"Psychopharmacology of the Aging Nervous System" was selected as the topic for Volume 20 of the Handbook of PsychopharmacoloffY. Senile dementia is now widely recognized as a medical and social problem likely to reach epidemic proportions by the turn of the century. By that time it is esti mated that almost 20% of the population in most developed countries will be over the age of 65 and at a conservative estimate 1 in 10 of them will suffer from a dementing illness. Many symposia have appeared over the last few years describing the neuropathological and neurochemical deficiencies in…mehr
"Psychopharmacology of the Aging Nervous System" was selected as the topic for Volume 20 of the Handbook of PsychopharmacoloffY. Senile dementia is now widely recognized as a medical and social problem likely to reach epidemic proportions by the turn of the century. By that time it is esti mated that almost 20% of the population in most developed countries will be over the age of 65 and at a conservative estimate 1 in 10 of them will suffer from a dementing illness. Many symposia have appeared over the last few years describing the neuropathological and neurochemical deficiencies in Alzheimer's and other forms of dementia, the neuropsychological features of the disease, and attempts to treat it. In this volume, we have selected topics and authors who are beginning to question some of the earlier assumptions and to ask different questions about dementia. In the first four chapters the neuropathology and neu rochemistry of dementia are reevaluated. It is important to understand therelationship between the formation of amyloid plaques and neurofibrillary tangles, the progressive degeneration in cortex, and the neurochemical deafferentation of cortex. In particular, the possibility is considered that the most severe pathology is seen in a well-defined limbo/cortical circuitry known to be involved in mnemonic processing. The growing interest in the genetic determinants of familial Alz heimer's is reviewed. It is also recognized that detailed comparisons of the neural and psychological characteristics of the various degenerative dis eases that impair cognitive processing may be valuable.
1 Neuropathological and Neurochemical Aspects of Alzheimer's Disease.- 1. Introduction.- 2. The Neuropathology of Alzheimer's Disease.- 3. Alzheimer-Type Changes in Conditions Other than Alzheimer's Disease.- 4. Alzheimer's Disease and Patient Age.- 5. Biochemical Correlates of Pathological Changes.- 6. Relationship between Plaques and Tangles and Nerve Cell Atrophy and Loss.- 7. Relationship between Extent of Pathological Changes and Degree of Dementia.- 8. Pathogenetic Considerations.- 9. Concluding Remarks.- 10. References.- 2 Basal Forebrain Cholinergic Neurons and Alzheimer's Disease.- 1. Introduction.- 2. Basal Forebrain Cholinergic Systems.- 3. Cholinergic Alterations in AD.- 4. Cholinergic Physiology.- 5. Conclusion.- 6. References.- 3 Neurochemical Studies in Dementia.- 1. Introduction.- 2. Alzheimer's Disease.- 3. Other Cortical Dementias.- 4. Subcortical Dementias.- 5. Alcohol Dementia.- 6. Confusional States.- 7. Summary.- 8. References.- 4 Chemical Neuroanatomy of Alzheimer's Disease.- 1. Introduction: Relationship of Neural Connections and Neurotransmitters with Alzheimer Pathology.- 2. Limbic and Cortical Connections and Neurotransmitters in Alzheimer's Disease.- 3. Brain Stem and Basal Forebrain-Cortical Connections and Neurotransmitters in Alzheimer's Disease.- 4. Implications for the Pathogenesis and Treatment of Alzheimer's Disease.- 5. References.- 5 Dementia in Parkinson's Disease.- 1. Introduction.- 2. Brain Lesions in Patients with Parkinson's Disease.- 3. Dementia and Lesions.- 4. Parkinsonian Dementia.- 5. Symptoms and Lesions.- 6. Conclusion.- 7. References.- 6 Alzheimer's Disease: Genetic Theories of Etiology.- 1. Introduction.- 2. The Genetic Hypothesis.- 3. Critical Methodological Issues.- 4. PredictedCharacteristics of Genetically Caused AD.- 5. Review of Previous Studies.- 6. Current Studies.- 7. Implications and Strategies for Future Research.- 8. References.- 7 The Cholinergic Hypothesis of Memory: A Review of Animal Experiments.- 1. Introduction.- 2. Conceptual Issues.- 3. Methodological Issues.- 4. Anatomy of Forebrain Cholinergic Pathways.- 5. Pharmacology of Central Cholinergic Neurons.- 6. Pharmacological Evidence for Cholinergic Involvement in Sensory, Attentional, and Motor Functions.- 7. Pharmacological Studies of Rodent Learning and Memory.- 8. Lesion Studies.- 9. Pharmacological Studies of Primate Memory.- 10. Summary and Concluding Remarks.- 11. References.- 8 Behavioral Models of Aging in Nonhuman Primates.- 1. Introduction.- 2. Some Characteristics of Age-Related Behavioral Deficits in Nonhuman Primates.- 3. Relationship of Age-Related Behavioral Deficits in Nonhuman Primates to Humans.- 4. Relationship of Age-Related Behavioral Deficits in Nonhuman Primates to Rodents.- 5. Possible Insights from Comparisons with Nonhuman Primates Given Discrete Brain Lesions.- 6. Possible Insights from Drugs That Impair Performance on Memory Tasks in Young Subjects.- 7. Drugs for Improving Age-Related Cognitive Losses: Current Status and Future Prospects.- 8. Synthesis and Discussion.- 9. References.- 9 Cholinergic Drugs and Human Cognitive Performance.- 1. Introduction.- 2. The Effects of Cholinergic Agents on Processes Involved in Learning and Memory in Experimental Animals.- 3. The Effects of Cholinergic Agents on Processes Involved in Learning and Memory in Young Adult Human Subjects.- 4. Clinical Trials of Cholinergic Agents in Patients with Dementia of the Alzheimer Type or Aged Volunteers.- 5. Implications and New Directions.- 6. References.- 10 Treatment ofDementia with Vasoactive Drugs.- 1. Background and Rationale.- 2. Traditional Vasodilators.- 3. Recent Developments and Future Prospects.- 4. References.- 11 New Pharmacological Perspectives on Nootropic Drugs.- 1. Introduction.- 2. Known Compounds.- 3. Goals of This Chapter.- 4. Distribution of Drugs in Brain.- 5. Neuropsychopharmacological Studies.- 6. Neurochemical Studies.- 7. Relationship to Endogenous Substances.- 8. Nootropic Drugs and Arguments for Supplementary Choline.- 9. Clues to the Mode of Action of Nootropic Drugs.- 10. Some Thoughts on Clinical Trials.- 11. Summary and Conclusion.- 12. References.
