3,077 results on '"Dementia, Multi-Infarct"'
Search Results
2. Registry for CADASIL
- Published
- 2024
3. Care of Persons With Dementia in Their Environments (COPE) in Programs of All-Inclusive Care of the Elderly (PACE)
- Author
-
Drexel University and Thomas Jefferson University
- Published
- 2024
4. Natural History Study of CADASIL
- Published
- 2024
5. Retina is a Marker for Cerebrovascular Heath
- Author
-
Michelle P. Lin, Principal Investigator
- Published
- 2024
6. AusCADASIL: An Australian Cohort of CADASIL
- Author
-
Prince of Wales Hospital, Sydney, John Hunter Hospital, St Vincent's Hospital - Sydney, Australia, Royal Brisbane and Women's Hospital, Melbourne Health, The University of Queensland, and Perminder Sachdev, Professor
- Published
- 2024
7. Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy (CADASIL) Study
- Author
-
National Institute on Aging (NIA)
- Published
- 2024
8. Alzheimer's Autism and Cognitive Impairment Stem Cell Treatment Study (ACIST)
- Published
- 2024
9. Mitochondrial Protection and Against Glutamate Neurotoxicity via Shh/Ptch1 Signaling Pathway to Ameliorate Cognitive Dysfunction by Kaixin San in Multi-Infarct Dementia Rats.
- Author
-
Li X, Wen W, Li P, Fu Y, Chen H, Wang F, Dai Y, and Xu S
- Subjects
- Animals, Cognitive Dysfunction chemically induced, Dementia, Multi-Infarct chemically induced, Disease Models, Animal, Glutamic Acid metabolism, Male, Memory Disorders chemically induced, Memory Disorders metabolism, Mitochondria metabolism, Neurons drug effects, Neurons metabolism, Patched-1 Receptor metabolism, Rats, Sprague-Dawley, Signal Transduction drug effects, Rats, Cognitive Dysfunction metabolism, Dementia, Multi-Infarct metabolism, Drugs, Chinese Herbal pharmacology, Glutamic Acid pharmacology, Mitochondria drug effects, Patched-1 Receptor drug effects
- Abstract
Multi-infarct dementia (MID), a prominent subtype of vascular dementia (VD), is responsible for at least 15 to 20 percent of dementia in the elderly. Mitochondrial dysfunctions and glutamate neurotoxicity due to chronic hypoperfusion and oxidative stress were regarded as the major risk factors in the pathogenesis. Kaixin San (KXS), a classic prescription of Beiji Qianjin Yaofang , was applied to treatment for "amnesia" and has been demonstrated to alleviate the cognitive deficit in a variety of dementias, including MID. However, little is known whether mitochondria and glutamate are associated with the protection of KXS in MID treatment. The aim of this study was to investigate the role of KXS in improving the cognitive function of MID rats through strengthening mitochondrial functions and antagonizing glutamate neurotoxicity via the Shh/Ptch1 signaling pathway. Our data showed that KXS significantly ameliorated memory impairment and hippocampal neuron damage in MID rats. Moreover, KXS improved hippocampal mitochondrial functions by reducing the degree of mitochondrial swelling, increasing the mitochondrial membrane potential (MMP), and elevating the energy charge (EC) and ATP content in MID rats. As expected, the concentration of glutamate and the expression of p-NMDAR1 were significantly reduced by KXS in the brain tissue of MID rats. Furthermore, our results showed that KXS noticeably activated the Shh/Ptch1 signaling pathway which was demonstrated by remarkable elevations of Ptch1, Smo, and Gli1 protein levels in the brain tissue of MID rats. Intriguingly, the inhibition of the Shh signaling pathway with cyclopamine significantly inhibited the protective effects of KXS on glutamate-induced neurotoxicity in PC12 cells. To sum up, these findings suggested that KXS protected MID rats from memory loss by rescuing mitochondrial functions as well as against glutamate neurotoxicity through activating Shh/Ptch1 signaling pathway., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Xiaoqiong Li et al.)
- Published
- 2021
- Full Text
- View/download PDF
10. CERebrolysin In CADASIL (CERICA)
- Author
-
idv Datenanalyse & Versuchsplanung and XClinical GmbH
- Published
- 2023
11. Rural Dementia Caregiver Project
- Author
-
National Institute on Aging (NIA)
- Published
- 2023
12. Adrenomedullin for CADASIL (AMCAD)
- Author
-
Masafumi Ihara, Director of Neurology, National Cerebral and Cardiovascular Center
- Published
- 2023
13. CADASIL Registry Study
- Author
-
Bin Cai, Professor
- Published
- 2023
14. MRI Study of Blood-brain Barrier Function in CADASIL
- Author
-
Chinese Academy of Sciences
- Published
- 2023
15. Establishment of a CSF Bank for the Development of Biomarkers of Smooth Muscle Cell (SMC) Damage in Monogenic Cerebral Small Vessel Disease (CSF-cSVD)
- Published
- 2023
16. Comparative Study Between Alzheimer's and Multi-infarct Dementia
- Author
-
AAEsraa, Assistant Lecturer
- Published
- 2023
17. Prognosis of Cerebral Small Vessel Disease (PRO-SVD)
- Published
- 2023
18. Signal Alteration of Substantia Nigra on 3.0T Susceptibility-weighted Imaging in Parkinson's Disease and Vascular Parkinsonism.
- Author
-
Zhao XJ, Niu XY, You HY, Zhou M, Ji XB, Liu Y, Wu L, and Ding XL
- Subjects
- Aged, Aged, 80 and over, Biomarkers analysis, Case-Control Studies, Dementia, Multi-Infarct pathology, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Parkinson Disease pathology, Sensitivity and Specificity, Substantia Nigra blood supply, Substantia Nigra pathology, Dementia, Multi-Infarct diagnostic imaging, Magnetic Resonance Imaging statistics & numerical data, Parkinson Disease diagnostic imaging, Substantia Nigra diagnostic imaging
- Abstract
Recent researches have found that 7 Tesla SWI can detect the alteration of substantia nigra hyperintensity in Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). The aim of this study was to investigate whether 3 Tesla SWI (3T SWI) can visualize anatomical alterations occurring in a hyperintense structure of the substantia nigra in PD and vascular parkinsonism (VP), and whether the evaluation of abnormal signal can be used as a factor in the differential diagnosis of PD and VP. Using 3 Tesla MRI, we evaluated 38 healthy subjects, 33 patients with PD and 34 patients with VP. Two blinded readers independently assessed the images. We found that the dorsolateral nigral hyperintensity was absent in 31 of 33 patients with PD and 15 of 34 patients with VP. The dorsolateral nigral hyperintensity was present in 19 of 34 patients with VP and 35 of 38 healthy controls. Group comparisons of absence of dorsolateral nigral hyperintensity revealed significant differences between the patients with PD and those with VP (P<0.001). The sensitivity of SWI for PD was 93.9% and the specificity was 92.1%. Visual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new simple diagnostic imaging marker for PD. And our study results indicate that 3T SWI can be used as a tool to identify PD and VP.
