Alois Alzheimer and vascular brain disease: Arteriosclerotic atrophy of the brain

Abstract

Alois Alzheimer is best known for his description of neurofibrillary changes in brain neurons of a demented patient, identifying a novel disease, soon named after him by Kraepelin. However, the range of his studies was broad, including vascular brain diseases, published between 1894 and 1902. Alzheimer described the clinical picture of Arteriosclerotic atrophy of the brain, differentiating it from other similar disorders. He stated that autopsy allowed pathological distinction between arteriosclerosis and syphilis, thereby achieving some of his objectives of segregating disorders and separating them from syphilis. His studies contributed greatly to establishing the key information on vascular brain diseases, predating the present state of knowledge on the issue, while providing early descriptions of what would be later regarded as the dimensional presentation of the now called "Vascular cognitive impairment", constituted by a spectrum that includes a stage of "Vascular cognitive impairment not dementia" and another of "Vascular dementia".

Alzheimer and vascular brain disease: Senile dementia

“… 18 It is opportune to reiterate that this was verified and suggested in relation to Arteriosclerotic atrophy of the brain in a previous paper. 3 An analyzes of Senile dementia based on Alzheimer's 1898 paper was performed by Förstl and Howard, where they commented on the clinical progression of Senile dementia etiopathogenesis according to Noetzli and Alzheimer, and on Arteriosclerotic brain atrophy. 19 In 1999, Román commented on Senile dementia, focusing on the main points of Alzheimer's study, and made remarks on Arteriosclerotic brain atrophy and also on some subforms.…”

“…Although he was not the only scholar to study this subject, he produced very comprehensive concepts, including novel pathological descriptions on vascular brain diseases. 3 …”

Alzheimer and vascular brain diseases: Focal and diffuse subforms

“…These studies contributed to establish key knowledge on what has become incorporated into the present status on the subject – the Vascular Cognitive Impairment spectrum. 2 , 3 …”

“…Besides the two main dementia forms, Arteriosclerotic atrophy of the brain ( arteriosklerotische Atrophie des Gehirns ) and Senile dementia ( senile Demenz ), both examined by the authors in previous papers, 2 , 3 Alzheimer identified and described a series of conditions (diseases) related to atheromatous vascular degeneration of the brain arteries which he designated "subforms". He was able to distinguish these processes according to their location and spread of the brain changes, manifested by cortical and/or subcortical clinical symptoms.…”