medigraphic.com
Academia Mexicana de Neurología, A.C.

2013, Número 5

<< Anterior Siguiente >>

Rev Mex Neuroci 2013; 14 (5)


Vasorreactividad cerebral por Doppler transcraneal en demencia tipo Alzheimer y demencia vascular

Malamud-Kessler C, Huertas-Navarro M, Campos-Sánchez M

Idioma: Español
Referencias bibliográficas: 53
Paginas: 254-261
Archivo PDF: 184.86 Kb.


RESUMEN

Introducción: La enfermedad de Alzheimer y la demencia vascular son las dos formas de deterioro cognitivo severo más importantes. Su distinción es de indiscutible importancia pronóstica y terapéutica.
Objetivo: Conocer si existen diferencias entre los parámetros de vasorreactividad cerebral medida por Doppler transcraneal en pacientes con demencia tipo Alzheimer y demencia vascular probable clínicamente definida.
Métodos: Se reclutaron 70 pacientes, divididos en dos grupos: demencia tipo Alzheimer y vascular probable clínicamente definida. Se consignaron los datos clínicos y se graduó la severidad de la demencia. Posteriormente, se procedió a realizar el Doppler transcraneal, consignándose los parámetros hemodinámicos antes y después de la prueba de apnea.
Resultados: La vasorreactividad cerebral medida por Doppler transcraneal demostró una sensibilidad de 52% (IC de 95%: 33.5-69.7) y una especificidad de 80% (IC de 95%: 66.18-89.1), para el diagnóstico diferencial de demencia vascular probable. No se demostró una relación entre la severidad, el tiempo de enfermedad o la presencia de factores de riesgo vascular con la vasorreactividad cerebral.
Conclusiones: Se puede constituir a este método como un examen de ayuda diagnóstica para la detección de demencia vascular probable. Se recomienda realizar nuevos estudios para establecer relaciones con respecto a la vasorreactividad cerebral, los factores de riesgo vascular, tiempo de enfermedad y severidad en demencia.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Kawas CH, Brookmeyer R. Aging and the public health effects of dementia. N Engl J Med 2001; 344: 1160-1.

  2. Llibre RJJ, Ferri CP, Acosta D, Guerra M, Huang Y, et al. Prevalence of dementia in Latin America, India, and China: A populationbased cross-sectional survey. Lancet 2008; 372: 464-74.

  3. Khachaturian ZS, Khachaturian AS. Public health premise for national research priorities: mortality versus disability. Alzheimers Dement 2005; 1: 2-4.

  4. Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, et al. Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors Lancet Neurol 2008; 7: 812-26.

  5. Custodio N, García A, Montesinos R, Escobar J, Bendezú L. Prevalencia de demencia en una población urbana de Lima-Perú: estudio puerta a puerta. An Fac Med 2008; 69: 233-8.

  6. Groves WC, Brandt J, Steinberg A, Warrent A, Rossenblat A, et al. Vascular Dementia and Alzheimer’s Disease: Is There a Difference? A Comparison of Symptoms by Disease Duration J Neuropsychiatry Clin Neurosci 2000; 3: 305-15.

  7. Dubois B, Feldman HH, Jacova C, De Kosky ST et al. Research criteria for the diagnosis of Alzheimer’s disease: Revising the NINCDS– ADRDA criteria Lancet Neurol 2007; 6: 734-46.

  8. McKhann G, Drachman D, Folstein M, Katzman M, Price D, et al. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDSADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34: 939-94.

  9. Diagnostic and Statistical Manual of Mental Disorders, 4° edition Text Revised (DSM-IV TR). American Psychiatric Association. American Psychiatric Press, 2000.

  10. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva, Switzerland: World Health Organization; 1993: 36-40.

  11. Chui HC, Victoroff JI, Margolin D, et al. Criteria for the diagnosis of ischemic vascular dementia proposed by the state of California Alzheimer’s disease diagnostic and treatment centers. Neurology 1992; 42: 473-80.

  12. Román GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, et al. Vascular dementia: Diagnostic criteria for research studies. Report of the NINDS-AIREN international workshop. Neurology 1993; 43: 250-60.

  13. Wiederkehr S, Simard M, Fortin C, Van Reekum R . Validity of the Clinical Diagnostic Criteria for Vascular Dementia: Critical Review. Part II. J Neuropsychiatry Clin Neurosci 2008; 20(2): 162-177.