- Published
- 2019
- Full Text
- View/download PDF
19. Blood Pressure and Dementia: Holistic Interventions.
- Subjects
- Aged, 80 and over, Dementia, Multi-Infarct psychology, Female, Holistic Nursing methods, Humans, Male, Dementia, Multi-Infarct complications, Hypertension complications
- Published
- 2019
- Full Text
- View/download PDF
20. [Clinical study of Alzheimer's disease. Differential diagnosis of Alzheimer-type dementia, multi-infarct dementia and Pick's disease of brain].
- Author
-
Hiroi T and Ikeda H
- Subjects
- Aged, Alzheimer Disease pathology, Brain pathology, Dementia pathology, Dementia, Multi-Infarct pathology, Diagnosis, Differential, Female, Humans, Middle Aged, Alzheimer Disease diagnosis, Dementia diagnosis, Dementia, Multi-Infarct diagnosis
- Published
- 1988
21. Virtual Individual Cognitive Stimulation Therapy: a Proof of Concept Study (V-iCST)
- Author
-
The University of Hong Kong
- Published
- 2022
22. Efficacy and Safety of Tocotrienols in CADASIL
- Published
- 2022
23. Safety and Efficacy of Fremanezumab for Migraine in Adult CADASIL
- Author
-
James F. Meschia, Principal Investigator
- Published
- 2022
24. Multi-infarct dementia of Swedish type is caused by a 3'UTR mutation of COL4A1.
- Author
-
Siitonen M, Börjesson-Hanson A, Pöyhönen M, Ora A, Pasanen P, Bras J, Kern S, Kern J, Andersen O, Stanescu H, Kleta R, Baumann M, Kalaria R, Kalimo H, Singleton A, Hardy J, Viitanen M, Myllykangas L, and Guerreiro R
- Subjects
- Dementia, Multi-Infarct physiopathology, Female, Genetic Association Studies, HEK293 Cells, Humans, Male, MicroRNAs genetics, MicroRNAs metabolism, Sweden, Transfection, 3' Untranslated Regions genetics, Collagen Type IV genetics, Dementia, Multi-Infarct genetics, Family Health, Genetic Predisposition to Disease genetics, Mutation genetics
- Published
- 2017
- Full Text
- View/download PDF
25. Middle Cerebral Artery Pulsatility Index is Associated with Cognitive Impairment in Lacunar Stroke.
- Author
-
Altmann M, Thommessen B, Rønning OM, Benth JŠ, Reichenbach AS, and Fure B
- Subjects
- Aged, Dementia, Multi-Infarct drug therapy, Female, Humans, Infarction, Middle Cerebral Artery drug therapy, Male, Middle Aged, Prospective Studies, Pulsatile Flow drug effects, Statistics as Topic, Stroke drug therapy, Stroke, Lacunar drug therapy, Thrombolytic Therapy, Ultrasonography, Doppler, Transcranial, Vascular Resistance drug effects, Vascular Resistance physiology, Dementia, Multi-Infarct diagnostic imaging, Dementia, Multi-Infarct physiopathology, Infarction, Middle Cerebral Artery diagnostic imaging, Infarction, Middle Cerebral Artery physiopathology, Pulsatile Flow physiology, Stroke diagnostic imaging, Stroke physiopathology, Stroke, Lacunar diagnostic imaging, Stroke, Lacunar physiopathology
- Abstract
Background and Purpose: Pulsatility index (PI) of the middle cerebral artery is postulated to reflect the vascular resistance in the artery distal of the probe, and has been reported to increase in small vessel disease, diabetes mellitus, ageing, and dementia. Lacunar infarcts are considered to be related to cognitive impairment. We therefore conducted a study to assess the association between cognitive impairment and PI in patients with a lacunar infarct., Methods: Consecutive patients presenting with an acute lacunar syndrome who were admitted to the stroke unit were enrolled. The patients were examined with Doppler ultrasonography of the intracranial arteries, and the PI of the middle cerebral artery was recorded. Cognitive function was evaluated by mini-mental state examination (MMSE), clock drawing test, and trail making test (TMT) A and B., Results: Among the 113 patients included, 85 patients had an acute lacunar infarct and 28 had one or more nonlacunar infarcts. The mean PI was 1.46 (SD = .33). PI was significantly (P < .05) associated with MMSE, TMT A and TMT B in patients with lacunar infarct, even after adjustment for multiple patient characteristics (age, sex, prestroke hypertension, smoking, previous stroke, and diabetes)., Conclusions: PI was associated with the cognitive performance in patients with lacunar infarcts and a lacunar syndrome. An elevated PI may be related to impairment in several cognitive domains. These findings suggest that transcranial Doppler ultrasonography could be an adjunct tool for early diagnosis of cognitive impairment after stroke., (Copyright © 2016 by the American Society of Neuroimaging.)
- Published
- 2016
- Full Text
- View/download PDF
26. [Effects of Tongluo Xingnao effervescent tablets on blood rheology, iNOS, VEGF and LDH-5 in MID rats].
- Author
-
Ren XY, Hu Y, Wei JP, Fu WJ, Xu SJ, and Wang YY
- Subjects
- Animals, Dementia, Multi-Infarct blood, Dementia, Multi-Infarct metabolism, Dementia, Multi-Infarct psychology, Hippocampus drug effects, Hippocampus metabolism, Humans, Isoenzymes genetics, Isoenzymes metabolism, L-Lactate Dehydrogenase genetics, Lactate Dehydrogenase 5, Learning drug effects, Male, Memory drug effects, Nitric Oxide Synthase Type II genetics, Rats, Rats, Sprague-Dawley, Rheology, Tablets administration & dosage, Vascular Endothelial Growth Factor A genetics, Blood Chemical Analysis, Dementia, Multi-Infarct drug therapy, Drugs, Chinese Herbal administration & dosage, L-Lactate Dehydrogenase metabolism, Nitric Oxide Synthase Type II metabolism, Vascular Endothelial Growth Factor A metabolism
- Abstract
The study was to explore effects of Tongluo Xingnao effervescent tablets on the blood rheology, iNOS, VEGF and LDH-5 in multi-infarct dementia(MID) model rats. Establish MID model rats were induced by microthrombosis, from which 50 successful model rats were randomly divided into five groups, such as the model control group, the dihydroergotoxine mesylate tablets(hydergine) group(0.7 mg•kg⁻¹), Tongluo Xingnao effervescent tablets high-dose, medium-dose and low-dose groups(7.56, 3.78, 1.89 g•kg⁻¹). Another ten rats in the sham group were randomly selected as the parallel control group. Each group was orally administered with drugs for 90 days. The learning and memory ability was evaluated with the Morris water maze test, while the whole blood viscosity and the erythrocyte aggregation index derived from abdominal aorta were measured in different shear rates. In addition, the levels of VEGF and iNOS in the serum were determined by ELISA kits. The expression of LDH-5 in hippocampus of rats was measured with immunohistochemistry and image quantitative analysis. The result showed that Tongluo Xingnao effervescent tablets notably decreased the escape latency of MID model rats, increased times of entering into the escape platform and prolonged retention time in medium ring, meanwhile the whole blood viscosity in MID model rats was also notably reduced in four shear rates, i.e. 1, 5, 30, 200 S⁻¹, erythrocyte aggregation index, serum VEGF and iNOS, and average optical density value of LDH-5, with a statistically significant differences compared with the model control group (P<0.05). In conclusion, Tongluo Xingnao effervescent tablets could improve the ability of learning and memory of MID model rats and the blood rheology, reduce the level of iNOS, VEGF and the expression of LDH-5, and then improved the brain energy supply., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)
- Published
- 2016
- Full Text
- View/download PDF
27. Imaging Study of Neurovascular Coupling in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy (CADASIL) (MACOUPLING-CAD)
- Published
- 2021
28. [Stroke and dementia - An epidemic of our century?].
