• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 40
  • 32
  • 11
  • 10
  • 7
  • 4
  • 4
  • 1
  • Tagged with
  • 108
  • 108
  • 108
  • 35
  • 21
  • 20
  • 19
  • 18
  • 14
  • 14
  • 12
  • 12
  • 11
  • 11
  • 10
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
91

Indicadores nutricionais em pacientes com doen?a de alzheimer: rela??es com fatores cl?nicos / Nutritional Indicators in Patients with Alzheimer's disease: Clinical factors relationship

Santos, Tamires Barbosa Nascimento dos 02 February 2017 (has links)
Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-04-04T11:51:15Z No. of bitstreams: 1 TAMIRES BARBOSA NASCIMENTO DOS SANTOS.pdf: 5285149 bytes, checksum: d224eb611ad840d86fa9cacfe3b79d1a (MD5) / Made available in DSpace on 2017-04-04T11:51:15Z (GMT). No. of bitstreams: 1 TAMIRES BARBOSA NASCIMENTO DOS SANTOS.pdf: 5285149 bytes, checksum: d224eb611ad840d86fa9cacfe3b79d1a (MD5) Previous issue date: 2017-02-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The increase of the population's average age, there was a prevalence increment on the chronic nerological disorders, degenerative such as the Alzheimer's Disease (AD). The deepening on the knowledge of the processes of lifestyle, regarding the nutritional state and its relations with the cognition are important for the guidance and conducting of the elderly people. This study aimed to analyze the nutritional status of elderly patients with AD and its relationship with the clinical aspects, neurocognitive, behavioral and lifestyle. 43 elderlies from the Clinical Neurology Ambulatory of the Celso Pierro Hospital and Maternity (PUCCampinas) were evaluated with the diagnosis of light, moderate and severe AD, according to the Clinical Dementia Rating (CDR) and 51 controls matched by age, gender, schooling and socioeconomic level, whith no history of cognitive decline. The procedures used were: clinical evaluation, mental State mini-exam, simple drawing memory, verbal fluency, clock drawing, functional ability, neuropsychiatric inventory (NPI), CDR, socioeconomic evaluation, physical and social activity (International Questionnaire of Physical Activity - IQPA short version), Mini Nutritional Assessment (MNA), Body mass Index (BMI), Waist circumference (WC), Arm Circumference (AC), Calf Circumference (CC), Triciptal Cutaneous Fold (TCF), Subscapular cutaneous fold (SCF), Muscular Arm circumference (MAC), Corrected Arm Muscle Area (CAMA), Thumb Adductor Muscle (TAM), Palmar Holding Force (PHF) and Bioelectric Impedance. Comparison were made between Alzheimer's Disease Group (ADG) and Control Group (CG) with sociodemographic aspects, lifestyle, cognitive, MNA, Nutritional indicators and nutritional indicators by gender Comparisons were made between CG and AD stages according to the CDR with nutritional variables, It were also performed correlations between PHF with anthropometric variables on the ADG and CG and between cognitive and anthropometric variables on the ADG. With suitable statistical tests the situation and level of significance of 5% in all cases. It was noticed that the ADG develops less social activity and has a smaller relationship network, less physically active, and has poor performance in Daily life activities, mostly in instrumental activities. GDA showed malnutrition with a decrease in total food intake and higher daily intake of some foods on the MNA. Among genders, woman showed diferences in most anthropometric measurements with lower values in the ADG. In the comparison between CG and fazes of ADG there were differences in some measures with lower values in the severe ADG, and higher in the CG. In the comparison between CG and ADG, CG versus light and moderate ADG versus severe ADG there was a difference for some anthropometric measurements. There were no differences between Light and Moderate stages. The Lean Mass (LM) composition measurements were lower in the ADG. No difference was seen on the WC and reactance comparison. There were correlations between PHF and anthropometric variables in the ADG but not between nutritional variables with socioeconomic aspects, behavioral, NPI, social and physical activities. The findings suggests a significant association between social and leisure activities during the eld and a lower dementia risk. In the MNA the lowest score indicates greater deterioration of mental state. As per the feeding, it was noticed that, possibly, ADG feeds with lower amount and higher quality, suggesting a better selection of food by the caregiver. The authors reports a significant difference between BMI in AD phases, with reduction in BMI at the severe stage compared to light and moderate. In the study, there was a greater presence of elderly individuals at malnutrition risk in the AD group when compared to the CG, suggesting that the malnutrition is a factor of risk to the dementia progression. The nutritionals variables were progressively more committed with the advancement of cognitive deficits, since there was a LM reduction trend with the AD progression, more evident in the transition from moderate to severe. / Com o aumento da idade m?dia da popula??o houve incremento de preval?ncia de afec??es neurol?gicas cr?nicas, degenerativas, como a Doen?a de Alzheimer (DA). O aprofundamento do conhecimento dos processos do estilo de vida no que se refere ao estado nutricional e de suas rela??es com a cogni??o s?o de import?ncia para orienta??o e conduta desses idosos. O objetivo desse trabalho foi analisar o estado nutricional de idosos com DA e sua rela??o com aspectos cl?nicos, neurocognitivos, comportamentais e de estilo de vida. Foram avaliados 43 idosos procedentes do ambulat?rio de Neurologia Cl?nica do Hospital e Maternidade Celso Pierro (PUC-Campinas) com diagn?stico de DA leve, moderado e grave, segundo o Clinical Dementia Rating (CDR) e 51 controles pareados por idade, g?nero, escolaridade e n?vel socioecon?mico, sem hist?ria de decl?nio cognitivo. Os procedimentos foram avalia??o cl?nica, Mini-Exame do estado mental, mem?ria do desenho simples, Flu?ncia Verbal, desenho do rel?gio, capacidade funcional, Invent?rio Neuropsiqui?trico (INP), CDR, avalia??o socioecon?mica, atividade f?sica (Question?rio Internacional de Atividade F?sica ? IPAQ vers?o curta) e sociais, Mini Avalia??o Nutricional (MAN), ?ndice de Massa Corp?rea (IMC), Circunfer?ncia da Cintura (CC), Circunfer?ncia do Bra?o (CB), Circunfer?ncia da Panturrilha (CP), Dobra Cut?nea Tricipital (DCT), Dobra Cut?nea Subescapular (DCSE), Circunfer?ncia Muscular do Bra?o (CMB), ?rea Muscular do Bra?o corrigida (AMBc), M?sculo Adutor do Polegar (MAP), For?a de Preens?o Palmar (FPP) e Imped?ncia Bioel?trica. Foi realizada a compara??o entre Grupo Doen?a de Alzheimer (GDA) e Grupo Controle (GC) com aspectos sociodemogr?ficos, estilo de vida, cognitivos, comportamentais, MAN, indicadores nutricionais e indicadores nutricionais por g?nero. Foram feitas compara??es entre GC e est?gios da DA de acordo com CDR com as vari?veis nutricionais, tamb?m foram realizadas correla??es entre FPP com vari?veis antropom?tricas no GDA e GC e entre vari?veis cognitivas e antropom?tricas no GDA. Com testes estat?sticos adequados a situa??o e n?vel de signific?ncia de 5% em todos os casos. Foi observado que o GDA desenvolve menos atividade social e tem rede de relacionamento menor, ? fisicamente menos ativo e tem desempenho inferior nas Atividades de Vida Di?ria, principalmente nas atividades instrumentais. O GDA apresentou desnutri??o com diminui??o da ingest?o alimentar total e maior ingest?o di?ria de alguns alimentos, na MAN. Entre os g?neros, as mulheres apresentaram diferen?a em mais medidas antropom?tricas, com valores menores no GDA. Na compara??o entre GC e fases do GDA, houve diferen?a em algumas medidas com valores menores no GDA grave e maior no GC. Na compara??o entre GC e GDA, GC versus GDA leve e moderado e GDA leve e moderado versus GDA grave houve diferen?a para algumas medidas antropom?tricas. N?o houve diferen?a entre os est?gios leve e moderado. As medidas de composi??o de Massa Magra (MM) foram menores no GDA. CC e Reat?ncia n?o apresentaram diferen?a em nenhuma compara??o. Houve correla??es entre FPP e vari?veis antropom?tricas nos GDA e n?o houve entre vari?veis nutricionais com aspectos socioecon?micos, comportamentais, INP, atividades sociais e f?sicas. Os achados da literatura sugerem uma associa??o significativa entre atividades sociais e de lazer durante a velhice e o menor risco de dem?ncia. Na MAN a menor pontua??o indica maior deteriora??o do estado mental. Quanto a alimenta??o, foi observado que possivelmente o GDA se alimenta com menor quantidade e maior qualidade, sugerindo uma melhor sele??o dos alimentos pelo cuidador. Os autores relatam diferen?a significativa entre IMC nas fases da DA, com redu??o no IMC no est?gio grave comparado ao leve e moderado. No estudo houve maior presen?a de idosos em risco de desnutri??o no grupo com DA quando comparados ao GC, sugerindo que a desnutri??o ? um fator de risco para a progress?o da dem?ncia. As vari?veis nutricionais foram progressivamente mais comprometidas com o avan?ar dos d?ficits cognitivos, pois houve uma tend?ncia a redu??o de MM com a progress?o da DA, sendo mais evidente na transi??o da fase moderada para o grave.
92

