1. RECENT ADVANCES IN DIAGNOSIS AND TREATMENT OF SCHIZOPHRENIA
AND ALZHEIMER/DEMENTIA
1. Introduction
 Definition of Neurological disease
 Health hazards due to neurological disease
2. Schizophrenia as neurological disorder
 Definition of schizophrenia
 Cause of schizophrenia
 Diagnosis of schizophrenia
 Biochemical & molecular analysis of schizophrenia
 Treatment of schizophrenia
 Limitation of treatment & future prospects for treatment of schizophrenia
3. Alzheimer as neurological disorder
 Definition of Alzheimer disease (AD)
 Cause of Alzheimer disease
 Diagnosis of Alzheimer disease
 Biochemical & molecular analysis of Alzheimer disease
 Treatment of Alzheimer disease
 Limitation in treatment & future prospect of treatment of Alzheimer disease

2. CONTENTS
1. What are neurological diseases? 1-4
2. Health hazards due to neurological disease 5-6
3. Schizophrenia or neurological disease 7-8
4. Definitions 7-8
5. Cause of schizophrenia 7-8
6. Diagnosis and treatments 9-10
7. Alzheimer Disease 11
8. Neurological Disorder 11-12
9. Diagnosis 13-16
10. Biochemical and molecular analysis of Alzheimer Disease 17-18
11. Treatment 18
12. Cause by enzymes 19-21
13. ICC 22
14. Parapsychology 23

3. What are Neurological Disorders?
The study of biology with nervous system is called neurology (the average weight of brain is
about 1400g in men and 1250g in women)
The study of disease of nervous system is called neurological disorder.
There are two categories of neurological disorder
Neurological disorder
↓
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↓ ↓
Neurosis Psychosis

4. Neurosis:
A Mental and emotional disorder that affect any part of the personality is a compound by less
destroys
Mental and emotional disorder that affects only part of the personality
Neurosis is a referred to disorder of sense and motion caused by general affecting of the nervous
system.
There are different types of neurosis:
1. Obbesive compulsive disorder
2. Impulse disorder
3. Anxiety
4. Hysteria
5. Phobias

5. PHYCHOSIS:
Psychosis refers to an abnormal condition of mind and its generic by psychiatric.
A loss of contact with reality (ICD- 290-299)
1. Schizophrenia
2. Personality
3. Bipolar
4. Post traumatic
5. Dissociative disorder

6. HEALTH HAZARDS DUE TO NEUROLOGICAL DISEASE:
Numerous brain disorders have importance in public health not only because of their frequency
but also related to their personal social and economical burden. The best knowledge of their
distribution and population under risk would favor the development of preventive and
therapeutic programs as well as needing of service including human resources equipment and
drugs.
The studies about cerebral disorder are predominantly based on patient of specific hospital in or
out patients’ wards specialized centers mainly university hospital. Recording this selection bias
the satisfies and / or more server disorder because of the lack of ample health care coverage and
no responsibility of centralized charts or records in defined areas. Another problem is the
definition of the population under risk.

7. What are neurological diseases?
The study of the nervous system and the structural and functional change occurring in them the
disease are divided into:
1. Congenital defects in development those in which degeneration reveals itself only after a
period of time.
2. Those in which distractive influence act upon a brain that was initially normal. The potter
was mainly vascular inflammatory toxic traumatic mechanical or a neoplastic.
TREATMENT:
NSAID opiods, gabapentin anticonvulsents and topical agents have all brain used with
variable success. Acupuncture is not effective human nerve growth factor (NGF) which
stimulated regeneration of damaged nerve fibers is being studied esp. to minimize the
neuropathy that antiretroviral drug cause pathological condition of the nervous system
that assend from the lower part of the body to the upper part.

