Dementia and Cognitive Impairment Reduction after Laser Transcatheter Treatment of Alzheimer’s Disease

Abstract

Reduced cerebral perfusion and microcirculation are found among AD causes, which should be considered in the development of new treatments for the disease. 165 patients with AD were examined. The examination plan included clinical assessment of dementia severity (CDR), cognitive function assessment (MMSE), laboratory examination, cerebral scintigraphy (SG), rheoencephalography (REG), cerebral CT and MRI, morphometric AD stages assessment (TDR) and cerebral multi-gated angiography (MUGA). 89 patients aged 34 - 79 (average age 67) were selected for the treatment: 31 (34.83%) male, 58 (65.17%) female patients. According to their AD stage, the patients were divided into: TDR-0 (preclinical stage)—10 (11.24%) patients, TDR-1 (early stage with mild dementia, mild cognitive impairment)—28 (31.46%) patients, TDR-2 (medium stage with moderate dementia, cognitive impairment sufficiently persistent)—34 (38.20%) patients, TDR-3 (late stage with sufficiently severe dementia and cognitive impairment)—17 (19.10%) patients. Test Group—46 (51.68%) patients—had transcatheter treatment with low-energy lasers. Control Group—43 (48.31%)—had conservative treatment with Memantin and Rivastigmine. The Test Group had cerebral microcirculation improvement leading to permanent dementia reduction and cognitive recovery which allowed transferring the patients to a lighter TDR group or withdrawing them from the scale. Control Group patients with earlier AD stages (TDR-0, TDR-1, TDR-2) obtained stabilization for a period of 6 months-3 years, with subsequent growth of dementia and cognitive impairment; patients with late AD stage (TDR-3) showed further increase of cognitive impairment and dementia. Transcatheter treatment allows reducing the effects of dyscirculatory angiopathy of Alzheimer’s type (DAAT) improving cerebral microcirculation and metabolism, which leads to permanent dementia regression and cognitive impairment reduction. These data show that AD treatment should be comprehensive and aimed at both the recovery of cerebral microcirculation and blood supply and the normalization of amyloid beta metabolism in the cerebral tissue.

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Maksimovich, I. (2015) Dementia and Cognitive Impairment Reduction after Laser Transcatheter Treatment of Alzheimer’s Disease. World Journal of Neuroscience, 5, 189-203. doi: 10.4236/wjns.2015.53021.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] 2015 Alzheimer’s Disease Facts and Figures.
https://www.alz.org/facts/downloads/facts_figures_2015.pdf
[2] Altman, R. and Rutledge, J.C. (2010) The Vascular Contribution to Alzheimer’s Disease. Clinical Science, 119, 407-421. http://dx.doi.org/10.1042/CS20100094
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950620/?tool=pubmed
[3] Sakai, K., Boche, D., Carare, R., Johnston, D., Holmes, C., Love, S. and Nicoll, J.A.R. (2014) Aβ Immunotherapy for Alzheimer’s Disease: Effects on apoE and Cerebral Vasculopathy. Acta Neuropathologica, 128, 777-789. http://dx.doi.org/10.1007/s00401-014-1340-9
http://link.springer.com/article/10.1007/s00401-014-1340-9 doi: 10.1007/s00401-014-1340-9
[4] Morel, F. (1950) An Apparently Dyshoric and Topical Angiopathy. Monatsschr Psychiat Neurol, 120, 352-357. http://www.ncbi.nlm.nih.gov/pubmed/14806299
[5] De la Torre, J.C. (1997) Hemodynamic Consequences of Deformed Microvessels in the Brain in Alzheimer’s Disease. Annals of New York Academy Sciences, 26, 75-91.
http://www.ncbi.nlm.nih.gov/pubmed/9329682?dopt=Abstract
[6] Skoog, I., Kalaria, R.N. and Breteler, M.M. (1999) Vascular Factors and Alzheimer Disease. Alzheimer Disease and Associated Disorders. 13, 106-114.
