Somatostatin cerebrospinal fluid levels in dementia

Summary Somatostatin levels were measured in cerebrospinal fluid of patients with Alzheimer's disease, multi-infarct dementia and normal pressure hydrocephalus and compared with levels from a normal control group. All pathological groups showed a statistically significant decrease of somatostatin with respect to the control group, but no significant differences were found amongst them. A negative correlation was found between the Mini Mental State Test and the somatostatin levels in Alzheimer's disease patients but not in the other groups. Our results confirm that the lower levels of somatostatin in cerebrospinal fluid are not specific to Alzheimer's disease and indicate that the decrease found in all the groups is probably the result of neuronal destruction or damage in the diseases examined.     

Dopamine-β-hydroxylase activities in serum and cerebrospinal fluid of aged and demented patients

Age-related changes in dopamine-β-hydroxylase (DBH) activities in serum and cerebrospinal fluid (CSF) were determined. In normal subjects, serum DBH activity increased gradually from the 3rd to the 8th decade, but decreased prominently in the 9th decade. DBH activity in CSF did not differ between younger and older subjects.Serum DBH activity decreased significantly in senile dementia of Alzheimer's type (SDAT, $\text{12.2 ± 8.8}\text{nmoles/min/ml}$, $\text{P < 0.05}$), but not in multi-infarct dementia (MID, $\text{13.9 ± 9.1}\text{nmoles/min/ml}$) compared to control subjects ($\text{17.1 ± 9.5}\text{nmoles/min/ml}$). The decrease of serum DBH in SDAT was more prominent in patients with severe dementia and/or severe brain atrophy. DBH activity in CSF was much lower than that in serum and did not correlate with each other. DBH activity in CSF obained from SDAT patients ($\text{1.60 ± 0.94}\text{nmoles/h/ml}$) and from MID patients ($\text{2.01 ± 0.99}\text{nmoles/h/ml}$) were both lower than that from other neurological diseases without dementia ($\text{4.04 ± 3.81}\text{nmoles/h/ml}$). DBH in CSF from SDAT patients was significantly lower ($\text{P < 0.05}$) than that from controls, but that from MID did not differ from controls.Noradrenergic nervous dysfunction is partly associated with pathophysiology and life expectancy of senile dementia of Alzheimer's type (SDAT).     

Acupuncture and medicated oxygen therapy for multiple infarctional dementia

Purpose To observe the clinical efficacy of acupuncture and medicated oxygen therapy in the treatment of multiple infarctional dementia (MID).Methods 150 cases of MID were randomized into three groups: group A in which 50 cases were treated by acupuncture and medicated oxygen, group B in which 50 cases were treated by acupuncture and inhaled oxygen and group C in which 50 cases were simply treated by acupuncture.Results The clinical effects were obviously better in group A than those in group B and group C (P<0.05,P<0.01).Conclusion Chinese medicine together with oxygen and acupuncture can improve brain blood circulation, activate brain cells, increase the volume of brain blood flow and its blood supply, and enhance the clinical effects. Author: HOU An-le (1952-), male, senior consultant doctor and professor Translator: XIAO Yuan-chun     

头穴丛刺对多梗死性痴呆患者血浆内皮素及智能的影响

目的：探讨头穴丛刺治疗多梗死性痴呆的疗效及对患者血浆内皮素的影响。方法：选取60名多梗死性痴呆（MID）患者随机分为针刺组和西药组,分别采用头穴丛刺疗法和哈伯因片治疗。治疗前后测定血浆内皮素含量及HDS、ADL及神经功能缺损评分,经统计学分析,P〉0.05,两组间无显著差异。结果：经8周治疗后,两组内皮素含量均有所降低,以针刺组降低更明显,两组比较P〈0.05,差异有统计学意义;针刺组与西药组HDS、ADL评分均有所提高,且与西药组比较P〈0.05,差异有统计学意义;针刺组神经功能缺损评分治疗后较治疗前有大幅度降低,差异有显著性意义,P〈0.05,但西药组治疗前后比较,差异无统计学意义,P〉0.05,提示针刺可降低MID患者的神经功能缺损评分,而西药组不能。结论：头穴丛刺疗法可改善MID患者的智能,降低患者血浆内皮素水平,提高HDS、ADL评分,并且可降低MID患者的神经功能缺损评分,改善症状。     

