A promising approach to the treatment of multi-infarct dementia

Abstract

Cerebrovascular multi-infarct dementia (MID) is associated with high fibrinogen levels and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells. One important goal in the treatment of MID therefore should be to reduce fibrinogen and lipoproteins and thereby to improve the Hemorheological State. The effect of heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP), a method for safe and immediate reduction of parameters relevant to hemorheology, such as plasma fibrinogen and the lipoproteins, was investigated in 141 patients with MID. All the patients underwent two HELP applications within 8 days. The impact of HELP on MID was studied by changes of laboratory data and by evaluation of clinical symptoms before and after treatment. Each HELP session caused an immediate, safe and significant reduction of important rheological parameters such as fibrinogen, whole blood viscosity at high and low shear rate, plasma viscosity and red cell transit time. Also total cholesterol and low-density lipoprotein, lipoprotein(a) and the triglycerides had been reduced significantly. The results in laboratory measurement were followed by a statistically significant improved neurologic recovery, represented in the values of the Mathew Scale, the Mini Mental State Examination and the Activities-of-Daily-Living-Test. These results can indicate the importance and influence of hemorheology on clinical symptoms in MID.