Design and quality of life in patients who are victims of cerebral vascular accident

Poster Presentations P2 P329

a ligand on AChE (enzyme kinetics). Results: The phytoconstituent of ethyl

acetate extract of C. asiatica in HPLC revealed the abundant presence of a tri-

terpene: asiatic acid. The IC50 value of asiatic acid on AChE was 85mM. Asi-

atic acid do not have cytotoxic effect as revealed by MTT assay. Under stress,

the AChE activity in hippocampus cell line is increased concomitant to neurite

formation results in decreased viability of cells. Asiatic acid reverse the above

phenomena so that viability of cells restored. Conclusions: The study re-

vealed the asiatic acid as a potent inhibitor of AChE, further it did not show

any cytotoxicity on hippocampus cell line. The report of asiatic acid as a cog-

nitive enhancer, use of AChE inhibitors in the ailment of AD for symptomatic

memory restoration together with our finding asiatic acid inhibition on AChE,

suggest the possible use of asiatic acid as a drug of choice in AD treatment.

Thus this study finds the phytoconstituent asiatic acid as a potential template

for designing new, selective and powerful anti - Alzheimer’s drugs.

P2-234 THE INTERACTIONS OF TROSPIUM AND

GALANTAMINE WITH LATE ONSET ALZHEIMER

DISEASE AND URINARY INCONTINENCE

Ahmet Turan Isik, Ergun Bozoglu, Turgay Celik, Huseyin Doruk, Gulhane

School of Medicine, Ankara, Turkey. Contact e-mail: [email protected]

Background: Cholinesterase inhibitors for the treatment of Alzheimer’s Dis-

ease (AD) and antimuscarinic agents for the treatment of urge urinary inconti-

nence (UUI) may reduce the potential effect of each other in the patients with

both diseases. Trospium has a relatively low lipophilicity and low CNS pene-

tration, and galantamine, a cholinesterase inhibitors, has also allosterically

modulates nicotinic cholinergic receptors. This study was designed to evaluate

the effects of dual use of trospium and galantamine in the elderly patients with

AD and UUI. Methods: One hundred and seventy eight elderly patients: 99

UUI patients (Group I, treated with trospium), 43 AD patients (Group II, treated

with galantamine) and 36 AD and UUI patients (Group III, treated with galant-

amine and trospium) were evaluated by geriatric assessments, the Global Per-

ception Index (GPI), Patients’ Satisfaction Question (PSQ), Estimated Patients’

Improvement (EPI), nocturia and pads/day at baseline and in the 6th month.

Results: Trospium increased the satisfaction of the patients in Groups I and

III according to the EPI, PSQ, GPI, number of nocturia and pads/day. Decreas-

ing in the GDS score was significant in the Group I and III (p<0.05). Decreasing

in the ADL score was significant in the Group III (p<0.05). The MMSE scores

were not significantly changed in the all groups during the 6 months.

Conclusions: Consequently, we have thought that a combination of trospium

and galantamine could be recommended for the management of the elderly

patients with UUI and AD, which are common problems in the elderly.

P2-235 THE ROLE OF STEROID SULFATASE INHIBITION

IN RATS WITH LOSS OF SEPTAL-HIPPOCAMPAL

CHOLINERGIC NEURONS: EFFECTS ON

HIPPOCAMPAL MUSCARINIC RECEPTOR

FUNCTION AND ALPHA-SECRETASE ENZYME

ACTIVITY

Vedavalli N. Pokala1, David A. Johnson2, 1Pacific University Oregon,

Hillsboro, OR, USA; 2Duquesne University, Pittsburgh, PA, USA.Contact e-mail: [email protected]

Background: Cholinergic hypofunction of the basal forebrain is a hallmark of

Alzheimer’s disease. Basal forebrain structures have cholinergic neurons that

project to areas of the brain associated with learning and memory eg. hippocam-

pus. The current study investigates the effect of cholinergic hypofunction on the

hippocampal muscarinic receptor function and hippocampal alpha and beta sec-

retase enzyme activity in rats. Neurosteroids such as dehydroepiandrosterone

sulfate (DHEAS), modulate cholinergic-muscarinic tone in the hippocampus.

Steroid sulfatase inhibitors (SSI) can enhance hippocampal acetylcholine

(ACh) by increasing DHEAS concentation. DU-14, a SSI was used to study

the effect of hippocampal cholinergic function and secretase enzyme levels.

