Fortnightly Review: Vascular dementia

Amar, Khaled; Wilcock, Gordon

doi:10.1136/bmj.312.7025.227

Cited by 58 publications

(8 citation statements)

References 60 publications

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“…All the subjects selected to enter the Alzheimer's Disease group satisfied the following criteria: 1) a diagnosis of Probable Alzheimer's Disease according to NINDS-ADRDA criteria [26]; 2) the CT brain scan showing mild/moderate global atrophy and/or mild/moderate bilateral temporo-parietal atrophy; 3) no history of hypertension, epilepsy, CVAs, diabetes, abnormal thyroid functions or any other multisystem/endocrinological disease; 4) Hachinski score lower than 4 [15]. All the subjects selected to enter the group with Dementia of the Binswanger Type 1) satisfied diagnostic criteria for vascular dementia (NINDS-AIREN) and research diagnostic criteria for Binswanger's Disease [1,34] 2) CT brain scan showed marked diffuse white matter disease, 3) they had no history of diabetes, abnormal thyroid function or other multi-system endocrinological disease, 4) the Hachinski score was higher than 4.…”

Section: Selection Of Subjectsmentioning

confidence: 99%

“…White matter disease is found in 70-90% cases of vascular dementia and is associated with a history of raised blood pressure, heart disease and diabetes. The psychopathology is represented by transient episodes of clouding of consciousness, slowing of mental processing, patchy psychological deficits, impaired attention and concentration [1], mood lability and increased risk of developing symptoms of depression and anxiety. Early symptoms may also include diminished judgement and behavioural extremes, such as apathy and social withdrawal appearing alongside disinhibition, irritability and aggressiveness [24,25,33].…”

Section: Introductionmentioning

confidence: 99%

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Is the Finding of Obsessional Behaviour Relevant to the Differental Diagnosis of Vascular Dementia of the Binswanger Type?

Lawrence

2000

Behavioural Neurology

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Whilst carrying out a pilot study with a structured questionnaire examining the difference in insight between a group of patients with Alzheimer's Disease and a second group with Vascular Dementia of the Binswanger Type, the incidental observation was made that the group of patients with Vascular Dementia of the Binswanger Type demonstrated more obsessional behaviour than the group of patients with Alzheimer's Disease. The obsessional behaviour differed from classical obsessive compulsive disorder insofar as the subjects were unaware of it whilst at the same time resisting change.

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Section: Selection Of Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is the Finding of Obsessional Behaviour Relevant to the Differental Diagnosis of Vascular Dementia of the Binswanger Type?

Lawrence

2000

Behavioural Neurology

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“…Special attention has to be given when attempting to make a differential diagnosis, to the following steps that may lead to a diagnosis of VD [93]: Detection of vascular risk factors, including hypertension, diabetes, orthostatic hypotension, smoking, cardiac arrhythmias and heart failure.Examination of the cardiovascular system that may be a cause of thromboembolism that results in transient ischemic episodes and a history of strokes.Neurological and psychometric assessments to evidence particular neurological deficits.A search for treatable factors that might lead to VD, such as hypothyroidism, neurosyphilis, vitamin B12 deficiency, cerebral vasculitis or frontal lobe tumors.…”

Section: Memantine Treatment For Vascular Dementiamentioning

confidence: 99%

N-Methyl D-Aspartate (NMDA) Receptor Antagonists and Memantine Treatment for Alzheimer’s Disease, Vascular Dementia and Parkinson’s Disease

