The effects of oral physostigmine on constructional and spatial abilities in dementia of the Alzheimer's type.
Item
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Title
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The effects of oral physostigmine on constructional and spatial abilities in dementia of the Alzheimer's type.
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Identifier
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AAI8821069
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identifier
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8821069
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Creator
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Blau, Alan Dennis.
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Contributor
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Adviser: Gordon Barr
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Date
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1988
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Psychobiology
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Abstract
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Recent scientific evidence has strongly implicated the cholinergic neurotransmitter system as a critical component in Alzheimer's disease. This dissertation was designed to investigate the role of the effects of physostigmine on certain cognitive functions in early Alzheimer's disease. Memory changes in patients with Alzheimer's disease is the most robust deficit. Nevertheless, there is a growing literature uncovering a variety of cognitive deficits which appear independent of changes in memory. Of these, visuo-spatial and constructional impairments are the most outstanding. The second major goal of this dissertation was to understand the nature of these cognitive deficits with the qualitative assessment of performance. Specifically designed battery of neuropsychological instruments shown to be sensitive to these types of abilities was administered. This battery included tests of spatial orientation, direct copy of simple and complex figures, and block and puzzle constructions. Subjects diagnosed with early dementia of the Alzheimer's type (DAT) were studied. The subject's spouses, when possible, served as one comparison group, and subjects from a normal aged population comprised the other. DAT subjects were given the test battery on three separate occasions. The first (initial baseline) was prior to any drug treatment. The second (best dose level), was at the most responsive dose level to physostigmine as determined by performance on tests of memory when subjects were titrated over a 8.0 to 12.0 mg. dose range over a three week period. A final testing (final baseline) occurred following drug wash-out. Comparison subjects were tested on a single occasion. There was no significant difference on a test of egocentric spatial ability between the groups. DAT subjects were significantly impaired compared to the comparison groups on all complex copying and constructional tasks. Task complexity resulted in a decrement in the performance of DAT subjects. Qualitative sequential analysis of the subject's individual performance indicated a planning and monitoring deficit in the DAT population, suggestive of frontal lobe dysfunction in the early phase of the disease. Physostigmine failed to improved performance on any of the tasks from the experimental battery when drug treated subjects were compared to a placebo treated group.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
