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Biomedical subjects

C G Gottfries

Publications and source records attributed to C G Gottfries.

At least 91 records · Page 5Linked to original sources
PubMed1991

The closure of a mental hospital in Sweden: characteristics of patients in long-term care facing relocation into the community.

A political decision to decentralize psychiatric care in a county of Sweden was made in October 1984, leading to the closure of the only large mental hospital in the area (290,000 inhabitants). The hospital is of the traditional type, with 490 beds and 1,294 staff members. It has units for long-term care, short-term care and rehabilitation and a unit for research and education. The long-term care is to cease completely and be replaced by community-based alternative types of care. In this study, the long-term population (n = 199) was characterized and their levels of functioning were measured. The results showed that 91% of the patients were 65 years old or more and that more than half of them were organically demented. Only 20% were chronic schizophrenics. All patients were cognitively impaired and 80% were also impaired in ADL functioning. A correlation between length of stay in hospital and ADL functioning was found in the organically demented group, but not in the group of chronic psychiatrically ill patients. Thirty-nine per cent of the population were severely impaired in ADL functioning and needed nursing care around the clock; 34% were moderately impaired and needed help and support that could be given in alternative types of care; 27% were not impaired at all to mildly impaired and could be relocated to some type of service apartment. Thus, all patients needed sheltered living arrangements and care provided by staff with adequate training.

Activities of Daily Living↗
PubMed1991

Nursing home care: factors influencing the quality of life in a restricted life situation.

The quality of life and care situation of 191 patients living in 4 nursing homes (NHs) were evaluated with regard to patient functional impairment and staff competence. Patient disability levels in the different NHs were similar. A high incidence of dementia in combination with somatic diseases were limitations to achieve quality of life. The patients had limited access to privacy. Their possibilities to communicate with the world outside, interpersonally, and via mass-media were small. Only about half of them went out of the NHs during their mean stay of 1.8 years, but they were often visited by relatives and friends. The staff seemed to be indifferent to the patients' needs, which was reflected in insufficient physical and mental training, bad mealtime routines and only a minute of time allowed for personal acquaintance at admittance. The competence of the nursing staff and their working in a nursing team seemed to be of major importance in the care situation for the quality of life available. It was evident that there was a great need to improve the care situation.

Activities of Daily Living↗
PubMed1991

Monoamine oxidase B in brains from patients with Alzheimer's disease: a biochemical and autoradiographical study.

In vitro quantitative autoradiography using [3H]L-deprenyl, an irreversible and preferential inhibitor of monoamine oxidase B, was performed to investigate the localization of the enzyme in brains from senile dementia of Alzheimer type and control cases. Brains from three male patients with the clinical diagnosis of senile dementia of Alzheimer type and from three male control patients, without any known clinical history of neurological disorder, were obtained at autopsy. Cryosections of 100 microns thickness were mounted on gelatinized glass plates and dried over desiccant for one week at -20 degrees C. The sections were incubated with 10 nM [3H]L-deprenyl for 1 h and then exposed to film for four weeks. The autoradiographs were analysed by computer-assisted densitometry. Monoamine oxidase-B activities were also estimated in 1% homogenates from 10 different regions, using 10 microM beta-[ethyl-14C]phenylethylamine, in order to study the consonance between the autoradiographical and biochemical techniques. Both [3H]L-deprenyl binding and monoamine oxidase-B activities in senile dementia of Alzheimer type were higher than in the controls in all brain regions studied. The increase was highest in the white matter (about 70%) and in the order of 20-50% in the various gray matter regions. A high correlation coefficient (r approximately 0.9) was obtained between [3H]L-deprenyl binding and monoamine oxidase-B activity, both in the senile dementia of Alzheimer type and in the control brains.

Aged↗
PubMed1991

Antibodies in the cerebrospinal fluid of some Alzheimer's disease patients recognize amoeboid microglial cells in the developing rat central nervous system.