"A influência do lítio no risco para a doença de Alzheimer" / The influence of lithium on the risk of Alzheimer's disease

Paula Villela Nunes 10 March 2006 (has links)
O lítio é freqüentemente utilizado no tratamento do Transtorno Bipolar, doença associada a um risco aumentado para demência. Evidências experimentais sugerem efeitos neuroproterores do lítio. O lítio inibe a amiloidogênese e a fosforilação da proteína tau tanto in vitro como in vivo. Estes são processos importantes na patogênese da doença de Alzheimer. O objetivo este estudo foi a investigação do efeito do lítio na prevalência de Transtorno Cognitivo Leve e doença de Alzheimer em 114 bipolares idosos eutímicos. Todos os sujeitos completaram uma avaliação catamnéstica, psicopatológica e cognitiva que incluía o mini-exame do estado mental (Mini-mental), o teste cognitivo de Cambridge (CAMCOG) e o questionário do informante sobre o declínio cognitivo do idoso (IQCODE). Foi feita uma comparação da prevalência de Transtorno Cognitivo Leve e doença de Alzheimer entre pacientes em uso de lítio e pacientes em uso de outros estabilizadores de humor. Os sujeitos que entraram na pesquisa tinham em média 68,2 ± 5,0 anos e preenchiam os critérios da Décima Revisão da Classificação Internacional de Doenças e Problemas de Saúde Relacionados (CID-10) para o transtorno bipolar. Durante a avaliação os bipolares estavam eutímicos. Eutimia foi definida como uma pontuação máxima de 7 pontos na escala de Hamilton de 21 pontos para Depressão e 4 na escala de Young para mania. 66 pacientes em uso contínuo do lítio por 6 anos em média foram comparados com 48 pacientes em tratamento com outros estabilizadores de humor. O diagnóstico de Transtorno Cognitivo Leve foi feito de acordo com os critérios de Petersen(1999) e de doença de Alzheimer de acordo com o critério do “National Institute for Communicative Disorders and Stroke - Alzheimer’s Disease and Related Disorders Association” (NINCDS/ADRDA). A prevalência de demência nesta amostra (19,4%) foi mais elevada do que o esperado para uma população comparável (7,1%). A prevalência de doença de Alzheimer entre aqueles com lítio foi 4,5% quando comparada com 33,3% entre aqueles sem lítio. Controlando idade e outras variáveis relacionadas ao curso da doença, o efeito do lítio na prevalência de doença de Alzheimer permaneceu significativo (OR = 0,079; p < 0,001). Nenhuma associação foi encontrada com Transtorno Cognitivo Leve. A alta da prevalência de doença de Alzheimer neste estudo está de acordo com as evidências de risco aumentado para demência em pacientes bipolares. Nesta amostra o tratamento com lítio reduziu a prevalência de Alzheimer aos níveis da população idosa em geral. Estes achados estão de acordo com os efeitos neuroprotetores do lítio em eventos cruciais para a patologia da doença de Alzheimer. Estudos prospectivos são necessários para avaliar se o lítio também pode ser efetivo na prevenção de doença de Alzheimer em outras populações. / Lithium is widely used in the treatment of bipolar disorder, a condition associated with an increased risk for dementia. Experimental evidence suggests that lithium has a neuroprotective effect. Both in vitro and in vivo, lithium inhibits amyloidogenesis and phosphorilation of tau protein, which are two crucial processes in the pathogenesis of Alzheimer’s disease. The objective of this study was to investigate the effect of lithium on the prevalence of Mild Cognitive Impairment and Alzheimer’s disease in 114 elderly euthymic bipolar patients. Subjects completed a thorough catamnestic, psychopathological and cognitive tests evaluation including the Mini-mental state evaluation, Cambridge cognitive test (CAMCOG) and the informant questionnaire on cognitive decline in the elderly (IQCODE). The prevalence of Mild Cognitive Impairment and Alzheimer’s disease between patients on lithium therapy and patients on treatment with other mood-stabilizing drugs was compared. Patients were 68.2 ± 5.0 years old and fulfilled of the International Classification of Diseases - 10th Revision (ICD-10) diagnosis for bipolar disorder. At the time of the evaluation patients were euthymic, as defined by a maximum score of 7 in the 21-item Hamilton Rating Scale for Depression, and 4 in the Young Mania Rating Scale. Sixty-six patients were continuously being treated with lithium for six years, on average, and 48 patients were receiving other mood-stabilizing drugs. Diagnosis of Mild Cognitive Impairment was made according to Petersen (1999) and of Alzheimer’s disease was made according to the National Institute for Communicative Disorders and Stroke - Alzheimer’s Disease and Related Disorders Association (NINCDS/ADRDA) criteria. The overall prevalence of dementia in our sample (19.4%) was higher than the prevalence expected in the age-comparable general population (7.1%). The prevalence of Alzheimer’s disease among lithium users was 4.5% as compared to 33.3% among non-users. After controlling for age and other variables related to the clinical course of the bipolar disorder, the effect of lithium on Alzheimer’s disease prevalence remained significant (OR = 0.079; p < 0.001). No association was found with Mild Cognitive Impairment. The higher prevalence of Alzheimer’s disease in our study supports the reports of increased risk for dementia in bipolar patients. In our sample, lithium treatment reduced the prevalence of Alzheimer’s disease to the levels of the general elderly population. This finding is in line with the neuroprotective effects of lithium on crucial events for the pathology of Alzheimer’s disease. Further prospective studies are needed to clarify whether lithium may also be effective in the prevention of Alzheimer’s disease in the general population.
93

