¹Okehazama Hospital, Brain Research Institute, Toyoake, Japan, ²Tokyo Metropolitan Institute of Medical Science, Neuropathology, Tokyo, Japan

Background: The agitation and irritability that accompany dementia are extremely distressing not only for patients but also for their caregivers. However, drug strategies for treating these psychiatric symptoms have not been sufficiently investigated, and the mechanism is unclear, so a strategy based on EBM is required.

Aims & Objectives: Among the dementia diseases, AGD is said to be easily accompanied by excitement and irritability. We will examine the neuropathologically affected areas of AGD and consider pharmaceutical strategies based on the phenomena.

Method: Using the post-mortem brain of AGD dementia patients, we observed the amygdala, which is involved in emotion, and identified the neuropathologically affected areas and determine if there is a network failure.

Results: Neuropathologically, the medial cortical region was strongly affected in AD, and the basolateral amygdala (BSA) was strongly affected in AGD. BSA is said to consist of 80% glutamatergic pyramidal neurons and 20% GABAergic interneurons. The excitability of AGD was thought to be caused by the overactivity of glutamatergic pyramidal cells.

Discussion & Conclusions: The irritability and aggressiveness of AGD, a form of limbic dementia, is thought to be related to the degenerative process of the ventrolateral amygdala, and anti-convulsive drugs ( i.e. valproic acid > carbamazepam) are thought to be effective. It is important to consider theoretical drug strategies for treating the psychiatric symptoms of dementia from the neuropathological background.