Skip to main content
SpringerLink
Log in

Perspective in the Treatment of Dementia

  • Chapter
Aging and Drug Therapy

Part of the book series: Ettore Majorana International Science Series ((PSLI))

  • 81 Accesses

Abstract

After long years of search for new and truly effective pharmacological treatment for aged and demented humans suffering cognitive deterioration, results are far from impressive. Nevertheless, it could be worth emphasizing some bodies of evidence which may represent valuable tools for prevention and treatment of degenerative dementia, namely of senile dementia of the Alzheimer type (SDAT). In the course of, normal aging, in fact, some phenomena occur that may play a role in mental deterioration; opportune clinical management of them, therefore, could reduce the possibility of a dementia syndrome. Blood-brain barrier permeability increases with aging (Link and Tibbling;1Amaducci et al2) and a defect of this system could permit the accumulation within the brain parenchyma of potentially toxic environmental compounds, including trace metals. It is well known, besides, that hypothyroidism and diabetes, both causing dementing illness, are characterized by an elevation of CSF proteins (Tourtellotte,3). Moreover, in Binswanger’s disease, as well as in other subcortical areteriosclerotie encephalopathies associated with mental deterioration there is a marked hypodensity of periventricular white matter; this finding has been attributed to chronic oedema of the centrum semiovale, possibly following blood-brain barrier alteration (Loizou et al4).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. H. Link and G. Tibbling, Principles of albumin and IgG, analyses in neurological disorders. II, Relation of the concentration of the proteins in serum and CSF,.Scan.J.C1in.Lab.Invest.37: 391 (1977)

    Article  Google Scholar 

  2. I Amaducci, R. Capparelli E. Galli 1982 Studio longitudinale delle IgG e di proteine liquorali nelle malattie infiammatorie del SNC, in:“International Workshop on : New techniques of cerebrospinal analysis” Piccin Padova (in Press)

    Google Scholar 

  3. W. W. Tourtellotte, On cerebral fluid IgG quotients in multiple sclerosis and other diseases. A review and a new formula to estimate the amount of IgG sinthesized per day by the CNS,J. Neurol. Sci10: 279 (1970)

    Article  Google Scholar 

  4. L. A. Loizou, B. E. Kendall, and J. Marshall, Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation,J. of Neurol. Neurosurg. Psychiat44: 294 (1982)

    Article  Google Scholar 

  5. G. M. de Courten-Myers, S. I. Yamaguchi and R. E. Myers, Accentuation of hypoxic anoxic brain injury by post exposure infusion of glucose solution,Neurology32: 110 (1982)

    Google Scholar 

  6. F. Plum, What makes the brain vulnerable to ischemia,Neurology32: 106 (1982)

    Google Scholar 

  7. L. Bakey and J. C. Lee, The effect of acute hypoxia and hypercapnia on the ultrastructure of the CNS,Brain91: 697 (1968)

    Article  Google Scholar 

  8. I. Feigin, G. Budzilovich, S. Weinberg, and J. Ocatu, Degeneration of the white matter in hypoxia acidosis and edema,Journ. Exper. Neurol32: 125 (1973)

    Article  Google Scholar 

  9. P. E. Duffy, M. Rapport, L. Graf, Glial Fibrillar Acidic Protein and Alzheimer-type Senile Dementia,Neurology30: 778 (1980)

    Article  Google Scholar 

  10. L. Amaducci, K.I. Forno, and L. F. Eng, Glial fibrillar acidic protein in cryogenic lesions of the rat brain,Neurosc. lett21: 27 (1981)

    Article  Google Scholar 

  11. R. T. Bartus, R. L. Dean, B. Beer and A. S. Lippa, The cholinergic hypothesis of geriatric memory dysfunction,Science217: 408 (1982)

    Article  ADS  Google Scholar 

  12. P. J. Whitehouse, D. C. Price, R. G. Struble, A. W. Clark, J. T. Coyle, and M. R. De Long, Alzheimer’s disease and Senile Dementia: loss of neurons in the Basal Forebrain.Science215: 1237 (1982)