- Author
-
Schrader J
- Subjects
- Cross-Sectional Studies, Dementia, Multi-Infarct etiology, Dementia, Multi-Infarct prevention & control, Epidemics prevention & control, Forecasting, Germany, Humans, Population Dynamics, Risk Factors, Stroke etiology, Stroke prevention & control, Cause of Death trends, Dementia, Multi-Infarct mortality, Epidemics statistics & numerical data, Stroke mortality
- Published
- 2015
- Full Text
- View/download PDF
29. Development of New Biomarkers With Magnetic Resonance Imaging for Longitudinal Studies in CADASIL Angiopathy (BIOMRI_CADA)
- Published
- 2020
30. Progressive cognitive deficits in a mouse model of recurrent photothrombotic stroke.
- Author
-
Schmidt A, Diederich K, Strecker JK, Geng B, Hoppen M, Duning T, Schäbitz WR, and Minnerup J
- Subjects
- Animals, Dementia, Multi-Infarct etiology, Disease Models, Animal, Intracranial Thrombosis complications, Male, Maze Learning physiology, Mice, Mice, Inbred C57BL, Recognition, Psychology physiology, Recurrence, Behavior, Animal physiology, Dementia, Multi-Infarct physiopathology, Disease Progression
- Abstract
Background and Purpose: In spite of its high disease burden, there is no specific treatment for multi-infarct dementia. The preclinical evaluation of candidate drugs is limited because an appropriate animal model is lacking. Therefore, we aimed to evaluate whether a mouse model of recurrent photothrombotic stroke is suitable for the preclinical investigation of multi-infarct dementia., Methods: Recurrent photothrombotic cortical infarcts were induced in 25 adult C57BL/6 mice. Twenty-five sham-operated animals served as controls. The object recognition test and the Morris water maze test were performed >6 weeks to assess cognitive deficits. Afterward, histological analyses were performed to characterize histopathologic changes associated with recurrent photothrombotic infarcts., Results: After the first infarct, the object recognition test showed a trend toward an impaired formation of recognition memories (P=0.08), and the Morris Water Maze test revealed significantly impaired spatial learning and memory functions (P<0.05). After recurrent infarcts, the object recognition test showed significant recognition memory deficits (P<0.001) and the Morris water maze test demonstrated persisting spatial learning and memory deficits (P<0.05). Histological analyses revealed remote astrogliosis in the hippocampus., Conclusions: Our results show progressive cognitive deficits in a mouse model of recurrent photothrombotic stroke. The presented model resembles the clinical features of human multi-infarct dementia and enables the investigation of its pathophysiological mechanisms and the evaluation of treatment strategies., (© 2015 American Heart Association, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
31. Effects of acupuncture on declined cerebral blood flow, impaired mitochondrial respiratory function and oxidative stress in multi-infarct dementia rats.
- Author
-
Zhang X, Wu B, Nie K, Jia Y, and Yu J
- Subjects
- Animals, Dementia, Multi-Infarct metabolism, Disease Models, Animal, Male, Rats, Rats, Wistar, Acupuncture Therapy, Cerebrovascular Circulation physiology, Cognition physiology, Dementia, Multi-Infarct therapy, Mitochondria metabolism, Oxidative Stress physiology
- Abstract
Brain energy disorders and oxidative stress due to chronic hypoperfusion were considered to be the major risk factors in the pathogenesis of dementia. In previous studies, we have demonstrated that acupuncture treatment improved cognitive function of VaD patients and multi-infarct dementia (MID) rats. Acupuncture therapy also increased the activities of glycometabolic enzymes in the brain. But it is not clear whether acupuncture treatment compensates neuronal energy deficit after cerebral ischemic through enhancing the activities of glucose metabolic enzymes and preserving mitochondrial function, and whether acupuncture neuroprotective effect is associated with activations of mitochondrial antioxidative defense system. So, the effect of acupuncture therapy on cognitive function, cerebral blood flow (CBF), mitochondrial respiratory function and oxidative stress in the brain of MID rats was investigated in this study. The results showed that acupuncture treatment significantly improved cognitive abilities and increased regional CBF of MID rats. Acupuncture elevated the activities of total SOD, CuZnSOD and MnSOD, decreased the level of malondialdehyde (MDA) and superoxide anion, regulated the ratio of reduced glutathione (GSH) and oxidized glutathione (GSSG) in mitochondria, and raised the level of the respiratory control index (RCI) and P/O ratio and the activities of mitochondrial respiratory enzymes of MID rats. These results indicated that acupuncture treatment improved cognitive function of MID rats; and this improvement might be due to increased CBF, which ameliorated mitochondrial dysfunction induced by ischemia and endogenous oxidative stress system of brain., (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
32. CADASIL or CADVaSIL?
- Author
-
Rafalowska J, Fidzianska A, Dziewulska D, Podlecka A, Szpak GM, and Kwiecinski H
- Subjects
- Adult, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct genetics, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Pedigree, Vascular Diseases classification, Vascular Diseases genetics, Vascular Diseases pathology, Dementia, Multi-Infarct classification, Dementia, Multi-Infarct pathology
- Abstract
In the present study, morphological examination of patients from two unrelated Polish families with CADASIL was performed. Using light microscopy, there were evident changes characteristic to the disease. On electron microscopy, deposits of granular osmiophillic material (GOM) were found not only in cerebral arteries and veins but also in cerebral capillaries and vessels of the internal organs. These findings indicate that pathological process in CADASIL is generalized and involves also small vessels devoid of smooth muscle cells. Therefore, we propose to consider a replacement for the name CADASIL that better reflects the morphological picture of the disease like, for example, cerebral autosomal dominant vasculopathy with subcortical infarcts and leukoencephalopathy (CADVaSIL) or, to preserve the commonly known acronym, cerebral autosomal dominant angiopathy with subcortical infarcts and leukoencephalopathy.
- Published
- 2004
- Full Text
- View/download PDF
33. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): from discovery to gene identification.
