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The neurochemistry of vascular dementia
C G Gottfries1, K Blennow, I Karlsson
1University of Göteborg, Department of Clinical Neuroscience, Mölndal Hospital, Sweden.
Insights
Vascular dementia (VAD) involves brain circulation changes, impacting neurotransmitters like serotonin and acetylcholine. White matter damage and hypothalamic neuropeptide changes are key findings in VAD brains.
Area of Science:
- Neuroscience
- Neurology
- Pathology
Background:
- Vascular dementia (VAD) is a cognitive impairment resulting from altered cerebral blood circulation.
- It is distinct from, though related to, multi-infarct dementia, which is a VAD subtype.
Purpose of the Study:
- To investigate neurochemical alterations in noninfarcted brain tissue of VAD patients.
- To explore the pathogenetic significance of observed white matter disturbances.
Main Methods:
- Neurochemical analysis of noninfarcted brain tissue from VAD patients.
- Assessment of neurotransmitter metabolism, enzyme activity, myelin components, and neuropeptide levels.
Main Results:
- Severely reduced serotonin metabolism and choline acetyltransferase activity.
- Significantly increased monoamine oxidase B in white matter.
- Marked decrease in myelin components, indicating significant white matter pathology.
- Increased hypothalamic neuropeptide levels, correlating with heightened hypothalamic-pituitary-adrenal axis activity.
Conclusions:
- Neurochemical changes, particularly in serotonin pathways and white matter integrity, are central to VAD pathogenesis.
- Increased hypothalamic neuropeptide levels may reflect a loss of serotonergic inhibitory control, contributing to HPA axis hyperactivity in VAD.
Abstract:
Vascular dementia (VAD) is cognitive impairment caused by changes in the blood circulation of the brain. It is not synonymous with multi-infarct dementia. The latter is a subgroup of VAD. Neurochemical investigations of noninfarcted brain tissue from patients with VAD show general changes in VAD brains. The serotonin metabolism is severely reduced and so is the activity of choline acetyltransferase. Monamine oxidase B is significantly increased in the white matter. A severe decrease in myelin components indicates white matter disturbances of such a degree that they must be considered to be of pathogenetic importance. The levels of some neuropeptides in the hypothalamus are increased. This is a finding which is in agreement with clinical findings of a high activity in the hypothalamic-pituitary-adrenal axis in patients with VAD. This high activity is possibly due to a loss of serotonergic inhibitory tone on the hypothalamus in VAD brains.