Clinical and biochemical responses to therapy in Alzheimer's disease and multi-infarct dementia

Eur Arch Psychiatry Neurol Sci. 1989;239(2):79-86. doi: 10.1007/BF01759579.


Memory performance, central monoaminergic function and sympathetic nerve activity were studied in patients with dementia of the Alzheimer type (DAT) or with multi-infarct dementia before and after 4 weeks with single or combined drug therapy (choline-piracetam). Analysis of the levels of 3-methoxy-4-hydroxyphenylglycol (MHPG), 3-methoxy-4-hydroxyphenylacetic acid (HVA) and 5-hydroxyindolacetic acid in the cerebrospinal fluid (CSF) and also in urine (plus 3-methoxy-4-hydroxy mandelic acid) showed that the basal values of HVA in the CSF and urine were lower in the more severely demented compared with the mildly demented subjects in both groups. The combined drug treatment resulted in a statistically significant increase in the MHPG level in the CSF of mildly demented subjects of the DAT group, while it seemed not to influence the other monoamine metabolites. The sympathetic nerve activity was similar in both patient groups and was unchanged after therapy. These findings suggest a dopaminergic deficit in advanced stages of the disease and a possible enhancement of the central noradrenergic output with therapy. No effects of therapy on memory performance or correlations between monoamine levels and memory test scores were noted.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / cerebrospinal fluid
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / psychology
  • Arousal / drug effects*
  • Blood Pressure / drug effects
  • Choline / therapeutic use*
  • Clinical Trials as Topic
  • Dementia, Multi-Infarct / cerebrospinal fluid
  • Dementia, Multi-Infarct / drug therapy*
  • Dementia, Multi-Infarct / psychology
  • Drug Therapy, Combination
  • Female
  • Glycols / cerebrospinal fluid*
  • Heart Rate / drug effects
  • Homovanillic Acid / cerebrospinal fluid*
  • Humans
  • Hydroxyindoleacetic Acid / cerebrospinal fluid*
  • Memory
  • Mental Recall / drug effects*
  • Methoxyhydroxyphenylglycol / cerebrospinal fluid*
  • Middle Aged
  • Neuropsychological Tests
  • Norepinephrine / blood
  • Piracetam / therapeutic use*
  • Pyrrolidinones / therapeutic use*


  • Glycols
  • Pyrrolidinones
  • Methoxyhydroxyphenylglycol
  • Hydroxyindoleacetic Acid
  • Choline
  • Norepinephrine
  • Homovanillic Acid
  • Piracetam