Neuropathological reports about denervation and amyloid angiopathy in dementia of Alzheimer''s type (DAT) as well as signs of selective incomplete white matter infarctions point to a vascular involvement within the degenerative process. In order to investigate potential alterations of cerebrovascular function we performed cerebral blood flow measurements before and after intravenous injection of 1 g acetazolamide using technetium-99m hexamethylpropyleneamine oxime and single photon emission tomography in 12 patients (6 female, 6 male; mean age 70.8 ± 9.6 years) with probable (senile) dementia of Alzheimer''s type (SDAT) and 9 controls (7 female, 2 male; mean age 71.2 ± 8.6 years). SDAT patients revealed significantly reduced cerebrovascular reactivity with lower values with increasing cognitive impairment. We discuss possible underlying mechanisms.
This study was designed to evaluate, whether investigations of cerebral blood flow can be a helpful diagnostic tool in the differential diagnosis between (senile) dementia of Alzheimer's type [(S)DAT] and geriatric depression with cognitive impairment. Under clinical routine conditions we performed Single Photon Emission Computed Tomography (SPECT) using 99mTc-Hexamethylpropyleneamine Oxime (HMPAO) in 23 patients with (S)DAT (14f, 9m; mean age 68.9 y), 17 patients with geriatric depression (9 f, 8 m; mean age 66.4 y) and 12 age-matched controls (9 f, 3 m; mean age 69.2 y). Semiquantitative analysis (corticocerebellar ratios) of eight different regions of interest (ROI) revealed a significantly (p < 0.05) reduced perfusion in the (S)DAT patients compared to the control group. The depression group exhibited perfusion values between the (S)DAT and control group. The difference between the depression and (S)DAT group was most prominent in the left parieto-occipital ROI (p = 0.008). We discuss the data with extensive regard to the literature and conclude that 99mTc-HMPAO SPECT is a valuable additional tool in the differential diagnosis of depression and dementia in the elderly.
Das Lithiumderivat 4 der Schiff-Base 3 aus (+)-Campher (1) und (Aminomethy1)phosphondure-diethylester (2) ceagiert mit Alkylhalogcnidcn diastereoselcktiv zu den Produkten 5. Die asyrnmetrischen lnduktionen variieren von 11% (Methyliodid) bis ca. . Die Hydrolyse der Verbindungen 5 liefert die Diethyl-(SHl -aminoalkyl)phosphonate 6, aus dcnen die (S)-(l-Arninoalkyl)phosphon&iuren 7 erhiiltlich sind.(1-Aminoalky1)phosphonsauren (Typ 7), die Phosphonsaureanaloga der a-Aminosauren, verdienen Beachtung wegen ihrer nachgewiesenen oder potentiellen biologischen AuBer der Schiff-Base 3 haben wir als Ausgangsmaterial noch die Schiff-Basen 8 und 9a erprobt. Das chirale Auxiliar
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