Amyloidogenesis in Alzheimer disease and scrapie.
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Alzheimer Disease↗
Biomedical subjects
M Barcikowska
Publications and source records attributed to M Barcikowska.
Alzheimer-type neuropathology and clinical symptoms of dementia in mentally retarded people without Down syndrome.
Postmortem morphometric analyses of Bielschowsky stained sections from brains of 70 mentally retarded people without Down syndrome, age 65 and over when they died, indicated Alzheimer-type neuropathology in 22 cases (31%) and a majority with at least presence of some Alzheimer-type lesions. Based upon information abstracted from clinical histories, however, old-age-associated dementia proved to be difficult to judge reliably. Nevertheless, for otherwise healthy individuals (n = 25), loss of motor skills, development of problem behaviors, and a 10-point drop in IQ appeared to be likely indicators of Alzheimer's disease. Prevalence estimates of Alzheimer-type neuropathology among nonretarded people and the present sample appear comparable, and projections must be made to address the special needs of this rapidly growing population of retarded people.
Aged↗
Laminar distribution of neuritic plaques in normal aging, Alzheimer's disease and Down's syndrome.
Quantitative studies of neuritic (senile) plaques in six cortical layers were carried out in brains from people with confirmed clinical and neuropathological diagnosis of senile dementia of the Alzheimer type (SDAT) and Down's syndrome (DS). The same studies were performed on brains of normal old-aged people. In Alzheimer disease (AD) and DS cases the highest numbers of neuritic plaques (NP) were observed in temporal lobe layers III and II and occipital lobe layers III, IV and II. In normal old-aged people the highest numbers of NP were found in temporal lobe III and V and in occipital lobe IV, III, and V layer. The plaque numbers in both temporal and occipital cortices of AD and DS were significantly higher than that of normal old-aged people but there was no difference between AD and DS.
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Frontotemporal dementia: An attempt at clinical characteristics.
The clinical recognition of frontotemporal dementia (FTD) depends on its differentiation from Alzheimer's disease (AD). From 212 patients primarily diagnosed as probable AD, 24 cases with mild dementia, absence of disturbances the presence of which would have prevented a full neuropsychological assessment, and brain CT with detailed visualization of hippocampus atrophy were chosen. On the basis of neuropsychological examination the patients were divided into two groups: 11 cases with predominant deficit in frontal system tasks (FTD group) and 13 cases with changes in cognitive functions typical of AD (AD group). Age at onset, duration, behavioral changes, psychotic symptoms, depression, speech disorders, neurologic deficit and hippocampal atrophy were analyzed in both groups. Statistically significant differences for behavioral disturbances and hippocampal atrophy were found. Early behavioral changes and lack of early hippocampal atrophy on CT may be useful features for differentiating between FTD and AD, especially when SPECT is not available.
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Magnetic resonance imaging-based hippocampal volumetry in patients with dementia of the Alzheimer type.
A volumetric magnetic resonance imaging assessment of the hippocampal region was done in 50 patients with Alzheimer-type dementia and 25 members of a control group. There were no significant volumetric differences between the right and left hippocampi. The volumetric hippocampal measurements were 39.4% smaller in dementia of the Alzheimer type than in controls. In the differentiation between the analyzed groups of patients, the method had a sensitivity of 95% and a specificity of 92%. A correlation of the hippocampal volumes with the severity of the dementia and the patient's age was found. The results confirmed the importance of hippocampal atrophy in the etiology of dementia. In vivo the quantitative assessment of the hippocampal formation is a valuable tool in the diagnosis of Alzheimer's disease.
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Dementia in Parkinson's disease.
The prevalence of dementia, assessed on the basis of the Wechsler scale (WAIS), was determined in a group of 88 patients with idiopathic Parkinson's disease (PD) lasting longer than 4 years. In this group, 19 patients (22%) were diagnosed as demented. They were significantly older at the time of evaluation (72.9 +/- 8.1 vs. 63.6 +/- 11.9), and also at the onset of the disease (61.1 +/- 10.6 vs. 54.4 +/- 12.1) than nondemented patients. Their parkinsonism, as judged on the base of the Activity of Daily Living Scale, was more pronounced (57.4 +/- 13.7 vs. 73.3 +/- 15.6) and they developed psychotic side-effects of L-DOPA treatment (53% vs. 9%) more often. A weak negative correlation between age and intellectual quotient (IQ) was found, and a much stronger positive correlation between education and IQ. 25 patients of those diagnosed previously as non-demented were reassessed for dementia after another 5 years of disease. Only two of them were found demented. Both died and an immunohistochemical study of their brains was performed. In the 2 cases we found neuropathological features of both PD (Lewy bodies) and Alzheimer's disease (AD)--neurofibrillary tangles (NFT) and senile plaques (SP). This finding may support the hypothesis that, at least in some cases, dementia in PD could be due to an accompanying AD.
Adult↗
[Frequency and intensity of behavioral and psychological symptoms in the course of Alzheimer's disease].
