Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements

We investigated the relation between cobalamin deficiency. clinical changes and brain junction in dementia patients. On admittance to the clinic. 24 p atients had cobalamin deficiency, and dementia with additional symptoms of delirium. During cobalamin supplementation, the patients underwent repeated regional cerebral blood flow! (rCBF) studies. psychiatric evaluations, and in some cases assessment with MMSE and the Organic Brain Syndrome scale. F ifteen patients who showed mild to moderate dementia improved clinically, a nd also showed a concomitant increase in their general CBF after treatment. In contrast, 9 patients who were severely demented showed no obvious clini cal improvement. and no general blood flow change. although some regional f lour increases were seen in sensory motor areas. We conclude that symptoms which probably indicated superimposed delirium such as clouding of consciou sness, disorientation and clinical fluctuation. responded to the vitamin B- 12 Supplementation, while the underlying dementia condition remained basica lly unchanged. The clinical improvement was also mirrored in general and fo cal rCBF changes. (C) 2000 Editrice Kurtis.