RESEARCH AND PERSPECTIVES IN ALZHEIMER'S DISEASE Fondation Ipsen Editor Yves Christen, Fondation Ipsen, Paris (France) Editorial Board Yves Agid, Hopital Piti6 Salpetriere, Paris (France) Albert Aguayo, The Montreal Hospital, Montreal (Canada) Luigi Amanducci. University of Florence, Florence (Italy) Brian H. Anderton, Institute of Psychiatry, London (GB) Raymond T. Bartus, Cortex, Irvine (USA) Anders Bjorklund, University of Lund (Sweden) Floyd Bloom, Scripps Clinic and Research Foundation, La Jolla (USA) Fram;ois Boller, Inserm U 324, Paris (France) Carl Cotman, University of California, Irvine (USA) Peter Davies. Albert Einstein College of Medicine, New York (USA) Andre Delacourte, Inserm U 16, Lille (France) Steven Ferris, New York University Medical Center, New York (USA) Jean-Fram;ois Foncin, Hopital Piti6 Salpetriere, Paris (France) Franr,;oise Forette, Hopital Broca, Paris (France) Fred Gage, University of California, La Jolla (USA) Carleton D. Gajdusek, National Institute of Health, Bethesda (USA) George G. Glenner, University of California, La Jolla (USA) Dmitry Goldgaber, State University of New York Stone Brook (USA) John Hardy, St. Mary's Hospital, Medical School, London (GB) and University of South Florida, Tampa (USA) Jean-Jaques Hauw, Hopital Piti6 Salpetriere, Paris (France) Robert Katzman, University of California, La Jolla (USA) Claude Kordon, Inserm U 159, Paris (France) Kenneth K. Kosik, Harvard Medical School Center of Neurological diseases and Brigham and Women's Hospital. Boston (USA) Yvon Lamour, Inserm U 161, Paris (France) Jacques Mallet, CNRS, Gif-sur-Yvette (France) Colin L. Masters, University of Melbourne, Parkville (Australia) Stanley 1. Rapoport, National Institute on Aging, Bethesda (USA) Andre Rascol, Hopital Purpan, Toulouse (France) Barry Reisberg, New York University Medical Center, New York (USA) Allen Roses, Duke University Medical Center, Durham (USA) Dennis 1. Selkoe, Harvard Medical School Center for Neurological Diseases and Brigham and Women's Hospital, Boston (USA) Michael L. Shelanski, Columbia University, New York (USA) Pierre-Marie Sinet, Hopital Necker, Paris (France) Peter St George-Hyslop, University of Toronto, Toronto (Canada) Robert Terry, University of California, La Jolla (USA) Henry Wisniewski, Institute for Basic Research in Development Disabilities, Staten Island (USA) Edouard Zarijian, Centre Hospitalier Universitaire, Caen (France) F. Boller F. Forette Z. Khachaturian M. Poncet Y. Christen (Eds.) Heterogeneity of Alzheimer's Disease Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona Budapest Boller, Francois, Prof. Dr. INSERM U324, 2ter rue de Alesia F-75015 Paris Forette, F. Hopital Broca 54 rue Pascal F-75013 Paris Khachaturian, Z.S. National Institute on Aging National Institutes of Health Bethesda, MD 20892, USA Poncet, Michel Clinique de Neurologie, CHU La Timone Bd Jean Moulin, F-13385 Marseille Cedex 05 Christen, Yves, PH. D. Fondation Ipsen pour La Recherche Therapeutique 30, rue Cambronne F-75737 Paris CEDEX 15 ISBN-13: 978-3-642-46778-3 e-ISBN-13: 978-3-642-46776-9 DOl: 10.1007/978-3-642-46776-9 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustration, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Violations fall under the prescutation act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1992 Softcover reprint of the hardcover 1s t edition 1992 The use of general descriptive names, trade marks, etc. in this publication even if the former are not especially identifed, is not to be taken as a sign that such names, as understood by the Trade marks and Merchandise Marks Act, may accordingly be used by anyone. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its a accuracy by consulting other pharmaceutical literature. Typesetting: Cicero Lasersatz, 8900 Augsburg 27/314515432 10-Printed on acid-free paper Preface This volume contains the proceedings of a symposium held in Marseille on April 6, 1992, on the topic "Heterogeneity of Alzheimer's disease." This was the eighth of a continuing and very successful series of meetings related to Alzheimer's disease organized by the Fondation Ipsen pour la Recherche Therapeutique. These symposia, known as "Colloques medecine et recherche," started in 1987 and have dealt with widely different aspects of the disease such as immunology, genetics, neuronal grafting, biological markers, imaging, growth factors, and last year's less conventional topic of Neurophilo sophy and Alzheimer's disease. The next IPSEN symposium dedicatet to Alz heimer's disease will take place in Lyon on June 21, 1993, and will deal with "Amyloid protein precursors in development, aging, and alzheimer's disease. " It is being organized by Konrad Beyreuther, Colin Masters, Marc Trillet, and Yves Christen. Until a few years ago, several names were used to refer to the most common cause of dementia in the elderly. They included such terms as "senile psycho sis," "organic brain syndrome," and "senile dementia." Following Kraepelin, the term "Alzheimer's disease" was often restricted to an uncommon condition starting at a younger age (before 60 or 65 years of age). In 1978, the conclu sions of a symposium organized by Robert Katzman, Robert Terry, and Katherine Bick pointed out that there was an "increasing recognition that the clinical and pathological manifestations are almost identical in the presenium and in the senium." This and the success in the United States of the Alzheimer Disease and Related Disorders Association (ADRDA, now called Alzheimer Association) were among the factors contributing to the much more wide spread use of the term "Alzheimer's disease" in recent years. Independently of the nomenclature, it has always been obvious to anyone dealing with demented patients that there are marked differences among pa tients. In fact, once we start taking a close look, we find that cases always differ from one another and that no patient is ever exactly like any other. Does this symply reflect the variability found in any disease, or does it represent the expression of different pathological phenomena? This symposium gathered researchers with backgrounds as different as epide miology, clinical neurology and geriatrics, neuropsychology, neuropathology, molecular biology, and genetics. The primary purpose of the meeting was to provide elements that might allow a rational answer to the question of hetero geneity of Alzheimer's disease. This question is of great theoretical interest, VI Preface but with the appearance of new therapeutic interventions, it may well start having a very significant practical importance. The city of Marseille and its neighbor Aix-en-Provence have a long-standing tradition of academic excellence in many fields including neurology and neuro sciences and we are indebted to the Mayor of Aix, Dr Jean-Francois Picheral, who provided a very warm welcome to the participants. Once again, the organization of the meeting was perfect in all respects, thanks to the efforts of Mrs. Jacqueline Mervaillie and her colleagues. We also wish to thank the contributors to this volume, the authors of posters, and all the participants to the meeting. Our particular gratitude goes to Dr. Zaven Khatchaturian who in the past several years has significantly contributed to the development of research on Alzheimer's disease in the United States and other countries. Our thanks also go to Professor Michel Poncet and Profesor George Serratrice who kindly acted as session chairs, and to Mary Lynn Gage who provided editorial assistance. Fran~ois Boller Yves Christen Contents An Overview of Scientific Issues Associated with the Heterogeneity of Alzheimer's Disease Z. S. Khachaturian . . . . . . . . . . . . . . . . . . . . . . . . . 1 A Comparison of Clinical Outcome and Survival in Various Forms of Alzheimer's Disease R. Mayeux, Y. Stern, and M. Sana . . . . . . . . . . . . . . . . . 4 Prognostic Implications of Symptomatic Behaviors in Alzheimer's Disease H. C. Chui, S. Lyness, E. Sobel, and L. S. Schneider 12 Heterogeneous Disappearance of Knowledge in Alzheimer's Disease 1. Ora/man ................. . 24 Neuropsychological Aspects of Alzheimer's Disease: Evidence for Inter- and Intra-Function Heterogeneity y. loanette, B. Ska, A. Poissant, and R. Beland. 33 Primary Progressive Aphasia: Sharpening the Focus on a Clinical Syndrome M.-M. Mesulam and S. Weintraub ..... 43 Therapeutic Drug Trials and Heterogeneity of Alzheimer's Disease F. Forette, P. Bert, V. Breuil, and F. Boller 67 Pro and Con for Heterogeneity of Alzheimer's Disease: A View from an Epidemiologist L. Amaducci and A. Lippi .......... . 