- Author
-
Fukutake T
- Subjects
- Adult, CADASIL genetics, Cerebrovascular Disorders classification, Cerebrovascular Disorders diagnosis, Cerebrovascular Disorders epidemiology, Dementia, Multi-Infarct classification, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct epidemiology, Diagnosis, Differential, Genetic Predisposition to Disease, Heredity, High-Temperature Requirement A Serine Peptidase 1, Humans, Leukoencephalopathy, Progressive Multifocal classification, Leukoencephalopathy, Progressive Multifocal diagnosis, Leukoencephalopathy, Progressive Multifocal epidemiology, Male, Phenotype, Predictive Value of Tests, Prognosis, Cerebral Arteries pathology, Cerebrovascular Disorders genetics, Dementia, Multi-Infarct genetics, Leukoencephalopathy, Progressive Multifocal genetics, Mutation, Serine Endopeptidases genetics
- Abstract
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a single-gene disorder directly affecting the cerebral small blood vessels, that is caused by mutations in the HTRA1 gene encoding HtrA serine peptidase/protease 1 (HTRA1). CARASIL is the second known genetic form of ischemic, nonhypertensive, cerebral small-vessel disease with an identified gene, along with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The exact prevalence of CARASIL is currently unknown, and to date approximately 50 patients have been reported, most of them from Japan and two from China. Genetically, no founder haplotype has been identified, and thus the disease is expected to be found more widely. The main clinical manifestations of CARASIL are ischemic stroke or stepwise deterioration in brain functions, progressive dementia, premature baldness, and attacks of severe low back pain or spondylosis deformans/disk herniation. The most characteristic findings on brain magnetic resonance imaging are diffuse white matter changes and multiple lacunar infarctions in the basal ganglia and thalamus. Histopathologically, CARASIL is characterized by intense arteriosclerosis, mainly in the small penetrating arteries, without granular osmiophilic materials or amyloid deposition. CARASIL is a prototype single-gene disorder of cerebral small vessels secondary to and distinct from CADASIL. CARASIL-associated mutant HTRA1 exhibited decreased protease activity and failed to repress transforming growth factor-β family signaling, indicating that the increased signaling causes arteriopathy in CARASIL. Therefore, HTRA1 represents another new gene to be considered in future studies of cerebral small-vessel diseases, as well as alopecia and degenerative vertebral/disk diseases., (Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
34. Vascular cognitive impairment in small vessel disease: clinical and neuropsychological features of lacunar state and Binswanger's disease.
- Author
-
Ramos-Estebanez C, Moral-Arce I, Gonzalez-Mandly A, Dhagubatti V, Gonzalez-Macias J, Munoz R, and Hernadez-Hernandez JL
- Subjects
- Aged, Aged, 80 and over, Cerebrovascular Disorders diagnostic imaging, Cerebrovascular Disorders physiopathology, Cerebrovascular Disorders psychology, Cognition Disorders diagnostic imaging, Cognition Disorders physiopathology, Cognition Disorders psychology, Dementia, Multi-Infarct diagnostic imaging, Dementia, Multi-Infarct physiopathology, Dementia, Multi-Infarct psychology, Dementia, Vascular diagnostic imaging, Dementia, Vascular physiopathology, Dementia, Vascular psychology, Early Diagnosis, Executive Function, Female, Gait Disorders, Neurologic etiology, Gait Disorders, Neurologic physiopathology, Humans, Hypertension etiology, Hypertension physiopathology, Logistic Models, Male, Neuropsychological Tests, Odds Ratio, Predictive Value of Tests, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Spain, Tomography, X-Ray Computed, Cerebrovascular Disorders complications, Cognition, Cognition Disorders etiology, Dementia, Multi-Infarct etiology, Dementia, Vascular etiology
- Abstract
Background: ischaemic cerebrovascular small vessel disease (SVD) is a prevalent and under-diagnosed condition that triggers vascular cognitive impairment (VCI)., Objective: to describe the neuropsychological and clinical profiles in SVD (Binswanger's disease, BD; lacunar state, LS) from the clinician's perspective at the VCI stage., Methods: a total of 1257 patients admitted to a tertiary center with a diagnosis of stroke, neuroradiological vascular disease, cognitive impairment/dementia, during a 13-year period were investigated. We prospectively assessed cognition in a subset of 141 patients with VCI (LS n = 28, BD n = 69, large vessel disease-LVD-n = 44) with MMSE, CAMDEX-H, WAIS-R, EXIT-25 and Trail making test., Results: executive dysfunction (ECD) (n = 89, 91.7% versus n = 10, 22.7%; P < 0.001) and gait disturbances (n = 74, 76.3% versus n = 15, 34.1%; P < 0.001) characterized SVD. Prior strokes (n = 9, 9.3% versus n = 23, 52.3%; P < 0.001) and embologenous cardiopathy (n = 39, 40.2% versus n = 28, 63.6%; P < 0.04) featured LVD cases. BD was defined by hypertension (n = 52, 75.4% versus n = 30, 44.1%; P < 0.001), ECD (n = 65, 94.2% versus n = 34, 47.2%; P < 0.001) and VCI onset with cognitive impairment but not strokes (n = 44, 63.8% versus n = 34, 50%; P < 0.01)., Conclusions: ECD and a frontal gait are SVD's clinical landmarks in our sample. LS and BD cases share a similar cognitive profile.
- Published
- 2011
- Full Text
- View/download PDF
35. CADASIL: a common form of hereditary arteriopathy causing brain infarcts and dementia.
- Author
-
Kalimo H, Ruchoux MM, Viitanen M, and Kalaria RN
- Subjects
- Arteries pathology, Brain Infarction genetics, Dementia physiopathology, Dementia, Multi-Infarct genetics, Dementia, Multi-Infarct pathology, Dementia, Multi-Infarct physiopathology, Diagnosis, Differential, Humans, Ischemic Attack, Transient genetics, Magnetic Resonance Imaging, Migraine Disorders genetics, Mutation, Missense, Myocytes, Smooth Muscle metabolism, Proto-Oncogene Proteins metabolism, Receptor, Notch3, Receptors, Notch, Dementia genetics, Dementia, Multi-Infarct complications, Dementia, Multi-Infarct diagnosis, Proto-Oncogene Proteins genetics, Receptors, Cell Surface
- Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebrovascular disease leading to cognitive decline and dementia. CADASIL usually begins with migraine in about one third of the patients. More severe manifestations, transient ischemic attacks or recurrent strokes, appear between 30 and 50 years of age. CADASIL, however, may be diagnosed well before the first stroke on the basis of characteristic white matter hyperintensities upon magnetic resonance imaging and presence of pathognomonic granular osmiophilic material in arterial walls, including dermal arteries, since the arteriopathy is generalized. Gradual destruction of vascular smooth muscle cells (VSMC) leads to progressive wall thickening and fibrosis and luminal narrowing in small and medium-sized penetrating arteries. The reduced cerebral blood flow finally causes lacunar infarcts, mainly in the basal ganglia and fronto-temporal white matter, which lead to cognitive deficits and dementia of the subcortical vascular type. CADASIL is caused by single missense mutations or small deletions in Notch3 gene encoding a transmembrane receptor Notch3, of which upon ligand binding a nuclear signaling protein is generated by regulated intramembrane proteolysis. Notch signaling is essential during development, regulating cellular differentiation. In adults Notch3 is expressed only in VSMCs and it may promote cell survival by inhibiting apoptosis, but its exact function is unknown. Mutations result in either a gain or loss of one (or rarely, 3) cysteine residue(s) in one of the 34 epidermal growth factor-like repeats in the extracellular amino-terminal region of Notch3. It is as yet unclear which disturbance in the Notch signaling pathway leads to the characteristic vascular pathology of CADASIL.
