Oxidativer Stress als Modulator der NMDA-Rezeptorexpression auf zerebrovaskulären Endothelzellen

Oxidativer Stress in Form reaktiver Sauerstoffspezies (ROS) und Exzitotoxizität durch supraphysiologische Konzentrationen des Neurotransmitters Glutamat sind nicht nur beteiligt an der Pathogenese vielzähliger neurodegenerativer Erkrankungen wie Schlaganfall, Hirntrauma, Alzheimer Demenz oder Multipler Sklerose, sondern spielen zudem eine Schlüsselrolle im dort beobachteten Zusammenbruch der Blut-Hirn-Schranke. Glutamat führt durch Stimulation neuronaler und endothelialer NMDA-Rezeptoren zu einer Generierung von ROS. Nicht verfolgt worden war bisher, welche Auswirkungen ROS umgekehrt auch auf den NMDA-Rezeptor haben könnten. Im Rahmen der vorliegenden Arbeit wurde daher untersucht, ob und in welcher Weise die Exposition gegenüber reaktiven Sauerstoffspezies einen Einfluss auf die Expression und Aktivierbarkeit von NMDA-Rezeptoren auf zerebrovaskulären Endothelzellen ausübt.rnEs konnte zunächst die Expression der funktionell obligaten NR-1 Untereinheit des NMDA-Rezeptors auf der verwendeten Zelllinie b.End3 mittels Immunfluoreszenz-Mikroskopie gesichert werden. Ein Nachweis von mRNA für die Untereinheiten NR1 und NR2B, C und D erfolgte mittels RT-PCR. In der Analyse der replizierten RNA zeigten sich Hinweise für eine heterogene Komposition der exprimierten endothelialen NMDA-Rezeptoren.rnEs konnte weiter mit Hilfe der In-Cell-Western-Technik gezeigt werden, dass die Expression des NMDA-Rezeptors durch transiente Stimulation mit reaktiven Sauerstoffspezies im Sinne einer Heraufregulation moduliert werden kann. Die Stimulation der Zellen mit den reaktiven Sauerstoffspezies O2-, ONOO- und H2O2 führte dabei im Experiment zu einer deutlichen Zunahme der NR1-Expression, die spätestens nach 72 Stunden höchst signifikant war.rnUm zu überprüfen, welche Bedeutung diese Überexpression für die Integrität der Blut-Hirn-Schranke unter den exzitotoxischen Bedingungen hoher Glutamatkonzentrationen haben könnte, wurde mit Hilfe des ECIS-Systems („Electrical Cell-Substrate Impedance Sensing“) die Impedanz ROS-präexponierter Endothelmonolayer gemessen. Auf Rezeptorstimulation mit dem spezifischen Agonisten NMDA reagierten die vorbehandelten Gruppen mit einem Abfall der Impedanz gegenüber der nicht vorbehandelten Kontrolle.rnrnDie vorliegenden Ergebnisse zeigen, dass ROS in der Lage sind, funktionelle endotheliale NMDA-Rezeptoren zu induzieren und auf diesem Weg zu einem verstärkten Abfall der BHS-Integrität unter den Bedingungen exzitotoxischen und oxidativen Stresses führen. Dies stellt einen neuen Mechanismus zur Erklärung der Pathogenese des Blut-Hirn-Schrankenversagens dar.

Marked increase of the astrocytic marker S100B in the cerebrospinal fluid of HIV-infected patients on LPV/r-monotherapy

Objective: To determine changes of cerebrospinal fluid (CSF) biomarkers of patients on monotherapy with lopinavir/ritonavir. Design: The Monotherapy Switzerland/Thailand study (MOST) trial compared monotherapy with ritonavir-boosted lopinavir with continued therapy. The trial was prematurely stopped due to virological failure in six patients on monotherapy. It, thus, offers a unique opportunity to assess brain markers in the early stage of HIV virological escape. Methods: Sixty-five CSF samples (34 on continued therapy and 31 on monotherapy) from 49 HIV-positive patients enrolled in MOST. Using enzyme-linked immunosorbent assay, we determined the CSF concentration of S100B (astrocytosis), neopterin (inflammation), total Tau (tTau), phosphorylated Tau (pTau), and amyloid-β 1–42 (Aβ), the latter three indicating neuronal damage. Controls were CSF samples of 29 HIV-negative patients with Alzheimer dementia. Results: In the CSF of monotherapy, concentrations of S100B and neopterin were significantly higher than in continued therapy (P = 0.006 and P = 0.013, respectively) and Alzheimer dementia patients (P < 0.0001 and P = 0.0005, respectively). In Alzheimer dementia, concentration of Aβ was lower than in monotherapy (P = 0.005) and continued therapy (P = 0.016) and concentrations of tTau were higher than in monotherapy (P = 0.019) and continued therapy (P = 0.001). There was no difference in pTau among the three groups. After removal of the 16 CSF with detectable viral load in the blood and/or CSF, only S100B remained significantly higher in monotherapy than in the two other groups. Conclusion: Despite full viral load-suppression in blood and CSF, antiretroviral monotherapy with lopinavir/ritonavir can raise CSF levels of S100B, suggesting astrocytic damage.

