Vascular Dementia Epidemic Analysis
As far as the aging of the population of Russia the magnitude of dementia “epidemic” in the elderly will increase. Its most common causes are the degenerative brain diseases: vascular and Alzheimer's diseases; in some people dementia is caused by a mixed pathology [1, 2].
Vascular dementia (VD) is not considered to be a separate disease with its own inherent pathology, although it there were several attempts to recognize the VD a separate disease. It is a heterogeneous syndrome, including several different clinical and pathological manifestations: preferential frontal brain cortex disorders with impairment of motor functions, attention and behavior.
In the pathogenesis of vascular dementia an activation of glutamatergic NMDA-receptors plays
a special role. Normally NMDA-receptors activation is connected with plasticity of the central nervous system structures, and it is responsible for learning and memory. However in pathological states a prolonged excessive activation of these receptors leads to neuronal cell death. At a supraspinal level the NMDA-receptors are localized in hippocampus, cortex of cerebral hemispheres (especially in anterior area), thalamus, striatum, cerebellum and brain stem, at the spinal level - mainly in the posterior horns in the substantia gelatinosa and in small quantities - in gray matter of spinal cord. Excessive activation of glutamate receptors is accompanied by a massive inflow of calcium and sodium ions into neurons, which leads to membrane depolarization and activation of voltage-dependent calcium channels and is accompanied by a greater increase of calcium ions entry to the cells.
Vascular dementia (VD) is not considered to be a separate disease with its own inherent pathology, although it there were several attempts to recognize the VD a separate disease. It is a heterogeneous syndrome, including several different clinical and pathological manifestations: preferential frontal brain cortex disorders with impairment of motor functions, attention and behavior.
In the pathogenesis of vascular dementia an activation of glutamatergic NMDA-receptors plays
a special role. Normally NMDA-receptors activation is connected with plasticity of the central nervous system structures, and it is responsible for learning and memory. However in pathological states a prolonged excessive activation of these receptors leads to neuronal cell death. At a supraspinal level the NMDA-receptors are localized in hippocampus, cortex of cerebral hemispheres (especially in anterior area), thalamus, striatum, cerebellum and brain stem, at the spinal level - mainly in the posterior horns in the substantia gelatinosa and in small quantities - in gray matter of spinal cord. Excessive activation of glutamate receptors is accompanied by a massive inflow of calcium and sodium ions into neurons, which leads to membrane depolarization and activation of voltage-dependent calcium channels and is accompanied by a greater increase of calcium ions entry to the cells.