The goal of the current study was to investigate the effect of selective cholinergic

lesion of the septal-hippocampal pathway and steroid sulfatase inhibition on

muscarinic receptor-coupled G protein activation. Methods: Male Sprague-

Dawley rats (275-300 g) were used in the study. Artifical cerebrospinal fluid

1 ul (sham control); or the selective cholinergic immunotoxin, 192 IgG-saporin

(SAP; 0.22 ug/ul) was infused through a stainless steel cannula placed in the me-

dial septum. DU-14 (30 mg/kg) or corn oil (1 ml/kg) was injected IP 8 days fol-

lowing SAP treatment. Measurement of agonist-stimulated 35[S] GTPgS

binding was used as to measure of muscarinic receptor activation. A secretase

enzyme activity assay was performed by the addition of a secretase-specific pep-

tide conjugated to the reporter molecules EDANS and DABCYL.The level of

secretase enzymatic activity in the membrane lysate was proportional to thefluo-

rometric reaction. Results: Decreased cholinergic enervation of the hippocam-

pus resulted in increased muscarinic receptor density but decreased imuscarinic

receptor sensitivity to activation. Further, there was a decrease in a-secretase en-

zyme activity in rats with cholinergic lesion. Inhibition of steroid sulfatase had

no effect enzyme activity in this model. Conclusions: The results support the

role of hippocampal muscarinic tone in modulating amyloid precursor protein

metabolism and suggests that enhancing excitatory neurosteroid concentrations

would not be an effective approach to decreasing beta-amyloid synthesis.

P2-236 DESIGN AND QUALITY OF LIFE IN PATIENTS WHO

ARE VICTIMS OF CEREBRAL VASCULAR

ACCIDENT

Rita de Cassia G. Marques1, Renne P. Alegria2, Ana A. Francisquetti3,1AACD- Association for the Welfare of the Handicapped Children, Sao

Paulo, Brazil; 2Faculty of Psychology of the University of Sao Paulo, SaoPaulo, Brazil; 3AACD- Association for the Welfare of the Handicapped

Children, Sao Paulo, Brazil. Contact e-mail: [email protected]

Background: The present study used the designs of self-portrait of patients

who are victims of Cerebral Vascular Accident as a way of stimulating cog-

nitive functions like perception, action, emotion, language, learning and

memory, in order to improve the quality of life of patients who suffered brain

damage.Formal aspects were analyzed: line, detail, size, rotation, use of

space, asymmetry, perseveration and gestalt.Then this work aims to compare

and analyze the formal aspects of self-portrait design and the replies of the

questionnaire of quality of life (SF-36) at the beginning and at the end of

the therapeutic workshop. Methods: Five patients victims of cerebral vascu-

lar accident, aged 55 to 68, three with ischemic vascular accident and two with

hemorrhagic accident vascular were assessed.Designs of the self-portrait

were done and the replies to the questionnaire of quality of life (SF-36)

were applied at the beginning and the end of the therapeutic workshop at

AACD. Results: There were improvements in all the items of the formal anal-

yses of the design of the self-portrait of the patients of the sample. 20% im-

proved the regular line, 40% made more details in the design and increased

their size, there was no more rotation, 60% showed improvement in the use

of the space, decrease of asymmetry in 20% of the lines, there was no more

perseveration and there was increase in the Gestalt in 20% of the designs.

Conclusions: Thus, we verify that in all the domains of questionnaire of qual-

ity of life (SF- 36) there was improvement in the patients, except in the item

pain. Therefore, we conclude that the repetitive stimulus in patients with brain

injury can help in the improvement of attention, memory, planning, perfor-

mance of the design and quality of life providing satisfaction in each end of

a work of art as it was seen in the making of the self-portrait.

P2-237 INCREASE HEALTH BURDEN IN THE

ASSOCIATION OF DEPRESSIVE SYMPTOMS IN

THE ELDERLY

Francine N. Ferreira1, Karol Casagrande Crepaldi1, Claudia Santana1,

Arthur Guerra Andrade1,2, Tania Correa de Toledo Ferraz Alves1,2, 1ABCregion Medical School, Santo Andre, Brazil; 2Associated Professor Uni-

versity of Sao Paulo Medical School, Sao Paulo Medical School, Brazil.

Contact e-mail: [email protected]

Background: Vascular factors, such as hypertension, atherosclerosis, and

type 2 diabetes are frequent seen in the elderly, and cognitive impairment as-

sociated to those factors are highly incapacitating. The presence of comorbid

depressive symptoms can also magnify the cognitive deficits and increase the

burden of dementia in the elderly. Methods: Local ethics committees

approved the study, and written informed consent was obtained from all sub-

jects after a complete description of the study. All subjects underwent a clin-

ical, neuropsychological, psychiatric, and socio-demographic evaluation,

mailto:[email protected]




Design and quality of life in patients who are victims of cerebral vascular accident

Documents

Transcript of Design and quality of life in patients who are victims of cerebral vascular accident