Transcript Team 1

We forgot our team name…
(A.K.A. Team 1)
Treatments for Alzheimer’s
Parkinson’s, Huntington’s and Vascular
types of dementia
By: Andrew, Anne, Connie and Diana
Alzheimer’s Disease
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A type of dementia characterized by progressive
neurological degeneration and deterioration of
mental functioning.
This disease results in impairment of :
Language
 Memory
 Visual-Spatial Orientation
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THERE IS NO CURE
Treatments
Drugs
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Cholinesterase Inhibitors (mild to moderate)
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Increase CNS acetylcholine (Ach) by inhibiting cholinesterase
activity in the synapse.
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Tacrine (Cognex)
Donepezil (Aricept)]
Galantamine (Razadyn (name changed from Reminyl June 2005))
Rivastigmine (Exelon)
Side Effects
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Nausea/Vomiting
Loss of appetite
Increased frequency of bowel movements
Possible liver damage (Tacrine)
Treatments
Drugs
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Memantine (moderate to severe)
 Works by regulating glutamate which plays a key role
in processing, storage and retrieval of information.
 Namenda
Side Effects
 Headache
 Constipation
 Confusion
 Dizziness
Drugs
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Enbrel?
Used for rheumatoid arthritis, ankylosing spondylitis,
and psoriatic arthritis
 Has not been approved for Alzheimer’s
 Therefore insurance does not pay.
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Alzheimer's Treatment Before and
After Enbrel
Enbrel for Alzheimer's Explanation
Gene Therapy Combined with Nerve
Growth Factor (NGF)
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Put extra copies of the gene in the brain of people with
Alzheimer’s for cellular growth factor and it slows the
degenerative condition.
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A study in 1996 involving monkeys (Tuszynski & Blesch) who
received grafts that produced NCF retained twice as many
cholinergic neurons than those receiving control grafts.
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A clinical trial on eight patients with mild AD (Tuszynski and
others, 2005) showed no adverse effects after 22 months and
showed increased metabolic activity and an autopsy performed
on another patient showed robust neuronal growth.
Stem Cells
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The use of embryonic stem cells have been touted as
possibilities in treating a variety of neurological diseases
Researchers have injected human neuronal stem cells
into the lateral ventricles of 2-month and 24 month old
rats, in the older rats it showed dramatic cognitive
improvement (Qu & others, 2001; Sugaya, 2005).
The use of stem cells, raises ethical concerns.
Interventions and Reality Orientation
Programs
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The use of mnemonic techniques
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Memory aids that help improve retrieval and storage
information.
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Rely on associative processes to link events.
Reality orientation programs
Allows AD patients to maintain awareness of who
they are.
 Support groups for families and caregivers.
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Parkinson’s Disease
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According to the University of Maryland Medicine
(UMM) Parkinson’s disease (PD) belongs to a group of
conditions called motor system disorders which are the
result of the loss of dopamine producing brain cells.
It is a slowly progressing degenerative disease that is
usually associated with the following symptoms: tremor or
trembling of the arms, jaw, legs and face, stiffness or rigidity
of limbs and trunk, brady-kinesia (slowness of movement),
postural instability, impaired balance and coordination.
Symptoms
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As the symptoms become more pronounced, patients
may have difficulty walking and talking, sleeping,
chewing, swallowing, completing daily tasks.
About 50,000 Americans are diagnosed with
Parkinson’s each year. It is believed that more people
suffer from Parkinson’s than multiple sclerosis,
muscular dystrophy and, amyotrophic lateral sclerosis
combined.
Prevalence and Treatments
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The prevalence of Parkinson's increases with age - appearing in
1% of people over 60 and 4-5% of those over 85 but, the
average onset is usually in the late fifties.
Young onset PD refers to symptoms that begin as early as in
the twenties and thirties.
There is no cure for Parkinson’s but, treatment is given based on
the severity of symptoms. The University of Maryland Medicine
says that anti-parkinsonian medication can be prescribed
depending on the degrees of functional impairment, cognitive
impairment, ability to tolerate the medications as well as advice
from physicians.
Drugs
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According to the National Institute of Neurological
Disorders and Stroke, Levadopa (L-Dopa), a natural
chemical found in plants and animals, has been used for
over thirty years to treat Parkinson’s Disease. Nerve cells
use the levadopa to make dopamine and replenish the
brain’s dwindling supply. This medication helps about ¾ of
patients. L-Dopa is used to help reduce brady-kinesia,
rigidity and tremors.
Other medications include Bromocriptine, Pramipexole,
Ropinirole which all mimic dopamine in the brain.
Treatment Options
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Surgery becomes an option when the disease does not
respond to drugs any longer or at all.
In a therapy called Deep Brain Stimulation (DBS)
electrodes are implanted into the brain and connected
to a device called a neurostimulator which can be
externally programmed. This neurostimulator is used to
deliver electrical stimulation to areas in the brain that
control movement. This blocks the abnormal nerve
signals that cause the tremors and other symptoms of
Parkinson’s Disease.
