Richard Prettyman

A Pilot Study of the Physiological and Behavioural Effects of Snoezelen in Dementia

Recent interest in the use of Snoezelen as an intervention for agitated behaviour in patients with dementia remains supported by limited evidence of efficacy. This pilot study aimed to develop an approach for assessing the effects of Snoezelen on agitated behaviour in patients with dementia and its comparability with an existing control intervention. Ten patients with dementia were randomised to receive a 4-week course of either Snoezelen or reminiscence therapy. The therapeutic effects were assessed using the Agitation Behaviour Mapping Instrument (ABMI) and the Cohen-Mansfield Agitation Inventory (CMAI) and by heart rate recording. Differences in dementia severity between the two groups hindered direct comparison of outcomes. Both interventions were well tolerated and the majority of both Snoezelen and reminiscence sessions were rated positively. The ABMI ratings suggested that Snoezelen might have reduced agitated behaviour during and immediately after the session but that this effect was short-lived. The CMAI scores indicated reduced agitated behaviour during the intervention period. Heart rate data showed both decreases and increases during the sessions for different participants. With minor modifications, the measures used will be appropriate for a full-scale comparative trial. Both interventions may have helpful short-term effects and while for some patients the sessions are primarily relaxing, for others they may have a more stimulating effect.

Therapeutic potential of cannabinoids in neurodegenerative disorders: a selective review.

The endocannabinoid system (ECS) is now recognised as an important modulator of various central nervous system processes. More recently, an increasing body of evidence has accumulated to suggest antioxidant, anti-inflammatory and neuroprotective roles of ECS. In this review we discuss the role and therapeutic potential of ECS in neurodegenerative disorders such as Alzheimers disease (AD), Parkinsons disease, multiple sclerosis, Huntingtons disease, Tourettes syndrome, brain ischemia and amyotrophic lateral sclerosis (ALS). Elements of the ECS, such as fatty acid amide hydrolase or the cannabinoid receptors are now considered as promising pharmacological targets for some diseases. Although still preliminary, recent reports suggest that modulation of the ECS may constitute a novel approach for the treatment of AD. There are windows of opportunity in conditions caused by acute events such as trauma and ischemia as well in conditions that may involve altered functionality of the target receptors of the ECS, such as in AD. The ECS changes in Parkinsons disease could be compensatory as well as pathogenic of the illness process and needs further understanding and clinical studies are still in the preliminary stage. There is not enough evidence to support use of cannabinoids in treating Huntingtons disease, tics and obsessive compulsive behaviour in Tourettes syndrome. Evidence on therapeutic use of cannabinoids in multiple sclerosis and ALS is currently limited. A major challenge for future research is the development of novel compounds with more selectivity for various components of the ECS which could target different neurotoxic pathways and be used in combination therapy.

Death‐associated protein kinase (DAPK1) in cerebral cortex of late‐onset Alzheimer's disease patients and aged controls

A. H. Hainsworth, R. C. Allsopp, A. Jim, J. F. Potter, J. Lowe, C. J. Talbot and R. J. Prettyman (2010) Neuropathology and Applied Neurobiology36, 17–24
Death‐associated protein kinase (DAPK1) in cerebral cortex of late‐onset Alzheimers disease patients and aged controls

A retrospective study of neuroradiological abnormalities detected on structural magnetic resonance imaging of the brain in elderly patients with cognitive impairment

Background. The aim of the study was to investigate the relationship between neuroradiological and clinical diagnosis in patients presenting with cognitive impairment, and also the relationship between the neuroradiological abnormalities and cognitive function as assessed by the Mini‐Mental State Examination (MMSE) score.

When do we discontinue anti-dementia drugs? Views expressed by clinicians in a national survey within the United Kingdom.

The use of anti-dementia medication is expected to rise with increasing demand and a growing elderly population. With the implementation of the “Living well with Dementia: National Dementia Strategy” document in the United Kingdom, there is an increased awareness along with an urge for early diagnosis and initiation of treatment.