http://dx.doi.org/10.1097/00002093-199912003-00016
[7] Kalaria, R.N. (2000) Vascular Factors in Alzheimer’s Disease. New York Academy of Sciences, New York. http://books.google.ru/books?id=jHZFAAAAYAAJ&hl=ru&source=gbs_book_similarbooks
[8] Maksimovich, I.V. (2008) Radiodiagnostics of Alzheimer’s Disease. Diagnostics and Intervention Radiology, 2, 27-38. http://radiology-diagnos.ru/sites/default/files/vol2_4_2008_p25-36.pdf
[9] De la Torre, J.C. and Stefano, G.B. (2000) Evidence That Alzheimer’s Disease Is a Microvascular Disorder: The Role of Constitutive Nitric Oxide. Brain Research Reviews, 34, 119-136.
http://www.ncbi.nlm.nih.gov/pubmed/11113503
[10] Maksimovich, I.V. (2011) Dyscirculatory Angiopathy of Alzheimer’s Type. Journal of Behavioral and Brain Science, 1, 57-68. http://www.scirp.org/journal/PaperInformation.aspx?paperID=4630
http://dx.doi.org/10.4236/jbbs.2011.12008
[11] Grammas, P., Sanchez, A., Tripathy, D., Luo, E. and Martinez, J. (2011) Vascular Signaling Abnormalities in Alzheimer Disease. Cleveland Clinic Journal of Medicine, 78, 50-53.
http://www.ncbi.nlm.nih.gov/pubmed/21972332
http://dx.doi.org/10.3949/ccjm.78.s1.09
[12] Baloiannis, S.J. and Baloiannis, I.S. (2012) The Vascular Factor in Alzheimer’s Disease: A Study in Golgi Technique and Electron Microscopy. Journal of the Neurological Sciences, 322, 117-121.
http://www.jns-journal.com/article/S0022-510X(12)00344-9/abstract http://dx.doi.org/10.1016/j.jns.2012.07.010
[13] Mielke, M.M., Rosenberg, P.B., Tschanz, J.L., Cook, L., et al. (2007) Vascular Factors Predict Rate of Progression in Alzheimer Disease. Neurology, 6, 1850-1858.
http://www.neurology.org/content/69/19/1850.short http://dx.doi.org/10.1212/01.wnl.0000279520.59792.fe
[14] Maksimovich, I.V. (2013) Importance of Vascular Factors in the Etiology and Pathogenesis of Alzheimer’s Disease. Alzheimer’s & Dementia, 9, 378-379.
http://www.alzheimersanddementia.com/article/S1552-5260(13)01396-4/abstract http://dx.doi.org/10.1016/j.jalz.2013.05.739
[15] Grammas, P., Martinez, J., Sanchez, P., Yin, X., Riley, J., Gay, D., Desobry, K., Tripathy, D., Luo, J., Evola, M. and Young, A. (2014) A New Paradigm for the Treatment of Alzheimer’s Disease: Targeting Vascular Activation. Journal of Alzheimer’s Disease, 40, 619-630.
http://www.ncbi.nlm.nih.gov/pubmed/24503617
[16] De la Torre, J.C. (2012) A Turning Point for Alzheimer’s Disease? Biofactors, 38, 78-83. http://www.ncbi.nlm.nih.gov/pubmed?term=De%20la%20Torre%20J.%20C.%20(2012)%20A%20 turning%20point%20for%20Alzheimer's%20disease%3F http://dx.doi.org/10.1002/biof.200
[17] Gjulev, N.M., Pustozertsev, V.G. and Gjulev, S.N. (2002) Cerebrovascular Diseases. BINOM, Moscow. http://www.combook.ru/product/158808/
[18] Luzha, D. (1973) X-Ray Anatomy of the Vascular System. Hungarian Academy of Sciences Publishing House, Budapest. http://www.twirpx.com/file/378198/
[19] Folkow, B. and Neil, E. (1971) Circulation. Oxford University Press, London-Toronto.
http://books.google.ru/books/about/%E5%BE%AA%E7%92%B0.html?hl=ru&id=KkQmNQEACAAJ
[20] Maksimovich, I.V. (2004) Transluminal Laser Angioplasty in Treatment of Ischemic Lesions of a Brain. M.D. Dissertation, Russian University of Friendship of the People, Moscow.
