忆立福治疗脑血管性痴呆57例疗效观察

目的 :观察促智药忆立福治疗血管性痴呆效果。方法 :将 5 7例符合VD标准病人分成二组 ;对照组Ⅰ组和治疗组 (Ⅱ )。Ⅰ组用维脑路通 0 4g ,胞二磷胆碱 0 5g。Ⅱ组在Ⅰ组基础上加用忆立福 60 0mg ,2周为一疗程 ,共 2个疗程后分别进行智力比较。结果 :忆立福提高VD患者的智力积分明显高于对照组 ,两组有显著差异 (P <0 0 5 )。结论 :忆立福对血管性痴呆有一定治疗作用     

忆立福治疗脑血管性痴呆57例疗效观察

目的：观察促智药忆立福治疗血管性痴呆效果。方法：将57例符合VD标准病人分成二组；对照组I组和治疗组（Ⅱ）。I组用维脑路通0.4g，胞二磷胆碱0.5g。Ⅱ组在I组基础上加用忆立福600mg，2周为一疗程，共2个疗程后分别进行智力比较。结果：忆立福提高VD患者的智力积分明显高于对照组，两组有显著差异（P＜0．05）。结论：忆立福对血管性痴呆有一定治疗作用。     

多发梗塞性痴呆的临床与CT

<正> 多发性梗塞性痴呆(Multi-infarct dementia MID)是老年人除Alzheimer氏病之外的另一类器质性痴呆。近年来,随着脑血管病发病率的增加及平均人口寿命的延长,脑血管性痴呆的患病率亦随之增长。     

都可喜治疗多发梗塞性痴呆67例临床观察

以都可喜(Duxil)治疗多发梗塞性痴呆(MID)67例,设有对照组。结果都可喜对MID的有效率为71.64％,经量表评定发现都可喜对情绪,行为障碍均能明显改善,定向力、记忆力和计算力有明显提高,对一般常识,社会功能也有改善,有助于大脑缺血所致功能障碍的恢复。     

多发梗塞性痴呆(MID)动物模型的改进与应用

目的为摸索一种操作性较强的多发梗塞性痴呆（ＭＩＤ）模型和观察一种治疗ＭＩＤ有较好临床疗效的中药复方制剂的作用机理。方法从颈外动脉逆行插管注入同种血栓栓子造成大鼠多发梗塞性痴呆,应用行为学和病理形态学进行观察。结果造模后脑内存在广泛而多发的梗塞灶,且无论学习成绩还是记忆成绩,手术造模组均明显低于空白对照组和假手术组（Ｐ＜０．０１或０．０５）,采用中药“健脑益智冲剂”和氢化麦角碱（Ｄｉｈｙｄｒｏｅｒｇｏｔｏｘｉｎｅ）药物干预后,上述病变得以明显改善,尤以造模药给予中药最佳。结论此模型是进行多发梗塞性痴呆基础研究和筛选新药的理想模型。     

CT对Alzheimer病和多发梗塞性痴呆的鉴别

本研究对５０例明确诊断及ＣＴ证实的Ａｌｚｈｅｉｍｅｒ病（ＡＤ）和多发梗塞性痴呆（ＭＩＤ），患者进行分析，发现ＡＤ的两脉络球间距离与侧脑室部间最大外径之商和头颅内横径与侧脑室体部间最大外径之商均值比ＭＩＤ为小（Ｐ〈０．００１）；第三脑室和外侧裂最大宽度比ＭＩＤ为大（Ｐ〈０．０１～０．００１），有无高血压中风史与脑室系统各部位退行性改变无直接关联，作者认为：ＡＤ和ＭＩＤ的ＣＴ表现主要区别在侧脑室体部晨     

31例多灶梗塞性痴呆的临床分析

本文分析31例多灶梗塞性痴呆(MID)的临床症状。男20例,女11例,平均年龄73.1±7.0岁。轻度痴呆9例;中度痴呆10例;重度痴呆12例。临床症状常见为情绪不稳定、幻觉妄想、口齿不清等。74.2％有神经体征,38.7％病人以功能性精神症状为早期症状。另外,结合本文资料,讨论了MID临床症状与病灶部位的关系及MID与Alzhejmer病的鉴别     

多发性脑梗死性痴呆相关因素和P300的研究

目的 搪塞多发性脑梗死性痴呆（ＭＩＤ）的相关因素及Ｐ３００对ＭＩＤ的诊断意义。方法对３８例ＭＩＤ和３２例无痴呆脑梗死口才的受教育程度、既往史、梗死部位进行对比分析,并用听觉Ｏｄｄ－ｂａｌｌ序列测试Ｐ３００,结果 ＭＩＤ组受教育程序低、高血压史、糖尿病史、〉２次卒中史、皮质梗死、皮质合并皮质下梗死、多发性梗死、双侧梗死者与对照组相比均有显著差异。ＭＩＤ组Ｐ３００潜伏期明显延长波幅显著降低。结论文化     

多梗塞性痴呆和Alzheimer型痴呆的SPECT和MRI比较研究

对２２例多梗塞性痴呆，１５例Ａｌｚｈｅｉｍｅｒ型痴呆病人和２４例同龄，同利手健康对照组作了单光子发射计算机断层显角和磁共振成象检查。结果发现ＳＰＥＣＴ在ＭＩＤ病人主要表现为多发性，局灶性脑放射性减低，两侧不对称，以额皮质，皮质下明显；ＤＡＴ病人主要表现为大脑皮质放射性对称性降低，以颞顶枕明显。     

