Edvinsson L, Minthon L, Ekman R, Gustafson L
Department of Internal Medicine, University of Lund, Sweden.
Dementia. 1993 May-Aug;4(3-4):167-71. doi: 10.1159/000107318.
The two major primary degenerative dementias, dementia of Alzheimer type (DAT) and frontal lobe degeneration of non-Alzheimer type (FLD) have several clinical features in common but also many symptoms that differ. In a clinical material of 80 patients with either of the two forms of dementia (DAT = 39, FLD = 41) we have studied the levels of neuropeptides in the cerebrospinal fluid (CSF) in order to find biochemical markers for CNS affection. The dementia forms were evaluated by careful clinical analysis, psychometric testing and measurement of regional cerebral blood flow. Approximately one third of the subjects died during the completion of the study and neuropathology was performed, confirming the diagnoses. We observed reductions in the CSF levels of antidiuretic hormone and somatostatin in both DAT and FLD. A strong tendency to reduction was noted for neuropeptide Y (NPY). There was a correlation with the duration of disease demonstrating a significant reduction in NPY levels in subjects with DAT. Most notably there was a strong reduction in the levels of delta sleep inducing peptide (DSIP) in DAT cases only. The levels of DSIP in FLD were the same as in controls. The reverse was found for corticotropin releasing factor (CRF) which had a significant reduction in FLD patients but not in those with DAT. The present study indicates a difference in the CSF levels of neuropeptides, observations that these may serve as biochemical markers which differentiate DAT and FLD.
两种主要的原发性退行性痴呆，即阿尔茨海默型痴呆（DAT）和非阿尔茨海默型额叶变性（FLD），有一些共同的临床特征，但也有许多不同的症状。在一个包含80例患有这两种痴呆形式之一的患者（DAT = 39例，FLD = 41例）的临床资料中，我们研究了脑脊液（CSF）中神经肽的水平，以便找到中枢神经系统病变的生化标志物。通过仔细的临床分析、心理测量测试和局部脑血流测量对痴呆形式进行评估。大约三分之一的受试者在研究完成期间死亡，并进行了神经病理学检查以确认诊断。我们观察到DAT和FLD患者脑脊液中抗利尿激素和生长抑素水平均降低。神经肽Y（NPY）有明显的降低趋势。与病程存在相关性，表明DAT患者的NPY水平显著降低。最值得注意的是，仅在DAT病例中，δ睡眠诱导肽（DSIP）水平大幅降低。FLD患者的DSIP水平与对照组相同。促肾上腺皮质激素释放因子（CRF）则相反，在FLD患者中显著降低，而在DAT患者中未降低。本研究表明脑脊液中神经肽水平存在差异，这些观察结果表明它们可能作为区分DAT和FLD的生化标志物。
