Neuropeptide changes in dementia: pathogenetic implications and diagnostic value.

The main object of this review is to describe the most significant alterations of neuropeptide patterns occurring in the brain and in the cerebral spinal fluid of demented patients and particularly of elderly patients with Alzheimer type dementia. The changes in concentration in the different brain areas are described along with their peripheral endocrine implications. Alterations in the synthesis and release of neuropeptides may play a significant role in the pathogenesis of dementia in elderly patients, in addition to the well known changes in classical neurotransmitter systems. Measurements of neuropeptide levels in cerebrospinal fluid or postmortem brain material as alleged biological markers for the diagnostic purpose, however, have produced controversial results. Neuropeptide changes in the demented brain show regional differences and are not specific and selective enough to differentiate between senile dementia, Alzheimer type dementia and other degenerative disorders.