Cholinergic dysfunction in vascular dementia

被引:59
作者
Román G.C. [1 ]
机构
[1] Department of Medicine/Neurology, Univ. of Texas Health Science Center, A. Murphy Veterans Admin. Hospital, San Antonio
关键词
Dementia; Mild Cognitive Impairment; Vascular Dementia; Rivastigmine; Basal Forebrain;
D O I
10.1007/s11920-005-0019-2
中图分类号
学科分类号
摘要
Vascular dementia (VaD) is the second most common type of dementia in the elderly after Alzheimer's disease (AD). Evidence is presented indicating the occurrence of cholinergic dysfunction in VaD, independent from AD. Controlled clinical trials of cholinesterase inhibitors (ChEls) in VaD and in patients with AD plus cerebrovascular disease are reviewed. Compared with placebo, ChEl treatment improves cognition, behavior, and activities of daily living. Cholinergic deficits in patients with VaD may result from ischemia of basal forebrain cholinergic nuclei that are irrigated by penetrating arteries that are highly susceptible to arterial hypertension, or from ischemic lesions in basal ganglia or white matter that sever the extensive cholinergic cortical projections. Cholinergic stimulation produces increases in cortical cerebral blood flow that may be relevant to the therapeutic effect of ChEls. Copyright © 2005 by Current Science Inc.
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页码:18 / 26
页数:8
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