1 Neuropathological and Neurochemical Aspects of Alzheimer's Disease.- 1. Introduction.- 2. The Neuropathology of Alzheimer's Disease.- 3. Alzheimer-Type Changes in Conditions Other than Alzheimer's Disease.- 4. Alzheimer's Disease and Patient Age.- 5. Biochemical Correlates of Pathological Changes.- 6. Relationship between Plaques and Tangles and Nerve Cell Atrophy and Loss.- 7. Relationship between Extent of Pathological Changes and Degree of Dementia.- 8. Pathogenetic Considerations.- 9. Concluding Remarks.- 10. References.- 2 Basal Forebrain Cholinergic Neurons and Alzheimer's Disease.- 1. Introduction.- 2. Basal Forebrain Cholinergic Systems.- 3. Cholinergic Alterations in AD.- 4. Cholinergic Physiology.- 5. Conclusion.- 6. References.- 3 Neurochemical Studies in Dementia.- 1. Introduction.- 2. Alzheimer's Disease.- 3. Other Cortical Dementias.- 4. Subcortical Dementias.- 5. Alcohol Dementia.- 6. Confusional States.- 7. Summary.- 8. References.- 4 Chemical Neuroanatomy of Alzheimer's Disease.- 1. Introduction: Relationship of Neural Connections and Neurotransmitters with Alzheimer Pathology.- 2. Limbic and Cortical Connections and Neurotransmitters in Alzheimer's Disease.- 3. Brain Stem and Basal Forebrain-Cortical Connections and Neurotransmitters in Alzheimer's Disease.- 4. Implications for the Pathogenesis and Treatment of Alzheimer's Disease.- 5. References.- 5 Dementia in Parkinson's Disease.- 1. Introduction.- 2. Brain Lesions in Patients with Parkinson's Disease.- 3. Dementia and Lesions.- 4. Parkinsonian Dementia.- 5. Symptoms and Lesions.- 6. Conclusion.- 7. References.- 6 Alzheimer's Disease: Genetic Theories of Etiology.- 1. Introduction.- 2. The Genetic Hypothesis.- 3. Critical Methodological Issues.- 4. PredictedCharacteristics of Genetically Caused AD.- 5. Review of Previous Studies.- 6. Current Studies.- 7. Implications and Strategies for Future Research.- 8. References.- 7 The Cholinergic Hypothesis of Memory: A Review of Animal Experiments.- 1. Introduction.- 2. Conceptual Issues.- 3. Methodological Issues.- 4. Anatomy of Forebrain Cholinergic Pathways.- 5. Pharmacology of Central Cholinergic Neurons.- 6. Pharmacological Evidence for Cholinergic Involvement in Sensory, Attentional, and Motor Functions.- 7. Pharmacological Studies of Rodent Learning and Memory.- 8. Lesion Studies.- 9. Pharmacological Studies of Primate Memory.- 10. Summary and Concluding Remarks.- 11. References.- 8 Behavioral Models of Aging in Nonhuman Primates.- 1. Introduction.- 2. Some Characteristics of Age-Related Behavioral Deficits in Nonhuman Primates.- 3. Relationship of Age-Related Behavioral Deficits in Nonhuman Primates to Humans.- 4. Relationship of Age-Related Behavioral Deficits in Nonhuman Primates to Rodents.- 5. Possible Insights from Comparisons with Nonhuman Primates Given Discrete Brain Lesions.- 6. Possible Insights from Drugs That Impair Performance on Memory Tasks in Young Subjects.- 7. Drugs for Improving Age-Related Cognitive Losses: Current Status and Future Prospects.- 8. Synthesis and Discussion.- 9. References.- 9 Cholinergic Drugs and Human Cognitive Performance.- 1. Introduction.- 2. The Effects of Cholinergic Agents on Processes Involved in Learning and Memory in Experimental Animals.- 3. The Effects of Cholinergic Agents on Processes Involved in Learning and Memory in Young Adult Human Subjects.- 4. Clinical Trials of Cholinergic Agents in Patients with Dementia of the Alzheimer Type or Aged Volunteers.- 5. Implications and New Directions.- 6. References.- 10 Treatment ofDementia with Vasoactive Drugs.- 1. Background and Rationale.- 2. Traditional Vasodilators.- 3. Recent Developments and Future Prospects.- 4. References.- 11 New Pharmacological Perspectives on Nootropic Drugs.- 1. Introduction.- 2. Known Compounds.- 3. Goals of This Chapter.- 4. Distribution of Drugs in Brain.- 5. Neuropsychopharmacological Studies.- 6. Neurochemical Studies.- 7. Relationship to Endogenous Substances.- 8. Nootropic Drugs and Arguments for Supplementary Choline.- 9. Clues to the Mode of Action of Nootropic Drugs.- 10. Some Thoughts on Clinical Trials.- 11. Summary and Conclusion.- 12. References.
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