Untersuchung genetischer und geschlechtlicher Einflüsse in der Alzheimerpathologie anhand des Maustiermodells 5XFAD / Research on genetic and gender effects concerning the Alzheimer´s disease based on the mouse model 5XFAD

Kratz, Sebastian 29 November 2010 (has links)
No description available.
94

Polymeric nanoparticles as original theranostic approach for alzheimer‟s disease

Brambilla, Davide 11 January 2012 (has links) (PDF)
The proof of concept of an original nanotechnology-based theranostic approach for Alzheimer‟s disease has been explored. Novel fluorescently tagged nanoparticles have been designed and employed for internalization and transcytosis studies across a recently developed human in vitro blood-brain barrier model. A small library of polymeric nanoparticles have been designed and their ability to capture the Amyloid β1-42 peptide, considered one of the causes of the Alzheimer‟s disease, has been investigated and quantified using an on purpose designed method.
95

Papel protetor do 2-feniletinil-butilterúrio em modelos de dano cognitivo em camundongos e na apoptose em células humanas / Protective role of 2-phenylethinyl-butyltellurium on models of cognitive deficits in mice and on apoptosis in human cells

Souza, Ana Cristina Guerra de 27 March 2013 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Memory is considered to be a process that has several stages, including acquisition, consolidation and retrieval. Memory impairment occurs when important synapses are modified. Alzheimer s disease (DA) is the most common cause of dementia. DA is characterized by cognitive damage, accumulation of the pathogenic amyloid-β (Aβ) peptide, and cholinergic dysfunction. Moreover, oxidative stress is associated with DA. Therapies used for dementia are still palliative rather than curative. Consequently, new therapies are urgently required. Biological effects of tellurium compounds have been studied, leading to a set of interesting and promising applications. Accordingly, 2-phenylethinyl-butyltellurium (PEBT), an organotellurium compound, has been reported as antioxidant. The purpose of this study was to characterize PEBT as a promising alternative for memory improvement and prevention of cognitive deficits, using experimental models of DA in mice. Initially, the present study was conducted to evaluate the effect of a single oral administration (p.o.) of PEBT at a dose of 10 mg/kg on memory, employing the step-down inhibitory avoidance task. PEBT administered 1 h before training, immediately after training or 1 h before the test session of the step-down inhibitory avoidance task increased the step-down latency time in comparison to the control mice, improving acquisition, consolidation, and retrieval of memory, respectively. The glutamate uptake, but not glutamate release, by cerebral cortex and hippocampal slices of mice was inhibited after 1 h of treatment with PEBT. After 24 h of PEBT exposure, the inhibition of cerebral cortex glutamate uptake disappeared. The improvement of memory by PEBT seems most likely to be mediated through an interaction with the amino acid transporters of the glutamatergic system. Thereafter, a subchronic PEBT treatment (1 mg/kg, p.o., for 10 days) after injection of Aβ(25-35) (3 nmol/3 μl/per site, intracerebroventricular) reversed Aβ-induced learning and memory deficits in the Morris water maze and step-down inhibitory avoidance tasks. In addition, PEBT (10 mg/kg, p.o.), administered 30 min before scopolamine (1 mg/kg, intraperitoneal), ameliorated memory deficit induced by this amnesic agent in the Morris water maze. Further, scopolamine was given 30 min before training and test or immediately post-training of step-down inhibitory avoidance task, inducing damage on acquisition, retrieval, and consolidation of memory, respectively. PEBT, administered 30 min before scopolamine, improved consolidation and retrieval stages, but not acquisition. General locomotor and exploratory activities, evaluated in the open-field test, were similar in all mice. Finally, the antiapoptotic effect of PEBT was evaluated. Human retinal pigment epithelial cells (ARPE-19 cell line) were exposed to in vitro oxidative stress by 10 ng/ml tumor necrosis factor-α and 600 μM H2O2. One hour PEBT incubation at concentrations of 7.5 and 10 μM attenuated the apoptosis induced by oxidative stress. This effect lasted up to 6 hours after oxidative stress induction. PEBT (5 and 10 μM) inhibited oxidative stress-induced poly (ADP-ribose) polymerase (PARP) cleavage and restored extracellular-signal-related kinase (ERK) phosphorylation decreased by oxidative stress. The protective mechanism exerted by PEBT against oxidative stress may involve PARP cleavage, regulation of ERK pathway, as well as its known antioxidant properties. In conclusion, the finds of the present thesis point out the ameliorative effect of PEBT on memory stages (acquisition, consolidation and retrieval). Likewise, PEBT improved memory impairment in mice. These effects seem to be due to strengthen the physiological glutamatergic tonus by PEBT and the antiapoptotic effect of PEBT. Therefore, PEBT could be considered a candidate for the prevention of memory deficits such as those observed in DA. / memória inclui pelo menos três tipos de processamento relacionados entre si: aquisição, consolidação e evocação. A memória é afetada quando as sinapses encarregadas de fazer ou evocar memórias encontram-se alteradas. A doença de Alzheimer (DA) é a causa mais comum de demência. A DA é caracterizada por danos cognitivos, acúmulo de peptídeo β-amiloide (Aβ) e disfunção colinérgica. Além disso, o estresse oxidativo está associado à DA. Uma vez que ainda não há cura para a DA e as terapias atuais são apenas paliativas, torna-se importante a busca de novos compostos para melhorar danos cognitivos. Com o estudo dos efeitos biológicos de compostos de telúrio, muitas aplicações estão sendo descobertas. Neste sentido, o composto orgânico de telúrio 2-feniletinil-butiltelúrio (PEBT) apresenta efeito antioxidante. O objetivo deste estudo foi caracterizar o PEBT como uma alternativa promissora para a melhora e prevenção de danos cognitivos, usando modelos experimentais da DA em camundongos. Primeiramente, avaliou-se o efeito de uma única dose oral (p.o) de PEBT (10 mg/kg) na memória, utilizando a tarefa da esquiva inibitória. O tratamento com PEBT 1 h antes do treino, imediatamente após o treino ou 1 h antes do teste da esquiva inibitória aumentou a latência comparada com os animais controles, melhorando a aquisição, consolidação e evocação da memória, respectivamente. A captação de glutamato, mas não a liberação deste neurotrasmissor, foi inibida em córtex e hipocampo de camundongos após 1 h de tratamento com PEBT. Após 24 h, a inibição da captação de glutamato no córtex não foi mais evidenciada. A melhora da memória causada pelo PEBT parece ser mediada através da interação com os transportadores de glutamato. Além disso, o tratamento subcrônico com PEBT (1 mg/kg, p.o., por 10 dias) após a injeção de Aβ(25-35) (3 nmol/3 μl/per site, intracerebroventricular) reverteu o prejuízo no aprendizado e na memória causados por Aβ nas tarefas do labirinto aquático de Morris e na esquiva inibitória. O PEBT (10 mg/kg, p.o.), adminstrado 30 min antes da escopolamina (1 mg/kg, intraperitoneal), também protegeu do dano de memória causado por este agente anticolinérgico no labirinto aquático de Morris. Quando a escopolamina foi administrada 30 min antes do treino ou teste, ou imediatamente após o treino da esquiva inibitória houve dano na aquisição, evocação e consolidação da memória, respectivamente. O PEBT, administrado 30 min antes da escopolamina, protegeu do dano na consolidação e evocação da memória, mas não na aquisição. Não houve diferença nas atividades locomotora e exploratória dos animais tratados com o PEBT no teste do campo aberto. Finalmente, o efeito antiapoptótico do PEBT foi avaliado. Células do epitélio pigmentado da retina humana (linhagem ARPE-19) foram expostas ao estresse oxidativo induzido pelo fator de necrose tumoral-α (10 ng/ml) e H2O2 (600 μM). O PEBT (7.5 e 10 μM), quando pré-incubado por 1 h, protegeu contra a apoptose induzida pelo estresse oxidativo e este efeito permaneceu até 6 h após a indução. O PEBT (5 e 10 μM) inibiu a clivagem da poli(ADP-ribose) polimerase (PARP) induzida por estresse oxidativo e, também, restaurou a fosforilação da quinase regulada por sinal extracelular (ERK). O efeito protetor do PEBT contra o estresse oxidativo parece envolver a clivagem da PARP e a regulação da fosforilaçao de ERK, além de sua atividade antioxidante. Nesse sentido, os resultados apresentados nesta tese destacam o efeito do PEBT na melhora das três fases da memória, bem como em modelos de dano cognitivos em camundongos. Estes resultados parecem estar relacionados ao aumento do tônus glutamatérgico causado pelo PEBT e seu efeito antiapoptótico. Assim sendo, estes dados sugerem que o PEBT poderá, futuramente, ser considerado candidato para a prevenção de danos de memória, como aqueles observados na DA.
96