8. SCHIZOPHRENIA:
A thought disorder affecting about 0.4-1.2% of the population marked by delusions hallucination
and disorganized speech and behavior (the positive symptoms) and by flat social withdraw and
absence of validation ( the negative symptoms) schizophrenia involve dysfunction in one or
more area such as interpersonal rotation work or education and self care associated feature
include appropriate affect, anhedonia , dysphoric mood abnormal psychomotor activity cognitive
dysfunction confusion took of insight and depersonalization. Abnormal neurological finding may
show a broad range of dysfunction including slow reaction time. Poor co-ordination
abnormalities in eye tracking and impaired sensory getting. Some individual drink excessive
amount of water and develop abnormalities in urine specific gravity and electrolyte balance
because none of its clinical features are diagnostic.
Schizophrenia remains a diagnosis of exclusion. It is important to include psychosis with known
organic cause such as temporal lobe epilepsy metabolic disturbance toxic substances or psycho
active drugs. The onset of schizophrenia typically occurs between the late teens and the mid 30s
onset prior to adolescent is rare gender differences suggest that women are more likely to have
later onset more prominent mood symptoms and a better prognosis hospital based studies show a
higher rate of schizophrenia in men where as community based studies suggest an equal sex
ratio.

9. ETIOLOGY:
The Cause of Schizophrenia is unknown
TREATMENT:
Medication used to control schizophrenia include antipsychotic drugs that act on dopamine
receptors in the brain such as chlorpromazine, flaphenazine, haloperidol and resperidone each of
these may be associated with significant side effects as a result drug treatment with any of them
requires careful monitoring supportive psychotherapy or cognitive behavioral therapy may be
helpful for the patient or family.
Generally in clinical practice only one therapeutic modality is used however it is believed that
since the disease is brought about by multiple information’s within a various such system a
multifaceted therapeutic.
The study is proposed to show how important is the magnitude of these disorder in different
regions as well as necessity of the researchers in the biological or epidemiological fields also it is
proposed to show how important is the magnitude of these disorders in different regions as well
as the necessity of researchers in biological and / or epidemiological fields also it is proposed to
personal minimal subsidies for the formation of health care. In this way it is proposed to show
the relevance of the brain disorder supervision and evolution health care program for these
patients all sources of data with possible and recognizable flaws.

10. MATERIAL AND METHODS:
The study is based on the data derived from hospital with links with the health care system
based on the SINTASE (Integrative system of statically treatment of strategies series of the
social security) it is based on the following data, coded by the international classification of
disease.
ALZHEIMER’S DISEASE:
Alzheimer Disease is the most common form of dementia of the old and its incidence increase
with age. Alzheimer disease is invidious progression and cause defects in memory cognitive
attention and motivation. Most AD suffers also have symptoms of Parkinson’s disease (PD) and
neurodegenerative of the substantia nigra.
NEUROPATHY OF ALZHIEMER DISEASE:
Patient with Alzhiemer disease have massive shrinkage of cortex and sub cortical structure two
characteristics lession are found particularly in the neocortex hippocampus and amygdala
neurotic plaques are extracellular deposits of β-amyloids peptide surrounded by degenerating
neuritis and glial cells activated by inflammatory process. Alzheimer disease in brain regions not
implicated in the disease and in the brain of normal old people. Neurofibrallery tangles are
cytoplasmic bundles of paired helical filaments (PHFs) made from an abnormal
hyperphosphorelated state of tau a protein normally associated with microtubules. The density of
tangles correlates with the severty of dementia death of glutamergic cells in the cortex and loss
of several transmitter system that protect to the cortex dominate the pathology.
FAMILIAL ALZHIEMER DISEASE:
Rare familial Alzheimer’s disease is infected to mutation in four genes and much idiopathic AD
might be accounted for by polymorphism of an apolipoprotein gene mutation of the gene for
amyloid precursor gene protein (located on chromosomes 21) which gene rise BA are linked to
early code for persimilins have mutation linked to early onset AD, and tau gene mutation are

11. seen in dementia with Parkinson disease. There are three common allele of apolipoprotien
(A.P.E) one of which polymorphism of the APOE gene could account for up to 90% of
idiopathic AD.
DIAGNOSIS:
The term denoting the disease or syndrome a person has or is belived to have the diagnosis form
the basis of patient care.
Antenatal diagnosis: parental diagnosis
CYTOLOGICAL DIAGNOSIS: identification of disease based on cells and tissues present in
body.
DIFFERENTIAL DIAGNOSIS: identification of a disease by comparison of illness
DUAL DIAGNOSIS: the presence of mental illness in a patient with a history of concurrent
substance abuse.
RADIOGRAPHIC DIAGNOSIS: identification of an illness by enterperation of radiographic
finding.

