) of the 155 controls (p less than 0.01). Only two (6%) of the 31 patients with lobar hemorrhage had leukoaraiosis on computed tomograms, compared with 17 (24%) of the 71 patients with basal ganglionic hemorrhage (p less than 0.05). Leukoaraiosis was significantly correlated with intracerebral hemorrhage after controlling for age and sex by using multiple logistic regression analysis, while the correlation disappeared after controlling for hypertension. Our results indicate that leukoaraiosis is not an independent risk factor for intracerebral hemorrhage.

Brain↗

Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door-to-door survey in Appignano, Macerata Province, Italy.

The purpose of this study was to investigate the prevalence of dementia in an Italian population using a door-to-door 2-phase design. As part of a social and health survey, we administered the Hodkinson abbreviated mental test to all persons over age 59 residing in the Commune of Appignano on January 1, 1987 (N = 778). We then investigated all subjects scoring 7 or less on the cognitive test following a standardized diagnostic protocol. We found 48 patients affected by dementia, yielding a crude prevalence ratio (cases per 100 population over age 59) of 6.2; prevalence ratios were 2.6 for Alzheimer's disease, 2.2 for multi-infarct dementia, 0.8 for mixed dementia, 0.4 for secondary dementia, and 0.3 for unspecified dementia. Age- and sex-specific prevalence ratios increased steeply with age and were consistently higher in women for Alzheimer's disease and in men for dementia of all types and multi-infarct dementia. Alzheimer's disease was slightly more frequent than multi-infarct dementia; however, the most common type of dementia varied across age groups. Most cases of Alzheimer's disease were sporadic and had a late age of onset. Comparison with other populations suggests that dementia of all types is as frequent in Appignano as elsewhere, and that Alzheimer's disease might be more frequent in rural than in urban populations.

Age Factors↗

Abnormalities of mitochondrial enzymes in hereditary ataxias.

The activity of 7 mitochondrial enzymes, fumarase, NAD-malate dehydrogenase (MDH), citrate synthase (CS), valine dehydrogenase (VDH), succinate dehydrogenase (SDH), glutamate dehydrogenase (GDH), pyruvate dehydrogenase complex (PDHC) has been measured in platelet preparations from patients affected by Friedreich's ataxia (FA), dominant and non-dominant olivopontocerebellar atrophy (DOPCA, NDOPCA) and normal individuals. Significant decreases of GDH (P less than 0.01), PDHC (P less than 0.01), VDH (P less than 0.05) and SDH (P less than 0.05) activities were observed in FA patients. Significant decreases of GDH (P less than 0.01), PDHC (P less than 0.01), VDH (P less than 0.05), SDH (P less than 0.05) and CS (P less than 0.05) activities were Observed in ND-OPCA patients, whereas in DOPCA patients only GDH activity was significantly (P less than 0.05) decreased. In 8 of 10 patients with FA and in all patients with NDOPCA the activity of one or more of 4 enzymes, i.e. GDH, VDH, SDH, PDHC, was lower than the lowest of control values. Four of 6 patients with DOPCA had GDH activity lower than the lowest of control values. These results indicate that abnormalities of mitochondrial metabolism is a constant element in hereditary ataxia and suggest that the alteration primary leading to the different types of ataxias should be related to mitochondrial oxidative metabolism, at least at a regulatory level.

Adolescent↗

Electronystagmography in the diagnosis of multiple sclerosis.

The aim of our study was to define the diagnostic importance of a complete electronystagmographic (ENG) examination (visual-vestibular, vestibular and visual suppression tests on caloric nystagmus) in patients affected by MS. Of 144 patients examined, 116 were definite and 28 possible. Descriptive data of the instrumental findings showed very frequent alterations of one or more subtests: pursuit movements and visual suppression test were especially pathological, in respectively 56% and 58% of the cases; spontaneous and/or evoked nystagmus was present in 45%. A comparison between clinical and instrumental evidence of brainstem/cerebellar involvement indicated that 18% of the definite and 32% of the possible MS cases presented a negative clinical examination with positive instrumental findings. The usefulness of including a comprehensive ENG examination to obtain paraclinical evidence of a second lesion in the CNS in early MS is discussed.

Adult↗

Ecological memory assessment in normal aging. A preliminary report on an Italian population.

