Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0752347 (Dementia with Lewy bodies)
 1,653 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent years have seen the introduction of several new antidepressants, many of which have selective effects on serotonin (5-HT) pathways. In most patients these drugs are as effective as traditional tricyclic antidepressants and are somewhat better tolerated. In the most severe depressive disorders, however, drugs such as clomipramine, that produce potent inhibition of both 5-HT and noradrenaline reuptake may be more effective. Lithium is increasingly used in the treatment of resistant depression but its role in the short-term management of mania is less certain because of the increased risk of relapse on sudden discontinuation. In the treatment of mania and prophylaxis of bipolar disorder, carbamazepine and valproate are alternatives to lithium. In dementia, the cholinesterase inhibitor, tacrine, produces worthwhile improvement in about 40% of patients able to tolerate adequate doses. There is concern about adverse effects of antipsychotic drugs in patients with dementia, particularly those with Lewy body disease.
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PMID:Advances in psychopharmacology: mood disorders and dementia. 894 56

There is a now a substantial body of evidence that suggests the new antipsychotic agent, risperidone, may be safe and effective for treating psychotic, affective or behavioural symptoms associated with various disorders other than schizophrenia, schizophreniform disorder or schizo-affective disorder. These conditions include bipolar disorder, obsessive-compulsive disorder, Tourette's syndrome, dementia, Lewy body disease, mental retardation, Parkinson's disease, idiopathic segmental dystonia and organic catatonia. Although much of the data is anecdotal or in the form of open studies, there is now emerging a small number of well controlled investigations supporting efficacy for mania, dementia, behavioural disturbance in mental retardation and conduct disorder. Conventional antipsychotics have long been used, either in a primary capacity or as an adjunct to treat these disorders; however, they have limited benefit, pose significant risks of extrapyramidal side-effects, and may cause the potentially life-threatening neuroleptic malignant syndrome. In contrast, risperidone at the recommended low doses may be efficacious and pose reduced risk of motor side-effects. This article reviews the evidence that risperidone may be an effective new treatment for disorders other than schizophrenia.
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PMID:Does risperidone have a place in the treatment of nonschizophrenic patients? 1119 55

This case report reviews the treatment of a 74-year-old man with an abdominal aortic aneurysm, bipolar affective disorder, and Lewy body dementia who demonstrated a remarkable positive response to an acute and maintenance course of electroconvulsive therapy (ECT) treatment. This is the first report with serial imaging of an abdominal aortic aneurysm during maintenance ECT. There are limited alternative therapies for those patients who do not meet surgical criteria for an abdominal aortic repair because of dementing disorders. In patients who suffer comorbid mood disorders, ECT has been shown to be an effective option in preserving quality of life and successfully stabilizing the level of agitation.
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PMID:Administration of ECT in a patient with an inoperable abdominal aortic aneurysm: serial imaging of the aorta during maintenance. 1279 63

The role of alpha-synuclein (alphaSyn) in schizophrenia is unknown, whereas in a recent animal model of depression, alpha- and gamma-synuclein have been related to its pathophysiology. Previous biochemical studies in Brodmann area 9 showed significant reduction of alphaSyn in both chronic schizophrenia and bipolar disorder. Here, prevalence and cerebral distribution of alphaSyn were examined in 80 autopsy cases of elderly subjects (41 chronic schizophrenia, 12 late live depression/LLD and bipolar disorder/BD, and 27 age-matched controls without neuropsychiatric disorders). Using immunohistochemistry, alphaSyn-positive lesions (Lewy bodies and neurites) were assessed semiquantitatively. Among 41 chronic schizophrenics, all except one showing low neuritic Braak stages (mean 1.46), three brains (7.3%) revealed only few alphaSyn-positive inclusions restricted to medullary nuclei. Among 12 LLD and BD patients with mean Braak stage 2.25, alphaSyn-positive pathology was seen in two cases (16.7%) with clinical LLD, but none in BD. Among 27 controls, showing mean neuritic Braak stage 2.6, seven brains (26%) with higher mean age showed alphaSyn-positive lesions, either isolated in substantia nigra and nucleus basalis of Meynert (n = 2 each), in medullary nuclei, locus ceruleus and substantia nigra (n = 2), with additional involvement of nucleus basalis (n = 1). This first preliminary study in non-demented psychiatric disorders indicates that alphaSyn/Lewy pathology in chronic schizophrenia is significantly less frequent than in clinically healthy elderly people (P < 0.01), showing 10-30% of so-called incidental Lewy body disease. Among chronic affective disorders, according to our small cohort, the incidence of Lewy-pathology in LLD appears to be comparable to a healthy elderly population, whereas its occurence in BD is to be elucidated.
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PMID:Lewy body/alpha-synucleinopathy in schizophrenia and depression: a preliminary neuropathological study. 1919 57

