阿尔茨海默病嗅觉障碍的研究

目的 :研究阿尔茨海默病 (AD)患者嗅觉障碍。方法 :配对的AD患者和正常老年人各 3 0例 ,分别行简易智能状态检查(MMSE)、日常生活活动量表 (ADL)、图片识别试验、气味感知阈值、图片介导的气味识别试验及气味再认记忆试验检查。结果 :AD组的气味感知、气味识别和气味再认记忆功能较正常对照组差 (P <0 0 1) ;相关分析显示 ,AD组患者的嗅觉障碍与MMSE总分密切相关 (P <0 0 5 ) ;结论 :AD患者的嗅觉功能全面受损 ,嗅觉障碍是疾病的早期症状 ,是认知障碍的简单反映     

嗅觉障碍与阿尔茨海默病

阿尔茨海默病（AD）为老年期常见的退行性神经变性疾病,以进行性记忆力、智力和认知功能减退为主要表现,至今病因未明,现有药物仅对疾病早期有效,因此,早诊断、早治疗意义重大。阿尔茨海默病的典型病理改变最先累及内嗅区皮质（EC）,然后逐渐向海马等扩散,最终累及全脑皮质。     

嗅觉障碍与阿尔茨海默病

阿尔茨海默病(AD)为老年期常见的退行性神经变性疾病,以进行性记忆力、智力和认知功能减退为主要表现,至今病因未明,现有药物仅对疾病早期有效,因此,早诊断、早治疗意义重大.     

阿尔茨海默病与帕金森病嗅觉障碍的对比研究

对比分析阿尔茨海默病(AD)与帕金森病(PD)嗅觉障碍状况，揭示AD与PD临床表现的相似与重叠。     

嗅觉障碍与阿尔茨海默病的研究进展

阿尔茨海默病(Alzheimer’s disease,AD)患者嗅觉系统病理改变与皮层退行性变的损害程度完全一致,而且嗅觉系统发生病变在时间上早于皮层病变。AD患者均有不同程度的嗅觉缺损,表现为嗅觉阈升高,嗅觉识别和嗅觉记忆减退。嗅觉缺损可见于AD的前期。是AD早期诊断的重要指标。嗅觉系统与大脑皮层许多部位有广泛联系,药物经嗅觉通路能被转运到脑内多个部位,通过嗅觉通路有可能找到治疗AD有效药物。     

阿尔茨海默病与血管性痴呆病人的脑CT及镜像书写研究

目的　比较阿尔茨海默病(AD)与血管性痴呆(VD)病人的脑CT及镜像书写。方法　采用经线测定法对29例AD及32例VD病人的脑CT进行了对比分析,同时对全数病例进行了利手、简明精神状态量表(MMSE)Hachinski缺血量表及总体衰退量表测定,采用汉语失语症检查法(草案)中书写部分进行检查,并将所得结果加以比较。结果　①AD组病人的两脉络球间距离与侧脑室体部间最大外经之商和头颅内横经与侧脑室体部间最大外经之商均值均明显较VD组病人为小(P<0 .01 )。第三脑室和外侧裂最大宽度则明显较VD组病人为大(P<0 .01)。②AD组病人的镜像书写发生率为48 .3%,明显低于VD组病人的78. 1% (P<0 .05 );而镜像书写分度为(5. 71±3 .69),明显高于VD组病人的(3 .78±3.14) (P<0 .05)。结论　AD及VD病人的脑CT及镜像书写各有其特点,可有助于两种疾病的诊断及鉴别。     

睡眠障碍与阿尔茨海默病交互作用机制

阿尔茨海默病是好发于老年人群的中枢神经系统退行性病变,为痴呆常见病因.流行病学调查结果显示,44％的阿尔茨海默病患者伴睡眠紊乱和(或)昼夜节律紊乱.越来越多的证据表明,脑组织β-淀粉样蛋白(Aβ)波动具有昼夜节律性,睡眠障碍可加速Aβ沉积,提示二者之间可能存在交互作用,其机制尚未完全明确.睡眠障碍可能与阿尔茨海默病发病过程中睡眠-觉醒调节系统和昼夜节律系统受累有关;睡眠障碍亦可影响神经元活性、神经递质分泌,并作为一种应激原影响Aβ的生成和代谢,加速阿尔茨海默病之病理生理过程.本文拟就其交互作用及可能机制的研究进展进行阐述.     