Olivares¹,

Deshpande²,

Shi³

et al. 2012

CAR

311

205

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Memantine, a partial antagonist of N-methyl-D-aspartate receptor (NMDAR), approved for moderate to severe Alzheimer’s disease (AD) treatment within the US and Europe under brand name Namenda (Forest), Axura and Akatinol (Merz), and Ebixa and Abixa (Lundbeck), may have potential in alleviating additional neurological conditions, such as vascular dementia (VD) and Parkinson’s disease (PD). In various animal models, memantine has been reported to be a neuroprotective agent that positively impacts both neurodegenerative and vascular processes. While excessive levels of glutamate result in neurotoxicity, in part through the over-activation of NMDARs, memantine—as a partial NMDAR antagonist, blocks the NMDA glutamate receptors to normalize the glutamatergic system and ameliorate cognitive and memory deficits. The key to memantine’s therapeutic action lies in its uncompetitive binding to the NMDAR through which low affinity and rapid off-rate kinetics of memantine at the level of the NMDAR-channel preserves the physiological function of the receptor, underpinning memantine’s tolerability and low adverse event profile. As the biochemical pathways evoked by NMDAR antagonism also play a role in PD and since no other drug is sufficiently effective to substitute for the first-line treatment of L-dopa despite its side effects, memantine may be useful in PD treatment with possibly fewer side effects. In spite of the relative modest nature of its adverse effects, memantine has been shown to provide only a moderate decrease in clinical deterioration in AD and VD, and hence efforts are being undertaken in the design of new and more potent memantine-based drugs to hopefully provide greater efficacy.

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“…Alzheimer's disease (AD) is the most common form of dementia [1], there were about 20-30 million sufferers worldwide in 2006, this incurable, degenerative, and terminal disease is predicted to affect 1 in 85 people globally by 2050 [2]. Four medications are currently approved by regulatory agencies such as the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) to treat the cognitive manifestations of AD: three are acetylcholinesterase inhibitors and the other is memantine, an N-methyl-D-aspartic acid (NMDA) receptor antagonist [3].…”

Section: Introductionmentioning

confidence: 99%

High‐performance liquid chromatographic determination of memantine hydrochloride in rat plasma using sensitive fluorometric derivatization

Xie

Zhou

Tong

et al. 2011

J of Separation Science

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In this study, we investigated a simple, sensitive and reliable liquid chromatography-fluorescence detection method for the determination of memantine hydrochloride in rat plasma which was based on derivatization with 9-fluorenylmethyl chloroformate (FMOC-Cl). For the first time, FMOC-Cl was introduced into derivatization of memantine hydrochloride in rat plasma. The amino groups of memantine hydrochloride and amantadine hydrochloride (internal standard) were trapped with FMOC-Cl to form memantine hydrochloride-FMOC-Cl and amantadine hydrochloride-FMOC-Cl compositions, which can be very compatible for LC-FLD. Precipitation of plasma proteins by acetonitrile was followed by vortex mixing and centrifugation. Chromatographic separation was performed on a C(18) column (DIAMONSIL 150 × 4.6 mm, id 5 μm) with a mobile phase consisting of acetonitrile and water at a flow rate of 1.0 mL/min. The retention times of memantine hydrochloride-FMOC-Cl and amantadine hydrochloride-FMOC-Cl compositions were 23.69 and 40.27 min, respectively. Optimal conditions for the derivatization of memantine hydrochloride were also described. The limit of quantification (LOQ) was 25 ng/mL for memantine hydrochloride in plasma, the linear range was 0.025-5.0 μg/mL in plasma with a correlation coefficient (r) of 0.9999. The relative standard deviations (RSDs) of intra-day and inter-day assays were 4.46-12.19 and 5.23-11.50%, respectively. The validated method was successfully applied to the determination of memantine hydrochloride in rat plasma samples.

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Fortnightly Review: Vascular dementia

Cited by 58 publications

References 60 publications

Is the Finding of Obsessional Behaviour Relevant to the Differental Diagnosis of Vascular Dementia of the Binswanger Type?

Is the Finding of Obsessional Behaviour Relevant to the Differental Diagnosis of Vascular Dementia of the Binswanger Type?

N-Methyl D-Aspartate (NMDA) Receptor Antagonists and Memantine Treatment for Alzheimer’s Disease, Vascular Dementia and Parkinson’s Disease

High‐performance liquid chromatographic determination of memantine hydrochloride in rat plasma using sensitive fluorometric derivatization

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