What Is Huntington’s Disease
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A genetic disease that causes degeneration of
brain cells
This degeneration causes:
Uncontrolled movements
 Loss of intellectual faculties
 Emotional disturbances
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Huntington’s Disease
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No Cure
Medications
Tranquilizers like Klonopin
 Antipsychotics like Haldol or Clozaril
 Antidepressants like Zoloft
 Lithium drugs like Lithobid
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Huntington’s Disease
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Physical Therapy/ Occupational Therapy
Speech Therapy
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Picture boards
Experimental Treatments
Cancer Drugs and AIDS drugs
 Coenzyme Q10
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Self - Care for Huntington’s
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Proper Hydration
Exercise Regularly
Continue proper nutrition
5,000 calories per day
 Vitamins and supplements
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What is Vascular Dementia?
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Second most common form of dementia in the U.S.
(helpguide.org).
Caused by blockages in the brain’s blood supply (helpguide.org).
Vascular dementia is a degenerative cerebrovascular disease
(helpguide.org).
Leads to a progressive decline in (helpguide.org):
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Memory
Cognitive functioning
Usually occurs between the ages of 60 and 70 (helpguide.org).
Affects more men than women (helpguide.org).
Most Common Vascular Dementia
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Multi-infarct dementia (helpguide.org).
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Series of small strokes – sometimes called transient ischemic attacks
(TIAs)
Often unnoticed
Damages the cortex of the brain
Temporary
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Partial blockages of blood supply
Brief impairments in consciousness or sight
Over time – the damage caused to brain tissue interferes with basic
cognitive functions and disrupts day to day functioning
When vascular dementia occurs with other types of dementia
(e.g., Alzheimer's) it is referred to as “mixed dementia”
(helpguide.org).
Treatment/Prevention of Vascular
Dementia
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No treatment can reverse damage caused by strokes
(psychnet-uk.com, 2008)
Lower your risk for a stroke (helpguide.org).
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Risk for vascular dementia is nine times higher following a
stroke
Risk factors of vascular dementia are the same as for
(psychnet-uk.com, 2008).
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Stroke
High blood pressure
Diabetes
High cholesterol and heart disease (psychnet-uk.com, 2008)
Prevention of Vascular Dementia
Things you can do (helpguide.org):
 Don’t smoke
 Exercise regularly
 Eat healthy (limit alcohol, salt and saturated fat)
 Try to reduce stress (relaxation techniques)
 Routine blood pressure checks
 Medications for blood pressure and blood thinners (e.g.,
Aspirin).
 Even surgery may be necessary to restore blood flow to the
brain.
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Carotid endarterectomy – removes blockage in the carotid artery (the
main blood vessel to the brain) (psychnet-uk.com).
Treatment of symptoms
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Controlling symptoms of dementia (psychnet-uk.com, 2008).
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Treatment varies with the specific disorder
Medications may be need to help with aggressive or agitated
behaviors (including behaviors dangerous to themselves or
others) (psychnet-uk.com, 2008).
Possible medications used (psychnet-uk.com, 2008):
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Anti-Psychotics
Beta Blockers (if related to central nervous system lesions).
Serotonin-Affecting Drugs (e.g., lithium, trazodone, buspirone,
clonazepam).
Dopamine Blockers
Carbamazepine
Fuoxetine, Imipramine
Stimulant drugs for mood (e.g., methylphenidate)
References
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Hill, C. Treatment of alzheimers. Retrieved April 18, 2008 from
http://alzheimers.about.com/od/treatmentofalzheimers/a/treatments.htm
Klein, S. B. & Thorne, B. M. (2006). Biological psychology. Worth: Washington D.C.
Seppa, N. (2005). Neuron savers: Gene therapy slows alzheimer’s disease. Retreived April 18, from
http://www.sciencenews.org/articles/20050430/fob1.asp
Helpguide.org (2007). Vascular dementia. Retrieved April 16, 2008 from
http://www.helpguide.org/elder/vascular_dementia.htm
Huntington’s Disease Society of America. (2008). Talking technology. Retrieved April 18, 2008, from
http://www.hdsa.org.
Mayo Clinic. (2008). Huntington’s disease. Retrieved April 18, 2008, from http://www.mayoclinic.com.
Mental health and psychology directory. (2008). Disorder information sheet. Retrieved April 16, 2008 from
http://www.psychnet-uk.com/dsm_iv/dementia.htm
National Institute of Neurological Disorders and Stroke. (2008). NINDS huntington’s disease information
page. Retrieved April 18, 2008, from http://www.ninds.nih.gov/disorders/huntington/huntington.htm.
National Institute of Neurological Disorders and Stroke. 2008 parkinson’s disease: hope through research. Retrieved
April 19, 2008, from http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm
University of Maryland Medicine. (2003, May). Nervous system diseases: Treatments for parkinson’s diseases. Retrieved
April 19, 2008 from the University of Maryland Medical System Web site:
http://www.umm.edu/nervous/parktrmt.htm
Wiki Page Link
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http://wiki.ggc.usg.edu/mediawiki/index.php/P
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