Abstract
The research focuses on the possibility of early detection of AD-specific vascular and atrophic brain changes in families which have a tendency to inherit the disease. The research includedthree families with AD inheritance. All patientsunderwent: cognitive function assessment(MMSE),determination of dementia severity(CDR) and AD stages (TDR), computed tomography (CT), magnetic resonance imaging (MRI), scintigraphy of the brain (SG), rheoencephalography (REG), and cerebral multigated angiography (MUGA). All patients with different AD stages, as well as their descendants, have specific atrophic changes in the temporal lobes of the brain. The degree of these changes increases as AD becomes more severe and ranges from 4% - 8% (TDR-0) to 33% - 62% (TDR-3) of the total mass of a healthy person’s temporal lobes. Simultaneously, thepatients examined have changes of microcirculation manifested by reduction of the capillarybed in the temporal and frontalparietal regions,the development of multiple arteriovenousshunts in the same areas, early venous dumping, anomalous expansion of venoustrunks that receive blood from the arterialvenous shunts, venous stasis on the frontoparietal boundary. Similar changes are found among AD patients’ descendants aged 8 - 11, the only difference being in the degree of temporal lobes atrophy which is 4.7%. This proves that microcirculatory disorders are primary and atrophic changes of the temporal lobes are secondary in AD development. The data obtained indicate that the examination of AD patients’ relatives should begin well before the possible manifestations of the disease, even in childhood. It will allow to reveal the possibility of inheritance and the signs of the disease at the earliest possible stage and to begin its treatment in time.
Highlights
Alzheimer’s disease (AD) was discovered more than a hundred years ago
Middle AD stage—mild dementia Tomography Dementia Rating Scale” (TDR)-2 (1 elderly patient): temporal lobes atrophy with 19% - 32% reduction of tissue mass which corresponds to 12 - 19 Mini-mental State Examination (MMSE) points
AD stage—mild dementia TDR-1 (2 sons and a daughter): temporal lobes atrophy with 9% - 18% reduction of tissue mass which corresponds to 20 - 25 MMSE points (Figures 2(a) and (b))
Summary
Alzheimer’s disease (AD) was discovered more than a hundred years ago. The etiology and pathogenesis of the disease, as well as the timing of the primary changes occurring in the brain, are not fully understood. According to the Alzheimer’s Association, there were 35.6 million people suffering from this disease worldwide in 2010. It is known that certain chemical changes in the brain occur 10 - 20 years before the primary clinical manifestations of the disease during sufficiently rare, genetically determined AD forms [3]. With sporadic AD, primary changes in brain tissue develop long before the clinical symptoms but the manifestation of these changes is low [4]; this form is characterized by inheritance of the disease
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