Využití koordinované rehabilitace v domově se zvláštním režimem / The use of coordinated rehabilitation in a home with special regime

RATHOVÁ, Lucie January 2018 (has links)
The aim of this diploma thesis is to identify options of how to use the systém of coordinated rehabilitation in a home with a special regime. To obtain information I used qualitative research methodology. Semi-standardized interviews served as the research tool. These interviews were carried out with 10 employees of a home with a special regime run by the City Institute of Social Services in Strakonice. The thesis is divided into a theoretical and a practical part. The theoretical part of the diploma thesis focuses on coordinated rehabilitation as a whole, further, it discusses the individual parts of coordinated rehabilitation. Other chapters describe the most frequent client diagnoses within the Home with a special regime, and finally the standards of social service quality are mentioned. The main research question: What are the options of using coordinated rehabilitation in a home with a special regime? Partial research question: Are employees informed about the options of coordinated rehabilitation? For the purposes of the interview I used questions focused on general identification data, questions focusing on the importance of coordinated rehabilitation, multidisciplinary team. Further, I asked about the individual components of coordinated rehabilitation, and finally, how individual planning is carried out. The result of this diploma thesis is a finding that individual components of coordinated rehabilitation are not fully mutually connected. It would be useful to provide employees with suitable courses to complete their missing knowledge. This diploma thesis might serve as a tool for improving care in the Home with a special regime, it might contribute to the Home with a special regime´s employer awareness of coordnated rehabilitiation, and connect it with practice.
97

Disseleneto de p-metoxi fenila atenua o prejuízo cognitivo e a injúria cerebral em um modelo da doença de alzheimer em roedores / P,p -methoxyl-diphenyl diselenide attenuates the cognitive impairment and the brain injury in a sporadic dementia of alzheimer's type in rodents