http://disseng.com/page/order/id/206426.html
[21] Maksimovich, I.V, and Gotman, L.N. (2006) Method of Complex Radiation Diagnostics at Preclinical and Clinical Stages of Alzheimer’s Disease. Russian Patent No. 2315559.
http://bankpatentov.ru/node/28577
[22] Maksimovich, I.V. (2010) Dyscirculatory Angiopathy of the Brain of Alzheimer’s Type. Alzheimer’s & Dementia, 6, e34. http://www.alzheimersanddementia.com/article/S1552-5260(10)02300-9/fulltext
http://dx.doi.org/10.1016/j.jalz.2010.08.108
[23] Maksimovich, I V. (2012) Vascular Factors in Alzheimer’s Disease. Health, 4, 735-742.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=23274 http://dx.doi.org/10.4236/health.2012.429114
[24] Maksimovich, I.V. (2013) Disorders of Cerebrovascular Angioarchitectonics and Microcirculation in the Etiology and Pathogenesis of Alzheimer’s Disease. Advances in Alzheimer’s Disease, 2, 171-181.
http://www.scirp.org/Journal/PaperInformation.aspx?paperID=40410&#abstract http://dx.doi.org/10.4236/aad.2013.24022
[25] Bell, R.D. and Zlokovic, B.V. (2009) Neurovascular Mechanisms and Blood-Brain Barrier Disorder in Alzheimer’s Disease. Acta Neuropathologica, 118, 103-113.
http://www.ncbi.nlm.nih.gov/pubmed/19319544
http://dx.doi.org/10.1007/s00401-009-0522-3
[26] Zlokovic, B.V. (2011) Neurovascular Pathways to Neurodegeneration in Alzheimer’s Disease and Other Disorders. Nature Reviews Neuroscience, 12, 723-738.
http://www.ncbi.nlm.nih.gov/pubmed/22048062 http://dx.doi.org/10.1038/nrn3114
[27] Provenzano, F.A., Muraskin, J., Tosto, G., Narkhede, A., Wasserman, B.T., Griffith, E.Y., Guzman, V.A., Meier, I.B., Zimmerman, M.E. and Brickman, A.M. (2013) White Matter Hyperintensities and Cerebral Amyloidosis: Necessary and Sufficient for Clinical Expression of Alzheimer Disease? JAMA Neurology, 70, 455-461. http://www.ncbi.nlm.nih.gov/pubmed/23420027
http://dx.doi.org/10.1001/jamaneurol.2013.1321
[28] Nishimura, T., Hashikawa, K., Fukuyama, H., Kubota, T., Kitamura, S., Matsuda, H., Hanyu, H., Nabatame, H., Oku, N., Tanabe, H., Kuwabara, Y., Jinnouchi, S. and Kubol, A. (2007) Decreased Cerebral Blood Flow and Prognosis of Alzheimer’s Disease: A Multicenter HMPAO-SPECT Study. Annals of Nuclear Medicine, 21, 15-23.
http://www.ncbi.nlm.nih.gov/pubmed/17373332 http://dx.doi.org/10.1007/bf03033995
[29] Maksimovich, I.V. and Polyaev, Y.A. (2010) The Importance of Early Diagnosis of Dyscircular Angiopathy of Alzheimer’s Type in the Study of Heredity of Alzheimer’s Disease. Alzheimer’s & Dementia, 6, e43. http://www.alzheimersanddementia.com/article/S1552-5260(10)02325-3/abstract http://dx.doi.org/10.1016/j.jalz.2010.08.133
[30] Maksimovich, I.V. (2012) Certain New Aspects of Etiology and Pathogenesis of Alzheimer’s Disease. Advances in Al-zheimer’s Disease, 1, 68-76. http://www.scirp.org/journal/PaperInformation.aspx?PaperID=25962 http://dx.doi.org/10.4236/aad.2012.13009
[31] Knickmeyer, R.C., Wang, J., Zhu, H., Geng, X., Woolson, S., Hamer, R.M., Konneker, T., Lin, W., Styner, M. and Gilmore, J.H. (2013) Common Variants in Psychiatric Risk Genes Predict Brain Structure at Birth. Cerebral Cortex, 1, 2.
