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  • 1
    ISSN: 1435-1463
    Keywords: Acetylcholine ; choline ; cerebrospinal fluid ; Alzheimer-type dementia ; vascular dementia of the Binswanger type ; multi-infarct dementia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The acetylcholine (ACh) and choline (Ch) concentrations in the cerebrospinal fluid were investigated in patients with vascular dementia of the Binswanger type (VDBT) or multiple small infarct type (MSID) as compared with patients with Alzheimer-type dementia (ATD). The ACh concentration in patients with ATD was found to be significantly lower than in controls (73%, p 〈 0.0001), and showed a significant positive correlation with dementia scale scores (rs=0.63, p 〈 0.03). The Ch concentration in the CSF of ATD patients was approximately the same as in controls. In VDBT/MSID patients, the ACh concentration was significantly lower than in controls (p 〈 0.001), also showing a significant positive correlation with dementia scale scores (rs=0.62, p 〈 0.02), but was significantly higher than in ATD patients (p 〈 0.001). Moreover, the Ch concentration in VDBT/MSID patients was significantly higher than in controls (p 〈 0.001) or ATD patients (p 〈 0.001). These results suggest that simultaneous determination of ACh and Ch concentrations in CSF may be useful for differentiating VDBT/MSID from ATD and that increasing the ACh level using cholinergic agents may be a beneficial therapeutic strategy for the treatment of ATD as well as VDBT/MSIT, and is worthy of further investigation.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-1463
    Keywords: Dopamine ; norepinephrine ; cerebrospinal fluid ; senile dementia of the Alzheimer type ; vascular dementia of the Binswanger type
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We measured the concentrations of total (conjugated and unconjugated) monoamines (dopamine, DA; norepinephrine, NE) and monoamine metabolites (homovanillic acid, HVA; 3-methoxy-4-hydroxyphenyleneglycol, MHPG; 5-hydroxyindoleacetic acid, 5-HIAA) in the cerebrospinal fluid (CSF), using HPLC-ECD in 11 patients with Alzheimer's disease (AD) or senile dementia of the Alzheimer type (SDAT), 17 patients with vascular dementia of the Binswanger type (VDBT), and 15 controls. In AD/SDAT, there was a significant decrease in the DA concentration and a significant increase in the MHPG concentration. The average NE concentration was not altered, but significantly increased with the progression of intellectual disability. There were no significant changes in HVA and 5-HIAA concentrations. Patients with VDBT showed a significant increase in the DA concentration and a significant decrease in HVA and 5-HIAA concentrations. The DA concentrations increased significantly with the progression of dementia and ventricular enlargement. These results indicate that the noradrenergic and dopaminergic system in particular are altered in AD/SDAT, while the dopaminergic and serotonergic systems are mainly involved in VDBT.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-1463
    Keywords: Urate ; xanthine ; vascular dementia of the Binswanger type ; Alzheimer type dementia ; Parkinson's disease ; cerebrospinal fluid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We determined the urate and xanthine concentrations in the cerebrospinal fluid (CSF) in patients with vascular dementia of the Binswanger type (VDBT), Alzheimer type dementia (ATD), and Parkinson's disease (PD). We found that the urate concentration was significantly increased in VDBT patients, but significantly decreased in ATD patients compared with controls. The ratio of the concentrations of uric acid (UCSF) to xanthine (XCSF) in the CSF (UCSF/XCSF) had a significant correlation with the ratio of the UCSF to the urate concentration in serum (Userum) (UCSF/Userum) in ATD and PD, whereas UCSF/Userum increased independently of UCSF/XCSF in VDBT. We concluded that the significant increase in the urate concentration in VDBT is mainly due to an impairment of the blood-brain barrier (BBB), and its significant reduction in ATD may reflect impaired brain metabolism.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1435-1463
    Keywords: Alzheimer type dementia ; vascular dementia of the Binswanger type ; serotonin ; kynurenine ; citalopram ; cerebrospinal fluid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied changes in the concentrations of serotonin (5-HT), kynurenine, and other indoleamines in the cerebrospinal fluid of patients with Alzheimer type dementia (ATD) and those with Binswanger type vascular dementia (VDBT), and changes in these indoleamine concentrations 2 weeks after administration of citalopram, a 5-HT uptake inhibitor. The concentrations of total 5-HT (p〈0.005) and kynurenine (p〈0.005) were significantly decreased in ATD patients in comparison to those of the controls. After citalopram administration, there was a remarkable increase in 5-HT concentration (249%, p〈0.0001) and a significant decrease in 5-HIAA concentration (22%, p〈0.02). In the VDBT patients, only 5-HT showed a significant decrease (p〈0.005) in comparison to the control values. It also increased significantly (214%) after citalopram administration. The 5-HT/tryptophan and kynurenine/tryptophan ratios were not correlated for the controls, but did significantly for the ATD and VDBT patients; after citalopram treatment, the increase in 5-HT/tryptophan was correlated significantly with that of kynurenine/tryptophan for ATD, but not for VDBT. These results suggest that both the serotonin and kynurenine pathways are impaired in ATD; whereas, the serotonin pathway alone is in VDBT, and that these impairments are ameliorated by the administration of citalopram.
    Type of Medium: Electronic Resource
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