Pinton, Simone 17 September 2012 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Alzheimer s disease (AD) is a progressive neurodegenerative disorder, mainly characterized by memory and intellectual capacity loss. AD is characterized by deposition of amyloid-β peptide, neurofibrillary tangles, neuroinflammation, energy metabolism impairment, oxidative stress and synaptic dysfunction and loss. Its multiple pathological pathways contribute to the difficulty of AD treatment and prevention. Thus, the development of new therapies for AD curing or treatment is a challenge. The purpose of this study was to indicate an organoselenium moiety, p,p -dimethoxyl-diphenyl diselenide [(MeOPhSe)2], as a promising alternative for the treatment and prevention of sporadic dementia of Alzheimer-type (SDAT), using an experimental model of dementia induced by intracerebroventricular (i.c.v.) injection of streptozotocin (STZ) in rodents. Initially, it was investigated the prophylactic action of (MeOPhSe)2. For this, mice were treated with (MeOPhSe)2 (25 mg/kg, by gavage) and STZ (2μl of 2,5mg/ml solution; i.c.v.) or vehicles, and 48h after that, the treatment was repeated. The tasks of step-down-type passive-avoidance (SDPA), Y-maze and Morris water-maze (MWM), that followed this treatment, showed that (MeOPhSe)2 protected against the impairment in learning and memory caused by i.c.v. injection of STZ in mice. (MeOPhSe)2 protected against the increase in reactive species (RS) and the reduction of glutathione (GSH) levels, as well as modulated the antioxidant enzymes. (MeOPhSe)2 inhibited the acetylcholinesterase (AChE) activity, which was increased by STZ. Subsequently, it was investigated the effectiveness of (MeOPhSe)2 in reversing the cognitive impairment and neuronal damage induced by STZ. Therefore, rats were injected with STZ (1.0 mg/8μl; 4μl/ventricle) twice, 48h apart. After 21 days of STZ injection, regular diet fed rats were supplemented with 10ppm of (MeOPhSe)2 during 30 days. At the end of this period, it was observed that (MeOPhSe)2 dietary supplementation reversed STZ-induced memory impairment in MWM, SDPA and object recognition tasks. The results on SDPA and object recognition tasks demonstrated that the (MeOPhSe)2 improved memory in rats per se. STZ enhanced the RS and protein nitration levels in cortex and decreased GSH levels on hippocampus of rats, (MeOPhSe)2 reversed these alterations. (MeOPhSe)2 normalized AChE activity (which was enhanced by STZ) in both cortex and hippocampus, but did not reverse the deficit in cerebral glucose metabolism (ATP turnover was decrease by STZ). (MeOPhSe)2 was effective in reducing STZ-induced neuronal (apoptosis) loss. Moreover, (MeOPhSe)2 suppressed neuroinflammation induced by STZ in the rats hippocampus. The organoselenium inhibited activation of microglia and astrogliosis. Based on these results, it was concluded that: 1) (MeOPhSe)2 protected and reversed the cognitive abilities decline; 2) the mechanisms involved in the neuroprotective effect of (MeOPhSe)2 are: antioxidant, AChE inhibitor; inflammation suppressor; 3) (MeOPhSe)2 did not alter the energy metabolism; and 4) (MeOPhSe)2 reduced the neuronal death. Therefore, the present study demonstrated that (MeOPhSe)2 is a promising alternative for the drug studies for treatment of cognitive disorders such as SDAT. / A doença de Alzheimer (DA) é uma síndrome neurodegenerativa progressiva caracterizada principalmente por uma perda da memória e da capacidade intelectual. Ela é caracterizada pelo depósito de fragmentos β-amilóides; emaranhados neurofibrilares; neuroinflamação; déficit do metabolismo energético; estresse oxidativo e deficiência da neurotransmissão. As múltiplas vias patológicas da DA dificultam sua prevenção e tratamento. Logo, o desenvolvimento de novas terapias para a DA é um desafio. Por esta razão, este trabalho procurou apontar uma nova molécula orgânica contendo selênio, o disseleneto de p-metoxi fenila [(MeOPhSe)2], como uma alternativa promissora para o tratamento e prevenção da demência decorrente da DA (DEDA), usando um modelo experimental de demência induzida pela injeção intracerebroventricular (i.c.v.) de estreptozotocina (ETZ) em roedores. Inicialmente, avaliou-se o efeito profilático do (MeOPhSe)2. Para tal, camundongos receberam uma dose oral do organoselênio (25mg/kg, gavage) 30 minutos antes da ETZ (2μl de uma solução 2,5mg/ml), esse procedimento foi repetido 48horas depois. Os testes da esquiva passiva, do labirinto em Y e aquático de Morris, que sucederam esse tratamento, revelaram que o (MeOPhSe)2 protegeu os camundongos do prejuízo cognitivo induzido pela ETZ. O (MeOPhSe)2 protegeu o tecido cerebral do aumento das espécies reativas (ER) e da diminuição dos níveis de glutationa (GSH) induzidos pela ETZ, assim como modulou a atividade de enzimas antioxidantes. O (MeOPhSe)2 inibiu a atividade da acetilcolinesterase (AChE), a qual foi estimulada pela ETZ. Posteriormente, investigou-se a efetividade do (MeOPhSe)2 em reverter o prejuízo cognitivo e os danos neuronais induzidos pela ETZ. Para isso, a ETZ foi injetada nos ratos (1μg/8μl, 4μl/ventrículo) em 0 e 48horas. Passados 21dias, iniciou-se uma suplementação dietética com 10ppm de (MeOPhSe)2 durante 30dias. Ao final deste período, observou-se que o (MeOPhSe)2 restaurou as habilidades cognitivas prejudicadas pela ETZ nos ratos, nos testes do labirinto aquático de Morris, esquiva passiva e reconhecimento do objeto. Os resultados referentes aos testes do reconhecimento do objeto e da esquiva passiva apontaram que o (MeOPhSe)2 melhorou per se a memória dos ratos. A ETZ aumentou os níveis de ER e de nitração de proteínas no córtex e diminuiu os níveis de GSH no hipocampo dos ratos, o (MeOPhSe)2 reverteu estas alterações. O organoselênio inibiu a atividade da AChE (aumentada pela ETZ) tanto no córtex como no hipocampo dos ratos, mas não modulou o metabolismo da glicose (ETZ diminuiu ATP-turnover). O (MeOPhSe)2 evitou a perda neuronal (apoptose) e inibiu os eventos neurodegenerativos (ativação da caspase-3) induzidos pela ETZ. O (MeOPhSe)2 suprimiu a neuroinflamação induzida pela ETZ no hipocampo dos ratos. O organoselênio inibiu a ativação das células gliais e astrócitárias. Baseado nestes resultados, conclui-se que: 1) O (MeOPhSe)2 protegeu e reverteu o declínio das habilidades cognitivas; 2) Os mecanismos envolvidos no efeito neuroprotetor do (MeOPhSe)2 são: antioxidante; inibidor da AChE; supressor da neuroinflamação; 3) O (MeOPhSe)2 não altera o metabolismo energético; e 4) O (MeOPhSe)2 reduziu a morte neuronal. Assim sendo, este trabalho demonstrou que o (MeOPhSe)2 é uma alternativa promissora para o estudo de drogas para o tratamento de desordens cognitivas como a DEDA.