美金刚与奥氮平治疗老年期痴呆的行为和精神症状对照研究

目的 探讨美金刚与奥氮平治疗老年期痴呆的行为和精神症状(BPSD)的疗效及不良反应.方法 将86例老年期BPSD患者分为美金刚组与奥氮平组,治疗8周.在治疗前、治疗2周末、4周末和8周末,采用痴呆病理行为评定量表(BEHAVE-AD)评定疗效,简易精神状况检查量表(MMSE)评定患者认知功能,日常生活能力量表(ADL)评定患者生活质量,治疗中需处理的不良反应症状量表(TESS)评定不良反应.结果 美金刚组在治疗后第2、4、8周末BEHAVE-AD评分较奥氮平组显著下降(t=2.12、t=2.23、t=2.28,P＜0.05).美金刚组在治疗后第8周末MMSE评分较治疗前显著升高(t=2.33,P＜0.05),奥氮平组治疗前后MMSE评分差异无显著性(t=0.42,P＞0.05),两组比较差异有显著性(t=2.04,P＜0.05).两组治疗后第8周末ADL评分显著下降(t1=2.35,t2=2.49,P＜0.05),两组比较差异无显著性(t=0.45,P＞0.05).美金刚组不良反应少于奥氮平组(x2=5.09,P＜0.05),两组在锥体外系反应(EPS)、口干、嗜睡、体质量增加方面差异有显著性(x2=4.62～6.86,P＜0.05).结论 美金刚对老年期痴呆患者的认知功能及行为和精神症状的改善均有效,且安全可靠.     

Behavioral and psychological symptoms of dementia (BPSD) in dementia with Lewy bodies

Behavioral and psychological symptoms of dementia (BPSD) bother patients with dementia with Lewy bodies (DLB) and their families so frequently that early diagnosis of DLB before the appearance of prominent cognitive impairment is important. Because BPSD in DLB can be reduced or improved by early intervention, medical intervention is important. Of BPSD in DLB, vivid visual hallucinations and delusions are most important. Other visual cognitive impairments and sleep disturbances, including disorders in rapid eye movement (REM) sleep, are also frequently seen. Cholinesterase inhibitors, including donepezil chloride, are the first choice for the therapy of BPSD; Yokukansan (a type of Kanpo (traditional Chinese herbal) medicine) is the second choice. When neither treatment is effective, atypical antipsychotics, such as quetiapine, risperidone, and aripiprazol, may be used.     

Development of a Korean version of the behavior rating scale for dementia (BRSD-K)

OBJECTIVE: The purpose of this study was to develop a Korean version of the behavior rating scale for dementia (BRSD-K) for evaluating behavioral and psychological symptoms of dementia. METHODS: The BRSD-K was administered to the informants of 268 subjects with dementia. Internal, inter-rater and test-retest reliabilities were tested. To evaluate construct validity, exploratory factor analysis was performed. To evaluate concurrent validity, Pearson correlation coefficients between BRSD-K scores and the corresponding scores of the Korean version of the neuropsychiatric inventory (NPI-K) were calculated. RESULTS: BRSD-K demonstrated substantially high levels of reliabilities. Factor analysis identified seven factors, i.e. depressive symptoms, irritability/aggression, psychotic symptoms, behavioral dysregulations, sleep disturbance, inertia, and appetite. Correlations between BRSD-K and corresponding NPI-K scores were statistically significant (p < 0.05). CONCLUSIONS: BRSD-K was found to be a reliable and valid instrument for evaluating BPSD.     

A controlled multicenter clinical study of citalopram and placebo in elderly depressed patients with and without concomitant dementia.

A total of 149 patients in 7 centers in Denmark, Norway and Sweden entered a 6-week double-blind trial intended to assess the antidepressant effect and safety of citalopram vs placebo in depressed elderly patients (65 years of age or older) who might also suffer from somatic disorders and/or senile dementia. Results of ratings on the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale and the Clinical Global Impression Scale provided consistent evidence that the citalopram-treated patients improved more than the placebo-treated patients. Results of ratings on the Gottfries-Bråne-Steen dementia rating scale indicated that both cognitive and emotional functioning improved significantly more in the citalopram-treated subgroup of patients with dementia than in the placebo-treated subgroup.     

A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease

Narasimhalu K, Effendy S, Sim CH, Lee JM, Chen I, Hia SB, Xue HL, Corrales MP, Chang HM, Wong MC, Chen CP, Tan EK. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease.
Acta Neurol Scand: 2010: 121: 217–224.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives – The safety and efficacy of early acetylcholinesterase inhibitors therapy in patients with cognitive impairment no dementia (CIND) after a cerebrovascular accident have not been examined. In this study, we investigated the safety and efficacy of rivastigmine in cognition, particularly executive function in patients with CIND because of cerebrovascular disease. Methods – This study was a 24‐week, double‐blind, randomized, placebo‐controlled trial of ischemic stroke patients seen at a tertiary hospital who had cognitive impairment no dementia because of cerebrovascular disease. The intervention was either rivastigmine or placebo up to 9 mg/day. The primary outcome of interest was mean change from baseline in the Ten‐Point Clock Drawing and Color Trails 1 and 2. Results – Fifty patients were randomized into rivastigmine (n = 25) and placebo (n = 25) arms. Patients in the rivastigmine group showed statistically significant improvement (1.70 vs 0.13, P = 0.02) on the animal subtask of the verbal fluency measure compared with placebo. There was also a trend (non‐significant) towards improvement in Color Trails II. Conclusions – In this pilot study, we demonstrated that rivastigmine was well tolerated in patients with CIND because of cerebrovascular disease and may potentially improve executive functioning.