多发性梗死性痴呆68例临床观察

目的分析多发性梗死性痴呆（MID）的发病机制、临床表现、治疗、转归及预后。方法对于多发性梗死性患者采用长谷川修改量表（HDS）评分及Hachinsk缺血计分量表（HIS）评分，HDS〈29．5分，HIS≥7分诊断痴呆，同时排除其他原因所致者。结果脑梗死后脑软化灶总体积超过50ml即可引起痴呆。MID发病相对迅速，呈阶梯性进展，临床表现主要为记忆力、计算力、情感障碍，晚期呈全面智能衰退。早期治疗可不同程度改善认知功能，重度痴呆病死率高，预后差。结论MID发病率、致残率、死亡率高，严重影响生活质量，积极治疗诱发脑血管病的相关疾病，减少脑血管病发病率即可减少本病发生。     

多发性梗死性痴呆68例临床观察

目的分析多发性梗死性痴呆(MID)的发病机制、临床表现、治疗、转归及预后。方法对于多发性梗死性患者采用长谷川修改量表(HDS)评分及Hachinsk缺血计分量表(HIS)评分,HDS<29.5分,HIS≥7分诊断痴呆,同时排除其他原因所致者。结果脑梗死后脑软化灶总体积超过50ml即可引起痴呆。MID发病相对迅速,呈阶梯性进展,临床表现主要为记忆力、计算力、情感障碍,晚期呈全面智能衰退。早期治疗可不同程度改善认知功能,重度痴呆病死率高,预后差。结论MID发病率、致残率、死亡率高,严重影响生活质量,积极治疗诱发脑血管病的相关疾病,减少脑血管病发病率即可减少本病发生。     

Acupuncture improved cognitive impairment caused by multi-infarct dementia in rats

Recent studies have demonstrated that acupuncture is feasible to treat vascular dementia (VD). The aim of this study was to present behavioral evidence that acupuncture could improve the learning and memory of multi-infarct dementia rats. The pattern of multi-infarct dementia in rats was made by injecting homogeneous emboli into the internal carotid artery. Of them the rats which showed damage in learning and memory (n = 43) were randomly allocated to 3 groups: impaired group (n = 14), acupuncture group (n = 15) and placebo-acupuncture group (n = 14). Moreover, normal group (n = 15) and sham-operated group (n = 15) were set as control groups. The acupuncture group was given acupuncture, which consisted of Tanzhong (CV17), Zhongwan (CV12), Qihai (CV6), Zusanli (ST36) and Xuehai (SP10). Morris water maze test was employed to assess spatial discriminational ability per group respectively and to analyze the curative effects of acupuncture. Compared to the impaired and placebo-acupuncture groups, no cognition impairment was found in the normal and sham-operated groups, and the statistic analysis showed that there were significant differences between normal and impaired groups in ANOVA. Shortened mean escape latency was detected in the acupuncture group compared with the impaired group during the same trial days. Search strategy changed from random pattern adopted by impaired and placebo-acupuncture rats to tendency or linear pattern popular in normal group. The present results suggested that the acupuncture exerted a protective effect on cognitive impairment caused by cerebral multi-infarction in rats, and acupuncture has a specificity of cure. Acupuncture as a potential clinic method in treating VD should be developed and investigated in the future.     

