Abstract:
:Memory loss and severe cognitive deficits in Alzheimer patients are supposed to be related to a reduction of acetylcholine as well as to central nervous deactivation. For the investigation of cholinergic deficits and deactivation, we used computer-assisted pupillometry. Cholinergic deficits caused by a particularly severe loss of cholinergic neurons may be responsible for cognitive and mnemonic performance deficits. The control of the pupillary diameter represents a balance between cholinergic and adrenergic innervation and is influenced directly or indirectly by central and autonomic nervous system inputs. Either of these systems could be affected in Alzheimer patients. A reduced innervation of the target muscle through neuronal cell death, axon retraction, reduced release, increased reuptake of altered amounts or function of neurotransmitter receptors seems to affect the pupillary response to cholinergic antagonists in Alzheimer patients. There is, however, no relationship between pupillary diameter and central deactivation, but between central nervous activation and pupillary oscillations which reflect the physiological corticodiencephalic activity, a relationship has to be assumed. Frequencies and amplitudes of pupillary oscillations measured by means of Fourier analysis are modulated corticodiencephalically. Therefore, Alzheimer patients were compared to healthy controls with respect to their pupillary diameters and responses to an acetylcholine antagonist. Twenty-nine patients, aged between 55 and 85 years, suffering from mild to moderate Alzheimer's disease (AD) and 29 normal controls of similar age (56-85 years) participated in the study. The cholinergic receptors of the pupil were blocked by the acetylcholine antagonist tropicamide. It could be assumed that the larger the pupillary dilatation, the larger the extent of cognitive deficits. Alzheimer patients show abnormal acetylcholine neurotransmission. Changes of pupillary diameter after instillation of 1 drop of 0.01% tropicamide solution were measured and Fourier analysis of pupillary oscillations was performed. Times of measurement were: 0 (baseline), 20, 40, 60, 80, and 100 min. After 4 min tropicamide was instilled. Forty min after the instillation of tropicamide into the left eye, the Alzheimer patients showed a pronounced dilatation of 41.57%. The dilatation in normal controls was 28.5%. Fourier analysis of pupillary oscillations (sum of frequency bands = power) demonstrated a marked deactivation (low amplitudes in low-frequency bands, but in contrast to our expectations no higher amplitudes in the higher frequency bands) in patients with AD which remained constant at all times of measurement. By means of discriminant analysis of pupillary diameter and pupillary oscillations (frequency band 0.00-1 Hz), 89. 7% were correctly predicted to be Alzheimer patients, 89% to be normal controls.
journal_name
Neuropsychobiologyjournal_title
Neuropsychobiologyauthors
Grünberger J,Linzmayer L,Walter H,Rainer M,Masching A,Pezawas L,Saletu-Zyhlarz G,Stöhr H,Grünberger Mdoi
10.1159/000026595keywords:
subject
Has Abstractpub_date
1999-01-01 00:00:00pages
40-6issue
1eissn
0302-282Xissn
1423-0224pii
26595journal_volume
40pub_type
杂志文章abstract::We present a randomized double-blind study on the efficacy of caroverine in the treatment of alcohol withdrawal symptoms. The group B Ca2+ channel blocking agent caroverine was tested against meprobamate in inpatient treatment of alcohol withdrawal. Patients of both groups were similar in age, weight, duration of drin...
journal_title:Neuropsychobiology
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1159/000317284
更新日期:2010-01-01 00:00:00
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journal_title:Neuropsychobiology
pub_type: 杂志文章
doi:10.1159/000117483
更新日期:1975-01-01 00:00:00
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journal_title:Neuropsychobiology
pub_type: 杂志文章
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更新日期:1979-01-01 00:00:00
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doi:10.1159/000327604
更新日期:2011-01-01 00:00:00
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journal_title:Neuropsychobiology
pub_type: 杂志文章
doi:10.1159/000118715
更新日期:1990-01-01 00:00:00
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更新日期:1989-01-01 00:00:00
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更新日期:2010-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1994-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2000-01-01 00:00:00
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journal_title:Neuropsychobiology
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doi:10.1159/000118558
更新日期:1989-01-01 00:00:00
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更新日期:1995-01-01 00:00:00
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journal_title:Neuropsychobiology
pub_type: 临床试验,杂志文章
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更新日期:1998-11-01 00:00:00
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更新日期:2014-01-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-01-01 00:00:00
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更新日期:2004-01-01 00:00:00
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journal_title:Neuropsychobiology
pub_type: 杂志文章
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更新日期:1994-01-01 00:00:00