Physical Aggression Is Associated With Preservation of Substantia Nigra Pars Compacta in Alzheimer Disease

Victoroff, Jeff; Zarow, Chris; Mack, Wendy J.; Hsu, Edward W.; Chui, Helena C.

doi:10.1001/archneur.1996.00550050058024

Cited by 48 publications

(21 citation statements)

References 59 publications

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“…Zubenko et al (1991) documented that psychosis was associated with increased norepinephrine in the substantia nigra. Furthermore, Victoro et al (1996) reported a relation between greater preservation of the substantia nigra pars compacta and aggression among patients with AD. These studies highlight the complex relationship between neurobiology and behavioral pathology in AD.…”

Section: Discussionmentioning

confidence: 99%

Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer's disease

Harwood

Barker

Ownby

et al. 2000

Int. J. Geriat. Psychiatry

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Objective This cross‐sectional study examined the relationship of behavioral and psychological symptoms to cognitive and functional impairment in Alzheimer's disease (AD). Design One hundred and fourteen patients were evaluated consecutively at a university‐affiliated outpatient memory disorders clinic and diagnosed with possible or probable Alzheimer's disease (AD) according to NINCDS‐ADRDA criteria. Subjects were assessed with the Behavioral Pathology in Alzheimer's Disease Scale (BEHAVE‐AD), Revised Memory and Behavior Problem Checklist (RMBPC), Blessed Dementia Scale (BDS), and Mini‐Mental State Examination (MMSE). Results Several symptoms of behavioral pathology showed associations with MMSE scores, including activity disturbances, delusions, and hallucinations. After controlling for the variance associated with the MMSE, activity disturbances, diurnal disturbances, delusions, and hallucinations were linked with BDS scores. Conclusions The results suggest that some non‐cognitive symptoms may be related to the neurobiologic mechanisms underlying the increased cognitive dysfunction in AD. Specific symptoms of behavioral pathology may also impact a patient's ability to perform important self‐maintenance behaviors. Copyright © 2000 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer's disease

Harwood

Barker

Ownby

et al. 2000

Int. J. Geriat. Psychiatry

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show abstract

“…It might therefore be considered whether such psychiatric disturbances are best conceptualized as 'complications' of Alzheimer's disease, or instead as heterogeneous components of the disease. This is potentially more than a semantic question, especially since there is evidence that the core neurobiological changes of dementia may produce both cognitive and noncognitive effects [32][33][34]. We may be better able to address this conceptual issue as more is learned about the relationship between the pathophysiological basis of cognitive changes and psychiatric features in neurodegenerative dementia.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Complications of Dementia: Impact on Caregivers

Victoroff

Mack

Nielson

1997

Dement Geriatr Cogn Disord

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This study was designed to determine the relationship between psychiatric features of dementia and their impact on caregivers. 35 patient-caregiver pairs were evaluated at two university-affiliated dementia clinics, using standard instruments to rate patient psychiatric features and caregiver burden and depression. There were highly significant correlations between patient agitation and both caregiver burden (r = 0.59, p = 0.0002) and depression (r = 61, p = 0.0001). These associations remained significant after adjusting for multiple demographic and dementia variables. There was no significant association between patient delusions, hallucinations, or depression and caregiver burden or depression. Agitation, particularly physical aggression, may impact caregivers even more than does the cognitive status of the demented patient.

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“…Ours is among the first reports examining neurochemical lesions of specific Alzheimer's disease subgroups (based on behavioral symptoms), and the first study, to our knowledge, that has specifically investigated neurotransmitter receptor distributions/concentrations in a behavioral subgroup of dementia. A recent study examining the neuropathological correlates of agitation and physical aggression in AD revealed that AD patients with histories of unequivocal interpersonal violence had significantly greater neuron counts in the substantia nigra pars compacta than did nonviolent patients (Victoroff et al, 1996). Therefore, other evidence is appearing that important differences in monamine neurotransmitter function may exist in this aggressive subgroup of AD patients.…”

Section: Discussionmentioning

confidence: 99%

Adrenergic Receptors in Alzheimer’s Disease Brain: Selective Increases in the Cerebella of Aggressive Patients

Russo-Neustadt

Cotman

1997

J. Neurosci.

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In this study, the distribution and concentration of ␤ 1 , ␤ 2 , and ␣ 2 adrenergic receptors were examined in the frontal cortex, hypothalamus, and cerebellum of Alzheimer's disease (AD) and age-matched control human brains by receptor autoradiography. The purpose of this study was to detect changes in adrenergic receptor concentrations in key areas of the brain known to affect behavior. For these studies, 3 H]UK-14,304 was used to localize the ␣ 2 sites. Essentially no significant difference in adrenergic receptor concentration was found between total AD cases taken together and control patients. It was found, however, that there were important distinctions within the AD group when cases were subdivided according to the presence or absence of aggression, agitation, and disruptive behavior. Aggressive AD patients had markedly increased (by ϳ70%) concentrations of ␣ 2 receptors in the cerebellar cortex compared with nonaggressive patients with similar levels of cognitive deficit. The levels of cerebellar ␣ 2 receptors in aggressive AD patients were slightly above the healthy elderly controls, suggesting that these receptors are preserved and perhaps increased in this subgroup of AD. ␤ 1 And ␤ 2 adrenergic receptors of the cerebellar cortex showed smaller but significant (ϳ25%) increases in concentration in aggressive AD subjects versus both nonaggressive AD patients and controls. No significant differences were found in adrenergic receptor concentrations within the frontal cortex or hypothalamus. These results point out the importance of distinguishing behavioral subgroups of AD when looking for specific neurochemical changes. These autoradiographic results may reflect the importance of the cerebellum in behavioral control.

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Physical Aggression Is Associated With Preservation of Substantia Nigra Pars Compacta in Alzheimer Disease

Abstract: Preservation of pigmented substantia nigra neurons may be a risk factor for physical aggression in AD.

Cited by 48 publications

References 59 publications

Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer's disease

Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer's disease

Psychiatric Complications of Dementia: Impact on Caregivers

Adrenergic Receptors in Alzheimer’s Disease Brain: Selective Increases in the Cerebella of Aggressive Patients

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