- Published
- 2002
- Full Text
- View/download PDF
36. Vascular and biochemical risk factors of vascular dementia after lacunar strokes (S-VaD) and after multiinfarcts in strategic areas (M-VaD).
- Author
-
Graban A, Bednarska-Makaruk M, Bochyńska A, Lipczyńska-Łojkowska W, Ryglewicz D, and Wehr H
- Subjects
- Aged, Atrial Fibrillation epidemiology, Brain pathology, Cholesterol, HDL blood, Coronary Artery Disease epidemiology, Dementia, Multi-Infarct blood, Dementia, Multi-Infarct etiology, Dementia, Vascular blood, Dementia, Vascular etiology, Female, Folic Acid Deficiency epidemiology, Humans, Hyperhomocysteinemia epidemiology, Hypertension epidemiology, Intracranial Arteriosclerosis complications, Intracranial Arteriosclerosis pathology, Lipids blood, Lipoproteins blood, Male, Risk Factors, Stroke complications, Stroke pathology, Vitamin B 12 Deficiency epidemiology, Dementia, Multi-Infarct epidemiology, Dementia, Vascular epidemiology, Intracranial Arteriosclerosis epidemiology, Stroke epidemiology
- Abstract
Vascular cognitive impairment is an important cause of cognitive decline in the elderly. Ischemic lesions in the brain have an influence on the natural history of dementia. Vascular dementia can be caused by small-vessels disease (S-VaD) or by large-artery atherosclerosis with vascular lesions in strategic areas of the brain (M-VaD). In both cases changes in white matter are observed. In 60 patients with S-VaD and in 34 with M-VaD the presence of vascular and biochemical risk factors was evaluated and compared to age and sex matched 126 controls without dementia. Coronary artery disease, atrial fibrillation, hypertension and strokes were observed more frequently in both investigated groups. Of biochemical risk factors, hyperhomocysteinemia (associated with low levels of folic acid and vitamin B 12) and low HDL cholesterol levels were found in both forms of VaD.
- Published
- 2009
- Full Text
- View/download PDF
37. Cognitive and psychiatric effects of vitamin B12 replacement in dementia with low serum B12 levels: a nursing home study.
- Author
-
van Dyck CH, Lyness JM, Rohrbaugh RM, and Siegal AP
- Subjects
- Aged, Aged, 80 and over, Alzheimer Disease diagnosis, Alzheimer Disease psychology, Brief Psychiatric Rating Scale statistics & numerical data, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct psychology, Female, Follow-Up Studies, Homes for the Aged, Humans, Injections, Intramuscular, Male, Mental Status Schedule statistics & numerical data, Nursing Homes, Psychometrics, Single-Blind Method, Vitamin B 12 Deficiency diagnosis, Vitamin B 12 Deficiency drug therapy, Vitamin B 12 Deficiency psychology, Alzheimer Disease drug therapy, Cognition Disorders drug therapy, Dementia, Multi-Infarct drug therapy, Vitamin B 12 administration & dosage
- Abstract
Background: The aim of this study is to determine whether B12 replacement would ameliorate cognitive and psychiatric symptoms in elderly subjects with dementia and low serum B12 levels., Methods: A test group (n = 28) of nursing home residents with low serum B12 levels (<250 pg/mL) and a matched comparison group (n = 28) with normal serum B12 levels (>300 pg/mL) were evaluated by blinded raters while the test group received intramuscular (IM) B12 replacement therapy. All subjects were assessed at baseline, 8 weeks, and 16 weeks with the Dementia Rating Scale, Brief Psychiatric Rating Scale, and Geriatric Depression Scale., Results: Although B12 replacement produced significant improvement in hematologic and metabolic parameters, it yielded no significant effect on cognitive or psychiatric variables. A few subjects evidenced notable individual treatment responses; however, these were not statistically more frequent than in the normal B12 group., Conclusions: These results suggest that B12 replacement is unlikely to benefit cognitive or psychiatric symptoms in the vast majority of elderly dementia patients with low serum B12 levels.
- Published
- 2009
- Full Text
- View/download PDF
38. CADASIL: neuropsychological findings in three generations of an affected family.
- Author
-
Harris JG and Filley CM
- Subjects
- Adult, Aged, DNA Mutational Analysis, Dementia genetics, Dementia, Multi-Infarct genetics, Dementia, Multi-Infarct pathology, Dementia, Vascular genetics, Diagnosis, Differential, Disease Progression, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Brain pathology, Chromosomes, Human, Pair 19 genetics, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct psychology, Mutation, Neuropsychological Tests
- Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary brain disease with a variety of neurologic and psychiatric manifestations. We studied 3 members of a family who each had leukoencephalopathy on neuroimaging studies and a characteristic mutation for CADASIL in the notch 3 region of chromosome 19q12. In all 3 cases, neurobehavioral impairment dominated the clinical picture, and a pattern of psychiatric dysfunction heralding cognitive decline emerged. Neuropsychological evaluation revealed diverse deficits, but a profile of frontal lobe dysfunction, declarative memory impairment suggestive of a retrieval deficit, and relatively preserved language was evident. These cases provide a cross-sectional study of the evolution of CADASIL, and suggest that, as in other diseases characterized by white matter dementia, psychiatric dysfunction may occur initially, followed by pervasive cognitive dysfunction later in the course of the disease. CADASIL should be considered in young adults with unexplained leukoencephalopathy on neuroimaging studies, and in those with neurobehavioral dysfunction and a suggestive family history.
- Published
- 2001
- Full Text
- View/download PDF
39. Reduced cerebrovascular CO(2) reactivity in CADASIL: A transcranial Doppler sonography study.
- Author
-
Pfefferkorn T, von Stuckrad-Barre S, Herzog J, Gasser T, Hamann GF, and Dichgans M
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Blood Flow Velocity, Dementia, Multi-Infarct genetics, Dementia, Multi-Infarct physiopathology, Female, Humans, Hypercapnia metabolism, Hypocapnia metabolism, Male, Middle Aged, Middle Cerebral Artery diagnostic imaging, Muscle, Smooth, Vascular physiopathology, Proto-Oncogene Proteins genetics, Receptor, Notch3, Receptors, Notch, Vascular Resistance, Carbon Dioxide metabolism, Cerebrovascular Circulation, Dementia, Multi-Infarct diagnostic imaging, Dementia, Multi-Infarct metabolism, Receptors, Cell Surface, Ultrasonography, Doppler, Transcranial
- Abstract
Background and Purpose: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukencephalopathy (CADASIL) is a hereditary angiopathy caused by mutations in Notch3. Cerebral microvessels show an accumulation of granular osmiophilic material in the vicinity of degenerating vascular smooth muscle cells. To study cerebrovascular function in CADASIL, we performed measurements on cerebral hemodynamics by using transcranial Doppler sonography., Methods: Middle cerebral artery (MCA) mean blood flow velocity (MFV), cerebrovascular CO(2) reactivity, and the resistance index were measured by bilateral transcranial Doppler sonography in 29 CADASIL individuals (mean age, 49.0+/-2.4 years) and an equal number of age- and sex-matched control subjects., Results: Compared with control subjects, CO(2) reactivity was reduced in CADASIL (33.4+/-2.7% versus 45.3+/-3.0%; P:<0.01). This difference remained significant when only nondisabled CADASIL individuals (Rankin=0, n=21) were included in the analysis (P:<0.05). CO(2) reactivity was significantly lower in disabled than in nondisabled CADASIL individuals (24.5+/-2.7% versus 36.8+/-3.4%; P:<0.05). MCA MFV was reduced in CADASIL (45.6+/-2.2 cm/s versus 54.2+/-2.4 cm/s; P:<0.05) and correlated negatively with age both in affected individuals (r=-0.314; P:<0.05) and control subjects (r=-0.339; P:<0.05). Resistance index was not significantly altered (59.0+/-1.0% versus 57.7+/-1.2%; P:=0.42)., Conclusions: In CADASIL, there is a reduction of both CO(2) reactivity and basal MCA MFV. The reduced CO(2) reactivity suggests functional impairment of cerebral vasoreactivity probably related to vascular smooth muscle cell dysfunction. The reduction of CO(2) reactivity in nondisabled CADASIL individuals suggests an early role of impaired cerebral vasoreactivity in the evolution of the disease.