http://cercor.oxfordjournals.org/content/early/2013/01/02/cercor.bhs401.full.pdf+html
[32] Maksimovich, I.V. (2006) Method for Endovascular Treatment of Alzheimer’s Disease. Russian Patent No. 2297860. http://worldwide.espacenet.com/publicationDetails/originalDocument?FT=D&date= 20070427&DB=EPODOC&locale=en_EP&CC=RU&NR=2297860C1&KC=C1
[33] Maksimovich, I.V. (2008) Method and Device for Endovascular Treatment of Alzheimer’s Disease. US Patent No. 7389776. http://www.freepatentsonline.com/7389776.pdf
[34] Maksimovich, I.V. (2012) Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type. Journal of Behavioral and Brain Science, 2, 67-81.
http://www.scirp.org/Journal/PaperInformation.aspx?paperID=17730&#abstract http://dx.doi.org/10.4236/jbbs.2012.21008
[35] Yang, X., Askarova, S., Sheng, W., et al. (2010) Low Energy Laser Light (632.8 nm) Suppresses Amyloid-β Peptide-Induced Oxidative and Inflammatory Responses in Astrocytes. Neuroscience, 171, 859-868. http://www.sciencedirect.com/science/article/pii/S030645221001273X?np=y
[36] Naeser, M.A. and Hamblin, M.R. (2011) Potential for Transcraniallaser or LED Therapy to Treatstroke, Traumatic Brain Injury, and Neurodegenerative Disease. Photomedicine and Laser Surgery, 29, 443-446. http://www.ncbi.nlm.nih.gov/pubmed/21728786 http://dx.doi.org/10.1089/pho.2011.9908
[37] Song, S., Zhou, F. and Chen, W. R. (2012) Low-Level Laser Therapy Regulates Microglial Function through Src-Mediated Signaling Pathways: Implications for Neurodegenerative Diseases. Journal of Neuroinflammation, 18, 219.
http://www.ncbi.nlm.nih.gov/pubmed/22989325 http://dx.doi.org/10.1186/1742-2094-9-219
[38] Barrett, D.W. and Gonzalez-Lima, F. (2013) Transcranial Infrared Laser Stimulation Produces Beneficial Cognitive and Emotional Effects in Humans. Neuroscience, 29, 13-23.
http://www.ncbi.nlm.nih.gov/pubmed/23200785 http://dx.doi.org/10.1016/j.neuroscience.2012.11.016
[39] Maksimovich, I.V. (2012) The Tomography Dementia Rating Scale: Morphologically Determined Scale of Alzheimer’s Disease Stages. Alzheimer’s & Dementia, 8, 335-336.
http://www.alzheimersanddementia.com/article/S1552-5260(12)01059-X/fulltext
[40] Maksimovich, I.V. (2012) The Tomography Dementia Rating Scale (TDR)—The Rating Scale of Alzheimer’s Disease Stages. Health, 4, 712-719.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=23257 http://dx.doi.org/10.4236/health.2012.429111
[41] Morris, J.C. (1993) The Clinical Dementia Rating (CDR): Current Version and Scoring Rules. Neurology, 11, 2412-2414. http://www.ncbi.nlm.nih.gov/pubmed/8232972
http://dx.doi.org/10.1212/wnl.43.11.2412-a
[42] Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975) “Mini-Mental State”. A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12, 189-198. http://www.ncbi.nlm.nih.gov/pubmed/1202204 http://dx.doi.org/10.1016/0022-3956(75)90026-6
[43] Maksimovich, I.V. Gotman, L.N. and Masyuk, S.M. (2006) Method of Determining Dimensions of Temporal Brain Lobes in Patients Suffering from Alzheimer’s Disease. Russian Patent No. 2306102. http://worldwide.espacenet.com/publicationDetails/biblio?DB=EPODOC&adjacent=true&locale=en_EP&FT=D&date=20070920&CC=RU&NR=2306102C1&KC=C1
[44] Matsunaga, S., Kishi, T. and Iwata, N. (2014) Combination Therapy with Cholinesterase Inhibitors and Memantine for Alzheimer’s Disease: A Systematic Review and Meta-Analysis. International Journal of Neuropsychopharmacology, 18, pii: pyu 115.
