A promising approach to the treatment of multi-infarct dementia

Cerebrovascular multi-infarct dementia (MID) is associated with high fibrin ogen levels and lipid fractions leading to an increase of both plasma and w hole blood viscosity as well as raised aggregability of blood cells. One im portant goal in the treatment of MID therefore should be to reduce fibrinog en and lipoproteins and thereby to improve the Hemorheological State. The e ffect of heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) , a method for safe and immediate reduction of parameters relevant to hemor heology, such as plasma fibrinogen and the lipoproteins, was investigated i n 141 patients with MID. All the patients underwent two HELP applications w ithin 8 days. The impact of HELP on MID was studied by changes of laborator y data and by evaluation of clinical symptoms before and after treatment. E ach HELP session caused an immediate, safe and significant reduction of imp ortant rheological parameters such as fibrinogen, whole blood viscosity at high and low shear rate, plasma viscosity and red cell transit time. Also t otal cholesterol and low-density lipoprotein, lipoprotein(a) and the trigly cerides had been reduced significantly. The results in laboratory measureme nt were followed by a statistically significant improved neurologic recover y, represented in the values of the Mathew Scale, the Mini Mental State Exa mination and the Activities-of-Daily-Living-Test. These results can indicat e the importance and influence of hemorheology on clinical symptoms in MID. (C) 2000 Elsevier Science Inc. All rights reserved.