- Published
- 2001
- Full Text
- View/download PDF
40. Multi-lacunar strokes mimicking atypical parkinsonism with an unusual neuroimaging presentation: état criblé.
- Author
-
Pedroso JL, Godeiro-Junior C, Felício AC, Maia AC Jr, Aquino CC, de Souza LT, and Barsottini OG
- Subjects
- Aged, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct drug therapy, Fatal Outcome, Humans, Male, Parkinsonian Disorders diagnosis, Parkinsonian Disorders drug therapy, Tomography, X-Ray Computed, Dementia, Multi-Infarct complications, Parkinsonian Disorders etiology
- Published
- 2008
- Full Text
- View/download PDF
41. Patterns of neuropsychological impairment in MCI patients with small subcortical infarcts or hippocampal atrophy.
- Author
-
Gainotti G, Ferraccioli M, Vita MG, and Marra C
- Subjects
- Aged, Alzheimer Disease physiopathology, Alzheimer Disease psychology, Atrophy, Attention physiology, Cognition Disorders physiopathology, Cognition Disorders psychology, Dementia, Multi-Infarct physiopathology, Dementia, Multi-Infarct psychology, Diagnosis, Differential, Female, Frontal Lobe physiopathology, Hippocampus physiopathology, Humans, Magnetic Resonance Imaging, Male, Mental Recall physiology, Mental Status Schedule statistics & numerical data, Middle Aged, Problem Solving physiology, Psychometrics, Alzheimer Disease diagnosis, Cognition Disorders diagnosis, Dementia, Multi-Infarct diagnosis, Hippocampus pathology, Neuropsychological Tests statistics & numerical data
- Abstract
We investigated whether MCI patients with hippocampal atrophy or multiple subcortical infarcts demonstrate neuropsychological patterns and markers considered typical of Alzheimer's disease (AD) and of vascular dementia (VD), respectively. An extensive neuropsychological battery, including tests of memory, visual-spatial and executive functions, language, attention, praxis and psychomotor speed, was administered to 36 mild cognitive impairment (MCI) patients with hippocampal atrophy and 41 MCI patients with multiple subcortical infarcts. Both groups of MCI patients were very mildly impaired and well matched in terms of MMSE scores. A clear, disproportionately severe, episodic memory disorder was observed in MCI patients with hippocampal atrophy. A less specific neuropsychological profile, consisting of impairment on an Action Naming task that is sensitive to frontal lobe lesions, was observed in MCI patients with multiple subcortical infarcts. In MCI patients, a disproportionately severe episodic memory impairment strongly points to an Alzheimer's type brain pathology, whereas the prevalence of executive deficits and other frontal lobe symptoms are a much weaker diagnostic marker of small vessel subcortical disease.
- Published
- 2008
- Full Text
- View/download PDF
42. Autosomal dominant leukoencephalopathy with mild clinical symptoms due to cerebrovascular dysfunctions: a new disease entity?
- Author
-
Hirabayashi S, Wada T, Kondo Y, and Arima K
- Subjects
- Adolescent, Adult, Aged, CADASIL diagnostic imaging, CADASIL pathology, Child, Dementia, Multi-Infarct diagnostic imaging, Dementia, Multi-Infarct pathology, Female, Humans, Magnetic Resonance Imaging, Male, Tomography, Emission-Computed, Single-Photon, CADASIL etiology, Cerebrovascular Disorders complications, Dementia, Multi-Infarct etiology, Family Health
- Abstract
A family with cerebrovascular dysfunctions and extensive white matter lesions was presented. The proband had suffered migraine. His brother showed syncopal episodes and migraine. His mother also suffered severe migraine with aura, and had transient hemiparesis during pregnancy. Their brain MRIs, being quite similar to each other, revealed diffuse bilateral deep white matter lesions, with no changes in serial follow-up. His grandmother showed similar white matter changes on CT, consistent with autosomal dominant inheritance. Lesions were considered to be due to chronic vasogenic edema based upon increased apparent diffusion coefficient (ADC) values on diffusion-weighted imaging, normal spectrum ratio of metabolites on (1)H MR spectroscopy, and decreased regional cerebral blood flows on single-photon emission CT (SPECT). A deficiency of genetically determined factors contributing to the autoregulation of small blood vessels might possibly lead to both clinical symptoms and white matter lesions through the breakdown of the blood-brain barrier and resultant vasogenic edema. Although cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) was suspected, neither NOTCH3 mutation nor granular osmiphilic material (GOM) in the arteriole walls were detected. Further accumulation of similar cases is necessary to establish the possibility of a new familial leukoencephalopathy.
- Published
- 2008
- Full Text
- View/download PDF
43. Protective effects of Nicotiflorin on reducing memory dysfunction, energy metabolism failure and oxidative stress in multi-infarct dementia model rats.
- Author
-
Huang JL, Fu ST, Jiang YY, Cao YB, Guo ML, Wang Y, and Xu Z
- Subjects
- Animals, Brain drug effects, Brain metabolism, Brain pathology, Dementia, Multi-Infarct metabolism, Dementia, Multi-Infarct pathology, Dementia, Multi-Infarct psychology, Disease Models, Animal, Energy Metabolism drug effects, Male, Maze Learning drug effects, Neuroprotective Agents pharmacology, Oxidative Stress drug effects, Rats, Rats, Sprague-Dawley, Dementia, Multi-Infarct drug therapy, Flavonoids pharmacology, Memory Disorders drug therapy, Phenols pharmacology
- Abstract
The present study aimed to determine whether Nicotiflorin, a natural flavonoid extracted from coronal of Carthamus tinctorius, has a protective effect on cerebral multi-infarct dementia in rats. The multi-infarct dementia model rats were prepared by injecting man-made micro-thrombi into the right hemisphere. The administration groups were treated once daily with 30, 60 and 120 mg/kg Nicotiflorin (i.g.) from 5 days before ischemia operation to 3 days after the operation for biochemical examination, 10 days for Morris water maze study and morphological observations and 20 days for eight-arm radial maze task. 2,3,5-triphenyltetrazolium chloride (TTC) staining showed that infarct volume of each Nicotiflorin administration group was much smaller than that of vehicle-treated multi-infarct dementia group, and hematoxylin and eosin (HE) staining showed that histopathological abnormalities of each Nicotiflorin group were also much lighter than that of vehicle-treated multi-infarct dementia group. Each Nicotiflorin group showed much better spatial memory performance in Morris water maze tests and eight-arm radial maze task compared with the vehicle-treated multi-infarct dementia group, significantly attenuated the elevation of lactic acid and malondialdehyde (MDA) contents and the decrease in lactate dehydrogenase (LDH), Na(+)K(+)ATPase, Ca(2+)Mg(2+)ATPase and superoxide dismutase (SOD) activity in the brain tissue which was composed of striatum, cortex and hippocampus of the ischemia hemisphere at day 3 after ischemia operation. These results suggest that Nicotiflorin has protective effects on reducing memory dysfunction, energy metabolism failure and oxidative stress in multi-infarct dementia model rats.