阿尔茨海默病相关睡眠障碍的临床管理

随着人口老年化的迅速发展,老年人口数量将越来越多,阿尔茨海默病(Alzheimer Disease,AD)的患病人数也将随之日益增多,并成为一个严重的社会问题和家庭问题。睡眠障碍包括觉醒频度和持续睡觉的增加,慢波睡眠和快动眼相(REM)睡眠的减少,以及日间瞌睡,或简单地概括为“睡眠/觉醒循环障碍”,即夜间睡眠或日间觉醒状态的“碎片化”[1]。在 AD 患者中,睡眠障碍的发生率为34％~82％[2]。睡眠障碍的发生不仅使患者的社会、认知功能进一步加重,同时还会加重其看护者的身心负担,进而引起他们的睡眠问题[3]。因此在 AD 治疗中,尽早发现或治疗 AD 患者的睡眠障碍,改善其睡眠质量,非常有必要。本文从睡眠障碍的临床管理角度,着重回顾了 AD 相关睡眠障碍的临床特点、发病机制、临床评估、治疗策略,为 AD 相关的睡眠障碍临床管理及后续相关研究提供参考。     

老年人群中睡眠障碍与阿尔茨海默病的关联性研究进展

阿尔茨海默病是常见于老年人的一种以认知功能下降为主要改变的疾病,对家庭及社会造成巨大的负担.睡眠障碍是阿尔茨海默病的重要临床表现之一,与其发生、发展高度交织.睡眠障碍的发生会影响着生理及心理的各项功能,从而引起一系列认知功能改变.现回顾近年睡眠及阿尔茨海默病的相关文献,阐述睡眠障碍与阿尔茨海默病的关联和可能的机制.     

多奈哌齐对阿尔茨海默病患者记忆障碍的作用

目的：探究多奈哌齐对阿尔茨海默病患者记忆障碍的作用。方法抽取我院2008-04-2012-05收治的阿尔茨海默病患者200例,并随机分成A组110例,B组90例,A组进行多奈哌齐治疗。在治疗前及治疗后的第1个月、第2个月、第4个月进行ADL测试和MMSE测试。结果 A组两项测试结果均明显优于B组,且2组的差距随用药时间的增长不断拉大（ P＜0.05）。结论多奈哌齐对阿尔茨海默病患者记忆障碍具有明显的改善作用,治疗效果良好。     

Predictors of severity of behavioral disturbance among community-dwelling elderly individuals with Alzheimer's disease: a 6-year follow-up study

To clarify which baseline factors, including apolipoprotein E (ApoE) genotyping and caregiver characteristics, predict the future severity of behavioral disturbance among community-dwelling elderly with Alzheimer's disease (AD), we conducted a longitudinal study for up to 6 years. Fourteen kinds of behavioral disturbance were evaluated. Analyses using data from 62 subjects with at least three annual assessments revealed that the baseline severity of behavioral disturbance was the strongest predictor of future severity, followed by baseline stage of dementia or use of support services. However, ApoE epsilon4 had only a marginal effect at most. The behavioral disturbances examined in the present study appear to be innately determined phenomena rather than merely representing stages of AD.     

