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Biomedical subjects

W Danielczyk

Publications and source records attributed to W Danielczyk.

At least 37 records · Page 2Linked to original sources
PubMed1990

Clinicopathological analysis of dementia disorders in the elderly.

The relative incidence of the major types of dementia disorders and the agreement rates between clinical and pathological diagnosis were analysed in consecutive autopsy series of 675 demented subjects from 3 hospitals (mean age 79.5 years, SD 9.6). Clinical assessment followed the DSM-III and ICD-9-NA criteria and NINCDS/ADRDA criteria for probable Alzheimer disease (AD) (McKhann et al. 1984), histological criteria for the diagnosis of AD those of the NIH/AARP Work Group (Khachaturian 1985) using a 4-degree rating scale for plaques and tangles in neocortex and hippocampus (Morris et al. 1988), and the criteria by Tierney et al. (1988) for 'pure' AD. Vascular dementia (MID) and other disorders were diagnosed according to current pathologic criteria. Clinical diagnosis of AD/SDAT was made in 59.2%, of MID in 21.7%, of mixed AD + MID in 3.1%, and of Parkinson's disease (PD) and other disorders in 16%. At autopsy, 76.7% fulfilled histological criteria for AD/SDAT, but only 60% were 'pure' forms, while 8.2% had additional features of PD and 7.9% coexisting vascular lesions indicating mixed SDAT + MID. 15.7% were MID with no or very little AD pathology, 7.4% other CNS disorders. 0.3% of the brains showed no abnormality beyond age-related changes. AD/SDAT had its highest incidence in a psychiatric population, MID and PD + SDAT in general and geriatric hospital cohorts. The overall coincidence rates for clinical and pathological diagnosis of AD/SDAT were 85.2%, for MIX and MID 60.5-61.9%, but only 51% for PD-PD/AD. These data and the results of other recent studies emphasize the need for more appropriate clinical and pathological criteria in the diagnosis of the dementias.

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PubMed1990

Course characteristics in the differentiation of dementia of the Alzheimer type and multi-infarct dementia.

Clinico-pathological studies have shown that the clinical diagnosis of multi-infarct dementia (MID) is even more difficult than that of dementia of the Alzheimer type (DAT). The study evaluated the significance of course characteristics for the diagnosis of MID and DAT. Course characteristics were rated when 57 demented patients were admitted to our neurogeriatric department. Diagnosis of MID and DAT, respectively, was established after a follow-up study with repeated neurological, psychiatric and neuropsychological investigations. In 21 cases diagnosis was confirmed by postmortem neuropathology. MID lacked the typical course of the disease in about two thirds of patients, while most DAT patients presented with the typical course of primary degenerative dementia. Features of the "typical" clinical course of MID (abrupt onset, stepwise deterioration) helped to exclude DAT, whereas MID could not be excluded on the basis of a history of insidious onset and gradual decline.

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PubMed1990

Depression in dementia of the Alzheimer type and in multi-infarct dementia.

The authors used the Hamilton Rating Scale for Depression and a rating of depressed mood to investigate the prevalence of depression in 55 patients with Alzheimer's disease, 37 patients with multi-infarct dementia, and 30 nondemented comparison subjects. The prevalence of depressed mood depended on the severity of dementia as measured by the Mini-Mental State examination and was significantly lower among patients in more severe stages of Alzheimer's disease but not among patients with severe multi-infarct dementia.

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PubMed1990

Right-left disorientation in dementia of the Alzheimer type.

We demonstrated that right-left orientation (R/L-O) on a confronting subject is more impaired in patients with dementia of the Alzheimer type than in patients with multi-infarct dementia of comparable degree of dementia. The impairment in R/L-O is independent of aphasia and spatial disorientation.

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PubMed1988

Nonspecificity of semantic impairment in dementia of Alzheimer's type.