12. IN NEURAL AND MENTAL ILLNESS USE
1) Computerized tomography scanning
2) PET: position emission tomography used but it is most costly.
3) MRI: magnetic resonance imaging
4) SPECT: single protein emission computerized tomography used and it is advanced
technique
5) EEG: electron encephalography used to absent of ray in your brain

13. RELAXATION TECHNIQUE: technique developed by Jacobson is the most commonly used
PHARMACOLOGICAL AGENTS: psychoactive drugs to reduce anxiety and depression help
to relieve headache analgesic are also used.
Yoga therapy is also used to reduce headache, depression, psychosis, neurosis, mental illness etc.
The steps of Yoga Therapy:
1. Krias or cleaning process
2. Asnas or postural pattern
3. Pranayams or breathing exercise
Approach is definitely more effective than a therapy against one causative factor. Various modes
of treatment tried in tension type headache include.
1) HYPNOTOIC SUGGESTION TECHNIQUE:
To induce relaxation and to overcome deeply buried unconscious Conflict.
2) BIOFEEDBACK TECHNIQUE:
Using electroencephalography (EEG) for general relaxation as well as relaxation of
specific muscle groups under tension
3) PSYCHOTHERAPEUTIC TECHNIQUE:
To make the Patient aware of pattern of maladjustment which are initiating the headache.

14. MOLECULAR AND BIOCHEMICAL MARKER:
Two pathways cleave amyloid precursor protein (APP). One of which lead to the
formation of BA is a normal secretary product found in human cerebrospinal fluid (CSF).
APP is over expressed in down syndromes and following brain isochemia and head injury
BA aggregates and is deposit to plaques where it is toxic leading to formation of
neurofibralliary tangles mutation of the APP gene in the production of BA and its
deposition in plaques presenilin mutation may not by altering the regulation of the APP
cleavage pathway
TAU AND ALZHIMEIR DISEASE:
Tau is protein needed for the assembly of microtubules Mutation of the tau gene are
linked to dementia in which neurofibrillary tangles are found extensively in the frontal
and temporal cortex but in which there are few plaques. Tau protein may disrupt
microtubules formation and increase aggregation of tau info PHFs. although tau in PHFs
is hyperphosphorelated that is not the result of mutation and the consequence of this
abnormal phosphorelation is unclear.
PHARMACOLOGICAL INTERVENTION IN ALZHIEMER DISEASE:
Acetyl cholinesterase (Ach) inhibitors which potentiate the effect of Ach released in the
cortex from cholinergic neurons can produce modust improvement in some patient anti
inflametry drugs can arrest cognitive declines. However, real progress will require novel
strategies for example the discovery of drugs to inhibit the enzyme that process APP.

15. TAU AND ALZHIEMER DISEASE
Trisomy 21 head injury ischemia mutation in APP and presenillin gene
↓ ↓ ↓ ↓
Over expression of APP
↓
Production of FBA
apoe E4 ← Aggregation of BA
↓
Neuritic plaques
↓ ↓
Trigrinoming complement cascade BA neurotoxicity
↓ ↓
Inflammatory response [Ca2 +]
↓ ↓
Activation of glial cells tau hyper phosphorelation
Disruption to cytoskelton ← mutation
in tau gene
↓
PHFs formation

16. PHF formation in tangles
↓
Dementia → Death of glutamate neurons----------------------------------------------------------
----------
→ Death of cholinergic neurons ↓
↓
Loss of nigrostationary pathway
↓
Parkinson’s disease

17. Β- Amyloid
Membrain
Extra cellular leumen of organells
Processing of amyloid precursor protein (APP) the β-amyloid domain of the molecules is
hatched.
SAPP: secrete amyloid precursor protein

18. INTERNATIONAL CODE FOR DISEASE
 ICD- 013 (central nervous system disorder)
 ICD-290-319 (mental disorder)
 ICD- 950-957 (injury to nerves and spinal cord)
In relation to the utility of this system for epidemiologic purpose the study of
ABRSCO (16) Demonstrate that the data are not expression of the total of the
reality but can favor the inferences for the evolution poverty is the more
concentrated
SINTASE can help to understand the regional inequalities of the health status of
the population.

19. PARAPSYCHOLOGY
A branch of psychology that deals with alleged instance of extrasensory
perception e.x - telepathy, psychokinesis, clairivyonce and associated
phenomenon.
The phenomenon of brain is called parapsychology.