多梗塞性痴呆患者外周血CD54、CD106和CD62p的表达及意义

目的:探讨多梗塞性痴呆患者外周血CD54、CD106和CD62p的变化及意义。方法:采用酶联免疫法测定了8例多梗塞性痴呆患者血清CD54、CD106、CD62p水平,并与23例健康人对照比较。结果:多梗塞性痴呆患者血清CD54、CD10及CD62p水平(CD54:469±76.33ngml,CD106:1103.3±98.96ngml,CD62p:18.22±8.90ngml)较对照组(CD54:196±45.91ngml,CD106:601.0±76.30ngml,CD62p:6.70±3.30ngml)高,差异具有显著性意义。CD54、CD106及CD62p水平与痴呆程度呈正相关。结论:CD54、CD106、CD62p参与了MID的病理变化过程,并与痴呆程度密切相关,在一定程度上反映了MID神经功能缺损的程度,可作为MID后监测病情变化的重要指标。     

The microvascular changes in cases of hereditary multi-infarct disease of the brain

A report on a cerebro-vascular disease with autosomal dominant inheritance, characterised by stroke-like episodes beginning in early adulthood and progressive dementia, afflicting one family living in Sweden was presented in 1977. Another afflicted member showing gait and coordination disturbances and impaired cognitive functions is now introduced. Magnetic resonance imaging revealed multiple brain lesions indicating ischaemic injuries. Previous autopsy studies of other cases revealed white matter atrophy, multiple infarcts and lacunes. In one patient who had died from a cerebral haemorrhage, obliteration of intracerebral arteries, occasionally with organised thrombi was present. Autopsy material has now been reinvestigated with special attention to changes of intracerebral arterioles. Cases with long duration of the disease presented pronounced fibrous thickening of the wall of numerous intracerebral arterioles, degeneration of smooth muscle cells of the media and obliteration of the lumen. Immunohistochemistry showed marked expression of fibrillary collagen types I, III and V and of the basal lamina components collagen type IV and laminin. These depositions are probably induced by some primary dysfunction of smooth muscle cells or endothelial cells. Perivascular reactive astrocytes with endothelin-1-like immunoreactivity were present in some brain regions. Endothelin-1 is the most powerful vasoconstrictor peptide known to date. Structural remodelling of intracerebral arterial vessels, actions of different vasoactive factors and rheological disturbances may all interfere with local blood flow in this disease and cause the parenchymal changes of the brain.Supported by grants from the Multiple Sclerosis Society of Sweden, Åhlén's stiftelse, Selander's stiftelse, Söderbergs Stiftelse and Stiftelsen Gamla Tjänarinnor. The first international workshop on this disease was arranged in Paris, France, May 19–21, 1993Holder of a Wenner-Gren Foundation scholarshipVisiting Professor from Shanghai     

Relationship of interleukin-1β and β2-microglobulin with neuropeptides in cerebrospinal fluid of patients with dementia of the Alzheimer type

We studied interleukin-1β (IL-1β), β₂-microglobulin (β₂-m, β-endorphin, substance P, neuropeptide Y and somatostatin concentrations in the cerebrospinal fluid of 13 patients with dementia of the Alzheimer type (DAT), 13 patients with multi-infarct dementia (MID) and 15 age-matched control subjects. Substance P was significantly lower in DAT than in controls (P < 0.05), as well as somatostatin in DAT as compared to both controls (P < 0.01) and MID (P < 0.05), whereas β₂-m was higher in DAT than in controls (P < 0.01). Neuropeptide Y, β-endorphin and IL-1β showed similar concentrations in the three groups studied. A significantly positive correlation was observed between IL-1β and substance P (r = 0.79, P < 0.01) and somtostatin (r = 0.75, P < 0.05) in DAT, which was not observed in MID. In addition, β₂-m showed a negative correlation with IL-1β (r = −0.73, P < 0.05) in DAT, and age correlated negatively with IL-1β in controls and MID, but positively in DAT. Therefore, these results support the idea that an altered relationship may exist in Alzheimer's disease between the nervous and immune system.