- Published
- 2007
- Full Text
- View/download PDF
44. Hereditary multi-infarct dementia of the Swedish type is a novel disorder different from NOTCH3 causing CADASIL.
- Author
-
Low WC, Junna M, Börjesson-Hanson A, Morris CM, Moss TH, Stevens DL, St Clair D, Mizuno T, Zhang WW, Mykkänen K, Wahlstrom J, Andersen O, Kalimo H, Viitanen M, and Kalaria RN
- Subjects
- Adult, Brain blood supply, Brain ultrastructure, Chromosome Mapping methods, DNA Mutational Analysis methods, Dementia, Multi-Infarct metabolism, Dementia, Multi-Infarct pathology, Female, Humans, Intracranial Arteriosclerosis genetics, Intracranial Arteriosclerosis pathology, Magnetic Resonance Imaging, Male, Microcirculation metabolism, Middle Aged, Mutation, Pedigree, Polymerase Chain Reaction methods, Receptor, Notch3, Receptors, Notch metabolism, Skin ultrastructure, CADASIL genetics, Dementia, Multi-Infarct genetics, Receptors, Notch genetics
- Abstract
Several hereditary small vessel diseases (SVDs) of the brain have been reported in recent years. In 1977, Sourander and Wålinder described hereditary multi-infarct dementia (MID) in a Swedish family. In the same year, Stevens and colleagues reported chronic familial vascular encephalopathy in an English family bearing a similar phenotype. These disorders have invariably been suggested to be cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) but their genetic identities remain unknown. We used molecular, radiological and neuropathological methods to characterize these disorders. Direct DNA sequencing unexpectedly confirmed that affected members of the English family carried the R141C mutation in the NOTCH3 gene diagnostic of CADASIL. However, we did not detect any pathogenic mutations in the entire 8091 bp reading frame of NOTCH3 or find clear evidence for NOTCH3 gene linkage in the Swedish DNA. This was consistent with the lack of hyperintense signals in the anterior temporal pole and external capsule in Swedish subjects upon magnetic resonance imaging. We further found no evidence for granular osmiophilic material in skin biopsy or post-mortem brain samples of affected members in the Swedish family. In addition, there was distinct lack of NOTCH3 N-terminal fragments in the cerebral microvasculature of the Swedish hereditary MID subjects compared to the intense accumulation in the English family afflicted with CADASIL. Several differences in arteriosclerotic changes in both the grey and white matter were also noted between the disorders. The sclerotic index values, density of collagen IV immunoreactivity in the microvasculature and number of perivascular macrophages were greater in the English CADASIL samples compared to those from the Swedish brains. Multiple approaches suggest that the Swedish family with hereditary MID suspected to be CADASIL has a different novel disorder with dissimilar pathological features and belongs to the growing number of genetically uncharacterized familial SVDs.
- Published
- 2007
- Full Text
- View/download PDF
45. Effect of acetaminophen on behavior, well-being, and psychotropic medication use in nursing home residents with moderate-to-severe dementia.
- Author
-
Chibnall JT, Tait RC, Harman B, and Luebbert RA
- Subjects
- Acetaminophen adverse effects, Activities of Daily Living classification, Activities of Daily Living psychology, Affective Symptoms diagnosis, Affective Symptoms drug therapy, Affective Symptoms psychology, Aged, Aged, 80 and over, Alzheimer Disease diagnosis, Alzheimer Disease psychology, Analgesics adverse effects, Cognition Disorders diagnosis, Cognition Disorders drug therapy, Cognition Disorders psychology, Cross-Over Studies, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct psychology, Dementia, Vascular diagnosis, Dementia, Vascular psychology, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Drug Therapy, Combination, Homes for the Aged, Humans, Male, Mental Disorders diagnosis, Mental Disorders psychology, Missouri, Neuropsychological Tests, Nursing Homes, Psychomotor Agitation diagnosis, Psychomotor Agitation drug therapy, Psychomotor Agitation psychology, Psychotropic Drugs adverse effects, Treatment Outcome, Acetaminophen administration & dosage, Alzheimer Disease drug therapy, Analgesics administration & dosage, Dementia, Multi-Infarct drug therapy, Dementia, Vascular drug therapy, Mental Disorders drug therapy, Psychotropic Drugs administration & dosage, Quality of Life psychology
- Abstract
Objectives: To evaluate the effect of regularly scheduled administration of analgesic medication on behavior, emotional well-being, and use of as-needed psychotropic medications in nursing home residents with moderate-to-severe dementia., Design: Randomized, double-blind, placebo-controlled, crossover trial., Setting: Nursing-home based., Participants: Twenty-five nursing home residents with moderate-to-severe dementia., Intervention: Participants received 4 weeks of acetaminophen (3,000 mg/d) and 4 weeks of placebo., Measurements: Behavior and emotional well-being were assessed using Dementia Care Mapping, an observational method that quantifies time spent in behaviors across 26 domains (e.g., social interaction, unattended distress) and assesses emotional state while behaviors are being observed. Agitation was measured using the Cohen-Mansfield Agitation Inventory. As-needed psychotropic medication use was aggregated from medication logs., Results: Participants spent more time in social interaction, engaged with media, talking to themselves, engaged in work-like activity, and experiencing unattended distress when they received acetaminophen than they did when they received placebo. Participants also spent less time in their rooms, less time removed from the nursing home unit, and less time performing personal care activities when they received acetaminophen. There were no effects on agitation, emotional well-being, or as-needed psychotropic medication use., Conclusion: Untreated pain inhibits activity in nursing home residents with moderate-to-severe dementia. Pain treatment in this group may facilitate engagement with the environment.
- Published
- 2005
- Full Text
- View/download PDF
46. Neuropathology lessons in vascular dementia.
- Author
-
Chui H
- Subjects
- Aged, Alzheimer Disease diagnosis, Alzheimer Disease pathology, Brain Mapping, Dementia, Multi-Infarct diagnosis, Dementia, Multi-Infarct etiology, Dementia, Vascular diagnosis, Dementia, Vascular etiology, Diagnosis, Differential, Diagnostic and Statistical Manual of Mental Disorders, Humans, Magnetic Resonance Imaging, Neuropsychological Tests, Brain pathology, Dementia, Multi-Infarct pathology, Dementia, Vascular pathology
- Published
- 2005
- Full Text
- View/download PDF
47. Effects of acupuncture on hemorheology, blood lipid content and nail fold microcirculation in multiple infarct dementia patients.
