The Alzheimer variant of Lewy body disease: A pathologically confirmed case-control study

The objective of the study was to identify clinical features that distinguish patients with dementia with Lewy bodies (DLB), who were classified as Alzheimer's disease ( AD) patients, from patients with AD. We examined a group of 27 patients from our memory clinic, originally diagnosed with AD, of whom 6 were postmortem found to have DLB. For the present study, we compared cognitive, noncognitive and neurological symptoms between the two groups. We found that there were no differences on ratings of dementia and scales for activities of daily living. Patients with DLB performed better on the MMSE and the memory subtest of the CAMCOG, but there was no difference in any other cognitive domain. Furthermore, genetic risk factors, including family history of dementia or allele frequency of the apolipoprotein epsilon 4, did not discriminate between the two groups, and there were no differences on CCT scans. Taken together, our findings suggest that Lewy body pathology may be present in patients who do not show the typical clinical features which distinguish DLB from AD. Copyright (C) 2005 S. Karger AG, Basel

Validation of the German Revised Addenbrooke's Cognitive Examination for Detecting Mild Cognitive Impairment, Mild Dementia in Alzheimer's Disease and Frontotemporal Lobar Degeneration

Background/Aims: The diagnostic accuracy of the German version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI), mild dementia in Alzheimer's disease (AD) and mild dementia in frontotemporal lobar degeneration (FTLD) in comparison with the conventional Mini Mental State Examination (MMSE) was assessed. Methods: The study encompasses 76 cognitively healthy elderly individuals, 75 patients with MCI, 56 with AD and 22 with FTLD. ACE-R and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic procedure. Statistical analysis was performed using the receiver operating characteristic method and regression analyses. Results: The optimal cut-off score for the ACE-R for detecting MCI, AD, and FTLD was 86/87, 82/83 and 83/84, respectively. ACE-R was superior to MMSE only in the detection of patients with FTLD {[}area under the curve (AUC): 0.97 vs. 0.92], whilst the accuracy of the two instruments did not differ in identifying MCI and AD. The ratio of the scores of the memory ACE-R subtest to verbal fluency subtest contributed significantly to the discrimination between AD and FTLD (optimal cut-off score: 2.30/2.31, AUC: 0.77), whereas the MMSE and ACE-R total scores did not. Conclusion: The German ACE-R is superior to the most commonly employed MMSE in detecting mild dementia in FTLD and in the differential diagnosis between AD and FTLD. Thus it might serve as a valuable instrument as part of a comprehensive diagnostic workup in specialist centres/clinics contributing to the diagnosis and differential diagnosis of the cause of dementia. Copyright (C) 2010 S. Karger AG, Base

Two-phase flow behaviour during a medium size cold leg LOCA test on PMK-2 (IAEA - SPE-4)

The experiment to the IAEA standard problem exercise No. 4 was carried out in April 1993 on the integral test facility PMK-2 in Budapest. It was a 3.2 mm break on the downcomer head. The high pressure injection cooling was assumed to be not available. As an accident management measure bleed and feed on the secondary side of the steam generator was applied. Research Center Rossendorf contributed to the experiment of SPE-4 by supplying needle shaped conductivity probes for the measurement of local void fractions in the primary circuit of the PMK-II test facility. In the course of the standard problem exercise No. 4 RCR contributed with posttest calculations using the thermalhydraulic code ATHLET. The report comprises a description of the initial and boundary conditions of the test and a phenomenological description of the thermalhydraulic events during the transient. The void fraction probe signals yields valuable information for deeper understanding of the thermalhydraulic occurrences and for code validation. This was the case particularly for correction of the level measurement. A description of the thermalhydraulic occurrences from the viewpoint of code verification is given and the results of RELAP5 (KFKI-AEKI) and of ATHLET-calculations (RCR) are compared. Referring to this description, the sensitivity of the result to main influences is investigated using the ATHLET-code

Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group

Background: Long before Alzheimer's disease was established as the leading cause of dementia in old age, cerebrovascular lesions were known to cause cognitive deterioration and associated disability. Since the middle of the last century, different diagnostic concepts for vascular dementia and related syndromes were put forward, yet no widely accepted diagnostic consensus exists to date. Discussion: Several international efforts, reviewed herein, are ongoing to define cognitive impairment due to cerebrovascular disease in its different stages and subtypes. The role of biomarkers is also being discussed, including cerebrospinal fluid proteins, structural and functional brain imaging, and genetic markers. The influence of risk factors, such as diet, exercise and different comorbidities, is emphasised by population-based research, and lifestyle changes are considered for the treatment and prevention of dementia. Conclusion: To improve the diagnosis and management of vascular cognitive impairment, further progress has to be made in understanding the relevant pathomechanisms, including shared mechanisms with Alzheimer's disease;bringing together fragmented research initiatives in coordinated international programs;testing if known risk factors are modifiable in prospective interventional studies;and defining the pre-dementia and pre-clinical stages in line with the concept of mild cognitive impairment due to Alzheimer's disease

temporary implementation and testing of a confocal sr μxrf system for bone analysis at the x ray fluorescence beamline at elettra

Abstract The confocal μ XRF spectrometer of Atominstitut (ATI) was transported and set up at the X-ray Fluorescence beamline at Elettra - Sincrotrone Trieste. It was successfully adjusted to the incoming beam (9.2 keV). Test measurements on a free-standing Cu wire were performed to determine the size of the focused micro-beam (non-confocal mode, 56 × 35 μ m 2 ) and the size of the confocal volume (confocal mode, 41 × 24 × 34 μ m 2 ) for the Cu–K α emission. In order to test the setup's capabilities, two areas on different human bone samples were measured in confocal scanning mode. For one of the samples the comparison with a previous μ XRF measurement, obtained with a low power X-ray tube in the lab, is presented

Association of chronic pain with biomarkers of neurodegeneration, microglial activation and inflammation in the CSF and impaired cognitive function

ObjectivesDebate surrounds the role of chronic pain as a risk factor for cognitive decline and dementia. This study aimed at examining the association of chronic pain with biomarkers of neurodegeneration using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI).MethodsParticipants were classified using the ATN classification. Chronic pain was defined as persistent or recurrent pain reported at baseline. For each ATN group, ANCOVA models identified differences in CSF levels of Aβ1‐42, ptau181, t‐tau, sTREM2 and cognitive function between chronic pain states. Differences in CSF levels of inflammatory markers between chronic pain states were further analysed. Linear mixed‐effect models examined longitudinal changes.ResultsThe study included 995 individuals with 605 (60.81%) reporting chronic pain at baseline. At baseline, individuals with suspected non‐Alzheimer's pathophysiology (SNAP) and chronic pain showed increased CSF levels of t‐tau and sTREM2. Chronic pain was associated with increased TNF‐α levels, irrespective of the ATN group. Longitudinally, an increase in ptau181 CSF levels was observed in chronic pain patients with negative amyloid and neurodegeneration markers. Amyloid positive and neurodegeneration negative chronic pain patients showed higher memory function cross‐sectionally. No significant longitudinal decline in cognitive function was observed for any ATN group.Interpretationour study suggests that chronic pain induces neuronal damage and microglial activation in particular subgroups of patients along the AD spectrum. Further studies are needed to confirm those findings.This article is protected by copyright. All rights reserved.</jats:sec