  14. Hatfield CF, Dudas RB, Dening T. Diagnostic tools for dementia. Maturitas 2009; 63: 181-5.

  15. Perrault A, Oremus M, Demers L, Vida S, Wolfson C. Review of outcome measurement instruments in Alzheimer’s disease drug trials: psychometric properties of behavior and mood scales. J Geriatr Psychiatry Neurol 2000; 13: 181-96.

  16. Martínez-Rivera M, Calatayud MT, Perez PP. Biomarcadores para la Enfermedad de Alzheimer y otras demencias degenerativas. Archivos de Medicina 2008; 4: 3.

  17. Oxford Project to Investigate Memory and Aging, University Department of Pharmacology, Oxford, UK. Oxford Project to Investigate Memory and Aging, University Department of Pharmacology, Oxford, UK.

  18. Iacono D, Markesbery WR, Gross M, Pletnikova O, Rudow G, Zandi P, Troncoso JC. The Nun study: clinically silent AD, neuronal hypertrophy, and linguistic skills in early life. Neurology 2009; 73: 665-73.

  19. Classen AHR J, Ramón-Días A, Martin-Cook K, Levine BD, Zhang R. Altered Cerebral Hemodynamics in Early Alzheimer Disease. J Alzheimers Dis 2009; 17: 621-9.

  20. Aaslid R. Cerebral Vasoregulation and Vasomotor Reactivity en: Baumgartner RW, Handbook of Neurovascular Ultrasound. First Edition. Switzerland, Karger: 2006. p. 216-29.

  21. Hennericci M, Neuerburg G, Heusler D. Arterias Cerebrales Intracraneales. Pruebas Funcionales. Volumen I. Vasos Cerebrales y Periféricos. 2a. Ed. New York: ALOCA; 2009. – AMOLCA; 2009. p. 110-13.

  22. Zanette EM, Fiesehi C, Bozzao L, Roberti C, Toni D, Argentino C, Lenzi GL. Comparison of cerebral angiography and Transcranial Doppler sonography in acute Stroke. Stroke 1989; 20: 899-903.

  23. Dahí A, Russell D, Nyberg-Hansen R, Rootwelt K. A comparison of regional cerebral blood flow and middle cerebral artery blood flow velocities: simultaneous measurements in healty subjects. J Cereb Blood Flow Metab 1992; 12; 1049-54.

  24. Dalil A, Lindegaard KE, Russell D, Nyberg-Hansen R, Rootwelt K, Sorteberg W, Nornes H. A comparison of transcranial Doppler and cerebral blood flow studies to assess cerebral vasoreactivity. Stroke 1992; 23: 15-19.

  25. Giller CA, Levine BD, Meyer Y, Buckey JC, D. Lane L, Borchers DJ. The cerebral hemodynamics of normotensive hypovolemia during lower-body negative pressure. Neurosurg 1992;76:961-6.

  26. Ceravolo MG, Minciotti P, Orlandini M, Provinciali L. Intra and interobserver variability of basal flow velocity and vascular reactivity measurements using transcranial Doppler sonography. Neurol Res 1992; 14(2 Suppl.): 122-4.

  27. Sorteberg W, Langmoen LA, Lindegaard KiF, Nornes H. Side-to-side differences and day-to-day variations of transcranial Doppler parameters in normal subjects. J Ultrasound Med 1990; 9: 403-9.

  28. Ries F, Horn R, Hillekamp J, Honisch C, Konig M, Solymosi L. Differentiation of multi-infarct and Alzheimer dementia by intracranial hemodynamic parameters Stroke 1993; 24; 228-35.

  29. Marcos A. Vasorreactividad y resistencia vascular periférica en el diagnóstico diferencial de la demencia vascular y la demencia tipo Alzheimer. (Tesis Doctoral) Madrid: Universidad Complutense de Madrid; 2003.

  30. Asil T, Uzuner N. Differentiation of Vascular Dementia and Alzheimer Disease: a functional transcranial Doppler ultrasonographic Study. J Ultrasound Med 2005; 24: 1065-70.

  31. Doepp F, Valdueza JM, Schreiber SJ. Assessment of cerebral hemodynamics in vascular and Alzheimer’s dementia. Neurol Res 2006; 28: 645-9.