The aim of the study was: 1) to estimate the occurrence and intensity of some psychopathological symptoms in the course of Alzheimer's disease, and 2) to examine whether the occurrence of behavioral and psychological symptoms increases with the deepening of dementia process among persons with Alzheimer's disease living in their homes with outpatient treatment. The study was conducted among 94 persons (38 men and 56 women ageing from 52 to 86 years (x = 72.4 +/- 6.9), with education: from 2 to 17 years (x = 11.2 +/- 3.7). Three subgroups were selected for study with regard to the intensity of dementia process, estimated according to Clinical Dementia Rating (CDR): very mild (n = 16, x = 71.4 +/- 6.7), mild (n = 43, x = 72.6 +/- 7.9), moderate (n = 35, x = 72.5 +/- 6.9). Subjects in group II and III fulfill diagnostic criteria of dementia according to ICD-10, DSM IV and criteria of probable AD according to NINCDS-ADRDA. In the estimation of occurrence of behavioral and psychological disturbances: Alzheimer's Disease Assessment Scale--non-cognitive behavior (ADAS-non-cog) and subscale "Change in Personality, Interests, Drive" of Blessed Dementia Scale were used. The results have shown that with the progress of dementia process, the occurrence of the following psychopathological symptoms such as: hallucinations, intensive motor activity, purposeless hyperactivity, pacing, rigidity increases and there is a relinquishment of hobbies. In addition, regardless of the stage of dementia, such behaviors as: apathy, depression, tearfullness, impaired emotional control and disturbances of appetite were observed relatively frequently.
Age Distribution↗
[Vascular risk factors in demented elderly: analysis of Alzheimer Clinic materials].
UNLABELLED: In recent years evidence is increasing that vascular disease is associated with cognitive impairment and dementia. Moreover, presence of cerebrovascular disease may intensify the clinical symptoms of Alzheimer's disease (AD). The aim of the study was to determine the prevalence of vascular risk factors in age and sex matched patients with dementia. We studied 109 patients with AD and 37 patients vascular dementia (VD). DSM-III-R test for dementia, NINCDS-ADRDA guidelines for AD and NINDS-ARIEN for VD were applied. RESULTS: Mean age of dementia onset in AD and VD was 65.8 SD 7.8 and 67.4 SD 7.0 years (p > 0.05), the duration of dementia, MMS and GDS for patients with AD and VD was not significantly different. Arterial hypertension was associated in 51.3% VD and 30.3% AD (p < 0.05), hypotension in 11.1 and 23.6% respectively (p > 0.05), atrial fibrillation was similar in AD and VD, coronary artery disease was presents 64.8% AD and 46.8 VD (p > 0.05) and type 2 diabetes in 21.6% and 10.1% (p > 0.05) respectively. No significant differences in serum lipid profile were found in both groups, except two times higher incidence of normal HDL-cholesterol concentration in AD compare to VD. The relation between alcohol consumption, cigarette smoking and head trauma was similar in both types of dementia. CONCLUSION: Vascular disease and AD have to some extent a shared aetiology, and risk factors that they have in common increase the risk of both disorders independently and vascular disease is perhaps involved in the aetiology of AD.
Adult↗
[Interaction evaluation between APOE epsilon 4 alleles and hippocampal atrophy. Preliminary communication].
In CT images the atrophy of medial parts of temporal lobes was evaluated in 60 patients with Alzheimer-type dementia. In the genotype of 30 patients at least one APOE epsilon 4 allele was identified, the other 30 patients served as the control group. The results of in vivo measurements of temporal lobe atrophy in the examined patients did not show statistically significant relations with APOE genotype which was probably due to entirely different nature and application of both tests.
Aged↗
[Alpha2-macroglobulin gene polymorphism in patients with Alzheimer's disease].
Recent studies suggest that alpha 2-macroglobulin (alpha 2 m) may play a role in the pathogenesis of Alzheimer's Disease (AD). The presence of alpha 2-macroglobulin G/G genotype is thought to increase the risk of AD. The aim of the study was to analyse alpha 2 m polymorphism in two groups: AD patients (n = 60, F = 41, M. = 19, mean age 73.3 +/- 6.3) and non-demented control group (n = 58, F = 36, M. = 22, mean age 73.1 +/- 8.3, mean MMSE score 27). Frequencies of genotypes A/A, A/G, G/G in AD group were: 0.46: 0.42: 0.12. In control group those frequencies were: 0.40: 0.48: 0.12. The lack of statistically significant difference between G/G frequencies in both groups of patients may suggest that alpha 2-macroglobulin G/G genotype is not a risk factor for AD.
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[Patterns of cognitive impairment and apolipoprotein genotype in persons with Alzheimer's disease].