    Article  ADS  Google Scholar 

  13. A. G. Karczmar, Overview: cholinergic drugs and behaviour. What effects may be expected from a “cholinergic” diet? in: “Choline and Lecithin in Brain Disorders. Nutrition and the Brain”, A. Barbeau, J.H. Growdon and R.J. Wurtman, eds., Raven Press, New York (1979)

    Google Scholar 

  14. A. G. Karczmar, S. Nishi, S. Minota, and G. Kindel, Electrophysiology, acetylcholine and acetylcholinesterase of imature spinale ganglia of the rabbit. An experimental study and a review.Gen. Pharmacol11: 127 (1980)

    Article  Google Scholar 

  15. I. Hanin, D. G. Spiker, A. G. Mallinger, U. Kopp, J. M. Himmelcoch, J. F. Neil and D. J. Kuffer, Blood choline and its meaning in psychiatric and neurologic disease states,in“Cholinergic Mechanisms: Phylogenetic Aspects, and Clinical Significance” G. Pepeu and H.-Ladinsky, eds., rlenum Press, New York (1980)

    Google Scholar 

  16. R. T. Bartus, Physostigmine and recent memory: effects in young and aged non human primates,Science206: 1087 (1979)

    Article  ADS  Google Scholar 

  17. J. E. Christie, A. Shering, J. Ferguson, A. Z. M. Glen, Physostigmine and arecholine effects of intravenous infusion in Alzheimer presenile dementia,Brit. J. Psych138: 46 (1981)

    Article  Google Scholar 

  18. N. Sitaram, H. Weingartner, J. C. Gillin, Human serial learning: enhancement with arecholine and choline, impairment with scopolamine,Science201: 274 (1978)

    Article  ADS  Google Scholar 

  19. IS. F. Leong, J. C. K. Lai., L. Lim, J. B. Clark, Energy-metabol¬ising enzymes in brain regions of adult and aging rats,J. Neurochem.37: 1548 (1981)

    Article  Google Scholar 

  20. N. R. Sims, C. C. T. Smith, A. N. Davison, D. M. Bowen, R. H. A. Flack, J. S. Snowden, D. Neary, Glucose metabolism and acetylcholine synthesis in relation to neuronal activity in Alzheimer’s disease,Lancet1: 333 (1980)

    Article  Google Scholar 

  21. K. Sherman, J. E. Kuster, R. L. Dean, R. T. Bartus, E. Friedman, Presynaptic cholinergic mechanism in brain of aged rats with memory impairments,Neurobiol. Ag2: 99 (1981)

    Article  Google Scholar 

  22. G. E. Gibson, J. P. Blass, Impaired synthesis of acetylcholine in brain accompanying mild hypoxia and hypoglycemia,J. Neurol.27: 37 (1976)

    Google Scholar 

  23. G. E. Gibson, T. E. Duffy, Impaired synthesis:of acetylcholine by mild hypoxic hypoxia of nitrous oxide,J. Neurochem36: 28 (1981)

    Article  Google Scholar 

  24. C. Giurgea, F. Mayersons, Differential pharmacological activity of three types of cortical evoked potentials,Arch.Int. Pharmacodyn.188: 401 (1970)

    Google Scholar 

  25. J. C. Gobert, Genese d’un medicament: le piracetam. Metabolization et recherchemJ: Pharma. Belg. 27: 281 (1972)

    Google Scholar 

  26. S. J. Sara, D. Lefevre, Hypoxia induced amnesia in one-trial learning and pharmacological protection by piracetam,Psychopharmacologica25: 32 (1972).

    Article  Google Scholar 

  27. R. E. Burnotte, J. C. Gobert, J. F. Temmerman, Piracetam (2-pyrrolidi none acetamide) induced modifications of the brain polyribosome pattern in ageing rats,Biochem.Pharmacol.22: 811 (1973)

    Article  Google Scholar 

  28. R. J. Wurtman, S. G. Magil, D. K. Feinstein, Piracetam diminishes hippocampal acetylcholine levels in rats,Life Sci. 28: 1091 (1980)

    Article  Google Scholar 

  29. P. B. Mindus, B. Cronholm, and S. E. Lavander, Does piracetam counteract the ECT-induced memory dysfunction in depressed patients?Acta. Psych. Scand. 51: 319 (1975)