Previous investigations have demonstrated that the cerebrospinal fluid from Alzheimer's disease patients contains antibodies that recognize specific neuronal populations in the adult rat central nervous system. These findings suggest a pathogenic role for immunological aberrations in this disorder. In the present report the investigation of antibodies in the cerebrospinal fluid of Alzheimer's disease patients was extended to developing rat central nervous system. The antibody in cerebrospinal fluid from Alzheimer's disease patients recognized entirely different types of antigens in the developing rat central nervous system as compared to adult rat central nervous system. One of the most remarkable differences was the recognition of amoeboid microglial cells. Diverse morphological forms of amoeboid microglial cells were observed, located mainly in the cavum septum pellucidum and in the corpus callosum. Electron microscopy revealed that the cerebrospinal fluid antibody from the Alzheimer's disease patients recognized specific membrane receptors in the macrophagic microglia. The unexpected recognition of amoeboid microglia by antibodies in Alzheimer's disease-cerebrospinal fluid is particularly interesting since these cells proliferate in response to nervous system disease and also engulf debris. The results add further support to the concept that inflammation and similar immune mechanisms may contribute to Alzheimer's disease pathogenesis.

Adult↗
PubMed1991

Hypothalamic monoamines and neuropeptides in dementia.

The concentrations of monoamines and various neuropeptides were determined in the hypothalamus of brains from patients with Alzheimer's disease and vascular dementia (n = 26) and compared with control values (n = 21). Decreased concentrations of 5-hydroxyindoleacetic acid (P less than 0.05) and homovanillic acid (P less than 0.01) were found, and increased arginine vasopressin- (P less than 0.01), galanin- (P less than 0.05) and somatostatin- (P less than 0.01) like immunoreactivity. It is proposed that this disequilibrium may be important for certain circadian symptoms, e.g. the changes in sleep/wake rhythms that are rather often observed in dementia.

Aged↗
PubMed1991

White-matter lesions on CT in Alzheimer patients: relation to clinical symptomatology and vascular factors.

Fifty-four patients with Alzheimer's disease (AD) were examined for white-matter lesions (WMLs) using computerized tomography. WMLs were more frequent in late-onset AD (LAD) (26/34-76%) than in early-onset AD (EAD) (5/20-25%) (p less than 0.0001), in AD without parietal predominance (10/11-91%) (p less than 0.005) than in AD with parietal predominance (5/15-33%), and in AD with confusional symptoms (11/12-92%) than in AD without confusional symptoms (4/14-29%) (p less than 0.001). The supine systolic blood pressure was higher in AD with WMLs (151 +/- 20) than in AD without WML (139 +/- 22) (p less than 0.05). AD patients with WMLs, but not those without WMLs, had a higher mean albumin ratio (7.5 +/- 2.7) than healthy controls (5.7 +/- 2.1) (p +/- 0.005). The finding of less focal (= less parietal) symptomatology in AD with WMLs than without WMLs suggests clinical significance of WMLs in AD, while the relations between blood pressure, BBB function and WMLs support the hypothesis of a vascular pathogenesis.

Aged↗
PubMed1991

Reduced concentrations of galanin, arginine vasopressin, neuropeptide Y and peptide YY in the temporal cortex but not in the hypothalamus of brains from schizophrenics.

Postmortem investigations were performed in brains from 14 schizophrenic patients and 21 controls matched for age and autopsy latency. Concentrations of galanin, delta-sleep-inducing peptide (DSIP), corticotropin-releasing factor (CRF), arginine vasopressin (AVP), neuropeptide Y (NPY) and peptide YY (PYY) were determined in the hypothalamus and grey matter from the temporal cortex. A significant positive correlation between age and the concentrations of galanin and CRF was found in the controls. No sex differences were found except a higher mean of CRF in the hypothalamus of the women. In the temporal cortex of the schizophrenic brains, galanin, AVP, NPY and PYY were significantly reduced. DSIP reduction only bordered on significance. CRF was not reduced. Comparing neuroleptic-treated vs non-treated schizophrenics, the treatment factor could not explain the reduced concentrations of neuropeptides in the temporal lobe. A comparison of controls with schizophrenics showed no significant differences in hypothalamic neuropeptide concentrations.

Age Factors↗
PubMed1991

Effect of citalopram, a selective 5-HT reuptake blocker, in emotionally disturbed patients with dementia.