Neurodegeneration in bipolar disorder (BPD) is poorly understood. Therefore, the current study was designed to assess the immunohistochemical changes in neurodegenerative markers in patients with BPD. Eleven consecutive autopsy cases diagnosed with BPD were analyzed. Sections were obtained from archival paraffin blocks of representative areas and stained using conventional methods, as well as immunostained with several antibodies to screen for neurodegenerative diseases. Age- and non-argyrophilic grains (AGs) degeneration matched controls were selected for each case. Clinical information was retrospectively collected from medical charts. All patients were men, and the average age of death was 70 years. Neuropathological diagnoses included dementia with grains (2), argyrophilic grain disease (2), corticobasal degeneration (CBD, 1), Lewy body disease (1), hypoxic encephalopathy (1) and cerebral infarction (1). All cases showed AGs to various degrees. Three patients died in their 50s; one demonstrated dementia with Lewy bodies, while the other two showed abundant AGs in the thalamus and amygdala. Of the three patients who died in their 60s, one showed AGs preferentially in the thalamus and amygdala, while the others demonstrated limbic predominance. The patients who died in/after their 70s demonstrated AGs similar to controls, except for the patient with CBD. Our data provides potentiality that neurodegenerative diseases may be an underlying pathology in certain cases of BPD.
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PMID:Neurodegenerative changes in patients with clinical history of bipolar disorders. 2581 79

Placebo is an intervention with no therapeutic effect that is used as a control in randomized controlled trials (RCTs). Placebo effects and responses can produce a beneficial effect that cannot be attributed to the properties of the intervention itself, since it is usually inactive, and should, therefore, be due to the patient's expectations about treatment (placebo effects), or confounding factors such as natural history, co-interventions, biases, among other co-factors (placebo responses). However, adverse events (AEs) may occur when using a placebo intervention, a phenomenon that is called nocebo. Like placebo, the nocebo effect is a cognitive and idiosyncratic phenomenon with specific biological bases, controlled by distinctive neurotransmitters within mapped brain areas most likely located within the network of the limbic system. Nocebo responses has been found to be very prevalent in various neurological conditions, in particular, in many brain disorders including headache, Parkinson's disease, Alzheimer's disease, depression, epilepsy, multiple sclerosis and motor neuron disease. Pooled AE rates in the placebo groups (nocebo AE rates) vary from 25% in the symptomatic treatment for multiple sclerosis RCTs to almost 80% in motor neuron disease RCTs. Pooled dropout rates because of AEs in the placebo groups (i.e., nocebo dropout rates) vary from 2% in multiple sclerosis RCTs to almost 10% in PD RCTs. Across all brain disorders, the nature of AEs reported in the placebo-treated subjects mirrors those reported by active drug-treated subjects, suggesting that awareness of drug side-effect profiles might have influenced patient expectations and, thus, nocebo responses. Unexplored brain diseases where nocebo should be studied further include mental disorders (i.e., schizophrenia and bipolar disorder), vascular disorders (i.e., acute ischemic stroke, vascular dementia), degenerative disorders (i.e., frontotemporal dementia, Lewy body dementia) and other systemic atrophies of the brain (i.e., hereditary ataxias).
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PMID:Nocebo Responses in Brain Diseases: A Systematic Review of the Current Literature. 3014 57