- Author
-
Liu Q
- Subjects
- Aged, Aged, 80 and over, Dementia, Multi-Infarct blood, Dementia, Multi-Infarct physiopathology, Female, Hemorheology, Humans, Male, Microcirculation, Middle Aged, Nails blood supply, Acupuncture Therapy, Dementia, Multi-Infarct therapy, Lipids blood
- Abstract
Forty-six cases of multiple infarct dementia (MID) in the treatment group were treated by acupuncture with the principle of supplementing the inferiority to clear the superiority and regulating spirit to invigorate intelligence. Changes of the blood lipid content, hemorheological indexes and nail fold microcirculation in the treatment group were compared with those in the randomly assigned control group. The data collected showed that the changes in the treatment group were remarkable, and part of them were superior to their counterparts obtained in the control group by statistical analysis. It is indicated that acupuncture can effectively regulate the affected hemodynamic state in MID.
- Published
- 2004
48. White matter lesion progression: a surrogate endpoint for trials in cerebral small-vessel disease.
- Author
-
Schmidt R, Scheltens P, Erkinjuntti T, Pantoni L, Markus HS, Wallin A, Barkhof F, and Fazekas F
- Subjects
- Arterioles pathology, Austria epidemiology, Biomarkers, Brain Ischemia complications, Cerebral Arterial Diseases epidemiology, Cerebral Arterial Diseases etiology, Cerebral Arteries pathology, Clinical Trials as Topic, Dementia, Multi-Infarct etiology, Dementia, Multi-Infarct pathology, Dementia, Vascular pathology, Disease Progression, Humans, Longitudinal Studies, Models, Neurological, Sample Size, Brain Ischemia pathology, Cerebral Arterial Diseases pathology, Dementia, Multi-Infarct prevention & control, Dementia, Vascular prevention & control, Magnetic Resonance Imaging, Myelin Sheath pathology
- Abstract
There is neuropathologic evidence that confluent MRI white matter lesions in the elderly reflect ischemic brain damage due to microangiopathy. The authors hypothesize that measuring changes in the progression of white matter lesions as shown by MRI may provide a surrogate marker in clinical trials on cerebral small-vessel disease in which the currently used primary outcomes are cognitive impairment and dementia. This hypothesis is based on evidence that confluent white matter lesions progress rapidly as shown in a recent follow-up study in community-dwelling subjects. The mean increase in lesion volume was 5.2 cm(3) after 3 years. Based on these data in a clinical trial, 195 subjects with confluent lesions would be required per treatment arm to demonstrate a 20% reduction in the rate of disease progression over a 3-year period. Like any other MRI metric, the change in white matter lesion volume cannot be considered preferable to clinical outcomes unless it has been demonstrated that it matters to the patient in terms of function.
- Published
- 2004
- Full Text
- View/download PDF
49. Retinal abnormalities in CADASIL: a retrospective study of 18 patients.
- Author
-
Cumurciuc R, Massin P, Pâques M, Krisovic V, Gaudric A, Bousser MG, and Chabriat H
- Subjects
- Adult, Aged, Cerebral Angiography methods, Dementia, Multi-Infarct diagnostic imaging, Female, Fluorescein Angiography, Hemianopsia diagnosis, Humans, Male, Middle Aged, Receptor, Notch3, Receptors, Notch, Retina diagnostic imaging, Retrospective Studies, Visual Acuity physiology, Visual Fields physiology, Dementia, Multi-Infarct genetics, Dementia, Multi-Infarct physiopathology, Point Mutation genetics, Proto-Oncogene Proteins genetics, Receptors, Cell Surface genetics, Retina abnormalities
- Abstract
Background: CADASIL is an inherited small vessel disease related to Notch3 gene mutations., Aim: To report retinal findings in symptomatic CADASIL patients., Methods: Assessment of visual acuity (VA), testing of visual fields (VF), funduscopic examination (FE), and fluorescein angiography (FA) were carried out in 18 symptomatic patients., Results: No visual symptoms were presented by our patients. VA was normal in all. Ophthalmologic abnormalities were found in 8 patients. VF were normal except for a right hemianopia in one subject due to ischemic stroke. FE and FA revealed significant abnormalities in seven other subjects (mean age: 55 years; range: 39-74): nerve fibre loss (n = 4), cotton wool spots (n = 3), sheathed arteries (n = 1), and tortuous arteries (n = 1). Only one patient with both tortuous arteries and nerve fibre loss had multiple vascular risk factors, and another patient with cotton wool spots was a current smoker., Discussion: FE and FA revealed silent retinal abnormalities in CADASIL patients with nerve fibre loss in 22% and cotton wool spots in 17%. The presence of these abnormal retinal findings does not seem related to the severity of the disorder but may be considered as peripheral markers of this genetic disease.
- Published
- 2004
- Full Text
- View/download PDF
50. Positron emission tomography examination of cerebral blood flow and glucose metabolism in young CADASIL patients.
- Author
-
Tuominen S, Miao Q, Kurki T, Tuisku S, Pöyhönen M, Kalimo H, Viitanen M, Sipilä HT, Bergman J, and Rinne JO
- Subjects
- Adult, Age Factors, Dementia, Multi-Infarct genetics, Dementia, Vascular diagnostic imaging, Dementia, Vascular genetics, Dementia, Vascular metabolism, Humans, Magnetic Resonance Imaging, Proto-Oncogene Proteins genetics, Receptor, Notch3, Receptors, Notch, Brain diagnostic imaging, Brain metabolism, Cerebrovascular Circulation, Dementia, Multi-Infarct diagnostic imaging, Dementia, Multi-Infarct metabolism, Glucose metabolism, Receptors, Cell Surface, Tomography, Emission-Computed
- Abstract
Background and Purpose: CADASIL causes repeated ischemic strokes leading to subcortical vascular dementia. The purpose of this study was to assess whether cerebral blood flow (CBF) and regional cerebral metabolic rates of glucose (rCMR(gluc)) in CADASIL patients are affected in early adulthood., Methods: CBF and rCMR(gluc) were examined with positron emission tomography in correlation with magnetic resonance imaging (MRI) in 14 adult (19 to 41 years) CADASIL patients with the Notch3 R133C mutation. Seven patients had experienced transient ischemic attack and 3 had experienced > or =1 strokes., Results: The mean CBF in the CADASIL patients was significantly lower in both frontal (P=0.019) and occipital (P=0.009) white matter (WM) than those in the controls. CBF decreased significantly with increased severity of the disease. The patients had lower mean rCMR(gluc) values than the controls, although differences were not statistically significant. Sum scores of semiquantitative MRI rating scale (Scheltens) correlated significantly with WM CBF but not with rCMR(gluc)., Conclusions: In CADASIL, there is an early and significant decrease in the CBF of WM associated with simultaneous MRI changes. These are obviously caused by the arteriopathy in long penetrating arteries and indicate early tissue damage, also expressed as impaired rCMR(gluc) in the WM.
- Published
- 2004
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.