Clinical findings with nimodipine in dementia: test of the calcium hypothesis.

Calcium toxicity seems to be involved in ischemic brain lesions like in vascular dementia and possibly in primary degenerative dementia of Alzheimer's type. The calcium channel blocker nimodipine readily passes the blood-brain barrier and may thus serve as a pharmacologic probe to test the hypothesis of calcium toxicity. Although nimodipine proved to be superior to placebo in a considerable amount of studies in dementia the concept of calcium toxicity cannot be accepted as established. This is due to some methodological flaws in the clinical trials as well as the limited effect size. Moreover, bridging to other findings especially in Alzheimer-type dementia like amyloid deposition and the relationship to apolipoprotein-E isotypes is still far from complete.