Term Paper: Alzheimer's Disease Has Developed

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[. . .] Using PET it is possible to even identify the minute details such as the number of receptors within particular areas of the brain. This in turn will help us identify defects in cholinergic transmission. [Bennett, 121]

Major causes for Alzheimer's Disease

Amyloid Plaques

There has been enormous amount of research in the field of dementia. Researchers have recently identified one of the important causes for Alzheimer's disease. Autopsy study of the brains of AD patients has revealed the presence of Amyloid plaques between the neurons of the brain. Amyloid and B-Amyloid are two proteins that are synthesized by the body. While in a normal healthy individual these proteins are easily broken down in the case of patients suffering from AD the protein structures seem to accumulate between the neurons forming hard and insoluble plaques. The neurons that immediately surround the plaques degenerate rapidly.

NeuroFibrillary Tangles

Intraneuronal neurofibrillary tangle is another cause for Alzheimer's disease. Biochemical analysis of these NeuroFibrillary tangles has revealed the presence of very high levels of phosporylated neuro protein called TAU. Under normal situation this protein is essential for the transport of nutrients within the neurons. However in the case of AD the abnormally high Phosporylated State of the 'tau' protein leads to neuronal death. The underlying problem for patients is that the above mentioned complications result in a general reduction of cholinergic transmission which is at the core of neurological communication. [American Health Assistance Foundation]

Treatment Methods

Restoring Cholinergic Transmission

Considerable reduction in cholinergic transmission is one of the primary causes for the loss of memory and other associated symptoms of Alzheimer's disease and other kinds of dementia. Hence pharmacological treatment for AD mainly revolves around rectifying this circulatory deficit within the brain. Compounds designed to enhance cholinergic transmission constitute an important part of the treatment plan. Acetylcholine the neurotransmitter of the brain is considerably broken down in-patients suffering from AD and other dementias. The underlying mechanism of the neurotransmitter can be simplified as follows. An electrical impulse generated passes along the nerve and when it reaches the end it triggers the release of chemical messengers known as neurotransmitters which in turn diffuse along the synaptic cleft and react with the specific receptor sites on the organ. Activation at the receptor junction initiates a series of chemical reactions resulting in a specific biological response.

It has to be observed that the above mentioned process of cholinergic transmission is adequately timed and controlled by the body using another enzyme called acetylcholinesterase (AChe). The job of AChe is to breakdown Acetylcholine once the signal transmission is effected between the cells. Currently pharmacological therapy for AD is mainly concerned with two types of drugs. That is drugs which stimulate the release of Acetylcholine using stimulators such as Choline and lecithin alongside the use of drugs like that inhibit the action of acetylcholinesterase are the mainstay treatment mechanisms. In particular the drug Glycerylphosphorylcholine has found to show significant positive results in the neurological parameters of the patients by increasing the levels of Acetylcholine in the brain. Among the cholinesterase inhibitors are drugs such as tacrine (cognex), Donepezil. Exelon etc. [Life Extension, September 2002]

Anti-inflammatory Drugs

Post-mortem studies of the affected brain have clearly indicated inflammation of the brain cells. In tune with this researchers have also turned their attention to anti-inflammatory drugs (ex aspirin) as a protection mechanism against Alzheimer's disease. Other research evidences indicate the role of free radical damage of the brain cells and hence there is also a concurrent research on the use of anti-oxidants for preventing the damage caused by free radicals. Further clinical tests for women has shed new light into the possible cause of the disease. Researchers have testified that post menopausal hormonal changes make women more vulnerable for AD. In this connection the role of oestrogen as a preventive factor is being studied.

Other forms of Dementia

Alzheimer's disease is the most common form of dementia with a prevalence ratio of 2/3. However there are other forms of dementia such as vascular dementia, Lewy body dementia, Fronto-temporal degeneration, etc. The overlapping of the symptoms in many varieties of dementia implies that specific disease prognosis is fraught with difficulties. However from the perspective of the clinician it is important to perform a differential diagnosis of the disease as it has implications for the treatment. One of the main differences between Alzheimer's disease and the other kinds of dementia is the pattern of progression of the disease. Alzheimer's disease is slowly progressive while vascular dementia shows a stepwise progression.

Vascular dementia occurs as a result of repeated strokes. The depletion of oxygen to the brain during a stroke attack may cause irreversible damage to particular areas or cells of the brain. Typically in cases of vascular dementia there are a visible holes in the brain surface. The degree of cognitive impairment is proportional to the volume of brain lost. Furthermore, unlike AD, vascular dementia is not caused due to neurochemical imbalance. Treatment methods usually involve the use of anti-inflammatory drugs to prevent blood coagulation and consequent depletion of nourishment to the brain. [Bennett, 77]

Lewy body dementia on the other hand is kind of fluctuating one wherein noticeable improvement alternates with degeneration. The presence of Lewy bodies (intra neuronal inclusions) in the cortex region of the bran is a characteristic feature of Lewy body dementia. Patients also exhibit wild hallucinations and recover soon after and there is also a symptomatic resemblance to Parkinson's disease. Typically these patients are treated with antipsychotic drugs. [Bennett, 80]

Conclusion

Alzheimer's disease is one of the degenerating forms of brain disorders, which casts considerable emotional strain on the patient as well as the family. The availability of a number of drugs to relieve the symptoms has considerably eased the life for the patient and the caregiver. Research is already underway in discovering the molecular pathogenesis of Alzheimer's disease and in the near future advancements in this area will enable new drug therapies based on mechanisms aimed at preventing the formation of plaques and neurofibrillory tangles within the brain. It is pertinent to mention that caring of patients with Alzheimer's disease involves much more than pharmacological treatment as it is equally important to attend to critical issues such as family management and environmental management. (From the patients viewpoint). This kind of an integrated approach will definitely reduce the stress on the patient and the care giver leading to better management of this debilitating disease.

Bibliography

Simon Lovestone and Martin Dunitz, " Early diagnosis and Treatment of Alzheimer's

Disease," Published by Martin Dunitz Ltd., 1998

Gerry Bennett and DR Mark Jones, "The Alzheimer's Handbook," Vermilion

Publishers, 2001

Designed by 'American Health Assistance Foundation', "AMYLOID PLAQUES AND NEUROFIBRILLARY TANGLES," Accessed on June 23rd, 2003, http://www.ahaf.org/alzdis/about/AmyloidPlaques.htm

European Therapy Helps Prevent Brain Aging and Restore Neurologic Function,"… [END OF PREVIEW]

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