  32. Schreiber SJ, Doepp F, Spruth E, Kopp UA, Valdueza JM. Ultrasonographic measurement of cerebral blood flow, cerebral circulation time and cerebral blood volume in vascular and Alzheimer’s dementia. J Neurol 2005; 252: 1171-7.

  33. Likitjaroen Y, Suwanwela NC, Phanthumchinda K. Vasoreactivity induced by acetazolamide in patients with vascular dementia vs. Alzheimer’s disease. J Neurol Sci 2009; 283: 32-5.

  34. Vicenzini E, Ricciardi MC, Altieri M, Puccinelli F, Binaffini N, Di Piero V, et al. Cerebrovascular Reactivity in Degenerative and Vascular Dementia: A Transcranial Doppler Study Eur Neurol 2007; 58: 84-9.

  35. Hachinski VC, Iliff LD, Zilhka E, et al. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632-7.

  36. Kleiser B, Krapf H, Widder B. Carbon Dioxide Reactivity and patterns of cerebral infarction in patiens with carotid occlusion. J Neurol 1991; 238: 392-4.

  37. Widder B, Kleiser B, Krapf H. Course of cerebrovascular reactivity in patients with carotid artery occlusions. Stroke 1994; 25: 1963-7.

  38. Krejza J, Szydlik P, Liebeskind DS, Kochanowicz J, Bronov O, et al. Age and Sex Variability and Normal Reference Values for the VMCA/VICA Index Am J Neuroradiol 2005; 26: 730-5.

  39. Ameriso SF, Paganini-Hill A, Meiselman HJ, Fisher M. Correlates of middle cerebral artery blood velocity in the elderly Stroke 1990; 21: 1579-83.

  40. Macko RF, Ameriso SF, Akmal M, Paganini-Hill A, Mohler JG, et al. Arterial oxygen content and age are determinants of middle cerebral artery blood flow velocity. Stroke 1993; 24: 1025-8.

  41. Krejza J, Mariak Z, Walecki J, Szydlik P, Lewko J, et al. Transcranial Color Doppler Sonography of Basal Cerebral Arteries in 182 Healthy Subjects: Age and sex variability and normal reference values of blood flow parameters. Am J Neuroradiol 1999; 172: 213-8.

  42. Black R, Greenberg B, Ryan J, Posner H, Seeburger J, Amatniek, et al. Scales as outcome measures for Alzheimer’s disease. Alzheimers Dement 2009; 4: 324-39.

  43. Hatfield CF, Dudas RB, Dening T. Diagnostic tools for dementia. Maturitas 2009; 63: 181-5.

  44. Fagundes Chavez ML, Comozzato AL, Godinho C, Kochhann R, Schuh A, et al. Validity of the Clinical Dementia Rating Scale for the Detection and Staging of Dementia in Brazilian Patients. Alzheimer Dis Assoc Disord 2007; 21: 210-7.

  45. Swinscow TDV. Statistics at Square One. 9th Ed. University of Southampton. Publishing Group;1997.

  46. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health. Version 2.3.1.

  47. Altman DG, Bland JM. Statistics Notes: Diagnostic tests 1: sensitivity and specificity. BMJ 1994; 308: 1552.

  48. Sloan MA, Alexandrov AV, Tegeler CH, Spencer MP, Caplan MR, et al. Assessment: Transcranial Doppler ultrasonography. Report of the Therapeutics and Technology assessment Subcommittee of the American Academy of Neurology. Neurology 2004; 62: 1468-81.

  49. Bishop CCR, Powell S, Rutt D, Browse NL. Transcranial Doppler measurement of middle cerebral artery blood flow velocity: a validation study. Stroke 1986; 17: 913-5.

  50. Muller M, Voges M, Piepgras U, Schimrig K. Assessment of cerebral vasomotor reactivity by transcranial Doppler ultrasound and breathholding. A comparison with acetazolamide as vasodilatory stimulus. Stroke 1995; 26: 96-100.

  51. Giller CA, Lam M, Roseland A. Periodic variations in transcranial Doppler mean velocities J Neuroimaging 1993; 3: 160-2.

  52. Aneriso SF, Sanger P, Fisher M. Age, hypertension and cerebral vasomotor reactivity. Am Neurol 1993; 34: 254-6.

  53. De la Torre JC, Alzheimer Disease as a Vascular Disorder: Nosological Evidence Stroke 2002; 33: 1152-62.




2020     |     www.medigraphic.com