Two psychometric tests designed to evaluate "verbal fluency" and "naming" as a measure of semantic memory were presented to 18 patients with Alzheimer's-type dementia, 16 other patients with multi-infarct dementia, and 14 age-matched control subjects. The diagnosis of multi-infarct dementia and Alzheimer's-type dementia was based on the commonly accepted criteria of the Diagnostic and Statistical Manual of Mental Disorders, ed 3. Although the patients with Alzheimer and multi-infarct dementias, respectively, suffered from a comparable degree of dementia (as determined by the Mini-Mental State examination), semantic memory was not specifically impaired in Alzheimer's-type dementia as opposed to multi-infarct dementia. In contrast semantic memory was correlated with the degree of dementia in both disease entities.

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PubMed1988

Treatment of impaired cerebral function in psychogeriatric patients with memantine--results of a phase II double-blind study.

Memantine was investigated in a phase II double-blind trial on 30 elderly patients by comparison with a placebo with the aid of several psychometric tests. It was found that vigilance, short-term memory, and concentration improve significantly under Memantine. It was also found that Memantine exerted a beneficial effect on psychiatric and neurological symptoms despite the presence of an organic psychosyndrome of many years' duration and multiple morbidity. The tolerance of the preparation was good in virtually all cases and a gradually increasing dosage is recommended. On the basis of these findings the authors assume that the therapeutic efficiency can be confirmed in a phase III trial.

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PubMed1988

Platelet MAO-B activity and the psychopathology of Parkinson's disease, senile dementia and multi-infarct dementia.

Monoamine oxidase-B (MAO-B) activity of platelets of an age- and sex-matched group of controls was compared with several groups of inpatients having non-familial dementia of Alzheimer type (DAT), Parkinson's disease (PD), multi-infarct dementia (MID), mixed types of these 3 diseases and a group of other central nervous system (CNS) organic disorders. All patients were subjected to several psychometric tests, including the Sandoz Clinical Assessment--Geriatric Scale, Hamilton Rating Scale for Depression, Mini-Mental State Examination and the Organic mental Disorder Scale (OMDS). A statistically significant enhancement of MAO-B activity could be observed in DAT patients and in PD patients, whereas the MID group showed a mean activity similar to that of the control group and the group with other organic CNS disorders. In DAT patients the degree of dementia in the OMDS test and the enhancement of MAO activity were positively correlated, but PD did not show such a correlation. It is concluded that the increase of MAO activity in PD and in DAT might be due to a disease-related enhanced affinity to oxygen and to such oxygen-derived radicals as superoxide or hydroxyl radicals. However, a possible drug-induced enhancement of MAO activity in PD cannot be excluded. Furthermore, the MAO-B activity values in platelets of individual patients or controls are not indicative of diagnosis or prognosis of any of these diseases and are of no disease-related specificity.

Adult↗
PubMed1987

Localization of MAO-A and MAO-B in human brain: a step in understanding the therapeutic action of L-deprenyl.

The discovery that MAO can be differentiated biochemically and pharmacologically into two forms, types A and B, with different substrate specificities and inhibitor sensitivities has renewed the interest in MAO inhibiting as a therapeutic agent. L-Deprenyl, a selective inhibitor of MAO-B, was introduced by us into clinical use as an adjunct to L-DOPA some years ago. This drug has found therapeutic importance in that it can potentiate the pharmacological action of L-DOPA. The mechanism underlying the action of L-deprenyl is thought to be related to its inhibition of MAO-B and thus increased levels of PEA and DA, as measured in the striatal and limbic region of human brain. Animal studies have indicated the MAO-A is mainly, but not exclusively, located in brain neurons, while MAO-B is preferentially placed in glia and astrocytes. In general human and primate brain studies show similar MAO distribution. The observation that MAO-B activity could not be located in the catecholaminergic neurons of human brain by the use of monoclonal antibody studies seriously questions the validity of this technique. The exact locations of MAO-A and -B in human brain are important to understand the mechanism of L-deprenyl action as an antiparkinson drug. If there is an absence of MAO-B from dopaminergic neurons, one may now consider that MAO-B activity within glia plays a far more important role than hitherto considered. This, however, is questionable.