Treatment of sleep disturbance in Alzheimer's disease

The prevalence of Alzheimer's disease (AD) is rapidly increasing as growing numbers of people around the world are living to old age. Sleep disturbances are a common, and often highly disruptive, behavioral symptom associated with AD. Nevertheless, the study of sleep in AD is relatively new. Little is known about the moderating factors that may alter a given patient's risk for developing sleep problems, or that may influence severity of presentation and persistence. Current treatments for improving sleep in AD fall into three broad categories: (i) pharmacological; (ii) cognitive-behavioral or psycho-educational strategies; and (iii) biological/circadian therapies. There are few studies demonstrating the efficacy of these treatments with community-dwelling AD patients, although studies with persons in institutional settings are promising. In this review, it is suggested that sleep problems in AD are multi-factorial, and influenced by a variety of demographic, physical, psychiatric and situational factors. These factors vary in how readily they can be modified and in how relevant they are to any individual case. Thus, when developing a treatment plan for sleep problems in a dementia patient, it is important to evaluate the underlying causes as well as the context in which the problems are occurring, and to target the intervention accordingly.     

阿尔兹海默病患者语义记忆障碍特征性研究

目的 探讨阿尔兹海默病(Alzheimer's disease, AD)患者语义记忆障碍的特点,揭示语义知识在大脑中组织的性质。方法 对43例AD患者及28例正常对照者进行一般认知功能测评和语义记忆评估。语义记忆评估选用常见的有生命类及无生命类物体,进行口头图片命名、口头声音命名、图片关联匹配、词语关联匹配测试。统计每一例被试对物体名称和物体语义关联匹配的正确比例,对数据进行群组分析和个体分析。结果 与正常对照组相比,AD组对有生命物体和无生命物体的名称及语义关联匹配均有损伤。10例患者在有生命物体的语义任务上的成绩显著差于在无生命物体的语义任务上的成绩,而另外6例患者在无生命物体的语义任务上的成绩显著差于在有生命物体的语义任务上的成绩。结论 AD患者存在语义记忆障碍,部分AD患者可出现语义范畴特异性损伤,且可出现语义障碍的范畴双分离现象。这表明有生命物体和无生命物体范畴在大脑内相对独立表征,与大脑中语义知识的分布式表征理论一致。     

帕金森病与阿尔茨海默病

普遍认为帕金森病和阿尔茨海默病是两个独立的、有着显著判别的疾病。但是,相当数量为证据表明,二者具有相互重叠的临床和神经病理特征、相似的病因和病变发生机制。因此,现在有人认为这两种疾病的部分病例可能是同一种神经元退行性变疾病的不同表现形式。本文拟对此作一介绍。     

Cerebrospinal fluid levels of insulin in patients with Alzheimer's disease

OBJECTIVES: Some previous reports suggested a potential role of insulin in memory and in the pathophysiology of Alzheimer's disease (AD). We assessed the cerebrospinal fluid (CSF) levels of insulin in patients with AD and in age and sex-matched controls trying to elucidate whether this value could be related with the risk or severity of AD. PATIENTS AND METHODS: We measured the CSF insulin levels in 27 patients with AD and 16 matched controls using a RadioImmunoanalysis method. RESULTS: CSF insulin levels did not differ significantly between AD-patient and control groups. These values were not correlated with age, age at onset, duration of the disease, and scores of the MiniMental State Examination in the AD group. CONCLUSION: These results suggest that CSF insulin concentrations are not related with the risk or severity of AD.     

Alzheimer's病患者的社会轻信度研究

目的观察认知功能正常老人和Alzheimer's病(AD)患者的社会轻信度的不同。方法将341例AD患者分为轻、中、重度亚组,认知功能正常的社区老年居民122例作为对照组,进行华山医院版成套神经心理检查,神经精神症状问卷(NPI)评价患者的精神症状。采用社会轻信量表(SVS)对知情者进行调查,评价入组者的SVS总分、轻信因子分及受骗因子分。结果与正常对照组比较,AD组的SVS总分、轻信因子分和受骗因子分均显著降低(P0.05~0.01)。轻度、中度、重度亚组患者年龄、性别和教育程度差异均无统计学意义(均P0.05)。三组间MMSE及NPI评分差异有统计学意义(F=228.348,P=0.026;F=12.293,P=0.029),但SVS轻信因子、受骗因子及总分差异无统计学意义(F=1.969,P=0.315;F=1.328,P=0.214;F=2.656,P=0.381)。SVS轻信因子、受骗因子及总分与NPI呈正相关(r=0.342,P=0.000;r=0.277,P=0.000;r=0.317,P=0.000),与年龄无相关性(r=-0.005,P=0.933;r=0.066,P=0.639;r=0.024,P=0.670),与受教育程度也无相关性(r=0.073,P=0.192;r=0.051,P=0.361;r=0.069,P=0.215)。结论AD患者的社会轻信度与其精神行为异常有关。SVS在正常人群中并不适用,在AD患者中可以有限的应用。     