74 Heterogeneity in Familial Alzheimer's Disease M. N. Rossor, A. M. Kennedy, and S. K. Newman 81 VIII Contents Molecular Genetic Evidence for Etiologic Heterogeneity of Alzheimer's Disease P. H. St George-Hyslop, D. R. Crapper McLachlan, f. L. Haines, A. Bruni, f.-F. Foncin, W. Lukiw, M. P. Montesi, M. Mortilla, L. Pinessi, R. f. Polinsky, D. Pollen, I.Rainero, E. Rogaev, S. Sorbi, R. Tanzi, R. Tupler, and G. Vaula . . . . . . . . . . . . . . . . . . . 88 Alzheimer's Disease: many Aetiologies; one Pathogenesis f. Hardy . ......................... . 96 Locus Heterogeneity of Alzheimer's Disease A. Roses, M. Pericak-Vance, M. Alberts, A. Saunders, H. Taylor, f. Gilbert, C. Schwartz bach, M. Peacock, f. Fink, R. Bhasin, and D. Goldgaber. . . . . . . . . . . . . . . . . . . . . . . . . . 101 Familial Alzheimer's Disease in Germans from Russia: A Model of Genetic Heterogeneity in Alzheimer's Disease T. D. Bird, E. M. Nemens, D. Nochlin, S. M. Sumi, E. M. Wijsman, and G. D. Schellenberg. . . . . . . . . . . . . . . . . . . . . . . .. 118 Protein Phosphorylation Regulates Processing of the Alzheimer BIA4-Amyloid Precursor Protein S. E. Gandy, G. L. Caporaso, T. V. Ramabhadran, f. D. Buxbaum, T. Suzuki, C. Nordstedt, K. Iverfeldt, A. f. Czernik, A. C. Nairn, and P. Greengard . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Alzheimer's Disease and Neuroanatomy: Hypotheses and Proposals C. Duyckaerts, P. Delaere, and i.-i. Hauw ............. 144 Distribution of Tau-PHF in Brodmann Areas Reveals a Heterogeneity of the Degenerating Process in Rostro-Caudal Regions and as a Function of Age P. Vermersch, B. Frigard, A. Wattez, and A. Delacourte . . . . . . .. 156 Alzheimer's Disease and Age-Related Pathology in Diffuse Lewy Body Disease D. W. Dickson, E. Wu, H. A. Crystal, L. A. Mattiace, S.-H. C. Yen, and P. Davies 168 Subject Index 187 Contributors Alberts, M. Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, MC 27710, USA Amaducci, L. Department of Neurologic and Psychiatric Sciences, University of Florence, Viale Morgagni 85, 50134 Florence, Italy Biland, R. Laboratoire TMophile-Alajouanine, C. H. C6te-des-Neiges, 4565, chemin de la Reine-Marie, Montreal, Quebec H3W 1W5, Canada Bert, P. H6pital Broca, 54 rue Pascal, 75013 Paris, France Bhasin, R. Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY 11794-8101, USA Bird, T. D. Departments of Medicine and Pathology, University of Washington Medical School and the VA Medical Center, Seattle, WA 98018, USA Boller, F. INSERM U324, 2ter rue d'Alexia, 75014 Paris, France Breuil, V. H6pital Broca, 54 rue Pascal, 75013 Paris, France Bruni, A. SMID-SUD, Scala 4, via dei Campione, Lamezzia Terme, CZ, Italy Buxbaum, 1. D. Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University, 1230 York Avenue, New York, NQ 10021, USA X Contributors Caporaso, G. L. Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University, 1230 York Avenue, New York, NY 10021, USA Chui, H. C. University of Southern California School of Medicine, Los Angeles and Geriatric Neurobehavior and Alzheimer Center, 12838 Erickson Street, Downey, CA 90242, USA Crapper McLachlan, D. R. Department of Medicine, Centre for Research in Neurodegenerative Disease, Tanz Neuroscience Building, Univesity of Toronto, Ontario M5S1A8, Canada Crystal, H. A. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA Czernik, A. I. Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University, 1230 York Avenue, New York, NY 10021, USA Davies, P. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA Delacourte, A. INSERM U 156, Place de Verdun, 59045 Lille CEDEX, France Delaere, P. Laboratoire de Neuropathologie R. Escourolle, Hopital de la Salpetriere, 47, Boulevard de l'Hopital, 75651 Parix CEDEX 13, France Dickson, D. W. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA Duyckaerts, C. Laboratoire de Neuropathologie R. Escourolle, Hopital de la Salpetriere, 47, Boulevard de l'Hopital, 75651 Paris CEDEX 13, France Fink, I. Department of Neurology, University of Michigan Medical Center, Ann Arbor, MI 48104, USA Foncin, I-F. Laboratoire de Neurohistologie, Ecole Pratique des Hautes Etudes, Hopital de la Salpetriere, 75651 Paris CEDEX 13, France
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