    Article  Google Scholar 

  30. S. Lloyd-Evans, J. C. Brocklehurst, and M. K. Palmer, Piracetam in chronic brain failure,Curr.Med.Res.Opin.6: 351 (1979)

    Article  Google Scholar 

  31. E. Friedman, K. A. Sherman, S. H. Ferris, B. Reisberg, R. T. Bartus and M. K. Schneck, Clinical response to choline plus piracetam in senile dementia: relation to red-cell choline levels,New Eng.J.Med.304: 1490 (1981)

    Article  Google Scholar 

  32. JK Blusztajn SH Zeisel RF Wurtman Phospholipids methylation and cholinergic neurons Transmethylation R Bochardt C Creveling E Usdin Elsevier Amsterdam (in press)

    Google Scholar 

  33. G. E Gibson, C. Peterson, Decrease in the release of acetylcholine in vitro with low oxygen,BIochem.Pharmacol.31: 11 (1982)

    Article  Google Scholar 

  34. D. M. Low, and C. Weil, Hydergine in senile mental impairment,Gerontology28: 54 (1982).

    Article  Google Scholar 

  35. W. Meier-Ruge, H. Enurene-gger, A. Enz, P. Gygax, P. Iwangoff, and N.Wiernspergez, Pharmacological aspects of dydydrogenated ergot alkaloids in experimental brain research,Pharmacology(Supp. l) 16: 45 (1978).

    Article  Google Scholar 

  36. J. M. Vigouret, H. R. BUrki, A. L. Jeton, P. E. ZUger, D. M. Loewe, Neurochemical and neuropharmacological investigations with four ergot derivates: bromocriptine, dihydroergotoxine, CF 25-397 and CM 29-712,Pharmacology(Supp,l) 16: 156 (1978)

    Article  Google Scholar 

  37. F. Casamenti, P. Mantovani, L. Amaducci, and G. Pepeu, Effect of phosphatidylserine on acetylcholine output from the cerebral cortex of the rat,J. Neurochem32: 529 (1979)

    Article  Google Scholar 

  38. F. Casamenti, P. Mantovani, L. Amaducci, and G. Pepeu, Effect of phosphatidylserine on acetylcholine output from the cerebral cortex of the rat,J. Neurochem32: 529 (1979)

    Article  Google Scholar 

  39. L. Amaducci, S. Sorbi, A. Albanese, and G. Gainotti, Cholineacetyltransferase (Char) activity differs in right and left human temporal lobes,Neurology31: 799 (1981)

    Article  Google Scholar 

  40. L. Amaducci, S. Sorbi, A. Albanese, and G. Gainotti, Cholineacetyltransferase (Char) activity differs in right and left human temporal lobes,Neurology31: 799 (1981)

    Article  Google Scholar 

  41. A. M. Oke, R. Keller, I. Mefford and R. N Adams, Lateralization in norepinephHne in human thalamus,Science200: 1411 (1978)

    Article  ADS  Google Scholar 

  42. G. Gainotti, Emotional behaviour and hemispheric side of the lesion,Cortex8: 41 (1972)

    Google Scholar 

  43. R. H. Perry, and E. K. Perry, Histochemistry of brain cholinesterase in normal old age and Alzheimer’s disease,in“Aging of the Brain and Dementia” L. Amaducci, A. N. Davison, P. Antuoni, eds., Raven Press, New York (1980)

    Google Scholar 

  44. R. G. Struble, L. C. Cork, P. J. Whitehouse, D. J. Price, Cholinergic innervation in neuritic plaques,Science 216: 413 (1.982)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Florence, Florence, Italy

    L. Bracco, D. Insitari & L. Amaducci

Authors
  1. L. Bracco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Insitari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Amaducci
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institute of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    G. Barbagallo-Sangiorgi

  2. School of Medicine, University College London, London, England

    A. N. Exton-Smith

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Plenum Press, New York

About this chapter

Cite this chapter

Bracco, L., Insitari, D., Amaducci, L. (1984). Perspective in the Treatment of Dementia. In: Barbagallo-Sangiorgi, G., Exton-Smith, A.N. (eds) Aging and Drug Therapy. Ettore Majorana International Science Series. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2791-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-2791-2_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9721-5

  • Online ISBN: 978-1-4613-2791-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation