CEREBROVASCULAR REACTIVITY TO ACETAZOLAMIDE IN (SENILE) DEMENTIA OF ALZHEIMERS TYPE - RELATIONSHIP TO DISEASE SEVERITY

Neuropathological reports about denervation and amyloid angiopathy in dementia of Alzheimer's type (DAT) as well as signs of selective incom plete white matter infarctions point to a vascular involvement within the degenerative process. In order to investigate potential alteration s of cerebrovascular function we performed cerebral blood flow measure ments before and after intravenous injection of Ig acetazolamide using technetium-99m hexamethylpropyleneamine oxime and single photon emiss ion tomography in 12 patients (6 female, 6 male; mean age 70.8 +/- 9.6 years) with probable (senile) dementia of Alzheimer's type (SDAT) and 9 controls (7 female, 2 male; mean age 71.2 +/- 8.6 years). SDAT pati ents revealed significantly reduced cerebrovascular reactivity with lo wer values with increasing cognitive impairment. We discuss possible u nderlying mechanisms.