NeuroSPECT Demonstrates Increased Cortical Function in Alzheimer＊s Disease Patients For At Least Two Years After Omental Transposition Neurosurgery.

作者：Shankle; William R MD; Mena; Ismael MD; Hara; Junko; O’ Heany; Terence

来源：Alasbimn Journal, 2006.

• Alzheimer&rsquo
• Disease
• Omentum
• NeuroSPECT
• HMPAO
• Clinical Improvement

Clinical improvement following surgical transposition of the omentum to the brain (OTS) has been observed in a variety of neurologic disorders, including stroke, encephalitis, cerebral palsy, spinal cord transaction and Alzheimer＊s disease. The basis for such improvement is not known, but may relate to the presence of stem cells and growth factors in the omentum, which have been implicated in angiogenesis, neurogenesis and neuronal survival. The present report describes the changes in brain activity in two patients with biopsy confirmed Alzheimer＊s disease (AD) whose course had entered a phase of more rapid decline prior to OTS. The patients were followed with disease severity(Clinical Dementia Rating Scale), cognitive (Mini-Mental Status Exam) and HMPAO NeuroSPECT measures for 22 and 42 months. Dementia severity lessened for 2 or more years while cortical activity in areas underneath, adjacent to, and contralateral to the omentum increased by 1〞2 standard deviations above the patient＊s preoperative baseline (maximum increase was 21%, 4 Standard Deviations). In the more mildly demented AD patient 22 months after OTS, the posterior cingulate cortex showed up to a 20% increase in activity compared to is preoperative level of activity. This is remarkable in that the omentum had no direct contact with the posterior cingulate gyrus, which is involved in the early stages of AD neuropathology (Braak and Braak stages 3〞4). These findings warrant further investigation into the mechanism(s) by which the omentum can improve cortical activity and clinical function for two or more years in Alzheimers＊ disease.Se ha comunicado mejor赤a cl赤nica despu谷s del implante quir迆rgico de Omento (delantal de los epiplones) en el cerebro en varias condiciones neurol車gicas que incluyen Infarto cerebral, Encefalitis, Transecciones de la m谷dula espinal y enfermedad de Alzheimer%26apos;s. La explicaci車n fisiopatol車gica de estas mejor赤as no es conocida pero puede relacionarse con la presencia de C谷lulas Madres y factores de crecimiento en el Omento que tendr赤an efectos sobre la angiog谷nesis, neurog谷nesis y sobrevida neuronal. El presente trabajo describe los cambios en la actividad cerebral en dos pacientes con diagn車stico de Enfermedad de Alzheimer%26apos;s confirmado por biopsia, cuya evoluci車n cl赤nica hab赤a entrado a una fase de r芍pida progresi車n antes del trasplante de Omento .Los pacientes fueron evaluados psicom谷tricamente mediante la escala de cl赤nica de severidad demencial , desde el punto de vista cognitivo el MMSE examination y Neurospect sequencial con HMPAO medido durante 22 y 42 meses r