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Objectives: To evaluate the changes in regional cerebral blood flow (rCBF) and memory performance in patients with age related cognitive decline (ARCD) who did and did not become demented during a follow up period.Methods: Twenty four patients with ARCD were recruited from an outpatient memory clinic, of whom 18 were followed up over a mean period of two years. Eighteen patients with mild to moderate probable Alzheimer's disease and 18 aged normal controls were followed up over a mean period of three years. Memory performance and rCBF were evaluated quantitatively at inclusion and during follow up, using single photon emission computed tomography with xenon-133 injection and three subtests of the Wechsler memory scale (logical memory, paired associated learning, and digit span).Results: Patients with ARCD showed decreased rCBF and memory performance at initial evaluation compared with controls. Five of them became demented during the follow up period, with further decline in memory and rCBF. At inclusion, the only feature that distinguished these five patients as a group from the remainder was a pronounced temporoparietal asymmetry. The 13 patients with ARCD who did not become demented still exhibited impaired memory and rCBF at follow up, but without any further decline and no increase in flow asymmetry.Conclusions: Apart from patients in the preclinical phase of Alzheimer's disease, the ARCD category includes non-demented patients who have brain dysfunction that may represent a distinct clinical entity. [ABSTRACT FROM AUTHOR]

Objective: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia.Methods: Fifteen patients with an acute vascular right hemiplegia and 16 matched healthy controls were studied. Motor function of the left limbs of each patient was evaluated on days 20 and 90 after their stroke using four validated tools (hand dynamometer, isokinetic dynamometer, finger tapping, and nine hole peg test).Results: There was a significant impairment of motor function of the left limbs of patients at day 20 compared with controls. The impairment had recovered almost completely at day 90 after the stroke.Conclusion: These results show the bilateral cerebral representation of the human motor system and suggest the participation of ipsilateral motor pathways in recovery after a stroke. [ABSTRACT FROM AUTHOR]

Regional cerebral blood flow was investigated using single photon emission computed tomography and xenon-133 intravenous injection in six patients with dementia of the Alzheimer type (DAT) with atypical focal clinical presentation, and in 20 age-matched healthy volunteers. The patients had a progressive and preponderant cognitive deficit and a focal hypoperfusion that correlated with the neuropsychological findings, whereas the average flow did not significantly differ from that of controls. The assessment of concordant haemodynamic and neuropsychological focal abnormalities could be useful in the diagnosis of atypical cases of DAT. [ABSTRACT FROM AUTHOR]

The apolipoprotein E (ApoE)-epsilon4 allele is associated in a dose dependent manner to an increased risk for Alzheimer's disease. However, the ApoE-epsilon4 allele effect does not account for all patients with Alzheimer's disease, and the existence of other genetic risk factors has been postulated. Kamboh et al reported an association between Alzheimer's disease and the A allele of alpha1-antichymotrypsin (Aact) gene, which was not confirmed in a larger series more recently analysed. The ApoE and Aact genotypes were analysed in 314 patients with Alzheimer's disease and 173 healthy controls, confirming the dose dependent effect of the ApoE-epsilon4 allele. Nevertheless, even using odds ratios adjusted for age and sex, there was no significant effect of the Aact genotype on Alzheimer's disease or on the ApoE-epsilon4 allele associated risk for Alzheimer's disease. [ABSTRACT FROM AUTHOR]