98

Cuidador de idosos com doença de Alzheimer : efeitos de grupos psico-educacionais e suporte domiciliar individualizado

Faleiros, Danilo Augusto de Melo 16 March 2009 (has links)
Made available in DSpace on 2016-06-02T19:46:04Z (GMT). No. of bitstreams: 1 2397.pdf: 698224 bytes, checksum: 7ce1123d029ba03759695333be6642bb (MD5) Previous issue date: 2009-03-16 / Universidade Federal de Minas Gerais / Dementia involves the loss of cognitive functions, interfering with the execution of even the most basic tasks of everyday life. Family eldercare providers are central figures in guaranteeing the wellbeing of their elderly relatives who develop dementia. However, when such a person becomes dependent on other family members, in addition to an increase in the caregiver s domestic chores, the behavior problems that arise can have a negative impact when caregivers are not well prepared for this situation, making the caregivers more susceptible to depression and contributing to the deterioration of their own physical and psychological wellbeing, making the caregiving context even more difficult. The objective of this study was to analyze the effects of psycho-educational support groups (PEG) for people caring for a relative with Alzheimer s disease (AD), associated with individual, home visits that were either training-oriented (Experimental Group EG) or listening-oriented (Control Group CG) in nature, with respect to the participants perceptions of burden, depressive symptoms and quality of life. The nine participants were randomly assigned to either the EG and CG. The EG participants received encouragement and assistance in operationalizing the concepts learned in the PEG, which addressed strategies for managing stress and depression and provided training in some of the social skills that are useful in establishing new routines (praise, constructive criticism, and asking for help). The CG received visits of the same duration, bus focused only on listening. The participants were interviewed about their situation, but did not receive individual assistance in operationalizing the strategies presented in the PEG. At the end of the first phase of the intervention, each group received the other type of home-based intervention. The data were analyzed using nonparametric tests (Mann-Whitney and Wilcoxon). The psycho-educational groups were effective in transmitting information, but did not reduce the caregivers perceptions of burden, reporting of depressive symptoms or change their quality of life ratings. After the caregivers received the training-oriented home visits (TV), their perceptions of burden significantly decreased and their quality of life ratings increased. The listeningbased visits had no significant effects on the caregivers. Six months later, an analysis of the follow-up measures indicate that improvements in perceptions of burden, frequency of depressive symptoms and quality of life scores were maintained by those who experienced the PEG coupled with TV. In conclusion, it is clear that professionals who offer orientation programs for family members caring for elderly relatives who have AD should further invest in evaluating the influence of home visits that focus on assisting these caregivers in adjusting their managerial and coping strategies, so as to increase our knowledge of how to blend group-based and individual psycho-educational supports in order to maximize the effects of such interventions. / A demência se caracteriza pela perda de funções cognitivas, comprometendo a execução normal das mais simples tarefas da vida diária. Os cuidadores familiares são pessoas chaves para garantir o bem-estar do seu familiar idoso com demência. Mas, além do aumento da carga de tarefas domésticas que ocorre quando um idoso se torna dependente, os distúrbios de comportamento do idoso dementado provocam um impacto negativo na vida dos cuidadores quando estes não são bem orientados. Isso os tornam mais vulneráveis ao desenvolvimento de quadros depressivos o que contribui para a deterioração de suas próprias condições físicas e psicológicas, complicando ainda mais a tarefa de cuidar. O presente trabalho teve como objetivo analisar os efeitos de um grupo psico-educacional (GPE) para cuidadores de idosos com doença de Alzheimer (DA), associado com um atendimento domiciliar individualizado que tinha como característica uma intervenção terapêutica com o cuidador (Grupo Experimental GE) ou a simples escuta deste (Grupo Controle GC). Os efeitos investigados incluíram as percepções dos participantes de burden, sintomas de depressão e qualidade de vida. Os nove participantes foram alocados aleatoriamente no GE e GC. No GE, os participantes receberam incentivo e suporte na operacionalização de conceitos aprendidos no GPE, os quais envolveram o manejo do estresse e da depressão e o treino de algumas habilidades sociais que são úteis no estabelecimento de rotinas novas (elogios, críticas construtivas e pedir ajuda). O grupo controle recebeu visitas com a mesma duração, mas focando apenas a escuta. Os participantes responderam a um roteiro de entrevista sobre sua situação, sem receber apoio individual na operacionalização das estratégias tratadas no GPE. Após a conclusão da primeira fase da intervenção, cada grupo recebeu o outro tipo de visita domiciliar. Análises feitas com os testes não-paramétricos Mann-Whitney e Wilcoxon mostraram que os grupos terapêuticos psico-educacionais foram eficazes para passar informação aos cuidadores, mas não aliviaram a sobrecarga ou afetaram a pontuação destes cuidadores nas medidas de sintomas depressivos ou qualidade de vida. Porém, quando os cuidadores obtiveram acompanhamento terapêutico individualizado, houve uma diminuição significativa do burden e um aumento da qualidade de vida. As visitas focando a escuta não levaram a nenhuma alteração por parte dos cuidadores. Os sintomas depressivos não foram afetados imediatamente por nenhum tipo de intervenção. Seis meses após o término das intervenções, foi feita outra avaliação (follow-up) a qual mostrou que a associação entre GPE a VTD foi efetiva na manutenção das melhorias nos escores de burden, depressão e qualidade de vida. Conclui-se que os profissionais que oferecem programas de orientação a cuidadores de idosos com demência deveriam investir mais na avaliação dos efeitos de visitas domiciliaras para ajudar cuidadores no aperfeiçoamento de suas estratégias de gerenciamento e enfrentamento do estresse e da sobrecarga. Assim, poder-se-ia conhecer melhor estes efeitos da combinação de grupos psico-educativos e de visitas domiciliares individualizadas, o que por fim, poderia ajudar a maximizar o potencial de impacto das intervenções com cuidadores de idosos com DA.
99

