神经病学课件：ALZHEIMER’S DISEASE.pptVIP

Physicians today use a number of tools to diagnose AD: a detailed patient history information from family and friends physical and neurological exams and lab tests neuropsychological tests imaging tools such as CT scan, or magnetic resonance imaging (MRI). PET scans are used primarily for research purposes Diagnosing AD Slide 30 Differential Diagnosis Slide 30 Cortical Basal Ganglionic Degeneration Dementia in Motor Neuron Disease Dementia With Lewy Bodies Depression Frontotemporal Dementia and Frontotemporal Lobar Degeneration Huntington Disease Dementia Normal Pressure Hydrocephalus Parkinson Disease Parkinson-Plus Syndromes Parkinson-Plus Syndromes Prion-Related Diseases Vascular Dementia Wilson Disease AD Imaging Studies Slide 32 CT and MRI demonstrate diffuse cortical atrophy with disproportionate volume loss in the medial temporal lobe structures. FDG-PET Slide 32 PiB PET Images Slide 32 Amyloid burden imaging compounds are under development (Pittsburgh Compound B). MRI and tau/A? PET Slide 35 Cholinestaerase inhibitors , including: Donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) have been approved for the treatment of AD AD Treatments Slide 33 N-methyl-d-aspartate (NMDA) receptor antagonists A drug called Ebixa (trade name for the drug memantine) was launched in the UK in 2002 Increasing role of glutamate overstimulation of NMDA receptors on the surface of neurons. Excessive calcium influx into the neuron through the NMDA surface channel. Researchers also are looking at other treatments, including: cholesterol-lowering drugs called statins anti-oxidants (vitamins) and folic acid anti-inflammatory drugs substances that prevent formation of beta-amyloid plaques nerve growth factor to keep neurons healthy AD Research: the Search for New Treatments Slide 33 Management of Noncognitive Symptoms Slide 40 Behavioural signs, such as aggression, psychomotor agitation, and psychosis (hallucinations and delusions) Depression -Serotonin reup