Forty-eight healthy volunteers were administered a computerized battery of "ecological" memory tests simulating real life everyday tasks and actions such as recalling people's names or telephone numbers. The group was dichotomized according to recent criteria proposed by a NIMH study group. Younger individuals (below 50 years of age) always showed better performances than those over 50. Although the learning curves were significantly lower for the older subgroup, the forgetting rate did not differ, suggesting that most of the memory complaints of the elderly might be attributable to the initial encoding phase of the memorizing activity rather than to a retrieval problem. It seems that easy distractability and inefficient strategic elaboration of incoming information are also, at least in part, responsible for the memory problems associated with normal aging. This article reports preliminary findings of a normative and representative Italian population sample.

Adult↗

Interrater reliability in assessing functional systems and disability on the Kurtzke scale in multiple sclerosis.

Interexaminer agreement in the use of quantitative scales for the evaluation of neurological deficits is essential to the reliability of clinical data from cooperative studies on multiple sclerosis. In this study, four neurologists, arranged into six pairs, examined 24 patients with definite multiple sclerosis and assessed each functional system and disability on the Kurtzke scale. As expressed by the kappa index, interobserver agreement was rather low, ranging from 30% to 50%. Sensory and mental functions turned out to be the most variable. The kappa indexes reached values above 85%, when raters who differed by no more than one point were considered as agreeing. A point difference on the scale of, at most, two units seemed to be a reliable index of clinical change. Moreover, these results pointed to the necessity for a specific training program for raters and for periodic control of interobserver variability in multicenter surveys.

Adult↗

Lysosomal enzymes in experimental allergic encephalomyelitis: time course and evidence of the source.

The lysosomal enzymes acid proteinase and beta-glucuronidase, were assayed in spinal cords of rats during the course of experimental allergic encephalomyelitis (EAE). Histological and histochemical examination was carried out versus controls, in selected areas of the same cords biochemically assayed, to look at the distribution of the lysosomal enzyme acid phosphatase. The biochemical assay showed a significant increase of the enzyme activities during the disease and the increase was significantly correlated with the intensity of the disease. The distribution in the nervous tissue of the increase in acid phosphatase activity observed in animals with EAE, suggests that endogenous nervous cells may contribute to the lysosomal enzyme increase in EAE.

Animals↗

Effectiveness of azathioprine treatment in multiple sclerosis.

As the effectiveness of continuous azathioprine therapy in multiple sclerosis (MS) is still controversial, we have conducted a prospective trial of the drug (2 mg/kg daily for at least 2 years) in patients with clinically definite MS, ie with remitting, remitting-progressive and progressive MS. At the end of an average 3-year follow-up 65% of the 40 patients with remitting-progressive had the same EDSS score as they had to start with. This was observed mainly in patients with longstanding MS and a high baseline EDSS. Of the 22 patients with a remitting course 77% showed no clinical deterioration and the annual relapse rate declined, although not significantly. In only one case did the remitting disease become remitting-progressive. Azathioprine would seem to have some efficacy in delaying the progression of remitting MS.

Adult↗

Risk factors and genetic background for Alzheimer's disease.

Analytic epidemiology has contributed significantly to the generation and testing of hypotheses of the causes of AD. Several case-control studies have indicated risk factors related to the genetic hypothesis, such as: the presence of cases of either AD or Down's syndrome in other family members and the advanced age of the mother at subject's birth. In this respect recent molecular biology studies on DNA from patients affected by the familial form of AD, have demonstrated a genetic polymorphism localized on chromosome 21. On the same chromosome, the gene coding for beta-amyloid has been also recently localized. Immune, viral and toxic factors, thought to cause AD, have been also investigated in case-control studies, none of them has been found consistently associated with the disease, with the only exception of the head trauma. On the other hand most case-control studies have been carried out in younger cases and no large studies are yet available for late onset patients.

Aluminum↗

Evaluation of Parkinson's disease: reliability of three rating scales.

We studied the three most commonly used rating scales in Parkinson's Disease (Hoehn and Yahr Clinical Staging, Webster Rating Scale, Columbia University Rating Scale) in order to examine the agreement between observers. Six neurologists, experts at using such scales, evaluated 48 patients suffering from the idiopathic form of Parkinson's Disease. Reliability using the K index was moderate, although a slight superiority was found with the Columbia University Rating Scale. Analysis of the various items used has suggested that scales of disability could be a valid alternative to those examined.

Adult↗

Lack of efficacy of phosphatidylcholine in ataxias.

We gave phosphatidylcholine orally at a daily dosage of 9 grams for 4 years to 20 subjects with Friedreich's ataxia (FA) and 24 with olivopontocerebellar atrophy (OPCA). There was no clinical improvement during the follow-up compared with 12 ataxic patients (six FA and six OPCA) who did not receive any treatment. A 6-month trial at a double dose did not have any significant effect. This study indicates that phosphatidylcholine does not change the natural course of ataxias.

Ataxia↗