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Alzheimer’s disease — one, two or several?

  • C. G. Gottfries
  • K. Blennow
  • B. Regland
  • A. Wallin
Part of the Key Topics in Brain Research book series (KEYTOPICS)

Summary

In the seventies, the two disorders, Alzheimer’s disease (AD) and senile dementia of the Alzheimer type (SDAT) were sampled into one group, the dementias of the Alzheimer type. This sampling cannot be justified from a scientific point of view. The phenomenology of the two disorders differentiate. In AD a symptomatology of parietal and temporal lobe dysfunction is present, while in SDAT the clinical picture is more diffuse and indicative of not only a cortical but also a subcortical dysfunction.

Brain imaging techniques indicate white matter low attenuation and central atrophy in SDAT, while in AD the cortical atrophy is predominant.

Laboratory data show that the SDAT group includes patients with vitamin B12 deficiency and increased platelet monoamine oxidase activity. In the CSF of patients with AD there are decreased concentrations of homovanillic acid.

While AD is considered a small, relatively homogeneous group of presenile dementias, SDAT is considered a heterogeneous group including several subgroups.

Keywords

Senile Dementia Brain Imaging Technique Visual Agnosia Presenile Dementia Late Onset Dementia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Andersson M (1989) Institutionalization of the elderly and characteristics of nursing home patients. In: Andersson M (ed) Elderly patients in nursing homes and in home care. Reports from the Department of Psychiatry and Neurochemistry, St. Jöen’ Hospital, Gothenburg University, NO. 18. Doctoral thesisGoogle Scholar
  2. Blennow K, Wallin A, Davidsson P, Fredman P, Gottfries CG, Karlsson I, Svennerholm L (1989) Intrathecal synthesis of immunoglobulins in patients with Alzheimer’s disease. SubmittedGoogle Scholar
  3. Blessed G, Tomlinson BE, Roth M (1968) The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 114: 797–811PubMedCrossRefGoogle Scholar
  4. Brine G, Gottfries CG, Blennow K, Karlsson I, Lekman A, Parnetti L, Svennerholm L, Wallin A (1989) Monoamine metabolites in cerebrospinal fluid and behavioural ratings in patients with early and late onset of Alzheimer dementia. Alz Dis Assoc Disord 3: 148–156CrossRefGoogle Scholar
  5. Brun A, Gustafson L (1976) Distribution of cerebral degeneration in Alzheimer’s disease. A clinicopathological study. Arch Psychiatr Nervenkr 223: 15–33Google Scholar
  6. Gottfries CG (1983) Biological changes in blood and cerebrospinal fluid. In: Reisberg B (ed) Alzheimer’s disease. The standard reference. The Free Press, Collier MacMillan, London, pp 122–130Google Scholar
  7. Gottfries CG (1985) Definition of normal aging, senile dementia and Alzheimer’s disease. In: Gottfries CG (ed) Normal aging, Alzheimer’s disease and senile dementia. Aspects on etiology, pathogenesis, diagnosis and treatment. Proceedings of two symposia held at the 14th CINP Congress, June 22–33, 1984, Florence, Italy. L’Université de Bruxelles, Brussels, pp 11–17Google Scholar
  8. Gottfries CG, Karlsson I, Svennerholm L (1985) Senile dementiaa “white matter” disease? In: Gottfries CG (ed) Normal aging. Alzheimer’s disease and senile dementia. Aspects on etiology, pathogenesis, diagnosis and treatment. Proceedings of two symposia held at the 14th CINP Congress, June 22–23, 1984, Florence, Italy. L’Université de Bruxelles, Brussels, pp 11–17Google Scholar
  9. Gottfries CG, Bartfai T, Carlsson A, Eckernäs SA, Svennerholm L (1986) Multiple biochemical deficits in both gray and white matter of Alzheimer brains. Prog Neuropsychopharmacol Biol Psychiatry 10: 405–413PubMedCrossRefGoogle Scholar
  10. Gustafson L, Nilsson L (1982) Differential diagnosis of presenile dementia on clinical grounds. Acta Psychiatr Scand 65: 194–209PubMedCrossRefGoogle Scholar
  11. Heston LL, Mastri AR, Anderson E, White J (1981) Dementia of the Alzheimer type: clinical genetics natural history and associated conditions. Arch Gen Psychiatry 38:1085 —1090Google Scholar
