Feb 2003
international
abstracts:
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Feb 2003 international |
IN THIS
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BEHAVIOURAL
SYMPTOMS OF
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alzheimer's
issues: february 2003 november 2002 august 2002 may 2002 february 2002 november 2001 august 2001 may 2001 february 2001 november 2000 august 2000 june 2000 march 2000 november 1999 may 1999 february 1999 september 1998 june 1998 march 1998 december 1997 |
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BEHAVIOURAL
SYMPTOMS OF |
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Efficacy of donepezil
on behavioral symptoms in (INT PSYCHOGERIATRICS 2002;14[4]:389-404) |
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To view this abstract at www.ipa-online.org
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| The apathy inventory: assessment of apathy and awareness in (INT J GERIATR PSYCHIATRY 2002;17:1099-1105) |
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P.H. ROBERT, S. CLAIRET, M. BENOIT, J. KOUTAICH, ET AL, NICE, FRANCE |
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(NEUROLOGY 2002;59:1721-1729) |
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D.L. MURMAN, MD, MS, Q. CHEN, MS, M.C. POWELL, BS, S.B. KUO, BS, ET AL, EAST LANSING, MI |
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The association between
mortality and incident dementia has been confirmed by Levy et al.
There is thus a great interest to follow-up on observations that cholinesterase
inhibitors, such as donepezil and rivastigmine, may be safe and effective
in Parkinson's disease (PD) associated dementia. Measurement tools such
as the Cognitive Drug Research computerized battery have been found to
be useful even in patients with MMSE scores below 10 (Ballard et al).
A number of randomized placebo-controlled studies in PD dementia are being
initiated and will include such measurements as outcome variables.
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The association of incident dementia with mortality in PD
(NEUROLOGY 2002;59:1708-1713) |
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G. LEVY, MD, M.-X. TANG, PHD, E.D. LOUIS, MD, MS, L.J. CÔTÉ, MD, ET AL, NEW YORK, NY |
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Fluctuations in attention: PD dementia vs DLB with parkinsonism (NEUROLOGY 2002;59:1714-1720) |
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Papassotiropoulos et al have reported evidence that a polymorphism of the gene CYP46, which regulates the hydroxylation of cholesterol and its removal from the brain, doubles the risk for late-onset AD. Furthermore, subjects with both CYP46 and apoE mutations have an increased risk as high as 9.6. As discussed in the excellent accompanying editorial by B. Wolozin, these data suggest an important role for lipid metabolism in the pathophysiology of AD, and support the need for clinical trials attempting to modify cholesterol metabolism in the brain. 
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(ARCH NEUROL 2003;60:29-35) |
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There is on-going debate about the role of herbal and non-conventional therapies for the treatment of dementia. What is not controversial is the need for more research and continuing medical education for physicians whose patients are already using these therapies. In an RCT with melantonin, Serfaty et al were unable to demonstrate any benefit for sleep in 25 dementia patients with significant sleep disturbances using actigraphy. Besides questions about efficacy, Dergal et al raised concerns about the safety of herbal preparations as well. In this study from a Memory Disorders Clinic in Toronto, investigators identified 11 potential herb-drug interactions in 195 patients over a six-week period. Finally, please consider reading an excellent review article on herbal remedies (De Smet. NEJM 2002;347[25]:2046-2056 -- refer to FAXBACK section. p. 12).
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Double blind randomised placebo controlled trial of low dose melatonin for sleep disorders in dementia (INT J GERIATR PSYCHIATRY 2002;117:1120-1127) |
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(DRUGS AGING 2002;19[11]:879-886) |
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In the first study
of neuropsychiatric symptoms in Mild Cognitive Impairment (MCI), Lyketsos
et al assessed subjects in the longitudinal Cardiovascular Health
Study and compared symptoms to subjects with Alzheimer's disease. In general,
there is significant neuropsychiatric symptom burden in MCI and prevalence
of symptoms falls midway between subjects with Alzheimer's disease and
normal controls. |
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(JAMA 2002;288[12]:1475-1483) |
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CONSTANTINE G. LYKETSOS, MD, MHS, OSCAR LOPEZ, MD, BEVERLY JONES, MD, ANNETTE L. FITZPATRICK, PHD, ET AL, BALTIMORE, MD |
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Sjögren
et al described the first series of patients to utilize vagus nerve stimulation
(VNS) to improve cognition in AD. This novel treatment involves implanting
a stimulator attached to the left vagus nerve by a surgical procedure. The
procedure and stimulator are approved for treatment of refractory seizure
disorder, and have recently been investigated for the treatment of depression.
The treatment is based on the clinical observation of improved mood and
cognition in the VNS-treated seizure disorder patients and the fact that
80% of the left vagus nerve contains afferent fibres that directly and indirectly
influence brain areas important for cognition and behaviour in AD. These
investigators suggest seven of 10 subjects improved cognitively with side
effects that were generally mild and transient. |
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(J CLIN PSYCHIATRY 2002;63[11]:972-980) |
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MAGNUS J.C.SJÖGREN, MD, PHD, PER T.O. HELLSTRÖM, M.A. MICHAEL A.G. JONSSON, MD, MAGNUS RUNNERSTAM, MD, PHD, ET AL, MÖLNDAL, SWEDEN |
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EDITORIAL |
Executive, or frontal systems impairment, is a key feature of many dementias and other neuropsychiatric illnesses. In a report from the Committee on Research of the American Neuropsychiatric Association, the authors review the history, anatomical substrates, assessment and treatment of executive control function. |
| Executive control function: a review of its promise and challenges for clinical research: a report from the Committee on Research of the American Neuropsychiatric Association (J NEUROPSYCHIATRY CLIN NEUROSCI 2002;14:377-405) |
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DONALD R. ROYALL, MD, EDWARD C. LAUTERBACH, MD, JEFFREY L. CUMMINGS, MD, ALLISON REEVE, MD, ET AL, SAN ANTONIO, TX |
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NEUROPSYCHAITRIC FEATURES OF FRONTOTEMPORAL DEMENTIA: EVALUATION OF CONSENSUS CRITERIA AND REVIEW |
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