In patients with Alzheimer's disease and vascular dementia, there are symptoms not only of cognitive impairment but also of emotional disturbance. Postmortem human brain studies have shown a disturbed metabolism of serotonin and overactivity of neuroendocrine-controlling factors in the hypothalamus. Treatment with a selective 5-HT reuptake blocker, citalopram, causes a significant reduction in postdexamethasone cortisol levels. Citalopram in patients with dementia disorders produces no improvement in psychomotor and cognitive behavior, but symptoms of emotional disturbance are reduced. Citalopram does not have a pure antidepressant effect; rather, the drug is considered an emotional stabilizer.

Alzheimer Disease↗
PubMed1991

The closure of a major psychiatric hospital. Characterization of the long-term population over one year at an early stage of deinstitutionalization.

A political decision to decentralize psychiatric care in a county in Sweden was arrived at in October 1984. This will lead to the closure of the only large psychiatric hospital in the area, which will be replaced by three smaller units. The long-term care in the hospital will cease completely and be replaced by district-based psychiatric services. All patients in the hospital's long-term unit were studied over one year at an early stage of deinstitutionalization. The results showed that 12% of patients were discharged during that year, mostly to other institutions, only 2 patients to their homes. Twenty-five per cent died, and one-year mortality was 40% for patients with severely impaired ADL functioning. The demented patients deteriorated significantly in ADL functioning.

Adult↗
PubMed1990

Neurochemical aspects on aging and diseases with cognitive impairment.

The concentrations of monoamines and cholineacetyl transferase (CAT) are reduced in brains from patients with normal aging. According to findings about the dopamine (DA) system, the age-sensitive decrease has its onset in the 60s and after that has a continuous progress. In patients with Alzheimer's disease (AD/SDAT), multiple changes indicate disturbed metabolism in the acetylcholine (ACh), DA, noradrenaline (NA), and 5-hydroxytryptamine (5-HT) systems. The activity of monoamine oxidase B (MAO-B) increases significantly with age and a further increase has been reported to occur in Alzheimer-afflicted brains. In the platelets, too, there is increased MAO-B activity in AD/SDAT patients. Increased enzyme activity is considered a marker of gliosis in the brain and a marker of macrocytosis in platelets. Gangliosides are reduced in several areas of the brain in AD/SDAT patients, which indicates a reduction of nerve terminals. Significantly reduced concentrations of myelin components have also been recorded in brains from patients with AD/SDAT, which is in agreement with histopathological findings. The neurochemical changes recorded in brains from normally aged individuals are very similar to those found in AD/SDAT brains, although the latter changes are more severe. Thus, it has been suggested that the pathological process in AD/SDAT may be an exacerbation of the process taking place in normal aging. The multiple neurochemical changes recorded in grey, as well as in white matter must still be considered changes of secondary nature. At the present level of knowledge, it is not possible to single out any one of these changes as of special etiological importance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1990

Disturbance of the 5-hydroxytryptamine metabolism in brains from patients with Alzheimer's dementia.

The 5-hydroxytryptamine (5-HT) system in the human brain is sensitive to aging. In dementia of the Alzheimer type (AD/SDAT), there are significantly reduced concentrations of 5-HT and 5-hydroxyindoleacetic acid (5-HIAA). 5-HT-sensitive imipramine binding is reduced by almost 50%, indicating a loss of presynaptic 5-HT terminals. There also seems to be reduced tryptophan hydroxylase activity in some brain areas. In cerebrospinal fluid (CSF) from AD/SDAT patients, the concentration of 5-HIAA is reduced, and the accumulation of 5-HIAA after probenecid loading is diminished. Biochemical findings together with structural findings in the raphe nuclei indicate that the disturbance of the 5-HT system is of the same magnitude as the disturbance of the cholinergic system. Reduced activity in the 5-HT system may be of importance for activity in the hypothalamus. There is an increased concentration of arginine vasopressin, which may explain the increased activity in the hypothalamic-pituitary-adrenal axis seen in patients with AD/SDAT. This activity is reduced when a selective 5-HT reuptake blocker is given. Pharmacological treatment with 5-HT reuptake blockers improves emotional disturbances, confusion, anxiety and depressed mood in patients with AD/SDAT.

