Related Experiment Videos
A promising approach to the treatment of multi-infarct dementia
1State Mental Clinic, Wagner-Jauregg Platz 18, 1-8053, Graz, Austria. walzl@aon.at
Insights
Heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) therapy significantly improved hemorheology in multi-infarct dementia (MID) patients. This treatment reduced key blood viscosity markers and led to better neurological recovery.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Hematology
Background:
- Cerebrovascular multi-infarct dementia (MID) is linked to elevated fibrinogen and lipid levels, increasing blood viscosity and cell aggregation.
- Improving hemorheology by reducing fibrinogen and lipoproteins is a key therapeutic goal for MID.
Purpose of the Study:
- To investigate the efficacy of heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) in reducing hemorheological parameters in MID patients.
- To assess the impact of HELP therapy on clinical symptoms and neurological recovery in MID.
Main Methods:
- 141 MID patients underwent two HELP sessions over 8 days.
- Laboratory data and clinical symptoms were evaluated before and after treatment.
- Neurological recovery was assessed using the Mathew Scale, Mini Mental State Examination, and Activities-of-Daily-Living-Test.
Main Results:
- Each HELP session significantly reduced plasma fibrinogen, whole blood viscosity, plasma viscosity, and red cell transit time.
- Total cholesterol, LDL, lipoprotein(a), and triglycerides were also significantly reduced.
- Statistically significant improvements were observed in neurological recovery scores.
Conclusions:
- HELP therapy effectively improves hemorheological parameters in MID patients.
- The reduction in blood viscosity and improved hemorheology correlate with enhanced neurological recovery.
- Hemorheology plays a crucial role in the clinical presentation and progression of MID.
Abstract:
Cerebrovascular multi-infarct dementia (MID) is associated with high fibrinogen levels and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells. One important goal in the treatment of MID therefore should be to reduce fibrinogen and lipoproteins and thereby to improve the Hemorheological State. The effect of heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP), a method for safe and immediate reduction of parameters relevant to hemorheology, such as plasma fibrinogen and the lipoproteins, was investigated in 141 patients with MID. All the patients underwent two HELP applications within 8 days. The impact of HELP on MID was studied by changes of laboratory data and by evaluation of clinical symptoms before and after treatment. Each HELP session caused an immediate, safe and significant reduction of important rheological parameters such as fibrinogen, whole blood viscosity at high and low shear rate, plasma viscosity and red cell transit time. Also total cholesterol and low-density lipoprotein, lipoprotein(a) and the triglycerides had been reduced significantly. The results in laboratory measurement were followed by a statistically significant improved neurologic recovery, represented in the values of the Mathew Scale, the Mini Mental State Examination and the Activities-of-Daily-Living-Test. These results can indicate the importance and influence of hemorheology on clinical symptoms in MID.