A importância da intervenção do fisioterapeuta na manutenção e/ou regressão dos défices nas funções motoras nos principais tipos de demência

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Language disorders in dementia of the Alzheimer type

The language profile of a group of 18 Alzheimer patients is documented and their performance on a standard aphasia test battery compared to a group of institutionalized, nonneurologically impaired control subjects matched for age, sex, and educational level. The Alzheimer patients scored significantly lower than the controls in the areas of verbal expression, auditory comprehension, repetition, reading, and writing. Articulation abilities were the same in each group. A language deficit was evident in all Alzheimer patients. The language disorder exhibited resembled a transcortical sensory aphasia. Syntax and phonology remained relatively intact but semantic abilities were impaired. The results support the inclusion of a language deficit as a diagnostic criterion of Alzheimer's disease.

A H-1 MRS study of probable Alzheimer's disease and normal aging: Implications for longitudinal monitoring of dementia progression

In order to evaluate the capability of H-1 MRS to monitor longitudinal changes in subjects with probable Alzheimer's disease (AD), the temporal stability of the metabolite measures N-acetylaspartate and N-acetylas-partylglutamate (NA), total Creatine (Cr), myo-Inositol (mI), total Choline (Chol), NA/Cr, mI/Cr, Chol/Cr and NA/mI were investigated in a cohort of normal older adults. Only the metabolite measures NA, mi, Cr, NA/Cr, mI/Cr, and NA/mI were found to be stable after a mean interval of 260 days. Relative and absolute metabolite measures from a cohort of patients with probable AD were subsequently compared with data from a sample of normal older adult control subjects, and correlated with mental status and the degree of atrophy in the localized voxel. Concentrations of NA, NA/Cr, and NA/mI were significantly reduced in the AD group with concomitant significant increases in mi and mI/Cr. There were no differences between the two groups in measures of Cr, Chol, or Chol/Cr. Significant correlations between mental status as measured by the Mini-Mental State Examination and NA/mI, mI/Cr and NA were found. These metabolite measures were also significantly correlated with the extent of atrophy (as measured by CSF and GM composition) in the spectroscopy voxel. (C) 1999 Elsevier Science Inc.

Response programming in dementia of the Alzheimer type: A kinematic analysis

Although planning is important for the functioning of patients with dementia of the Alzheimer Type (DAT), little is known about response programming in DAT. This study used a cueing paradigm coupled with quantitative kinematic analysis to document the preparation and execution of movements made by a group of 12 DAT patients and their age and sex matched controls. Participants connected a series of targets placed upon a WACOM SD420 graphics tablet, in response to the pattern of illumination of a set of light emitting diodes (LEDs). In one condition, participants could programme the upcoming movement, whilst in another they were forced to reprogramme this movement on-line (i.e. they were not provided with advance information about the location of the upcoming target). DAT patients were found to have programming deficits, taking longer to initiate movements; particularly in the absence of cues. While problems spontaneously programming a movement might cause a greater reliance upon on-line guidance, when both groups were required to guide the movement on-line, DAT patients continued to show slower and less efficient movements implying declining sensori-motor function; these differences were not simply due to strategy or medication status. (C) 1997 Elsevier Science Ltd.

Comparative effects of ageing and dementia of the Alzheimer type on orientation of visual attention

Age-related changes and the effects of dementia of the Alzheimer type (DAT) were investigated during a visual orienting attention task in which attention was pre-cued to one or other hemifields. Central cues were either valid, neutral, invalid or NoGo (inhibitory). The response time cost-benefit analysis showed a decreased benefit after valid cueing in the old compared with the young group with no change in the cost of invalid cueing. The older group were also slower over all cue types. These results suggest there is an age-related reduced ability to covertly orient attention in a visual hemifield before target onset. In contrast, the DAT group showed an increased response time benefit and showed a trend for a decreased cost in response time compared with controls. This was due to slowest response times after neutral cues. They also made significantly more response errors particularly following neutral cueing, and were less able to inhibit responses on NoGo trials than controls. The increased benefit and reduced cost found in the DAT group was interpreted as an impairment in dividing attention between left and right target locations.

Proton spectroscopy in Alzheimer`s disease and cognitive impairment no dementia: A community-based study

Objective: To describe the findings of proton magnetic resonance spectroscopy (H-1-MRS) in Alzheimer`s disease (AD) and cognitive impairment, no dementia (CIND) elderly from a community-based sample. Methods: Thirteen patients with AD, 12 with CIND and 15 normal individuals were evaluated. The H-1-MRS was performed in the right temporal, left parietal and medial occipital regions studying the metabolites N-acetylaspartate (NAA), creatine (Cr), choline (Cho) and myoinositol (ml). The clinical diagnosis was based on standardized cognitive tests - MMSE and CAMDEX - and the results correlated with the H-1-MRS. Results: Parietal Cho was higher in control individuals and lower in CIND subjects. AD and control groups were better identified by temporal and parietal ml combined with the temporal NAA/Cr ratio. CIND was better identified by parietal Cho. Conclusion: The H-1-MRS findings confirmed the hypothesis that metabolic alterations are present since the first symptoms of cognitively impaired elderly subjects. These results suggest that combining MRS from different cerebral regions can help in the diagnosis and follow-up of community elderly individuals with memory complaints and AD. Copyright (C) 2008 S. Karger AG, Basel.