  12. Ishii T, Haga S (1976) Immuno-electron microscopic localization of immunoglobulins in amyloid fibrils of senile plaques. Acta Neuropathol (Berl) 36: 243–249CrossRefGoogle Scholar
  13. Jorm AF, Korten AE, Henderson AS (1987) The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 76: 465–479PubMedCrossRefGoogle Scholar
  14. Kaye JA, May C, Daly E, Atack JR, Sweeney DJ, Luxenberg JS, Kay AD, Kaufman S, Milstein S, Friedland RP, Rapoport SI (1988) Cerebrospinal fluid monoamine markers are decreased in dementia of the Alzheimer type with extrapyramidal features. Neurology 38: 554–557PubMedCrossRefGoogle Scholar
  15. Kraepelin E (1910) Senile and pre-senile dementias. Johann Ambrosius Barth, Leipzig, pp 533–554, 593–632Google Scholar
  16. Mayeux R, Stern Y, Spanton S (1985) Heterogeneity in dementia of the Alzheimer type. Evidence of subgroups. Neurology 35: 453–461PubMedCrossRefGoogle Scholar
  17. McRae Degueurce A, Serney B, Haglid K, Rosengren L, Karlsson JE, Karlsson I, Wallin A, Svennerholm L, Gottfries CG, Dahlström A (1988) CSF from Alzheimer’s patients contain antibodies recognizing cholinergic neurons in the rodent central nervous system. SubmittedGoogle Scholar
  18. Merriam A, Aronson MK, Gaston T, Wei SL, Katz I (1988) The psychiatric symptoms of Alzheimer’s disease. J Am Geriatr Soc 36: 7–12PubMedGoogle Scholar
  19. Regland B, Gottfries CG, Oreland L, Svennerholm L (1988) Low B12 levels related to high activity of platelet MAO in patients with dementia disorders. A retrospective study. Acta Psychiatr Scand 78: 451–457Google Scholar
  20. Regland B (1990) Abnormalities of vitamin B-12 and other essential nutrients in dementia of Alzheimer type, and their clinical relevance. In: Fowler Ch J, Carlson LA, Gottfries CG, Winblad B (eds) Biological markers in dementia of Alzheimer type. Proceedings of the Stiftelsen Gamla Tjänarinnor Symposium on aging and aging disorders No. 1. Smith Gordon and Company Limited, London, pp 215–219Google Scholar
  21. Rossor MN, Iversen LL, Reynolds GP, Mounjoy CQ, Roth M (1984) Neuro-chemical characteristics of early and late onset types of Alzheimer’s disease. Br Med J 288: 961–964CrossRefGoogle Scholar
  22. Scott JM, Dinn JJ, Wilson P, Weir DG (1981) Pathogenesis of subacute combined degeneration: a result of methyl group deficiency. Lancet 11: 334–337CrossRefGoogle Scholar
  23. Singh VK, Fudenberg HH (1986) Detection of brain autoantibodies in the serum of patients with Alzheimer’s disease but not with Down’s syndrome. Immunol Lett 12: 277–280PubMedCrossRefGoogle Scholar
  24. Sjögren T, Sjögren H, Lindgren AGH (1952) Morbus Alzheimer and morbus Pick. A genetic, clinical and patho-anatomical study. Acta Psychiatr Neurol Scand [Suppl 82]Google Scholar
  25. Sourander P, Sjögren H (1970) The concept of Alzheimer’s disease and its clinical implications. In: Wolstenholme FEW, O’Connor M (eds) Alzheimer’s disease and related conditions. Churchill, London, pp 11–36Google Scholar
  26. Svennerholm L, Gottfries CG, Karlsson I (1988) Neurochemical changes in white matter of patients with Alzheimer’s disease. In: Serlupi Crescenzi G (ed) A multidisciplinary approach to myelin disease. Plenum, New York, pp 319–328Google Scholar
  27. Wallin A, Blennow K, Gottfries CG, Längström G, Uhlemann C (1989a) White matter low attenuation on computed tomography in Alzheimer’s disease and vascular dementia. Acta Neurol Scand 80: 518–523PubMedCrossRefGoogle Scholar
  28. Wallin A, Alafuzoff I, Carlsson A, Eckernäs S, Gottfries CG, Svennerholm L, Winblad B (1989b) Neurotransmitter deficits in a non-multi-infarct category of vascular dementia. Acta Neurol Scand 79: 397–406PubMedCrossRefGoogle Scholar
  29. Williams A, Papadopoulos N, Chase TN (1980) Demonstration of CSF gamma-globulin banding in presenile dementia. Neurology 30: 882–884PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1990

Authors and Affiliations

  • C. G. Gottfries
    • 1
  • K. Blennow
    • 1
  • B. Regland
    • 1
  • A. Wallin
    • 1
  1. 1.Department of Psychiatry and NeurochemistryGothenburg UniversityGothenburgSweden

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