Patient Care Neurology & Psychiatry - November 2007 - (Page 11) ILLUSTRATION: JOHN B. STANDRIDGE, MD; ELAINE KURIE Key: ADDLs, Abeta-derived diffusable ligands; APP, amyloid precursor protein; MAP, mitogen-activated protein kinase; NFT, neurofibrillary tangles; ROS, reactive oxygen species. APP formation is encoded by the APP gene, a process that is accelerated by vascular hypoperfusion. Abeta is derived by sequential cleavage of APP by beta-secretase, then the gamma-secretase complex. Abeta1-40 colocalizes with ApoE 4, and in atherosclerotic vessels CAA develops and promotes hypoperfusion and oxidation. Abeta1-42 selfassociates into toxic dodecamer ADDLs. ADDLs profoundly and rapidly block synaptic information processing and also bind to the synaptic spines inducing morphologic changes in the synaptic spine cytoplasm. Transformed Abeta1-42, inflammatory proteins, and vascular endothelial oxidative/inflammatory stresses promote activation of tau kinases that contribute to tau hyperphosphorylation and cleavage. Subsequent disruption of the cholinergic neuron cytoskeleton impairs cellular nutritive factors and induces lesions of cholinergic nuclei. MAP kinase promotes cell cycle reactivation and apoptosis. Acceleration of the entire process hastens cholinergic neuronal death.
Table of Contents Feed for the Digital Edition of Patient Care Neurology & Psychiatry - November 2007 Patient Care Neurology & Psychiatry - November 2007 Contents Research Digest Medicine in the News The 15-Minute Visit Dementia workup and treatment: Do the drugs really work? Help for Your Patients Who Suffer from Specific Phobias Clinical Clips Case & Comment The Science of Healing Classified Advertising Patient Care Neurology & Psychiatry - November 2007 Patient Care Neurology & Psychiatry - November 2007 - Patient Care Neurology & Psychiatry - November 2007 (Page Cover1) Patient Care Neurology & Psychiatry - November 2007 - Patient Care Neurology & Psychiatry - November 2007 (Page Cover2) Patient Care Neurology & Psychiatry - November 2007 - Patient Care Neurology & Psychiatry - November 2007 (Page 1) Patient Care Neurology & Psychiatry - November 2007 - Research Digest (Page 2) Patient Care Neurology & Psychiatry - November 2007 - Contents (Page 3) Patient Care Neurology & Psychiatry - November 2007 - Contents (Page 4) Patient Care Neurology & Psychiatry - November 2007 - Contents (Page 5) Patient Care Neurology & Psychiatry - November 2007 - Contents (Page 6) Patient Care Neurology & Psychiatry - November 2007 - Medicine in the News (Page 7) Patient Care Neurology & Psychiatry - November 2007 - Medicine in the News (Page 8) Patient Care Neurology & Psychiatry - November 2007 - The 15-Minute Visit (Page 9) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 10) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 11) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 12) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 13) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 14) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 15) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 16) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 17) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 18) Patient Care Neurology & Psychiatry - November 2007 - Dementia workup and treatment: Do the drugs really work? (Page 19) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 20) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 21) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 22) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 23) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 24) Patient Care Neurology & Psychiatry - November 2007 - Help for Your Patients Who Suffer from Specific Phobias (Page 25) Patient Care Neurology & Psychiatry - November 2007 - Clinical Clips (Page 26) Patient Care Neurology & Psychiatry - November 2007 - Case & Comment (Page 27) Patient Care Neurology & Psychiatry - November 2007 - Case & Comment (Page 28) Patient Care Neurology & Psychiatry - November 2007 - The Science of Healing (Page 29) Patient Care Neurology & Psychiatry - November 2007 - The Science of Healing (Page 30) Patient Care Neurology & Psychiatry - November 2007 - Classified Advertising (Page 31) Patient Care Neurology & Psychiatry - November 2007 - Classified Advertising (Page 32) Patient Care Neurology & Psychiatry - November 2007 - Classified Advertising (Page Cover3) Patient Care Neurology & Psychiatry - November 2007 - Classified Advertising (Page Cover4)
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