Neurochemical investigations in patients with dementia of Alzheimer type and their clinical value
The clinical diagnosis of dementia of Alzheimer type (DAT) relies on the identification of a dementia syndrome in the absence of other known etiologies, which results in a diagnostic validity of approximately 90 percent. Thus, the identification of a biological ante-mortem marker of DAT would be of great help. Investigations on post-mortem tissue have established several cascades of cell biological events in the affected brain, e.g. cholinergic degeneration, free oxygen radical toxicity, impairment of glucose metabolism, which we used as a rationale for testing the diagnosis utility of related parameters in DAT patients. Acetylcholine (ACh) and choline, and vitamin E in the CSF as well as neuroendocrine changes after a GHRH/CRH challenge and hormonal changes after an oral glucose tolerance in DAT patients were measured. For ACh concentration in CSF and neuroendocrine changes after GHRH as well as insulin release after OGTT, there were subtle changes from controls. The potential use of these parameters as diagnostic markers of Alzheimer’s disease in the alive patient is discussed.
KeywordsOral Glucose Tolerance Test Senile Dementia Medial Temporal Lobe Atrophy Choline Level BioI Psychiatry
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