False item recognition in patients with Alzheimer's disease

Recent evidence suggests that patients with Alzheimer's disease (AD), as compared with normal individuals, exhibit increased false recognition by stimulus repetition in the Deese-Roediger-McDermott (DRM) task or associative recognition memory tasks, probably due to impaired recollection-based monitoring. However, because of possible alternative explanations for the findings of these previous studies, the evidence for impaired recollection-based monitoring in AD patients remains inconclusive. In this study, we employed stimulus repetition in old/new recognition judgments of single-item picture memory without a factor of association between the stimuli and examined whether AD patients showed increased false item recognition as compared with healthy controls. AD patients and healthy controls studied single-item pictures presented either once or three times. They were later asked to make an old/new recognition judgment in response to (a) Same pictures, pictures identical to those seen at encoding, (b) Similar lures, novel pictures similar to but not identical to those seen at encoding, and (c) Dissimilar lures, novel pictures not similar to those seen at encoding. For Same pictures, repeated presentation of stimuli increased the proportion of “old” responses in both groups. For Similar lures, repeated presentation of stimuli increased the rate of “old” responses in AD patients but not in control subjects. The results of the present study clearly demonstrated elevated false recognition by stimulus repetition in single-item recognition in AD patients. The present findings strongly support the view that AD patients are impaired in their ability to use item-specific recollection in order to avoid false recognition.     

临床疗效总评量表在阿尔茨海默病疗效评估中的应用探讨

目的探讨临床疗效总评量表(CGI)在阿尔茨海默病(AD)疗效评估中的应用价值。方法对30例接受盐酸美金刚治疗的阿尔茨海默病患者,在治疗前、治疗4个月末分别进行简易智力状态检查(MMSE)、阿尔茨海默病评定量表-认知分量表(ADAS-cog)、日常生活能力量表(ADL)、CGI评分,通过相关分析考察CGI的效度。结果基线时病情严重程度(SI)与MMSE时间定向、地点定向、注意力及计算力、执行功能、书面表达的分值及总分的相关系数为-0.516～-0.680(P<0.01),与ADAS-cog所有因子分及总分的相关系数为0.507～0.880(P<0.01),与ADL行走、做饭、做家务、吃饭、穿衣、梳洗、洗衣、洗澡、购物、上厕所、打电话、自理经济、躯体生活自理量表、工具性日常生活能力量表的分值及总分的相关系数为0.462～0.745(P<0.05)。4个月末疗效总评(GI)与ADAS-cog单词回忆、命名、口语理解的分值及总分、ADL打电话的分值等治疗前后差值的相关系数为-0.365～-0.444(P<0.05),4个月末疗效指数(EI)与ADAS-cog命名、结构、回忆指令、找词困难的分值及总分治疗前后差值的相关...     

阿尔茨海默病患者血清中microRNAs表达谱的研究

目的探讨阿尔茨海默病(AD)患者血清中microRNAs与阿尔茨海默病之间的关系,寻求一种可能作为辅助诊断AD的早期生物标志物。方法研究对象分为AD组和对照组,分别取其血清并提取microRNAs,利用microRNA基因芯片检测出表达差异的microRNAs,并用实时荧光定量PCR(QT-PCR)的方法进行验证。结果基因芯片筛选出43个与AD相关的差异表达microRNAs(P0.05),其中microRNA-107及microRNA-222的表达水平在AD患者中均显著低于对照组(P0.01),与QT-PCR验证结果一致。结论 MicroRNA-107及microRNA-222可能通过多种途径影响AD的发生发展,有望成为一种辅助诊断AD的早期生物标志物。