Journal of Neurology

, Volume 256, Issue 5, pp 758–767

Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease

Authors

    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Marina Boziki
    • B’ Department of Neurology, AHEPA University Hospital Aristotle University of Thessaloniki
  • Emmanuel Gavalas
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Christos Zavos
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Nikolaos Grigoriadis
    • B’ Department of Neurology, AHEPA University Hospital Aristotle University of Thessaloniki
  • Georgia Deretzi
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Dimitrios Tzilves
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Panagiotis Katsinelos
    • Department of Endoscopy and Motility UnitCentral Hospital
  • Magda Tsolaki
    • Third Neurological Clinic, Papanikolaou HospitalAristotle University of Thessaloniki
  • Dimitrios Chatzopoulos
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
  • Ioannis Venizelos
    • Department of Gastroenterology, Second Medical Clinic, Ippokration HospitalAristotle University of Thessaloniki
Original Communication

DOI: 10.1007/s00415-009-5011-z

Cite this article as:
Kountouras, J., Boziki, M., Gavalas, E. et al. J Neurol (2009) 256: 758. doi:10.1007/s00415-009-5011-z

Abstract

Infectious agents have been proposed as potential causes of Alzheimer’s disease (AD). Recently, we documented a high prevalence of Helicobacter pylori (Hp) infection in patients with AD. We aim to access the effect of Hp eradication on the AD cognitive (MMSE: Mini Mental State Examination and CAMCOG: Cambridge Cognitive Examination for the Elderly) and functional (FRSSD: Functional Rating Scale for Symptoms of Dementia) status parameters. In the first part of the study, a total of 50 consecutive patients with AD and 30 age-matched anaemic controls underwent an upper gastrointestinal endoscopy, and gastric mucosal biopsies were obtained to detect the presence of Hp infection by histologic analysis and rapid urease test. Serum anti-Hp-specific IgG level was analysed by enzyme-linked immunosorbent assay. In the second part, Hp-positive AD patients received a triple eradication regimen (omeprazole, clarithromycin and amoxicillin), and all patients were followed up for 2 years, while under the same treatment with cholinesterase inhibitors. Hp was detected in 88% of AD patients and in 46.7% of controls (P < 0.001). Hp eradication was successful in 84.8% of treated patients. At the 2-year clinical endpoint, cognitive and functional status parameters improved in the subgroup of patients where Hp eradication was successful (< 0.001 and P = 0.049 for MMSE and CAMCOG, respectively; < 0.001 for FRSSD), but not in the other patients. Hp eradication may positively influence AD manifestations, suggesting a possible common link between Hp and AD.

Keywords

Alzheimer’s disease Helicobacter pylori Histologic analysis Rapid urease test

Copyright information

© Springer-Verlag 2009