The aim of this study was to test the possible relationship between patterns of cognitive deficits--especially impairment of memory processes--and ApoE genotype in patients with AD. Fifty seven right-handed subjects (31 males and 26 females) were tested in this study. The age of subjects ranged from 50 to 79, the education lasted from 11 to 16 years. All subjects were diagnosed as probable AD patients on the basis of DSM IV and NINCDS-ADRDA criteria. Each subject was examined for: 1) ApoE genotype, 2) general level of activity (GDS and MMSE), 3) neuropsychological evaluation of cognitive processes, using full test battery. 37 patients had at least one of ApoE epsilon 4 allele (e2/4, 3 and 4/4) and 20 patients had none of ApoE 4 allele (e 2/3 and 3/3). The group of tested subjects were subdivided into 2 groups. The first group was comprised by 31 patients with 3-rd stage (according to GDS) of mental activity. Twenty six patients with 4-th stage were included into the second group. Those subgroups did not significantly differ if age, education, gender or ApoE allele were considered. Experimental data were normalized and then analyzed using a statistical package SPSS/PC+. The analysis of variance showed that the type of test, stage of disease and two-way interaction ApoE x type of test were highly significant (P < 0.0001). Some results were obvious and not surprising (e.g. that results of patients with 4-th stage were much worse than the results of patients with stage 3-rd). It turned out that the best results were obtained by our patients in naming tests, the worst--in learning test with distraction. Patients with ApoE epsilon 4 performed better than patients with none ApoE epsilon 4 in the Rey's test, in the similarity test and in the test which required repeating numbers starting from the last one. The differences between the subgroups of patients with different ApoE alleles were confirmed by different distributions of correlations. All statistical analyses were repeated for more homogenous group of patients (only with stage 3-rd). The pattern of results resembled the previous one (i.e. better performance in the same tests) with one exception: additionally, in delayed recall test patients with none ApoE epsilon 4 performed much better that ApoE epsilon 4. Our results showed that some cognitive processes depended on ApoE genotype. Patients with none ApoE epsilon 4 genotype had less severe deficits in delayed recall of new information. On the other hand, working memory appeared to be less affected in patients with ApoE epsilon 4 genotype. Independent of genotype, both group showed similar impairment of learning ability without deficits in remote memory.
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[A case of Alzheimer's disease simulating Creutzfeldt-Jakob disease].
A case of Alzheimer's disease simulating Creutzfeldt-Jakob disease--We report here a case of 67-year old man with frank dementia accompanied by extrapyramidal syndrome and myoclonic jerks. The diagnosis of Creutzfeldt-Jakob disease was suggested but the neuropathological examination revealed features most compatible with Alzheimer's disease. The "gray area" between both cerebral amyloidoses was discussed.
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[Lesions of the insula and operculum: a syndrome].
A case of a clinical syndrome with transient hemiparesis, hemihypaesthesia, lancinating pains of a hand and "thalamic" position of this hand in a 60-year-old women. The clinical diagnosis was that of Dejérine-Roussy syndrome. Histological examination disclosed lesion of the lower part of the cortex of the insula, temporal aperculum- ventral part of the claustrum, capsula extrema and externa and also the uncinate and fronto-occipital fascicles.
Cerebral Cortex↗
[Risk factors in Alzheimer's disease].
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Aged↗
[A case of progressive multifocal leucoencephalopathy during chronic lymphocytic leukaemia].
We report here a case of PML in the course of untreated chronic lymphocytic leukaemia. The diagnosis of PML was based on the presence of typical histologic findings in the white matter: focal demyelination, abnormal oligodendroglia with basophilic intranuclear inclusions and enlarged bizarre astrocytes. It was confirmed by immunohistochemistry which revealed JC papova-virus antigens in brain tissue and by in-situ hybridization which showed JC virus genomic DNA in oligodendroglial nuclei. Virus particles in the nuclei of abnormal oligodendrocytes and astrocytes were demonstrated by thin-section electron-microscopy.
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Subacute sensory neuronopathy in small cell cancer of the lung. Immunocytochemical study of 2 cases.
Two cases of subacute sensory neuronopathy (SSN) associated with small cell lung cancer are reported. In both cases motor disability, attributed to motor neuropathy and neuronopathy, respectively, accompanied SSN. Immunohistochemical studies performed provide further data suggesting the involvement of humoral antibodies and the participation of protease inhibitors in the pathogenesis of SSN.
Autoantibodies↗
[Extrapyramidal signs in Alzheimer's disease].
Extrapyramidal signs were assessed in 112 patients satisfying NINCDS/ADRDA criteria for probable Alzheimer's disease. They were present in 50% of the patients. The most common features of them were bradykinesia and rigidity. Resting tremor was rarely encountered. There were no significant differences in age of onset, symptom duration, presence of primitive reflexes and psychotic symptoms between cases with and without extrapyramidal signs, while the presence of extrapyramidal signs was associated with statistically significant greater dementia severity.
Age of Onset↗
[A case of disseminated Lewy bodies disease: clinical and neurological finding].
We introduce a case of diffuse Lewy body disease (DLBD) diagnosed post mortem. Clinically patient was assessed as severe Alzheimer's disease. Typical picture of DLBD was disclosed immunohistochemically; anti-ubiquitin staining revealed numerous temporal, neocortical Lewy bodies, CA2/3 alterations and scanty senile plaques.
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