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100%, then was obtained. It would be helpful to extend this analysis to a larger sample, to look at the concentrations in different stages of the disease, to demonstrate that these changes are not seen in other diseases, and to compare those plasma concentrations with those in brain tissue, CSF, and serum. If one could better discern the nature of unusual cases, it would permit the construction of more complicated discriminant functions that could be used in the general population for presymptomatic patients or those with very mild AD. These increases in plasma concentration may parallel the concentrations in the hippocampus secondary to its poor blood-brain barrier. This limited pilot study demonstrates that the discriminant analysis number may be an economic predictor to use in conjunction with present neurologic and psychologic tests to screen accurately for moderate Alzheimer's disease.
Acknowledgment We wish to thank the Chicago College of Osteopathic Medicine; K. Suarez, PhD, Director of Research; D. Richardson, PhD, and L. Gierke,DO, for the generous use of the pathology department; the Department of Biochemistry, especially Mr Howard Wassoff, who provided insight and answers; L. Van Winkle, PhD, for his critique; J. Kopp, MD, and the staff and residents of Windsor Manor Nursing Home; Pete Meyer (PhD candidate) for his thorough dissection and analysis of the statistics, and especially Mrs Sandy Miulli, who spent long hours helping the primary author at the nursing home and in the laboratory.
References 1. Hyman BT, Van Hoesen GW, Kromer L,J, et al: Perforant
pathway changes and the memory impairment of Alzheimer's disease. Ann Neurol 1986;20:472-481. 2. Hardy J, Cowburn R, Barton A, et al: Region specific loss of glutamate innvervation in Alzheimer's disease. Neurosci Lett 1987;73:77-80. 3. Sasaki H, Muramoto 0, Kanazawa I, et al: Regional distribution of amino acid transmitters in postmortem brains of presenile and senile dementia of Alzheimer's type. Ann Neurol 1986;19:263-269. 4. Wolf-Klein GP, Silverstone FA, Levy AP, et al: Screening for Alzheimer's disease by clock drawing. J Am Geriatr Soc 1989;37:730-734. 5. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, rev. Washington, DC, American Psychiatric Association, 1987. 6. Meister A: Glutamine synthetase from mammalian tissues, in Meister A (ed): Methods inEnzymology. New York, Academic Press mc, 1985, vol 113, pp 185-199.
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