Animals↗
PubMed1987

Terguride: partial dopamine agonist in the treatment of Parkinson's disease.

In an open trial, 15 patients with PD (mostly stage V) were treated with the partial DA agonist, terguride, a derivative of lisuride. To the basic therapy, consisting of L-dopa plus benserazide and amantadine, a slowly increasing dosage of TDHL up to a maximum of 1.5 mg/day t.i.d. was added. There were 3 drop-outs; 12 patients completed the trial which lasted for 12 weeks. At this time a significant improvement in total score, bradykinesia, and functional score was seen, as well as a marked improvement in tremors score in the patients who showed this symptom (Columbia Rating Scale). As side-effects, dyskinesias occurred in two patients, psychotic symptoms in one, and marked orthostatic symptoms in one patient. No significant differences before and after 12 weeks TDHL treatment were found in the concentrations of noradrenaline, adrenaline, serotonin, and 5-hydroxy-indole-acetic-acid in plasma. It is concluded that TDHL is effective even in advanced stages of PD, and it is speculated that partial DA agonists may become important in the treatment of PD and might possibly have an advantage over "classical" DA agonists.

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PubMed1986

[Psychological changes in Parkinson disease].

The most frequent psychic disturbances in Parkinson patients are reversible toxic psychoses usually triggered by the antiparkinsonian therapy. One also finds depression and demential syndromes. The appearance of psychiatric complications shows a relation to age, duration, course and stage of the disease, drug dosage and occasionally to situational factors. The pharmacotoxic psychoses, to a certain degree, can be considered as specific for the terminal stages of the disease. They occur in two out of three patients and curtail therapeutic facilities decisively. Depression can not be considered as an integral part of the majority of Morbus Parkinson varieties, since its incidence and severity in old people afflicted with chronic disease, other than parkinson's disease, are not any lower. Dementing processes, in spite of the presently higher average age of the Parkinson population, show a more severe course in other cerebral diseases, like SDAT and MID than in the typical Parkinson patient, free from other cerebral affections. The additional appearance of SDAT and/or MID, with ageing is, however, equally possible.

Antiparkinson Agents↗
PubMed1986

[The aging human from the neuropsychiatric viewpoint].

Aging processes facilitate the occurrence of neuropsychiatric disorders. Diseases of the brain but also extracerebral disorders, together with sociocultural influences lead to psychic disturbances. These become more and more frequent dependent on the remarkable increase in life span. The most important psychiatric diseases in aged people are the organic psychosyndrome, depression and dementia. Exact differential diagnostic criteria are essential for the therapeutic strategies of choice.

Age Factors↗
PubMed1983

Various mental behavioral disorders in Parkinson's disease, primary degenerative senile dementia, and multiple infarction dementia.

Following 2-4 years of hospitalization, the mental and physical ability of 21 patients with typical idiopathic PD, 10 patients with atypical Parkinson's syndrome and signs of cerebral arteriosclerosis, 29 patients with MID. and 14 patients with senile dementia of the Alzheimer type were evaluated according to various rating scales. All idiopathic parkinsonian patients had suffered from the disease for over 8 years. All patients were over 70 years of age and continuously subjected to the same environment. EEG and CT was performed. A rating scale consisting of 18 items for evaluation of the mental and physical capacity and ability to cope with daily psychosocial demands was used for each patient. Statistically highly significant differences resulted between the relative good mental ability of patients with idiopathic Parkinson's syndrome, with the exception of some brief pharmacotoxic psychoses, and the lower rating scores of patients with senile dementia of Alzheimer type and multiple infarction dementia. A smaller subgroup of patients with Parkinson's syndrome and additional focal signs in the neurological status and EEG showed moderate mental functional loss and a more frequent incidence of pharmacotoxic psychoses than the patients with idiopathic PD. Just as few congruencies of mental ability were found between patients with idiopathic, typical PD and patients with senile dementia of the Alzheimer type as between idiopathic PD and MID. Permanent dementia is not characteristic of patients with typical idiopathic PD even in advanced age. It is, however, for patients with MID and SDAT.

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