ABSTRACT
The 7th annual meeting of the memory clinics of Germany, Switzerland and Austria in March 2002 in Göttingen, Germany was an optimal opportunity to make an inventory about the state of the art in diagnostic and therapy of dementia and mild cognitive impairment in German-speaking memory clinics. Several problems were discussed including difficulties in 1) diagnosis of patients with aphasia or foreign patients, 2) handling of demented patients without a caregiver, 3) psychological support for patients, who have been diagnosed in a very early stage, 4) misunderstandings between general practitioners, neurologists and psychiatrists in private practice on the one hand and the memory clinics on the other hand, 5) recommendations for prevention of dementia, 6) recommendations concerning dementia and car driving and 7) questions of genetic counselling. The following paper is a summary of the results of a workshop in Göttingen and gives practical recommendations based on the experiences of the memory clinics.
Subject(s)
Dementia/diagnosis , Dementia/therapy , Memory Disorders/diagnosis , Memory Disorders/therapy , Aged , Alzheimer Disease/diagnosis , Alzheimer Disease/drug therapy , Alzheimer Disease/prevention & control , Alzheimer Disease/therapy , Austria , Cognition Disorders/diagnosis , Cognition Disorders/drug therapy , Cognition Disorders/therapy , Controlled Clinical Trials as Topic , Dementia/drug therapy , Dementia, Vascular/diagnosis , Dementia, Vascular/drug therapy , Dementia, Vascular/therapy , Diagnosis, Differential , Follow-Up Studies , Germany , Humans , Memory Disorders/drug therapy , Risk Factors , Switzerland , Time FactorsABSTRACT
Sensation seeking scale (SSS) scores were determined in 15 alcohol dependent men with a positive family history for alcoholism (FHP), in 15 alcohol dependent men with a negative family history for alcoholism (FHN) and in 15 well-matched healthy male controls (CONTR). Both FHPs and FHNs suffered from longlasting alcohol dependence meeting ICD-10 and DSM-III-R diagnostic criteria. Dopamine activity was neuroendocrinologically assessed by measuring the amount of growth hormone released after stimulation with the dopamine receptor agonist apomorphine. Planned comparisons within a one-way ANOVA yielded significantly elevated levels of boredom susceptibility (BOS) in both FHPs and FHNs against CONTRs. SSS total scores, while approaching statistical significance, were elevated in FHPs only. Partial correlations (controlling for age, body weight, alcohol intake and duration of dependence) were calculated to examine the relationship between SSS and dopamine activity. Among the SSS subtraits, BOS revealed the highest correlation in each group. However, only in CONTRs did the relationship between BOS and dopamine activity reach statistical significance.
ABSTRACT
Fifteen alcohol dependent men with an alcohol dependent first degree relative (i.e. family history positive or FHP), 15 well matched alcohol dependent men without a family history for alcohol dependence (i.e. family history negative or FHN), and 15 healthy controls (CONTR) participated in this study. The three groups were compared according to their postsynaptic D2 dopamine receptor function as assessed by growth hormone release after stimulation with the dopamine receptor agonist apomorphine. Statistical evaluation was done by planned comparisons within a one-way ANOVA. Alcohol dependent subjects significantly differed from CONTRs as long as family history was not taken into account (t(42) = 2.38; P = 0.022*). When differentiating according to family history, both FHPs and FHNs maintained a blunted growth hormone response. However, the difference between FHNs and CONTRs, though present, dropped out of statistical significance (t(42) = 1.65; P = 0.105); at the same time, the difference between FHPs and CONTRs became slightly stronger (t(42) = 2.47; p = 0.017*). In conclusion, our data give neuroendocrinological support to the assumption that a reduced D2 dopamine receptor function in alcohol dependent men is not only a state marker of residual heavy drinking but also a genetically determined trait marker.
Subject(s)
Alcoholism/genetics , Apomorphine , Dopamine Agonists , Growth Hormone/blood , Receptors, Dopamine D2/genetics , Adult , Alcoholism/physiopathology , Alcoholism/rehabilitation , Humans , Male , Middle Aged , Patient Admission , Receptors, Dopamine D2/physiology , Reference ValuesABSTRACT
The personality traits "novelty seeking", "harm avoidance", and "reward dependence" were rated using Cloninger's Tridimensional Personality Questionnaire in 20 male inpatients, suffering from moderate to severe alcohol dependence (ICD-10, DSM-III-R). The same individuals' dopamine receptor sensitivity was determined by stimulating a neuroendocrine response with a dopamine receptor agonist (apomorphine). The amount of growth hormone released was measured and taken as a biological parameter for the sensitivity of D2 dopamine receptors located in the hypothalamus. Our data indicate that in abstinent alcohol-dependent men no statistically significant correlation exists between a person's apomorphine-induced growth hormone release and his "harm avoidance" or "reward dependence" score. On the other hand, a significant correlation (r = .47; p = .035) was found between growth hormone release and the person's "novelty seeking" score. This result supports Cloninger's hypothesis by giving neuroendocrine evidence that the personality dimension "novelty seeking" is related to dopaminergic activity in alcohol-dependent men.