http://www.ncbi.nlm.nih.gov/pubmed/25548104 http://dx.doi.org/10.1016/j.jalz.2014.05.1710
[45] Grossberg, G.T., Farlow, M.R., Meng, X. and Velting, D.M. (2015) Evaluating High-Dose Rivastigmine Patch in Severe Alzheimer’s Disease: Analyses with Concomitant Memantine Usage as a Factor. Current Alzheimer Research, 12, 53-60. http://www.ncbi.nlm.nih.gov/pubmed/25523430
http://dx.doi.org/10.2174/1567205011666141218122835
[46] Wilkinson, D. (2001) Drugs for Treatment of Alzheimer’s Disease. International Journal of Clinical Practice, 55, 129-134. http://www.ncbi.nlm.nih.gov/pubmed/11321852
[47] Maksimovich, I.V. (2012) Transcatheter Treatment of Atherosclerotic Lesions of the Brain Complicated by Vascular Dementia Development. World Journal of Neuroscience, 2, 200-209.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=24664 http://dx.doi.org/10.4236/wjns.2012.24031
[48] Chizhov, G.K., Kovalskaia, N.I. and Kozlov, V.I. (1991) The Effect of Helium-Neon Laser Radiation on the energy Metabolic Indices of the Myocardium. Bulletin of Experimental Biology and Medicine, 111, 302-305. http://www.ncbi.nlm.nih.gov/pubmed/2054512
[49] Kozlov, V.I. and Azizov, G.A. (2007) Pathophysiological Characteristics of Microcirculatory Disorders in Chronic Arterial Ischaemia of Lower Limbs. Angiology and Vascular Surgery, 13, 17-23.
http://www.ncbi.nlm.nih.gov/pubmed/17679971 http://dx.doi.org/10.1007/BF00840904
[50] Moskvin, S.V. (2008) System Analysis of Efficiency in Controlling Biological Systems with Low-Energy Laser Radiation. Doctor Thesis, Tula. http://www.dissers.info/disser_323120.html
[51] Mak, M.C. and Cheing, G.L. (2012) Immediate Effects of Monochromatic Infrared Energy on Microcirculation in Healthy Subjects. Photomedicine and Laser Surgery, 30, 193-199.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Mak+MC%2C+Cheing+GL. http://dx.doi.org/10.1089/pho.2011.3012
[52] Starck, T., Nissila, J., Aunio, A., Abou-Elseoud, A., Remes, J., Nikkinen, J., Timonen, M., Takala, T., Tervonen, O. and Kiviniemi, V. (2012) Stimulating Brain Tissue with Bright Light Alters Functional Connectivity in Brain at the Resting State. World Journal of Neuroscience, 2, 81-90.
http://www.scirp.org/Journal/PaperInformation.aspx?paperID=19417&#abstract
http://dx.doi.org/10.4236/ wjns.2012.22012
[53] Hashmi, J.T., Huang, Y.Y., Osmani, B.Z., et al. (2010) Role of Low-Level Laser Therapy in Neurorehabilitation, PM & R, 2, S292-S305. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065857/
[54] Stephan, W., Banas, L.J., Bennett, M. and Tunceroglu, H. (2012) Efficacy of Super-Pulsed 905 nm Low Level Laser Therapy (LLLT) in the Management of Traumatic Brain Injury (TBI): A Case Study. World Journal of Neuroscience, 2, 231-233.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=24793&#abstract http://dx.doi.org/10.4236/wjns.2012.24035
[55] Konstantinovic, L.M., Jelic, M.B., Jeremic, A., Stevanovic V.B., Milanovic, S.D. and Filipovic, S.R. (2013) Transcranial Application of Near-Infrared Low-Level Laser Can Modulate Cortical Excitability. Lasers in Surgery and Medicine, 45, 648-653. http://www.ncbi.nlm.nih.gov/pubmed/24136303
http://dx.doi.org/10.1002/lsm.22190

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