Horizontal Component of Electro‐Oculogram as a Parameter of Arousal in Dementia: Relationship between Intellectual Improvement and Increasing Arousal under Pharmacotherapy

Abstract

Although nootropics and metabolically active compounds sometimes attenuate intellectual deficits of dementia patients, this mechanism has not been discussed or investigated. The authors hypothesized that these compounds act to enhance attention and/or concentration by increasing the arousal level, and then improve intellectual functions. Based on this hypothesis, the authors investigated the arousal level and the improvement of intellectual functions in ten patients with Alzheimer type dementia and ten patients with multi-infarct dementia before and after 3 months pharmacotherapy using bifemelane hydrochloride. They then analyzed whether the increases in arousal level involves or relates to the improvement of intellectual functions. On the 20 patients, psychological tests were carried out, and the arousal level was evaluated using the frequency of rapid eye movements in the electro-oculogram (EOG) before and after 3 months administration of bifemelane hydrochloride. As a result, a significant positive correlation was observed between the improvement on the Hasegawa's dementia scale and the rate of increase in rapid eye movements in the EOG. The EOG monitoring can be a great help in establishing an objective evaluation method on drug efficacy.

Fluctuations of Source Locations of EEG Activity during Transition from Alertness to Sleep in Alzheimer’s Disease and Vascular Dementia

“…This suggests that vigilance control mechanisms may not affect intellectual competence in general, although lowered vigilance reduces cognitive performance [14] and accordingly, transient cognitive decrement may result from transient lowering of vigilance [10][11][12].…”

“…It has been argued that these fluctuations in cognition may be a result of fluctuations of vigilance [10][11][12], i.e., a deterioration in the control of the vigilance level [13][14][15].…”

Effects of Bifemelane on the Calcium Level and ATP Release of the Human Origin Astrocyte Clonal Cell

“…Interestingly, the drug induced rapid onset and highly reversible blocking effects on the SOCC activated in the cells treated with thapsigargin and bathed in normal medium (5). Although the dose required to cause the effect seemed to be much higher than its therapeutic dose, the effects of bifemelane on the [Ca 2+ ] i of astrocytes found in our previous study might have some relationship to the pharmacological and therapeutic efficiency of the drug (6,7).…”

Demência vascular: dificuldades diagnósticas e tratamento

“…• Métodos de neuroimagem (TC, RM -volume lesional, número e topografia das lesões, gravidade de leucoaraiose, grau de atrofia e dilatação ventricular) 7,9,20,76 • Eletrofisiológicos (EEG espectral, coerência eletrencefalográfica, eletro-oculografia, análise do ciclo sonovigília, potenciais cognitivos, potenciais motores) 1,19,23,35,44,45,48,67,72,76 • Bioquímicos e hormonais (interleucina-1, histamina, fator de necrose tissular, complexos imunes circulantes, alfa-1-antitripsina e alfa-2-macroglobulina, GH, PRL, androsterona, cortisol urinário; CRH, neuropeptídeos, endotelina-1 e colinesterase no LCR) 5,[11][12][13][14]37,47,57,58,71,82 • Neuropsicológicos (vários conjuntos de testes, baterias de testes, escalas de gravidade de demê-ncia) 6,8,26,35,53,59,60,67,68,79 • Provas funcionais (SPECT, PET, espectroscopia por RM) 10,20,21,49,50,81…”

“…Um número muito pequeno de pacientes é habitualmente estudado, com divisões em subgrupos que tornam ainda mais difícil a interpretação dos resultados (p.ex. pentoxifilina 6 , citidina 29 , CDP-colina 13 , bifemelane 72 ). Como mencionado, uma miríade de métodos de avaliação de eficácia é utilizada, tornando difícil a comparação de diversas intervenções.…”