Semantic priming in Alzheimer's dementia: Evidence for dissociation of automatic and attentional processes

The nature of the semantic memory deficit in dementia of the Alzheimer's type (DAT) was investigated in a semantic priming task which was designed to assess both automatic and attention-induced priming effects. Ten DAT patients and 10 age-matched control subjects completed a word naming semantic priming task in which both relatedness proportion (RP) and stimulus-onset asynchrony (SOA) were varied. A clear dissociation between automatic and attentional priming effects in both groups was demonstrated; however, the DAT subjects pattern of priming deviated significantly from that of the normal controls. The DAT patients failed to produce any priming under conditions which encouraged automatic semantic processing and produced facilitation only when the RP was high. In addition, the DAT group produced hyperpriming, with significantly larger facilitation effects than the control group. These results suggest an impairment of automatic spreading activation in DAT and have implications for theories of semantic memory impairment in DAT as well as models of normal priming. (C) 2001 Academic Press.

Screening for memory disorders, dementia and Alzheimer's disease

Dementia and its most common cause, Alzheimer’s disease, affect memory and occur predominantly in the elderly. Dementia has become increasingly prevalent in the world as health has improved and life expectancy has increased. However, the fields of clinical care have not responded adequately to develop diagnostic tools and treatments for this rapidly increasing group of conditions. While scientists search for cures for the numerous causes of dementia, improvement of diagnostic measures are needed now and should begin with screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations.

Continuing to care for people with dementia: Alzheimer Society of Ireland

The Alzheimer Society of Ireland in conjunction with St. Luke’s Home has published a report ‘Continuing to care for people with dementia’ which explores Irish family carers’ experience of their relative’s transition to a nursing home.�� The report was researched and written by Professor Murna Downs, Bradford Dementia Group, University of Bradford. The full report is available below:Continuing to care for people with dementia����

Caring places: planning for aged care and dementia 2010-2050: Alzheimer's Australia

Alzheimer’s Australia recently commissioned research group Access Economics to model different scenarios for the supply of aged care, to identify strategies to increase consumer choice and to promote service flexibility, and to identify funding options for a sustainable aged care system into the future. The report, Caring places: planning for aged care and dementia 2010-2050, found that the number of people with dementia will quadruple by 2050 to nearly 1 million.Caring places: planning for aged care and dementia 2010-2050

Frontotemporal Dementia Research Coming of Age: Alzheimer Research Forum

Long the obscure cousins of Alzheimer's, the frontotemporal dementias last month stood in the glare of a large three-day meeting devoted specifically to this particular group of diseases. FTD is an isolating and ruinous progressive illness. Sufferers exhibit a range of disturbing, aberrant behaviors and often reckless financial decisions, all coupled with a puzzling emotional flatness that makes it impossible for them to realize it's actually wrong to cheat on a spouse or spend the family savings. In the wake of some recent genetic and biochemical advances, FTD research is now quickly picking up speed, and a new sense of optimism pervaded the 7th International Conference on Frontotemporal Dementias. Madolyn Bowman Rogers captured its essence-read her series to learn what FTD is, and how new research is changing its diagnosis, biological understanding, and the search for new treatments.Frontotemporal Dementia Research Comes of AgeNeuroimaging Opens Window to Disease, Better DiagnosisDissecting the Pathways Behind Frontotemporal DementiaClinical Trials a Ripple, Scientists Hope for a WaveView PDF of the entire series.��

Frontotemporal Dementia Research Coming of Age: Alzheimer Research Forum

Long the obscure cousins of Alzheimer's, the frontotemporal dementias last month stood in the glare of a large three-day meeting devoted specifically to this particular group of diseases. FTD is an isolating and ruinous progressive illness. Sufferers exhibit a range of disturbing, aberrant behaviors and often reckless financial decisions, all coupled with a puzzling emotional flatness that makes it impossible for them to realize it's actually wrong to cheat on a spouse or spend the family savings. In the wake of some recent genetic and biochemical advances, FTD research is now quickly picking up speed, and a new sense of optimism pervaded the 7th International Conference on Frontotemporal Dementias. Madolyn Bowman Rogers captured its essence-read her series to learn what FTD is, and how new research is changing its diagnosis, biological understanding, and the search for new treatments.Frontotemporal Dementia Research Comes of AgeNeuroimaging Opens Window to Disease, Better DiagnosisDissecting the Pathways Behind Frontotemporal DementiaClinical Trials a Ripple, Scientists Hope for a WaveView PDF of the entire series.��