Morphologie der Mikroglia in Assoziation zu Amyloidablagerungen und Tau-Pathologien im caninen Gehirn

Schmidt, Franziska 09 September 2014 (has links)
Altersassoziiert entwickeln Hunde eine Erkrankung, die in vielen Aspekten der Alzheimer-Krankheit des Menschen ähnelt. Das canine kognitive Dysfunktionssyndrom äußert sich klinisch u.a. durch Desorientierung in vertrauter Umgebung, Vergessen von Kommandos und einen gestörten Schlaf-Wach-Rhythmus. Aus der Literatur ist bekannt, dass in den Gehirnen von alten Hunden regelmäßig Aβ- und selten Tauablagerungen zu beobachten sind. Allerdings erfolgte bisher kein Nachweis des hochgradig zytotoxischen und modifizierten pE3Aβ. Auch Veränderungen der mikroglialen Morphologie wurden bisher nicht beschrieben. Insgesamt lagen in dieser Studie 24 euthanasierte Rasse- und Mischlingshunde verschiedenen Alters vor. Fünf dieser Tiere besaßen ein durchschnittliches Alter von 2,1 Jahren und dienten als Kontrollgruppe. Die anderen 19 Hunde waren 8 bis 19 Jahre alt und wurden entsprechend ihrer Größe und des Gewichts in die drei Kategorien kleine (≤ 10 kg), mittelgroße (10 – 25 kg) und große Hunde (> 25 kg) unterteilt. Die Gehirne wurden aus den Schädeln präpariert und in 4 % Paraformaldehyd fixiert. Anschließend erfolgte die Präparation des frontalen und entorhinalen Kortex sowie der Hippokampusformation, die in 30%iger Saccharoselösung vitrifiziert und mittels Methylbutan bei -80 °C eingefroren wurden. Von den Regionen wurden Kryoschnitte mit einer Dicke von 40 µm angefertigt und diese anhand immunhistologischer Färbungen auf das Vorhandensein von Ablagerungen, bestehend aus den Amyloidsubtypen Aβ8-17 und pE3Aβ, sowie aus hyperphosphorylierten Tau, untersucht. Die Morphologie und das Aktivitätsstadium der Mikroglia wurden mit Antikörpern gegen Iba1 und TAL.1B5 analysiert. Zusätzlich erfolgte eine Untersuchung anhand des Filament Tracer. Stereologische Analysemethoden wurden zur Quantifizierung der Aβ-Ablagerungen und der Mikroglia angewandt. Disseminierte Plaques fanden sich bereits ab 9 Jahren. In den untersuchten Gehirnregionen von alten Hunden zeichnete sich ein progressiver Verlauf der Ablagerungen ab. Da insbesondere kleinere Hunde ein höheres Alter erreichten als mittelgroße und große Hunde konnten in dieser Kategorie vermehrt Plaques beobachtet werden. Den alten Tieren gemein war, dass in den untersuchten Gehirnregionen pE3Aβ-Plaques häufiger vorlagen als Plaques, die aus Aβ8-17 bestanden. Kleinere parenchymale und meningeale Gefäße des frontalen Kortex schienen besonders anfällig gegenüber pE3Aβ-Ablagerungen zu sein. Im entorhinalen Kortex von kleinen Hunden war die Menge an gefäßassoziierten Aβ8-17- und pE3Aβ-Ablagerungen annähernd gleich. Bei mittelgroßen und großen Hunden dominierte im entorhinalen Kortex und ventralen Hippokampus die Anzahl an gefäßassoziierten Aβ8-17-Ablagerungen. Bei kleinen Hunden existierten im ventralen Hippokampus signifikant mehr gefäßassoziierte Aβ8-17- als pE3Aβ-Ablagerungen. Hyperphosphoryliertes Tau fand sich in der Hippokampusformation von drei Hunden im Alter von 11 bzw. 15 Jahren. Der Schweregrad war unterschiedlich ausgeprägt, sodass nur ein Hund eine hochgradige Pathologie mit NFTs und neuritischen Plaques aufwies. Einhergehend mit dem Alter und einer assoziierten Proteinpathologie fanden sich Veränderungen der mikroglialen Morphologie. Neben ramifizierten Mikroglia lagen in den untersuchten Gehirnregionen aktivierte Mikroglia vor. Einige Mikroglia wiesen Zeichen einer Seneszenz auf und waren insbesondere in den Gehirnen von Hunden mit einer hochgradigen Aβ- bzw. Tau-Pathologie vorhanden. Zusammenfassend ist festzustellen, dass mit dieser Studie eine nähere Charakterisierung des caninen kognitiven Dysfunktionssyndroms erfolgte. Die Befunde sind von hoher translationaler Bedeutung und fördern die Etablierung des Hundes als natürliches Modelltier zur Untersuchung von Alterungsprozessen des Gehirns und für die Erforschung des initialen Stadiums der Alzheimer-Krankheit.:1 Einleitung 2 Literaturübersicht 2.1 Das canine kognitive Dysfunktionssyndrom 2.2 Pathogenese der Proteinablagerungen 2.2.1 Amyloid-Pathologie 2.2.2 Tau-Pathologie 2.3 Mikroglia 2.3.1 Ursprung und Formen 2.3.2 Die Rolle der Mikroglia beim Morbus Alzheimer 2.4 Assoziation des CCDS zum Morbus Alzheimer 3 Tiere, Material und Methoden 3.1 Hunde 3.2 Gehirnproben 3.2.1 Gewinnung und Kryofixierung der Gehirne 3.2.2 Makroskopische Untersuchung der Gehirne 3.2.3 Untersuchte Gehirnregionen 3.2.4 Histologische Färbungen 3.3 Immunohistochemische und Immunfluoreszenzfärbungen 3.3.1 Antikörper und Seren 3.3.2 Protokoll der ABC-Methode 3.3.3 Protokoll zur Immunfluoreszenz 3.3.4 Kontrollen 3.4 Auswertung der Färbungen 3.4.1 Deskriptive Analyse der Präparate 3.4.2 Quantitative Analyse der immunhistochemischen Befunde 3.4.3 Statistische Auswertung 4 Ergebnisse 4.1 Anamnestische Merkmale der Hunde 4.1.1 Gruppeneinteilung in Größen- und Gewichtskategorien 4.1.2 Altersverteilung 4.1.3 Symptomatik 4.2 Pathologisch-histologische Untersuchung der Gehirne 4.2.1 Altersabhängige pathologische Gehirnveränderungen 4.2.2 Anteil der grauen Substanz des frontalen Kortex 4.2.3 Pathologisch-histologische Charakterisierung ausgewählter Hirnareale 4.2.3.1 Kontrollgruppe 4.2.3.2 Gehirne der alten Hunde 4.2.3.3 Korrelation der altersassoziierten Neuropathologie mit der Größen- und Gewichtskategorie 4.2.3.4 Statistische Auswertung 4.3 Detektion, Charakterisierung und Quantifizierung des Aβ-Proteins 4.3.1 Immunhistochemische Darstellung des Aβ-Proteins 4.3.1.1 Kontrollgruppe 4.3.1.2 Altersassoziierte Verteilung der Aβ-Ablagerungen 4.3.2 Morphologie der Aβ-Ablagerungen 4.3.3 Assoziation der Aβ-Ablagerungen mit der Größen- und Gewichtskategorie 4.3.4 Histochemische Darstellung des Aβ-Proteins 4.3.5 Quantifizierung der Aβ-Ablagerungen 4.4 Immunhistologische Darstellung von Tau-Pathologien 4.4.1 Kontrollgruppe 4.4.2 Alte Hunde der Versuchsgruppen 4.5 Charakterisierung und Quantifizierung der Mikroglia 4.5.1 Darstellung der Mikroglia 4.5.1.1 Kontrollgruppe 4.5.1.2 Alte Hunde der Versuchsgruppen 4.5.2 Assoziation der mikroglialen Morphologie zu den Größen- und Gewichtskategorien der untersuchten Hunde 4.5.3 Auswertung morphologischer Parameter mit dem Filament Tracer 4.5.4 Quantifizierung der Mikroglia 4.5.4.1 Untersuchung der Anzahl der Mikroglia in Assoziation zur Neuropathologie 4.5.4.2 Untersuchung der Anzahl der Mikroglia in Assoziation zu den Größen- und Gewichtskategorien 4.5.5 Nachweis HLA DR-positiver Mikroglia 4.5.5.1 Kontrollgruppe 4.5.5.2 Alte Versuchshunde 5 Diskussion 5.1 Hundepopulation 5.2 Pathologisch-histologische Untersuchung der Gehirne 5.3 Aβ-Pathologie 5.3.1 Parenchymale Aβ-Plaques 5.3.2 Gefäßassoziiertes Aβ-Protein 5.4 Tau-Pathologie 5.4.1 Häufigkeit innerhalb der Hundepopulation und kritische Wertung der Färbemethodik 5.4.2 Zusammenhang der Tau-Pathologie mit den Aβ-Ablagerungen 5.5 Mikroglia 5.5.1 Unterschiede in der Anzahl der Mikroglia zwischen jungen und alten Hunden 5.5.2 Unterschiede der Morphologie der Mikroglia zwischen jungen und alten Hunden 5.5.3 Detektion von dystrophischen Mikroglia in den Gehirnen von alten Hunden 5.6 Schlussfolgerungen 5.7 Ausblick 6 Zusammenfassung 7 Summary 8 Literaturverzeichnis 9 Anhang 9.1 Tabellarische Übersichten zu den Studientieren 9.2 Protokoll der H&E-Färbung 9.3 Übersicht einzelner Ergebnisse des humanen Gewebes 9.4 Tabellarische Übersichten der verwendeten Materialien Abbildungsverzeichnis Tabellenverzeichnis / Dogs develop an age-associated cognitive dysfunction syndrome with several aspects resembling Alzheimer\\\''s disease. Affected animals show signs of dis-orientation in their familiar surroundings, dementia, and a disturbed circadian rhythm. The underlying neurodegenerative disease is associated with patho-logic changes in the brain including regularly deposition of β-pleated amyloid and rarely hyperphosphorylated tau