Alzheimer Disease↗
PubMed1990

Investigations on auto-antibodies in Alzheimer's and Parkinson's diseases, using defined neuronal cultures.

In immunocytochemical studies, the CSF from Parkinson disease (PD) patients and from Alzheimer disease (AD) patients were investigated for the presence of neuron specific antibodies using dopaminergic and cholinergic neuronal cultures from embryonic rat brain, respectively. Dopamine containing cell bodies were labelled by Parkinsonian CSF-IgG, while cholinergic neurons, identified with a-NGF-receptor antibodies, were recognized by CSF from AD-patients. The CSF from PD-patients was investigated after autologous adrenal transplantation. CSF was removed 7 d, 5 months and 1 year after operation. When added to 18 d neuronal cultures for 3 d, the 7 d CSF caused neuronal cell and a glial reaction. The 4 months CSF caused cell death, but markedly less than the 7 d CSF. One year after transplantation the CSF had no toxic effects; these cultures were similar to control cultures. It is concluded that CSF from PD patients may contain aggressive IgG-species specific for DA neurons, and that the amount of such antibodies decrease after adrenal transplant operations. It is suggested that neurodegenerative diseases may become aggravated by autoimmune reactions.

Alzheimer Disease↗
PubMed1990

Visualization of brain monoamine oxidase B (MAO-B) in dementia of Alzheimer's type by means of large cryosection autoradiography: a pilot study.

Quantitative autoradiography, using 3H-deprenyl, was applied to study the regional localization of MAO-B in large cryosections from 3 control brains and 3 brains from patients with Alzheimer's disease (AD). High 3H-L-deprenyl binding was found in e.g. basal ganglia, cingulate gyrus, and insula cortex. Temporal cortex, parietal cortex, occipital cortex and various nuclei of the thalamus, showed moderate density, while low binding was observed in e.g. white matter. When the brains from the controls were compared with those with AD, the mean values for 3H-deprenyl binding was higher in the latter group, however, more generalised than previously reported.

Aged↗
PubMed1990

Pharmacological treatment strategies in Alzheimer type dementia.

Substitution of cholinergic drugs in the treatment of Alzheimer type dementia (AD/SDAT) has hitherto not been very successful. Accumulating data indicate that monoamines are disturbed in AD/SDAT patients. The selective 5-hydroxytryptamine re-uptake blocker, Citalopram, has proven effective in reducing overactivity in the hypothalamic-pituitary-adrenal axis and in improving emotional disturbances in patients with dementia. Efforts to substitute the dopaminergic system have hitherto been negative. Neither has treatment with neuropeptides made any breakthrough in the treatment of demented patients. Nootropics are drugs like Piracetam that are assumed to activate the metabolism of the neurons. Although these drugs have proven effects on the CNS in animal experiments these effects cannot be reproduced in man to the same extent. A subgroup of patients with late onset dementia has reduced concentrations of vitamin B12 and atrophic gastritis. Whether the vitamin B12 deficiency or deficiency of other essential nutrients, is of importance for the brain dysfunction is not clarified. Treatment trials with vitamin B12, folic acid, S-adenosylmethionine and acetyl L-carnitine are in progress. GM1 has proven effect in peripheral nerve damage. GM1 seems not to penetrate the blood brain barrier. If the effect of GM1 and eventually nerve growth factors should be tested in patients with dementia the administration must obviously be directly into the ventricular space.

Alzheimer Disease↗
PubMed1990

Intrathecal synthesis of immunoglobulins in patients with Alzheimer's disease.

Serum and cerebrospinal fluid (CSF) of 45 patients with Alzheimer's disease (AD) and 24 healthy controls were examined in order to investigate the possibility of an intrathecal synthesis of immunoglobulins in AD. The group of AD patients showed higher IgG and IgM indices than the control group. Five (11%) AD patients had an intrathecal IgG synthesis and 7 (15%) an intrathecal IgM synthesis. In total, 12 (26%) AD patients had an intrathecal immunoglobulin synthesis, while there was none among the controls. This finding supports the hypothesis that immunological mechanisms may play a role in the etiology and/or pathogenesis of Alzheimer's disease, at least in a subgroup of patients.

Aged↗