accumulation. However, there have been no reports of the highly cytotoxic and modified pE3Aβ in the canine brain. Equally, altered microglial morphology has not been documented so far. For this study 24 euthanized thoroughbred dogs and mongrels of different ages were available. Five of these animals had an average age of 2.1 years and served as control group. The remaining 19 dogs were 8 to 19 years old. Accor-ding to their height and weight these dogs were divided into 3 different categories including small (≤ 10 kg), medium (11 - 25 kg) and large dogs (> 25 kg). Brains were dissected from the skulls and fixed in 4 % paraformaldehyde. Afterwards the frontal and entorhinal cortex as well as the hippocampal for-mation were isolated, vitrificated in 30 % sucrose solution and frozen to -80 °C by methylbutane. These regions were sliced into 40 µm thick sections and subsequently stained by immunohistology in order to detect deposits of Aβ8-17, pE3Aβ and hyperphosphorylated tau, respectively. Antibodies against Iba1 and TAL.1B5 were used to analyze microglial morphology and activation status. Additionally further investigations were made with the Filament Tracer of Imaris software. Stereological analysis methods served for the quantification of Aβ depositions and microglia. Disseminated Aβ plaques were detected in dogs from 9 years on. Within the examined brain regions of elderly dogs a progressive course of Aβ depositions was observed. Especially small dogs had a longer lifespan than medium and large dogs with the result that more plaques were deposited in the brains of small dogs. Elderly dogs had in common that pE3Aβ-plaques where more often located in the examined brain regions than plaques containing Aβ8-17. Minor parenchymal and meningeal vessels seemed to be susceptible especially to pE3Aβ depositions. The amount of vessel-associated Aβ8-17 and pE3Aβ in the entorhinal cortex of small dogs was almost equal. Within the entorhinal cortex of medium and large dogs the amount of vessel-associated Aβ8-17 predominated. The ventral hippocampus of small dogs showed significantly more vessel-associated Aβ8-17 than pE3Aβ depositions. Hyperphosphorylated tau was present in the hippocampal formations of 3 dogs with an age of 11 and 15 years, respectively. The degree of severity varied with the result that only one dog showed a high-grade pathology with development of NFTs and neuritic plaques. Accompanied by age and associated protein pathology altered microglial morphology was detected. Alongside with ramified microglia, activated cells were identified in the examined brain regions. Several microglia showed signs of senescence and were present in the brains of dogs with severe Aβ and tau pathology. Summarizing, this study facilitated a further characterization of the canine cognitive dysfunction syndrome. The results are of highly translational importance and encourage the establishment of the dog as a natural animal model for studying age-associated processes and the initial stage of Alzheimer’s disease.:1 Einleitung 2 Literaturübersicht 2.1 Das canine kognitive Dysfunktionssyndrom 2.2 Pathogenese der Proteinablagerungen 2.2.1 Amyloid-Pathologie 2.2.2 Tau-Pathologie 2.3 Mikroglia 2.3.1 Ursprung und Formen 2.3.2 Die Rolle der Mikroglia beim Morbus Alzheimer 2.4 Assoziation des CCDS zum Morbus Alzheimer 3 Tiere, Material und Methoden 3.1 Hunde 3.2 Gehirnproben 3.2.1 Gewinnung und Kryofixierung der Gehirne 3.2.2 Makroskopische Untersuchung der Gehirne 3.2.3 Untersuchte Gehirnregionen 3.2.4 Histologische Färbungen 3.3 Immunohistochemische und Immunfluoreszenzfärbungen 3.3.1 Antikörper und Seren 3.3.2 Protokoll der ABC-Methode 3.3.3 Protokoll zur Immunfluoreszenz 3.3.4 Kontrollen 3.4 Auswertung der Färbungen 3.4.1 Deskriptive Analyse der Präparate 3.4.2 Quantitative Analyse der immunhistochemischen Befunde 3.4.3 Statistische Auswertung 4 Ergebnisse 4.1 Anamnestische Merkmale der Hunde 4.1.1 Gruppeneinteilung in Größen- und Gewichtskategorien 4.1.2 Altersverteilung 4.1.3 Symptomatik 4.2 Pathologisch-histologische Untersuchung der Gehirne 4.2.1 Altersabhängige pathologische Gehirnveränderungen 4.2.2 Anteil der grauen Substanz des frontalen Kortex 4.2.3 Pathologisch-histologische Charakterisierung ausgewählter Hirnareale 4.2.3.1 Kontrollgruppe 4.2.3.2 Gehirne der alten Hunde 4.2.3.3 Korrelation der altersassoziierten Neuropathologie mit der Größen- und Gewichtskategorie 4.2.3.4 Statistische Auswertung 4.3 Detektion, Charakterisierung und Quantifizierung des Aβ-Proteins 4.3.1 Immunhistochemische Darstellung des Aβ-Proteins 4.3.1.1 Kontrollgruppe 4.3.1.2 Altersassoziierte Verteilung der Aβ-Ablagerungen 4.3.2 Morphologie der Aβ-Ablagerungen 4.3.3 Assoziation der Aβ-Ablagerungen mit der Größen- und Gewichtskategorie 4.3.4 Histochemische Darstellung des Aβ-Proteins 4.3.5 Quantifizierung der Aβ-Ablagerungen 4.4 Immunhistologische Darstellung von Tau-Pathologien 4.4.1 Kontrollgruppe 4.4.2 Alte Hunde der Versuchsgruppen 4.5 Charakterisierung und Quantifizierung der Mikroglia 4.5.1 Darstellung der Mikroglia 4.5.1.1 Kontrollgruppe 4.5.1.2 Alte Hunde der Versuchsgruppen 4.5.2 Assoziation der mikroglialen Morphologie zu den Größen- und Gewichtskategorien der untersuchten Hunde 4.5.3 Auswertung morphologischer Parameter mit dem Filament Tracer 4.5.4 Quantifizierung der Mikroglia 4.5.4.1 Untersuchung der Anzahl der Mikroglia in Assoziation zur Neuropathologie 4.5.4.2 Untersuchung der Anzahl der Mikroglia in Assoziation zu den Größen- und Gewichtskategorien 4.5.5 Nachweis HLA DR-positiver Mikroglia 4.5.5.1 Kontrollgruppe 4.5.5.2 Alte Versuchshunde 5 Diskussion 5.1 Hundepopulation 5.2 Pathologisch-histologische Untersuchung der Gehirne 5.3 Aβ-Pathologie 5.3.1 Parenchymale Aβ-Plaques 5.3.2 Gefäßassoziiertes Aβ-Protein 5.4 Tau-Pathologie 5.4.1 Häufigkeit innerhalb der Hundepopulation und kritische Wertung der Färbemethodik 5.4.2 Zusammenhang der Tau-Pathologie mit den Aβ-Ablagerungen 5.5 Mikroglia 5.5.1 Unterschiede in der Anzahl der Mikroglia zwischen jungen und alten Hunden 5.5.2 Unterschiede der Morphologie der Mikroglia zwischen jungen und alten Hunden 5.5.3 Detektion von dystrophischen Mikroglia in den Gehirnen von alten Hunden 5.6 Schlussfolgerungen 5.7 Ausblick 6 Zusammenfassung 7 Summary 8 Literaturverzeichnis 9 Anhang 9.1 Tabellarische Übersichten zu den Studientieren 9.2 Protokoll der H&E-Färbung 9.3 Übersicht einzelner Ergebnisse des humanen Gewebes 9.4 Tabellarische Übersichten der verwendeten Materialien Abbildungsverzeichnis Tabellenverzeichnis
100

Contribution of FDG-PET and MRI to improve Understanding, Detection and Differentiation of Dementia

Dukart, Jürgen 02 October 2011 (has links)
Progression and pattern of changes in different biomarkers of Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD) like [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) have been carefully investigated over the past decades. However, there have been substantially less studies investigating the potential of combining these imaging modalities to make use of multimodal information to further improve understanding, detection and differentiation of various dementia syndromes. Further the role of preprocessing has been rarely addressed in previous research although different preprocessing algorithms have been shown to substantially affect diagnostic accuracy of dementia. In the present work common preprocessing procedures used to scale FDG-PET data were compared to each other. Further, FDG-PET and MRI information were jointly analyzed using univariate and multivariate techniques. The results suggest a highly differential effect of different scaling procedures of FDG-PET data onto detection and differentiation of various dementia syndromes. Additionally, it has been shown that combining multimodal information does further improve automatic detection and differentiation of AD and FTLD.

Page generated in 0.0546 seconds